Transcription
Aloha everybody. We are here with my favorite keto doctor in the world. I don't know if you really want to call it keto. He's like the best doctor I know, and I've got to meet some of your patients, and it's really cool to hear them just preach how amazing of a doctor you are. So, welcome today.
Thanks. Yeah, thanks for having me. Great to talk to you guys.
Thank you very much. Thanks for being with us, Ted. Uh, you know, you're, I think the first time I met you was in, uh, Low Carb Seattle. Uh, and I saw your, I think it was the first time I saw a presentation by you as well. And one of the things that really, I don't know if this is the engineering background that I have and you have too, but the way you put things in your presentation about energy metabolism, just like it was kind of an aha moment for me. Like, yeah, it's really kind of simple, you know, when you look at how pr, you know, your body processes these fuels. It's like sun and plants, and then it's basically electrons coming into your body. And I, that really struck me. And, uh, can you, let's, uh, one of the first things I want to start talking about is, uh, energy metabolism in general because I think there's a lot of, uh, misunderstanding out there about, uh, fat and how it's processed and what happens to fat when you eat it. Right? Right. Kind of a, you know, important thing when it comes to like ketogenic lifestyles and stuff because that's kind of the one thing that there's some disagreement on and whatnot. So, but we get so many, uh, people coming to us and say, I worked with a keto coach that told me, oh, you're not losing weight, add some more fat, 10 tablespoons of oil. And, yeah, why don't you tell us what really happens to it?
Got it. Okay. All right. Sure. Yeah, absolutely. So, fat, when you eat fat, it's basically broken down in your intestines and absorbed and goes into these chylomicrons. And it ends up going pretty much directly to your fat cells. So, every time you eat fat, it, it, it's a very slow process. It has to basically slowly absorb through the wall of your small intestine, get packaged into chylomicrons. It gets dumped out into your lymphatic duct, your, in your lymphatics, I mean, your thoracic duct in your lymphatics. It ends up going to the liver and getting repackaged. It ends up in your fat cells finally, like 12 hours later. It's very slow, it's very passive. It doesn't change your body's metabolism or your insulin levels much at all. And it's kind of just passively happening in the background. But basically, almost every bit of fat you eat is just immediately passively stored in your fat cells to be released later as free fatty acids. So, free fatty acids, non-esterified fatty acids, one of the major fuels in your bloodstream is only released from your adipocytes. So, like, basically, you eat the fat, it's immediately stored in your fat cells, and then it's slowly released later as these non-esterified fatty acids bound to albumin. And that's how you run your body off of these fats. But they're only released from your adipocytes. So, so basically, every bit of fat you eat gets stored in your fat cells, like pretty much immediately passively. It does. And it take, it's such a slow process that you don't really feel it. Like, it's not giving you a ton of immediate satiety. It's not improving your performance. It's sort of background, it's sort of passive. And statistically speaking, about 99% of all the fat in your fat cells came from dietary fat. Basically, you eat fat, gets stored as fat, which you're releasing later. And so eating refined fat is, refined fat has horrible satiety per calorie. It's tons of calories with very little satiety. And you can literally, we have studies in every animal on the planet. If you add refined fat to their diet, they will just slowly passively immediately get fatter. We have studies in humans, monkeys, pigs, rats, mice. You pour oil on their feed and just adding a refined fat that adds calories and the satiety, and they will immediately passively get fatter. This is literally how we create obesity in rats and mice for research in rodent models. You add refined fats and omnivore mammals just get fatter. And that's how it works. It's basically eating fat makes you fat. Like, I, I hate to say it like that, but these refined fats are terrible. Versatility. Two important points you, you touched on there. And that is, there's a lot of belief too that, you know, the fat you're, when you're obese, a lot in eating a high carb diet, a lot of that came from carbohydrates. But that's not the case, right? Because mostly it's carbohydrates displacing fat oxidation and allowing all that dietary fat to be stored, right?
Exactly. Right, right. So, carbs and fats have two totally different storage compartments. You know, fat is not water-soluble and is only stored basically in your fat cells. And then carbs are water-soluble and have to be stored as glycogen in your liver, your muscles. And when you eat carbs, like if carb, if you're not eating any carbs, you're burning pretty much all fat, mostly fat. As soon as you eat carbohydrate, you're just smoothly displacing fat oxidation with carbohydrate oxidation, isocalorically. And then when the carbs are all gone, you smoothly go back to burning fat. It's really like just this sort of smooth gradient where you're eating more carbs, you're burning more carbs and less fat. Eating less carbs, you're burning more fat again. And that's just how the system works. So, the problem with refined carbs is they have horrible satiety per calorie. And so if you eat a bunch of refined carbs, you're starving three hours later. You didn't get protein, you didn't get minerals, you didn't get all these things you need. And they have a really high caloric density. So, like your breakfast cereal, um, you know, very little weight and volume, huge caloric density, very little protein or minerals or satiety. It's just a tidy for calories, terrible. Um, your blood sugar goes way up, three hours later goes way down, you're hypoglycemic, you're starving, you're eating more. But refined fat is really not much better. Now, the thing that's better about refined fat is you won't get the glycemic excursion and then the fall that makes you feel hypoglycemic three hours later. So, you're just kind of like this, but you're just passively getting fatter. And you got no satiety at all. So, refined carbs are really terrible first time calorie, but refined fat is pretty bad too. You're not gonna get as much hypoglycemia three or four hours later. Um, and you're not gonna change your whole body metabolism from this carb or fat thing, but it's really bad for satiety for calories. So, you really don't want to eat much fat. Sorry.
Once again. Oh, sorry. My theory. I'm serious. Interrupting. Like, we always tell people, chew your calories. It's, you know, like, get the fat in the steak. But for me, I prefer a filet mignon anyway, any day. But you don't need to add all of this, add a stick of butter to the steak. Yeah. And to us, we're like, or MCT oil. Or MCT. Oh, do a shot of MCT oil. I don't have the chart, but I'll put it in this notes below. Uh, if you, I compared the nutrients in MCT oil to sugar. Sugar, sugar, sugar has more. Yeah. It's, they're basically, you know, both terrible. Yeah. Refined fat is garbage for satiety per calorie. Like, you literally want to avoid it. It's, I mean, I'm right there with you guys. And, and thank you for bringing this up because it's something that's just killing the whole keto, like, you know, the, the word keto is, is already going down in Google search trends. Like, it's going to be dead in a couple years. I hate to say it.
Well, I totally agree with you. Like, that's why I said, we want you to be like the keto doctor, but really, I mean, we just want you to be like the nutrition doctor, whatever. Because I don't really like that word that much anymore anyway. But I first mentioned that it does have that name. But I first met you on the low carb cruise. And at that time, this was, this was like when we first had kids, maybe nine years ago or so. Um, I would do these pure protein days and like, you know, refer people to do these pure protein days. And on that cruise, people are like, no, no, no, Maria, too much protein turns into sugar. And I was like, oh, really? You know, like these doctors and like very influential keto people told me this. I was like, oh, okay. So I went home and I'm like, Craig, you know, people are telling me on the cruise that we can't do this pure protein day, we need to add a bunch of fat. And so we're like, okay, let's try it. And guess what? We just got fatter. Yeah. Right. And I know, you were talking about that too, for a hot minute. You kind of were like, oh, I guess you're right. Yeah. Try that. And, yeah. Oh, yeah. I was there too. I was like, okay, I'll just eat macadamia nuts and bacon and butter. Oh, I was totally doing that like five years ago. I didn't know. I was like, oh, I heard too much protein was bad. But, you know, after researching it, I realized it's just kind of not true. And, uh, it's really more about satiety per calorie. And I think that's what, you know, people need to spend more time looking at. And that's the really important thing is satiety per calorie. Because a lot of people will say, well, I eat fat and I stay full a long time. Right? Because you just ate too much. Yeah. I drink a bulletproof coffee with four or 500 calories and I'm, I'm, I'm full until dinner time. Well, guess what? If you ate seven eggs instead, it would be hard to eat them. You probably won't even be hungry at dinnertime. Exactly. More nutrients in it, right? Right. People just don't know exactly what they're eating. They're like, well, if I eat all this butter, I'm super not hungry. That's tons of satiety. So what are you talking about? Well, yeah, but you just need a billion trillion calories and you have no idea. And that's exactly right. Like, people don't actually know what they're eating. And so I, like, you know, it gives me a lot of satiety eating an entire pizza. But that's like 20,000 calories. And so like the satin for calorie is terrible. So it's all about, like you said, per calorie. Exactly.
One question I get all the time, I know you probably get it too, is like, what about the kidneys? Because, you know, we're told too much protein is very bad for the kidneys. What's your response to that?
Right. I mean, this is basically completely not evidence-based. The problem is, when you have kidney damage, you spill protein in your urine. And so doctors will use the amount of protein in your urine to see how bad your kidney damage is. And then also, if you eat a lot of protein, you can have more protein in your urine, even though it's not harming your kidneys. So, somehow doctors got to this point where we're like, uh, protein gives you protein in your urine, kidney damage gives you protein in your urine, protein gives you kidney damage. Yeah. It's just like, but it's completely fraudulently wrong. Now, we have a meta-analysis that shows that higher protein diets are actually protective against kidney damage. They're awesome for your kidneys. If you eat tons of protein, your kidney literally gets larger and stronger, and your glomerular filtration rate goes up. It's like a bodybuilder doing curls all day long. It's like your bicep gets bigger. So your kidneys like actually more bulletproof on higher.
That's a very good point. Because a lot of people when they start this way and start to prioritize protein, they will see their GFR go up, right? And some doctors will say, oh, you're getting fatty liver, sorry, getting kidney damage, your kidneys aren't liking this lifestyle. But you're saying, no, it's getting stronger and that's why it's going up, right?
Right, right. And yes, and blood urea nitrogen will always go up in higher protein diets, but it's not harming you at all. And so some doctors are like, that could be bad. But yeah, it's just completely not evidence-based. So, and there is no evidence that high protein diets harm your kidneys at all. And then to take it one step further, like most nephrologists will recommend some amount of protein restriction for people who have known existing kidney damage. And even that's not evidence-based. So, the vast majority of people with bad kidneys don't benefit from protein restriction. We have these, um, huge meta-analyses on protein restriction in the setting of chronic kidney disease. And like, only, you know, 5% of chronic kidney disease, if you have this rare primary glomerulonephritis, like a primary glomerular disease, which is super rare, um, protein restriction maybe helps it a little bit, but only in men and not in women. And it was like 1%. And the studies that showed this were deeply flawed. And then we have just a mountain of other evidence in people who have the more common kinds of kidney failure, diabetes, and high blood pressure. None of these people have ever been shown to benefit from protein restriction at all. So, like, if you have diabetes in diabetic nephropathy and your kidney function decreases, you actually don't benefit from protein restriction. And doctors are still recommending protein restriction even though it's not evidence-based. So, this is definitely a huge problem.
Yeah, absolutely. On that front, uh, the next question, a lot of people get then is, okay, what about mTOR and aging, right? So, you eat a lot of protein, you trigger a lot of mTOR, and mTOR has some weak associations with aging. So, can you talk a little bit about that?
Right, right. So, the thing that triggers mTOR the most is being over fat and have chronically high insulin levels. You know what I'm saying? So, if I eat, let's say, I eat, uh, twice as much protein as I did before, and I'm way thinner, I'm actually going to get less area under the curve mTOR stimulation because I'm leaner. All the fuels in my bloodstream are always lower 24 hours a day. By fasting insulin's way lower, my, like, you know, I have patients who are bodybuilders, they're fasting insulin levels of one, their triglycerides are a 30, their A1C is a 4.0. Like, the fuels in their bloodstream are so low, their mTOR signaling is low. But they're eating, you know, 200 grams of protein a day instead of 100 grams of protein a day. Well, who cares? Someone over here eating 100 grams of protein a day could be, you know, 100 pounds overweight, and they're fasting insulin's 50, and their blood sugar is too high, and their triglycerides are, you know, 300, and they're just basically a wash with energy toxicity. Insulin is chronically one or two orders of magnitude higher. And it's because they're eating less protein, they have less satiety per calorie, and they're constantly overeating calories, and they're just fatter 24/7/365 with more fuels in their bloodstream. So, like, that, the whole idea doesn't even make sense. If you can eat a little bit more protein and be thinner, your mTOR signaling is actually much, much lower than someone who's like worried about how much protein they're eating. So, it's completely mind-blowingly ridiculous.
Well, that's the thing. I was supposed to, I did write recipes for Dr. Rosedale for this book, I think it was maybe nine years ago. It never happened. Um, but he wanted me to keep the recipes below 20 grams of protein per meal, per meal. And it was very difficult. It was, I mean, eggs, it was hard to get. You know, it was a really fatty protein. And, uh, I just don't know if he really ever ended up believing in it because the book never happened. The recipes are sitting there. But yeah.
Right. Well, I mean, I love Dr. Rosedale. He's an awesome guy. I've met him. Right? He's cool. I, you know, he's a super smart guy and he's really cool. But I don't think we see eye to eye on the protein issue. And, you know, so, yeah. I hear you say he's little, he's like me. He was like my size.
So, uh, one thing I wanted to touch on before we completely move off of it is back to the, you know, the dietary fat. Um, so a lot of people say, well, there's other things that can happen in the body, or, you know, the fat can go right through you, or, you know, possibly some other things that are happening to the fat, like cellular wall building. All the stuff. I mean, what kind of percentages are you talking about for those kind of uses of fat?
Well, okay. So, like, I have this crazy study from 50 years ago or something where people basically drank like 10,000 calories of corn oil every day, and they measured their stool to see what their absorption of the fat was. And it was, it always remained at like a high 90%, you know, 98% absorbed or something. So, you, you really are absorbing the fat that you eat most of the time. And it really does end up in your fat cells. There's basically no other place it can go because it's not water-soluble. So, I'm not sure what people, yeah, a lot of people have magical beliefs about metabolism if they don't understand it well enough. Yeah. And the reality is, your body is just a machine. It's literally just a mechanical machine. When you, when you put fat in your body, it physically has to go someplace. And that's in your fat cells because that's the only non-water-soluble storage compartment. Better hope it goes to your fat cells, right? Because otherwise, it's going to build up. If they're full, it just circulates in your bloodstream. And that's why your triglycerides are 500. You know?
But this is what's frustrating is, uh, at KetoCon, the last time we had KetoCon, uh, we walked into the building and this one, you know, keto doctor came up to me like, Marie, I got to tell you about my experiment. He's like, I just drank the shake, and it was butter, MCT oil, coconut oil, it was all pure fat. And my insulin didn't go up at all. And then the next day, I had a plate of eggs, bacon, and my insulin went up so many points. And I was like, dude, I have to get the stage. I don't even have enough time to tell you what's wrong with that picture.
Right. Tell us what's wrong with that picture. And I think a good point here too, is recently, uh, the Hall came out with, uh, another kind of this, you know, insulin carbohydrate model. And that kind of thinking. And I think that relates to it a lot. Is that we, they're in this community, there's such an irrational fear of insulin spiking at all. And, and the thought that if insulin rises, I'm storing fat. But you can't store what you don't eat, right? Like if there's no fat there to store it for, insulin goes up a little bit, right? Nothing.
Exactly. Right. Mechanically, all these carbon atoms have to go somewhere. When you eat fat, the carbons literally end up in your fat cells. And when you eat glucose, they literally end up in your liver and muscles. And then when any of that's burned, you exhale the carbon atoms. And you can literally just count all the carbons and see where everything goes. And none of it's magic at all. There's no magical anything happening. It's very mechanical. And once you kind of understand it, uh, I mean, I have like an edge because I'm a mechanical engineer. Your body really is just this mechanical machine. Um, and then I think you asked me a question about, um, I don't think I'm answering your question that you originally asked. Just, I know Craig has some questions about getting into insulin. Is insulin the devil? I mean, I know you have a graphic. I watched you and Marty, you know, you had this, this devil image of insulin. And it's like, well, you need it, right?
Yeah. So, okay. All right. So, here's, I think a lot of people don't understand what insulin is actually doing. Here's the deal with insulin, right? Your entire body is just poised to, uh, melt down every bit of tissue you have into energy and flood your bloodstream with it for emergency use. So, like, um, glucagon is like this lead foot on the accelerator. Where if insulin is not there to stop it, you'll just literally have wide open lipolysis, flood your bloodstream with fatty acids, flood your bloodstream with glucose from stored glycogen, like every tissue in your body will break down, catabolism, and flood your bloodstream with energy without insulin. And that's for emergency purposes. The default is that you just have tons of energy in your bloodstream. And if glucagon wasn't there, norepinephrine, epinephrine, cortisol, every single one of these hormones will break down every tissue in your body, flood your bloodstream with energy, and you've got tons of energy. And the only thing holding that back is insulin, right? So, like, look at a type 1 diabetic. They don't have insulin. They're melting down their entire body into energy. They're, they've got, you know, the free fatty acids in their bloodstream is off the charts. They have wide open lipolysis. They've dumped all their glycogen into glucose, ketones, every fuel is maxed out in the bloodstream. You give them insulin, and all that stops, right? Like, you're sitting there right now in a fasted state, and the only reason you're, the fatty acids in your bloodstream aren't off the charts is because your pancreas is constantly monitoring the fuels in your bloodstream. And if the fatty acids go up a little too high, insulin also goes up and tamps that back down. It's like a very sensitive thermostat that's constantly monitoring. There's a, your pancreas is a fuel pressure sensor and it's monitoring the fuels in your bloodstream and keeping them down by suppressing lipolysis, right? And so, what ends up happening is that, you know, your insulin is just trying to keep the fuels out of the bloodstream by keeping them in your cells. And then as you get fatter and fatter, like, let's say I gain a hundred pounds, I eat a hundred pounds of butter and I gain a hundred pounds. Now all my fat cells are too full, they don't want any more fat. So the fat is just circulating in my bloodstream. And my pancreas is just dumping out insulin trying to clear it, but none of the cells want it. And then all my muscle cells are full of fat, and now they don't want glucose either. And so all these fuels are really high in my bloodstream, and insulin gets higher and higher and higher, but none of the cells are listening to it. So I just have too much fuel in my bloodstream. So, high chronically high insulin is just a sign of energy toxicity. It just means you have way too much fuel in your bloodstream, which means you have way too much fuel in your cells. And it's the whole thing backs up. And so, the, the high insulin itself isn't really the problem. It's just a marker for the actual problem, which is energy toxicity, too many fuels in your bloodstream, and then too many fuels in your cells. The, the reason the carbohydrate insulin model is wrong and completely broken is because the carbohydrate insulin model says, you eat carbs, your insulin shoots up, drives all the energy into your fat cells, and then you have internal starvation where you don't have enough fuel in your bloodstream. Uh, that never happens. At every step in the fattening process, the fuels in your bloodstream are higher as you're getting fatter than they would be in a thin person who's not getting fatter. You know what I'm saying? So, as I'm getting fatter, every fuel in my bloodstream is higher than someone who's thin. If, if someone's eating a, like, a really high satiety per calorie diet, so they're super thin and they're not getting fatter, um, all of their fuels in the bloodstream will be lower than someone who's actively getting fatter or is too fat or diabetic. Glucose will be higher in the fattening person, triglycerides, free fatty acids, every fuel at all times will be higher in the bloodstream because insulin is just reacting to those fuels in the bloodstream. It's, it's the cart and it's not the horse, you know what I'm saying? It's just reacting. And so the internal starvation thing is not happening. As people are getting fatter, they have higher fuels.
Gary Taubes, please. Yeah, we should have him on. People, I look, I love Gary Taubes. I love David Ludwig. I love these guys. I loved the carbohydrate insulin model for a long time because it really spoke to me because it says what you eat determines how much you're going to eat, right? The carbohydrate insulin model, I love the fact that how much you eat is downstream from what you eat. You know what I'm saying? If you eat salmon and asparagus, you're going to eat way fewer calories and you're just going to be thinner than if I'm eating like sugar and oil. If I eat sugar and oil, I'm going to eat way more calories and I'm going to be fatter and I'm going to be less healthy. I'm going to have worse body composition. And so what you eat definitely determines how much you're going to eat. And so I love that. But the carbohydrate insulin model says it's because insulin went up, drove all the fuels into your cells, and then you're internally starving, which is completely backwards and absolutely wrong. Insulin is just reacting to fuels in the bloodstream if they have no place to go. So it's actually completely reversed wrong. The reason people get fatter is because they're eating foods with low satiety per calorie. If I eat a food that has tons of satiety, it's got protein, minerals, micronutrients, and only one calorie. Like, if I eat a one calorie food, but I got boom, all the protein, micronutrients, and everything I need, I'm going to have amazing results because I have ridiculous high satiety per calorie. And then if you're just eating like sugar and oil, your satiety per calorie is, you know, sub-zero. It's like completely horrible. You're going to eat a billion calories and you're just going to get fatter and better and fatter. And we have these studies in animal models, you know, you give them refined carbs and refined fats, and they just gain a billion pounds. And so it really comes down to satiety per calorie, which is destroyed by refined carbs and refined fats, either one or especially both. And that makes you overeat. And then your insulin is high. It's not the other way around. It's not like, how I ate carbs and then my insulin shot up and that made me internally starving. It's actually, no one's ever documented this internal starvation part with low fuels in the bloodstream. That's never been documented because it doesn't exist.
Yeah, I think, uh, the way I like to look at insulin, you know, that model looks at insulin as like this hammer that drives things out of the blood into storage whenever it goes up. And I think you've got some graphics on this too. I like to think of it as a more like a net holding back the floodgates, right? Or, you know, a dam, like you've shown in some of your graphics, where it's this dam just kind of holding back the floodgates of all this energy. And you have more energy to hold back, the, you know, dam has to get bigger. Then that has to get bigger to hold back from flooding the bloodstream. And that's where that basal insulin can go up and up as you get over fat.
Yep. Exactly. Exactly. It's just very mechanical and it's really just responding to those jewels. If you eat fat, it's going to end up in fat storage regardless if you have the spike of an insulin or not, right?
Yes. And that's what. And this is so, if you're, if someone's a type 2 diabetic, if you drink a whole gallon of heavy cream, right? Tomorrow morning, 12 hours later, you're going to have the highest fasting blood sugar you've ever seen. And all the whole low carbohydrates, like, whoa, there must have been, look at the trace carbs in heavy cream. It's got to be, let's trace carbs. They don't get it. It's like, when you eat all this fat, it slowly passively goes into your fat cells, enlarges them all, you're slightly fatter, you're slightly more insulin resistant, your fasting insulin has to go up just to try to hold it back out of your bloodstream. And then your sugar has to go up too because you don't have any place for any energy to go. And so fat is basically, eventually isocalorically raising your insulin just as much as carbs are, but it's raising basal insulin. Carbs raise glucose and insulin immediately and then it goes back down. Fat just raises your basal insulin. Fish. Now you're fatter and you're more insulin resistant. And I think a lot of people don't get that. And, you know, glucometers are not helping because everyone looks at their economy, they get a big spike and they're like, oh, well, that was bad. Yeah. If you could actually see your basal creeping up 12 hours later, where you're slightly fatter and slightly more insulin resistant, or if you had a glucometer that showed your triglycerides because you drink your heavy cream, your oil, your triglycerides are gonna do this four times higher thing or more if you're over fat. I mean, like, we, I've seen extreme triglyceride excursions in people who are eating a lot of fat. Like, you know, we get these crazy numbers in the clinic. And so you don't have a triglyceride glucometer at home. I guess it would be called a triglyceridometer or whatever, but you don't have that at home. And if you did, if you had a sensor that showed you your free fatty acids and your insulin and your triglycerides at all these time points, you'd realize, oh, hey, when I eat refined fat, the next morning I'm like way worse metabolically than I am right now.
And another question related that I've had, uh, uh, sometimes people will see a higher fasting glucose in the morning if they overate fat the prior day. Can you talk about that connection?
Hell yes. And like, it's exactly just what I was saying. Like, imagine, or right now, do a thought experiment. Or right now, you eat 100 pounds of butter, right? Um, and tomorrow morning, 12 hours later, your, every fat cell in your body is like expanded, right? Now, all your cells are really refusing glucose, right? Your triglycerides are going to be higher because the vessels don't want fat. Um, your muscle cells are filled with fat, so they don't want glucose. All your cells are in energy refusal mode. And that, and then your blood sugar is going to be way higher. Your insulin is going to be higher because it's trying to get the fuels out of the bloodstream, but it can't. All your cells are full. Your, everything goes up, right? And so that's how fat makes you fatter and more insulin resistant. It's just such a slow process. It's really showing up, you know, 12 hours down the road. So, it's very confusing to a lot of type 2 diabetics. They're like, man, I never eat carbs, but my fasting sugar is, you know, 150. What the hell? It's literally how many grams of fat you ate the day before, full stop.
This was so frustrating. I was on, I went to Costa Rica to be on a television show with a couple doctors, and I was the chef. And I planned, you know, protein meals or whatever. But then they all brought in all of this heavy cream. And they were like, I'm fasting until one o'clock, Maria. I was like, you just put like 500 calories in your coffee. You are not fasting. Do not be mistaken. But other people were telling them that is okay, right?
Yeah. I mean, hopefully everybody will look back at this sort of thing 10 or 20 years ago, and it'll just be a laughingstock. I mean, I think we're already at that point, but not everybody is. And so, yeah, we just need to get more people to realize that refined fat is not helping anyone with anything at all, ever, period. But going back to the CGM issue, I wore a CGM and my highest numbers were when I was running. And we are getting a lot of people like buying these, you know, CGMs or trying them out, and they're like, oh, I ate so much protein and it went up so much. I was like, that's not always a bad thing. So, does it mean I should stop running because my blood sugar went up?
Exactly. That's a beautiful point. Like, like most people hit, you know, diabetic range glucose when they're doing maximum intensity exercise. And that's not harmful and that's not bad for you. And these spikes in the glucose are not necessarily that terrible. And what you're not seeing is your giant spike in triglycerides when you eat all that fat. Like, if people could literally see that, they would be like, oh, hey, refined carb, refined fat, both doing crazy stuff to the fuels in my bloodstream. Both have horrible satiety for calorie. Uh, both are not helping my body composition. Maybe I should eat some protein instead.
Well, I think the, uh, CGMs are great. And for a lot of people, it can really be enlightening, if depending on their diet. But what I think is good, kind of happening in, in certain communities, especially with the, you know, kind of bad information that people follow in the keto community about glucose and insulin, is that it can actually be counterproductive in a lot of cases. And we have people doing this where they're like, well, I ate more protein, but my, my glucose went up 20 points, or my glucose spiked. And we're like, well, okay, how much? Like 20 points. So it's like, went from 80 to 100. So what? Right? Like, they want this flat line for glucose. Yeah. Not necessarily the best way. It really isn't. Yeah. It's, I mean, yeah, it's just really eating through glucometer can be problematic because you'd literally just eat butter all day long and then you'd wonder why now your fasting sugars, you know, 150, even though you never eat carbs. And that, it's just, it's definitely a problem. It's a huge problem.
So on that related question that I want to make sure to ask, ask, which is, so you get some people who will then say, okay, I'm going to lower my fat and I'm going to up my protein. And as a result, they end up with higher fasting glucose the next day, or, you know, over a course of a week or whatever, in the mornings, their fasting glucose might creep up to 100, 110. So in those cases, what's happening? And is that a concern?
Well, probably they're actually eating more grams of fat than they realize. And they probably are getting slightly worse. Uh, like, for example, let's say you're a diabetic, but you do everything right. You're just eating lean protein, super high satiety per calorie, you're shaving off grams of carbs and fat, you're exercising, you're losing weight. You will steadily see your fasting blood sugar get lower and lower and lower and lower and lower. That will happen. There might be blips, there's up and downs, it's never linear. You know, there'll be days where you're just, your cortisol stresses you out and it'll be higher, and you'll be like, I don't know what happened. But like, if you, if you zoom way out and look at the trend over weeks and months and years, you will steadily have a lower fasting blood sugar if you're doing all the right stuff. And that's higher satiety per calorie diet, which is usually way more protein and way less refined carbs and fats and exercise to deplete, um, intramuscular triglycerides and stuff like that.
What's that? What about sleep? Is there a relation there?
Oh, yeah. A huge relationship. Like, just sleep deprivation will immediately increase insulin resistance and cortisol and stress and all these things. So, there are all these other factors. But it's true that if you're doing everything right, over time, you should see your fasting blood sugar go down. If it's, if it's abnormally high, and so that is that usually means you're doing something wrong. And it's typically having no actual clue how many grams of fat you're eating a day.
I agree with that. You know, there's studies that shown that people on average underestimate how many calories they eat by like 45%, and overestimate their exercise by like 41% or something crazy, right? But, you know, back to that, there are some people that they say they are getting a, you know, a lower amount of fat and they upped the protein. And I think this might be related to insulin resistance. So if they're insulin resistant, they might initially until they can shrink those fat cells. Is it, is it possible that, uh, the morning fasting glucose could go up because of the insulin resistance?
Well, I mean, yeah, the more insulin resistant you are, the more your blood sugar goes up. But again, and and again, there's a lot of other factors like day-to-day cortisol and stress and sleep and blah, blah. But honestly, if you're doing everything right, your blood sugar should be eventually lower. So the first thing I would suspect in someone who says, oh, hey, I'm doing what you told me, but my, um, fasting blood sugar is going up, you really have to literally count how many grams of fat you're eating every day. Because everybody in the low carb world, we know our carbs. Oh, I eat 20 grams of carbs. Like, we're tracking our carbs. We know our carbs. I'm trying to go from one gram of carb a day to zero by never eating any salads. And now I'm just a carnivore. Or, you know, I was a rock cardboard, but I was worried about glycogen and the liver. I was eating so like, you know, if you're trying to shave your carbs super low, you might have absolutely no clue how many grams of fat you're eating a day. And so, you know, like a lot of people in the low carb world, they can't really tell you how many grams of fat they are today. And so that's typically the number one problem.
Is it, do you think it still is the issue for somebody like, for example, Dr. Sean Baker? He has a kind of a higher fasting glucose. Do you think that's more related to his level of activity and, and one thing, he's a lot of fatty ribeyes.
True. I actually cannot explain what's going on with Dr. Baker. Like, I have really tried to explain his fasting glucose and A1C seems too high to me. Yeah. And I don't have a good explanation for it. I don't think that's due to his amount of exercise. And I, I mean, I hate to say this, but I think that if he was leaner, he would have lower blood sugar and A1C. Like, like, if, like, if he just did like a bodybuilding show prep and just got scary lean, uh, I would be curious to see what his A1C and blood sugar is. I like, like, no disrespect to Dr. Baker, who I love. Plus, like, I don't want him to kill me. Like, he can physically kill me with his very hands pretty easily. So, so sorry, Dr. Baker, don't kill me. But, like, if he got like super, super stage lean, uh, I would love to see his blood sugar and A1C. And I'm guessing they would be normal.
Was it a year ago he did lean down by eating lean meat and he started doing marlene? But yeah, very interesting.
One more question I wanted to ask you before maybe we get into a few, uh, questions from, uh, people online here. Um, so let's talk about, let's, let's reverse insulin resistance. Let's reverse our over fat situation in our bodies. You're going to want to, in our case, we're going to cut the carbs down. We're going to get enough protein, you know, for your lean mass, so you get, get adequate at least enough, uh, protein. And then you're gonna adjust fat, right? So now the question becomes, how low should fat go? And how low can fat go? Especially in the, in, you know, there's, I'm sure there's context here. If you're doing it one day, like a one protein sparing day for the week, maybe it's a little lower of a fat minimum. Or then also, the second question, then is, what is the fat minimum if you're say going to be in a calorie deficit for three months because you have a lot of weight to lose? What's the kind of floor there that you want?
Gotcha. Okay. All right. So, like, we're famous in the low carbosphere by saying that humans never have to eat any glucose ever. Like, you can literally eat zero carbs. You never need carbs. You never need glucose. Uh, right. Okay. That's true. Um, there are a lot of things about fat that that's actually also true for. Like, so, like, the requirement for saturated fat in the human diet is absolutely zero. You can literally make every bit of saturated fat you need on your own. You, you would be fine if you never ate any saturated fat. The amount of cholesterol that humans require in their diet is zero. You literally never have to eat cholesterol. So you can manufacture your own saturated fat and cholesterol just like you can manufacture your own glucose. Now, a lot of low carbs are like, well, that's not optimal. And yeah, it's probably not optimal to never eat any carbs at all either. Like, these are both on a U-shaped curve. But the point is, you really don't need a ton of fat. Like, the amount of essential fatty acids that humans require in their diet, it's under 10 grams a day. I mean, it's extremely small. And when we do these, um, protein sparing modified fast liquid diets for pre-bariatric surgery patients, I mean, sometimes there will be as few as 10 grams of fat in these formulations. Like, you probably want about 10 grams of fat so you don't get gallstones. And so you have your essential fatty acids. And I don't think that anyone wants to go that low indefinitely. But for short periods of time, you can certainly survive on 10 grams of fat. I would say that your average person for any kind of length of time probably does not want to go below about 30 grams of fat per day. And if you look at bodybuilders doing show prep, they're very low to go below 30. I'm sorry, 30 grams of fat a day. And they're typically never going below 20% of calories from fat and maybe 30% of calories from fat. So, you always want some fat around. And in fact, if you go way too low in fat, you start getting like some major negative health, uh, impact. Your testosterone goes down, and your energy goes down, and a lot of stuff like that. So, for most people, I'm like, okay, you definitely need at least 20 or 30 of your calories and at least 30 grams of fat. Um, and but, you know, it's, it's actually, if you have tons of fat in your body, you can get away with these fairly low amounts of fat, um, indefinitely because you, you already have a lot of fat. I'm not saying like, don't eat any fat, but I'm saying a lot of people can really cut back without any problems.
Well, that's the thing. Craig did this great chart and he posted it on his Facebook wall. And it was about, we're on the same page when it comes to this extended fasting. We don't like it because you're going to lose muscle mass whether you want to believe it or not, it happens, right? We are more of, hey, let's hit our protein goal so it at least, you know, stave off that muscle, maintain muscle, and you get your nutrients in because of, you know, how nutrient dense the animal proteins are. And someone made a comment, she's like, I'm a trainer, and when I have my athletes do protein sparing modified fast days, they do terrible. We're like, why would you have a lean athlete do a protein sparing modified fast day, right? She ended up deleting her comment because a lot of people kind of like, why would you, this isn't for lean people. But what we got was, we also got some other people in the keto community or whatever, are pushing back on us saying protein spirit by fast are dangerous, dangerous. But, but the same people say, don't eat for three days, if you don't do a three-day fat, that's fine. Yeah, that's completely ridiculous. We're saying at least hit your minimum for protein and enough fat for your gallbladder and all of that. And a lot of people are like, um, even someone here is saying, why don't you speak to autophagy? And we're like, well, work out. That's better for it. Yeah, it's way better for you. Absolutely.
So that's actually one of the questions here. And I'll throw it up there. But, uh, asking, uh, what about autophagy? So, you know, you get into this fasting realm and the one of the main thing that they talk about about extended fasting is tafaji, autophagy. One of the things I'd like to point out is the, the Nobel Prize winner for autophagy, I can't say is.
He's a Japanese fan. I can't say his name. I can't remember it. Uh, but he, he actually estimates that every one to two months, we turn over all of our protein cells through autophagy. All of them. And, you know, and that's, that's no fasting. That's not, that's just normal human beings living. So my question is, why do we have to speed that process up if we're going to turn them all over in one or two months anyway?
Well, okay. First of all, autophagy is honestly a totally BS buzzword that has no actual real meaning. Like, no one can actually measure this. Most of the studies that were referencing this were done outside of the body in extraordinarily artificial conditions with extraordinarily artificial measurement systems. And there's really, like, nobody really knows what autophagy is. You can't really tell when you're doing it. This is like, it's almost purely theoretical. So it's kind of garbage to even use this term at all. So anyone who's really talking about like, they know what the hell they're saying is literally filled with crap. So it's kind of like a fake buzzword to begin with.
But it really comes down to, uh, mTOR signaling. And it comes down to like, either your hypocaloric or hypochloric, if you got plenty of energy or not enough energy. And the idea is that you kind of want to balance out the times when there's, uh, too much energy with times when there's not enough energy. And things that reduce energy availability theoretically are driving this autopsy process. And that's under eating calories or expending more calories. So you can either do it with, uh, just eating less calories, uh, eating higher satiety per calorie foods, so you're eating less calories, exercising more to expend more energy. Any time you're in a low energy state, you're going to theoretically be driving this process forward. And that could be intermittent fasting, or just eating less, or just being thinner, or doing more cardio, or all of these things. And so it's kind of a garbage term, uh, for just like managing your energy and not being in a surplus all the time.
Yeah, there's lots of studies that I've shown. One specifically looked at 36-hour fast versus strength training. And the strength training, the empty, again, they can't measure it, but the signals for autophagy, the markers that they look for, were higher from strength training than the 36-hour fast. Nobody wants to work. Yeah, but and guess what? You're doing instead of losing muscle by eating nothing, you're gaining muscle. So I mean, win-win, right?
But I also heard you say about the whole extended fasting, they don't touch on healing like what you actually are putting in your mouth. So after you don't eat for three days, then you just, you're so hungry, you eat a bunch of junk. Exactly. You're just going to refeed with higher and higher energy density foods because that's how your body's wired. So it's not really optimal.
So another interesting question here, and this is related to the kind of the minimum fat and why not, but, uh, one about PE diet and negative possible negative effects on women's hormones because there's a lot of people that believe, you know, women have to eat more fat for hormones. Can you talk to that?
Well, okay. So like, big picture, I, I'm not a huge fan of like, extreme protein sparing modified fast, or extreme extended fast, or extremely low calorie, or, you know, 100% protein, zero percent fat. I don't like any of that. I like, I think everybody should eat now, the way they're going to eat forever. And what you do is you drive, you tweak your protein up a little, and you're carving your fats down a little, so that you're at a slight caloric deficit, maybe 300 calories a day. And you're just gradually cruising down to your ideal body weight and stay there. And you're, you're leveraging higher protein and lower energy so that you're just slowly improving body composition, more lean mass, less fat mass. And you're doing it in a sustainable way, in an enjoyable way, in a way that you're not starving out of your mind, in a way that you're not tanking all your hormones.
And so take wherever your diet is now, track it so you know actually what the hell you're eating. And then get your protein percent higher and your refined carbs and fine fats lower, but not insane. Don't go straight to egg whites and whey protein and that's it. You want to do this in a sustainable way so that you will slowly gradually go down your ideal body weight and enjoy the process the whole time and feel good. You know what I mean? Like everyone's super extreme. So they're like, oh, if protein's good and carbs and fats are bad, I'm just going to eat 100% whey powder. You know, that's my diet now. That's not going to work. You can't do. Like everyone goes just all or nothing. It's like, okay, carbs are bad now. I'm keto. Now I'm carnivore. Uh, I basically can't eat plants. Or it's like, you know, protein's good. Okay, egg whites. It's my only food from now on. Let's see how it goes. And so I, the PE diet is more about finding where you're at and then raising the protein energy ratios slightly in a sustainable way so that you're driving just a moderate caloric deficit of maybe 300 calories. You don't want to go extreme with it, or you are going to screw up your hormones.
Absolutely. You have your opinion diet book? Because we only have the ebook. Can you show us your book? Do you have it? I don't have it. Oh man, everybody pick her book. Here's a link. Thank you. Definitely check it out. Um, we'll put the link in the notes too, as well, when we, uh, speaking of the PE post this. But, uh, another question kind of related to that, uh, where did it go? Um, so this question is, uh, so do the total calories matter if you're not hungry? For example, if you're getting high protein, low carbs, and lower fat, and say 1200 calories, but you're satiated, is that okay for, you know, doing day after day?
That's totally okay. And what happens is the fatter people are, the longer they can go with low calories. You know what I mean? If you're like 500 pounds overweight, you could do a protein sparing modified fast and just eat 800 calories of protein. You know, like you could do that for weeks without being that hungry. But as you get leaner and leaner and leaner, you're just going to get hungrier and hungrier. You're going to have to up the calories more. And so it really scales up or down to how over fat you are.
I will say that in people who are dangerously over fat and dangerously energy toxic, like if you have raging, out of control diabetes and you're so awash with energy that your A1C is super high, uh, yes, you should actually be on a protein sparing modified fast where you just eat the protein. And you probably won't be that hungry. And you will be able to do that for longer than most people. And you are just going to steadily burn off that extra energy. So it scales up or down with how over fat and energy toxic you are. And the worse off you are, the more you can get away with protein sparing modified fats.
We had a client this last, uh, just gonna bring that up, Tyler. Um, he's doing his stuff on YouTube also. But he was 600, 630, 645 pounds. Forty-five pounds. And he lost a hundred pounds in two months basically doing mostly protein sparing. I mean, you know, not every day, but you know, around that. Um, what was really interesting about him though, is that, uh, his A1C at four, 645 pounds was 5.6. Yeah, I think his fasting glucose is like 90 something. And I was trying to tell my mom, just amazing. The personal fat threshold. Do you think you would just had a lot of fat cells, or do you think genetically maybe he could? Because for background here, personal fat fat thresholds basically, you have a certain number of fat cells on your body. Most people after a certain age, when they're young, don't create new fat cells. They just fill them or shrink them. And do you think in his case, he just had a lot of fat cells to fill, or do you think, uh, he genetically maybe can make more new fat cells?
I, I think he's actually manufacturing more fat cells. In fact, I know that. So these people literally have the ability to perform adipocyte hyperplasia, where they sprout new baby fat cells from stem cells. And so they're literally just growing more and more and more and more adipocytes, adipose tissue. And that's very genetic. And some people cannot do that genetically. Like, like you guys. Like, like if I, if I told you guys, I will pay you one billion dollars to get to 300 pounds, you couldn't do it. You literally couldn't do it. You just leave that million dollars. Did you see? I'll go 300, 300. I don't know. Okay. Most people don't know. I am half my size that I was. I'm about 50 pounds less than I was. But yeah, I was just before and afters. But I, I guess I, I maybe, I mean 500 pounds. But there's, there's a point where you physically couldn't do it. Like for all the money in the world, you couldn't get fatter. And so that's super genetic. That's what that's all I'm saying.
And on that contrary of that, you know, we've had clients, 105-pound woman, type 2 diabetic, you know, off the charts. She'd let it go, go so long because she didn't gain weight. You know, that's your body's natural, "Hey, I'm gaining weight, I should probably change my diet." She never did. She ate sugar, just junk. She burned out her beta cells. Now she's basically with type 1.5. Now she can't milk insulin either. And I mean, that's even the other end of this. I'll never forget her because she said, Maria, we live in a vain society. And I wish that I would gain weight when I cheated because I don't really care because I don't gain weight. But she was having strokes. I think she had her second stroke and she was only like 30 years old.
But we want to respect your time, though, Ted. Um, do you want to tell us where everybody can find you?
Oh, yeah. Well, I mean, you know, I'm on Twitter at Ted Naim. And, um, I'm the probably the best thing I have is the book, which you can get at thepediet.com. And, yeah, those are probably the best place to find me.
And we'll have the link to your book in the show notes for everybody to check it out. It's, it's wild. It's great.
Oh, thank you. Thank you.
But just thanks for the time, Ted. Uh, everybody, please check him out. He's got a YouTube channel too. We'll link that below. He has funny cats. Puts out some funny videos that are really, uh, educational. Really, uh, some of the best explanations of energy metabolism out there. So I encourage everybody to check it out.
Oh, well, thanks a lot, you guys. And you guys keep up the good work. I really appreciate what you guys are doing.
Thank you, Dr. Ted. We hope to see you in the future at some events.
Sounds good.