#1175 - Chris Kresser & Dr. Joel Kahn

September 27, 2018

Chris Kresser, M.S., L.Ac is a globally recognized leader in the fields of ancestral health, Paleo nutrition, and functional and integrative medicine. Dr. Joel Kahn is one of the world’s top cardiologists and believes that plant-based nutrition is the most powerful source of preventative medicine on the planet. https://chriskresser.com/rogan https://drjoelkahn.com/joe-rogan-experience-reference-guide/

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today's the big date today is a big debate date today is dr. Joel Kahn and Chris Crusher Kresser Chris Kresser say that 50 times fast times before this is dr. Joel Khan's first appearance in the podcast and what this discussion and debate is is about plant-based vegan diets versus what Chris refers to or they refer to as paleo or

what do you call a nutria what

Nutri War which is the new one that I've heard I've heard ancestral diet is another one but the ideas mostly vegetables with meat and maybe some organ meat

who we left all the ethics aside and no for a lot of people that's a big issue but we did not have enough time to really want I mean we got way down the weeds many times just discussing the nutrition aspects of it but I think we got through it with about as good a job as you could ever do and I credit these two gentlemen because they kept their cool they they debated but they never got personal and even though things were under dispute the way they handled it was admirable so thank you Chris and thank you Joel and please welcome dr. Joel Kahn and Chris Kresser

The Joe Rogan Experience

gentlemen thank you very much for being here really appreciate it dr. Khan before we get started one just tell everybody what your background is you will be representing the vegan portion of this discussion tell people about yourself a little bit thank you I feel like the head broccoli in the United States today but I am from Motown Motor City bad ass born and raised University of Michigan School of Medicine Summa cumlaude Internal Medicine training Cardiology training in Dallas Texas very hard to be vegan in Dallas but I did it in the 80s cuz I've been doing this 42 year vegan 42 deer again then that's impressive age 18 and then Kansas City Missouri another tough time to eat plants and only they Steakhouse KC Masterpiece did training and stenting I was blasting open heart attacks from 1990 on came back to Michigan very active cath lab heart attack your dead I bring you back practice 24 hours a day with great partners and about

three to four years ago I used all these Decades of plant-based medicine I've been basically bringing my family up with an teaching patients but opened a completely preventive cardiology practice and along the way with my wife and son we now own three plant-based restaurants to in Detroit one in Austin Texas write books do TV write blogs teach teach teach not going to stop 250 there's a lot of erectile dysfunction to stamp out that's my passion oh my God what else in life well can we can get that later somewhere in that makes their okay and if people want to read more about you website is Dr J o e l k a h n dr. Joel contact Starbucks right by but I bought a bunch of medical papers and a whole lot of blogs awesome and Chris

yeah Chris Kresser demanda riot at UC Berkeley and then got a Masters of Science and co-director the California Center for functional medicine which is a functional medicine clinic in in here in California up in Berkeley and I came to this from my own experience with chronic illness I as as you know Joe got really sick I'm back in my early twenties when I was traveling around the world and you know conventional medicine didn't have much to offer for me and so that let me on a path of trying to figure out the best approach from a diet and behavior and lifestyle perspective to heal from my own chronic illness and then not evolved into me starting to right now it started a Blog and a website and then I wrote a couple of books and now have an organization that trains practitioners and functional medicine and also trains health coaches

one point in time were vegan I was a macrobiotic vegan I was Apprentice sing with a macrobiotic Chef so if you can for folks in a regular vegan macrobiotic is a particular philosophy it's a particular approach that came from Japan and it's vegan but it's it's you know it's heavily influenced by Japanese tradition and Cuisine and it has some kind of different beliefs than a typical vegan approach so I was when I was originally studying Chinese medicine I was working in an apprentice thing with a macrobiotic vegan chef and we were going around cooking for people who are really ill often people with cancer who are following a macrobiotic diet and before that I've been a vegetarian for quite a while as well when I was traveling around the world and got sick actually I was I was vegetarian that point too and you discover through your own personal we doing over there buddy

you discovered over there through your own personal practice that you your body work better and your illnesses went away when you change your diet away from Mac biotic for me personally vegetarian diet and particularly vegan diet was a disaster but I'm just one person I don't put a lot of stock into a single person's experience one way or the other but certainly that did lead me down the path of questioning some of my earlier beliefs that I had about vegetarianism and veganism and it led me to make some different choices that is important to discuss hear that everybody's body really is different and different people's bodies and lifestyle that what they're going to have different requirements absolutely I mean I would say just to start off as whole discussion if we're trying to answer the question what's the optimal diet for everyone I think that's a terrible question

question work we share a lot in common as human beings we have a lot of important differences to and from the beginning I've always argued that there's no one-size-fits-all approach when it comes to diet but I think there are some common themes and week and I'm sure we'll get to the house later I think that's really important it's really important to discuss that people really do have different quirements yeah a little bit as we need to but it we also Chris Knight share a lot in common I mean one if we ate together it would probably 90% the same and we both are really respect what we call functional medicine root cause medicine I don't write scripts without thinking about the patient he certainly doesn't do that without thinking about the entire patient it's pretty unusual I'm working to represent a very small section I I honor what he's doing with his new book on kvetch medicine the rest is what is happening throughout medicine and it's necessary cuz it just where would just run out of dollars in and help when were just pushing pills and not even asking a person what they eat out they sleep you know

I don't think we have a patient leave the office and actually asked what date today and I'm on a really important point and I'm glad you did did it right off the bat the biggest problem with nutritional research epidemiology is it it starts with the assumption that there is one diet for everybody that's that's something that's rarely discussed this idea that you know should everyone be on a low-carb diet should everyone be on a high carb you know low fat low fat diet you know should everyone do this should everyone do that in the whole you know there's a guy in Australia Professor who calls calls this approach nutrition ISM this idea that we can reduce Foods down into these individual components

just like macronutrients and protein fat carbohydrates and we can figure out what works best for everyone just by looking at these isolated components without considering it the whole context of the diet so I think you know Joey would agree that if you talk about a diet is 50% calories and fat and one diet is there getting all of those fat calories from pizza and chips and candy bars and things like that and then another diet they're getting 50% of fat from avocados and olive oil and even your eggs in animal food those are two totally different diets and yet in the scientific literature those are equated as the same because they're all they're looking at is the calories from fat are not considering the quality of the diet and I'll just adding and again we go anywhere with this conversation but a lot of brahma's been in Precision of language so even the word low carb diet I had a low-carb diet if we talk low refined carbs I don't eat white flour out of sugar a very careful about all those compose

I need a very high complex carbohydrate diet so well that's there a giant study that's been released last years of pure study talks about carbs in the dye they didn't different shaped complex in Define very hard to know what to do with data that doesn't spread that apart and in your own life I mean low fat high fat man we need to talk about is it soy bean oil that soon I will processed and Rance it or we talked about avocados and healthy Whole Foods so the Precision of language even protein protein the big dividers animal versus plants anytime that word comes up we need to differentiate what will be precise and then we'll help more people for precise illuminate this for people what is the problem with epidemiology studies I'll go there real quick I mean I don't think there's a problem but there are part of the solution they're not the whole solution a lot of scientist I'll give a shout out to Los Angeles brightest nutrition mind somebody that I know Chris

to valter Longo No Label not vegan that feeling that nothing is at USC been honored by the Royal Academy of Swedish medicine which is a Nobel Prize Committee in this that he says you know you do basic science and then you do an epidemiology study to test the hypothesis you see something in a Petri dishes he sitting in a mouse you see something in a Cell you ask the question is animal protein Pro longevity Pro early aging explaining epidemiology studies are people not my fine and Lucy in a Petri dish looks like it might cause accelerated aging in a single cell that's about chemistry that is something you honor but it's a long jump from there to human then you look at a database sometimes it's a crappy old database sometimes it's Harvard has his gigantic ongoing database Loma Linda an hour from here has a gigantic databases epic study this pier study mention you can test

hypothesis what happens if our data may be crappy but it's still data and it allows you to go further with a hundred thousand fifty thousand people 500,000 people can what do we have the day to ask a question does protein correlate with survival protein correlate with early death animal protein plant protein these Studies have been coming out a lot lately and they let your parts it out now it's what you know Chris talks about do you know everything about the person in the database you know smoke or do you know diabetes are they go to the gym to lift weights they smoke dope days smoke crack you know you don't know everything nowadays most of these things are going to ask how your blood pressure cholesterol all the basics to try and take those factors away and isolate the question you're asking it will be imperfect and then you go to the best study but it won't it won't happen often the randomized clinical trial I mean there's never been a randomized clinical trials smoking cuz I'll be on ethical you're never going to do it it was epidemiology that prove in association strong enough to recommend to the public don't smoke they'll never be around in my style and not

parachutes don't need a randomized trial you know taking folic acid in a pregnant woman did not have spina bifida doesn't need a randomized trial and there's some things are so pressing the public health can't allow that and there's even more than that the last little section is you can study old people Chris enjoy studying ancient societies I enjoy studying the elderly in current in a modern environment which is called the Blue zones and there's others but you know what old people do the old healthy people what we would like to be would you like to be 90 and have your brains and have your joints and everything working what we have that database so that that little for pod pedestal to sit on basic epidemiology randomize studies and centenarian study allows you to make reasonable conclusions and I will be wrong sometimes when I can be very long I think there's a huge problems with epidemiology studies

and then try to draw inferences from their behavior about associations with disease so let's say we we take group and we look and see you know how much saturated fat a day eating we separate them into low consumption me and consumption hiconsumption and in a prospective study were watching them over time we might then look 20 years later and see how many people had heart attack and died okay and then we try to correlate that with their amount of saturated fat intake now I actually just published two articles with going in detail on the problems with observational nutritional research and you can find a Matt Kresser. Co / Rogan there's a whole bunch of information that we're going to be talking about today there so people can go and get the details themselves but I'll just give you three of the I think the the worst problems with nutritional epidemiology the first is data collection so there's a saying in science which is that

Taylor are only as good as the as the tool used to collect them all right and it in nutrition observational studies the tool used to collect data is a questionnaire okay and so that relies completely on memory and we know that memory is not a precise accurate or literal representation of events it's more like a highly edited anecdote of what happened in the past and bad little bit like the Cavanaugh thing going on right back in a bag in the 13th century you have Francis Bacon you said for something to be scientific it has to be independently reservable measurable and falsifiable and then accurate and valid valid and so it lets you use an analogy if you're saying they're eating an apple and I'm watching you do that I can observe that you're eating the Apple I can measure how much of the Opera you eat and I can confirm or refute that you're eating the Apple if you tell me that you were eating an apple 15 years ago or 10 years ago

I obviously can observe that I obviously can't measure it and I obviously can't confirm or refute it and yet our entire Foundation of nutritional epidemiology is based on that basically people reporting on what they ate at some time in the past so I know how much of a problem is this there's a guy named Edward Archer who's done some really interesting studies and he looked at the end Haynes data the nurses Health Data which is one of the longest running nutrition studies 39 years and he found that the self-reported calorie intake and no studies was either physiologically impossible or incompatible with life so the average person in those studies reported a calorie intake that would not support an elderly bedridden frail woman

so they just is just an Acura it's completely inaccurate and the people who are most likely to under report are people who are overweight and obese so if you have calories or not much under-reported all nutrition comes through calories everything we get fat protein carbohydrates micronutrients they all come through calories so calories are that under-reported that completely invalidates the date of this is an obesity study so they're they're under reported because of Shannon obesity study it's just every Americans are overweight and obese the majority of Americans are overweight and obese and we need a data set of Americans are going to have the majority of them overweight or over be so it or RB so that's the first problem the second problem is a healthy user bias which I know we talked about before but it's basically the idea that because you know when someone engages in an unhealthy and a behavior that is perceived as unhealthy they are more likely to engage in other behaviors that are perceived as unhealthy and vice versa

so let's say you do a study of people who ate eat more red meat while red meat has been perceived as unhealthy for a long time and so what we know is that in those observational studies the people who eat more red meat or else you're smoking more they have higher body mass index they're eating less fewer fruits and vegetables and have a lower level of Education there less physically active so how do you know that it's the red me that's causing the problem and not those other things you don't because they cannot control for all those potential confounding factors the third problem with observational research and maybe the biggest is that the the relative risks in nutrition are so low that they're indistinguishable from chance so in field outside of nutrition and epidemiology nobody would consider a relative risk an increase in rest less than 100% a doubling to be really worth paying attention to so to put this in perspective

observational studies that Joe is referring to that confirmed it is that cigarette smoking lead to lung cancer that showed in between a 1000 and 3000 percent increase in lung cancer in smokers okay and the studies that have shown that eating aflatoxin which is a mycotoxin increase liver cancer risk that's 600% increase okay the DIA RC who report that suggested that process red meat was a percentage in that was 18% increase most epidemiologist you talk to will say that is so low that it's really in the student indistinguishable from chance especially given the healthy user by us in the problems with the data collection that I mentioned before so the studies that are cited so when people are talking about red meat causes cancer they're literally talking about something that showed an 18% increase

British people that I'm also assuming sugar it was that translates into four and a half there were four and a half cases of cancer out of a hundred in people with no lowest intake of processed meat and not went up to 5.3 cases out of a hundred in people with the highest intake of process me so you know there quotes like if you if you look even 20 years ago like there's an article in science the journal science and Marsha and Ja who is the former editor of New England Journal of Medicine was quoted as saying we wouldn't even accept the paper for publication if it didn't have at least a 200% increase especially if it was a new Association or the the biological mechanism wasn't known and here we are today saying that you know this increase that by 7% or by 10% and when you consider that the data is usually questionnaires at what people ate and all of these confounding factors like

exercising and fruit and vegetable consumption and things like that or not accounted for then we're really just playing games with numbers is part of the problem as well that there's this clickbait culture now in terms of Journalism where they just want to publish something that says H study shows at 18% of people eat red make a cancer that's a huge problem and there is a study that was done that showed that 43% of findings came from observational studies were portrayed in the media as being causal which which any epidemiologist would tell you that that's a fopa you can't do that but nobody is going to click on a headline that says you know

small association between these two variables scene we don't know what it means but please read the story it's really interesting if we throw up the DME ology away we just run away about 80% in nutrition knowledge cuz that is the most common kind of study and that still leaves us with basic science which is rocking at Lisa's with randomized clinical trials with your very hard and nutrition and they're very expensive and there's less than we need and if I only leaves us with the studying old healthy people centenarian stays with this go to Loma Linda 10 times more people in Loma Linda are over a hundred then there are in Los Angeles 10 an hour east of here what what's going on over there it's enter the Seventh Day Adventist Church which teaches people eat your veggies Don't drink don't smoke an exercise so it's an amazing life that warranted

in church and they in 1958 got too much funding from the government Explorer why the heck are they live in 12 years 8 years 10 years longer and they parts that out in probably a thousand Publications there you know that it's not a randomized study you know it wasn't LA versus Loma Linda will feed you different diets if I won't ever happen but it is a reliable long term P review this does published in the finest the journals and it at least let you ask questions I mean why is there a hundred and four year old cardiac surgeon Elliott Worsham walking around doing his gardening and I just finished operating on a heart patient to me that's in the South if we throw epidemiology out we are left with food frequency questionnaire is wet. Chris said is the source of a lot of these epidemiologist I see you fill out a four-page or 40 pages in Loma Linda to 58 page survey but you do it once

that's called the purest study the headlines you seen them cheese eggs meat are good for hard to spend the news last two weeks I come from a giant learn ASL study they did one food frequency questionnaire at the beginning 12 years later the reporting the day that it's all click-bait headlines it's like you say people love to see the stuff so if we throw out some studies we have to throw out the largest nutritional study that's been reported and the most recent one that's getting all the headlights it's got to be played Fair now you go to Loma Linda it's every 4 years or asking you go to Harvard School Pub house every for it they update the data so if you change your diet that's the week that you fill out the survey and then you get healthy or you get sick and you make changes and then they're kind of your dead or alive well I might be what you did your 6 now what you filled out your wants are there there are better and worse forms the second I'd say healthy is your bias aside the people pick a certain diet might have other Lifestyles it might be as are more important it's going to be true of the Paleo group I mean these guys are at I'll look at Chris he looks wonderful in southeast then he's not the Obesity

can the 75% that overweight and obese I mean that's true in the plant Community to some extent we have chubby vegans oh my God there's no observational studies with significant number of the Paleo dieters do I know that this is not an issue for Paleo PT don't have it mean you don't because it's a new movement that hasn't had the data but it's not the cast stones that plan face eaters go to the gym more it's probably true we don't know but and that's a third thing to stop you for second graders do get lumped in with the Paleo group they consider paleo group part of the meat eater group like when people talk about these epidemia epidemiology studies where they show that people they consume read me it's about more likely to get sick Millenia cancer there is no referring to paleo dieters that are eating avocado and grass-fed beef in 15 years and I thought of that 1985 2002 Loren cordain Publishers book in 2002 the book didn't sell republish two

I'm kind of took off this is a relatively new moment so if you filled out the study in Loma Linda in 1958 you don't have to worry there weren't too many people following a classic paleo diet this also true at Harvard the last is just the relative risk That's What I Call disappear statistics I'm a I'm a heart attack not a statistician but there are some exceptions I mean anybody and I'll just say I've got a red button on my website that says Rogan references cuz I thought it would be good to have people a place to go just like Chris mention that I'm not massaging the data its scientific Fairview data there was a study October 2016 October one 2016 songs from Harvard 6,000 people observational data animal protein and plant protein that you let me go to 2014 Morgan Lovin this is an amazing Harvard research a beautiful woman Morgan Lovin she looked at 6 thousand people prospectively observation fill out all these data if you were an animal protein eater that's called meet you had a three to four hundred percent increase and cancer risk

three to four times isn't 1.1 1.08 18% the date is there this is a pair of your data if you ate plant-based proteins is risk of cancer goes down this is in the highest but this is also an epidemiology study that's where 18 in a nobody's going to do a randomized study of 6,000 people you eat beans and I think I have a good example that can clear some of this up so you mention to Loma Linda and The Seventh-Day Adventist study so first of all let me just make a comment about observational nutritional research it can there a good observational study in their bad ones you can design an observational study in a way that controls for some of these potentially confounding factors like the healthy user buys etcetera so but this is a story that will I think clear some of the stop so they're about eat study

major cities of compared lifespan in in vegetarians and vegans and omnivores so the earlier studies or three studies that were Seventh-day Adventist study so they were done in the Seventh-day Adventist Community which dimension is a religious group that has as part of its Credo you know a healthy lifestyle diet and lifestyle 2808 vegetarian diet but also you know live healthy fruits and vegetables don't smoke don't drink excessively etcetera. So you know health-conscious group of people and the the the the first one at the Seventh-day Adventist study in the Netherlands compared with the general population which is just garbage because of the healthy user by so we can we can just cross that one off the list the two Seventh-day Adventist studies that were done in Loma Linda in the US they did a better job because they compared

people who do eat meat on August the Seventh Day Adventist population with people who don't and there was a slight advantage in lifespan and in the vegetarian versus the meat eaters but one of those studies didn't control for smoking and body mass index so that data is highly suspect and the other study did and there was a slight advantage since then there have been for studies that I think did a much better job so this is kind of an interesting design so they said let's try to find a group of more health-conscious on divorce to compare these vegetarians against so they the first one was called the health food shop or study so they looked at people who shop at health food stores when the idea is people who shop at health food stores are going to be generally more health-conscious and makes my health food store you mean like a Whole Foods or are we there is no Whole Foods at this point that was the idea all right and so that study found that both groups vegetarians an omnivore to shop at health food stores had a hugely reduced risk of death compared to the general population

but there was no difference between vegetarians and omnivores second study Oxford vegetarian study in the UK they recruited people by first they recruited vegetarians and then they asked the vegetarians to ask their friends who also ate meat so that the idea was the people that the vegetarians were hanging out with might be more health-conscious than the general population same result big difference in the in life span between those two groups in the general population but no difference between vegetarians and omnivores epic Oxford cohort same thing same way of recruiting people same result big difference between the two groups in the Omnivore's but no difference between vegetarians and omnivores and then the Heidelberg study was in the in Germany and it's a similar way they I think they recruited people who read vegetarian magazines and then they ask them to bring their friends or family members who ate meat big difference in life span between the two groups and general population no difference between vegetarians and omnivores and then

the 45 and up study that was recently done in Australia this was a little different because they didn't set out to find you no more health-conscious people instead they looked at 250,000 people big sample size and he did a much better job of controlling for all of the various factors that might affect know the results so exercise physical activity fruit and vegetable consumption cigarette smoking alcohol education level because we know that has a big impact on my span and they found that there was no difference in life span between omnivores fit and vegetarians and not study as well then they've been two men analysis of all of the studies that have looked at this both meta-analyses found no difference between vegetarians and omnivores in in total in life span so I think this is a really good example of what we're talking about here that's all observations and data so we're not throwing it out or saying we should throw it out but all of those studies did a better job at dealing with the potential

Falls of observational studies and when they did that they found no difference so and I want to point out that it those ways of picking more health-conscious on divorce they still were comparing like someone on a Paleo type of diet with the vegetarian they were just guessing that someone who chopped at a health food store was at least a little more conscious about health in the general population so quickly quickly quickly I just want to go back for a minute to meet and cancer World Health Organization is not a vegan group it's not enough in group now it's a fairly well respected international organization that puts out the claim so although I actually Chris had the date right 18% increase in cancer risk with processed red meat that we make that clear I hope you don't eat too many hot dog salami bologna pepperoni vets the well it may be more than I just put a sister it's junkie pieces of animal that they're putting into a hot dog that was a girl but that's an 18% increase

four and a half percent of 5 and a half percent it's still 50 to 60 thousand people year they get colon cancer if that date is right they wouldn't get colon cancer if they just would stop eating hot dog at a minimum and I know Chris will agree freaking hospitals are serving hot dogs in the date is out there that it promotes cancer two people getting chemotherapy with the IV pole it's Insanity so 50,000 people avoid colorectal cancer with small differences at the World Health Organization so it was eight hundred papers in 22 World expert there's no perfect study but when they announced it October 25th 2015 the world was shocked you just said that process would make causes cancer they didn't say related they were strong enough day to take out they been beat up they publish more day do they have him back down that's why I put that out the healthy user bias will exist in Pella Community when the studies done cuz they give me look at paleofx it's everything and I honor that don't mean we should promote healthy lifestyle Foods only one part of this I mean we will all at this table live longer than the average American we're not smoking to pack a day we don't have 38-inch waist line

the whole deal we're doing the whole thing hopefully you guys are enjoying a little Oak Cabernet now and then that's always on the list just don't overdo it but the healthy is your bias that particular that Health Food study paper 1996 April paper in the paper in the limitations they beat themselves up we were missing this of that anyway just read the paper it's not that it doesn't bring up an interesting point but to say that we again throw away all these papers cuz they are by us the last thing and I'm done multivariate analysis Chris was just talking about better studies at Factor all the stuff that's not bore your audience was statistics statistics but they're surely they building on does animal protein associated with an increased risk of cancer and put in smoking and weight and diabetes and blood pressure and vegetable intake and alcohol intake and family has and then you just isolate the one thing is there a free bowls are there downsides of course but all modern epidemiology does multivariate analysis to try and isolated you know you can cast stones everywhere but you know there are

Light of the World Health Organization I mean there's 21 organization say limit your saturated fat in your diet and none that are international Society say increase it so you put the nutrition science needs incorporated as much as you can with his much reliability and at the end of the day you can see will still have questioned what I used to say Don't eat much cholesterol now they don't they used to say limit your total fat now they don't know it's wrong cuz they've gone out is only as strong as a commander used to be $300 to science doesn't support it's good limiting dietary cholesterol and won't let me go back in and it to the Limit what does that they who is this year's and they are used for School menus and Hospital menus it was a big buzz in 2016

they no longer giving a so many milligrams of cholesterol day you never exceed they said what can stick the number USDA behind the curve total mortality is the most important point we should be talking about here that means dust from any cause Okay so if because that's what we care about most right if you if I die of it you know if I if an intervention reduces the risk of a heart attack but increases the risk of cancer I'm not happy with that but in fact I'd rather go out have a heart attack and in my sunshine. So you need to consider total mortality and if something you know if meat increases the risk of cancer and cancer mortality then why are we seeing that in the studies that compared lifespan with vegetarian is on divorce we have as I said we have five studies it did a better job of controlling for that healthy user buys there was no difference in any of those studies there's not a single study that shit that

compared you relatively equivalent groups of people that shows that vegetarians or vegans have a lifespan Advantage. There's not and so if you know red meat is if we're saying red meat and processed meat increases the risk of cancer by 18% maybe maybe not but that's not showing up in any of the total the total mortality data the second thing in this is a really good example what we talked about the very beginning of the show contacts is everything quality is more important than quantity so let's talk let's think about processing me so there's several proposed mechanisms for how processed meat causes cancer one is that it increases and nitroso compounds or nocs which damage damage the got lining another is it when you cook meat at high temperatures at forms hedera cyclic amiens rhca switch damage that got another is that the heme iron content in meat causes oxidative stress and and increases the risk of cancer that way and then there's tea

mayo and u v g seat but let me just give you a few examples of why contacts is important so there's evidence that chlorophyll rich green vegetables prevent myoglobin from being turned into and Nitro so compound so if you're eating processed meat but you're also eating kale and broccoli then it's not going to have the same effect on the body as if you're just eating a hotdog cruciferous vegetables and spices and marinades have been shown to reduce the formation of hetero cyclic Amy's are hca's so same thing if you're if you're marinating meat or if you're eating broccoli and cruciferous vegetables with meat it's not going to have the same impact there are several Studies have shown that eating fruits and vegetables attenuates the oxidative capacity of heme iron and even reduces the absorption of iron in the gut and you know dietary antioxidants have been shown to reduce the risk of gastric cancer so he my iron intake really you can think of it as a proxy

crappy diet in these observational studies is a quote from a study that did find a relationship with him iron and cardiovascular disease but the study study author himself said with respect to him iron intake we found a significant Association only in the studies that were based on American cohorts they didn't find an association in the Netherlands Canada France Italy Japan and Sweden which suggests that it's because of the standard crappy American diet your most people are eating processed meat in in the US are eating it in the form of hot dogs and all kinds of other on Helen sugar and it's another example of how to use I'm not saying I'm open to the possibility that too much processed meat can be problematic but you have to consider the contact it's not going to have the same effect if someone's eating a ton of fruits and vegetables versus that someone who's on a standard American diet and we have no studies that separate that out

cuz I really want your listeners Come Away with a few tips from Chris and I that make a difference cuz I know you're listening aren't going to stop eating meat at the end of the show Chris just said meet with vegetables is safer than meat without vegetables meat with chlorophyll is safe for the meat without I can give you a cardiac study said agree I said process mean yeah if you want the same agree here I want people to hear this but doing when you grill how many people in the audience Grill BBQ everybody if you grill meat another chemical group that swarm to call Advanced glycation end-products a G-Eazy go along with the list but if you grill meat that's marinated and we want this is a tip in dark beer this is science random I sign to put a piece of beef and dark beer in your grill it you don't create as many of these toxic chemicals as a dried piece of beef so let's like that's like right now everybody listening next time you eat meat get a salad next time you meet order broccoli next time your bacon get a no sliced

Beto's you will actually improve your help there's this classic and I was just in the Cardiology that they took a healthy volunteers and they took him down the hospital cafeteria and they fed him a hospital burger and they were measuring on their arm how they are arteries function Cardiology topic artery function goes down in 3 hours when you get a hospital bourbon it acts like you just had a toxin in your body you did they took the same group a week later they had to meet the same burger with a big Sal didn't see that finding I mean I want this to be an important point and everybody should be jamming fruits and vegetables or at least vegetables with some fruits you can go low glycemic berries I'm fine with the pie is cantaloupe and apples pick up your veggies listeners and you'll counteract lot of the crap that's out there in the world that is important message I don't disagree with that we glossed over this very quickly in the beginning of this but there was a dispute about cholesterol and a dispute about saturated fat you were saying that saturated fat that there's recommend

directions to reduce saturated fat and reduce cholesterol it was not common to have a heart attack heart attack for described in 1916 not to say they didn't happen but the first medical article that use the word myocardial infarction 1916 1940 there were not many heart attack scene in the modern American city after World War II we are economy went up in the City of Minneapolis executive started suffering heart attacks it was also Franklin Delano Roosevelt died of high blood pressure If years later Eisenhower had a massive heart attack that's when our government National Institutes of Health started finally major money into studies like the Framingham study or from Newton Framingham to city outside of Boston and they basically invaded this town in 1958 till today so we're spending money we're going to figure this crap out the idea had come up heart disease wasn't just aging heart disease could be explained by what's called respect

smoking might not you can smoke and lived a hundred but it's going to increase your risk and then they got into blood pressure and cholesterol and family history they identified what we call risk factors so until that point. It was not considered a factor in the development of number one killer of men and women I want to point out and Chris put some ice on his website I do to during this interview every 39 seconds in American dies of heart disease every 39 second most frequent cause of death so there will be about 200 people perhaps it will die during this podcast to the number one killer and 80% of its preventable Chris is going to prevent them I'm going to prevent them cuz the biggest enemy out there smoking and crap diet calorie rich and processed food scraps at. Standard American diet it became apparent in the early 1950s diet might play a role and notorious scientist and many others his name Decker ancel Keys PhD PhD at two of them suggested dietary fat might be a factor it was a hypothesis it's his early

stage epidemiology doesn't prove anything he went out and did studies other people went on did studies in the idea transitioned actually he was criticized for saying dietary fat is the conversation transition there's some good fats like omega-3 fatty acids are essential you have to have them and then maybe polyunsaturated fats from plants are more helpful but the focus went on saturated fat in food which Bakery is chicken red meat pizza as of the highest sources and subsequent update accumulated that guidelines started to suggest we got this huge problem with heart disease we should limit saturated fat in the diet it was never limit off at 35% of calories that's not in anybody's word a low-fat diet and that has now promulgated in 21 International statements there is no opposite whether it's a World Health Organization American Heart Association Mary College of Cardiology Institute of Institute of medicine says eat as little saturated fat as possible

show me more clear these are highbrow these are not associated with vegan movements are paleo movement sure whatever these are medical authorities if there was half and half you say controversy 21:21 say the same thing they might pick a different cut off point but we will enhance the health and cut down number one killer whether it's an Asian with Jarod weather in Australia weather it's in the United States has unanimity basic science cuz there is basic science and let me tell you when you eat foods rich in saturated fat which is called meat cheese and eggs and such receptors on your liver for cholesterol I've got cholesterol my blood I'd like to get some of it out into the liver to metabolize I need a receptor you eat saturated fats receptors go down cholesterol has no place to Go Clarksville stays in the blood bumps into a tree while I'm putting a stent in the artery that's the basic biochemistry then they had epidemiology studies flawed perfect it doesn't matter there was stuff

everybody just go read Clark 1997 395 call metabolic studies change the diet see what happened you had States rate affect cholesterol skyrockets on average not in a single person if I give you a steak Christmas taking me a stake or Cross Road rise differently would rise rise differently it's are microbial it's our genetics it would rise so if that's a problem in the studies when your average everything together so they had that and then finally finally they looked at populations that live over a hundred these are called the pillars of longevity they don't eat foods rich in saturated fat they have a little bit of a lot of things a lot of olive oil and it'll be increased they eat almost no dietary fat in Okinawa Japan and they live what they have the greatest longevity in the world in 1978 almost no dietary fat about six seven percent well that is the basis for a major push to say cut back on animal products cuz that's larger with the exception of coconut and palm

saturated fat cause I'm so that couch in the gate that is to throw out every major health agency in the world and I don't believe Chris Kresser can do that no disrespect I don't think Chris can throw out a hundred years of cholesterol let's pack a little bit here first of all that we consume has all of the fats in it polyunsaturated mono unsaturated and saturated fat and in fact 2 tablespoons of olive oil has more saturated fat than a 7 oz pork chop that's a little known facts the oily fish mackerel you know which all of these Health agencies a jealous talking about advised us to eat has twice the total fat in one and a half times the saturated fat that were of the meat that were told to avoid does it make sense that nature you know would include that that you can eat your mackerel and the polyunsaturated fats in it are good for you but the saturated fat in it is bad for you that's kind of nonsensical but you know

talk a little bit more about the research so they're never really was good evidence to suggest that dietary cholesterol and saturated fat or connected to heart disease and Zoe harcombe who has a PHD in nutritional researcher she wrote her thesis or PhD thesis on the evidence back in the 70s that led to the restrictions on saturated fat and cholesterol and then she also review the evidence all the way up until 2016 and and if I have this information on my website if you go Kresser. Co / Rogan you can find it and what you're fine is there never was really good at evidence to support the limitations on on saturated fat and cholesterol and people have started to look at this more recently and for example you have a meta-analysis of observational studies including about 350,000 parts

depends recently that found no relationship between saturated fat intake and cardiovascular disease you have an exhaustive review of studies something like 25 randomized controlled trials gold standard of clinical evidence almost 40 observational studies involving 650,000 participants and I'll read you a quote from the conclusion current evidence does not clearly support cardiovascular guidelines that encourage High consumption of polyunsaturated fatty acids and low consumption of saturated fatty acids and I'll look one of my favorite quotes is the philosopher Anatole France even if 50 million people say a foolish thing it's still a foolish thing

and the other thing to consider is that the history of science is really the history of most scientists being wrong about most things most of the time and you know in science we have to continually challenge our are hypotheses and try to falsify them and that's how the scientific process moves forward and that's why in 2010 the US federal government removed restrictions on total fat where is before there was a restriction on total fat because they they acknowledge that the research was showing that not all fat is the same and that you know we don't need to be restricting fat from avocados and things like that and then 2015 they remove the restriction on dietary cholesterol and now they did that fairly quietly because how do you think it looks when people have been told to you no limit their fat and limit their cholesterol and then the federal agency goes back on that that recommendation after so many years of telling people to do that people lose faith in the agent

is it a bigger issue in these guidelines and don't take it from me you know I'm I'm I'm not expecting anyone to believe me and that's why I put all of the the studies and the research supporting this at Kresser. Co / Rogan but how about Johnny and it is who's one of the most renowned epidemiologist in the world he's a professor of medicine at Stanford and he has wrote written some skating critiques of nutritional research recently that have been published in Jama and British medical journal so here's a quote from one of them some nutrition scientist much of the public often considered epidemiological Association the nutritional factors to represent causal effect that can inform Public Health policy and guidelines however the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles the field needs radical reform and he goes on to point out that meta-analyses of observational Studies have found it almost all foods are associated with the higher risk of death if you

what's the data in certain ways so it's not enough to say that. You know governments are recommending this or that we have to look at the science what the science of saying is I said you two recent matter now she's covering over a million people are not showing the relationship between saturated fat and heart disease and they're not showing any benefit from replacing saturated fat with polyunsaturated fats so these organizations Joel that you were describing why do you think that they recommend based on what Chris is just said why do you think that they recommend reducing your saturated fat reducing your cholesterol and thank you and you know that the important it which we are going to technical in the weeds but I want to bring it back this discussion is do you have a stroke heart attack erectile dysfunction loses leg or do you not because at least one factor in developing of these horrible medical problems or 80% preventable at least one of it as your nutrition and the continent attrition and there's no doubt it's a single most important factor it's never been

okay but why do stop gnats organizations are saying this if he says he's don't support that I disagree that the science sure if that's okay with that cuz there is difference is there they're okay both you know contents of food feta contents of food but they're chemically different in the volume weight is very very different cholesterol only comes from animal saturated fat is the animals and plants depend on the food source so when this rise and heart attacks developed research began in 1948 and 1950 and 1958 there were observations made that carefully done dietary logs suggested these were hypotheses there might be a connection between what you eat in heart attacks and then it's centered on is it full time protein foods high in sugar foods high in fatty sources ultimate I got sophisticated food giant plant fat sources foods high in animal fat sources so by the late 1950s there was a very

strong consensus ready that foods high in animal products with saturated fat they go together what type of meat egg and cheese maybe a roll let me give you an example 1959 you grew up in Japan you have a cholesterol of 120 you almost never see a heart attack you move to Hawaii because there's migration your cholesterol Rises 280 welcome to America your heart attack risk triples you move to this great City Los Angeles this is probably should 1959 your cholesterol is now 2:10 you have 10 times a heart attack risk that you had when you lived in Japan genetics don't change that quick this is within one generation they're called me see people that leave Japan to move to California the nisei and there's the nisei hand study that track these people now is it the air is it that they adopted other bad habits shirt could be but within a very short time that 10 times a risk of heart attack so public research in dollars this device is correlated with animal fats and proteins and why isn't it correlated with sugar and refined

so carefully done studies say and I think we all agree more so now cuz we're overweight and now we're more insulin resistant and added sugars in the diet are more important in 2018 then they were in the country was thin in 1960 they weren't good down there and good novel when you parse it out multivariate analysis there's a stronger relationship between the number one food and studies like this is usually butter more than red meat it's actually better that's just an R-value it's got stitches and I want to go so deep into the statistics it is somewhere there is sugar I'll give you a classic study if you could hold sugar the same an increase dietary saturated fat heart disease Rockets if you could hold Center to Fat the same increase sugar in these manipulations coronary heart disease doesn't think I've been inside of Hearts fifteen thousand times I've never scoop sugar out of a blocked artery ATS Coupe cholesterol out of blocked arteries 20% of every blockage in the heart is close to the fact that was discovered in 1910 it's never very then we fed animal

she have something to say about that yeah so that doesn't mean that the cholesterol is there because people are eating at Joe you know that I could be though let's say let's look at their what the research says again here so they've done control feeding studies where they fed people to to four eggs a day and those show that in 75% of cases I have zero impact on blood cholesterol levels for the other 25% of people there turn Piper responders and in that group dietary cholesterol does modestly increase LDL cholesterol but also increases HDL cholesterol and it does not increase the risk of heart disease this is why the did guidelines were changed on dietary cholesterol is there is no evidence that the consuming dietary cholesterol increases the risk of blood cholesterol most people and even when it does there's no evidence that it increases the risk of a heart attack which is again why do dietary guidelines changed for saturated fat again most of the studies that showed harm where short-term studies

longer-term Studies have shown that on average eating saturated fat does not increase saturated fat levels in the blood and of all of the long-term studies that looked at it that's only one showed any association between saturated fat intake and cholesterol levels in the blood then we have a meta-analysis lots of meta-analyses actually but one of the best-known meta-analyses was of Seventeen randomized controlled Trials of low carb diets that were high in saturated fats in published in the journal obesity reviews and they found that low carb diets and either increased or decreased LDL cholesterol but what they did find was it low carb diets were associated with decreasing bodyweight improvements and several cardiovascular risk risk factors including triglycerides fasting glucose blood pressure body mass index abdominal circumference plasma insulin C-reactive protein as well as an increase in HDL cholesterol now they have now been

10 meta-analyses of randomized control trial is looking at low carb diets for weight loss all 10 showed that the low carb diet either I'll performed in most cases or was was on this at the same level as low fat diet there have been several meta-analyses now you can see them all at presser. Co / Joe Rogan that have looked at low-carb diets for diabetes and even cardiovascular risk markers and all of these meta-analyses have found that low-carb diets are superior for glycemic control for reducing insulin for reducing triglycerides and have beneficial effects across the board without increasing cardiovascular risk markers so we're now we're talking about randomized control trial which is the best form of evidence that we have and we're not seeing any harm from you know increase consumption of saturated fat so is the problem that you're siding epidemiology studies from the 1940s in the 1950s

yes I would definitely need to do prefer randomized control trial is over. Kind of evidence for sure why do you continue to go back to these studies from the 1940s and 1950s the beginning but they took 14 topics and put them into one from metal now sister a mice control so low carb low fat I mean they're all different topics and I don't know how you put that all together it you need Clarity and laser focus so we were talking saturated fat I mean so hypothesis is generated saturated fat in the diet butter eggs and cheese maybe bad for heart disease something killing Americans left to right in 1949 250 that's going to countries were widely different diet let's see what they're eating latech she take their freaking diet back to Minneapolis let's analyze it so it's not guessing that food frequency questionnaire for taking their meals back the United States analyzer but boom there's a relationship between dietary saturated fat and your risk 50-year follow-up there's no short-term follow-up the studying referred to as 50 or felt

1958 to now and that strongly suggested the dietary saturated fat and heart disease that doesn't that's not what's called the ultimate randomized clinical study but it's one high-quality second study done in China the same time with your years of follow-up so these are right up to date there's Publications right now from studies starting at then but the Publications or not but then you get the best kind of study okay I'm still in saturated fat I'm not talking any other topic you put people in a metabolic Ward at the National Institute of Health 395 these studies published in 1979 you change their diet this is the ultimate careful experiment it might be for 4 weeks or 6 weeks you up there saturated fat there cholesterol Rises for sure as can be where all different the change in cholesterol is consistent you're going to go up 20% 20% is that we started different poisons you have to track the change in cholesterol

Chris refer to can I go off on a tangent it's really interesting this will Fascinate your listeners but it's right on the topic 2008 this is published data I don't bullshit on this 2008 Mexico City the national day international Dairy Council meet and they publish their notes which is why we noticed and they said we are losing the battle people are eating less Dairy around the world and we are losing sales well we can do is influence researchers influence Acquisitions Council in the world just happened in Mexico City that year then they go meet in porch go let me go meet a New York whatever 2008 we're going to put dollars into changing research and influencing people doesn't mean it's all bad they publish those notes that are Global Initiative for the next year they look for sympathetic researchers that would change public opinion that was right before the milk mustache campaign they find a guy I actually respect now but I'm going to beat him up a little dr. Ronald Kraus MD in Berkeley Cal

corner right by him runs at a lipid Center he's had be funding for 10 years he said very funny all the sudden he's speaking the dairy industry is all over in 2010 2 years later he publishes we call it a meta-analysis that's not new research that's statistical playing with previous studies that can be fair can be unfair whatever whatever it is their conclusion is they could not find and verified that saturated fat in the diet butter eggs and cheese raises the risk of heart disease they never said eat butter eggs and cheese I just couldn't verify what's amazing it's an American Journal clinical nutrition that same Journal is a is a editorial that destroys the study this is 15 reasons this is horrible epidemiology by guy named Jeremiah Stanley I've never seen a medical journal destroy a piece that they accepted for publication okay so everything's like to Stir It Up and 2014 a guy named child republish is a similar analysis that is the reason that Time Magazine put on the cover of butter is bad

because it was not in the research it's a meta-analysis it's all following this Mexico City offer to fund the dairy

positive Publications at a study so bad that both the journal required them to adjust and republish the data cuz of mistakes the Harvard School of Public Health should take this thing away statistically this is nonsense since those two times and that's just the bottom line we have had confusion in the public we've got experts like Chris experts like me experts like dr. Mark Hyman experts Like dr. Walter Willett I don't know there is a quote from the tobacco industry that our product is confusion they didn't care about winning the battle in the public infuser just going to keep on doing habits they have and that is got to stop you just conspiracy theories I'd like to be treated and the Pendulum of a 1997 395 the best and stays in the world take you eat more fat your cholesterol goes out it was clear still clear and the guidelines set at the guidelines still say that the guy still say limits

the 1950s in 1940s in retrospect valid why do you think it's because we're going back to observational studies done 50 60 years ago that suffer from all the problems that I mentioned it to begin with and several more that we didn't have time to go into we have randomized control trial now and you know observational studies were never meant to prove a hypothesis they're meant to generate a hypothesis and it's true that in some cases it's not possible to do a randomized control trial like with cigarette smoking you'd have to you know to have the trial last for so long and you have to isolate people in the ward so they were exposed to air pollution and other factors that can affect the results you can't do that but in that case the risk was 1000 and 3000 % higher so their criteria called The Bradford Hill criteria which you can use

and apply to observational studies to assess the chance that there's a causal relationship and in the case of smoking which actually was when the Bradford Bradford Hill criteria were created that relate. Meet many of those criteria in the case of nutrition research very seldom do they meet more than a couple of the Bradford Hill criteria now observational research in order to be valuable needs to be confirmed United States have the results need to be replicated in a randomized control trial that's how science is supposed to work but there was one analysis that found it. 0 of 52 claims that were made in observational nutrition studies were replicated when they were tested later and in fact 5 were replicated in the opposite direction in other words they when they did an experiment they found the opposite result of what the observational study suggested so good examples of this are observational studies originally suggested that beta carotene an antioxidant that people with the highest intake

beta carotene that something like a 30% reduce risk of death what does not really possible anyways but then when they started doing trials where they were giving people beta carotene supplements not only did it not improve their lifespan they got more cancer and increase the risk of cancer so this is why it's so important not to rely just on observational data and to do these experiments now going back to saturated fat as I said we've got a 2013 meta analysis of 20 randomized controlled trials they found it low carb high protein diets that the great improvements and glycemic control compared to low-fat American Heart Association American diabetic Association diet we've got a 2014 meta analysis of 10 randomized control trial that showed that low-carb diets are more effective than high carb diet for patients with type 2 diabetes and we've got another Med analysis of 25 randomized controlled trials just published in 2018 that sound the same thing

so you know science Marches On we we we learn more we change and now we've got randomized controlled trials it'll replacing some of the observational evidence from the fifties and sixties and seventies which by the way in in dr. Harkins paper you see that that evidence was never strong to begin with and this is what we should be looking at so why are you consistently bring up these studies 450s cuz Chris is mixing everything up he's talking low carb day too let's talk low carb diet that's keto diet slow-cooked I disconnect bring up these studies from the 1950s and 1960s carb diets are high in saturated fat good 1959 G6 1997 Clark 395 randomized looking for you jack up the saturated fat in your diet you jack up your quest off we can talk about cholesterol in a minute but Quest all matters all day if that's what matters and hire an assassin 95 Ram 1997

1997 through 95 I love to see that randomized control trial in a meta-analysis in metabolic Ward the tightest dietary exchange that is that's how many were there they V Temple now 395 individual studies that played with fat content of diet and looked at markers of cardiovascular exercise 395 controlled trials in metabolic work the other going to be short turn that's true you got to read the literature it's there it's alright I've read the literature dispute hit right so what is your issue with this I'm not aware of 395 randomized control trial that have been done in a metabolic word on the desk

so I'd love to learn more about that if that's true but I'm not stuck in the 1950s but you know if you don't agree that science has moved far past that and our understanding of nutrition and understanding of the the mechanisms of the effect of the food and the body all that is change radically

are we have not changed our website says but understanding of the sun tabs relations made in the 50s and 60s have held up which is like 21 International Society still say you put a lower your written to have held up that saturated fat in the diet chicken eggs cheese beef is related to raise your cholesterol is related to your increase risk of heart attack 1950s epidemiology studies initial initial word studies and such the first the first chink in the in the armor was a 2010 I gave you the background to it the Siri to Reno study the child restarting but they have been we've decided to throw up 50 years of scientist mentioned several other meta-analyses of I don't probably 50 randomized controlled trials collectively these are

modern studies showing Joel what is the difference like what why why do you think that these old studies are applicable and why you dismissing this new evidence so Chris and I can resolve this issue British medical journal 1997 dietary lipids in blood cholesterol 395 individual diet Eric's parents put together the meta analysis it's a classic study that people know that she has to mated if we can lower the saturated fat content of the British population by 60% we would save X number how to text isn't that so to answer your question why do I think old studies irrelevant you have to keep probing and questioning and probing a question but in till this date every Major Medical Society not want if there's one you'd question 21 International sizes say you will further the populist Health if you lower saturated fat in the diet and we can't pinpoint the amount of cholesterol you should lower which is only

animal sources for you should lower to as low as possible according to USDA epidemiology studies as as we said we would use when you really call them if that is the new science like whatever they have studied today like what what they're better methods of detection more more understanding more data to go from would you agree that we should look at new studies I wish you would let me tell you one what is he going to say let me tell you when I publish the study in 2012 this man quoted 100,000 times for major medical journal it uses something called Mindy lien randomization we don't need to do randomized clinical trials all the time they're these gigantic databases now about genetic abnormalities and certain other parameters so there is a database with 300,000 people we know it's called their Snips you pry her Snips you know Chris's biology and jeans aren't they

same as mine in the variability if you're born with one of nine Snips that keeps your cholesterol low your entire life this is a genetic gift to you that observation in this major study corner all of the world's first authors Brian Ferentz but on their number 5 LDL randomization is new data that it is an advantage of your survival advantage of risk of heart attack stroke to have a low LDL your whole life new data is it consistent with 60 years of science but boom it sure was we actually have learned stuff that has changed our mind when you do that same Cutting Edge science on HDL the happy one the high one you cannot show the same Association anymore we're totally confused by the HDL particle LDL is the focus of atherosclerosis low LDL and I just finished dr. Loren cordain I'd love to talk about the history of the Paley moment dr. Loren cordain with the first popular book a PhD in Colorado has written an article in 2004 says the ideal LDL cholesterol is 5271

and he should be a cardiologist cuz I'm going to hug them for that cuz he thought that saturated fat raises your blood cholesterol increase your risk of heart attack and stroke this is the founding this is what the hell is this 2004 in a big call Jeremiah this is peer reviewed it was an editorial but his pair of you 5270 elldale I'm really cool there with Loren cordain and 5270r but I understanding of nutrition is Advanced pretty radically since 2014 I mean I've never been a logical about paleo my first buck it's like I'm recommending dairy products and I don't want to get longer than this cuz you so what is your response though to all these studies that he was reciting you you're citing these old studies that seem to contradict what he saying but these new studies that he's showing and you could we go over them again but you didn't address

what is what why are the results of different of the new studies well people better at statistics in Maywood CA manipulation of what's called Med and now she's our new studies I mean these are old studies lumped together with different analyses that led to a conclusion that was a randomized control trial Modern Family here we got 40 years or 40 year randomized control trial we have 5th and 7th edition of study of 50 years of the same problems and randomize control trials are not short-term many of them are go up to 2 years and length if we're going to see changes and lipids we're going to see them within a few weeks and certainly

within a few months so if we're not seeing them in a few months we're not going to see them later and you know that if you look at dr. Harkins paper sheet reviews all of them the meta-analyses and looking at saturated fat and the connection with heart disease there 39 meta-analyses of rtt's or prospective cohort study that looked at saturated fat in health outcomes 3539 did not show significant correlation between saturated fat in any outcome gay 35 of 39 of the 4 that did one but I was more related to trans fats not saturated fats one show to benefit of replacing saturated fat with polyunsaturated fat but it excluded to studies that would have totally changed the result and as I mentioned there's the meta analysis of 25 rcts in 40 observational studies that showed no benefit of replacing saturated fat with polyunsaturated fat and then the last two were Cochran reviews and in those two saturated fat and cardiovascular disease work or related

saturated fat was not correlated with total mortality cardiovascular disease mortality fatal heart attack non fatal heart attack stroke or death from heart disease or just from any diagnosis of diabetes virtually none showed that eating saturated fat will increase your risk of heart disease and none showed that it will increase your risk of death from any cause so that is pretty damning evidence now if I could summarize for you or get you to summarize your position is that his reciting of these older studies that they are not relevant that they are epidemiology study that they are they are not as as rigorous and that this new evidence is based on new understanding and new science and that he's ignoring this of it early studies showed some relationship they were short very short term between eating saturated fat and then and then cholesterol

problem is they were using cholesterol is a proxy marker they weren't looking at did people eat saturated fat and dime or they looked at did saturated fat increase cholesterol so when they when they did longer-term studies there's no increase in cholesterol on average that doesn't mean no one will experience an increase that's not true some people will but on average there was no increase in and then when they looked at it they just took cholesterol out of the equation let's just look at is there an increase in heart attacks or death from eating saturated fat when they did that there's no increase in in in these are. Those are observational studies and we have all these randomized control trial so you're showing no no increase in cholesterol no increase in insulin levels and actually a decrease in all of those markers Joe

important stuff and a lot of stuff was said and I doubt it unless you're really high level you understood I just want to pick out one thing Chris said does anybody know what the Cochrane database oh where the flap his mouth Cochran Cochrane is a group of scientists that try to be very objective very independent don't have any emotional any books any supplements any food and nothing and we all love supplements around the stable but let's get out of that Cochrane database every 5 years comes out with a statement is saturated fat relate to the risk of heart disease in 2015 the most recent Hooper look up Hooper look up Cochrane database yes it does Chris said it but he flew by it no it wasn't powerful enough that your choice of butter eggs meat and cheese necessarily predicted your total lifespan but it absolutely predicted your risk of developing heart attack and Stroke of corn is Independence Day but how did it do that how does it do it in the diet lowers the LDL

my liver Chris is labor when you don't have LDL receptors or less than you should on the surface of your liver cells your LDL stays in your blood it gets into your interior wall that's my field don't jack with me on artery walls it gets picked up by monocytes become macrophages become for myself and you fucking dead and that's how it starts when you eat saturated fat there's a chain of events that biologists and chemist and scientist know there's no question 1985 Nobel Prize in medicine I publish described which one of us is a scientist around the table I've got it open it's a journal American kind of Hajime please read the conclusion so the lower your LDL level beginning in life the greater is reduction your risk of developing a heart attack and stroke and I'll give you an interesting statistic if you take Lipitor and you drop your LDL cholesterol 30% you will typically drop your risk of a heart attack if you're in the car

free range by 30% if you drop your LDL by 30% cuz you're born with a genetic gift that it's just lower than the average American you drop your risk of heart attack by 90% when you keep your cholesterol down your whole life until your blood cholesterol level your whole life you are golden in the heart attack and stroke risk the problem was he do we pick up people at age 50 60 and we start Jack mother died in Jack with their drugs and that's wonderful they've had 50 60 years of deterring there arteries and we help them we can't help them like teaching children eat fruits and vegetables and stay away from hot dog that's where we got to go that's the second gone care get kids healthy okay because I got the whole life please what is wrong with what he said there's there's Illusions to rent what's the number one two things wrong and I am really not trying to nitpick he doesn't like epidemiology but he totally uses epidemiology to support his case you can't have it both ways I love basic biochemistry I love epidemiology I love random my studies I love sitting there and then study my Foundation is brought in this was called

scientific method that used by scientist Los Angeles and that's what caught me at the number to besides that there's there's Illusions two significant randomized clinical trials in meta-analyses we got to keep the science clean as can be a the Breakthrough has been the meta-analyses Siri to Reno Chaudhry 2010 2014-2015 they have severe flaws they're not new research their rehashing old data there has not been a randomized clinical trial that really challenges the coronary heart disease risk of eating at increase after a 5.3 right now where is American journal of clinical nutrition 2013 Jolla a holla I'm not sure how to pronounce the name these are all of my website if you got a crecer. CO / research you can see them or Crestor. Co / Rogan you scroll down to the saturated fat section you can see them this is a total of 20 randomized controlled trials and there was

slow carb low GI Mediterranean and high protein diets are effective in improving various markers of cardiovascular risk and people with diabetes should be considered the overall strategy of diabetes management and then we've got one from snore guard systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes and this was a review of 10 rcts and they found Not only was a low-carb diet more effective for diabetes than the low fat diet the greater the carbohydrate restriction the greater the effect and then we have one from 2018 this is sainsbury at all and this is effective dietary carbohydrate restriction on glycemic control in adults with diabetes and they found that the low carb the conclusion this review suggested low carb restricted or carbohydrates stick to die it's could be offered to people living with diabetes as part of an individual

device management plan so these are finding that these These are the reviews of several randomized control trial that are finding that there's no increase in cardiovascular risk markers is actually an improvement in cardiovascular risk markers and there's an improvement in diabetes markers like blood sugar insulin weight visceral fat Etc so I mean this is the the gold standard of evidence that we have is is randomized control trial and meta-analyses of course they do that there are problems they can be done poorly they can be done well that's true of any kind of scientific research but we can throw out really the highest standard of evidence is meta-analysis a randomized control trial is because you can just anyone can pick one randomized control trial to support their view what a man analysis does is it looks at all of the evidence and it looks at the quality of evidence and then it comes up with a result from looking at all these trials and that's that's where science

is today and he's low carb diets are high in saturated fat they're high in saturated fat they're explicitly doing a trial where they're doing a low-carb diet that's the tire and monounsaturated fat but those are rare generally people who reading low carb diets reading a lot more saturated fat Joe just three quick bullet points Denver when it is low carb literature were talking saturated fat and coronary disease that's a mixture it's not the topic which I buy number to these are by the time they were talking about that low carbs a whole different nutritional. Something I can touch you acting like that stuff we haven't seen it that's a no protein but mostly I could say don't do that that's called me you can do low carb and jack up fat that doesn't necessarily mean you're jacking up your Saturday if that I do low carb plant-based that's a whole different topic but it is not number what these are pancakes one is low carb it's not the main topic that's dominated cardiovascular research for 60 years which is consistent to this day and every guideline limit saturated fat she don't die of a heart attack stroke

number 2i just these are words your listeners may not know is he said are biomarkers studies I'm talking about dying of heart attacks having heart attacks having stroke I care if your blood sugar marker called hemoglobin A1c Coast eye care if your LDL in your high-sensitivity C-reactive protein goes down but that's not life and death those are biomarkers usually correlated with Better Health if you're not tracking an artery you're not in my scientific field because I track arteries in clinic we track arteries in the our research studies and I think that's the second thing I wanted to say but you know I'm not here to actually in the gate the data that compared to the crappy calorie-rich and process died the most Americans are eating what Chris is presenting as alternative diet won't improve numbers in the lab absolutely it's a better choice I like your diet I do Joe I like your diet Chris cuz I'm looking at people walking in Wendy's and Hardees and McDonald and Hospital cafeteria and gas station that's what we need to shut down

down and we'll make a main difference at all we're left with is Chris's die Joe's diet and Joe's diet or have an amazing country then you can decide what you want okay we were still weak but I still need to bring you back to this what he's talking about in terms of saturated fat and not being a risk and not increasing your cholesterol you seem to disagree with that sure cuz the second says it does I mean he just started to buy a sign that says let me clarify something to I wasn't I'm not just talking about biomarkers biomarkers are important but I was the one who argued for looking at total mortality is the most important then point and mortality from any of these other diseases in front of the conclusion from dr. heart comes paper where she reviewed all of the evidence on saturated fat at that I talked about before I just mentioned 3539 studies didn't show any relationship here's a conclusion no meta-analysis of randomized controlled trials and or prospective cohort study

those are observational studies has found any significant difference for dietary fat interventions and all-cause mortality that's deaths from any cause or deaths from heart disease or associated with dietary fat and heart disease mortality another words there's no Med analysis of randomized control trial to shows that eating more saturated fat will will increase your risk of death and your take on this is that this is the latest science and that would he siding in terms of the studies of the 1950s and 1960s aren't really relevant and I even called you like I said earlier that there are there's a meta-analysis of studies including 350,000 participants that found no relationship between saturated fat intake and cardiovascular disease and then I'm more recent review that included both randomized control trial 25 of them and 40 observational studies with 650,000 participants that they concluded

current evidence doesn't clearly support cardiovascular guidelines and encourage High consumption of polyunsaturated fat and low consumption of saturated fat so whether you look at the epidemiology or whether you look at the randomized control trial in the med and now she's a randomized controlled trials you end up in the same place Joel most modern day that we already talked this everybody please Google Cochrane database saturated fat 2015 Hooper is the author introduction is reducing saturated fat reduces serum cholesterol but we're not sure of the important so we took 15 randomize studies with 59,000 participants the conclusion there is a potentially important reduction and heart disease risk by reducing saturated fat in your diet 2015 which is why 21 International societies are solid that we will help the public we will help the listeners have your piece of meat making 4 ounces not 14 oz have your bank and make it one strip not for strips have

Archie's just don't eat it every day and don't eat large amounts amount of cheese United States has gone insane cuz of USDA finds cheese manufacturers 2015 I can't get you a better one. Phil update Cochrane database in 2020 it'll be the same what's your take on what he said though here's Johnny and I don't care with the best science in the world cuz I deal with patients who have serious disease I can tell my patients the most up-to-date analysis of randomized clinical studies say saturated fat in your diet raise your cholesterol lowering saturated fat like eating less animal products at least mention to several meta-analyses from 2008 we have to look at the weight of evidence there lots of studies are up list all the time and that's again why I'm looking at meta-analyses of randomized control trial looking at very large reviews of observational studies

over a million participants and you end up in the same place of course we can go and find one study here one study there that is different has a different result but that's not the scientific method the scientific method is to look at the weight of the evidence and to continue to evaluate. Overtime is the evidence changes and you know this is a great quote from Johnny and it is the Stanford epidemiologist that I mention that it reminds us that we can't just rely on the past to inform the present he said claimed research findings May often be simply accurate measures of the prevailing bias and that what that means is that let's say you know you have a paper that you know 30 40 50 years ago that says saturated fat increases the risk of cholesterol then later somebody makes that claim in a paper just like that initial sentence saturated fat raises cholesterol you see a limb number there referencing that one paper

then a couple years later somebody else makes that same claim they reference the second paper which was referencing the first paper and on and on it goes and the whole thing is a house of cards that's what most people don't realize what that what did I just got science again he's making comments that have no reference certainly if there's miss quatch the references on my website paper that quoted a reference and everybody simply passively keeps recording that reference it was wrong in the beginning I can give you a real life internet example would be close to Gary Todd's my new friend but sometimes my adversary but I can't give you a letter to reference it might be one but these are very general statements I just want to say I think we should move on but you shouldn't because we're not we're not really clearing this up what is she saying

the best scientific analysis of the global topic does saturated fat Rich containing foods Witcher animal Source Foods at high amount your diet increase risk of dying a heart attack or stroke or having a stroke go to the biochemistry that's a trip in your diet will lower his number of LDL receptors on your liver and your blood cholesterol goes up that's back by 395 metabolic but that is about chemistry then you get to epidemiology countries that eat more saturated fat Finland great story and I got to tell it 1970 the highest heart attack rate in the world was Finland guys were dying your age image of the highest rates the lowest heart attack rate in the Mediterranean was Crete 40% of calories worth of fat and Finland 40% of calories from fat and Creeks is how can that happen cuz I'm not an advocate for a low fat diet except for various like the clinical cases it was olive oil in Crete that's very low not zero low in saturated fat it was cheese it was me it was beef it was butter in Finland they instituted a national program to lower

the continents a tree fell in the diner Finland five years later hard to have dropped 80% give it to you understand that he's he's saying something totally different you or your siding epidemiologist Elizabeth what chemistry then I went to epidemiologist wrong with what he said he's not being brought with the scientist getting he's getting mired in the woods I'm telling you the broadest view from 50000 feet up about chemistry support epidemiology supports at 395 metabolic Ward studies my randomize mendelian randomization Steve said though because he's not looking at the entire you go to Loma Linda Okinawa go to eat gross to go to Costa Rica and you go to Sardinia if you would live to a hundred and you're still operating on somebody's heart is your diet likely hiding animals at three fat or not to answer is it isn't it's as low as 3% of the diet in Okinawa couldn't have possibly the other factors are biased it that there's a great next day and it came out that show that just following the top five

Health behaviors which are basic they were talking about not smoking not drinking maintaining a healthy body weight getting some physical activity and eating a quote healthy a relatively healthy diet like not junk all the time increases your lifespan by 13 years and that are you can do well if you can't look at these at these populations and make inferences about animal products being the driving Factor one way or the other because there's just too many other factors there's no way to control for all those factors in a study and that's why we have to come back to the scientific method we use observational studies to come up with hypotheses then we do randomized controlled trials to either confirm or refute those hypotheses as I said before in many cases what is apparent in observational studies or what seems apparent that is not later confirmed and randomized controlled trials and that's where we're at now is saturated fat and dietary cholesterol I just mentioned three very large

meta-analyses of randomized controlled trials that failed to confirm any association of saturated fat and heart disease and saturated fat and increase in these risk markers and I mentioned to reviews of very large observational study data including 350000 and in one study and 650 in another showing no relationship so the mechanistic arguments about liver you know that saturated fat does this or that but that's not convincing if it's not showing up in in the data if it did that then we would see it in the observational studies in the random my studies. Specifically Joel what is your take on what he just said well we just had another gong moment so Chris just quoted and it's actually a little bit comical a Harvard School of Public Health study on how do you live 14 years longer it's epidemiology but he's using it the senior author is dr. Walter Willett a guy he calls a vegan Pro Advocate who's not at all vegan is r in the book

the Mediterranean diet with all kinds of animal recipes in it which is fine with me so brilliant brilliant brilliant senior Harvard research her but she's using data that he says is weak and such yet the teaching point is there how do you live 14 years longer you don't smoke exercise 30 minutes a day he'd better than average that's a very broad but you'd better than average you keep your waist under 25 BMI under 25 and you have a few alcoholic beverages a week I want your listeners to write that down cuz that is solid epidemiologic data that's very consistent across across the Spectrum so let's all use something to teach your listeners but that's my point so you can't look at cultures that have a completely different lifestyle than than the standard American lifestyle and draw any inferences about animal products or a really good example of this is you know the Seventh-day Adventist the clean is that it's the vegetarian diet that makes them live longer than the general population but they

I mentioned before as part of their belief system they don't smoke they don't drink they have a healthy lifestyle in general what if there was another population that also had those kind of belief systems about not smoking not drinking and healthy lifestyle but they also ate meat Will turns out there is the Mormons and there's been three studies on Mormons and each of the Mormon the studies have been done on Mormons found that their mortality I'll give you the exact numbers here

and just a second

for whatever reason that's not coming up here but their risk of death compared to the general population was something like 50% lower than the general population on average and yet they're eating and not vegetarian like The Seventh-Day Adventist so your point to bring that epidemiology study in the first place bring up healthy lifestyle increasing your lifespan by 14 years is to show that any positive move is going to show it whether it's just exercise and not eating sugar or whatever is going to show an increase in your life span just to show how hard it is to isolate single variables in the influence of those single variables in an observational study on on those effects and no this is something that you noticed at Johnny and it is said over and over again is it it's almost impossible if not impossible to disentangle the influences of all of these single variables in observational research and again I'm not saying we shouldn't use

motivational research I'm saying we should be circumspect about how we use it we should be aware of the limitations in the flaws and keep those in mind when we're designing observational studies and when were interpreting the results so Joe what is your opinion on what he saying about saturated fat and cholesterol and mortality risk okay I think I've said it but I just shared another common moment we're both lifestyle medicine doctors of which nutrition is just one part we just went through a list of Lifestyle factors we now add sleep we had social support we had stress management skills not all smoking diet exercise and and the size your body but we are aligned and you know and we will go at patience side-by-side into a lot of the exactly the same thing in fact I think the only thing there's probably about lifestyle medicine is Optimum Nutrition to prevent chronic disease and there's probably more than one path but God knows the plant-based Medicine group has a tremendous body to science

I'll conclude one more time and I don't know how many times I can say it the highest level of Sciences integrate all that's available biochemistries on the side saturated fat raises your risk of coronary heart disease it doesn't mean nobody eats a no saturated fat. But you can lower it a tional studies were there to epidemiology studies were to test a hypothesis they confirm Finland and creative talk about it won't go there again randomized clinical trials have confirmed it Hooper Cochrane database 2015 my study 2012 widely cited worldwide has confirmed it to get your LDL cholesterol down genetically or by diet as long as you can as early as you can and find out the last as what an old healthy people do actually Chris I just think there's a good concert to let your listeners know it isn't all about lifespan in fact lifespan United States is dropping which is very scary for all the freaking money we spend on health there something called healthspan which is to avoid chronic disease and die dancing or die swimming or die skydiving but don't die in the freaking hospital to pay

tubing at raking it in a Foley up your hoo-hoo and many of these studies that show you can reduce your risk of heart disease stroke and diabetes are talking about better quality of life so when you put all that together the centenarian studies that have low saturated fat diet I just one more piece I just mentioned for incredibly solid piece of evidence not one it's for it's all vets out there it's what Nobel Prize winners use when they describe the cholesterol pathogen is this correct often considered and you should have perhaps the world's leading expert nutrition longevity and such will say you incorporate all the bases for nutritional evaluation you keep it big picture you don't that's he calls it pixel mentality you don't even hung up but one study you got the whole picture about chemistry epidemiology randomized clinical trials finally centenarian studies I think it's very consistent you will enhance your help by lowering animal-based products now week

tigers at 70% 80% 90% plant-based Loren cordain and the founder of the Paleo movement to avoid eating we were talking about 70% plants on your plate I love you know I'm not telling people quit eating meat today or your die I'm not a reactionary but it's to say that plant-based medicine doesn't have a strong bases that I can't reverse plaque with just plant-based medicine we haven't even talked about the ability to do that but is is absolute heresy because it in fact is one of most powerful piece of nutrition we have okay but what's wrong with these studies that he's talking about their pixel mentalities picking one I know you don't know how observational data of over a million people and you know three different Med analysis of 20 to 25 randomized control trial of each is pixel mentality this is this gold standard for assessing a question like this in medicine it's not mechanistic data or mechanistic arguments don't make

are not persuasive if they don't translate into real outcomes that you can measure in randomized controlled trials are observational studies die trying to boil this down so what is your take on that without any references of the past and people lived in Mongolia that live longer these are the three disruptive randomize trials from 2010 on the question the relationship and I'm not referring to crosses researcher or chowdhury's you want me to do it again wrong with what he saying I'm just an expert here and I'm baffled so I'm trying to boil this down with his little rhetoric as possible okay it takes a heretic conspiracy attitude to say everybody's got it wrong for 60 years 21 International societies have the wrong big could but it's a controversy Siri to say that that

Cooper Cochrane database 2015 they've got it wrong that metabolic word studies got it wrong this is one or two or three piece of data and their observational you don't throw babies with straps for animal control trial someone else but they're not it's not a new study it's taking previous studies and let me give you a quick example in the choudhry meta-analysis created butter is back in the cover of Time Magazine created a whole forever out there that we can go back to eating all these great Foods at Atkins wants us to eat they correlated your blood cholesterol with your risk of having heart disease they couldn't confirm it but they allowed people in that men and Elsa silver on Lipitor of course you're on a medicine lowers your cholesterol they didn't exclude those people that has been resounded criticized as yes it looks good it's in the journal it's a meta-analysis that is fraudulent or at least relatively inappropriate statistics

you know it's it's so technically it's beyond I think the importance of this discussion but I just say 50 thousand feet elevation view of the best nutrition is again for pillars that I keep talking about indicates you be very wise to limit the amount of saturated fat and that's endorsed by every Major Medical Society in the world that's not controversial is that so I don't I don't think it's a conspiracy I think it's just a natural progression of Science and we were using think the world was flat over time as the evidence evolves in his boot we beat we become more educated and aware of why you implying that it's at some sort of a belief in a conspiracy well Chris is suggesting we got it wrong which means the American Heart the American cause the World Health Institute of medicine that European Society atherosclerosis the Australian Society of Health

all these people that tell you 10% or less saturated fat some say as little as you can possibly dinner. I've got it wrong and that suggest has been a total of misrepresentation of all the signs and what are their recommendations based on is it based on Old science how long have they been saying this and what is it based on and have they adjusted to this new science he's discussing Labor Day Republic Republic Republic should the USDA republishes every 5 years 2016 not long ago 2016 was the last USDA publication there do it again in 2020 but doesn't science change pretty rapidly not that fast not that fast there's nothing new since 2013 That Rocks the idea that 21 International societies got it wrong there's nothing there isn't the 2015 report did not use that there was the USDA set up the nutrition evidence library to help conduct systemic reviews to answer some of these questions

listen in the 2015 report the committee stated that it didn't use that database for 70% of the topics and the the lot of its guidelines haven't used any newer science from since 2010 and there had been large reviews as I just mentioned these these three reviews that I mentioned one was in 2013 when was in 2017 and one was in 2018 these are the reviews of the randomized controlled trials it didn't show increase in cardiovascular risk markers from saturated fat consumption and then we had those observation reviews of observational studies of 300000 and 650000 people I think the same thing will happen with saturated fat as I said in 2010 they change their recommendations on total fat they used to limit total fat and then they change those in 2010-2015 they change their recommendation on dietary cholesterol and I

probably the next time you know maybe it's the next time maybe it's the time after that you'll see a change in the saturated fat guidelines and it's not it's not a big conspiracy I'm not I'm staying you know so your take is that these organizations are behind the curve yes and if we want to talk about conflicts of interest there are huge conflict of interest in these organizations something like 40% of the funding of the why don't want to get this number wrong but a lot the American Heart Association American diabetic Association lot of these organizations have funding from big food Coca-Cola you talk to a nutritionist who goes to these conferences and date you know there's like Nestle bars in Coca-Cola at the nutrition conferences that's hilarious yeah it's hilarious isn't it I mean it's it's actually funny and sad at the same time and so I'm not saying there's a big conspiracy but I am saying there's a problem in terms of scientific Integrity when you have these org

positions their tops with creating the guidelines that have these Financial conflicts of interest that's not really how it should be but I don't I don't even want to go too far down that road because we don't need to go there in order to show that the scientists it what the what the science is showing in pure reviewed journals so Joel what is wrong with what he just said

I'll say this until 2020 USDA guidelines come in actually think he's factually wrong cuz he has State guidelines to keep the percentage of calories from saturated fat to 35% or less I could be wrong and I'm not encyclopedia I know they say and I I'm speculating that it will eventually change their their guidelines on saturated fat because the science Racquetball and I will buy you guys are all paid trip to Bali if you see in the 2020 guidelines of saturated fat is still not to be limited to Voice singer that sang with that right so what's wrong with what he said well it's about I greet there are conflicts of funding but they're not unique to any particular sector we just had one of the most famous food psychologist in Connecticut Brian wants it goes a hero of mine said heat on small plates because we didn't small plates your Mindful and you don't go

bass had to have six papers were jacked and had to resign it's pervasive it's a problem doesn't mean there's not been naughty good scientist and I think most the people we've been talking about our large a good scientist that the reputation hasn't been tainted I don't want to get get to Meijer in this but if you look at the egg industry prior to 1990 about 30% of egg studies and nutrition were funded by the egg board since 1990s 92% it's a conflict who's got the money to study nutrition it's not the broccoli grow shop you we could get in the weeds again what is wrong with what he said but he's predicting that they'll be a change in the wreck against 2015 Hooper in 2016 USA that changes anybody to question that they should not recognize and follow the leadership 21 International society that are out there to try and improve but at least I'll be there cuz those 21 International societies and all these

friend organizations they rely on current science to make the recommendations correct / and are they often behind the curve it goes through this whole process is not a nuisance 2016 it's an expensive but they did change like he said their total fat requirements they did change what they believed to be healthy and not healthy wasn't incorrect change the limitation on total fat in 2010 and then they changed the limitation on dietary cholesterol in 2004 so it is not healthy so what's wrong with what he saying about saturated fat they didn't change that trade of fat so if we stick just now I own the current science right so he saying that the current science is showing that there is no negative consequence of saturated fat that's BS that's BS so what is wrong with these studies at deciding

I don't know I have not read every article in the world nor has Chris I don't know specifically there are three famous studies that I've read Siri Torino Chaudhry and dishes those have been dissected Dozer Venture you don't believe the ones he siding I don't I don't know actually he would probably site those to support his case but they've been so resounded Lee criticized that and they created fervor and all I don't know this has been criticism but you could say the same thing about the vegetarian lifespan studies the DIA RC report on Boston Scientific by any stretch of the imagination there are the paper stand the authors have defended against those criticisms and it's nothing like what he told was just talking about with Brian wansink who had to all the papers were proven to be fraudulent he had to retract and there's nothing like that is happened with those papers

and those were not the ones that I cited anyways I just want to say that you sdn 2015 said total fat intake should be 20 to 35% of all your calories they didn't eliminate anything in 2010 that's 2015 I think that's a fact that they are Chris they clearly change the classical recommendation to say as little as possible they just didn't put a number on it we all know that my Cardiology Group went bananas and got them dad that sends as keep cholesterol as low as possible Chris it says cholesterol is no longer a nutrient of concern but you were talking that they remove the total fat intake that's actually an accurate it's right here at man we got the guideline open I mean we work and we're we're allowed to make mistakes were trying to incorporate the whole world literature we're just two guys is that a mistake Chris I mean

it's a mistake so what is how did it was his mistake what did he say that we said that then 2010 that USDA guidelines which are supposed to be filed by schools and colleges in the restroom moved a total fat percentage recommendation it remains at 20 to 35% that I have a modest fat intake I have to look at this specific language to see my recollection is that in the same way that there's some contradiction with a cholesterol there's a sentence that says cholesterol is no longer a nutrient of concern and then Joel mention that he and his cardiologists friends got them the add something back that was you know kind of seem to step back from that and I think the same thing happened with total fat I don't know and I can't I don't have it to look at right now can we buy purses so because it says seems like a major point of dispute and Joel says it's because it's still the question at hand is what do the matter now.

is a randomized controlled trials and what do they do the reviews large reviews of observational studies including over a million participants suggest about the influence of saturated fat on important markers like heart disease and total mortality I'm still waiting to hear about a study that shows that eating more saturated a convincing review of meta-analyses a meta-analysis of randomized control trial or even large observational data that lasted for more than a short. Of time that shows the eating saturated fat

and I'm not even talked about in the context of a healthy diet which is a whole other discussion but just in any diet increases the risk of heart disease because we were discussing this on the assumption that the USDA had changed the requirements for fat Joel saying that's mistake I really think we should clarify that we should find out if he's right and go to choosemyplate.gov it's right here 2015-2020 questions about the USDA guidelines is it healthy diets can include up to 35% of calories from fat they put a clear-cut limit on it it's a government so what was it that you remembered from 2010 and did you remember it wrong Ashley

let's see here

this is a fucking complicated I so bad yeah eat your vegetables everything else follows

have some fun love your fellow man

I have an attitude this game for my paper it was talking about the the shift in the guidelines and I need to you know if why don't you tell us a joke. Joel and we will get into this crazy plant-based High complex carb diets he reverses diabetes isn't that his newsletter came out just as I'm pulling up here in bumped into Chris we actually walked in exactly same time he quotes the New Testament and I'm going to read this cuz as a Jewish boy I just got to read it one man's Faith allows indeed everything there's some people around the table with another man's Faith allows indeed only vegetables the man who eats everything must not look down and him movie it's only vegetables that man who does not eat everything must not condemn the man who does there should be peace I think that is such a freaking beautiful cats because we do need to leave

as promoters of Healthy Lifestyles whether we call it the Harvard School of Public Health out of Live 14 years longer blue zones how to live like Loma Linda weather you want to eat game that you hunt that is probably 8 times less than saturated fat than what you're buying at the damn grocery store you know people eat your vegetables people be really quality over quantity and I'm going to tell you at some point let's talk about eating less and taking some breaks meeting so you can activate anti-aging Pathways but you know it isn't all food it sometimes too much food is probably one of the biggest problem sure they're sure that we all agree about that. I think the real question is in for someone like me really doesn't know I am baffled by the saturated fat dispute because it seems to be there's like to one of you is got to be wrong here the evidence is got a point one way or the other Chris is saying the evidence points did being not an issue at all and you're saying it points to being World War major issue worldwide consensus I'm needing help

these groups are ReliOn current signs that may or may not be behind the times I want you I don't want to step back and just clarify my position here because I'm not saying you don't we start by saying there's no one-size-fits-all right so he said he's just tell us about averages they tell us what happens on average when a group of people do something they don't tell us actually what happens for a person a person B person see and I can be different so if you get like some people may experience a slight increase in their cholesterol from eating saturated fat some people might actually experience a slight decrease and on a net basis that averages out right I think the next the next generation of science is going to be more of an understanding of how various dietary components in various Foods affect people on an individual level cuz let's say there's someone who's got genetic polymorphisms that that mean that for that person if they eat a diet it's very high in saturated

got their LDL particle number which is a risk factor for heart disease is going to go up I've seen that in my clinic absolutely I'm not saying that saturated fat will never increase cholesterol or LDL particle number in people that's just not true and it will and it will happen in some cases but I'm just I'm reporting on the science as in terms of the general question of is saturated fat going to increase the risk of heart disease and is it going to increase the risk of death on average according to the available research in the answer to that is no now then the next question is like should you Joe eat a varied a diet high in saturated fat or should I or should Jamie that's a different question and unfortunately science is not we've been so focused on these population level recommendations in the idea that there's one diet that works for everyone

and we don't have a lot of research that answers that question that's a big gap in current science two questions 1 did you find out if you made an error on this 2010 requirement from the USDA so this came from a study that's that reference said despite the lack of evidence supporting low-fat diets only in 2010 did the dietary guidelines committee stop recommend limits on total fat but I don't have the full guidelines in front of me and and I'm I'm not sure what the the language says so I could have made an error possible so you you made it based on that what you just said that was what I'm saying another studying now in terms of saturated fat isn't there or decreased risk when you consume saturated fat with refined sugars they're absolutely is this is another example of where is context matters well let me just even step back a second and say that

the primary sources of saturated fat in this is important understand when you're looking at epidemiological data so the sources of saturated fat in the American diet 33% comes from Pizza desserts candy potato chips pasta tortillas burritos and tacos 24 and a half percent is unaccounted for but most likely processed foods according to the authors and then not 10% is almost 10% sausages hot dogs bacon Ribs & Burgers so the vast majority of saturated 13% is chicken and mix chicken dishes I think KFC or chicken nuggets and eggs and mix egg dishes so the vast majority of saturated fat that Americans are eating

is coming from junk so even in an observational even if we did see an increase in in harm from saturated fat in observational studies we still couldn't say that that would be true for someone who is eating what I would call like a neutral or Diet which is you know Whole Foods fruits and vegetables nuts and seeds some starchy plants like sweet potatoes and animal products including saturated fat we have no research that suggest the saturated fat in that context is harmful what is the mechanism that makes saturated fat more harmful when it's consumed with sugar

well you have there is an interesting study that was done by the show that in the context of a ketogenic diet where there's no not no sugar essentially or very low amounts of sugar that dietary saturated fat will actually decrease blood levels of saturated fatty acids and it if you're eating refined carbohydrates then you you see an increase in saturated fatty acids that comes from the effects of insulin essentially let me find you the specific so it's if you eating a high-carbohydrate diet it will

increase insulin which inhibits the oxidation of saturated fat and so then when insulin levels are high saturated fat tends to be stored rather than being burned is fuel and then high carb diet can right now I mean refined carbs here not fruits and vegetables can promote the synthesis of saturated fat in the liver so it actually causes the liver to make more saturated fatty acids in in the serum but this study here is this showed that can control feeding Studies have shown that refined carbohydrates will actually increase levels of saturated fat in the blood where is eating saturated fat in the diet does not if there if the diet is not high and in those carbohydrates Joe what's your take on that the only keep pointing make to answer your question about to Chris is why does high sugar diet combined with high saturated fat diets because I got to go back to biochemistry this is serious science where is saturated fat

it's usually found in meat and other animal based products it does exist in plants like salmon avocado salmon and olives and olive oil but anyways there's a pathway get inside but it's real stuff the approach the amino acids found in red meat L combined with their saturated fat this content triggers a pathway that accelerates aging you don't want to eat fast that's called mtor pathway the igf-1 pepper then you eat a diet rich in Sugar what we know about chemistry right here in Los Angeles University of Southern California loud your intelligence to eat a lot of sugar you activate another agent pathway called PK Rass and these two Pathways Emperor I just one peek a rest will make you an old man and old woman quicker so when you're eating pastries which is high saturated fat and high sugar or you're eating meat with a Coke how common is that I mean my God I hamburger and Coke you're activating everything we know about science it will make you age faster that sucks so is that true that eating meat and then

no acids accelerate the aging process there's no studies that show that eating meat in the context of a healthy diet it shortens your life span and if it's so if that were true then we would see that in the data but you'll you're talking about an actual physical mechanism that accelerates the aging process as well not attempt or igf-1 is one pathway in PK rest to cut back entry level science it's not I'm not I'm not stretching on the limb here but

it'll protein is really amino acids you know I get this question you're a vegan where do you get your protein mansour's where do you get your amino acids cuz my body breaks protein down into the building blocks and then I build it back up to whoever the hell I need it for its amino acids in meat there's amino acids in my edamame wherever I want to get him the split of those 20 minutes is different of me than it is in edamame there's more methane in the more loose and very technical stuff leucine and there is some mixes at branched chain amino acid leucine I don't know what the hell that does your aging but we do know that meet rich in Messiah then will activate mtor and igf-1 and it is a very strong factor in aging you want a low messiaen and diet to another reason plant-based heaters need to take B12 to keep their home assistant messiaen in down at separate topic but yes the amino acid mix found in animal protein is different than the amino acid mixed vegetable protein which is why when Morgan Levine looks at the question what's your survival what's your cancer is which

heart risk on animal protein and plant protein plant protein beats the crap out of animal protein this is high-level cell metabolism trying to publish a paper and some glasses beat the crap out of me because there's a 302 Forum 2% increase in cancer of those that diets concentrated in protein of animal source and there's a 25% reduction in cardiovascular disease Selma Tazon 2014 Morgan Levine of Harvard nobody's questioning or work October one 2016 song at Harvard animal protein and plant protein lead to very different outcomes in large database observational studies at the highest level cuz you can't take 6000 people in randomize him in that way so if you're waiting for that resolve the question it was good Lots actually not the case d d i r c panel that confirmed it concluded that that process meat led to an 18% increase in skin cancer risk which again is like indistinguishable from chance using that low of a relative risk they there conclude

fresh red meat was 0 to 1 .02 that's a 2% increase in many other Studies have shown that unprocessed red meat is not associated with increasing cancer risk and is not associated with increasing heart disease risk so again you can talk about these proposed mechanisms all day long but if it's not showing up in actual events that are meaningful to people then you might be missing something maybe red meat does you know act in certain way that would you might think would increase the risk. But maybe it does other things that reduce the risk of death and that's why we can't just focus on mechanistic studies we have to look at actual endpoints that matter to people in terms of the quality of animal Destin cancer matter Chris and I know you know what I just said they don't there's nothing the studies don't show that fresh meat increases the risk of fresh red meat increase the risk of death and cancer and heart disease in Joel what was the number

sing Hickory hundred percent it's right there anybody like March 4th 2014 cell metabolism Morgan Lovin right here animal protein 75% increase in death 400% increase in cancer over 18 your follow-up these findings were not found with plant-based protein so let's talk about reviews even use of observational studies and one that and reviews of meta-analyses are not science and you would prefer to draw conclusions based on a single study the overall high level of mtor igf-1 PK right I was just referring to research that several large reviews and have not found a relationship between red fresh red meat and cancer and fresh red meat and heart disease so hard to look at reviews of the conclude lots of studies and just a single study that support a particular viewpoint

maybe maybe maybe we need more than the 300% what is that none of this is original science and in one of the highest all the other risk factors and the rest of their diet smoking sedentary lifestyle obesity all the burial. There's a 2011 meta analysis of 34 perspective studies on red meat in colorectal cancer with said the event that's 34 studies the available epidemiologic data are not sufficient to support an independent and unequivocal positive association between red meat intake and colorectal cancer 2015 meta-analysis did find a relationship with processed meat but did not find a relationship with fresh red meat

is also an issue of dose response if we if red meat did cause cancer than you'd expect to see a continuous increase in cancer rates as the the intake of red meat increase but in many cases you actually see the opposite you can see a decrease in cancer rates in the people who ate the most red meat witch costume doubt on that Association and again you know we come back to the route to risk it like that you know even with processed meat it's only 18% and you have to consider the healthy user bias that we talked about before and with fresh red meat it's either nothing 0 or maybe like 2% and that's just like that. Level in observational research is not distinguishable from chance you cannot draw any conclusions on that and you cannot assume that someone who's eating a neutral or Diet with fresh Whole Foods and is including some red meat in that diet is going to have the same response as someone who's eating pizza candy

hot dogs and all kinds of other junk food that's just common sense will tell you that hence the problem with these exactly Joel

Chris you want to low igf-1 her igf-1 you want to load your phone you know what to say I want to live a long healthy life hat I don't know I don't want to be I don't want to be obsessing over individual markers I want to live a long healthy life with you like a lot of markers when it comes a low carb studies you want a low igf-1 for survival The Sciences strong this is Ellie saying so we're not making this any way to see the meat that raises igf-1 in the least periodically take a break raises insulin growth factor and cuz it's on males are for women for women well just goes the frequency of breast cancer women that's women so you know there is a relationship between animal products have breast cancer and there's eight opposite relation these are relationships there is there are is petri dish that mean to say go back about chemistry you take breast cancer cells in a Petri dish and put plant proteins I stop growing you put animal proteins they start growing that's that's pretty good science

petri dish they happen to be human breast cancer cells but until you do a randomized controlled study of animals are special at they won't be done should have breast cancer patient eat pork broccoli yeah let's Dong The Bell there again for sure and I can tell you how to cook the broccoli so they get the best benefits he broccoli Sprouts you can 50 times more the benefits of broccoli you were going to respond to that

yeah I come back to important and Poets total mortality or deaths from any causes and diseases I'm not you know not persuaded by mechanisms unless they're tied to it were that we care about I think mechanisms are interesting but as I said if if you have to be aware that if foods to have multiple effects they might think you don't have one impact that you might think would be the harm but then they could have several other impacts that would be beneficial and that's why you need to look at the real outcomes because there been so many examples in the past of of of ideas where the mechanism that was originally proposed for the harm doesn't turn out to be what we thought it was and so I told immortality is the most important Point deaths from all causes but then also deaths from from specific conditions are important too and you and I would put that hire in the hierarchy of evidence and mechanisms

absolutely Joe

don't know how you been doing the unbelievable dedication explosion of scientist around the country around the world you know come up with mechanisms of disease cuz we're on the verge of the unbelievable breakthrough to change your genetics and altering mechanism you understand you can't do it I think Chris has it backwards more commonly basic science drives questioning a human population epidemiologic study and then maybe a randomized clinical trial that's usual progression for example we have not even talked cholesterol is literally has been all saturated fat 1975 my mentors in Dallas Texas but this is relevant to anything Brown and Goldstein basic science identify your liver cell has a receptor call Dale they were scepter nobody knew it it completely controls the metabolism of cholesterol in the body they didn't find it there's a disease where you don't have that receptor in your cholesterol mm and you die before your 15 and I took care of those children and Dallas Texas and 9699 from that came the development of a drug called mevacor and Lipitor

Lovastatin all the rest and we were able to test in humans does that basic science make a difference Kaboom the for A study says you live longer if you have heart disease you to take a step the other side effects to others this net go down to the bottom line you want your LDL cholesterol like Loren cordain the founder of the Modern Family move it said 50 to 70 and it's all consistent across epidemiology basic biochemistry randomized clinical studies and what's the average LDL cholesterol in a hundred in Okinawa in Loma Linda ldls are 70 or 80 infect humans are the only free living animal on the planet with an LDL cholesterol over 80 cuz we eat and we Gorge and we have jacked up saturated fat that dries are cluster up with the only animal on the planet and we're suffering terribly does saturated fat raise your cholesterol at the hope we need to keep coming back to dietary cholesterol and dietary saturated fat the evidence is showing that on average they do not raise

cholesterol in the blood and even when they do that that doesn't translate into an increased risk of heart disease that's what the data show we've talked about I mean I don't know what more I can say I actually haven't said I call bullshit on that that's called the heck is that equation in the keys equation I share their data on controlled feeding you mentioned metabolic word studies as a high standard of evidence controlled egg feeding studies were 75% of people experience no change in their blood cholesterol from eating to four eggs a day we have not talked cholesterol we been talkin Saturday if that were talking about a job right now but you just a saturated fat and cholesterol is blood cholesterol to deny that is is whack and I'm sorry that's called the heck is that equation Google it look it up on Wikipedia is it called the keys equation the change in the

change session of saturated fat raises cholesterol in the blood people but on average the studies are saying that it doesn't have a scene if it's just a girl and some people will find a significant raise rising of their cholesterol and that again more importantly serum cholesterol where can we care about it because it will increase your risk of heart attack right as I said before large studies that have forgotten about cholesterol just analyze the relationship between saturated fat intake and and heart attacks which is what everyone cares about right if they're thinking about cholesterol is like that the middle is is a a mediator in that situation so they remove that and they just say does eating saturated fat increase your risk of heart disease

Large review of 350,000 participants did not show a relationship on average so is the concept that cholesterol is just one factor and then perhaps we isolated it as more significant than it really asking are typical reduction is Paradigm absolutely there are many factors that contribute to heart disease and that's one of them and so that's why I again it's important to look at the studies that directly examine the relationship between saturated fat intake and heart disease rather than doing this dance where we go. Does it increase cholesterol and then assuming that high cholesterol will lead to heart attack Joe I'm sure you can understand why this is so confusing for me I actually feel really badly for sure for sure just and listen to No no no and I thank you both for doing because this is the kind of conversation that you just don't get to have will you get to experts with opposing views and you have a decent conversation where you go over all the actual details

I wouldn't get to see how each one of you thinks about these things and how you draw these conclusions I agree that actually I think it's great and all but yeah we've had a couple moments of clarity and advice and I just want people to have as many as possible because you know it does matter what friend of mine says heart disease is not theoretical I mean we've had many 39 2nd s what we've been doing this to just to respond I mean

does saturated fat Rich diet raise cholesterol absolutely it's such a tight relationship there's a line with a correlation that just straight up now cause you for a second what is wrong with these studies that he showing that's that show that it doesn't in most people I believe and again there studies that are being reference but we're not looking at and that's a limitation we can live with that since 2010 the question is come up does an increase saturated fat cause coronary heart disease that has been questioned in some studies the idea that it doesn't raise blood cholesterol is it's the reason all the guidelines up their 2015 2016 still say limit saturated fat because it sounds hasn't changed there's such a tight correlation the line is straight up percentage of dietary fat percentage of dietary saturated fat blood cholesterol blood clash of the challenges how much yours is going to raise and how much mine is going to raise going to depend on your genetics any microbial and where you're starting if I ate a steak make less Togo's up

I ate an egg this is been shown cuz I don't eat any dietary cholesterol is a plant eater my cholesterol skyrockets you become habituated eating two three eggs a day and the curve flattens out after two three eggs a day which is for 500 mg of cholesterol day it's like if you smoke 20 cigarettes and you go to 24 e pretty hard to show much of a difference to three eggs a day for a chronic cheater is tough to challenge so your body just creates a tolerance for it is at least there's that there's a level of absorption there. Starts to level off but an interesting statistic a toothpick is 100 mg most of his seat 3 to 400 milligrams of cholesterol day 3242 pics of fat what's 150 gram so that's why the saturated fat it's like overwhelmingly more of a topic then 32324 toothpicks of cholesterol a day okay I just come back to the studies to 248 today controlled metabolic word feeding studies do not have any impact on blood cholesterol in

75% of people that's pretty that's about as conclusive is the evidence can get an okay and then they're always there at Kresser. Co / Rogan and here it is

if you if you Google Kresser saturated fat you'll bet the first article that comes up so this is Dad I use from 2009 dietary cholesterol and coronary artery disease a systemic review

how to show I know your viewers maybe reviews can see it I don't know that's called saturated fat in the diet that's called changing your LDL that's called the line going up like a straight rocket and then we're so we can pull it up on the Block anybody that it's called hegstad equation 8 mg s t e d from the late 1970s I know but the equation comes from headset who was one of the doctors who was involved with the McGovern report in 1977 which was the original report that led to a limitation on dietary cholesterol and saturated fat so I think that's a little bit outdated perhaps Chad like I said what's wrong I just said though if humans

address at one study doesn't you know the exception doesn't make the rule we have a meta-analysis of observational studies including 350,000 participants that found no relationship between saturated fat intake and cardiovascular disease at the review of 25 rcts in 40 observational studies 650000 people that concluded that replacing saturated fat with polyunsaturated fat doesn't lower the risk of cardiovascular disease we have to look at the weight of the evidence we can't just choose one study or a mechanistic argument to support our view I mean this study is flawed and outdated how to study that's a that's a that he was an equation that was meant to represent the relationship between saturated fat intake and see if blood cholesterol bit was created created by doctor in the in the late 70s that was originally involved in this diet heart hypothesis in the McGovern report

slide to the restrictions on cholesterol and saturated fat in the first place so yes I am saying that we should be looking at more recent evidence large reviews of meta of observational studies and then meta-analyses a randomized control trial stats that's the much more persuasive source of evidence for me to

it was based on metabolic word carefully done studies at Harvard it was the equation drive from Human data at where you put people in change your diet dietary change studies drives up LDL cholesterol is plotted out the plots very clear it's changing cholesterol to dietary saturated fat it's well accepted in the medical community and its incorporating the guy like it'll never change human physiology is not going to change LDL receptors don't change it all goes back to basic biochemistry when we understand that we can manipulate it to Better Health we could do it for pharmacology we can do through diet will be doing it through gene therapy stem cell therapy but we don't understand about chemistry were cutting out a pillar we have to have for Better Health

Chris

I don't know how many more times I mean I feel like I'm just saying the same thing over and over again we have to look at the the research the weight of the evidence we have to look at randomized controlled trials that actually look at what happens when people consume saturated fat in dietary you say your measuring in a randomized control trial you're controlling you know you're you're measuring what happens when people eat saturated fat and cholesterol and then you do a meta-analysis of these controlled trials near you're finding what I what I just said that's way more persuasive to me what is your take on that Jewel

the Royal Academy of Sciences I mean I totally disagree with Chris that human physiology didn't change for 1985 Nobel Prize to 2018 that it's that the relationship between eating saturated fat lowering your LDL receptor raising your blood LDL developing at the Roma I go in at 3 in the morning and bust open your plaques you have has not changed how are these studies made and what's wrong with him then

nothing's changed but I understand the biochemistry of are lipid metabolism in cells of course as always advancements but the LDL receptor has led to the Staten field a new class of drugs called pcsk9 Inhibitors it's all because about country that people are living longer living better there plaques are being reduced through lifestyle medicine but thank God we also pharmacology that's it writes what is wrong with these studies the studies that are showing these results at he's describing the year disputing what is wrong with these studies and what is wrong with the results again I would urge everybody to take the bride high-level view of Science and not pixels what's the basic biochemistry I know we're circling around what's the epidemiology what's the clinical randomized Rosen what's the centenarian studies there there is no new data that you lived a hundred by adding saturated fat turd I'd you talking about that we're talking about the actual physical results on human bodies when you consume saturated fat what he's just describing

I mean it would take a new metabolic word study that negated the keys equation the eggs that equation is linear relationship 395 mad about it doesn't exist what do you think that Chris I'm mad about work study that says eating saturated fat or we have randomized controlled trials which is a very high standard of evidence and observational data large amounts of observational data that have been reviewed then answer this question and we also we have your mini RC T's of low carb diets and even ketogenic diets that are not showing significant impact review of all the previous science on dietary cholesterol and eggs and the conclusion says read over all recent intervention studies with eggs recent

demonstrate that the additional dietary cholesterol does not negatively affect serum lipids and in some cases appears to improve lipoprotein particle profiles like have a beneficial effect and HDL functionality which is the so-called good cholesterol and he talks about here in the conclusion that big shift LDL particles to the last instrumental large buoyant LDL which is last atherogenic he says eggs also typically increase HDL he says that eggs probably have other beneficial impacts on in terms of their phospholipid contacts, and if there's no relationship between the consumption of eggs and and heart disease so this is a 2018 review it's by Christopher blesso dietary cholesterol serum lipids and heart heart disease are eggs working for or against you published in nutrients is it possible that that's correct and if there's just some misunderstanding about the previous data

it's a different topic its eggs it's cholesterol we were talking saturated fat does it raise your glass tile saw the different topics and then we've been reduced a very hot topic about LDL particle size which we should break down and talk about some not sure quite how to respond cuz we got off track by shifting to consistently low carb and eggs and other thing we were talking about cholesterol what were his blood cholesterol so I stand by the fact human physiology will not change we have her set for understanding of human physiology advance

I don't give me example until 20 years ago nobody ever heard a word pcsk9 God or somebody gave us a protein in her blood pcsk9 that goes your liver sits in a receptor causes the LDL receptor to go internal and you're freaking blood clots go goes up now there's a class of drugs that's an antibody to pcsk9 lowers your cholesterol dramatically for finding it reduces black in those risk architecture new science amazing totally consistent with what brown and goats and showing that led the stands now we have a new treatment that's a wonderful thing it didn't rock the boat we still don't know to this day why we have that a protein in your blood and if you're lucky enough to be born with a low level of pcsk9 your cholesterol lower you have less disease you live longer that was part of the day that I published in 2012 with Brian Ferentz and Wayne State University so yes we've learned more about human physiology totally consistent didn't disrupt anything and led the better treatment that's great

has has human physiology been challenged I'll give you another we've learned and Chris mentioned this I think it's fair to go there's like a court of law he opened it up and cross-examining nobody in the world ever heard the word of four letters tmao 2011 cardiologist sitting at the Cleveland Clinic said there's got to be more in the blood that hurts arteries let's go find him they found this chemical they learned how to measure it they Patton how to measure at tml they took 4,000 people on the cath lab table they said I wonder if the level of T male in the blood correlates with how to clog up your arteries are but Doom it worked perfect then they figure it out if you eat red meat that has rich in L-Carnitine amino acid G Texas rich in choline nutrient that goes directly LED your liver to create email they took studies where they reduced carnitine produced colon the diet email goes down what does tml do it stunt your HDL so it doesn't reverse class will transport it causes LDL to enter the cell wall in crate foam cells macrophages play

and you get a heart attack it actually screws up your kidney and cause it to be fibrosed if you have heart failure diabetes or heart disease or hypertension your tml's up I've actually grown more tameo levels I think any physician United States this is my baby new human physiology that is not lettuce to back off the idea that limiting the Animal product consumption in this case specifically egg yolk and red meat may have benefits your house we just learned a new tablet or what what increases what in the diet increases tmao orders of magnitude more than Mercury and their situation of seafood and take with heart disease mortality can we use epidemiology studies or is that their off the tablet I said before we can use epidemiology when we use it wisely but as you said or done you said I always use epidemiology hundred percent of the time I just wanted to talk to you about large reviews of epidemiology that that that suggests that heart that saturated fat and cholesterol

increase the risk of heart disease so if you can answer the question I heard of fish with cardio What would most doctors and researchers say about fish consumption and cardiovascular disease and mortality most since it has saturated fat most high level 2018 and advisors are two meals a week of fish balancing out with 19 Mi plant-based is the USDA guidelines to Longo the data there are few things that that are associated with a greater decrease in cardiovascular disease risk than fish consumption tmao is if you look at a graph and you can if you Google let's see maybe Jamie you can Alyssa crecer tmao

and you click on that first link red meat and tmao

how do you scroll down and there's a picture there's a picture of scroll down there you go so that picture shows the increase in tmao from eggs beef cheese milk clams and then look at COD and halibut wow references in the article go as always you can see it there at their increasing tmao as I said orders of magnitude more than beef or egg you can't even see eggs and be fair and the data show that fish consumption I think almost every public health authority would recommend you would agree with this is reducing the risk of heart disease and mortality so tmao is another mechanism it's another interesting mechanism but not there

Anderson is not fully understood and then again we have to to look at the data on red meat consumption and heart disease and mortality to to really figure this out we can't yet too speculative mechanism I don't disagree that it's important to look at mechanisms but you can't draw conclusions based on them and this single fact about tmao just kind of blows the thing apart the other thing about tmao to know is it at certain types of gut bacteria metabolize choline and carnitine into tmao whereas others don't and so a lot of scientists have speculated that high tmao levels are essentially a result of a disrupted got microbiome

and that makes sense if you have 60% of the calories that Americans are consuming are from Ultra process food and we know that that totally screws up the gut microbiome then if you get a person eating a standard American diet then their TMA looked at tml levels may go up with red meat where is if you take someone who's got a healthy microbiome cuz they're eating you know lots of plant foods that support healthy got then you may not see the same Association and part of that what supports that is their study showing it a brief axeman which is an antibiotic that treats bacterial overgrowth in the small intestine reduces serum tmao levels which suggests that it's mediated by the gut microbiome so consumption of fish has been universally shown to decrease heart disease the mechanism is interesting but overall it may be very complicated with many factors and we might not know all of them and then that's what takes us back to the

look at the data on whether red meat increases the risk of death or heart disease

Joe

Chris's reference was giving credit to another bloggers article that's not science you have to go to the blogger's article look at it was number 16 there is there a Slap Slappy reference number 15 I mean a man a pilot study okay so it's not a Blog it's actually is a Hot Topic right now that is largely being research in terms of egg yolk and meat consumption is really matter it's not the limiter signs you're coming up with pharmacological agents right now to block it and we'll we'll see a new class of drugs or just reported with significant or is it more important to concentrate on gut biome and healthy diet why we instantly giving the ball to Pharmaceuticals what you asked the question is there any new human physiology

that's relevant we started with pcsk9 I'm introducing tmao is new human physiology that's relevant that could lead to improvements in clinical outcomes of suggest buy a talking about what he just showed you guys miss the graph that he gave you a study for the graph and you just would have lost over it right the one that contributed fish is a flesh source of Tamil we can talk about whether fishing 2018 is uniformly healthy but that's not what he saying and he's also talking about gut biome we got bacteria then the consumption of red meat being significantly last in the consumption of fish which is universally said to be a good thing for your heart so a bunch of layers are real quick everybody who studies tmao knows that the microbiome as a critical component two people can eat a steak that's classic study Cleveland Clinic study feed a vegan a steak this is a classic Cleveland Clinic research study in the New England Journal of Medicine I don't make t m i l why does my microbiome is different than you

feeding on the border state they make tml within 12 hours and now I'm eating a standard American diet sure but nonetheless it's it pointed to the fact that it was the microbiome you give a mouse meat and give it an antibiotic the website of Michael Obama won't make tml 50ml dependency the microbiome dependency of to email is well known science so that that is not denigrate the topic I mean it it's a side topic is fish always healthy in a world of DDT PCB Mercury I don't know about Chris's practice for every patient I see gets blood mercury levels and those that eat routinely heavy are very often subject and now I'm bringing up 2018 clinical data and I'm bringing relevant clinical material for that hug tell you about the absolute mechanism that's caused by the consumption of me he brought up fish consumption which

vastly elevates this and yet fish consumption is not correlated with heart disease in fact it's correlated with people having healthy hearts

so if you're suggesting me is the recommendation today and this discussion eat fish but limited egg yolk and meet I'd agree with that that's not what it says because the fish consumption vasiliy elevates what you were saying was a significant issue he saying it's not a significant issue that it's a mechanism and it's an interesting mechanism but it's part of a much larger and probably very poorly understood situation I don't think that's completely true what we do know is that true well I would say that's true and I would say it's another proxy marker for a crappy. Crappy diet what we know is that eating red meat in the context of a standard American diet May slightly raised your tmao but not nearly as much as eating fish will see you brought up is tmao and he's basically just squash that argument but I think he's a scientifically wrong because again the well for the body and the mean is that

so what about the fish because a few specific fish in the number one the way that egg yolk and red meat Cleveland Clinic going to go Journal medicine is is this a step of ingesting the precursor going to get microbiome going through an enzyme called lies in your small intestine going to your liver is TMA and gray metabolize that email that process is correlate with a score after his grossest that process is correlated with increased activity of LDL within your cell wall went by epidemiologist of this rapid development from 2011 to 2013 to now so it's specific spot in fish fish flash already has preformed tmao we don't know if it activates LDL activation we don't know if it's the nobodies looked at the correlation of fish flesh preformed tmao and a 4000 patient stay in a cat that paper we don't know they're wonderful questions to ask but until they're done

there is reason to be concerned that there's a new pathway that might be involved in food that raises your TMA increase the risk of heart disease and you'd see people who are eating the most fish having the most heart attacks not the opposite of what you see that that's I think that's reductionist because what does fish have to bring up tmao in the first place cuz you brought it up and more relaxing back to what I just said because I zoomed out a little bit to look at the actual relationship with mortality that was a blood level that's not a source grossest that's how come that's not kidney function that's not stroke risk and harvest which happens you're talking about tmao

I am talking about to grab showed was tmao back it up you eat red make you make tomato can Michael buy almost have a certain Constitution you eat egg yolk you make tmao that's a certain Constitution is it good to have high levels at tml in the blood weather there from fish egg yolk red meat the science of Justice not good what can you do to lower your Gmail how does a sign suggest it's no good if there's large levels of tmao that come from fish when you eat that fish is directly correlated with less heart disease what it would take an evaluation what's the calorie content of the United States it from Cod halibut red meat and egg yolk I would think the calorie content of egg yolk and red meat is higher than cotton help it I don't have that data and that's a Global Perspective but if you are up to date in the sign just had like the Lee dallow tml life which again I'm going to say with all buildings have drum or blood levels on the table United States I believe according to Cleveland heart Labs you will want to do all steps to lower it and maybe you want to leave

complimentary benefit that fish is shown maybe from omega-3 to say that the tmao from fish is healthy but the tmao from beef and eggs is not year old science tmao is a massive concern that is scientifically true that it how is it scientifically true if there's so much tmao and fish and there's no concern there's two species of fish that have the highest levels you saw the other levels are what are the other ones in general is hiring sensationally hotter than magnitude higher percentage 24 times higher

like I might have even mentioned that in my in my original article the problem is you brought up to you met on the first place like it was this well but let me just add molecular nutrition food research 2016 does fish protein when it elevates tml accelerate atherosclerosis according to a research study when fish raised tml the accelerate atherosclerosis that anybody can check the reference laid out there I cannot say the name Yaz decosky

a petri dish data is a petri dish and looking for a minute it's basic biochemistry what happens to atherosclerosis in arteries when you feed this is mouse data that's how you generate what has been done in humans yet why you bringing up as pure fact that fish is a superfood I've already knocked it down for several reasons one to put the fish intake is associated with increased risk of diabetes I'm sorry that's epidemiology fish is with increased risk of diabetes so the question is is there a randomized study basic biochemistry you would understand it from the saturated fat content of fish it would be largely epidemiologic say things like the New York but when you say epidemiology studies you're asking people what do you eat on a regular basis and they say fish and french fries and hot dogs you say oh the fish is associated with an a

Greece that's where all these other things and then it's not isolated it's connected other things without isolated what you're trying to isolate out things by multivariate analysis for diabetes and fish really is that real one review that said that and he was a 2000 review because there's an 2012 review that does not find any association between fish consumption and diabetes so you're thinking that says that this was four hundred and forty thousand people with an average of 11 year follow-up published in the American Diabetes Association Diabetes Care Journal so yeah I don't think it it's hard I think to make a claim that fish consumption is is harmful of evidence and yes there are concerns now about toxins in it might change over time and they're also issues with overfishing in

all that but on story story were talking about just the association of fish consumption and Health and Longevity and I think if you got a hundred times just in the room maybe 99 of them would agree that that's another few things in and nutritional research there less controversial than that maybe nutrition intake of fish was correlated positively with the increase risk of diabetes in The Sciences out there is it crystal clear as as as well defined as the heck is that equation dietary saturated fat changing clutch don't know is it in the association that could be of concern and basic biochemistry said fish have saturated fat that could possibly cause something called lipotoxicity fish have animal protein We Ready talk where animal proteins very different in plant protein concept is plausible sure is it resolved does not result is fish a better choice than eating fried chicken or a piece of Philly Hoagie steak absolutely it's a very just pulled some

it says the file is not supported beneficial effect of total fish type of fish or EPA and DHA intake on the risk of type 2 diabetes alternatively other dietary components such as selenium and unmeasured contaminants present present in fish might explain our results positively with the risk of type 2 diabetes that says there's epidemiology that should be further study but maybe somebody wants to cut back there fish but we're looking in a single study here we need to look at the weight of evidence Jamie your bad man made of our findings do not support a beneficial effect of total fish type of fish or epad PA on the intake on the risk of type 2 diabetes I can't even lean fish was associated with developing type 2 diabetes fatty fish

you probably want that omega-3 but you know it's I'm not telling anybody it's a resolve issue is it you're saying tmao animal protein is what causes this problem protection more specific it's choline and carnitine in an egg yolk it's not really animal protein that's what you said tmao that's not good for you I'll though if you're hungry on an island in your dying eat meat we all recognize it but if you're looking for Optimal Health you should be concerned about a saturated fat content you should be concerned that animal protein accelerates aging through is it been proven that animal protein accelerates aging stop class science I mean just because you say it doesn't mean true we need to be open to the possibility that high and take some assigning which isn't one of the amino acids in

animal protein in the absence of sufficient intakes of glycine which is another amino acid its in animal proteins in an intake of nutrients like B12 and B6 and benign which is folate could some of the animal studies suggest that that has an effect on longevity but this is why I've always been an advocate of eating nose-to-tail so not just eating lean meats that are very high in the signing making sure you're getting enough of the glycine rich foods bone broth etcetera and then you're also eating plenty of you know I mix Diet that contains B12 and folate and B6 and the other nutrients that balance out the effects of excess Metheny as well as fiber for a healthy gut box and when you pulled up that that conclusion know if I can meet her in me

so that whole carnivore diet conclusions accumulated evidence generated from this med analysis does not support the overall inverse Association of fish or fish oil in intake with incidence of diabetes. Saying that they couldn't confirm us fish and take doesn't lower the risk of diabetes it's not saying that it increases the risk so it says it's not but there's no relationship there taking allies so it's not the one saying that it causes diabetes or whatever it does say when it when it where it where is it say that it causes diabetes and what is the study of the cause of this is classic Association okay don't know if it's the protein the fat the Mercury the pcbs a DDT or the other day fish and chips, this is clearly not to the level of saying processed red meat cause cancer this is saying fish consumption in some studies is associated with type 2 diabetes teaser heaven

flood studies would you agree I wouldn't throw them all under the bus now that's how science works I mean it slowly plods forward smiling

yeah I mean we were starting brought up tmao and then that's how we got on to the fish yeah and diabetes I think there is not no strong evidence that fish causes diabetes eating fish causes diabetes there's a lot of evidence that suggested eating Seafood reduces significantly D the incidence of cardiovascular disease and again if tml were a problem then eating a lot of fish should not have that impact and you believe that this is probably why I shouldn't say you play do you believe this is from essential fatty acids that are found in fish but take Aleve fatty fish yeah I think that's possible given what we know about EPA and DHA which are the long-chain essential fatty acids and their benefits and it could be fish is also a really great source of selenium as it as that one study said in 16 of the 25 top sources of selenium come from ocean fish fish is a great source of bioavailable protein there lots of reasons why

why fish consumption could be beneficial so in your opinion this sort of highlights that there is a lot of complex different moving parts that we don't totally understand and that this is why you don't want to rely completely on just the mechanisms and these things that are occurring a petri dishes or my studies are they selling those lines so I'm going back to the Bradford Hill criteria that we and I mentioned before which are ways of kind of determining whether associations that show up and observational studies might be causal the plaza built one of one of the criteria's mechanism is there a possible mechanism that could explain the relationship between this variable and not variable but there are other criteria strength consistency specificity temporality biological gradient like a dose-response coherent experiment analogy so yes mechanisms are great with important to study them I'm

for that and we we absolutely need to correlate them with real outcomes and real human beings to see both an observational studies that are well design and and randomized controlled trials to see if it makes sense and it and tmao I think it's a great example of that does it

fair to say that we really just are looking at a puzzle and we don't have all the pieces I think you can say that in many cases and in this case for sure I disagree there's a tremendous group and you can pose up if you want Jamie call true Health Initiative it's more than 400 I call World experts and nutrition fairy Divergent food philosophies paleo Mediterranean plant that there's no consensus to advise the public on a healthy diet for humans. That's what we what we said was that there's it's a complex puzzle and we don't have all the pieces I agree with that but we have enough to make rent while he's just agreeing cuz we've been rough we have enough to make recommendations to the public and the true Health initiatives has crystallized that that's not what we were discussing right there about recommendations to the public were talking about mechanisms and whether or not it's understood all the different moving pieces in terms of how your body absorbs nutrients

food it's good and it's an endless flow of new knowledge what I said but the wide why did you disagree with that I didn't disagree that that's an accurate assessment that we don't have all the pieces to the puzzle it would definitely go to buy the pieces we have enough to make recommendations and then we'll reevaluate and I'll do you want another new meat problem it's coolest latest science sure okay Jamie will you go to please meat allergy on Google University of Virginia atherosclerosis the little toe tic toe you got it baby you're so good it's a number 2 hit on Google but this is something that is caused by an adverse reaction to a tank you've got to listen or hear who's in Virginia Maybe

is there a Segway question of whether the average person should eat meat though I started my fish died so this is I don't know what that go to the second one I'll have the picture just real quick you live in Virginia and the Punic my cath lab table cuz you're in the emergency room for whatever reason okay I draw a blood sample on you 24% of those people have a antibody to alpha-gal which is a carbohydrate found in meat and that shocks people there are carbohydrates and only red meat specifically and only red meats Pacifica 24% of Virginia and show the antibody so that was interesting and some are now developing anaphylaxis carrying epi-pens cuz they have a meteorology that isn't 2.4% of 24% have the antibody what was discovered University of Virginia is Ruth and look at their heart arteries by ultrasound the mall

black they have the higher is there tighter than a bike brand new science it's an association nobody knows there is of course the possibility of inflammation from immune activation that's wild date and I don't wish that on people I wish we live in a world that people didn't have nut allergies didn't have lactose intolerance and didn't have meat allergies but the reality is there may be a pathway previously unknown that is hot in this all goes back to your question is there any new physiology about this whole past this is a pathogen activated allergy that's from a severe allergic reaction since I actually like why I don't think this is a mechanism that has existed for a long time ago saying anything about this is something that's only been discovered over the last couple decades of those 24% that have the antibody very few had the full Clinic

syndrome but it still correlated with heart disease the point is keep an open mind I don't see the day that killing them is tick borne disease or the tick-borne disease is like because it is fairly recent discovery of is it advancing and evolving and getting more potent I doubt you know the basic biochemistry of meat and the carbohydrates in meat have changed he has the has the lone star tick become more frequent cross reaction between glyphosate and being bit by tick and intestinal permeability there's all kinds of crazy ideas that need to be pursued cuz someone was cry Santo's round off cartwheel has Bay Area spare relation is not causation when I know you agree with this job we have to keep that in mind I mean it's that there's a great study done one of my favorites

it was purposely done to illustrate the danger of assuming that correlation equals causation it was a study done of the most common diagnosis for hospitalization in Canada 10.6 million people and they found a 24 diagnosis were significantly associated with the participant astrological signs are born under the sign of Leo had a 15% higher risk of being hospitalized for gastrointestinal Hemorrhage and sagittarians had a 38% higher risk of being hospitalized for an arm fracture now remember that the cat that says proposed increase in risk for for processed meat and cancer is 18% so the these risks are on this process process me a Sagittarian has a higher risk of being if we believe in this correlation data you know you can't assume

relations or causation I mean that's basic and I and it doesn't again there extent you can use Bradford Hill and other things to strengthen the association but you need to test it with an experiment or the association needs to be strong it needs to be over a hundred percent at least two really rise out of the noise and then say okay we're really seeing a signal let me give you another example there was a recent study just published it showed that women pregnant women with the highest maternal consumption of gluten had a tooth. Of type 1 diabetes in their offspring and their children that was a double that was over a hundred percent so that is actually worth paying attention to because that's so such a large you know increase in risk that it it doesn't confirm it by any stretch but it does mean maybe we should look into this further if that was a 5% increase risk I mean you might as well say that the sagittarians have a higher risk of arm fracture is it fair

say that were when were doing all these nutritional studies that you were looking at a property of data yeah I'm in Johnny Johnny and it had a quote let's see if I can quickly find it cuz we're comparing all these different studies and me and obviously Joel things one thing you think another thing ever given the complicated associations of eating behaviors and patterns lost my place given the complicated associations of eating behaviors and patterns with mini time varying social and behavioral factors that also affect health no currently available cohort include sufficient information to address confounding in nutrition Association so he saying layperson translation there's so many factors that affect our health from our sleep to our physical activity to our weather we smoke or we drink your arse are social relationships there was a study

but I think I talked about in one of my previous appearances that shows that having not having enough good relationships will increase your risk of death more than smoking 15 cigarettes a day no studies are controlling for that got microbiome we now knows really important for overall health are any studies comparing for PPO actually controlling for people's the state of people's got microbiome absolutely not which is a problem with the tmao research so again it doesn't mean that observational studies are not useful in means we have to take him with a huge grain of salt and the the the fewer things that are actually controlled for the bigger the grain of salt will be Joe

are you mad kind of here since it it's so overwhelming and there's so many spots in the date of the were unable to advise the public again I don't do that I think we have more than enough data can go to Michael Pollan eat food not too much mostly plants everybody loves it cuz it's consistent with the overwhelming 50,000 level look and go to True Health Initiative that says 50000 level though the whole level of biology basic science centenarian randomized clinical trials epidemiology you got to talk to a patient Monday morning I don't want to get mired in confusion I'm going to tell that patient eat real food don't eat too much and eat mostly plants because that is a synthesis of 50 years in nutritional research are we going to evolve that to something more brilliant you my dad now fast five days a month or don't eat 12 hours a day we might be able to refine it with some of the new science on a using fasting intelligently but that's pretty strong when I go to

true health initiative and say it's all confusing before hundred scientific International experts say eat locally Source close to the ground lamb predominant with water 400 sign to say that's pretty reasonable that I can tell my patient on Monday is something they can actually activate and we'll figure out tmao with a blocker with fish with eggs with calling or whether the stick allergy ended up spreading in the Michigan or California and there's a way to deal with it but for now these are critically simple lessons for the pub at actually agree with that including the part about plants I mean my recommendation is your plate should be in a 2/3 or 3/4 plants and and in the end in animal products animal food so but the question here is not that should we eat a healthy Whole Foods diet we both agree on that hundred percent the question is whether animal foods should be a part of the diet based on their nutrient density which unfortunately we haven't had a chance to get into

nearby availability and the fact that humans and our hominid ancestors have been consuming them for over two and a half million years you know that's my my argument is that on that plate for most people they're going to benefit from having some animal Foods how much you know what proportions of carbohydrate fat protein and all that that depends on the person and you're going to see big difference is actually from person to person but you know I think today is made it clear there's no convincing data that shows that completely removing animal products from that plate is going to lead to a longer life-span or significant reductions in disease let me put it this way what is the benefit of putting that 1/4 of your plate putting animal protein like what it what is the nutrient density of it that makes her lots of benefits yeah so animal protein is

more nutrient-dense in essential nutrients making it clear that I support you in both plants and animals food so animals are in animal foods are high in B12 bioavailable zinc iron calcium choline taurine creatine and not just hire in terms of the actual amount but higher in the amount that you do you absorb and that's a very key point where is plant Foods tend to be higher in carotenoids polyphenols flavonoid dialysis fights between cruciferous vegetables and fiber and those are important as well and so to get the best of you know the the most the widest spectrum of nutrient density we want to eat the animals for those nutrients at animal food and then the plant foods for those other nutrients

and what would be negative about removing the animal products from that one quarter of your play what what could you not fill in with plant protein is clearly some people get by with just plant protein B12 is that is the biggest issue for sure it's not really found in that in plant Foods except for some exotic species of wild mushrooms in and Nori and plants and mushrooms aren't really plants right but yeah and non animal Foods yeah I guess you could say but if it's it's not just a question of what's theoretically possible it's a question of looking at the studies that show us what are the average you know how common are nutrient deficiencies on omnivorous versus vegetarian and vegan diets and if you go to cresser. Co / Rogan there's a whole section on that links to a very in-depth article that shows that for example

vegetarians and vegans the average omnivore the rate of B12 depletion is 11% and then for vegetarian to 77% in for vegans it's 92% 92% of depletion which is the first stage is four stages of B12 deficiency and that's the first stage and the earliest studies that showed less of a difference used only serum B12 is a mark but it turns out that CM B12 is not a very accurate marker of B12 deficiency and we need to be using more accurate markers like Holo transcobalamin methylmalonic acid and homocysteine it when you use those newer markers you see those broad brought you a very big differences in deficiency rates and furthermore there was a study done in vegans and vegetarians in the Netherlands state where they like at summer camp so these were people who are educated vegetarians and vegans they were really into it and the average serum B12 level for them even what was below two hundred

which is in a deficiency State and even the people who are supplementing had significant levels of B12 deficiency and that's probably because Studies have shown that the amount that you need to supplement with is about a hundred times higher than the RDA so the RDA is 2.5 micrograms and you really need 250 Mi to get your levels up and if you're deficient you need 200 times more than the RDA 500 micrograms and this all the studies are there on on my site so it is a problem that B12 non-existent plant-based Foods or that it's not as bioavailable it's it doesn't exist the true true cobalamin absorbable B12 doesn't exist in in plant Foods you can't you can get other gyms of an implant even algae even out so but the B12 supplement is probably

based on what like what's it coming from well that doesn't really make the difference it's are they taking enough to me but I hope that anyone who is listening to this make sure that they're getting enough B12 you know what is it coming from if it's not coming from that corner and make me 1212 but it's the bacteria hanging on the care and we make me 12 to but it's in a coal mine and we can absorb it in the small intestine right so but yeah just making sure that if someone is following this diet they're getting enough B12 and if they're using the right markers to assess their status Sierra B12 only goes out of range in the final stages of B12 deficiency and by then it can be too late some of the effects of B12 deficiency are irreversible so it's a pretty serious thing and it's it's a really important thing for any vegetarian or vegan to be aware I've given those big differences and depletion between the popular

so tell if you've been a vegan since you've been 18 obviously you must have been on top of all the supplementation and making sure that you get your right nutrients but it's out it number one it's responsible for a healthcare practitioner to advise somebody eating plant-based to take vitamin B12 absolutely there are people that do it because it's for to fight him any food and Nori if you eat sushi and nutritional yeast I don't advise my patients to Reliant food because there's a neurologic and hematologic potential for trouble if you don't be 12 it actually takes years to deplete your B12 it's an interesting statistic I want to come back to humans 90% of all B12 right now is being given to feed lock cows cuz they don't need dirt anymore they're inside a building that has no dirt they don't get B12 but the public wants B12 Rich meet so they give B-12 the cows to make pick up there is there is there little vegans these cause they don't have a source anymore no animal that you only talked about factory farm factory farming if you're out there eating dirt in the field you're going to have a

how do you go on when you say that so is it impossible to live a healthy plant-based lifestyle without supplementation know many many people do you say you don't remember men that I don't recommend it but they should get blood work now your vitamin D know your omega-3 and no you are B12 I'm all for Optimal Health and I'm practicing high-level medicine but I have friends that adamantly show me their blood work I don't take pills and look at my blood work I mean name a snake by its not my medical recommendation the official recommendations is every everybody over age 50 and then I had States take B12 for brain and middle of whatever your diet and that's a wise advice whether you take a multivitamin every couple of days like dr. Longo recommends there's this is a real problem nobody is the night at Chris's laid it out well it's such a simple solution I'm going to demonstrate my B12

and what's the source of your B12 it's synthesized methylcobalamin I just got 1,000 micrograms of vitamin B12 with 400 Mi with 400 mg of DHA with 2000 international units of vitamin D3 and I do all vegan I just need to know where the door and I'm done you know it's all living organisms that it's made applicable mean some people leave is the Preferred Choice which I think Chris would agree with so contrary to popular belief it can be gotten by completely Humane and ethical ways if your of the LG G4 DHA at synthesize for B12 and vitamin D3 is synthesized to it used to be made from cow's secretion called Sheep secretion call landline but synthesize now but it does beg the question of whether we should be following a diet that can't meet are essential nutrient needs and that leads to deficiencies of many other nutrients much more commonly than an omnivorous

and you know my position has always been we should get as many nutrients is food as well as we can because that's the way that humans are adapted to getting nutrients there's issues with supplementation sometimes you know both like it getting too much of a nutrient is can be a problem in several cases that's not the case and b12 which is great because means people could take really high doses and it won't be a problem but as I mentioned a lot of vegetarians and vegans wear supplementing or still at risk and still deficient because Sierra and b12 is the main marker that is used in this country and and not even most Physicians don't test for Sierra B12 I know this you probably noticed you're from people come in they've never had to be 12. But then when they do get the serum B12 test it's going to miss a large percentage of people who are already on items do I do a methylmalonic methylmalonic methylmalonic acid and and homocysteine are much more important markers and I agree if you look at average

assisting levels in vegans and vegetarians are significantly higher than in omnivores because of this issue because of the high prevalence of of B12 deficiency and ironic about that is a lot of people turn to a plant-based I don't even want to say plant-based cuz I would consider a neutral or paleo diet to be plant-based too but they're cardiovascular health and yet you seeing much higher rates rates of homocysteine like the average in vegans is 16 which is a rate it's clearly associated with increased risk of not only cardiovascular disease but also dementia and Alzheimer's support for people we are prone to have a few holes in the wall that an intelligent person knows how to plug it sits vitamin D it's DHA it's B12 you might want to say hi

I dine taurine Vanadium chromium I just got those that's what I do every other day I'm totally complete my patients are totally complete the industry has provided solutions to a relatively simple problem I don't want to surprise you got a mouthful is it is it fair to say that you believe that with a vegan diet is it's like you can essentially hack your way to a better healthier Life by just adding a few things like B12 a few other nutrients that you're not going to get from the diet but with those together you feel like you're far healthier when I didn't get I substituted by when I don't want I'm not taking in which is Animal Center if that animal protein I'm not taking into the main disagreement hear the two of you is whether or not saturated fat and I would both agree as Educators all the public and specifically plant eaters should be aware nutrition deficiencies a two-year paleo Phillips that he said the people were deficient in iodine on the Paleo

diet for Asians have much higher rates of iodine in a matter of much higher rates of iodine deficiency in paleo paleo paleo diet is the issue is about the first scientist showed up and I honor the paleo diet there is good reason to consider it as a food option will use news world report does not agree with that but to send them a basing it on there not scientists well there Pamela scientist question is just what you know what's going to happen for the average person who's following these diets and I agree 100% with y'all that you know we have to educate people on whatever diet there on I've I've I've said this to people that's why I'm not I've never advocated strict paleo I think I can work for some people

I've never been ideological about that because I actually think that both fat fermented dairy how it is really beneficial when it's well tolerated and one of the reasons for it is iodine Dairy is actually one of the best sources of iodine in the diet and it's not because the dairy products contain iodine but they're stored in tanks that Iota for is the cleanser that's used for the tank switch and outside the three top sources of iodine would be well I die salt is the main one that's why it was added to Salt in the first place by a lot of people on a healthy diet remove iodized salt in favor of sea salt which I think is a good choice over all but one of the downsides of that is it there no longer consuming the main source of iodine then dairy products and then see vegetables is Joe manchin what Kelvin hijiki

Iron Man and Nori not as much which is the only see vegetable that most Americans consume in the form of sushi remove Dairy iodized salt and they're not eating sea vegetables and yes that is a risk for iodine deficiency I've written about that but let's look at things like calcium let's look at iron let's look at zinc let's look it choline let's look at Orion that's a good creatine let's look at retinol which is preformed vitamin A let's look at EPA and DHA all of these are shown to be lower in vegetarians and vegans and they are and omnivores and it just yes you can supplement but it just you know the supplements have the same effect like liquid calcium dietary calcium has inversely related to heart disease and kidney stones meaning the the more dietary calcium you eat the lower risk of those conditions but when you look at studies on calcium supplements the opposite

true calcium supplements are associated with an increase in heart disease increase in kidney stones so Associated by epidemiology studies about that Siri is that the because you went with supplemental calcium is not the same as dietary calcium you get a large bolus of calcium that goes into your blood all at once and then it can get into the soft tissues which can make them stiffer which is Joel will tell you is not good for your heart health and so my point is that supplements don't always affect the body in the same way that's why I just think it's better to get nutrients from food if you can because that's the way we've been getting them for millions of years you know let's talk about something I think you guys can both agree on cuz I am baffled by this carnivore diet and baffled baffled by how many people are clean to it as a Panacea I'm baffled by whether or not it's a physiological

fact or whether there's a placebo effect going on I have a theory please so some of the benefits of fasting but allows people to process for longer because it's providing some nutrition you know most if you look in the scientific literature fasting is like the cure-all for everything fasting is the cure what time water fasting so you can do it for two three four weeks try that for a year year of water fast so muscular guy that lost it was 300 SQ extremely obese in track to write which is really really happened with weight loss so I don't have any evidence but meat is absorbed very high up in the digestive tract

and so when you only eat meat it's a low residue diet there's nothing left over to irritate or inflamed the got my theory is a lot of people who are benefiting from this have a really disrupted gut microbiome Alessio Fasano has argued that leaky gut is kind of a precondition for autoimmunity and this the carnivore diet is essentially like a gut raster a fast and so I don't get no doubt that people are benefiting from it the question is what is the long-term implications there is no I mean there's a few people that have been doing the same anecdotal evidence people and doing it for a few decades well you know it's pretty cool that I'm actually going on my homeboy Sean Baker's podcast in a few weeks we each other I love you brother we're going to have an honest discussion as much as you can to say why is Michaela Peterson feeling good and you got to love that and out of that if she had done water fasting transitioning to an Ultra Clean Diet would she have done as well who knows but too

could Sean Baker's labs and say pre diabetic low testosterone High be when I'm concerned all though he just published is coronary calcium scan a zero and I either they just got little kids I don't want to go to drop dead but there's its way preliminary for the bandwagon that's bro testosterone thing though is he said that he had been dead lifting the day before and the day before he took his test kit. If she be significantly decrease testosterone but if your hundred thirty-seven I can't memorize his last total testosterone is less than 250 it's an adverse mortality predictor and he wants to be alive he doesn't need to do it McKayla Peterson and Jordan might need to do it until they find a better path John's has been adopted it so there's any of the biggest puzzle is that quickly cook it one of the things that plant eaters and

people that fill 3/4 their plate with food and vegetables get way more and everybody else is lots of vitamin C and vitamin C builds healthy walls and build healthy immune systems you love vitamin C I love I didn't say I love it from Foods I don't mind it as a supplement I don't mind it intravenous vitamin C is Linus Pauling it is so many benefits the body where are these people when every chart says a meat has no vitamin C are they eating raw meat which might have vitamin C are they eating Porygon mate which might have somebody let me say me stop you there because I'll tell you what these explanations been today the explanation to me has been that there is a decrease absorption of vitamin C when you're consuming vitamin C with all these other things cruciferous vegetables carbohydrates all these different things that there's some sort of a there's an adverse effect is that is that a fact if you take a thousand milligrams of Vitamin C O deserve a lot of e to take 10,000 mg in percentage you won't absorb as much but you still get more than a thousand mg but there's also this theory that since you're eating basically and

added glucose diet that there's some kind of competition in US glucose and see so even if they get up I touch this either absorbing it high proficiently nobody knows they have developed in your vehicles from Google Genesis it's a low-carb diet no doubt it I mean the point is we just don't know why. Ryan and I think so risky I mean as a as a practitioner myself and if someone has dealt with chronic illness who wasn't able to find help anywhere else I mean I do not begrudge people for sticking with some writing it been tried everything and nothing is worth and they do this may feel good I mean who can blame them it's early dinner with Jordan Jordan Peterson and he's eating his big giant steaks and he looks great and is lighter than he's been since he was 25 years old I'm 100% empathetic with cuz I've been through something like that myself but to then take that and

say that we're certain that it's safe is a big Leah unless he's tracking carotid and coronary and doing a year of beer beer you know it's an experiment you might not want to run bitch run those texts and that's another kind of consider another guy that I fall online I'm sorry for the Jon's name but he Advocates organ meat and you saying that organ meat if you just eating steak that you've got an issue but if you take into account liver and heart kidneys that you were going to get all these essential nutrients from that you're you're still not getting vitamin C that I'm aware of any time you're not getting carotenoids and flavonoids good summation of is it possible that there's some mechanism that's going on I mean absolute on

best picture using steak and cheese so it's apparently not in Olney died and I'm not slamming them I really wish him well and he can do what he wants I don't know tell is important though because the organ meats and then Mike matter I have lysine and other nutrients that are really important you're only eating lean meat that I think yeah I would be very concerned about that children do not try this at home someone tried to get me they were saying you should try a carnivore diet for 90 days and I said well the real problem of diabetes I eat game and that's extremely smart and I like vegetables I like to eat vegetables with essentially every single meal yeah that's very smart but I do think that it's entirely possible that maybe it's people that have this distracted my gut microbiome but that some people might be alert like one of things that Michaela Peterson brought up when she

the podcast it it it might very well be that she's allergic to almost everything she has some sort of allergic reaction you I think you both think that that could be because of a fucked-up got my apps that she just hasn't had evaluated she she started to laugh when I talk to my naturopath that's what you should have kept on doing her got Annalise Gunter got healed I mean maybe that would have helped her so you know what does naturopath it's like good psychics yeah but let's say you get in a car accident and your spine is crushed you know most short of a miracle do you know that's not that persons not going to read fully regain their 100% of their you know musculoskeletal capabilities right but we don't have that same understanding with other conditions but let's say I go you know too

Indonesia and I get pain parasites and you know it like and then I'd have to take tons of antibiotics to deal with that is my gut ever going to return to 100% of the function that that it had before that even with all the right things maybe not and so I'm not saying that they the people should give up hope but I'm I'm saying that like that we have we have two separate between this is helping me and it's making me feel great and nothing else worked for and we know what hundred percent certainty that this is safe for the long-term very different questions and again I'm totally empathetic to that you know and I would probably do the same thing just want to show up that has gone through this process of being strong and healthy I might even say hey hey you know if I maybe I'll die 5 years earlier but I'll enjoy the rent you know those years of my life I won't be in pain and discomfort the entire time then sign me up or I might I might say to myself will wait it can't be that good for me to be inflamed

all the time and like you know it it. Can't be good for me so maybe even though that all meat diet might have some downsides it actually might be reducing inflammation and and therefore that will cancel out we just don't know what about it all meat diet the thing that gets me is there's no vitamin supplementation like what about an all meat diet with good supplementation a multivitamin and pretty smart idea 3 coming out it's being questioned I mean it is it is Central to Health in the medical literature dr. Denis burkitt from England went to Africa describe fiber describe it we're just all kinds of chronic diseases that you were a book called the fiber man and all it's being questioned now it's so entrenched have we got it all wrong and only plants have fiber is a good question where they getting there fiber their meat is sticking in their colon It's called putrefaction for days and days that's visit yeah well it said that is what happens and say hi

every single person when you chew it well and drink water does it always gets. It's generally thought that it's fiber that is the process of moving abdominal contents what to eat and I'll plan. I think they're still there's definitely controversy about 5 rare but I think the weight of the evidence Still Still. Suggested fermentable carbohydrates fiber potentially beneficial because they are very important for the microbiome and we have the young people like Justin sonnenburg at Sanford he's done a lot of good work here do we know what time you were censored the know but we also know that virtually every human population that's ever been studied had significant amount of fiber in their diet so so if they consumed the Warriors consume milk and meat and blood at certain times of year when they were you know it and other times you they did eat more plants

Santana why the wise rent lots of plans for me even Inuit the traditional Inuit you know they had during certain times a year like the winter when the ground was covered with snow they had a very low intake of plant foods but they would still trade for them and then during the summer when when they were able to collect berries and things like that they would definitely do that so at every culture that we know of that's been said he ate some combination of animal and plant Foods you know what ratio what amount you know that varies from place to place depending on where they are but that's that's what the anthropological data show me to super super cool piece of data I'll go quick there's a professor University of Pittsburgh Stephen O'Keefe who took 20 African Americans in Pittsburgh eating an inner-city not healthy diet and 20 whirl Africans in South Africa eating from the bush and larger plants and they switch them for 20 days and they measure every single thing that can measure in the microbiome in

stool metabolites tmao and all the rest your body is so amazing that 20 days on a better diet what what I would call The Royal African died a better diet the other was in incredible changes towards help making butyric acid having back to write as in prove it tell her I mean changes Andy the real African suffered American illness in terms of what you can measure within 2 weeks now there's day that I just learned yesterday in Los Angeles that I might go buy them changes in 5 days you go to a low sugar low protein plant diet this is University of Southern California I can tell you 5 days make other piercings microbiome what change would she feel better I don't know I'm just pointing out just the remarkable resiliency and that's part of the issue you can feed a human a whole lot of diets and make it through procreation which is our main purpose of evolutionary biology to beer we're talking about from procreation to death for Optimal Health longevity healthspan there's more than one path but let's not beat on our planet face

the people out there because we've shown you can reverse atherosclerosis Weaver shown you can reverse prostate cancer University of California self UCSF and we've shown you can lengthen your telomeres which may have implications for longevity so you telling me I don't think that's been published it should be an interesting project you know it takes about 3 to 6 months so you have the number didn't know it's not been looked at a diet rich in you no vegetables and fruits and animal Foods you know that the kind of benefits do it why do we have studies to tell a patient with the 99% blockage of come to me go eat meat that's PMS ago and now I have studies that show that switching from

standard American diet to neutral or diet or just as you coindesk Sarah Ballantyne and this is the idea is just plant-based with meat yeah yeah yeah it's it's a Whole Foods diet with fruits vegetables nuts and seeds some starchy plant and animal Foods when should I let Bailey out to prom with Palio's Paleolithic people didn't really like that they to Walgreens so when we meet I don't think for me for me Nutri bars a more inclusive term that just means what that what I said it doesn't mess up some new to voicemail might include some dairy products they might include some grains are legumes but what they're eating whole real foods and their including animal Foods there to distinguish sap from vegan or vegetarian in the criticism of the Paleolithic diet or calling it the Paleolithic diet that people in the pillow

arid actually did experience at least some form of Agriculture keep up there's been recent data that suggested green consumption in Lagoon consumption went back further than it was originally thought it was whether those were prominent parts of the diet or fall back Foods is another question and does that even matter I mean that this is why I've argued that the evolutionary perspective is important it's just a way of generating hypotheses kind of like observational research but I know it's not an you can't look at what our ancestors ate and say you think therefore that's what we should eat Brown you can look at it and say oh that's interesting let's test this out so how does it reverse heart disease ketogenic diet into the mirrors there's no sense that he's out there just made it to know

how does a reverse heart disease you go back to Los Angeles California 1948 dr. Lester Morrison internist it's real answer saw that in the country of Norway and World War II where they dropped her animal food consumption cause of the Nazis heart disease slowed for those two three years he said I wonder what happened to my heart patients in Los Angeles had a hundred of them there was no treatment in 1948 he put half of them on a low animal diet with very high plants that have to make like Los Angeles people hate years later 50% on the high plant low fat diet were alive 0% on The Standard Los Angeles died in the new series of people said let's start doing that more routinely ultimately they were randomized clinical studies using cath lab techniques using ultrasound tech Nature's and pet scanning this shows it actually causes small decreases the amount of plaque in your heart arteries which results in tripling a blood flow cuz it's of its fluid physiology that is for r squared so small decreases and plaque nobody ever that you could decrease

liquid diet and lifestyle but you can cause a big increasing flow So within 3-4 weeks chest pain goes away within 3-4 months trust us get better and as you keep going number two hospitalizations procedures go down dramatically to-the-point initially small studies got the big enough in 2010 Medicare said we'll pay for patients to learn how to do this reversal lifestyle they don't pay for Mediterranean diet they don't pay for DASH diet they don't pay for Paleo keto nutriv are they favored plant-based diets for advanced heart the only because these concepts of neutral bar in paleo have not been around for very long so all you said that do not study okay, can I pass a million can you do it which I agree with is that a plant a vegan or plant-based kind of diet compared to a standard American diet will reverse markers of atherosclerosis

that statement but we there's no we don't have research it's not like Studies have been done taking people from standard American to neutral or paleo and we haven't seen benefits we have our CTS have shown significant benefits in cardiovascular markers Market in neutral or diet and paleo and low carb for that matter and ketogenic said the real issues the standard American diet is killing people movie soundtrack. Evidence against so it's it's how long how long have these Concepts been around neutral or paleo how many Studies have been done looking comparing for example let's do it would be great if we had a study where you at standard American diet then you had two different groups you had our control group of standard American diet then you had you know vegan diet and then you had nutriv or paleo we don't have that study so we can't say that the eating a diet that's rich

whole foods that contain some animal Foods isn't going to reverse atherosclerosis we can't say that so I think one thing that we can absolutely agree on is that the standard American diet sucks and that a vegan diet is superior to the standard American diet these these these two things that are green and I can't do you can't eat dairy candidates can eat fish canning meat Whole Food plant-based is really the proper medical term what do you eat my face because you know you don't want to be just eating pasta all day I have Selena crying now the dispute is whether or not animal protein and organ Meats will advance your health and I make indebted to Superior diet when you add that one quarter of your plate nutrient density so I have this

play on my website San Mateo I think Milo and my friends is terrible maillot and cos / Rogen and he looked at nutrient density of a food stand in categorize them based on nutrient density and he was only looking at as he was looking at essential nutrients to all the vitamins and minerals that we absolutely need for how he wasn't looking at polyphenols in flavonoids and things like that with your beneficial but we don't absolutely need so that the number one food in terms of nutrient density do you want I guess what River Oregon Oregon score of 754 next highest shellfish 643 and I've often said this to my patients like her scale and only eat organ meats and shellfish you be doing really well because of just how nutrient-dense they are

funny too lean fish is 375 and then vegetables are 352 so that you know that are on there but organ meat shellfish fatty fish lean fish are all higher than than vegetables and no grains and legumes don't even really make the they know we're close and turned so I think that's it I think we can all agree that when someone goes from the standard American diet to the vegan diet there's a real reason why they're experiencing significant health benefits particularly if they supplement highly-processed I'm assuming they're eating a Whole Foods cookies and stuff like that unfortunately people do people do people eat the standard American diet like paleo donuts and paleo

I like it you can do it on any dietary Brush Hill Foods and was going to say you know I never have proposed except for one small subset that everybody needs to eat a completely plant-based diet but if they do they're probably going to have good help there's a concert called the Spectrum dr. Dean ornish some people beat up on but he's done all these studies and reversal bathrooms grossest and celebrate around the world has a book called the Spectrum go as far towards it as you can I love you wherever you're at you choose or not judging you and that's I think the message for your listeners I mean it what you're eating vegetables or fruit or maybe it's just vegetables every meal that's the example people need to hear and they don't need to abandon everything else just don't do it with a donut don't deal with a bagel don't do these calorie empty and also the time restricted eating I think we all agree on this and 12 hours a day I'm a big fan of for 5 days a month lowering calories with low protein low sugar now the science is coming out unbelievable it's right here from Los Angeles people and I was of you

and at one point and a vegetarian and I have friends there vegans and vegetarians again I'm not icy hot to go about this city ask who I am and so I want to say thanks to someone who is a vegetarian or vegan and just to show how nutrient-dense organ Meats in shellfish are if you wanted to be a vegan but you're not you know ideologically opposed to eating some small amount of Animal product or animal food you can eat one clam one oyster and 4 grams which is a tiny amount of liver a day and you would completely meet your needs for B12 zinc copper choline and many other nutrients with no other consumption of animal foods be on that so this is what I said before like the spectrum is large and some people might consume a higher percentage of animal food some people could see him just that much and they would still improve their health and well-being by doing that from then eating a strictly plant diet

and one thing that I do have to tell you Joel unfortunately is that you keep saying that Nick and Nate Diaz are vegan and they're not set up a bunch of times when he won the fight he was not using Kyrie Irving and Serena Williams I mean Serena Williams autoimmune disease called necessary to be plant-based to be at work last athlete obviously not is it compatible to be a you know who Patrick boobay Mendes yells world record for powerlifting then he's been plant-based his whole life big Patrick Patrick when is this big stocky German but he'll is 1200 pounds and he has the world record he hasn't even be some meat Nick Delgado nimai Delgado point is it's an option to be a super athlete

without animal products or seeing it more and more recovery we're troll on your Cuts but it happens to stop beating on us cuz we're doing pretty well

oh yeah if Diaz has gone back to eating fish and vegetables it's a whole lot better than the crap American diet they let it cut out all the animals make wait I got it got it got it completely vegan Sean O'Malley was for a while but he found himself to have much more energy when he started eating meat but he might have been he might have been doing it wrong or not sell probiotic supplementation yeah believe it and I'll buy this really cool this I figured name right now the chef that cooks for 15 Tennessee Titans any other just kicking ass and Griff Whalen used to be with the Miami Dolphins Africa where he is now Oakland Raiders have a great great tight end in such a mean it's possible that we can say Scott jurek set the world record for the Appalachian Trail faster the person eating beans I mean insane level of Apple

Fitness the Appalachian Trail fastest human to ever accomplishing on beans and pretty cool I mean this was such a amazing thing to watch a documentary should we wrap this up we obviously wish we left out on the table is still a lot of it that's disputed but I think one thing that we came to a really solid conclusion as a standard American diet sucks and any deviation from it that's a whole food based diet especially with proper nutrients that are supplemented if you're vegan or what-have-you is going to be better than standard American diet the dispute is whether or not the nutrient dense organ Meats shellfish meat fish these things would eggs that these would benefit you significantly and I think that's

go to Chris eye on or what he's doing I mean we may have this dispute about saturated fat and cholesterol that's not unimportant but he is a prime practitioner he's treating people at the right level I believe I'm doing that in Detroit in the people come to see me you know where the solution we're not the problem despite the differences and you're a good man to bring the sign in in a point on that out yourself admirably mean this is a very emotional tightly-contested sort of a dispute and I I thank you both very much for being here will thanks for the opportunity to go I mean this have the chance to do this for what almost 4 hours now that's amazing and it serves people because on most TV segments it's like 5 minutes I'm just get the headlines and there's no doubt so where you get these clickbait articles and it's confusing so thanks for giving us the chance to really dive deeply on it anybody that wants more download Chris's references go to my website the Rogan references you know we need more studying this

references you can keep yourself busy for Twitter which is on my page but attitude anyway Dr j k a h n dr. j Kahn and Chris Chris Kresser. Com Rogan for all the retards she s s e r e s s e r / Rogan and then Chris Kresser Twitter alright beautiful thank you guys thank you thank you everybody for tuning into the podcast I hope you enjoyed it and I hope you got something out of that and I certainly did thank you to our sponsors thank you to butcher box go to butcherbox.com music code Rogan at checkout to add $20 off plus free bacon to your first or order almost almost got through it

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