Ep. 111: Stevia vs. Sugar, Ketogenic Diets for Epilepsy, and Spore-Based vs Standard Probiotics (Q & A) 

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In this episode we discuss:

  • How spore-based probiotics differ from typical probiotics and whether we should be using either of them to improve our gut health 
  • Whether low-carb or ketogenic diets are an ideal solution for epilepsy 
  • The role of gut health and metabolism in epileptic seizures 
  • Concerns with using low- or no-calorie sweeteners 
  • Whether stevia is actually any better than artificial sweeteners

0:00 – intro 

1:17 – whether spore-based probiotics can cause bacterial overgrowths like SIBO 

4:53 – the drawbacks of standard probiotic use and the limitations of stool testing 

9:55 – how spore-based probiotics protect against pathogenic bacteria and endotoxin and which spore-based product Jay recommends 

15:39 – long-term benefits of spore-based probiotics and how long you need to use them for these benefits 

21:05 – whether low-carb or ketogenic diets are necessary to improve epilepsy 

29:25 – using ketones for fuel and why the production of ketones isn't the problem on a ketogenic diet  

30:48 – the main drivers of epileptic seizures and how ketones help to prevent or reverse them 

34:17 – the role of the gut microbiome in brain health and epilepsy 

42:18 – concerns with low- or no-calorie sweeteners like stevia 

48:03 – whether we should be concerned about the lack of nutrients in table sugar, honey, and maple syrup 

58:22 – the essential role of both macro and micronutrient density in promoting mitochondrial health 

54:55 – stevia as a potential endocrine disruptor that may have negative effects on the thyroid, liver, and kidneys

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Jay Feldman 0:05
Should you be using spore based probiotics for gut health ketogenic diets for epilepsy and stevia as an alternative to other sweeteners? We'll be answering these questions in today's episode, Episode 111 of the Energy Balance Podcast, the podcast where we explore health and nutrition from the bioenergetic view, and teach you how to maximize your cellular energy to maximize your health. In today's episode, we'll be discussing how spore based probiotics differ from typical probiotics, and whether we should be using either of them to improve our gut health. We'll also be going over whether low carb or ketogenic diets are an ideal solution for epilepsy. We'll be discussing the role of gut health and metabolism and epileptic seizures, the concerns with using low or no calorie sweeteners, and whether stevia is actually any better than artificial sweeteners. As always, to check out the show notes for today's episode, you can head over to Jay Feldman wellness.com/podcast, where you can take a look at the studies, articles, and anything else that we referenced throughout today's episode. And with that, let's get started.

Alright, so first up, we have Mullet T, who asks, What if you've taken spore based or soil based probiotics in the past? How do you know whether or not they're colonized? And how do you decolonize? If they have, and this was a question on one of our previous podcasts, it was episode 28. Discussing concerns with using probiotics. And so this person is basically saying, Should we be concerned if we use if we've used soil based probiotics? Do they colonize? How do you decolonize them. And so the first thing that I would mention here is that I would put soil or spore based probiotics, which are essentially the same, and a separate category from regular probiotics, including the ones that we were talking about in that episode. So in that episode, we were talking about kind of the standard probiotics that you would get in most supplements. And you know, this is gonna be like the lactobacillus and Bifidobacteria, and things like that. These are the typical probiotics. And normally people are using them to try to replenish bacteria that maybe they're missing, or they're trying to use it for various other gut related issues that they're trying to resolve. And we were cautioning against that for a number of reasons. We talked about a study where there was concerns regarding SIBO, with probiotics, where when the probiotics were used, there was actually a strong association with overgrowth of the exact same strains that they were using in the supplements. So essentially, the probiotics instead of colonizing the large intestine, we're colonizing the small intestine, which of course, we don't want. We also talked about and I don't know if we talked about these things in as much detail. But these are just other concerns with using kind of standard probiotics, there's some evidence that they actually interfere with the restoration of a healthy microbiome after antibiotic use. So that's a concern as well. We also talked about how using probiotics, even if they did work, they definitely don't address what's really causing an imbalanced microbiome in the first place. You know, in general, when we're looking at the microbiome, we want to make sure we're feeding the right things and creating a healthy environment for the right bacteria to grow. And trying to just add in probiotics doesn't actually address those issues. And again, we also talked about the fact that it doesn't actually help to recolonize the large intestine anyway. And there's also some evidence that using probiotics, when someone's dealing with leaky gut or intestinal permeability, can allow for the bacteria to then leak through the intestines and create an inflammatory state, which of course, we don't want either. So there were all these concerns that we brought up when it came to probiotics. And because of that, we were essentially saying that, we would recommend caution when it comes to probiotics, we wouldn't just recommend using them universally or kind of without regard to any possible negative effects. Not to say that there's never situations where they could be beneficial, but especially in the way that the use currently basically, like kind of popped is just a standard multivitamin is if they can do no harm. Although, of course, multivitamins kind of fall in the same category where there are certain concerns there that we do want to be aware of. But that aside, we were basically suggesting, like that might not be the best approach when it comes to restoring healthy microbiome. But as I was saying, when comes to spore based probiotics, I would say these are kind of a totally different animal and don't necessarily work in the same way. And I would actually say these are relatively beneficial or generally beneficial, if used properly and if the right strains are used. And so maybe I'll let you comment first mike on just kind of the standard probiotics, and then we'll talk more about the soil or spore based ones.

Mike 4:53
Yeah, so I think it's important with the probiotics. And so I think it's important to understand that there is a delineation between the sport biotics and the probiotics as you mentioned, but then when we get into probiotics, I also think it's important understand that there's a delineation between certain species of probiotics as well. And so you can have as an example a lactobacillus acidophilus, you can have a DDS 1, which would be a different strain of lactobacillus acidophilus, then lack of like a general lactobacillus acidophilus that you would find in any probiotic bottle. So there's there's a bit of nuance when it comes to the probiotic perspective. But I think the general idea to understand here is that there probiotics aren't blanketly a beneficial thing. There's been many times myself, where I've taken probiotics, or even clients that I've worked with, who use probiotics and develop pretty gnarly symptoms from them, for example, pretty extreme brain fog. And there's some there's some research looking at this, talking about the possibility that some of these probiotic species can actually produce something called D-lactate, which can lead to some metabolic issues and brain fog symptoms and things like this. So while probiotics can be helpful in certain circumstances, I definitely use them at certain times, with different people depending on what they have going on. It also needs to be understood. And there needs to be a word of caution about the actual potentially negative effects of probiotics, and when they should be used. And when they shouldn't be used as an example, there are cautions against probiotics and people of people who are elderly or immunocompromised, because there are some studies where people have taken certain probiotics, and actually gotten sepsis from them, where the probiotics are actually able to get into the bloodstream. So I think it's when we're talking about probiotics, we can't just blanket it in one term, like probiotics that encapsulates all the species and all their different effects. We want to understand what strain of probiotic we're using, what species what strain, what are the specific effects, what are the metabolites that they're producing? are they producing D lactate? are they producing large amounts of histamine? And then from there, we also want to understand, you know, is this the right context to use these probiotics? So that, for me is something that I'm weighing when I'm considering taking a probiotic when I'm considering testing a probiotic, or I'm considering using the probiotics with somebody who's dealing with pretty significant gut issues, the idea that you just have this one a day probiotic, and it's your microbiome is solidified, as I think, you know, a huge overgeneralization of gross overgeneralization on what is actually going on and how the microbiome works. And this is also to talk about that, in the microbiome studies, a lot of these species don't actually colonize the gut, which is what we'll talk about here with the spore biotics, that doesn't necessarily mean that they don't have a benefit. But it also, it doesn't mean that you're like, specifically, beneficially changing your whole microbiome and changing the whole ecosystem, because again, there's this community of bacteria in the gut that are all interplaying and feeding off of each other and having a variety of different effects. So there's more than just throw in a probiotic in the morning, and you're good to go. It's like what substrate Are you putting in there, what food you're putting in there? What's the poly phenols? What's your stress profile? What's going on with your transit time, all these components will also shift what's going on. So we want to take a broader perspective as well, instead of this, that, you know, it's nice to think that I take this probiotic and I'm good to go. But at the same time, and in some circumstances, for some people, certain probiotics, particularly spore biotics can actually be really helpful if they are struggling with the gut issues. But it's also important to understand you know, that there, there is some pros and cons and we want to actually understand the cons because the mainstream perspective, just hypes these things up as like the best thing ever. And then, you know, people then get a negative reaction, they can think, oh, maybe it's the probiotic. Right,

Jay Feldman 8:37
right. There's it's not even considered as a possibility, not necessarily even by the individual, but by anyone, right? I mean, they're considered to be entirely benign. In the vast majority of cases, I think it's one of the most common supplements that normally we suggest people stop when they're coming to us and dealing with issues. So yeah, definitely something to be to have caution with. And also the idea that you can get, you know, some sort of stool tests done, and then just replace the microbes, the microbes that you're deficient with using a probiotic is totally misguided, as, as you were saying, they don't colonize the large intestine, and the vast majority of cases, that doesn't mean they can't have benefits, but at the very least, it's not just as simple as you're deficient in this one. So provided not to mention also that the bacterial composition of the stool is not the same as the bacterial composition in the colon in many cases. So a couple of missteps there if that's what's being suggested. So definitely something to have caution around and consider with. Yeah, I mean, I guess I would be very careful with and I think that that brings us to the other side, which is this soil based or spore based bacteria. And then the question, part of the question was about colonization. And then I think it's also just worth mentioning prior to that, that in general, I would consider spore based probiotics more so as anti microbials than pro attics, and what that means is that they tend to kill off other bacteria or other microbes. And I would say that that's largely what accounts for their benefits. And we talked in a few different episodes, including that episode talking about probiotics, about how overgrowth of harmful microbes, you know, bacteria, fungi, being the more common ones, is a major issue, really common issue, we talked about endotoxin all the time, this is basically a huge piece of what we're talking about. And using something like a spore based probiotic in the right context, can help to lower the production, or just the growth of harmful bacteria or kill off the overgrowth. And that can make a huge difference, it can be really, really helpful. So I do think it's a good tool to have when we're talking about ways to clear out overgrowth of bacteria. And the way that they do this is actually by colonizing in most cases and producing certain compounds that kill off the other bacteria. And so, we actually want the colonization of the spore based species when we're using them. That's the point. However, it's not something that's going to like they don't stay long term. They typically are just going to be colonizing while we're using them. And then they clear out after. And so there's just a couple of quotes I wanted to share briefly from some studies describing this. The first one is a study titled survival and persistence of bacillus clausii in the human gastrointestinal tract, following oral administration as more based probiotic formulation. And they stayed this study demonstrates that be quasi spores are able to survive during transit in the human gut and persist in the intestine being recovered in feces for up to 12 days after a single administration. The progressive decline in clausii excretion to a complete washout and less than two weeks shown in all volunteers indicates that this bacterium does not give rise to a permanent population competing with or even substituting the resident flora. So basically exactly what we're describing here with this particular species, where one dose leads to colonization for up to 12 days. And of course, normally for using spore based probiotics you can use use them for longer. But after two weeks of stopping the spore based probiotic, there was a complete clearance of the species in all the all of the participants. So that's pretty clear on and then the, the next one is actually looking at a different species, and they state the effects of probiotic prebiotic and synbiotic diets containing Bacillus coagulans, and inulin. On rat intestinal microbiota specimens, of course, looking at rats, and in the study, they state, the obvious decline in spores count through passing GI tract, and high surviving spore counts and fecal samples showed that spores are not the normal resident of GI microbiota, and affects intestinal microbiota by temporary proliferation. And conclusion the present study clearly showed probiotic coagulants was efficient and beneficially modulating GI microbiota, and considering transitional characteristics of B coagulans. Daily consumption of probiotic products is necessary for any long term effect. So again, same thing as that first study. In this case, they also talked about the benefits of the sport based probiotic and species in this quote. But yeah, so that's my kind of couple of quick thoughts here, when it comes to the spore based probiotics. And the last thing I want to mention, well, two quick things. So one, not all spore based probiotic strains, or species are equal. There's very particular ones that have a lot more research on them, which I think will lead to a lot of caution around most of the products that are out there. And there's really only one in particular that I do recommend. And I've seen a lot of very consistent beneficial results when it comes to this product. But before I mentioned that, I just wanted to mention that, you know, if you're interested in spore based probiotics, it's very likely that you're looking to restore improve your gut health. And if that is the case, if you're looking to restore your gut health and optimally support your metabolism, and along with that, lose weight and improve digestion, get amazing sleep, rebalance hormones, boost your energy and so much more. With clear action steps and strategies alongside personalized guidance from me that 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 exactly on how to restore your gut health, as well as other videos on regulating blood sugar, losing weight without destroying your metabolism, boosting your metabolism, getting amazing restorative sleep, rebalancing your hormones and tons more. It also includes resources like a sample meal plan and supplement guide, as well as access to a private community. So again, head over to Jay Feldman wellness.com/solution to check out all the details. And so in talking about spore based probiotic products in particular strains, there's one product in particular that I recommend, and then I'll let you go ahead and Mike, and that product is Corebiotic and specifically the Corebiotic sensitive. The sensitive one doesn't have any prebiotics in there. This is something that I do talk about quite a bit in the energy balance solution, you know, have descriptions on how to use it and everything. But in any case, this is really the only product I'd recommend. I know people have experiences using lots of others. And I've seen, I've worked with people who have used tons of different products out there. But I've seen consistently better results using this one. And I think the research behind the strains that are in this product, as well as the dosing or the potency of each, or the amount of each bacteria that's in there, makes it just stand out as far as spore based probiotics go. So just wanted to mention that. But yeah, go ahead, Mike.

Mike 15:35
Yeah, so there's, there's quite a few pieces there that that you pointed out. And I think the key piece to highlight was that the spore biotics don't actually long term colonize the gut, they colonize the gut for about looks like 12 days, and some of the rat studies is like maybe a little bit longer, maybe two weeks or so. And so basically, the spore based probiotics are a short term solution to actually help you to clear out some dysbiosis or gut issue so that you can move past or clear out the problematic pathogenic bacteria or clear up a dysbiosis or anything along these lines or the way I also tend to use them as somebody is running antibiotics say they have a skin infection, bronchitis, pneumonia, whatever the different circumstances, then I'll probably introduce some of the spore biotics to help clear up some of the niches or shore up some of the niches in the gut. So you don't wind up getting opportunistic overgrowth of different pathogenic bacteria like C. Diff, or something like overgrowth of fungal pathogens like Candida. So in these circumstances, the spore based probiotics are apps actually, kind of ideal, because if you can use them, you're not worried about long term colonization. And in particular, you're not worried about them over growing in the small intestine, where they can create issues like SIBO, where you get bloating, gas, brain fog, etc, every time you eat. Because once you stop taking them, within a few days, they should be out of your system. So you're, it's relatively safe. When you think about this, that, you know, you're gonna have them only for a short period of time. Now with that said, just because these, these bacteria don't actually colonize the gut the long in the long term, doesn't mean that they don't actually have long term effects. And so some of the long term effects that we that we can see from these is that the spore based probiotics while they shift the ecosystem in this short period of time, they can actually decrease the endotoxin producing bacteria like E. coli and an increase lactobacillus. Now if you're dealing with a dysbiosis, and this is able to just move the system in nudge in the direction that you need, so that you can regain some normalized gut function, then this is great, this should be able to help kick you out of there. And then you could stop taking them once, you know, once you get to this better spot. The other thing and this ties in with what you were saying, Jay, with the calling of spore based probiotics, anti microbials is that many of the spore based probiotics actually produce antibiotics locally, inside the intestine, which is actually quite interesting because the the antibiotics that they produce the bacteriocins are able to kill multidrug resistant pathogenic species of bacteria, and some of them are able to kill like pretty resistant bacteria. So that that's, that's also really cool to way to get rid of some of the pathogens. The other thing that these spore based bacteria can do is that they can interact with the immune system to lower the inflammatory burden in the gut. So they're actually able to modulate the immune function and minimize an excessive inflammatory stimuli. So to help normalize things. And then other elements that they can do is there's some studies showing in humans, that taking the spore based probiotics are actually able to lower circulating endotoxin levels. And basically, this would be probably through lowering pathogenic bacteria sharing up gut integrity and then lowering an inflammatory immune response in the gut. So you have some these short term effects, that may be able to shift a dysbiotic situation or problematic situation, move you out of that. And then you can have a long term ramification of that, even though there's a short term colonization. So the benefits of the spore based probiotics is that they last the short term, so that in case you have a negative response, there'll be out of the system, within a couple days, they're unlikely to actually create an overgrowth inside the small intestine. And then it can help move the ecosystem and shift the inflammatory profile of the gut relative, if you're having a hard time that can lead to a long ranging positive effect. Now, the reason that and I guess we kind of touched on this in the beginning, but I want to reiterate here, the benefit here versus the other probiotic species is this lack of potential of actually colonizing the the small intestine and creating SIBO symptoms and producing different metabolites. So the fact that we have an option here that was able to minimize that is extremely beneficial. And it's something that if I say, I'm working with a client, and they have quite a bit of gut issues, and they've had a bad response, other probiotics probiotics actually become a really good viable option in conjunction with herbal anti microbials and whatnot. To help shift the microbiome and moving in a positive direction, on, you know, with a couple other components so that they're, you know, they're able to start digesting foods again, and not everything that they're taking in is is like creating a poisonous response to them.

Jay Feldman 20:14
Yeah, all great points there. And the one that I just want to make sure that we echo here, that you said is that just because it colonizes short term does not mean that effects are short term, just like any other antimicrobial or antibiotic or whatever you're using. Ideally, it's going to help not permanently but help fully shift the microbiome and shift the state so that that long term, you're in a better spot. The The idea here is not that this is something we're relying on forever, like you might with a probiotic, I mean, people tend to take probiotics like daily as if that's keeping their microbiome healthy. But as you're getting out, this is something we would use as a tool to fix up the state of the gut, fix up the microbiome, and then you would no longer need to use it. And you know, your your ideal, healthy bioenergetic diet would keep your garden in a good spot. So yeah, I think that was all pretty clear. So let's move on to the next question, which is from Kelsey. She says, from what I understand clinical keto diets have been shown to be very helpful for some kinds of epilepsy. What do you think is the mechanism for that? What can help us learn about non epileptic metabolism? And so I'm gonna let you start us off here, Mike. But I did just want to mention, there's been obviously a ton of episodes where we've discussed possible benefits or ways through which you can experience benefits on a low carb keto carnivore diet, but why they're still not ideal. We'll be echoing that same sentiment today. But I will link back to prior episodes where we've talked about how you know, yes, these sorts of diets can benefit autoimmunity and lead to weight loss. And, you know, a number of other situations. We recently talked about benefits in terms of brain health. And of course, there'll be a lot of overlap with that here. But that doesn't mean that these are ideal diets, it doesn't mean that they don't come at a metabolic cost. And so I'll let you take it away here.

Mike 22:00
Yeah. So to start out, I want to there's some interesting work from actually Dr. Dominic D'Agostino, who Jay had a debate with well, it actually wasn't really a debate on ketosis. So it essentially wound up not being a debate. But there's some interesting work here where Dr. Dominic D'Agostino has shown that you don't necessarily need to go into a ketogenic state to get the benefits for epilepsy for from ketosis, you can actually just take ketones, and then the ketones have specific beneficial effects on on epilepsy, and seizures. And I guess, just to clarify for people really quickly, Epilepsy is a state where people are more prone to developing seizures, pretty significant seizures, on a regular basis. And so what they want to do or what they're trying to do is figure out ways in which these seizures can be minimized because it can actually drastically decrease the quality of life for somebody who has epilepsy. And so the keto diet, traditionally moving into ketosis has been shown to show benefit for seizures. However, what we're seeing now is that you don't actually have to go into this extremely low carbohydrate diet to get the benefit of ketones for seizures. Now, you can in some of the studies, like there's a study here from as as mentioned, Dr. Dominic D'Agostino, basically what they're saying is the the taking exogenous seizures, ketones was able to actually minimize seizures and rats despite the meeting and 60% carbohydrate diet. So what they say is the anti seizure effects the ketone esters were first reported in a unique seizure model, which uses hyperbaric hyperoxia to reliably induce epileptic like or i.e. tonic clonic tonic clonic seizures in normal rats, a condition known as CNS oxygen toxicity. The rats in his study, were eating standard rodent chow with an abundant carbohydrate intake greater than 60%. Before induced into hyper keto anemia, a single oral dose oral dose of ketone Ester, BD-AcAc2 to induce rapid and sustained ketosis and prolong the latency to seizures by 574%. So basically, you have animals who are eating a high carbohydrate diet, all they did was introduced ketones into the diet, and the animals were actually protected from seizures in a model where they expose them to high levels of oxygen to induce toxicity. Now, on the benefits of ketones here, because they're shifting the metabolism in terms like carb versus fat oxidation, I don't think it's entirely that the ketones actually burn closer to sugars than fatty acids do. And this obviously, the central nervous system can't directly burn fatty acids, so the ketone is another option. But there's some other effects that the ketones have that may be indirect of oxidizing the fatty acids, Indra, indirectly oxidizing fatty acids, then carbohydrates. So as an example here, what we're showing is that the ketone bodies actually have a direct anti inflammatory effect. The ketone homebodies can increase GABA and decrease aspartate in the central nervous system. So GABA is the inhibitory neurotransmitter, it helps to calm the central nervous system down helps to relax things, it helps to lower that the seizure activity. And most of the anti seizure drugs are actually drugs that activate or interact with the GABAergic system. So the ketones themselves can increase GABA activity. And then they can lower a excitatory amino acid and neurotransmitter called aspartate. And what they do is they're actually shifting the metabolism of glutamate away from aspartate and towards GABA. And glutamate is also involved in excitotoxicity, and, and seizures as well. So having this effect is actually quite beneficial. And this is somewhat independent, there's a metabolic change. But this is someone independent of like carbs versus fat oxidation. Now, what I want to show here is there's also some quotes or there's also some some information showing that ketone bodies can be used instead of having to go on a keto diet. So there's a quote here and they say, importantly, if ketone supplements prove safe and efficacious in human trials, they may provide a tool for achieving ketosis in patients who are unable or unwilling or uninterested in consuming a classic keto diet. Modified Atkins diet. ketone supplementation may also help circumvent some of the difficulties associated with this dietary therapy, as it allows for a rapid dose dependent induction and ketosis which can be sustained with prolonged consumption and monitored precisely with commercially available technologies, ie blood ketone meters simultaneously, it can provide patients with the opportunity to reap the benefits of therapeutic ketosis without the practical and social difficulties of a highly restrictive diet. And the last piece that I want to talk about here is that medium chain triglycerides, which were all the rage for a while, which is essentially just a portion of coconut oil can also be used to generate ketones instead of going into a ketogenic diet or a ketosis diet. Now, why is all this important? Well, this is important because basically, there's a series of issues with the keto diet, you know, there's changes in the stress hormones, glucagon, adrenaline, cortisol, there's a lowering of thyroid function, there's problems in the mitochondria, because your if you go on the keto diet, you're relying primarily on fatty acid oxidation, which creates more reactive oxygen species. So if you can reap the benefits of ketone bodies in disorder, like epilepsy, where the ketone bodies have a very specific effect to minimize the epileptic seizures, then without having to actually have the negative effects of running into a keto diet, then this is a great option. And basically, this is what they're researching now is like, can we just use ketone bodies themselves. So overall, I think the final picture or perspective on my end is, let's if you have epilepsy if you're dealing with the seizures, and we have a known effect of these ketone bodies on helping to minimize the seizures, and they can possibly offer poor perform, or minimize the amount of anti seizure medications that can be used, because those medications have a ton of problems, then I would say have a normal or optimized diet. We have carbohydrates, all type of stuff. You don't want to go on this extremely restrictive diet, and then add in ketone bodies to actually have these specific anti inflammatory GABAergic. And seizure protective effects.

Jay Feldman 28:18
Yeah, I think that's a great point, a great sentiment, definitely one that I echo, there's a few things that I would want to that I want to come back to. So for one, there are, and this is kind of what you're saying, Let's go for adding if this is an option of just adding ketones providing the same benefit, that's much better than going on a low carb or ketogenic diet. And that's because of the cost there. And one of the clear ones is in the downregulation, of the metabolic state, contributing to hypothyroidism contributing to excess stress. And this is something that is seen on people who are on long term ketogenic diets for something like epilepsy. And I'll refer to a paper that I did talk about with Dom on that kind of debate or discussion, where hypothyroidism is seen on on long term ketogenic diets and people with epilepsy because of these effects. So I think that's a great point, if we can get the same benefits from the ketones themselves. That is, I think, still not fully clear. I think there's still some debate on that, but it's at least promising and definitely worth considering. And also, there's, I would say, really no negative to it. And again, so that's the next thing I want to clarify is the concerns with the ketogenic diet is not the production of the ketones. It's the lack of carbohydrates and the inherent stress that that causes. And so if we're able to provide the ketones or MCT oil as a precursor to ketones, that's great. I also wanted to clarify again, we're not concerned about the burning of the ketones like the using of the ketones as fuel in the mitochondria to produce energy. As you were saying, Mike, they're actually used very similarly to glucose, in contrast with fatty acids, which are used very dissimilar ly from glucose almost opposite And there's reasons for that we've discussed in the past, I'll link back to those episodes and articles and everything. But when we're on a low carb diet, the vast majority of our body is running on fat. And then a small amount is running on ketones. Mostly, it's just going to be the brain. When we're on a carbohydrate based diet, you're going to have some amount of the body running on fat, and then the rest is running on glucose, including the brain. So there's a difference in what the brain is using either glucose or ketones. It's never using fat except for maybe very, very tiny portions. And that's because of how inefficiently fat is metabolized. And how much oxidative stress it causes, which we'll come back to, but the body will be running on more carbs versus more fat. And that's where the big concern comes in, as well as the energetic and hormonal state that results from the lack of carbohydrates. So I wanted to mention that. But for you to kind of back up a little bit in terms of epilepsy as a whole, there's a few things that we see there that I think are really clear, and help to point us in the direction of what tends to drive the seizures in the state. And typically, we see things like elevated oxidative stress, elevated levels of lactate, elevated levels of prolactin, and then elevated glutamate and lower GABA activity. And that was something that I mentioned to Mike. And so what that points to is a couple of different things, we basically have some hormonal and neurotransmitter kind of dysregulation, some excess excitation in the brain, and a lack of relaxation. And we also have poor metabolism, as indicated by the excess lactate, which only is really going to happen when we aren't able to effectively convert glucose all the way to ATP using the Krebs cycle and electron transport chain. And we instead have to rely on glycolysis, where we're converting that glucose to lactate. And when we see that, that means things are not working well metabolically. Same thing with oxidative stress, typically, that's going to happen in the same state where we're producing a lot of reactive oxygen species due to poor inefficient mitochondrial respiration. So these are these are what we have is the clearest drivers of seizures in the state. And there's a number of ways that a ketogenic diet can contribute their to providing relief. And a couple of the things that I wanted to kind of tack on to. So when we have the metabolic effects, which is largely going to be that when we're not oxidizing glucose, while we're not converting that glucose well to ATP, providing an alternate fuel and ketones is beneficial, because we can then produce ATP without of the reactive oxygen species production without excess lactate buildup. And that's better, it's a lot better to be running on ketones than glucose. If we can't use the glucose, well, if we can use the glucose, well, there shouldn't be any difference. There shouldn't be any benefit to ketones over glucose. In fact, in that state out out extra safe, glucose enters out the ketones due to a bit more carbon dioxide production, and a slightly better FADH2 to NADH ratio. So that'd be the first thing, but what we see is when either providing ketones or going on a ketogenic diet, we provide this alternate fuel, and that's beneficial. We also do a couple of like the ketones themselves in the brain do a couple of other things. So they lower oxidative stress and inflammation in part by inducing uncoupling, which reduces the reactive oxygen species production. Of course, it's not an ideal thing to be relying on because when we're uncoupling, we're not effectively producing ATP. But at the very least, we're going to lower oxidative stress, which is really important in a case like this, as we were saying, also, Mike, we the ketones themselves will help to induce adenosine release, which helps to increase the GABAergic activity and reduce the excitation that's beneficial. And one of the mechanisms through which it does that is through this uncoupling through this lowering of oxidative stress. There's also possibilities that it's doing it through other mechanisms as well. But that's not fully identified at this point. And that's, I would say, where those kinds of anti inflammatory effects are coming from basically providing this alternate fuel. So we're stopping the kind of inflammatory state from poor glucose oxidation, and the induction of things like uncoupling to reduce reactive oxygen species. And I would say those are the main kind of metabolic reasons or direct reasons as to how the ketones themselves are helping. But there's another huge one, which I hear talked about very little, which is the effects on the gut. And there's good evidence that the gut microbiome is one of the main things that mediates the anti seizure effect of the ketogenic diet. And so I'm going to share a quote from a study that's describing exactly that. It's titled The gut microbiota mediates the anti seizure effects of the ketogenic diet. And they state here we show that the gut microbiota is altered by the ketogenic diet and this is required for protection against acute electrically induced seizures and spontaneous tonic clonic seizures in two mouse models, mice treated with antibiotics or rare germ free or resistant to ketogenic diet mediated seizure protection, enrichment of ants gnotobiotic co-colonization with ketogenic diet associated Akkermansia and Parabacteroides restores seizure protection. Moreover, transplantation of the ketogenic diet, gut microbiota, and treatment with accurate Akkermansia and Parabacteroides, each confer seizure production to mice fed a control diet. Overall, the study reveals that the gut microbiota modulates host metabolism, and seizure susceptibility in mice. It also talks about how this directly contributes to the increase in GABA relative to glutamate levels in the brain based on the alterations here in the microbiome. And what they essentially found again, was, you could have rats that were not on a ketogenic diet, or actually mice, not on a ketogenic diet, you could transplant the microbiome from the mice that were on the ketogenic diet, to the mice that are not on it and get the exact same benefits in terms of seizures. Or you can just add into two different species that they were talking about to a mouse that's not on the ketogenic diet, and get the same benefit suggesting this major major factor here being the gut microbiome. And we know that A, that a poorly, I mean, like poor gut health, and an imbalanced microbiome drives increases in endotoxin. And that, of course, will directly interfere with metabolism in the brain directly increase oxidative stress in the brain. Obviously, it'll also have effects on glutamate and GABA affects the general hormonal state. So there's a ton of things going on there. But the gut microbiome is a huge mediating factor here between the benefits of a ketogenic diet and the seizures in terms of epilepsy as well. So that's one that I think is really important to mention. And again, in both of these situations, whether we're talking poor glucose metabolism, or poor gut health, we can resolve both of those issues without needing a low carb diet. And I would say, that's always ideal, as we're kind of suggesting, because of the inherent negatives of low carb. The last thing I want to mention, and I'll let you share some closing thoughts on this one, Mike, is just that there is some conflicting information as to whether the administration of ketones on its own can fully lead to the same benefit in terms of seizures. I know I saw a study when kind of reading through some research for this, that showed that the infusion of beta hydroxy butyrate was not effective for reducing seizures relative to the ketogenic diet. So again, it might depend on, on what like the exact design of the study and all of that, but yeah, so that would be basically my closing thoughts. Here. We have two main drivers as to why the ketogenic diet helps. Ideally, we can accomplish both of those without the ketogenic diet. Even if we are adding ketones, that still is not resolving the underlying problem. So we would still want to fix the glucose metabolism, we would still want to fix up the gut microbiome. But if I didn't ketones leads to relief, I would say by all means, it's something I would I would implement as well. Yep. Yeah,

Mike 37:49
a couple things just to tack on here. So in the in the study that I talked about, that Dr. D'Agostino had done, what they found was that you needed elevations of not just by beta hydroxybutyrate, but you also needed acetyl acetate and the other ketone bodies to actually have the effect. So it was it was dependent upon having all three ketone bodies, not just beta hydroxy butyrate, which is probably why they didn't find the benefit in that study. Then the other thing, in terms of the gut microbiome piece, something I want to point out is that you don't necessarily have to go on a low carbohydrate diet to get increases in some of these species like akkermansia, you can use different herbal components or shift the diet in different ways to increase some of these different bacteria without actually running into the problem of a low carbohydrate diet as well. So basically, this is this research is helpful, because it lets us say like, Hey, this thing that we're doing will have this effect on the gut microbiome. And then the next piece from there is like, well, if we actually are able to mimic or create recreate this effect, without running a low carbohydrate diet, we could still get these benefits. So again, you don't necessarily have to run a low carbohydrate diet, or a keto diet to have increases and necromancy in the gut, and you don't have to run a low carbohydrate or keto diet to increase ketone bodies. So then the the I mean, there's still, as you pointed out, Jay, we still need more research in this area. But it'd be I think, beneficial to find out what are the other mechanisms that the keto diet is actually working through to minimize the seizure activity in epilepsy. And then from there, we can figure out, you know, are there other ways to modulate this, we don't have to go on to this very problematic diet do this effect on the hormonal systems and mitochondrial systems and other other areas throughout the body, so that we can have this these beneficial effects and minimize seizure activity or having to rely on problematic drugs and something I want to point out, and this is a I think it'd be like, this is like a little nuanced piece. When you run the keto diet, while you may be helping to fix issues with glucose oxidation in the brain, because of the upregulation of ketone body bodies, the rest of the body will actually have to rely on fatty acid oxidation, which should be actually be problematic from mitochondrial standpoint, as opposed to glucose oxidation. And because that's the this is the reason I say this, I see inside the Keto sphere this in arguments, oh, well, the, the ketone bodies have all these benefits inside the central nervous system. So we have to go on this lower carbohydrate diet without understanding that the ketones are being created or produced to go to the central nervous system when there isn't enough glucose availability, because the central nervous system can't actually use fatty acids. So you're getting this benefit, you're or you're perhaps you're getting this benefit of ketones inside the central nervous system for a variety of different reasons. But then the rest of the body has to run on fatty acids. So again, that's another thing that we would want to minimize. And part of the problems with the fatty acid oxidation is about the production of ROS. And over reduction of the electron transport chain. And I go into the specific details of this on my YouTube channel, Mike Fave Science where I talked about the Randle cycle and reverse electron transport. And then Jay and I have also covered this stuff, pretty pretty in depth and multiple other podcasts that we have done talking about the difference between carbon fat oxidation. So this circuit with this in mind, again, there's other ways to go about this unnecessarily dropping the carbohydrate intake. And I think that that would be ideal so that we don't cause these other issues. Again, whenever in every interventions we put into place. We want to see what is the risk versus reward, what are the pros and cons of this circumstance? And then run from there. So that we're we have a full risk profile, we're and we're having a net benefit instead of creating new problems as we move forward.

Jay Feldman 41:40
Yeah, yeah, I think that pretty well covers it. And I did want to just say, when it comes to increasing Akkermansia production, most of the things that are pointed to there are having very little to do with low carb diets. It's things like poly phenols butyrate, which is going to come from prebiotics in things like fruits and vegetables. So those are typically the things that are pointed to that are going to increase species like Akkermansia. So yeah, definitely something that can be accomplished without low carbon ideally without low carb because of those concerns that that we've both mentioned. So with that in mind, let's hop on to the next question. We have Elizabeth who says, I noticed stevia in the yellow zone for additives in the food guide. I'm curious if all stevia products are created equal. I've been using a raw stevia leaf powder to make homemade cacao dipped tart cherries for years considering this treat pretty much guilt free, I consumed a lot of these cacao covered cherries pretty much daily, I'd be interested in any studies or information you may have on the downside of stevia, and what she's referring to the yellow zone for additives in the food guide, she's referring to the energy balanced food guide, which you can find that Jay Feldman wellness.com/guide. So there are a few different things then that I want to cover here. One is like specific effects of stevia, itself. But I wanted to start with the idea of using something like stevia any sort of low or no calorie sweetener. And so, in general, the idea of behind using something like that is that we want to get the sweet taste without the carbohydrates without the sugar. And, as we've, as we always talked about that only makes sense if carbohydrates or sugar are bad. And I think that's not the case, right? So we actually really benefit from getting enough carbohydrates, whether that's coming from fruit or honey, or other sweeteners that we'll discuss. And in general, if we try to, if we have a desire for the sweet taste, and we're getting that sweet taste without the equivalent amount of carbohydrates, we're actually setting ourselves up for dysregulation in terms of our hunger and in terms of overeating as well. Because the whole reason why we're craving or desiring the carbohydrates is because we actually need that fuel. You know, our brains are using that glucose, various other organs are needing the glucose and carbohydrates. And so you know, fructose, of course, we talked about that a lot with the liver and various other organ systems. And that's the whole purpose. That's the whole reason why we might have a taste or craving for carbohydrates. And so we want to provide that that's the number one way that we're going to lower the stress hormones, it's massively important for pretty much every system you can think of whether we're talking increasing reproductive hormones, or you know, improving gut health or various other things. So the first thought here would be why you're even thinking of using the stevia in the first place. And also, if there is this situation when we're concerned about overeating, or we're concerned about having too much carbohydrates, normally, that's a sign of some other sort of issue. And we've we talked about this in the weight loss series, and I think in a couple of other episodes, where our hunger signals are largely determined by energy availability by ATP levels, specifically in the hypothalamus in the brain, and in the liver. And so when we're not effectively producing energy from the food that's coming in, we're going to be in this dysregulated state where we're eating quote enough off, but not effectively converting it to energy. And so we're still chronically deeply hungry, even though maybe we feel physically full, or we are craving more food and more carbohydrates. In that situation, the issue is our inability to effectively produce energy. And so that's where we want to put our focus here, as opposed to on trying to avoid the calories or avoid the carbohydrates, which we actually really need those. So they'll just kind of be my starting place. And then maybe we'll briefly talk about some of the harmful effects of stevia itself. Yeah, I

Mike 45:28
mean, for me, that was pretty much the same perspective is, I don't think there's any there should be any guilt, because you mentioned that this is her guilt free way of consuming the chocolate tart cherries. There's no guilt in having tart cherries, chocolate and some sugar present. Especially if everything else in the diet is dialed in effectively, right? If you if you have a solid diet of calories, macros, micronutrients, all this stuff is dialed in appropriately. And then you have some sugar to sweeten or honey or maple syrup, or whatever the thing is, it's that's not really a problem. The bigger problem with the sugar intake is more of somebody's basing the vast majority of their diet around granulated sugar. And it's like I'm on a carnivore diet plus soda, or carnivore diet and, and or dairy based diet, I'm just adding in granulated sugar to all of my meals. That's where people start to really see issues. And the issues are related. You know, we've talked about this before, but it's mostly to the lack of polyphenol content, and the lack of vitamins and minerals. So if you're adding in a bit of sugar to make your tart cherries and chocolates, chocolate mixture sweeter, you have poly phenols, you have vitamins and minerals, you have the fiber content. So I'm not really seeing that much of a problem with that again, especially once a dye is dialed in effectively. And if somebody is wondering how they can effectively diet their dial their diet in or get a baseline structure, they have a guide on my website, Mike, they've dot com called the nutrition blueprints, they could check it out there. But yeah, I'm not really seeing, like where the guilt is around having the sugar here. So I think from the that's the primary perspective, before we even consider whether stevia is problematic or not. I think this this mindset around sugar being something that you have to have guilt about having is the essential component to hone in on here. And this isn't a you know, call this individual out or say anything negative about this mindset, it just to bring the mindset into question and start to you know, take an objective look at this and say like, is there really a problem with the sugar. And when you start to like when you start to go through even if you looked at studies where they're feeding people excessive amounts of sugar, even if their intake is isocaloric, or they're not in a surplus or things like this, you're not really seeing this thing where they're gaining tons of weight or anything along those lines. So with that said, again, having a bit of sugar, I don't think it's problematic personally. And then yeah, we can jump into the components with stevia now because there's there's a lot of stuff around a lot of different elements around stevia, I think it's not fully clear on whether it's problematic or not. Yeah,

Jay Feldman 48:01
yeah. And I'll let you start us off with that in a moment. But just to make it clear, so we would recommend using sweeteners with carbohydrates with sugar in them as opposed to stevia that can be honey, it can be maple syrup, it can be granulated table sugar, and as you were saying, like the biggest concerns was sugar that it doesn't have polyphenols. In this case, we're talking about already getting into poly phenols, elsewhere, and almost always combining it with things that will have some poly phenols. And it doesn't have vitamins and minerals. And we don't need every single, like part of the food that's coming in to have vitamins and minerals. We it's not like we waste massive, massive amounts of vitamins and minerals with everything we do, we should actually retain them really well, when we're functioning well, metabolically. And while we talk about those things as being important, I think in the health sphere, there's way too much emphasis on vitamins and minerals in a way that I think is a little myopic, but also kind of non self aware. Like, for example, you hear this a lot when we're talking about a paleo or ketogenic diet, yet, you'll talk about in those cases using MCT oil, coconut oil, lots of fat sources for your for your, for your diet, right, that's where you're getting most of your fuel from even olive oil, tallow, butter, those things are not nutrient dense at all. They might have small amounts, very small amounts of fat soluble vitamins, but they're not giving you the B vitamins that you would need to actually produce energy. They're not giving you minerals. And again, the amount of fat soluble vitamins in the actual fat itself is very, very small. When you're talking about, you know, really nutrient dense animal foods, it's the protein containing ones it's like the liver or in the meat, it's the meat it's not the fat that tends to have the vast majority of the micronutrients anyway, so I really don't think some table sugar is much of an issue at all. And as you were getting at Mike unless it's really a large portion of your diet, it should be totally fine, especially in a context like this. So yep, yeah, feel free to to tack on to that and then hop in with with some maybe possible concerns with stevia. Yeah,

Mike 49:59
so The other thing I'd mentioned here is that it's known inside the research that high sugar like granulated sugar diets are problematic, but also overfeeding animals, and even humans fat sources is also problematic. So anytime you get a situation where you're drastically increasing the energy source, and even high super high protein diets are problematic. So in any circumstance, where we're going to take one macronutrient, we're going to slam it and really high quantities and you know, in these relatively refined components, we're going to see issues period. And this is this is about, you know, are you taking this substrate? And are you converting it to energy effectively? What's your requirement for the substrate and conversion to energy? What's the context where you're having the substrate and converting it into energy? And that's the most important piece. So to just blanketly. Assume, and I'm, again, I'm not trying to straw man, the individual acids question. I'm just trying to question the perspective that you brought up Jay, in the Keto spheres, where essentially, if you just blatantly assume that sugar is toxic, or you have the other camps where fat is toxic, then you miss the understanding of the contextual component where you actually need carbohydrate, you actually need fat you actually need protein in certain amounts for optimal health. Do you need these things to live? Probably not protein? Yes, carbs and fats, you could probably get away with really small amounts of both of them and still live. But the question is about optimal health, not whether we can just live or not, that's kind of irrelevant to the entire health spheres, whether you can live without something. Now, the next piece that I want to talk about is, while you need micronutrient density, you also need calories and fuel. At a certain point, you can't just build your diet out of the most micro niche, micronutrient dense foods. And this is what a lot of people that I work with do. It's the economy like, yeah, I eat the most nutrient dense diet, I have organ meats, I have seafood, I have spices, I have, you know, these really nutrient dense vegetables, but they're in a super caloric deficit, and they have zero carbohydrate in your diet, and they're having problems because you that's one factor to optimize when constructing a diet. But there's other factors that are also important to optimize. And that's also nutrient density in terms of energy, energetic substrate, because macronutrients protein, carbs and fats are also nutrients. So we want to have enough of these things, we want to have have the threshold of fat intake, the threshold of carbohydrate intake, the threshold of protein intake, and of the vitamins and minerals, so we can function optimally and minimize this restrictive mindset of X, Y, and Z thing is just terrible for you, or is, you know, you should be guilty about having it. So we need to like create all these other strategies around instead of saying, Alright, is my as my diet set up appropriately, and I want to add some sweeteners. So my dark chocolate, tart cherries taste better. And I'm like, can I use some maple syrup or honey or some granulated sugar to do that, most likely, that is not going to be an issue. Again, this is the this is where the nuanced perspective, this stuff becomes very important. Instead of dialing in just one one view, right? It's just sugars bad or just we need micronutrient density, it's like, add a couple other perspectives and a couple other principles and bring them together to create a holistic view or a comprehensive view of setting up the diet. I mean, that's what we're here to do. I'm not saying everybody needs to go out and no read all the research to figure these components out. It'd be you know, do read the research when you can, but the goal here is we're trying to expand the perspective because I think both you and I came from this perspective at one point as well, where sugar or carbs to this absolute evil, evil thing. And we could only have it if we earned our carbs, or we can only have some, we couldn't have like one cheat day, and that wouldn't be guilty now. And that actually led to problems down the line metabolically that when we start adding carbs actually fixed. So just that I think that would be my further perspective of this. And, and I think this, these mindsets are actually some of the most important things to dial in, when you're coming from a lower carbohydrate background and starting to add carbohydrates into the diet is to remove this guilt, and the shame and the negative emotion around having carbohydrate or some of these other things and try to come from it from an objective perspective of, well, what do I actually need for my body to function appropriately?

Jay Feldman 54:16
Yep. Yeah, I totally agree. And we talked about this. And we did a whole series on like anti diets and binge eating and relationships with food and things like that. So link back to those. If that's something of interest someone a bit more. I think those topics can't be understated. I mean, it's so valuable to shift that mindset, right. I mean, in talking with people and working with people, I think that's one of the biggest areas that a lot of people find freedom, of course, in addition to the benefits that they feel physiologically physically, the relief psychologically is huge. So yeah, just shifting that relationship shifting the way we think about food for sure. So coming back to stevia itself and possible concerns there. Do you want to start us off with those my

Mike 55:01
Yeah. So when I was going through the research and looking at stevia, there are some problematic components with stevia. And then so there's there's studies talking about issues with stevia. And then there's also studies talking about the benefits of stevia. So my take on this, and I'll Jay, I'll let you go through some of the different elements, some of the different problematic components, some of the beneficial components are seeing if they're saying and improves insulin sensitivity. They're saying it was never a protective so protects the kidney protects the liver, etc. But something to point out is how these studies are constructed, is extremely important in understanding this. So if you do like really high doses of stevia, or you know, particularly in some of the animal studies, you see pretty significant problems. In normal dosages or smaller dosages for humans. I think that, you know, if you if you had a product and it had a bit of stevia on it, is it this toxic thing that's going to cause all these problems like say like sucralose, or Acesulfame potassium, or some of the other problematic sweeteners would probably not so small amounts, it's not a I don't think it's a terrible thing. But at the end of the day, like I wouldn't prioritize using stevia as your sweetener for your different food components, I would just go and actually have the different carbohydrates in you know, fruit juice, whole fruits, dried fruits, fresh fruits, the honey, the maple syrup, the granulated sugar, and you know, in amounts needed, like you're gonna have some of your coffee fine. I think that all of those things are the things I would prioritize instead of just getting the sweet flavor from from the Stevia glycosides. And especially when we know that while there are some research studies showing some benefit in certain contexts and certain dosages, there's also some research showing problematic effects in certain contexts and certain dosages. So with this skew, where it's not like uniformly does this is like a good thing. Overall, I would want to put a word of caution around using it in higher quantities on a regular basis. And then beyond that, even before that, as I mentioned, I think we should just be having the carbohydrates in general, because we actually need these fuel sources. Instead of trying to like find all these unique ways that we can have this sweet taste and not have calories or whatever the different component is.

Jay Feldman 57:13
Yeah, agreed. And when looking at the research, it is a bit of a mixed bag. But when we're talking about something that a doesn't even from our view, and as we've described, doesn't really make much sense to us in the first place, and may have possible negatives, and we know is for sure gonna be missing out on all the benefits that come from sugar and carbohydrates. It doesn't make a lot of sense to be kind of rolling the dice with it. Of course, if you're having an occasional here and there, not necessarily the worst thing, that's why I have it in the yellow category as opposed to the red in the food guide. But something that I think has legitimate possible concerns. And just a couple of those to touch on them. For one is there's some evidence of it being an endocrine disruptor, where it's been shown to have some antagonism of the progesterone receptor. Although in that study, it actually increased progesterone levels, potentially is like a reflexive reaction and response which we don't want. That's not the way we would want to increase progesterone levels. There's some evidence and other studies about lowering progesterone, progesterone levels and increasing estrogen. There's some evidence and studies of it lowering testosterone and opposing the androgen receptor as well as the progesterone receptor, and also interfering with male fertility. Again, doses are probably a lot higher than the average person will consume, but who knows as far as accumulation and again, we don't want small amounts of this happening either. So you know, as you were saying, there's some potential positive some some studies showing protective effects but some concerns on the endocrine side. And then there's a couple of studies that show some pretty particularly negative effects. One is in terms of inflammation and liver and kidney damage. So this is a study titled The Hidden hazardous effects of stevia and sucralose consumption in male and female albino mice in comparison to sucrose, and they state after 18 weeks significant elevations in liver and kidney function enzymes are observed in male and female mice administered administrated with both non caloric sweeteners Histopathological examination and sucralose and stevia administrative groups confirmed to the biochemical results where it revealed a severe damage and liver and kidney sections. And they then go on to state that a vigorous elevation and levels of different immunoglobulins and pro inflammatory cytokines that was accompanied by a significant reduction in level of anti inflammatory cytokines il 10, interleukin 10, was observed in male and female mice groups administrated with sucralose or stevia. So showing both of those two having considerable negative effects relative to in this case, also looking at sucrose, the sucrose had some increases in inflammation. Again, both of these things are all these things were used in pretty high doses. And obviously not ideal context. But in this case, really the major concerns of both stevia and sucralose which again stevia is the natural sweetener here, sucralose, being the artificial one and most people would assume that stevia would not have the same effect on sucralose, but seeing some concerning effects here. And then the last one that I want to mention has to do with some effects on thyroid and weight. And so this is a study titled evaluation of supplementary stevia leaves and stevioside and broiler diets. These are probably the chickens, effects on feed intake, nutrient metabolism, blood parameters and growth performance. And they state dietary stevia reduced blood glucose, dietary stevia reduced blood levels of glucose, triglycerides and T3 but had no effect on non esterified fatty acids. In contrast, stevioside only decreased T3. Both the stevia leaves and stevioside diets significantly increased abdominal fat content. So lowering T3 and increasing abdominal fat content is normally the opposite of what we're looking for if we're trying to add stevia in. And again, obviously, both these studies looking at animal models, looking at doses beyond what's kind of typically used, but enough reason to have some caution here, especially when, for other reasons. You know, we would say stevia doesn't seem like the best option. Anything to quickly conclude with Mike. No,

Mike 1:01:01
I just, I pretty much said my piece before. Again, I would use real sugar sources and stevia if it's in small amounts and a product that you're using, I wouldn't worry about it because it's studies where they saw problems where we're in much higher doses, but I also wouldn't say that it's necessarily a panacea for improving health or constructing a diet appropriately.

Jay Feldman 1:01:22
Yeah, yep. Great. All right. If you did enjoy that episode, please leave a like or comment if you're watching on YouTube. And if you're listening elsewhere, please leave a review or leave us a five star rating on iTunes. All 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, head over to Jay Feldman wellness.com/podcast. And if you are dealing with any of the low energy symptoms that we described a bit today or others like chronic cravings and hunger, low energy fatigue, joint pain, weight gain, digestive symptoms, brain fog, poor sleep hormonal imbalances, or low energy conditions like autoimmune conditions, high blood pressure, insulin resistance, high cholesterol or various other metabolic issues or chronic health issues, then head over to Jay Feldman wellness.com/energy to sign up for a free energy balanced mini course, where I'll walk you through how to adjust your diet and lifestyle to resolve these low energy symptoms and conditions by maximizing your cellular energy. So again, to sign up for that free mini course head over to Jay Feldman wellness.com/energy. And with that, I'll see you on the next episode.

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