Well with Arielle Lorre - 71: Dr. Spencer Nadolsky - Myth Busting Diet Trends (Keto, IF, Food Combining & More!)

Episode Date: August 19, 2020

In this episode I talk to board certified family and bariatric physician and lipid specialist Dr. Spencer Nadolsky about popular diet trends and their true efficacy when it comes weight loss, weight management and quality of life. We cover everything including: the ketogenic diet, intermittent fasting, food combining, carnivore vs. plant based diets, sugar vs. artificial sweeteners, macros, insulin resistance and PCOS diets and so much more! Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Sonderger Go to your Reisadviseur Orsoniccars. The following podcast is A Dear Media Production Hey, welcome to the Blond Files podcast. I'm your host, Arial Lori, and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything

in between, no topic is off limits. I know there is so much information out there, so I'm here to help you navigate it all and live your best life. Thanks for listening. Let's get into it. Hi, everybody. Welcome to the show. I am just going to jump right into today's episode. because it's just so good. I'm talking to Dr. Spencer Ndalski. He's a board-certified family and bariatric, which is weight loss for those who don't know, physician and a lipid specialist. And in this episode, we break down a lot of the most popular diet myths and trends. And we talk about the realities and the efficacy of them all. So we start with keto and we work our way through food combining, macros, insulin resistance, and PCOS diets, carnivore and plant-based

diets, natural versus artificial sugars, and we close out with intermittent fasting. So make sure you guys stay till the end. There's so much information. And we are mainly discussing this all from a diet and weight management point of view. So keep that in mind. But what the doctor has to say may surprise you. So enjoy. All right. So welcome Dr. Nidalcchi. Thank you so much for coming on. Thanks for having me.

So excited to chat with you. Talk about all these trendy fad diets. What's real, what's not? What's BS? And just really get into it. But to start off, why don't you tell everybody a little bit about yourself and your background and your training and what you do now? Yeah. Just a quick little history of my life. I grew up in a very academically, minded family as well as athletic family. My dad is a biology chemistry teacher and wrestling coach, football coach. My brother who's four years older than I am very successful athlete and did very well wrestling in high school and in college and then went on to be a doctor. And I kind of followed in his footsteps. Same kind of thing. I used nutrition and exercise science to get really good at sports. Scholarship, whatever, went to UNC Chapel Hill, did really well wrestling there.

And everybody said, oh, you're going to be this sports medicine orthopedic doctor guy and help people, athletes get better. And I said, you know what, I really want to help the general population. Just get healthier. Just take a fraction of my obsession for sports and athletics and performance and just use that to get people just from unhealthy to healthy, not necessarily super performers. So went to medical school. Then afterwards, you choose a specialty. I chose family medicine, which is the broadest of all medicines of specialties to study. And then afterwards, I also added a few specialties of what like obesity medicine and something

called lipidology, which is basically a study of cholesterol and kind of like cardiometabolic disease. So now my big thing is, yeah, kind of spreading that idea of lifestyle as medicine through the internet because I think our medical system is a little bit archaic. and it kind of burns doctors out. It's even burning me out even through training because I was like, wait a second, I only get like five to ten minutes with a patient. I'm going to actually help them change their lifestyle.

And people say doctors don't know anything about nutrition, blah, blah, blah, blah, blah. Well, it's also a problem because even if they did know anything, they wouldn't even have the time or means to do it. And then you wouldn't even get reimbursed for it because we don't really get reimbursed for that. We get reimbursed for other things. So that's kind of my thing. So now I work with this company Renaissance periodization. I oversee their awesome coaching program that they have,

and we try to develop other like do-it-yourself programs for losing weight and keeping it off in a sustainable scientific manner. That's my elevator pitch, probably more than an elevator, but whatever. I'm curious how you feel about all of the fads and trends and internet experts, It's coaching, you know, all of it. It's like, seems like anybody can be an expert and, you know, try to guide people through lifestyle, weight loss, all of that. So how is that for you as like an actual expert? Well, so that's kind of why I started getting into social media. Social media gives a platform to anybody and gives, which is a double-edged sword because obviously

it gives platforms to maybe scientists and physicians who, you know, are good at their craft. but don't necessarily reach that many people other than maybe publishing studies or their own subset of patients themselves. But then it also gives rise to the, you know, I call them quacks, the charlatans, the scammers where these people are so slick at marketing, they're actually going to propel themselves even further

than any scientist or physician will, unless the physician becomes one of these scammers, which we can talk about too. So it's a double-edged short. So what I did, I was like, look at it, if I can somehow make science funny, sexy, and health in that sort of way, then that's what I'm going to do. So, you know, I as a wrestler and football player, I built a lot of muscle. I kind of looked like a bodybuilder. And I was like, I'm going to use my physique and say, like, look, I'm a doctor who lifts weights.

Lifting weights is good medicine. Looking sexy is also good at making people healthier and improving, you know, patients when they come in, they're like, I don't want to necessarily reverse my type two diabetes. They're like, I want to look and feel the way I did when I was younger. So, you know, the ends justify the means, I guess you could say. So what I did is I first started sharing like my anecdotes and little cases on Facebook and just like, oh, I helped a patient, you know, reverse their type 2 diabetes or whatever you want to say, doing this, this and this. And I kind of grew my Facebook.

And then eventually I got an Instagram and was making little infographics. And then eventually my style, I'm very, like, if you knew me in person, I make kind of lewd, crude jokes, just like ridiculous things. And so I was like, this isn't actually my persona. And I like to be who I am online too, because it feels more natural. So I started making memes. And now I basically make fun of these types of gurus and quacks. So that's my thing. I kind of hit.

It's actually a poor bedside manner. Like it's not actually my bedside manner. or if you knew me in person, like in a patient room, I'm very empathetic to, you know, trying to lose weight and keep it off because it's tough. But like online when somebody's like, you know, like today I made a keto, I make a keto joke once a week. Because like, so the scammers and these Biasters will say that

in order to sell their program, they have to make their program seem special. Right. So they're going to say, yeah, if you want to fix your hormones, you got to go keto because keto is the only thing that works on your hormones or fill in the blank. It doesn't have to be keto. They're going to go fill it in intermittent fasting, whatever it is, cutting out gluten, plants, paradox, whatever, all these different things. And so what I do is I make a funny, hard-hitting meme that makes fun of the situation. And then what I do is in the caption, I kind of explain it a little bit more.

So like, I don't necessarily attack these gurus head on. If you know Lane Norton, he does that a little bit more. Whereas other groups, they'll say like, hey, why don't you just put out your best information and just leave it at that? Whereas I go, well, I like to poke fun at those things because I think it's, I think it is good to directly address some of these myths. But at the same time, I don't want to waste my energy even propping up some of these gurus.

I don't want to give them any more attention than they deserve. So I'll discuss the topic. And maybe sometimes mention it if they, people are like, are you talking about this person. I'm like, yeah, I am. They don't want to mention them by name. Right. Not necessarily because I hate giving them, you know, using your platform to even give them any more credibility that you're even talking about them. But people have questions about these certain topics. And so that's basically what I do. Yeah, it's interesting. I mean, it feels like with health and wellness, but also we're living in a time where like anybody can say something about

anything. And if you're the loudest voice or you're the best marketer, that's who people are going to listen to. And I mean, you can literally make stuff up and get a whole group of people to believe it. Yeah, the more extreme you are and the bolder you are with the claims. So what it does is, and this is a marketing thing. I had to take marketing classes and courses because I was trying to learn what's making people tick? I don't understand. If you're too vanilla online, like you just kind of like, oh, you kind of diet and exercise. And if you just get the kind of the science, people don't necessarily pay attention. But when you make a bold claim, like, it's your hormones, it's not calories. And this is the only thing that affects your hormones. So you got to do this

and not that. And people have been frustrated counting their calories and different things like that. So they're like, yes, that must be it. And it really, what it'll do is it'll make the scientific people mad. So they'll start talking and yelling at the person, which elevates their status. And then it'll get their strong followers fighting with them. So what it does, it really just the algorithms of social media start propping these people up. It's funny to see. And so now my big thing is I try not to go to their page and say too much unless I know the person. And I kind of give them a little message.

I came in, you should probably stop promoting this. Instead, I take a screenshot and make a comment about it. But yeah, it's an interesting phenomenon. Last week, I talked a little about how important preparation is when it comes to eating a healthy, balanced diet. And one of the keys to having a healthier relationship with food for me has been always having yummy, nutritious food on hand. So I'm not making poor choices. And you guys, Sakara is so good for this. And it's such a great way to ensure that you're getting delicious, healthy food for all of your meals and snacks.

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and it is amazing, and I've talked about this before, but you guys know that I am obsessed with their bars too. So Sakara is delivered fresh nationwide, and they are offering you guys, my listeners, 20% off their first order when they go to Sakara.com slash blonde. That's S-A-K-A-R-A-com slash blonde, B-L-O-N-D-E, or enter blonde, B-L-O-N-D-E at Check out. Again, that's saccarra.com slash blonde to get 20% off your first order. Hi, guys. My name is Sarah Nicole and I am the host of the papaya podcast where each week we dish out some sweetness mixed in with some seeds of wisdom all through candid conversations in a very real and tangible way. I want everyone to know that they're not alone and that we share in these

experiences called life. And sometimes when we get to know somebody else's story, it changes ours a little bit as well. So I want you to tune in with us on Mondays. Subscribe. I rate and review it and keep these conversations going with us. You can tune in behind the scenes at the papaya podcast and the birds papaya on Instagram as well. Can't wait to see you next week. I feel like we all have confirmation bias, right? So like if I'm going to find the information that I want to find to support my theory about myself. Yeah, no, that's absolutely true.

And you see it on social media too because then you'll start blocking people that you don't like or unfollowing. And you start only following it. It becomes an echo chamber of what. we want to hear and then it just builds up this, like you said, the confirmation biases. Right. Exactly. So let's get into some of these myths and trends and I gave people on Instagram an opportunity to throw out the ones that they wanted to hear covered. And I'm sure I'm sure they're the ones that you hear about all the time. So there are some big, big ones. So I also got a message from somebody who went to med school with you. And she said, ask him,

what do you think about keto? Awesome. So why don't we start with that one, the big granddaddy of them all right now? Yeah, keto. So look, ketogenic diets are great for certain individuals. What they do is you basically cut out most of the carbohydrate that you're eating. Tends to be carbohydrate-laden foods are calorie-laden foods because what we think about carbohydrates, we think about pastas, pizzas, cookies, cakes, chips.

they also are loaded with fat. We're not talking about, hey, if you're going very low carb, you should cut out your lentils or cut out, you know, cut out the blueberries and those types of things that are nutrient-dense, filling, but relatively low calorie for how much nutrients they have. So when people are like, yeah, they went keto and they lost weight, they usually cut out these cookies and cakes and pies. And you can't have those things unless they're, doing the fat bomb cookies, which don't taste that good anyway, and in which case, they

usually aren't actually successful on ketogenic diet. So the proposed theory of ketogenic diets is that you're not, carbohydrates increase your insulin. So when you eat carbohydrate, the sugar gets into, the glucose gets into your blood, your pancreas senses it, sends out insulin hormone that helps the sugar then get into your cells, whether it's your fat, your muscle, or other cells. And now when we learn in med school that insulin is the fat storage hormone. So more insulin you have, the more fat you're going to store.

So what it's thought is that if you don't eat carbohydrates, you don't increase your insulin levels, you're not going to be storing fat. You're just going to be burning fat the whole time. That's the whole idea. Unfortunately, they've tested this. Fortunately or unfortunately, I don't know what it is. But they've actually tested this and it's not necessarily, it's not true. You can eat high carbohydrate diets.

as long as you're eating the same amount of calories and you still lose weight. In fact, I have tons of patients who have done both keto and not keto, and it seems to follow the same results as the study. So ketogenic diets, though, do. People say they feel satiated on them, and that's the real reason, not necessarily this hormonal thing. And it might be true for certain individuals. You feel better on a ketogenic diet.

You don't feel as miserable. Usually people say, hey, we need sugar to keep a, energized, not necessarily. What we can do is break down the fat. We don't need carbohydrate. We can break down the fat. We can make these ketone bodies and use those as fuel. And after a while, you start feeling pretty good on a ketogenic diet if you do it right. So there are individuals that will feel energized and satiated and feel great and they don't have to eat that much and they'll lose weight and they'll say, keto work for me and nothing else worked for me. And that's fine. That's great. but it's not something necessarily special about it hormonally from a fat burning standpoint.

So if you want to do it and you seem to feel great and you can sustain that for long periods of time, you basically eat mostly meat, animal products and vegetables, great. But a lot of people, what I find is that they feel it's too restrictive for them. They don't really like the way it feels and they want to do something else. And you've got to make sure that they understand, yes, you can lose weight doing other things, we just got to make sure you can sustain it for a longer periods of time. So nothing super special. And again, we've had rigorous studies where they put people in metabolic ward chambers where they're measuring every little thing that's going on with these people.

And they put them on ketogenic diets versus other types of diets. It doesn't matter what they do. As long as the calories are fewer, they'll lose weight. Interesting. Because I feel like I've heard about studies where, you know, they show them, but keto could reverse diabetes. And so is that? Yes. So when I say reverse diabetes, it's kind of a big topic on Twitter, the scientists are yelling at each other.

We probably want to say put diabetes into remission because it's a chronic disease. It doesn't really matter. If you're saying reverse, it means, hey, your blood sugars are normal. And ideally when your pancreas is working like normal again. So when you do a ketogenic diet, you're not eating carbohydrate. Yes, your blood sugars. acutely, meaning right at that initial phase of starting the ketogenic diet, your blood sugars will

improve because you're not eating anything to spike your blood sugars. And then eventually, as you lose weight, you'll start getting that reversal of the underlying what we call pathophysiology, the underlying issue when it comes to type 2 diabetes, the insulin resistance, and then also the fat that's stored around our organs like the pancreas. When we have fat and all this extra fat that's stored in the areas around our body. Our pancreas doesn't work and the tissues don't even respond to the insulin that's available. So as you actually lose weight with the ketogenic diet, you eventually put the diabetes into remission.

But there may be a benefit in the beginning part because you're not eating any carbohydrate to even spike your sugar, but that doesn't mean it reverses it right away. It just means that you're not eating any carbohydrates so your blood sugars aren't as high. you can also do a high carbohydrate, low fat diet, low calorie diet, and also reverse your type 2 diabetes. It just, you won't see that initial improvement in your blood sugars necessarily right away. But you'll see it pretty quickly. As you start losing weight, you'll see this, despite having these kind of spikes when you eat

the carbohydrate. Over time, as you start losing that fat that's around your organs, you actually see the improvement in the blood sugars and you can also reverse it that way too. So it's not necessarily. And people say, if you have insulin resistance, you can't eat carbohydrates, you won't lose weight. That's not true either. People eat carbohydrates all the time. As long as you're eating fewer calories, you'll also reverse the insulin resistance.

And you'll still lose fat in a clinically meaningful manner. You guys do not fast forward because I am super excited to share this brand with you. Okay. I want to talk about CBD. CBD is very trendy right now. And I have to admit, I haven't dabbled in it before. because as you know, I'm sober, and from what I had always heard, you just kind of never know what you're going to get. Then I was introduced to Ned, and I got to talk to the founders, and now I am a

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even doing keto. I mean, you look at all of these products now that are marketed as keto and it's like they have tons of sugar. Like maybe they're really high fat, but they're also like moderately high carb and sugar and all of that. So a lot of people might not even really be going into like true ketosis, right? So even, okay, so it's possible that or it's possible. So here's what's, what happens as well. So everybody, the thing is people like cookies, cakes, and and all these different things. So they're going to make keto products. And I kind of mentioned this earlier.

So they're eating these high fat, low-carb products. But they're tasty. So we can't get around the energy balance, meaning you still have to eat fewer calories than you're taking it. There's nothing special that you're going to start burning extra fat just because you're on a ketogenic diet, more than a low-fat, high-carb at the same amount of protein, the same amount of calories.

So what people will do, they'll start eating way more calories because they're eating these tasty keto bombs or fat bombs. And so they're like, what I'm keto, how am I not losing weight? Because you're still eating too many calories because you're eating these tasty things that are easily overeaten. Just like you're eating cookies and cakes with carbohydrates in them, you're not losing weight when you're on a ketogenic diet because you're eating these fat bombs. If you cut out these super tasty foods, you eat fewer calories because it just doesn't taste as good. You know, so just eat less of it. And that's what I do. I said, I feel attacked.

Yeah, well, or, you know, people put butter on their rib eyes. And it's like, well, okay, you know, how about you just stop putting butter on your butter on your rib eyes? You'll still, you know, just eat the rib eye if you want. Or if you feel like you're still not losing weight instead of eating a ribby, eat a New York strip. It's a little bit leaner, a little bit less fat, fewer calories, feels you up, more protein and that type of thing.

So you can still, I see it all the time. And that's why when people say, how did you feel a ketogenic diet, it's like, well, you're still eating too many calories. You know, you can't get around it. I know we want to believe the magical hormonal magic behind it, but it's just doesn't work. It's not true. So I like poking fun of keto because it's hot and everybody likes to believe the story. Truthfully, I've had patients do quite well on it, but they do have to do it right. If you're eating keto cookies, maybe you'll still be okay.

but like, you know, keto cookies don't taste as good as the real cookies anyway. So maybe you'll still eat fewer calories. But these things are loaded. They're like more calories in these keto cookies than regular cookies. Yeah. Anyway. Okay. So you were talking about insulin resistance earlier and carbohydrates.

I know you've talked about PCOS, but a lot of people that follow me do have been diagnosed with PCOS. And yeah, so what are your thoughts on diet and PCOS? Yeah. So I did a YouTube video on, on, the mechanisms of why those with PCOS and extra weight, mind you. So there's multiple types, we call phenotypes, how somebody presents when they have PCOS. They don't, you know, it's the same thing as like when somebody sees somebody with type, or when they hear somebody has type 2 diabetes, they picture someone with a lot of weight or whatever.

But each of us have a different amount of fat that we can hold before we start having these metabolic problems. So even in PCOS, not everybody has excess weight. So usually when it comes to people with PCOS who are struggling with weight loss, and again, not everybody, I have patients who have abs who have PCOS and never struggled with weight. So I don't want to perpetuate this myth that if you have PCOS, you automatically can't lose weight or whatever. There is a certain phenotype with PCOS where they have insulin resistance and they struggle to lose fat. And so when you start looking at what's the issue here, is it something that's, do they defy physics, right? You know, calorie deficits don't work for whatever reason.

And that's not true. What turns out is that it may be there's a subset of people with PCOS may have a lower metabolic rate, basal metabolic rate, maybe. The studies are kind of mixed in that. There's some that suggest that earlier and then some newer ones that say, no, that's not necessarily true. there's possibly something with the inflammation that's going on that changes the communication between your brain and your gut, which makes you hungrier, which means your appetites and cravings are a little bit higher, which means that you're eating more than you think. And that's that I don't want to say that in a non-empathetic way, because I understand it's

really tough if you have certain nudges to have you eat a little bit more servings or take a few more helpings or have an extra few chips or whatever. I'm not saying you lack willpower. What I'm saying is that it's on a subconscious level that maybe you're eating a little bit more. There's higher instances of binge eating disorder in those with PCOS who struggle to lose weight. And when I did the video, I got so many women reaching out that said, oh, I'm so glad you mentioned this.

And it's not like, you need to stop eating so much, you know, wagging your finger, white coat on, sterile room, whatever, non-epathetic ways. close the doors, you know, I make skits about that because it's a classic doctor thing. Like you need to put down the cookies and whatever. Right. It's not that. It's more like understanding like, hey, well, these things could be happening. You know, higher rates of depression, less body appreciation, these types of things,

increase binge eating disorder. It's a vicious cycle. So inflammation changes in your cravings, changing all the stuff can increase risks of binge eating. So that's another possible reason. And then we get into some of those hormonal reasons. And the hormonal things that change would be like higher androgens. Those are what people think of like male hormones. But women have androgens as well.

It's just usually we think of them males because they're higher. That's what gives us the facial hair and all the stuff. But women with higher androgens can get the facial hair and whatnot. That's why you see some of those things in PCOS. And there are some changes hormonally that can change. where we store the fat. So if you're in storing fat and burning fat. So if you're burning fat in other places and you can't even notice it and you feel like

you're storing fat around your abdomen or different areas, that can also increase, you know, dislike for your self-image and that type of thing, which can increase the risk of binge eating. But bottom line is that like there hasn't been any specific diet that works better than another diet specifically for losing weight with those with PCOS. So what we did, at RP, we adjusted our original diet templates that work. We've had like hundreds of thousands of people use these diet templates. So now we just made these PCOS diet templates.

We don't get into weird things. Like, you know, you'll see the guru say you got to cut out dairy. You got to cut out gluten. And no, you don't have to. There's nothing. There's actually no data that suggests that that works any better than cutting out other foods and lowering your, your caloric intake. So what we did was adjusted these things and,

helped with some of the hunger. And so now we have hundreds of women doing this and they're like, wow, I'm actually eating carbs again. And despite my insulin resistance, I lost 20, 25 pounds or 30 pounds or whatever it is. So it's pretty cool. So yeah, no diet works necessarily better than another one. We still have to follow the principles of energy balance, but we do want to control hunger. We want to control the binge eating if it's there. Obviously, if there's binge eating, just following a diet plan might actually make things worse. So I'm particular about telling people those with binge eating, talk to your doctor. We have medicines that can help with the brain that shut off that signal that makes you

just go for more food. And then we also, obviously, I'd have people work with a psychologist, work on cognitive behavioral therapy, kind of breaking that cycle of those triggers. So those are, yeah, with PCOS, it's an interesting thing because the other thing, sorry for kind of rambling on this, I don't want people to think that they're broken. I get a lot of people that say, I have PCOS, which means I can't lose weight. I'm broken. I'm like, well, that's actually not true.

What's true are these little things which may push you a certain direction, but it doesn't mean you're broken. It's just these are barriers that we'll have to work around. I never want anybody to think that they're broken. I mean, there are some, I will say, there are some people with monogenic mutations genetically, very rare. I wouldn't call them broken, but those are big hurdles. they're very rare. So I won't even, I just want to say that, that, if anybody's necessarily

broken, those are the biggest barriers we'd have to get over for someone like that. But PCOS isn't one of those. Yeah. And I feel like if you have that kind of self-defeating belief, you're probably going to make lifestyle choices that are in line with that and not like finding a solution. So you mentioned energy, thermodynamics, right? Is a calorie, a calorie, a calorie, a calorie. Yeah, yeah. So when people say like a calorie is a calorie, it's a unit of energy. When people say a calorie is not a calorie, is what they're saying is a macronutrient isn't a macronutrient. So, you know, we have calories made out of food stuff, but we have these different macronutrients. And if they follow you, they probably understand this. But, you know, we have protein, fat, and carbohydrate. And each gram of each have different calories. So a gram of each. If protein has four calories, a gram of carbohydrate has four calories, a gram of fat has nine. And if you count alcohol, it has seven, but generally don't discuss that as much unless people want to have a drink or two with a meal and then you can count it.

But in general, we talk about fat protein and carbohydrates. Now, metabolizing and utilizing each gram is going to be different of each type is going to be different from another. So yeah, we store fat really readily and it has nine calories per gram. So we think, oh, just cut out fat. Then that's the easiest way. Well, that's not necessarily true because we have other ways of compensating of eating more carbohydrate or whatever. And the other thing is a gram of protein.

It actually takes more energy to utilize that and metabolize the protein than it does for carbohydrates or fat. So when people say a calorie isn't a calorie, what they really mean is a gram of, Protein isn't carbohydrates and carbohydrate isn't fat. But when we really get down to the scientific meaning of a calorie, it's a unit of energy and it all comes down to energy balance in the end. But these different things will have different effects on our body. Like proteins more satiating than eating fat or carbohydrate. So a gram of protein isn't a gram of those other things in that sense.

Yeah, I mean, I remember a few years ago, like if it fits your macros was a big thing. And it's like, well, okay, you can eat a bag of gummy bears and it's the same as eating, you know, whatever. Yeah. But what is that doing to your body? Right. So if you lived in a lab and if you were getting fed, gummy worms versus, I don't know, let's say the problem is gummy worms don't have any fiber. So I'm trying to think of something. Let's say you have gummy worms and then you drink a fiber shake, a metamusal shake or something like that to make up for the

fiber. And then let's compare that to lentils, which have no fat in them, just like the gummy worms, and you somehow equate the fiber, and then we equate the protein because lentils also have protein, so maybe take a little bit of protein shake with you. If we look at these people and give them the same amount, they should lose weight at the same rate if we can somehow equate it in a lab. The problem is, in a free living situation, if you give somebody gummy worms and a metamusal shake and protein shake, they're probably not going to feel as well and as satiated as if they, the lentils and with a little bit of chicken breast or something like that. Not to mention, there's, you know, the nutrient differences, we'd have to give a multivitamin to the other group, too, to make up for that. So technically, yes, if it fits your macros, if you're living in a laboratory, sure. But if you're living in a free living situation, and that's why we, you know, with RP,

we're not an if it fits your macros group. We agree macros and calories are the most important thing just strictly when it comes to weight loss, but we do promote food. I say food quality, but people don't like that term. So I'll say we promote using wholly unprocessed foods as much as possible. possible. And then you can get into the argument, well, yogurt, Greek yogurt, plain is still somewhat processed, whatever. I mean, we, anyway. Right. You can go down a rabbit hole. We can go down a rabbit hole. But as opposed to gummy worms, I mean, people know that gummy worms and cookies are pretty

processed, what we call like highly palatable types of foods as opposed to lentils. I keep saying lentils, because those are like not super palatable, but lentils and vegetables and starches that are, you know, like boiled sweet potatoes or something or whatever. Difference. Difference is there. So what about with sugar? If somebody is trying to reduce sugar and they're using artificial sweeteners

and people say that artificial sweeteners can make you gain weight, where do you stand on that? Yeah, great question. There's actually some really interesting, studies. So the long-term what we call epidemiological observational studies where people report what they eat and then we watch what happens to them over time, it looks like those who eat higher amounts of artificial sweeteners, or we can call them non-nutrative sweeteners as well because things like stevia and some of these other not artificial that could be natural sweeteners

should have similar effects on the body. Because what you're doing is you're giving a sweetness without that caloric load that we're used to when it comes to sugar. So when you look at what happens these people over time, it looks like they have higher incidences of metabolic syndrome. And metabolic syndrome is just usually a combination, a cluster of things like abdominal obesity, blood pressure increases, blood sugar increases, blood lipid increases. And they have higher instances of strokes and things like that. So it's like, wow, these things are causing people to gain weight.

When we actually put them in an experimental trial where we replace, we actually look at the differences of non-nutrative sweeteners versus sugar, the people that use a non-nutritive sweeteners in an experimental protocol, they actually lose weight. So what's probably happening is it's not a causation thing, at least in strict terms. People think that maybe over time, people that are eating these artificial sweeteners or non-nutritive sweeteners, they're not getting a caloric load with the sweet.

So what they do is they may overcompensate some other way and eat more in other meals or whatever. So let's say you have a diet Coke or whatever and you're then going to be craving more sugary carbly foods later. That's what some people think. And they'll talk about what these things call. called taste sense in our in our intestinal tract that we have like taste receptors all through it not just in our mouth but all through our digestive tract and maybe they're sensing some of this sweetness and then we're subconsciously eating more later the thing is in an experimental trial is up to two years people lose more weight with these non-nutriative sweetener so I'm a big fan of

reducing the sweetness in your diet regardless I think and not in a not in a way that's like oh we just got to stay more natural. It's more of like, hey, if we can stay away, because I think most people know that when they eat fewer sweet things, they crave sweet things less. There will be people that say, hey, I switched out my regular soda for diet soda, and I lost 30, 50 pounds because they're drinking two liters a day. And you'll see that too.

And some people may think that the diet soda may make them help crave fewer. It's individual, but like in the end, I really like eating fewer sweet foods as much as possible. regardless. But the studies, experimental, more rigorous studies in these observational studies show that they actually help with weight loss, not weight gain. Interesting. Do you have thoughts on food combining? This is a really popular one, it seems, these days. I don't know much about it, but it was one of the main ones that people asked me about. Interesting. So I thought this was something that kind of died out 10 years ago or so, because what they'll say is like, don't eat this

with that. And it would be interesting to see there may be some gurus pushing this at this moment. I have my finger on the pulse on certain things because of my patients when they'll bring up something. And I'm like, oh, I should address this or my followers sent me a message. But before, it was like, you don't want to eat your carbs with your fat because then you'll store more, store more fat. The insulin will go up and then you'll also store the fat more readily. And in the end of the day, really, when they've done these different studies, it just doesn't matter. It doesn't matter. It's all the energy balance, average energy balance at the end of day, which means no matter what, fewer calories over time.

There may be some acute differences in what we'd call like glycemia and lipamia, where you may have acute changes at that one moment where you get higher blood sugar spikes and higher blood lipid spikes. We don't measure that unless in a research setting, but there may be a difference there. So if you eat a hamburger with just tons of French fries, so high fat carb load, that may be acutely more inflammatory than, say, if you ate lentils. That's those damn lentils, I say. Your favorite.

My favorite. So we'll just say a higher carb and a higher calorie, but carb high, lower fat, but calories are same. You may see some differences there, but in terms of like weight loss over long term, it really, it's really average over the day of energy balance. But, you know, I think it's a good, it would probably, if you're eating high carb, high fat meals, it's, it's probably best not to do that regardless anyway, because that means you're probably eating lots of pizza, lots of hamburgers and french fries, which again, I don't think it's a problem. If you do that, you know, occasionally, I love pizza and fries.

well, but ideally it wouldn't be doing that. But mixed meals, I have not seen anything to really show a clinically meaningful difference in terms of weight loss. Right. Do you have thoughts on like the carnivore diet, plant-based? Yeah. Everyone seems to think that their way is the best, right? Yeah. I'm friends with the, with, well, friends, it may be an adversarial relationship with some of them, but, but I actually have, so two of the, the biggest carnivore pushers right now, two doctors actually. Friends or not, I don't know, my buddies maybe, and I've talked to these. Anyway, smart guys, they're ripped, you know, they look good, and they feel great.

And a lot of people that follow a carnivore diet, they feel great. There are no studies on it. That doesn't mean it's not something. It just means there's not a lot of data on it. The caution that I would give is that I'm a lipidologist. So what I see, I see those with diet-induced increases in their cholesterol, like major increases, not just like a slight little bump where it's like, eh, everything else improved and you have a slight little bump. I'm not worried about it. I see some of these individuals that come in with

their LDL cholesterol, what people think is the bad, the atherosclerosis causing cholesterol, particles, it comes in sky high. Like they looks like they have a genetic cause for it. And it's really just their diet. So that's the caution I give, you know, dietitians that are really into micronutrients, they'll probably say, hey, I'm really worried about the lack of vitamin C and scurvy possibility. But, you know, these guys claim that there's no scurvy and so vitamin D deficiency what we'd see back in the 1800s or 1700s when they started giving limes to people. But they claim they're not seeing that. I would be worried about some of those things, but man, if you you give someone who's eating what we call like that standard American diet of pizza and and

burgers and french fries and not eating lentils i'm just kidding about the lentils but if you see them eating these high calorie diets and you give them a carnivore diet just eating pure meat it's actually hard to overeat that i mean i wouldn't be able to do it i i know i'm 200 and about 20 pounds i'm pretty lean and if i did that i would probably oh man i'd probably get to under 200 pounds easily just because it would be very hard for me to overeat meat or even want to eat that much. It's not, you know, it's not palatable at all. High protein. You'd go into ketosis.

You'd probably feel very satiated. You'd feel okay after a couple of weeks of adjusting to it. And so if you take someone that has high blood pressure, their joints are kind of swollen from extra fluid retention. Their blood sugars are elevated. they just feel like crap all the time and you get them to lose 10, 20% of their weight

regardless of the method they could eat bananas all day and it would probably do the same thing. They're going to feel great. And so we're seeing that a lot. And I don't necessarily think it's a bad option other than I do worry about long-term micronutrient

deficiencies and stuff, but they're my friend Sean Baker. So he's the doctor who kind of promoted this idea of a carnivore diet. big meathead orthopedic doctors. He's like 6'5. He's jacked, 50-year-old guy. And he's actually collecting money right now to kind of start running studies.

I say, like, what is going on with these people? Because people are claiming they feel good. But, you know, anecdotes and case studies are fine, but we really need to see more robust data. And quite frankly, I think it's fine. If you go from eating, you know, again, pizza and whatever to eating just meat, you know, I worry about cholesterol. all stuff, but like really, if they improve all their metabolic abnormalities, and they

sustainably do it. Like, Womaita's tell a patient, like, they come in feeling great. They reversed all their chronic conditions. You're an idiot for just eating me. No, I'd be like, all right, just keep doing it. Like, quality of life is so much more important right now. You're feeling great. It looks like everything else improved.

Maybe there's some increases in your cholesterol. But I actually like making fun of carnivore, too, just because it's, I think it's ridiculous, but some people just, they do so well with it. So what am I to say to them? I don't think it's a bad thing necessarily. Plant-based diets, there's a big push from that from most lifestyle doctors. You know, the thing is you can look at it ethically, and that's a different question than the ethics around eating no animal products

is different than the health outcomes for eating no animal products. And my personal opinion is that for a quality of life standpoint, having some animal products is probably fine for health outcomes. But, you know, we do have a lot of data showing, hey, mostly plant-based. And I'll say plant-based doesn't have to be 100% plant-based. I would say, you know, somewhere around 80 to 90% of your food is coming from whole-food plant-based, not Oreos or whatever. Lots of lentils.

Lots of tons of lentils, as long as you don't have. have issues with like IBS and it just bloats you up and you feel like crap afterwards. There are a lot of people that have issues with that. But lots of lentils and beans and and vegetables and fruit. But it's the same thing. It's hard to overeat that stuff. If you ever get a bunch of lentil, you're not going to be able to overeat it unless you pour some oil in it, pour some butter in it, which obviously wouldn't be plant-based, but pour some, let's say some olive oil or avocado oil or something, mix them, some avocados, throw them in there, salt it up really nicely, and then basically put it in a frying pan or something like that. It's hard to overeat

lentils and vegetables and fruit. So you'll see people just, same thing as a carnivore or a genetic diet, if done appropriately, they'll just drop massive amounts of weight, improve all their chronic diseases and they never have high cholesterol because they're not eating any animal product with saturated fat. Their saturated fats low unless they're drinking coconut oil or something like that, which is plant-based but high-saturated fat. But everything will improve and their cholesterol will improve, whereas everything improves with a carnivore diet, but generally you see a slight bump in cholesterol.

Not everybody, but some. So same thing. I really like it. High nutrient base. And as long as you tolerate it well, fine. I'm more of a mix. I'm an omnivore. So I do like, I like cheese, like yogurt.

And I think that's okay. Most outcome trials and data show that dairy is beneficial for health purposes. I think everybody listening just went, what? You've been told that dairy is the enemy. Yeah, I don't know why people think. I mean, it's like yogurt and low fat cheeses. You know, some people will say high fat cheeses too, but I'm kind of a, I think it's easier to overeat these high fat cheese.

But yeah, highly anti-inflammatory, very, very healthful for physique and health overall. Can maybe have some, regardless of caloric intake, might have some blood pressure lowering properties, all sorts of different things, and anti-inflammatory properties. But in general, it's hard to overeat low-fat yogurts, plain yogurts, unless you put a little fat in it, put a little bit of, sugar fruit and stuff like that, not even still. Yeah.

Okay. The other really big, popular one right now is intermittent fasting. Yeah. What are your thoughts on that? Yeah. Again, there are, so I'll tell you a quick, this is a fun little patient story. They tried chronic dietary restriction, which means you're just trying to keep their, they were trying to keep their calories at what, we'll say like 2000 or 1600 a day,

something like that. And they just, something about trying to do that daily, they didn't lose any weight. Then they go, all right, let me try an alternate day fasting approach where they eat whatever they want, you know, just trying to focus on healthy options, healthier whole food type of options on one day and then a couple days a week, they'll basically eat a very tiny meal for or dinner or breakfast, whatever the one that they pick. And then they kind of alternate. And boom, 30 pounds lost.

They resolve all their health conditions, and they feel like this is sustainable for them because after about a two-week or three-week period, at first they were super hungry on those days, but their body adjusts to where it's not hard fasting on those days. And there's some interesting physiologic reasons for that, but the body adjusts and you don't get as hungry on those days. and for whatever reason it works better with their life and schedule.

So was it magical? Did it help them lose weight regardless of energy balance? No, when you actually look at the calculations, they lost as much weight as you'd predict because they're not eating as much. But they're able to do it because they felt better doing it and it's fit to their schedule better. That's it. So like when you look at these randomized trials, we think of these populations and it's like,

well, this diet works and this diet doesn't. But, you know, everybody's going through their own shit, you know, like someone just got married, someone just had a death in the family, someone moved, someone had their job change, someone has kids now, someone's just going through some crap with money, whatever. And it may be that a certain diet didn't work with their lifestyle, regardless of physiology or whatever, just something with in terms of their life. We're social creatures. We're not animals.

we have all sorts of different variables going on in our lives. So an intermittent fasting diet, yeah, physiologically, it might have some benefits in terms of hunger suppression over time. But it also has some really interesting things. If people are used to going and getting a frappuccino from Starbucks in the morning, and all of a sudden they go not an alternate day fasting period, but where they do a time-restricted fasting where they move their eating window from 12 to like 6 is a popular strategy.

You know, sometimes they do an eight-hour, but we'll say a six-hour time-restricted window. All of a sudden, they skip that frappuccino. Maybe they have a little bit of black coffee because it doesn't break the fast. And all of a sudden, they literally can't eat some of those things. And they stop eating at six. So instead of their nighttime snack and you're like, I can't break the fast, and then they feel better after a few weeks or so of doing that. And it just lowers the amount of food that you're eating.

they feel great doing it, fits their lifestyle better. That's the magic. And I like to reveal the magic behind these diets and stuff because it will be very successful for certain individuals, but there will be a lot of people that fail. And we never see the failures. So all we see is a selection, what we call a selection bias. And meaning you see like, okay, so I love my company RP,

but we post our transformation photos. So it looks like we're amazing, right? we have all these transfer. I mean, people lose 100, 200 pounds and just look amazing. But there are failures in there, too, from a marketing standpoint, that's not, why you wouldn't do that? So when you see these people that are just amazing transformations with carnivore, keto, for every one awesome transformation, I don't know how many failures, probably 10, 20, 30, 40, I don't

know. There's a lot. Most people fail these things. So they feel broken. It comes back to, I don't want people to have this unbroken mindset. that, oh, you said this ketogenic diet was going to work because it fixed my hormones. Oh, my God, it didn't work. Well, it didn't work because you were eating those fat bombs and you just didn't like the way

the food was eating or the food was. Oh, the intermittent fasting didn't work? Yeah, because, you know, sometimes you want to have brunch with your friends and you couldn't because you're supposed to be fasting and then all of a sudden it broke your cycle and whatever and you fall off the diet plan. So if you understand it, if you understand the principles and use these diets as tools to then meet the principles, that's the importance,

because I don't want anybody thinking they're broken. And again, even if you try to, like, I don't want to call anybody a failure either, even if they understand the principles, there's tons of people to understand the principles, and they still won't be able, they still won't be successful simply because of the body and our environments

fight us so hard. And so that's another thing. That's a whole other conversation of understanding how hard it is to lose weight and keep it off in the first place because it's just hard. for multiple reasons. Life or body, environments, everything there. So anyway, that's my, sorry, that's a ramble on intermittent fasting and everything. No, I love it. I want to have that

other conversation. I feel like maybe we should do a part two one of these days. Yeah. So it sounds like your, your kind of philosophy is that like these diets work for different people because when you find something that you like that's sustainable for you, and you're adopting healthier habits and you're reducing your caloric intake, that's it. There's no like secret sauce. It's just finding something that is sustainable for you that fits your lifestyle and is palatable and all of those things. Yeah. And that's not sexy. So, you know, the people that come to me are the people that are fed up with the crap. They're just fed up with just being fed marketing BS from from these other scammers and they've done so many different diets and they want to understand the science and at least

understand why they failed and then maybe when they understand why they failed they can find a way to then use those tools for their betterment in the long run so yeah exactly and i'm not going to say like look eat your you know gummy bears and whatever as long as you're eating fewer calories no i i promote a mostly whole food type of unprocessed food uh diet as much as possible because that's what's going to you sustain in long run, satiety and everything like that. And obviously micronutrients likely beneficial in the long run. And then there's a group of people that dieting might be psychologically harmful to them. And there's a lot of people like that on the internet.

And I guarantee there's people listening going, well, geez, like, dieting just makes me feel like crap anyway. And I feel like all I think about is food. And those are the people where I'd go, let's pull back a little bit. Don't even, you shouldn't be dieting then. Maybe we should focus on other health behaviors other than food fixation. But that's, again, that's a whole other discussion as well. Part two coming soon. Yeah, I mean, that was my experience with macros.

Like I found that like, oh, well, 1,600 calories. I felt really full and satiated all day. And I was getting lean. So like, it would be really easy to go to 1,400 calories. And then from 1,400 calories, I could go to 1,200 calories. I could go to 1,200 and I could eat, you know, kind of like low nutrient-dense foods and eat like a high volume. So I felt, and then I just got fixated on it, like you said. And so it became disordered.

And then the numbers follow you around even when you're trying to stop. And I know that a lot of people listening have had that experience. So it's tough. It's tough to find balance. That's an interesting. Yeah. It's so interesting because so many people have gone through that. And as opposed to just looking at it as a tool, you know, it's easier said than done because I did

it for a while for just a being as precise as possible for a bodybuilding show. I just wanted to do it once. And I was like, oh, man, I feel like I'm afterwards, I'm like, I don't want to be fixated on these numbers. And it was actually tough for me. And if it was tough for me, I can imagine other people out there who have followed it for longer than I did. And it's hard to get out of that mindset. So, yeah, interesting. Yeah. Well, this was fascinating. Thank you so, so much. Where can everybody find you. Yeah, so you can do the Instagram at Dr. Nodalski, D-R-N-A-D-R-N-A-D-O-L-S-K-Y.

You can follow our R-P-E-N-S-E-S-R-P-Strength. And then we do a bunch of YouTube R-P-E-T-U-T-U-T-R-P-E-T-EU-T-R-P, and then Renaissance-Puritization.com or R-P-Strength. Great memes. Yeah, great memes.

Great meme. Thank you. Thanks for having me. I hope you enjoyed that episode. If you liked it, and if you like the show in general, please take a second to rate, review, and subscribe. It goes a long way, and it's actually the best way to support the show. Also, if you want to see more about each episode, you can head over to The Blonde Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Ariel Laurie.