Transcription
Professor Tim NOS is a distinguished figure in exercise science and Sports Medicine, holding multiple degrees from the University of Cape Town. He co-founded the Sports Science Institute of South Africa and received numerous accolades. With over 750 publications, he's an accomplished author and co-founder of the NO Foundation and the Nutrition Network. He advocates for low-carbohydrate, high-fat diets and supports research through his foundation, Eat Better South Africa.
"So excited to be on this call with you and to touch base again and to hear about everything that you're doing because you guys are just doing so incredibly well with the NO expansion. And I saw you just read the textbook and everything. But I want to start with a very, very basic question. You know, you are one of the world's most renowned experts in the field of health and exercise science. Um, and I'd love for you to share your perspective on a very fundamental question, which is what I'm asking everyone on this podcast, and that is, what is health?"
"Okay, and we started and going. Yes, please. Well, I think that what's really important is when you wake up in the morning and that you have enthusiasm and you're ready to go. And that's the state that I like to think of that you've always got. You feel positive, that there's a future ahead of you. And so that you're not physically constrained. I think those are, you know, certainly as you get older, the risk that you're going to get a chronic degenerative disease is so high, and that becomes limiting. But then you've got the mental side that can be limiting. So it's really both. You must combine the two. You must be physically strong and largely disease-free. But then you must also have the mental capacity to enjoy life and look forward to it and be enthusiastic. So, and I think that, like, health is something you only realize when it's gone. That's when you realize that, gosh, I took it for for granted. So I certainly don't take it for granted anymore that you wake up every morning and you feel ready to go and that everything's working perfectly. But that's the state that you're looking for. And I think another is another point. As you get to my age, you start, you want to die perfectly. You have to have a perfect death. And you need to build up to that because, I mean, you know, my father's illness and that influenced me greatly. And I never wanted to put my own children or grandchildren through that. You know, I want to wake up dead one morning, and that's the way to go. But it takes effort to get there. And if you do that, if you can delay your incapacitation for as long as possible until your last moment, that's the ideal. So, so, so those are my views. That it's the state that you, that you, you wake up every day with enthusiasm and with the capacity, both mentally and physically, to do what you want to do, and that you don't have limitations. And those are the things that you have to work on."
"And so what does the perfect death look like to you?"
"It's the one, you know, you don't know about. Well, I mean, no one knows about the death. But it's the one where you literally go to bed at night and you, you don't wake up the next morning. That's, that's the perfect death. And that you don't have a long debilitation. I think that's one of the keys is this long descent that you get. And I'm, there's no doubt in my mind that that descent is driven by chronic disease, obviously. So you've got to stop the chronic diseases or you get them so that you don't have major symptoms and disability. Disability is the issue. That's what you don't want to have the disabilities."
"Professor, your concept of health and what it means to be healthy, and how to achieve health or restore yourself to health, however you want to word it, changed dramatically throughout the years. Um, can you take me through that progression? Because I met you at a very specific time. Um, but it would be so cool to just hear that progression."
"Okay, so I, I was very active at schools, but sport and endurance exercise was never an issue. And then I very fortunately got into endurance sports for many years and was very active and very fit and very healthy. And then unfortunately, that was the time of the high carbohydrate promoting the high carbohydrate diet. And unfortunately, I turned out to have severe insulin resistance. And so that, this eventually, within a few years, I could tell that there was something wrong, but I didn't know what it was. And I was just thought it was just aging. And then ultimately, after 33 years of promoting this high carbohydrate diet, I eventually converted, fortunately, by reading the book by Eric Westman, The New Atkins for the New You. And that was the life-changer for me because I realized that everything I'd been saying was wrong. And I, and I very quickly realized as I changed my diet that all the symptoms I'd been developing over 20 years had suddenly disappeared. So I had this miraculous recovery. And then I discovered I type two diabetes. And so then I understood what my problem was. Here I was, trying to be very active, but profoundly insulin resistant, eating a high carbohydrate diet and suffering the consequences. And then when I took the carbs out, I became very healthy. And that's, that's pretty much when we met. And since then, I, I, I say I should be dead now. I'm talking to you from the grave because my father had his diabetes for 10 years and then was crippled by it and died. And I've had my diabetes, which is in remission, fortunately. I've had it for well over 10 years and currently I don't have any overt symptoms that I'm aware of. So I'm not suggesting that I'm never going to get the symptoms or the clinical picture of type 2 diabetes, the complications. I'm not claiming that. But so far, I've put it off for 12 to 14 years, which is, which is pretty miraculous, as I said. So that's how I changed my health. And one of the beauties of this, knowing the solution, is that if I were to die tomorrow, I would have no regrets because I actually did what I could. And that you can only do so much. And then you can't do any more than that. And you have to accept that we're all going to die. So, so I'm very happy that I've done the best I can and I'm going fine. And let's just hope it continues for a couple more decades."
"I hope so too. I mean, you know, I was very much there when your shift happened from this high carbohydrate, very much endurance athlete, carb loading, I mean, the law of running and everything, you know, you promoted carbs in the biggest way, right? And, um, when that shift happened, and I will never forget how fierce that backlash was from the medical community in South Africa. I mean, with our conference, our CME or CPD points were revoked because of the dieticians saying that the information that Eric Westman, Gary Taubes, Jeff Volek, Steve Phinney, you, Rob Cyrs, Dale Eales, Peter Attia, Jason Fung was putting forward was going to kill people. And here we are, 10 years later, right? And has it, I mean, I don't want to say has it killed anybody, but look how much has changed. I mean, the work that you have done is incredible. Um, how was that experience for you of going through that process? Because I know personally, it was very hard."
"Yeah, yeah. No, thanks to people like you who supported me, that made it a lot easier. And of course, my family. And I think that, and ultimately, I knew that we were right. So that didn't worry me. So, but it was extremely tough. And for a long period, I had post-traumatic stress disorder. In other words, when I talked about the trial, I would get, I'd feel sick again, and I'd get all those symptoms, which was very unusual because otherwise, I was fine. But I remember particularly giving one lecture to doctors. And that, that was what was really difficult was lecturing to doctors and suspecting in the audience that there were many who were not taking, who still had the same feelings. And one of them, I was ill for a day or two afterwards. But that, that's gone now. So it was much more stressful than I would ever admit initially. But now we've passed it. And we produced the textbook, which hopefully you'll draw attention to. It was published about a month ago."
"Yes, yeah. And that to me is an astonishing achievement because it shows that this, the ketogenic, low-carb, the keto diet is the most studied diet ever, and it's the most effective diet ever. And so anyone who says, you know, there's no evidence or whatever, well, we put the evidence, 500 pages of evidence. And when we submitted, there were 20, a quarter of a million words of referencing. So that the references alone were 250,000 words. So that's how much evidence. And what was so beautiful was that all the leaders in the field of low-carb donated their time. They wrote their life history. This is what they've done. It's their life's work. And it's captured there. And it's an astonishing book. That is, it should be revolutionary. It will be revolutionary, no doubt."
"Okay, tell me some highlights from the book. Some of your..."
"Well, I think the main highlight is that we got all the best people in the world to write on every organ system in the body. Okay? So there was nothing that we left out. And you mentioned earlier that the neurological side, that's covered completely. The cardiovascular, the respiratory, the metabolic, the diabetes, obviously, is a big focus, but it's all there. So any specialist in any medical discipline has to read the book to get up to date on what nutritional advice he should be giving his, he or she should be giving his patients with all these variety of diseases. You know, there's a lovely, I realized the other day, I was tweeting, and the very first medical textbook was written by Sir, Sir William Osler. And what happened to Sir William Osler was that he was employed at the very famous hospital, John Hopkins Hospital, which is started by the nurses group in America. And he was told, you know, this hospital has to have 50% ladies and 50% men as the for doctor training because no women were being trained for medicine in those days, or if they were, they were very few. So John's Hopkins completely broke everything and said they had to be 50% women. Unfortunately, they'd invested their money in the railway stock, and the stock broke for whatever reason. So Sir William Osler couldn't teach for a year. So he sat at home and wrote a textbook. And it became the original text for clinicians. Incredible. But what was crucial was that he decided that he would look at the evidence of what medicine could do for patients. What did we know? And they knew nothing. So he came to the conclusion that medicine wasn't really helping people. They knew the diseases, but the treatments were ineffective, as you can imagine they would have been in the 1880s. And so he became a therapeutic nihilist. I.E., he was saying that there's nothing that's going to help. We've just produced the book that says there's no problem. We can solve all these problems just through diet. So it's the exact opposite of Sir William Osler's original medical textbook."
"That is absolutely incredible. The stark contrast from this like hopelessness, right? In that actually, what we're doing with medicine is not helping our patients and not improving any outcomes, to this revelation that such a simple intervention, and I shouldn't use the word simple, but I don't mean simple as in behaviorally implementing it, simple, but like there's something that we can do that can change the outcomes of every organ system in the body. I mean, that's phenomenal."
"So what is the main aim with this textbook? Like, what is, what do we need to do? Where does this need to be in the world?"
"Well, basically, every medical student needs to have that textbook on his, on his shelf and to be taught from it, or if not taught from it, but to read it. So that would be, obviously, the goal. But that's going to take a long time because we first have to get the students, or the, sorry, the teachers to accept this teaching and start teaching it. But that's the reason we wrote it. And the revolution in medicine. So when we wrote the book, The Real Meal Revolution, that was about changing individuals, their choices. Now, this is the Real Meal Revolution for doctors and how they can train, teach their patients, or treat their patients more effectively. So that's the goal. Every, everyone, medical student must know about the book and refer to it. And if they're not being taught that material, at least now they know where they can find it."
"Phenomenal. Can, can you name some of the experts who collaborated with you on this book?"
"Well, you mentioned some of them already. It literally is the, it is the, we've got the cascade of every single person who's of any influence in this field is there. Um, I, I don't want to go start because we're going to leave somebody out. But really, literally the best people in each discipline is there. I mean, I can go and collect the book and quickly read it out if you liked. So we didn't leave anyone out."
"Love that, actually. If you don't mind, I will do that. So just hold on a second. Thank you."
"Well, so here's the great book. Oh, it's beautiful. The cover reminds me of the Time magazine cover."
"Yes, that's right. It's beautiful."
"Okay. And it is 540 pages and it weighs quite a lot too. And it's one of the most expensive books that anyone will ever have."
"How much is it? And that's a complaint, but we didn't set the price. The price is set by the publishers. Okay. And so, but I did make the point that all the authors gave their time freely. That no one was paid. Yeah. We paid the editors, and there was a huge editing job. And the NO Foundation provided the funding for the editors. So that's, so that's a cost we incurred. And but that isn't built into the cost of the books that we had to incur ourselves. Yeah."
"Okay. So the first experts up are Katherine Crofts and Mickey Bendor. And Katherine is one of the world leaders on describing insulin resistance. She's from Oakland. And Mickey Bendor is a professor from Israel. Yeah. And he's the guy who's dug up all the bones of the elephants in the, in Israel, in those areas where where the Neanderthals were. And he worked out that humans started eating very fat animals like elephants and rhinoceroses and hippopotamuses. And there was a crucial adaptation we made. And then once we'd killed all those animals, we got into trouble. And that's when agriculture, we had to go and look for agriculture to provide carbohydrates to replace the protein and fat. But that's, so that's the evolutionary species-specific diet for humans. And I think it's a brilliant start to the book, explaining exactly why you need to eat this diet, because that's the diet we're, we're adapted to. The second chapter is on nutritional aspects, and it's Amber O'Hearn. Yeah, who's one of the world authorities on fasting and ketosis. And in my trial, I'm sure you'll remember if you were there on that date, I quoted her talks because the idiots we were debating with had not the first clue about ketosis, not the first clue. No. So here were these leading South African experts, medical experts, telling us that ketosis is going to kill you, and they didn't have a clue what the difference between nutritional ketosis and diabetic ketoacidosis."
"I remember Amber. I remember using a lot of her slides. And so that was amazing. Then Eric Westman, William Yancy, and Neville Wellington. Neville's the local doctor who's very involved in low-carb promotion and treating diabetes very successfully. But Westman and Yancy were of course the first to publish papers showing that this diet versus type 2 diabetes. So that's the second, and that's how we manage type 2 diabetes and other diseases. Then the third chapter is on the endocrine. And here we have a list of about 15 people who contributed. Robert Cyrs, Hasina Kaji from the Sports, sorry, from the Nutrition Network and the NO Foundation, Neville Wellington, the same, Mark Cucuzella, who is from, from, you know, very well indeed, West Virginia. And he, in fact, started the diet after coming to South, came to South Africa to run the Comrades Marathon. And we had a conference, he'd organized a conference, and I spoke. And then he decided he better check on his blood glucose levels and so on. And he discovered he was pre-diabetic, despite the fact that he could run a two and a half hour marathon at his age. You see, he was incredibly healthy and fit. So he converted. Then we have Karin Riley, Diana Isaacs, Nadia Patrone, yep, Ian Lake, Lori Raj from Cape Town, Shaun McKelvie, William Yancy again, Susan Wolever, Campbell Murdoch from Britain, Brian Lenzkes from the United States, Caroline Roberts, David Carvin, David Unwin, who's very well known as the, the next Nobel Prize winner, because he's the guy who used his own medical practice to reverse type two diabetes and now has reversed well over a hundred people in his practice. And he's just, you know, that's how easy it is. Then Eric Westman again, Miriam Berridge, Graham Phillips, Ali Al-Lawati, Nafisa Ishmael, Daniel Katumo, and Annie Sophie Brazu. So I don't know all of those people, but they personally, I don't know them, but they've all contributed in this area. And so they cover all the endocrine organs, diabetes, polycystic ovarian syndrome, body weight control, thyroids, insulin resistance, adrenals, and the hypothalamic-pituitary axis. Then the fourth chapter is cardiovascular disease and its association with insulin resistance and cholesterol. Yes. And the three authors are Nadir Ali, David Diamond, who's very well known for being the man who promotes the anti-statin story. Uh-huh. And Sarah Rice from Cape Town, who was a key editor in the whole book. Fantastic."
"Then in neurology, and now this addresses the pathology of neurological disorders. And we've got cerebrovascular disease and stroke, epilepsy, Alzheimer's disease, mood disorders, multiple sclerosis, Parkinson's disease, autism, migraine, amyotrophic lateral sclerosis, traumatic brain injury. So that gives you an idea of the extent to which we've covered neurological diseases in one book. And there's close to 100 pages on neurological diseases. And I mentioned that because a lot of people think that it's all type 2 diabetes and low-carb diets, and that's not the case. So the authors there are Michael Hoffmann, Robert Cyrs, who we've mentioned, and Chers, who is at your conference, our conference, yeah. Meredith Kof, Eric Kof, David Perlmutter, Matthew Phillips, Georgia Eades, also extremely well known in the field. Amy Berger again, Angela Stanton, who's very, very active in migraine research. Lori Routch from Cape Town, Julian Fenwick, Joshua Rossi, Eliza Marie Rossi, Elizabeth Gonzalez, and Fabian Rossi. So those are the people who have contributed to the neurology. And you can hear that we, some of those names will be very well known to you. Yeah."
"Then chapter six is on cancer. Oh, so imagine that. A whole, again, another, another 60 pages on cancer. And the authors are myself. I looked at the history of cancer and the fact that it's a modern disease. Didn't happen in people who ate at conventional diets. Miriam Camman, Thomas Seyfried, who's been leading the story about nutritional basis for cancer. Peter Attia, Dominic D'Agostino, also very well known. And we're currently involved with research with him."
"You are? Yes. On low-carb and performance. I must come back to that, please. Let's come back to that when we finished, because that's very exciting. And, uh, we pushed the boundaries a bit there. The next author is Gabriel Arish, Mandi Morello, Christos Chinopoulos, Martha Tettenborn, and Nasha Winters. So those are some of the world-leading researchers on this diet and cancer."
"Then musculoskeletal and immunological considerations. Well, there's our great friend Gary Fettke, who was also at our conference, you remember, from Tasmania. Bob Kaplan, Shawn Baker, who is this carnivore who is just in his 50s. He's, he's South African. Enormous, enormous physically and strong. But, you know, he's South African."
"No, I didn't know that. South African."
"Yeah. So, and Sarah Rice again, helped with the editing of that. So we've got musculoskeletal conditions, gout, aging, autoimmunity, and autoimmunity, comparing whether you should be eating a plant-based or animal-based nutrition. Well, then gastrointestinal health and therapeutic carbohydrate restriction. One of the great leaders in the field, Natasha Campbell-McBride. She didn't make our conference, but she's written widely on the topic. Sarah Rice helps again, and Tamson Murphy, who's one of the leading dieticians with whom we work with at the NO Foundation and the Nutrition Network. So the topics are the human digestive system and health and disease, diet and gastrointestinal diseases, and the microbiome. There's a whole section on the microbiome."
"Wow."
"So the next chapter is on exercise and sports performance. And Karen Zin, who was one of my expert witnesses, has been the person largely in charge of that. I contributed, as did Cliff Harvey, James Smith, and Christopher Webster from Cape Town, and Katherine Sans. So we look at the evidence that the low-carbohydrate diet is effective for human performance. And what I'll quickly then add, what are we doing overseas with a chap called Philip Prince, who's also South African? Okay. Who, who got a scholarship to study in America playing tennis and decided to stay. And because he trained by my book when he was in Cape Town, he, after the trial, it ended, he spoke to me. I was at a conference, I think, in Ohio State. And he said, we really must do some research together because they've got a great lab and so on. And so we asked the question, okay, so he said, what question do you want to answer? I said, well, we've got to see whether on a low-carbohydrate diet, you can exercise reasonably well. Yeah. So I said, well, why don't we do a 5-kilometer time trial on the treadmill? And so he took 10 athletes. They, half of them would eat the low-carb diet, and then they'd go onto the high-carb diet. The other group would start on the high-carb diet, then go on the low-carb diet. So they did this. And after six weeks on the diet, they converted and so on. And there was no difference in performance. So that was great. Both ways. Yeah. It made no difference. And in fact, I believe that nutrition has nothing to do with exercise performance now. But, okay, wait. Oh, okay. I need to get back to that as well. Okay. So, so the next thing he said, I said, well, okay, okay, well, you know, we've got to make it higher intensity exercise. We've got to get them to do a mile repetition mile. So then they did the same type of trial. And they finished the performance trial was a one-mile performance trial. And again, there was no difference in performance. So I said, the problem is, the people who don't like us will say, yes, but you see, it's because they had enough carbohydrate on board. Yes, because a mile is too short. Yeah. So I said, what we have to do is deplete them from from muscle carbohydrate or glycogen. Have them repeat six times 800 meters because we know that that will deplete their muscle glycogen. And if it's the model's true, then by the fifth or the sixth interval, they'll be falling on the treadmill and not able to continue, you see. So there was the theory. And of course, nothing happened. No difference in performance. But, but what he did do, and I didn't tell him to do this, they measured the metabolism while the people were doing their high-intensity exercise. Now, the textbooks say that once you go above 85% of your maximum, you burn zero grams of carbohydrate. Zero grams. That's what the textbook says. And all the authorities. It's like the world is round, not flat. It's the same. You burn zero carbohydrates, fat, sorry, zero fat. So it turns out that we had our people not exercising at 85%, but at 86%. So they were just above the cut-off point. And they had the highest rates of fat oxidation ever measured in humans anywhere in history. This means that the VO2 max tests that they put the athletes through to tell them whether they're fat burners or carb burners is not right. Now, what they do is they actually, they do test them at quite high intensities. But then if you're carb adapted, you won't burn fat during the VO2 max test. You stop burning fat quite high, at quite a high intensity. But we showed that the only way you can test for real fat oxidation is you've got to do intervals in people who are carbohydrate depleted. That's the key. Because once you're carbohydrate depleted, then you will burn fat at high rates. Wow. Now, the interesting point is that the rates of fat oxidation with two grams per minute, which turns out to be 76 kilojoules per minute. Now, the world's greatest runner and ultra-marathon distance, Eliud Kipchoge, weighs 52 kilograms. He runs at 21 kilometers an hour. And at that speed, he's burning 76 kilojoules per minute, which means that he could burn every single kilojoule could come from fat. Which is totally the difference to. But it's because the world will tell you, oh, but the Kenyan marathon runners, they just burn, they only eat carbs, which they do. Yes. Or we could hear the Tour de France, which is currently showing, so that these guys need the carbs because when they're exercising at high intensity, they're burning carbs. So, so we've really disproved that. You've just turned it on its head again. Yeah. Another thing. Now, so we've now, we've now in the middle, or so, just about to start the definitive tests to see whether we're right or whether we're wrong. So currently, I'm working on a long review article. Okay. I decided I better look at every single study that's ever been of carb ingestion and exercise performance. Only you propose, okay? Yeah. And the point is, we, the carb ingestion story is solved in 1939, completely solved. Okay. How? But it's written in German, so no one reads it. And what happens next is that the industry comes along, of course, as you know. Yeah. And they fund scientists, including myself, yeah, who are biased towards carbs. And so we start finding that carbs are essential, blah, blah. But then not only are they essential, but the more you take, the better. Yeah. And without any evidence, they changed the idea that the theory of how carbs work is changed. And it's changed to make sure that they, we, including myself, tell the athletes, you must take as much carbs as you possibly can. But there's no evidence to support that because no one tries to disprove it. And what we've done is we've started the disproof. But now we've got the final disproof. Because if you watch the Tour de France, for example, you will hear every second, oh, the people have got to take their carbs. And I know, I don't want to date this interview, but yesterday, one guy had a terrible day. Yeah. And he says, oh, it was because I didn't get my, the food wasn't getting to my muscles, which has got nothing to do with it. He was exhausted. And he was exhausted for all sorts of other reasons. But, you see, but they reduced it to, it's all the carbs in the muscles and how much carbs you can burn during exercise that determines whether you perform well or not. And everything else is the, it's brainless. You, you cut off the brain. Yeah. Yeah. But, but we're pretty sure that's not the case. And instead of pushing high carbs, we're trying to find the minutest amount of carbs that you need to improve your performance. And once we prove that, we'll know the mechanism. And we're pretty sure we know what the mechanism is. And then we can tell athletes what they should properly be eating during, before, and during competition."
"So how far is that from being completed? Sorry to interrupt."
"Well, the study will be done by December. That's when it'll be done. And so we'll write it up by March, April next year. But the study, the review I'm working on, I hope to finish in about a month's time. And it'll be published by the end of the year. And that, that gives all the evidence why we were completely wrong and how we misinterpreted the evidence."
"I love that you do that, Professor. I love that you go back and you look through absolutely every single thing to find where we went wrong. And so always pointing to science and history to really identify exactly what it is and where it went wrong and how to fix it. I love that. Thank you."
"So, you know, I, I'm always looking for conspiracy theories. And, but, you know, one of the first political things that ever happened in my life was John Kennedy was assassinated. I mean, I remember it. I was, it was 1963. So I was 13 years old. And I can remember we, we were asleep because we're obviously South Africa is behind, sorry, ahead of American time. And I can remember someone coming into the dormitory and saying, President Kennedy's just been shot and killed in Dallas on that particular November the 22nd, 1963. So I've always been interested in what happened. And I've just read a book in which the guy finally puts the whole story together. But the point is, he says, every little fact matters. And in the dis, in the analysis of what happened, they just ignored key evidence. It was just ignored for obvious reasons, because there were political reasons why they didn't want to expose what happened. But he said, every little fact counts. And I've spent 40 years. The first article I ever written on carbs and exercise was in the New England Journal of Medicine. It was a letter in 1983. So that's 40 years ago. So, so I don't think anyone in the world has been studying carbs and exercise for as long as I have. And I've only now found, sort of, finally getting the answers to understand the whole story."
"Wow, Professor. That's incredible. But again, the point was that I had to spend the last year looking for that, the tiny little facts that make the difference. And I want to also, okay, let's finish with the book. But I also want to ask you about this German study, the 1939 one, when you're..."
"Let's finish with the book. Okay. So then chapter 10 is therapeutic fasting. And there we have Jason Fung, our great friend. Yes. And he's just such a strong. And of course, going back to our conference, you remember that we asked him at the last minute, Professor. I remember so clearly. You said to me, there is a superstar in the low-carb fasting space. He's in Canada. His name is Jason Fung. He's like a little piece of dynamite. We need to get him to the conference. You spotted him before anybody really knew who he was. Yeah. And he acknowledges that because he said his career took off from that moment. So we helped build his career. Great. So he's the main author of that chapter, therapeutic fasting. And then we have managing the patient, psychological, behavioral, and ethical considerations. And that's would be some of your friends, Jen Unwin, Trudy Deacon, Jan Ifland, and Mark Friedman, together with Joan Adams, who was the lady who was in charge of my trial. That woman. So she even gets a starring role in the book. Yes. So that's the extent of the book. It's, you can see we've had amazing contributions from so many people."
"Professor, that is absolutely incredible. Congratulations on putting that together. I mean, those names are stellar names in the space. But not only are they incredible names in the space, they are genuinely phenomenal humans with hearts who are who treat patients right in an ethical, wonderful manner, where they are looking at reversing chronic disease essentially through diet and exercise, and not the over-prescription of medication, which is something that is rife in society, especially in the United States, where I'm living now."
"So I hope that we get the textbook into the medical schools."
"Yeah, sorry, yeah."
"So, you know, what strikes me about, and I know you'll agree with this, but these people are special because they all, we've all been through this story of being sick and then finding the solution. That's what really binds us more than anything."
"Personal experience. A life moment in your own journey of health, and then translating it in how you treat your patients. So that's, that's very important. And then because I think all of us have been criticized and sidelined and canceled, every single one in that, in that book. Yep. And that's why they're so keen to give their information and their knowledge."
"I love that. So where's the book available to purchase?"
"Yeah, it is, it's on Amazon now. So it's published by Academic Press. So let's say it again, it's Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health. And it is very expensive. It's like a hundred odd dollars. But then it's a textbook. And textbooks are expensive. I mean, it was, it wasn't written for, you know, the layperson. And hopefully, we'll be able to take some of this material and produce a, a sort of layperson's book using the same material."
"Earlier, though, that The Real Meal Revolution was written for the individual, right? So you have, in a way, already produced that book. And here's the book for medical professionals who treat patients. And so I'm excited to see the next book because if there's one thing you are phenomenal at, it's writing. I mean, many, but your books are so engaging and so cool to read. So I am very excited to see what's coming. But I want us to circle back on this, and I don't know if these two things are related. You mentioned nutrition has nothing to do with exercise performance, and you also mentioned that you're working with D'Agostino to research low-carb performance."
"Yeah. So Dom is part of the team. There's a team of us, including Jeff Volek, because Philip Prince, who started it, he works at Grove City College in Pennsylvania. And he, firstly, the team is unbelievable because they produce, they do research immaculately. That's the key. And this, you have to, for example, you have to get people who are prepared to change their diet and be meticulous in their diet for at least six weeks. And we found that they were meticulous because we monitored them on a daily basis, measuring their glucoses and their ketones. So we could see that they, with CGM, which I'll just add something on that, the CGMs were added at the last minute, and we managed to get them donated. And we found, believe it or not, now these are athletes. They're not the world's greatest athletes, but they're middle-aged, up to say 40, from 25 to 40. They're all lean, and they're all training. And 10% of them, sorry, 30%, three of the 10 were pre-diabetic on the high-carb diet. They had no clue. When they went on the high-fat diet, disappeared completely, normalized. So that proves to us that it's the carbs. It's not the lack of exercise, it's not an obesity, because all that changed in the trial was they cut the carb content, they didn't cut the calories, and they didn't do more exercise or or lose weight. So the only thing that changed was their carb, and probably you could say processed food intake. Yeah. And their diabetes completely disappeared. And we've also got a link to their metabolism because those who burnt the most fat, remember we said three grams per minute, they were the ones who had the best glucose control and benefited the most. So many of those were the ones who were pre-diabetic, who scored these very high fat oxidation rates. So there's something going on there as well. So that's where Dom fits in to those studies. And we, so those are the studies we're doing at the moment. And as I said, we'll have some results by the end of the year."
"That's incredibly exciting. Okay, let's get back to that other great statement she made, which is nutrition has nothing to do with exercise performance."
"Okay. So, so the problem arises. So I told you the 1939, yes, three guys, Bögh-Sørensen, Christensen, and Hansen. They're from, they're in Stockholm. Okay. And Bögh is the main, he's the main researcher, but he's also the main subject. So he gets on the bicycle and pedals for as long as he can. Okay. And what can they measure? They can measure blood glucose. So they measure blood glucose, and they can measure oxygen as well. So his glucose goes like this, and then it drops, and he becomes exhausted, and he can't do anything. And they gave him some glucose, and of course, within five minutes, he's starting to feel better. And in 20 minutes, he says, fine, I can go on forever. And he goes on forever, you see. So, so they show that as his blood glucose falls, he starts to feel tired and weak. And they reverse that, and he's fine. But they also showed another thing, which has been forgotten. They show, they confirmed, or as best they could, that that glucose, all it was doing was raising the blood glucose. It wasn't being used by the muscles to any great extent. Any, it wasn't increasing muscle glucose use. So that's the story. So they write that in German. And six months ago, two of my great friends, one of my very, very best friends who was at medical school with me, he speaks German, his wife speaks German. I said, you must please translate these two articles for me. And they do. And there it is. All it is, they said, okay, what happens as you exercise? Your glucose falls. And you must take the glucose. And then that, the brain's slowing you down because you can't, you can't continue, or you'll damage your brain. There's too little glucose for the brain. So it stops. And you reverse that. So they said it's a central brain mechanism that stops you. And when you reverse it, they can carry on. And that's now the theory. So this is established 1939. Okay. Then we have the war. Okay. And there are no studies in physiology. Kind of dies. Exercise physiology dies. And then it starts to reemerge in the 1980s. Okay. At the same time that the sports drink industry is just emerging. And so who funds the next group of studies? The sports drink industry and the people making carbohydrate supplements. So, but before that, one other big thing happens in 1937, sorry, 1967. This is two years before I go to medical school. Yeah. A group of Scandinavians developed a biopsy technique where you stick a needle into the muscle. Yeah. And you cut out a bit of muscle and you pull it out. And they measure glycogen, the carbohydrate in it. That's what they start measuring. And then all of a sudden, that's everything. Everything can be explained by glycogen in the muscles. So that, so then that's where we came in. That's where I come in. And we buy our biopsy needles and we start promoting this idea that you've got to stock lots of glycogen in the muscles for exercise. And so that's why I go on this thing, this wrong track with the rest of the world. Yeah. So, so, so a year and a half ago, I look at my, the slides I've been projecting for 40 years. And I notice in that original study from these Scandinavians, I notice a problem. That although they show your muscle glycogen goes down, at the same time, they show your blood glucose goes down. And so when you're exhausted, the blood glucose is extremely low. And they said, oh, we can ignore the glucose, it's all muscle glycogen. But you can't do that because the whole theory up to that point was it's the blood glucose that's important. Yeah. So that's what made me start questioning what was happening. Was the blood glucose the real regulator, or was it the muscle glycogen? Okay. And that's why we started testing these different trials to see if you start exercise with low muscle glycogen, can you perform well? And we said, yes, you can. So therefore, the idea that you have to have muscle glycogen is false. And so, so that's the basic point. At this point, we will show it, I hope, in these trials that as long as you keep your glucose normal, carbohydrates are irrelevant. You can burn fat, you can burn fat or carbohydrates, doesn't matter. But you can't allow the glucose to fall because that's when you're in trouble. So how do you, so that's what we're testing at the moment. Got it. And we're doing it, we're doing it in a way that we're going to get the answer from this one experiment. These experiments are going to give us the answer. I have no doubt you're going to get the answer, Professor."
"Professor, if nutrition has nothing to do with exercise performance, what is the biggest driver of optimal, of of of high performance?"
"Sorry, I should say macronutrients. In other words, the carbs, the fats, macro. That's what I meant. So it doesn't, if you live on a high-fat diet or you live on a high-carbohydrate diet, your performance is going to be the same. Got it. It's not going to be different. Okay. And that's obviously, you have to have the right nutrition. Okay, which, you know, you can't be vitamin B12 or iron deficient. That's obviously. So you obviously need the optimum nutrition. But I'm not sure we really fully understand what is optimal nutrition. Before it was, you know, have lots of vegetables and lots of carbohydrates and grains. And that's not right. So I'm still not sure that we know the full answer because we have, we have people doing extremely well on meat-only diets. We have people doing very well on mixed diets. We have people doing very, some people doing quite well on vegetarian diets, not that I'm suggesting that's the ideal. But there's such a range of different diets that people do perform on on everything."
"So what is, I mean, you've debunked so many myths and addressed so many misconceptions in the space when it comes to nutrition and performance. Um, where are we headed next? Like, what's, what's the next? Because you're such a visionary in understanding where the research needs to go and what we need to focus on. Like, what's next? Like, you've done so much to change perceptions and beliefs and challenge them. What's next?"
"Well, we have to get back, as you know, to eating the diet that for which humans are evolved. And we've got to take out the sugar and the carbs from our children. That's where the problem starts. I mean, as you know, and that's a great challenge. And the only solution, really, is that we've got to teach people that you're responsible for your own health. And nutrition is number one, and exercise is number two, and sleep, etcetera. So, so I live the life thinking exercise was number one, and I proved that's not the case. But exercise is terribly, terribly important. But you can exercise all you like if you're on the wrong diet, you, you're not going to, it's not going to help. So the nutrition is so disturbed because of industrial influence on our nutrition. And then we have the medical profession is completely controlled by the pharmaceutical industry and the food industry, as we exposed in my trial. Yeah. That's, we have to reverse that. And so people have to learn that. And then we have all these vaccines as well. And I mean, you come from your, you know, all about that in your, in the United States. And people now think, well, you, to make children healthy, you vaccinate them. I mean, that's, and that's the worst unhealthy."
"That's right. So it starts from the mother's pregnancy. She's got to eat properly, as you know. That's the beginning. And then you've got to win the child onto proper foods and get rid of all the junk, ultra-processed foods. So it's a, it's a massive challenge. And it, I don't know where it begins. I'm very hopeful Robert Kennedy wins the election, the presidential election. That is a question I have for you."
"Okay. Because he's promised to change the nutrition. And he looks fantastic. You know, he's, he's very masculine. He's so masculine, people say he's taking steroids. So he admitted he does replace testosterone. But that's not the same as taking steroids. I feel at the age that he's at, like that's completely normal and probably should be addressed in so many men, especially American men. And I think this is a whole different talk that we don't need to get into right now. But I am very hopeful that Robert Kennedy gets into some kind of leadership position because everything I've heard him say is absolutely beautiful. And do you know that he's sober? He's in recovery as well."
"Yes, I heard that. I didn't realize that. Yes. So he admitted."
I think I don't know where he said it, but I sort of picked it up only the last week or two. Yeah. And I, because he spoke to some, he spoke to an addict in some way and said, you know, we share commonalities. Maybe Russell Brand, because he's, you know. Oh, that's exactly right. Yes, it was him. Yeah, yeah.
So, you know, to me, anyone who is in recovery from any addiction or alcoholism or whatever is immediately a phenomenal person because the behavior change that needs to happen, emotionally, mentally, the physical change that needs to happen is immense. And it, it takes a lot of training and practice. But I know we're almost at the end. Um, I do. Is there anything we didn't cover that you want to mention? Um, or, you know, I just think that, you know, people, you've got to get rid of the medical profession. You can't rely on the profession, as you know, to make you healthy. Once you get to the doctors, you're in real trouble. So, yeah, you've got to do it by yourself and experiment and find out what works for you. So even then, even we may have the, some of the rules, we don't have all the rules for the individual, and some of the things we say would be wrong for, for certain individuals.
I, I'm so glad to be my age. I'm 74 and a few weeks, and to, to look around and to see the people haven't looked after their health at my age, and they have certain characteristics. They've lost all their muscle. They've got no more muscle, and they, they curve forward, and they're in this position. And once you see that, I call that the Dead Man's Curve. So, you know, you gotta, you've got to get rid of that Dead Man's Curve. And so I do that with, with lots of gym work and CrossFit.
Thank you. Sorry. No, I must tell you, of course. So when you invited me to the CrossFit conference, yes, in Madison, Wisconsin, and you told me I had to go to the gym the next morning, and we went, and then, and then I couldn't walk for a week. So, and then when I came back to Cape Town, you put me in touch with Tyron. Yeah. And we have just had this amazing relationship, and we've had such a good time that he's now training both my daughter Candice and our granddaughter Anabelle. Yeah. So, so that's all your fault. Oh, I will take full credit. Thank you. Yeah.
So, but I, I can tell you that it's been miraculous for me because I think, you know, what, what I, sorry, what I did learn, and people have confirmed this to me, that there's an age at which running no longer gives you the benefits it did when you were young. Okay? So aerobic exercise gives you lots of advantages when you're young, but once you turn about 60, I don't think the benefits are the same. If you need, now you need to convert to something like CrossFit, where you do a completely different high-intensity, short-duration exercise. Yeah. Rather than this long, hung-out aerobic exercise. Yeah. I'm not suggesting some aerobic exercise are not good at our age, but it's much more important to do the heavy weight, the weight training, and the gymnastics as part of CrossFit. So I've just benefited so immensely from your, from your help. It's been amazing. I, I look forward to every session. I did one this morning. I was finished at the end, couldn't stand up, but at least I don't get stiff and can't walk for a week. I love.
Okay, wait. What's your favorite CrossFit movement? Well, I know it's the CrossFit draws from very wall balls. You love. I got them. I used to. The things that I used to hate were burpees and wall balls. Okay. And now I love them. I'm not burpee so much, but wall balls, I've really got the technique, and so I love that. I love that so much. I think, I mean, for me as well, I don't like burpees. Being tall, you and I are both. Burpees are not that easy, right? Um, but wall balls, being tall is a definite advantage getting that ball over that line. Oh, well, prop. This conversation has made my heart so happy. I am honestly, you have been the greatest mentor in my life. There is no one person who has had a bigger impact on my professional career and trajectory. And you know, when I look at like everything that we did together, and how this conference that I'm organizing is almost coming full circle for me in reestablishing myself on focusing what is so important to me, which is health and helping individuals find what works for them, which is what you were saying as well. I cannot thank you enough for the grace, the beauty, the information, and everything that you have imparted on me. So thank you so much. Bra, for the profound role you've played in my life.
Well, that's really kind of you. It's really, I, I really appreciate that very much. But we must remember how we met and why we met, and that I must, that you carry the genes that influenced my life even before you were born.