Ep. 109: Chris Palmer’s “Brain Energy”, Type 1 Diabetes, and Low-Fat Diets For Weight Loss (Q & A)

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In this episode we discuss:

  • Our thoughts on Chris Palmer’s “Brain Energy” theory of mental health 
  • Why low carb diets are not the solution for anxiety and depression and what to do instead 
  • What most people miss when it comes to weight loss and why we shouldn’t focus on fat-burning 
  • Strategies to optimally manage blood sugar for Type 1 Diabetes 
  • Whether we should lower our fat intake to lose weight  

0:00 – intro 

1:19 – our take on Chris Palmer's “Brain Energy” theory of mental health disorders 

5:04 – challenging the misconception of a separation between the brain and body  

8:03 – why low-carb, ketogenic, and carnivore diets can produce temporary mental health benefits  

10:36 – how impaired energy production underlies poor brain health and how to fix it without using low-carb diets

14:05 – how fat burning can temporarily relieve symptoms of poor glucose utilization (with a major cost) 

18:29 – why fatty acid oxidation is our default metabolic state under stress and underlies all chronic disease 

22:20 – whether ketogenic diets promote metabolic flexibility  

24:53 – poor glucose metabolism as a driver of Alzheimer’s disease and other mental health conditions   

28:13 – the adaptive benefit of burning fat during stress 

31:31 – blood sugar management for Type 1 Diabetes and whether a low-carb diet is optimal 

38:13 – whether lowering fat intake is necessary for burning and losing fat 

42:09 – whether improving metabolic function alone is enough to reduce stored fat and when a decrease in dietary fat intake may be necessary 

47:32 – the difference between subcutaneous fat and visceral fat and their potential implications  

50:34 – how to fix our hunger signals to prevent excessive eating  

54:33 – weighing the costs of extreme diets and the need for more innovative thinking around health  

Links from this episode

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Jay Feldman 0:05
Despite what you may have heard, low carb diets are not the long term solution for mental health disorders or for fat loss. But that doesn't mean that low fat diets are either. We'll be discussing all of this in today's episode of the energy balanced podcast, a Podcast where we explore health and nutrition from the bioenergetic view, and teach you how to maximize your cellular energy to maximize your health. Today's episode is a q&a episode, where we'll be discussing our thoughts on Chris Palmer's brain energy theory of mental health. We'll also be discussing why low carb diets are not the solution for anxiety and depression and what to do instead, we'll also go over what most people miss when it comes to weight loss, and why we shouldn't be focusing on fat burning. We'll also go over strategies to optimally manage blood sugar for type one diabetes, and whether we should lower fat intake to lose weight. To check out the show notes for today's episode, where you can take a look at the studies and articles and anything else that we reference, head over to Jay Feldman wellness.com/podcast. And with that, let's get started.

So Kathy asks, our says, love everything you and Mike do. I'm hooked by your content and podcast. Can you help address anxiety and depression, as discussed by Chris Palmer in his new book on brain health and the metabolism? How can we reconcile many of the results seen in in terms of mental health, using keto slash low carb slash carnivore. So you know, the disclaimer, as always, that what we're going to discuss here is not personal at all toward Chris. And instead, we're just discussing the view and not getting into all the nuances and all of that either. Again, we can do that in the future if if you guys would like but just kind of talking about this in a broad sense and know, nothing personal here. No tax, we're just discussing the concepts, the ideas, the perspective. So go ahead and start us off.

Mike 2:10
Yeah. The other thing is, we also haven't read his book. So that's to be yes. Yeah,

Jay Feldman 2:14
I've, yeah, yeah. Thank you for mentioning that. Yeah, we haven't read his book. We have listened to some interviews and read some of his own. I haven't read any articles. I've just listened to some interviews of him.

Mike 2:25
I've read his articles. And I listened to some of his interviews, but the articles are like, on like, the he does like a lot of articles, I think on psychology today. He's a couple there. And they're, they're quite basic. Like, I don't think they were helpful for the overall view. I think, if we really wanted to get like specific on the you'd have to read the book. So it's not about debating the like, really fine points, at least for me, it's about the overall picture. So there's two pieces here. The first thing for anyone who's not aware as Chris Palmer, I think he's a Harvard psychologist, psychiatrist. And he, he wrote a book and basically the book discusses or the general idea some of his general ideas. I don't know the specifics of the book. But the general ideas that he discusses overall, is that a lot of mental dysfunction or disorders, schizophrenia, ADHD, depression, anxiety, etc, a lot of these different disorders, I don't know all the specific ones. Again, I want to be clear, there are actually a problem of energy metabolism in the brain. And not necessarily like these specific neurotransmitter imbalances that need to be fixed. Like the, essentially those aren't the main problems. It's the energy dysfunction is underlying it as far as I understood, and that's leading to these other things downstream. And so that's the first piece so energy dysfunction or metabolism is driving neurological dysfunction. That's the I think the key point number one, and then point number two would be that the way one of the ways to fix this that at least he discusses is using a keto diet, which I we've talked kind of at length about some of the issues with ketosis, and low carbohydrate diets, and then brain function. So I know Jay, there's some there's some episodes you will want to link about those. But essentially, the disagreement the the first piece we both agree with at large I don't know the finer details that he cites for that. But I think for us, this is kind of like a no brainers. This is again, like yes, of course, metabolism underlies all these processes. Because in order for neurotransmitter production, and order for different signaling between different neurons in order for like a general executive functions, mood regulation, all of that is extremely energy dependent. And any degradation in energy production is probably going to affect those things. And it's not the other thing is I would say it's even beyond the brain. So I would say energy dysfunctional cross the entire system also affects the brain. And something for me that's been a key, a key tenant that I want to like expand on here is that, I think in Western society, there's an idea of mind and body separation, or spirit and body separation or consciousness is separate from the body. But what I want to highlight here is I think that consciousness is generated by the body, which is a very different perspective overall. And that also kind of explains some of the things that I think both you and I see with clients is that if there is problems going on physiologically, low calorie dieting, issues inside the gut, hormonal disruption, there's direct effects on mood, there's direct effects on thinking ability, there's direct effects on sleep, there's direct effects, and all these processes that are happening inside the central nervous system. And again, there's this tendency to think, although you have the brain and the central nervous system and the blood brain barrier, and they're all separate, and it's like, no, none of this system is separate, like there is a degree of separation. But it the whole system is all working together on multiple different levels, we can try to reductively, break everything out into all the pieces. But I think as a whole the like, the parts are not equaling the whole, it's like to one, your stomach plus your liver plus your central nervous system is way more than all of those things together. When you generate the body, you generate consciousness, you have a synergy instead of a summation. So those are very different different processes overall. So I agree with the pieces that he puts that he posits there, I think, but again, it's kind of a no brainer from the perspective that we discussed and and what we see on a regular basis with clients. And then as far as ketosis, I just don't think that ketosis is the best way to optimize mitochondrial function and energy production over the long term. Now, there are certain circumstances where ketosis or use of ketones may actually be quite helpful. And so that's important to discuss because that's those are very specific context. And when we're talking if we're going to talk about somebody who has like intractable epilepsy, versus somebody who's like a normal, healthy individual who's trying to manage their depression and anxiety, I don't think that that study there specifically correlate or gives us specific information about translating ketosis to somebody with depression and anxiety. So there's, I don't want to go into the full ketosis issue. And the full issue of having a low carbohydrate, high fat diet, but some of the things you can think about are some of the things that we have discussed changing hormonal profile changing glucagon, cortisol, thyroid hormone, sex, steroids, etc. Problems with oxidizing carbs versus fats inside the mitochondria with RLS production with fats. And then what I want to mention here now, so that's, that's kind of the whole picture. The main piece that I want to mention now and get specifically to the question is, could you help address anxiety and depression, specifically, and why we're seeing these mental health improvements in keto, low carb and carnivore. So for this piece overall, I think a lot of the benefit that you're seeing in these diets is a lot of people are coming off of standard American diets or like crappy diets go into keto, low carb carnivore and having a bunch of success, but are there decreasing carbs? Yes, but they're also changing the diet completely. So now you're on like a higher vegetable, higher nutrient density, lower polyunsaturated fat diet, overall, and you're like you're eating adequate protein, and you're looking at your total intake and possibly increasing your activity levels, you're losing excess body fat on these diets a lot of times, and and you're also changing the microbiome very directly. And I think in my experience, a lot of times, mental dysfunction is directly tied with what's going on inside the gut in the microbiome. And so shifting to some of these diets can actually help to change the microbiome and minimize heavy amounts of fermentable substrate going inside the colon, which for if, depending on the person's situation, a lot of times, even though there's microbiome studies showing that like whole grains do X, Y, and Z, or eating ridiculous numbers of FODMAPs changes in microbiome this way, in practice with a lot of people, it actually makes them feel terrible can cause mood dysregulation can cause changes in sleep can cause issues with like brain fog or thinking dysfunction. So I think a lot of the benefits are seen not just from like a carbs versus fat oxidation perspective. I think it's a massive dietary change. And then specifically, there's also direct changes inside the gut that account for a lot of the benefits overall.

Jay Feldman 9:49
Yeah, a lot of great points there. A lot of great points. And I think I would really echo all of them. I don't know, too much new that, but I'll kind of just mentioned a few things. So one as you started discussing brain health, mental health, in terms of metabolic dysfunction, impairments and energy production is great. I mean, that's we are fully in agreement on that perspective. And I have heard Chris Palmer, get various examples of people dealing with all sorts of pretty intense conditions, and seeing massive improvements by making certain changes. And that's amazing. And I'm glad that that perspective is gaining some traction. And as you were saying, I think the biggest disagreement is on how we fix the metabolic dysfunction seen in these disorders. And that's, you know, that's, I think, the essence of this question as far as well as low carb DHA, the best route or, or some other, you know, something else, the best route. And we've talked about this a few different times, we've talked about mental health from the bioenergetic view, we haven't done a whole series on it, but we've talked about it, you know, in parts of different episodes, holding back to those, I also wrote an article talking about depression, the issues with the chemical imbalance theory and why it does come down to an energetic state. That's really the problem there not only with depression, but other issues as well like anxiety and more intense, or potentially intense psychological disorders as well. And we've seen it you were mentioned it, you know, seeing it with clients, seeing massive improvements in mood, depression, anxiety, and also detriments, in those things, seeing those things fluctuate along with a metabolic state along with eating something that's irritating and causing endotoxin production, along with eating too high of protein to carbohydrates, all sorts of things like that, that can cause those things to get worse in a momentary instance, and a better in a momentary instance, when doing the opposite. I mean, that's, that is incredible. And just such so clearly illustrates these things in action. And you mentioned brain fog as well, a big another one that's very clear, you know, very clear to see and have people see pretty dramatic improvements in these kinds of things. So we're, yeah, so what agreement on I think, the larger premise here? And the question is, well, how do we solve this issue, and much like a lot of the other issues, whether it's autoimmune, or fatty liver, or whatever else, the main, within the alternative health sphere, the primary solution that is given right now is cutting out carbs in any iteration, whether it's carnivore or keto, or fasting or any anything else within those lines. And, of course, there's all the nuances, but we've we've discussed this, even recently, we did that episode discussing the results from like the Paleo medicina clinic, and how they've seen improvements in different autoimmune conditions and things like that from going low carb. And we've talked about this in various instances. And there's no doubt as you were saying that low carb can lead to considerable benefits, this can be a because you're just shifting to a better diet, then whatever you want before for talking standard American diet, hypertufa, also just not even being concentrated or focused or intentional about your health, it can also come along with increased physical activity and better sleep habits, and all the other things that come along with shifting to a better diet and lifestyle. So that could be a huge part of it. But also, there's very clear relief from the gut side of things you have, as you were saying, you can have huge basically, if you're coming from a state where your gut is not particularly healthy, and you have a very unhealthy gut microbiome, and you're producing a lot of endotoxin, that will cause all sorts of problems. And that can include neurological disorders. We've talked about this being implicated in virtually every chronic health condition and issue. And so if you stop feeding this, these overgrowth of harmful bacteria, and stop that adult endotoxin production that can lead to incredible benefits. And whether we're talking fasting or any iteration of low carb, that is probably the most central reason why people feel considerably better. And the last one, which goes hand in hand with that is also relief from poor glucose oxidation. So the ability to metabolize glucose is the most sensitive to derangement in our environment. If you're eating poop, if you're not getting enough nutrients, if you're under stress, if you're not getting enough sleep, if any of those things happen. The first thing metabolically to go is your ability to metabolize glucose, carbohydrates, your default will be to fall back into fat metabolism. Anytime things are going wrong. Anytime you're under stress, whatever it is, you will default back to fat metabolism and you will not be able to oxidize glucose fully, you will also be relying on glycolysis. So you won't be like glucose will be going all the way through the Krebs cycle electron transport chain, you'll be in a glycolytic state along with fat metabolism. That is not a healthy state to be in. But anyway to backtrack from that your glucose metabolism is very, very sensitive. And so if you are eating a carbohydrate rich diet, but you have all these you're eating buffo you're not getting enough nutrients. Have you have a lot of endotoxin, all of that you're stuck in the state where you're not actually metabolizing glucose, effectively, you're not producing ATP? Well, you're going to be under the influence of stress hormones, your brains probably can have some issues. If it's not metabolized in that glucose well, and it can't rely on fat metabolism. So then you're going to be in a in a pretty rough state. And if you then say, All right, we're going to shift the whole body to fat metabolism, and then we're going to use ketones for the brain. And for a couple other areas, that's going to lead to a much better state than the dysfunctional state. It's not because keto is the best diet for health or because ketones are the best fuel to use, or because fat is the best fuel to use. But because you're finding relief from a dysregulated state, a compromised state. And so that's another huge piece here. If you take someone who is not metabolizing glucose, well, because of the poor environment, they aren't just genetically poor at metabolizing. Glucose, it's because of the things that we're doing to ourselves. So if you take someone in that state and give them ketones, and then it lights their brain up, and they're doing so much better, a that's great and experience those benefits, and that's better than the state you were in. But B that is a sign that you are not metabolizing glucose well, and if you want to actually fix the system, the solution is in fixing your ability to produce energy from glucose, fixing all the things in your environment that are interfering with that. If you're wondering how you can fix your metabolism and your ability to utilize glucose, the energy balanced food guide is the best place to start. This free food guide will help you determine exactly what to do to optimally support your metabolism and help you lose weight, improve your digestion, get amazing sleep, boost your energy, improve mental health disorders, and so much more. The energy balanced 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 Jay Feldman wellness.com/guide To download your free energy balanced food guide. And so this is I think that is the low dose things encapsulate why people have these benefits on low carb, and specifically even more so in the brain side of things, you can have these benefits because the brain can't rely on fat metabolism, that fat metabolism is so inefficient creates so much reactive oxygen species and on and on, that the brain can't use it. So the other tissues in your body can get by on the fat, but your brain is stuck poorly oxidizing glucose. So as soon as you provide those ketones, if you're in that state, it can bring a huge amount of relief, again, aside from endotoxin, and all of that. And so that can be even more so reason why you're going to see benefits on the mental health side when it comes to a low carb diet. But again, long term, there are major costs to low carb diet. We've talked about these things at nauseam. So I'll link back to episodes where we've discussed them and where we've talked about these things specifically for the brain and all of that. And the other point, too, which is that you can relieve yourself of endotoxin and a really bad standard American diet. And you can fix your glucose oxidation without going low carb without those costs. So that is the solution that we prefer. That's the route that we think is best to go for fixing metabolic dysfunction. And that includes metabolic dysfunction in the brain that underlies these conditions. And so I think that is, I think that is that explains the benefits there. But it also explains why that's not the optimal route to fix these problems.

Mike 18:24
Yeah, there's a couple points I want to add. And I want to highlight specifically. So the first one is that the default state of the body in any type of stress or dysfunction is actually fatty acid oxidation, which is something that is I don't think recognized, and I think a lot of people gloss over. So and this is important, because a lot of people's site going low carb or on keto diets to improve metabolic flexibility, which is Go ahead. I didn't want to say something.

Jay Feldman 18:57
Well, it's just gonna set you said default. I just wanted to be clear, like default state under stress under sub optimal conditions, not default state Yeah, under

Mike 19:04
under stress or or dysfunction is fatty acid stress start. So starvation, low carbohydrate diet, stressful circumstances. And then also metabolic dysfunction, it the default state is higher fatty acid oxidation. We actually discussed this in a paper where we were showing that under stressful circumstances, the body will drastically increase metabolism. So I guess this kind of goes to a point about some of the Herman Pontzer stuff that we had discussed, but you can drastically increase metabolism. But what winds up happening is you change the the amount of fatty acids that are oxidized to drastically increase them. And so when you're under stress,

Jay Feldman 19:46
and you see so just just to illustrate this real quick that we met because we mentioned this in the nutrition with Judy episodes, too. You see this in every chronic health condition. You see it in diabetes, you see increased fat utilization, heart failure, it is In the heart failure, you see it in obesity. You see it in. There's another example is going to give as well, we see in fatty liver disease. I mean, we've talked through all of these things like that shift happens very clearly in all of these chronic health states. Yeah, yeah, it's

Mike 20:15
bait in it. That's the main point that I think is so central to understand here is that with any dysfunction, your body goes to fatty acid oxidation, it doesn't default to carbohydrate oxidation. So and because that's, that's the idea that people think is like, Oh, if you were gonna just run low carb diets and eat a bunch of eat a ton of fat, because then we'll be metabolically flexible, it's like you are now metabolically inflexible, you are now going to have a harder time oxidizing carbohydrate, just when the cells are oxidizing fatty acids, at large there, they are going to be insulin resistant. That is a very normal process. Now there's a question of whether you can flip back and forth and that would be physiologic insulin resistance in quotations versus a pathological situation where you're a diabetic and you know, type two diabetic, you cannot oxidize carbohydrate effectively, even if you eat it, versus somebody who's on a keto diet. And then once the carbs again, they can eventually switch back over to eating carbohydrate. But again, in both the certain depending on if they fixed the underlying state. Yes, if they didn't come to keto from type two diabetes, or something like that, as well. Yeah. But overall, the the main point here is that it defaults that and I wanted to highlight that very specifically, because I think that's super important to understand overall, is that your body's going to run on fats, as soon as you start having problems if you don't have enough food, fatty acid oxidation. If you're sleeping overnight, you run through glycogen fatty acid oxidation, if you're fasting fatty acid oxidation, if you're starving fatty acid oxidation, if you're if you're running away from a wild animal, for an it's been tracking you for days, you're gonna use glycogen at first to run away and then fatty acid oxidation. And it's just things are going to keep moving in that direction. And then basically, it's the degree to which the rest of your tissues, oxidized fatty acids, and your central nervous system. Basically, the all the glucose that's left gets spared for the central nervous system and tissues that cannot use fatty acids, which include red blood cells and things like that. So that's point number one. Point number two is the metabolic flexibility piece, which is running on fatty acid oxidation, decreases metabolic flexibility. And then the piece to tie these together into the initial point is that long term, keto, carnivore, low carb, etc. Well initially solves people's problems, because it pushes the fatty acid oxidation and all the problems that come with that a lot of people that I think both you and I work with, actually develop problems on the low carbohydrate diets that include brain fog, mood, dysfunction, anxiety, depression, insomnia, etc, that then are corrected by bringing carbohydrates on board and making further adjustments to the diet. So there's, it's can they help things initially, in these different contexts? Yes. Is a Keto, low carb carnivore diet often better than the standard American diet? And a lot of the Western diets and things that are out there that most people are eating? Yes. Or can it be better? Yes. Is it the most optimal diet for health overall? Unlikely, very unlikely, I would say actually, no. And so in those circumstances, and those circumstances, there's like, we kind of discussed all the mechanisms. But I think it's important understand that the long term oxidation of fatty acids is actually a problem, you don't want to drive that kind of what you're saying is like, if you have the dysfunction, having ketones on board and correct and changing the diet can correct some of those other underlying processes. And it can relieve the pressure on the system of having a lot of carbohydrate that it can effectively oxidize with all these fatty acids floating around. But it's it doesn't, it doesn't solve the problem necessarily long term, it just kind of puts it to some degree on hold in that short term period of time. So that I think those are really important to put in my default state is fatty acid oxidation for dysfunction, or for stress or for starvation. Running on fatty acids doesn't improve your metabolic flexibility, it makes it worse. And then these problems in the long term can actually lead to issues with anxiety, depression, brain fog, insomnia, etc. When running low carbohydrate keto, carnivore diets for extended periods of time for a decent portion of the population that does those diets.

Jay Feldman 24:43
Yeah, yeah, those are really, really important points. And we see that also specifically in the conditions that we're talking about here when it comes to mental health conditions and degeneration, for example, when it comes to Alzheimer's, that's been really, you know, relatively recently in the last decade or so. though being termed as type three diabetes, and in some ways it's aptly named that way, right? Because the essential problem in type two diabetes is poor glucose metabolism and inability to metabolize glucose, not excess insulin, not excess carb consumption, none of those things. It's it's an inability to use the carbohydrates. And we've discussed this before, I'll link back to that. Well, you see the same thing in Alzheimer's, you see, not a I mean, that's not again, an insulin problem or anything like that. It's that in the Alzheimer's brain, there is poor glucose metabolism, there's dysregulation in terms of glucose metabolism. And so yeah, I mean, they're seeing you're seeing that as the underlying driver of dysfunction in both states. And so it the solute, what you're pointing out by saying that in these chronic health conditions, that there is a shift to fatty acid oxidation, a shift toward lipolysis. And a shift away from compromise glucose oxidation, is that this is not a health state that we want to mimic, this is a backup default state, for when there is dysfunction present. And it's better than dying. It's better than you know, and starvation leading to death. But it is associated with all of the compromises all of the adaptive compromises that come with a low energy state, it is a thing that drives us to decrease our thyroid function, decrease our reproductive function, and on and on, it leads to energy deficits, because it's so much less efficient. And in terms of energy production, and glucose. And so, yeah, it's, instead of it being like, this is the optimal state, it's this is the state of dysfunction. That is what fatty acid oxidation is. And so the goal here again, would be let's fix the glucose oxidation, let's fix the likely endotoxin problem, let's fix the likely nutrient problems. And those things will not only lead to the same improvement in the metabolic conditions, that are all, you know, going on in terms of mental health, but also will lead to long term health, which I think is the main goal.

Mike 26:55
Yeah, I think it's important to understand that these states, even though they're not ideal, are still better than dysfunction, the like higher levels of dysfunction. So it's just because something works for a particular circumstance doesn't necessarily mean it's the best option available. But it's still like getting the job done. In those circumstances, the ideal situation would be to oxidize carbohydrate effectively, without having those the underlying without developing those issues overall. So that that's, that would kind of be like the ideal state you're shooting for, there's a way to get there. And it's again, it's not. There's more than just like eating cars versus not eating carbs in that carbohydrate oxidation issue, right? Because if your car depends on where your carbs are coming from, and your digestive process, all those types of things. But yeah, that there's like a spectrum of options and having like high levels of metabolic dysfunction, and then plugging away in a Western diet is probably way worse than just running low, like a low carb, keto, carnivore esque diet for a number of reasons. But there's problems here still. So ideally, you'd want to be able to have adequate carbohydrates, adequate fats, adequate proteins, and a properly constructed nutrient dense from multiple different meanings diet. The other thing that I just wanted to to tailor in here and kind of put into perspective, really quickly on why the body defaults to fatty acid oxidation, is because fatty acids are the we can store a ton of fatty acids, you can't really store that much glycogen. And the the central nervous system in certain tissues need carbohydrate or certain Yeah, like red blood cells and the brain and the spinal cord need carbohydrate. They cannot run on fatty acids, can they run on ketones? Yes, but they're still always going to have glucose oxidation. And so what happens is you can store a lot of fat, you can't store the much carbs. So the body saves those carbs for those tissues. And everything else that can run on fats is going to be running on fats. And so basically, it's a very intelligent system that's there for the stressful circumstances. And it helps you prevent you from shredding your lean tissue, your muscle mass, and going through all your glycogen stores and leaving your central nervous system with nothing. But at the same time, there are costs at running on fatty acids over an extended period of time. And I do you want to reiterate, I have worked with quite a few people who have to while some things improved initially on their low carb, carnivore keto journey, including possibly sleep and brain function, and possibly they lost weight and possibly exercise improved initially, over time that did lead to problems. And again, they improved from where they were before they got better, of course. And then, over time, they developed other issues because this wasn't this isn't an optimal solution. It's just better than what they were doing before. And that's a very important perspective, because I think a lot of you will, oh, well, it worked for this person. And it's like, we're not saying it doesn't work. We're just saying it's not ideal, and there are optimal, and that's, I think, an important distinction.

Jay Feldman 29:56
Yeah, and what does working look like? Right? Are we talking benefit for three months? We're for 10 years. And a lot of the people that we work with are the people who had benefits for a month, three months, six months, a year, two years, five years, 10 years on these various load versions of low carb diet, fasting, stress induced, you know, hormetic interventions. And then, at one point or another, started to feel those effects, you know, started to see the compromises to all of their functions. So, yeah, that's what is what does it really mean for it to work?

Mike 30:30
Yeah, yeah, of course. So, yeah, I'm ready to move on to the next one. I don't have too much to add on this one. I think we killed it like we the horse has been buried at this point.

Jay Feldman 30:42
I think so too. And there's a question or two questions actually, on type one diabetes, and its management that I think dovetails nicely in here. And so, first question, here's on foglia, who says, What would you recommend someone with type one diabetes to do a low carb high fat diet makes it much easier to control. The only time I still eat sugar is when I have hypoglycemia, or before exercise, usually honey or raw milk, but the amount varies from day to day. And then the other question here was from Celeste Kelsey, who says Your channel is my best source for learning how to eat for metabolic health. But I have the same concern as and foglia does the advice change for a type one diabetic. So this also dovetails in with an episode we did talking about rubbles perspective on the Biogen energetic diet and blood sugar balance. And so when it comes to type one diabetes, where you have to be the manager of your blood sugar, because your pancreas won't do it for you, there is even more reason to want to have a stable blood sugar as possible for easy management. So something that Robin discussed was well, on a low carb diet, you don't get the highs and lows, your blood sugar's kept stable. And it's true. And that's because things like glucagon, and if needed adrenaline and cortisol will help to provide the sugar that you are not providing from your diet. And that comes at a major cost. And we talked about that cost. Well, when you're not producing insulin, and you're relying on those stress hormones to produce the sugar instead of consuming it and the state of type one diabetes, you still have all those same costs. So yes, it's much easier because you don't have to dose insulin throughout the day, as much or, or even at all, depending on the specifics. it while it's much easier to do this on a low carb diet and your blood sugar says stays much more stable. It comes at the cost of relying on the stress hormones to produce the glucose, and everything that comes with that. That can lead to everything from protein wasting to turning down thyroid function and things like that. So even though that's easier, I don't think that makes it optimal. And I would say instead, optimal, would look like consuming carbohydrates on a consistent basis, having really good glucose metabolism, and being able to dose insulin appropriately for those things to get, you know, just like, you know, somebody who doesn't have type one diabetes, they're having that insulin production throughout the day as well, in order to maintain a high metabolic rate and a high metabolic state, and a high energy state where you're not depressing thyroid and sexual reproduction and all of that. So I'd say that, if possible, which this is much more difficult for someone who has type one diabetes, but I would say the goal would be to maintain a comfortably high carb diet and be able to dose the insulin appropriately as well to also maintain good steady blood sugar. And that's going to lead to the best state. Now, again, the I can say that simply, but it can be a very difficult thing to do in practice, and will probably take a lot of time to adjust and things like that. But I do think that that's worth it. And that's what I would work toward. There is somebody who in the kind of bioenergetic sphere, who has type one diabetes, and a lot of info on it and works with people with type two, type one diabetes, his name is Isaac Pullman. I'll link to his website and Instagram account in the shownotes. But I would recommend taking a look at his content as well. Just for some specific guidance here. Yeah,

Mike 34:02
I pretty much come from the same perspective there. I don't want to like heavily reiterate any of your points, but essentially, low fat, if you are low, low carbohydrate, high fat, sure, it's easier to manage less blood glucose dips, but again, it comes at a cost as far as managing the type one diabetes with the with like a higher carbohydrate diet. I think it probably again, I don't I don't have type one diabetes, so I don't have direct experience with this. But I have worked with quite a few diabetics, including type one diabetics in my time working in the hospital. And something that I've seen makes things way easier for type one diabetics is having consistency. So having consistent diet, having consistent meal times, and then you can kind of get a sense of what at some point you will definitively get a sense one your insulin needs are for the different different meals and The different eating times and things that you're using on a regular basis. And that will make things a bit easier. So unfortunately, the because of the nature of this disease process, essentially the pancreas for anyone, for anyone who's not fully aware of the type one diabetes, how exactly it works, the pancreas doesn't work anymore to a large extent doesn't produce adequate amounts of insulin. So you have to take exogenous insulin. And for somebody with type one diabetes, that's it's kind of annoying, because you have to dose your insulin based on your carbohydrate intake. And if you don't, your blood sugar gets too high. And if you do too much insulin and blood sugar gets too low. And so this is kind of this like, hard back and forth. So I would just say that, the easiest thing to do is get a really consistent diet with really consistent meal times, tweak and figure out what your insulin dosing is, and then run that consistently with with minor variations. And again, what I was trying to say is it's it is unfortunate because it it requires a bit more regimentation requires a bit more discipline, it requires a bit more monotony, to some extent. But I think the what you're essentially, the decision will ultimately come down in theory to convenience versus optimal health outcomes to a large extent, because I think there's a cost with doing like a low, a low carbohydrate diet, even if it is more convenient. And with a high carbohydrate diet is less convenient on with this particular context on multiple levels. But there is actually I think, a health benefit and having adequate carbohydrate on a consistent basis. So it's a, I think the individual has to determine what outcomes they're shooting for here, overall. Now, you may have some you may actually function and feel better with some more carbohydrates present that may help to minimize the convenience costs. But it's going to Yeah, those are some things to factor in. I know, it's annoying, because I've had to manage type one diabetics, blood sugar in the hospital before, particularly people who are in diabetic ketoacidosis, and things like that, and checking blood sugar every hour, 30 minutes and dosing is really, really annoying. Sometimes I get it, I 100% get it?

Jay Feldman 37:15
Yeah, one, the more problems there are, especially like if you take someone in ketoacidosis. But the more problems there are, and who's been that far from type one diabetes, I mean, that's a state of the worst metabolic dysfunction when you're all the way there. But the more problems there are with glucose metabolism, the harder it is to manage blood sugar, and the bigger the spikes will be and all of that. So I a lot of the principles are still going to be incredibly important, as well as balancing carbs, protein and fructose glucose and all of that and considering digestibility. But yeah, it will require a little bit more nuanced detail when it comes to those things to to manage it properly. In this case, yeah, yeah. Right. So kind of circling back to problems with low carb and better suppose the benefits of fat oxidation and lipolysis, and things like that. There's another question here, that is related. This is from stone, and they say hi, J, can visceral fat be used for everyday hormonal processes, if one has an abundance of calories from carbs, so that one is not in a stressful state of ketosis, Then shouldn't you lower fat intake so that the body quickly burns through stored visceral fat? Thanks. So we talked a bit about this idea when we in our discussion on the physiology of fat loss without a calorie deficit. And in short here, I would say that when it and we talked about it, also with the with the bread, Marshall, sed diet and all of that fire in a bottle, the croissant diet, we've talked about it as well there. But I think when it comes to fat loss, there's a little bit too much focus on what's actually going on in the fat tissue. And also trying to get rid of the fat that's in the fat stores trying to release it and have it be burned. And with that has also come to little focus on what causes substrate to be stored as fat because what you have in the fat stores is a an equation a balance between what comes in and is stored as fat and what comes out. So you can get the same amount of fat loss if you have, these are ridiculous numbers, but just throwing it out there. If you were burning, if you were releasing and burning 11 pounds of fat from your fat stores, and your fat stores took up 10 pounds of fat, well, then you have one pound of fat loss. Whereas if you released and burned one pound of fat from your fat stores and the fat stores took in zero, then you would also have one pound of fat loss. You can have the same thing in both situations. So to just focus on the fat release in fat burning side is really missing what's actually going on in terms of the regulation there. And when it comes to what's going on with that storage that's going to be incredibly important and that's dependent on what's going on with stress hormones. You know, cortisol, adrenaline, especial cortisol specifically Because the drive, the storage of things is fat, but also, if we're not using substrate well for not converting carbon, carbs and fats to energy, then those walls will be taken up by fat stores and will be converted to fat. So we want to keep all of those things in mind when considering fat loss. And in terms of the question of, do we need to lower fat intake so that the body quickly burns through stored visceral fat? Well, for one, nothing here has to be quick, we can lose that normally slow and steady, I think goes very well. And even if you're talking about, you know, a pound a week, which I think is on the fast side, I would normally say you know, half a pound a week is great half to half pound to a pound, whatever it is, if you're really focusing on fat loss, if we're going to take even a pound a week, we're talking about, so that's 454 grams divided by seven, that's 65 grams of fat loss a day. That's we're not talking about high numbers here, and nothing like has to be quick, per se. So that's kind of part one. And along with that, there's research that we've referenced before, I don't know if it was in that physiology of fat loss without a calorie deficit episode or a different one. But it suggests that an average 180 pound person would have the amount of glycolysis, that releases about 190 grams of triglycerides, from stored fat every day. So, you know, as I was, as I just said, If you lost if you kind of, in that equation of fat balance, if there's a 65 gram less going in and coming out, then that would be a pound of fat loss in a week. And just at basis at rest, you're releasing around 190 grams of triglyceride from the fat stores on a given day, if you're 180 pounds. And of course, you know, a little bit less if it's lowered. But so, in short, you don't need to be doing anything to focus on releasing fat, it's going, there's always going to be some baseline level of lipolysis going on. And then if you add any amount of walking or other physical activity, and you know, anything like that, it's going to increase from there. So that's really not where I'd be placing the focus. So that's kind of the first thought. The second thing I wanted to mention here is the question of visceral fat, maybe compared to other fat stores. And when it comes to visceral fat, even more, so here, we're not talking about a lot of fat, you know, when we're talking about the total amount of fat on your body, we're talking 20 pounds, 30 pounds, maybe 7080 100 pounds, I mean, we're talking about large fat stores, or I'm talking about visceral fat, normally, it's a pound, two pounds, pound and a half, I mean, three, four, we're talking much smaller numbers here. So again, the focus, I think, really shouldn't be on, how do we get all this fat to leave the visceral stores? But rather, how do we improve our metabolic state improve our ability to use substrate improve the function of the liver, right, that's going to be incredibly important when it comes to the production of visceral fat. And we talked in that fatty liver series about how the main thing that causes fat production at the liver and causes fatty liver is metabolic dysfunction is as derangement of, of our ability to produce energy. And so if you just revert those things, you will very slowly and it doesn't have to be fast, you'll be burning up those stores and using those stores and storing less and producing less. And that will lead to improvements there. So the short answer here is, I would vote if you're focusing on the quote, right things of just improving your metabolism, it should take care of all the rest. And I don't necessarily think that someone should lower their fat intake so that you're pulling more from the fat stores. Now, I will include one caveat here, which is that if somebody is in a pretty metabolically deranged state, and maybe is very overweight, there is probably going to be more fat being released and circulating on a regular basis, and maybe less fat being used as well. So your fat needs might be lower. That doesn't mean that we want to decrease our fat intake to a point where it's causing stress, because that will happen if our free fatty acids drop too low, just like if our glucose drops too low. it'll activate stress systems. And so we don't want to do that. But we might just have lower fat needs because of the amount of fat circulating and that we're not using it as much. So I wouldn't say you want to lower your fat intake beyond those needs, but your needs might be a little bit lower than somebody else if you're in that state. So that's kind of the way that I would think about it. What do you think, like,

Mike 44:21
I think overall, like what's gonna determine the weight loss situation is what's going on as far as like energy, not necessarily carbs versus fat. And I think that that's the central point to understand. Because you can be on a, you could be on a high carb diet, and you can lose weight, even though your fatty acid oxidation or at least as low kind of what you're pointing out. Or you can also be on a keto diet or a high fat diet, and you can be doing tons of fat and you can still be storing fat even though your fatty acid release and oxidation is high. So the most important thing in the picture or is not is your carb? Like, if you're eating more fat, then you have to lower your carbs. Or if you're eating more carbs, and you have to lower your fat, the question still comes down, like what amount of these things do you need for your context? And then as far as the weight picture, it comes down to energy. And it's not just again, it's not this base, oh, I eat this much calories. And then this is this is how many calories are coming out from like, exercise? It's like, you are things flowing appropriately through the system. Are you taking substrate and converting it into its more basic pieces, fatty acids, amino acids, monosaccharides? And then turning those things into energy? Is that happening effectively? are you improving that process? Okay, if that's working good, great. Are you then at that point, you're producing energy? Well, things are going on a regular basis? Are you drastically overeating on a regular basis? Or are you eating the right amount for what that particular circumstance that you need consistently? Okay, if you are, then you're, and you're likely going to lose weight, most people that I'd say, I think that both you and I work with, you get diet, right, you minimize gut problems, you make sure that they have enough micronutrients on a regular basis. And then they start, you know, maybe they go for a walk two times a day or something. And it's like, oh, wow, I'm just losing a pound per week, I don't know how I'm doing it. And a lot of times, because energy is flowing correctly, now, they're eating the amount of food both or both fats and carbs that they need on a regular basis. And then they don't have to drive stress too high to make things work, things start starting to work in the appropriate fashion. So that's, that's where you're trying to get to instead of like, well, my carbs are this, my fat needs to be that it's not about that it's how much do you particularly need, it's not this, they're in this, they're not in a war with each other inside the body. In terms of at the cells, specifically, if you're oxidizing fats, you're not going to oxidize carbs. And if you're oxidizing carbs, you're unlikely to oxidize fats. So in though at an individual cell, yes, but then again, how many cells are in the body, and then there's different things happen happening in different places like economy and France, is happening to a large extent outside of the economy in Mexico. So the energy production in your right bicep is there's the difference between what's going on in your left sigmoid colon, so that those are important things to keep in perspective, all you have what's going on over the course of the whole body. The other thing I want to just tie in here very quickly is that visceral fat accumulation is often a particularly heavy, visceral fat accumulation, like you see in the guys in the US, usually a Western thing with a really large bellies, that is usually an inflammatory process, that is usually endotoxin plus liver dysfunction, plus digestive problems, etc, etc, etc. That is metabolic dysfunction that's different than the, you know, the 29 year old guy or the 30, something year old woman who is bulking up for you know, there's, they're eating more in general, and they're putting on a bunch of subcutaneous fat, the subcutaneous fat gain is normal that you're going to have that your body is going to store the excess substrate that it has as fat, that's a completely normal process. And for the healthy storage is in the subcutaneous, subcutaneous compartments, the visceral fat storage, I don't think that the visceral fat is inherently like toxic. But what I think it is, is it's indicative of an underlying issue from endotoxin perspective, from a glucocorticoid perspective, from dysfunction at the liver, there's multiple things going on there. And the visceral fat is indicating like, hey, we actually have a problem going on here, where it's like starting to store things in a visceral fat versus just having more fat overall in the subcutaneous area. And they look at this. And they basically see their strong correlations with all types of disease processes and mortality with visceral fat. Whereas with subcutaneous fat, it's like, and nothing really happens, you just have you have a bunch of extra fat, and probably because you just were like, eating more substrate than you needed. And again, that's, this is a normal process, if you eat more substrate than your body is going to oxidize, then you will store it as fat. But in a lot of these circumstances, the point is fixing the oxidation in the first place, figuring out how much you actually need, and in for visceral fat, specifically, minimizing the processes and dysfunction that are actually driving the problem overall. And so there's multiple things that go into that. So that would be the main focus and I want to I want to minimize this. Again, I want to really minimize the idea that it's fat versus carbs. It's you need both you need them both in a certain amount it's going to be there's estimates that you can find for yourself, but a lot of times you're gonna have to tweak it to your individual context. And then it's important to like stop thinking about things from a restrictive mindset or like a scarcity mindset around the Different, the different macronutrients understand you have a protein need, you have a carb need, you have a fat need, there's certain types of proteins that are best to use. And then there's within those, there's ones that are best for you. And then the same thing with carbs and fats. And then you also want to make sure that you're all having sources that provide you with micronutrients. That's the frame to work from, and make sure that's in the context of you're having enough energy on a regular basis for yourself for your particular outcomes and goals without tarnishing your health. Those are really important pieces overall that I want to highlight.

Jay Feldman 50:33
Yeah, yeah, great points there. And I want to add in a couple of things to what you were saying that, yes, you can gain fat from eating more substrate or having more substrate than is needed. But I think, as we pointed out, in the episode talking about weight loss, you're not going to eat more than as needed, because all of us hunger signals are determined by how much ATP we have and everything else. If your metabolic function is working properly, if you have a good well functioning metabolism, if you don't, then you can have deranged hunger signals that will cause you to eat more, because you're not actually getting the energy from the substrate. And that substrates not being effectively converted to energy. So you've got both things happening at the same time, leading to the body fat storage. So I still would say that the essence there, the thing that it comes down to is the metabolic dysfunction. And that is exactly what you were saying with all of these processes. And when we talked about the fatty liver situation, which is, you know, a large part of the visceral fat is fat accumulation there, we did that whole series talking about fatty liver disease. And the solutions were not eat less fat, it wasn't that eating fat is causing fat to accumulate at the liver. And the solutions weren't eat less fructose, either. It was that these are this is a state that's a product of dysfunction, driven by issues in the metabolic pathways, you know, and it was driven by things like polyunsaturated fats and endotoxin. And excess oxidative stress due to various means it wasn't caused by eating too much fat, and that everyone's just needs to lower their fat intake or, again, from too much fructose or something like that. So more, to come back to what to do with fat intake, you might if you're dealing with fatty liver disease, you might have lower fat needs. And so that's something to keep in mind. And you might need lower fat intake than somebody else who isn't dealing with that. But it's not because the fat is the problem, per se. So that's, I think, what we're kind of continuing to come back to

Mike 52:26
Yeah, what are the the thing here is always the context, right, that's probably the most important piece. So it's like, if you have a liver that has a ton of fat inside of it with problems oxidizing the substrate, and you have a lot of endotoxin coming into the liver, and you have a high upregulation of glucocorticoid signaling that's releasing a lot of fatty acids in the liver is like just overloaded with fat, like just drowning and all this fat, taking the pressure off the system can indeed be helpful. But it's it the a lot of times, even in the research, there's multiple things that have to go on to get to that state. And then once you're in the state, there's multiple things that have to go on. To get out of that state, take the pressure off the system, give it the adequate nutrients, it needs, minimize the negative factors, like endotoxin, help to lower the cortisol ceiling, take the stress off the system overall, and, and help to pull out bile acids, all these different types of things. That's why with all of the disease processes, there's, there's a very significant difference in context between a healthy individual and an individual dealing with dysfunction. And in the strategies that go with a healthy individual versus an individual who's dealing with dysfunction are going to be different. If you have in the fat loss situation. If you have a someone who's healthy, they put on a decent amount of subcutaneous fat, their diets good, they don't really have any significant problems, it's not going to be that hard for them to start to lose the weight. And that's what you see a lot of times with generally younger people, because they're usually healthier overall. It's like, oh, I just, I just stopped eating that. And it's like, Oh, I lost 10 pounds. And it's like, yes, because they are met, metabolism works, it's a very easy thing for them to adjust. But when you start developing all this dysfunction, unless that dysfunctions corrected, it's the you have to either resort to like really strong arming the system with very extreme means, or you have to fix the system first. And then things can start to work appropriately again. So the problem is, is that with the extreme means there's there are costs to that in the long run. And it's important to understand the cost that are coming into that circumstance for the out for the outcome or the benefit that you're looking to achieve. And that's why we are always talking about the context and like understanding the different process so that you can fully understand the investment that you're putting into your different decisions. Everything is going to come down to a cost benefit analysis, but you really need to understand what your costs are and what your benefits are. The other thing is if I have a circle stance where I can get the outcome and benefit that I want and decrease the level of cost that is clearly a favorable circumstance to go with. And that's, that's essentially what we're trying to do here. And what we're discussing is, how can we optimize and understand these processes and the metabolic, the flow of substrate through metabolism? How can we correct the different dysfunctions there, so that we can mitigate we don't have to resort to the strong arm processes, we can minimize the downsides from them. And we can still achieve the outcomes that we're looking for. It's like, how can we think about this differently? Instead of how can we just like keep thinking about things in the same context and just getting more data in the same context, let's actually just change the paradigm. And I just interesting note there is that a lot of the people that we're talking about Herman Pontzer, Chris Palmer, the what makes their theories or ideas so revolutionary, is that they just thought about the things differently, instead of thinking within the same thinking, in the same way, with the same information, like, oh, maybe, maybe metab, maybe there's some underlying process with all these metabolic, all this metabolic dysfunction with neurologic problems like, well, what an idea, right? Like, instead of like, we have this unique problem in each of these situations, and we need this very specific, specific reductive, unique treatment, it's not like there couldn't be some unifying factor, or with Herman Pontzer. So it's like, well, maybe we can't just endlessly exercise ourselves to lose weight, maybe there's like actually a negative cost to doing that. And so it's kind of the same thing with a lot of weight loss, I was like, maybe there's a negative cost to severely decreasing calories on a consistent basis, particularly somebody with like a high level of dysfunction. And maybe there's a way to improve their ability to use substrates, you don't have to put them on a protein sparing modified fast with a one to one protein energy ratio, or things like that, maybe you can actually, like get things flowing appropriately. And then they can slowly and progressively lose weight without coming out the back end with cold hands, cold feet, insomnia, digestive problems, and TSH of like seven and T three all the way in the bottom of the reference range. I'm not saying though all those things exactly happened. But it's like, those are exaggerations of the general trend that you tend to see with people coming out of the back end of those circumstances.

Jay Feldman 57:25
Yeah, yeah, I agree. It, you know, requires a shift of thinking here and a shift of blame away from calories away from carbs away from fats, away from random genetic drivers of disease. And that completely changes the solutions to so I think that's what's exciting about the bioenergetic paradigm is, is that it, it unifies the different dysfunctional states and their drivers, and it also therefore unifies the solution and gives, also, you know, relative to something like genetics gives you a lot of control, but relative, you can actually do something to fix the state. But also, relative to the idea that calories are the problem or non protein macronutrients are the problem is that it also gives you the freedom from needing to constantly restrict and constantly live in this low calorie, low energy state where you force yourself to get by on willpower until you crash, and instead actually allows you to feel good at the same time as maintaining a good body composition and improving dysfunctional, potentially disease states or conditions and things like that. And so I think it's a it's it's, I suppose revolutionary in those ways, but exciting and and definitely preferable. Those ways as well. Yeah.

Mike 58:47
Yeah, of course. All

Jay Feldman 58:49
right. That's going to do it for today's episode. If you did enjoy it, please leave a like or comment if you're watching on YouTube. And if you're listening elsewhere, please leave a review or five star rating on iTunes or Spotify. All of those things really do a lot to help support the podcast and are very much appreciated. To check out the show notes for today's episode, where you can take a look at the studies and articles and anything else that we referenced. Throughout today's episode, you can head over to Jay Feldman wellness.com/podcast. And if you're looking to optimally support your metabolism, and lose weight, improve your digestion, get amazing sleep, rebalance your hormones, boost your energy, improve mental health disorders, and so much more with clear action steps and strategies. Along with personalized guidance from me, head over to Jay Feldman wellness.com/solution where you can find all of the information for the energy balanced solution program. This program includes customized health coaching a video library with videos on restoring gut health, losing weight without destroying your metabolism, boosting your metabolism, getting amazing restorative sleep, how to rebalance your hormones and tons more. It also includes resources like a sample meal plan and supplement guide, as well as a prize The community so head over to Jay Feldman wellness.com/solution to check out all the details and with that I'll see you in the next episode

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