#21 – Nina Teicholz

Few people in this world have done more to unearth the fallacy and shoddy evidence behind our dietary guidelines than Nina Teicholz. Her book The Big Fat Surprise is one of the seminal books opening our eyes to the problems the dietary guidelines have caused and their complete lack of quality evidence. But Nina didn’t stop there. As director of the Nutrition Coalition, Nina is spearheading the effort to make sure nutritional recommendations are based on quality science or aren’t made at all. On the surface it makes sense that we would all agree on that. Yet there is no shortage of controversy and deception still happening and the 2020 guidelines committee may not help matters much. Hear Nina’s perspective on this, plus some the advances we have made, and where we can find hope for the future.

#20 – Dr. Ryan Lowery

Dr. Ryan Lowery has firmly established himself as one of the leading researchers and thought leaders in the field of ketogenic lifestyles. He has clinical experience and research spanning from athletic performance to longevity to neurocognitive disorders. His goal is to bridge the gap between academia, research, and practical individual implementation, and he does an amazing job of that. In this interview we continuously cycle between research and practical tips that everyone is sure to get something out of this discussion. We discuss optimal amounts of protein on a ketogenic diet, ketones for longevity, role of exogenous ketones, how to read the labels of synthetic ketogenic products and so much more.

Dr. Robert Cywes

Dr Robert Cywes is an expert at weight loss surgeries. But if it were up to him, he might not do any of them. His first step is always to help his patients break their addiction to carbohydrates. He still uses surgery in the right situation, but he is the first to admit that surgery without addressing the underling carbohydrate problem is destined to fail. His focus on emotional attachment, finding alternative to meet our emotional needs, and whole lifestyle intervention is a refreshing break from the “just have this surgery and everything gets better” approach. If you or a loved one is thinking about bariatric surgery or struggling with weight loss, this episode is for you.

Lauren Weiss, PhD

Anyone who has tried to change a habit knows that it involves much more than knowing what to do. You also need to know how to do it – how to make the change and how to make it stick. Lauren Bartell Weiss has made it her job to help people understand this concept. With a PhD in Behavioral Nutrition, a background in nutritional research, and a clinical nutritional practice, Lauren has the knowledge, the passion and the experience to help people achieve their goals. In this interview she shares her experience in the research world, and more importantly, provides numerous take home points and strategies to help achieve meaningful lifestyle change.

Dan Scholnick

Dan Scholnick once said, “It seems like every VC I know in Silicon Valley is on some kind of a low carb diet.” Dan is no exception. Despite having the diagnosis of familial hypercholesterolemia, he decided to try his hand at a low carb diet after hearing a talk by Gary Taubes. Since then, Dan has experimented with numerous diets to see which work best for him, but he also has “put his money where his mouth is” by being an early investor in BulletProof Coffee. In this discussion we discuss his personal journey, as well as the role silicon valley plays in the emerging health and nutrition scene. For instance, how do they evaluate a company that produces a product we could all make on our own? And what does he think of the emerging trends of lab grown meat or hydroponic vegetables versus making current agriculture and farming practices more efficient? Dan has a unique perspective as patient, investor, and self described biohacker.

Meat and Homocysteine- Irrelevant or Dangerous?

Do we have to avoid meat if we have high homocysteine levels? Not really.

 

What our body does with homocysteine is more important than our food intake. I thought this was easier to explain in video form, so you can see my 4 minute explanation here:

The bottom line is we need to know our methylation status, make sure we have adequate levels of folate, B12 and B6, and make sure we have adequate choline (found in egg yolks).  If all those are perfect, and we still have elevated homocysteine, then we may want to experiment with a diet low in methionine to see if it makes a difference.

 

As always, however, we have to evaluate our overall health picture and not get too hung up on one blood marker. The more important questions to ask are how does homocysteine affect my overall health, and how will altering my supplements or diet change the big picture?

 

Hopefully this helps! Let me know if you have any comments or questions.

 

Thanks for reading (and watching!)

Bret Scher MD FACC

Dr. John Limansky

Dr. John Limansky is the Keto Hacking MD and a well-known podcast host. He helps high performance clients use a ketogenic diet to improve their performance, their health and their lives. Plus, he helps them understand how to be an ultimate biohacker.

What does biohacking really mean? Does it have to be a complicated intervention, or can it be a simple lifestyle change? Which of the numerous biohacking tools are really worth the investment? After listening to this episode, you will have clear answers to these questions and more.

LCHF and “Healthy” Whole Grains: Do we Need Them?

Here it is again. The term “healthy” connected as a descriptor.

We see it all the time. Healthy Whole Grains. It reminds me of the common use of “fruits and vegetables,” as if they are one in the same.

Are whole grains, by definition, “healthy?”

For a full, in depth description, see the Whole Grains Guide on Diet Doctor, where I was the medical editor and reviewer.

For the quick answer, let’s leave it as a “maybe.”

If you choose to eat refined grains, white flour, processed snack foods, in essence the Standard American Diet, then switching to whole grains will almost certainly improve your health. And that is where the majority evidence in favor of whole grains stops. Compared to refined grains, they are great.

Who should eat whole grains?

If you are insulin sensitive, live in a society where you are physically active for most the day, eat fewer calories than most industrialized nations, and maintain a healthy body weight, then whole grains can be a healthy part of your diet. Observation of the Blue Zone countries demonstrate that whole grains can be part of a healthy lifestyle in that setting.

We cannot, however, extrapolate those findings above to apply to all Americans, Europeans, Asians etc. and say whole grains are by definition “healthy.”

Who should not eat whole grains?

If you are metabolically unhealthy with diabetes, metabolic syndrome or insulin resistance (estimated to be 88% of all Americans), then whole grains are anything but “healthy.” Borrow a continuous glucose monitor for a day and see how your blood glucose responds to whole grains. If you aren’t perfectly metabolically healthy, it isn’t pretty.

Instead, if you eat a whole-foods, low carb diet without grains and sugars, then whole grains have no necessary role and no association with health.

Enjoy the more detailed guide from DietDoctor.

Thanks for reading,

Bret Scher, MD FACC

Low Carb Denver 2019

They just keep getting better. These low carb conferences keep raising the bar, and they keep exceeding my expectations.

Low Carb Denver was no exception.

 

Robb Wolf on Low Carb Myths

 

The conference started out with Robb Wolf dispelling the unfounded myths that low carb is dangerous or associated with dying earlier. The quality of science that gets promoted in the media is nauseating, and Robb did a wonderful job highlighting that. (Plus, we had a fantastic podcast interview later that day, so stay tuned for that!)

 

Georgia Ede on the EAT Lancet Report

Next up was Georgia Ede, who destroyed the EAT Lancet report. By saying “destroyed,” I don’t mean she was malicious or attacking. Rather, Georgia was her usual incredibly analytical and science-based self. She showed how the report was based on faulty science, and how the recommendations weren’t even supported by the faulty data they used. It is mind boggling how this amounts to a well-funded PR campaign masquerading as science, and Georgia was masterful at demonstrating this fact.  Bonus- Georgia sat down for another action packed podcast interview. (You will love this one!)

 

Low Carb Practical Implications

From there, we got into practical implications such as how low carb might be an adjunctive treatment in cancer, how it can be safe in pregnancy, and Jason Fung showing how PCOS is essentially a disease of hyperinsulinemia. What’s the best treatment for hyperinsulinemia? Let’s say it together… LCHF! (and I had an amazing podcast interview with Jason as well!)

Then the controversy started.

 

LCHF Controversy

Kudos to the organizers for stirring things up with presentations followed by a civil debate between Dr. Dariush Mozafarrian and Gary Taubes.  It’s important to recognize intelligent opinions and scientific interpretation don’t always agree. This was a nicely highlighted in this section.

There are plenty of times when opinions and “data” against low carb are based on weak or nonexistent science. The discussion with Gary and Dariush showed the nuances of interpreting science, something I aim to continually help with!

 

Zoe Harcombe on Fiber

Fast forward to day two when Zoe Harcombe brought down the house with a riveting talk on how we don’t need fiber. None. Not at all. Zilch. If we eat tons of refined carbs, then fiber is helpful. If we don’t, then don’t worry about fiber! This was a great talk with perfectly placed “potty humor” as Zoe called it.

 

My Talk

Next came my favorite part of the conference. But then again I am biased. It was a 1-2-3 cholesterol punch with Dr. Paul Mason, myself, and Dr. Nadir Ali all discussing different aspects of cholesterol. The take home is that things are different with LCHF. The physiology changes and the existing cholesterol evidence does not reflect the specific subset who follow a healthy low carb diet. That much we know.

Yet, there is much we don’t know. These back-to-back-to-back talks helped highlight this.  That’s why I advise everyone following a LCHF lifestyle to see a practitioner experienced with LCHF. It doesn’t mean ignore cholesterol, but it does mean seeing it in a different light.

As if the first two days weren’t enough, day three kicked off with Dr. Eric Westman, followed by Dave Feldman sharing his amazing N=1 clinical data from the past year. Beware of coffee and high triglycerides!

 

The Diet Doctor on Long-Term LCHF Diets

Then came The Diet Doctor himself, Dr. Andreas Eenfeldt showing us how low carb diets do work in the long term. We just have to stick with them. This was a nice compliment to the earlier talk from Dr. David and Jen Unwin showing us how hope is a powerful force to maintain compliance and behavioral change.

 

LCHF and Sexual Health

And then we had a new topic for the LCHF meeting, sexual health. Perfectly delivered by stand-up comedian and low carb physician Dr. Priyanka Wali, her talk showed us how the number of problems LCHF helps continue to add up. That is why most of the time we are better off thinking of LCHF as an overall healthy lifestyle rather than a “treatment” for a specific disease.

LCHF Community

Despite all these amazing talks, however, the real star was the community. The interactions I had and witnessed between everyone, healthcare providers or not, showed the level of engagement, intelligence, and hope this community represents.

My personal highlight may have been having dinner with an ER doc, family practice doc, forage agronomist and ceramics teacher.  All of us with eclectic backgrounds, and all of us wanting to improve the health of the world (people and the environment).

It was a week’s worth of interactions packed into three days. And it leaves me hopeful for the future of science, the future of nutrition, and the future of health.

Thanks for reading!

Bret Scher, MD FACC

Prof. Andrew Mente

The PURE study is one of the largest epidemiological studies in recent memory, and its findings seriously question the dietary guidelines around fat, carbohydrates and salt. In fact, the PURE study suggests that higher fat intake reduced mortality, that lower salt intake increases mortality, and it even shows us how LDL is a poor predictor of health outcomes. As an epidemiology study, how much faith can we place in the results, and how do these results fit into to our current knowledge base? Professor Mente helps us make sense of these questions and more.

Bret Scher, MD FACC

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