Transcription
Patients lost weight and, you know, my cholesterol dropped a little bit, so it all seemed good. And then I started looking at, you know, the parallels to the patient population. I started seeing normal weight people start to have elevations in their hemoglobin A1C. And [music] it's like, yeah, this just is not adding up. I was seeing what I wanted to see, extreme human bias as far as the plant-based diet seemed to to be a good thing and I was looking for things to make it to be a good thing.
Welcome back to Metabolic Mind. So, how are we supposed to eat a plant-based diet? We're sort of told that that is kind of the best diet, especially within the cardiology world. As a cardiologist myself, I hear that all the time. I personally don't believe that. I think there is no one best diet, but I'm really curious to hear from others about their journey. So, today I'm joined by Dr. Jamie Delaney.
Now, Dr. Delaney is a cardiologist. She uh went to medical school at West Virginia University and then did a residency and cardiology fellowship at the University of Pittsburgh. And now she lives in Florida where she has a private practice. But, here's the kicker. Her practice for years has been a plant-based practice. She herself is plant-based and she designed her medical practice to be a plant-based practice. But, as we're going to hear in this interview, through her own experiences, through endurance running and just through her personal health, she realized plant-based wasn't working as well for her and she ended up transitioning to a low-carb ketogenic diet both for herself and now starting to institute it into her practice as well. So, I'm really curious to hear about her experience and why she made that change, what she's seen in that change, and how that changed her focus in general about, you know, this concept of metabolic health, LDL, cardiovascular health, nutritional nutritional interventions, and do we really know the one best way. So, with all that as as the setup, I hope you enjoy this interview with Dr. Jamie Delaney.
Well, Dr. Jamie Delaney, welcome to Metabolic Mind. Thanks for joining me today.
>> Thank you very much for having me. It's an honor to be able to speak with you in live.
>> That's great. Yeah, and I'm I'm excited to have another cardiologist on. I mean, this is a it's a treat for me for sure. Um and I really want to get into your story cuz I think it's such a great story and we can talk about, you know, all the different dietary interventions, how they affect people personally, how it affected you and professionally and and what it means for metabolic health and what you think optimal medical care is. We're going to get into all that, but like I like to start, tell me something that you think medicine gets wrong that you really wish were different.
>> I think we don't take time to actually listen to the patient and individualize care. Um over the course of my 30-year practice, um you see more and more algorithms and just menu doctoring. And I have always maintained that I love physical exam, I love talking to people, and individualizing care. And I think that's really what's lacking today.
>> Yeah, you know what? It's so funny. You're you're spot-on, I think, with that. And I can remember all the way back to my residency. And one of my big mentors in residency, you know, as we're rounding, he said, you know, I see the path of where this is going that we just have order sets. There's like an A-fib order set. There's an an acute MI order set. And you you just don't even think about what's in the order set. You just know it's the treatment plan and you end up treating everybody as if they're an average rather than, you know, really thinking about it. So, your answer just sort of brought me back to that that he was spot-on. Like he was spot-on that that's sort of really sort of what we have to fight against, right? So, you've probably seen that um evolution in your practice as well. And have you felt like you've been fighting against that for so long?
>> We we have and that's partly what led me to change my practice to to more of a membership uh practice aimed at wellness through nutrition and lifestyle changes. Um, so that we could get away from that. And, uh, you know, it's always frustrating. I don't have to go to the hospital very often because we have a small practice. We take care of people. They don't have to go to the hospital. They don't get chest pain or heart failure. So, it but I when I do, for whatever reason, you know, the "Are you on all these different medications before you can discharge somebody?" is always, you know, very frustrating because, you know, a lot of times it's not really what they need.
>> Right. Right. Yeah, and then if they're not on it, it's almost more of a headache for you because you have to document so much more and like sort of defend um, not putting them on a medication as opposed to defending putting them on a medication, showing that they have a specific indication for it.
>> Absolutely.
>> Yeah. Well, so let's get into your background a little bit. I mean, tell us the story about your personal journey and then how that impacted your professional journey.
>> I always tell people that I I wouldn't be a physician if it wasn't for my family history. Diabetes everywhere. Both grandparents, uh, died from and I had a grandmother die at 57, a grandfather die at 48 of heart disease, another grandmother die at 72. My parents both had diabetes. And it's, you know, it's drove me into medicine, but it also drove me, personally, to run away from those two big diagnosis. And I decided that I was going to start running, you know, uh, to try to avoid getting these I was going to send a message that exercise is so important. So, I started doing marathons and I'd hang my marathon posters up everywhere to try to motivate everybody and it never did. But, you know, nevertheless, it was running that led me to hear about a plant-based diet with Dr. Esselstyn. And I came up in the in the era of low-fat. Everything was, you know, low-fat American Heart everything low-fat, low-fat, low-fat. Even raised that way for the most part. And so, that resonated with me. I'm of Irish and Italian descent. So, bread and pasta and potatoes and vegetables that all that all sounded great, you know, and so I kind of went head first into that kind of you know, it's like I can really implement this into my practice and I did it myself and lost a little weight. Some things cleared up. Patients lost weight and you know, my cholesterol dropped a little bit. So it all seemed good and the practice went along. Actually we're 10 years into a membership practice that was based originally on plant-based diet and exercise and mobility and things. And my running in the same parallel, my running actually progressed. We did Ironman and then I started doing ultras. And the ultra running I started having bonks like highs and lows. So the longer you run, the more you have to eat and typically runners eat carbohydrates and they eat these gels and every 30 minutes you start eating these gels and all of a sudden, you know, I would start to have these, you know, feel good, you feel bad, you feel good, you feel bad and then you feel just bad cuz you can't take any in. And even after some long runs, I would come home and say we have, you know, a breakfast and a big bowl of fruit and maybe, you know, vegan pancakes and I would get so tired that it's like and I thought, well, I just ran 20 miles, you know, I but I almost like needed a nap and it's like, wait a minute.
And then I started looking at, you know, the parallel to the patient population. I started seeing normal weight people start to have elevations in their hemoglobin A1C.
>> Yeah, so high blood sugar from despite doing everything right, yeah.
>> doing everything normal weight, little bit of a belly and increasing hemoglobin A1Cs and some of those same symptoms of insulin resistance, the fatigue after meals, the fatigue before meals. The other thing, the in the armor, we started measuring DHA levels and anybody that didn't eat fish or supplement had terribly low DHA levels and you know, as we all know, our brain or, you know, a large part of our brain or retina are DHA. So I said, there's some chinks in the armor here about what we're doing." And right about that time, Dr. Noakes and Dr. Cook make publish that paper looking at the low-carb athletes and not doing any worse. I just don't need to back up a little bit. I love Dr. Noakes. I followed the Lore of Running, all his books. And when I heard he went keto a few years ago because of glucose intolerance, I was like, "Man, the man has lost his mind."
>> Yeah, so a lot of people probably don't know that Dr. Noakes started strongly in the carb camp, that you needed carbohydrates for performance, and and he was and because of his personal journey, that's what brought him over to keto. So, yeah, so you saw that transformation and said, "He's crazy.
>> What are you doing?" Yeah, Dr. Noakes has lost his mind. I can't believe it. The guy should be eating plant-based. And of course, then fast forward, I'm starting to have these symptoms, and they come up with this paper, and it's like, "You know, I'm going to try it. My next ultra, I'm actually going to try to fuel low-carb." And I did. I, you know, instead of taking a gel every 30 minutes after the first hour, I would drag that gel over, you know, an hour and a half. So, very low carbohydrate intake, just electrolytes. And I no bonks. I felt wonderful. But what happened the next day was even more surprising. I get up and I walk down the stairs, and I'm not sore a bit. And it's like, "What is going on?" So, Andrew and I, you know, had a I was like, "I understand that, you know, I didn't bonk because I didn't have the insulin spike. But I said the lack of soreness, this blows my mind. I want more." And it was a lecture of his talk I never hit me, you know, insulin is a storage. It seems stupid as a physician that didn't hit me, but it seems so stupid now. But insulin is a storage hormone, and no wonder I couldn't metabolize my own fat stores because I had this insulin all over the place.
>> So, interesting, you came at it from the athletic and the sort of like elite performance side of things. And then how did you then sort of translate into, you know, sort of general health and then to your medical practice?
>> So, I fueled low-carb and of course I wasn't going to go low-carb. You know, I wasn't going to change my diet. You know, that would just be crazy. And then I, you know, like I said, I felt better. And then, you know, I started thinking it's like I'm having insulin resistance. I am just having insulin resistance symptoms. And I was like, "Oh, I just ran before I did it that way." And it's like, "No, you know, I am insulin resistant." And that's what led me to start looking at the practice, you know, and starting to see that it was all over the place. And again, you know, we have a small practice, so I was able to go through our whole practice numbers and review hemoglobin A1Cs and I was starting to see these these these markers tick up. And then we started looking at symptoms and insulin levels and it's like, "Oh, we've got problems." So, we started to, you know, I did the whole thing as far as, you know, and as you know, I heard you talk about, uh, you know, on one of your talks that you were, you know, trained alongside Dean Ornish back in the day and you know, he was around and you were plant-based and so when you're plant-based, I mean, it becomes a religion for some people. And for me to, you know, all of a sudden, hey, um, this was a huge change.
>> Yeah, yeah. So, that's right. You know, my training program, it was an Ornish-based program. So, it wasn't actually with Dean Ornish, but it was an Ornish-based program. Um, so, yeah, I mean, I was trained that that was the right way. And so it was a it was a big adjustment for me to realize that no, that's that's not the only way. And in fact, it might not be the best way and that there are other ways to do it. So, how did you feel? Did you feel like you were had been misled or duped or, you know, was there any of that?
>> Yes. I mean, I guess the first thing is like egg on my face that I, you know, I missed I missed this concept. And so, uh, I went back around, you know, after, um, I actually read Dr. Noakes's book, um, The Lore of Nutrition. And about his journey with, you you him being raked across the coals when he changed his views. And in that book, I was still somewhat, you know, it's like, uh, you know, this is bad, this is bad. And I uh, he referenced, you have to read this book by Tina Teek, uh, Nina Teicholz, uh, the Big Fat Surprise. Nina Teicholz, yeah. Teicholz. And so, I read the book and um, actually I listened to the book and part of it was while running and I was, you know, actually starting to swear as I was running because it was like, I cannot believe I fell for these things. You know, it's like I I liken it to getting off one side of the seesaw and getting onto the other side and seeing things from a whole new different perspective. And it's like, yeah, this just is not adding up. I was seeing what I wanted to see. Extreme human bias as far as the plant-based diet seemed to to be a good thing and I was looking for things to make it to be a good thing. And um, you know, maybe some of the evidence wasn't near as strong as I had hoped it was.
>> So, you you start to see your patients' A1Cs ticking up, um, your own blood sugar's ticking up. You have the athletic experience with low carb. Um, so, what was it like then going low carb yourself and, you know, how far did you go? Did you go to a keto diet? Did you How was it eating meat right away? Like, give give me some of those details.
>> Well, it's it's even a little bit more complicated because my dietitian is actually my daughter uh, for the practice. And she has pretty much been vegan since she was in high school. You know, and so, she was, you know, she's been plant-based from the get-go, so to speak. So, we had to have some family meeting mediations, uh, type of talks. Um, and you know, we sat down and and we talked. It's like, listen, I, you know, I I am insulin resistant. I have this I have this terrible family history. My parents started getting diabetes, you you in their 50s. I don't want diabetes. I don't want to go down this road. I have to make some changes. So, we had added fish back because of the DHA. So, we were eating fish. And, you know, it's like and tofu was low carb, so that, you know, that kind of worked. And it's like, but if I pull out beans are very high carb and protein source, so that's not going to really work. So, if I pull out beans and I pull out grains and I pull out potatoes, I've got to put something back in. I'm running 60 mi a week, you know, this something's got to give here. I'm not going to meet I'm never going to recover. So, I'm definitely going to I'm I'm going to add eggs back in. And I'm going to add eggs back in. But, in the back of my mind, I knew I was going to add eggs and I was going to add bacon was coming. And butter was coming, you know, I mean, and it was and it was really a pretty much a slippery slope at that point. I mean, it was eggs and eggs and bacon and then it was beef and I got a glu- continuous glucose monitor. And the first thing that happened that really pushed me into the deep end was I put the glucose monitor on and I went and got a poke bowl with white rice and edamame and salmon and my glucose shot up to like 160. Well, maybe their white rice has sugar in it, so I'll try another place's poke bowl. And it's like, no. Yeah, and and I was a big sourdough baker, you know, so I so I tried a piece of sourdough bread and it's like, oh, that was awful, you know. And the other thing that was really interesting with the glucose monitor was when I sometimes before I would when I would run, if I ate something before, so let's say I had a piece of toast and I went out and ran, about a mile or two into it, I'd have a crash to the point where I'd get a little shaky, little sweaty. And I thought initially my glucose was tanking and it's like, well, you know, you have high insulin levels, um you just, you know, that's just part of your genetics and you're tanking. When I put the glucose monitor on, I was kind of shocked that it wasn't when it was low that I felt the symptoms, it was after it peaked and right as it went down, like that roller coaster, the top of the hill coming down, that's when I would have the symptoms. And I kind of had that repeated a couple times, you know, and it's like, okay, I'm out. It's it's over, you know, I mean, it was over. I don't want those symptoms. And so, I pretty much went whole in, you know, um full on Dr. Noakes and and one of his books has a little guide there, the green things, you know, that you the Banting diet little um map. And so, I said, well, I'll keep my greens in, you know, my salad in, uh broccoli, some cauliflower, but then everything else I'm going to add, um you know, animal products back in.
>> So, you made these these changes for your own personal health. How did you feel then translating that to your medical practice? Cuz here all these patients came to see you pretty much for a plant-based approach, right? Now, you are making these personal changes and and how did you feel about how, you know, now having this discussion with your patients?
>> It was, you know, again, it was like, oh, this is going to be a little bit difficult. Um but I've always been very transparent and with having a small practice, I really know my patients. And um so, there's a relationship with them and we do lectures every week. Um nutrition and, you know, lectures, dietary lectures, um just general health lectures. And I, you know, did a did a lecture, so I hear it comes. Addie and I, who she's my daughter dietitian, we did that kind of a town hall. And introduced the whole thing in full transparency that this is what I am seeing in myself, this is what I'm seeing in the practice. I've tried this, you know, I've done the glucose monitoring, uh I've tried this on myself. And, you know, I think that some people would benefit from it and this is another tool in our toolbox. It certainly doesn't mean everybody in the practice needs to do this. But if they are having some of these symptoms, then perhaps it would be something that we could try.
>> And was there were were people hesitant? Like if you sat down with a patient and said, "Look, you know, you came to see me for a plant-based approach and we've been doing that, but now your A1C is going up and I'm worried that you're becoming insulin resistant. I think we should lower your carbs and add in animal foods." Like were a lot of people just shocked and like, "No, I'm not doing that. Like I'm plant-based. That's the way to go." Or or were people more open to it through the discussion?
>> I was afraid. Um you know, when I transitioned my practice from a general practice, we went way down and then built back up and it's like, "Okay, here we go again." But actually everybody was very the majority of people were very appreciative of my openness and my willingness to review the literature and do a deep dive and then present this evidence to them and they say like, "Hey, if you're in, we're in. Just you know, what do we need to do?" There were some um who had been doing well. It's like, "I want to stay plant-based." It's like, "Fine." There were very few people that were angry. And typically there there were a few women that wanted their husbands to be plant-based because they had significant cardiovascular disease and they were resistant. And by kind of bringing them into the practice, the peer pressure had made them more plant-based. They thought that I was really pulling the carpet out from under them. It's like, "Now we don't have any support for us wanting to our husbands uh to be, you know, plant-based." And that was really the the biggest pushback. And obviously, you know, again, I preached the gospel of plant-based nutrition, you know, of all the things that, you know, plants have phytonutrients and antioxidants and you know, all the different views that are for the large part um associations and not necessarily causations. And when people adopt a plant-based diet and when people adopt any diet somewhat radical, whether it's keto or plant-based, and they give up Twinkies and apple pie and all these things and lose weight and start exercising, they get healthy for a while. You know, I think you mentioned in a podcast, you know, was it the plants or was it the exercise and the lack of smoking and the you know, lack of processed foods that made people better. And you know, when we started really looking at some of the people that came with significant vascular disease, they were probably insulin resistant to start with. And maybe they lost weight and got a little better for a time and then it started to shift the other way again.
>> Yeah, so I mean, I guess you kind of answered this, but um you know, I wanted to ask you with the with cardiology being so plant-based focused, you know, um uh what was his name? Uh Kim Williams saying there are cardiologists who are plant-based and cardiologists who haven't read the literature. Like which is just so, I don't know. Anyway, I won't put my opinion in there, but you know, it's so plant-based and and you were in that, so what what was wrong about that?
>> I believe that most of that data came at a time where people just looked at a fasting glucose and we all know anybody can pass a fasting glucose if you fast long enough. Hemoglobin A1Cs weren't really measured all that much in those, you know, some of those studies. Insulin certainly wasn't mentioned. Not unlike all of cardiology, pretty much put diabetes in its own category. You know, if you have it, it's a bad thing, but we're going to ignore it and let the endocrinologists handle it. And we're just going to focus on cholesterol. So, I think it was largely ignored. Again, when you start looking at it, well, how many of those people got better just because they got rid of a lot of other bad things. You know, again, bias there that we're not going to people are getting better, so why change?
>> Yeah. Well, and what about just the concept of metabolic health? Like when you were think back to, you know, 10 years ago, 15 years ago in your practice, I mean, was there even this concept of metabolic health? Because sort of like you already mentioned and I and I chimed in there like it was like you had diabetes or you didn't and there wasn't an in between of metabolic health. That's sort of how I feel like we were trained. I'm curious if you felt the same and if now focusing more on metabolic health you think has been benefiting the patients more. So, uh give me your thoughts there.
>> Well, I mean, you know, traditional diabetes or, you know, metabolic health to me was high triglycerides, increased waist to hip ratio. So, you know, you had the the typical shape, right? The more apple apple type shape, increased waist to hip type, thin arms, thin legs, big in the middle. You know, those were pre-diabetics or diabetics, you know, that's something, you know, you got to it has to be addressed, so to speak. Um and it typically you looked at it as weight loss. Um you need to lose weight. You need to be on a plant-based diet. And, you know, unfortunately, some people didn't lose weight or they, you know, they couldn't lose weight eating a high carbohydrate diet cuz they couldn't restrict themselves enough to actually get, you know, get significant weight weight loss. But if that didn't work, that's pretty much, you know, they got a diabetic medication if they were true diabetics, but otherwise, exercise, do what you can, and and that's all we have.
>> Yeah, and so now though that you've changed the dietary approach, do you feel like, you know, metabolic health has become more of the focus and um seen more movement in metabolic health as opposed to just focusing on LDL or just focusing on fasting blood sugar or or sort of more rudimentary markers? I'm curious how you how you've adapted there.
>> Absolutely. I you know, I believe that that really that metabolic health is the driver of all of them. I've always been of the mindset that nothing happens in a vacuum. Um no one just has a heart attack because they have high cholesterol. Um certainly diabetes is diabetes trumps everything. So, if you have diabetes and you smoke, you're really in trouble. If you have diabetes and high cholesterol, you're really in trouble. Um but you have one of these other factors, you know, if you're a little over you know, you might dance around it for a little bit. Um so, we started measuring insulin levels uh in people, you know, to see and of course and actually asking people about their symptoms. I would tell them my story and and they would be just nodding and you know, it's like, "Yeah, you know, I have to go sit down and I doze off after breakfast or I doze off after a high-carb meal." Um or other things, you know, my energy or inflammation, you know, so the inflammatory markers. We check um high-sensitivity CRP and the HDL and triglyceride markers. And going back and looking at those specifically, it's amazing. Because it all you can go back and you can track, you know, insulin starts to go into that resistant range, you know, the the the uh Quest Laboratories just say it has to be over 18, right? But we know that insulin resistance is, you know, much much lower. So, they have, you know, an insulin level fasting insulin level of eight, triglycerides twice what their HDL is, and a hemoglobin A1C that's creeping up over the years. And it's like, "Whoa, this all goes together now."
>> Mhm. And they can all still be in the normal range, right? Like HDL goes from 48 to 42, triglycerides go from 90 to 130. Um and like I said, insulin goes from 8 to 14. Those are all {quote} {unquote} normal, but clearly showing signs of a metabolic dysfunction, insulin resistance progressing that way, but if you're not testing it, if you're not following it, or if you're only using the {quote} {unquote} normal range, then it's so easy to miss and I don't know, to me I could get on my soapbox for days about this. Like medicine really is short-sided that way because it's it is more prevention. It is more the upfront, the upstream treatment and not the the waiting for a disease to happen to treat, which is not how we're really structured. So, I don't know. I don't know there's no question there. I'm just venting, but what do you think about that?
>> you know what what I found was so the people that in my practice, there's several but it maybe had their they've had bypass, they've had stents, they've had significant vascular disease. They're you know, they're you know, 70 years old, this started when they were 50. When I looked back over their labs, say from 2022 to 2026, some of those people always had low HDLs, but their triglycerides started creeping up. And again, like you say, not and not in the really terribly abnormal range, but that ratio. We saw right away when we added fish back into the diet cuz I was afraid. You know, I mean I'm plant-based, I've you know, I've drank the Kool-Aid all the way and it's like, "Oh my gosh, you know, when I we add fish back in, I'm going to see people's cholesterol skyrocket, you know, they're going to string me up." And so I would and it's like all of a sudden their HDL went up and their triglycerides went down with the fish. And it's like, "Wow, this you know, this is a good thing." Because again, you know, when you read the plant-based literature view from that is like, "Oh, it's not it's not going to work out so well." Then I also, you know, I have a family history of dementia. So, I started looking into some of the the metabolism of cholesterol and LDL with regard to brain health. And it's like, you know, and and again, glucose and it's like, "This is not necessarily what we should be aiming for. Metabolic health is, you know, more of the situation." So,
>> Well, let's talk about LDL for a minute here. So, you know, the diet to lower LDL is a plant-based diet. You will likely lower your LDL. Now, that's very different than saying that's the best diet for dementia or for metabolic health or for cardiovascular disease. It's It's saying it's true to say that is the diet to lower LDL. So, in transitioning to more of a low-carb omnivore style diet or even a keto diet, a number of things can happen to LDL. It can go down, it can stay the same, it can, you know, change from the small dense to the larger LDL, or it can go up. Um so, how do you handle that as a cardiologist and with your patients? If you see LDL go up in the setting of metabolic health improving and and other improvements?
>> I think that metabolic health is so much more important that I'm willing to watch that marker. And And like you say, if we're going small fluffy LDL, you know, do particle size, if that's in the right direction, great. Um if HDL and triglyceride ratio are better than then I think we've made progress. I'm not not to the 3-month mark in myself or a lot of patients, but when I, you know, I have prepared myself just because of a family history that I'm probably going to see my LDL rise and and I'm and I'm not going to blink over it.
>> Yeah. Okay. Very good. So, how do you feel? The what what's changed for you? What would you point to some of the biggest differences since you've changed your personal life?
>> Well, again, the it's it's taken um with the glucose monitor, it's it's taken 3 or 4 weeks to get that glucose to stay down. Um and get it into levels that make me, you know, happy about. But the biggest thing is how I feel. Um energy levels better, but it's the day-to-day, you know, I I'm I'm 63 years old. I run about 60 miles a week. So, if I go out and run 7 or 8 miles in the morning, you know, I come to the office, I sit down, you know, I get up and you're a little stiff. You know, and I just like, well, I'm 63. Well, that went away. You know, all of a sudden it's like I don't have those those those stiffness. Again, after long runs, I don't I put all this in play kind of abruptly. I did a challenge um that was 267 mi in 16 days. And so, you had 16 days or less than 90 hours to complete 267 mi. Had to be documented on Strava, outside. I think there were 144 people entered. You could do it anywhere. It wasn't, you know, at a location. Do where you live. And uh I think 73 people completed it. But I in order to work and do it, I was getting up before 5:00 and running 7 I averaged 17 mi a day. And I started it at the same time that I started keto.
>> Oh, [laughter] wow. Okay.
>> So, I So, one, I wanted to see fueling 17 mi every morning on uh basically 15 g for the 3 and 1/2 hours and 40 minutes for the most part um of carbohydrate. That's all I took in plus electrolytes. So, it was a drink that had 4 g of carbohydrate over, you know, and there were two or three of those. That's all I used for fuel. And I ran 17 mi every morning before I went to work. And I kind of thought that, you know, that at some point the wheels are going to fall off. I'm going to wake up. I'm going to be sore. Something's going to ache or whatever. And I just kept waking up and running 17 mi. And the the pace I didn't slow my pace down. I thought I was going to have to walk. I thought I'd be so buggered up that I, you know, have to walk or do something or spread it out over the day. Got up, did the 17 mi every day. And at first, I was afraid. I carried some gummy bears with me, you know, that if I like bonked, I thought, well, I'll take a gummy bear if you know, and I just ended up carrying the same five gummy bears. So, that really sold me because I had never completed that many miles in a 16-day period. And I'm actually and I actually used it as a mini training camp because in July, I'm doing a mountain race in Leadville Colorado, a 50-miler, and then I'm actually going to do the Leadville 100 in August. So, I figured that would be a good training camp. If I could survive that, still go to work and function, that'd help me to get ready.
>> Wow.
>> So.
>> Leadville with the altitude and the elevation gain and the mileage, like goodness, that's a that's a challenge. So, that's remarkable.
>> And living in And living in Florida.
>> Yeah.
>> [laughter]
>> You're not exactly training at elevation to get ready for it.
>> No, no. I You know, I have to go up the stairs in my house to get 13 ft, you know, so.
>> [laughter]
>> Wow. All right. Well, um what advice do you have for other cardiologists who are plant-based or other any physician who's plant-based and believes truly believes that they've been trained for that, that is the right way to go, the evidence supports it, that's what they That's how they help their patients the most by helping their patients be plant-based. What advice do you have for them?
>> Metabolic health um is so so important, you know, 10 times the risk of increased risk of cardiovascular disease versus probably 1.3 times with LDL. I think that we have to as cardiologists focus on metabolic health. And we have to address that. Um what regardless of of how you practice, whether it's plant-based or not. I don't know too many plant-based cardiologists, actually. You know, in town or in the town where I live, I'm the only one that addresses nutrition. Uh people just say, you know, we'll fix we'll put another stent in if you need it. That's kind of how it's approached for the most part. But, I look around, even my colleagues that are, you know, in the hospital with their their own physicians with their own stents, you know, it's like, "Hey, you know, metabolic health is something that we should all be aware of." And not just even for cardiovascular disease, but you know, just risk for an inflammation, cancer, and quality of life. I I think that I think that it's huge. I think more people should pay attention to it. But again, the the medicine is, like we talked about at the very beginning, it's all a matter of getting how many people can you get through your your office in a day as opposed to, you know, and just treat the symptoms and people don't want to hear it. The only thing I will say about my patient population is there were a lot of people relieved. It's almost like I Yes, like you mean I can eat, you know, I can go out with my friends now. You know, and I could order off a menu now for the most part, you know, instead of just getting a salad. And so a lot of people have actually embraced it. It gives them a little bit more freedom in their nutrition. So I I do think that it's been it's been a good thing. I know it's been a good thing in my household. We, you know, you you convince yourself that, you know, you're okay doing what you were doing, but our family has actually embraced embraced the way we felt. My son-in-law is a strength and conditioning coach and he does jujitsu like Andrew and he was trying to make weight in on he's plant-based and as making weight plant-based to go down a class, he was having trouble and, you know, he adopted the diet along with us and, you know, he made weight very easily. And so he was in the in the, you know, and and recovered well. So, you know, I think when people are trying it, it just people want to feel good.
>> How about your daughter? Is she still plant-based? Is she
>> Yes. Yeah, no no she she's in she's, you know, and she realized that she was she too was having some insulin resistance symptoms, some crashes with, you know, high carbohydrate meals and some allergy symptoms that that went away. They're still very, you know, they're in their 30s. So 30-year-olds can do a lot of things without noticing much, but but she but in general they they both feel better. It makes her feel good to see people doing well. Um, you know, so
>> should say that, you know, you could be a plant-based, um, you can eat a plant-based keto diet or
>> And we have people
>> carnivore keto diet or everything in between, a Mediterranean keto diet, right? It's low carb and ketosis does not dictate the absolute foods you have to eat or the type of diet you have to eat. So, yeah, there's a range there. Although, it can be more challenging, of course.
>> Yeah, and and we've worked with some people that want to stay plant-based that, you know, that they're are they're doing a version of that or incorporating at least lowering the carbs a little bit, you know, more of a tofu-based rather than cutting back on some of the beans and things. Uh or more of a pescetarian aspect of things and it's it's helped. Could I ask you a question?
>> Absolutely.
>> So, with with ketosis, you know, I've been following not only a continuous glucose monitor, but I follow ketone levels. How important do you think that is to and what levels? I hear the numbers at 0.5 to 1.5 and quite frankly, I hang out at 0.3 to 0.4 a lot of the times. And it seems to be and even though I'm basically I'm not eating any fruit at this point, just eating the, you know, the vegetables we talked about. The one time that I hit 0.6, I had a lot more fat in my diet that day.
>> Yeah, so, you know, I think it all depends on what your goals are. Like, why you're eating this way. And so, here at Metabolic Mind where we talk a lot about the mental health benefits, treating serious mental illness, for the brain-based therapies, it seems that a ketone level is important. So, trying to get to the 1.5, the twos, it's going to vary for everybody, but the there does seem to be a signal. Higher ketones means greater effect. For improving metabolic health, I'm not so sure that's the case. I don't think we have those same signals. So, you know, being very low carb and being in, you know, {quote} {unquote} light ketosis, a 0.3, 0.5, 0.6, whatever, that might be all you need, right? That you you may still get tremendous benefits, metabolic health benefits, and feel better, and even be able to think more clearly. All that can still happen at that low ketone level, which is very different though than treating sort of a serious brain disorder or brain diagnosis. So, I I we have to really draw the line in terms of like what are our goals. So, you know, if someone comes to me and says, I just can't get my ketones up, my first question is always, well, why do you need your ketones up? Maybe we don't need them up, right? So, I I I think that's the the right way to see it from my standpoint. Uh when I spoke with Andrew, well, I think I listened to a podcast that was on with the KetoneIQ people. And um so, we I did use those in uh my my last two ultras, and I used them on a long runs. I've used them on long runs.
>> ketones, the drinks. Yeah.
>> Yeah, exogenous ketones. And they definitely make a difference. You know, I mean, it's you can, you know, we we kind of do loops if we're here in, you know, running from home and we'll do, you know, 8 or 9 mi, come in, get more water, and go back out. And when you have the ketones, you know, it's a definite perk. And again, the day I had like .6, um I definitely felt it. You know, so, there there's definitely something to it.
>> Well, I'm super curious to see how, you know, research and experience in, you know, ultra endurance athletes, how that would translate to, you know, the everyday person just trying to be more focused at work or just be more present with their family or, you know, get to the gym more often, right? How do you if it helps in one, it might help in the other. What what's the what's the connection there? I'm really curious to see if we get some research and more clinical experience on that. But, anyway, there's a lot to be told. But, thank you so much for joining me today and sharing your story and your journey. I think it's fascinating. Um if people want to, you know, learn more about you and and hear more about what you're doing, where can we direct them to go?
>> I do a podcast, Jamie Delaney Wellness Podcast. Um that's on all the different channels, and my website is drdelaney.com. I'll spell it out, d o c t o r d u l a n e y. Um and I'm Jamie Jaimala Delaney on, you know, Instagram. I try to post there a fair amount uh as well.
>> Very good. Very good. Well, thank you very much. I really appreciate you joining me today.
>> Thank you so much for having me. It's been a great pleasure.
>> I have I have got to admit I was excited to have Dr. Delaney on because I see a lot of similarities, right? I was trained in in a very plant-based, um vegan dietary approach. And through my own experience, personally and with my practice, eventually evolved to focus more on cardiometabolic health and metabolic health in general, and that led me to a low-carb approach. And Dr. Delaney had a very similar approach, but she was a little bit different in that she practiced in her own practice that she developed as a plant-based approach. And to undo that actually takes a lot. I mean, I guess I didn't get into it as much with her, but I can imagine she must have been very anxious and nervous to to make that change in her in her practice, but it sounds like it's gone well so far. And really, you know, the focus on metabolic health, and that there isn't just one diet to achieve it. And this {quote} {unquote}, you know, best diet, plant-based diet, really is not the best diet for everyone. And it's really letting the people's lab markers and their experiences and their symptoms and how they feel direct what is best in in that low-carb definitely has a a uh a place for that. And that's what Dr. Delaney is experiencing for herself and her patients. And so, I really appreciate her sharing the stories. And to to be continued, right? Maybe we'll have her back in a year to see um how things have have progressed for a year. But I think it it really shows that the broader concept of, you know, we hear so much about the one diet, the one best diet, that everybody needs to eat this way. Um and that's just not the case. And we really need to focus on how people are doing individually, how they're feeling, and are they living their best lives. Um and not that low-carb and keto is the one diet for everybody either, right? I would not say that either. Um but I think we can clearly see that the impact metabolic health and to impact how people are feeling any subset of the population is going to be the right approach. So, we have to be aware of it um and willing to go where the evidence directs us, both the scientific evidence and the anecdotal evidence. And that's what Dr. Delaney did. So, all right, that's enough from my soapbox for today. I hope you enjoyed this interview and we'll see you here next time at Metabolic Mind. Thank you for watching. If you want to see more, check out these recommended videos. Also, if you haven't already, don't forget to subscribe to our channel to stay up-to-date with our content and help us expand the movement. And if you want to sign up for our newsletter, access our resources, read the latest research, or check out the Think Smart Framework, click here to visit our website. See you on the next video.