Episode 124: Gary Taubes makes a case for the ketogenic diet and its metabolic benefits

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times that the stems on top stem. Temp, taught stem talk. Welcome to stem. Talk for introduce you, to Fascinating People Who passionately inhabit, the scientific and Technical frontiers of our society. Hi, I'm your host Don Cornelius and joining me to introduce today's podcast as man behind the curtain. Dr. Ken for diet. Jim sees director and chairman of the double secret selection committee that selects all the guests to appear on stem talk. Hi Don, great to be here. So, today we have science and health journalist. Gary, taubes, joining us.

To talk about his new book, the Case for keto rethinking weight control and the science, and practice of low carb, high fat eating. This is Gary. Second appearance on stem talk. We had a lot of ground to cover since his last appearance was way back in 2016. And so we have divided his interview into two parts. In today's interview. We will talk to Gary about his new book, and his reasons for writing it. So our interview with Gary and 2016 followed the release of his book.

The case against sugar, a book that went on to become a New York Times bestseller. And the case for Quito is Gary's. Fourth book. He has written about diet and chronic disease. His two, most recent books, as well as his two earlier books, good calories, bad calories, and why we get fat followed a 2002 New York Times article that suggested, the low-fat Orthodoxy that held sway in America since the 1970s might be wrong. So when good calories, bad calories, came out, Michael Pollan, the author of The Omnivore's Dilemma wrote that Gary's book was

really important and also destined to change the way that we think about eating with the case for keto Gary is once again encouraging people to rethink about the way they eat in part, two of our interview with Gary. We will dig deeper into his efforts to set the record straight about the role of diet and weight control in preventing chronic disease as well as the role that diet plays in helping people improve their health spans and lifespans Gary turns you journalism. Back in the

In 70s, after receiving, His Master's Degree in Aeronautical, Engineering from Stanford University today. He continues to practice journalism and is the founder and board chairman of the nutrition science initiative. But before Ken, and I get to our interview with Gary, we have some housekeeping to take care of first. We really appreciate all of you who have subscribed to stem talk and we are especially appreciative of all the wonderful five star reviews. As always, the double secret selection committee has been continually and carefully. Reviewing

ITunes, Google, Stitcher and other podcast apps for the wittiest and most lavishly. Praise filled reviews to read on stem talk. If you hear you review right on stem talk, just contact us at stem talk at ihmc. Dot U s-- to claim your official stem talk t-shirt today. Are we need review was posted by someone who goes by the moniker stem fan 53, the review is titled, exceptional unique and eclectic. The review reads as a non-scientist.

Relish both the content and form and how topics are presented. Both Ken and Dawn are super prepared, curious and knowledgeable in interweaving the science and biographical aspects of their guests. Truly a favorite. Well, thank you so much time. Fan 53, and thank you to all of our other stem talk, listeners is helps them talk become such a great success. Okay, and now, on to our interview with Gary tubs,

Stem tank Potsdam talk. Hi, welcome to stem talk. I'm your host Don Cornelius and joining us. Today is Gary taubes Gary. Welcome to stem

talk. Thank you for having

me. And also joining us is Kevin Ford. Hello, Don, and hello, Gary. So Gary, welcome back to the show. First of all, so we have to ask you, how's life in California? We're just going to guess that being in lockdown because of covid isn't such a bad thing for a writer.

No, I have a friend who said she's been in lockdown since

Before. So, it's has not changed. Yeah, I feel the same hasn't changed my life all that much, except reading the daily papers and keeping up with the news on the Internet is dismaying as it is for

everyone. It's a full-time job. Anyway,

indeed hard to focus on other work when the world seems to be going to hell in a

So the case for keto is your fourth book that has followed an expanded on your 2002 article in the New York Times magazine, which was entitled. What if it's all been a big fat lie. So I'm wondering, did you first see that? You would end up writing for books about the relationship between diet and chronic disease? When the article first came out 20 years ago,

short answer, absolutely not. I did write that article in part. There was a book. I very much wanted to write about the problems with the

Science of nutrition. I realize that from the two articles that preceded that New York Times magazine, be said to investigative pieces together took me almost two years for the journal science. And I knew that the nutrition and obesity research was what my physicist friends would have called Rife with pathological science, but I couldn't afford to do that book because I also knew it would take up a few years in my life and I couldn't get a large enough Advanced when I got that Infamous, New York Times magazine.

Asean, cover Story. The advanced problem was solved. I got enough money to pay for four years of my life. And then I spent five years writing the book turned out and doing that research, that there was a world of implications, and good, and bad science to unpack in the nutrition obesity chronic disease field. So the further and I dug the more, you know, I could have written the first draft of good calories, bad calories.

Ruiz was four hundred thousand words unfinished and eventually we published around a hundred and eighty thousand. So I knew that there was a lot to unpack there. Just has taken me 20 years to do it, and I still have two more books. I want to write

in that New York Times article. You questioned the effectiveness of low-fat diets, which the government's dietary guidelines have been consistently recommending. Since the late 1970s you highlighter researching your article that indicated, a low-carb.

Which was indeed an effective way for many people to lose weight and generally improve their health almost overnight. You became one of the nation's number one, Public Health enemies in some circles at least in the minds of, you know, many nutritionists and a good chunk of the medical establishment, but you must have sort of expected that kind of pushback. When you wrote the article because you are going against sort of the approved narrative. Did you expect it, or was it a surprise to you?

I knew it was going to be the most controversial article, the New York Times magazine had run since they ran a piece by a friend of mine on the inutility recycling. I didn't expect the fierceness of the response. That was a little bit like being kicked in the head in retrospect. I and I completely understand that, but I, when I originally the original article for the Times magazine, I led with dr. David Ludwig. Who is this young?

Young obesity, pediatric, endocrinologist at Boston's children's hospital. He was associated with Harvard. He was treating children with obesity with he called carbohydrate modified diets, and you know, very low carbohydrate diets, rather than low fat diets. And I saw him as a politically, correct. Sort of a way to get into this article where it wouldn't offend anyone. And they would say, oh, well for our young idealistic Harvard, Professor is doing this and it's

I think we should take seriously and then down below in the article III discussed the influence of Atkins. Dr. Robert Adkins who became famous and Wealthy for pushing a ketogenic diet. And then after I handed in the editor said, but we love it. But put Atkins in the lead. And I remember, I wrote a lead in which I said if the medical community had waking up in Time Square naked kind of nightmare scenario.

Would be that their dietary advice to eat less fat was wrong and doing more harm than good. And that dr. Robert Atkins and his crazy. Ketogenic diet was may be right or maybe both. And I read this to my wife and I said, I love this and I'll never run a word of it. It's cousin, got a prayer in hell, and then I sent it in to the editors and they ran it exactly. As I wrote it, and then, they put a porterhouse steak on the cover, this, the greasiest photo of a steak.

Could they could get photographed with a pat of butter on and they even told me later they picked the greasy. So on they could find to, you know, up the the tension between what we were saying and what the conventional wisdom was. I remember that steak? Yeah, most many people do. Yeah,

I remember thinking. Oh, this should be good when I saw the cover because I had read your pieces in science, and I recognized your name from

I think you are on the staff there, you had written some stuff about physics to I think, but anyway, I remember I recognized your name and I saw the steak and I thought, oh, this will be good.

Yeah, and this is, you can challenge. You can't expect it to journalists to challenge in this case in effect. Wow, and that article was 60 years of thinking, now. I'm backed it up to a ninety or a hundred years of conventional wisdom and you make the argument that the, the research

Nicole research establishment that the investigators working on this, the public health authorities promoting at the dieticians who have learned this and in school and are promoting it to their patients. And all these people are just wrong with the hell expecting people, and effectively, all of them to disagree with you. And if it was a small publication, I was writing for then, then then they could just ignore me, but putting it on the cover of the New York Times Magazine made it impossible.

Possible to ignore.

I've learned to largely ignore the New York Times. So I would have been immune to that response.

I'm leaning in that direction. That's smart surgery and certainly in the fields. I know well and it's always a problem. You assume that the fields, you don't they're getting it right, but if they're, if we can trust, the paper of record, who can we trust? And this is another three-hour conversation. We probably shouldn't have. It is

so Gary and Mike.

Pollan's book The Omnivore's Dilemma, he has a few lines in his introduction about how dr. Robert Atkins, brought Americans, the very welcome news that they could eat more meat and lose weight. Just so long as they laid off the bread and pasta. And Michael even mentioned your 2002 New York Times article and how you wrote about new studies suggesting that the low-fat Orthodoxy of the 1970s might be wrong, and it was not fat that made his fat. But rather the carbohydrates that we eat and he then wrote about how bread and pasta started disappearing, almost overnight from Supermarket shelves.

Elves and restaurant menus as a result of your article. So do you remember that period? And we're curious where you surprised by how the Atkins and other low carb approaches like the South Beach Diet? For example, suddenly became so popular. Well, they had

always been popular. That's one of the interesting things but they had always been something you never talked about. I mean Atkins book Atkins diet Revolution was at one point was the best selling book in history, but then it was

Her crack, or a one of the things that I mean, that Tipping Point in that article of mine. And this is what's interested in using that phrase Tipping Point, Malcolm Gladwell in the New York or three years earlier. Had done a piece on Obesity, the Pima Paradox, who was called a beautifully written pieces. Malcolm's, always aren't in it. He and effect made fun of diet books and fad, diets, and Adkins in particular. And when I came along in 2001, we were basically had the same assignment, which was to

Stand the Obesity epidemic, and Malcolm had sided with the conventional wisdom. By the time I came along in 2001. I had investigators like David Ludwig at Harvard and Eric Westman at Duke who were taking these diet. Seriously, and then I Came Upon and I could die, could Shadow them and their practices. I spent time with David up at Harvard. I spent time with Eric, Westman down at Duke, but then there had been five clinical trials pun, that had been completed but never not yet published. They had been discussed in conference.

So I could discuss some of the end. The really interesting, what they did you randomize, you are be subjects which were anything from adults, weighing 280 pounds in one trial to adolescents in another but you randomize them to either the conventional diet approach which at the time was a low fat calorie restricted diet of the kind that the American Heart Association was promoting for virtually everyone in America or Atkins diet, which is what we call keto today and Adkins is high fat, High saturated.

Added fat eat as much as you like. So the idea the conventional wisdom is that fat people can fat because they eat as much as they like. So by that thinking the Atkins diet should cause more weight gain and the conventional wisdom is that dietary fat saturated, fat causes heart disease. So by that thinking the Atkins diet should you know, up heart disease, risk factors. And that's why Adkins was always considered a quack and in all five of these trials, the

Subjects randomized to the Atkins diet, not only lost more weight, despite getting to eat as much as they wanted. They had better. Heart disease, risk factors, despite eating a high fat, High saturated fat diet because I had come from a hard Science Background, my take was look, my hypothesis was a high fat and saturated fat causes heart disease, but this is Trials do not confirm that hypothesis and our height. Everyone's hypothesis is if you get to eat as much as you want, you'll just get

Fatter in these trials. Don't confirm that hypothesis. So maybe those hypotheses are wrong and that's never how the medical community has embraced it. But that's how I that's how I came away. And that was the germ of skepticism that. In fact, that everything else. I did

on the jacket of your book, good calories, bad calories, which was your first book to follow the 2002. New York Times article. There's a blurb from Michael Pollan. We mentioned earlier that reads. This is a vitally important.

Destined to change the way we think about eating good calories bad calories. However, didn't change the nation's dietary guidelines or the American Heart association's low-fat diet recommendations

or how Michael Pollan thought.

Yeah. Well then that would even be harder. But here we are 20 years later and the ketogenic diet is really very popular. It's one of Google's, most popular Search terms every month. So what's driving is interested in the diet.

It's certainly not driven by the official story or by the US dietary guidelines or general medical advice. We'll come back to the guidelines later. But how do you see this diet? Maintaining its popularity? What's driving it?

Now, at one point. I wanted to call the case for key to, I wanted to call it in defense of fad diets. Okay, so it's relatively simple. We have obesity and diabetes. Epidemics.

Using word to use nowadays, but the explosions in the prevalence of obesity and diabetes at begin around the 1960s to the point. That three and four Americans are overweight or obese, and one in 10 have diabetes. These are stunning numbers and you can argue that for effectively. All of these people, the conventional wisdom failed them. So at one time or another in their life, they struggled mightily to control their weight and they probably still struggle mightily to control.

Their weight and they don't succeed and controlling. Their weight means trying to eat less and exercise more and eat mostly plants and eat low-fat diets and healthy diets. And you know, they however you want to Define it. Those are things. These people are all going to try their things. We all have all tried. If you are functionally intelligent in the 21st century and you're overweight and obese, you have tried eating less and exercising. More. You've tried low-fat diets. You probably tried mostly plants. You may have

Vegetarian or vegan at some point, you are going to get to ketogenic diets keto because they're the most popular fad diets out there. And so if they work for you and by work, we mean allow you to achieve and maintain a healthy weight without hunger, then you're likely to stick with it and what I did and colleagues people like Nina tie Schultz and and many others is we managed to communicate.

The idea that these diets are not deadly that the clinical trials, tell us, they're benign. So this way of eating can be tried and, and to me, that's that's, it's a direct result of the Obesity and diabetes epidemic. Some more people get heavier. The more people are going to try keto and if it works, the more people are going to try and sustain it. And now you have a World Of Products out there that make it easier

and people have friends that suddenly look different and they say, what happened to you and they tell them.

Yeah, and that's the one of the points I made in my new book is I estimate one. When I first started this, 20 odd years ago. I could find, maybe a maybe they were a half dozen or a dozen physicians, in the country who were prescribing, these diets, their patients and eating them themselves and believe that this was a healthy thing to do and half of those had written diet books, you know, Adkins mikeandmary. Danny needs the sugar Buster's, guys in 2011, when I published

Why we get fat and I had a chapter at the back of the book giving advice on how to do the diet. Now, to think about it, kind of a chapter that indicate the case for Quito is a massive expansion of. I found a half dozen doctors. I could interview who had clinical experience with these diets. So I could use them to discuss the challenges and how best to eat this way for the case, for keto estimate. There's now a few tens of thousands of Physicians out there all of whom have gone through what Gladwell has called a

Version experience, which means they were getting heavier. They were getting obese or diabetic or tried all the conventional approaches exercise. Some of them were world-class athletes. Who found themselves with either pre-diabetes or diabetes or obesity and they eventually tried low-carb, high-fat ketogenic diets, and it worked. And now they prescribed it to their patients and they see it work with their patients. So they're frustrated.

They're delighted that they can make their patients healthy or which is why they went into medicine. They're frustrated with the push by the continued. Embracing by the authorities of this idea. That these diets are dangerous and people shouldn't can't eat this way. Let alone

And I'm Gary. I'm at nose. So your 2011 best-seller, which you've been talking about, why we get fat condensed, a massive research you did for good calories, bad calories, and also provided new arguments and research for the hormonal cause of obesity in which the consumption of sugar and carbohydrates drives insulin resistance, which in turn drives obesity and diabetes. And at the heart of both of these books is your argument that there has been misinterpretation of nutritional scientific data, which is ultimately been used to develop a US Food policy that

Men's a low fat diet as we've been talking about. Since these two books came out, there has been a steady accumulation of studies supporting carbohydrate restriction and the safety of saturated fats, some guessing that has to be pretty rewarding for you.

It's rewarding on one level, you know, again, when I first started this 20 years ago, so a healthy diet, 20 years ago, is defined as a diet that was low in salt and low in saturated fat and maybe low in fat and maybe high in

We plants that that would have been the conventional thinking, 20 years ago today. If you were to ask nutritionist to define a healthy diet, the first thing they would say is it slow and ultra-processed Foods by which they mean sugar. And highly refined grains that are not-for-profit. I co-founded the new see funded, a study at Stanford. Those going to compare low-fat diet to a low-carb diet. And then the principal investigator Christopher Gardener insisted that he both died at approaches restrict.

Hers and refined grains because he thought it was unethical if he allowed one of the diet groups to eat those, even though they're so you have a low fat group restricting, sugar and refined grains, which are carbs and it's called low fat, but it's carbohydrate restricted. So this has become conventional thinking, I don't think anyone in the Public Health Arena says, thanks Gary towns who really appreciate all you've done. Getting us to pay more attention to that but nonetheless it has shifted. The problem is

All the baggage from the loaf. A tiara has stuck with us as well. So as you mentioned we still have the USDA while they don't talk about their dietary approaches as low-fat and the idea is you're supposed to still restrict saturated fat, but replace it with polyunsaturated fats. The dietary approach is that they promote or still de facto low-fat high-carb diets. And while they don't, they now restrict what they consider a healthy level.

Full of sugar consumption. They don't suggest people abstain from sugar consumption entirely, which is something I might

Stem talk is an educational service of the Florida Institute for human and machine cognition, a not-for-profit research lab pioneering, groundbreaking Technologies aimed at leveraging and extending human. Cognition perception, Locomotion and resilience. Well following on that theme. Your your new book, the Case for key. Do you really see?

To be an attempt to clarify, the all the misunderstandings that people have not only about low carb, high fat kid in genic diet, but just set the record straight about Decades of misunderstandings that we've had as a society about diet, weight control and overall health, not surprisingly for you. But that is quite an ambitious undertaking. You know, what motivated you for this particular book. It sort of makes sense in a way. If you look at your string of Publications on this topic, but was there a particular Niche that you were?

Trying to scratch with this

book. Well, the book actually started out with the idea that I should just write my food rules. You know, we've talked about Michael Pollan, a bit. Michael had Omnivore's Dilemma and then in defense of food, and then he published a book called food worlds, which just sees, you know, took him. I've been told it took him three weeks to write where it was, you know, all the clever little things that people had written to him about how you should eat, you know? Yeah, like

you're less parsley vegetables. Yeah.

Yeah, so I was going to do something like that and then I decided I didn't want to do that. I just didn't interest me and rather I wanted to in effect, learn where we were in 2017 when I started the reporting. That's because I knew like said that thousands of Physicians were taking this up and prescribing it to their patients. And clearly, I, and I also had now a decade, since my first book to come out to be criticized by people.

So what I wanted to do was dress a lot of those criticisms because that's how the conventional thinking went. And much of it still came down to this. Embracing of the idea that a calorie is a calorie and we get fat because we eat too much and to me that's the most destructive. Paradigm. Obesity researchers could have come up with and I think the people who promote it which is still 99% of the research establishment the clinicians.

Just don't think at throw they number and have the opportunity. Really think what this means and what this implies. So I wanted to go through and discuss all the things that implies this idea that obesity is caused by eating too much which seems intuitively obvious until you think about it. Rather than the idea that obesity is a sort of hormonal dysregulation of the physiological mechanisms that control fat accumulation. I was reading a book recently, wonderful book written by a young woman who struggles

Severe obesity and it's called what we don't talk about when we talk about fat and she says, she tried every diet none of them works. And she's railing about all the the burden of living with obesity in this modern society and even the Physicians or constantly trying to tell her to lose weight and it's a heartbreaking book. But in it she says look some people are just built fat and that idea that some people are just built fad is as intuitively obvious or should be more intuitively obvious than the idea.

That we could fact. As we eat too much and I've argued this in my previous books, you know you go outside. You see someone sitting on a park bench, who's 400 pounds are 300 pounds. All you know about them is that they have this unfortunate burden of accumulating too much fat, you know, nothing about how much they necks or Sighs. And yet our conventional thinking is I got fat because they ate too much and didn't exercise enough and not that they have some kind of dysregulation of fat accumulation, if they were 8 feet tall, you know.

We had a secreting too much growth hormone. It's clearly hormonal problem. If they were eight feet tall and 400 pounds. You would know. It's a hormonal problem because they would kind of look built like other people, but if they're six feet tall and 400 pounds, you blame their appetite or maybe their genes that are making them eat too much and I just had to go after this one more time. I'll have to go after it again. One of the it. The next book I'm writing is purely on diabetes and this

The overeating hypothesis of obesity is fundamental to how we understand diabetes. And then I want to write a book. That's just a history of thinking on Obesity and research so people can see how we Embrace this idea. And why, and on the basis of what data which is virtually non and how it infected everything that came

As you talked about a bit already. There's a growing Acceptance in the medical community, that low-carb diets can be an effective way to lose weight. But Physicians are typically still pretty reluctant to recommend low carb or ketogenic diets and particular because they said, they don't know much about their long-term safety. So instead, many Physicians will stick to the Viewpoint, that a low-fat, we're going to say, Mediterranean diet. And I know we talked about this before and some talk. We're not quite sure what that means is, the safest and most effective way to eat yet. And you've researched what evidence have you found?

And that a quote-unquote, Mediterranean diet is safer and healthier in the long term than a ketogenic diet.

And well, this is one of the problems with the research in general, in order to answer that question. You would need a clinical trial randomized control trial. They randomized subjects to a Mediterranean diet or a low-carb, high-fat ketogenic diet. And the reason I keep using that long terminology is because I still don't know how important it is to be in ketosis. Anyway, you, do you randomize.

Has your subjects, you run them out for 5 10 or 20 years, the more subjects you have the short of the follow-up past and B and you can get a real idea of whether or not the Mediterranean diet is safer.

Yeah. I have no idea what that even means though. Gary does it

mean? Yeah. It made it rain is a large diverse place with,

you know, people eating lamb and arugula in one place and the next place, eating pizza and pasta, you know, it's unclear. What that

And it's always been unclear what it means. I actually, I spent a couple of years living in Paris in the mid-80s. And it's funny because a Greek restaurants in Paris of which there were a lot of them were always the ones that had the beef in the window, you know, part of me or said I and they were the ones selling shwarma out front which I still don't know what it is, so I can tell you, but it was meat animal products Source, but it is this conception of a Mediterranean diet is mostly plants and olive oil is

Yeah, it means if never been to the

Mediterranean, right? It's a lot of

lamb, lot of beef. Well, it might have shape, right? It might have been what in fact that the conception comes from, what some Mediterranean Islanders were written were eating in the decade, post-world War II, but they had also gone through severe families during World War II. So, they were not typical Americans. There's so many issues

with this and that particular Island though, that was studied. Those people had no choice, but to eat

that and is

Soon as they did have

choices. They went back to their lamb and

and veggies. Yeah, you

know, well, we even the at one point last, I looked around 5 years ago. If you asked somebody, what population eats the most cheese per capita. It wasn't the French. It was the Greeks because of their fate of consumption and when they're poor Fed was the main source of protein in their diet. So again you have this remember I used the phrase pathological

Science And discussing why I got into nutrition research pathological science is a phrase coined by a Nobel Laureate, chemist named Irving langmuir, used it back on a lecture at IBM in 1957. It means the science of things that aren't so. Okay. It's not about fraud or misconduct. It's about all the ways that people can fool themselves into believing. Something's true. That's not and scientists are prone to this. Just like all the rest of us are and there's the

Implication is always been that. There is a lot of path logic. There's a lot of science being generated and produce to get people Publications and get them funding and get them into academic positions and keep them in academic positions. That's pretty much, you know, I think of it almost as noise generation in nutrition and obesity research because it's a difficult to actually test your hypotheses, you know, I was discussing the problems with testing the hypothesis that a Mediterranean diet is safe for them.

In a ketogenic diet, the researchers have pretty much stopped doing rigorous test their expense. They usually have to be funded by the NIH and planned for years in advance. To get them to even have a chance of think you're doing it, right. So, rather than testing, their hypotheses have just chosen to assume that their hypotheses are probably true. Because that's what they, and most of their colleagues believe. And it's sort of the worst tendencies in science. And it's what

Rigorous science argued, you cannot ever do because the goal of science, right is to establish reliable knowledge, not to just assume that what we think is true is so we have problems throughout the nutrition and obesity world. And yeah, the problem with a person like me a journalist criticizing this or even when researchers criticized at the response is to criticize the

critics, right? It's typically at hominin response, you know.

Yeah, you saw that in your case. And you saw it Nina's case.

Well, not only that even the academics. Oh, yeah, pretty cheap. The research people don't say? Yeah, the one of my fundamental problems been with the nurses health study at Harvard because they the researchers involved. Walter Willett and mayor Stan for another's. Have driven nutrition thinking in this country. They're very, they're considered to be very influential because there are at Harvard. I'm not and they have this big

Study that generates associations between disease and die and then they assume that the association's are causal. They don't Advocate that they be tested. They don't go down to Congress to lobby for funding to test them. They don't insist to their funding agents at the NIH that they should test him. They just say, look, because we've done this, we assume this is true and there's copious evidence that it's not, but even then if nothing else, if they were real, scientists, they wouldn't be Lobby.

Going to test their hypotheses. That's what scientists do. They test hypotheses. I mean we can go after it on so many different levels. The initial problem here though, said it's simple. Just this idea that obesity is caused by overeating. It is everywhere in this field. It influences how we think even about heart disease and cancer and diabetes and it's naive almost Beyond conceptual it must cause it is

close by

Reading but if by you're reading the wrong things, so

over eating well, but also want to use a phrase like overeating. Your it

means I know I'm pulling your leg. Yeah. Okay. As your leg feel it

a little bit. Okay,

you know, we're talking about ketogenic diets. And you know, I actually know a person that consumes an incredibly unhealthy kid, Janek diet and has not

Ernst many of the benefits that so many people do and I'm exaggerating here, but essentially, this person has a diet of Crisco, you remember, Crisco shortening, sort of Crisco and bacon died that now, I'm exaggerating and I tease him, right? But this is the kind of things. This guy, devours, and he somehow from a podcast, got the idea that the quality of what he eats, doesn't matter. It sort of as long as it's fat.

So, let me just cut to the Chase and say this is not working for him, and it should be surprising. It's not working for him. Right? And I understand, this is nothing like what you're suggesting, but, the reason I bring this up, you see, might wonder why did can bring his unusual friend up. Well, the reason I brought him up is, this is exactly how many of the critics essentially cartoon. The ketogenic diet, right? They sort of have a scheming cartoon of it. That, it's the Crisco and

Bacon diet or it's the, you know, some

other butter and bacon diet. Yeah,

it's sort of a cartoon. It's a way of dismissing something without real serious discussion. And I think that's widespread. I mean, you see it, particularly in the media particularly journalists, do this.

Yeah. It's there are a lot of ways to dismiss it again to to address. It is to confront some real tension between

The nutritional wisdom, right? One way I discuss in the book. As I said, we have sort of two mutually exclusive definitions of the concept of a healthy diet. So the conventional wisdom is a healthy diet is a diet with fruits vegetables, whole grains, beans legumes, you know, red meat in moderation. No processed meat, fish and two green vegetables, right? And that's, and we know that the so why why is it healthy? Because we believe if you eat that died, you'll live as long as possible based on the

A tional epidemiology folks like, you know Walter Willett screw, but Harvard with their nurses health study because that's what healthy people tend to eat. So one definition is we should always eat the way healthy, people tend to eat and then we should ignore the fact that the reason healthy people tend to eat this way is because that's how they were told to eat 40 years ago when the study started. So the health conscious people embraced these thinking and so healthy people tend to be health conscious people and now we don't know.

There are healthy because of how much reading or whether their health conscious, the alternative definition of a healthy diet. Is if a doctor tells his patient to give up sugars, starches and refined grains and beans and legumes to and live off of, you know, meat fish and fowl and green leafy, vegetables, and eat plenty of fat. They'll get healthy. So one is a hypothesis-driven definition. If you eat this way, we won't necessarily see any change in your health, but we think you'll

Live longer than you would otherwise and the other is a based on clinical observation. If I tell you to give up carbs abstain from carbohydrates and replace those calories with fat, not Crisco, but healthy fan is natural fats from Whole Foods. You'll get healthier and like to watch it happen. Your way. Don't come down, your blood pressure will come down, your blood sugar will come in to control your own inflammation, or reduce in the Physicians report this all the time there.

Realizes the world of biases involved with what Physicians think they're seeing in their patients, but when you see, chronic diseases, going into remission, that's a pretty powerful observation and specially if it's reproducible. So in patient after patient or maybe yourself, so how does a medical research Community deal with that? And one way to do it is to cartoon, you know, go after strong men, but I was reading an article just today in the

Insider Business, Insider forget which and which basically they said, look any diet that recommends you could eat bacon as a snack is an unhealthy diet and I want to ask the woman involved. How do we know bacon is unhealthy the reporter and she's going to respond. Why everybody thinks that way? And then I'm going to say. But how do we know? It's unhealthy show me the studies and we're going to get nowhere and she's going to think I'm annoying, and I'm going to continue to think she's a bad Journal.

But it sort of visited a lot of con. Once you Embrace a paradigm, is truth based on such unreliable evidence. It's almost impossible to

Gary, we know that there are many degrees of carbohydrate restriction that can be termed low-carb. But do you think there's a threshold that people should aim for in order to derive the metabolic benefits of a low-carb diet? And then a second question, what's your take on whether a ketogenic diet provides additional benefits over General? Carbohydrate restriction, and of course, we definitely appreciate that. This depends on the context to a substantial

extent. Okay. So let me unpack that thinking a little bit here.

Let's define what we mean by a diet working. So the conventional wisdom today, which is insane. Is that a diet? The diet will is the diet. That works is a diet, you'll maintain so they don't care if you lose weight or your blood pressure improves, your blood sugar gets under control. If you're say you're on some kind of diet and your sustaining that diet, the conventional, the medical establishment. Today is happy with you. In fact, the American Diabetes Association takes that one step further. They now recommend their doctors.

Tell their newly diagnosed diabetic patients to continue eating exactly as many carbohydrates as they've always eaten because their patients are going to do that anyway, and if the doctors tell him to do, what that way, the doctor is going to have faith, the patients are following their

advice and it makes it easier to dose the patient with insulin, you know

you. Yeah, that's kind of the logic you. It's as long as they don't change at all, you know, how to dose. Exactly, tell them to change and you change their dose and then they don't change. Now, your dosing incorrectly.

You know, but anyway, so, you know, we're arguing what I'm arguing is diets work. When they you have some chronic disorder intractable disorder that right now is at best being treated with pharmaceutical therapy. So blood pressure is too high or blood sugar's out of control or your weight is out of control. We don't have pharmaceutical therapy. That really works for wait anymore. So you want to reverse that? And the fundamental Concept in the ketogenic diet. That's low carb high fat approach. Is that carbohydrate?