Theresa Piela

Okay, welcome to episode 13 of the Bioenergetics View. I'm your host, Teresa Piela, joined as always by Jay Feldman and Mike Fave. Today we'll be talking about Dr. Ken Berry's interesting views on fruit and honey while eating a carnivore diet, as well as his claims that fructose causes glycation. We'll also dive into a listener's question discussing whether fat versus sugar metabolism is preferable for ATP production and limiting reactive oxygen species and some of the nuance there. So diving right into around the internet, we can start with this clip.

 Theresa Piela

All right, I think I've been doing it wrong, guys. I've been eating honey and fruit every day of the year, so I should probably just leave. curious, Mike, what was your reaction to this?

 

there's a quite a few things here that are, think, pretty problematic. A lot of logical fallacies and lot of, you know, conflationary perspective. So the first thing is that in different environments, fruit grows different times of the year. So maybe if you live in a really Northern environment, you'll have fruit for like two weeks of the year. But in other environments, you'll typically have fruit for many months throughout the year. So it really depends on where you are. So just like on a, on a

 

like in the face in general. think that is incorrect, that assumption. The next thing is that bears and humans have like very different physiology because bears are hibernating animals and humans are not hibernating animals. So to try to say that humans eat fruit to get fat for the winter, I think is very questionable. And in general, because we don't have a hibernation period like other mammals do, like bears. The other thing is that

 

The bears don't necessarily eat fruit to get fat for the winter per se or the sugars, the fructose in the fruit doesn't necessarily make the bears fat in and of itself. What makes the bears fat is they have a huge change in hormones, like a variety of hormones and metabolic rate as they go into hibernation. Some of those hormones being leptin, ghrelin, thyroid hormones, glucocorticoids, and then there's also changes in mitochondrial function.

 

And there's an induction and what they call a hyperphagia or an extreme hunger period for the bears prior to hibernating so that they can gain body fat and then hibernate throughout the winter. So this is more of a metabolic phenomenon and the bears do seek out food, including berries in that time frame. But the large increases in body fat is driven by the hormonal changes and the drastically increased intake of food altogether that is done to gain fat for the winter.

 

Jay Feldman (03:12.398)

So we have a very different physiology between humans to the extent that they are studying bears now to see, well, bears get extremely fat, like have a very high body fat percentage going into hibernation. They have really high lipids. They have overt insulin resistance and things like this and they don't develop metabolic concerns like atherosclerosis and things like this in the hibernation stage. So they're trying to see what is different between bears and humans that allow bears to have these things and not develop the same disease processes that humans do and again different physiology so One fruit can be depending on where you are fruit is available for much longer than two weeks not to mention other Carbohydrate sources. I know fructose was the major thing here too And I guess another thing to put it put in a place here is that humans evolved as an equatorial species initially which would throw Shade into this idea that like we would be at these really high latitudes all the time, you know But the people talk talking about the evolutionary perspective. Then the next thing is that the bears are hibernating animals, humans are not. And so we have drastic metabolic changes there. And even with that, the bears are gaining weight not because they're eating fructose in general or berries in general. They're gaining weight because of hormonal changes and changes in amounts of food and appetite and metabolic changes prior to going into hibernation. So it's kind of it's the argument and is just like a logical fallacy is a conflation that doesn't really make much sense when you actually get into the details of it. It sounds nice, I think. We're like, oh yeah, the bears eat the berries and the honey and you know, that's probably what makes them fat. I remember at one point when we were in in low carb, Jay and I were talking about some of this stuff. We were in Miami, we'd have conversations about some of these things. But when you actually dig into it just a little bit, there's tons of papers on PubMed talking about this. Even Richard Johnson is a author on one of the papers looking at bear physiology and trying to understand.

What's going on with bears and metabolic diseases, you see that it's not really, that's not the reason that they are necessarily gaining weight in that way. It's more of like direct metabolic changes and hormonal changes that happen prior to hibernation.

 

Theresa Piela

Yeah, it seems like he's playing on the fear aspect too, know, fear of fat and using that as a hook to get people to latch on to this idea and, you know, without even breaking it down or like Mike was saying, thinking about, is there any truth in this? Can we actually make the comparison between humans and bears? Jay, what was your reaction watching this clip? You pulled this one up, didn't you?

 

Theresa Piela

Yeah, I found it interesting that he mentioned how we eat them because they're sweet and they taste good as if, if something's pleasurable, we should be questioning that and, and trying to use our, you know, our willpower to, to not listen to our body. think it's just an interesting frame and it's, it's no wonder so many people are confused if our, if our impulses and those, those natural drives are all then to question and, and we should, we should be fighting them basically.

 

Theresa Piela

Yeah, the body starts to riot.

 

I think it's also interesting to look at and say like we don't even have to go to other animal species to see that a high carb diet isn't pushing obesity and things like this. And that there's access to carbs year round. So we can look at other species which have been looked at that have access to higher carbohydrate intakes throughout the year, more than two weeks, including groups like the Hadza and then you have other hunter gatherer groups that still exist.

 

They are on high carb intakes and they are not getting fat and hibernating for the winter and they do live in areas where there isn't really necessarily a winter. So I think you have evidence in existing human groups on what would be typically considered their normal diet. You have evidence in like our closest genetic relatives as far as animals go. And then if you think about human evolution in general, the vast majority of our evolutionary period would arguably not have been in cold environments where we have

 

fruit available for only two weeks out of the year. So it's a like on multiple lines of evidence. It's like this is like again, like as Jay pointed out, like kind of cherry picking a particular model and then conflating it with our circumstance when it doesn't even make sense. And the reason I point out some of the evolutionary stuff is because we keep seeing that pop up in the comments. And I want to open the can of worms, but it's just like we've only for millions and millions of years, we didn't get any carbohydrate. And it's like, I'm not really so sure about

 

I'm so sure about that. If you actually go through and look at the evidence and then, know, conflating some of these other animal models, doesn't even, doesn't even make sense.

 

Theresa Piela(13:05.666)

Yeah, similarly, just the primal approach being framed as better. We aren't living the way we used to. So to confuse it with maybe an unfounded frame and then saying that we should be going back to how we, our ancestors ate and the foods that they had access to and the foods that they chose, it doesn't really apply to our modern environment. In fact, we could argue that so many of the assaults in our environment require us to be more skillful and more

 

adaptive and, you know, really use our tools with intention instead of just doing what is primal or living in a more like scarcity based way like Ken Barry was talking about how if we didn't have access to these things.

 

Theresa Piela

Yeah. Mike, any more notes to add before we watch his other clip?

 

Mike Fave

No, no, I don't. There's like, it's a whole can of worms to get into all the evolutionary stuff. And we keep, I keep seeing it in my comments and I keep seeing it on the comments on, on Jay's and I's videos here. And the claims that are made are kind of like somewhat absurd. And, and I don't mean that in an offensive way, but like they're just blatantly absurd, like kind of like this conflation of our metabolism with bare metabolism. And they're not, they're easily like just with a cursed research. And looking at the evolutionary pathways that we know so far. Like even if you were to use the line of evidence of evolution and what was happening in the past, like it still doesn't support that perspective. So it's just a weird line of argumentation that we see. like, we're going to hone in on this really narrow timeframe in our evolutionary development and say like, see, look, this was the best time for X, Y and Z reason. And so it's like, it's a little bit myopic, I think, like especially when you start expanding out timelines.

 

And you also consider current context and the other evidence that we have. So, and I think relying on just that piece is also pretty weak. I think you'd want to have multiple pieces, multiple elements that you're looking at to try to gauge and figure out what we're doing with diet and how we're managing health instead of just like just this evolutionary perspective. Cause I think it could give you a very limited lens and then it alters your decisions in weird ways, which justifies some of the, I mean, that's what some of these proponents are using to justify diets like the carnivore diet.

 

Right. And then even the hybridization of fruit stuff is also an interesting line as if we don't actually breed animals in a particular way, like change milk yields on cows or change the amount of meat that you get from particular types of animals as well. It's like the whole entire perspective. It's it's very myopic and it knows there is some truth to some of it, but the larger context of it, you when you start to actually look at it overall, it doesn't really make much sense.

 

Theresa Piela

This clip fits really well with our theme today. Just the short clips that go viral are so popular on the internet that are confusing and might require some breaking down. So let's watch this one.

 

Theresa Piela

Jay, do you remember when you were all sticky?

 

Jay Feldman 

back in the day. Well, okay, he's entertaining. But as you were watching this, I mean, there's a couple, there's several points to break down. And I think we could start with just talking about what is glycation? Is it something we should be concerned about? And talking about how it's actually formed in the body.

 

Theresa Piela

Mike, jump on in. What was your reaction to this?

Mike Fave:

I think there's a fundamental... I think this is like a little factoid that we get which is true, right? So, fructose is 10 times more glycating than glucose on its base statement like that's 100 % true. We see that in the research but it's like in the context of the body, does this even matter? I think Jay pointed out and this doesn't really matter. When you... There's studies looking at fasting glucose or fasting fructose levels even in diabetics.

And what we're looking at is 0.21 milligrams per deciliter. And to put that in context, so you have 0.21 milligrams per deciliter of fructose. A typical fasting glucose level is gonna be like, you know, ideally you want in the 70s to 80 milligrams per deciliter in 70s and 80s. So many times more amounts of glucose. So even to sit here and argue that fructose is more glycating than glucose is absolutely irrelevant. Like it doesn't matter especially in the context of diet of dietary intake and especially in the context of metabolism of fructose, right? So that's the first thing. The next thing is that the driver of carbohydrate-based glycation is typically due to metabolic dysfunction. So what winds up happening is you have hyperglycemia, you have issues in glucose metabolism. The carbohydrate glucose gets fed into glycolysis.

 

And when there's problems in glycolysis or there's problems with utilization of glucose at the cell in general, what you wind up seeing is a shunting of glucose towards the polyol pathway with production of sorbitol and subsequent production of fructose. And then you get at the tissue level because of the metabolic dysfunction, the changes in glycation. You get increased glycation end products, glyoxalate and methylglyoxal. So the problem is not necessarily carbohydrate intake.

 

Jay Feldman

The problem and you see this in diabetics even at even if they're to have high fasting glucose levels and they don't have carbohydrate intake. It's the metabolic dysfunction predisposed to shift towards glycation not necessarily the carbohydrate intake driving the glycation acutely in each circumstance. So I think this is the fundamental thing to pay attention to and another thing to point out is some of the best tests we have to measure glycation are fructosamine and hemoglobin A1c.

 

And one of our, one of the primary proponents of a low carbohydrate diet, like a ketogenic carnivore diet is Dr. Sean Baker and his measure of glycation via his hemoglobin A1C is in the sixes. So he's not eating any carbs yet he is heavily glycating his hemoglobin and that's a non-enzymatic reaction. And that again is because of changes in glucose metabolism at the cell, whether he's eating the carbs or not. So I think the fundamental problem that we're looking at

 

is really what's going on with the glucose metabolism. Not are you having carbohydrates or not? And that's just driving glycation because that's clearly not the case. There's many, you can look at studies where people improve their hemoglobin A1Cs even with carbohydrates present inside the diet. So that's the, I think those are first two important points for me is that the glute, like the how much one thing glycates the other is kind of like how much more fructose is glycating than glucose is irrelevant because in the body you're never going to have high blood levels.

 

of fructose and you get hot, you will only see higher tissue levels of fructose with metabolic dysfunction because the carbohydrate is not being used appropriately. The second piece being that the alterations of carbohydrate metabolism is what drives that glycation process. The last piece I want to mention this, this tails into what Jay was saying is on low carbohydrate diets, you actually see increased end products of glyc... or increased glycating products like methylglyoxal.

 

because of the change in metabolism and the shift towards the fatty acid oxidation and ketone production. So even in states where you don't have carbohydrates, even if you're on this ketogenic diet to protect yourself from glycation, you are producing products that drive glycation like methylglyoxal and this is directly shown in humans. So it's, I think the fundamental piece to understand is what is going on metabolically that is the central driver and less so like

 

Jay Feldman 

I ate some carbs and I glycate. And the one piece I want to back up to here is that I don't think and I don't think it's born out in the research that eating carbohydrates drives that metabolic dysfunction. And we see this in studies where people actually improve their blood glucose tolerance and decrease hemoglobin A and C levels even with high carbohydrate intake, right? So it's not just eating carbs drives this process. I even had a comment under my video recently.

 

Somebody saying, you know, like I made a video about how I have like a high sugar diet and they say, you're gonna glycate, you're gonna have all this, this glycation. It's like my last hemoglobin A1C value after almost a decade on a high carbohydrate diet was like, I think it was like 5.2 or something like this. So well within the normal and optimal range indicating that I am not having non-enzymatic glycation happening despite the carbohydrate intake. And again, this is because the, am... effectively utilizing the carbohydrates and not having the metabolic dysfunction that's driving that glycation process. So I think that's the more important piece to focus on than to like talk about well, know, fructose is more glycating than glucose. It's like it almost doesn't, it really just doesn't matter here. And then like all the other pieces that come after that, it's like nice visuals and it's a great story, but it's like it's fiction. It's a fictional story. It's a conflation, it's association of conflation to give this image where that's not actually what's happening overall.

 

Yeah, I think it can be pretty convincing too, just to hear someone say it so confidently. And like you mentioned, the images, you're kind of locked in and all of these videos have that in common, whether, I mean, not to throw Ken Berry under the bus, but a lot of these wellness doctor influencers are doing the same thing. They'll say something, maybe it's framed completely incorrectly. They've got the...

 

Theresa Piela

the candy, the sugars, the fruit. So we're just kind of mesmerized. Well, maybe we're not mesmerized, but most people might be mesmerized and forget to ask other questions. And Jay, I'm wondering, you briefly brought this up, how PUFA might be more of a problem in terms of causing these glycation end products. If someone actually is dealing with pretty serious glycation, Would your thought be to do a higher carb, lower fat diet? What would be your approach?

 

Mike Fave

Unless they were consuming a bunch of polyunsaturated fat or like processed chips and things like that.

Well, I have heard family members actually mention and ask me about their A1C test and following up with how they're trying to eat less sugar and eat less baked goods. And I think it's really important to discuss the nuance of this for people that are really trying to improve their health. And, you know, they get this test from their doctor and they're really concerned about developing diabetes or they're pre-diabetic and...

 

and then they take out maybe what could be the most helpful fruits and all the polyphenols and anti-inflammatory compounds that might actually help restore some of their glucose metabolism.

 

Yeah, I think that I want just tagging into that tree. So I think, I think it's really important to understand what exactly is going on with hemoglobin A1C in the blood like overall. So you have, you have, if you think about the blood is basically a pipeline that when we talk about like fuel sources between the liver and between the cells, right? So if somebody is not utilizing their fuel effectively at the cellular level, you can get a backup of

 

of whatever that fuel source is, both carbs and fats in the blood. That's why you see the lipid panel change. That's why you see changes in blood glucose values. That's why you see changes in hemoglobin A1c. And so again, this boils down to the fundamental problem of whatever is going on at the cell, it needs to be fixed so that the oxidation of both fats and of carbohydrates is working effectively. And I think people typically see if they're having metabolic dysfunction in general,

 

A1C go down and blood glucose levels go down when they don't have carbohydrate in general and that's because if you're not taking up that fuel source at the cellular level, then you just leave more of that in the bloodstream and then basically the more carbohydrate you have in the bloodstream overall, the more likely you are to have this non-enzymatic glycation process where the glucose interacts with some of the amino acids in hemoglobin and creates hemoglobin A1C.

 

Jay Feldman 

But that doesn't mean that lowering the carbohydrates fixes the problem at the cell. It just means now you have less overall amount of carbohydrate floating around in the pipes. So you get less glycation but the fundamental problem of metabolism still hasn't been addressed. And that's why when you take people go on low carbohydrate diets, like even in the ketogenic diet studies or there's like a meta-analysis on keto diets.

 

What you see is hemoglobin A1C and blood glucose values go back like drop within the first six months. But then at the 12 month mark, they don't actually find a significant difference in those values because again, what winds up happening is initially you don't have the carbohydrates, the values start to drop and then over time and I see this with lot of people that I've worked with and you also see this with people in the carnivore diet, including prominent influencers like Dr. Sean Baker, you start to see that blood glucose starts to creep up again.

 

through gluconeogenesis and then glucose tolerance is even worse down the line because now you're primarily using fatty acids. So again, the problem is what like one we are looking at abstract values to gauge what's going on in the body. Hemoglobin A1c is giving us a rough idea of average blood glucose values and that gives us if you understand that in the context of I have this pipeline with fuel moving through it and the problem is either something going on with production at the liver or

 

something going on with uptake at the cell and then it's like, I need to fix these problems. But a lot of people are focusing on just what's going on in the pipeline. And then that's why you get these interpretations of, I just want to lower carbohydrate intake. Okay. And then my ANC goes down and then I'm good. And it's like, no, you want to fix what's going on at the cellular level. You want to see, okay, is there micronutrient problems going on? Is there dysbiosis endotoxinia going on? Is there long-term chronic stress and the stress hormones are impacting things?

 

Is there things going on with excessive amounts of body fat present and then the body fat is actually leaking free fatty acids, inflammatory meat years and that's affecting what's going on at the cellular level. These are the things that we want to start to address because ideally a healthy individual should be able to oxidize both carbohydrate and fatty acids. You know, at normally there shouldn't be any problems at all with using either fuel source. So just removing one fuel source doesn't necessarily solve the problem, but it does make lab values look better.

 

Jay Feldman 

at least for a period of time. But the ideal like solving the problem would be I'm eating carbohydrates and I'm actually seeing a lower A1C value and my glucose curve is much better overall. My oral glucose tolerance test is much better overall and my insulin levels are ideal. That's where it's like, okay, these are ideal targets and in that circumstances, you would have less advanced glycation end products because you're not going to shift metabolism or the glucose towards the polyol pathway which will then drive

 

some of the glycation that we see in the diabetic or the impaired glucose tolerance state. And so again, that's why the metabolism piece is the most important. And when you think about the blood test, at least when I think about the blood test, I think, okay, I have this pipe that's moving fuel back and forth. And the problem is either at the use of that fuel at the cellular level and or something going on at the production level. And they oftentimes go together because when you have insulin resistance, when you have issues metabolically,

 

you start to have the liver itself will start to increase outflow of carbohydrate and fats and things like this to help meet that lack of energy supply at the cellular level. So these are things that, you know, they kind of go hand in hand, but we don't want to, we want to be careful using an abstract marker to try to gauge these things. So you need to have the context around it, I think appropriate. And so for your relatives, the recommendation or the thought process of Maya would be to try to figure out

 

Like what is going on overall? What's going on with body composition? What's going on with hormones? What's going on with micronutrients? What's going on with the gut? What's going on with endotoxin? Look at this overarching picture and then start to solve those problems so that at the end of the day, weight is stable, hemoglobin A1c is dialed in, blood glucose levels are optimized, hormones look good, and they're eating carbohydrates and also fats. Because it's not necessarily that you want, have to, the whole thing now is you have to choose your fuel source, right? We all have to either do fats or do carbs.

 

And I think the more appropriate frame is that there's going to be some mix of fuels for all of us, including fats and carbs. That's going to be optimal because you're going to need fats and you're going to need carbs and you're going to need protein not to survive, but for optimal health because that's we're going to get into that eventually. the idea that these things aren't essential for survival is again, like irrelevant. Nobody here is just trying to get by. Everybody is trying to optimize their health. And so it's like figuring out what that mix is going to be with carbs and fats.

 

Jay Feldman 

That you can optimize your blood glucose regulation, your hormones, digestion, et cetera, and set up the diet appropriately from there. So I think that is the, that's like the perceptual shift, at least for me, when I'm thinking about it, instead of just like, what's, oh, my A1C is this, so I need to drop all my carbs. It's like a little bit of a knee jerk reaction without the proper context. And I think clips that we see from people like Dr. Ken Berry create this perspective because they're very misleading and it creates this fear.

 

I'm gonna have, I'm gonna have sugar and I'm gonna get glycated like that melting candy in the picture. And it's like, not necessarily. That's not really how it works. When you actually dig into the mechanisms. And also, I guess one caveat here is we're talking about carbohydrates and sugar, I think for all three of us. None of us are sitting here saying like, hey, we should all be plowing Sour Patch Kids and Jelly Beans and Cokes all day long. We're talking about figuring out which carbohydrate sources work for your system, help you to feel well, that you digest well, keep your stress low and things like this. So fruits, tubers, maybe use some honey, some maple syrup or sugar with your coffees or whatever the thing is, but prioritize like more nutrient dense carbohydrate sources overall. So I want to put that here as well because it's like people feel like, you're pro sugar, like you're pro high sugar. And it's like, yeah, from like fruits and juices and things like this and potentially tubers, which is I think have vastly different effects.

 

On the physiology when you look in the research than just, you know, just sitting there and spooning granulated sugar or eating some of these candies and stuff like this, which is again, I point that out because that's the imagery that we get shown for sugar in this video here.

Even the pro or pro metabolic approach, I was talking to a client recently and he asked, yeah, isn't that the Pepsi diet? And it's, it's just interesting to see how it's interpreted. Similarly, like when we get one test back, like the A1, getting that level of the A1C, I've noticed people can kind of hyper-focus and trying to think of how can they change and control and manipulate that one data point as opposed to like what Mike was just saying. 

 

Theresa Piela

Can we look at the  bigger picture and see how we can support metabolism in a more sustainable and, you know, life-giving way as opposed to trying to nitpick and micromanage, which I think would drive most people crazy. And maybe people listening can relate to that where like it's one test result and it feels like if only they can fix that, then their health problems will go away. I see the same thing with like SIBO tests, for example, they think if they can just eradicate the SIBO and do all these protocols, then every other health problem will work itself out. Maybe not, I haven't seen that happen yet, that would be great, or we're simplified and create more stress than we need to when we can just look bigger picture.

 

Jay Feldman 

The one thing I want to point out here with that Jay is that you actually can gauge what's going on with these different foods like relatively well, but you just have to use multiple markers, right? So like you can use A1C, you can look at fructosamine and then insulin and then fasting glucose and you can look at your response to carbohydrate based meal. You can look at what's going on with body composition. Like there's a lot of ways that you can gauge and it's frustrating me because you have this is like let's change the argument and like, let's put this implicit belief that we can't test this thing. Like Bart K does this too with like, it's a, it's a construct. It's a construct. It's like, come on man. Like we actually have metrics and we have components that we can look at here to gauge how people are handling this particular fuel fuel source. If you actually understand the physiology appropriately. So when you understand the physiology appropriately and you understand the pathways and what's going on and you look at a person's symptoms,and you will get a multitude of values together. You can gauge to some extent how this person is metabolizing these different components. And there also is more in-depth testing. I'm not saying people have to go and do this, but there is more in-depth testing to look at and say like, okay, this person is actually moving carbohydrate into the Krebs cycle appropriately. They're not shunting towards lactate. And then things are flowing through the Krebs cycle in the correct way. People don't even have to go and do this though. You can, how are you feeling? How are you sleeping?

 

How are you feeling after your meals? What's going on with your body composition with the dietary setup? Do you look at some basic markers in your labs and see how things are shifting? So you can get a gauge on this type of stuff. If you have all of these things moving in the right direction, then you can comfortably say, okay, things at large are going well and you don't have to have this like one singular test that tells you what your fructose levels are in your...in this particular cell in your body that tells you if it's glycating or not. There's like a variety of metrics you can gauge and use your own real, your experience from your symptoms, which is real time data plus testing to gauge what's going on. I mean, for me with clients, that's what I'm doing. It's like, okay, your blood glucose is looking better. I'll give you an example. I have a client who I work with who's he's on insulin. He's insulin dependent type two diabetic. His insulin usage went from 200 units when he started to averaging 60 now.

 

Jay Feldman 

So it's like, you can't sit here and tell me that his insulin sensitivity hasn't improved and I doubled his carbohydrate intake. So it's like, you can't, you can't say, and then now we're at a circumstance where even on the 60 units of insulin that he has per day, he's actually getting lows now. So he has to, because the pump is overshooting his values. I just spoke with him last night. So these are components where it's like, that's a way that you can say, okay, my carbohydrate tolerance, my insulin sensitivity, these things are improving in an A1C value.

When we started 8.9, we just got a test back last week. It's at seven. So you're not going to sit here and say the carbohydrates in this individual. Well, he's just having this, this, this hidden, like, unknown glycation going on or is we don't know what's going to happen. It's like the guy was low carb before he was already low carb, high fat before this. And we switched over and now things are improving overall. This is like, I have another guy I'm working with the late onset type one diabetes. Same thing. He's at a circumstance where he went keto, his numbers dropped initially.

And then over time, he needed more more and more more insulin if he had any amount of carbohydrate because he became more and more insulin resistant. And then we brought carbohydrates in and now he needs less insulin overall for a drastically increased amount of carbohydrate in the diet and his A1C values have gotten better overall. So again, like you can't get to a circumstance more extreme than a type 1 diabetic on that's insulin dependent and a type 2 diabetic that is insulin dependent.

So have two circumstances where adjusting the diet appropriately, fixing the metabolic problems at the cellular level and seeing that they need less insulin for more carbohydrate and all their A1C values get into better ranges overall. like, me another example, like show me another way to gauge this. Wow, their body comp is better and all of this type of stuff. So like you can gauge. I think that it's a disservice to tell people that you can't get a sense of what's going on and create this unknown boogeyman that's in the closet that you don't know that's there or not. It's like you can actually tell to some extent, even if it's somewhat indirect, what is going on metabolically. And this stuff is direct, right? Cause you're seeing like insulin dosage changing with carbohydrate doses. Like I don't know how else you can gauge. Like I don't know how much further you're gonna go.

 

Theresa Piela

I also imagine that a type 1 diabetic would have really strong sugar cravings and feel a lot better when they can eat as much glucose, fructose blends as possible. Is that correct? you guys seen that too?

Mike Fave

So for me with the clients that I work with with type 1 diabetes, the benefit of the like keto stuff is that it's easier for blood glucose control because you don't have to like dose the insulin quite as like quite as much quite as frequently stuff like this. But yeah, a lot of things do tend to get significantly better when the person is able to like organize the carbohydrates effectively. It's just it's logistically more annoying because since your pancreas isn't producing the insulin, you have to kind of gauge and meter how much insulin you're going to use for a certain amount of carbohydrate. So for me, when I have that circumstance, try it like they feel better symptomatically, but then they have this logistical hurdle. And so what I tend to do is try to like set a specific amount of carbohydrates per meal. And then we have a standardized dosing of insulin. So we can track and see how much insulin they need per carbohydrate bolus. And then we, we, we standardized that.

And then basically it's just, just know how much they're going to have to use because the meals are relatively like they're structured. set. yeah, symptoms get better. One lady I was working with type one when she was, she was keto type one diabetic on insulin. Lipids were like in the eight hundreds. The only thing like total cholesterol was all the way in the eight hundreds and an LDL was in like the six to seven hundreds. The only thing we changed was we changed her diet, covered up her micronutrients, brought carbohydrate on board.

And then her lipid values dropped down into the two hundreds and the doctors were like ready to do, you know, basically she went to the doctor. The doctor said we need to get a yuan statins, PCSK9 inhibitors, all the stuff. And then what we wound up, what we wound up doing was being like, okay, she's like, I want to try diet first. So then we started working together and then we changed the diet and the lipids came right down. And then insulin usage was like, we standardized it and was logistically easier for her and she felt better overall. Blood values looked better overall and things were.

 

Jay Feldman 

Things were good from there. So these are, you know, these are like case studies that where it's like, yeah, you can gauge what's going on. And I think her circumstance was unique with the lipids and type one, the type one diabetes and the and like being on a really high fat diet. I think like there's a culmination of multiple metabolic things going on there that was leading to that, which is why just organizing the diet with carbohydrates got things under control. And yeah, once the logistics are managed, I do tend to see

The clients that I work with type one diabetes feel better with carbohydrate on board.

And I love that it honors that intuition again, instead of being swallowed by the fear from videos like this, the body is wisely communicating what it might be needed in order to correct some abnormalities or metabolic derangement. So I'm glad they've got you, and you, Jay.

 

Jay Feldman 

I think the lows, if they're having a lot of lows, that's the big thing that I, that's one of the big problems with the carbs is overshooting the insulin and getting lows post meal. It also again, depends on regimen, right? Cause if they have a long acting across the day and then there's short acting with meals, that's sometimes where I see people, if they start getting carbs, they start getting insulin sensitive. They start getting some lows sometimes unless it's adjusted appropriately. This is where the, that's where the logistical stuff is the most difficult with type one. Cause you don't have your pancreas automatically doing it now.

 

Theresa Piela

So many boogie men.

Are you guys ready to shift to the Q and A portion? All right. So Donovan was chatting with Grok and he was wondering about ATP versus ROS production per calorie for fat versus sugar metabolism. And he says, Grok's answer is the opposite of what you guys are saying on your podcasts. This is very concerning for me right now after following you guys for almost a year now. I'm not sure what to believe.

Even the energy output of saturated fats, ATP production, is way higher than what you claim. I'm all for understanding stress, but part of the reasons you give for the stress are partly related to reduced efficiency of energy and drastically increased ROS of fat metabolism. Help me out here. I understand that the body needs glucose, and this can create stress in creating glucose, but if this information is true, then what am I to believe?

If I am misunderstanding you or misunderstanding the below information, then I apologize from my emotional outburst. So, Donovan, thank you for your question, by the way. I think this will be helpful for a lot of people. Grok responded first by going over ATP per molecule from glucose being about 30 to 32. That's an estimate. And then per calorie would be about 0.042.

 

And what was interesting is that they mentioned how in terms of ROS output, moderate per calorie in the glucose-driven state, and it can spike with excess glucose. When we compare that to fat or Grox response, ATP per molecule is about 106 to 108 per calorie would be similar to glucose, 0.046, 0.047.

 

Theresa Piela

And they also mentioned slightly lower port per ATP in terms of ROS output due to FADH2 reliance, which I know you guys will break down, and how it can rise under mitochondrial stress. So per molecule glucose yields 30 to 32 ATP through oxidative phosphorylation relying heavily on NADH. They argue this pathway, when functioning well, keeps ROS in check because the electron transport chain run smoothly, with electrons efficiently funneled to ATP production rather than leaking to form superoxide. Fats, like palmitate, yield far more ATP per molecule, about 106 to 108 ATP, but the process, beta oxidation, leans on a 1 to 1 NADH-FADH2 ratio. FADH2 feeds into complex 2, bypassing complex 1, a major ROS producer, which they suggest could mean less ROS per unit of substrate oxidized on a per calorie basis, though fats still edge out slightly. And it's comparing 0.046 to 0.047 ATP per calorie versus 0.042 to 0.044 ATP per calorie of glucose as Grok calculated. So no, you're not off base. They do say sugars outperform fats in ATP yield and ROS production, especially per unit of metabolic effort. If I've misread their take, It'd be on under emphasizing fast potential RS advantage via complex to something studies think at, but they downplay. let's start from the top. Mike, do you want to start start off here?

 

Jay Feldman 

Yeah. I think I just to frame this in general, I think this is one of the fundamental problems with AI. And I don't think this is, I don't think this is about Donovan at all. I think this is specifically about AI being a problem. Now here's the major problems with AI that I see that are exemplified by this. prompting the AI is like an art to ask it the question so that it understands the output that you want it to give you. So that's the first thing because some of the way that the AI is phrasing this is potentially related to the prompt. And even when I've interacted with the AI, I will ask it certain things. And then if I don't prompt it this very specific way that I need it to give me the output, it gives me really weird responses and answers. So that's the first thing I think.

 

You know, that's actually a big thing. Now, the one that's even more important than this is that the AIs get stuff wrong all the time. But the thing is, is that they get very specific things, very detailed things wrong. And like overarching pictures of some things are all right. And this creates a sense of like, the AI is giving me this truthful, this correct answer, this appropriate answer.

But it's not appropriate, but it's hard to parse out whether the answer is correct or appropriate or not unless you really specifically know the information. So, and again, like this is, I've gone into conversations with Chachi BT, with Grok, with multiple different AIs, and I run into this problem all the time. it's, some of it is hallucination. Like I've definitely got hallucinated responses that were like the like foundational tenants were just objectively wrong or but the thing are objectively wrong. But the thing is, is like unless you actually knew the specific thing you were asking about before you asked the question, you won't know that it's wrong. It's like I was having conversations back and forth with AI about very specific chemical pathways like organic chemistry. And I was trying to understand things. So I was reading a paper and then having the conversation with the AI and the AI was telling me things that were incorrect, at least based on what the paper was saying. And the only reason I could know the difference because I was actually reading the paper.

 

Jay Feldman 

To understand what's going on. And this is a case here where the AI is like making blatantly incorrect claims. Like the things it's saying are false, but you won't be able to tell it sounds good. It sounds right. It seems like it makes sense. They're talking about all the same things. That's using the terminology. So I think that's a huge problem with the AI stuff is that it needs like, it needs to be vetted in the user. If they're asking a question about something that they don't know, they can't critically vet the AI, which you know, For Donovan, he's like, look, I'm not really sure what's going on here. So let me ask somebody, let me ask you guys, cause you guys seem like you know what you're talking about with this. And I think that's, that's actually like a decent solution to try to either go in the research or read something or talk to somebody who you feel like they know the information. For me, that's what I'm doing, right? I'm going to go find a paper to vet what, what this thing is talking about. So I think for Donovan, I think it's like a good approach to try to vet the AI statements that have blatantly accepting them.

 

And then I think for everybody in general, it's important to understand this about the AI that like it could be 90 % correct and it could be 10 % incorrect or it could be 98 % correct and 2 % incorrect, but you don't know where the 2 % incorrect is. And that's a huge problem because sometimes that 2 % incorrect is really important and can like really fundamentally change how you think about things. here, but the main, one of the major problems with what the AI is discussing and there's there's blatant things around like, you know, the amount of ATP per molecule. When you start to look at metabolism, the size of the molecule, the number of carbons versus glucose and palmitate is significantly different. And then when you look at how they're metabolized in the mitochondria, that accounts in large part for the changes in ATP. So it's like you're not comparing apples to apples when you're looking at the metabolism of the glucose versus the fats because of the differences in carbons and how they're metabolized. So like comparing them on a basis here of, you know, how much ATP per molecule isn't necessarily super helpful to try to gauge which is a better fuel source. And Chad GBT like frames it this way and like, well, fats produce more ATP and this is something you see in the low carb sphere. It's like, well, that doesn't really matter that much. It's like saying that glucose or that fructose is more, it creates more glycation than glucose. It's like that doesn't really matter that much.

 

Jay Feldman 

when you understand things in the appropriate context. Now, the next problem here, the next huge problem that we get into is that ChadGBT is saying that fats create less ROS per ATP than glucose because they produce more FADH2, which runs through complex two, and complex one, which is where NADH runs through and carbs produce more than NADH, that's the site where more ROS is produced. They're saying, well, since more ROS is produced at complex 1 and more NADH is produced by carbs, then if you're oxidizing carbs, you get more ROS. And since fats use more FADH, which gets processed by complex 2, when you get less ROS, that's actually completely incorrect. And that's not how it works at all. It's like blatantly false. And I actually have a video on this on my science channel talking about reverse electron transport and the problem of reverse electrons transport is driven by the fats producing more FADH2 in ratio to NADH, driving more electrons through complex two. And then that is what pushes the ROS production at complex one. So this is actually an 180 degree opposite statement of what is actually going on in the mitochondria and physiologically. And again, like unless you actually go and read the like really nuanced paper on what's going on between carb metabolism and fat metabolism and then the ratios of NADH and FADH2 and how that affects things at the electron transport chain, you can't vet this statement. So it seems correct. It sounds about right. know, Jay and I maybe said some similar sounding things on the podcast, but chat GBT is, it's like blatantly false here. So this is, this is what I think the biggest thing, this is the most foundational piece. the ATP per unit molecule I mentioned too, but the FAD, the FATs drive, specifically drive increased ROS at complex 1 by producing more FADH and hogging coenzyme Q at complex 2. So that's the, this is why I think it gets wrong not to mention, Chaby GPT alludes to this, but carbs produce more CO2 and it's not that the CO2 necessarily mops up that ROS more. It's more that the more CO2 that's produced allows for an increased unloading of oxygen at the tissues to serve as the electron carrier at the electron transport chain, which also can speed up the rates of reaction overall because it creates a feed-forward reaction inside the mitochondria. So there's like again, like it gives hints to the CO2, doesn't get to the core points that we've talked about, kind of like gives a separate semi straw man argument or an incomplete argument from what we've discussed and it completely gets the fat versus carb utilization.

inside the mitochondria and electron transport chain wrong. And again, like, I think it's like, this is problem with the AIs. Even when I was going through some of the organic chemistry I was having a conversation with the AI about, like I had to correct it multiple times. It's like, yeah, by the way, I didn't get that right. Once you prompt it, but I would have only known to correct it because I was reading papers on the side to try to make sure what it was saying was like a hundred percent correct. So I can understand this part, the particular mechanisms I was looking at. So I think this is, That's the, I guess, debunking Grokken and also one of the big things if anybody's using AI to keep an eye out for that you need to really vet the answers because if there's like a fundamental thing like this that's wrong, it completely changes how you're actually going to understand what your interventions are down the line with your diet. And that could be a huge problem. That could be right. Because this, if you take Grok's word, was like, I'm going to, I'm going to eat a high fat diet, low carb diet because that's going to create less ROS than mitochondria. It's like it's actually you're doing the opposite of what you're shooting to do and that's a huge, that's a huge, huge problem.

Yeah, I've seen similarly even using a chat GPT trying to find certain studies and it will completely make them up and even give me a PMID and then I'll go search it and it's not real. I mean, I've even fallen into the trap myself, Mike, I love that you've emphasized doing a little bit more research and using it like a tool and maybe having some fun with it and asking questions that are feeling curious for you.

 

Theresa Piela

Taking the time to maybe fill in the gaps and question everything it says. Jay, when you look at this, this summary and its response, any other holes you wanna hone in on and talk about?

 

Jay Feldman 

The one thing I want to mention here too, is I think it is difficult for people to read some of the research. I think that is something that people do struggle with. I have had people say it's like, you and Jay all the time, you guys like, yeah, just read the research. like, I tried to read the research. I didn't really know what 100 % they were saying. So I do think it's important, even if you don't go with the papers, maybe try to look in some textbooks or something like this. And then on top of that, I mean, part of...

What I see part of our role is, is to like explain some of these concepts appropriately so that people in like try to make it, you know, more approachable for people, little like less of the lingo to try to break it down as much as we can in the videos so people can kind of understand things while still citing the research. Cause I think there's, you have other people, you know, like Dr. Ken Berry, who's trying to make it approachable to people, but you have to fundamentally be correct when you use your analogy first. You can't start just making an analogy to make it approachable. And then the like principles behind the analogy, like the entire perspective is incorrect. So the first thing and that's, you people say, you read too much research, you cite too much research. It's like that is a way for us to be like, hey, this is what they're saying in the papers directly. So you don't have to just take my word for it or take Jay's word for it. And then it's like, OK, now we're going to explain in our best of our ability what this means.

 

So that you, like in normal English, right? Cause the papers aren't written in normal English. That's part of the barrier is like you have all these terms like NADH and FADH2. It's like, what does that mean? It's like alphabet soup. I don't know. So the goal is to try to like make it as best as possible, a little bit more approachable. And other thing I want to say here that can be important is like, if you are getting, like if you're doing this stuff, you're feeling better, things are moving better in another direction is all like all together.

 

You can also gauge by your experience and some of your outcomes as well. Now you have to be careful here, right? Cause people go on keto and like the first, like after you get through your keto flu is like, I feel way better. And this is the best diet ever. But it's like, at the same time, you want to use some of your experience to adjust and rely on some of your own internal guidance system with what you're doing and try to figure out what's going to work best for you while trying to understand some of the mechanisms to the best of your ability, trying to understand the perspective as much as possible.

 

Jay Feldman

I'd say you want to like combine both like the real world experience on top of the theory. So you want to say is I'm going to do this and I want to see this outcome and then you test it out. That's just the whole perceived think act model, right? Is I have a perception that something's going on. I've been on keto for a year now. I can't sleep. My gut is like I'm all sensitive to all these different types of foods and I feel stressed out and I'm getting energy crashes and whatever else. I lost the weight initially, so that was great, but something needs to change. So like if I have a bit of carbohydrate, you know, do I feel better? Do some of my numbers get better over time? These types of things you want to set that up and engage from there when you're doing this type of stuff. So that you have the real world experience and you have some of the understanding of the mechanisms and theories like as you're going through that process. And then once you see your outcome, then you can adjust and go from there. Cause I think as much as for me, as much as I understand a lot of this research and read the research and like I'm, you know, how I'm having conversations with AI to figure out really in depth mechanisms about certain things as well.

And then going back and forth with the papers to parse that together. At the end of the day, a lot of things that I learned and a lot of the things that that prompted me to go ask those questions, to go read those papers was I experienced something in my own personal life. I was like, Hey, I need to change this. I need to fix this. What's the next step? What's the best thing to do? What am I actually looking for defining that set of goals and then figuring out how I'm going to get there and testing it out and then just adjusting. So it's this constant iterative process of trying to figure out what's going to work best for your system and then trying to understand why. And I think, you know, when you put it into that context, I think that is maybe at least when I'm, when I'm working with people, I find that that's a little bit more approachable. And we start to say like, what can we do to like move the needle in this particular direction? And also the why becomes important. The why and the how are important. Cause like, how are we getting this needle to move? How are we getting that A1C to drop? That's very important instead of like, it just dropped. It's like how and why is it happening and is it happening?

 

So you wanna have all three together instead of, yeah, drop them, good to go. So these are, I think, really important things. And the other thing I wanna mention here too is that just because, like, I don't think there's actually any paradoxes with this stuff. So just because you got better results on, or like you lost weight or you got better hemoglobin A1C when you dropped carbs initially doesn't mean then that adding carbs were necessarily the problem, or if you add carbs in, that things are gonna get worse.

 

 

 

Mike Fave

So there's like, it's, that's why we try to put the mechanisms and the pictures together and the context together here. That stuff is important. So you can understand again, why did this particular thing happen? I think these are, these, these components are really important. So, and I think even when Jay and I are like going and looking at somebody else's work, we usually start from the perspective of, okay, let's just understand this guy or this, this lady's, this point of view. Like let's just get into their shoes, understand what their point of view is. And then like, maybe like I go into it. I'm like, maybe I'm wrong.

Maybe I don't know what I'm talking about here and this person knows something more than what I do. So I get in, I try to fully understand the perspective that they're coming from. And then I work back from there instead of going in with this person is just completely wrong. They don't know what they're talking about. And I'm just gonna like invalidate it. And that's how over time, for me, it's been, every time we go through and we talk about some dynamic, like I learned something every time. Every single time we talk about somebody's perspective, like, we even with the vitamin A stuff, with the oxalate stuff, like I think for both you and IJ, like we get so deep into the weeds of trying to understand what's going on that we learn so much along the way. And it actually gives us a better picture as we go forward and helps us to work out some of the kinks and some of our own perspectives and improve them as we go. I think for everybody, I'd say, see things as this iterative ongoing organically unfolding process. This was something that was central to Dr. Pete's work. And this was something that like, this how I thought about things and how I viewed things was a massive like shift for me, like a life changing shift for me. Instead of saying like, I need to have my line drawn in the sand and I always believe this going forward or else I'm hypocrite and I don't know what I'm talking about. It was more like, I'm probably know like what I know in some of these areas I probably know pretty well right now. And there's things that I need to continue to learn. And as I learn more, you know, you see, you have to learn more more and more and more. So it just keeps going. Like it's gonna, it's like an endless thing. So I would approach this stuff.

Like that as well and I think that will eliminate some of the fear and some of the pressure of like, need to absolutely know this thing right now and like I need the exact answer. So I'm go to Grok and Grok's gonna give me this answer and now I'm more confused. It's like, it's gonna take time and understanding and working with the stuff to get it down pat. I think that's the, for me that was really important in my process and I think that may be helpful for other people. As saying with clients, that's how I try to approach things as well. It's like, let's just set this up and see how things adjust and we'll tweak and go from there. The other thing is a lot of people are like the response to things are very individualized, right? Like Teresa, we talked even on the other podcast, you do well with starches and I do well with sugars and then Jay's kind of in the middle between both. And it's like, we're all in this like bio-energetic, pro-metabolic perspective, but how we're skinning the cat is different based on our different contexts. then, you know, I think that's...

Those are also important things to consider as well and integrate into the process that there's going to be individualization with this, which inherently requires you to go through the process yourself and work out some of these components and use your real time experience as you move forward.

Love that you're emphasizing staying open and not necessarily needing to know or thinking that you've come to this conclusion or almost like you've pinned down this truth or this absolute because I'm sure all three of us are continuing to evolve and refine and even question things that we thought were true. And I think back to carnivore days where

There was absolutely a period of time where I thought this was, that was the answer. You know, it just felt like this is the ideal optimal diet. And I kind of brainwash myself in a way and to look back and see that as a beautiful learning opportunity that there's so much to be said about staying curious and not letting fear dictate the way we take in information. And I'm not saying Donovan did that at all. In fact, it seems like he was using his curiosity just to see if he could vet what you two were saying on a different podcast. maybe taking, know, continuing to be curious, ask the questions outside of chat GBT or whatever source that is. 

 

Theresa Piela

And yes, Mike, love the emphasis on experimenting, gathering data and recalibrating as new information reveals itself, as the body maybe presents things that you wouldn't really see in a paper or in a study, but you've got that firsthand data point that something is amiss or your body's trying to nudge you in a specific direction. I we can overcomplicate things sometimes when if we tune into real-time symptoms and feedback, there's so much to be said and yes I know sometimes that might feel complicated to try to parse out what is leading to what but if we can calm down and stay curious let fear be over in that corner and use the curiosity as we investigate and and play around it can be kind of a fun process as things start to improve.

 

Theresa Piela

I think now's a good time to wrap up this episode. Do you two feel like you've gotten a good conversation in today?

 

All right, Mike, where can people find you?

Mike Fave

They can find me here on the Bioenergetics view as well as on Energy Balance and they can also find me on my website MikeFvbe.com and my YouTube channel MikeFave. 

Theresa Piela

Awesome. And you can find me at Living Roots Wellness on Instagram or livingrootswellness.com or my tapping community at tappingwitht.com and also on the app store. All right, guys. Thank you so much for listening. Thanks for watching. Feel free to drop any questions below. We'd love to see them and we will see you on the next episode.