EPIC Talk About All Things Health and Carnivore with Dr Paul Mason, MD!

welcome to the plant free MD podcast with Dr Anthony Chaffey where we discuss diet and nutrition and how this affects health and chronic disease and show you how you can use this to optimize your health and happiness both mentally and physically hey guys just want to take a second to thank our sponsor at carnivore bar I don't promote many products because honestly all you need to be healthy is to just eat meat for those times that you're out hiking road tripping or stuck at work and you want nutritious snack that is just meat fat and salt if you want it the carnivore bar is a great option so I like this product not because it's just pure meat but also because I want the carnivore Market to thrive as well and the more we support meat only products the more meat only products that will be available in the mainstream so if this sounds like something you'd like to get behind check it out using my discount code Anthony to get 10 off which also applies to subscriptions giving you 25 uh hey everyone this is Dr Anthony chafee here again with another episode of the plant free MD and today I have a very special guest someone who I've become good friends with recently Dr Paul Mason who I've been a big fan of his work for quite some time and watching all of his YouTube and conference talk so uh Paul thank you so much for coming on thanks Anthony and can I just say look it's an absolute honor to be here and uh I'm actually a little bit in all myself because you've done some absolutely get out of town fantastic work and you're probably not going to brag about it yourself but you're a recent talk at a conference you know plants are trying to kill you just absolutely smacked it out of the park so I think that's going to be a million view video so if you guys haven't already watched it get on to it great video and uh yeah it's you know absolutely honored to be here well thanks man I appreciate it um so for for people out there that haven't come across your work can you tell us a bit about yourself and where you come from what you do but like yourself I live in Australia thank you so yeah I'm a sports and exercise medicine physician and so uh my background in terms of medicine uh I started sort of you know conventionally medical practice and then very early on in the piece I actually discovered low carbohydrate diets and I discovered the science in a an editorial in the British medical journal and at the time I was suffering metabolic syndrome which as you know is defined by five features and you know in particular I had incredibly high blood pressure and I have very high triglycerides and my HL level wasn't up to speed and you only need three of the five criteria I wasn't obese I didn't have a abdominal adiposity and as far as I know I didn't have fasting elevated fasting glucose but I never tested that but I certainly met the diagnostic criteria for having metabolic syndrome and when I came across this editorial I thought good grief this can't be true I mean this totally contradicts everything that I learned in medical school and I learned it in medical school so it must be true but the problem was it was actually authored by two doctors and scientists whom I respect greatly so Professor Timothy Knox and Professor Peter Brookner and I consider both of them friends now um which is uh you know I'm incredibly grateful for that but I sort of said well these guys aren't loonies they're sort of doyends of sports medicine and you know within our field we we understand it it's not coming from a very good evidence base so these guys have actually introduced a emoticum of science to the whole process so I went and had a look at the references and I thought oh this might there might be something there so I sort of embarked upon a personal Journey with quite frankly fantastic results and over time and I think like with many people and this is over more than 10 years that initial low carbohydrate diet has morphed into various versions of ketogenic diets Paleolithic diets and then tending towards uh you know basically a largely plant-free diet or tending towards carnivore diet so it's been an interesting journey and I'm always excited when I can chat with like-minded folk yeah well that yeah well me too I mean that was the thing too um so when did you sort of get to the point where you just stopped eating all plants all together and you just been really doing carnivore well I mean I honestly I can't remember but probably for at least four years five years I've had very little vegetable matter and it wasn't a conscious decision it was almost hedonistic desires when I say that it's like I I only wanted to eat things that I enjoyed eating and two that didn't make me feel bad afterwards and as it turned out I realized that you know when I would consume lots of cauli rice and all of these low carb Staples um it would you know it didn't agree with me it didn't sit well at least it didn't agree with my gastrointestinal tract so I sort of ended up steering away from that and over so often my wife would make a comment about oh you haven't eaten any veggies and it's like no yeah I know thanks for putting it out and even back then I didn't really have any concerns about nutrient deficiencies because I knew enough about nutrition I had done enough reading to know that all the essential nutrients that we actually needed were able to be provided by my diet at the time so in this in essence I sort of stumbled on Carnival through Hedonism that's good and um well that's good and then so you've you've done a number of uh talks at various low-carb conferences medical conferences that that um sort of specialize in this sort of alternate view uh thinking like you know Professor Knox um and um and you know Steve Finney and things like that they've all sort of they've very very hard science based um evidence-based uh conclusions but shorted to the the the tangential to traditional medicine so some of the things what are some of the things that you've discovered since you've sort of had this Awakening that you know everything you learned in medical school wasn't wasn't quite picture perfect what are some of the things that you've come through that have been uh you know probably quite controversial but you think that you know really really uh stand up well I mean if we try to the the list is too long so number one saturated fat won't kill you saturated fat uh doesn't increase LDL LDL for all intents and purposes if it's undamaged isn't inherently harmful if you restrict salt intake the way the government or the advisory panels advise us to then you could actually increase your chance of dying fiber is not an essential nutrient in actual fact it's an anti-nutrient it's the opposite of a nutrient the fact that it's not digested by definition means consuming fiber is akin to a malabsorption mild digestion disorder it just goes on and on seed oils which have been promoted polyunsaturated oils that have been promoted are healthy uh you know and not necessarily so it's not the fact that the seed oils are bad the omega-6s are bad but there's certain chemicals and constituents and oxidative properties within seed oils uh that are bad so there's just a couple of I guess the foundation pillars of the food pyramid uh so if you said well what's wrong with what we get taught about nutrition it's just the foundations yeah yeah so you know speaking about seed oils you know that's something that that generally the proponents of seed oils try to try to produce oh it's not that bad it's not that big a deal I know that you're going to have a a debate with Lane Norton in uh I think February you said and that's the plan yeah yeah and so and he's someone that that from what I understand doesn't doesn't think that seed oils are that big of a deal that actually isn't a problem so what are your thoughts on on ceto I just sort of Flesh those out a bit well the interesting thing about seed oils is that we've got research data that demonstrates them but I guess that the problem has been we've had limited mechanistic understandings or at least a widespread knowledge of the mechanistic understandings of their harm have not been well known so it comes down to a couple of key things so first of all there's uh I guess there's a common view within the low carb sphere that omega-6 fats are in inherently inflammatory and because seed oils have abundant omega-6 fats that's why they're harmful and this has been born out of associational research where we have a look at the ratio of omega-6 and omega-3 fats within people's red blood cells and other tissues of their body and we find that people with more omega-6 fats in their red blood cells do far worse on multiple parameters multiple autoimmune diseases allergic diseases so on and so forth cardiovascular disease inflammatory diseases you name it it's uh having a high level of omega-6 fats in your cells is associated with adverse outcomes but this is only associational and I personally do not believe that it's an inherent property of omega-6 fats that is harmful and I don't believe that's what's making seed oils harmful so the fact remains that omega-6 fats are essential oils without them we're not doing so good that's a very definition of essential so there's two Key properties of seed oils that makes them harmful so the first one is its tendency to oxidize so a tendency to oxidize it it's akin to the chemical process of rusting it's what happens when you have free radicals that rip electrons away from other molecules or atoms and they damage them and if you do that to a fat or a protein within the body that's going to have deleterious outcomes and we know that seed oils by virtue of their chemical structure these polyunsaturated bonds where these double bonds between two adjacent carbon atoms that is very very reactive we've also demonstrated that when you consume an oxidized oil that gets incorporated into the lipoproteins of your body things like colon microns are what most people would have heard of low density lipoprotein what is called bad cholesterol LDL and then you've got circulating oxidation products so think about it if you've got an unhealthy diet your LDL basically becomes a vehicle to carry oxidation around your circulation so that's a connection between oxidation and damage of your blood vessels and LDL is basically the vehicle for that so that's obviously not going to be a good thing so oxidation is a component of seed oils which is you know harmful but one thing that is not well understood and that's something which I'm going to hope to promote a little bit more over the coming months is something which I turn fake plant cholesterol you would have heard of plant sterols or phytosterol and these these chemicals I I think we can mount a very strong argument they they are absolutely deleterious to the human body and they are in high concentration in seed oils and vegetable oils they're in basically every plant food so we get a not insignificant contribution to our phytosterol or fake plant cholesterol load from Syria reals by virtue of how much we eat but on a grand for ground basis seed oils provide us with the with the most now the thing is this imitates cholesterol and in some cases the body can absorb it but when it absorbs it the body tries to do things with it that it would normally do that it would normally use cholesterol for but because of some molecular variation very subtle molecular variation it can't do it so it basically leads to deficient functions of things that cholesterol is normally used for now the irony is that we use these plant sterols to try and lower our body's lipoprotein levels because as you know lipoproteins contain cholesterol and if you can create defective cholesterol within the body then it's going to have trouble synthesizing low density lipoprotein or synthesizing vldl very low density lipoprotein which shrinks down into low density lipoprotein so that that's how these our cholesterol levels well you know what we call our cholesterol levels our lipoprotein levels are actually lowered with plant sterol so we often use this therapeutic to lower people's cholesterol but here's a question for you if this is such a good thing what would happen to somebody who would absorb an unusually large amount of these plant sterols they must have very good cardiovascular health because it would lower their cholesterol and it would be very good for them that if we follow this Theory through to the logical conclusion that's where we should be if plant sterols are good because they lower your LDL people who absorb more plant steriles would do better and this is in the context of the fact that most of us will only absorb about one percent of the plant sterols we consume because our body is doing its standards to try not to absorb them it's kicking them out but if you consume a bucket load NSAID oils in a standard Western diet then some is going to get through so we only absorb about one percent but some people absorb a lot more they've got a genetic change in their DNA that leads to just excess absorption of plants sterols that condition is called cytosterolemia s-i-t-o-s-t-e-r-o-l-a-e-m-i-a you can drop out that a if you're uh don't speak the queen's English now we can talk about the spelling thing between different countries later um but cytosterolemia is a condition and I quote that is associated with advanced severe premature atherosclerosis huh yeah so these plant steriles which we're giving people to prevent heart disease if you just happen to absorb more of them than is normal then you're probably going to die of a heart attack well that's a bit odd so I mean these are the kind of things that we should be looking at we should be understanding biology everybody wants to throw up oh I've done this epidemiological study and I've done that epidemiological study and they don't really have any basis for understanding root cause mechanisms so basically a lot of what they say is biologically implausible oh let's go into you know for biological implaus ability the next time you know somebody says oh you shouldn't eat saturated fat play a little game okay so why shouldn't we at saturate a fact because it will raise your LDL and ldl's bad for you okay great how does it raise my LDL and they won't have an answer there is no known plausible biological mechanism either demonstrated experimentally or even postulated by which saturated fat increases LDL levels low density lipoprotein levels and those kind of shock a lot of people and in actual fact what it is is that on a standard Western diet where you're consuming vegetable oils the plant sterols are lowering they're artificially lowering they're taking your LDL level from a healthy normal physiological level and they're lowering it and all that happens if you remove the seed oils from the diet you allow your LDL level to return to a normal physiological level so let's talk about evidence for this so we're making bold claims we need we need science how about a study from British medical journal that looked at what happened when they supplemented people with different fats and they had a look at the impact on their LDL levels so they used a coconut oil that was 96 saturated fat from memory you know the standard is about 92 but in this study I believe from memory it was 96 of that traded fat and they compared it with butter which was only 66 saturated fat so the people who consume the butter the LDL level went up moderate amount what do you think happened to the people who consume the coconut oil 96 saturated fat given that you know we know that saturated fat increases LDL well their LDL levels actually went down now the interesting thing was it wasn't really much discussion about this in the paper I actually had to go to one of the appendices to actually get the data when I'm sorry I was saying well I can see why they're keeping quiet about that because I'm sure that's not the point they're wanting to make bigger but I mean if they were genuine scientists that would have been the headline of the paper you know saturated fat does not you know 96 saturated fat in coconut oil lowers LDL I mean that's an important empirical observation that informs our understanding of science and instead it's left to people like you and me to troll through the papers and have a look at the appendices in the supplementary data to actually find where there's been a bit of mischievous reporting yeah and that's and that's the thing too like um because that that is so pervasive in our understanding as medicine as medical practitioners and just lay people but it's one of those examples of something that just gets repeated and repeated and repeated and people have heard it so many times it's just taught in medical school but nobody asks where does that come from what's the origin of it yeah well I mean the interesting thing was that I came across that when the Genesis of my lecture on fiber came about I was writing a chat book uh a chapter for a medical textbook on nutrition and as you know when you're doing writing an academic text everything needs to be referenced to the nth degree and I was low carb at this stage um but I hadn't ever looked into the science of fiber so I got the fiber and said you know recommendations yes 30 grams of fiber a day is recommended for adults here's a reference I looked at it and said well that's an advisory statement you know what I think about advisory statements not much it's like well let me go to The Advisory statement and I'll see where their references were and followed the chain back and it would always stop you could see an opinion but nowhere was the evidence actually cited and I'm like well this is odd I mean I'm I'm looking at research on Fiverr and there's a few things that are absolutely well known so yes it does increase the bulk of your feces if you ingest something that the body can't absorb at all then it's going to have to come out the other end so your thesis is going to be larger that that's obvious it's an irritant and it can increase trans at times so things can travel through your intestines quicker yes that is true but when we actually looked at it in terms of symptoms of constipation so as a doctor you don't have somebody come to you and say oh doc um just over the last few months my poops have been quite small there's no pain or bloating but they're just a bit small do you think you could just make them a bit bigger or you don't have anybody saying you know look I uh I did a a test and it's taking uh two and a half days for my contents to Transit all the way through the gastrointestinal tract do you think you could speed that up 12 or 24 hours I mean people people aren't aware of this they have no symptoms people care about pain they care about bloating they compare you know they they complain about bleeding these kind of things actual genuine symptoms that adversely impact on people's lives and when I went looking at the literature for evidence that fiber could benefit these things the the diagnostic symptoms of basically constipation we use in the clinic the data was absent and instead I found a beautiful experimental trial where they actually put people on different levels of fiber in their diets they had subjects who all had idiopathic constipation so idiopathic if you're not medically trained so idio means idiot and empathic means pathetic so it's just the diagnosed diagnostic label a doctor gives to something when we don't understand it so it's more a reflection on the doctor he'll give the diagnosis because it's basically idiopathic means I don't understand it and I really have no intention of trying to find out but anyway so these people had constipation idiopathic constipation and they were all on you know you know moderately high fiber diets so then a bunch of them were placed on even higher fiber diets and across five domains their symptoms all got worse and some of them were put on low fiber diets and their symptoms across the board generally improved and then a group of them the largest cohort were placed on zero fiber diets and in every case all symptoms of constipation were completely eliminated and to date in terms of looking at symptoms of constipation not fecal Transit rate or mass or any of these you know surrogate markers which don't mean anything to the real patient not the patients that I'm seeing but the real things like pain and bloating are zero fiber diet was hugely hugely successful so this was the case that I'm sort of writing a textbook chapter and I'm sort of thinking wow my understanding is completely been thrown on its end so I had a choice I could either ignore the science and just you know not open myself to any criticism and write it as a as I was writing it or I could say well no I just got to call it the way I see it I've got to be you know it's an academic textbook I have to be a bit scientific but typing myself up to some potentially up and some criticism but that's unfortunate you know that's what that's what the public expects us to do yeah and that's the thing too is that um you know when we're in you know in the medicine I'm sure you come across this you know on different you know surgical rotations or you know uh or just come across in the hospitals when someone has like diverticulitis or a bowel anastomoses or conservatively treated um uh appendicitis was the first thing they do they put them on a low residue diet they put them on a low to no fiber diet because this has to rest the bowel why is that I mean wouldn't that wouldn't that mean that there's inherent harm being caused by the fiber fiber was good for you if this gave benefit to your colon wouldn't that be exactly what you want in in times of stress like that yeah but and like I know you and I have talked about this before I actually did two colorectal surgery rotations as a junior doctor now the choice was because I don't like doing night shifts so I'd rather do colorectal surgery than stay awake all night um I'm just that kind of guy but the patients there actually taught me a lot and the interesting thing was looking at colostomy bags and the patients are smarter than the doctors because that figured out that if they just had low residue Foods you know meats and things like that that don't contain any fiber then their bag when it came to getting change it might have a little bit of fluid in it but it had very very little fecal matter because everything they were eating was able to be digested and assimilated into their body whereas the fiber and they said if you if they had a lot of vegetable and fruits and vegetables then their bag would be overflowing and this is really speaks to the LIE where you have these uh activists who say oh don't eat meat it will putrify in your stomach and the exact opposite is true so um basically rotting under the action of bacteria that's what fiber does that's what foods that are non-male digested do if you're consuming something like meat and you've got a hyper acidic stomach that can help break it down and you'll absorb it all then there's going to be very very little residue that will come out of your gastrointestinal tract and a lot of people when they go to a meat heavy diet report to me I've I've just got incredibly little amount of fecal matter a very little fecal bulk and you know so it actually was much nicer for the patients with the colostomy bag so colostomy bag is basically where you've had bowel surgery and you redirect the intestine coming out through the abdominal wall and so people on a low residue diet they have much more pleasant experience changing their colostomy bags yeah and that um that was on my size well there was this study a while ago they were looking at protein absorption from different different sources or plant sources and animal sources and they found that like by sending people with classmates they're feeding different things and just study the contents of the class me back very little of the of the animal-based protein was actually getting into the classmate bag were quite a large proportion of the you know plant proteins yeah in there as well and that yeah I have seen that study and uh it's interesting that when you tweet something like that out you get a lot of haters yeah of course you do yeah because well because we're supposed to be eating plants for her before didn't you know we have flat teeth like a cow well the whole interesting thing is I read a paper that was promoting uh insect protein recently so all pathogens and these things aside which is a gonna be a huge problem to overcome um they were actually comparing uh insect protein favorably saying it's just as well absorbed as plant proteins oh you adjust it wow and I'm it was fantastic I'm saying well you know if you set the bar low enough anything looks good right yeah I mean it's just as just as absorbable as asphalt if not more so you know like I mean it's even better than this horrible thing and it doesn't work well you know that's that's funny there was um it was actually funny Once I saw years ago there was a study that China did yeah just subjected their college students to because you can in a totalitarian dictatorship and they just put these college students on just crickets and they're like yeah you're just going to eat like crickets or grasshoppers that's all you're going to eat and they they've made them just eat these things and they just want to see what happened they were they were convinced that this was going to make them actually very sick and they thought oh this would be fun let's watch a lot of people die and um and and in fact they found the opposite they found the people actually getting much more healthy and you know their academic scores were going up their their body happiness was improving basically they were putting them on a carnivore diet but just you know the bug version of it and it was this was actually so much better than just like the traditional sort of diet that you know these people with health uh were improving but I thought but it was funny though because you could you could tell by reading it that they were actually hoping for the opposite expecting the opposite to happen like they were going to have very poor health outcomes but they end up panicking actually uh these benefits that's fascinating to be honest I haven't looked into the nutrition of crickets but I wonder what the nutrient profile is across the board well I think it'd be high protein probably less fat I mean I guess when I'm talking about protein food and I think we miss a trick I think we need to be doing what Nina Tai Schultz is saying and not talking about Foods as proteins or not because whenever you have a food that's naturally high in protein it's also naturally high in nutrients we're talking about the micronutrients so your vitamins and minerals yeah and so basically if you've got a piece of any natural food that's high in protein is largely also going to be quite high in you know it's going to be good for you but the question is with crickets I I don't know and I've never looked into it but I'd be curious to know uh what level of nutrients they actually have across the board and yeah we know for example that you know when will taught in medical school that a healthy adult should have five years of B12 stores within the liver so you've got a long a large reservoir of that and you can go for a long time on it a B12 deficient Diet before you'll actually become sick with the symptoms of B12 deficiency so you know whether or not you can do the cricket diet for a short period of time and then your reserves will be depleted or whether it's sustainable it would be it would be interesting because you know you think about it it is an animal it's a whole being and so it's going to have I think it would I certainly I think well it's an insect I wouldn't call it an animal well technically it's a kingdom Animalia right so but uh but it's uh no but it's not like a big one but but I would imagine that they would have more bioavailable nutrients than obviously any sort of plant material but oh yeah absolutely yeah yeah yeah and so yeah it would be interesting I don't know if this is going to be Complete Nutrition I wouldn't even Hazard a guess but um but uh well I would get I would guess not no yeah but it's an interesting study bloody interesting study it is yeah and and well that's also the thing too is like you it's always compared to what right you know they're eating a bunch of rice and low protein low-fat sort of foods low animal low animal Source nutrition and now you're getting you know the opposite and maybe that's not as good it's certainly not going to be as good as a steak presumably but at the same time it's going to be comparatively better to from where they were before yeah yeah and um yeah and there was also there was also study I think it was like they looked at like going back to the fiber thing there's like 2 000 um colonoscopies that they did and they looked at all the different sort of factors that that went into uh diverticulosis and they looked at you know meat consumption fat consumption constipation and fiber numbers of bowel motions all these different parameters they found the only things that correlated with uh the development of diverticulosis were increased fiber consumption and increased number of bowel motions a day and they found it was actually sort of uh six seven hundred percent increase correlation between those constipation did not you know a traditional hard you know you know uh on the Bristol stool chart uh constipation well I'm surprised there wasn't an inverse relationship between fiber consumption and constipation the the way I explained in my lecture is like so you've got the anal sphincter it's a small hole now the solution if you're trying to pass something through a small hole the solution isn't to make it bigger yeah yeah you know if you've got if you've got an arterial Road a main arterial Road and you've got a traffic jam you don't help the traffic flow by adding more cars yeah well I think it does I mean I think that this this study didn't look into that in particular but like I mean you certainly see this you know you you get like neurogenic uh colons and things like that you know people on a bunch of medications and they get just these big um intestinal obstructions there's just lots of wood really you know there's just like a ton of fiber and they get dried out and they just have this huge you know mass and uh and they can't go anywhere you know and if you're wondering what causes diverticuli so there's a little bulgings out of the colon I mean we just know from physics that if you double the radius you know that then the pressure's increased by that to the power of four I think so it's uh the wall stresses it when you start to increase the diameter of whatever is transiting through the colon there is a massive increase in wall pressures so it's very likely that these uh diverticulate the the out pouchings uh uh basically subject a cause of mechanical stress yeah and like I sort of think of it in the same way as like heart disease you know where you have you're working against this high pressure gradient for years and years and years and years and then the organ just eventually fails you know you get left heart failure and I sort of think of that with with this study would sort of demonstrate that that you're overworking the colon you're you're you're I mean it's massive you know increasingly diameter increasing the amount of bulk that they have to pass through and also increasing the number and frequency of it a day and you just sort of you just run out of juice in these and the this organ just fails that's why I sort of think of it as as colon failure you know is similar to uh heart failure well I think just also look I don't know if I'd yeah totally agree with that but I think one thing that we Overlook with the intestines and this is where inflammatory bowel disease is so important especially on a carnivore style diet is that we have functions such as processing of fructose and synthesis of HDL cholesterol that occurs in the intestines so we often see people with a you know a poor HDL level and we we want to blame saturated fat and so on and so forth but if you're having trouble synthesizing HDL you need to understand well some are very synthesized in the intestines and if you've got inflammatory bowel disease that can impact on the intestinal function also fructose absorption so I have incorrectly in previous lectures I've sort of been parroting the Mantra that we understood at the time that fructose basically you know had no no safety margin for consumption within the body we had no capacity to store it as glycogen as we do with glucose and so on and so forth but as it turns out the intestines can actually process metabolize fructose for us so and I think that's one of the significant reasons why when people go on a strict Elimination Diet which would be an all meat diet and they improve their gastrointestinal Health we often see there's significant improvements in metabolic Health occurring coincidentally so it's impossible to tease them apart so you know I track hundreds of patients results and we often see that when the inflammatory markers are proving their metabolic markers are improving at the same rate nice oh sorry yeah so I think there's just a whole lot more to the intestinal function that we we don't understand so I don't know if you've ever you know gotten into the encryptin effect the Gip and glp1 these are absolutely fascinating and these are actually basically they're called incretins they're basically little signaling hormones that have more impact on insulin release than blood sugar levels themselves and bile acid for example is one of the factors that leads to a strong it it travels down the gastrointestinal tract and you've got receptors in the distal small intestine that will stimulate the release of glucagon like peptide and it's basically a balance you've got a gip1 proximilian GL Gip sorry proximilian glp1 more distally and if you're consuming something that is incredibly readily digested or broken down rapidly then it can it's simulate the early one but not stimulate the later one and the later one is actually what is better for metabolic health and interestingly when you're looking at these weight loss injections that have taken the World by storm at the moment they're basically glp1 analog so basically imitating the action of glp one which is basically what a uh a good ketogenic diet should do is exactly the same mechanism so you can pay a lot of money for an injection that isn't available anyway or you can just eat healthy but I think where there's a lot more that we're going to learn in coming years about the gastrointestinal functions and how that relates to metabolic health and cardiovascular health yeah it sounds like it I mean we're really I mean even just like the microbiome and all the different sorts of you know functionalities that were just well I'm skeptical on the microbiome I think that's a I think that's a lot of noise and a lot of science at the moment I think we've just gone far ahead of time so I mean what we do know we've got Decades of data on patients who have been on ketogenic diets with epilepsy so when they analyze their microbiome they show we we separate the microbiome into two phyla so we've got the backroad deities and the ferment cuties and we know that there's a prominent I believe there's a predominance now that I haven't looked at this in some time at the backroad deities is actually greater in people with good metabolic Health it also happens to be greater on people on ketogenic diets because basically your microbiome eats what you eat and we know that bacteria Thrive and survive on their preferred nutrient so when you consume a particular kind of nutrient that's going to feed a particular kind of bacteria and as you know bacteria proliferate and they divide and double incredibly rapidly so we've done studies on microbiomes where they today we'll take a sample tonight you eat this meal that you don't normally eat will change your diet 24 hours later we'll take the microbiome again it will be completely different so people are thinking it's so causative but what it is it's actually associational so a particular microbiome just reflects your metabolic health because the microbiome changes with your diet there's some other brilliant examples I don't know if you've heard of trehalose it's an artificial sweetener that is put into Dairy because of its impact on freezing point now I'm a little sketch on the exact dates but about the year 2000 uh the Japanese scientists actually managed to refine a process which it could be produced on an industrial scale and then it progressively began to get introduced into Food Supplies around the world so it's in frozen dairy so things like ice cream and frozen yogurts now if you understand that some bacteria prefers to eat certain foods there's one particular kind of bacteria called Clostridium difficile that's got a particular it's particularly fond of treholos now this is the bacteria that leads to a condition called pseudomembranous colitis which is a life-threatening it's one of the one of the emergencies that we have in gastrointestinal diseases that will kill you and kill you quickly and there's ever since trehalos was introduced into the food supply there's been whatever country it's been introduced into that's been followed by an epidemic of this condition pseudomemembranous colitis related to this bug the Clostridium difficile blood just simply liking the fact that it could eat a lot of the you know it eats treholos very nicely another example is that um if you've ever looked at the research on probiotics for treating or preventing travelers diarrhea so I've just told you that you know if you don't feed the bugs in your gut their preferred diet then they'll die so when you take these uh probiotics these are basically bugs the only way they've been shown to work in preventing traveler's diarrhea is if you constantly consume them at quite high dose regularly because otherwise the population is just displaced it dies out and when it's gone then it can no longer displace a pathogenic bacteria so I first came across the study several years ago there's a condition called necrotizing enterocolitis which is a life-threatening illness infection of the intestines that often affects premature infants newborn infants and they did a study in India and they came up with a probiotic that they hoped a bacteria that was not dangerous that they hope would prevent these dangerous bacteria getting a foothold and they found that when they gave the babies this uh this probiotic by itself it didn't prevent necrotizing enterocolitis so then they came up with a concept well that was smart they said well it's because we need to we need to feed the bacteria what it needs so it can go in a foothold so they developed they came up with a term called a symbiotic for Synergy where they also provided a a carbohydrate I believe it was a sugar that that particular bacteria would like to consume and they gave it as a combination and when they gave it as a combination it was very effective so you have to understand that you know even if you consume a probiotic uh if you're not feeding it it's particular food stuffs it's just going to die off and the other bacteria are going to take its place now in some cases there may be a role you know fecal microbiota transplants and stuff like that is an interesting area but by and large the science of probiotics is a long way behind what the claims are being made I'll I'll just give you some an example so a pharmacist a friend of mine so these are you know you go into the chemist and you'll see you've got these refrigerators full of all their refrigerated probiotics so they're obviously the good ones because they need to be kept cold they said to me actually that's nothing but a marketing stunt he said there's no reason they're all freeze-dried there's no reason why it actually needs to be kept refrigerated we just do that for marketing I'm like you're kidding right I haven't read it nobody's obviously going to publish any papers on that so I can't attest to the absolute veracity of that but certainly that was what he was led to believe by the uh the company the the salespeople of the company and uh I've probably just got one more story on the abuse of science with probiotics um just have to be a little bit careful about exactly how much I say but let that well we don't give any brand names or anything away um but there is a probiotic that is very popular and it's it's a million multi-million dollar market for treating and preventing inflammatory bowel disease it's a very it's a propriety blend anybody who's ever any doctor would has worked in gastrointestinal health will know about it and it's quite expensive now the interesting thing is that the study on which this propriety blend of probiotics has been shown to be beneficial I think had six participants so a friend of mine who I shouldn't name did some research he teamed up with the company here they gave him product and he did some a larger scale study on the efficacy of this supplement and he found it was worthless it didn't do anything at all when he went to publish he was threatened with legal action to date this data has never seen the light of day there's still thousands of people out there every day consuming this probiotic thinking that it's doing good for them on the basis of a study of six participants when there's better better research out there that has been hidden I actually I actually heard about that I ran into uh with the person you're talking about at um yeah yes yes yeah and he actually he told me about that and we'll keep everyone on uh quiet but it was it was I believe it was at least one of the institutions here in Perth and um and they had all the data and so apparently the abstract is still available so you can you can find the abstract but everything else is uh is gone it's hidden so it can't be published but the abstract is available online and uh yeah that's that's wild and like yeah they they found the public has no idea The Wider public has no idea how the scientific process is abused in medicine to tell the narrative that that large forces want to be want to have told yeah no it's it's really really bad and I and then even when you you do have real research going out you have the The Waters muddied by a lot of this industry research that that puts out a bunch of you know conflicting data out there and then you say oh well you know on balance I mean there's 30 studies that say this is good for you 30 studies that say is bad for you like oh what do you know I guess we just need some more studies like no if you stop to you know if if every you know all 30 of the you know the good for you studies come from the company trying to sell you the product you know you have to be a little suspect and all the other ones say that it's bad for you you know I think I know what I'm gonna just like err on the side of caution of and um no but it is very bad and that's the problem is because people I think that's the thing is just people just aren't cynical enough these days they just they just really have this faith in humanity that everyone just wants the best for everyone it's just it simply isn't true and you know people are out for their own interests and and you and if you understand that you understand how human nature works then you can survive and everyone can can be happy in that but you need to protect yourself as well well many of my patients will attest that what I'd like to tell them is that nobody cares about you more than you and that's a simple fact and that even Mia said Doctor I have conflicts of interest and they're not always visible and I try to be honest about them but generally that my conflicts of interest uh hinge around uh you know what what could uh you know be considered reasonable medicine and basically me covering myself so I I draw a very fine line I don't tell people what they should do when it goes against guidelines but I will educate the most of the science so I think if I'm presenting the patient with peer-reviewed science I think I'm On Solid ground but at the end of the day so uh up in you know often say people want to have a firm recommendation you know do I need to take this that nor do I not need to take the Statin obviously that's going to put me on a medical legally you know thin ice sometimes if we say stop taking the Statin and a cardiologist an expert cardiologist told them to take the standard so I won't do that but also say well nobody cares about you more than you you're going to have to make up the own decision it's called informed consent let me show you the evidence this is the evidence of benefit this is the evidence of Harms now you make the decision yeah yeah which is all you can do um I've spoken to people as well uh just because obviously you have a lot of people reach out to you on online and everything uh in this in this whole space and there are a number of people who have basically said to the Cardiology I don't really feel comfortable taking the Statin and the cardiologist says if you don't take the stat and you don't get to see me anymore like I won't treat your other conditions your other cardiac conditions if you don't take this drug which I think is is a bit uh on the on the level of extortion really well have you um as you know uh I co-authored a paper recently on the benefit of statins with uh David Diamond and Ben Beckman and that's actually been incredibly well received um it's had something over 50 000 downloads it's in the top one percent of papers ever published in terms of views and it's uh so check it out if you it's uh just look up uh yeah anyway Google David Diamond Ben bickman Paul Mason and statins and you'll come up with that paper it's open access so free to download but what we actually did we analyzed the data of the Statin trial so first of all let's make something clear so we've got two types of uh indications for Statin therapy one's primary prevention one Statin secondary prevention primary prevention primary number one it means you want to stop having the first heart attack so there is no compelling evidence that statins are beneficial if you've never had a heart attack full stop so let's just throw that out to one side there's just it's not even worth going there that's out that's gone number two secondary prevention you've had a you've got cardiac disease already or you've had an event or so on and so forth so we're looking at reducing harms so this is where the story gets a bit murkier so when we when we analyzed well there's other papers that had already done the analysis we just uh you know collated a few together and presented them all as one and they actually looked at the benefit of statins for secondary prevention with reference to triglyceride and HDL levels and what you actually found is that the any measurable benefit of statins basically diminished to the point of insignificance if you had a good triglyceride and HDL level and so people on low carbohydrate diets we know that the the trend for their triglycerides in HDL is towards one of improvement the triglycerides will go down the HDL will go up so in essence what our paper says that if you have a typical lipid response on a low carbohydrate diet which may mean that your LDL goes up because you're not having these fake plant cholesterols but you should also have a lowering of your triglycerides and an elevation of your HDL and if you've got that Trifecta the findings and you end up with a good triglyceride to HCL ratio then there's no substantive evidence that even if you've had a heart attack before secondary prevention that you'll derive a mortality benefit from consuming statins now we actually put this paper so I was actually invited to to contribute to this paper by David and he basically had a lot of the science and I said well look what what we really need to do there's a lot of clinicians out there who want to stop their patients statins but they feel threatened they don't feel that they can do that and I know this for a fact because I get questions I get emails I get phone calls from these doctors all the time asking what can I do what should I do so by publishing this paper it's got over 270 odd references it's very well researched it's something that we're very proud of and it very clearly presents the data and I've actually given uh some cardiologists and lipidologists the chance to rebut any points that we've made in the paper and basically they have chickened off so Ethan Weiss was one who was making a lot of noise earlier and unfortunately he felt it was unreasonable that he actually read the paper before we debate it so he he felt that my that unreasonable request was a deal breaker um so anyway but uh but that's that's the interesting thing he's actually commented on a paper that he refuses to read yeah uh if that's not the height you know of audacity I don't know what is yeah and and uh just willful ignorance I mean how do you how do you comment on something that you don't even know about you know as um John story Mill said if you only know your side of the argument then you don't know much because if you haven't heard it in its most uh persuasive form from the horse's mouth not you know from someone else giving a straw man uh depiction of it but from the from you know the mouth of Paul Mason himself the author of the study you know you don't even know what the argument is you don't even know what this paper is saying so how can you comment on it if you don't even you don't even know the claims of the study how can you comment on it uh to be honest I was a bit disappointed I was actually quite looking forward to it um but anyway I'm sure if there's any cardiologists or lipidologists out there who want to have a discussion you know and I'm not talking about some of those crazies who live in mum's basement I'm talking about people who you know know medicine um yeah let's uh let's talk yeah absolutely um I'm just gonna pause for two seconds okay so just to sort of switch gears here um there's been a prevalence of increased depression anxiety over the years and a lot of people are finding that switching diets even to keto but especially carnivores found that they've uh significantly improved their symptoms um what can you tell us about about like depression even the causes of depression well I think that inflammation plays a key role so I I'm sure you've all seen the research that when people get an acute viral illness they also suffer short-term depression and I actually think that this comes directly back to neurotransmitter synthesis now I know that there was a recent systematic review that said oh the neurotransmitter hypothesis of mood disturbance is wrong I had a look at that no I wasn't 100 convinced I still think there is some evidence that neurotransmitter problems actually underlie a lot of mental illness what I'm not convinced of is that the drug company has the solution so the way I think about it is that we've got the the major neurotransmitters are what we call the cuticle manager neurotransmitters dopamine serotonin and noradrenaline and their synthesis uh you know in States of depression and a few other things and we have actually seen that there can be lower levels of those within the cerego spinal fluid the thing is they're lower because there's a problem with the production and the drug companies don't offer you a solution to producing more what they do is they say we've got a drug that slows the removal of those neurotransmitters from the brain it just slows it down so if you've got a a little bit of this in your brain that'll just mean that it hangs around for a little bit longer and if you're thinking about it if you've got a major deficit of neurotransmitters and you're just sort of slowing down the the breakdown of one of them how much impact is that going to have and most people would say yeah not much and that's probably true because when we look at the data on the absolute efficacy of antidepressant medication it's quite underwhelming like it's marginal at best I think you'd say that if antidepressants do have a benefit it's a marginal benefit and the reason for that is likely to be logical because if the underlying group course if the problem is deficient production of neurotransmitters then what's you know just inhibited inhibiting their outtake Inhibitors you know which is going to make it last a bit longer it's not gonna fix the problem so you might ask well you know you you're out on a limb here because everybody else says that either neurotransmitters don't matter or you know where's your proof for this so the one of the first papers I came across that actually gave me a definitive basis for this theory was done in the 1980s and it was on people with celiac disease and they actually did lumbar punches they sampled the cerebus vinyl fill with the fluid that circulates around the brain and they're measured neurotransmitter levels within that and they actually found that for people with celiac disease when they consumed gluten the level of serotonin in their brain fluid actually fell and when they eliminated gluten from their diet it increased so we actually do have definitive evidence that dietary change impacts on the level of neurotransmitters within brain fluid so I think well that's a pretty good place to start and then what is there any other mechanisms can we get any other biological understanding uh underlying these so the thing about the catacolomonergic neurotransmitters is that you know that they they come from an amino acid so tryptophan and they they have quite a complex biochemical pathway before they end up into their neurotransmitters at the end and there's a number of cofactors that are necessary so for example you need iron and in a state of iron deficiency that is therefore predictably biochemistry says if you don't have enough iron then your catacombin and cut a column energy neurotransmitter synthesis is going to be impaired so does this potentially relate back to the guy with man flu who wakes up like an angry bear in the morning uh absolutely it does so there's a condition we call it nutritional immunity and it was first coined in about 1975 but nobody's ever heard of it but it's an exceptionally important concept and it goes back to the heart of this so it comes down to the fact that most any pathogen that can infect us needs iron and our body is a buffet of iron we've got iron circulating around in our blood wonderful lady dark so any pathogen that invades our circulation we've just got iron on tap so it is a protective mechanism that we have our immune systems have that whenever we get an infection that we reduce our circulating levels of iron and we'd reduce it rapidly so we've got what we we can measure iron free iron in the in circulating around in our blood and we've done studies where we inject people with inflammatory chemicals lipopolysaccharides and we can get a reduction in circulating iron in the order of 50 within two hours following that so this is a robust response that we have to inflammatory marker so if we just take iron out of our circulation though sure we starve bacteria yep that's fair so where does it go so we've got a storage form of iron called ferritin we're stored in ferritin molecules so what actually happens is that when you get inflamed the amount of iron circulated around in your blood will reduce and your amount of stored iron will go up now the average doctor will do a blood test and say oh your ferritin levels are super high you've got heaps of iron you don't have an iron deficiency but that's only half the story so you don't have an absolute iron efficiency you've got enough iron there but the question is can your body access it so with an inflammatory signal it basically means that you're channeling all the iron into storage but you're not letting any come out it's what we call a functional deficiency so in the state of inflammation when you say you get this virus you get the man flu you end up with a functional line deficiency and that's going to impair your ability to synthesize neurotransmitters so I think this elegantly explains the the concept that we see of why you know you get depressed when you get a viral illness or indeed any other short-term illness and this is just a preserved response of our immune system because it actually by restricting the excess of pathogens to iron it makes it easier for our immune system to eradicate those pathogens unfortunately all the biochemical processes which require iron are then going to be deficient and that includes transmitter synthesis it also includes energy production through the mitochondria we know that the a lot of the the functions within the electron transport chain within the mitochondria are dependent on iron so you'll have less mitochondrial efficiency less so we know for example at work in sports medicine that we don't want to put an athlete out on the park who's got a systemic illness because they're just not going to perform it's you know it's for The Athlete's benefit and also to the team's detriment if you've got that athlete out there because you're better off getting a reserve in who's healthy who's going to we're going to be fresh and going to be able to perform at their capacity and I'm sure you know as a ex-professional rugby player you'll found that in the past when you've had a viral illness you just haven't you know you repeat efforts the maximum if it's the anaerobic you know ability that you've had on the field is going to be necessarily harmed and deficient yeah it does I was uh you know when I was eating sort of normal diet I was I was sick all the time I was I would get like a cold like every single month I would get pneumonia two or three times a year because I had like and then and when you got the cold your performance would suffer it would but at the same time I was sort of used to it because I was always sick and so like you know my my performance was just always like my me playing sick was sort of uh was was sort of the norm and so it was just like I was well then it was like oh then it was just like outrageous what I was able to do but yeah no it absolutely makes it makes a huge difference but then let's talk about the difference between infectious inflammation and autoimmune inflammation so everybody throws this word around inflammation like they know what it means but in actual fact very few people actually get a sense of what it is it's basically a response of the body that will help it clear an infection because when we say autoimmune inflammation that means the body is attacking itself but that is an abnormal response and the body is responding with the same chemicals the same cytokines the same signaling molecules that it would use if you actually had an infection so the body is it basically assumes almost that you've got an infection it's attacking itself it's a case of molecular mimicry and we can talk exactly about what autoimmune diseases are later but let's just say when you've got a chronic inflammation so rather than having a cold that you you feel crap for a week and you feel a bit depressed and then you get over it and your mood comes back when you have autoimmune inflammation that hangs around for months or years at a time and that can then lead to long-term depression of your mood and this is why we see these people will report profound improvements when they go on Carnivore style diets um with respect to their mood and that's because once you eliminate the underlying inflammation and they're probably treating background autoimmune diseases that they often may not know that they had um you know their body then is able to synthesize these neurotransmitters it might have been that they were deficient in B12 or zinc which are two other nutrients required for catacolom energy neurotransmitter synthesis it might be that they're freeing up their iron stores and that the iron is released from the ferritin it might be that they've actually just got enough iron into the body they might have had an absolute whatever it is but there's multiple Pathways by which your mood can improve on a carnivore style diet but one thing that really struck me and I'm sure you've heard it before is that people say that their relationship with food when they transition from a low carb or a ketogenic diet to a carnivore style diet improves immensely because a lot of people so that the Paradigm is calories in calories out you just got to eat less and exercise more and the fact is a lot of people try that and they end up with borderline Eating Disorders because basically disordered eating behavior is the only way that you can maintain a slim physique on a standard High carbohydrate diet you have to restrict you have to purge you have to over exercise you have to go without you you can't eat until you're full it's just a it leads to a terrible relationship with food one that's predicated on guilt and shame so and then people go to a carnivore diet and they say that they just change this they no longer have this absurd craving for food or they they no longer you know have to whiten the clip and when they see a chocolate brownie or something like that and I believe the reason largely comes down to the level of neurotransmitters within the brain so dopamine is a neurotransmitter that's involved in the reward pathway it reinforces behavior and it makes you feel good and in actual fact the survival of the human species is predicated on dopamine so there's two behaviors that we need to engage in as a species otherwise with it we need to eat and we need to procreate and both those behaviors release dopamine into the mesialympic pathway in their brain and they're reinforcing we we release dopamine we eat something you know or you know we engage in relations and we get dopamine and say hey that was nice we might do it again and that's the dopamine is a chemical driver by which the human species actually is allowed to survive now what happens though so you can think about it that you are hardwired to chase dopamine that's a fact what happens if you've got chronic inflammation and your level of dopamine synthesis is deficient you're living in a gray cloud but you're hardwired to chase dopamine that means the desire to change dope to to get a squirt of dopamine into your main limbic pathway is going to be almost impossible to resist and in modern society how do you do that how do you squirt dopamine you know living in Australia 2022 how do you squirt dopamine into your brain you eat something sweet you eat some food that you should not eat so this is the the premise of binge eating the premise of food cravings I believe largely it makes sense that it's an effective or a relative dopamine deficiency and I've have dozens of patients who tell me that once they got on top of their inflammation they went on a proper Elimination Diet they figured out what the problem was that they could they didn't have urges to food they didn't have to White Knuckle it they didn't they no longer had to you know live in guilt and shame that the problem is that uh you know you have craving and then you give into that craving because that's a biological desire that you you simply can't beat and then they'd feel terrible afterwards they felt that they'd done the wrong thing that's an awful way to live and there's so many people who seemingly uh get their lives back they get a sense of control back once they deal with it and then um and that's some certainly something that um we also seen some of some of the data like um Georgia Eid published a paper a couple months ago just looking at just keto not even not even full carnivore with uh psychiatric patients with intractable conditions uh refractory to to Medical interventions uh major depression uh OCD bipolar and even schizoaffective disorder and they found that these people who medications had failed all improved with these dietary changes every single month well and there's other there's other Realms to that as well I mean the ketogenic diet so we know that insulin resistance is a genuine problem in the brain so what does insulin resistance mean well it means that the brain can't take up sugar the way it used to so we know that one of the substrates one of the fuels for the brain is glucose and unfortunately uh you know given its label is now type 3 diabetes for example with dementia we know that as you get older the the brain becomes less efficient at taking up glucose so there's parts of the brain in particular that becomes starved of energy they just don't function that well but the good news is that ketones can serve as an adequate substrate for this so ketones absolutely fantastic they can cross a blood brain barrier they can actually then be reconstituted because fatty acids can't cross the blood brain barrier so if you're trying to build neural tissue or build new connections on and so forth you actually need to have ketones in there to do that by the way so you have ketones they can actually provide the brain with energy when glucose cannot and we've actually got lovely pet studies positron emission technology studies where we actually use labor glucose and labeled ketones and actually see the level of uptake in the brain and you basically see that in a demented patient there's huge tracts of the brain that are just not active that it's basically waste tissue and when you get them in ketosis that the brain just comes alive again and there's plenty of studies that show that even giving people Ketone drinks you'll get a very short-term increase in cognitive function I don't recommend Ketone supplements I think nothing beats lifestyle but I mean there's absolute you know no doubt and I'm sure that providing some of those regions of the brain with more energy through ketones no doubt that would also facilitate neurotransmitter synthesis so it's a combined effect but absolutely the ketogenic diets uh you know for all manner of diseases relating to the brain you know not a bad thing at all yeah yeah definitely um so sort of uh talking about the sort of the Practical aspect of this you know even going on a carnivore diet some people can have different problems especially with like autoimmune issues and things like that uh what are some of the carnivore foods that actually can be problematic yeah so I mean this is a huge topic Anthony so I mean the simple fact is like this is not an ideology people think oh you're you know you sometimes you recommend a carnivore diet for a patient it's an ideology of anti-vegan agenda and that that's a slight of crap it's absolutely nothing of the sort so it comes down to science and what a lot of people on Carnival diet get really upset at well not really upset but they get surprised at and maybe a bit disappointed a little bit sad is that when I say there's a bunch of foods that are commonly consumed on a carnivore diet that is also pro-inflammatory so just because something is an animal food does not automatically make it safe for everyone or does not make it healthy or non-inflammatory for everyone so my favorite study to illustrate this point well the most favorite condition is something called eosinophilic esophagitis now this is based on the premise that this is we use this as a model of inflammatory bowel disease and as you know the inflammatory bowel disease is a a condition a type of a condition affecting the gastrointestinal tract that significantly increases the risk of most every other autoimmune disease misery loves company if you've got inflammatory bowel disease um we won't go through the mechanism right now but your risk of developing other autoimmune diseases using increased greatly so the principle is that if you've got this so sorry I've lost my train of thought there I've got two Avenues which way were we going uh so we're talking about um you were talking about uh different pro-inflammatory uh oh yes yes yes yeah so e is anaphylic esophagitis so we'll come back so here's anaphylic esophagitis is a form of inflammatory bowel disease but it's lovely because we can actually biopsy it so we can stick a camera down your throat take a small sample of tissue and have a look at it and we can say yes that's inflamed you've got all these inflammatory cells now eosinophils is a type of white blood cell we've got five different types of white blood cells and we don't usually appreciate the fact that autoimmune disease can be impacted by probably all five types but we can measure ears and affils and we can assess this inflammatory bowel disease and we can assess the progress much easier or this inflammatory esophageal disease much easier than we can the traditional Crohn's disease and even ulcerative colitis and we've got some empirical studies where they said well what happens if we just cut out these Foods there's a certain set of foods and they call it the six foot Elimination Diet and confusingly different Studies have slightly different set of six different foods but that's all right but I mean they're generally the same and one study demonstrated that when you put people on the six food Elimination Diet about 73 about three quarters of them actually induced and sustained a prolonged remission of the disease basically I don't know if you could call it a cure but remission is pretty much the disease activity was not detected just by cutting out these six Foods so then the question is what God's green earth were these six foods and I'm afraid to say that it included Dairy very provocative especially milk eggs fish Seafood nuts and saves which would include coffee now I know for a fact that a number of the cannibal patients that come to see me are consuming at least some of those Foods and when when I mentioned that and they're usually in chalk now we can do a blood test something called ears in a field catonic protein which is a blood marker for the the basically the immune activation of eosinophils and this is a very good metric that we can measure in the blood that tends to respond to diet quite well so what we usually do we usually go through an experiment and we we measure the level of is in a full catatonic protein we trial some eliminations and we we see what we can get to improve it but then the question is well once you've cut out all of those Foods that's a damn restrictive diet do you need to stay on a diet that restrictive and the answer is probably not so about a third of subjects in the study who went into remission risks were reactive to at least three different foods another third were reactive to two Foods and another third was only reactive to a single food so what that shows you is that on average people are reactive to at least two different foods so that means a singular Elimination Diet is not going to cut it so if you're just going to say I'm going to cut out these Foods one at a time then on the balance of probability you'll still be consuming your food that is causing some inflammation and you'll probably also be consuming that food in a higher proportion so you may very well not be able to visualize the improvements in your ears and feel like cationic protein level inflammatory markers or your symptoms that you'd expect so the reality is that if you're testing for these then you need to eliminate all of the items at once and then do singular reintroductions back over time and so that's usually what we do and it's interesting that for most people Dairy is actually the worst and this is a tragedy because this is a staple of people on ketogenic diets for a long time and I also think it the singular most common reason why there's some people who do badly on ketogenic diets and we can't deny that within it while on average we can say that people on a low carb ketogenic diet are healthier yet that is true on average but there is absolutely individuals who don't do so well and I have no doubt that there is a a major reason for that I'll take you back to a study that they did um the English the the colonial English out of the the nature their good-natured hearts they were looking after the uh the health of the tribes people in uh in Africa and I think the article was focused on economic productivity so I'm obviously being very sarcastic there and but they basically said well look the health of the natives is not as good as would like it to be we think we can improve their economic productivity maybe nutrition has something to do with it so this was done back in the 20s and 30s and I actually got a couple of it's not indexed online for obvious reasons it's a bit odd but I've managed to get copy of the paper and they actually had two tribes one called the akakuyu and one called the Maasai now these trials were in adjacent areas akakuyu were largely vegetarian and the Maasai at least a Warrior age males would only consume meat and dairy so this is a perfect natural study and also because they are adjacent territories they would intermix with marriage so the genetics were very similar so we would argue that the difference between the tribes is caused by nurture not by Nature it's caused by lifestyle not by genetics and what they actually found that in almost every parameter the Warrior age massage consuming and exclusively meat and milk diet we're far healthier they had less rates of diabetes or something like five inches taller fifty percent stronger so that uh hand grip dynamometry so 50 stronger so they were just more robust they had less joint deformity so on and so forth but there was one notable area where it was often say catastrophic but they were quite poor and that was autoimmune arthritis inflammatory arthritis where their immune system was attacking their joints so back then they couldn't test for a lot of different antibodies that these products that the immune system produces that attacks the body but there's one called a pentameric antibody um called rheumatoid factor pentameric meaning it's made of five different components it makes it quite large and that made it one of the very first ones to be able to be tested In The Blood using technology even back in the 1930s and they found that 30 percent of the Maasai warrior my age males these weren't old had detectable levels of rheumatoid factor in their blood basically their immune systems were at hacking their joints so and that real I think that reveals a lot that really tells us a lot that you know I don't believe it was to meet that they were consuming that was causing that I do believe it was the dairy and when we have a look at other research uh so we we understand well the the immune reactivities that can be caused by gluten consumption well we know that there's cross-reactivity between casein significant cross-reactivity between casein which forms 80 of the protein fraction of dairy and gliadin which is a protein fragment of gluten that causes all the problems so unfortunately I think uh you know for a lot of people if they have autoimmune disease inflammatory disease if they're having problems dairy uh is absolutely uh can be the culprit and it gets worse it gets worse because we talked about food cravings before and a lot of people when I say well maybe you should try giving up Dairy it's like I've just asked them to hand over their firstborn child and you just get this sense of addiction and the thing is Dairy contains morphine an opiate like heroin most doctors have no idea it's called caseomorphine it's literally Dairy literally contains morphine Dairy is literally addictive and this should be no surprise if we think about what the function of milk is the function of milk is to take a little creature that's feeble and vulnerable a little baby can grow it up as quick and as robust as you can to get as much good nutrition as much fat and as much protein as possible as you can into it and so to do that you have to make it over eat now given that it you know it's not loaded with fructose already you know it's not synthesized by a scientist what what solution you know what solution is there to make make people want to over consumed area or make babies either consume Dairy let's throw some morphine in there let's make it like an addictive drug and it does a job beautifully and here's the other thing when we're in medical school and I'm sure you had the same training I did the saying was the hand that writes the script for the opiate writes the script for the laxative because we know that morphine causes constipation and so some people who are complaining about constipation because what actually happens is morphine inhibits what we call the peristaltic activity the contractile motion through the gastrointestinal tract so Dairy obviously being an opiate that can cross-react with what we call the new opioid receptor which is where the the opiates will act on in the human body that will cause constipation that's another cause of constipation yeah and so and so in your practice like obviously you're treating people with Karma do you put them on Carnivore yourself or do they find you because they've been on carnivore it's a bit of a mix and I don't always put people I I'm a big believer in informed decision making and I give patients the option and as I said before this is not an ideology it's not plants versus meat there's a lot of plant foods that some people can consume without overt adverse effects now not necessarily a lot but usually people can consume some so if people have a preference for saying no I you know I don't want to be a social prior it's important I live with a family I want to have mixed meals on and so forth there's a variety of reasons so it won't necessarily be about you know going on a strict meat-based carnivore diet but if people are open to that and I believe that they've been informed adequately informed and they want to make that decision I will support them in that decision yeah and then so you'd use sports medicine so you obviously work with a lot of athletes and and presumably a lot of top athletes without you know disclosing you know any any information um how is this how has this affected your practice in helping them have you gotten have you gotten people onto uh carnivore data has this improved their athletic performance and uh that that you've seen and they've seen yes yeah bull answer yes I uh yeah I mean I yeah and look some of my patients have actually come out and in the paper and there's been some media coverage of people who have uh you know you know reported that their careers have been rejuvenated and so on and so forth and that's very satisfying but obviously we have to respect a medical legal confidentiality yeah 100 the um the reason I ask is because so many people say about what Carnival day I was like well you would but you can't actually have a top top tier athletic performance without carbohydrates carbohydrates what gives you energy like it would basically just be yourself well I mean that that's just bollocks I mean that's just a lot of you know that's rubbish nonsense well I mean look out how slow moving you know cheetahs and Panthers are you know I mean they're just weighed down by all that meat you know they they're starving for some carbs you know well the I mean I without saying too much I mean there is increasing recognition of the benefits of a a very low carbohydrate diets uh within many Elite Sporting teams now uh in the landscape that I'm involved in anyway and I have to say I am directly involved with athletes at the highest level yeah and that's um I think that's something that is the sort of the last hurdle for a lot of people especially those that are interested in sports and Athletics and and you know well is this is this good for me in certain respects sure but am I going to be the athlete that I want I've certainly seen this in my own in my own career my own um you know physical uh Endeavors and also and people that I've met with you know it's not a not secret but I I um worked with uh Ryan Talbot who uh was a was a college uh track athlete in uh at the University of Michigan or Michigan State sorry and he decided to switch to decathlon which is obviously very very uh grueling set of events and he went carnivore right before that in his second decathlon he won the Big Ten Championship set a School record and earned All-American honors second ever decathlon and a six-month into carnivore and he said uh that that he sent me a message once he said he was very thankful because he said that this has turned me into the athlete I've always wanted to be I mean and that must be so heartening when you get those kind of messages yeah yeah absolutely yeah it was it's really nice like I mean I I trust this because I've looked into it to such a degree I think I I truly believe this is this is backed by the data that this is this is the optimal way for human beings to eat and this is just the best thing for us to do health-wise um but I I'm I'm constantly afraid that I'm wrong and I'm misleading a lot of people down the wrong path and so I'm constantly checking constantly checking constantly checking like how can I be wrong is there something else I'm missing here and so far so good but it is I think you and I have I mean we're basically the same we're we're in our 40s I'm allowed to say that and I'm as healthy as I've ever been I mean that's a simple fact and it comes down to nutrition because I don't do a fraction of the exercise that I used to have time to do yeah I mean you know you know with a family and you know practice and trying to do research and all that you know you I just don't have time and I know that's a bit hypocritical being a sports medicine physician we should be all about exercise exercise but the reality is I I don't do as much exercise as I'd like to um but I still feel that I can I can focus for 12 hours in a day if I've if I've got a long day um you know where I've got to stand up in theater for 12 hours I can do that no problems I can still Focus I'm not a blithering idiot at the end of the day it's you know it's you know and so what if my LDL went up a touch yeah I don't know I don't know if it did I actually don't bother testing it yeah well that's the thing and uh and I I you know I'm of the same opinion that like you know my HDL is high my triglycerides are low my LDL is exactly where it's supposed to be because it's healthy I haven't damaged it and so whatever it is it's physiological and uh yeah so yeah it is nice to see that it is nice to see you know I still get very excited when people send me messages they've lost all this weight they're all their markers have improved uh they're off all these medications and all these different things add up and I'm like and I know that that would happen because I've seen it so many times before and I understand why it's going to happen but it's still very reassuring every time I see it's like oh thank God you know and well actually just one point on LDL that we haven't talked about so we've talked about how you know when it's damaged it becomes harmful but uh I just want to talk about the U-shaped curve that exists between cholesterol and or cause mentality because it's an indisputable fact that people with the very highest levels of cholesterol uh over on a popular large population scale we're not talking about the LDL studies just cholesterol full stop that they tend to have shorter life expectancies so the question is so let's break this down a little bit so first of all whether or not you derive any benefit from taking a Statin with high cholesterol can be predicted by the triglyceride to HL ratio so the first thing you should do well the first thing I do with my patients this is not medical advice the first thing that I do with my patients is have a look at their triglyceride to HR ratio and then I use that to inform the discussion I have with them about what likely benefits or side effects of you know what's the ratio of that um they're likely to have with taking a Statin versus not taking a Statin and if my patients have an excellent drugless right to HL ratio then really there's no reason to subject yourself to the not inconsiderable side effect profile of statins now number two is that a high cholesterol level in and of itself can be a sign of another issue what do I mean by that so vitamin B12 deficiency can increase the synthesis of cholesterol folate deficiency can increase the synthesis of cholesterol and inflammatory state for example an elevated level of a cytokine called tumor necrosis Factor Alpha can increase the synthesis of cholesterol we know that a hemochromatosis Gene can upset your lipid balance so what we call the hfe1 gene or hemochromatosis carrier state or hemochromatosis itself as a as a disease an oxidation state there's multiple reasons why your cholesterol might be high so we're not saying if you have a high cholesterol you can ignore it if your triglyceride to HDL ratio is good what we're saying is that there's no evidence that you'll get a benefit from a Statin but you still probably should have some visibility but if your cholesterol is tripled that there may be something else going on and if I know I'm going to beat the same old drum again but Dairy and other foods that trigger autoimmune reactions that are commonly consumed on those kind of diets so I said human and crisis Factor alpha or B12 deficiency if you're getting gut inflammation that might impair your ability to absorb B12 for example so you need to have visibility that there might be something else that with a more nuanced understanding of actually what leads the body to synthesize lipoproteins you can actually dig down a little bit deeper and hopefully get to the root root of the problem yeah and and speaking of what you're talking about cholesterol and heart disease and everything like that um there's one of the talks you gave um at the conference and Gold Coast recently talking about sort of like a uh more to do with uh cardiovascular disease being uh stimulated by my coagulation in fact not necessarily um you know by the the uh yeah same sort of models that we are before can you tell us a bit about that right so I'm gonna have to give a shout out to um Kendrick David Diamond there's a couple of other thought leaders here who have really been focused on atherosclerosis so when we talk about atherosclerosis so you've got the artery you've got the Lumen of the artery now in the Lumen of the archery you've got these little fatty deposits that line it and we're basically taught that those fatty deposits are cholesterol well no so they're actually um they contain things that look like cholesterol crystals within them so we just assume that the LDL particles get deposited into the lining of the the blood vessel and it just builds up and leads to a fatty lump and nothing could be further from the truth in actual fact and I won't go through all the details now because it's probably about a 15 minute explanation in and of itself I've got a lecture coming out shortly on this topic in actual fact it looks like these these uh fatty deposits are actually made of old blood clots so basically if you damage if you were to scratch the inside of a blood vessel then you'd form a blood clot and over time that blood clot would mature and that blood clot essentially so would have a lot of red blood cells in it that's what blood clots are red blood cells contain a lot of cholesterol a lot of lipids and there's a a bunch of other things in them so it actually looks like uh the news that you know if you've got a pro clotting tendency then that increases your risk of heart disease now interestingly we talk about the triglyceride to HL ratio being a very important factor to predict your risk of having a sudden blockage of an artery so sudden blockages of arteries happen with a blood clot not the fatty deposits if you get a fatty deposit gradually your body will build a detour a bypass and that that will actually what we call a collateral circulation and in actual fact if you just have a fatty deposits that build that you know that end up narrowing your arteries over time then you'll probably end up with Bypass or collateral circulation and it can often have a hundred percent blockage without having too many side effects but if you go from a very open artery to suddenly occluding because of a blood clot then that's what we call a heart attack and this tendency to form clots correlates very strongly to the triglyceride to HDL ratio and I talk about this a lot in the lecture so this brings the whole model back together so like you were saying before about how you like to try and you know look for holes in your theory so when I was looking at this clotting Theory I said well we've got very strong data on the triglyceride to HL so if this clotting theory is true then it must also relate back to triglycerides in HDL and it does it they're absolutely in lock step so this then comes back to the fact of well if it's these sudden clots forming in the blood vessels that block them off and cause heart attacks and they end up forming these fatty deposits and what factors lead to you know excessive coagulation tendency uh so things like diabetes excess blood sugar things like oxidative stress things like inhaling pollution because these pollution molecules go through uh get absorbed into your your circulation so this is all every all the cardiovascular risk factors that we understand the classical ones they absolutely are consistent and explanatory with regards to this clotting model of heart disease so it's just a different way of thinking about it now it doesn't mean we have to necessarily do a lot that's different and that's the beauty of our understanding of you know we've already understood that oxidation is something that's bad and we know that breathing and pollution that smoking is bad and so on and so forth it does provide us with a couple of other nuances so if we accept for example that oxidation is a key trigger then perhaps given that you know we live in polluted cities we we can't avoid oxidative stress that comes from inhaling pollutants maybe we can take some antioxidant supplements now there's some potent antioxidant supplements out there you've got an acetyl cysteine glutathione coenzyme Q10 selenium melatonin most people think of melatonin as a sleep aid that that's rubbish in actual fact nocturnal animals secrete melatonin before they wake up so it doesn't really make sense that it would have exact opposite effects in different species in actual fact it's a potent mitochondrial antioxidants so you know that it does afford to see the other opportunities and we know that then maybe uh consuming olive oil which everybody thinks olive oil is wonderful well that's still got a bit of oxidation potential so if we're trying to reduce our overall oxidation load you know maybe even things like olive oil wouldn't be recommended besides the fact that they also contain fake plant cholesterol so it's a really interesting model it it makes a heck of a lot of sense and it really reinforces the point that we shouldn't have blood sugar levels that are going up and down like a roller coaster we shouldn't be consuming oxidized foods and we should try and do things that lower our oxidation stress yeah well I think that's the thing is that uh you know we have we've had such a poor understanding of it to begin with you know none of our models have really explained things properly though you know uh you know lipid uh model of heart disease that you know certainly didn't pan out from my from my point of view and so it's very you know it's it's uh important that we look at other Alternatives that's that's uh very interesting that that's come out yeah so and I'm quite excited but just one other point too when we talked about the red blood cells um so I told you how we can actually absorb the phytosterols the fake plant cholesterol about one percent and in actual fact the one of the best issues to look at these is our red blood cells and we can actually see them get incorporated into the red blood cell membrane and there's very good evidence that the level of plant sterols within red blood cells directly contributes to their fragility EG they burst and they die early and this is one reason so you would have heard of people who they say well their blood sugar goes up on a carnivore diet often what we call the hba1c which is a measure of blood sugar will often go incredibly high on a carnivore diet and removing the plant sterols from the diet is actually the cause of that so let's think about what HBA once here is everybody gets bent out of shape I actually think the more I use it and I think I use it more than most people the more I understand it has significant limitation so you get a red blood cell it's swimming around in a soup of glucose so we have something called non-enzymatic glycation where the glucose molecule will just passively attach to the red blood cell so the more glucose there is in your blood the more glucose molecules will attach to the red blood cell and then we measure that as hba1c but that's not the full story so the concentration of sugar is not the only metric affecting this so you've got what we call glycation Inhibitors which I won't bore you with the details of but there's molecules like carnosine and duration so the longer that that red blood cell is put in that soup then the more sugar molecules will attach if you put in there for two minutes narrow your molecule will grab onto it if you put it in there for you know two years it's going to look like sugar so if your red blood cells have got these plant sterols in them then they're very fragile and they're bursting all the time then they're not going to be very odd so the average age of your red blood cells is going to be quite short so your hva1c is going to be artificially lowered what happens if you rip out all of these plant sterols from your diet and your red blood cells over time they get healthier they're going to live longer so they're going to sit in this soup of sugar for a much longer period of time in that situation your hba1c is not going to be proportional to your fasting blood sugar level or your average blood sugar level it's going to be much higher and that's simply because your red blood cells are healthier and they can live for longer and we can prove this and I do prove it in my patients you would have heard of reticular sites it's a term for a new red blood cell so basically when a when a blood cell is formed first form it has a little bit of RNA in it it's a little bit bigger and it's a little bit purplish it's a reticular site looks different to more mature red blood cells so we can actually get a sense for how many new red blood cells your body is producing by looking at the number of reticular sites if you're having a lot of seed oils that are leading to a very fragile red blood cells then your body is going to have to produce a lot of new red blood cells to replace the ones that are dying prematurely so you'll have a high reticular site count whereas when you go on a carnivore diet if we do a consecutive measurement of your reticular science we'll see that even when your red cell count the number of red blood cells you're having is staying stable your reticular site count the number of new red blood cells will be falling and we can directly infer from that that your red blood cells are living longer and coincident with that we'll see this elevated hbr1c which Bears no resemblance to reality of your actual blood glucose levels so if patients are concerned I'll often get them to use a continuous glucose monitor and we can demonstrate they'll have pancake flat blood glucose levels while the hbo1c is higher that's just a marker of improved red blood cell lifespan yeah you know I often wondered about that I sort of theorized that that you know that probably would that you know like that your red blood cells would likely live longer just because your all your cells are going to be healthier and as such you would be exposed to glycation uh longer and that you would yeah or you know have that eye so that's that's that's great that that's um that's what you're actually seeing in the lab work yeah and if you because I know reticular sites is in their standard blood test but I find it invaluable for that because if you've got oxidative stress in your body then you're red blood cells are going to die earlier so monitoring reticular sites is one of those things that I like to do yeah interesting um also there's one more thing if you have a moment if you have enough time we might drop a bomb on people and see your thoughts on vitamin D because this is something that a lot of people um they uh you know they ask about you know is this something you should supplement if you're not getting enough of it it is a hormone is that it has a you know a very specific and important uh biological effects in your body but something that you pointed out was that um you know we'll let you tell it but that this may not be as straight cut and dry as just more vitamin D good uh yeah so can we just pause for a second yeah so sorry about that I'm actually at a uh a sports medicine conference our our annual conference and I've just ducked out for a session I just had to answer a query so yeah so the whole thing about vitamin D is this uh mistake again of correlation and causation and unfortunately uh I think a lot of people have fallen for the mistake of believing that correlation proves causation essentially I believe vitamin D is very important up to a point for certain things but not as important as a lot of people would make out it's not a miracle cure for chronovirus for example so we know that if you don't have enough you'll get bone disease you'll get osteomalacia you'll have impaired mineralization of bone you'll get rickets and so on and so forth and that clearly is going to be a problem but you know if you've got you know a modicum of vitamin D levels that's enough to prevent that so then the question is well we notice that people when they have high vitamin D levels they tend to live longer therefore that must prove that vitamin D is good for you right well not necessarily so vitamin D is a fat soluble vitamin so that means if you're obese then you've got a larger volume that can absorb vitamin D out of your circulation so your blood levels of vitamin D will be inversely related to your level of tissue adiposity and this is true so we've actually got some studies where we expose people to sunlight or we give them Vitamin D supplements and we find that the level of increment of the vitamin D levels within their Serum is impaired if they have excess fat so basically the fat tissue acts as a sink and draws vitamin D out of the circulation so therefore if you lose weight or if you have less body fat then your vitamin D levels are going to be greater so vitamin D level can be a surrogate marker for good metabolic health for for low fat levels and this is perfectly consistent with the research and the science we have on chronovirus we know that obese individuals are more likely to suffer complications from coronavirus and that people in good metabolic Health who are who are lean are more likely to survive so vitamin D in effect can just be a surrogate marker for that so then there's several other questions that arise so let's talk about uh sunlight so everybody says well you need to go into the sun to get your vitamin D well is this historically true we've got you know a large proportion of the world pigmented skin that doesn't generate vitamin D very well it doesn't seem to make a lot of sense that people with white skin would have such a strong evolutionary advantage from being able to produce vitamin D that doesn't doesn't make logical sense why and indeed we don't see it we don't see a massive difference between longevity between people of different skin pigmentations so the reason is that historically if we look at the Inuit population so they've got pigmented skin and they they don't really ever see the Sun so when they were first studied you know back nearly 100 years ago they were found to have actually I'm not sure exactly when the study Falls might have been 90 years ago they were found to have quite adequate vitamin D levels why where did they get the vitamin D from so remember vitamin D is a fat soluble vitamin well it's in the fat of animals that we consume as well so if you're having a lot of animal produce then you're consuming vitamin D it's only in more modern times that we consider you need sun exposure to actually get vitamin D because historically when we weren't afraid of saturated fats in food we could get all the vitamin D we needed from diet so that that's a very natural way you can get all the vitamin D you need from diet so then why do we produce it when we go into the Sun and why only pale people why not dark-skinned people why don't they produce much vitamin D so vitamin D has actually been synthesized as the sunscreen for 500 million years in phytoplankton so this is something that is absolutely huge it's just the right size shape and size of a molecule that will absorb the ultraviolet B rays that would normally damage the DNA of our cells so our bodies actually synthesize vitamin D as a sunscreen and that's such a bizarre concept but we've got a lot of proof for that as well so when you think about it the body's producing 50 000 units of vitamin D in an afternoon in the sun exposure that's clearly in excess of what we need to produce for health it's only producing that much big to try and protect you to try and prevent you from getting sunburned so vitamin D production and in response to UVB exposure is nothing more than a protection against sunburn so Ansel key is seven countries study they actually had a subset of the the study where they actually looked at cholesterol levels in people who are exposed to the Sun and they found that their cholesterol levels were lower now why because vitamin D is made from syndrome cholesterol so necessarily people with more cholesterol can make more vitamin D and therefore they'll be better protected from the Sun and this is the experience that we see in the ketogenic Community we have a lot of people say I can go into the Sun and I don't burn like I used to and you know we make all these arguments about you know h e and all this kind of stuff in vegetable oils that's not the case it's your ability it's the plant sterols play a role because if you have plant sterols remember I said that impairs the natural functions the biochemical functions that cholesterol is needed for one of which is to synthesize effective vitamin D is a sunscreen but basically if you have higher cholesterol levels you can produce more vitamin D and you'll be better protected against the Sun and by not having fake plants Australian that mix to to muck up your vitamin D synthesis you'll also that will lead to a better protection as well so this very premise that you know you need to go into the sun to get your vitamin D no you need a healthy diet to get your vitamin D and this is the whole point that people are taking you know buckets of Vitamin D supplements saying it's going to make me healthy now vitamin D is a surrogate marker for good health if you have a high vitamin D level that's coming from a healthy lifestyle that's arising from the fact that you consume a lot of healthy foods rich in vitamin D then that's associated with good health if you've got a very high vitamin D level because you you have a bucket of it every night well so what that doesn't necessarily prove that you've got a healthy lifestyle that's not necessarily a direct correlation between healthy lifestyle and levels of vitamin D in somebody who supplements so that's why I generally don't recommend that people's supplement as long as they've got a motor come over acceptable vitamin D level I generally recommend that they don't need to supplement with vitamin D and I'd prefer to see them get adequate vitamin D stores through a healthy lifestyle now there's one other point here and that's about sun exposure so I am absolutely not saying that sunlight is not healthy what I'm saying is that some sunlight is not healthy so generally there's three types of UV radiation and only two of them will penetrate the atmosphere except on areas where we've got ozone depletion we don't need to talk about that but that's UVA and UVB they're different wavelengths UVA is quite a long wavelength and that means it penetrates the atmosphere very nicely UVB is a little bit shorter so it doesn't penetrate the atmosphere quite as well so if we imagine that we've got the uh the surface of the Earth and then you've got a layer of atmosphere on top of the Earth so well this is a conference that I'm at by the way um if the sun's directly overhead you can see the thickness of atmosphere that it's going to be going through is quite small so UVB which actually gets effectively attenuated as it passes through the atmosphere this is going to be the optimal direction that UVB can get down to cause sunburn whereas if the sun's low in the sky and it's coming in on an angle you can see it could be going through a much longer thickness of atmosphere relatively and that will actually attenuate out the UVB rays now the UVA is less affected because of the longer wavelength so that will still get through so what this means is that when the sun's liar in the sky you get UVA radiation without getting a much less UVB radiation in the middle of the day when the sun's overhead that that's when you produce vitamin D um that's when you get sunburned now the key factor is that ultraviolet a radiation produces a very important factor for Health it stimulates something called nitric oxide synthase which I think in 2006 or thereabouts made probably a different year it got molecule of the Year pretty important molecule and that has been associated with improved blood sugar control improved blood pressure and basically a bunch of good effects and in actual fact this is likely to be a very good reason um for sun exposure actually being associated with longevity not only sun exposure so here's a crazy study there's actually studies that demonstrate that some induced skin cancer basal cell carcinoma and squamous cell carcinoma in a population study in Denmark was associated with an increase in lifespan of about 10 years similar to the you know the benefit in terms of people who have been lifelong smokers in reverse so people with skin cancer on average live longer this is not to say the skin cancer was good this was to say there was something else about the lifestyle of these people that may have been good and I think the most likely explanation for that is the fact that if they they were exposing themselves to the Sun not only sure they were getting skin cancers which indicates they were probably getting UVB damage but they're also getting UVA and I think there's some inherently good properties from ultraviolet a given that it assists with the synthesis of nitric oxide so my uh you know vitamin D rant is not to say that you shouldn't expose yourself to the sun it's say that you should expose yourself to the sun in a way that you won't get sunburned now in New Zealand they've got a really nice way of doing this they just look at the length of your Shadow and as a surrogate marker of the length of your Shadow is shorter than you then that is suggesting the sun's getting pretty overhead and the view UV indexes uh the UVB index is probably going to be you know getting up there and you're more likely to burn and that's a really nice rule of thumb in Australia we try and have a rule say expose yourself in between 10 a.m and 3 P.M well that's a nonsense rule because what happens if you live in Hobart or if you live in Brisbane the different latitudes what about summer and what about winter different seasons so different the latitude and season will actually impact the height of the Sun in the sky at different points of time during the day so it makes far more sense to have an absolute rule that actually more closely reflects the massive atmosphere that the sun rays are passing through and the length of your Shadow I think is a good marker for that so I think that's enough on that soapbox from another moment as well you know but you can actually add to your point um about vitamin D just you know being protective as a sunblock I remember reading article years ago talking about how Vitamin D is actually synthesize on the surface of your skin and therefore if you want to absorb it you actually have to let it soak in it took about six hours to soak in and so if you went out to the beach you went out in the sun you'd have all this vitamin D on your skin but then people would take a shower to get the sweat off them and they'd wash off all the vitamin D and so this was saying that you really need to let it soak in so when you're out at sun exposure you need to wait for at least six hours to absorb all the vitamin D so that actually fits right in line with your and I sort of missed a trick there so obviously if it's being produced on you know within the skin like that it's hectic why would it why would the body produce it there yeah exactly yeah on the surface of the skin and it's a sunscreen yeah what is that um I was interested when you said that um it was it was produced as a um a sunscreen for like 500 million years how where did we see that how do we how Plankton So within the fossil record okay right and so how did they figure out that it was used as a as a sunscreen I believe well I think it's I'm not exactly sure the mechanisms but they did relate it back to DNA damage and without vitamin D production apparently their DNA was destroyed um so they couldn't survive so I I presume they've probably um going back to the fossil record they've found equivalent phytoplankton today that look identical to that and they've probably done experiments where they've impaired their vitamin D synthesis and seen that they get fried up in the sun I didn't delve down into the molecular genetic you know genetics of what they did but I imagine that's the only reasonable way you could draw that conclusion yeah well that's that's super interesting anyway and it's um you know something that I've had to reconsider now too since since seeing your uh your your silk box around it the car at the car breath that made me sort of think about like hmm all right you know maybe we should think about this um well that's cool it's really interesting well hey Paul thank you so much I think we've been talking for almost uh three hours now so so I'll let you go back to your your conference but uh it was uh thank you so much for doing this so we definitely have to do it again there's certainly a lot more that we could talk about and I appreciate you taking the time no it's been an absolutely wonderful time I've enjoyed it for a second awesome well great well um can you tell us like where people can find you and look at your stuff and and uh and see more about you the practice in Sydney um for anybody who's residing in Australia I've also do teleconferencing so uh I can consult that way the link to bookings can be found at my Twitter handle Dr Paul Mason MD so I do a little bit of Twitter and I'll have to start doing a bit more social media interestingly I've noticed that uh in the last few weeks even without doing many tweets I've been getting a spike in my number of followers so I think that uh my shadow Banning which I've must have had going on for the last couple of years has been lifted and I'm seeing my followers go up it must be something to do with Mr musk in his recent purchase out of Twitter jail yeah well I must have been in Twitter jail without actually realizing it it's just because I haven't I've been quite busy I haven't done any tweets recently and I've just been noticing I've been you know getting another 30 or 40 followers every day without really doing anything I was like well it's uh yeah it's good to be out of Twitter jail yeah um but yeah so a lot of my actually go up on the low carb down under YouTube channel now if you don't follow this channel it's a great one there's a fantastic talk on there recently plants are trying to kill you by a friend of mine seriously that that's an absolute cracker of the lecture um and it just provides things in a logical coherent fashion that will allow you know it'll just give you ammunition if people are saying oh you have to eat plants they're good for you um you know ask a question what exactly why and how and yeah so I haven't seen that lecture get onto it and if you want to check out some of mine then do that too yeah well I definitely encourage everyone to do that like I've really really enjoyed your lectures they're they're they break down very complex ideas it's very simple straightforward [Music] descriptions and and you and you just back it up everything's backed up with evidence-based you know you cite your sources you have your references you say like study study study study study and you go through the actual literature and data and evidence and crunch it down and I think that's very very useful to people that are trying to figure out what God's name is going on because there's so many conflicting views so I appreciate those from you oh thank you much appreciated very welcome all right man I will see you next time take care [Music]