Carnivore Diet Specialist: What The Keto Diet Is Really Doing To Your Body! Can It Cure 43% Of Mental Illnesses? The Truth About The Keto Diet!

0:00:03 – Most people will experience tremendous reductions
0:00:05 in anxiety within three days to three weeks
0:00:06 of starting a ketogenic diet.
0:00:09 In fact, we did a study where patients with bipolar disorder,
0:00:11 major depression, or schizophrenia tried the ketogenic diet
0:00:15 and 43% achieved clinical remission
0:00:16 from their chronic mental illness
0:00:20 and 64% of them left on less psychiatric medication
0:00:22 as it improves the balance of chemicals in the brain.
0:00:24 But the question is,
0:00:26 what’s causing those chemical imbalances in the first place?
0:00:28 And so let’s start there.
0:00:30 Dr. Georgia Ead is a Harvard-trained psychiatrist
0:00:33 who specializes in nutritional science and mental health.
0:00:34 – She was one of the first psychiatrists
0:00:36 to offer nutrition-based approaches
0:00:38 as an alternative to psychiatric medications
0:00:40 to optimize brain function and enhance performance.
0:00:44 – People need to know how powerful nutrition strategies
0:00:44 can be for the brain
0:00:46 because if you’re feeding it the wrong way,
0:00:47 things will go wrong
0:00:49 and that’s exactly what happened to me.
0:00:51 My health was declining in my early 40s
0:00:53 in ways that was true for a lot of my patients,
0:00:54 chronic fatigue and IBS,
0:00:56 being really anxious and depressed.
0:00:58 And so I did all kinds of tests
0:00:59 and they said there’s nothing wrong.
0:01:00 Of course, there was something wrong.
0:01:04 So I instinctively started experimenting with my diet
0:01:05 and the diet that I ended up on
0:01:07 was backwards from what we’re told is healthy for us.
0:01:09 It should theoretically kill me,
0:01:11 but it resolved every single one of my symptoms.
0:01:12 And so I studied for years,
0:01:15 learning things about food that most people don’t know
0:01:17 and which foods contain the nutrients the brain needs
0:01:19 or the ingredients that damage the brain
0:01:21 and found three principles of nutrition.
0:01:24 They can help you in ways no medicine can,
0:01:26 as well as improve mood, memory, concentration,
0:01:27 stamina, productivity.
0:01:29 So let’s unpack that.
0:01:32 – I find it incredibly fascinating
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0:02:09 Thank you so much for your time.
0:02:11 (upbeat music)
0:02:13 – Dr. Georgia Eid,
0:02:17 how do you define what it is you do?
0:02:21 – I’m a psychiatrist specializing
0:02:24 in nutritional and metabolic psychiatry.
0:02:26 So how food affects the brain
0:02:28 and how food affects brain metabolism
0:02:31 and how brain metabolism affects our mental health.
0:02:34 – This is a fairly new phrase, metabolic psychiatry.
0:02:36 Am I right in thinking that?
0:02:37 – Yes, it’s a really,
0:02:40 it’s a very new field and really exciting field.
0:02:44 The term itself was coined by Dr. Shabani Sethi,
0:02:48 who’s a metabolic psychiatrist at Stanford University.
0:02:50 And maybe five years ago or so,
0:02:51 maybe a little longer than that,
0:02:52 so it’s a very, very new field.
0:02:56 It’s even newer than the other exciting new field
0:02:58 in psychiatry, which is nutritional psychiatry.
0:03:01 And so, and this is a really exciting time
0:03:02 to be a psychiatrist.
0:03:07 And it’s also a really exciting time or a hopeful time,
0:03:11 an empowering time for people with mental health conditions,
0:03:16 because we’re finally able to explore root causes,
0:03:19 the real root causes, the deeper root causes
0:03:21 of mental health conditions that go beyond
0:03:22 things like what we’re told all the time,
0:03:25 which are these mysterious chemical imbalances
0:03:27 that need to be addressed with medication.
0:03:31 We now understand that the real drivers,
0:03:34 the primary drivers of mental health conditions
0:03:36 are inflammation of the brain,
0:03:38 something called oxidative stress,
0:03:41 which is why we’re always told to eat more antioxidants
0:03:44 and insulin resistance or prediabetes,
0:03:48 which is now affects more than 90% of Americans.
0:03:50 – In your work, you talk a lot about the ketogenic diet.
0:03:54 Why is that so prevalent in your work?
0:03:56 – Because the ketogenic diet energizes the brain differently,
0:03:58 so it really fundamentally changes
0:04:01 the brain’s operating system.
0:04:05 So when you switch from a high carbohydrate,
0:04:09 high insulin diet to a low insulin,
0:04:11 which is usually a low carbohydrate diet,
0:04:16 ketogenic diet, the way that cells receive energy
0:04:22 their mixture of fuels that they’re using changes.
0:04:27 And that has profound influences on just about every pathway,
0:04:30 just about every chemical pathway inside of that cell.
0:04:32 So it is as though you are fundamentally changing
0:04:36 the brain’s operating system in very healthy ways
0:04:41 that allow not brain cells not only to work better,
0:04:45 but for brain cells to heal.
0:04:48 So the longer you stay on a ketogenic diet,
0:04:51 the more brain healing can take place.
0:04:54 – And what is your sort of academic and career experience?
0:04:54 What’s that?
0:04:56 Can you run me through that sort of timeline?
0:05:00 – Yeah, so I got a degree in undergraduate degree
0:05:03 at Carleton College in Minnesota in biology.
0:05:05 So I always have loved science and biology,
0:05:07 understanding how things work.
0:05:11 And then for years, I worked as a laboratory research assistant,
0:05:14 different types of research labs around the world,
0:05:17 Boston, Munich, including in diabetes research,
0:05:22 until I figured out what I wanted to do.
0:05:24 And I decided that I wanted to go to medical school.
0:05:27 So then four years of medical school
0:05:29 at the University of Vermont in Burlington, Vermont,
0:05:32 which is a great place to go to medical school.
0:05:36 And then four years of psychiatry residency training
0:05:38 at a Harvard program called Cambridge Hospital
0:05:40 in Cambridge, Massachusetts.
0:05:43 And then, so it was 25 years ago
0:05:45 that I finished my psychiatry residency training
0:05:48 and I’ve been practicing psychiatry ever since.
0:05:51 – And what does practicing psychiatry involve?
0:05:54 – What it usually involves for most psychiatrists
0:05:57 is psychotherapy and medications.
0:05:59 And for some psychiatrists only medications,
0:06:03 some psychiatrists prefer to focus exclusively
0:06:06 on psychopharmacology or medication management.
0:06:08 There are some psychiatrists who choose to focus
0:06:12 only on psychotherapy and don’t prescribe medications,
0:06:14 but the vast majority of psychiatrists
0:06:18 offer a combination of both medications and psychotherapy.
0:06:21 – And when did nutrition become part of your career?
0:06:24 – Well, I never thought about the relationship
0:06:27 between food and the brain once.
0:06:31 During medical school, we had maybe two or three hours
0:06:34 worth of nutrition lectures in four years.
0:06:38 And in four years of psychiatry residency,
0:06:40 we didn’t talk about food and the brain once.
0:06:43 So I honestly had no idea how important it was
0:06:45 to brain health.
0:06:47 So I practiced conventionally as I was saying,
0:06:50 medications and psychotherapy for the first 10 years
0:06:52 of my practice.
0:06:55 And as much as I love my work,
0:07:00 it was becoming painfully obvious that most people
0:07:03 in my practice were just not getting that much better.
0:07:05 No matter how hard I tried.
0:07:08 And it wasn’t just true for me.
0:07:11 It wasn’t as though I was thinking, well,
0:07:13 maybe I don’t have enough experience
0:07:15 or maybe I’m not reading enough
0:07:18 or maybe I need more supervision.
0:07:21 When am I going to be able to really be able to help people?
0:07:22 Because when I looked around,
0:07:24 even very senior psychiatrists
0:07:27 who had been in practice for decades,
0:07:28 the same was true for them.
0:07:33 I mean, we had been taught to think of mental illnesses
0:07:36 as chronic, mysterious and incurable.
0:07:38 And that the best way you can help people
0:07:42 is to support them with medications and psychotherapy.
0:07:45 But that these are lifelong illnesses
0:07:47 that we really don’t understand very well
0:07:49 and that we can do very little about.
0:07:53 – Presumably there’s like a significant social component
0:07:54 to mental illnesses as well, right?
0:07:55 – Absolutely.
0:07:58 I mean, the brain is a very responsive organ
0:08:00 and it’s listening to,
0:08:02 it’s not just paying attention to the food you eat.
0:08:04 It’s paying attention to every aspect of your life.
0:08:06 How much light the brain receives.
0:08:09 How much love you have in your life.
0:08:11 How much you love your work.
0:08:13 What kinds of people are around you.
0:08:18 How you use your body, exercise, stress, everything.
0:08:20 Everything matters to the brain.
0:08:23 But most people are led to believe
0:08:26 that food doesn’t matter that much to the brain.
0:08:29 And that’s partly because
0:08:31 we’ve only recently started to think about it.
0:08:35 But the other piece is that the information
0:08:38 that we’re given about how to feed the brain
0:08:40 and the body properly isn’t correct.
0:08:42 And so when people are trying their best
0:08:46 to improve their mental health using nutritional strategies,
0:08:48 those strategies fail most people
0:08:50 because those strategies are grounded
0:08:52 in the wrong information.
0:08:53 And so a lot of people just think,
0:08:56 oh, well, you know, I tried eating more whole foods, right?
0:09:00 I tried putting blueberries on my oatmeal
0:09:02 or making my flaxseed smoothie every morning
0:09:04 or eating more plants than animals.
0:09:05 I tried all of those things
0:09:07 and they just didn’t help very much.
0:09:09 So I’m just gonna go back
0:09:10 to eating everything in moderation
0:09:14 because it doesn’t seem to matter.
0:09:18 But what’s really great about you inviting me here
0:09:20 to talk with you today is that people need to know
0:09:23 how powerful an intervention,
0:09:25 these nutrition strategies can be.
0:09:28 They can help you in ways no medicine can.
0:09:32 In days to weeks, in many cases,
0:09:34 people can experience meaningful improvement
0:09:36 to their mood, their memory, their concentration,
0:09:38 their stamina, their productivity
0:09:42 and their mental stability,
0:09:45 their effectiveness in their lives,
0:09:47 if they have the right information
0:09:48 about how to change their diet.
0:09:52 So you have to know which changes
0:09:53 are the ones that are worth making
0:09:56 and they’re not the ones we’re used to hearing about.
0:09:58 – Is there a particular case study that comes to mind
0:10:00 when you think about this?
0:10:01 Is there a most prominent case study
0:10:04 or a first case study that was a eureka moment for you?
0:10:08 – I wouldn’t say there was a eureka moment case in my life
0:10:11 because I came to it in a different way.
0:10:13 My eureka moment really came
0:10:15 through my own personal experience.
0:10:17 I think a lot of physicians
0:10:22 who practice nutritional and metabolic strategies,
0:10:26 most of us stumble into this work accidentally
0:10:28 because we’re not taught it.
0:10:30 And most of us stumble into it
0:10:32 either because a patient comes to us and says,
0:10:34 “Hey, I’ve tried this new way of eating
0:10:36 “and that’s why I’m so much healthier
0:10:38 “than when you saw me a year ago.”
0:10:42 Or the physician themselves encounters
0:10:44 their own health challenges,
0:10:47 uses the conventional nutrition approaches,
0:10:48 they don’t help and they find
0:10:50 that they’re kind of left to their own devices
0:10:52 to solve their own health problems.
0:10:54 And that’s exactly what happened to me.
0:10:57 So when I was experiencing all kinds
0:11:02 of health issues in my early 40s,
0:11:05 despite doing everything correctly,
0:11:09 eating low-fat, low-cholesterol,
0:11:11 calorie-restricted diet
0:11:15 that was high in fiber,
0:11:19 mostly whole foods and exercising religiously,
0:11:21 despite doing all of those things,
0:11:23 my health was declining in my early 40s
0:11:26 in ways that was true for a lot of my patients as well.
0:11:29 And I had no idea how to help my patients with these issues.
0:11:32 These were things like chronic fatigue and IBS
0:11:35 and fibromyalgia and migraine headaches,
0:11:37 very common in middle-aged people and older
0:11:39 and even younger people nowadays.
0:11:42 So when I encountered those issues
0:11:45 and I was working at Harvard at the time,
0:11:47 I had access to all kinds of specialists,
0:11:50 caring, intelligent, thorough,
0:11:53 they did all kinds of tests, all kinds of tests.
0:11:55 And they said everything is normal,
0:11:56 there’s nothing wrong.
0:11:58 Of course there was something wrong,
0:12:03 but I instinctively started experimenting with my diet.
0:12:10 And long story short, six months later,
0:12:14 trial and error changes, food and symptom journal
0:12:17 at the end of six months, and this was back in 2007,
0:12:24 the diet that I ended up on purely by trial and error
0:12:26 was almost upside down and backwards
0:12:27 from what we’re told is healthy for us.
0:12:28 And that was the diet that resolved
0:12:31 every single one of my physical health symptoms.
0:12:35 But as a psychiatrist, what really got my attention
0:12:39 was that it improved my mental health significantly.
0:12:41 And I wasn’t even trying.
0:12:43 I wasn’t even aware that my mental health
0:12:45 needed that much attention.
0:12:48 I think like most people, I was walking around
0:12:51 with suboptimal mental health,
0:12:53 more anxiety than was necessary,
0:12:58 than was slumping in the middle of the day,
0:13:02 brain energy faltering a couple of hours after lunch,
0:13:04 coming home at the end of the day,
0:13:06 and being completely spent and not being able
0:13:08 to get anything else done after five o’clock,
0:13:10 being really anxious on a Sunday night
0:13:11 before a Monday morning work,
0:13:14 being depressed in the winter time.
0:13:19 I mean, all of these things we think of as really normal.
0:13:23 We’ve come to expect so little of our mental health.
0:13:26 We’ve come to expect poor mental health as normal.
0:13:28 And it isn’t.
0:13:33 If you feed the brain properly, it works better.
0:13:35 And you can expect so much more of yourself.
0:13:37 So when that happened to me, I thought,
0:13:39 well, that’s interesting.
0:13:41 This diet seems to be good for the brain.
0:13:42 – Which diet was that?
0:13:46 – This was a mostly meat, low carbohydrate,
0:13:50 low fiber, low cholesterol, high fat diet.
0:13:55 No whole grains, no legumes, very few plant foods,
0:14:00 mostly seafood, meat, poultry, non-starchy vegetables,
0:14:03 and fats from whole foods.
0:14:06 It really was as simple as that.
0:14:11 And a diet similar to that is one of the starting places
0:14:12 in the books.
0:14:14 I have a variety of different dietary strategies
0:14:16 that people can explore in the book, not just one.
0:14:18 So it’s different places for people to grab on,
0:14:21 depending on what they feel comfortable doing.
0:14:26 But that way of eating resolved all of my physical issues
0:14:28 and mental health issues I wasn’t even aware
0:14:30 needed attention.
0:14:35 And that really was what inspired me
0:14:38 to begin studying nutrition.
0:14:41 I certainly did not go out and start recommending
0:14:43 this dietary pattern to my patients
0:14:45 that would have been reckless.
0:14:47 I didn’t know the first thing about nutrition.
0:14:50 And based on the little that I did know,
0:14:53 the diet that I had ended up on should theoretically kill me.
0:14:56 So it could be dangerous for people.
0:14:59 And so I studied for years independently,
0:15:01 took a graduate course at the Harvard School of Public Health
0:15:03 and studied independently, read everything
0:15:06 I’d put my hands on, studied the primary literature,
0:15:07 the actual scientific studies,
0:15:10 to try to understand, okay, why?
0:15:11 Why is red meat bad for us?
0:15:14 What’s the difference between red meat and white meat?
0:15:16 Why are whole grains good for us?
0:15:17 Why are whole grains good for us,
0:15:19 but refined grains are bad for us?
0:15:22 Why do we need a rainbow of fruits and vegetables?
0:15:24 Are some of them more important than others?
0:15:27 Are they all equally beneficial?
0:15:31 I mean, I just became so curious about food.
0:15:33 I really wanted to get to the bottom of it.
0:15:35 So for years, I studied nutrition
0:15:38 and fell in love with nutrition science.
0:15:41 And it’s a lot of what I share in the book
0:15:42 is all these fascinating things about foods
0:15:44 that most people don’t know.
0:15:48 And that can really, such as that it’s interesting,
0:15:50 it’s useful.
0:15:53 It’s empowering because if you understand
0:15:56 which foods contain the nutrients the brain needs,
0:15:59 which foods contain the ingredients that damage the brain,
0:16:03 which foods are going to damage brain metabolism
0:16:06 and cause inflammation and cause oxidative stress,
0:16:10 cause all of these things that we’re told we need to fight
0:16:15 with supplements and superfoods, that’s the real power.
0:16:18 The real power in dietary change
0:16:21 is not adding special things to the diet.
0:16:23 It’s actually subtracting the things
0:16:24 that are harming the brain
0:16:27 and working against your best efforts.
0:16:29 It’s just like anything,
0:16:31 you don’t make money by spending money,
0:16:33 you make money by not spending money, right?
0:16:37 So it’s the power of subtraction.
0:16:38 What are you not doing?
0:16:42 And that’s really step one is first do no harm.
0:16:45 Understand where the harm is coming from in the diet
0:16:47 because it’s not where you think it’s coming from.
0:16:48 It’s not coming from the red meat.
0:16:50 It’s not coming from the cholesterol.
0:16:53 It’s not coming from the saturated fat.
0:16:56 So if you understand where the damage is coming from,
0:16:59 then you can turn things around very quickly.
0:17:03 – You used a word there, you used the word explore
0:17:05 as it relates to different diets
0:17:07 that you’ve written about in your book
0:17:09 and that are available online.
0:17:12 From what I understood there,
0:17:13 you’re not saying that one diet
0:17:15 is the right diet for everybody.
0:17:17 You’re saying that it’s almost,
0:17:19 the word explore suggests sort of experimentation,
0:17:21 personal experimentation.
0:17:23 And what worked for you in that case
0:17:24 might not necessarily work for someone else
0:17:26 in a different situation.
0:17:27 Is that accurate?
0:17:28 – That’s exactly right.
0:17:30 And you’re bringing up a really important point Stephen,
0:17:35 which is that there are two levels of dietary knowledge.
0:17:38 So one is that there are fundamental nutrition principles
0:17:40 that apply to all human beings.
0:17:44 These are the rules, the cells require these nutrients
0:17:46 and you must consume foods
0:17:48 that provide those nutrients to those cells
0:17:50 and you must exclude these certain ingredients
0:17:52 that can damage those cells
0:17:54 and you must keep your glucose and insulin levels
0:17:56 and in the right range for your personal metabolism.
0:18:00 You have to nourish, protect and energize yourselves.
0:18:04 You must do that, but then beyond that.
0:18:07 So those rules and the rules that you have to follow
0:18:10 to get there are not commonly known.
0:18:13 But then beyond that, there’s the personalization
0:18:14 because we are all different.
0:18:16 We’re not different in what our cells need,
0:18:18 but we’re different in what we can tolerate.
0:18:20 We’re different in our metabolic health.
0:18:22 We’re different in how old we are,
0:18:27 how active we are, what conditions we already have,
0:18:29 what conditions we’re most at risk for,
0:18:32 what our goals are, what our preferences are
0:18:36 and whether we have food sensitivities, for example.
0:18:42 And so all of those pieces, food intolerances
0:18:46 and different goals and different aspects of our lives,
0:18:48 that’s where the personalization comes in.
0:18:49 And I teach people in the book
0:18:52 how to take these fundamental principles.
0:18:54 So I teach them what the fundamental principles are,
0:18:55 which are very simple.
0:18:58 Nutrition is not rocket science.
0:19:02 And then show them how to personalize it
0:19:05 to their metabolism, to their preferences, to their goals.
0:19:06 – What are the fundamental principles?
0:19:07 Let’s start there.
0:19:08 – So the fundamental principles
0:19:11 are nourish, protect, energize.
0:19:15 So nourish, what does a brain healthy diet look like?
0:19:19 And by brain healthy, we are talking about
0:19:20 what’s healthy for all cells
0:19:24 because it wouldn’t make any sense for the human body
0:19:27 to require a different diet for every organ you possess.
0:19:29 So a brain healthy diet is a diet that’s healthy
0:19:31 for every organ in the body.
0:19:33 So it’s good for the brain, it’s good for the heart,
0:19:35 it’s good for the liver, et cetera.
0:19:37 So what is a brain healthy diet?
0:19:40 It needs to nourish, protect and energize, nourish.
0:19:45 It must contain and be able to safely deliver
0:19:47 all essential nutrients to your cells.
0:19:50 So you have to know where those nutrients are.
0:19:54 You cannot, using whole food principles
0:19:55 and not including supplements
0:19:58 or especially fortified processed foods,
0:19:59 you cannot meet that goal
0:20:02 without including some animal foods in your diet.
0:20:04 That’s just the truth of our biology.
0:20:09 Protect, protect the brain from damaging ingredients.
0:20:11 So what damages the brain?
0:20:14 Inflammation, which you can’t see or feel.
0:20:17 It’s not so the brain is red or swollen or sore.
0:20:19 The brain doesn’t have nerve endings,
0:20:21 but many, many people have brain inflammation
0:20:23 without being aware of it.
0:20:24 That’s a main driver of depression
0:20:27 and all kinds of other brain conditions.
0:20:31 So you need to exclude.
0:20:34 Protection is not about addition, it’s about subtraction.
0:20:37 You need to subtract the foods from your diet
0:20:39 that cause inflammation,
0:20:42 that cause something called oxidative stress,
0:20:46 which is why we’re always told to eat more antioxidants.
0:20:47 What we really need to be told is
0:20:49 what’s causing all that oxidative stress
0:20:52 in the first place and remove those things
0:20:56 because the antioxidant strategy really doesn’t work
0:20:59 and energize, nourish, protect, energize.
0:21:01 The third principle is energize,
0:21:02 which means the brain,
0:21:06 which is a very high energy electrical organ.
0:21:09 It needs a constant supply of high quality,
0:21:11 clean burning energy.
0:21:13 And if you’re eating the wrong way,
0:21:17 your brain will gradually lose its ability over time
0:21:19 to generate energy.
0:21:22 That’s primarily about getting your glucose
0:21:24 and insulin levels into a healthy range,
0:21:26 not just your glucose,
0:21:28 although getting your glucose levels
0:21:30 in a healthy range is extremely important.
0:21:33 You have to go one step further
0:21:35 ’cause underneath that glucose,
0:21:37 you need to know what’s happening with insulin.
0:21:41 And that’s a really empowering strategy.
0:21:43 It’s sort of next level, right?
0:21:46 So getting your glucose and insulin levels down
0:21:51 will allow your brain to energize itself
0:21:56 in the most clean, efficient, and reliable way possible.
0:21:59 – Nourish, protect, and energize.
0:22:01 And then beyond there, you said there’s a level above that.
0:22:03 So that’s the sort of fundamental level.
0:22:05 Beyond there is you go into sort of personalization,
0:22:07 what’s best for you?
0:22:08 And is that where this sort of trial and error
0:22:10 comes into play?
0:22:11 – Exactly.
0:22:14 So these principles nourish, protect, energize,
0:22:16 the nourish you need to include some animal foods,
0:22:17 the protect you need to exclude things
0:22:20 like refined carbohydrates and vegetable oils,
0:22:23 which are the signature ingredients
0:22:26 of the standard American diet or standard Western diet.
0:22:31 And the energize is the glucose and insulin levels,
0:22:34 which for some people, a level of personalization
0:22:36 begins here at the energized piece
0:22:40 because if you have excellent metabolic health,
0:22:42 and we can talk about what that means,
0:22:44 then you may not need to eat a ketogenic diet
0:22:48 to really get those glucose and insulin levels
0:22:52 under control and thoroughly energize your brain cells.
0:22:55 But if you have significant metabolic damage,
0:22:58 if you’re sedentary, if you’re older,
0:23:01 if you have pre-diabetes or type two diabetes,
0:23:05 then you may need to reduce the amount
0:23:08 of carbohydrate in your diet, even from whole foods.
0:23:11 You may even need to go to a ketogenic level.
0:23:15 And that’s where assessing your metabolic health,
0:23:18 understanding where you stand
0:23:20 on the insulin resistant spectrum,
0:23:23 the spectrum of metabolic health,
0:23:24 that’s the empowering piece.
0:23:27 Because if you know where you stand
0:23:29 on the insulin resistant spectrum,
0:23:31 and you can get your glucose and insulin levels
0:23:32 into a healthy range,
0:23:35 then you have tremendous power
0:23:38 over your emotional, intellectual,
0:23:41 and your physical health future.
0:23:42 It’s really the number one risk factor
0:23:46 for almost all chronic diseases, mental and physical.
0:23:47 So personalization starts
0:23:49 with a metabolic personalization.
0:23:53 So how much carbohydrate can you safely tolerate?
0:23:55 That’s one example.
0:23:57 But then there’s another level of personalization
0:24:00 that has to do with how well does your immune system work?
0:24:04 How robust is your gut function, your gut barrier?
0:24:07 Many of us have lost our ability
0:24:11 to safely and comfortably tolerate a wide variety
0:24:14 of foods that we should be able to tolerate.
0:24:19 And that’s because our environment multiple toxins
0:24:23 in the environment have broken down a lot of our defenses,
0:24:26 our gut barrier, our blood brain barrier.
0:24:30 And in our immune system has become overwhelmed
0:24:33 by trying to process lots of toxic ingredients
0:24:34 in our environment.
0:24:37 So these are things like plastics and pesticides
0:24:41 and antibiotics and food additives
0:24:44 and all kinds of, you know,
0:24:48 ultra-processed foods that we were never designed to handle.
0:24:52 These are really stressful on the human body
0:24:54 and they do break down our defenses over time.
0:24:56 So this level of personalization
0:24:58 is very much about trial and error,
0:25:03 but to save people some of that frustration
0:25:05 of trial and error approaches,
0:25:09 I give them very specific lists of foods
0:25:15 that are more likely to be culprits than others.
0:25:18 And so that helps cut back
0:25:20 on some of the trial and error elimination.
0:25:26 – This keto diet, you did a study on the ketogenic diet.
0:25:27 Got the study here.
0:25:30 The ketogenic diet for refractory mental illness,
0:25:34 a retrospective analysis of 31 inpatients.
0:25:38 What is the ketogenic diet for someone that might not know?
0:25:40 – So a lot of people think
0:25:42 or they’ve heard about a ketogenic diet
0:25:44 as a weight loss diet.
0:25:47 They think of it, maybe it’s a fad weight loss diet.
0:25:49 They think of it as very, very low carbohydrate diet.
0:25:51 They might think of it as a diet
0:25:53 that’s very high in meat and dairy products.
0:25:58 But actually the ketogenic diet was originally created
0:26:02 in 1921, more than 100 years ago,
0:26:07 to stabilize brain chemistry in children with severe seizures.
0:26:11 And this was long before the availability
0:26:14 of useful seizure medications.
0:26:18 So these were children who were having multiple seizures
0:26:20 per day in many cases.
0:26:22 And so the ketogenic diet was designed back then,
0:26:24 created back then a very strict version
0:26:28 of the ketogenic diet to get as close as possible
0:26:33 to fasting without starving children to death.
0:26:38 Because for millennia, people had noticed
0:26:42 that those with epilepsy would often improve
0:26:45 if they were fasting, but you can’t fast forever.
0:26:47 So how do you get close to fasting?
0:26:49 This is the original fasting mimicking diet.
0:26:51 How do you get as close to fasting as you can
0:26:53 while still providing some nutrition?
0:26:56 So that was the original goal of the ketogenic diet.
0:26:59 It was very successful for seizures.
0:27:03 More than 50% of children had more than a 50%,
0:27:06 and adults as well, it’s since been shown,
0:27:09 more than 50% response rate in children and adults,
0:27:13 and 10 to 20% completely free of seizures
0:27:14 following a ketogenic diet.
0:27:17 – How’s it acting on the brain?
0:27:18 What’s it doing to the brain?
0:27:21 – The ketogenic diet does many, many things.
0:27:24 It’s like a multi-purpose tool for brain health.
0:27:26 So one thing it does, ’cause we talked about
0:27:31 how some of the root causes of mental illnesses,
0:27:35 which are only relatively recently a focus of research,
0:27:38 are inflammation and oxidative stress
0:27:40 and insulin resistance.
0:27:43 The ketogenic diet reduces inflammation,
0:27:45 it reduces oxidative stress,
0:27:48 and it reduces insulin resistance.
0:27:51 It also improves the balance of chemicals in the brain.
0:27:56 So a lot of people think of mental illnesses
0:28:00 as problems with chemical imbalances in the brain.
0:28:03 And these are the chemicals that they’re talking about.
0:28:05 You might have heard of serotonin or dopamine
0:28:06 or norepinephrine.
0:28:08 There are others, glutamate, GABA,
0:28:10 many different chemicals in the brain
0:28:13 are associated with, or in some cases,
0:28:18 even very much causing mental health symptoms.
0:28:19 But the question is,
0:28:23 what’s causing those chemical imbalances in the first place?
0:28:25 And one of the things
0:28:27 that’s causing those chemical imbalances
0:28:30 is that inflammation and oxidative stress.
0:28:33 But another thing is that the brain is,
0:28:34 if you’re feeding it the wrong way,
0:28:38 it will not be able to, in many cases,
0:28:40 produce energy reliably.
0:28:42 And if it can’t produce energy reliably,
0:28:45 all kinds of things will go wrong
0:28:48 and in quite spectacular fashion,
0:28:50 what actually goes wrong is going to depend on who you are.
0:28:53 And that’s where our individual differences come in.
0:28:57 So if you and I eat exactly the same bad diet,
0:28:59 depending on what runs in your family
0:29:02 and how you’ve lived your life to this point,
0:29:03 you might develop Alzheimer’s disease,
0:29:05 you might develop bipolar disorder,
0:29:07 you might develop type two diabetes,
0:29:09 you might develop fatty liver disease.
0:29:12 I might develop completely different conditions.
0:29:16 I might develop cardiovascular disease.
0:29:18 I might develop depression.
0:29:20 I might develop ADHD.
0:29:23 And that’s where the individual differences are.
0:29:28 But all of these conditions are just metabolic malfunction,
0:29:32 really, at the heart of it, that’s what’s going on.
0:29:35 If cells aren’t functioning properly,
0:29:38 you will develop a disease, physical and mental diseases.
0:29:39 And which ones you get,
0:29:42 it’s really kind of luck of the draw.
0:29:47 But you have tremendous control over what you are at risk for
0:29:49 if you understand how to help yourselves
0:29:51 operate at their personal best.
0:29:55 – Can you tell me about what you learned in this study
0:29:57 and what this study concluded?
0:30:02 – Yes, so this was the work of my friend and colleague,
0:30:04 Dr. Albert Denault.
0:30:06 He’s a psychiatrist who’s been practicing
0:30:10 in Toulouse, France for more than 35 years.
0:30:15 So after witnessing a young family member,
0:30:17 someone in his extended family,
0:30:20 with autism and seizures improved within weeks
0:30:22 of adopting a ketogenic diet,
0:30:27 he thought, well, I wonder if this diet could help my patients,
0:30:31 especially my patients who are not responding
0:30:35 to anything else that I have tried to help them,
0:30:39 psychotherapy, medications, hospitalization.
0:30:44 And so he invited 31 of his most treatment-resistant patients
0:30:48 with bipolar disorder, major depression,
0:30:52 or schizophrenia to come into the hospital
0:30:57 and voluntarily try a very mildly ketogenic
0:31:00 whole foods diet in the hospital under his supervision
0:31:03 to see whether or not they would respond.
0:31:07 And this was, these were folks who, these are all adults,
0:31:10 these were people who had been ill for an average of 10 years,
0:31:13 some for as long as 30 years.
0:31:15 These were people who were taking
0:31:17 when they came into the hospital
0:31:18 at the beginning of the study,
0:31:22 an average of five psychiatric medications,
0:31:25 not at all unusual for people with chronic mental illness,
0:31:28 and all of them had one or more markers
0:31:32 of poor metabolic health, obesity, high blood pressure,
0:31:34 high blood sugar, things like that.
0:31:37 So these were people with poor metabolic health
0:31:39 and poor mental health.
0:31:42 And they eagerly came into the hospital
0:31:45 to try this intervention because nothing else had helped them.
0:31:49 And what was remarkable about what he observed
0:31:53 was that of the 31 people, 28 were able to stay
0:31:56 on the ketogenic diet for more than two weeks,
0:31:59 which is what you need to do to start to see benefit.
0:32:02 Every single one of them improved
0:32:07 to the point that 43% of them achieved clinical remission
0:32:11 from their primary psychiatric treatment,
0:32:13 resistant chronic mental illness.
0:32:16 And 64% of them left the hospital
0:32:18 unless psychiatric medication.
0:32:22 And all of them improved metabolically as well.
0:32:24 And you do not see results like this
0:32:27 in conventional psychiatric care.
0:32:29 – So there’s a few things that spring to mind
0:32:30 when you talk about this study.
0:32:32 The first is that they were inside a hospital.
0:32:33 – Yes.
0:32:35 – So I guess that’s a confounding factor potentially.
0:32:37 – Oh yeah. Well, a blessing and a curse.
0:32:42 So a blessing is that the diet was very carefully supervised.
0:32:43 Six days out of seven,
0:32:46 they were allowed to go home on Sundays.
0:32:48 And which still I’m just mentioning, but that,
0:32:51 but they had tremendous amount of support and supervision.
0:32:54 And that’s really, really helpful
0:32:57 when you’re switching from a standard high carbohydrate diet
0:32:59 to a low carbohydrate diet.
0:33:03 They also had very careful medical and psychiatric supervision,
0:33:05 which is also really important
0:33:08 because when you change to a ketogenic diet,
0:33:12 brain chemistry fundamentally changes
0:33:14 in ways that can at first,
0:33:18 when you’re transitioning from one operating mode
0:33:21 to another operating mode, it’s stressful.
0:33:25 And sometimes you can feel worse before you feel better.
0:33:27 And medications can be affected.
0:33:31 So medications need to be monitored and everything,
0:33:32 everything changes.
0:33:34 These are all really healthy.
0:33:36 Your blood sugar can drop.
0:33:37 Your blood pressure can drop,
0:33:40 especially if you’re taking blood sugar lowering medications
0:33:43 or blood pressure lowering medications.
0:33:44 If you switch to a ketogenic diet,
0:33:48 it’s so effective at lowering blood sugar.
0:33:50 Many physicians who prescribe
0:33:53 blood sugar lowering medications for diabetes
0:33:57 need to cut the diabetes medication in half on day one
0:34:00 in order to prevent dangerously low blood sugar
0:34:03 because you’ve got a medication that’s lowering blood sugar.
0:34:06 Now you’ve added a diet that lowers blood sugar,
0:34:08 and this could be potentially dangerous.
0:34:11 The diet on its own is not dangerous.
0:34:14 It’s the diet in combination with medications.
0:34:16 So you need to know what you’re doing.
0:34:18 And so, yes.
0:34:20 – In the case of these 31 adults,
0:34:22 so a certain proportion of them, was it 28?
0:34:24 That managed to see it through?
0:34:24 – 28 of 31.
0:34:25 – 28 sort of three.
0:34:29 Had I just restricted their calories, for example,
0:34:31 but kept them on whatever diet they were on?
0:34:33 Would I have seen an improvement as well?
0:34:35 – That study has not been done to the best of my knowledge.
0:34:38 However, you’re bringing up a really interesting point.
0:34:40 So what a ketogenic diet is,
0:34:41 is really not about carbohydrate.
0:34:44 The definition of a ketogenic diet
0:34:47 is any diet that lowers insulin levels
0:34:49 to the fat burning point.
0:34:51 So that if you’re insulin,
0:34:54 you can’t burn fat if your insulin levels are too high.
0:34:57 And most people are walking around with insulin levels
0:34:59 that are high 24 hours a day.
0:35:01 They don’t even come down overnight
0:35:03 ’cause people are just eating too much,
0:35:04 too frequently in the wrong foods.
0:35:08 To get into ketosis or generate ketones,
0:35:10 you need to lower your insulin levels
0:35:12 to the fat burning point.
0:35:15 And if you’re burning fat vigorously,
0:35:17 the liver will turn some of that fat,
0:35:19 chop that fat into ketones,
0:35:23 which are very small fragments of ready to burn fat.
0:35:26 And these cross easily into the brain
0:35:27 and can be burned for energy.
0:35:29 And they can bridge any energy gaps that may be there,
0:35:31 which many of us have.
0:35:34 – If these people had done the Mediterranean diet,
0:35:37 would they have seen the same consequences?
0:35:38 – The Mediterranean, oh, sorry, please.
0:35:41 – I imagine they were probably on the Western diet.
0:35:42 They’re like the American diet,
0:35:45 which is ultra processed, high sugar.
0:35:47 So bringing them into a controlled environment
0:35:49 and just depriving them of that
0:35:52 would have surely caused just,
0:35:54 that on its own would have been beneficial.
0:35:58 – Yes, so I wrote in the paper and I mentioned this,
0:35:59 you’re making a really excellent point.
0:36:02 And I address this in the paper is that
0:36:06 because when you change from a standard junkie,
0:36:10 modern diet to a ketogenic diet that’s whole foods,
0:36:12 you’re changing a lot of variables, right?
0:36:14 So how do we know that it had anything
0:36:16 to do with the ketones, right?
0:36:18 And this is a good question and a fair question.
0:36:19 And we don’t know the answer,
0:36:22 but new studies are helping us to understand that.
0:36:24 But before we get to that,
0:36:26 I just wanted to say the point you’re making
0:36:29 is so important because there are lots of ways
0:36:31 to lower your insulin levels.
0:36:34 So you can lower your insulin levels through fasting,
0:36:35 intermittent fasting.
0:36:38 You can lower your insulin levels through exercise.
0:36:39 You can lower your insulin levels
0:36:41 through calorie restriction.
0:36:45 If you restrict your calories below 750 grams per day,
0:36:48 many people will go into ketosis.
0:36:50 That’s another version of a fasting mimicking diet
0:36:53 made popular by Dr. Walter Longo.
0:36:57 So there are many ways to lower your insulin levels.
0:37:00 The ketogenic diet is just one way to do that,
0:37:02 but the ketogenic diet is the only way
0:37:06 to safely, sustainably maintain
0:37:08 a state of ketosis long-term.
0:37:09 So you can initiate,
0:37:12 you can get into ketosis using these other strategies,
0:37:14 but you can’t fast forever.
0:37:16 You can’t exercise all day long.
0:37:19 You can’t restrict calories below 750
0:37:21 for the rest of your life,
0:37:23 but you can safely and comfortably eat
0:37:25 a well-formulated ketogenic diet,
0:37:27 which is very low in carbohydrate,
0:37:30 moderate in protein, not excessive in protein,
0:37:32 and relatively higher in fat,
0:37:37 depending on your energy needs, indefinitely.
0:37:39 – Sustainably, use the word sustainably there.
0:37:40 That’s kind of always been my challenge
0:37:44 with the keto diet is being able to stay on it.
0:37:46 I mean, you saw in this particular study
0:37:48 that even trying to get people to do it for two weeks
0:37:51 resulted in some portion of them dropping out.
0:37:52 – Yes.
0:37:54 – Why is it so hard to stay on the ketogenic diet?
0:37:56 I’ve managed to do it for,
0:37:57 I was saying to you before we start recording,
0:37:59 once a year, around this time of year,
0:38:01 I do it for about eight weeks,
0:38:05 and it has a really profound impact on a lot of my life.
0:38:07 It helps me feel more focused.
0:38:09 My body composition radically changes
0:38:12 faster than any other diet or thing
0:38:15 that I’ve ever tried faster than just exercise alone.
0:38:19 I sleep a little bit better as well, I noticed,
0:38:22 but you’ve been doing it for a long time.
0:38:24 You’ve been doing it for roughly almost 10 years.
0:38:26 – For the better part of, I mean,
0:38:28 more often than I’ll say,
0:38:32 I’ve been following a ketogenic diet for 12 years,
0:38:34 and I agree with you, it’s not always easy.
0:38:36 I’m not perfect about it myself,
0:38:37 but I have been on the ketogenic diet,
0:38:40 the lion’s share of the last 12 years.
0:38:43 It being hard is an important factor,
0:38:44 because when you’re trying to prescribe it to somebody
0:38:47 who has got treatment-resistant depression,
0:38:49 or is really suffering in some way,
0:38:51 I imagine they’ll find it even harder than I do.
0:38:53 – Yes and no. – Okay.
0:38:56 – So it’s hard, well, it’s definitely,
0:38:57 there’s no question about it
0:38:59 that’s hard to eat a low carbohydrate diet
0:39:02 and a high carbohydrate world.
0:39:05 So there’s that, there’s the environmental temptations
0:39:08 and the social temptations and the habits and the addiction.
0:39:13 Sugar addiction is a very real biochemical phenomenon.
0:39:14 So there’s that.
0:39:19 But I mean, I’ve been, I had a weight issue growing up,
0:39:22 everyone in my family did,
0:39:26 and I’ve been on lots of different diets in my life.
0:39:29 This is the easiest one to stay on.
0:39:30 I can’t say about any other diet
0:39:31 that I’ve followed for 12 years.
0:39:34 And the reason why is this diet
0:39:38 really stabilizes appetite hormones.
0:39:41 So your cells are getting energized in between meals.
0:39:44 You’re not getting those spikes and crashes in glucose,
0:39:47 which cause spikes and crashes in appetite hormones,
0:39:52 satiety hormones, stress hormones, reproductive hormones,
0:39:55 brain chemistry, you’re not getting,
0:39:57 you’re not on that roller coaster anymore.
0:40:00 So your cells are being satisfied,
0:40:03 they’re getting the energy needs satisfied in between meals,
0:40:06 and everything is quiet and calm on the inside.
0:40:10 It doesn’t mean you’re 100% protected against temptation.
0:40:13 So I describe it to my patients with food addiction,
0:40:17 I describe being in ketosis as a suit of armor.
0:40:19 The sword can still get you,
0:40:22 but you’re not 100% protected,
0:40:24 but you’ve got a real fighting chance.
0:40:27 And for anybody who’s never tried a ketogenic diet
0:40:31 and been on it for at least, I would say six to 12 weeks,
0:40:35 most people have no idea how much easier it is
0:40:40 to follow a healthy eating plan
0:40:42 when their appetite is in good control.
0:40:45 A lot of people know they’ve shifted into ketosis
0:40:48 without even checking their ketone meter,
0:40:51 because they can go for so long without eating
0:40:53 while they’ve been thinking about food.
0:40:54 They can work through lunch
0:40:57 and not even realize that they’ve missed a meal.
0:41:01 Most people, the way we eat most of us now,
0:41:03 are thinking about food all the time.
0:41:04 You haven’t even finished breakfast
0:41:06 and you’re already thinking what we’re gonna have for lunch.
0:41:09 You’re carrying food around with you everywhere you go.
0:41:12 You’re eating at least six times a day in many cases.
0:41:14 This is not, I mean, we would never have survived
0:41:18 as a species if we needed to eat six times a day.
0:41:22 So we’re not eating in a way that is nourishing us
0:41:23 and satisfying us.
0:41:26 We’re eating in a way that’s making us hungry.
0:41:28 – I find what you’ve said there
0:41:31 to be sort of true in my experience,
0:41:34 especially in the context of the roller coaster analogy.
0:41:37 So when I’m not on ketosis,
0:41:40 I do feel like sometimes I’m in a bit of a roller coaster
0:41:44 of like temptation, craving, et cetera.
0:41:45 And then when I do ketosis
0:41:48 and I get past the first week or two,
0:41:51 the roller coaster seems to stop.
0:41:52 – Right.
0:41:53 – I’m off the roller coaster.
0:41:56 It’s then maybe six, eight weeks later,
0:41:57 your busy life happens,
0:41:59 you’re traveling, you’re tired.
0:42:01 That temptation creeps in
0:42:04 and it just takes that one moment of weakness
0:42:07 in my head to then fling me off ketosis
0:42:09 and all my effort is gone.
0:42:11 And in my head, the way I’ve always thought about it,
0:42:11 and I’m sure this is wrong,
0:42:13 but I’ve thought about it like,
0:42:16 it takes a couple of days to get into a state of ketosis.
0:42:18 And then once you’re in,
0:42:21 and I usually get a headache on my way into ketosis,
0:42:23 I feel a little bit bad on the way in.
0:42:25 And then once I’m in there, it’s fine.
0:42:27 So when I have something that breaks my keto,
0:42:29 this is what I refer to in my girlfriend talk about it,
0:42:31 I’ve broken my keto, whatever.
0:42:33 I think, oh my God, I’ve got to go through another headache
0:42:36 and another five days of, you know,
0:42:37 getting back into it.
0:42:40 What, is that correct?
0:42:42 – It’s a very common experience
0:42:45 because there are these adjustments
0:42:48 that happen inside with your physiology
0:42:51 as you’re shifting from one operating system to another.
0:42:53 When you’re shifting from a carbohydrate burning system
0:42:56 to a more, you’re shifting your ratio of your fuels
0:42:58 to the body and the brain or a hybrid engine.
0:43:02 So we’re never burning 100% fat.
0:43:05 We’re burning a mixture of fat and carbohydrate.
0:43:07 When you’re shifting from a system
0:43:09 that’s fueled almost entirely by carbohydrate
0:43:12 almost all the time to a system
0:43:14 where you’re burning more fat than carbohydrate,
0:43:17 that’s uncomfortable for some people
0:43:22 shifting back and forth, especially if what they have,
0:43:25 if the reason why you’ve broken your keto
0:43:28 is because you’ve had something
0:43:29 that has a lot of refined carbohydrate in,
0:43:33 a lot of sugar or flour in it, for example.
0:43:36 So it depends on what you’ve eaten
0:43:38 and how much and for how long.
0:43:43 But many people do experience the so-called keto flu
0:43:46 when they are shifting from a carbohydrate based system
0:43:48 to a fat based metabolism.
0:43:52 And some of this can be, much of this can be prevented
0:43:53 in a couple of different ways.
0:43:55 One is with electrolyte supplementation,
0:43:58 supplementing electrolytes to keep your salt balance
0:44:01 even as you’re transitioning.
0:44:04 And another is by transitioning slowly
0:44:07 onto the ketogenic diet rather than all at once.
0:44:09 And so, and there are many, there are other tips
0:44:11 in the book about how to do this more comfortably,
0:44:13 but those are the two big ones.
0:44:15 And going slowly, so in the book,
0:44:17 I don’t recommend that people start
0:44:20 on a ketogenic diet just straight away,
0:44:23 like learn about it on a Monday, start it on a Tuesday,
0:44:26 but ease into ketosis over a week or two.
0:44:31 And there’s a kind of a moderate carbohydrate plan
0:44:33 in the book that allows people to do this.
0:44:36 So you follow that plan for a couple of weeks
0:44:39 to gradually lower those glucose and insulin levels.
0:44:41 It’s gonna be a lot more comfortable.
0:44:44 It’s gonna be a lot less of a shock to the brain and body.
0:44:49 And if you’re supplementing electrolytes and going slowly,
0:44:53 most of these quote, keto flu symptoms will not occur
0:44:55 or they’ll be very brief and mild.
0:44:58 So again, these are positive.
0:45:01 It’s a positive change to have these electrolyte changes.
0:45:05 And all of these things are good,
0:45:08 but there is this transition period,
0:45:10 which can sometimes be uncomfortable.
0:45:15 And this is not to say that it’s dangerous.
0:45:17 Again, it’s a very, we’re designed,
0:45:21 our biology is designed for us to be able to shift back
0:45:24 and forth between fat and carbohydrate as fuel sources,
0:45:28 but many of us have lost some of our metabolic flexibility
0:45:30 because we’ve done some damage to our metabolic engines
0:45:32 by eating the wrong way for too long.
0:45:35 So we don’t shift as comfortably back and forth
0:45:37 as we used to be able to.
0:45:38 – I guess most people don’t even know
0:45:40 what foods are included in a keto diet
0:45:42 because most diets are restrictive to the point
0:45:45 that people think they just make your life miserable.
0:45:47 But what are the sort of big misconceptions you’ve seen
0:45:50 with the foods you’re able to eat on a ketogenic diet?
0:45:53 – Yeah, so because a ketogenic diet,
0:45:55 because the definition of a ketogenic diet
0:45:59 is any way of eating that lowers insulin levels enough
0:46:02 to turn on fat burning and generate ketones in the blood,
0:46:08 because it’s about insulin, it’s really not a food list.
0:46:12 So you can, it’s not about plants and animals,
0:46:14 it’s not even about fat or carbohydrate,
0:46:17 it’s about understanding how to lower your insulin levels,
0:46:21 which you can do with a vegan dietary pattern,
0:46:24 with a vegetarian dietary pattern,
0:46:26 with an omnivore dietary pattern,
0:46:30 or even with a carnivore dietary pattern.
0:46:33 So whatever your dietary preferences are,
0:46:34 you can get the benefits,
0:46:37 the brain healing benefits of ketosis.
0:46:40 So it’s not about the foods you’re eating,
0:46:41 it’s more about understanding
0:46:43 what raises and lowers insulin.
0:46:45 The things that raise and lower insulin
0:46:49 are refined carbohydrates, whole foods carbohydrates,
0:46:52 refined proteins, like protein powders,
0:46:54 whole food sources of protein,
0:46:56 and guess what barely touches insulin at all?
0:47:00 Fat, fat is metabolically the quietest
0:47:02 and safest macronutrient you can eat,
0:47:04 because it barely stimulates insulin.
0:47:07 – Is ketosis a state?
0:47:09 Like, is it like a binary states?
0:47:11 Like, now I’m in ketosis and now I’m not.
0:47:18 – So yes, but there’s, yes, let me put it this way.
0:47:22 That most experts will agree
0:47:27 that in order to be “in ketosis,”
0:47:30 your level of beta-hydroxybutyrate
0:47:32 on a blood ketone meter,
0:47:37 a blood ketone meter is prick your finger
0:47:41 and put a drop of blood on this little test strip,
0:47:44 and it will read the amount of a particular ketone
0:47:46 in the blood called beta-hydroxybutyrate,
0:47:48 and it will give you a reading.
0:47:52 If that reading is 0.5 millimole or higher,
0:47:55 you are in ketosis, in ketosis.
0:47:56 So what does that mean?
0:47:58 Why is the cutoff 0.5?
0:48:00 Because three things have to happen
0:48:03 for you to get to at least 0.5.
0:48:06 One is your glucose levels have to come down.
0:48:09 The second thing is your insulin levels have to come down.
0:48:11 The third thing is you have to burn off
0:48:15 a certain amount of the storage starch in your liver.
0:48:18 We have a storage tank for carbohydrate in our liver.
0:48:20 It’s not very big.
0:48:22 It holds less than a day’s worth of carbohydrate
0:48:24 because really, as animals,
0:48:27 we’re designed to store energy as fat.
0:48:31 Carbohydrate’s there for quick energy emergency short-term.
0:48:34 For better or for worse,
0:48:38 we have almost an unlimited capability to store fat.
0:48:42 We can store months and months and months for the fat.
0:48:46 And so we can only store a very small amount of carbohydrate.
0:48:50 So if your storage tank in the liver is full,
0:48:52 your body will not switch to fat burning
0:48:54 because it says, oh, we’ve got plenty of starch to burn.
0:48:55 Let’s start there.
0:48:57 Once it comes down to a certain point,
0:48:59 the body goes, oh, running out of energy,
0:49:01 let’s go to fat now.
0:49:04 And that’s when the liver will start breaking fat down,
0:49:07 whether it’s fat on your body or fat from your plate,
0:49:10 and start chopping it up into these ketones.
0:49:13 And so those three things have to happen.
0:49:14 And once that happens,
0:49:17 you’ll see the ketone levels rise on the meter.
0:49:20 So most people who are not eating a ketogenic diet
0:49:22 are walking around with ketone levels
0:49:25 either undetectable or they’re 0.2 or they’re 0.3.
0:49:29 They might float up above 0.5 every once in a while
0:49:31 if they’re not eating for a long time
0:49:34 or if they’ve just exercised.
0:49:35 But for the most part,
0:49:39 most people eating a typical diet are not in ketosis.
0:49:42 And when you get above 0.5,
0:49:44 a lot of metabolic magic starts to happen
0:49:48 because there are lots of pathways in the body and brain
0:49:52 that are not very active unless you’re in ketosis.
0:49:54 And those are the healing pathways,
0:49:57 the recycling and maintenance and cleanup pathways,
0:49:59 the recovery pathways.
0:50:04 All of us, this is something that I came to appreciate
0:50:06 a number of years ago as I’ve been studying this,
0:50:09 is that there are many people,
0:50:10 unfortunately or fortunately,
0:50:13 there are many people who discover
0:50:15 with mental health issues
0:50:17 that they need to be in ketosis long-term
0:50:18 in order to be well.
0:50:22 But I’ve become convinced by the science
0:50:27 that all of us need to be in ketosis at least intermittently.
0:50:33 All of us need to spend some time in ketosis
0:50:36 on a regular basis or else we can’t heal.
0:50:41 We’ll only be, it’s like a manufacturing plant
0:50:45 where the plant is just running 24/7, 12 months a year.
0:50:49 And they never take time to replace the parts
0:50:50 or clean up the floor.
0:50:54 Or they never do any maintenance work or repair work.
0:50:56 And so eventually everything breaks down.
0:50:58 – And when you say ketosis again,
0:51:00 you’re not saying the keto diet,
0:51:05 you’re saying the low levels of glucose and insulin.
0:51:06 – Exactly.
0:51:08 And that can be achieved by calorie restriction,
0:51:10 potentially fasting, I guess you could achieve it.
0:51:12 And other diets like the Mediterranean diet
0:51:15 if administered in the right sort of doses, right?
0:51:18 – Well, we should come back to the Mediterranean diet
0:51:20 in a minute, but the first part of your question
0:51:23 is important because ketosis is,
0:51:24 you can, as you said,
0:51:27 you can get into ketosis a variety of different ways.
0:51:28 If you’re eating properly,
0:51:31 and this would have been our evolutionary heritage,
0:51:34 our ancestors, especially our prehistoric ancestors,
0:51:40 they didn’t have access to these lots and lots
0:51:43 of refined carbohydrates a long time ago.
0:51:47 They were eating carbohydrates from whole foods,
0:51:50 fruits and starchy root vegetables, right?
0:51:54 And so even grains and beans are very, very relatively
0:51:57 much newer sources of carbohydrate.
0:51:59 So let’s think about fruits and vegetables.
0:52:02 But they would have been, we can only guess,
0:52:04 they’re looking at their diets.
0:52:06 We don’t have proof of this, but think about it.
0:52:08 If you’re eating in a way where your insulin levels
0:52:11 are allowed to come down overnight,
0:52:14 if you’re eating a balanced diet, so to speak,
0:52:16 but it’s got everything it needs in it,
0:52:18 and it’s not giving you exaggerated spikes
0:52:20 in your glucose and exaggerated spikes in your insulin,
0:52:24 and you’re not eating six times a day or all day long,
0:52:27 your insulin levels will naturally come down overnight.
0:52:29 And that will allow you to go into a healing mode.
0:52:33 So I believe that if people have the right information
0:52:36 about what a healthy diet is supposed to look like,
0:52:39 they may not even need to, in many cases,
0:52:42 especially if you’re younger or athletic
0:52:44 or don’t have a lot of metabolic damage already.
0:52:50 You may not need to lower your carbohydrate intake
0:52:52 during the day, you might just need to be careful
0:52:56 about what kinds of carbohydrate you eat and how often.
0:53:00 So for example, it’s known that in children
0:53:03 who are eating a regular diet,
0:53:07 many of them wake up the next morning in ketosis.
0:53:09 They’re metabolically much healthier
0:53:12 than we are as we get older.
0:53:15 So they’re much more metabolically flexible,
0:53:18 and so now they didn’t go on a ketogenic diet,
0:53:20 they’re eating a regular diet,
0:53:22 they slept overnight, didn’t eat anything,
0:53:24 the next morning they were in ketosis.
0:53:26 That’s not true for all children,
0:53:27 but it’s true for enough children
0:53:29 that we know it’s possible.
0:53:32 Most adults, it takes them several days at least
0:53:33 to get into ketosis,
0:53:36 even if they’re not eating anything at all.
0:53:39 So fasting can take two to three days at a minimum
0:53:41 for most people to get into ketosis,
0:53:44 but some people it can take a whole week.
0:53:45 – And you talked about children there,
0:53:48 one of the big conversations at the moment around children
0:53:52 is the rise in ADHD diagnosis.
0:53:54 And there’s a lot of different sort of thoughts
0:53:56 on the causal factors of this,
0:53:58 and what is it that’s making children
0:54:00 be diagnosed at higher and higher rates
0:54:02 with these sort of neurodivergent disorders?
0:54:06 Is there any evidence to suggest that what we’re eating
0:54:09 is playing a role in these neurodivergent disorders?
0:54:14 – Yes, the first thing I would like to tell you about
0:54:16 is that there were studies,
0:54:19 quite a few studies back in ’80s, ’90s and early 2000s
0:54:23 in Europe by a variety of different research teams
0:54:27 that explored exactly the question you’re asking,
0:54:32 and what they did was they placed children with ADHD,
0:54:37 some quite severe ADHD, even hospital level ADHD,
0:54:41 and put them on something called a few foods diet.
0:54:44 This is, the scientist called it an oligoantigenic diet,
0:54:47 which just means it’s kind of a low allergen diet.
0:54:50 So they removed all of the common culprits
0:54:54 and they focus mostly on just a few whole foods
0:54:56 and a few extras.
0:54:58 So very specifically describing this diet,
0:55:03 most of these diets were chicken, lamb, fruits, vegetables,
0:55:07 and sometimes they’d throw in some apple juice and margarine
0:55:08 ’cause they couldn’t use butter
0:55:11 because dairy is a common allergen.
0:55:14 So, but these were mostly whole foods diets,
0:55:19 poultry, red meat, fruits, vegetables,
0:55:24 and they’re 62 to 82% response rate to these diets,
0:55:26 no matter which study you looked at.
0:55:27 And in some of these studies,
0:55:30 there was a 70% cure rate within weeks
0:55:33 of changing the diet to a few foods diet.
0:55:35 So what does this tell us?
0:55:40 It doesn’t tell us which foods were the problem.
0:55:43 It tells us that food can be the problem,
0:55:46 that if you make the right dietary changes,
0:55:51 it’s possible for children, even with very severe ADHD,
0:55:53 to improve within weeks to the point
0:55:56 that they no longer qualify for having ADHD anymore.
0:55:58 – Because there’s a change in the symptoms.
0:56:01 – Oh yes, the children’s behavior
0:56:04 as rated by parents and teachers
0:56:06 and the researchers themselves.
0:56:08 – So I’ve just did some research
0:56:10 to find some stats on this.
0:56:11 – Sure.
0:56:13 – Diet modification isn’t widely prescribed
0:56:16 as a way to alleviate ADHD symptoms, is it?
0:56:19 It says, as of 2019, major health organizations,
0:56:22 including the American Academy of Pediatrics
0:56:25 and the National Institute of Health and Care Excellence
0:56:26 do not recommend dietary modifications
0:56:29 of standard treatment for ADHD due to insufficient evidence.
0:56:33 A 2014 review found that elimination diets
0:56:35 might offer minor benefits in a subset of children,
0:56:37 particularly those with food sensitivities or allergies.
0:56:39 However, these benefits are not substantial enough
0:56:41 to advocate for widespread dietary changes
0:56:42 in ADHD management.
0:56:49 – So what I would say to that is there are multiple studies
0:56:52 all pointing in the same direction
0:56:55 that I think give parents and families and children
0:56:58 tremendous hope with really no risk.
0:57:01 What are we doing instead?
0:57:04 We’re medicating children.
0:57:06 We’re giving children stimulants,
0:57:09 which can stunt their growth, make them anxious,
0:57:11 and cost money.
0:57:17 And one of the reasons I do this work
0:57:23 is because I really don’t think that for most people,
0:57:26 the right thing to do is to medicate our way
0:57:28 out of this situation.
0:57:31 I mean, just about every mental
0:57:33 and physical health issue we have,
0:57:37 we think about, we’ve just kind of been conditioned
0:57:39 to think about medications as the solution,
0:57:41 but medications don’t solve problems.
0:57:42 They cover them up.
0:57:44 And what we really wanna do is wanna get
0:57:46 to the root of these problems
0:57:48 and not just treat them,
0:57:51 which nutrition interventions can do in many cases,
0:57:54 but perhaps even prevent them
0:57:56 from happening in the first place.
0:57:58 – Can they all be treated by,
0:58:02 ’cause I was, I guess, technically diagnosed with ADHD,
0:58:04 but I don’t take any medication for it.
0:58:05 I’m, it’s a personal choice.
0:58:09 I personally just don’t think
0:58:11 that the net impact of my life
0:58:12 is worth taking any medication.
0:58:15 I also have friends with ADHD
0:58:17 who have significantly worse symptoms.
0:58:20 When I say worse, I mean more pronounced symptoms than I do.
0:58:24 So my personal decision was just not to take medication.
0:58:26 However, I sat here with a guy called Dr. Amen,
0:58:29 who has a daughter who had ADHD.
0:58:31 She got the medication and it turned her life around.
0:58:33 Like she went on to become super successful,
0:58:35 but was like struggling in school.
0:58:38 So it’s really difficult, isn’t it?
0:58:41 ‘Cause it’s such a personalized sort of personal decision.
0:58:46 And some people have it more extreme
0:58:50 and in a way that makes their life more dysfunctional
0:58:52 than others, you know?
0:58:54 And some of my friends do really say,
0:58:57 they say, “Oh, I took this medication for my ADHD
0:58:59 or my attention issues, whatever.”
0:59:01 And it’s been revolutionary for me.
0:59:04 They just like, they just offload on me
0:59:06 at how profound it’s been for them.
0:59:11 So I guess it goes back to being a personal.
0:59:13 – It does, but you know,
0:59:18 so I have a lot of experience treating ADHD
0:59:22 because I worked for two years at an ADHD specialty clinic
0:59:24 called the Hallowell Center outside of Boston.
0:59:27 I also worked for 13 years in college mental health
0:59:29 at Harvard and at Smith College
0:59:33 and saw lots and lots and lots of students with ADHD.
0:59:36 Most of who actually had it, some of who didn’t.
0:59:38 Some who were just looking for stimulants.
0:59:41 But I can tell you as a psychiatrist
0:59:43 who’s prescribed medications for 25 years,
0:59:46 the stimulants are some of the most effective medicines
0:59:47 we have in our toolbox.
0:59:53 For the people it works for, it works very, very well.
0:59:55 So, and it can be life changing.
0:59:59 A lot of people think of ADHD as, oh, a minor issue.
1:00:01 Oh, you can’t concentrate or maybe you daydream
1:00:06 or maybe you’re fidgety or maybe you get distracted.
1:00:08 ADHD can be a really serious condition.
1:00:10 Just like all mental health conditions,
1:00:14 it exists on a spectrum of mild to very severe.
1:00:18 And so, people with ADHD are much higher risk
1:00:19 for suicidal ideation.
1:00:21 They’re much higher risk for substance abuse.
1:00:23 They’re much higher risk for accidents.
1:00:26 They’re much higher risk for depression, for anxiety.
1:00:31 And twice the rate of divorce
1:00:33 in people with adults with ADHD,
1:00:37 these are serious can be for some people
1:00:39 really disabling conditions.
1:00:41 People cannot function in their lives.
1:00:42 They can’t function in their relationships.
1:00:45 They can’t hold a job.
1:00:49 You know, they feel so frustrated and powerless.
1:00:51 I mean, I was telling you that I worked with students
1:00:55 in, you know, these elite universities, right?
1:00:58 These are very intelligent people
1:01:01 who were struggling 10 times harder
1:01:03 than their peers in classes.
1:01:05 They had to work so much harder.
1:01:07 They had to stay up four or five hours
1:01:09 later than everybody else.
1:01:11 And they did ’cause they were hardworking,
1:01:13 but they’re really suffering.
1:01:17 And this discrepancy between how smart I am
1:01:19 and how much I think I should be able to do
1:01:21 and how much I’m actually able to do
1:01:24 makes me feel bad about myself, right?
1:01:26 They feel bad about themselves.
1:01:28 And because they know they’re capable of more,
1:01:30 but they can’t get there.
1:01:32 And it’s a real biological condition.
1:01:34 Now, the great thing about,
1:01:36 this is a perfect example that you could,
1:01:37 we could have this conversation
1:01:39 about any mental health condition,
1:01:41 but ADHD is a great example
1:01:45 because there’s always a risk benefit analysis
1:01:46 when you’re thinking about
1:01:48 how we’re gonna treat this condition.
1:01:49 So do you wanna take medication?
1:01:51 What are the pros and cons of that?
1:01:53 Does the medication work for you?
1:01:55 Does it give you side effects?
1:01:57 Can you access the medication?
1:01:59 Can you afford the medication?
1:02:02 How hard is lifestyle change for you?
1:02:05 One of the most powerful interventions for ADHD,
1:02:08 and I think you’re probably just maybe
1:02:10 one of the most stellar examples
1:02:11 I can think of is this,
1:02:16 change your lifestyle to suit your strengths,
1:02:17 play to your strengths,
1:02:21 and don’t try to swim upstream against your weaknesses.
1:02:25 People with ADHD often have tremendous talents
1:02:27 in certain areas and are tremendously gifted
1:02:30 in certain ways because they can make connections,
1:02:32 ’cause they don’t always think in a straight line,
1:02:35 because they often have very diverse interests
1:02:39 and they can pull different kinds of information together,
1:02:43 and given the right path,
1:02:45 they can be hugely successful, right?
1:02:48 But that’s not possible for everybody,
1:02:50 and for more severe cases of ADHD,
1:02:52 it’s not possible at all.
1:02:54 Has there been any studies on the link
1:02:57 between the ketogenic diet and ADHD?
1:02:59 So not yet, but I’m very excited
1:03:03 to be involved in two brand new studies
1:03:05 of the ketogenic diet for ADHD.
1:03:09 So one is a ketogenic diet for adults with ADHD
1:03:11 and depression that’s getting started
1:03:13 at Oxford University in 2025,
1:03:17 and the other is a study of ketogenic diets
1:03:20 for ADHD and adults at the University of Michigan.
1:03:23 It’s also gonna be starting in 2025.
1:03:26 We have no data on ketogenic diets and ADHD,
1:03:28 but we have good reason to believe,
1:03:30 the reason we were able to get funding for these studies
1:03:33 is because there’s reason to believe
1:03:35 that it could be useful,
1:03:38 and because when you look at ADHD,
1:03:41 you see clues to poor metabolic health.
1:03:43 So for example, children with obesity
1:03:45 are twice as likely to have ADHD.
1:03:48 Obesity is a marker for insulin resistance.
1:03:50 Adults with type two diabetes
1:03:53 are twice as likely to have ADHD.
1:03:56 Type two diabetes is severe end stage insulin resistance,
1:04:00 and the ketogenic diet is the most effective way
1:04:04 to address insulin resistance that we have at our disposal.
1:04:06 – Is it hard to establish cause and effect there?
1:04:08 I was thinking about the diabetes one
1:04:11 where if you’ve had ADHD, maybe your life has been harder.
1:04:12 Again, I don’t know what I’m talking about here,
1:04:14 but maybe your life has been harder,
1:04:15 and if your life has been harder,
1:04:18 you’re more likely to be obese potentially.
1:04:22 If you’ve gone, had more stress and you’ve had a worse,
1:04:24 a worse, more challenging job,
1:04:29 then so is it, and will a test be able
1:04:31 to exclude these sort of confounding factors
1:04:33 to the point that we’ll know for sure?
1:04:36 – I think that would be a very difficult study to design,
1:04:39 but I think what I can tell you from my clinical work,
1:04:42 ’cause I work, I’m a general psychiatrist,
1:04:45 so I see adults of all ages
1:04:49 and with all psychiatric conditions from major to minor,
1:04:53 and I’ve worked, as I said, with people with ADHD,
1:04:56 hundreds and hundreds of patients with ADHD.
1:04:59 What I can tell you is that it’s the same with medication.
1:05:02 If someone comes in and says to me,
1:05:04 I can’t tell if this medication is working,
1:05:08 so should I keep taking it?
1:05:10 And I’ll say, well, you know,
1:05:13 if you can’t feel it working, that’s not working.
1:05:17 So when the diet works, it works regardless
1:05:19 of what’s going on around the person.
1:05:22 So, and this is true for all conditions that I’ve worked with.
1:05:25 So people with bipolar disorder, people with depression,
1:05:29 people with ADHD, people with PTSD, people with anxiety,
1:05:32 as you have said, we talked about
1:05:34 the ketogenic diet’s not easy to stick to, right?
1:05:37 People fall off the ketogenic diet all the time,
1:05:41 sometimes accidentally, sometimes intentionally, right?
1:05:43 And you can see their symptoms come back
1:05:46 within often 24 hours,
1:05:49 even though their external factors have not changed,
1:05:51 your life hasn’t changed, it’s the diet.
1:05:55 And when you follow the actual ketone levels daily,
1:05:56 you can make that correlation.
1:06:00 So what’s really exciting about both of these studies
1:06:03 is it’s not just getting somebody into ketosis,
1:06:06 it’s tracking on a day-to-day basis
1:06:10 their ketone level and their attention symptoms
1:06:13 and seeing if we can see them go up and down together.
1:06:16 And we’ve always got a little bit of data already
1:06:20 from a pilot study by Ali Huston
1:06:22 at Oxford University.
1:06:25 We’re starting to see some signals there,
1:06:27 but it’s too early, really.
1:06:30 We need to actually launch the official study.
1:06:35 So in my patients, it’s a phenomenon I’ve seen
1:06:37 over and over and over again.
1:06:41 A great example is I have a patient
1:06:44 that I worked with for a couple of years
1:06:48 who had a condition called bipolar disorder type two.
1:06:52 So it’s a form of bipolar disorder.
1:06:54 Bipolar disorder people used to call manic depression.
1:06:56 You’ve got periods of mania,
1:07:00 often followed by periods of deep depression.
1:07:02 Bipolar type two is a milder form
1:07:04 where you don’t get quite as manic,
1:07:08 but you still can get very depressed.
1:07:11 So hit bipolar two.
1:07:14 And whenever, so he came to me
1:07:16 because he wanted to try a ketogenic diet
1:07:20 for bipolar disorder because he had heard it might help.
1:07:23 So the other issue he was dealing with
1:07:26 was that he and his wife were having some difficulties,
1:07:28 some difficulty in their relationship
1:07:30 that had started up a few years before.
1:07:32 And every time they got into an argument,
1:07:34 he would want to die
1:07:37 and he would start to think about ways of killing himself.
1:07:40 Every single time he went on the ketogenic diet,
1:07:42 the suicidal ideation went away,
1:07:44 even though his wife had not.
1:07:49 So he used to associate the depression with the marriage,
1:07:51 but he learned over time
1:07:54 to associate it with his metabolic state,
1:07:56 that when he was in ketosis,
1:07:58 he could then imagine other ways
1:08:00 of coping with the stress in his marriage
1:08:01 other than just killing himself.
1:08:04 So a lot of people say to me
1:08:07 that the ketogenic diet gives them this space.
1:08:10 It allows them to pull back
1:08:12 and see things from a different perspective.
1:08:14 It buys them time, perspective.
1:08:19 It’s like a buffer so that people aren’t reacting
1:08:22 as reflexively to difficult situations.
1:08:24 Situation hasn’t changed,
1:08:27 but people are able to deal with the situation
1:08:29 in a more effective way.
1:08:31 They feel they have more control,
1:08:33 not just over their emotions,
1:08:34 but also over their behaviors
1:08:36 and how they react to situations.
1:08:39 – At my company Flight Studio,
1:08:40 which is part of my bigger company flight group,
1:08:42 we’re constantly looking for ways
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1:09:37 And for people that have food addictions
1:09:39 and binge eating problems,
1:09:41 the ketogenic diet,
1:09:43 I guess it’s knocking you off that roller coaster.
1:09:45 Well, being in a state of ketosis
1:09:46 is knocking you off that roller coaster
1:09:50 of craving, eating, craving, eating, craving, eating.
1:09:51 Is that accurate?
1:09:52 Is that what it’s doing?
1:09:55 – Yes, so the ketogenic diet
1:09:59 by lowering and stabilizing glucose and insulin levels,
1:10:02 the thing about insulin is that
1:10:04 a lot of people think about insulin
1:10:05 as a blood sugar regulator.
1:10:08 They think of it as, oh, when your glucose goes up,
1:10:11 the insulin brings it down, and that’s true.
1:10:15 But that’s, it’s just one of many important roles
1:10:18 that insulin has, it’s the one it’s most famous for.
1:10:21 But the thing that is not well known
1:10:23 is that insulin is so much more
1:10:24 than a blood sugar regulator,
1:10:28 it’s actually a master metabolic hormone.
1:10:32 And it’s regulating the activity of every cell in the body.
1:10:36 Every cell has an insulin receptor on its surface,
1:10:38 multiple insulin receptors,
1:10:41 to pay attention to the insulin level in the blood.
1:10:46 And so when you’re on a glucose and insulin roller coaster,
1:10:50 that’s just where the trouble begins.
1:10:53 Insulin is talking to and controlling the behavior
1:10:58 and levels and activity of many other hormones in the blood,
1:11:02 including stress hormones like adrenaline and cortisol,
1:11:06 reproductive hormones like estrogen and testosterone,
1:11:09 your blood pressure regulating hormones,
1:11:12 your satiety hormones, the hormones that make you feel full
1:11:14 after you eat your hunger hormones.
1:11:18 So many other hormones are on this roller coaster
1:11:21 that you’re unstable from within.
1:11:23 And people often will think, well,
1:11:26 I’m stressed and that’s why I’m eating.
1:11:30 I feel really anxious, I get irritable, I get stressed,
1:11:32 I’m hungry, I need to eat and then I feel better.
1:11:34 And that’s true, they will.
1:11:36 They will feel better for a few hours.
1:11:38 But what happens four to five hours later,
1:11:40 if they’ve eaten something
1:11:42 that’s spiked their glucose and insulin again,
1:11:47 is there’s this great study with healthy teenage boys.
1:11:49 They took healthy teenage boys
1:11:52 and they gave them either a sugar-free cola,
1:11:58 caffeine-free, or a caffeine-free cola sweetened with sugar.
1:12:02 And the boys who had the sugar-sweetened cola,
1:12:03 they’re adrenaline levels,
1:12:06 they’re stress hormones of adrenaline,
1:12:10 quadrupled four to five hours after drinking the soda.
1:12:14 And the boys who drank the other soda stayed flat.
1:12:17 It’s the food that’s causing the stress
1:12:19 that’s causing the food.
1:12:21 There’s this vicious cycle.
1:12:25 If people understood that most of what’s happening there,
1:12:27 it’s not your fault that you wanna overeat those foods,
1:12:32 they are designed to be overeaten by chemical engineers.
1:12:37 This is very intelligent engineering that’s going on,
1:12:38 very clever.
1:12:42 And you will sell more of a product
1:12:44 if you make it irresistible and if you make it unsatisfying.
1:12:48 How many people feel that they can’t control
1:12:50 their consumption of certain foods?
1:12:52 That’s by design.
1:12:55 If you wanna keep eating it, you’ll buy more of it.
1:13:00 If you eat real food, you have to stop after a little while.
1:13:02 They’re so satisfying.
1:13:06 Things like meat, seafood, poultry, eggs, fruit, vegetables,
1:13:09 even fruits, fruits, some people will overeat fruit.
1:13:12 But fruit has fiber, it has water.
1:13:16 It’s really hard to eat 10 pieces of fruit.
1:13:20 Very easy to drink a bottle of,
1:13:22 there’s several bottles of fruit juice.
1:13:27 Very easy to eat multiple packages of candy
1:13:31 because what happens with ultra-processed carbohydrates,
1:13:32 these refined carbohydrates,
1:13:35 they blow past your hormonal stop signs.
1:13:37 And that’s not your fault.
1:13:40 But if you understand that that’s what’s happening,
1:13:45 then it takes a few days, you gotta step away from them.
1:13:49 But on the other side is tremendous freedom and control.
1:13:52 – The gentleman you mentioned in that case
1:13:54 today a second ago, you referred to as Carl,
1:13:55 which I guess is a cloaked name.
1:13:59 He’s the one that had the bipolar disorder?
1:14:01 – No, Carl is a different case.
1:14:03 – Okay, tell me about Carl.
1:14:05 – Yeah, so I opened the book with the story of Carl,
1:14:08 who has generously allowed me to share his story.
1:14:13 Gentleman, great guy in his mid-60s
1:14:17 who had had lifelong depression and anxiety.
1:14:22 And for years, he didn’t seek any treatment.
1:14:25 And then maybe about 15 years or so
1:14:27 before he consulted with me,
1:14:31 he went to a psychiatry specialty clinic
1:14:34 for some specialized brain imaging
1:14:37 and extensive evaluation
1:14:39 and lots and lots of specialized tests.
1:14:44 And he left the clinic with thousands of dollars later
1:14:49 with three diagnoses, depression, anxiety and ADHD
1:14:52 and three prescriptions, one for depression,
1:14:54 one for anxiety, one for ADHD.
1:14:56 So he started those medications
1:14:59 and his depression got a lot better,
1:15:03 but he then had a brand new problem on his hands,
1:15:05 which was he was becoming manic
1:15:07 and he had never had mania before.
1:15:10 So he was going to uncharacteristically energetic
1:15:15 and irritable and unpleasant.
1:15:17 And so it was changing,
1:15:19 it was changing his character, his personality,
1:15:20 his certain behavior in a certain way
1:15:23 that was becoming very unpleasant at work and at home.
1:15:27 So he then turned to marijuana
1:15:29 to try to take the edge off,
1:15:31 develop to marijuana addiction.
1:15:33 Now he’s got another problem.
1:15:35 And so he thought to himself,
1:15:38 you know, this isn’t what I signed up for.
1:15:39 I was trying to solve a problem
1:15:41 and now I’ve got two new problems on my hands.
1:15:44 So he took himself off the medications
1:15:47 and said, you know, I can’t use medication,
1:15:48 medication’s not for me.
1:15:54 I’m going to try to manage my mood issues,
1:15:57 my depression, anxiety with rigorous exercise.
1:16:00 I’m going to let exercise be my medicine.
1:16:05 And he started cycling bikes over 100 miles a week.
1:16:08 And it actually helped a lot.
1:16:11 It didn’t completely resolve all of his symptoms,
1:16:16 but it brought them down to a very manageable level
1:16:18 for years.
1:16:20 So exercise was his medicine.
1:16:23 Exercise improves metabolic health.
1:16:26 And so he was still eating a standard American diet.
1:16:28 He’d never tried any dietary changes before.
1:16:33 And then what happened is as he entered his 60s,
1:16:37 the depression and anxiety started to rise in the background.
1:16:39 Exercise wasn’t working quite as well as it had.
1:16:42 And then just before he met with me,
1:16:45 something stressful had happened at work
1:16:48 and it was essentially a shift in his job description
1:16:50 which was making him anxious.
1:16:53 And he started experiencing very suddenly
1:16:58 these bouts of agitation and anxiety and restlessness
1:17:01 and exercise being his medicine.
1:17:05 He would cycle on the weekends.
1:17:09 And at night, if it was happening on a week night,
1:17:11 a work night, he would be walking
1:17:13 ’cause he couldn’t bike at night when it was dark.
1:17:17 He would walk sometimes eight, even 25 miles
1:17:19 to try to get rid of this excess energy.
1:17:21 And he said, I don’t have time for this.
1:17:25 I can’t exercise enough to keep my symptoms under control.
1:17:26 He didn’t know what else to do.
1:17:29 He starts searching online for solutions,
1:17:32 came across information about carnivore diets
1:17:35 and mental health, contacted me for a consult
1:17:39 and said, I wanna try the carnivore diet for my anxiety.
1:17:43 And I mean, there were lots of other things
1:17:47 we could have done to improve the quality of his diet
1:17:48 but this is what he wanted to do
1:17:50 because he was hoping that would bring him
1:17:53 the fastest relief.
1:17:55 So switched to a carnivore diet,
1:17:57 three to four pounds of fatty meat per day,
1:17:58 mostly pork and beef.
1:18:01 This was dairy free, no plants.
1:18:05 And he checked his ketones using urine testing
1:18:08 which is less expensive than blood testing.
1:18:11 He’s in mild ketosis every day using urine strips.
1:18:14 And he started to improve by week three.
1:18:17 By week six, his score was zero
1:18:19 on all his depression and anxiety scales.
1:18:23 He had no symptoms at all of depression and anxiety,
1:18:27 not just of those recent extreme symptoms
1:18:28 that he was experiencing,
1:18:31 but the symptoms that went back his entire life
1:18:33 that had never completely resolved before.
1:18:38 So he said, I’ve never felt this well in my entire life.
1:18:41 And so this is the power of these strategies
1:18:45 is they don’t just reduce symptoms a little bit.
1:18:48 They actually have the power to heal
1:18:51 the underlying problem in ways that,
1:18:53 I mean, this is a phrase I’ve heard so many times,
1:18:56 I feel better than I’ve ever felt in my entire life.
1:18:59 You don’t hear that when you prescribe medications
1:19:00 for people generally.
1:19:03 – That was in 2019, what’s that?
1:19:06 I couldn’t tell you what year, but that sounds right.
1:19:07 – How is he doing now?
1:19:11 – Yeah, I mean, we still talk with each other
1:19:12 several times a year.
1:19:13 He’s doing very well.
1:19:16 In fact, so one of the interesting things
1:19:18 about what happened with this diet
1:19:21 is that during that long period of intermittent agitation,
1:19:26 he’s a very physically fit guy because of all the exercise
1:19:28 and he was lean.
1:19:31 He lost 10 pounds during that period of agitation
1:19:32 that he could not afford to lose.
1:19:35 When he first started working on the, he was underweight.
1:19:40 And despite eating four pounds of fatty meat per day,
1:19:42 he couldn’t regain that 10 pounds
1:19:45 unless we added back some carbohydrate into the diet.
1:19:47 This is really, this is a subtle point,
1:19:50 but for athletes sometimes,
1:19:53 especially in the early phase of the transition,
1:19:56 there needs to be a certain amount of carbohydrate
1:20:00 in the diet to support high performance.
1:20:01 – He didn’t stay on the carnival diet?
1:20:02 – No, he did not.
1:20:04 So he was on the carnival diet for many months.
1:20:08 And then because he couldn’t regain that weight,
1:20:09 I asked him, I said, well, you know,
1:20:11 I think we need to put some carbohydrate in
1:20:13 to help you regain this weight.
1:20:16 And so I asked him which foods he missed the most,
1:20:19 gave him a list of whole foods to choose from.
1:20:22 And the things he missed most were potatoes and yogurt.
1:20:24 So some starchy root vegetables,
1:20:27 some plain unsweetened yogurt,
1:20:30 up to about 100 grams of carbohydrate per day
1:20:31 seemed to be about right for the days
1:20:34 when he was, excuse me, exercising.
1:20:37 On the days when he wasn’t exercising, he would cut it back.
1:20:41 So he was tailoring it to his personal energy needs.
1:20:45 And so this is another interesting thing
1:20:48 about what happened for him is that,
1:20:52 I mean, his scales are still at zero,
1:20:54 but he has been, as we’ve talked to each other
1:20:56 on and off over the years,
1:21:00 he has been able to make adjustments to his diet,
1:21:01 understanding the principles.
1:21:02 If you understand the principles,
1:21:04 then you know which changes you can get away with
1:21:08 and which changes you can’t, and he has stayed well.
1:21:10 – There’s a couple of key things people always talk about
1:21:11 when they hear the carnivore diet.
1:21:14 The first is they say there’s nutritional deficiencies
1:21:17 to the diet that aren’t like sustainable.
1:21:19 So if you eliminate certain food groups,
1:21:23 like fibers, vitamin Cs, vitamin E, magnesiums, et cetera,
1:21:26 then which are essential nutrients,
1:21:27 then you’re gonna have problems.
1:21:31 So a carnivore diet theoretically does provide
1:21:32 all essential nutrients.
1:21:35 So if you look at what is inside animal foods,
1:21:38 you will find all essential nutrients.
1:21:40 You can’t say that of any plant food.
1:21:42 There’s not a plant food on earth
1:21:45 that provides all essential nutrients.
1:21:49 Animal foods can, I would say meat, seafood, poultry.
1:21:50 Eggs are missing a couple of nutrients
1:21:53 and dairy is missing even more.
1:21:57 But meat, seafood, and poultry contain every nutrient we need.
1:22:00 – The question is how much do you need?
1:22:01 – Like fiber.
1:22:03 – Oh, well, fiber’s not a nutrient.
1:22:04 – Oh, okay.
1:22:06 But do you get fiber in a carnivore diet?
1:22:08 – There are different definitions of carnivore,
1:22:13 but the strictest sort of purist definition of carnivore
1:22:16 is animal foods only, and fiber comes from plants.
1:22:17 So it’s fiber-free.
1:22:19 A true carnivore diet is fiber-free.
1:22:23 – So could you last on a true carnivore diet
1:22:25 without getting some kind of like gut microbiome issue
1:22:29 or some kind of, ’cause you need fiber, right?
1:22:29 – Why?
1:22:32 – I thought it was good for like digestion
1:22:35 and your gut microbiome and stuff like that.
1:22:36 – What does it do?
1:22:39 – A lot of people tell me that it prevents glucose
1:22:40 going into the blood or something.
1:22:42 – Where’s the glucose coming from?
1:22:44 – So you don’t need it?
1:22:47 – Fiber is very helpful, and I spell this out in the book,
1:22:50 so because there’s, we have a lot of half truths
1:22:52 in our minds about food.
1:22:56 Even people who are paying really close attention
1:22:59 to nutrition science
1:23:03 have a lot of half truths in their minds about food.
1:23:05 So yes, fiber, for example,
1:23:09 you’re exactly right, lowers glucose spikes,
1:23:12 but the glucose is coming from a diet
1:23:13 that’s too high in sugar,
1:23:15 and so you won’t get glucose spikes
1:23:19 if you regulate your glucose levels.
1:23:22 So that’s one interesting thing about fiber.
1:23:25 So if you’re eating a high carbohydrate diet,
1:23:28 fiber can soften your glucose spikes, and that’s a plus,
1:23:30 but there’s a more effective way to lower your glucose spikes
1:23:34 is to not get a glucose spike in the first place.
1:23:36 And that may not require
1:23:38 taking all the carbohydrate out of your diet.
1:23:42 It might just mean lowering it to your personal tolerance.
1:23:44 Another thing people often say about fiber
1:23:47 is that it sweeps your colon clean of toxins
1:23:51 and that might otherwise build up
1:23:53 and cause problems.
1:23:55 But fiber, there’s no evidence
1:23:57 that fiber is sweeping anything clean,
1:23:59 or there’s never been a study that demonstrates this.
1:24:03 It’s really just a belief about what we imagine fiber
1:24:05 as being like the broom of the intestines,
1:24:07 but that’s just a belief.
1:24:10 There’s no science behind that whatsoever.
1:24:13 The intestines clean themselves.
1:24:15 The lining sheds regularly, actually very frequently,
1:24:20 and the border of the intestines sweep themselves clean.
1:24:24 So the intestine knows how to take care of itself that way,
1:24:26 but the biggest myth about fiber
1:24:28 is that it’s good for digestion
1:24:33 because fiber, by definition, is indigestible by humans.
1:24:36 So there are two kinds of fiber.
1:24:38 There’s soluble and insoluble,
1:24:41 and the soluble is the kind that holds water,
1:24:43 it’s like an apple,
1:24:46 and the insoluble is the tough, stringy, woody stuff
1:24:49 that you might find in broccoli, for example.
1:24:53 So the soluble fiber, the bacteria
1:24:55 and the lower parts of our intestine
1:24:58 can ferment that to a certain extent,
1:25:02 but then we can’t make use of the sugars
1:25:04 that it’s releasing.
1:25:06 – Right here, fiber is traditionally considered essential
1:25:09 for feeding beneficial gut bacteria
1:25:12 and promoting regular bowel movements.
1:25:14 – Yes, okay, so a couple of things to unpack there.
1:25:18 So one is that a lot of people,
1:25:20 there are quite a few papers on this,
1:25:21 claiming that we need fiber
1:25:24 because we need to feed our cells butyrate,
1:25:26 which is a breakdown product of fiber,
1:25:29 but butyrate, if you think about what a ketone is,
1:25:31 it’s beta hydroxybutyrate,
1:25:33 feeds the intestinal cells just as well.
1:25:37 So you don’t need to eat fiber to feed your cells butyrate.
1:25:39 If you think that the cells need butyrate,
1:25:41 then you can get it from a ketogenic diet.
1:25:45 So I explained that in the book too,
1:25:47 is that there’s more than one way
1:25:48 to generate that molecule.
1:25:53 – Can someone exist on the carnival diet,
1:25:55 like the extreme version of the carnival diet,
1:26:00 for a long time without any supplementation?
1:26:01 – So we really don’t know
1:26:04 and we really don’t have any long-term data
1:26:06 on any dietary pattern.
1:26:09 I think this is really important for people to understand
1:26:12 is this very common criticism of diets
1:26:14 that we feel uncomfortable with
1:26:15 or might be worried about,
1:26:18 like ketogenic diets or carnivore diets,
1:26:19 because they’re so different
1:26:21 from what we’re told we’re supposed to eat.
1:26:24 There’s a lot of fear and worry about them.
1:26:29 And so, well, okay, it’s normalized my blood sugar level.
1:26:32 I used to have type two diabetes.
1:26:34 You know, I’ve lost 50 pounds.
1:26:36 My depression went away.
1:26:39 I normalized my coronary artery calcium scores.
1:26:42 I’m at lower risk for cardiovascular disease.
1:26:43 My triglycerides came down.
1:26:47 You know, I feel better in every way,
1:26:50 like all of my health markers have improved.
1:26:53 And so when you show people study after study after study
1:26:54 of a ketogenic diet,
1:26:59 improving multiple aspects of metabolic health
1:27:00 and physical health and mental health,
1:27:02 it’s cured my seizures.
1:27:04 It’s cured my bipolar, whatever it was.
1:27:08 The only sort of the last thing somebody could say is,
1:27:13 well, yes, okay, it’s made you extraordinarily healthy now,
1:27:16 but I wonder what’s gonna happen 20 years from now.
1:27:17 Nobody can tell you that
1:27:20 because there’s no way you could design
1:27:22 a 20 year long study of any diet.
1:27:24 So you could say this about the Mediterranean diet.
1:27:26 You could say this about a carnivore diet.
1:27:27 You could say this about a vegan diet.
1:27:30 Well, vegan diet, unsupplemented, is fatal.
1:27:34 It has dangerous nutritional holes.
1:27:37 So why aren’t we saying this about vegan diets?
1:27:40 When we can look at a vegan diet and see
1:27:43 that it’s incompatible with human life
1:27:46 unless you eat fortified processed foods or supplement,
1:27:48 which most people in the world cannot do,
1:27:51 we look at a carnivore diet
1:27:53 and you can actually find all of the nutrients
1:27:55 in these animal foods.
1:27:58 And that’s the diet that you’re more worried about
1:28:01 because theoretically, long-term,
1:28:02 something bad might happen.
1:28:05 Now, I am not at all saying
1:28:08 that a carnivore diet is the right diet for everybody
1:28:10 or that it’s even the right approach
1:28:12 for everybody to consider.
1:28:16 But I think we have to keep an open mind and stay curious
1:28:18 and look at the biology of food
1:28:20 and allow people to make their own.
1:28:24 I’m nutritionally pro-choice,
1:28:29 which means if you came to me with a mental health issue,
1:28:34 I would support you in optimizing the diet of your choice
1:28:38 and making it as brain-healthy as I possibly could
1:28:42 because it’s very important that you feel comfortable
1:28:44 with the diet that you’re eating.
1:28:47 And so there are lots of ways to do that.
1:28:49 But I think it’s really important.
1:28:51 And one thing I encourage people to do in my work
1:28:55 and in my book is to open our minds
1:28:57 and get curious about food,
1:28:59 the biology of food, the biology of the brain,
1:29:02 because most of what we hear about nutrition
1:29:04 doesn’t come from biology.
1:29:08 It doesn’t come from clinical experiments
1:29:11 or information about how cells work
1:29:14 or about what’s actually inside food.
1:29:17 It comes from this type of study
1:29:19 called a nutrition epidemiology study,
1:29:22 which is just questionnaire-based guesswork,
1:29:25 untested theories about what we should eat.
1:29:27 Most of what we believe about nutrition
1:29:32 is untested theories, wild guesses and wishful thinking.
1:29:35 – Many of the people that choose a keto diet
1:29:38 do it for sort of superficial reasons.
1:29:39 – Sure.
1:29:40 – You know, I think it’s probably one of the reasons
1:29:43 why I do it once a year for a couple of weeks.
1:29:46 Why does it help you to lose weight?
1:29:49 Is that again, just because of calorie restriction?
1:29:51 – So it’s insulin.
1:29:54 So everybody out there who’s trying to lose weight,
1:29:56 they need to know one thing.
1:30:00 And it works if you cannot burn fat
1:30:02 if your insulin levels are too high.
1:30:05 So if you know what raises insulin,
1:30:08 you can turn that insulin knob down.
1:30:11 If you know how to do that, you will lose weight.
1:30:14 It’s a biological fact.
1:30:18 So when you turn down insulin, you will burn fat.
1:30:21 So a ketogenic diet, you can’t produce ketones
1:30:23 unless your insulin is low enough.
1:30:26 So a ketogenic, the ketones on that meter
1:30:28 are showing you that you are burning fat.
1:30:31 You can’t make ketones unless you’re burning fat.
1:30:35 So you really cannot burn fat unless you’re in ketosis.
1:30:37 You don’t necessarily have to be in ketosis all the time.
1:30:38 You don’t necessarily have to have
1:30:40 very high ketone levels.
1:30:43 But if you’re not in ketosis, you’re not burning fat.
1:30:48 So if you’re not in ketosis, the brain can’t even see
1:30:52 that you’ve got spare energy to burn.
1:30:57 You might have 200, 300 pounds of stored energy as fat.
1:31:01 The brain will still ask you to eat more carbohydrate
1:31:03 because it’s not in fat burning mode.
1:31:05 So it’s in carbohydrate burning mode.
1:31:07 When it’s hungry, it’s gonna look for more carbohydrate.
1:31:10 You have to teach it.
1:31:13 You have to bring your body into fat burning mode
1:31:17 and train your body, give yourself some time a few weeks
1:31:20 to learn how to burn fat again and stay there.
1:31:23 My mother is 91 years old.
1:31:27 She has lost 50 pounds on a ketogenic diet.
1:31:31 It is never too late to all she has to do
1:31:33 is make sure that there are ketones on her meter.
1:31:36 When her glucose meter was nice and stable,
1:31:38 she wasn’t losing weight
1:31:42 because the insulin was still too high.
1:31:45 The ketones tell you, the ketones are essentially
1:31:47 a mirror image of your insulin level.
1:31:50 So we don’t have a home insulin level test yet.
1:31:54 We have fabulous continuous glucose monitors,
1:31:56 which I recommend anybody out there
1:31:58 with a mental health issue or physical,
1:32:02 anybody out there who can afford $45 or $50
1:32:05 for a single two week glucose sensor,
1:32:07 which are now available in the United States
1:32:10 over the counter, which they weren’t before.
1:32:13 I think you’ve had them in the UK for a lot longer.
1:32:15 You can see what your glucose levels are doing
1:32:18 in response to your lifestyle, your food choices,
1:32:20 your exercise, et cetera.
1:32:23 It can’t tell you what’s going on with your insulin level.
1:32:26 So you can have a nice, beautiful, stable glucose level
1:32:28 nice in the healthy range.
1:32:30 Your insulin could still be too high
1:32:31 and you still might just be,
1:32:33 you’re burning all that glucose for energy.
1:32:37 A ketone meter will tell you if you’re burning fat.
1:32:40 – And what Amazon now says, sort of $50 or,
1:32:42 there’s ones for $40 as well.
1:32:44 One for $30 as well.
1:32:46 Interesting, okay.
1:32:47 I think I’m gonna try one.
1:32:48 I’ve never actually done one before.
1:32:49 So I guess I didn’t really know
1:32:52 if I was in ketosis or not, but I just…
1:32:57 Oh, it’s so useful because if you’re following
1:33:01 a ketogenic diet, the thing that makes it ketogenic
1:33:02 is the ketones.
1:33:06 And so, you were telling me before we started recording
1:33:08 that you’re always looking up which foods are keto,
1:33:09 which foods aren’t keto.
1:33:12 And it’s really not so much about that.
1:33:14 You could eat almost anything on a ketogenic diet
1:33:18 if you understand how much to have and when.
1:33:24 But in any case, the ketone meter
1:33:26 will tell you if you’re in ketosis.
1:33:29 And if you’re not in ketosis, you can tweak your plan.
1:33:33 So all of this is in the book, but you can,
1:33:38 the most important thing about a ketogenic diet
1:33:42 is getting into good, consistent daily ketosis
1:33:45 for at least six weeks straight.
1:33:48 That sends the daily signal to your cells.
1:33:49 We’re burning fat now.
1:33:51 We’re burning fat now.
1:33:53 We need to learn how to burn fat.
1:33:55 There are enzyme systems and pathways and cells
1:33:59 that need to ramp up and it takes time.
1:34:02 So it takes a while for the body and brain
1:34:06 to kind of learn how to burn fat again.
1:34:08 And it doesn’t happen overnight.
1:34:12 – In terms of energy, there are so many reasons
1:34:15 why I’m a big matchup fan, if you don’t already know by now.
1:34:16 And so much so that I actually invested
1:34:19 in the UK’s leading match up company called Perfect Ted.
1:34:21 And one of my favorite Perfect Ted products
1:34:23 is these delicious matcha pouches
1:34:25 that come in every flavor from salted caramel
1:34:29 to peach flavor, to mint flavor, to berry flavor.
1:34:32 One of my favorites is this vanilla flavor,
1:34:34 which I’m gonna make in just two seconds.
1:34:37 You just take this mixer here,
1:34:38 get a little bit of a powder,
1:34:41 pop it on top of the shaker like that,
1:34:42 put the lid on.
1:34:46 Shake, shake, shake.
1:34:48 Delicious.
1:34:49 If you haven’t tried this yet,
1:34:51 you can find Perfect Ted at Tesco and Holland Barrett Stores
1:34:56 or online where you can get 40% off with my code, Diary40.
1:34:59 Head to perfected.com and put in code Diary40
1:35:02 to try this delicious multi-flavored matcha now.
1:35:03 Highly recommend.
1:35:05 And if you do it, please tag me, send me a message online.
1:35:12 – What part of your work sort of overlays with psychology?
1:35:13 You know, when someone comes to you
1:35:14 and they’ve, they’re like,
1:35:15 you know, when someone comes to you
1:35:18 and they’re experiencing some anxiety or depression
1:35:22 or something and they’re describing their life
1:35:24 and their life is full of trauma and hard things
1:35:26 and they got fired from their job.
1:35:31 It seems a little bit peculiar to talk to them about diet
1:35:32 in that moment.
1:35:33 It seems peculiar.
1:35:37 Do you ever think first about like
1:35:40 some kind of psychological prescription?
1:35:44 – Oh, you know, I got some,
1:35:47 my training at Cambridge Hospital
1:35:51 in psychiatry residency is very psychotherapy focused.
1:35:54 I got really excellent training in psychotherapy
1:35:57 and I still use it every day in my work.
1:36:01 We’re not throwing the baby out with a bathwater here.
1:36:04 In fact, the psychology of people’s relationship
1:36:07 with food is really important to address.
1:36:09 I mean, most of what I do,
1:36:12 I mean, I could, I could teach you in an hour,
1:36:14 everything you needed to know
1:36:15 about why you should switch
1:36:17 to a ketogenic diet for mental health
1:36:19 and I could give you a little sheet
1:36:21 and you could go off and do it, right?
1:36:24 I would, I would be rapidly obsolete,
1:36:28 which would be a good problem to have, right?
1:36:30 But what actually is happening,
1:36:33 most of the work I’m doing is not about,
1:36:34 here’s the science, here’s why you need to do it,
1:36:36 here’s what’s happening in your brain,
1:36:37 here’s the food list.
1:36:39 It would be so easy if that’s what it were.
1:36:42 We are human beings and we have really complicated
1:36:45 relationships with food, we have history with food,
1:36:47 we have spiritual attachments to food,
1:36:49 cultural attachments to food,
1:36:52 political beliefs about food
1:36:54 and a lot of us have addictions
1:36:57 and attachments to food that go back a long way.
1:37:01 So most of it is about helping people understand
1:37:04 and sort of hold their hand through that process
1:37:06 of making that behavior change.
1:37:11 And whatever’s going on in their life is also important.
1:37:14 – So how would you approach that with your patients?
1:37:17 – So in the first interview with somebody,
1:37:20 I usually take 90 minutes to two hours
1:37:22 when I’m first working with a patient
1:37:25 and I might do that two or three times
1:37:29 before we actually begin discussing what to do with diet
1:37:31 because I really wanna understand
1:37:35 all of the different pieces of the puzzle,
1:37:37 not just, oh, what are you eating?
1:37:39 Here’s what you should eat.
1:37:41 That doesn’t work for most people
1:37:46 and because there are gonna be challenges that come up
1:37:49 and if the better I know that person,
1:37:51 the better I can help them through those challenges.
1:37:54 So it’s not, it’s definitely not,
1:37:57 it’s not like I hand them a prescription for a diet
1:37:59 and send them out the door.
1:38:02 I love understanding where people are coming from.
1:38:06 The challenges they’re facing in their lives
1:38:10 and how that all intersects with their metabolic health,
1:38:14 their exercise, why are they not exercising?
1:38:15 How is their sleep?
1:38:16 How are their relationships?
1:38:19 Who in their life is supportive of them
1:38:20 changing their diet?
1:38:24 Who in their life is skeptical and worried?
1:38:26 ‘Cause that could be a major factor for people.
1:38:29 If one person in the family wants or needs
1:38:31 to go on a ketogenic diet for mental health
1:38:34 and nobody else in the family thinks it’s a good idea,
1:38:36 that’s really tough for people.
1:38:39 You’ve got a plan for all of that and talk it through.
1:38:41 Say, okay, here are the roadblocks we might face.
1:38:43 How are we gonna deal with these when they come up?
1:38:46 So I could give many, many examples
1:38:49 but the psychotherapy, the psychology of it
1:38:53 is why using ketogenic diets to treat mental health
1:38:56 conditions is usually best done as a team.
1:39:02 Ideally, if you can, a ketodietician or nutrition therapist
1:39:05 who’s very skilled at using ketogenic diets,
1:39:07 designing them and personalizing
1:39:09 for whatever you like to eat.
1:39:12 So you’ll have an enjoyable, diverse diet
1:39:15 that meets your needs and your desires.
1:39:16 So you won’t get bored
1:39:19 and you’ll enjoy the food you’re eating.
1:39:22 And a prescriber, especially if you’re taking medication
1:39:24 or have any mental or physical health issues,
1:39:26 you’ll need a prescribing professional,
1:39:30 primary care doctor or psychiatrist or both
1:39:32 depending on what’s going on for you
1:39:34 to manage the medications and help you
1:39:36 through that transition period
1:39:37 where there are so many different things changing
1:39:41 in your physiology that it can sometimes be uncomfortable
1:39:42 if you don’t plan properly
1:39:46 and set the person up for success.
1:39:50 And a coach, a therapist, a psychologist or a coach
1:39:54 for motivation and support and it can be a cheerleader
1:39:58 but also to reflect back to you how things are going
1:40:00 and keep you moving forward
1:40:02 because the first few weeks are the hardest.
1:40:04 And once you get past about week three,
1:40:07 week three is a real turning point for a lot of people,
1:40:11 your cells just kind of settle in
1:40:13 to a new way of operating.
1:40:15 And it’s this very noticeable shift
1:40:19 that takes place in people’s bodies and brains
1:40:22 and that many people have never experienced before.
1:40:24 – As it relates to anxiety,
1:40:27 what does the research say about the role
1:40:32 that keto can play in reducing someone’s anxiety?
1:40:37 – Yeah, so anxiety, if you talk to any practitioner
1:40:40 who has been using ketogenic diets in their work,
1:40:43 whether it’s a psychiatric practitioner
1:40:45 or a medical practitioner,
1:40:47 there are a couple of things they’ll tell you
1:40:51 that are the most predictable benefits
1:40:52 of a ketogenic diet.
1:40:55 One is reduced anxiety
1:40:57 and the other is mental clarity.
1:41:01 So most people will experience tremendous reductions
1:41:05 in anxiety within, often within three days
1:41:07 to three weeks of starting a ketogenic diet.
1:41:10 And the mental clarity is one of those things
1:41:13 that you hear from almost everybody.
1:41:16 So the anxiety is, remember we were talking
1:41:17 about this roller coaster,
1:41:20 those stress hormones are on a roller coaster.
1:41:22 Life can cause stress
1:41:24 and stress can unbalance your chemistry.
1:41:27 There’s no question about that.
1:41:28 But your food can also do that.
1:41:30 Your diet can also unbalance your stress hormones.
1:41:33 So, and this is, comes back to your question about,
1:41:36 you know, life stressors, you don’t wanna ignore those
1:41:38 because they still count
1:41:40 and they’re still affecting your metabolic health.
1:41:43 Stress raises your cortisol levels
1:41:45 and cortisol levels are dangerous
1:41:47 for long-term brain health, high cortisol levels.
1:41:50 Most mental health conditions come along
1:41:52 with dysregulated or poor regulation
1:41:54 of cortisol levels in the brain.
1:41:58 And too much cortisol can over time damage the brain,
1:42:00 including the hippocampus,
1:42:02 which is the brain’s learning and memory center.
1:42:05 So stress, whether it’s coming from inside the body
1:42:06 from the foods you’re eating
1:42:09 or outside the body from your life,
1:42:10 both of those need to be addressed,
1:42:12 not just the dietary stress.
1:42:14 There’s some studies that I just found
1:42:18 a 2023 systemic review examined the efficacy
1:42:20 of low carbohydrate ketogenic diets
1:42:22 and treating mood and anxiety disorders.
1:42:24 The review highlighted potential benefits
1:42:27 but emphasized the necessity for randomized control trials
1:42:29 to establish definitive conclusions.
1:42:31 That was the Cambridge University Press
1:42:34 and slightly separate to that on serious mental illnesses.
1:42:35 I think you talk about this in your work as well.
1:42:38 A 2024 pilot study conducted by Stanford Medicine
1:42:40 investigated the effects of a ketogenic diet
1:42:43 on participants with schizophrenia and bipolar
1:42:44 and participants reported improvements
1:42:46 in energy, sleep, mood and quality of life,
1:42:49 suggesting that ketogenic diet may stabilize brain functions
1:42:51 in serious mental illnesses as well.
1:42:55 Really, really fascinating, really fascinating.
1:42:57 I never really thought about the ketogenic diet’s impact
1:42:58 on my mental health.
1:42:59 I used to think, I’ll be honest,
1:43:04 the reason I do it is helps me become more focused.
1:43:05 It changes my body composition
1:43:07 and really at the end of the year for me
1:43:08 or at the start of the year,
1:43:10 it’s a nice way to kind of reset,
1:43:11 that’s kind of how I see it.
1:43:14 I want to come into the year feeling good
1:43:16 and strong and focused.
1:43:20 So I do it over sort of Christmas, New Year, January time
1:43:21 every year with my partner.
1:43:24 But I never really considered the downstream consequences,
1:43:26 things like mental health and those other things,
1:43:28 but it makes sense.
1:43:29 We have a closing tradition on this podcast
1:43:31 where the last guest leaves a question for the next guest,
1:43:34 not knowing who they’re leaving it for.
1:43:37 And the question that’s been left for you
1:43:42 is what would you say to someone who wanted to have less regret
1:43:47 and more contentment and peace on their deathbed?
1:43:58 – I’m trying to think about what, for myself personally,
1:43:59 what I would have regretted.
1:44:04 You know, you might want me to say
1:44:07 that I would have regretted not having written this book
1:44:09 and that’s true, but honestly,
1:44:11 it’s about finding a really good,
1:44:13 healthy relationship in your life.
1:44:16 I mean, if I hadn’t accomplished that in my life,
1:44:18 I would have more regrets than not writing this book.
1:44:22 – Thank you, thank you for writing this book
1:44:24 because it’s such a comprehensive analysis
1:44:27 of this poorly understood link
1:44:29 between the things we put in our mouth
1:44:31 and the impact it has on our mind, helistically.
1:44:32 And I don’t think enough people,
1:44:34 especially if we think back decades,
1:44:37 even thought to really uncover this sort of link.
1:44:40 I never, I think before even starting this podcast,
1:44:41 never really understood the concept
1:44:45 of metabolic and metabolic psychiatry
1:44:47 and that there was an association between the two.
1:44:48 The great thing about your book
1:44:51 is that you don’t need to be a scientist to understand it.
1:44:54 It’s clearly written for people like me
1:44:57 who don’t have a profound knowledge of science
1:44:59 and medicine and psychiatry,
1:45:04 but are able to learn and advance the decisions we make
1:45:06 just by reading your book.
1:45:08 It has been such a smash hit for so many people.
1:45:09 I was looking at some of the reviews earlier on
1:45:10 and people really, really love it.
1:45:13 You wrote it, you published it this year, January?
1:45:15 – January. – January.
1:45:17 And I highly recommend anyone that is intrigued
1:45:19 by any of the subject matters that we spoke about today
1:45:22 to go and get a copy, I’ll link it below.
1:45:24 And it has some extraordinary people on the back
1:45:26 who, some of which I’ve interviewed,
1:45:30 at least one of which I’ve interviewed in Jason.
1:45:31 Is there anything else you wanted to say
1:45:33 about who this book is for?
1:45:36 – Yeah, I mean, I really want people
1:45:38 with mental health conditions,
1:45:40 even if they think they’ve tried everything,
1:45:43 if you’re willing to try one more thing,
1:45:44 hope is on the menu.
1:45:46 – A powerful plan to improve mood,
1:45:48 overcome anxiety, and protect memory
1:45:51 for a lifetime of optimal mental health.
1:45:53 Thank you so much for the work that you do.
1:45:55 – Thank you very much, Stephen, for your work.
1:45:58 (upbeat music)
1:46:00 – Do you know that 80% of New Year’s resolutions
1:46:01 fail by February?
1:46:04 It’s because we focus too much on the end goal,
1:46:06 and we forget the small daily actions
1:46:07 that actually move us forward.
1:46:09 Those actions that are easy to do
1:46:10 are also easy not to do in life.
1:46:13 It’s easy to save a dollar, so it’s also easy not to.
1:46:15 Making one small improvement each day,
1:46:18 one tiny step in the right direction
1:46:19 has a big difference over time.
1:46:21 And that is the 1% mindset,
1:46:24 which is why we created the 1% diary,
1:46:27 a 90 day journal designed to help you stay consistent
1:46:29 and focus on the small wins
1:46:30 and make real progress over time.
1:46:33 It also gives you access to the 1% community,
1:46:35 a space where you can stay accountable,
1:46:37 motivated, inspired, along with many others
1:46:38 on the same journey.
1:46:40 We launched the 1% diary in November,
1:46:41 and it sold out.
1:46:43 So now we’re doing a second drop.
1:46:46 Join the wait list at thediary.com,
1:46:47 and you’ll be the first to know
1:46:48 as soon as it’s back in stock.
1:46:49 I’ll put the link below.
1:46:52 (upbeat music)
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1:46:57 (upbeat music)
1:47:00 (upbeat music)
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