What can you tell me about this?

>> Well, if you look at the science, it's

enhancing cognition. We've seen a 50%

improvement in how individuals were able

to read and absorb information of better

decision-m and also we did a study and

showed that it delayed the progression

of metastatic cancer. And I've actually

taken this a number of times because

having been in research for the last 15

years and having lived with multiple

chronic diseases, one of which I

reversed. Some of the most powerful

strategies like this were not being told

to me when I went to the doctor's

office. So, let's dig deeper.

>> Dr. Andrew Cutnick is a research

scientist who's worked on over 100

studies on metabolic health, diabetes,

and the keto diet.

>> And through his findings, he's helping

people prevent chronic diseases, improve

cognition, and optimize performance. I

went through some pretty dramatic

moments in my childhood. You know, I did

everything I was told, right? I

exercised all the time. I ate what I was

supposed to eat, but I still became

obese.

>> You weighed about 255 lbs.

>> Yep. And I had no idea how damaging that

actually was to my body. And I think the

vast majority of people also don't, but

over 20% of children have obesity.

That's quadrupled over the last 30

years. And a big part of that is when it

comes to food, what looks healthy isn't

always healthy. And it's not by

accident. And it wasn't soon after that

I ended up getting diagnosed with a

chronic irreversible disease that

obesity puts you at risk for. And that

immediately turned into a journey to

understand how to be healthy. And I came

across this diet a little over a decade

ago called the ketogenic diet. So then I

went into the science of this diet and

found positive impacts on things like

diabetes, obesity, Alzheimer's, serious

mental illness, chronic diseases. And I

was like, "Oh wow." Cuz a lot of people

don't realize that many of these are not

just preventable but also reversible.

And you did the longest study ever done

of its kind on the impact of the

ketogenic diet on a patient that had

type 1 diabetes.

>> Yes. Let me let me tell you all about

it.

>> I see messages all the time in the

comments section that some of you didn't

realize you didn't subscribe. So, if you

could do me a favor and double check if

you're a subscriber to this channel,

that would be tremendously appreciated.

It's the simple, it's the free thing

that anybody that watches this show

frequently can do to help us here to

keep everything going in this show in

the trajectory it's on. So please do

double check if you've subscribed and uh

thank you so much because in a strange

way you are you're part of our history

and you're on this journey with us and I

appreciate you for that. So yeah, thank

you

Dr. Andrew Kutnik. If you had to try and

sort of summarize and encapsulate what

you spent the last couple of decades of

your life focused on and really trying

to accomplish, prove, understand from

the highest level. What exactly is that?

The core of my mission, Stephen, is

really to empower individuals to take

control of their own health. It's

empowering them with science, you know,

bridging science to actual action. You

know, science is very complex. It's very

hard to break it down, but having been

in, you know, research for the last 15

years and having lived with

multiple chronic diseases, uh, one of

which I reversed and one of which I is

irreversible. Um, I I my mission is to

empower patients with the same tools and

strategies I had access to. uh so they

can take control to maximize their

health and performance.

>> For the average person who may not be as

knowledgeable about health and fitness,

what are the areas of health that you've

spent the last 15 years researching and

trying to understand?

>> I would call it, you know, Stephen like

metabolism in a broad terms. Now I would

say you know to break that down further

for people to understand that metabolism

is trying to understand how the body

metabolizes or utilizes things like

nutrients or food. So you have oranges

here. What's what's in that food? How

when you ingest it will your body

respond to it? Both from you know

glucose levels which I'm sure many have

heard of to insulin responses to all

this different nuance. A lot of that

comes down to nutrition but it also is

things like exercise. Exercise such a

powerful impact on metabolism,

incredibly important for overall health.

But from a personal perspective, this

journey has been very honestly selfish

for me. I wanted to understand how to

get the best performance, the best for

health for myself. And I very quickly

realized that uh you know some of the

most powerful strategies out there were

actually not necessarily the ones that

were being told to me when I went to the

doctor's office because I went through

some some pretty dramatic moments uh

early on in my my journey with with

trying to overcome some of these these

challenges.

>> So take me back to the start of your

story in the earliest context that's

relevant to understand

why you became the person you became. I

mean, I've got some photos here from

your from your childhood which are

>> Yeah.

>> very very telling. And you know, some of

our listeners might be listening on

audio alone, so they might not be able

to see these these visuals on the

screen.

>> So, if you could describe some of these

these pictures for me

>> when Yeah.

Um

it brings back some powerful memories of

uh the challenges with obesity for me.

Um you know the the picture on the right

is just a picture with on a a family

adventure um where we went to the we go

I go fishing with my dad a lot. You know

I'm very heavy at the time. I was, you

know, uh, obese and, um, and the picture

on the right here, this really gets me

because, um, you know, I did, you did

everything I was told, right? I

exercised all the time. I ate what I I

was supposed to eat or what my doctor

recommended, what the fitness magazines

recommended, but I was just constantly

challenged with gaining more and more

fat tissue. And I had no idea how

damaging that actually was to my body.

And, and I think the vast majority of

people also don't. Um, over 68% of

America right now is obese. Okay, that

means 7 out of 10 people walking around

the street in the United States of

America have obesity. And we know that

the second you start building more and

more fat tissue on your body, insulin

levels rise almost double immediately

before you even have symptoms of obesity

or uh tissue damage or organ damage or

anything along those lines. We know that

that almost immediately reduces insulin

sensitivity. So how well insulin, this

very powerful fat storage hormone, is

able to actually bring nutrients from

the blood into tissues. That goes down

around 34 to 35% uh and early stages of

obesity.

>> And just to summarize for a muggle like

me, insulin is basically the uber which

takes things out of your blood and puts

them where they need to be.

>> It's essentially like a thermostat for

blood glucose. That's how most people

know it. So as blood glucose levels

rise, it works as a thermostat to let's

say release cool air to bring it back

down. In this case, releases insulin to

bring blood glucose back into range. As

blood glucose drops, insulin is stopped.

It stops releasing insulin out of these

cells called the beta cells. And

ultimately, what your body is trying to

do is keep the, you know, one teaspoon

of sugar that's in your blood that is

critical for your life. If it goes up,

it can cause damage. If it goes low, it

can be life-threatening. in this very

very tight range and it build it builds

a number of mechanisms to ultimately

make sure and ensure that you don't go

outside of that range. But imagine

losing the one molecule that directly

controls it.

>> You're wearing two devices I believe on

you at the moment. So you've got this

>> Yeah.

>> What is the device on your arm?

>> It's an insulin pump.

>> Yeah.

>> So Stephen, your body produces insulin.

Most people who are probably listening

to this, they their body probably also

produces insulin unless they have type 1

diabetes. And so when my body no longer

produces this molecule anymore, there's

got to be a way to get it. It sits on my

arm 24/7 because it's a way of

essentially packaging a pancreas that I

don't have anymore and putting it on my

arm and and and a way of getting that

same type of of insulin.

>> And you have a CGM as well.

>> Yeah. So on my stomach here, so on my

stomach here is a CGM,

>> which is a continuous glucose monitor.

>> CGM is a way of tracking sugar levels or

glucose levels.

>> And both of those devices link to your

phone, which is in front of you. Um, and

I'll throw that up on the screen so

people can see,

>> yes,

>> what that what that kind of looks like.

>> So on this device, you have

a green line that is glucose levels.

Okay, my blood sugar says that it's 109

right now. Which means that the

interstitial

signal of glucose is

>> interstitial meaning within not in the

blood but in the tissues.

>> Yeah. So the amount of glucose right

outside the blood around the tissues and

that signal is an indication of the

amount of glucose in the blood. That's

the green line. Okay, it says that I'm

109 right now. So average blood sugar

levels using milligrams per deciliter is

70 to 120. That's considered normal.

Below that is blue lines almost like

looks like squares and triangles. Those

are illustrations of insulin being

administered but they're not perfect

devices. Despite them being premier and

you know the most advanced technology on

the market, there are significant

limitations to them. Um, I have actually

I saw a clip of yours that I was

watching earlier that said you think

having high blood sugar over a long time

is the biggest cause of long-term health

problems.

>> When you're focused on improving your

overall health, you have to find out

what matters most, right? So, what

what's the hierarchy uh uh in the

health, you know, 1 2 3 4 5? What

matters most on that? And we can look at

that by looking at risk factors uh for

future disease. Well, the number one

cause of death in the United States and

across many parts of the world is

cardiovascular disease. Well, it's also

the number one cause of death in people

with diabetes. And when you look at what

are the strongest predictors of

developing some form of cardiovascular

disease,

a measure called HBA1C comes up at the

top. HBA1C is a average measurement of

your blood glucose over a two to three

month period of time. And that is

incredibly powerful at predicting future

risk for let's say diseases of the eye,

diseases of the kidney or even

cardiovascular disease. And so when I

think about how do we tackle uh

improving health or in in particularly

in these these common much more common

diseases,

glucose control sits at the very top of

that pyramid. And if unregulated, it's

equivalent to analogy I often use, which

is you're you're driving a car and

you're focused on what type of rims you

have, but you don't even have an engine

in the car. Like your engine doesn't

work, or you don't have an a chassis or

an axis, but yet you're you're focused

on rims or a sound system. And so the

number one factor, particularly in

diseases like diabetes, that matters

most is HBA1C.

>> So does that just mean that we should be

eating less sugar?

So if we wanted to control the most

powerful risk factor in diabetes,

we would need to understand how to

regulate it. Right? So then let's look

at the science of this. Well, the

science says that carbohydrates,

food is the most potent factor in

regulating elevations in glucose at

every single meal of the day. Well, most

people are eating three to four plus

meals every single day. And so the very

first logical thing to look at is food

because what you're consuming has the

most potent impact on glucose control

and glucose control has the most potent

impact on your health not only today but

in the future. And so focusing on on

nutrition makes sense. But this isn't

like a new phenomenon. We've known that

nutrition could be potentially

life-saving for people. There's a a you

know there's something called a

ketogenic diet if someone's heard this

before. It's a diet that dramatically

reduces the amount of carbohydrates in

the food. And the dramatic reduction in

carbohydrates in the food was used to

save lives of patients with type 1 and

type 2 diabetes since there was the

first report ever known to my knowledge

is in 19 or 1796 by a gentleman named a

physician called John Row. He published

a report on two cases of diabetes

malitis using basically a carbohydrate

replete or reduced diet to resolve the

disease. But we know that some of the

most premier diabetists meaning people

who study diabetes or treat people with

diabetes were utilizing these strategies

for over a hundred years before we then

discovered in 1921 that this diet could

also help neurological disorders like

seizures and beyond. And so the the

phenomenon of nutrition playing a role

in overall health is is certainly not

new. It's actually only recently that

we're rediscovering century old wisdom

of what nutrition can do for overall

health uh due to the emergence of an

explosion in science that has really

drove a ton of public interest into this

kind of unique dietary strategy.

>> So the ketogenic diet then um it's a

diet that I'm familiar with because it's

a diet that I cycle in and out of

throughout the year. probably I'm in a

ketogenic state three or four times a

year and I use the little keto reader

just to check my blood ketone levels.

What is the what for anyone that's

unfamiliar with the ke ketogenic diet? I

I'm a bit of an advocate for it. So I'm

fairly familiar but I that's also taught

me how unfamiliar people are with it

because I talk to my friends about it

and there's a lot of misconceptions.

>> Yeah.

>> If you're on a ketogenic diet, what are

you eating?

>> So typically what when someone

visualizes a ketogenic diet, I think

there's a lot of misinformation. and

they think it's just steak and bacon.

Um, and I guess for some people it might

be that, but it's actually uh if we're

talking about a well- formulated

ketogenic diet, we're talking about

green leafy vegetables, things that we

typically associate with health. You

know, salads, uh, broccoli, asparagus,

cauliflower, these kind of uh,

nutrient-dense green leafy vegetables

that are high in fiber and

phytonutrients.

Then you also have protein as a

component of that. that can come from

meat that can come from fish in the form

of salmon, eggs, uh cheeses, a little

bit comes along for the ride and things

like nuts. And then you also have the

rest of the diet which is made up of

fat. And this can come a lot of times

from um various plant forms. This can

come, you know, from like olive oil,

avocado oil.

>> And what are you removing then?

>> Sugary starchy carbohydrates. So you're

you're you know you're not having

bagels, you're not having donuts, um

white rice, pastas, these type of foods.

The reason they're not a part of this

diet is because these foods rapidly

elevate blood sugar levels. And the

rapid elevation in blood sugar also

spikes insulin. Insulin shuts down fat

breakdown and the ability to take that

fat to the liver. The liver built this

amazing mechanism to be able to convert

fat to ketone bodies because ketone

bodies fat can't actually longchain

fatty acids which is the primary form of

fat that you consume in the food you eat

and also the type that's broken down

from your own fat tissue can't readily

cross the bloodb brain barrier. And we

know that glucose is a fuel for the

brain. But what happens if you fast or

you don't consume a lot of carbohydrates

and you have low insulin levels and you

can't con transport the fat which is now

your primary fuel source on a ketogenic

diet because you reduce glucose or

carbohydrates in the diet which causes a

reduction in glucose. The reduction in

glucose lowers insulin. The reduction in

insulin causes fat to be rapidly broken

down and now becomes your primary fuel

source.

>> And so there's an evolutionary basis for

this, right? Because once upon a time we

might have gone long periods of time

without eating something. And so our

body turns inwards and starts using our

fat stores as a mechanism to to to fuel

our body and that's why it produces

ketones. Basically the evolution of this

diet was believed to be a cyclical

meaning on and off pattern in human

history because if we were to go through

bouts of abundance in food, we probably

consume it as much as we can in one

moment and then we're seeking the next

meal and seeking the next meal. What

happens in that in between time? If

you're 100% reliant on having food 24/7

like we do in our current food

environment, you would never survive

evolutionarily

beyond a few days.

With the ability to switch from a

carbohydrate-based metabolism over to a

fat-based metabolism, we store months

and months and months of fat energy in

the event that we don't have nutrient.

So it's a one of the most powerful

survival mechanisms we have to survive

uh moments of famine. But we also have

known since bib times of biblical text

that fasting has therapeutic potential.

You know most potently in and the

ability to what would be described as

attenuate seizures. You know convulsion

like behavior was described when you

just completely eliminate food. actually

a common strategy in many religious

practices because of its quote unquote

healing properties. Well, now we

actually know that fasting induces a

state of ketosis and we know that

ketosis is actually shown to in many of

these cases have a therapeutic impact in

many of these environments like a

seizure like seizures. We've known since

the 1920 one out of the Mayo Clinic that

ketogenic diets not only mimic the

physiology of fasting but also attenuate

the seizures in children with epilepsy.

And that work has subsequently gone on

to John Hopkins and other research

institutes to show that this is a very

verified strategy for not just epilepsy

but it has been used for obesity, type 1

diabetes, type two diabetes for for

centuries at this point. Um, and it all

starts with the reduction of

carbohydrates in the diet.

>> One of the things that's been most

beneficial to me, but also I know Joe

Rogan has talked about this before is as

a sort of a podcaster that spends a lot

of time talking, you notice high

variance in your ability to think,

articulate yourself

>> for long periods of time based on my

blood ketone levels and my

>> my sort my diet broadly um but

specifically the amount of ketones that

are in my blood.

Why is that? Why is it that I feel like

I'm more effective in communication and

thinking when I'm on the ketogenic diet

or taking exogenous ketones versus when

I'm having a normal western high higher

carb diet? A lot of people

would know why this is if they had the

same tools and insight that type 1

diabetes gives. Because when you're

consuming that diet, what is often

happening is near constant elevations

and dips, elevations and dips, highs and

lows in blood sugar levels that we know

are ascribed to changes in energy

levels. So, we know that high blood

sugar levels, someone can Google if

they're they're so interested to look up

the term high blood sugar hyperlycemia

or low blood sugar or hypoglycemia and

just type in symptoms and you'll see a

laundry list of things like fatigue,

irritability, lack of concentration, uh

shakiness. These are all symptoms of a

lot of what you're describing, right?

Which is change in your your your

ability to concentrate, your energy

levels. It's a very very clear that

glucose levels are linked to that. We

also know that the chain

>> ju just to be clear. So is that when I'm

at the high or the low in the glucose?

So if I you know if you if you ate one

of these right now

>> what are these oranges? Tangerines.

>> Oranges. Yep.

>> Um if you ate one of these right now,

your blood glucose levels are going to

go up presumably.

>> Yes. Because these oranges are composed

of bound sugar molecules together. So

most fruit has a structural component to

it which is why you see an it it has

like a has is has mass to it right it's

not just a liquid and then that

structural component binds together as a

part of it sugar that's bound together

they call them polysaccharides and those

polysaccharides when you consume them

your gut actually takes those breaks

them down into individual glucose

molecules

to then be absorbed into the bloodstream

that's when the insulin is released,

that's when the insulin takes that

glucose and stores it into tissues like

the muscle and the liver uh for future

glucose needs. Uh and so yes, we would

presume that with this high or oranges

or even most fruits, pastas, rices would

all elevate blood sugar levels, but then

that accompanies with a high insulin

load, right? So the more of the oranges,

the more insulin that you would need.

And you know, despite many of these

foods being considered very healthy,

those with

metabolic disease or metabolic

dysfunction may not may have a be more

vulnerable to even what would typically

be considered healthy foods. Um, and

type 1 diabetes is a is a powerful

example of that.

>> So, you said you'd you'd open to eating

one of these. We've got your blood

glucose and insulin levels, which we're

going to put on screen for people that

are watching. And it'll be interesting

to see how quickly we see that orange,

which is considered a health food by

many people, have an impact on your

glucose and insulin levels.

>> So, yeah. So, so what I'm I'm going to

do is normally I would I would never do

this, but I I think it's very important

for people to understand,

especially those at home who either have

a chronic disease, which is most

Americans at this point, or kids who

have a disease like diabetes, what the

impact really could be. So let's say

oranges are considered a superfood uh by

the American Diabetes Association. So

it's a fruit highly recommended by

almost every organization USDA f or USDA

American Diabetes Association and beyond

the amount of or is three oranges.

Three oranges is probably going to make

up around h 70 to 90 grams of

carbohydrates. For me, my energy needs

is around calculated it around 3,000

calories per day. Now, the activity I'm

consuming,

if I were to

eat the amount of carbohydrates

recommended per day, which is around 55%

by, let's say, the USDA guidelines, that

I would need to consume at least or more

than this at le if I split up all my

calories over four meals. And so,

This is

an opportunity to see what this will

actually do to blood sugar levels

and

type 1 diabetes if you consume will be a

near equivalent to around a fifth the

amount of carbohydrates that I would

consume per day if I was on a standard

diet.

>> The the ketogenic diet they typically

say that to stay within it you need to

be below is it roughly 50 grams of

carbohydrates a day? And it's roughly

because 50 grams of carbohydrates per

day is a

rough number that we suspect most people

will be able to get carbohydrates low

enough to where insulin would be

sufficiently low to produce ketone

bodies.

>> Okay.

>> Yeah.

>> So there's variance depending on your

insulin sensitivity and insulin response

and I guess body weight as well is going

to be a factor. big factor, major factor

because anytime you're talking about

things like uh glucose, insulin is

always very individualized responses to

each individual person.

>> I don't really I don't I try and stay

away from fruit these days. I don't

know. I I berries and raspberries and

stuff like that and cuz people tell me

there's like polyphenols and black

blackberries,

>> but those are totally uh co cohesive

with the ketogenic diet

>> because they're higher in fiber. So like

you know half of where you're consuming,

not half, but a large portion of it

fiber. So it's more about the net

carbohydrates. It's the the glycemic

metabolic impact of the food. So

>> if the fiber is non-digestible, which in

fruit it isn't, then it shouldn't it

doesn't count, right? So higher fiber

content. Most of the vegetables on a

ketogenic diet are higher fiber, you

know,

>> because you know it's the it's the total

carbohydrate to fiber ratio. So the net

carbohydrates that really matter because

that's the amount of that's the

metabolic real metabolic impact of food.

Yeah. A lot of a lot of keto friendly

foods say like net carbs or one gram or

something, but you look at it and you go

[ __ ] it says 20.

>> It's total [ __ ] man. Is it?

>> So, oh, 100%. Um, so I I've tested two

different foods that are keto friendly

on the label. Same as calories, same as

like fat, protein, even fiber. Um, and

they can produce completely different

responses. I mean, the food environment

nowadays, you essentially need almost a

PhD in nutrition or biochemistry to walk

into a grocery store and be able to

understand what the hell's on the label.

It's it is and I I don't want to sit

here and say like, oh, they they don't

know. Like, no, they they know. I mean,

there's are companies who have tons of

resources, food scientists galore, and

they're putting zero sugar on the label

and keto friendly a as a trick because

it's associated with health benefits,

right? There's all these studies on

ketogenic diets that can they can show

to improve health. And so they want to

have that on their label. But what is

often happening if you look on the back

of the label, there's about a hundred

different ingredients they can swap

sugar for for something that has the

same exact metabolic effect as sugar. So

malitol, maltodextrin,

um all these different ingredients that

are going to cause glucose to go up

rapidly, they'll just swap it and now

you can put on your label zero sugar.

Have you been in a ketogenic diet since

you were diagnosed with diabetes? Have

you cycled in and out of it yourself?

And if so, what have you noticed in

terms of when you are in that diet and

when you're not? So, I actually came

across this diet a little over a decade

ago. What I found is that almost every

blood meter that I was taking, this is

before CGMs were present, I had to just

prick my blood, you know, six to 10

times a day to see what my blood sugars

were. I was finding that I was very

rarely outside of the normal range. And

I was also finding that I wasn't feeling

these extreme highs and lows anymore

when I transitioned to a ketogenic diet

almost immediately. My insulin

requirements dropped substantially uh

around 40 a little over 40%. So the uh

the amount of insulin I needed to take

dropped dramatically, but I didn't have

continuous glucose monitor. I didn't

have this instant feedback of like what

is my blood sugar doing? I just know I

needed a heck of a lot less insulin. And

so what happened was I went into my

doctor's office at the time. He happened

to be the American Diabetes Association

president at the time. He's like, "I've

never seen a blood sugar level in the

normal range with someone with type 1

diabetes before." He said, "What are you

doing?" From that point forward, that's

when for me it like transitions even

into like a lifelong journey of like,

"Wow, you know, obviously nutrition had

a huge impact on me losing weight when I

had obesity. Now it was directly

regulating this very powerful disease

where upon diagnosis nearly all patients

are going to have high invariable

glucose levels for the rest of their

life. 99% of patients will never see

normal metabolic control again for their

life. 100% of them are expected to get

insulin resistance. And within 3 years

we see neuroanatomical changes within

the brain of children who are diagnosed.

What does that mean?

>> So it means that when we look at MRI

scans of the brain, we see that children

with high and variable glucose levels

with this disease with type 1 diabetes,

they have shifts in the type of white

and gray matter. The sections of the

brain that are associated with normal

brain development and childhood, they're

not developing the same way. We and we

see this within 3 years and it's

directly linked to the poor glucose

control. We also know that we see signs

of the early signals of aththeroscerotic

progression in children within four

years.

>> Atheroscerotic progression, what's that?

>> So,

one of the primary causes of death in

individuals across the world is

cardiovascular disease. And how do we

get that? Well,

you have changes in your blood vessel

and how it functions is the first and

earliest signal of future what will

ultimately be plaque or this kind of

blockages within the blood vessel which

ultimately cause things like heart

attacks or strokes. Well, in type 1

diabetes, we see that children who have

high invariable glucose levels, again,

99% of patients are expected to just

live this way for the rest of their

life. If they follow standard of care,

if they follow the doctor's orders,

they're going to see changes in how

their blood vessels literally

functionally and structurally change.

Their blood vessels will now shift from

being this very compliant uh almost like

a a smooth wave to that blood vessel now

becomes very rigid. It starts to build

collagen at more and more collagen

around it becomes stiffer and stiffer.

It's almost like taking a hose and

turning on a hose and pinching the hose.

When you pinch the hose, as you become

stiffer and as you shrink the size of

the blood vessel, it goes faster. And so

we can measure that by the speed of the

blood in the body. Another clear signal

and one of the most powerful signals

that the blood vessel is starting to

change before you see plaque, before you

see blockages, I mean decades prior.

These are all happening in childhood by

the way. You know, 10 to, you know, 10

to 14 year olds diagnosed with type 1

diabetes. we see that the blood vessel

isn't able to respond to what they call

sheer stress Stephen. So that means

let's say you go for a run uh this

morning Stephen and your blood pressure

initially increases because as your

heart rate increases the speed of the

blood increases the amount of pressure

on the vascular wall increases that a

phenomenon when the blood moves fast

through blood vessels it it causes

stress against the blood vessels. That's

not a bad thing. It's actually a signal

for the blood vessel to release

something called nitric oxide. Nitric

oxide is a potent called vaso diilator.

It causes the blood vessels to open up

and this is how your body responds

normally to stress. Okay, you go for an

exercise vasoddilation or vaso

constriction then vaso dilation um or

you know and these are normal responses

the body has. Well, what happens in type

1 diabetes very early on is that the

ability to produce nitric oxide is

diminished. You're not able to respond

to high stress load. So, not only are

the blood vessels becoming stiffer, but

now the blood vessels aren't able to

even respond as well to the stress. And

so, as you're looking at this and you're

looking over time, you see these early

signals of athoscorotic progression.

also see very early on that it was once

expected that all patients with type 1

diabetes would have eye damage some form

of eye damage called retinopathy where

you start to lose vision eventually can

go blind within 20 years of diagnosis.

So most people are diagnosed in 10 to 14

years of age which means by 30 to 34

years of age you're going to see a lot

of patients who have altered eye

function andor some who are blind. Now

that has extended out over time, but we

know that all patients with this disease

because of high and variable glucose

levels are expected to get at least one

complication in their lifetime if they

follow standard of care advice today.

Even with the best technologies out

there, there is no pharmaceutical

intervention. There is no technology

that normalizes this disease. And the

effects of these high invariable glucose

levels and insulin resistance that

accompanies it

is cumulative

dose dependent and not completely

reversible. Which means that once you're

diagnosed, the clock starts ticking. It

just like smoking. The more you do, the

earlier you do it, the earlier the

impact and the more lost life you

probably will get. And there was a study

done with 326 participants that found

that the keto diet can increase glycemic

control of patients with diabetes. That

was in the precision nutrition

publication. When it says it can

increase glycemic control, what does

that mean?

>> So is that what we were talking about

there with

>> Yes. So if you when you do a diet known

as a ketogenic diet, you're reducing

carbohydrates. Well, when carbohydrates

are consumed, they elevate glucose

levels. Well, if you dramatically reduce

the amount of carbohydrates consumed,

you're not having those same type of

glucose elevations and fluctuations

because you're not consuming the most

potent glucose elevating factor in our

life, which is carbohydrates. And so

when they talk about improvements in

glycemic control, it is the measure of

24-hour over multiple day levels of

glucose in the circulation. And how well

is that being controlled within a normal

healthy range?

>> And so is your goal then to

encourage people to restrict

carbohydrates

>> in their diet? But you know because

carbohydrates and sugar have been

somewhat I guess demonized because you

never really hear many good things about

sugar.

>> Um so so what is what is your goal here?

What is the advice to the listener? Is

it to restrict their their

carbohydrates?

>> To be very conscious of what they're

consuming because nutrition has a

powerful potent impact on overall

health. And for those patients who have

chronic disease, which is unfortunately

the overwhelming majority of us, yes,

carbohydrates can be a very restricting

carbohydrates can have a powerful

therapeutic effect on diseases like type

2 diabetes. The American Diabetes

Association in their 2019 consensus

report described type 2 diabetes as the

most evidence-based nutritional

strategy. We know that it can have

potential positive impacts on things

like uh Alzheimer's disease. There are

studies that have looked at this. We

also know that for

>> carbohydrate restriction we

>> Yep. So, and I like to term this

therapeutic carbohydrate restriction

because it's the therapeutic outcome of

a carbohydrate reduction. Um and that's

really the goal of this is can you

improve your overall health. Many people

will just do this simply to improve, you

know, to lose weight, to feel, like you

say, to feel more cognitively alert. But

in my case where you're along further

along the metabolic spectrum with

diseases like diabetes, it has a even

more uh potent impact on how you feel,

even more potent impact on your overall

health. Um, and but unfortunately about

93% of Americans have some form of

metabolic derangement, uh, as cited by

multiple studies and multiple research

groups. You did a 10-year study on the

impact of the ketogenic diet on a

patient that had type 1 diabetes. I

think this is this is most certainly the

longest study ever done of its type

where you took one individual and over

10 years you I guess controlled their

diet. So, we had access to

the ability to monitor uh a unique

patient who had type 1 diabetes and they

were diagnosed and had followed the

American Diabetes Association diet, a

healthy diet for 6 years and then

switched over in 2013 to a ketogenic

diet. Upon the initiation of the diet

and post, they had DEXA scans. They

controlled their calorie intake, their

body composition. they weren't taking

any additional medications and we were

able to monitor the impact over a

10-year period

while controlling all those variables.

And why that's so important is because

one of the common concerns of a

ketogenic diet is the hypothetical risk

it can increase cardiovascular disease.

And the reason that

they think that it can increase

cardiovascular disease or it's

hypothesized that it will is because of

the elevation in LDL that often

accompanies an increase in saturated fat

in the diet. Now saturated fat comes

from things like animal proteins, uh

it's in coconuts as well. What we found

is that despite a near doubling in LDL

cholesterol on this diet, which again

should be associated with worsening

cardiovascular health, we did an

advanced cardiovascular assessment in in

this patient and found that despite

doubling LDL, they had maintained

completely normal glycemic control,

which again based on all the data says

is the number one risk factor. They

reduced their insulin load over 40%.

And their cardiovascular health was not

only better than the average patient of

similar age and sex with type 1

diabetes, it was better in almost every

single category than people even without

type 1 diabetes.

despite the doubling of LDL cholesterol,

it illustrated that over a 10-ear

period, it maintained not only no sign

of cardiovascular disease, but

remarkable cardiovascular health. And

and in fact, we actually followed on

that study with the largest ever

analysis of the impact of nutrition,

particularly carbohydrates, in over

46,000 patients with type 1 diabetes. We

showed that in over 70% of all reports

of very low carbohydrate ketogenic diets

that patients were completely able to

normalize their glucose control,

normalize the most potent risk factor

for disease of type 1 diabetes.

>> And is this this is a sort of a spectrum

of I'll put that on the screen for

people to see the different sort of

stages and categorizations of being

normal, pre-diabetic, and diabetic.

Right.

>> Correct. Yes. So normal is anything less

than 5.7% HBA1C. Pre-diabetic is that

5.7 number up to 6.4. And then diabetic

is anywhere between 6.5 all the way up

into essentially uh there's no cap on

how high that number can go. I

>> I mean I noticed your your blood sugar

levels have uh risen quite dramatically

to

>> that. So what you see initially is is

probably only the first phase of this,

right? So started at an average of

around 100 milligs per deciliter on

average. And once the food is then

consumed cuz once you consume the food

it takes some time to break down into

glucose that glucose then goes into the

blood and then the blood then moves

glucose into this compartment around the

cells which called the interstitial

fluid. And now we're starting to see the

direct impact of just consuming probably

a fifth of the amount of carbohydrates I

should consume from a superfood. Um this

you know oranges are considered both a

citrus in a fruit and this is considered

like a superfood by the American

Diabetes Association uh in the context

of diabetes.

>> So when the glucose spike is high, so

you've just eaten some oranges, the

spike is going up.

>> Yeah.

What does someone feel and then what do

they feel when it's then crashes down

and goes below? Because it started at

about 100. So I imagine that it's going

to go up to whatever it goes up to and

then it's not going to drop back down to

100. It's going to drop below 100

typically in a in a normal um

non-diabetic person, right?

>> So 100's right around the uh normal. So

what you'd hope would happen is that

you're going to go up just a little bit,

insulin's going to respond quickly, and

you're going to come back down to

normal. if you have total healthy

metabolic function. Again, the vast

majority of us do not. But in this case,

what's going to what would be predicted

to happen is that as blood sugar

elevates and insulin responds,

it's going to go as high as the amount

of glucose that's present in the food.

Okay? But at the same time, the my pod

is also which is holding my insulin is

immediately trying to respond. it's

immediately trying to say, "Okay, oh no,

we need to bring this and keep this into

a normal range." Um, and so it's trying

to release insulin. And so you can see

on the screen that there's this massive

uptick in the blue line, which is the

initial response in insulin immediately

to the elevation in glucose. This is

exactly what happens in normal

physiology. Yet no one can measure it,

but you can see it here.

>> So how would I feel when the glucose

spike is high? Do I feel energetic? Do I

feel focused? Or do I feel tired? My

personal experience here Stephen is that

as blood sugar becomes very high I

become my focus reduces my I become

fatigued. Uh I can also according to my

wife become irritable. Um and but you

can even look this up you know you can

look up what are the symptoms of

hypoglycemia what are the symptoms of

elevated glucose levels above the normal

range which is normal 70 to 120. That's

when you can start to see uh very

clearly that the evidence over time has

shown a a very clear impact on not only

how you feel physically but also your

mental health status as well. Oh, I've

just looked up the symptoms here and it

says um the common immediate symptoms of

having a high glucose spike is you feel

thirsty, dry mouth, um frequent

urination, headache, brain fog, fatigue,

sluggishness, blurry vision. Um,

and then once you go down and you crash

or your glucose really drops below the

normal range, what do you feel then?

Typically,

>> so a lot of how I like to describe this

is almost like imagine you're outside

and it's sunny outside and you're having

a great day, great conversation with

other friends, and then all of a sudden,

very rapidly, clouds come over top.

Everyone kind of dissipates and it

starts to rain. It's almost like it's

it's we know that glucose levels have a

direct impact on the neurobiology of the

brain. Meaning how the brain functions,

how it operates, and particularly at

very high glucose levels, you know,

typically above 180 milligs per

deciliter, you start to see signals of

inflammation, signals of stress, like

oxidative stress in the body if people

have heard of that before. And that can

start to cause damage on tissues and

cause a stress response. But the problem

here, Stephen, is that most patients are

living there 24/7.

>> I was looking at some of the symptoms

here, and it says the short-term crash

you get after a spike, um, after a rapid

rise

is a bit of an insulin overshoot. So,

it's reactive hypoglycemia, which is the

sugar crash. And then you might feel in

that crash jittery or shaky, hungry,

often craving carbs and sugar again,

irritable, anxious, weak, or

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Replet's core plan. You did a study in

2025, I believe, on the impact of the

ketogenic diet on physical performance.

you know, if the ketogenic diet has all

these therapeutic potentials, you know,

going back for over two centuries, what

is truly the impact of it on

performance? Because that's one of the

primary reasons where someone were to

walk into a a clinical setting and say,

"Well, yeah, you can do this, but I've

heard it's going to decrease my

performance."

>> Physical performance.

>> Physical performance. And so we were

very very interested in this because we

thought okay

it it

you know when we look at why

carbohydrates are currently being

recommended as sports nutrition is

because since 1921 they've been shown to

improve performance and how they showed

that in 1921 was that physicians out of

Harvard and um and Boston actually

watched Boston marathoners half of which

who would come wouldn't even finish the

race slurred words they would uh have

like almost pale skin, shaky, weren't

able to articulate their words or some

wouldn't finish at all. And what they

were finding was that these when they

tested the blood of these individuals

that they were finding that glucose

levels were low. Basically, they reached

what they call hypoglycemia. It's a

medical term to describe very low blood

sugar levels. And

then next year they provided

carbohydrates and these marathoners in

the Boston Marathon and all of them

improve their performance. And so since

192 or 1925 actually we've known that

carbohydrates can improve performance.

But we what has happened though over

time is that in 1960s

we there was a measurement technique

called the Birdstrom method where you

actually did a muscle biopsy pulled out

muscle tissue and found that oh wow

there's actually glucose stored in the

muscle. So it must be really important

for physical performance. If the muscle

which is used to contract and move the

body during physical performance that if

glucose is in that tissue, it must be

essential for performance. And then

after they discovered that there was all

these associations between low glucose

levels in the muscle called glycogen,

low glycogen and fatigue. Then after

that the in the 1980s they were able to

look at the amount of

sugar, carbohydrates and fat that the

body was burning during exercise. And

what they found at that stage is that oh

wow it looks like the the amount that

people are able to sustain intense

exercise is proportional to how many

carbohydrates they're burning.

And then there was a few modeling

studies Stephen that then looked at okay

what's the relationship between

let's say uh the intensity of exercise

and what type of fuel you use whether it

be fat or carbohydrates

and they found that they modeled it okay

and said okay well at lower intensities

you must burn almost all fat and at very

high intensities you must burn carbs and

there was a number of studies in 2017 to

2020, three different studies that

looked at the ketogenic diet over a 5day

to 3 week period. And they saw that in

those studies that there was a decline

in performance by around 2%.

>> If you were in the ketogenic diet, if

you were on the ketogenic diet,

>> correct? Compared to a high carb diet.

>> Yeah.

>> And so what did that tell these

researchers? Well, it said, "Okay, well

obviously the ketogenic diet must impair

performance." And there's all this

evidence since 1921s that the amount of

carbohydrates, glycogen, how much carbs

you're you're consuming is essential

performance. But here's the kicker is

that

one major confounder of all this is that

we've known for quite a long period of

time that the adaptation to a ketogenic

diet is not one week, it's not two

weeks, not even three, it's four weeks

or more. And when you say adaptation,

you mean your body's transition to being

in a a state where it's efficient at

burning using ketones.

>> So the body's ability to

lower its glucose oxidation or the

amount of carbohydrates it's burning for

fuel because you're giving your body

less of it. The amount of fat that's

being utilized for fuel goes up

dramatically. And then you produce way

more ketone bodies. And ketones are now

being used as not only a a body uh

tissue substrate meaning energy for the

muscle but also for the brain. And so

it's this transition over. But when

people were looking at these studies

they were just looking at some of the

metrics of what happens when you your

body transforms when you reduce

carbohydrates.

>> Okay. So what we wanted to do is say,

okay, if there's all these

healthpromoting benefits of a ketogenic

diet, that sounds great, but all these

studies and sports dogma would say

that's going to impair performance.

Okay, so let's test that. Let's actually

put athletes on a ketogenic diet for 4

weeks. We are going to control not only

their calories, we're going to control

their body composition, we're going to

control their activity level. We're

going to control all these key

confounders that many of these prior

studies never controlled so that we

could truly test the diet induced so the

macronutrient meaning the shift from

carbs to fat effect on performance but

we're going to do it in the same person.

So now we're going to control their

genetics. We're going to control their

environment. Once we did that, Stephen,

we tested what most people think is a,

you know, a very glucose dependent form

of exercise. We asked them to do 6 by

800 meter sprints. They were on a high

carb diet and then they switched to a

low carb diet. Now, what happened this

is all randomized uh and controlled.

When they switched over,

they had no deterioration in performance

>> at four weeks. at the four-week mark in

a form of exercise that we would expect

would be extremely glucose dependent,

extremely carbohydrate dependent.

>> But before 4 weeks, was there an

impairment in their performance?

>> So what we were interested in, Stephen,

is studying at the end. So we didn't

look intermediately. We exclusively look

at the end time point because the the

question was, well, if is there a

difference once you stick to this diet?

Because if you you go on this diet,

ideally you're you're sticking with it

over time. And so

if it is true that you require

carbohydrates, we then also measured how

many carbohydrates and fat they were

burning during exercise.

And it was over what we call 85% of

their V2 max, which means 85% of their

total maximum oxygen consumption during

exercise.

That is when we would expect almost no

fat to be oxidized or to be burned and

almost exclusively carbohydrates. Well,

we found that these athletes recorded

the highest levels of fat burning during

exercise ever reported in the

literature, illustrating that when these

athletes,

>> the ketogenic

>> ketogenic diet that when these diets

adapted to the diet for sufficiently

long, they had record levels of fat

oxidation even at very high intensity

levels. which means that fat was able to

provide nutrients and fuel at very very

intense forms of exercise when we would

expect only carbohydrates would be

relevant and utilizable.

So many of my friends um that are

endurance athletes or that are involved

in things like cycling talk about

exogenous ketones. Um I'm a co-owner of

a company that produces exogenous

ketones. That's my disclaimer. I've got

the product here. What can you tell me

about products like this? Exogenous

ketone products. Exogenous meaning

externally supplemented, I guess,

>> right? So, with a ketogenic diet, you

produce them. Your liver produces them

for you. With um exogenous, you're

consuming these. Well, why would you

consume them? Why not just do a

ketogenic diet? Well, we know that a

ketogenic diet

takes time to adapt. We just talked

about that with physical performance

that we see that you know up to four

weeks to see the full effect on on

performance or more. Well, what happens

if you're let's say a war fighter or

someone who's going out into the field

or immediately wants to flip into this

state? You can't do that unless there

was a molecule that you could consume

that could rapidly elevate ketone bodies

in circulation within minutes.

Insert exogenous ketone bodies. We have

known since the 1960s

that the product in there was studied by

MIT uh in the aerospace department

called 13butane dial. It that it was

able to be consumed and rapidly elevate

ketone bodies in circulation. There was

a study in 2016 called the metabolic

optimization $10 million program from

DARPA. DARPA being the

>> DARPA is an advanced research

organization from the United States

government where they fund very high

risk high reward programs and one of

which was the the the use and testing of

ketone bodies. And so that uh molecule

that they tested was um utilized the

same molecule that's in there and they

kind of uh tweaked some of the

formulations a bit and they showed that

and we know that this is the same for

this molecule as well that when you

consume them it rapidly changes

metabolism almost uh not identical to

what happens with the ketogenic diet but

it has a almost direct impact. It has a

blood glucose lowering effect. it

directly binds to receptors like the um

they call GPR 109A or uh or some other

key receptors that directly uh impact

inflammation. So it directly blocks

something called NLRP3 inflammosome

which is a molecule that leads to

increases in inflammation. We also know

that it changes the way that our genes

are used in the body called epigenetic

signaling. And so the uh consumption of

ketone bodies can actually change the

molecules on our genes and and how those

molecules are ultimately manifested and

that increases our antioxidant capacity

meaning our ability to block oxidative

stress in the body. We we see all these

powerful effects, these rapid shifts in

metabolism within the body. And this

2016 study showed that just orally

consuming these molecules could rapidly

shift metabolism, but that it was also

linked to an improvement in physical

performance. But if you look beyond that

and just like uh these these kind of

studies because we looked at them in

athletes, we looked at them in healthy

individuals and then also in military

settings. But we've also there's studies

looking at this in patients at risk for

cognitive decline. So patients at risk

for Alzheimer's disease. They've shown

that in a six-month study administering

exogenous uh ketone bodies was able to

attenuate the decline in uh cognition

that we know happens with advanced age.

>> And just to be clear there, you're

saying it reduces the decline. It

doesn't

>> correct

>> cure Alzheimer's or fix Alzheimer's. It

just delays.

>> Accurate. Yes. It's it's we know that as

individuals age, you're on a precipitous

or or steady decline in in brain

function. Um, and so the goal is to to

offset or to stop the decline. You know,

that's our goal. We want to maintain

normal uh brain function and our ability

to think clearly and to understand

things clearly like reading and and

doing problems and solving problems.

There have also been this emergence of

studies in the world of psychiatry. I

think there's around 11 ongoing active

clinical trials looking at the impact

and interaction of ketonebased therapies

and brain health uh particularly serious

mental illness. One in four adults in

the United States actually over one in

four adults in the United States has

serious mental illness. In fact, I

believe over the numbers are over 20% of

of adults are taking some type of psycho

uh altering medication. At its core, we

see all these relationships

between underlying metabolism being a

key

factor contributing to mental health

status. and the application of the this

unique diet which we know increases

ketone bodies which appear to have

direct impacts on the brain now seems to

be linked to improved serious mental

illness and it'll be interesting to see

where the that evolves but it's just a

fascinating world to imagine that

nutrition not a medication not a

technology but the the simply going to

the grocery store and swapping the

things you choose in there can lead to

these powerful powerful therapeutic

effects um in people of all sorts of

different conditions uh or disorders.

>> On one of the studies that I read about

the administration of exogenous ketones

and the impact it has on brain network

stability was from 2020 where they

investigated if brain network stability

responds to two major brain fuels either

glucose or ketones. And participants

came to the laboratory on two occasions

and drank exogenous ketones or glucose.

And after cons consuming these drinks,

they underwent an MRI scan. Strikingly,

the study showed that ketones increased

the stability of brain networks. In

contrast, glucose decreased the

stability of the network. The network

stability was 87% greater after ketone

consumption than stability measured

after glucose consumption. And in that

study which is on PubMed, the last line

of the abstract says, "Dietary

interventions resulting in ketone

utilization increase available energy

and thus may show potential in

protecting the aging of the brain which

is super interesting.

>> So we did a study uh looking at cancer

and applying exogenous ketones and a

very aggressive form of metastatic

cancer. And what we saw in in my work in

graduate school is that when applying

disogenous ketones that it delayed the

progression of the metastatic cancer,

but it also

when looking at body weight reduced the

rapid decline in body weight we

sometimes see with cancer. A phenomenon

called cexia which is a way a term to

describe the wa rapid wasting of body

tissue with disease. And it is no more

aggressive than the context of cancer

particularly metastatic cancer is where

it's most common and when we saw the

lack of decline in body weight I then

looked at where the body weight was

coming from and it was clear that the

lack of body weight decline

was because of the preservation of in

muscle mass. So it also appeared and

there's been a number of what they call

clinical physiology studies. those

studies that actually directly

manipulate human beings with molecules

and tests, you know, like muscle tissues

and how they function. We see that

exogenous ketone administration can

dramatically reduce the amount of muscle

breakdown uh or breakdown of muscle

tissue. Uh essentially illustrating it

may be a powerful mechanism in promoting

healthy muscle mass as well. In terms of

being in a ketogenic diet, one of the

things I'm always quite concerned about

is am I still able to gain muscle mass

if I'm in a ketogenic diet? Because I

>> Yeah, I when I go into a ketogenic diet

and I stop having carbohydrates, I tend

to lose weight rapidly and shred.

>> Yeah.

>> The fats falls off and I get very lean

but

>> yeah,

>> more skinny.

>> You smiled though because maybe you like

to be more shredded. Um, so a phenomenon

with the ketogenic diet. So there's no

deterioration in muscle mass with the

ketogenic diet. There have been plenty

of studies that have shown that you're

able to maintain muscle mass

>> and build it.

>> Yes. And build it. So they've shown that

as well. So Jeff Volic out of Ohio State

University has done a number of studies

in this area. Um, looking at individuals

who were actually on a

reduced intake diet. So they're reducing

less calories. So they had less energy

in the diet. And then they were also

doing the ketogenic diet. It was

actually a military study and they

showed that they were able to maintain

uh muscle mass just as much as if

someone was on a high carb diet um while

under a caloric restriction or another

way of describing that is like a semi

starving starvation state. So there's no

impact negative impact that we see with

these diets on muscle mass. However, to

your per your personal example, one of

the first things that happens when you

go onto a ketogenic diet is there's a

naturatic effect or natures effect, but

basically you reduce the amount of

sodium in the body. So, you you you p

you piss it out basically and um you so

you hold less water weight and that's

one of the first things. That's why

people see this rapid shift in body

weight initially when they're you know

on a ketogenic diet, which for many

people is great because if they're

trying to do it to lose weight, that's

like immediate reinforcement. But

sometimes it's water weight. Well, water

is in both the fat and the muscle. So,

it's it's not necessarily that you're

losing any muscle mass per se, but it

just might be in a phenomena less water

weight. And in some context, that might

be beneficial. Right? If you're in a

sport where you have a

power toweight ratio, but you're able to

maintain the same power at a lower

weight simply by shifting water, that's

great. Um, as long as you're able to

function equivalently. Is there anything

I do need to be thinking about in terms

of my diet to make sure I'm still

gaining weight just to I guess to keep

to keep my protein levels high?

>> So, the most important thing related to

your diet when it comes to trying to

build muscle mass is to exercise hard

and with resistance exercise. Uh that's

the most important thing when it comes

to your diet to enhance that effect.

Protein is one of the the most powerful

nutrients you can consume to augment

that response. Another is to ensure

you're having uh sufficient

calories. Right? So if you're in a

caloric deficit, so you said that you

know you tend to eat less calories

because you're probably not as hungry.

Um well, yes, that's one of the most

powerful ways to lose not only fat but

also muscle is to just not eat food or

>> I think that's it because I I lose my

appetite when I when I'm in the

ketogenic diet.

>> I also lose my appetite a little bit

when I take these um exogenous ketones

like Ketone IQ.

>> Yeah. And I've seen some of the studies

that show that there's roughly 20%

decrease in

um appetite

when you take exogenous ketones

according to one particular study that I

read. But when I when I'm in the

ketogenic diet, I it's like food is I

get hungry but then I start eating and I

stop very quickly.

>> Yeah.

>> And it's really bizarre. Like I was I

was in Cape Town for 10 days or two

weeks writing my book. And so I had the

chef there and the chef cooks me my food

and makes this amazing food and I'm so

hungry. I look at it I'm like amazing. I

start eating it. I have like five or six

bites and I'm done. And only when I'm in

the ketogenic diet, there's something

going on in my body which just doesn't

just doesn't want to binge eat like I

sometimes did.

>> So there's two things to talk about. One

is the type of foods you're consuming on

a ketogenic diet and the other is what

is happening in your body in your

metabolism on the diet. So there's a a

book called Always Hungry by a physician

u endocrinologist named David Lugwid and

he's kind of coined this carbohydrate

insulin model and um you know it's semi

somewhat controversial but the the

reality is that there's there's some

important notes in it. One related to

hunger which is if you're able to have a

fuel source on a ketogenic diet that's

sustained over time. So you don't have

the up and downs of glucose and up and

downs insulin. these constant swings.

Whereas on a ketogenic diet, you have

this sustained level of fuel influx,

right? So you have this nutrient

availability in the blood. So glucose

levels are much more stabilized, insulin

is much more stabilized, and you don't

have those fluctuations particle.

That might be one potential reason. But

the other potential reason is that when

you're on a ketogenic diet, you tend to

not consume the type of foods that drive

hunger. So again, we talked about in the

grocery store, the 70% of the grocery

store, particularly in the center of the

grocery store that is highly processed

where they combine

carbohydrates with with salt or fat or

some combination there in that makes it

highly palatable or very very tasty, you

know, increase the dopamine response,

this positive reinforcement response of

the food. Um, that drives people to to

seek more of that pleasure response and

as a result, they want to consume more.

So, everyone has probably felt this

example where you're in a restaurant,

you've eaten enough food to where you

feel physically full. You're like, "Oh,

I'm totally full. Like, I don't want to

eat any more food." Someone walks by

with your favorite dessert. And you're

like, "Oh, well, h I could eat that."

You're literally physically full, but

yet you want to consume more food. This

is a is a a phenomenon that has been the

struggle of of in America and the the

rest of the world essentially now um

where the food environment often drives

people to over consume and it's not by

accident. These are like well conducted

strategies in the food industry to lead

to these positive pleasure responses.

>> I think about this with bread in the

restaurant. You know they give you bread

first.

>> Yeah. That's a good It's a solid

strategy, Stephen, to cause you to want

to consume start to finish not only the

bread, get a big meal, and follow on

with dessert. You know, it it is a is a

is a great strategy for ensuring that,

but it's also the same strategy that,

you know, Doritos is using where like

you you combine this mixture of new uh

molecules in the food that you consume

it, you get, oh, this tastes great.

Pringles.

>> The same exact thing where you combine

these different components and it forces

you this like, "Oh, this tastes great. I

need more." And you never feel full. One

of the most common tricks that the the

food industry utilizes in these

environments is that they one they they

certainly are aware of this, right? And

so when you consume these type of foods

together, they they know they consume

more of it, but sometimes people aren't

even aware of it. And best example of

this, go look at the back of most of the

bacon

on the grocery store aisle. Go look at

the back of most peanut butters, almond

butters, nut butters in the grocery

store. Most of them have added salt and

added sugar. Even to levels where you

don't even taste it, but go look at the

label. The reason those are added is to

increase the flavor profile, the

positive brain response to the food. so

that you consume more of it. And this is

a huge part in why people always feel

hungry in today's food environment.

They're always seeking more food

and they can't get off that hamster

wheel. They're always over consuming or

always referring to this phenomenon

called food noise where they always feel

the drive to consume foods or they never

feel full. And

>> it's and it's because of the sugar and

the soap. It is because the food is

composed and made in such a way to be to

have a flavor profile that your brain

says

not just eat one bite, eat as much as

possible because we're always seeking

these pleasure responses, right? In our

lives, in our world, it's this is even

independent of food.

>> So, what do we do about this?

So the solution for most people in this

situation is to try to focus number one

don't consume liquid calories. That's

like a dead giveaway bad move because

those are abundance of calories

will drive people often to over consume

them and very drive this pleasure

response in the brain.

>> Liquid calories. What's a liquid

calorie?

>> So let's say you have uh a soda or a

Coke.

>> Yeah. So basically completely void of

any nutrients and really high in

calories, spikes your glucose through

the roof, insulin through the roof, and

then often makes you hungrier

afterwards, not less hungry by having

>> like orange juice

>> is another great example.

>> Smoothies, those those fruit smoothies

people have.

>> Exactly. In fact, just taking fruit and

then blending it up actually increases

the speed by which it's absorbed changes

the hormonal response and leads to a

worse outcome for most people. Most

people think a fruit smoothie is a

healthy thing.

>> Yeah, I don't know about that. Um, I

would I think that when you take fruit,

which for most reasons isn't terrible,

right? Like, it's not these are

nutrient-dense foods, if people can

consume them and get away from them,

great. If you have a metabolic disease,

you might be more vulnerable to, let's

say, glucose elevations. But when you

then take foods like that, it could be

any foods. It could be taking potatoes

and then making mashed potatoes. By

simply changing or blending that food

up, you're now taking a lot of the

structural components that your body

would take time to digest and you're

removing them and you basically almost

are like almost turning on like a small

hose that's just giving a little bit of

water at a time and it's turning it on

all the way. you know, you're rapidly

increasing the speed of how the

nutrients enter the body and it

completely changes the hormonal response

of molecules like GLP-1 and and normal

levels of GLP1 in the body are

completely altered. The insulin response

is also altered

>> and GLP1 is the hunger hormone.

>> It's known for being related to hunger

because it's released in response to

food. It changes the brain's hunger

drive and most people know of it because

of

>> oimpic simaglletide wobi traipide um all

these GLP-1 receptor agonists that

are

increasing GOP1 levels not to normal

levels they're increasing them to super

physiologic levels mean levels that

would never be observed or ever seen

in normal settings of the body.

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So, I want to give the audience that are

listening some practical ways that they

can change their life to live a better

life and to navigate the food

environment we live in. But just to just

generally the advice that you would give

if you had the ear of I don't know five

million people right now and you could

say something to them to help them live

better lives, to perform better. What

advice would you give them?

>> Number one is I would say be conscious

of the food you're consuming and what

you're consuming on a daily basis. The

impact of food is is equivalent to

medicine. It is and sometimes more

powerful than medicine. So, uh what you

drink, what you eat, you know, focusing

on whole foods, not consuming liquid

calories. And if you're someone who

could benefit uniquely from stable

glucose levels, lower insulin levels,

like someone who has some type of

metabolic disorder like I do, reducing