Medical Professor: “I Taught Lies in Medical School”

In this episode, we talk about metabolic dysfunction. What is metabolic dysfunction? Why is it possibly causing all the major diseases and illnesses that contribute to people dying, including heart disease, type 2 diabetes, insulin resistance or hyperinsulinemia, and all the other various diseases that people are dying from today?

And so in this conversation, we also then talk about Alzheimer's. How is Alzheimer's related to metabolic dysfunction or all of these modern diseases? In this conversation, we talk to a medical professor that used to teach all of these medical students how to treat patients, and then why he decided to change his mind and leave standard care for more of metabolic therapy, and what even is metabolic therapy. I now eat a lot of meat, and so do they. If you want to thrive, you need to eat meat. Meat is required.

Hey guys, my name is Judy Cho, and I'm board-certified in holistic nutrition, and I have a private functional medicine practice where we focus on root cause healing, and that often starts with the carnivore cures all meat elimination diet. Today, I had the pleasure of sitting down with Dr. Robert Lufkin. He has recently released a New York Times bestseller called "Lies I Taught in Medical School." So, yes, he was a professor in medical school and is also a physician. We talk through many of the diseases that are currently affecting millions of people around the world. And in this conversation, we talk about why Dr. Lufkin has changed his mind about what he was teaching in medical school and what are probably the best things we can do for our health, for our longevity, and for us not to have chronic illness. And even if we have chronic illness, what are things we can do to reverse some of the progression? A lot of illnesses we have today are progressive. Meaning that you can take a pill today for type 2 diabetes, but the progression of it is still occurring. That's why these are all band-aids. And I always talk about how we should not be relying on band-aids long-term because it will impact your longevity.

All right, guys. Let's get right into the interview. Hi, Dr. Lufkin. I'm very excited to have you on my channel. For the people that may not have heard of your work yet, if you can introduce yourself.

>> Yeah, thanks. Thanks, Judy. I'm I'm so excited about this conversation. And, uh, my mom was a dietician. So I grew up with in in that kind of environment and all. But basically, uh, my story is, I'm a I'm a physician by training. Actually, I started out in radiology, and I've spent mine, really my entire career as a as a professor at primarily UCLA, but eventually USC here in Los Angeles, which are large medical schools. And it, it basically allowed me to teach and do research and also see patients. So, it is a great, uh, great way. And then lately, I, for reasons we could talk about, I've gotten interested in metabolic health and longevity and, um, how lifestyle can dramatically affect that.

>> What's so fascinating about you is that you actually taught the students that went through medical school, and then you're also a physician, and now you're not sort of teaching that as your thing. What made you shift from, I guess, the conventional medical model? What made you sort of become disillusioned with it?

>> In my work, I'm critical of sort of Western medicine. It's not really East-West, but it's allopathic medicine, sort of orthodox medicine. And, you know, your listeners are probably saying, "Wait a minute, you're a medical school professor. You're the problem, right? You're you're the, you know, that you are allopathic medicine." And even though I'm critical of allopathic medicine, I think in the in the 20th century, our medical profession really transformed the world. It made the world so much a better place. The pills, the surgeries that were developed really revolutionized healthcare, largely through public health measures, but still, it elevated all of humanity. And the problem is, in the 21st century, we're facing a tsunami of these chronic diseases that I actually experienced that we could talk about if you want. These chronic diseases that, while they were present in the 20th century, things like diabetes, hypertension, cancer, Alzheimer's, heart disease, even mental illness, these things are now in biblical numbers that were never before seen in history. And the the problem is, when Western medicine takes the same pills and surgeries that were so effective in the 20th century and applies them to these chronic diseases, they don't really work. They, they may treat the symptoms and make you feel better, but for the majority of them, they don't really affect the root cause, and the disease continues to progress. And that, that's really, that's really the challenge, I think, and that's what kind of got me interested in it. I had a personal experience I can share with your audience if you want. I was teaching and minding my own business as a professor when I came down with four of these chronic diseases myself. These are common diseases that most adult Americans have at least one of them, and many have more than one. I got these four diseases. I went to my doctors, and they said, "Don't worry about it. Here's a prescription for each one." I got four different prescriptions. And I, I said, "Well, hey, you know, what about lifestyle? I hear stuff about that. Does that, is that going to help?" And they go, "Nah, that really doesn't work. You know, you're going to be on these pills for the rest of your life, so get used to it." You know, and, and at that point, I had my kids were young, still in elementary school, and I realized that this wasn't going to end well, you know, knowing what I knew about the natural progression of these diseases and everything. And so, I, it forced me out of self-interest to really go back and look at the literature and kind of re-educate myself at the at the progress that had been made. And there was a lot of knowledge that I wasn't aware of, breakthroughs about how lifestyle can actually change these diseases. And so, long story short, I made a few relatively mild changes in my own lifestyle. When I went back to my doctors, they couldn't believe it. They thought the labs were broken. And bas, basically, I was able to reverse all four chronic diseases, stopped all medications, uh, just through changing my lifestyle. And, and since then, now I've, I've made it my mission in life to help others take back their health and hopefully not make the same mistakes that I was making.

>> What's so fascinating is you mentioned that your mother was a dietician, but you were also teaching in medical school. Was there a gap between what you were raised and being taught about nutrition or the importance of nutrition and then how what you were teaching?

>> Being being raised with my mom with nutrition, I, I was sort of seeped in the idea that food mattered. Okay.

>> The only problem was the teaching at the time was it was it was the wrong sort of stuff. In other words, we avoided eggs, you know, especially egg yolks. We religiously substituted margarine for butter and replaced, you know, healthy butter with seed oils and, and this kind of thing. We, we always got the low-fat options, as many people, you know, this was this was the way it was taught back then. This was a while ago, but, but so.

>> Some of it's still taught though, I would say. Some of it's still taught.

>> Yeah. Sadly. Yeah. Sadly, it still is. And in medical school, there was there was very little nutrition taught, you know, as you know, you know, so, um, but what was taught was probably incorrect for those reasons, you know, substituting sugar for fats in your diet and going to a, you know, high sugar, low fat thinking it was a healthy option, you know, seed oils instead of healthy, healthy fats, those kind of things. So I was aware of the nutrition advice from my mom, but it didn't seem to work even though I followed it myself, and that's probably one of the reasons, one of the reasons I developed those chronic diseases, uh, over the years.

>> So I have to ask, a lot of the people that are watching and listening to this have not been cared for properly in the standard care model. They still have chronic illness. A lot of them have been told that their illnesses also cannot be reversed, that they just have to take a medicine. If their cholesterol is out of range, they are recommended a statin, and then they're sort of almost fear-mongered to take it, or they can have a cardiovascular event. And then a lot of the, the, I guess, the tinfoil hat, uh, thought is that because medical schools are all funded by Big Pharma, um, the lessons are taught in a certain way to only give medications. How much of that, since you're, you were really plugged into that, how much of it is that Pharma is really pushing the model of medical education? Is it just that they do fund in the background, but you're just taught a certain allopathic way? If you can share a little bit more insight for us to understand, you know, what happens in medical school?

>> Yeah, it's a great question. And, and first of all, I want to say, you know, I don't believe that anybody, including physicians, gets up, most people, and wants to do harm to others, you know, so it's not like we're going to harm people by these choices. But having said that, I think I, I don't think it's a conspiracy, you know, I think it's literally just the way the system is, and we, we have to be aware of it. Just like when my mom would go to the dietician conferences, they were sponsored by McDonald's and Coca-Cola and, you know, the junk food industry was, and still to a large extent, funding nutrition science. They pay for the professorships and the education and everything. Well, in medical school, it is funded by, to a large part, by pharmaceutical industry because that's that's where the money is. And not in a bad way, it's just that's the revenue machine. And, um, some of the options for these chronic diseases, like like we talked about, like lifestyle, don't necessarily generate any revenue. So there's, there's not necessarily a fasting lobby going in and telling people to do fasting as a healthy thing or, you know, so it's just, it's just the way the the the system is. But it's, it's very corrupting because, you know, the papers are sp, the research is sponsored by, um, in a large part by pharmaceutical manufacturers, device manufacturers that all have products that they want, they want to do to help people. So if you have, if you have an alternative that doesn't involve a sale of something or a prevention, it's much harder to get that in the system. And the, and the system is really set up around treatment. Um, you know, one, one realization I had, even though I'm a doctor, I realize now that doctors don't make me healthy, you know, as a patient. If I want to be healthy, that's what I, I, that's on me myself. Doctors just make me less sick. That's their job to handle disease. But if I want to stay healthy and prevent disease, that's that's me through lifestyle and the life, life choices that I make.

>> No, that's great. I love that. In medical school, if you could go back, what is one quote-unquote lie? And that's really from your book that I'm, um, talking about, but what is one lie that you could go back and change?

>> A lot of a lot of the metabolic illness is related to insulin resistance, and that is tied to nutrition and choices about food groups that we eat, in particular carbohydrates and starches and, you know, high glucose. And not recognizing that is a big problem, uh, for people in their diets, about how harmful sugars and refined carbohydrates and junk food in general, but how, how bad those can be. And if I can just give an example, the type 2 diabetes is, uh, the most common type of diabetes, and it, it is exploding now. It just came out a report a few months ago that fully one-third of teenagers, of adolescents are now pre-diabetic in the United States. The adult numbers are even higher, diabetic or pre-diabetic. And this is diabetes is a serious disease, and pre-diabetes is diabetes, really. It's, and it's a serious disease. It, it, it leads to all the chronic diseases we mentioned: hypertension, obesity, uh, cancer, heart attack, stroke, Alzheimer's, and mental illness. They're all increased dramatically with diabetes. So, if I get diabetes today, I go to the, my doctor, and they will recommend some drugs, you know, things like metformin initially, and then later on, insulin and things like that. And these things will control the symptoms. They'll keep me from dying. And I'm not recommending anyone not, you know, not take what their doctor recommends, uh, or stop taking what their doctor has recommended. These are very serious medications. But the problem is, those diabetes medications will keep you from dying from a hypoglycemia, and they are life-saving, truly. But when you treat diabetes that way, it is what's called a chronic progressive disease. In other words, it keeps going on to what, what all the, all the chronic diseases I mentioned, plus complications like the number one cause of surgical amputations in America is type two diabetes. The number one cause of of renal failure and dialysis is diabetes. The number one cause of retinal blindness is diabetes, and on and on and on. So, if you treat diabetes the way that the medical system treats it, it doesn't kill you immediately, but it becomes a chronic progressive disease in most, in most cases. And the interesting thing is, the really disturbing thing is that, and I don't believe this is communicated enough to the patients, that there's another treatment for type two diabetes that has been shown in prospective control trials that works in the majority of people, and that is, if you just cut out carbohydrates and, and refined carbohydrates and sugars and go to essentially a low-carb diet. For the majority of people, they can decrease their medication, in many cases, get off medication entirely. But the interesting thing happens when you treat diabetes by removing the the basically the the sugars and the carbohydrates that drive it. It no longer becomes chronic progressive. It basically stops, and you don't get all these downstream effects, and it doesn't get worse and worse and worse. You basically arrest the disease, and I don't think this is communicated enough to patients.

>> So what you just shared, um, a lot of the community understands that because they are trying low carb, they do see numbers improve. Do they understand that in medical school? So do they teach what you just shared in medical school?

>> Yeah, I mean, it's, I think, I mean, the studies are out there, published long ago, did them, and other people have done them, that you can reverse type two diabetes with this. The pushback a lot of physicians have, and, and rightly so, is, well, you know, I can, I can prescribe a pill or a medicine in five minutes, but to explain how to, you know, a whole diet and everything, patients aren't receptive to it. And let me put the blame too, on not just on doctors in the healthcare system, but also on patients, including myself. You know, I'm basically lazy as a patient. If I go into a doctor and the doctor says, "Okay, you have this disease. I can give you a pill for it that you take once a day for the rest of your life," or even surgery where you maybe have to take a week off from work and then recover, but then you're done for the rest of your life. You don't have to change who you are. You don't have to change your lifestyle. I would rather have a pill or surgery than get a lecture about what I have to eat and exercise and all that other stuff, because that literally changes who I am. So, you know, patients are asking for pills or surgery, but I don't believe it's being presented to them in in the clear way that it's not an equal choice. You have pills or surgery, you'll continue to get worse and worse and worse in, in many cases, whereas, if you change your lifestyle, you will stop it, and you'll get better in so many other dimensions of your life. And I think that's the problem. So, it's not just the healthcare system, but it's also the the patients, you know, that we're all kind of, we're all resisting lifestyle changes because it's harder work than just a pill or surgery.

>> Yeah. Yeah, it's fascinating because you're right, the maybe the two options are provided, but one is the the pill version, though it's progressive, and that's maybe the part that needs to be emphasized more of, if you take the pill, which is easier, you don't have to change anything, and your blood sugar won't be as high, or, but there is a, there's a cost, like down the road, it, the one pill may end up turning to two, and then insulin, and, and that's the part I think that people, if maybe they knew, but in general, I agree, I think it is really hard to change, and as humans, we want the least, you know, the, the path that has the least resistance. I see it all the time in our practice, even with our most diligent clients, so I totally get it. What is taught about obesity in medical school? And then what do you think? Is obesity a genetic thing? Is it just people are not moving enough? They're not eating too much? I mean, what do you think about obesity?

Hey guys, just a really quick break. Nutrition with Judy's private practice is now called Empower Functional Health. I started as a nutritional therapist, but we have become much more all-encompassing. At Empower Functional Health, we do functional medicine, chronic illness, autoimmune, gut health, environmental illness such as CIRS, mold illness, Lyme. Regardless of all these names, the goal for us is always to get you root cause healing answers. And of course, carnivore, the all-meat elimination diet is always on the table. Food, the right food is always medicine. We offer functional tests, prescription meds, and really everything to get you closer to root cause where you can just eat the meats you enjoy and live the life that you are meant to, symptom-free. The goal is to get off meds, supplements, and everything else that your body no longer needs support in. Our practice, whether it's Nutrition with Judy, sharing podcasts and free content, or our private practice, Empower Functional Health, our goal is to support you guys in the barbell theory. We give a lot of free content, our evidence-based research. We don't use Substack. We give all our stuff away for free. And we interview with the best and make it super tactical so you have clinical pearls that you could walk away with and try in your own healing journey. And then we work with some people and a smaller subset one-on-one to provide that level of personalized care. And as we heal these people that are chronically ill, we find these clinical pearls and golden nuggets that we can share then more publicly so that we can make wellness for all. Hopefully, the content and the guides and the free stuff we give out is enough for you to heal. But if it's not, you can always come and work with us in our private practice so that you can get more personalized care. If you want to learn more, make sure to check out empowerfunctionalhealth.com.

>> Yeah, that's, that's there's there's a fundamental sort of lie about that or misconception that I believe that is is still the way obesity is being taught today. And just to frame obesity, obesity is one of those chronic diseases that's that that basically took off in the 1980s and '90s like all these other chronic diseases to the point where today most adult Americans are obese or overweight. Um, and that's that's just the way it is. And obesity is is one of the leading risk factors for cancer now and for all the other chronic diseases we talk about. So, obesity, obesity is a, a big problem. Um, the, the solution for obesity, the current teaching that's even still taught at my, my medical school is that, uh, you just need to exercise more and eat less, right? And that, that's wrong on both counts because exercise, as you know, um, it's almost impossible to, to, you know, work off a bad diet because the number of calories you expend on a given exercise, you, you quickly overcome them with one muffin from Starbucks, you know, so the, the math doesn't work out. And plus, exercise makes you hungry, you know, the expression, work up a diet, I mean, work up an appetite, right? So that's the problem. And the other problem is that just eat less. That makes the assumption that all calories are equal. You know, calories in, calories out. That's all that matters. But we know metabolically that calories from different food groups, the three food groups respond or cause the body to respond very differently. A, a fat, a rather, a carbohydrate calorie tells the body to store fat and, and gain weight. A fat calorie doesn't have that same effect. And that's why a 100 calories of potato chips leads to a thousand calories of potato chips because you can't, you can't stop eating and it triggers these hunger things. Whereas 100 calories of a hard-boiled egg, nobody eats the whole dozen of eggs afterwards. You know, it's just not a problem. So the myth that calories in equals calories out and just eat less is not the problem. It's eat, it's what you eat. As you know, I'm just obviously preaching to the choir. I'm telling you that, you know, you, what you already know better than I do.

>> No, it, it, it totally makes sense. If you were treating again, and a patient came in and they're not fully metabolically unwell yet, what are some labs that you would run or certain indicators? And then how much do you put importance on labs versus physical symptoms or their physical features?

>> One of the other kind of realizations I had, um, going through this process was that these diseases, these chronic diseases that I spoke about, they don't begin when the doctor diagnoses them. In, in other words, they, they begin years to decades before the doctor makes the diagnosis. And so, if I wait until the doctor says, "Oh, your fasting glucose is up. You're pre-diabetic or you're diabetic," or "Oh, you forgot your keys, you've got Alzheimer's," you know, you, if I wait till that point, I've missed a tremendous opportunity for for prevention. And that's really the, the thing. And the, the, the earliest signs for these diseases, um, may not be something that we can see. We may, or they may be very vague symptoms. They just, you just feel off or something like that. So, the, so to answer your question, the blood markers are really important. Unfortunately, the ones that the, the usual ones that doctors rely on miss many of these diseases, are miss fundamentally metabolic disturbance. As one example is fasting glucose. That's kind of the, the test for diabetes and insulin resistance, or a hemoglobin A1C, which is a related test that measures the average glucose levels over 90 days. Basically, those two tests are great, and they are literally the diagnostic criteria for diabetes and pre-diabetes. The problem is that before your glucose ever goes up, if, when you have insulin resistance, insulin is the hormone, you know, I'm sure your audience knows that that.

>> Oh, please share. Please share.

>> No, no, that, that, uh, it's, it's a major, um, nutrient. It has many, many functions, but one of the things it does is it responds to high glucose levels and helps the body clear glucose. So, when we have a lot of glucose in our diet, insulin, uh, begins pumping out of the pancreas at very high levels to keep the sugar under control, which is damaging at high levels. And the more, the more sugar we eat, the more insulin comes out of the pancreas to keep our glucose levels normal. And the problem is, over time, the, our insulin levels get higher and higher and higher from the pancreas to keep up with the amount of sugar. And this is called insulin resistance. But the point is, insulin levels get very, very high for many years, even decades, before we ever see any abnormalities in fasting glucose or hemoglobin A1C. So, the problem is, you can have a normal fasting glucose, normal hemoglobin A1C, but if your fasting insulin is completely elevated, it means you're, you're very sick, and you're on, you're on the way to to diabetes and all these other things. So, blood tests are important, but you've got to do the right one. So, fasting insulin instead of fast, or in addition to fasting glucose, and, and you, most doctors don't run it. Uh, other things, you know, with heart attacks, we, we, you know, we hear about LDL cholesterol and all these things. Well, actually, a much better indicator is HDL cholesterol and triglycerides. Those reflect metabolic health, and abnormal triglycerides, too high, or abnormal HDL, too low, is a much greater risk factor for a heart attack than an LDL cholesterol. Most people who come into the emergency room with a heart attack have normal cholesterol.

>> Right. Blood pressure. You mentioned that so many people, or the medical model has blood pressure misunderstood. Um, and it's one of the thoughts that if you have high blood pressure, that equates to having a cardiovascular event. What are your thoughts about blood pressure? Is it really the salt?

>> Yeah, I mean, well, first of all, high blood pressure is definitely a risk factor for cardiovascular events, stroke, heart attack, all these things. High blood pressure is very serious. And that's why every, you know, every doctor visit anywhere you go, you always get your blood pressure checked because it's silent. You may not feel it. And it's a great way to, you know, help people by detecting this early. I, I think the, the relationship to salt is is challenging because, uh, the amount of salt in our diet is not that much higher than what we had in the past where salt was used as a preservative. And I think it's more nuanced than that. In other words, even getting back to what I said about the pills and, and surgeries that are developed, treating the symptoms, the, the pills and the pills for for hypertension are very effective in lowering the blood pressure. But I think the problem is, is they mistake the root cause, which in my opinion, in many cases, is tied to metabolic dysfunction. So, when, when we have, uh, insulin resistance, it has effects on the kidney in retaining salt and raising the blood pressure. So, I think it's much better to treat hypertension long-term with lifestyle and low carbohydrate diet. That's one of the effects, you know, as you know, of low carbohydrate diet is people get dizzy because their blood pressure drops, especially if they're on blood pressure medicines. It's just their body telling they don't need the pills anymore, right? In some cases, in many cases, I think the interesting thing is that the blood pressure medicines, and again, don't stop taking them if your doctor recommended them, but, but a more root cause, broader approach is, if you get your lifestyle in order, for many patients with with correct diet, you will be able to get off your blood pressure medicines. I did. That was one of my four diseases was hypertension.

>> And so now you don't take any medication?

>> Uh, yeah, basically. I had gout, which is, you know, arthritis. I had hypertension. I had diabetes, pre-diabetes, and I had, um, abnormal blood lipids. And, you know, you, you can imagine the drugs for each one of those. And, and, uh, basically with lifestyle change, relatively simple ones, uh, I reversed the conditions to the point that I don't need the medications anymore.

>> Let me ask you about gout now that you're talking about it. So, there are fears about eating a lot of red meat because it supposedly contributes to gout. Do you reduce your red meat consumption? What are your thoughts about that?

>> No, I mean, I, I think, you know, I think red meat is one of the, or meat is one of the healthiest things you can eat. I mean, it's, I'm not, I don't mean to make a judgment about vegans or carnivores because I realize it's very politically charged. And I was even a vegan for 10 years myself. So, but, uh, >> uh, and I love my vegetarian friends and I love my carnivore friends. I just wish they could get along better. But, you know, as a dietitian, you know, it's very easy to be healthy on a, on a carnivore meat-based diet. It's much more challenging on a vegetable-based diet because there's certain nutrients that you, that you miss out on. So, you've really got to pay attention to it. So, I think that's the, you know, that's the challenge there.

>> But what about for gout? So, so.

>> Oh, for gout, yeah.

>> If you can explain a little bit. So, there is a fear that my gout is exacerbated by red meat. For you, that didn't happen, and so you don't think there's a real connection?

>> That, that didn't happen for me. You know, there's that link with purines and meats and, and certain things, and every, everybody's different. But I think there's a lot of overemphasis on that. And personally, I think a stronger factor is fructose metabolism, >> because, you know, with fructose, uh, we can, we can go through the pathways there, but basically, it, it elevates uric acid. And, uh, there, there's a great book about, uh, uric acid, "Drop Acid," that talks about uric acid kind of being an, an, a known marker of metabolic disease, which it is. And I found with, with, uh, changing my lifestyle, which was basically getting rid of junk food, which is high in sugars, starch, refined sugars, and seed oils, when I got rid of the junk food, my, my gout, my uric acid levels, which is the marker for gout, >> just went down. So, um, I think again, the general lifestyle recommendations are good as a starting place, just like, but then we have to personalize it. In other words, for our diet, some of us are, you know, can't tolerate dairy. So, okay, we'll pull that off. And other people may be more sensitive to to issues with meat, or they may have other issues there. But as a starting point, I, you know, I, I would, I would address the gout with with limiting fructose and, uh, junk foods.

>> No, that totally makes sense. We didn't define what metabolic dysfunction is. So, for anyone that's just watching this and they're like, they keep saying that the issue is metabolic dysfunction. What does that mean? If you can summarize that, because then I want to ask you a few questions of how that then dysfunction is also related to Alzheimer's.

>> Yeah, metabolic dysfunction is sort of a broad classification. You know, metabolism relates to to mitochondrial function and energy production in the cell, which is sort of the final common pathway that food gets converted to energy. In, in a broader sense, metabolic function sort of encompasses abnormalities that include insulin resistance as, as fundamental, chronic inflammation secondary, and then oxidative stress as well. So, these three conditions linked together are, are tied to metabolic dysfunction. And Gerald Raven famously in the '80s or '90s, uh, came up with, uh, the idea that metabolic dysfunction is linked to, you can, you can measure things: abdominal girth, your waistline, your hypertension, your blood glucose. There, so there are few things you can measure. And disturbingly, when those criteria were applied to the US adult population, they found that almost 90% of adults in America had at least one indicator of metabolic dysfunction.

>> Okay. No, that was beautiful. That was great. So, tell me now, how is metabolic dysfunction in fact related to Alzheimer's? And I'm only asking because a lot of people will say, "Just work your brain, you know, do Sudoku puzzles, and that will help your brain stay healthy," but there's this metabolic side to it. If you can explain, what does Alzheimer's have to do with metabolic dysfunction?

>> Yeah, and that's kind of the, the, the recurring theme in my book. I go through, I go through the diseases I had, and then I have a chapter on heart disease, cancer, Alzheimer's disease, mental illness, and I run through all of them, and the common theme beneath all of them is that they respond to metabolic therapies. In other words, there are certain lifestyle things and therapeutic approaches that get your metabolism in order, um, and, and things like going into ketosis and all. And it's fascinating because going into ketosis and a metabolically favorable diet can improve, you know, weight loss. It improves hypertension. It improves cardiovascular disease. It's now used as an adjunctive therapy for cancer treatments, going into ketosis, and for Alzheimer's disease. Fascinatingly, there are many patients that respond to ketogenic diets or even exogenous ketones, as, as Dr. Kelly has a book about that, where her husband had severe Alzheimer's. She was a neonatal oncologist who used MCT oils, coconut oil in, in the neonatal ICU, and she gave it to her husband, and this is, this is an exogenous ketone essentially, and was able to significantly reverse his, his Alzheimer's disease from this metabolic intervention. And Heather Sanderson, I don't know if you've had her on the podcast, she's a physician that works in Alzheimer's, uh, clinics, and she has a, a bunch of Alzheimer's, uh, essentially retirement homes, but it's interesting in her retirement homes, the patients get treated, then they go home, which is usually not the case with Alzheimer's disease. It's usually a one-way street. And I, I've had her on my podcast. I've talked to her several times about it. And, you know, she says, "Well, one of the fundamental things we do when these patients come in is we put them on a, a metabolically healthy diet, which is essentially a ketogenic diet." And I, and I go, "Okay, how do we know, you know, come on, Heather, how do we know it's the diet? You know, maybe it's something else." And she goes, "Well, for some of the patients, it's really dramatic. Like Mr. Jones here, when he's in ketosis, his grandchildren come into the room, and he hugs them, and he knows all their names. But when he goes out of ketosis, and they come and visit him, it's just a blank wall. He doesn't recognize them anymore." And for some, some patients, it can be as dramatic as that. And interestingly, sort of to, to continue the arc one more, Chris Palmer and others are now advocating metabolic psychiatry, which is using ketogenic diets for mental illness. And again, not all patients respond to this, but the fact that any of them do is, is remarkable. And, and Chris, I had the same conversation with Chris about a schizophrenic patient who, you know, went out of the hospital and got off all meds, went back home, and got a job, began working. And Chris said, "Well, it was a ketogenic therapy." And I go, "Come on, Chris. You know, how do you know it's, how do you know it's the, the ketosis?" He goes, "Well, very simply, when Mr. Jones, different Mr. Jones, when Mr. Jones, when he knows when he's when he's in ketosis because he's, he's, he's normal. But he says if he eats some junk food, or he, you know, eats the wrong food that takes him out of ketosis, he can sense it right away because voices start talking to him again, which, you know, your audience may know is the hallmark for for schizophrenia. When you hear voices, that's that's really indicative of that disease. And so,

>> Um, and so in terms of Alzheimer's then, would you say that being in ketosis can just stop the progression or can it actually reverse some of the progression?

>> Well, with, with Dr. Kelly's, uh, experience that she wrote about in a book, um, it actually reversed her husband's, her mocha score, which is the, the mental status score, and it really improved him. So people actually can improve on this, and it's not 100%, it's not all people. But again, the fact that any people respond to this, everybody, every person with Alzheimer's should try it at least because it's, there's no downside to it, really, other than the, you know, whatever inconvenience it is about changing your, your diet and all. But Alzheimer's is, is challenging, you know, if you think about it, Alzheimer's represents the ultimate failure of the medical establishment. You think about it, we've had decades of time and essentially unlimited financial resources to combat this, this disease, and there's not a single pharmaceutical that has any significant effect on the, on the trajectory of the disease. And, you know, part of it is, it's based on this amyloid hypothesis, which increasingly, there's now, you know, out-and-out fraud in some of the scientific articles that were done about it. But, but the whole amyloid theory is, is being relooked at. And we may be, part of it is, uh, not everyone with amyloid, with amyloid has Alzheimer's disease, and not everyone with Alzheimer's disease has amyloid in their brain. So, it's probably, Alzheimer's is complicated, obviously, and it may, it's probably not even one disease. Uh, Dale Bredesen has a great approach to it with his, you know, his approach to Alzheimer's. And, you know, for some people, it's vitamin D deficiency. You fix that, and their, their, their mental, their brain fog comes back. Or, or it may be a parasite, or it may be mold, or, you know, it may be all sorts of things. And for some people, it's sensitivity. You know, it's, it's metabolic dysfunction that drives inflammation, and that drives the Alzheimer's. So, um, yeah, I think, you know, Alzheimer's is, is challenging. And, you know, hopefully, hopefully, we're, we're going to get some clarity with it in the future.

>> There is a subset of people that believe that it's type three diabetes. Do you want to explain why they, like, how can Alzheimer's be type three diabetes?

>> Yeah, I mean, well, first of all, like all the chronic diseases I mentioned, people with diabetes have a much higher rate of all of those diseases. So, and, and diabetes is insulin resistance by, by definition. Type, type 2 diabetes. There's a school of thought about Alzheimer's. There's one consistent finding about Alzheimer's. The, the amyloid is not a consistent finding, but one consistent finding is almost all patients have disordered glucose metabolism in their brain as, as a sign of Alzheimer's, as even an early sign of Alzheimer's that may, may predate the, the subjective experience of it in the patient. What does that mean? That means if you put them in a, a scanner, like a positron emission tomography scanner, a PET scanner with a glucose FDG glucose isotope, you'll see decreased glucose uptake in the brain. So, it's like insulin resistance in the brain. And the people, as you know, there are two metabolic systems in, in our body. We can either burn glucose or we can burn fat or ketones, and you, you switch back and forth between those. When the brain is not able to burn glucose very well, then we get brain fog. We get brain symptoms. But when ketones are available, they allow the brain to function. Some people say even more efficiently than on glucose. And in these patients, these Alzheimer's patients who have this insulin resistance of the brain or glucose abnormalities, they do, they do great when they're given ketones. And that may explain some of the things we talked about before.

>> At what point are there symptoms of people struggling with dementia, Alzheimer's? What are like the first clues of that going on?

>> And, and to be clear, dementia is, is Alzheimer's is one type of dementia. There are other types of dementia, frontal lobe dementia, there's dementia related to toxicities and, and other things like that. So, Alzheimer's is a subset of, of dementia. The other interesting thing about dementia is that, um, you know, the obvious thing, like I mentioned earlier, you know, people, you can't remember names anymore. You walk into a room, you can't, you don't remember why you got there, or you, you know, forget keys, forget your wife's name or something. Those are, you know, those are some, some early signs. But it's interesting that the higher the education level of the person, the longer it takes to reach those, reach those symptoms. So, you know, if you have like a college professor or something, they, they could seem to be normal, and they don't forget their keys. They don't forget things, but their mental capacities decrease by 50%. You just don't notice it anymore. So, part of it depends on your kind of cognitive reserve. That's always something to take into consideration when you're evaluating people above that baseline. But some of the things can be very, uh, subtle. But fortunately, you know, there are some earlier tests now. And Alzheimer's, just like all the other chronic diseases we mentioned, doesn't start when you, when you forget things. It starts decades to years before. And that's why everyone should, in my opinion, embrace a healthy lifestyle to delay and push back those chronic diseases. Don't wait until your doctor diagnoses one of them.

>> One thing I want to ask is a lot of our clients, the PE, the community watching this, they will try a low carb carnivore diet, and then their cholesterol goes up, and it's, you know, on the LabCorp Quest labs, it shows it's out of range. And then their doctor will say, "If you don't get on a statin, you will have a cardiovascular event. It's not a matter of if, it's a matter of when." And so they get scared. And so I see even in all the forums, "My doctor says I need to get on a statin. I feel better, but I'm scared." And so you, as a doctor and as a professor that taught medical students, what would you say to the people that go to their doctor and then they hear this? Like, how do we feel some level of comfort that maybe statins aren't the best thing, but, you know, what, what should they do and how should they feel comfort, and maybe the diet is okay?

>> That's a really important question because there, there is a lot of controversy about this. There's, there's one camp, largely with sort of mainstream cardiology, the American College of Cardiology, cardiologists, their whole profession is around treating LDL cholesterol with statins and other drugs. And they firmly believe in the diet-heart hypothesis with fat causing heart disease and that the number one risk factor is, you know, LDL cholesterol or elevated fats in there. And so they recommend a low-fat diet, which turns out to be a high-sugar diet, you know, because of the macronutrients, we don't, we don't adjust the proteins, but we just, we, we shift, as your audience well knows, sugars and fats, carbohydrates and fats. And the problem is, the high carbohydrate diet is what drives metabolic disease. There's another camp about metabolic disease being a greater driver for heart disease. Uh, and I believe, I, I fall into that camp. And you, you can calculate what are called hazard ratios for having a heart attack or heart disease. And elevated LDL cholesterol is, it does have an effect there. But the hazard ratio for smoking is much greater. The hazard ratio from metabolic dysfunction, as measured by LDL, I'm sorry, by HDL and triglycerides, is much better. Diabetes is a much higher risk for heart attack than having LDL cholesterol. So, would you rather have diabetes or would you rather have LDL cholesterol? The other thing is, I mentioned before, most patients who come in to have a heart attack have a normal cholesterol, normal LDL cholesterol. It's challenging there. And then statins is a whole conversation. And I have a whole chapter in the book about it. But statins, again, I'm not advocating anyone stop any prescriptions you're on, but you need to, you need to look at it very closely. I, I think they're, they're overused. They can be a benefit for people who have pre-existing heart attacks. In some cases, they can add value, but, but for prevention, for many patients, they, you have to weigh it against the risk. And the risk is lowering your cholesterol. You have muscle effects. You have brain effects and other things that, um, you need to take into consideration. One thing people can do if you really don't want to be on a statin and your doctor says, "Well, your LDL cholesterol is high." One thing you can do is get a coronary artery calcium score, which is just a CT scan. Takes about 15 minutes, looking for calcium in your coronary arteries. And if it's zero, even the zero means normal, healthy, no calcium. Calcium is indicative of heart disease. If you have a zero score, even the American College of Cardiology, even the most conservative cardiologists will admit you don't need a statin. So, you know, so.

>> Okay. So, I guess that's the route people can take. It's hard though, because what if a person then goes and gets the calcium scan and then they have plaque from a while ago, pre their low carb diet, but then now they're even more full to get on? So, it's, I think the ultimate thing is know who you're going to and knowing, I guess, what camp they fall into and have assurance in maybe all the other markers you're talking about, like your insulin level, your A1C, and, and also your lifestyle. Like, are your symptoms improving? Do you have less brain fog? Is your blood sugar more balanced? Do you have more energy? And then we have to challenge the narrative because the narrative has not worked for these individuals, including myself. And so it's just hard because when you have the white coat syndrome and you're like, but.

I think they know what they're sharing, and so you sort of get scared. I get it. Um, but it is pervasive in our community. It's unfortunate.

>> Yeah. And it's good to rec Oh, it's good to recognize that there are differences of opinion in the medical profession. There, there is disagreement about the use of statins, you know, and who knows if, you know, if I'm right or they're right. You know, time will tell. But looking at the evidence, it's not settled science. And we all need to be open-minded when we, when we look at these, these medical choices that we're offered.

>> No, I love that. I think having discernment and really knowing all the information before you just get on a medication, and especially long term, is super important. Tell me a little bit about your book. Where can we get it? Um, if you want to share anything that maybe we've missed that the book also covers that in case someone is interested in getting your book. And the title of your book. Oh, the title of the book is Lies I Taught in Medical School, which uh.

>> Love it. I love it.

>> It's um, it's available at usual bookstores, independent bookstores, Barnes & Noble, Amazon, uh, your public library. Uh, so, and if you want, you can go to my website and you can actually download a free chapter of it. Uh, which is a great way to check it out and see if you, you know, see if it resonates with you or not.

>> If you want to tell some of the chapters so that people get a sense of.

>> Yeah.

>> Yeah. Yeah, we basically I start off with kind of my own journey, uh, my own experience that I went through there, and then we talk about metabolism and sort of get, get everybody up to speed with the basic principles. We talk about things like mTor and different things like that. And then, then there's a series of chapters for each of the chronic diseases, obesity, hypertension, diabetes, cancer, heart disease, Alzheimer's disease, mental illness. And then the penultimate chapter is something I didn't intend to write about, but if you actually start this lifestyle, if you, if you get your life in order with this lifestyle and you decrease your risk of those diseases, those are the diseases that people die of statistically. So the next chapter is about longevity, which is kind of an unexpected bonus. And, and we talk about cutting edge longevity, things like rapamycin and other stuff like that as well. And then the last chapter is just the plan on how to implement it.

>> Okay. Well, thank you so much for your time. Where can people find you? You mentioned a podcast. We just talked about your book, but if you could just share and your website, and then I'll also put it in the show notes. Um,

>> sure. Uh, my, uh, my website is robertlufkinmd.com and we have a podcast that, uh, we cover a lot of these topics and hopefully Judy will be on it soon as well to talk about your new book. Um, uh, I'm, um, I'm active on social media. My wife says too active, but so, so please, uh, please follow me at the usual channels and say hi.

>> Well, thank you so much. You're such a delight to talk to and you could tell you're a professor in the way that you explain things. I've had so many people on this podcast and, um, it's, it's great. Please keep doing the work that you're doing. I will put all your information in the show notes. So, thank you.

>> Thanks. Thanks, Judy. This has been fun.

If you think of type 2 diabetes as one of the biggest risk factors of all other diseases or illnesses, then we know we need to control our blood sugar. And one simple way to do that is to reduce foods that have sugar or carbohydrates in general. We cannot reduce the amount of proteins we need because that's the building block. So our only other energy source then is fats. So it's either good fats you eat or sugars you eat. But we have seen over and over that sugars when you consume a lot of it that it causes all of this hyperinsulinemia, metabolic syndrome and metabolic dysfunction that then causes all of these other illnesses.

Now, there are people that will say sugar alone does not cause metabolic dysfunction. But most people don't eat sugar alone. It's with sugar and all the other stuff processed together that makes it very not ideal for metabolic health. Everyone's sugar tolerance is going to vary. Some people may be able to tolerate some amount of carbohydrates, but the key is that at a certain point, too many carbohydrates can cause insulin resistance. And if you have insulin resistance and high blood sugar, then it will impact your digestion. So reducing carbohydrates, processed carbs, processed foods ideally will allow you to have metabolic health.

All right, guys. Make sure to eat a lot of meat, take care of your bodies because it is the only place you have to live. I will talk to you later. Bye, guys.