The Sugar Doctor: The Simple Diet That Prevents 80% of Disease!

What can you tell me about this? >> Well, if you look at the science, it's. enhancing cognition. We've seen a 50%. improvement in how individuals were able. to read and absorb information of better. decision-m and also we did a study and. showed that it delayed the progression. of metastatic cancer. And I've actually. taken this a number of times because. having been in research for the last 15. years and having lived with multiple. chronic diseases, one of which I. reversed. Some of the most powerful. strategies like this were not being told. to me when I went to the doctor's. office. So, let's dig deeper.

>> Dr. Andrew Cutnick is a research. scientist who's worked on over 100. studies on metabolic health, diabetes, and the keto diet. >> And through his findings, he's helping. people prevent chronic diseases, improve. cognition, and optimize performance. I. went through some pretty dramatic. moments in my childhood. You know, I did. everything I was told, right? I. exercised all the time. I ate what I was. supposed to eat, but I still became. obese. >> You weighed about 255 lbs. >> Yep. And I had no idea how damaging that.

actually was to my body. And I think the. vast majority of people also don't, but. over 20% of children have obesity. That's quadrupled over the last 30. years. And a big part of that is when it. comes to food, what looks healthy isn't. always healthy. And it's not by. accident. And it wasn't soon after that. I ended up getting diagnosed with a. chronic irreversible disease that. obesity puts you at risk for. And that. immediately turned into a journey to. understand how to be healthy. And I came. across this diet a little over a decade. ago called the ketogenic diet. So then I. went into the science of this diet and.

found positive impacts on things like. diabetes, obesity, Alzheimer's, serious. mental illness, chronic diseases. And I. was like, "Oh wow." Cuz a lot of people. don't realize that many of these are not. just preventable but also reversible. And you did the longest study ever done. of its kind on the impact of the. ketogenic diet on a patient that had. type 1 diabetes. >> Yes. Let me let me tell you all about. it. >> I see messages all the time in the. comments section that some of you didn't. realize you didn't subscribe. So, if you. could do me a favor and double check if.

you're a subscriber to this channel, that would be tremendously appreciated. It's the simple, it's the free thing. that anybody that watches this show. frequently can do to help us here to. keep everything going in this show in. the trajectory it's on. So please do. double check if you've subscribed and uh. thank you so much because in a strange. way you are you're part of our history. and you're on this journey with us and I. appreciate you for that. So yeah, thank. you. Dr. Andrew Kutnik. If you had to try and. sort of summarize and encapsulate what.

you spent the last couple of decades of. your life focused on and really trying. to accomplish, prove, understand from. the highest level. What exactly is that? The core of my mission, Stephen, is. really to empower individuals to take. control of their own health. It's. empowering them with science, you know, bridging science to actual action. You. know, science is very complex. It's very. hard to break it down, but having been. in, you know, research for the last 15. years and having lived with. multiple chronic diseases, uh, one of.

which I reversed and one of which I is. irreversible. Um, I I my mission is to. empower patients with the same tools and. strategies I had access to. uh so they. can take control to maximize their. health and performance. >> For the average person who may not be as. knowledgeable about health and fitness, what are the areas of health that you've. spent the last 15 years researching and. trying to understand? >> I would call it, you know, Stephen like. metabolism in a broad terms. Now I would. say you know to break that down further.

for people to understand that metabolism. is trying to understand how the body. metabolizes or utilizes things like. nutrients or food. So you have oranges. here. What's what's in that food? How. when you ingest it will your body. respond to it? Both from you know. glucose levels which I'm sure many have. heard of to insulin responses to all. this different nuance. A lot of that. comes down to nutrition but it also is. things like exercise. Exercise such a. powerful impact on metabolism,

incredibly important for overall health. But from a personal perspective, this. journey has been very honestly selfish. for me. I wanted to understand how to. get the best performance, the best for. health for myself. And I very quickly. realized that uh you know some of the. most powerful strategies out there were. actually not necessarily the ones that. were being told to me when I went to the. doctor's office because I went through. some some pretty dramatic moments uh. early on in my my journey with with. trying to overcome some of these these. challenges.

>> So take me back to the start of your. story in the earliest context that's. relevant to understand. why you became the person you became. I. mean, I've got some photos here from. your from your childhood which are. >> Yeah. >> very very telling. And you know, some of. our listeners might be listening on. audio alone, so they might not be able. to see these these visuals on the. screen. >> So, if you could describe some of these. these pictures for me. >> when Yeah.

Um. it brings back some powerful memories of. uh the challenges with obesity for me. Um you know the the picture on the right. is just a picture with on a a family. adventure um where we went to the we go. I go fishing with my dad a lot. You know. I'm very heavy at the time. I was, you. know, uh, obese and, um, and the picture. on the right here, this really gets me. because, um, you know, I did, you did. everything I was told, right? I.

exercised all the time. I ate what I I. was supposed to eat or what my doctor. recommended, what the fitness magazines. recommended, but I was just constantly. challenged with gaining more and more. fat tissue. And I had no idea how. damaging that actually was to my body. And, and I think the vast majority of. people also don't. Um, over 68% of. America right now is obese. Okay, that. means 7 out of 10 people walking around. the street in the United States of. America have obesity. And we know that.

the second you start building more and. more fat tissue on your body, insulin. levels rise almost double immediately. before you even have symptoms of obesity. or uh tissue damage or organ damage or. anything along those lines. We know that. that almost immediately reduces insulin. sensitivity. So how well insulin, this. very powerful fat storage hormone, is. able to actually bring nutrients from. the blood into tissues. That goes down. around 34 to 35% uh and early stages of.

obesity. >> And just to summarize for a muggle like. me, insulin is basically the uber which. takes things out of your blood and puts. them where they need to be. >> It's essentially like a thermostat for. blood glucose. That's how most people. know it. So as blood glucose levels. rise, it works as a thermostat to let's. say release cool air to bring it back. down. In this case, releases insulin to. bring blood glucose back into range. As. blood glucose drops, insulin is stopped. It stops releasing insulin out of these.

cells called the beta cells. And. ultimately, what your body is trying to. do is keep the, you know, one teaspoon. of sugar that's in your blood that is. critical for your life. If it goes up, it can cause damage. If it goes low, it. can be life-threatening. in this very. very tight range and it build it builds. a number of mechanisms to ultimately. make sure and ensure that you don't go. outside of that range. But imagine. losing the one molecule that directly. controls it. >> You're wearing two devices I believe on. you at the moment. So you've got this.

>> Yeah. >> What is the device on your arm? >> It's an insulin pump. >> Yeah. >> So Stephen, your body produces insulin. Most people who are probably listening. to this, they their body probably also. produces insulin unless they have type 1. diabetes. And so when my body no longer. produces this molecule anymore, there's. got to be a way to get it. It sits on my. arm 24/7 because it's a way of. essentially packaging a pancreas that I. don't have anymore and putting it on my. arm and and and a way of getting that.

same type of of insulin. >> And you have a CGM as well. >> Yeah. So on my stomach here, so on my. stomach here is a CGM, >> which is a continuous glucose monitor. >> CGM is a way of tracking sugar levels or. glucose levels. >> And both of those devices link to your. phone, which is in front of you. Um, and. I'll throw that up on the screen so. people can see, >> yes, >> what that what that kind of looks like. >> So on this device, you have. a green line that is glucose levels.

Okay, my blood sugar says that it's 109. right now. Which means that the. interstitial. signal of glucose is. >> interstitial meaning within not in the. blood but in the tissues. >> Yeah. So the amount of glucose right. outside the blood around the tissues and. that signal is an indication of the. amount of glucose in the blood. That's. the green line. Okay, it says that I'm. 109 right now. So average blood sugar. levels using milligrams per deciliter is.

70 to 120. That's considered normal. Below that is blue lines almost like. looks like squares and triangles. Those. are illustrations of insulin being. administered but they're not perfect. devices. Despite them being premier and. you know the most advanced technology on. the market, there are significant. limitations to them. Um, I have actually. I saw a clip of yours that I was. watching earlier that said you think. having high blood sugar over a long time.

is the biggest cause of long-term health. problems. >> When you're focused on improving your. overall health, you have to find out. what matters most, right? So, what. what's the hierarchy uh uh in the. health, you know, 1 2 3 4 5? What. matters most on that? And we can look at. that by looking at risk factors uh for. future disease. Well, the number one. cause of death in the United States and. across many parts of the world is. cardiovascular disease. Well, it's also. the number one cause of death in people. with diabetes. And when you look at what.

are the strongest predictors of. developing some form of cardiovascular. disease, a measure called HBA1C comes up at the. top. HBA1C is a average measurement of. your blood glucose over a two to three. month period of time. And that is. incredibly powerful at predicting future. risk for let's say diseases of the eye, diseases of the kidney or even. cardiovascular disease. And so when I. think about how do we tackle uh.

improving health or in in particularly. in these these common much more common. diseases, glucose control sits at the very top of. that pyramid. And if unregulated, it's. equivalent to analogy I often use, which. is you're you're driving a car and. you're focused on what type of rims you. have, but you don't even have an engine. in the car. Like your engine doesn't. work, or you don't have an a chassis or. an axis, but yet you're you're focused.

on rims or a sound system. And so the. number one factor, particularly in. diseases like diabetes, that matters. most is HBA1C. >> So does that just mean that we should be. eating less sugar? So if we wanted to control the most. powerful risk factor in diabetes, we would need to understand how to. regulate it. Right? So then let's look. at the science of this. Well, the. science says that carbohydrates,

food is the most potent factor in. regulating elevations in glucose at. every single meal of the day. Well, most. people are eating three to four plus. meals every single day. And so the very. first logical thing to look at is food. because what you're consuming has the. most potent impact on glucose control. and glucose control has the most potent. impact on your health not only today but. in the future. And so focusing on on. nutrition makes sense. But this isn't.

like a new phenomenon. We've known that. nutrition could be potentially. life-saving for people. There's a a you. know there's something called a. ketogenic diet if someone's heard this. before. It's a diet that dramatically. reduces the amount of carbohydrates in. the food. And the dramatic reduction in. carbohydrates in the food was used to. save lives of patients with type 1 and. type 2 diabetes since there was the. first report ever known to my knowledge. is in 19 or 1796 by a gentleman named a.

physician called John Row. He published. a report on two cases of diabetes. malitis using basically a carbohydrate. replete or reduced diet to resolve the. disease. But we know that some of the. most premier diabetists meaning people. who study diabetes or treat people with. diabetes were utilizing these strategies. for over a hundred years before we then. discovered in 1921 that this diet could. also help neurological disorders like. seizures and beyond. And so the the.

phenomenon of nutrition playing a role. in overall health is is certainly not. new. It's actually only recently that. we're rediscovering century old wisdom. of what nutrition can do for overall. health uh due to the emergence of an. explosion in science that has really. drove a ton of public interest into this. kind of unique dietary strategy. >> So the ketogenic diet then um it's a. diet that I'm familiar with because it's. a diet that I cycle in and out of. throughout the year. probably I'm in a. ketogenic state three or four times a. year and I use the little keto reader.

just to check my blood ketone levels. What is the what for anyone that's. unfamiliar with the ke ketogenic diet? I. I'm a bit of an advocate for it. So I'm. fairly familiar but I that's also taught. me how unfamiliar people are with it. because I talk to my friends about it. and there's a lot of misconceptions. >> Yeah. >> If you're on a ketogenic diet, what are. you eating? >> So typically what when someone. visualizes a ketogenic diet, I think. there's a lot of misinformation. and. they think it's just steak and bacon. Um, and I guess for some people it might. be that, but it's actually uh if we're.

talking about a well- formulated. ketogenic diet, we're talking about. green leafy vegetables, things that we. typically associate with health. You. know, salads, uh, broccoli, asparagus, cauliflower, these kind of uh, nutrient-dense green leafy vegetables. that are high in fiber and. phytonutrients. Then you also have protein as a. component of that. that can come from. meat that can come from fish in the form. of salmon, eggs, uh cheeses, a little. bit comes along for the ride and things. like nuts. And then you also have the.

rest of the diet which is made up of. fat. And this can come a lot of times. from um various plant forms. This can. come, you know, from like olive oil, avocado oil. >> And what are you removing then? >> Sugary starchy carbohydrates. So you're. you're you know you're not having. bagels, you're not having donuts, um. white rice, pastas, these type of foods. The reason they're not a part of this. diet is because these foods rapidly. elevate blood sugar levels. And the.

rapid elevation in blood sugar also. spikes insulin. Insulin shuts down fat. breakdown and the ability to take that. fat to the liver. The liver built this. amazing mechanism to be able to convert. fat to ketone bodies because ketone. bodies fat can't actually longchain. fatty acids which is the primary form of. fat that you consume in the food you eat. and also the type that's broken down. from your own fat tissue can't readily.

cross the bloodb brain barrier. And we. know that glucose is a fuel for the. brain. But what happens if you fast or. you don't consume a lot of carbohydrates. and you have low insulin levels and you. can't con transport the fat which is now. your primary fuel source on a ketogenic. diet because you reduce glucose or. carbohydrates in the diet which causes a. reduction in glucose. The reduction in. glucose lowers insulin. The reduction in. insulin causes fat to be rapidly broken. down and now becomes your primary fuel.

source. >> And so there's an evolutionary basis for. this, right? Because once upon a time we. might have gone long periods of time. without eating something. And so our. body turns inwards and starts using our. fat stores as a mechanism to to to fuel. our body and that's why it produces. ketones. Basically the evolution of this. diet was believed to be a cyclical. meaning on and off pattern in human. history because if we were to go through.

bouts of abundance in food, we probably. consume it as much as we can in one. moment and then we're seeking the next. meal and seeking the next meal. What. happens in that in between time? If. you're 100% reliant on having food 24/7. like we do in our current food. environment, you would never survive. evolutionarily. beyond a few days. With the ability to switch from a. carbohydrate-based metabolism over to a. fat-based metabolism, we store months. and months and months of fat energy in.

the event that we don't have nutrient. So it's a one of the most powerful. survival mechanisms we have to survive. uh moments of famine. But we also have. known since bib times of biblical text. that fasting has therapeutic potential. You know most potently in and the. ability to what would be described as. attenuate seizures. You know convulsion. like behavior was described when you. just completely eliminate food. actually. a common strategy in many religious. practices because of its quote unquote.

healing properties. Well, now we. actually know that fasting induces a. state of ketosis and we know that. ketosis is actually shown to in many of. these cases have a therapeutic impact in. many of these environments like a. seizure like seizures. We've known since. the 1920 one out of the Mayo Clinic that. ketogenic diets not only mimic the. physiology of fasting but also attenuate. the seizures in children with epilepsy. And that work has subsequently gone on.

to John Hopkins and other research. institutes to show that this is a very. verified strategy for not just epilepsy. but it has been used for obesity, type 1. diabetes, type two diabetes for for. centuries at this point. Um, and it all. starts with the reduction of. carbohydrates in the diet. >> One of the things that's been most. beneficial to me, but also I know Joe. Rogan has talked about this before is as. a sort of a podcaster that spends a lot. of time talking, you notice high. variance in your ability to think, articulate yourself. >> for long periods of time based on my.

blood ketone levels and my. >> my sort my diet broadly um but. specifically the amount of ketones that. are in my blood. Why is that? Why is it that I feel like. I'm more effective in communication and. thinking when I'm on the ketogenic diet. or taking exogenous ketones versus when. I'm having a normal western high higher. carb diet? A lot of people. would know why this is if they had the.

same tools and insight that type 1. diabetes gives. Because when you're. consuming that diet, what is often. happening is near constant elevations. and dips, elevations and dips, highs and. lows in blood sugar levels that we know. are ascribed to changes in energy. levels. So, we know that high blood. sugar levels, someone can Google if. they're they're so interested to look up. the term high blood sugar hyperlycemia.

or low blood sugar or hypoglycemia and. just type in symptoms and you'll see a. laundry list of things like fatigue, irritability, lack of concentration, uh. shakiness. These are all symptoms of a. lot of what you're describing, right? Which is change in your your your. ability to concentrate, your energy. levels. It's a very very clear that. glucose levels are linked to that. We. also know that the chain. >> ju just to be clear. So is that when I'm. at the high or the low in the glucose? So if I you know if you if you ate one.

of these right now. >> what are these oranges? Tangerines. >> Oranges. Yep. >> Um if you ate one of these right now, your blood glucose levels are going to. go up presumably. >> Yes. Because these oranges are composed. of bound sugar molecules together. So. most fruit has a structural component to. it which is why you see an it it has. like a has is has mass to it right it's. not just a liquid and then that. structural component binds together as a.

part of it sugar that's bound together. they call them polysaccharides and those. polysaccharides when you consume them. your gut actually takes those breaks. them down into individual glucose. molecules. to then be absorbed into the bloodstream. that's when the insulin is released, that's when the insulin takes that. glucose and stores it into tissues like. the muscle and the liver uh for future. glucose needs. Uh and so yes, we would. presume that with this high or oranges.

or even most fruits, pastas, rices would. all elevate blood sugar levels, but then. that accompanies with a high insulin. load, right? So the more of the oranges, the more insulin that you would need. And you know, despite many of these. foods being considered very healthy, those with. metabolic disease or metabolic. dysfunction may not may have a be more. vulnerable to even what would typically. be considered healthy foods. Um, and. type 1 diabetes is a is a powerful. example of that. >> So, you said you'd you'd open to eating.

one of these. We've got your blood. glucose and insulin levels, which we're. going to put on screen for people that. are watching. And it'll be interesting. to see how quickly we see that orange, which is considered a health food by. many people, have an impact on your. glucose and insulin levels. >> So, yeah. So, so what I'm I'm going to. do is normally I would I would never do. this, but I I think it's very important. for people to understand, especially those at home who either have. a chronic disease, which is most. Americans at this point, or kids who. have a disease like diabetes, what the.

impact really could be. So let's say. oranges are considered a superfood uh by. the American Diabetes Association. So. it's a fruit highly recommended by. almost every organization USDA f or USDA. American Diabetes Association and beyond. the amount of or is three oranges. Three oranges is probably going to make. up around h 70 to 90 grams of. carbohydrates. For me, my energy needs.

is around calculated it around 3,000. calories per day. Now, the activity I'm. consuming, if I were to. eat the amount of carbohydrates. recommended per day, which is around 55%. by, let's say, the USDA guidelines, that. I would need to consume at least or more. than this at le if I split up all my. calories over four meals. And so, This is.

an opportunity to see what this will. actually do to blood sugar levels. and. type 1 diabetes if you consume will be a. near equivalent to around a fifth the. amount of carbohydrates that I would. consume per day if I was on a standard. diet. >> The the ketogenic diet they typically. say that to stay within it you need to. be below is it roughly 50 grams of. carbohydrates a day? And it's roughly. because 50 grams of carbohydrates per. day is a.

rough number that we suspect most people. will be able to get carbohydrates low. enough to where insulin would be. sufficiently low to produce ketone. bodies. >> Okay. >> Yeah. >> So there's variance depending on your. insulin sensitivity and insulin response. and I guess body weight as well is going. to be a factor. big factor, major factor. because anytime you're talking about. things like uh glucose, insulin is. always very individualized responses to. each individual person. >> I don't really I don't I try and stay. away from fruit these days. I don't. know. I I berries and raspberries and.

stuff like that and cuz people tell me. there's like polyphenols and black. blackberries, >> but those are totally uh co cohesive. with the ketogenic diet. >> because they're higher in fiber. So like. you know half of where you're consuming, not half, but a large portion of it. fiber. So it's more about the net. carbohydrates. It's the the glycemic. metabolic impact of the food. So. >> if the fiber is non-digestible, which in. fruit it isn't, then it shouldn't it. doesn't count, right? So higher fiber. content. Most of the vegetables on a. ketogenic diet are higher fiber, you.

know, >> because you know it's the it's the total. carbohydrate to fiber ratio. So the net. carbohydrates that really matter because. that's the amount of that's the. metabolic real metabolic impact of food. Yeah. A lot of a lot of keto friendly. foods say like net carbs or one gram or. something, but you look at it and you go. [ __ ] it says 20. >> It's total [ __ ] man. Is it? >> So, oh, 100%. Um, so I I've tested two. different foods that are keto friendly. on the label. Same as calories, same as. like fat, protein, even fiber. Um, and.

they can produce completely different. responses. I mean, the food environment. nowadays, you essentially need almost a. PhD in nutrition or biochemistry to walk. into a grocery store and be able to. understand what the hell's on the label. It's it is and I I don't want to sit. here and say like, oh, they they don't. know. Like, no, they they know. I mean, there's are companies who have tons of. resources, food scientists galore, and. they're putting zero sugar on the label. and keto friendly a as a trick because. it's associated with health benefits,

right? There's all these studies on. ketogenic diets that can they can show. to improve health. And so they want to. have that on their label. But what is. often happening if you look on the back. of the label, there's about a hundred. different ingredients they can swap. sugar for for something that has the. same exact metabolic effect as sugar. So. malitol, maltodextrin, um all these different ingredients that. are going to cause glucose to go up. rapidly, they'll just swap it and now. you can put on your label zero sugar. Have you been in a ketogenic diet since. you were diagnosed with diabetes? Have.

you cycled in and out of it yourself? And if so, what have you noticed in. terms of when you are in that diet and. when you're not? So, I actually came. across this diet a little over a decade. ago. What I found is that almost every. blood meter that I was taking, this is. before CGMs were present, I had to just. prick my blood, you know, six to 10. times a day to see what my blood sugars. were. I was finding that I was very. rarely outside of the normal range. And. I was also finding that I wasn't feeling. these extreme highs and lows anymore. when I transitioned to a ketogenic diet.

almost immediately. My insulin. requirements dropped substantially uh. around 40 a little over 40%. So the uh. the amount of insulin I needed to take. dropped dramatically, but I didn't have. continuous glucose monitor. I didn't. have this instant feedback of like what. is my blood sugar doing? I just know I. needed a heck of a lot less insulin. And. so what happened was I went into my. doctor's office at the time. He happened. to be the American Diabetes Association. president at the time. He's like, "I've.

never seen a blood sugar level in the. normal range with someone with type 1. diabetes before." He said, "What are you. doing?" From that point forward, that's. when for me it like transitions even. into like a lifelong journey of like, "Wow, you know, obviously nutrition had. a huge impact on me losing weight when I. had obesity. Now it was directly. regulating this very powerful disease. where upon diagnosis nearly all patients. are going to have high invariable.

glucose levels for the rest of their. life. 99% of patients will never see. normal metabolic control again for their. life. 100% of them are expected to get. insulin resistance. And within 3 years. we see neuroanatomical changes within. the brain of children who are diagnosed. What does that mean? >> So it means that when we look at MRI. scans of the brain, we see that children. with high and variable glucose levels. with this disease with type 1 diabetes, they have shifts in the type of white.

and gray matter. The sections of the. brain that are associated with normal. brain development and childhood, they're. not developing the same way. We and we. see this within 3 years and it's. directly linked to the poor glucose. control. We also know that we see signs. of the early signals of aththeroscerotic. progression in children within four. years. >> Atheroscerotic progression, what's that? >> So, one of the primary causes of death in.

individuals across the world is. cardiovascular disease. And how do we. get that? Well, you have changes in your blood vessel. and how it functions is the first and. earliest signal of future what will. ultimately be plaque or this kind of. blockages within the blood vessel which. ultimately cause things like heart. attacks or strokes. Well, in type 1. diabetes, we see that children who have. high invariable glucose levels, again, 99% of patients are expected to just. live this way for the rest of their. life. If they follow standard of care,

if they follow the doctor's orders, they're going to see changes in how. their blood vessels literally. functionally and structurally change. Their blood vessels will now shift from. being this very compliant uh almost like. a a smooth wave to that blood vessel now. becomes very rigid. It starts to build. collagen at more and more collagen. around it becomes stiffer and stiffer. It's almost like taking a hose and. turning on a hose and pinching the hose.

When you pinch the hose, as you become. stiffer and as you shrink the size of. the blood vessel, it goes faster. And so. we can measure that by the speed of the. blood in the body. Another clear signal. and one of the most powerful signals. that the blood vessel is starting to. change before you see plaque, before you. see blockages, I mean decades prior. These are all happening in childhood by. the way. You know, 10 to, you know, 10. to 14 year olds diagnosed with type 1. diabetes. we see that the blood vessel. isn't able to respond to what they call.

sheer stress Stephen. So that means. let's say you go for a run uh this. morning Stephen and your blood pressure. initially increases because as your. heart rate increases the speed of the. blood increases the amount of pressure. on the vascular wall increases that a. phenomenon when the blood moves fast. through blood vessels it it causes. stress against the blood vessels. That's. not a bad thing. It's actually a signal. for the blood vessel to release. something called nitric oxide. Nitric. oxide is a potent called vaso diilator.

It causes the blood vessels to open up. and this is how your body responds. normally to stress. Okay, you go for an. exercise vasoddilation or vaso. constriction then vaso dilation um or. you know and these are normal responses. the body has. Well, what happens in type. 1 diabetes very early on is that the. ability to produce nitric oxide is. diminished. You're not able to respond. to high stress load. So, not only are. the blood vessels becoming stiffer, but.

now the blood vessels aren't able to. even respond as well to the stress. And. so, as you're looking at this and you're. looking over time, you see these early. signals of athoscorotic progression. also see very early on that it was once. expected that all patients with type 1. diabetes would have eye damage some form. of eye damage called retinopathy where. you start to lose vision eventually can. go blind within 20 years of diagnosis. So most people are diagnosed in 10 to 14.

years of age which means by 30 to 34. years of age you're going to see a lot. of patients who have altered eye. function andor some who are blind. Now. that has extended out over time, but we. know that all patients with this disease. because of high and variable glucose. levels are expected to get at least one. complication in their lifetime if they. follow standard of care advice today. Even with the best technologies out.

there, there is no pharmaceutical. intervention. There is no technology. that normalizes this disease. And the. effects of these high invariable glucose. levels and insulin resistance that. accompanies it. is cumulative. dose dependent and not completely. reversible. Which means that once you're. diagnosed, the clock starts ticking. It. just like smoking. The more you do, the. earlier you do it, the earlier the. impact and the more lost life you. probably will get. And there was a study.

done with 326 participants that found. that the keto diet can increase glycemic. control of patients with diabetes. That. was in the precision nutrition. publication. When it says it can. increase glycemic control, what does. that mean? >> So is that what we were talking about. there with. >> Yes. So if you when you do a diet known. as a ketogenic diet, you're reducing. carbohydrates. Well, when carbohydrates. are consumed, they elevate glucose.

levels. Well, if you dramatically reduce. the amount of carbohydrates consumed, you're not having those same type of. glucose elevations and fluctuations. because you're not consuming the most. potent glucose elevating factor in our. life, which is carbohydrates. And so. when they talk about improvements in. glycemic control, it is the measure of. 24-hour over multiple day levels of. glucose in the circulation. And how well. is that being controlled within a normal.

healthy range? >> And so is your goal then to. encourage people to restrict. carbohydrates. >> in their diet? But you know because. carbohydrates and sugar have been. somewhat I guess demonized because you. never really hear many good things about. sugar. >> Um so so what is what is your goal here? What is the advice to the listener? Is. it to restrict their their. carbohydrates? >> To be very conscious of what they're. consuming because nutrition has a. powerful potent impact on overall.

health. And for those patients who have. chronic disease, which is unfortunately. the overwhelming majority of us, yes, carbohydrates can be a very restricting. carbohydrates can have a powerful. therapeutic effect on diseases like type. 2 diabetes. The American Diabetes. Association in their 2019 consensus. report described type 2 diabetes as the. most evidence-based nutritional. strategy. We know that it can have.

potential positive impacts on things. like uh Alzheimer's disease. There are. studies that have looked at this. We. also know that for. >> carbohydrate restriction we. >> Yep. So, and I like to term this. therapeutic carbohydrate restriction. because it's the therapeutic outcome of. a carbohydrate reduction. Um and that's. really the goal of this is can you. improve your overall health. Many people. will just do this simply to improve, you. know, to lose weight, to feel, like you. say, to feel more cognitively alert. But. in my case where you're along further.

along the metabolic spectrum with. diseases like diabetes, it has a even. more uh potent impact on how you feel, even more potent impact on your overall. health. Um, and but unfortunately about. 93% of Americans have some form of. metabolic derangement, uh, as cited by. multiple studies and multiple research. groups. You did a 10-year study on the. impact of the ketogenic diet on a. patient that had type 1 diabetes. I. think this is this is most certainly the. longest study ever done of its type.

where you took one individual and over. 10 years you I guess controlled their. diet. So, we had access to. the ability to monitor uh a unique. patient who had type 1 diabetes and they. were diagnosed and had followed the. American Diabetes Association diet, a. healthy diet for 6 years and then. switched over in 2013 to a ketogenic. diet. Upon the initiation of the diet. and post, they had DEXA scans. They.

controlled their calorie intake, their. body composition. they weren't taking. any additional medications and we were. able to monitor the impact over a. 10-year period. while controlling all those variables. And why that's so important is because. one of the common concerns of a. ketogenic diet is the hypothetical risk. it can increase cardiovascular disease. And the reason that. they think that it can increase. cardiovascular disease or it's. hypothesized that it will is because of.

the elevation in LDL that often. accompanies an increase in saturated fat. in the diet. Now saturated fat comes. from things like animal proteins, uh. it's in coconuts as well. What we found. is that despite a near doubling in LDL. cholesterol on this diet, which again. should be associated with worsening. cardiovascular health, we did an. advanced cardiovascular assessment in in. this patient and found that despite. doubling LDL, they had maintained. completely normal glycemic control,

which again based on all the data says. is the number one risk factor. They. reduced their insulin load over 40%. And their cardiovascular health was not. only better than the average patient of. similar age and sex with type 1. diabetes, it was better in almost every. single category than people even without. type 1 diabetes. despite the doubling of LDL cholesterol,

it illustrated that over a 10-ear. period, it maintained not only no sign. of cardiovascular disease, but. remarkable cardiovascular health. And. and in fact, we actually followed on. that study with the largest ever. analysis of the impact of nutrition, particularly carbohydrates, in over. 46,000 patients with type 1 diabetes. We. showed that in over 70% of all reports. of very low carbohydrate ketogenic diets. that patients were completely able to.

normalize their glucose control, normalize the most potent risk factor. for disease of type 1 diabetes. >> And is this this is a sort of a spectrum. of I'll put that on the screen for. people to see the different sort of. stages and categorizations of being. normal, pre-diabetic, and diabetic. Right. >> Correct. Yes. So normal is anything less. than 5.7% HBA1C. Pre-diabetic is that. 5.7 number up to 6.4. And then diabetic.

is anywhere between 6.5 all the way up. into essentially uh there's no cap on. how high that number can go. I. >> I mean I noticed your your blood sugar. levels have uh risen quite dramatically. to. >> that. So what you see initially is is. probably only the first phase of this, right? So started at an average of. around 100 milligs per deciliter on. average. And once the food is then. consumed cuz once you consume the food.

it takes some time to break down into. glucose that glucose then goes into the. blood and then the blood then moves. glucose into this compartment around the. cells which called the interstitial. fluid. And now we're starting to see the. direct impact of just consuming probably. a fifth of the amount of carbohydrates I. should consume from a superfood. Um this. you know oranges are considered both a. citrus in a fruit and this is considered. like a superfood by the American. Diabetes Association uh in the context. of diabetes.

>> So when the glucose spike is high, so. you've just eaten some oranges, the. spike is going up. >> Yeah. What does someone feel and then what do. they feel when it's then crashes down. and goes below? Because it started at. about 100. So I imagine that it's going. to go up to whatever it goes up to and. then it's not going to drop back down to. 100. It's going to drop below 100. typically in a in a normal um. non-diabetic person, right? >> So 100's right around the uh normal. So.

what you'd hope would happen is that. you're going to go up just a little bit, insulin's going to respond quickly, and. you're going to come back down to. normal. if you have total healthy. metabolic function. Again, the vast. majority of us do not. But in this case, what's going to what would be predicted. to happen is that as blood sugar. elevates and insulin responds, it's going to go as high as the amount. of glucose that's present in the food. Okay? But at the same time, the my pod. is also which is holding my insulin is.

immediately trying to respond. it's. immediately trying to say, "Okay, oh no, we need to bring this and keep this into. a normal range." Um, and so it's trying. to release insulin. And so you can see. on the screen that there's this massive. uptick in the blue line, which is the. initial response in insulin immediately. to the elevation in glucose. This is. exactly what happens in normal. physiology. Yet no one can measure it, but you can see it here. >> So how would I feel when the glucose. spike is high? Do I feel energetic? Do I. feel focused? Or do I feel tired? My. personal experience here Stephen is that.

as blood sugar becomes very high I. become my focus reduces my I become. fatigued. Uh I can also according to my. wife become irritable. Um and but you. can even look this up you know you can. look up what are the symptoms of. hypoglycemia what are the symptoms of. elevated glucose levels above the normal. range which is normal 70 to 120. That's. when you can start to see uh very. clearly that the evidence over time has.

shown a a very clear impact on not only. how you feel physically but also your. mental health status as well. Oh, I've. just looked up the symptoms here and it. says um the common immediate symptoms of. having a high glucose spike is you feel. thirsty, dry mouth, um frequent. urination, headache, brain fog, fatigue, sluggishness, blurry vision. Um, and then once you go down and you crash. or your glucose really drops below the. normal range, what do you feel then?

Typically, >> so a lot of how I like to describe this. is almost like imagine you're outside. and it's sunny outside and you're having. a great day, great conversation with. other friends, and then all of a sudden, very rapidly, clouds come over top. Everyone kind of dissipates and it. starts to rain. It's almost like it's. it's we know that glucose levels have a. direct impact on the neurobiology of the. brain. Meaning how the brain functions, how it operates, and particularly at.

very high glucose levels, you know, typically above 180 milligs per. deciliter, you start to see signals of. inflammation, signals of stress, like. oxidative stress in the body if people. have heard of that before. And that can. start to cause damage on tissues and. cause a stress response. But the problem. here, Stephen, is that most patients are. living there 24/7. >> I was looking at some of the symptoms. here, and it says the short-term crash. you get after a spike, um, after a rapid. rise. is a bit of an insulin overshoot. So,

it's reactive hypoglycemia, which is the. sugar crash. And then you might feel in. that crash jittery or shaky, hungry, often craving carbs and sugar again, irritable, anxious, weak, or. lightheaded. I stayed up until 3:00 a.m. the night I first tried Replet, and it. blew my mind. Replet, our sponsor of. this podcast, are one of the most. powerful AI platforms I've come across. They allow you to turn any idea you have. into real working apps in minutes using. plain English. Just describe what you.

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these therapeutic potentials, you know, going back for over two centuries, what. is truly the impact of it on. performance? Because that's one of the. primary reasons where someone were to. walk into a a clinical setting and say, "Well, yeah, you can do this, but I've. heard it's going to decrease my. performance.". >> Physical performance. >> Physical performance. And so we were. very very interested in this because we. thought okay. it it. you know when we look at why. carbohydrates are currently being. recommended as sports nutrition is.

because since 1921 they've been shown to. improve performance and how they showed. that in 1921 was that physicians out of. Harvard and um and Boston actually. watched Boston marathoners half of which. who would come wouldn't even finish the. race slurred words they would uh have. like almost pale skin, shaky, weren't. able to articulate their words or some. wouldn't finish at all. And what they. were finding was that these when they. tested the blood of these individuals. that they were finding that glucose. levels were low. Basically, they reached.

what they call hypoglycemia. It's a. medical term to describe very low blood. sugar levels. And. then next year they provided. carbohydrates and these marathoners in. the Boston Marathon and all of them. improve their performance. And so since. 192 or 1925 actually we've known that. carbohydrates can improve performance. But we what has happened though over. time is that in 1960s. we there was a measurement technique. called the Birdstrom method where you.

actually did a muscle biopsy pulled out. muscle tissue and found that oh wow. there's actually glucose stored in the. muscle. So it must be really important. for physical performance. If the muscle. which is used to contract and move the. body during physical performance that if. glucose is in that tissue, it must be. essential for performance. And then. after they discovered that there was all. these associations between low glucose. levels in the muscle called glycogen, low glycogen and fatigue. Then after.

that the in the 1980s they were able to. look at the amount of. sugar, carbohydrates and fat that the. body was burning during exercise. And. what they found at that stage is that oh. wow it looks like the the amount that. people are able to sustain intense. exercise is proportional to how many. carbohydrates they're burning. And then there was a few modeling.

studies Stephen that then looked at okay. what's the relationship between. let's say uh the intensity of exercise. and what type of fuel you use whether it. be fat or carbohydrates. and they found that they modeled it okay. and said okay well at lower intensities. you must burn almost all fat and at very. high intensities you must burn carbs and. there was a number of studies in 2017 to.

2020, three different studies that. looked at the ketogenic diet over a 5day. to 3 week period. And they saw that in. those studies that there was a decline. in performance by around 2%. >> If you were in the ketogenic diet, if. you were on the ketogenic diet, >> correct? Compared to a high carb diet. >> Yeah. >> And so what did that tell these. researchers? Well, it said, "Okay, well. obviously the ketogenic diet must impair. performance." And there's all this. evidence since 1921s that the amount of. carbohydrates, glycogen, how much carbs.

you're you're consuming is essential. performance. But here's the kicker is. that. one major confounder of all this is that. we've known for quite a long period of. time that the adaptation to a ketogenic. diet is not one week, it's not two. weeks, not even three, it's four weeks. or more. And when you say adaptation, you mean your body's transition to being. in a a state where it's efficient at. burning using ketones. >> So the body's ability to.

lower its glucose oxidation or the. amount of carbohydrates it's burning for. fuel because you're giving your body. less of it. The amount of fat that's. being utilized for fuel goes up. dramatically. And then you produce way. more ketone bodies. And ketones are now. being used as not only a a body uh. tissue substrate meaning energy for the. muscle but also for the brain. And so. it's this transition over. But when. people were looking at these studies.

they were just looking at some of the. metrics of what happens when you your. body transforms when you reduce. carbohydrates. >> Okay. So what we wanted to do is say, okay, if there's all these. healthpromoting benefits of a ketogenic. diet, that sounds great, but all these. studies and sports dogma would say. that's going to impair performance. Okay, so let's test that. Let's actually. put athletes on a ketogenic diet for 4. weeks. We are going to control not only.

their calories, we're going to control. their body composition, we're going to. control their activity level. We're. going to control all these key. confounders that many of these prior. studies never controlled so that we. could truly test the diet induced so the. macronutrient meaning the shift from. carbs to fat effect on performance but. we're going to do it in the same person. So now we're going to control their. genetics. We're going to control their. environment. Once we did that, Stephen,

we tested what most people think is a, you know, a very glucose dependent form. of exercise. We asked them to do 6 by. 800 meter sprints. They were on a high. carb diet and then they switched to a. low carb diet. Now, what happened this. is all randomized uh and controlled. When they switched over, they had no deterioration in performance. >> at four weeks. at the four-week mark in. a form of exercise that we would expect.

would be extremely glucose dependent, extremely carbohydrate dependent. >> But before 4 weeks, was there an. impairment in their performance? >> So what we were interested in, Stephen, is studying at the end. So we didn't. look intermediately. We exclusively look. at the end time point because the the. question was, well, if is there a. difference once you stick to this diet? Because if you you go on this diet, ideally you're you're sticking with it. over time. And so. if it is true that you require.

carbohydrates, we then also measured how. many carbohydrates and fat they were. burning during exercise. And it was over what we call 85% of. their V2 max, which means 85% of their. total maximum oxygen consumption during. exercise. That is when we would expect almost no. fat to be oxidized or to be burned and. almost exclusively carbohydrates. Well,

we found that these athletes recorded. the highest levels of fat burning during. exercise ever reported in the. literature, illustrating that when these. athletes, >> the ketogenic. >> ketogenic diet that when these diets. adapted to the diet for sufficiently. long, they had record levels of fat. oxidation even at very high intensity. levels. which means that fat was able to. provide nutrients and fuel at very very.

intense forms of exercise when we would. expect only carbohydrates would be. relevant and utilizable. So many of my friends um that are. endurance athletes or that are involved. in things like cycling talk about. exogenous ketones. Um I'm a co-owner of. a company that produces exogenous. ketones. That's my disclaimer. I've got. the product here. What can you tell me. about products like this? Exogenous. ketone products. Exogenous meaning.

externally supplemented, I guess, >> right? So, with a ketogenic diet, you. produce them. Your liver produces them. for you. With um exogenous, you're. consuming these. Well, why would you. consume them? Why not just do a. ketogenic diet? Well, we know that a. ketogenic diet. takes time to adapt. We just talked. about that with physical performance. that we see that you know up to four. weeks to see the full effect on on. performance or more. Well, what happens.

if you're let's say a war fighter or. someone who's going out into the field. or immediately wants to flip into this. state? You can't do that unless there. was a molecule that you could consume. that could rapidly elevate ketone bodies. in circulation within minutes. Insert exogenous ketone bodies. We have. known since the 1960s. that the product in there was studied by. MIT uh in the aerospace department.

called 13butane dial. It that it was. able to be consumed and rapidly elevate. ketone bodies in circulation. There was. a study in 2016 called the metabolic. optimization $10 million program from. DARPA. DARPA being the. >> DARPA is an advanced research. organization from the United States. government where they fund very high. risk high reward programs and one of. which was the the the use and testing of. ketone bodies. And so that uh molecule. that they tested was um utilized the.

same molecule that's in there and they. kind of uh tweaked some of the. formulations a bit and they showed that. and we know that this is the same for. this molecule as well that when you. consume them it rapidly changes. metabolism almost uh not identical to. what happens with the ketogenic diet but. it has a almost direct impact. It has a. blood glucose lowering effect. it. directly binds to receptors like the um. they call GPR 109A or uh or some other.

key receptors that directly uh impact. inflammation. So it directly blocks. something called NLRP3 inflammosome. which is a molecule that leads to. increases in inflammation. We also know. that it changes the way that our genes. are used in the body called epigenetic. signaling. And so the uh consumption of. ketone bodies can actually change the. molecules on our genes and and how those. molecules are ultimately manifested and.

that increases our antioxidant capacity. meaning our ability to block oxidative. stress in the body. We we see all these. powerful effects, these rapid shifts in. metabolism within the body. And this. 2016 study showed that just orally. consuming these molecules could rapidly. shift metabolism, but that it was also. linked to an improvement in physical. performance. But if you look beyond that. and just like uh these these kind of. studies because we looked at them in. athletes, we looked at them in healthy.

individuals and then also in military. settings. But we've also there's studies. looking at this in patients at risk for. cognitive decline. So patients at risk. for Alzheimer's disease. They've shown. that in a six-month study administering. exogenous uh ketone bodies was able to. attenuate the decline in uh cognition. that we know happens with advanced age. >> And just to be clear there, you're. saying it reduces the decline. It. doesn't. >> correct. >> cure Alzheimer's or fix Alzheimer's. It. just delays.

>> Accurate. Yes. It's it's we know that as. individuals age, you're on a precipitous. or or steady decline in in brain. function. Um, and so the goal is to to. offset or to stop the decline. You know, that's our goal. We want to maintain. normal uh brain function and our ability. to think clearly and to understand. things clearly like reading and and. doing problems and solving problems. There have also been this emergence of. studies in the world of psychiatry. I.

think there's around 11 ongoing active. clinical trials looking at the impact. and interaction of ketonebased therapies. and brain health uh particularly serious. mental illness. One in four adults in. the United States actually over one in. four adults in the United States has. serious mental illness. In fact, I. believe over the numbers are over 20% of. of adults are taking some type of psycho. uh altering medication. At its core, we. see all these relationships.

between underlying metabolism being a. key. factor contributing to mental health. status. and the application of the this. unique diet which we know increases. ketone bodies which appear to have. direct impacts on the brain now seems to. be linked to improved serious mental. illness and it'll be interesting to see. where the that evolves but it's just a. fascinating world to imagine that. nutrition not a medication not a. technology but the the simply going to.

the grocery store and swapping the. things you choose in there can lead to. these powerful powerful therapeutic. effects um in people of all sorts of. different conditions uh or disorders. >> On one of the studies that I read about. the administration of exogenous ketones. and the impact it has on brain network. stability was from 2020 where they. investigated if brain network stability. responds to two major brain fuels either. glucose or ketones. And participants. came to the laboratory on two occasions.

and drank exogenous ketones or glucose. And after cons consuming these drinks, they underwent an MRI scan. Strikingly, the study showed that ketones increased. the stability of brain networks. In. contrast, glucose decreased the. stability of the network. The network. stability was 87% greater after ketone. consumption than stability measured. after glucose consumption. And in that. study which is on PubMed, the last line. of the abstract says, "Dietary. interventions resulting in ketone. utilization increase available energy.

and thus may show potential in. protecting the aging of the brain which. is super interesting. >> So we did a study uh looking at cancer. and applying exogenous ketones and a. very aggressive form of metastatic. cancer. And what we saw in in my work in. graduate school is that when applying. disogenous ketones that it delayed the. progression of the metastatic cancer, but it also. when looking at body weight reduced the.

rapid decline in body weight we. sometimes see with cancer. A phenomenon. called cexia which is a way a term to. describe the wa rapid wasting of body. tissue with disease. And it is no more. aggressive than the context of cancer. particularly metastatic cancer is where. it's most common and when we saw the. lack of decline in body weight I then. looked at where the body weight was. coming from and it was clear that the. lack of body weight decline.

was because of the preservation of in. muscle mass. So it also appeared and. there's been a number of what they call. clinical physiology studies. those. studies that actually directly. manipulate human beings with molecules. and tests, you know, like muscle tissues. and how they function. We see that. exogenous ketone administration can. dramatically reduce the amount of muscle. breakdown uh or breakdown of muscle.

tissue. Uh essentially illustrating it. may be a powerful mechanism in promoting. healthy muscle mass as well. In terms of. being in a ketogenic diet, one of the. things I'm always quite concerned about. is am I still able to gain muscle mass. if I'm in a ketogenic diet? Because I. >> Yeah, I when I go into a ketogenic diet. and I stop having carbohydrates, I tend. to lose weight rapidly and shred. >> Yeah. >> The fats falls off and I get very lean. but. >> yeah,

>> more skinny. >> You smiled though because maybe you like. to be more shredded. Um, so a phenomenon. with the ketogenic diet. So there's no. deterioration in muscle mass with the. ketogenic diet. There have been plenty. of studies that have shown that you're. able to maintain muscle mass. >> and build it. >> Yes. And build it. So they've shown that. as well. So Jeff Volic out of Ohio State. University has done a number of studies. in this area. Um, looking at individuals. who were actually on a. reduced intake diet. So they're reducing. less calories. So they had less energy.

in the diet. And then they were also. doing the ketogenic diet. It was. actually a military study and they. showed that they were able to maintain. uh muscle mass just as much as if. someone was on a high carb diet um while. under a caloric restriction or another. way of describing that is like a semi. starving starvation state. So there's no. impact negative impact that we see with. these diets on muscle mass. However, to. your per your personal example, one of. the first things that happens when you. go onto a ketogenic diet is there's a.

naturatic effect or natures effect, but. basically you reduce the amount of. sodium in the body. So, you you you p. you piss it out basically and um you so. you hold less water weight and that's. one of the first things. That's why. people see this rapid shift in body. weight initially when they're you know. on a ketogenic diet, which for many. people is great because if they're. trying to do it to lose weight, that's. like immediate reinforcement. But. sometimes it's water weight. Well, water. is in both the fat and the muscle. So, it's it's not necessarily that you're. losing any muscle mass per se, but it.

just might be in a phenomena less water. weight. And in some context, that might. be beneficial. Right? If you're in a. sport where you have a. power toweight ratio, but you're able to. maintain the same power at a lower. weight simply by shifting water, that's. great. Um, as long as you're able to. function equivalently. Is there anything. I do need to be thinking about in terms. of my diet to make sure I'm still. gaining weight just to I guess to keep. to keep my protein levels high? >> So, the most important thing related to. your diet when it comes to trying to.

build muscle mass is to exercise hard. and with resistance exercise. Uh that's. the most important thing when it comes. to your diet to enhance that effect. Protein is one of the the most powerful. nutrients you can consume to augment. that response. Another is to ensure. you're having uh sufficient. calories. Right? So if you're in a. caloric deficit, so you said that you. know you tend to eat less calories. because you're probably not as hungry. Um well, yes, that's one of the most. powerful ways to lose not only fat but.

also muscle is to just not eat food or. >> I think that's it because I I lose my. appetite when I when I'm in the. ketogenic diet. >> I also lose my appetite a little bit. when I take these um exogenous ketones. like Ketone IQ. >> Yeah. And I've seen some of the studies. that show that there's roughly 20%. decrease in. um appetite. when you take exogenous ketones. according to one particular study that I. read. But when I when I'm in the. ketogenic diet, I it's like food is I. get hungry but then I start eating and I.

stop very quickly. >> Yeah. >> And it's really bizarre. Like I was I. was in Cape Town for 10 days or two. weeks writing my book. And so I had the. chef there and the chef cooks me my food. and makes this amazing food and I'm so. hungry. I look at it I'm like amazing. I. start eating it. I have like five or six. bites and I'm done. And only when I'm in. the ketogenic diet, there's something. going on in my body which just doesn't. just doesn't want to binge eat like I. sometimes did. >> So there's two things to talk about. One. is the type of foods you're consuming on. a ketogenic diet and the other is what.

is happening in your body in your. metabolism on the diet. So there's a a. book called Always Hungry by a physician. u endocrinologist named David Lugwid and. he's kind of coined this carbohydrate. insulin model and um you know it's semi. somewhat controversial but the the. reality is that there's there's some. important notes in it. One related to. hunger which is if you're able to have a. fuel source on a ketogenic diet that's. sustained over time. So you don't have. the up and downs of glucose and up and.

downs insulin. these constant swings. Whereas on a ketogenic diet, you have. this sustained level of fuel influx, right? So you have this nutrient. availability in the blood. So glucose. levels are much more stabilized, insulin. is much more stabilized, and you don't. have those fluctuations particle. That might be one potential reason. But. the other potential reason is that when. you're on a ketogenic diet, you tend to. not consume the type of foods that drive. hunger. So again, we talked about in the. grocery store, the 70% of the grocery. store, particularly in the center of the.

grocery store that is highly processed. where they combine. carbohydrates with with salt or fat or. some combination there in that makes it. highly palatable or very very tasty, you. know, increase the dopamine response, this positive reinforcement response of. the food. Um, that drives people to to. seek more of that pleasure response and. as a result, they want to consume more. So, everyone has probably felt this. example where you're in a restaurant, you've eaten enough food to where you. feel physically full. You're like, "Oh,

I'm totally full. Like, I don't want to. eat any more food." Someone walks by. with your favorite dessert. And you're. like, "Oh, well, h I could eat that.". You're literally physically full, but. yet you want to consume more food. This. is a is a a phenomenon that has been the. struggle of of in America and the the. rest of the world essentially now um. where the food environment often drives.

people to over consume and it's not by. accident. These are like well conducted. strategies in the food industry to lead. to these positive pleasure responses. >> I think about this with bread in the. restaurant. You know they give you bread. first. >> Yeah. That's a good It's a solid. strategy, Stephen, to cause you to want. to consume start to finish not only the. bread, get a big meal, and follow on. with dessert. You know, it it is a is a. is a great strategy for ensuring that,

but it's also the same strategy that, you know, Doritos is using where like. you you combine this mixture of new uh. molecules in the food that you consume. it, you get, oh, this tastes great. Pringles. >> The same exact thing where you combine. these different components and it forces. you this like, "Oh, this tastes great. I. need more." And you never feel full. One. of the most common tricks that the the. food industry utilizes in these. environments is that they one they they.

certainly are aware of this, right? And. so when you consume these type of foods. together, they they know they consume. more of it, but sometimes people aren't. even aware of it. And best example of. this, go look at the back of most of the. bacon. on the grocery store aisle. Go look at. the back of most peanut butters, almond. butters, nut butters in the grocery. store. Most of them have added salt and. added sugar. Even to levels where you.

don't even taste it, but go look at the. label. The reason those are added is to. increase the flavor profile, the. positive brain response to the food. so. that you consume more of it. And this is. a huge part in why people always feel. hungry in today's food environment. They're always seeking more food. and they can't get off that hamster. wheel. They're always over consuming or. always referring to this phenomenon.

called food noise where they always feel. the drive to consume foods or they never. feel full. And. >> it's and it's because of the sugar and. the soap. It is because the food is. composed and made in such a way to be to. have a flavor profile that your brain. says. not just eat one bite, eat as much as. possible because we're always seeking. these pleasure responses, right? In our. lives, in our world, it's this is even.

independent of food. >> So, what do we do about this? So the solution for most people in this. situation is to try to focus number one. don't consume liquid calories. That's. like a dead giveaway bad move because. those are abundance of calories. will drive people often to over consume. them and very drive this pleasure. response in the brain. >> Liquid calories. What's a liquid. calorie? >> So let's say you have uh a soda or a.

Coke. >> Yeah. So basically completely void of. any nutrients and really high in. calories, spikes your glucose through. the roof, insulin through the roof, and. then often makes you hungrier. afterwards, not less hungry by having. >> like orange juice. >> is another great example. >> Smoothies, those those fruit smoothies. people have. >> Exactly. In fact, just taking fruit and. then blending it up actually increases. the speed by which it's absorbed changes. the hormonal response and leads to a. worse outcome for most people. Most. people think a fruit smoothie is a.

healthy thing. >> Yeah, I don't know about that. Um, I. would I think that when you take fruit, which for most reasons isn't terrible, right? Like, it's not these are. nutrient-dense foods, if people can. consume them and get away from them, great. If you have a metabolic disease, you might be more vulnerable to, let's. say, glucose elevations. But when you. then take foods like that, it could be. any foods. It could be taking potatoes. and then making mashed potatoes. By. simply changing or blending that food. up, you're now taking a lot of the.

structural components that your body. would take time to digest and you're. removing them and you basically almost. are like almost turning on like a small. hose that's just giving a little bit of. water at a time and it's turning it on. all the way. you know, you're rapidly. increasing the speed of how the. nutrients enter the body and it. completely changes the hormonal response. of molecules like GLP-1 and and normal. levels of GLP1 in the body are. completely altered. The insulin response. is also altered. >> and GLP1 is the hunger hormone.

>> It's known for being related to hunger. because it's released in response to. food. It changes the brain's hunger. drive and most people know of it because. of. >> oimpic simaglletide wobi traipide um all. these GLP-1 receptor agonists that. are. increasing GOP1 levels not to normal. levels they're increasing them to super.

physiologic levels mean levels that. would never be observed or ever seen. in normal settings of the body. >> I've just invested millions into this. and become a co-owner of the company. It's a company called Ketone IQ. And the. story is quite interesting. I started. talking about ketosis on this podcast. and the fact that I'm very low carb, very, very low sugar, and my body. produces ketones, which have made me. incredibly focused, have improved my. endurance, have improved my mood, and. have made me more capable at doing what.

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stephvenbartlet.stan.store. So, I want to give the audience that are. listening some practical ways that they. can change their life to live a better. life and to navigate the food. environment we live in. But just to just. generally the advice that you would give. if you had the ear of I don't know five. million people right now and you could. say something to them to help them live. better lives, to perform better. What. advice would you give them? >> Number one is I would say be conscious. of the food you're consuming and what. you're consuming on a daily basis. The.

impact of food is is equivalent to. medicine. It is and sometimes more. powerful than medicine. So, uh what you. drink, what you eat, you know, focusing. on whole foods, not consuming liquid. calories. And if you're someone who. could benefit uniquely from stable. glucose levels, lower insulin levels, like someone who has some type of. metabolic disorder like I do, reducing. carbohydrates oftentimes can be a very. powerful strategy. In fact, known to. prevent and reverse things like obesity. and type 2 diabetes with emerging.

evidence for its potential ability to. put things like serious mental illness. into remission, but we'll see as more. evidence comes out. Exercise on a. regular basis. We know that exercise. might not be the primary the lack of. exercise might not be the primary driver. for why someone is or isn't obese, but. we do know that physical activity. promotes health. We do know that. physical activity uh is extremely. important for overall well-being. And so. >> you've got big muscles. >> Oh, well, >> is that somewhat linked to your your. type 1 diabetes at all? Is that is that.

part of your strategy? You know, look, I. was obese at one point. And so I I've. since that point taken a very I become, you know, obsessed with trying to find. out how to be bigger, stronger, faster, optimize my metabolic health, optimize. my performance. And so it's been a. lifelong kind of self-experiment in that. in that journey. But yeah, exercise is. just important in general. But it's for. me it's about all the different. experiments and and strategies I can use. with exercise uh with resistance. exercise and beyond to kind of play.

around with what affects my body, what. affects my insulin, how do I increase my. overall metabolic health and what I have. seen is that that's directly linked to. my performance. >> How often do you exercise? >> I try to exercise every single day. Um. as much as I. >> How long for and what types of exercise? So what I do right now is I typically do. weightlifting for 30 minutes to an hour. every or six days a week. Um and then I. will go typically ride a bike to.

jiu-jitsu. So Brazilian jiu-jitsu which. can be uniquely almost like a mixed. exercise, intense exercise where it's. going to be extremely intense for like 5. minutes and then you have a one or two. minute break. Extremely intense and then. a break. Uh and I do that typically. around 5 days a week. Um, I also try to. purposely engage in some type of aerobic. exercise when I can. If I I wasn't able. to do as much jiu-jitsu one day or as. much uh resistance exercise. I always. try to add on some type of. cardiovascular work, whether that be a.

run, a bike, or these aerodyine bikes. where it's just lower and upper body. I. find those to be incredibly uh effective. and powerful tools and actually um uh. just not causing damage to muscle tissue. but also allowing you to improve your. overall cardiovascular health. >> What does your diet look like? >> So I tend to wake up and not think about. food. That's one thing that I've also. experienced similar to you that when I. switched to a ketogenic diet, not only. improve my glucose and insulin, but I. also found that with a ketogenic diet.

that I. don't feel hungry. So, I would wake up. and I don't tend to eat food right away. In fact, I enjoy when I don't eat food more so. than when I do eat food often times just. because not because I don't enjoy the. feeling of sitting down and having food. I love that. But. the experience and lived quality of life. of not having high variable glucose. levels, high insulin levels, and the. uncertainty that comes with that in my. daily life, I enjoy the 23 hours or 22.

hours of my day where I have the. stability, not the the moments in time. where I'm introducing uncertainty and. variability. to dumb that down a little bit. What I'm. saying is that when I when I don't eat I. wake up and I don't eat food because I. find that it I'm not hungry, but I also. find that it makes managing diabetes. easier. >> And so, do you eat once a day or twice a. day or. >> I tend to eat two to three times a day, you know, sometimes right before.

jiu-jitsu or weightlifting jiu-jitsu, always afterwards and always before uh. sometimes before bed. try not to do it. right before bed um because it tends to. impact my sleep quality a little bit. But I find that I just eat whenever I. feel hungry and I try to give myself. sufficient protein to be able to respond. to the the exercise that I'm doing. >> So, I've got the first one's about being. intentional about your food choices. The. second one is about exercise. >> Mhm. >> Anything else? >> Well, sleep's really important. You. know, these are these are, you know,

Stephen, this isn't like uh oh, like. this is the most revolutionary advice of. all time, but these these core. foundational components, good nutrition. tailored to your specific needs, exercising as much as you can, and. getting good sleep are the pillars of. health. If you don't have those. corrected, then you're wasting your time. everywhere else. And is there anything. as it relates to glucose. that surprised you? Because you're.

someone that sees a lot of this data. I. mean, you you you you walk around with. the the the two devices on that you've. mentioned and you're you're looking at. the insulin and glucose response. Is. there anything that people don't. understand as having a really pronounced. impact on their glucose levels that they. wouldn't expect? Like orange juice is. one of the ones that growing up I. thought [ __ ] I thought this was a. healthy thing. I used to I used to drink. Sunny Delight thinking I was putting all. these amazing vitamins in my body. >> and now I actually look back and regret. it and I you know. >> not to be judgmental over any parents.

because parenting is very hard but. sometimes I'll see parents giving their. children like a big glass of orange. juice and in my head I just see the. glucose spike that that child's about to. have. It's funny when you mention. parenting because I have a three and a. six-year-old at home and it's amazing. when they try one of these foods, these. very sugary foods, these very tasty. foods, they. it's almost like they become incessant. on wanting it again. You know, like. normal food isn't good enough anymore.

Um, and I think that's a great illustration. of of what many of us adults are are. challenged with on a daily basis, but. yet many people are just unaware of the. impact that it's having on their. metabolism, impacting it's having on. their hunger, the impact that that's. going to lead to on their future health. >> And is there anything that you've. spotted from your experiments with your. your CGM and your insulin device that. people should most certainly avoid? So, you said liquid calories. Is there. anything else that causes a really. pronounced or unexpected glucose. response? Yeah, you know, there's so.

many honestly, Stephen, over time that. it's honest, it's really hard to. pinpoint any singular one. A lot of the. foods that are out there are often. surprisingly challenging on glucose. levels, on insulin levels, particularly. the processed foods, because what. happens when you make these food. products is that you're trusting the. food company to put ingredients in there. that you're going to respond favorably. to, that your metabolism will respond. well to. And the truth is that that's.

far from a guarantee and in many cases. maybe uh less likely than it is likely. And so yeah, I don't have a singular. example for you, Stephen. I just But. I've experienced it numerous times. >> So I've got a a small list here. Um. sugary drinks, white bread and bagels, white rice. That surprised me a lot cuz. I used to think white rice Oh, really? I. I thought growing up rice was like a. health food. >> Okay. Well, so on that note, white rice, potatoes, potatoes in any form. >> Sweet potatoes tend to have less of a.

glycemic response, but it's still going. to have a a potent glycemic response. >> So, mashed or baked potatoes, obviously, French fries. Yeah, >> for sure. French fries. Most of like. pasta is a big one. >> Cereal, refined cereals, >> most cereals are actually worse than the. foods I just described on blood sugar. and insulin by a long shot. In fact, uh. mo most of the you know these. hearthealthy cereals um. these these would I would never blood.

sugar would just spike through the roof. portion of the amount I ate. So yeah, it. it I wouldn't I wouldn't be consuming a. lot of those. And I think I think most. people at this stage in the the health. and science world would also generally. align with with that that those aren't. necessarily the best foods to consume. we would think, you know, more more of. the less glycemic or less the foods that. have less of an impact on glucose. levels, less of a impact on insulin. levels. You know, one one thing I. constantly hear, especially in the.

research and clinical community is like, well, look, you know, not everyone needs. to be concerned about that because, you. know, people can respond to a lot of. these foods just fine. And I say, "You're you're right." Except that over. half of America has pre-diabetes. and 90 plus% have some form of. measurement that indicates that their. metabolic health is impaired and over 86. 68% are obese and now children are.

affected with these diseases with. obesity and pre-diabetes and around 20%. So it it's it's the fact that we are now. less healthy than than we've ever been. Um. >> we don't have the foundation to support. >> Correct. And I think you know when we. think about healthy nutrition, we think. about exercise. We describe them as medicine, but the. reality is these are just normal aspects. of things you should do every single day.

because that's what our bodies were made. to do. And when we don't do those. things, this is when health. deteriorates. This is when we're. challenging our body to maintain normal. health. >> One of the surprising ones for me was. dried fruit. And it said while while. fruit contains natural sugars, the. process of drying it concentrates those. sugars. This removes the water and can. make the sugar more readily available. for absorption, leading to a higher. glucose spike compared to fresh fruit. Typically, people think of dried fruit. as being a health food as well. >> Yeah. I don't I don't touch those. because unless I I don't have any.

glucose on me and I my blood sugar is. going down for some reason and I stay in. dangerously low levels, that's when I. consume those foods. Otherwise, I would. I would not consume them just because of. how quickly they raise blood sugar. levels. >> Do you think everybody should try the. ketogenic diet? >> Ooh, that is a good question. I think. Wow. What I would say is that you will never. know the potential of its benefit or.

lack thereof if you don't try. Like. anything in life, we are we're left to. assume what everyone else is like. You. might have we've talked about the. ketogenic diet numerous times here. We. talked about exogenous ketones numerous. times here. But if you don't try it, you don't know. how it'll work for you. In science, Stephen, one of the most important. things to appreciate is that we often. publish bar graphs look like this. You. know, the a line uh that illustrates the.

average outcome of a group of people. But what you don't appreciate is that. that line or that bar graph is made up. of numerous individuals who all average. to that number. But what if you're the. person who's at the very high dot or the. very bottom dot, meaning that you're the. what they call an outlier or someone who. responded negatively or positively to. that and then you just follow the.

average advice that that study showed. Well, oh, look, I tried this approach. and it didn't it didn't work for me. Uh, I'm just going to keep trying cuz this. study said that I should. Well, no. you. might be the person who was in that. study who didn't respond just like the. person on the opposite end of the. spectrum who did who averaged out to the. metal. >> So when in that study that talked about. the impact of exogenous ketones on brain. stability, someone might have had 100%. improvement in brain stability and. someone might have had 20% improvement.

or whatever and they've averaged it out. um across a bigger group of people. So. if you you are that person that had a. 100% gain in brain stability, it's a. pretty unbelievable tool for you to. understand based on your body. >> Exactly. And and that's that's always. the case in science. I mean there are. and there sometimes we look at this as. responders and non-responders. Um but. actually in the study where we gave um. uh the product from ketone IQ in the the. SOCOM study, we actually saw that nearly.

all of them saw an increase in SPO2. nearly all themselves an increase in. heart rate but that's rare that is rare. >> sp2. >> ah so uh the amount of oxygen in the. blood so the the measure that would. indicate whether someone. >> uh in these low oxygen environments had. more blood or less more oxygen or less. oxygen. >> ultimately it's it's important to try I. I think it's I would always say yes you. should try because or any nutrition. strategy because you should try.

different ones I've probably tried over. plus different diets only honestly maybe. like 15 or 20 at this point in my life. I've just come to find that the. ketogenic diet for all the reasons we. described and because I have type 1. diabetes and I had obese or have type 1. diabetes but had obesity. find that a ketogenic diet is remarkably. powerful at helping me live a. dramatically improved quality of life. not have the increased risk for the high. invariable glucose levels, high insulin. levels that lead to a a near guarantee.

of complications and 10 to 20 years of. lost life and expectancy. That's why I. do it. >> I have a closing tradition on this. podcast where the next guest leaves a. question for the next guest not knowing. who they're leaving it for. And this is. a really tough question. >> So, it's a very strange question as. well, but I'm going to ask you it. anyway. >> Yeah. The question is. what is outside the simulation?

I think it depends on your philosophy. on how our existence. is. with the limitations. of understanding that our awareness of. our world is completely limited to our. our brain's capacity and. our interpretation and then explanation.

of the world and the term of a. simulation or lack, you know, however. you want to frame it, I believe is is. always going to be limited by our. brain's ability to understand and. articulate that. >> So, what do you think is outside the. simulation? >> Consciousness. >> You think consciousness is outside the. simulation? I think that. our ability to have not consciousness,

Stephen, but our ability to. operate beyond. consciousness. >> Got me on that one, man. That was a that. >> tough question. >> Yeah, it is a tough question. That's. that's that's a it's a burner right. there. I don't know. Do do you think. there is do you think there is a god. >> beyond beyond this all this stuff that. we see here? >> I'm going to give you the most real. honest answer possible. >> Yeah. >> I don't think we ever can actually. answer that question accurately.

>> So your your answer therefore is you. don't know. >> I don't know and I don't think I'll ever. know. >> Yeah. Okay. Thank you. Thank you so much for doing. the work that you do. really appreciate. that because you know so many of my. friends in this field and even Michael. the founder of the the ketone product on. my on my uh table here talk about you as. being the sort of gold standard of. research science and um thought. leadership on the subject of ketones and. more broadly on the subject of um. glucose and all of the adjacent subjects. like insulin. So you've really pushed.

the field forward and the thinking. forward in this space in a really. profound way and you're only just. getting started at 34 years old which is. remarkable. we're basically the same age. and uh you've had such a tremendous. impact on the field of health and that's. born out of the story that you told at. the start through your own. complications. So although it was it's. such a tragic thing to be have such a. diagnosis at such a young age, what's. come from that is a beautiful thing for. so many people um that will better. understand themselves and their their. illnesses but also their performance and. um everything correlate related to that. because of you. So please keep doing the.

research you're doing and spreading the. word in the way you're spreading it. because it's much much needed work and. it's it's important work. So, thank you. so much and thank you for giving me your. time today, >> Stephen. That was an honor. Appreciate. it, sir. >> Make sure you keep what I'm about to say. to yourself. I'm inviting 10,000 of you. to come even deeper into the diary of a. CEO. Welcome to my inner circle. This is. a brand new private community that I'm. launching to the world. We have so many. incredible things that happen that you. are never shown. We have the briefs that. are on my iPad when I'm recording the. conversation. We have clips we've never.

released. We have behindthe-scenes. conversations with the guests and also. the episodes that we've never ever. released and so much more. In the. circle, you'll have direct access to me. You can tell us what you want this show. to be, who you want us to interview, and. the types of conversations you would. love us to have. But remember, for now, we're only inviting the first 10,000. people that join before it closes. So, if you want to join our private closed. community, head to the link in the. description below or go to. daccircle.com.

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