Transcription
Last time you were on, we talked about lipotoxicity because you had just presented on that at Low Carb for Better Health last year. Let's make that the catalyst for this conversation. I guess let's kind of do like a refresher on what lipotoxicity is, and then from there, we can have all these tangents to dive into. So, give us an overview of that again.
Yeah. So basically, it, the lipotoxicity kind of originates because of personal fat threshold. So, everybody has, uh, when, when we're younger, we tend to make a lot of new fat cells. That's, uh, hyperplasia. That's where you create a new fat cell and then start filling it. Uh, uh, hypertrophy is where you have a fat cell and you're filling it up. Okay? So, those are the two mechanisms in which you can store fat properly. Um, you don't want it stored in other ways, like, you know, around the organs or in, in the organs, fatty liver, these kinds of things, you don't want that, or sitting in the blood with sky-high triglycerides, you don't want that. Um, so those are the two ways you, you can make fat. And when you're young, you can make lots of new fat cells pretty easy, uh, but for genetic reasons, uh, but for reasons we don't even fully understand, when you, when you're like a toddler, you stop making lots of new fat cells and you just fill up and empty the ones that you have.
Vast majority of people.
And so that creates a threshold, right? Where if you, uh, these fat cells, they only can get so big before the, the membrane actually, the integrity of that membrane, sorry, the membrane will fail. And so if it'll, the fat cell itself, when it gets full enough, will say, "No, no more fat in me because I'm too full." If it gets bigger, it's got a mechanism to shut down fat storage so that it doesn't burst. And what happens is, if you get a lot of fat cells in this state now, where does the fat go to be stored? It doesn't have any place to go because the fat cells are saying, "No, I don't, I don't want it." So now your triglycerides shoot up. You're, you get fatty liver, fatty pancreas, fats accumulating where you don't want it. What's that called? Type two diabetes, metabolic syndrome. And that's the main root cause of diabetes, type two diabetes. Um, but what it also, and that, and that's why you can have somebody who's, you know, we, we've had women 110 pounds that are type two diabetic because they just don't have a lot of fat cells, and but the ones they have are stuffed.
Uh, and then on the other end of it, you can have somebody 100 pounds overweight and their metabolic markers look normal. And we talked, we have a great case study of that. This is kind of where it gets a little muddy with people's notion of, um, you know, healthy at any weight, where they can point to people that are incredibly overweight that have reasonably healthy biomarkers and lab panels, and it's like, "See, they've got no metabolic dysfunction." That's not really healthy by any means, but that's kind of how that gets clouded, so to speak.
Yeah. And that's what we talked about here with Tyler. Tyler was, uh, 645 lbs, and he's a case study I put in here that kind of shows the power of personal fat threshold. So, I earlier I said almost nobody, uh, can create new fat cells in abundance when they get older.
Well, there's a few, there's a few genetic variants that can. Tyler's one of them. And the, the proof of that is his, his blood panel, his, uh, I want to get it wrong, so I'll look at it. His, uh, his insulin was like three. Here it is. So his insulin level was, uh, or glucose was 50, but that was abnormally low for, for him. It's normally like, uh, around 90. His, um, insulin was 3.5, his triglycerides were 77, HDL 42, A1C 5.6, homeir, which is kind of a marker of insulin resistance. If you're below one, you're insulin sensitive. He was .4. So, he's showing no signs of insulin resistance even though he's 645 pounds. And that's because he can continue to make new fat cells. And I believe that he would never get insulin resistant if his body just keeps making new fat cells and keeping the cell, fat cells small.
Right? Um, now his case, obviously, like his quality of life is at a detriment, like joint health, all that stuff.
Totally. You know, preface that as this is not healthy at any weight. This is the, the body showing you what it's capable of if you can continue to make new fat cells and keep the fat cells small. He has a lot of problems, like the pressure on your heart with all that weight and your organs, the joints. He, he wants to lose weight and he's been losing weight, and it's a big problem for him health-wise outside of the insulin resistance. But from, from that perspective, he probably would never get insulin resistant. Now, in regards to that being a benefit to that adipose tissue, this is why, like lipotoxicity, for instance, is not necessarily a positive thing long term, because that basically reduces the personal fat threshold and increases the likelihood of you developing insulin resistance if you exceed that threshold, so to speak, right?
Yeah. Liposuction, you're actually taking fat cells out. And that's why liposuction works, right? Because if you, if you, if, if your body could just make lots of new fat cells whenever it wanted to, if you sucked fat out of one area, it would just make new fat cells in there and build them back up. You know, liposuction wouldn't work. But that's why it works is because most people don't make new fat cells, so you take them out. But you're right, once they're out, now you have less fat cells to fill up and your, your fat threshold is lower. So you can, your, your metabolic flexibility goes down or has a lower threshold. So you, you could, you know, that's just hypothetical, if, if your fat threshold is, you know, around 40 lbs of extra body fat and you've just sucked out of some of those, now your threshold, you can only gain maybe 20 or 30 lbs of body fat before you hit this limit.
Instead of the 50. So you get, you have a little less metabolic flexibility when it comes to that. This is a total side tangent, but I was just recently made aware of this, but apparently, um, I didn't even know this existed, but basically like fat transplants throughout the body. So like using,
fat from your hips to add to fat elsewhere where it's more desirable, for instance, like, does that
impact that personal fat threshold or does your body adopt that transplant as if it had never been moved in the first place?
So what that does is, when those, when they do those surgeries, I believe, I can't remember the number, but it's a pretty significant amount of those fat cells don't, uh,
regenerate or,
yeah, you know, if you, if you put in a certain amount, I don't know if it's 60% that live and the rest die off because they don't, they don't assimilate to the new area properly. Uh, so you do lose some fat, uh, by doing that process. But some of it will be, you know, picked back up and, and used. So it does, it does work, but it does reduce somewhat the fat cells because some of them don't make the transfer.
Gotcha. Gotcha. So as it pertains to health, what should be like, an overarching goal with personal fat threshold? Like, is there, like, should somebody actually go and get their genes tested to see what their snips are as it relates to their ability to add more fat cells? Should someone try and stay within a certain, you know, percentage of additional adipose tissue to improve overall markers of health? Like, what, what's your take on that?
Yeah. So, uh, um, I don't know if there, I don't believe there's any genetic test to, to determine that. Uh, they don't have anything established, but, uh, there is genetic variance in different populations. Um, and I know, I believe you saw, did you see Dr. Nadir Ali's presentation at, uh, Meatstock?
I didn't see his presentation, but I am a big fan of Dr. Nadir, for sure.
He's a great guy. Uh, he did a presentation and he talked about, you know, with an Asian background, you have to be a little more careful because genetically, the Asian population does have a lower fat threshold. And this is why we see a lot of populations, it's, it's a little bit of the part of the Asian paradox, right? Where they, you know, you don't see as much obesity, but in some areas, you see quite a bit of diabetes now. Uh, as they move to more modern, you know, American style, uh, diets, you'll see a lot of diabetes and type, type two diabetes specifically. Uh, but you don't see as much obesity as you see here in America. And that's partly the genetic factor of what their fat threshold is. So they're hitting, they, they have less fat cells, so they hit that threshold and become type two diabetic without gaining a lot of weight.
And so Dr. Nadir actually talked about that in his presentation, saying, you know, "What, I have to be a little more careful how much weight I gain because I, you know, this metabolic breakdown is going to start happening sooner for somebody like me because of my genetics."
So you said you mentioned homeir earlier. Is that kind of like the, a very tangible test people can and should use to figure out if they're nearing that personal fat threshold?
Yeah. So a good thing to watch is your blood markers. And so the things that, things that are going to really indicate this is happening are fasting insulin and fasting glucose and fasting triglycerides as well. Uh, if you think about them, you know, in the body, if your fasting insulin is high, let's say it's 20 all day long, you should not have a bunch of fat and, and glucose in the bloodstream, right? Your insulin's hammering to get that out of the bloodstream. So, it shouldn't be in there if it's that high. Uh, but it's that high because you have all this extra fuel in the blood and the fat cells are not taking it. And so, you, you're in that metabolic breakdown state. And so, homeir basically looks at, uh, fasting insulin and fasting glucose, and it, and you can look up the calculator online. You punch those in and it gives you a number. Uh, below one, you're insulin sensitive. One to two, you're, uh, starting to get a little issue, and above, or three, maybe it is, and then above three, you're, you're insulin resistant. And, and the reasoning behind it is, if you've got, and you can be insulin resistant on that marker with a fasting glucose of 90. Because if your insulin is 20 or 30, but your fasting insulin and your fasting glucose is 90. Yeah, your fasting glucose is normal, but your insulin, your pancreas is working really hard to keep that normal. And the analogy I've used is like a car. If your, if your car is, you know, doing 55 miles an hour, well, looks good, right? That's fine. But if you're at redline RPMs, not good for the engine, right?
Uh, that whole time. If you're sitting at maybe even a little higher, 65, but your RPMs are like 2,000. Your, your engine's idling along. It's, it's totally fine with that. And that would be, say, a fasting glucose of 95 or 100, little higher, but your insulin's three. Pancreas has no problem controlling the glucose. It's doing it with very little insulin. So that's kind of the gauge that I gives you.
And that, I think, would be more telling of overall metabolic health than like an A1C, for instance, because that's looking at the average glucose over a three-month span. Like, I just did my homeir test before jumping on this podcast, and I was at .08, uh, so below that one range. So I'm not at risk of insulin resistance anytime soon, I don't think.
Yeah. No, definitely not. And your physique will dictate that as well. I mean, you're obviously below your fat threshold. I mean, you've had more body fat in the past. Uh, and your muscle mass. So the two, two biggest contributors to that. Let's go back to what we're just talking about. Glucose and, and, uh, free, uh, triglycerides. That's the, that's the fuel in your bloodstream. If you want to get rid of glucose, where do you put it? Muscle, glycogen. So, the more muscle you have, the more places you have to store glucose.
Mhm.
The fat cells, the smaller the fat cells are, the more space you have to store fat. So, that's, that's what you call gaining metabolic flexibility, is increasing muscle mass while shrinking your fat cells and creating room to potentially store fat. That's the flexibility that, you know, gives you a very insulin sensitive state.
Totally. How [snorts] would you, I think we probably touched on this a little bit on our last podcast, so people should definitely listen to that. But like, as it relates to lipotoxicity, how does that compare to glucose toxicity or gluco-toxicity and just energy toxicity as a whole? Like,
Yeah.
Is it basically two sides of the same coin?
Yeah, it is. And, and, you know, Dr. No in, uh, down in Cape Town. I, I got to speak down there last year at his conference, and it was really interesting 'cause I did my presentation first on lipotoxicity, and he afterwards kind of went back and forth with me a little bit on it, on talking more about the glucose side of it. And he then, the next day, he did, he, his presentation, and after his presentation, I went up and, and asked a question and basically stated, "I completely agree with what you're saying as well, but I think it's two sides of the same coin." And so, basically, if you have glycogen stores that are full, so you're not super active, but you have a ton of glucose coming in, there's no place to store the glucose anymore, and now you've got high glucose levels in your blood. Um, and then the body has to take that extra glucose and turn it into fat and store it in your fat cells.
That's the spillover, de novo lipogenesis. It's where it converts the glu, the extra excess glucose into, uh, fatty acids. Um, so there is a spillover, though, for that mechanism. And that's why my position on, you know, insulin resistance is, yes, that will elevate the glucose side of the equation in the blood and the issues that can come with that. But the thing that can affect both of them is when the fat cells are full, because there is no good spillover for fat. Once those fat cells are full, what's the spillover mechanism? It's sky-high triglycerides, fat in the liver, fat in the pancreas, nothing that you want. And so, at least on the glucose side, you do have a spillover where you turn it into fat and store it as fat. So, they are two sides of the same coin, but I think the lipotoxicity side is much more dangerous because that can actually cause the glucose to go up, too. So, the way I, I talk about this is, it's kind of like if you're herding brown cows and white cows, you don't really care what color they are, but the more of them there are, the harder your job is,
right?
And the brown cows and white cows are the glucose and fatty acids, triglycerides in the bloodstream. Pancreas has to control both. And so, if the fat is out of control because the fat cells are full, it's going to have a harder time controlling glucose, too. And glucose will fly up as well. And that's why we see, we've had several cases I put in this book, people that eat a zero carbohydrate carnivore diet, but they were doing very high fat, and they were at their fat threshold. So there was no place for that fat to go. Their triglyceride shot way up, but their glucose actually, in one case, doubled their fasting glucose. So that's why the whole thing can kind of fall apart. So if someone's past their personal fat threshold and they're consuming zero carbs, so too much energy from dietary fat, they would expect to see pretty significant elevation in triglycerides. Like, would there be an instance in which they are below their personal fat threshold but also see an increase in triglycerides, or is that a prerequisite?
Um, fasting triglycerides, not necessarily. Uh, you know, there, if, if you've got storage space, the pancreas is going to do its job and it's going to throw the excess into storage. Um, and so you won't have the triglycerides being high in the blood. Um, it's mostly when there's, you start running out of storage space, then they're going to creep up. And that's another way you can tell, you know, if you're eating, you know, that's why we, we are big proponents of watching your blood markers because you wouldn't know necessarily that this is happening, right? You're just, you feel good eating, you know, carnivore diet, but, you know, in his case, he was one of those that was quite lean, you know, he was at a, what most people consider a normal weight, and yet his triglycerides were way up, his glucose was way up, and, and he was having all these issues.
Um, what, what was, um, this can be highly individualized, but like, when you look at someone that's doing a zero carb diet and they see their glucose increase significantly, at what point is it too high? Like, you're not going to get the prominent spikes that you likely would if you're consuming a bunch of, you know, chocolate cake, for instance, but like, at what trending glucose range for a carnivore would be considered too high?
Well, and this is where, you know, obviously with triglycerides or glucose, there's, there's two, ver, two things, right? There's post-meal, postprandial, and then there's fasting or, you know, basal levels. Um, post-meal, I mean, we're not, I'm not super, you know, if, if you, if you have a post-meal spike of glucose of over 100 points, yeah, it's probably something going on. If it's 30
over 100 points, not simply a measurement of greater than. Yeah, if it goes [clears throat] from, say, 90 to 190, then there might be a little something going on there. Uh, if it goes up, you know, again, it's very individual, very dependent on a lot of factors, but, you know, 30, 40 points, I'm, I'm not concerned. Uh, but the one that would concern me is the fasting, much more. If your fasting goes up 30, 40 points, there's something going on. You know, if your fasting goes from 90 to 130, okay, something's not right here. You know, you shouldn't be having a fasting glucose going up that much. Same thing with triglycerides. You know, if you're 100 normally and so all of a sudden your triglycerides are 200, 250 fasting, there's something's going on, you know, and so that's a good way to kind of look into it.
It's interesting because I'm, I'm always tracking all of my intake. I'm tracking my macros. I'm tracking my blood panels. Like, I've got a really good pulse on everything. And I will see,
you know, tangibly higher glucose and trigs in the context of a surplus when I'm in a building phase
than I am when I'm in a deficit, you know, getting ready for competition prep or something. But it's always still within a very healthy range. I think it's within a healthy range because I'm not,
you know, I have a lot of muscle to act as a glucose disposal agent.
Um, and I'm using that energy in triglycerides with my training. So like, I have a pretty high output as well. Um, but yeah, I feel like simply getting these tests done on a regular basis is the single best thing anybody can do to have a pulse on things. And if you're, you know, not getting your blood panels drawn, but you're, you're probably not getting an MRI of your abdomen if you're not getting blood panels drawn. But if you're seeing an increase in visceral fat, that's like
an obvious indicator that you are in some degree of energy toxicity.
Definitely. Yeah. You can get that, uh, the ectopic, the fat around the organ. So if your, if your abdomen is bulging out a bit and you know you can pinch still the small amount of fat outside the muscle, then yeah, there's, there's an accumulation underneath around the organs, which is not good. And a great, a great metric in general is the height to weight ratio. Um, and so your, your waist circumference ideally should be half your height. Uh, and if it's not, you know, and your, your abdomen's growing, yeah, there's some sign of something going on.
That would you wouldn't really be able to tell that from a pinch test, though. That's going to be just adipose tissue, right? That you're pinching.
Yeah. Yeah. I'm saying if, if you don't have a lot of adipose outside of the muscle,
but your abdomen is growing in size.
Yeah. Yeah.
Probably underneath, right? On the organs, which isn't ideal.
Would you put much stock in like a DEXA scan for measuring, you know, visceral fat? I know like an MRI is going to be the gold standard there from an imaging standpoint, but like, would a DEXA scan give you a pretty solid indicator as well?
I, I'm not big on DEXA. I haven't done one myself, but I believe they can show a little bit of that, can't they, of where the, where the fat is.
Yeah. I mean, it's an X-ray technology, so like, you've got that. It's, it's not going to be as, you know, accurate as an MRI, for instance. But I feel like if, if it's showing that you don't have excessive visceral fat from a DEXA, probably doesn't warrant getting an MRI scan to validate that. I think it's probably fine.
That's probably, Yeah, I would agree with that.
Okay.
Yeah. I actually just got some more labs done myself 'cause I want to get my testosterone checked and, uh, I did a cholesterol panel and GL and, uh, A1C and a few other things. Uh, I was actually happily surprised by, or happily, uh, confirmed by some of the things that my testosterone, I don't take any testosterone replacement or anything like that. I've been eating this way for 20 years. Uh, my testosterone is 781, I think.
Nice. That's rocking, man.
Free higher than mine right now.
Free test was like 108, I think. Um, so yeah, I was pretty happy with that.
Did that trend up or down or hold stable from the last test?
Uh, last test was probably eight years ago, and I think it was, is actually up from that. I think it was 740 last time. So yeah.
Nice. What do you think the main contributing factor towards the high total and free is?
I would have to say diet and lifestyle. I mean, of course, there's genetics, genetic factors to that somewhat, but, you know, I, I don't vary off my diet. You know, I'm not one of those that'll go on vacation and have whatever I want and then go back. Uh, I've been eating this way for 20 years. Been, been, uh, the good thing is, uh, the last two years since I got my hip replaced with my, you know, Lyme disease and all the stuff I've had. Uh, I've been able to move more and I've been able to walk every day with my pup and get back into the room, weight room, and lift some weights. So, I've been trying to be more consistent with that, and I think maybe that's helping as well.
Nice. Did you get your sex hormone binding globulin tested too?
Yes, I did. Um, shoot, I can't remember what it was. It was in the normal range, so almost, not quite directly in the middle, slightly on the higher side, but totally in the green. Uh,
mine's always a little on the higher side as well. And I don't know why. I think with me, like, I've never had super high total or free test, and I think, I mean, obviously my training's dialed in, my nutrition's dialed in. So I think for me, it's just stress and genetics at this point.
Totally could be that. And I, I've had, you know, stress, of course, putting out, spending three months sitting at a computer trying to, we did this whole book ourselves. So it was like the layout and in design, and I'm not an in-design expert, but, you know, doing the colors and the layout of the text and the images and all that, like, we did it all ourselves. And so, yeah, and been audiobook, and yeah, it's been a, a, a crazy six months of work, and I'm ready for some time off and do some hunting.
Hey, well, you've, you've both earned it for sure, man. Can't ever go wrong with the hunting. That's therapeutic right there.
Oh yeah, for sure. And then the fishing as well. Yeah, absolutely. Um, talk a little bit about the, uh, let's talk about the Randle cycle. I feel like people are talking about that more. Um, what does that mean exactly? Uh, if you were to kind of break it down, and is that a, does that kind of disprove metabolic flexibility as it relates to people's concept of it, where you can just dual fuel switch at will?
Yeah. So, it kind of starts with something called oxidative priority. And oxidation is what is basically turning fuels into energy in your cells. And the, the priority comes from, you could basically think of it one of two ways. Either reverse order of storage capacity, or in, in order of toxicity. And so the first one in the oxidative priority is alcohol, because there's no place to store alcohol and it's very toxic to your body. If you have very high levels, it could kill you. And so it becomes a first priority. And when you, other fuels are coming in with the alcohol, carbohydrates, fats, they're getting mostly stored away while you burn off this alcohol because no place to store it. Next priority is is glucose, because you have some storage capacity. You know, maybe average person, maybe what, 1,600 calories in their muscle glycogen and maybe another 400 in their liver. Mhm.
Uh, so you have some storage capacity, but again, very high glucose levels can kill you as well. So it's important, um, and, and important thing about the muscle is, most people barely tap into their muscle glycogen, right? So on a daily basis, you know, if you're not doing a high intensity, you're not, you're not getting into that muscle glycogen very much. So you're just dealing with 400 calories that, you know, your liver can have for capacity. And then the last one is fat, because fat, you know, while it's, you know, high, sky-high triglycerides are not good long term, in the short term, I mean, do you, you don't fall over and die from a, you know, triglycerides being a certain level, you know, it's more of a glucose or alcohol thing. So not quite as toxic in the short term, and you, you know, most people or some people have almost unlimited capacity to store fat, you know, even lean athletes, you know, with 10% body fat will have 25, 30,000 calories in, in, uh, fat stored on their body. Um, and there's people out there like the person I just showed you with a million calories stored on their body. Um, and so that creates this priority. Um, and then when you look at taking the alcohol out, you're really kind of left with, the only fuels are glucose and fat. Protein is not a preferred fuel of the body. It's the building blocks for muscle, hair, skin, nails, all the things it needs, autophagy, everything it needs to protein, amino acids for every day. Um, so you look at carbs and fat. Now you're down to those two things. And the Randle cycle is basically just looking at those two things, carbohydrates and fats. And study after study have shown the more carbohydrates you eat, the less fat gets oxidized in the body or burned. So the more carbohydrates in the diet, the less fat is burned. The less carbohydrates, the more fat is burned. So it's like this, you know, it just, the, uh, oxidative priority of the carbohydrates overrules the fat. So whatever carbohydrates you eat, you, you burn that much less fat. And that's essentially the Randle cycle.
And not consuming carbohydrates, your body's able to produce whatever, you know, minimal glucose requirements it has internally obviously through gluconeogenesis. Like when you do not bring carbs back into the equation dietarily speaking, it's not like your body forgets how to metabolize glucose. So, you don't lose metabolic flexibility in that regard. There may be like a slight, you know, lag or delay, kind of like, um, the opposite of like keto flu, for instance, with the reintroduction of carbohydrates, but not like a complete removal of the ability to metabolize glucose.
Yeah. That, that's where people, some, you know, physicians or healthcare professionals, they'll do like a glucose tolerance test on you when you've been eating carnivore or keto for a long term, and, and you'll get an exaggerated response. Well, yeah, the body isn't used to it. You haven't been eating it. If you eat the, if you eat higher carbohydrate for two or three days before the test, you'll be totally fine. Um, but yeah, it's, the body needs to adjust.
Makes total sense. I've got a list of things I want to make sure to cover here. Um,
so in regards to, uh, personal fat threshold, kind of bouncing back. I normally don't have any notes, but there's so many things I wanted to make sure we cover.
Um, with regards to personal fat threshold, have you dug in at all to see if different types of fats contribute more or less to reaching that threshold? Like, for instance, stearic acid versus palmitic acid, things of that nature.
Uh, I haven't, but I would say that, um, at the end of the day, it's, you know, any fat that is going to fill that up beyond its capacity. Um, now, are there some that maybe inhibit the fat cells' function a little bit and maybe, you know, affect it, you know, in certain ways, possibly? I've seen some, you know, interesting stuff on that. Um, but at the end of the day, it's, it's when that fat cell just gets too, too full and it does not. So I would say the biggest factor is that, for sure, just the capacity in general.
And with regards to hitting threshold, whether it come from, you know, glucose toxicity or lipid, lipo, lipotoxicity,
Um, I'm assuming it's just energy in general, so overconsumption of fuel substrate, which kind of brings us full circle back to the energy balance, which often times gets a lot of flack in the keto carnivore space because calories don't count, right?
Yeah. Yeah. That's, that's something that's a little frustrating in general is, you know, clearly, I mean, if it's, if it's not, if calories don't count, then I guess I'm an anomaly 'cause I can, I can gain, lose 5, 10 pounds of body fat eating zero carbohydrate.
[clears throat]
You know, you just eat certain foods that, you know, dairy specifically is a, is a, is a big one. Um, or typically for me, it's over the holidays, you know, I'll just overindulge a little bit and not move as much because it's, you know, Thanksgiving and Christmas, and, uh, I'll put on a few pounds. That shouldn't be possible, right? Well, it is. And you see it all the time. And literally almost, almost daily, but for sure multiple per week, we get people coming, coming to us saying, "I'm, I'm just eating, I'm following the advice of carnivore of eating just the fattiest cuts and maybe adding butter to the steaks, and then I'm not losing any weight, even though I'm, you know, 80 lbs or 100 lbs overweight." Or in some cases, even gained weight. And, you know, they don't know what to do. Uh, and that, you know, it's espec, and most of the time, it's a post-menopausal woman
that we get. That's our biggest, and probably, uh, client clientele. Uh, and I, there's so many other factors that play into it. Yeah. If you're a 20 or 30 something man, eat all the fattiest cuts and add butter, and I'll bet you you'll get to a great weight if you're coming from a standard American diet. Uh, there's, there's a lot of factors that happen to the metabolism, especially post-menopausal women, or just every, when you get older in general, or if you're obese. Obesity by itself is typically leptin resistance is, is also involved. So leptin resistance means leptin's the hormone that says, "I'm full. Stop eating." And if you have leptin resistance, you don't get that signal as well. And almost everybody who's, you know, obese or 100 pounds overweight has some level of leptin resistance, and they don't, they don't stop eating when they should, right? And so, you know, these factors all play into it. But, yeah, at the end of the day, you can overeat anything and gain weight.
It's really frustrating for me. I know it's frustrating for you as well, 'cause like,
I don't understand what has to be this either-or argument. Why can't it be a both and? I mean, hormones obviously impact
huge factor
everything, and energy intake, energy output matters. So why can't we look at these more cohesively in tandem and then optimize? And that's why I think there's a stronger argument for a well-formulated ketogenic diet in the context of, you know, moderating, manipulating your energy balance, because your hormones are going to be more in check with those foods coming in as opposed to hyperpalatable processed sugary junk foods.
Yeah. I don't know why. I mean, do you have any pulse as to why the keto carnivore community, of which we're so very fond, we've both been in it for years,
is by and large so resistant to this notion of energy balance? Because energy balance
I think,
we, this, this could be like a three-hour podcast right here, but like,
calories in and of themselves are not, I mean, it's just an energy of a unit of measurement. Like, that that should not be labeled good or bad. It's just inherently a unit of measurement.
Yeah.
And when you look at the inputs and variables that we have control over, what you put in your mouth, you have control over much more so than you do directly impacting your hormonal balances. So using calories as a way to notate that and quantify it and manipulate it makes sense. Obviously, focusing on the macro distribution is key, but when you do that, you can by default calculate the total caloric consumption. But when it comes to our community, why do you think there's this massive push against the notion of calorie intake and just such an emphasis on insulin being the boogeyman?
You know, I think there's a couple components to it. You know, people get in these silos and they just, this is the one and only way. And I, I like that. That's one of the things I love about you is you just, you're open to more ideas and things that you personally, I, I'm always learning. It's one of the reasons we wrote this book is I've learned a lot in the past eight years and I want to get that out there and I want to, I, I don't want to stay in that silo of, it's, this is the only way. Uh, but I think a part of it too comes from the whole carbohydrate insulin model. Um, and this again could be a whole episode, but, you know, it basically says that, um, carbohydrates raise insulin, and that in high insulin locks energy away and doesn't allow you to burn fat from your fat cells and all that kind of stuff. So then it inherently would say that calories don't matter. As long as you have insulin low, calories won't matter. But the, there's multiple problems with that. Number one, uh, is that, you know, if that was true, um, everybody, uh, fully understands that as you lose body fat, your fasting insulin goes down, right? So that's well understood. Um, so if, if this was true, that this model was true, then shouldn't the first five pounds be the hardest to lose because your insulin is the highest? Your fasting insulin is going to be very high when you're obese, and then the last five pounds be the easiest to lose because your insulin is
Wish that were the case. That'd make competition prep.
Exactly. Exactly. You know, we, we can see this. We, we see it every day. Um, and, you know, and, and I make the case that fasting insulin is a much bigger problem or issue to address than post-meal insulin, because post-meal is a pulse. You know, you get [clears throat] you eat protein, you're going to get a pulse of insulin because it needs to, to utilize the protein. You have to have insulin to, to utilize it and use it for the body. Um, carbohydrates, even bigger, fat, a little bit, but actually more fat actually affects the baseline or basal insulin more, a little bit. Um, but at the end of the day, if you integrate the curve, going back to my engineering days, if you look at the insulin and integrate under the curve, how much total insulin is being used all day long by fasting insulin versus the insulin with meals, they, there's data on type 1 diabetics where about 80% of the insulin for the day was for basal or fasting insulin levels, and only 20% was for meals when they're eating low carb. So basal insulin is a thing you really need to worry about. And, uh, that's why we address some of these things like getting below your fat threshold, gaining that, you know, increasing muscle mass to, to drive insulin down, that fasting insulin.
Yeah. No, I totally agree with you on all fronts. Um, not to play devil's advocate, but just out of curiosity. So people often times point to type 1 diabetics, um, which they're taking exogenous insulin,
and are relatively thin more often than not because they don't have as much, they don't have their body producing it endogenously, obviously.
What is the mechanism as to why there are some type 1 diabetics, like I've got an employee that's type 1 diabetic.
Um, he does not eat very much food at all. Like, it's crazy to me how little he eats, yet he does have quite a bit of extra body fat. Like, what is the driver there?
That's interesting. Uh, yeah, you know, exogenous insulin is obviously never going to be as, you know, anything exogenous is never going to be as quite as effective as internal. Um, one of the things, you know, what's his body composition like? Because you know, the more muscle,
I guess he's probably around 35. He's got a lot of muscle, but he's probably around 35% body fat.
Okay.
30, 35, somewhere in there.
Yeah, that's interesting. I'm not, I'm not sure what the mechanisms happening there. Uh, obviously genetics and a lot of factors play into it, but, uh, at the end of the day, you know, we've had, you know, type 1 diabetics that are overweight. Typically, it's, you know, the food in combination with the dosing that's driving the, the fat storage, right?
Um,
Yeah, I'm not sure. It's interesting.
Yeah. I mean, I, I'm asking 'cause I honestly don't know. Like, I'm scratching my head by, I mean, it'd be one thing if I was like watching him sneak in a bunch of food.
Yeah.
But that's not the case. He's just not eating that much.
Um,
Very interesting.
Yeah, I don't have that one figured out.
Um, what about when it comes to,
gluconeogenesis? Demand driven versus supply driven. What's your stance on that? Because a lot of people are of the opinion that, hey, you know, too much protein just turns into chocolate cake. And I both know that's not the case. But,
I feel like to an extent, excess protein consumption certainly can lend itself to lower ketones and higher glucose overall.
Definitely. And that's more the insulin side, I believe. So, you know, more protein, you eat a little more insulin, which will drive ketones down more. Uh, but, you know, at the end of the day, I think protein, there's protein gets turned into glucose at kind of a, a rate, if you will, a low rate, low percentage. I think it only increases significantly if you, if you get very excessive amounts of protein, which, you know, for a typical person, if it's, if you're not drinking shakes, uh, you know, whey shakes and that kind of stuff, you're eating whole foods, it's going to be very hard to get to those levels, uh, 'cause it's just, you know, eating over 200 grams of protein to 300 grams of protein is just going to be too hard for the typical person, right? Um, but, you know, you get above those levels, and yeah, you could probably see the rate increase somewhat. Uh, but at the end of the day, you know, top up your glycogen levels, then, and your, your muscle or whatever, not, not a big, not a big deal. It's not like those levels are going to cause any problems of glucose from the protein.
Uh, and then the other side would be if your body just needs more glucose. So, if you are glycogen depleted and you're eating no carbohydrates, the body's got to make it out of protein. So you'd rather be out of the dietary protein than off your muscle, you know, your body's protein. And so that, those are the two factors I would say where it does get increased. But I don't think either are harmful in any way, right? I, I'd rather, uh, the protein I ate was turned into glucose to store to, to, you know, keep my blood sugar stable and top up my liver or whatever I need than using it off my own body. And you, you can do that through dietary fat through the, you know, the glycerol backbone as well from,
there's definitely standpoint,
a chunk of glucose you can get off of there. I think it's about 10% of the energy from the, your fat stores and ends up being glucose if you're burning the fat.
Um, but yeah, it's, uh, uh, it's not enough to, for the total dietary needs of the day for the majority of people. Is it possible that somebody like the, uh, Tyler I showed you earlier at 645 pounds could get enough fat to, uh, get enough glucose to, to stabilize that? Possibly. You know, it's going to definitely be dependent on how much body fat you have. Uh, but if you're, if you're within 20 pounds of goal weight, I'm guessing you're not getting enough glucose. You have to make some.
You would definitely be consuming protein, hopefully. So like, the body's going to preferentially use that to some extent. I would think that like for me, if I'm an excessively high protein relative to fat, I don't feel as good. Like I feel like,
I don't feel like I'm any less fat adapted because I've been doing this for so long, obviously, but I don't feel like I start to notice some of the adverse effects of, you know, similar to if I was consuming too many carbohydrates, like my joints are hurting a little bit, I've got less mental cognition and clarity. Um, obviously ketones a little bit lower, glucose a little bit higher, but,
I'm pushing the extremes on everything when I'm doing that. Like, I'm testing things, like I'm, I'm going to the nth degree.
I don't think the masses would have to worry about that so much.
Well, that, that's one of the themes of this book as well, is none of this is a one-size-fits-all. You know, you, somebody who's very lean like yourself, you need more fat in the diet because you need energy. Protein's not a good energy source. Uh, protein's kind of an emergency energy source, if you need it for something, if, if your glucose levels are dropping too low or whatever.
Um, but yeah, it's, it's a very independent, very, uh, individual approach. You need to adjust the diet based on your goals and your situation. You know, somebody who's got seizures or Alzheimer's, I'm going to pump the fat way up in their diet because I want a lot of ketones to help fuel the brain. Um, you know, somebody who's 100 pounds overweight, I'm gonna leverage more protein and, and moderate the fat down a bit because I want them to burn more fat off their body. So, it's, yeah, very individual.
What, what's your stance on, I guess, if someone has a ton of weight to lose, uh, Tyler, as an example, you know, 600 some odd pounds,
he's likely not going to feel optimal if he was trying to lose all that and reach goal weight in one fell swoop. Like, he would have to be at such a caloric deficit for so long that,
psychologically, that would be taxing, uh, metabolically, hormonally, like all of that.
would start to degrade over time.
>> How would you recommend people go through like a maintenance phase or a slight surplus phase or just kind of make it more manageable?
>> Yeah. What we typically do is we sprinkle sprinkle in these maintenance days or overfeeding days we call them. Uh, and it depends on their situation. Very, very individual. But, uh, you know, like somebody like Tyler, 645 lbs, he could probably eat protein sparing modified fast every day and still have enough fuel to fuel his body cuz he's got so much to tap into.
Well, would that be healthy for him to do every day? No. uh you know I think he did when we he was working with us maybe two or three days a week and then every every week to every other week we'd add a maintenance day and that's just to you know keep the metabolism honest shake it up and add that maintenance day to to not only for for his psyche right like one of the things he loved is pizza and we're trying to keep him uh dairyf free to help with weight loss but on his on his maintenance days he could have keto pizza. You know, if if if he's going to be on this journey for years and can never have his favorite food, he's not going to make it. And that's where we got to balance what's optimal versus what you can stick with. And that's one of the themes in here as well with the spectrum of diets is that, you know, what's the biggest uh failure of any diet protocol? Non-compliance.
>> Yep.
>> They can't stick with it. So, you got to find what you can stick with for life. And if that's carnivore, great. All the power to you. But if it's, you know, keto or some version of high protein, low carb approach, great. You know, whatever you can stick with long term, that's the most important thing.
>> 100%. Yeah. I feel like a lot of people, like I get a lot of people that come to me because I'll speak on reverse dieting and things of that nature. I feel like a lot of people in the keto carnivore space and often times the, you know, middle-aged women that are going through menopause, it seems, they've like just been chronically restricting for years on end, and they may be eating all the right foods,
>> but they may just not be eating enough of the right foods and like their hair is falling out. They're just metabolically, you know, degraded. Hormones are in a state of flux. Like everything is far from optimal. and telling them the benefits of eating at a slight surplus to bring those back up to functional realities is like the hardest sell as a coach, but it's like so crucially important.
>> Yeah. And that's, you know, like like I said, if they've been eating a thousand calories for the last year or something.
>> Yeah. That's one of the things we when the hCG diet, remember that was such a craze? Eating like 600 calories a day for long periods of time. I mean, not only the biggest problem with that was such a low protein, but you know, at those levels, you're just gonna metabolic adaptation's going to happen and you get you're gonna have to claw your way back from that. So, yeah, there's again, none of it's a one-size because we get people on the other side of it that postmenopausal women that again, like I just said, we're eating super highfat, you know, fatty ribe eyes with butter and all that and they're gaining weight on that side, too. So, it's really individual. You got to look at, okay, where were you? What are you doing? You know, and then this is where uh a bit of macro tracking can really be helpful because if you don't know what you're eating, there's nothing you can adjust up or down, right? If you don't, well, how many how much protein you eating? I don't know. I'm just eating this. And that once you track even for a few days or a week, oh, okay, I'm here and now I know I need to go here or I need to go here. You know, you don't know where to go if you don't measure it.
[snorts]
>> Yeah, totally agree, man. Like that. That's obviously a big frustration of mine, too. people be so hesitant to track and just know the numbers. Same reason like you would want to know your lab works, your blood panels right there.
>> Same thing with food consumption. And I feel like a lot of people
>> if they've got weight to lose, they don't want to be uncomfortable. They don't want to, you know, weight train or they don't want to just feel hunger.
>> And for me, when I'm in a prep, the sensation of hunger, like I just have to make peace with it. Like it's going to come and I can be eating a well formulated ketogenic carnivore diet. And there's this notion that you should never be hungry if you're eating real food. And that's just not reality either.
>> That is a frustrating one for me too in this community. You know, it's hunger is not the devil, right? Like if you have a lot of weight to lose and you want to lose it all, you're going to experience a little bit of hunger. And but it's also understanding what hunger is too. Like a lot of times people, you know, the it'd be kind of hunger, but was it really hunger or it's just that you always eat a snack before bed and you like to you like to do that and it's a habit
>> or, you know, sometimes it'll even be, you know, low electrolytes. You just you haven't been on your electrolytes, you drink some electrolytes and you feel better, uh, you know, or the amount of fluids you're drinking. So, there's a lot of factors there, but yeah, I completely agree with you. It's uh it's one of those things that a little bit of hunger or and and understanding what real hunger is is an important thing uh to understand.
>> Completely agree. I know Maria wrote the chapter on the the um peptides and HRT, but
>> I can't recall last time you were here. Did we talk about the GOP craze and and those peptides or touch on that?
>> I don't know if we touched on that. I don't think so.
>> Do you have a stance on that? like what it's from a societal psychological standpoint what's your stance and also from like a
>> physiological standpoint like is what's going on there mechanistically and what's going to be the downstream effect
>> uh you know there's what we look at it is it's another tool uh for very specific situations and uh you know if if you're the kind of person that has you know tried keto or carnivore multiple times you can't stick with it the food noise is just too much for you, the constant that food noise you always have. Some of these are really good for that. They they can shut off that food noise and help you not, you know, help you to stay stay on track. And if it's uh a lot of times if you just get past that you know everything is like a a habit in general whether it's that eating a snack in the evening or if you can if uh I think it's 14 days of of doing something you can start forming a new habit and so if you do the these for a period of time just to get off of that habit get off of that shut down that food noise for a while and then lose the weight and get back into a situation where now you can control those cravings and stuff better. I think it can be a tool for certain people. Um, I don't think anybody should be on it long term. I mean, we don't know the long-term effects of these things. Uh, but I think it can be a tool for certain people. Uh, I'm a little concerned about some of the new ones that are coming out, these like quadruple and antagonists and where it's like,
>> yeah, like Reddit truth and all those.
>> Yeah. all of them ones that are coming out that like shut down the uh so one of the problems with GLP ones is you have to be even more cognizant about lifting weights and preserving muscle cuz they can you know 40 50% of the weight lost is is muscle loss in a lot of these cases um where if if you eat a ketogenic or car carnivore diet and you're really into strength training resistance training you can get your muscle loss to like less than 10%. which is ideal at that point. It's basically no muscle loss because you're always going to lose a little lean mass whether it's cell walls or whatever it is. Um, but you know, they're creating these multi-agonist ones now where one of them that they're working on it'll stop muscle loss or thing that inhibits muscle growth. Well, if you're inhibiting inhibiting muscle growth or uh the opposite uh muscle uh loss, your heart's a muscle, right? Now, is your heart going to get enlarged and like so there's a I feel like they're playing around a little too much with these now and and getting into some dangerous situations that could potentially happen.
>> It's uh it's there. I've seen several studies and some of them conflict, but like they were showing the the percentage of the weight loss that was lean tissue and then obviously kind of like you said lean tissue is everything that's not atapost tissue. So that could be fluid. So that's kind of a a skewed study because you're probably not actually losing that much skeletal muscle tissue on these drugs in the context of that short-term study. However, if you're eating much less food, you're in a significant deficit. You're going to be in a heightened catabolic state. And if you're not weight training in that setting that you are for sure losing skeletal muscle tissue regardless of what any study shows.
>> Yeah, absolutely. That's regardless of diet or you know anything. And uh you know and I I I know there was a recent one that looked at one of these uh GLP1s and said that they had similar strength at the end even though there was more muscle loss
>> saying you know this but that's true with anything you know, it's true with any diet in anything you're going to have some organ loss or different you know things that will will shrink in mass of your lean mass. Uh, so I I'm not really sold on that as far as, you know, you you could you could do the exact same thing for a ketogenic diet that said 10% was muscle loss when really it's not all muscle, it's
>> other stuff, right?
>> So your your book is it live yet now?
>> Yeah. Yeah. So there's uh we have the ebook, paperback, and audio book. The the [clears throat] hard cover is going to be available in a few weeks. It's it's up for pre-order right now.
>> How what book number is this for y'all collectively? just got to be like freaking 25 or something.
>> If you include like ebooks, it's Yeah, probably like 25, maybe 20, maybe more if you go way back.
>> That's insane, man. That's insane. So, this one is exciting for me cuz it's specifically talking about metabolic health um metabolic pathways.
>> What is different between this book and the ones previous? Like what is what was the reason and the demand for this book to be written in the first place? I guess
>> we've always wanted to write our own nutrition book, not with a publisher. Um, you know, the last real nutrition book we wrote was our Keto the Complete Guide, which was uh, you know, probably eight years ago or nine years ago when we're actually writing the book. You know, it takes a year plus to write something like this. Uh, this one probably took almost two years, you know, a year and a half plus just to write it and then, uh, we put it all together ourselves. Um and and part of it was we learned more especially about certain things like you know Maria want wanted to really cover HRT and how important that is for women uh and then peptides as well which she did she she did a whole chapter on that but I also learned a lot about just a deeper understanding of biology and you know biochemistry and how the body works. Uh and so I wanted to cover that in a lot more detail than I've covered it in the past. you know, things like personal fat threshold and, you know, how the body works and metabolism. Um, and we had the freedom to do it by doing it self-published, but put everything we wanted to put into it and not be restricted in any way by a publisher saying, you know, this or that. So, this was that's why we self-published it, too, is we wanted to put everything we wanted to put into this the way we wanted it done and and that's it. So, that's how we get four almost 400 pages of of uh everything we know pretty much.
>> Nice. Nice. I've I've not the book that I've written, I went self-published, right, too. So, I've not really ever been confined by the publishing company, but like in y'all's regard, are they pretty strict on what they allow and not as far as like the metabolic, the biology, the science, like they don't want you diving deep into that? Uh it's more about like they would want you to like probably narrow this down and you know not do this chapter, not do this one, focus on this category kind of thing. Uh and uh you know in that cont. Uh yeah, it's probably just that how they would they probably would have had us maybe not do the hormone chapter, maybe not do the peptide chapter, you know, like focusing in on a certain category kind of thing. Uh we wanted it to be kind of everything we know about metabolic health, including the things we mentioned, supplements, all the things that we have seen over 25 plus years of helping people. What really helps?
>> Well, now that this book is out, what's the next big thing on the horizon? You're going to probably take a little breather from writing for a while, right?
>> Oh, yeah. [laughter] This might be my last nutrition book we ever write cuz it was just so much work. And we put everything in here. And uh you know, my focus right now is uh getting my brother over here to get some watering holes dug for our deer. [laughter]
>> You were showing me the the the map of that when we were at Kosa together. So, that that looks promising for sure. Season's going to be looking good.
>> Oh, I'm excited. uh you know, watering holes around here can be uh even more effective than a feed a feed plot cuz they always need water and if they have to go all the way down to the river to get it uh and and instead stay right here and get it right on the land and and stay on the property, it's going to be a big benefit, I think. So, I'm excited about that.
>> And that's going to be done before this season starts.
>> Yeah, we're going to hopefully put them in in a couple weeks. Maria's going on a low carb cruise and going to come over for a few days and help me out.
>> Nice, man. Well, shoot. I don't mind digging. You let me know. I'll come up to Wisconsin. I'll grab a shovel.
>> That would be awesome. No, that'd be cool. Have a Guys Guys hunting prep weekend. [laughter]
>> That'd be good. That'd be good. When's the next time I'm going to see you? What conference are we going to be at together? Are you going to go to Low Carb for Better Health?
>> Uh, I'm not uh I wasn't uh I'm not a speaker this year. Uh but and I don't actually have I I did quite a few last year, you know, South Africa and Go Car for better health and San Diego and uh and then there's all this book stuff. So I'm actually not planning on any um presentations or speaking things this year.
[snorts]
>> I'm taking I'm taking it easy this summer.
>> Hey, that's good, man. Take it lowkey. Spend some time with the boys. Spend some time outside hunting. Just relax, brother. You deserve it.
>> We got to get one of these things together, too. Little hunting.
>> I'd be all for it. I'd be all for it. I think, you know, we can we can go to my farm, your place, whatever. We'll do some hunting. We'll do some fishing. We'll we'll have some camaraderie around a a steak and a campfire and call it good, man.
>> That sounds awesome.
>> Well, always a pleasure, Craig. Definitely keep doing what you're doing. Keep fighting a good fight. For anybody that does not know where to find you, where do they where do they go?
>> Uh, ketoaria.com is the easiest. I put all of our links there for social media and our blog and website and everything. And this latest book, the complete title is what again?
>> Uh, the art of metabolic health, the science-based guide to fat loss, hormone health, and metabolic resilience. So,
>> beautiful. Beautiful. I do appreciate the copy.
>> I appreciate you.
>> I absolutely enjoy having you on the podcast every time. You've always got an open invitation, you and Maria both, and I look forward to sharing a steak with you here soon, ma'am.
>> All right. Good to see you.
>> Till next time. Take care.