Dr Berry & Dr Eric Westman [KETO Truths & Keto Myths]
Dr Berry & Dr Eric Westman [KETO Truths & Keto Myths]
Check out the video on Dr Berry & Dr Eric Westman [KETO Truths & Keto Myths].
Hello tribe Dr Ken Berry here today I've got a very rare treat for you uh we're live inside of our private Community today and so if you're watching this on YouTube and you're not part of our community that's why you're not able to ask ask questions uh Nisha and I are going live inside of our group all the time and every now and then we'll have a.
An esteemed colleague join us and so today I have the great honor and privilege of speaking again with Dr Eric Westman who is one of the ogs in ketogenic research welcome Dr Westman thank you it's always a pleasure to talk to you absolutely absolutely I'm really excited to do this with you there as you.
Know keto got really really popular they're a few years back and it that's kind of waned a bit in popular culture and so for just the average person they would think well I think keto it was just a fad diet it's kind of dying off and you might think that until you go to a website called clinicaltrials.gov.
And you see how many active ketogenic diet research studies are ongoing right now and that's one of the things I wanted to ask you about and let you tell everybody about uh their last time I looked and it's been a few months there was over a hundred active trials going on right now all around the world about a therapeutic ketogenic diet for either.
This condition that condition this disease Etc and and many more that are scheduled to begin soon that have already been registered at clinical trials.gov so uh I I also I I want to tell you this on Twitter the other day somebody commented on one of my posts.
And they said God I wish keto would die already and I I don't I'm sure I reply replied somewhat epithely and sardonically you know it's like well sorry I hate to burst your bubble but keto's not going anywhere keto's actually becoming more and more firmly ensconced in nutrition science and medical science.
By the day and so take it Dr Westman tell us what projects are going on do you have any uh research projects scheduled or ongoing right now what's the state of the research on a therapeutic ketogenic diet yeah thank you and I agree with you that the um low carb slash keto slash you know no.
Junk food is hopefully is here to stay and the science um has gone on for a long time and I got into it about 20 some years ago and you know back then I was worried about all the things that people who come to it for the first time now are worried about so I'm like relax I was worried about that 20 years ago.
Now I'm not um but uh the the research that we did uh I didn't create our method I I just studied it and uh the low carb diet is um as we teach it is is 20 gram total grams per day or less which is actually almost carnivore I mean when you when you look at the foods that we have um that we advise people to have because.
We want to make sure people get into a fat burning state so now yeah the the research uh I I have followed Dom D'Agostino at University of South Florida for a while and Dom is not an MD like us he's not a physician but he is a basic scientist and he did a talk at low carb uh Boca that's Symposium for metabolic health and I think he said.
There were 300 studies if you include all of the basic science ones uh looking at keto diets now and the big news in the clinical world for me is while we're seeing heart failure reversal in our clinic and we talk about it anecdotally there are no published papers but now there is a Department of Defense funded study with Steve Finney and Jeff volack.
As Leaders or investigators and I've known them for a long time and it's really important for these studies to be funded and then done to get the the attention and The credibility the the removal of disbelief although that will probably never happen totally you know so um the clinical clinical practice of.
Low-carb keto carnivore is at least 20 years ahead of the science and I want to kind of break this talk up into keto truths keto myths and so you've already hit two keto truths number one is your ketogenic diet if it's to be truly a therapeutic ketogenic diet it needs to be under 20 total grams of carbohydrates a day now keto product.
Manufacturers love to talk about net carbs don't they doctor and the danger with that is that a lot of the fiber that they use is is actually soluble and actually can be broken down in your small intestine and converted into some degree of carbohydrates and a good friend of mine Kim Howerton she once did 20 total or 20 net grams of carbs a day.
And with keto products and she was she was eating about 110 total grams of carbs a day but it was still 20 20 net grams right so truth number one 20 grams total carbs not net carbs and then the second thing you hinted at was that heart failures being studied right now by the Department of Defense to be treated with the therapeutic ketogenic.
Diet and that's because we now know I think we've known this for years but nobody ever talked about it uh cardiac muscle cells actually burn ketones more efficiently then they burn glucose and so I predict within 10 years that it will be state-of-the-art Medical Practice that.
If you have somebody with any degree of heart failure you're going to put them on a ketogenic diet immediately so that you can you can increase the ejection fraction and their cardiac efficiency what do you think about that yeah well I I don't know timelines very well it's always you know it's like uh.
Every study is longer it takes longer than you you anticipate and uh but I I agree the but but even so the heart uh there's the heart muscle and then there's the the the uh pipes if you will coronary arteries that Supply the muscle and then there's the electrical system so right and then there's the hormonal system so they're really kind of four.
Parts of the heart so when someone says you know a diet's bad for the heart I'm well which part right so so we know the muscle itself runs great it's like a diesel engine on fatty acids and ketones I mean you want it there pumping you know just non-stop the the arteries themselves of course that's the coronary arteries that's the quote the diet it's.
Bad for the heart people are actually talking about those pipes the arteries and I'm hopeful that Within in that 10-year okay 15-year time it'll be recognized that the low carb keto and carnivore type diets are actually healthy and and does not promote coronary disease but there's a prejudging prejudice and discrimination.
Against high-fat diets and 10 you know 20 years ago I would say hi I would stutter because you know it was so wrong you know like I'm not supposed to say you know the swear word you know or fat but now you know so even you know recently there there they are talking about you know there there you'll again talking about ldls when uh uh anyway.
There are still those kinds of preconceptions uh and it is really important to have the research started getting done and then you know don't don't get us wrong when you start a study you don't know the result yet and that actually got the whole diet World in trouble because they started this low-fat diet thing had a study with.
48 000 women all around the country and they taught it as if they knew the answer to the study yep and then when the study was done it didn't work I remember that very well but you trained this whole country basically of nutrition folks to think that low fat was better but it was a study and the results were so anyway we're very.
Hopeful and optimistic that these studies will be positive and and in our pilot work in our clinics what we see is really all favorable but you know it's important to have that follow-up science done for several reasons one is there may be nuances to this maybe not everyone should do it all right and then to get the powers that be the the payers.
The the Medicare that the the Aetna and other insurers to pay for things like you know having you see someone to tell you not eat carbs right now that's not being paid for yeah to get all of these things paid for you need to have that kind of science done in a formal way it's just and you know we want that for drugs because drugs carry harm.
Potentially and uh and it's kind of sad that we need that level for for what you know you and I know is kind of what people have always eaten for a long long time but uh uh and there's no harm to taking sugar and starch out of the diet unless someone's on medicine that makes things too strong so uh but as it's my current research program is is basically.
Me doing anecdotes and and review uh reviewing papers um I I wrote a a chapter in a book that's coming out on the ketogenic diet out of Professor Tim Knox and the the notes foundation and nutrition Network out of South Africa they've been working on this for a couple years now it's going to be a great textbook.
Absolutely nutrition and this will be the second major textbook and you know all these dominoes have fallen so far that I changed the name of our clinic at Duke to the Duke keto medicine clinic because biologically and metabolically this is very different and it's a medically uh powerful sort of tool not only for.
Reversing things but for preventing problems so uh and you know I well being the the old Professor that I am I guess my the the chief and and department chair who are now you know I don't know how many years younger than I am they they didn't give me any grief about changing the clinic name so I do run the Duke keto medicine clinic now and when.
People come in asking for well what about these new drugs I I kind of go did you see the name of the clinic uh I'll refer you to my friends but not you know that said um I I don't see I don't know how to create an academic Clinic called the carnivore Clinic you know I'm trying to find a academic metabolic place and well Endocrinology thinks they own.
Obesity you know they they don't have practical answers until now these drugs are coming out that are you know actually have me a little worried because they're so strong in in if you don't know the kind of boundaries of you know yeah people should eat every day you know something healthy or you know don't go a week.
Without eating and that's what some of these medicines do and and some doctors are so naive they think well oh great you lost 20 pounds in a week fantastic no no no that's that's not the healthiest way to do it so but that's so my my research uh really was uh the the beginning of opening up this area going back to the year 2002 and then we.
Published papers up until well we started doing review papers and and um I've actually become that doctor that that you're supposed to be aware of or wary of that they don't collect much new data anymore they just do review articles but but there are other people collecting new data it's not like I'm not paying attention and and I'm now in.
A position where I I'm reviewing other articles uh part of the peer review process to give articles a fair shake you know there's one that that I I can't tell you what it is yet but it should come out soon where the alternate reviewer said rejected because you know because it's not possible and so I had to come in and.
Explain to the the the reviewer the editors basically on how actually this is possible given the new paper that David Ludwig the carbohydrate uh insulin model I'm an author on that one um and well we'll we'll see I I just give my opinion in the editors vote yay or nay whether it gets published but um uh but you know I I still in the in the.
Clinic four days a week uh and I have just one day for for this sort of activity during daytime weekday hours um but you know it's certainly like you this is a a mission uh a way that people so many people can benefit from this that uh and and if you got into this doctor thing because you wanted to help people I mean it's just so reinforcing.
And uh so wonderful to see it help so many people absolutely and I I remember the first uh low-carb cruise I went on you were there and I asked the question and I've made it a habit to ask this question every time I speak in front of a group of people about a proper human diet I asked how many you know Healthcare Providers are in the audience.
And there was just a few mainly speakers there weren't many health care providers in the audience and now when I ask that question I was recently at low carb Denver and Dr Westman it was it was bordering on half the route were either MD's dos Pas NPS RNs LPNs pharmacists dentists physical therapists ptas I mean I met so.
Many Health Care Providers at one level or another at low carb Denver and that to me is very very reassuring uh that more and more Health Care Providers are seeing the writing on the wall it's really it's it's hard to see it it's hard to not see it after you've had your 20th or your 50th patient come in who you haven't seen for.
A year and you're like holy crap Fred you look great what did you do keto well the first time Fritz is that you're like oh Fred's always been kind of weird anyway but then after you've seen the 50th fret in a row one of the one of the powers of being in Primary Care is you know is is to be able to see anecdotes firsthand.
And if you see one or two you're like nah that's weird I'll keep my eye I'll keep my finger on that pulse that's probably just complete coincidence but after you see 50 anecdotes 100 antidotes at some point you're like is this a trend or is this really just an ungodly astronomical coincidence and I think that Health Care Providers especially in.
The primary care trenches they see this they see that and after so many anecdotes uh they're like okay let me let me look into the research on this and thanks to you and Finney and voic and and so many other people we have this body of research and I've heard it said before and I think it's true that the the low carb ketogenic diet way of.
Eating is the most researched way of eating on the planet and for many plant-based doctors usually cardiologists right an endocrinologist they don't they're they're not aware of this research and so when they when when Fred goes to see the endocrinologist and he says yeah I lost 100 pounds on keto.
And my once they used to be 13 now it's 5.2 they think Fred's crazy and then when they hear one of my videos they think well that redneck's crazy and then when I hear one of your videos they're like Well he seems like a scholar and a gentleman but I think he must be crazy and so it's it's really hard to move Overton's window.
For health care providers because they've got these huge powers that be in the AMA and the AHA and the Ada who they're not interested in talking about this at least in in the mainstream media it might be on page 232 of their latest uh updated manual but they're not going to talk about this in a press release right and so did you.
Have Marcia says did you did you have any Kickback or any friction get changing the name of your clinic at Duke University in North Carolina it's a changing the name to the basically the keto Clinic no no because you know I play the politics within my organization meaning I I am in a building with my my peers uh I'm in the division of General.
Internal Medicine which is in the department of medicine at Duke University and uh it's really important to you know for for a couple years I brag about a patient I go down the hall and you know and show the other doctors and like oh okay you know so I did that to them through the years and actually several of them are are you know quite.
Familiar with using it in their practice and and um uh but that you know and um that's really important for even if you're in private practice on your own I'm sure with when you had other doctors you would send a report back I I don't have the the staff to send a letter saying oh look your patient thank you so much for the referral you know like I.
Remember remember that the old days the doctors would dictate these letters and yeah I'm afraid I I don't have those resources but I did the politics of making sure my my uh Division and then my department was aware of the good things that were happening and then financially I played the politics of the financial politics of of cozying up to.
The surgeons so the orthopedic surgery the the heart transplant surgery folks not not weight loss surgery but we're still kind of philosophically on different planets but but if I can send people to operations that couldn't be done before including heart transplants then that makes uh money for the system and and yeah so I've I've done that.
Consciously knowing that I I have to get the bills paid and but but I don't have a practice of my own to have to worry about that I'm within the university private practice and so I got no pushback and even still you know for several years it's been named that and um so we'll see I mean the leadership is.
Kind of defined by the second Clinic that's named the keto medicine clinic if I'm the only one for for decades then I mean I'm out on a limit I didn't really lead anybody but there are so many other practitioners doing this uh and uh Gary taubs even wrote a book called the kids for keto and in there he Chronicles all the pre well at least a hundred.
Practitioners who are using this uh but um so it's actually helped to change the name because I get that recognition if someone wants to do it and then yeah I'm getting a little tired of trying to figure out how to get the latest medicine and all this I mean and it's too hard and so I I'm offloading that to other people and want to focus.
On people who have selected to just change the food to change the health uh because it's so powerful and and um uh uh and then I I do like kind of pushing the limit on what things can be fixed those anecdotes and you know getting four or five anecdotes together into a paper and then having other people read it and and that's worked in in several.
Areas that I hadn't anticipated this McArdle disease glycogen storage disease is fixed by running the muscle on fat rather than holding it back on the fat uh the type 1 diabetes surveying the the group um of people following a Facebook group surveying this group um uh so it's actually kind of a.
Grassroots uh a learning model here we're learning from people in the trenches but we want to influence the people in charge of Grants and grant funding uh the the way it works is that you have to convince a a group of reviewers in order to get a grant funded so let's say I'm a young PhD researcher at Hobbit and I've.
Watched a couple of this crazy Dr Barry's videos and a couple of videos by Dr Westman and I'm like man that seems really like a powerful intervention I'm going to do I'm going to do a research study on a ketogenic diet for fatty liver let's say I know I want to only research this and so I take this to my department chair talk us through the.
Politics that would be involved in that and all the different ways that that idea could be snuffed out without ever seeing the light of day because most people think no you know Common Sense people like me they're like no if something works then everybody's going to be interested in that just by definition if.
It worked in 100 people why would we not immediately do a study to see if it really truly has a provable therapeutic benefit talk to us about the behind the scenes politics you mentioned you had to you you kind of play some politics with the surgeons and with other people people don't understand that that kind of stuff goes on they think no no people.
Just gossip and there's politics at the barber shop or at the truck stop no no no and yeah take us behind the curtain my doctor and tell us about the politics that would snuff that study and the politics that you've encountered personally over the last two decades that you've been researching a ketogenic diet.
Well it's not a perhaps a coincidence you mentioned fatty liver because I have a you know direct personal experience our paper on fatty liver being reversed with a low carb keto diet almost carnivore or carnivore like should I say um uh is published you know 14 years ago and so we took this paper before it was published to our powers that be in fact.
One of the professors is still here at Duke you know 15 years later and they said well oh well that that's fine but the grants they write they want to study people with fatty liver and then find out what the mechanism is so they can create a drug for it so they weren't interested in fixing it with a diet so even though the the mechanism of.
Fixing it might be figured out by studying people on a low carb diet whose fatty liver is getting fixed no they would rather go and look into the cell to say well it's this enzyme problem and if we give this treatment we you know we can write a patent and then accompany its money so that that's one problem is that not all science is done to actually.
Help the person in front of me it's done to figure out a mechanism find out a drug so actually and funny you mentioned however because I would say go talk to David Ludwig who's in the Pediatric Group there so now they're they're like people I mean it's sad to have to say it but they're really like their allies it's not like this is a war or or a.
Board game with uh you know of allies and and we're against but but on the other hand it is kind of like that because they won't give you the dismissive you know oh well you're crazy so so they're now you know uh David Ludwig at Harvard with with his group he's got a but it's Pediatrics so if you want to do it in adults that there's an.
Artificial separation that you'd have to talk to the adult Internal Medicine people um and uh but now I at a low-carb Denver by the way your talk was fantastic um I I thought it was a great meeting um especially uh for for your viewers and uh well and many of them were there as you said you know anyone in the tribe.
Razor or you had to stand up or raise their hands it was great to see um and I hope if you were there that you enjoyed the meeting too um absolutely and somebody asked earlier can doctors get continuing medical education credits for keto low carb even carnivore conferences and and I got I think 22 hours of CME at low carb Denver.
Now not every keto conference offers CME there's a obviously a bunch of Hoops to jump through in order to get get accredited by the aafp or the uh the the internists or whoever you're trying to get accredited with for for CME or CEUs but yes low carb Denver offered about 20 25 credit hours and then the society for metabolic Health practitioners they also.
Have CME that that Health Care Providers can earn by taking little courses or by going to their meetings and so yeah more and more these these meetings are being approved for continuing medical education for all levels of practice of of medicine and health care I heard I heard a guy once say that in academic medicine and academic nutrition.
It's uh publish or perish and patent or remain a pauper and so you you hinted at that earlier that literally every study because even uh universities like Harvard who have billion dollar endowments they only have so much money they can spend a year on research and if a research study is going to cost a lot of money and there's absolutely not.
Going to be a patentable pill or a patentable injection or a patentable infusion or a patentable surgical uh instrument come from that study and then they've got this other study that's going to cost the same but there's a potentially a billion dollar drug that can be patented on the other side of that.
Guess what right yeah well of course there there are ways to get other studies done but it's less favored and and at a place like Duke the NIH grants are the ones that are most coveted because they they just have other perks that come with it and and the esteem from it um but at low carb Denver I I learned of the a group.
Or was reminded of the group at the University of Alabama Birmingham they have a nice group of nih-funded researchers now and uh Amy Goss who gave a talk on Sunday um is studying childhood fatty liver so you know and this is now becoming an epidemic you know can you know that that in childhood type 2 diabetes I mean this.
Didn't exist when we were in treated right and the idea that you would get fatty liver and then get cirrhosis or liver failure so I I've had the the um awkward situation of someone who had a liver transplant already now having fatty liver eating carbs sure and the transplant was done because of fatty liver.
So even even the transplant program that put in the new liver didn't understand that it was basically carbs that was causing the fatty liver sure and I'm sure they warned that patient you can't ever drink a drop of alcohol never take acetaminophen right never really never drink acetone probably reduce fat in the food because it's getting low fat lots.
Of fruit smoothies 100 yes yeah and so they literally were destroying the liver they had just transplanted with the dietary advice they gave the patient at discharge so that student that or the one who wants to do a project I try to steer them either to you know the Pediatric Group at Harvard the University of Alabama Birmingham Ohio.
State University where Jeff volich is on the University of Michigan where Laura saslow is uh Tulane Lydia bazano so and will Yancey here at Duke has a small research group uh going but um it's so you know it's like little seeds are growing it's just incredibly slow yeah and the I think part of the.
Incongruity that people feel is that we all know how quickly something can become a worldwide fat that can happen overnight almost right but how does some how do you change the practice of medicine well it takes these studies it takes takes first case reports then case series and then some mechanistic studies and then a larger.
More control study or two it takes two decades right and and many people have uh alleged that the only way to change Medical Practice is when all the old gray-haired men die and younger people take their positions right but I decided very early on and you know we've talked about this multiple times I'm not going to wait 20 years I'm going to get this.
Word out there now because it's not like I'm promoting some weird pharmaceutical drug I'm literally promoting meat and veg which humans have eaten for three and a half million years it's not like I'm promoting some radioactive infusion I'm I'm literally saying eat beef and it's okay to eat butter and it's okay to have some low carb.
Vegetables and a few nuts and a few berries that's keto keto is meat and veg that's what keto is and but but it got so popular if you had a 10 million dollar Grant you could give people radioactivity and and instrument catheters in them and do all these things because of the risk um it's as if the the universities want.
Money well they want the money from the research um to defray costs and risks and feed mouths but you're right so when we're talking about nutrition uh most medical the medical world really doesn't understand it so it's been handed over to non-medical nutrition and dietetic experts many of.
Whom never had clinical practice experience never had people come to them asking for drugs to lose weight one of the phds who did a study on a low carb diet came up and gave a presentation and said well there's a strange thing that happens when people cut carbs out they're not interested in food food and they eat less and it's number 10 on the.
Disinterest scale and she said this is not a good thing and I said Diane Diane Stadler was her name Diane people come to me for pills to have this kind of effect what do you mean that's a fantastic thing so so it's like they're seeing the same thing and then describing it as terrible or you know it doesn't follow the guidelines where God.
These guidelines are not like the tablets from Moses that say you know that the God says you have to have bread I mean you know they're all man-made guidelines and and so yeah because this is really risk free I mean unless you're on medicine you gotta be careful because you gotta make sure you don't have side effects.
From medicines as you get off of them but um we really in this world of nutrition don't need those kinds of Trials to determine the safety of it although the perception is we need them right because oh my God you're telling people to eat fat and and you know yeah what kind of person are you you're telling people to eat meat veg I don't.
Understand that sounds very dangerous and very unusual um now so we're we're live with us now go ahead sarcasm that was sorry I was a little sarcasm yeah we're live right now in our private group we have 5 000 members in this group and I want to tell the tribe members Now's the Time if you have a specific question for Dr Westman.
You can even ask me a question but he's the man of the hour ask ask him your questions I want to answer as many tribe questions as we can get to today if that's okay with you doctor and then absolutely if a question brings up a point feel free to Riff on it uh and then if anybody's watching this on YouTube and you'd like to be part of.
This kind of private live q a with some of the leading researchers and leading uh thought leaders in the world of nutrition low carb diets keto diets ketovor carnivore proper human diets you might want to consider joining our community the the web address is in the Chiron that's scrolling on the screen below so now's.
Your time uh tribe members if you have questions for Dr Westman uh type them and beat succinct and pithy but not laconic in your question to ask we need relevant information but no Superfluous information so that we can answer as many as we possibly can uh doc let's talk about a few keto myths what are the most common things that you see on the.
Internet you hear at conferences you hear uh some maybe some of your colleagues when you guys are getting together for morning rounds and they're like well I heard keto does this or that what are some of just the very common myth that there's just not a grain of Truth too that's just complete foolishness.
Well it causes ketoacidosis so the the kind of inability to know there's a difference between ketosis and ketoacidosis in fact I hadn't seen ketoacidosis in my patients until these drugs came out where you leak glucose into the urine and these drugs actually give the risk of the ketoacidosis not not the diet uh but and I know that it's.
Going to be bad for the heart because the LDL goes up that I still get right there are people following the guidelines of you if there's an LDL of this you got to put put on a pill so I advise people to uh you know just say you're using lifestyle to treat the cholesterol and it's called metabolic syndrome the triglyceride and HDL and.
Then as kind of a joke I'll just tell your doctor you're doing the Mediterranean diet right right yeah yeah whole food low carb Mediterranean that I think that's a great way to put it because you said the key word Mediterranean which will meet with immediate approval by the doctor yeah yeah it's almost like you know oh made.
In America must be great you know or you know more nuanced to that but um so but then there are a lot of myths or misunderstandings on how to implement it with the Advent of all these keto products that aren't keto yep keto is a metabolic state that you achieve by keeping the carbs really low and it really hasn't you know in to the to the.
Point of the detractors or critics there there hasn't been a study that I'm aware of of a hundred people on Bulletproof Coffee for weight loss for six months you know these all these things came out without really being vetted and tested and it can get you into rabbit holes of oh I have stomach upset because I'm drinking medium chain triglyceride which.
I never recommended I never so how you do it there's a lot of uh misconceptions and I think you and I both kind of have a similar approach where you don't want to have all of these keto like products out there absolutely the sugar alcohols and all that and and bears don't I mean they don't even drink coffee do they no no they don't.
Know I tell people all the time if it says keto on the package 100 avoid it that's not going away now it may be less bad so if you're about to eat some keto cereal first of all that ain't keto okay because my definition of Keto was unprocessed Whole Foods one ingredient in Foods foods that we would have had.
Access to thousands of years ago and there weren't no cereal before we started building factories right and so there is no such thing as keto cereal that's an oxymoron and it's so but it may be less bad than Lucky Charms yes that that may be absolutely true but that don't make it good right Mary's got a question and I love that.
She asked you this question because I know you and I uh our recommendations on this differ a little which is totally fine uh please talk about omega-6 to omega-3 ratios and the dangers if any of seed oils any studies showing problems Etc thank you yeah well so we have a different approach because.
Um as an academic at a university I have to have high level papers to support my position or or maybe I just feel like I have to I mean but but I so I have a I'm straddling one one leg in the academic world show me the paper show me the data in one leg in the oh my gosh so many things get better and there aren't studies to say that yet but I see it and.
We're we're stuttering studying and if it's not harmful and why not continue it so the whole idea of the the seed oil is omega-3 omega-6 ratio best I can tell it goes way back to the Zone diet and and actually Steve Finney talks about this a lot and you know Finney is like an EF Hutton says you know Finney's I I trust him implicitly.
Except he's a little too smart he he I I need some you know human level total intact human research to back up if at all possible something to ask my patients to do that's difficult so so I know keto kind of came out with this whole glomming on of the the macros and the avoiding seed oils and keeping the carbs low and and then the keto drinks.
And all the keto all these it all kind of just went out there all at once now disentangling in fact I I met um uh what's her name she wrote uh deep nutrition um Kate Shanahan yeah saw it at a meeting and we were chatting and and I asked her a question about.
This and she was so into this that really didn't she didn't understand what low carb was and and and so when I even asked well you know maybe it was a bad day I don't know but sometimes you only have a a moment with people and I try to figure out where they're coming from but um if you just change the seed oils and omega-3 omega-6 people would not lose.
Weight I agree and I told her well so you're saying that if people had a low carb diet without regard to seed oils let them have them they would do worse than those who had seed oil and she said yeah and I I don't think so so the street cred like you and I have a and it's really important to follow someone who's been in the.
Clinic just see the different ways this plays out and to find the the individualization and personalization that sometimes you know we can't figure out or deal with over the internet I mean people will come in I doing some internet teaching now and and they come to my clinic because they find and then but they forgot to tell me you know XYZ.
That were critical elements you know so anyway uh the omega-3 omega-6 I think is a minor thing compared to carb reduction now if you were trying to find the perfect diet on earth like you're trying to do right you know you might take that and say well you want to be aware of that and do the so I I'm trying to get the I'm trying to grab people and get.
Them out of the river you know and you're trying to they're out of the river and you're brushing them off dressing them off I don't know the right metaphor but it's more important to cut the carbs down really low yeah and they're obsess about making you have to make your own salad dressing and you have to be worried about all these.
Things so but if you can do all that I'm not against it but I don't have a paper it but I'm telling me if you see one where where we're real people real humans were were assessed some way or ideally randomized to worrying about their their omega-3 omega-6 are not worrying about it ideally if it was under low carb circumstances because.
Because that's where where you and I are we're trying how do we augment what we already know is so beneficial and and so yeah I don't tell my people to obsess about worrying about seed oils and vegetable oils um if that's going to distract them from the greater important message of keeping carbs low no and I I agree when it comes.
To weight loss and reversing fatty liver and reversing type 2 diabetes and lowering hypertension it's all about cutting the hell out of the carbohydrates now uh the only papers I've seen that that you know there are some people out there who are fairly influential school and fairly intelligent who like Kate Shanahan who I.
Love I love her I've met her recently and I just she is amazing and she's writing a book right now about the seed oil problem and but the I don't know of a single as you say whole human study that's not a in vitro or some kind of you know isolated in Vivo mechanistic thing uh but absolutely my my first three tenants when I started doing what.
I do back in 2017 were stop all sugar definitely added sugar but also that a lot of natural sugar as well step two eliminate all the grains and I think that those two that's the first two steps right there and you if you do those two things you're gonna slash the carb intake by 70 80 90 percent right but then step three is is get rid of all.
The vegetable seed oils because I've seen some mechanistic papers that made me think that they probably do contribute if you're eating too high of a ratio of omega-6 to omega-3 that they do contribute to some chronic inappropriate inflammation and and you know we know that that chronic inflammation can lead to things like.
Heart attacks and strokes if depending on where the inflammation is but I agree with you there's no human Papers written in actual whole human beings showing that if you give them canola versus uh beef Tallow that their levels of inflammation are going to be higher then the approaches we teach you're not going to get much of that anyway right so as.
Long as you these are things that are typically found in in products uh and you know and Ultra processed stuff that you're going to be minimizing by the proper human diet or a low carb keto these are like kissing cousins I mean I don't know how to play it but they're both super low in carbs and and uh you know I if you're able to go the extra.
Mile to do to um and then and get certain circumstances if say someone has an inflammatory disease and we haven't been able to fix it then I might add that in so it's kind of like uh um I remember we were uh in the same uh audiences a few times and I I would say you know how many of you had trouble.
With nuts at the beginning over consuming them and you know all you know half I think it was 50 and then I'd say how many of you had trouble with artificial sweeteners at first you know and you know there's a trickle here and there and um I I think if you're in a relationship trying to fix a tough medical problem.
What's what's the downside exactly I totally agree and so the big thing for me about the the vegetable seed oils the omega-6 to Omega-3 ratio is that we've only been eating this high of an omega-6 to Omega-3 ratio for just a few decades before the Advent of cottonseed oil about 1910 the average person in the world was eating approximately four to.
One omega-6 to omega-3 and then if you go back even further in time a few thousand years it was probably pretty close to one to one omega-6 to omega-3 fatty acids according to the anthropological research when they but obviously that's kind of indirect right because you can't you don't have a time machine you can't.
Go back and actually measure uh but so but there are people they get so hung up on the omega-6 to omega-3 thing that they'll recommend people to avoid pork all together and avoid chicken altogether because they don't have as low of an omega-6 Omega-3 ratio and I think that's that when you start doing that sort of thing this you're you're.
Trying to establish some kind of religion or you know what I'm saying like that's you that's not you can't say oh you can eat this meat but not that meat no either meat's good humans or meat's not good for humans yeah so put it together I think that's a relatively minor.
Thing you know if you want to incorporate that in sure I don't see a downside do it yeah absolutely Julianne says I've only lost 26 pounds on key divorce since uh June of 22. first of all Julie and congratulations for losing 26 pounds good job um so for nine months got fasting insulin today and it's 22. my ABC's 5.0.
Glucose 98 he didn't do a c peptide which is fine because you got your fasting insulin and you're not injecting insulin so fasting insulin is is that's exactly what we needed to know is this why I'm losing so slow any tips yeah so a couple of things I'd like to know is where you are in the weight loss Journey you know are you at.
It sounds like you're still on your way or you know so yeah insulin although the the couple studies that were done seeing if low carb diets led to Greater weight loss if you're insulin resistant or not we're done in the hands of the Stanford Group which really they don't give low carb Affairs Shake in fact drug Collegian talked me into writing a paper.
That basically said you know foul you you penalize the low carb group in in the keto group inappropriately and and they wrote a letter in response that basically said yeah we did so but they didn't admit it but but anyway um it you know clinically it seems that um uh this will work whether you have insulin resistance or not you may have.
To be just really super strict the more insulin resistant you are yeah so if you're so I'm so nine months 20 pounds let's there's another 100 pounds to lose you want to go like you're starting over get super strict and we did a study that we never published because it was so few people and I was just busy with all other kinds of things where a couple.
People were knocked out of ketosis for two weeks after one meal of carbs that doesn't happen to everybody remember for every physiological process there is a normal distribution curve some people would be knocked out of ketosis for literally 30 minutes if they if they ate a bad meal other people if they're very insulin resistant or.
Hyperinsulinemic that could knock you out of ketosis for multiple days or even up to two weeks and and they've got research that they didn't publish that showed that for some people it's two weeks that they're knocked out of ketosis and I think the fat I'm so glad you got your doctor to check a fasting insulin because I think what that.
Reveals to us is that you're even though you're eating keto board or You Think You Are you're still hyperinsulating and that is definitely slowing down your body's ability to metabolize and get rid of fat and so if you're willing Julianne the answer for you carnivore baby beef butter bacon and eggs that's what's.
Going to lower your fasting insulin down hopefully under 15 hopefully under 10 but definitely it's going to get it under 15 and you're going to notice that the the weight loss which by what by which you mean fat loss is going to pick up while still you're going to be eating so much protein that you're going to maintain the vast majority of your.
Muscle mass and definitely keep your bone strength as well do you agree with that doctor absolutely yeah I'm under even um when I troubleshoot like this I might even bring up the idea that you might measure ketones I don't know if you use that and I think for some people that's very beneficial I agree but then some people.
They're just like tell me what to eat and I'll do it and they that is their style and they're like I'm not gonna I'll lose that meter in a week that's me I would lose it uh and so they just like give me a list and I'll do that but some people need that feedback from a ketone monitor or glucometer or a CGM and I don't think that's bad in any way just.
The difference in personality is different in in styles of living your life but if somebody needs that I'm I'm wholeheartedly for that that study we did actually measured breath blood and urine ketones all at the same time and that's right I love that you said that tell us how concordant are those three in that.
At least in that small study that you did because you hear very commonly people say I don't check your urinary ketones they're just terribly inaccurate and I know that they're they're definitely not as accurate as serum or uh acetone on the breath but what did you find in your when you actually did a study what did you find.
Well in we had five people so it's a small sample but the they hung together pretty well so that the urine and the blood were close I mean it wasn't perfect but so we kind of think of the blood as the the gold standard and so it but the urine was good I mean measuring urine ketones goes way back to the Dr Atkins days and even the breath.
Um it wasn't bad although other things can interfere with the breath um interestingly the the study uh lead who did helped me do that has developed a breath meter and you can't get it retail yet but basically what she's doing is going to companies and saying here use this meter the breath meter so you don't have to prick your finger or.
Mess with the urine and then there's this little list of foods well it's my list of foods because she came to my clinic and took it yeah yeah so basically it's not the meter that makes it work but she's always coupling the meter with the list she's she's it's going really well and hopefully we'll see this product come out on to for the.
Naysayers for the people who need to see a number or or to have that daily feedback I understand that I get that uh but I'm like you I don't have people measure urine or bladder breath ketones unless I'm troubleshooting like in this case yeah I agree West Lynn says how often do you see triglycerides go up on a.
Carnivore diet I'm nine pounds away from gold weight well done Westland and probably a lean mass hyper responder uh which so we will first let's take the first question first and then we'll talk about how uh Lane Mass hyper responder actually you wouldn't see that yeah you know there are these things called Snips meaning uh you have a.
Genetic difference that might have you have a certain metabolism I think it's maybe one in a hundred it's not very common and um this ownyourlabs.com that Dave Feldman and Siobhan Huggins have put together you can actually get your labs done and I'm they last I heard they have a couple.
Thousand people involved and I hope we would be able to show that normal distribution or or maybe it's skewed I don't know what what did triglycerides look like on people who don't eat carbs you know we know they're going to be ketones in the blood for a lot of people we know that the the HDL is going to be a little high and maybe the LDL will be.
A little high but I bet it'll have a a percentage of folks who have high triglyceride or relative and then that my next question is how high so that um if it's a thousand I'm going to be agitated and want to do something about it yeah but it's and uh you know 100-ish uh 200 I I'm not going to be too worked.
Up about it if the other parameters look good yeah exactly in my experience with for somebody like Wes Lynn my first question is typically well what did your triglycerides used to be and because of the way she worded her question you would assume she'd had that check before but then very often they're like oh I don't think anybody's ever checked them.
Before it's like well there's no telling what they probably were a thousand before and now they're 300 that's a huge Improvement the second thing is is triglycerides are one of the things that it matters if you're fasting or not and Doc are you aware that that especially young doctors but many doctors tell their patients you don't have to fast.
For blood work that's that's useless there's no point doing that but triglycerides and glucose are absolutely affected if you haven't fasted for 12 to 14 hours so somebody who ate four hours ago depending on what you ate you're triglycerides and your glucose are going to be maybe double of what your actual.
Fasted number would be but their doctor told them it was fine they didn't have to fast yeah you know we've witnessed a sort of um how should I say um trimming down I was going to say dumbing down but uh or or uh cost effective you can say that on this channel doctor it's okay.
Um what what um you know how it was the least we can spend and still get almost the same that's really kind of gone through modern medicine at least in the U.S and so you're getting shortcuts here and there and no one ever does a glucose tolerance test anymore and you have to pay out of pocket at other clinics if you want that generally so um yeah I.
Think um the uh uh I know I forget my points but um the triglyceride is a a metabolic uh um uh transporter uh you know Fuel and you want triglycerides although I've seen them down to you know 30 in some people uh who are who are apparently not using that LDL model fuel for fat.
Transport so that you're um that's where you see the triglyceride in the blood it's when you get triglyceride on that LDL they then they call it a vldl it's the same molecule but um you know and I had to kind of work that out by doing a clay model for myself of all of these different.
Cholesterol particles and you know I don't worry so much about the cholesterol metabolism I worry about the the glucose and Insulin triglyceride and HDL in the blood if so those are the things to focus on in the blood absolutely and I think that what Dr Westman just said speaks to to the age difference between he and I he used a.
Clay model and I just use the internet I'm just messing with you but then the last point was could I be a lean mass hyper responder and so the the diagnostic criteria for lean mass hyper responder which most of us in the ketogenic Community think is a an actual thing there's there's at least two research studies going on right now.
About that Dave Feldman is in charge of the the one that's probably if if his if his research project comes out with the true bill it's going to upend uh lipidology and Cardiology I don't even know what those guys are going to do with that but lean mass hyper responder would have a very high total cholesterol a very high LDL cholesterol in a uh a.
Very high HDL cholesterol but a very low triglycerides so you're almost certainly not a lean mess hyper responder Judy Tucker is a member of our tribe and she wanted to say hi to you Dr Westman she was on the cover of women's world with you yes that's awesome that's awesome uh Shirley Pugh says question can we track the.
Inflammation or the impre the improving of inflammation as time goes on how would we track that well so I I practice in a university Private Practice within insurance payments for things and my patients get upset if they have to pay for anything so I don't do a lot of inflammatory marker testing but you can measure some.
Of these things um and uh if you wanted to look at C-reactive protein or other inflammatory markers even you know if any Steve you know EF Hunton said Steve Finney has been talking about the white blood count for ages in fact I remember the in the it was when I first met him the early 2000s.
This low carb diet lowers the white blood count and that's a marker of inflammation and it's like Steve that that's just so non-specific you know it's meaning it could be related to your you know the virus you had and all these different things but sure enough in these studies that have been done that white blood count is a a sign of.
Inflammation is generally lower not no not so low that you don't have the ability to fight inflammation and that's an important Point uh you need some inflammation yes and it's called constitutive inflammation meaning if you're if you have a cut that inflammatory process will help you heal that cut I remember.
Um gosh uh it was low carb um it was a low-carb eating uh Doug Reynolds so the Symposium for metabolic health and there was a speaker I don't know if you've known much about them he's kind of a medical entrepreneur Joe Mercola Dr Mercola um came in and gave a talk about how you.
Don't want to eat anything that causes inflammation and you know but and then he leaves the meeting so we call this um swooping and swooping and pooping where you come in you you leave your your poop and then you leave the meeting so the rest of the meeting people came up to the microphone and said well you.
Know Dr magola says you don't want to eat those Foods because they cause inflammation well but you have to eat something so right actually it would be avoidance of all inflammatory things so much that he basically said well I'm just fasting all the time well that's what you would have to do because literally regardless.
What food you eat if you eat Lucky Charms with chocolate milk that causes inflammation if you eat grass-fed grass-finished Panda massaged ribeye that causes inflammation every food you eat your immune system in your gut is very very active you're going to have an inflammatory response anytime you eat to anything that acute Rea acute phase.
Inflammation that's good that's normal that's proper you want that that's how your immune system is monitoring what goes down your gullets but and so Dr Westman is exactly right tests like the the leukocyte count white blood cells uh CRP ESR home assisting there are many acute phase reactants and they all tend to track back towards the low end of.
Normal when you're eating a proper human diet but they're so non-specific an elevated CRP could mean that you're going to die any second of a heart attack it could mean that it could also mean that you've got an infected pimple on your left buttock yeah but it could right it could.
Literally mean either thing and so oh yeah I've really stubbed my toe and almost pulled my toenail off last week yeah that's going to make your CRP go up and so you can see uh patterns of the inflammation by checking these markers but they're so non-specific that they they're not really giving you concrete black and white look at the inflammation.
I'd love it if we had some specific but even a cardiac CRP as you know doc that's just that's measuring inflammation that they gave it that name I think LabCorp named it that just so it sounded really important so more doctors would order it and maybe the insurance was to cover it but it just checks the CRP uh so yeah but that's I hope that.
Answers that question Shirley um remember the teeth are part of the body even though we got no training in medical school boy I learned three things about teeth in medical school doctor they're white hopefully they're hard and you chew with them and in in in in in med school we had a dental school.
The next the in at the University of Tennessee and the medical students and dental students there was a huge rivalry we played flag football and there were many broken uh tear fibulas and many broken collarbones it was It was supposed to be flagged it was pretty rough and so a medical student had written that in a bathroom stall.
Everything you need to know about teeth to become a dentist number one they're white number two they're hard number three you chew with them congratulations you're Now dentist and but there's actually more to the story than that well so uh the Westin price Story the dentist who went around the world in the 1930s to look at people's teeth it's a.
Fabulous uh demonstration that without modern Foods the teeth are basically perfect healthy no no cavities and all but I wanted to mention that it was inflammation I remember a group presenting abstracts at meetings on how the periodontal disease can cause heart attacks oh no it can't be can't be you know but so even you know so be good to.
Your teeth good hygiene with you know floss and brush regularly and you don't want periodontal disease because that creates inflammation that non-specific inflammation that can then lead to that Cascade of problems on the arteries and there was a Dr Otto Schaefer in Canada who chronicled first the natives native populations got cavities and periodontal.
Disease and then 20 years later they got heart disease yep of course it was ignored and oh it can't because teeth aren't part of the body I mean For Heaven's Sake you know yeah absolutely uh what about let's see I saw one here that would be a good oh yes uh Mary says can electrolyte imbalances cause Afib certainly and.
Um the uh I guess most common thing would be the hypokalemia low potassium levels and that's in my clinic is most commonly caused by diuretic medicines that are used for blood pressure you know it's kind of like um doctors in my area don't ask people about what they eat but they give them diagnoses and then they give them pills and then when.
The pills cause a side effect they give a pill for the side effect of the pill um so uh yeah and I mean there's um a small signal I think uh I don't know the occurrence any strong weight loss program that causes fluid shifts and electrolyte changes might cause a fib and through the years I can think of maybe one or two patients.
Who it was temporarily related to changing the diet of course they had all these other problems going on and um but and it's at such a rate it's kind of like uh the kidney stone so someone might get a kidney stone they may have had it in there for a long time or if it was generated actually any weight loss program or Diet change and and there are.
A lot of people eating regular like American diets getting kidney stones so there's a a rate in in all diets and I don't know that it's any higher on a low carb diet um and and then gout of course in a medical world can happen but you get people through the gout and then they never have gout again exactly and so.
Um that afib and electrolytes um when you're starting out I have people watch a video of me going through a handout and we talk about keto adaptation how if you can take sodium salt and bullion is a way to do it during that first week or two of course if you have medications for high blood pressure heart failure or kidney failure.
You don't want to add salt but if you're not in the clinical population then you want to add an electrolyte called sodium or or get one of these element other sort of proprietary Blends um do you do you have one yet I haven't kept up on if you no no I try not to I try not to uh sell products uh I do I'd recommend that.
People use either Redmond's relight or elements they both have unflavored so that if if the cephalic phase insulin response is strong and you you personally just a sweet taste in your mouth won't elevate your insulin we know that that's a potential mechanism for many people and I suspect that people who are more High insulin resistant or.
Hyperinsulinemic I suspect that they're much more sensitive to the Sweet Taste in their mouth so I recommend they get the unflavored Reed Martin took your adapter life course and there's a link to that down in the show notes if anybody wants to actually learn from the master himself uh and she then she listened to me and dropped her A1C from.
17 which is ungodly High down to 6.9 in 12 weeks three months later she had reversed her type 2 diabetes it was now she just has pre-diabetes at 6.4 excellent excellent start reads uh obviously you're not finished yet you've still got work to do because we want that to be under 5.7 uh what do you feel I want to know what you feel doc when.
You when you read a comment like this because as as Healthcare Providers and uh you know practicing Physicians we know what happens to a patient with an A1C of 17 and it don't take a long damn time to happen they're going to lose a foot they're going to go blind they're going to have kidney failure they're going to have liver failure they're.
Going to have a heart attack they're going to have a stroke something disastrous is going to happen in a few months yeah uh what what what's your I want to know you're you're a very you know soft and cuddly guy what how does what does this make you feel when you read a comment like this to know that you had this impact on Reed Martin who.
You've never met you literally saved her life is literally what you did and I used the word literally literally in this case well but but like you we were trained in accultured into the the the idea that doctors help people and save lives I mean right I thought that's what we were supposed to do and then a lot of doctors.
Get off on a tangent but I I feel good I I know it's not it's like um uh it's expected now you know it's not like it's you know oh my gosh what a wonderful thing because it will it would be I guess like if if you were a surgeon and it was the thousandth appendix you took out you saved a life and the the people Doctor goes out to the waiting room oh.
My God you saved my life I got my pet I don't think people do gush about that because well that's what surgeons are trained to do but I do understand that we're kind of unusual as doctors and my actually show a way that's different than other doctors and no so I I feel good and I feel like it's my job and and want to pass the.
Baton and as many people as we can absolutely and you know when at low carb Denver you were there there were a lot of young Health Care Providers there are actually two Family Medicine residents I don't know if you had a chance to meet them or not it's a husband and wife team that are on fire for keto ketovor carnivore like that's going to be their.
Life Laura and Matt yes absolutely I freaking love those guys and and there's that's happening more and more I have medical students reach out to me on the YouTube channel I have we've got inside of our our private uh Community we've got multiple Health Care Providers at every level some retired some still practicing.
Some in training right now but they're they're all hungry for the Brazil adults they want to be the doc sitting on a YouTube live video One Day hearing that you just saved a person's life who you've never met or laid your hands on because that's kind of sexy Dr Westman that that you you have that ability as a Healer because most healers you know.
They gotta they gotta put their hands on you and they gotta talk to you and they gotta write you a prescription then maybe you get better uh but you just literally saved a woman's life if you've never met maybe you never will meet that's kind of sexy is it not when I think is sexy I think of you can not me but you know we we're uh I used.
To change the subject I have to deflect this um there was a were uh forward and and uh induction and the same book I don't know if you know it's my one of my patients who I I could not fix I mean she had Eating Disorders was hospitalized at UNC and came in asking for a hundred ketone strips and just got.
So obsessed and then I lost track of her she surfaces in a book called The dietitian's Dilemma by Michelle Hearn Rebecca I know Rebecca Chicago area in Total Transformation and Rebecca a farmer and I'm afraid I remember the name of her book but you're in the.
Beginning and I'm in the okay you're gonna find it fantastic but basically my tailor Journey that's it right there guess who wrote the full work for this book doc you did so and it's it's interesting because you're saying there that you met her when she was better and I say in there that I knew her when she was Ill yeah.
And and um uh it's a transformational null story using super low carb carnivore approach like Michelle yeah and um uh anyway I I'm glad you you're did you see that I was in there too yeah I did I saw that yeah I wasn't gonna bring that up but if you guys know anyone who has been diagnosed with an eating disorder.
And I I use that term uh in it for a specific reason not that they have an eating disorder but they've been diagnosed with an eating disorder you need to buy them a copy of this book okay this book is powerful she was misdiagnosed with an eating disorder because she has a her has a very sensitive gut she needs to be a.
Carnivore she's on that normal distribution curve where she needs to eat nothing but meat or meat and eggs and that's that's her best health but when she was eating all the processed carbs and all of the fiber she her her stomach hurt constantly 24 7 and and she learned as a young girl to associate oh if I eat my my tummy hurts so I'm just.
Not going to eat well that was also she was coming of age right when the eating disorder diagnosis was becoming very popular and so she just got stuffed into that funnel even though she should never have been put there and it it literally makes you want to cry thinking about it as a healthcare provider like her life was literal Hill for a decade.
Misdiagnosed as an eating disorder and what she really was was a carnivore that was being you know she was basically a cat being fed a a sheep's diet and that's of course your tummy is going to hurt if you're not made to eat that diet and so if you know anyone who's been diagnosed with an eating disorder my Taylor Journey please get them a copy of.
That book Lisa says is there any policy shift policies shift reikito carnivore at the American diabetic Association well so um there's a paper that's been out several years that supports the use of low carb diets even says that the low carb diet is best to reduce blood sugars.
Dr Yancey will Yancey here at Duke with me is an author on that uh and yet you know there's no press release about it so you know it really is like the the association to keep you diabetic eat your car no I hate to say that but well no you're kind of right because there is option now in their handbook but it's on page 214. yeah in the fine print but you.
Would think that literally they would hold a press conference and say hey guys low carb low carb low carb yeah but look who's funding them oh does that matter oh you you already touched on that earlier didn't you yeah that does matter so drug companies uh have a role no question but uh the uh uh I guess uh bring all it's about diabetes together.
You don't want to go on a medicine that lowers the blood sugar at the expense of gaining weight that's right insulin insulin is a like yeah you don't want to go on the needle in fact I there was a 80-ish year old woman in the clinic this last week and was trying to get well and why did you do this 10 I've seen her for about 10 years now why did you do this.
She said my mom had sugar you know when she took that needle everything went downhill and you know I remember as a young doctor I said well that's crazy that the the the diabetes just got worse and you know no now if you're on a medicine that causes you to gain more weight and weight is the problem that's causing the insulin.
Resistance in the first place you're always going to have diabetes and those doctors are right you're always going to have diabetes but they're I think unwittingly no causing it I I absolutely I can't imagine that the endocrinologist thinks they're perpetuating The Diabetes by giving insulin but they are but do you you realize the the the cognitive.
Dissonance that that has to be involved in that and you also realize because you had an epiphany ER as a young doctor just like I did I'm I'm doing this all wrong I literally there's this whole huge subsection of physiology that I either didn't learn in med school or just immediately forgot it and can you.
Imagine a very successful endocrinologist that's been prescribing insulin in all the varied forms and Glipizide and Lobby writing glimepiride and all the other type 2 diabetes medications that work by giving you hyperinsulinemia which you probably already have anyway thereby dooming you.
To become obese or even severely obese can you imagine when when they when it hits them when it Dawns on them dude you've been doing this to your patients for how many years you've been causing them to be obese there'll be some cognitive protective mechanism I'm sure there comes I mean it was a there was a character caricaturist in the.
1850s or so lampooned all the different professions he lampooned lawyers and Lampoon doctors and and there was one in the in this book lithograph on doctors and it's you know a nurse going I'm sorry but sorry doctor but the patient died and the doctor says well he didn't take my medicine and she says yes he did well then he took too much no he didn't.
Then he took too little you know Southern we we have ways of of protecting our egos from we caused all of this to happen um yeah yeah but it it I I guess I'm odd maybe but I immediately realized it just dawned on me like somebody hit me in the head with a wrench you've been hurting people with the the dietary advice.
You've been giving you've literally been harming people in direct contradiction to the oath that you took and meant uh good newcomer question Kell wants to know what are the good fats Dr Westman what fats do you recommend and what fats would you say yeah minimize those fats or avoid those fats.
Well I think any natural fat is fine so if you eat meat poultry fish and shellfish and eggs from that is real food you're going to be getting great fats so I don't worry about saturated fat in fact this fellow came in this week how do I raise the HDL is in the 20s it was super low so well you need more saturated fat and eggs he was.
Like well I was told not to eat those things you know anyway anything that comes naturally I I don't worry about so it's the fats that come in the ultra processed foods and this is a shift but the the world Experts of nutrition have several papers consensus papers saying saturated fat is not a health problem so I mean if I'm inferring am I worried.
About saturated fats no no trans fats are not found to any great degree in natural foods and they're the ones that are thought of as the bad ones and it's interesting to see some nutrition experts sort of pivoted from okay we're not going to talk about saturated fats so we're going to talk trans fats now yep yep and then like it.
Wasn't they weren't saying saturated fats were so bad and now well it's kind of fading away that saturated fat thing it is unless you're an organization based on the belief that saturated fat is the problem and that's the American Heart Association yeah so they will never I think they have they've definitely stepped back in saying eating.
Cholesterol high cholesterol foods in your diet is meaningless with regard to heart disease risk they they've said that formally in their last uh document update and they now I'm pretty sure they no longer give an upper limit of intake for saturated fat anymore they still use the the vague language if you probably want to minimize it but they don't say.
Do not eat more than this amount of saturated fat a day so Lisa is in it she's a member of our tribe and she is a dentist and she she says she true story Physicians know nothing about teeth and she's absolutely right she is absolutely right and every time I remember about teeth from medical school is they get in the way in gross anatomy lab when you're.
Trying to look at the tonsils and look at other structures in the back of the mouth when you're intubating all right now 100 yes when you're intubating in the emergency department yeah absolutely uh let's see let me find one more good question doctor I really appreciate you doing this uh KF says that you are also amazing Dr Westman uh both of us.
Changing lives thumbs up for a great presentation come on there's got to be one more question here uh Julianne's doing this with her husband because she loves him he's currently pre-diabetic don't worry Julian that'll be corrected before long um I don't see another question any final myth that really is a burr under.
Your saddle or any final keto truth that it really annoys you that that the general population or doctors in general just are oblivious to this keto truth or to this keto myth well um now this is going to date me and uh but um that Dr Atkins died of a heart attack right no I sits on the ice in New York City bumped his head and bled into his.
Brain sadly and I know the Doctor Who found him actually in New York City that's Keith Berkowitz who saw a lot of Dr Atkins patients and follow-up actually Keith worked with Dr Atkins and um the so the kind of the I don't quite know what to do with these folks it's the Physicians committee for irresponsible medicine the uh I've known.
Neil Barnard for for ages now and he still kind of goes oh when people are eating eggs and you know all you know it's just yeah I mean that's a little irritating because yeah their group their their group that assisted the surreptitious finding of the death certificate from Dr Atkins and got it and worldwide attention and it set back.
The the implementation of this probably five years yeah you know absolutely so say the name of the organization properly I want people to know uh and Neil Barnard he's a great animal rights activist I think he's very good at that but I think he's a terrible physician he gives terrible nutrition advice and he started an organization and it's called.
What doctor well I know I I it's the Physicians committee for responsible medicine and I always make a mistake and call irresponsible medicine because you know it's like the Peacekeeper missile I mean or you know Military Intelligence I mean you know these are I think they're protesting a little they're trying to.
Say it a little too much and I totally agree Dr Westman thank you so much for doing this it's been a pleasure uh every time we get together either in person uh either on the Internet or IRL you know what that means Dr Westman in real life oh you know I was hoping you wouldn't know but it's a pleasure either way and.
You're doing great work and you you need to be very proud of the work that you've done and the work you're doing you have saved the lives of thousands of people who've never met you and in my estimation that's that means you're a pretty damn good doctor Dr Westman so thank you so much for being with me thanks a lot for doing this and thanks.
To our tribe if you'd like to have access to Future private live q and A's with some of the preeminent that way sorry authorities in the world about a proper human diet consider becoming a member of our private Community there's a link in the show notes thanks so much doc have a great day I'm sorry I made you miss the last.
Little bit of the football game that's okay thank you Ken see you next time bye-bye
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