Theresa Piela  0:00  
Okay, welcome to the bioenergetic view. I'm your host, Theresa piela, joined, as always, by Jay Feldman and Mike Fave today, we'll be discussing one of Sean Baker's posts comparing gluconeogenesis to cholesterol synthesis,

is it? Does he have any legitimacy comparing glucose, gluconeogenesis to cholesterol synthesis? Let's just kind of break down his argument from the from the basis, and see if we have anything we can pull from this. 

Mike Fave  1:57  
So to directly answer your question, no, they're different pathways that are involved in different processes, and they're doing different things. So the arguments aren't comparable, as the physiology between them is quite different. So it's you know, you're he's making a he's making comparison to make his point. But it doesn't, doesn't even make sense, like it's not a you, the perspective in which you would up regulate cholesterol synthesis versus up regulate gluconeogenesis are for different purposes. And the fundamental question here for gluconeogenesis around energy, an energy substrate to revive energy altogether, and also, there's also other components here that aren't,

Theresa Piela  11:59  
it seems like, it Seems like there's, there's no sense in it, but don't tell him I said that, he won't hear me, right?

Mike Fave  12:06  
He's a nice guy. He's not going to get mouth ring. Oh, sorry. Sean, yeah. I mean,

Theresa Piela  12:12  
I understand people have to put out content, but, yeah, this one's interesting. Jay, what was your reaction? Like a nice guy? Theresa, go ahead. Jay, okay,

Jay Feldman  12:22  
yeah. I mean,

Mike Fave  2:39  
aren't correct. So we're aren't the argument that he presents is a little bit of a straw man argument here. So the first thing is, the question is not about just stressing out your liver, at least the the pro metabolic perspective to start, wasn't that up regulating gluconeogenesis stress is like the biggest problem is that it stresses out your liver. Now it's a portion of it, in the sense that up regulating gluconeogenesis leads to a net negative ATP status at the liver, because the ATP has to sacrifice, or the liver has to sacrifice ATP to to produce glucose in this process as well as detoxify ammonia. So from a, if you're in the context of of gluconeogenesis, if you are have a you're trying to produce energy, right? The fundamental goal here is to produce an or a fuel source, which is glucose, that you can produce energy so you don't in the process of doing that. The goal would not be to have a net negative energy status. So that's, that's one thing is like, from an efficiency standpoint, it's a like, a terribly inefficient process to produce glucose. And fundamentally, the body already knows this, and is already has mechanisms to counteract this, which is ketogenesis. So when you you have, when you start to push high levels of gluconeogenesis, or you don't have carbohydrates coming in, eventually you move towards a ketogenic state, depending on how much protein you actually are taking into the diet. So that's one thing is, it's not really about stressing out the liver. Stressing out the liver is one component of it due to energy depletion, but the fundamental component of it is this is like the worst way to generate energy. Now, the next thing is, the argument from the pro metabolic side isn't necessarily which I think this is in response to pro metabolic maybe it's not. But from a pro metabolic standpoint, the argument isn't necessarily for people to have a low fat, low cholesterol diet. The argument here is have adequate carbohydrates in the diet, and to make sure that there's not an excessively high fat intake. So it's the it's kind of setting up a false dichotomy, that you are either on a high fat, low carb diet or a low fat, high carb diet. The question from from our perspective, is, what is the optimal amount of fat required? For absorption of of micronutrients, like fat soluble vitamins, for production of cholesterol, for stabilization of blood glucose, for the release of bile acids, for satiety, etc, etc, etc, not, oh, we just need to make fat as low as possible. That was never the perspective, and that wasn't that's not the point. So this is a false dichotomy on the other side. So there's not really looking at 300 to 1,000% increase in cholesterol production. We're not it's not a push for that. So that's another thing to keep in mind. And then now, from there, we get into the we get into the next piece here. And just because our body is designed to do something doesn't necessarily mean that it is beneficial or optimal. So this, this also isn't a question of is this, is our body designed to do this? The fundamental question that everybody in health is asking, so it's a weird frame that he's entering here that is like irrational to the fundamental goal of what provides optimal health. We're not, we're trying to determine what is optimal, not just what is and when you start to look at the breakdown in terms of forcing gluconeogenesis, you start to see that there's negative ramifications of doing that, especially at a certain point. So the question more gets to not, is gluconeogenesis good or bad? It's like, Yes, we all know fundamentally gluconeogenesis is going to occur. The question is, how much gluconeogenesis is actually optimal for our health? Do we want to ramp up gluconeogenesis? So it's, it's a question of, what are we pushing where's the optimal level? Because we're always going to have some of this occur. And it's, that's the same thing with fatty acid oxidation. So this is like the he's setting up a false dichotomy and and then also arguing between these two separate processes, completely missing what the fundamental purpose is of the bioenergetic or pro metabolic argument against running some of the carnivore diet. Now here's the thing, there's problems with massively ramping up gluconeogenesis, and these are the arguments, or at least some of the arguments, against gluconeogenesis. So one gluconeogenesis, in the process of producing glucose, particularly from amino acids, leads to production of ammonia, which is a toxin. It is a metabolic toxin. It has to be processed. The body is capable of processing it, but in doing so, it requires the utilization of a variety of different resources, including ATP, including energy. Now this, and with that said, this is a net negative process energetically for both the liver and the kidney also this. The gluconeogenic process comes with an up regulation of a variety of negative hormone responses. And so the question isn't, is glucagon or cortisol or adrenaline bad? That's no it's not that these things are fundamentally bad by themselves. It's do we want to optimize for these hormones at a higher level, and given what their effects are, what we see in different disease states, like type two diabetes, compared to glucose tolerance, et cetera, where you see higher levels of these things, and also what their particular effects are, terms of forcing fatty acid oxidation, in terms of breaking down muscle tissue, in terms of impairing insulin sensitivity, we don't want to select for higher amounts of these and forcing gluconeogenesis necessitates increasing these hormones. So we're like we're pushing in a direction that's not ideal when we're starting to heavily up regulate gluconeogenesis. And the other thing is, in this gluconeogenic process, when this typically goes on, and particularly in the context of a carnivore diet, you're also drastically up regulating fatty acid oxidation, which will drive more mitochondrial Ros, drive further insulin resistance, lower CO two, decrease antioxidant status, etc. And then on top of that, you move when you're pushing gluconeogenesis towards a catabolic state where you're degrading amino acids as well as glycerol backbones, but also you're pushing quite a bit of amino acid degradation. So all of this together, these are net negative things, just especially to like push at a very high level. So the question is, again, how much gluconeogenesis do we want to push and the art so the argument isn't, do we have it or do we not have it? Is that we don't want to have high amounts of it, and these are some of the reasons why. And this is especially in the in the case that you can just take exogenous glucose, you can have exogenous carbohydrate. So you don't need to run through all these back pathways and drive all these external processes to have this negative impact, or to that, or to to get this glucose molecule, to get the carbohydrate, you can just take in carbohydrate without having to go through any of this, and just have an adequate protein intake and then also have an adequate fat intake. So the whole argument here. It's a false dichotomy. It's a straw man against what's actually being presented and the context in which is being framed makes no sense. The question is not, you know, do we have these processes in our body, or we have these processes in our body? So therefore they are fine. The question is, what is the optimal state? What are the things that we. Need to do as humans, as individuals, to optimize our health long term. And that the turn that involves, like, how much carbohydrate versus not, how much protein, how much fats, etc. And the last piece I want to talk about here is that he says here, this is kind of like believing that breathing, which also rides stress, is bad to do too much. And it is, it is bad to breathe too much. So it's like he fundamentally either doesn't understand physiology, but excessive breathing, aka hyperventilation, blows off CO two, drives respiratory alkalosis and creates a stress response, which is something we see with your typical What's this guy's name? Wim Hof. Wim Hof, breathing, exactly. So, so, yeah, so breathing too much is bad. The question is not, is breathing good or bad? How much breathing is bad is yes. Can there be a too much? There can be a too much, just like there can be too much protein, and there can be of too much pushing towards gluconeogenesis, and there can be not enough carbohydrates, and you can also have a state where you can have too much carbohydrates for somebody? So the question is, how much? And we want to be precise about that. So again, like this whole, whole statement, whole argument is just, it's like a nothing burger, like it doesn't actually get to the core of what the arguments and points that we're talking about are, and it dismisses a lot of really important facts, like, Well, we do gluconeogenesis, so therefore it's fine, and it's like, that's not even the argument. It's like a completely tangential point that's not relevant to the conversation.

Theresa Piela  11:28  
Yeah, it reminds me of just the kind of the state of chronic stress. You know, someone who hates their job has a really stressful home life. They're kind of just surviving. They don't have any time to thrive or create just because their body is equipped to handle that doesn't mean it's anywhere close to what would be ideal if we're thinking about like a really, a really well functioning organism, like it's, it's, yeah, it's just, I agree, Mike, it's, it's a silly frame, and I and I,

Jay Feldman  12:24  
think you touched on a lot of the really important points here. There's, I mean, a number of overarching, just like obvious issues with the entire post. And that's really what you were digging into, Mike for one again, we have a straw man where people aren't saying or maybe some people are but the real argument, the informed argument, isn't that gluconeogenesis is driving the stress, it's that it's a product of stress. It is the result of stress, and that stress that is happening is not ideal. And you know, the requirement there is energy deficiency driving adaptive stress hormones like glucagon, adrenaline and cortisol, all of which can drive gluconeogenesis. And then, you know, each of those are adaptive, right? They provide fuel, one of those fuels being glucose, via gluconeogenesis, also fatty acid release from the fat tissue, and this helps us deal with stress. No one is saying that it is bad to have these hormones, that we would be better off if these hormones didn't exist, or that any amount of these hormones is bad and it's better if you have zero like none of that is what we're saying. Again, we hear these straw men all the time. Just because too much cortisol is bad doesn't mean we're saying that you should have zero cortisol. Again, these things shouldn't have to be said. But anyway, when it comes here, you know, comes to this question of gluconeogenesis, the concern is the underlying stress that drives the stress hormones that drives gluconeogenesis, and gluconeogenesis up regulation being a reflection of that. So just to make that part clear, and then, as you you know, you touched on some of the details there. Mike, you know, in terms of concerns at the liver more specifically, but you know, on a broader sense, we're concerned about the underlying energy deficiency driving the stress hormones, and then the downstream effects of those, right? The stress hormones are going to lower t4 to t3 conversion. They're going to end up driving up regulation of fatty acid metabolism, and have a number of other downstream effects which are then concerning, which again, comes back to the frame here, which, I mean, you just, you can't put a post like this out and really be thinking through it very much, like, it's just incompatible with, like, any level of critical thinking here. You know this idea, like, just because your body can do something, it's okay, like, so you're saying that there's no biological effect of anything that happens to our bodies. Like, what is disease? What is a response to, I don't know, eating 3000 calories of PUFA, or 10,000 calories of PUFA, like your body handles that. It just you might not like what the response is. You might not like the effects that happens. And. And you know, along these lines, most of the low carb people are saying that the the normal things that your body does when there's glucose consumption, when there's carbohydrate consumption, like producing insulin, is inherently harmful. You know, even though it's something that your body can can do, you know, it's a normal part of of human physiology. Again, it's like saying that our bodies are designed to produce fat when we eat 15,000 calories a day. So it's not unhealthy to have excess body fat, because we're designed to do that. That's our normal response. It's like the I don't know like to put a post out like this. It just isn't obvious, like just lack of thought, which, again, is, I think, a theme when we go through a lot of these, these sorts of of posts reels, whatever it is, is, is, you know, the nature of social media necessitating just putting out frequent, frequent, like content. Yes, frequent content, but just like content without value, right? Like, just, just like numbers. It's just a numbers game. It's just a, you know, you have to post every day, and it doesn't matter, like, whether there's any effort being put into it, for all we know. I mean, maybe Sean didn't write this. I mean, who knows. But anyway, when it comes to creating a diet for optimal health, there's a lot of conflicting information out there, and that's why I've created the energy balance food guide to help you determine exactly what to eat, to optimally support your metabolism and help you lose weight, improve your digestion, get amazing sleep, boost your energy and so much more. The energy balance Food Guide is a one page infographic that organizes foods on a spectrum based on how effectively they support your metabolism, and it also has a separate spectrum that adjusts the scale for you in the case that you're dealing with various digestive symptoms, the food guide makes it extremely easy to get started with a bioenergetic approach to optimizing your health. So head over to J Feldman wellness.com/guide to download your free energy balance Food Guide. Yeah. And then, as we've talked about, like, the stress hormones here, it's like saying that just because cortisol is produced in response to stress, like, that's a normal body or normal body's response. So having high cortisol levels isn't bad, like that is what we're equating here. And then to take it a step further and say that breathing is stressful, he said breathing also provides stress. So it's bad to do too much, which, as you said, My hyperventilation is very much stressful. It's a huge consideration. But also normal breathing isn't stressful. And that brings us to a second or third, whatever number we are here, crucial oversight here, which is that stress doesn't just mean whatever you want it to mean like you don't get to pretend that anything that you want causes stress, or any process that our body undergoes causes stress. It has a real definition when we're talking about physiological stress, and if you don't have a functional definition there, of course, the response when someone says that a low carb diet drives stress, the response is going to be, well, that's nonsense. Everything causes stress. Breathing causes stress. I don't feel stressed right now and I'm on a low carb diet, it's like, Well, it sounds like we're talking about different things when we're discussing stress here. And that's important. And maybe if we are able to kind of rectify that, if we're able to get on the same page there, we can actually go somewhere instead of the straw men and kind of just poorly thought out arguments and and kind of valueless content. So I don't think of anything else to say,

Theresa Piela  18:38  
well, at least he's a nice guy. The

Mike Fave  18:41  
one thing I do want to just mention here, though, is that even with breathing, like we have for a lot of these things, we have defined ranges as what's considered optimal in different contexts. So it's it again, I think the most important thing that we're looking for is from a fundamental health standpoint, like a we want to we want to get to clear definitions of what we're discussing, right? Even with stress, we wanted to find, like, what is we actually talking about with stress? In the bioenergetic perspective, we're talking about energy supply and demand mismatches, talking about having an excessive demand or a lack of supply, or factors impeding the flow or conversion of fuel sources into energy, and then that leading to a lack of energy, fundamentally causing stress. So like, we have a clear definition of what stress is. And then from there, you can actually, when you create a line in the sand and you come up with a definition, then now you can work through stuff so that you're not just making arbitrary statements and remarks. And then we're also, we want to get to a point. And this is the same thing with, like, the same thing with the lab ranges, stuff, all this, all these components, is we want to get to figure out what is optimal in the context. We want to understand like from these things, what is the what are we shooting for in terms of optimal markers and optimal outcomes? Instead of saying, Oh, well, the body can do this, it's a irrelevant to argument that the body can do that thing. The question is, what is the impact of that long term on the body? Right? Whether that's because you see this, it's like, oh, well, cortisol is not bad. Cortisol responds to stress. It's like cortisol and high levels is fundamentally bad. Now you need to have some cortisol 100% nobody's arguing that you want to have zero cortisol or zero of any hormones. It's like, after a certain point, and we can see this in research. This is not just about population distribution averages that we see with these lab ratings. I see that in the comments, well, oh, all the lab ranges are just distributions. It's just the average values. It's like, there's actually research, a lot of research, on individual lab values targeting what's the optimal lab value for different things, like TSH being around two, being associated with some of the lowest mortality, two or less. If you start going over, it's pretty negative. And if you go too low, there's also some negative ramifications of the research. So we have data on these try and understand what's optimal. And so you have the optimal range. And then on top of that, you can have the effects of these particular hormones. If cortisol gets too high, there's immunosuppression, there's degradation of muscle tissue, there's there's degradation of the central nervous system, there's increased blood pressure, there's damage to the cardiovascular system, there's impaired blood glucose regulation. So the argument so then the thing is, like the stress itself, driving cortisol isn't good, and then while cortisol helps to respond, driving high levels of cortisol over the long term is also bad. It's also not a good thing. And that's the same thing with gluconeogenesis. Can your body, when it doesn't have adequate glucose, create glucose through the process of gluconeogenesis? Yes it can. Does it do that on a regular basis? Yes it does. Is there a limit or a threshold at which that starts to become pathogenic and has negative ramifications long term. Yes, there is there is a limit and there is a threshold. And the question that we're asking is, where is the limit of that and what is the context that creates that limit? So we actually have some tangible recommendations and adjustments that people can make to fundamentally improve their health, instead of like, well, our body is gluconeogenesis, and it always does it. So therefore, it's fine. It's like, is a complete it's like the moderation argument, that it like everything in moderation. It's like, that means absolutely nothing. We want precision to know where exactly we're going to be. I think these types of arguments it, it's like even saying, well, trying to make an argument, oh, breathing, breathing too much. Uh, haha, that couldn't be bad. And it's like, that literally proves the point right there that you like a fundamental misunderstanding of physiology. And if you can, even when I was in the ICU, we would be understand, we would understand what was going on with a person based on the respiration rate. If I come in there and the person's breathing in a certain pattern and in a certain rate, I know that they're under severe metabolic distress, or trying to blow off CO two because they're having significant metabolic dysfunction. So it's like there's actually definitions of two there. Also, if I go into a room and somebody's respiratory rate is extremely low and they've been getting opiates, well they're probably getting a little bit too much. Little bit too much opiates, and they can get respiratory depression, have a problem. So we have defined standards and ranges for these things to try to understand what's optimal and then stay within those particular ranges to prevent problems, to prevent ramifications on either side of these spectrums. So this argument doesn't get to the point of that. And it's like, you know, if this is where your standpoint is, and it's like, what is the rest of your fundamental understanding of health and getting outcomes for people? It makes me question that very heavily, because the the This doesn't seem like somebody who's looking for a precision and understanding and making particular adjustments or finding an optimal range for people, like, Oh, our body just does this, so therefore it's fine, like it's not even a rational argument.

Jay Feldman  23:45  
Yeah, and I think you're what you're pointing to is that there's a huge piece that's missed, which is that our bodies are incredibly complex, intelligent, adaptive systems, and so there's no adaptation. There's no response that happens in a vacuum or in isolation. If your body's recognizing there's a lack of glucose, yes, it up regulates glucagon, among potentially other hormones to increase gluconeogenesis. But that's not it. That lack of glucose in the environment acts as a signal in other ways. And we can see that based on the downstream effects of those hormones, for example, the consequence in terms of reducing t4 to t3 conversion and again, to then say, Oh, well, that's it. And all t3 does is support glucose metabolism. So you don't need t3 is, again, looking at this in a vacuum and not recognizing the fact that t3 is going to have direct effects in terms of reproductive hormones and immune function and digestion and cognitive function and skin health and cardiovascular health, and literally every other thing you could think of, because this isn't just happening in a vacuum. And so to your as you're getting at, Mike, it's like, if that's the depth of of your of like, complexity of your view of human physiology. I mean, how are you how can you help anybody to improve health issues like you, you're just, it's so. Myopic and reductionist. So, yeah, I think what we're getting under the crux of it, I mean, that's, that's really the concern here.

Theresa Piela  25:09  
All right, shall we move on to another interesting argument? Yes, of course. So when I was looking at Dr Cyrus website, it was interesting. He was saying carbs are toxic, harmful substance often eaten in response to emotional tension, which is kind of the crux of his argument, that it's not carbs that are problematic, it's your relationship with them. And he says he helps convert people from toxic sugar burners to healthy fat keto burners, and address the root cause of addiction to carbs from an emotional management perspective. So there's already some interesting things going on there. Carbs aren't bad, but they're toxic, but it's only because of how people think about them, how they relate to them. But let's start with this first clip and see what he has to say.

Speaker 1  25:58  
Remember this, carbohydrates do no harm. Ooh, that's a big statement. Carbohydrates do no harm, okay, our relationship with them is the problem. Our relationship with carbohydrates is the problem. Okay, no mammal exists without carbohydrates, and without the consumption of carbohydrates. Okay? They're in milk, and they're not there because somebody was playing a prank on us. They're there on purpose, glucose and galactose. So the point is that those influence hormonal cycling. Now when you are when you shift from using carbohydrates as a small component of food to trigger insulin toward using it as a drug to manage your emotional need, you overwhelm and distort the system, and that causes metabolic dysfunction. So insulin is always high, and whether you are a high producer of insulin or a low producer of insulin, diseases occur from all of that, but it's the hormonal disruption that occurs in our bodies, based on what we do or our age, or whatever it may be, that influences metabolic health, and nobody looks at that. How many people know anything about glucagon? I measure it in every single patient all the time, because glucagon is more important than insulin.

Theresa Piela  27:24  
Okay, Jay, so it's just my emotional tension and drama that's causing me to want to eat carbohydrates. Am I? Am I interpreting this correctly?

Jay Feldman  27:36  
It sounds like it, sounds like it, and the cars do no harm, except if you have this bad emotional relationship to them. Or, more accurately, what he's really saying is small amounts of carbs do no harm, but after that, they definitely do harm, as we hear not only throughout this clip, but the rest of the clips. And as you mentioned, like on his website and everything, I mean, it's the frame here is, is almost like I want to say something outrageous that people don't expect me to say, and that also will sound profound and will be different from what you're normally hearing. But also, I'm going to say the same thing, which is that carbs in small amounts are okay, at least in terms of, like, of milk that you know a baby's getting. But outside of that, if you're eating more carbs, it's because of this emotional issue, and that's definitely going to cause harm because of the impact on hormones like glucagon and, yeah, I mean, it's, you know, there's not too much being said here. I think it'll be an interesting frame when we then look at the things he says later, because he definitely talks a lot about harm from carbohydrates and totally independent of any emotions or psychological relationship with them, just based on the physiology. So I don't think it's, it doesn't sound really genuine to me because of that, like it's, it just directly contradicts the things he says later, and you know, he says later, that eating too much carbs causes diabetes and obesity. He blames eating too much carbs as for the reason why people need bariatric surgeries we'll talk about later. So, yeah. I mean, I don't, yeah. The other thing is this framing of one hormone being more important than the other, that glucagon is more important than insulin. Again, it seems like one of these kind of tactics to talk about something that people don't talk about as much and frame it as if, like, you're the expert on this topic, and it's something very different. We'll definitely be talking a lot about glucagon. He has a few other clips about it, and it'll be interesting to dig into those. But it's reminiscent of someone else who did the exact same thing. They were talking about one hormone being like, more important than the other ones. I can't remember who it was. Mike, do you remember who that was?

Mike Fave  29:42  
Was his name, Marty. Oh,

Jay Feldman  29:45  
is it Marty Kendall?

Mike Fave  29:47  
Marty Kendall, like, yeah, went after the podcast because we were talking about glucagon being problematic, ah.

Jay Feldman  29:55  
And he was saying that we were, he was saying that we were saying that,

Mike Fave  29:59  
yeah, he was. He. He was saying, we were talking about how glucagon is a feat, like, a central piece in type two diabetes. It's its levels are elevated and it drives insulin resistance. And then he was, I think, framing who, like, he name dropped you, and then like, didn't really address any of our arguments. Made an article about it, but didn't it. Didn't like counteract, but that was, I don't know if that's what you're talking about, but that's who I remember when we made the glucagon series, and that guy made the article about it,

Jay Feldman  30:27  
yeah, yeah, that sounds right, one of the very early bioenergetic view episodes. Okay.

Theresa Piela  30:32  
Anyway, he must have had some pretty high glucogon levels, right?

Mike Fave  30:37  
A lot of these, a lot of these guys select they they think that glucagon is a beneficial hormone, so they select for glucagon which day and I have talked about, and like, we've talked about at length in multiple different videos, but it's, it's highly problematic. So it's, for me, it's weird to see this, this doctor, Dr Sai, was promoting it, or, like, seemingly starting to push, like he's going to the benefits of glucagon, which is really questionable, like it makes me think that he hasn't actually read the papers on glucagons influence and impact inside type two diabetes, and basically being able to reverse type two diabetes by blocking glucagon signaling or abolishing the glucagon receptor through genetic mechanisms in mice. So because the glucagon increases blood glucose levels and drives peripheral insulin resistance directly, that's one of the major functions of glucagon signaling. But for this clip here with him, just, I mean, it's he, I think this. He's slow walking out of carnivore. It's basically my take on this. I think that he is. He's like, trying. He's like, realizes that some clients need carbohydrates, and people are doing better with carbohydrates. And he's recognizing that people are coming and saying, like, Hey, I'm having problems with this carnivore stuff. And then they add carbs, and then they get better. The tide is shifting that direction. You're starting to see a lot of people do this. A lot of these carnivore influencers are shifting over as well. And so I think he's like popping on the wave here, but he has, like, one foot in carnivore, carnivore ideology, and like one foot trying to rectify the idea that carbohydrates aren't the problem with carnivore ideology. And then tacitly, slow walk that process over. But the way he describes things is that it seems that he doesn't fundamentally still understand the physiology in terms of why insulin resistance actually develops or why insulin is high, so I don't think he gets it yet. Maybe it'll take a little bit more time. But basically, it's not that you eat carbohydrates and then you have chronically high insulin levels, right? That's not the problem. You eat carbohydrates, insulin acutely rises and comes back down. Chronically elevated insulin levels to be talked about multiple times are a problem of metabolism at the cell. So until Dr siwes starts to understand what's going on metabolically at the cell, he will have these weird perspectives where he highlights glucagon as this beneficial hormone, or as the hormone of interest, and insulin is the bad guy, and tries to create these dichotomies between them, instead of understanding what's fundamentally going on and why is glucagon elevating the state wise. Or why is glucagon signaling increase in these states? Why is insulin signaling increase in the states they should have a paradoxical or Reciprocal inhibition of each other, where, when insulin is high, glucagon is low, and glucagon is high, insulin is low. So it's just weird takes, but I think it's part of his transition into into this fear. And then the other thing that really rubs me the wrong way, though, with this whole perspective, is just this addiction thing. It's like, oh, you're just addicted to carbohydrates. That's the problem. It's you. It's your fault. You have original sin, you have carbohydrate addiction, you have trauma, and you're just trying to use carbohydrates. And again, it's a fundamental misunderstanding of stress pathways, stress hormones, and why people actually have cravings for carbohydrates when they're stressed. It is an intelligent response to minimize tissue degradation through the stress hormones like glucagon, adrenaline, cortisol, to break, to raise the energy substrate supply, or the fuel supply. You're like, Oh, your body basically says, Hey, instead of me raising these stress hormones because I have this increased energy demand externally, or maybe a lack of energy supply, how about I crave this external fuel source that I can go and eat. And therefore, I don't have to break my tissues down so I can maintain my energy, my structure, right? I don't have to break down my structure to continue to exist. And so this framing of the addiction thing and pushing it as a, oh, you're just an addict, and you can't control yourself with carbohydrates, and that's why you shouldn't really have them. But we kind of need them as, again, like a completely, complete, like, it's a story. It's like a fable. It doesn't really tell us what's going on in terms of, in terms physiologically, why people are craving them, and also, people aren't having these disorders because they are just eating too many carbohydrates. You can talk about food addiction in the sense of highly processed foods. That incorporate very heavily refined carbohydrates with a bunch of fats and salts and additives, etc, etc, and say that creates reward pathways, or creates addictive pathways, or tendencies towards food. But I'm not really seeing people out here with blueberry addiction. Maybe when you first come off a low carb diet and you haven't had carbs for, god knows how long you start to have carbs you're going to want to eat. But outside of that, most people that I've worked with, and I think it's probably the same for you guys, and even from my own experience, like I have carbs every day, I'm not addicted to carbs. I don't I don't feel like I need to overeat them a lot. But it just when I first transitioned out of low carb, I was like, Oh, I really want to have some carbohydrates. And then after that kind of stable, stabilized. And again, I think the food choice here is really important, because you have engineered foods that are there to make people really want something, and then you have foods where it's like blueberries or potatoes or something like this, that don't drive that same response. And we and we need to differentiate that, because not all carbs, not all carbohydrate foods, are the same. There's differences in how they're metabolized. There's differences in how people the people's preferences for them, and there's different differences in terms of their effects on hormonal systems, digestive processes, etc. So just lumping in as carbs, I think, is also like, not really helpful for the audience, and creates a false paradigm for people. Yeah.

Jay Feldman  36:19  
Just to add real quick, I would say to that even the kind of processed food addiction is still a reflection of an underlying physiological deficiency, or need, so to speak. But obviously, as you're saying, too, there's also some kind of taking advantage of of certain reward pathways and things like that. But still, I think that's that's a layer on top of, still a physiological need, like other addiction too. But obviously that's a whole other conversation. Yeah, I

Mike Fave  36:46  
think that's a marketing piece, though, right? Because people have the cravings for the food, and you're marketed that if I crave carbs, I have a cookie, right? Or when you think of something salty, you think potato chips. And so I think that's where it's not that I shouldn't, don't think people should feel bad for wanting those things, but I think they need to understand that this is a craving for a particular nutrient, whether that's salt, whether that's starch, whether that's fat, and there's probably better ways to meet it than your difficult your typical store bought junk that we have nowadays, and I think that is, you know, And those things also enhance the craving once you start eating some of those, those foods, specifically, it's very easy to start to eat very large volumes without having the same levels of satiety with the typical foods that we would have responded to. So I agree with you, Jay, I don't think it's just, I don't think it's I think there's a marketing component that we you know, when you grow up, it's like, what snacks you have instead of having fruit, you have gushers, that's what or fruit roll ups or whatever else

Theresa Piela  37:46  
which might digest better for some sensitive guts out there. So maybe there is that wise, adaptive quality in terms of the person really just trying to feel better, and, you know, trying, trying to get closer to a better feeling state, with all the shame packaged into that, but let's, let's watch a couple more of these clips. Because, you know, carbs aren't bad, but they will make you overweight. So let's see what he says about that.

Speaker 1  38:13  
The two lessons I learned as a bariatric surgeon is, number one, the problem wasn't eating fat. And remember, in the era that I grew up in, everybody blamed fat for being fat, okay? And it was clear that these that my bariatric population, were not fat because they ate fat. They were fat because 80 to 90% of their diet was carbohydrate. And when you measure the insulin, their insulin levels were perpetually, massively elevated.

Theresa Piela  38:40  
Okay, let's let's add in a bit more before

Speaker 1  38:43  
we chat. If you look at calories, and let's say you eat 5000 calories from 5000 calories of sugar, 80% of those calories of sugar or carbohydrate, and you look at 5000 calories of fat and protein, same caloric load, you will not gain significant weight on the protein, or I don't call it protein on the animal product, but you will gain weight on the sugar, and the reason for that is you're triggering insulin.

Theresa Piela  39:12  
Okay, Jay, So insulin is the problem. Now, can you explain this to me, please? I'm lost in his in his hog wash, well,

Jay Feldman  39:21  
and this was what I was getting at, right? We we start out carbs do no harm, and then it's these people were obese because they're eating a diet of 80 to 90% carbs, their insulin was massively elevated, and then you only gain weight if you have this elevated insulin from carbs, you won't even gain weight from fat and protein. I mean, that's again, direct contradiction with where we started in this, in this interview. But, yeah, okay, so as a starting place, I don't think his patients were eating 80 to 90% carbs, you know, for their for their diets like I don't think they were getting 80 to 90% of their calories from carbs. Very. Really, nobody is doing that. There are some very, very, I mean, vegans and even vegetarians, probably not, like super low fat vegans are probably hitting that, maybe like fruitarians, but it's that's like a really hard diet to attain 80 to 90% carbs.

Theresa Piela  40:21  
I will add that when I was fruitarian, I was emaciated, you know. So, you know, 99% carbs, I could not keep any weight on. So, I mean, kind of a weight loss, stressful hack, if anyone's interested, would not recommend it. But back to what you were saying.

Mike Fave  40:37  
There is a population that was studied to eat 80 to 90% carbs. And they also did not have any obesity,

Jay Feldman  40:46  
right? But they did have super high insulin levels, right?

Mike Fave  40:49  
No, well, I don't, I don't know if they tested their insulin, but from a metabolic standpoint, it was, I think it was the Papua New Guineans of two casenta. They didn't have any. They their diet is like just largely sweet potato, like they ate sweet potato, and they didn't have any obvious signs of any of the chronic metabolic diseases they had. They smoked like chimneys. So they had oral health problems and lung issues, and then they had some arthritic concerns probably be from, like rank amino acid deficiencies and fat soluble vitamin deficiencies and whatever else. Because no one's saying that 80 90% carb diet is good, but they weren't obese. There wasn't obesity, and there wasn't there wasn't like obvious signs in the studies of type two diabetes or anything like this in the population. And on top of that, Japan, I think, up until a certain time frame, was like 84% carbohydrate diet from rice, yeah, yeah.

Jay Feldman  41:43  
Well, and that's what I was getting at. So the two key sent to from what I've seen, no signs of metabolic syndrome at all, even, like with age and everything, and incredibly high glucose tolerance. So, and that's what you see in the people who are, you know, in these native cultures where they're eating these super, super high carb diets, they have the best oral glucose tolerance tests results of anybody, and they have low insulin levels when you do look at fasting insulin. And the ones that we do have that data for like that is these are not the people who are going in for bariatric surgery, that's for sure. And with that, just looking at like the what's available as far as the data for like the Western diet, from what I've seen in terms of the most recent CDC data, the average Western diet is about 46% carbs, 36% fat and 16% protein, give or take a little bit on each of those. So a very, very far cry from an 80 to 90% carbohydrate containing diet. And again, what we actually do see in the people who are on those diets is no metabolic syndrome, not being overweight and incredible insulin sensitivity, not saying that we're advocating for these right major potential issues with protein deficiency and with that low of fat intake and everything. We're not saying that this is ideal, but to say that that's what was causing people's issues is, I mean, that's just astounding. Just to touch real briefly on the other piece, which is that if you eat 5000 calories of carbs versus of mostly carbs, or high amount of carbs versus 5000 calories of a high amount of fat, you won't gain weight because of not triggering insulin. So two things to mention here. One is you do trigger insulin when you consume protein pretty considerably. So that's the first thing. You're still going to have insulin, even if you're just eating protein and fat. But the second thing is we have over study, over feeding, studies that look at consuming large amounts of carbs or large amounts of fats or adding them on top of an otherwise kind of normal diet. And what we see pretty consistently is that over feeding with carbs leads to less weight gain than over feeding with fats. So just again, direct contradiction here, and this idea, which, again, is also directly contradicting what he said, is a starting place as a premise that carbs aren't harmful, but this idea that carbs drive weight gain and are harmful because of increasing insulin, and insulin is the bad guy, which we'll get into as he starts to talk about glucagon is just so, so inaccurate. I mean, it doesn't take looking through too much research to really put those pieces together. And this, this whole carb insulin model, that insulin is driving fat gain, is not at all supported. And we see numerous studies looking at high carb, lower fat diets versus high fat, lower carb diets, and what we see is, even in the case of low insulin, it doesn't prevent fat gain. And you can there are some of these studies where there's more fat gain, you know, on a low carb, high fat diet, despite insulin levels being far lower, like it's there's just so much direct evidence against that.

Theresa Piela  44:41  
All right, yeah, Mike, anything to add before we shift into glucagon discussions? No.

Mike Fave  44:47  
I mean, I just think both the statements that he made are false, like, blatantly false. I don't like going out and just saying statement like that, because it's like you want to provide some proof, but the you. These are, like, easily verifiable things that you can see now, you can't verify his specific population, but because I don't know his client base, right? I don't know who's worked with, Dr Cyrus. So fine, like, maybe, like, maybe he had people eating 80, 90% carbs. But I think the probability of that is so unlikely that I just don't think that. I don't I think that he probably didn't even look at what their dietary composition was. Because I've had multiple clients that I've worked with who had gone to a bariatric surgeon and had gotten the surgery, and they didn't look at their diet in terms of their macronutrient breakdown, their total caloric and like, one of my close friends, had bariatric surgery, and when before he went to do the surges, like, I don't think it's a good idea, man, there's some long term ramifications here, and you can easily lose the weight just by setting up a reasonable diet. And when I looked at his diet, like he was already under eating calories, so he couldn't eat less calories than he was already eating. I mean, he I guess he could, but it was like borderline starvation. And his diet was crap, like, it was just a terrible diet. The food quality was poor. The food choice for poor, it wasn't 80 to 90% carbs. And he had other underlying problems going on in terms of his hormones, like his thyroid function wasn't great, and there's a lot of other things there. And I like, I asked him to do those labs to see, I asked him to see what was going on. And I was like, did your doctor do this? Ask you any of the stuff doing? He said, No. So I don't, I don't, I don't know how much they're looking he's looking at the diet. Maybe he does look at the diet, I don't know, but I think it's extremely unlikely that there was 80, 90% carbohydrate intake in his population. And the fact that he even said that makes me think that he didn't look at the diets. And then on top of that, you can very easily go and look at multiple studies over feeding studies and see that whether one is creates more fat gain than the other, doesn't matter. But the fact that you can over feed either fats or carbs and you will still see weight gain on either setup, no, it doesn't like this is very easily verifiable, so it's like a false dichotomy that was set up and no one's eating 5000 calories of protein. Not going to happen. You will have serious problems before you get to 5000 calories of protein, just even from a digestive standpoint, let alone the other problems that would come from eating that much protein in a day. So it's really whether you're going to overeat fat or carbs is a fundamental question, and both of them lead to fat gain. So it's just, these are just blatantly false statements, and it's a false dichotomy that's getting erected, which, again, when you go out and you make statements like this, and starts to make you question, Does this person actually read the study, like, read research or or understand the mechanism that player just saying whatever they want to say, and going from there? And it seems more to be the latter. And I don't usually like to make statements like that, but these claims are just so bold and just so kind of outlandish that I'm not really sure that this is, like, like, it's, I think there's a very high probability that this is just, like, pulling stuff out of thin air in some of the in some of these statements, because, just because, like, when you look at the actual data this, it's like, so far off. It doesn't even support doesn't support it.

Jay Feldman  48:02  
Yeah, and we'll get into that too with the glucagon here in a second. I mean literally, just the same thing, but just real quick. Wanted to mention for someone who's like, thinking of the average Westerner who's going to get one of these surgeries and is obese, and they're thinking, okay, they're eating french fries and ice cream and pizza and cookies. So they're eating an 80 to 90% carb diet. Like, if those two things are equating to you, then that's showing that you're really not digging into this very much. Like, it's show, like, there's a lot of dogmatic thinking showing because those like, if you look at the macro breakdown of all those things, we're probably higher on the fat side than carbs right now from those foods. So, yeah, you're it's not easy to eat an 80 to 90% carb diet. It definitely does not include those sorts of processed foods and that most people are like blaming health issues on, and potentially rightfully so. But yeah, I think there's, as you said, Mike, just a lot of outlandish claims that I don't think were verified in in any way.

Theresa Piela  49:00  
Yeah, and I'm thinking too, if someone is really obese and they're they are craving these hyper palatable foods that are high fat, highly processed, lots of PUFA, they probably, they likely have a thyroid issue. And, you know, not, not starting there and going to the aggressive, like, cut their stomach out, or they leave, like, two inches, right? They they leave a very

Mike Fave  49:23  
surgery you get. Depends on which surgery you get. There's multiple ones, and they do different things and

Theresa Piela  49:29  
different ones. But, yeah, well, yeah, just the concept of, you know, like, we don't like how this is working. Forget all the other factors. Cut this out. It's such a western approach versus, okay, what's going on with the individual. What is keeping them in such a Hypo metabolic stress state? Can we feed them better? Can we, like, rejuvenate the system before we hack into it? But let's see what he says about glucagon.

Speaker 1  49:52  
Remember, I said earlier on that glucagon is the most important of the metabolic hormones when you're metabolically healthy, and the problem is when you. You switch off glucagon, or you separate glucagon from insulin, and when insulin becomes the dominant elevated hormone, that's what causes metabolic harm. Okay? Because we don't see glucagon resistance, but we see insulin resistance.

Theresa Piela  50:22  
Okay? And then he's going to talk a little

Speaker 1  50:24  
bit more glucagon. Job is to provide energy to your cells, period. And of all the human traits, of all the animal traits, the single most important thing is energy provision to the cell. Without energy provision to the cell, you die. Okay? So the priority of a species is cellular energy provision, and glucagons job is to be sensitive to intracellular energy supply and respond to intracellular energy supply by producing and releasing energy from the human body.

Theresa Piela  51:08  
So Mike, essentially, he's, he agrees with us that energy is probably the most important thing we need to be looking at. But then he's like, let's do it in the most stressful way, and let's only look at this one indicator showing that stress is propping up the system is, uh, is that essentially what he's saying here?

Mike Fave  51:25  
Oh, so there's, like, a couple problems here, because glucagon doesn't provide energy to the cell. Glucagon provides fuel to the cell, which then has to be converted into energy, and then the the some of the major mediating factors in terms of whether glucagon is released or not, and gluconeogenesis is up regulated, is determined on external energy provision in the form of carbohydrate, and then subsequent insulin signaling. So and like glucagon is shut off by intra islet so inside the pancreas, release of insulin that turns the the production of glucagon from alpha cells in the pancreas down and stops the release. So it's not necessarily that it's just an intracellular problem is that there's an extracellular component, and so like, the understanding of the physiology of glucagon is off, and what glucagon is actually providing, it's providing fuel substrate. It's not providing energy. The other thing is, insulin is also directing fuel substrate. So it's taking exogenous fuel substrate and directing it as well. So they're both providing substrate, they're both pushing substrate towards the cell. They're just different substrates in different contexts, to large extent, right? Because glucon is forcing some of the fatty acid oxidation, directing more of the glucose production for the tissues that are using it. So there's a little bit more that goes on there. But on top of that, in metabolic dysfunction, it is characterized by high levels of glucagon. The more insulin resistant you become, the more your your glucose tolerance is impaired, the higher the glucagon levels, the less glucagon the the less response of glucagon to insulin you have so type two diabetics are characterized by a high fasting glucagon and an inability to shut off glucagon when exposed to carbohydrate into insulin signaling. And it's because the alpha cells, there's there's a lot of there's a lot more research that needs to go on specifically around this. Like, even as I was reading papers on this, they're not 100% sure exactly what goes on, but the alpha cells in the pancreas, which which release glucagon stop responding to the insulin release, and so you still get glucagon output, and you still get gluconeogenesis, even with insulin signaling and even with carbohydrates coming in. So the the metabolically impaired state is a state of high insulin and high glucagon and high blood glucose and high free fatty acids. And the fundamental problem is a breakdown of energy production at the cellular level. So it's clear that he doesn't understand how these different hormones interplay with each other. It's not just an insulin problem. The high levels of insulin that are that you typically see in type two diabetic states are a function of a lack of clearance of insulin, the cells are not responding to insulin, are not taking up the insulin and degrading the insulin and bringing in carbohydrate or glucose, bringing glucose with it. So you have a high circulating insulin due to a lack of response. It's not just because the pancreas is pumping out tons of insulin. I mean, in some people, you have an increase. You can have this, this compensation with production of insulin, but a large portion is due to impaired clearance. So it's again, like there's more to the picture, and it's not glucagon or insulin, both of them are dysregulated in states of impaired energy metabolism or in states of insulin resistance, and glucagon is typically high, and it's not a good thing to have a high glucon, because, again, glucagon forces fatty acid oxidation at the cell. It's one of the main things that it does. And then if you're driving fatty acid oxidation at the cell under hormonal regulation, you will have impaired glucose tolerance because of what happens via the Randall cycle. And this is a hormonal overlay into the system. These are, this is like, again, like a kind of a lack of understanding of what's at. Actually going on in terms of glucagon signaling versus insulin signaling, and why is insulin high? And is glucagon high or low in these, these different states? So it's, um, yeah. And I would say, fundamentally, if we were going to choose hormones in terms of, like, what was, what was fundamentally to good or ideal to optimize for, the goal would be to optimize for insulin signaling in the sense that you have you respond to insulin effectively, and you take in carbohydrates, you use the carbohydrates effectively, so that you don't have to have heavily relying glucagon and break down your body structure, break down your body stores, and force fatty acid oxidation up and up regulation these other pathways. So the I wouldn't put try to posit that insulin is the bad guy and glucagon is the good guy. It's a false dichotomy. There's more going on in the circumstance and fundamentally, like, I wouldn't optimize, as we talked about with Sean Baker, wouldn't be ideal to optimize for glucagon. It's probably like, not like they're trying to figure out how to lower glucagon signaling right now in type two diabetics, how to minimize glucagon signaling to improve blood glucose tolerance and insulin sensitivity, and they're creating drugs for that, and they're putting animal models together to knock out glucagon signaling. And again, as I mentioned previously, that reverses type two diabetes in the animal models. So just, I don't know if he's like reading the glucagon papers or what, maybe we can send him some of those. They'll be linked. They'll be linked. They're linked in the glue gone. Episode that we did, Jay has a whole page on the website.

Jay Feldman  56:32  
Oh yeah. Sun resistance episodes,

Theresa Piela  56:35  
okay, well, just, just putting that out there. Dr Cyrus, but Jay, anything else he he that brought up an interesting reaction for you, or maybe something he described incorrectly that stood out. Well, I love the starting

Jay Feldman  56:49  
place, which we heard in the the most recent clip about the relationship between glucagon and energy. It's kind of like in the last episode, when we were talking about Richard Smith The NAD plus NADH ratio. It's like we're inching in the right direction. And so recognizing that glucagon one of our primary stress hormones, but all stress hormones really are reacting to or responding to, cellular energy deficiency, is crucial. And also, along with that, recognizing that we need to have enough cellular energy, that's fundamental to health. And when we don't have enough, and we don't produce it efficiently, that's what causes disease like, that's we're so close, like, that's so important to be there. And I think that we're, as you were saying, Mike, maybe this is a part of kind of inching toward bringing carbs in and being more open to that. I think that the glucagon piece, even though he's not framing it that way, could also be pivoted in that way. I mean, he just has to flip his view 180 degrees. But I don't know, no big deal. I mean, I there's nothing wrong with evolving your view. And I think coming to the recognition that the energy deficiency is a a problem and B is what glucagon is responding to, is like, we're right there. We're almost there, to the recognition that you actually don't want high glucagon, because it's signaling that there is an energy deficiency there. So you don't want to be relying on elevated glucagon that is a direct reflection of an underlying energy deficiency, whether it's due to mitochondrial dysfunction and issues with energy production, like in the case of insulin resistance, or if it's in the case of carb deprivation or calorie deprivation, like fasting or starvation, which will also do the same thing, because that will lead to that low energy supply due to a lack of fuel, and drive up stress, and that'll drive an increase in glucagon. So I think we're we're really onto something there, like I'm glad to be having that side of the conversation. And I just think then we want to recognize that if glucagon is responding to an intracellular energy deficiency. Why would we want to be in a state that up regulates glucagon due to an intracellular energy deficiency, when that's the problem, like if we are recognizing that that is an issue here, we don't want to have elevated glucagon like we do reliably on a low carb diet. And so that's kind of the first piece. Then, as you said, Mike, we see elevated glucagon, hyper gluco anemia, in insulin resistance, reliably in type two diabetes, very, very reliably. And again, this is due to the same energy deficiency going on in the cells, although in this case, it's driven mostly by mitochondrial dysfunction due to all sorts of different drivers, as opposed to just the absence of carbohydrates or just the absence of of calories. And as you noted, Mike, the elevated glucagon is actually part of the pathology. It's part of what's driving the insulin resistance, by forcing fatty acid availability, by releasing fat from the tissues, and forcing fatty acid utilization, or encouraging that in inside of the cells. And that's actually a driver of insulin resistance, as opposed to the way he's framing it, where he's framing it as the insulin resistance is driven When insulin becomes dominant and glucagon is switched off. The reality is that both, as you said, Mike, both glucagon and insulin are elevated here, and both glucose and fatty acids are elevated here. And the reality is that to fix the insulin resistance, which is increasing our utilization of glucose. Yes, there's if you take out the glucose or the insulin, you won't fix that issue. You bring the glucose back in, you still have the same problem. You still can't use it efficiently. If you take out the fatty acids, you actually resolve that issue. You actually see improved glucose uptake and neutralization. It's still not perfect. There's still underlying metabolic dysfunction, but you see improvement there. Again, that's if you lower the fatty acids, or if you lower the glucagon, if you lower the impact of glucagon, largely because of the increase in fatty acids, you actually improve insulin sensitivity. You actually reverse the insulin resistant state, not entirely, but like dramatically. And on the flip side, you can also cause insulin resistance with excess glucagon. And you see that in in people who have tumors that drive like that cause increased glucagon production, which is a glucagon OMA, and it causes insulin resistance on its own, and they take it out and lower the glucagon levels, and the insulin resistance goes away. So we have a huge driver here of of insulin resistance being glucagon. It's definitely not something we want to see out regulated. And it's not just because of that. It's because it's a reflection of the underlying energy of deficiency, and as a result of that, because our bodies are cohesive, adaptive, intelligent systems, when they recognize there's an underlying energy deficiency, they're then going to adapt to that. And one of those adaptations is lowering our metabolic rate by reducing t4 to t3 conversion, which glucagon directly does? It also slows down digestion. It has some impacts on immune function, all from glucagon, but also it'll lower metabolic rate via the reduction in thyroid hormone conversion. So that's not something we want that's driving further energy deficiency, which we're recognizing is the issue. So I think we're just one step away from that. The only other thing I want to mention is that we do see evidence for glucagon resistance. He said, we don't see glucagon resistance, we see insulin resistance. But actually, in the state of insulin resistance, there is glucagon resistance as well. And this has been described since I saw a study from 1973 talking about this glucagon resistance, and it's something that we've talked about a little bit in those insulin resistance episodes, the hyperglycogon anemia and the quote unquote glucagon resistance alongside the quote unquote insulin resistance. And again, in both cases here, I would say fundamentally, the resistance piece is because our bodies are calibrating based on the energetic state of the cells, not based on just hormonal interplay. And so when you have problems with energy production, then you're not going to see the kind of proper hormonal response that's when you see insulin resistance. It's not because the cells just decided to stop responding to insulin. It's because they functionally can't, because you can't take up more glucose when they're already full of glucose. On the flip side, even though insulin is supposed to lower, glucagon when you're in an energy deficient state, glucagon is still sensing that even if insulin is present. So of course, you're just so of course, you're still going to be seeing elevated glucagon there, and that's where we have this confluence of energy deficiency, elevated stress hormones, and elevated substrate that we can actually use. And then we saw the downstream effects of that energy deficiency, and that's metabolic syndrome, that's fatty liver disease, that's insulin resistance, and yeah, glucagon is a major driver there. So I think obviously some of that was missed, but I think we're like, I'm glad that this is where the conversation is going again, like we mentioned with with Richard Smith and NAD plus NADH ratio, like I do think it's going in an actual constructive direction, and hopefully will lead people to recognize that having carbohydrates isn't the issue, and they actually do no harm, and avoiding carbohydrates actually does do harm through all of these mechanisms.

Theresa Piela  1:03:30  
Well said, Jay, just to honor time, do you want to shift to the success story when I don't think we'll have time for the Q and A today? Okay? So joy, 80 JJ, sharing their success, they were saying I was keto back in 2020, 2021, and they lost 76 pounds. I never really felt good, as I never was a big meat or big I never was a big meat or fat eater to begin with. Anyway, I gained back slowly, 30 pounds, I started to add carbs, like fruit, which I hadn't eaten in over two years. I also started resistance training. My gut and brain never felt better. Adding fruit, more vegetables and sweet potatoes, I actually eat wfpb,

Mike Fave  1:04:15  
whole food plant based.

Theresa Piela  1:04:16  
Ah, thank you. Thanks, Mike. Mostly with Sometimes adding eggs and dairy. I lost so far 22 pounds, and my labs have improved in the good range. Most important, I feel so much better. Ah. I mean, that's exactly similar to the last comment, the feeling better. Like the body really doesn't lie as much as we like to confuse ourselves and create stories of what we think we should be going after hyper focusing on the the best test is just general well being, General, general sense of feeling good and not feeling stressed or agitated or distracted or filled with Doom and fear and blood sugar swings, which, you know, I think we've all experienced in our own. Way. Do you guys have anything to add to that? Mike Jay, well, just a quick disclaimer.

Jay Feldman  1:05:05  
Of course, we do advocate for consuming animal products, so it's great that this person's doing well, but just wanted to mention that since they mentioned the plant based approach, but great to see the improvements after low carb and keto and with adding carbs in, and great that they are still doing some dairy and eggs. And obviously we would say there's more benefit from including other healthy animal

Mike Fave  1:05:28  
sources too. Yeah, I'm glad that joy is feeling better overall. And then, yeah, I think that it's important to keep good quality animal protein or animal sources in there for micronutrients and for just like easy, easily accessible protein on a consistent basis, but it is, I think eggs and dairy can easily do that in the context of a diet where the rest of it is plant based, you know, fruits, tubers, things like this. So that's great. And again, like some people are going to do better with with different sources versus others. So if she does best with eggs and dairy and the rest of the foods being primarily plant based. I think that's great, as long as she's covering her micronutrients.

Theresa Piela  1:06:05  
Yeah, for sure. And I'm happy that she was able to recover, because I feel like a lot of people, they go keto, they go carnivore, and then, you know, years later, they're struggling with something like sweet potatoes. You know, they're it's and not to paint a terrible picture that you're going to be damaged forever. But you know not to minimize the harm that some of these interventions can cause. But that's awesome, that joy has is feeling better than ever with like what I would see as sometimes a more complicated food to build tolerance back to. So yeah, all right, let's close out here. Mike, where can people find you?

Mike Fave  1:06:42  
They can find me at my YouTube channel, Mike fave, as well as my website.

Jay Feldman  1:06:46  
Mikefabe.com All right, Jay. My website is Jay Feldman wellness.com lots of free information. There links to the podcast and everything and social media, YouTube, this podcast, all that.

Theresa Piela  1:07:00  
All right, and you can find me at tapping with tea app and community, and also on Instagram at living roots wellness, alrighty, thanks everyone for tuning in. We will see you next time you.