The Oreo Diet Explained

The punchline was the Oreo cookies slaughtered the statin for LDL lowering.

No way. Really?

They were twice as powerful and they acted in one third the time. So the drop in LDL was a 71% reduction on the Oreo cookies in about two weeks. And then.

Hey, just got done recording with Nick Norwitz, super smart researcher and public science health educator. We primarily focused on seed oils, but we got into some other things too, including Oreos. You won't want to miss this one. Check out the show notes@bengreenfieldlife.com NickNorwitz Here we go. Today's podcast guest is somebody who I've actually really been looking forward to interviewing. He's super smart, he's a researcher, he's an educator. You may have seen some of his fascinating videos on YouTube. And his name is Nick Norwitz. He's an MD and a PhD. Really good background in metabolism and in cell biology and biochemistry. So he knows his stuff. I was going to say you're a smart cookie, Nick, in allusion to your self inflicted Oreo test, but you've probably gotten that before.

Yeah, not smart cookie per se before, but I'll never live down the Oreo cookie experiment.

Yeah, give the. I mean I know you've got some extensive podcasts about your Oreo cookie experiment, but it's my understanding that that kind of got you a little bit Internet famous. What's kind of like the 1 to 2 minute overview of that experiment?

Well, let me go into the motivation behind that experiment because the headline was and to be clear, when I say headline I mean like media but also peer reviewed literature that like Harvard scientist lowers his cholesterol with Oreo cookies. Now on the surface that just seems like a complete troll in clickbait. And the reason is it's exactly what it is. It is clickbait. But what is clickbait with a purpose? So I did this experiment, I was forget second or third year medical student and the motivation behind it was like I have my toes in a lot of different ponds or puddles. A researcher. I was trained to be a clinician. So I was in medical school and then also a young person like exploring this new thing that has not been accessible to any other prior generation of academics, social media. And to me it's really fascinating like how you can use this tool to access people's imaginations, bring people to the table and have difficult conversations. And part of that is just telling a story around science. So what I started to do is explore how could I take some of the More esoteric, nerdy things, you know, that I love to study, be it like lean mass, hyper responders and cholesterol metabolism, inter organ mitohermesis, whatever, and translate it into something that people go like, oh, that's interesting, I want to learn about that. So I imagined and I engineered an experiment around something that we were studying at the time. We had like nine, ten papers on this topic on lean mass, hyper responder. So basically high level, when some people go very low carb, their cholesterol and in particular LDL goes through the roof.

When they go low carb. So it'd be like low carb. I'm assuming that means like slightly higher fat, their LDL goes through the roof. Right, that's. That seems like something you'd expect.

No, actually, no. So. So. Well, really yes and no. Because here's, here's the caveat. One of the reasons we're interested in studying this is because ketogenic diets, they're exploding in terms of their different clinical utility. So, you know, epilepsy, diabetes, obesity, but not just diseases associated with, you know, having excess adiposity, but also mental health conditions, bipolar, depression. But there's a major clinical obstacle to the broad acceptance, and that is this phenomenon that in a minority, not a majority, but in a minority, cholesterol goes up. And it's kind of like a boogeyman in medicine. If you don't know why it happens, it's just gonna pop out in random patients. Then you get this fear mongering around, well, we're not gonna put this patient on low carb because what if their cholesterol goes through the roof, God forbid? Right?

Yeah, yeah. And could I clarify, I don't wanna rabbit hole too much here, but the reason I said obvious is I think a lot of people would just assume, well, if you're eating low carb, you're eating more fat. So you'd expect the cholesterol to go up if you're convinced that cholesterol responds like that acutely to dietary fat intake. But are you saying that cholesterol went way, way higher than what would be expected in a small group of individuals?

Two things. First, actually, if you look at the literature, at the population level, if you put people on low carb diets, even if they're higher saturated fat, low carb diets, most people do not see an increase in LDL cholesterol.

Okay, Even, even that would surprise a lot of people.

And some people see a decrease. So here's something really fascinating and you can look this up. This was a paper in the American Journal of Clinical Nutrition. It was, if you want like, you know, to appeal to the hierarchy of evidence, a Meta analysis of 41 human randomized controlled trials, non observational meta of 41 human randomized control trials. What did we see? If you look at all the human randomized control trials for low carb diets and you break them up by body mass index category, so lean category, like 18 point or like less than 25, then overweight 25 to 30, and then obesity categories, what you see is if people have overweight or obesity, there's no change in ldl, no significant change if they have class two obesity. So more obesity. When you go low carb, LDL actually goes down at a population level. And it specifically, this is the weird thing, the lean and generally insulin sensitive people who see the increase in ldl. So first, first paradox is okay, if we assume LDL goes up and that's a bad thing, then why are we seeing this bad response in the lean healthy people? That's the first paradox and actually dose response. So if you take the individual participant level data and you plot it out, the higher the bmi, the smaller the increase or even decrease you see in ldl. And I'll just add, I know I'm saying a lot, but we see this at the individual patient level. So I've written many articles on this, but one case that I shared recently, it was a patient treated by my friend Dr. Adrian Sotomota, and he had a patient who had obesity, a BMI. I forget the starting BMI. Let's say at around 40, it was like, you know, quite substantial obesity. And he put him on a ketogenic diet and the patient started losing weight. As he lost weight, he lost weight, he just got healthier and healthier and his LDL and APOB stayed low until he got to the BMI, like the Healthy Range BMI, 25, 24. And then his LDL did his hairpin turn and just shot through the roof, like more than doubled. And so what we're seeing here is at population levels and individual levels, there's a, there's paradox number one. And, and that is LDL can go up, but it's only in a minority of people. What minority? The lean, insulin sensitive, athletic, healthy people. It's kind of weird, right?

Yeah. And it is kind of weird too that it happened to the guy whose cholesterol didn't start to go up until he got lean.

Right.

Indicating that maybe it's not purely driven by genetics or could it be that this person had the genetics, but the adiposity was somehow protective, if you want to call it that, against the cholesterol increase?

Right. So here's a really important nuance is when people see LDL levels as high as we're talking, when I'm talking high, I mean my LDL is peaked at my LDL574. If you tell a doctor that number, they think a few things. Either you have a lab error, you made an error, or this patient's gonna die. Because those levels are so high, they're only seen based on common medical knowledge in a very rare condition known as homozygous familial hypercholesterolemia. Studying these rare patients, like a 1 in 1 million condition, actually ended up getting a Nobel prize, but it's very rare. So most clinicians never see these levels in their career. And an important thing is that example, familial hypercholesterolemia. You're right, it's a genetic disorder. So you're born with these high levels. This is different. This is a metabolic response. So my levels, if I eat a mixed diet, including say Oreo cookies, my LDL is like 90. As soon as I restrict carbs irrespective of saturated fat, my LDL goes through the roof. This happens at population levels and individual levels. So the question is why? And I'll just say at a very high level so I can finally answer your question. It probably has to do with fat fuel trafficking. So when you're lean and you're insulin sensitive, when you go low carb, you switch into fat burning mode. Much better. And that trafficking of fat around the body requires a cholesterol carrying system. If you people want the nitty gritty, they can look up lipid energy model on PubMed and read that paper. But okay, now we're going to get back to Oreo. If we're right in this method, in this mechanism, then if you have someone who does have this response and it's being driven by a need for cholesterol containing particles to traffic fat fuel. What if you just add back in carb fuel? That should reverse the effect.

Yeah, I'm tracking.

Okay. So I decided, you know, we actually already prior to Oreo study had like, you know, case series where patients did this or doctors did it with their patients and was very effective, but it wasn't getting headlines. People didn't want to talk about it. So I'm like, I'm ticked off. People need to like study this, learn about this because this is Fascinating and very clinically relevant. So I'm like, how can I get attention on this? And I'm like, well, I bet you like a Harvard med student lowering his cholesterol with Oreo cookies and comparing it to statins probably would do the trick. So I went to Harvard's institutional review board. I told them a prior AO was going to do this, and then I announced the experiment before I did it. And then what I did is this experiment and it was a crossover, which meant I did the Oreo intervention, which was I lock in a strict keto diet and then add on Oreo cookies. So not even a swap. I wasn't swapping out fat. In fact, since Oreo is half fat, I was adding fat, but I was also adding carbs and sugar. Then I did a washout period to kind of reset. And I did then high intensity statin therapy. So 20 mgs of Rosuvastatin Crestor for six weeks. And the punchline was the Oreo cookies slaughtered the statin for LDL lowering.

No way. Really?

They were twice as powerful and they acted in one third the time. So the drop in LDL was a 71% reduction on the Oreo cookies in about two weeks and then 32.5% for the statin. So the statin had the expected effect. The Oreos were just way more powerful. And the point was to highlight, hey, if we understand the physiology, we can get really fascinating results. And obviously it's a very provocative finding. Yes, you could call it clickbait, but it was also legitimate science. So that's the Spiel on Oreo vs. Statin. But the lesson I want to highlight here is actually nothing about lipids. I mean, kind of people can delve into that if they want. I have a ton of content, but I, as a, like a young academic, somebody who's trained to be a doctor, somebody who's, you know, done a lot of academic science, spent many hours running clinical trials and in labs doing, you know, wet lab research. We right now are living at a fascinating time where academia and the general public are like, colliding violently because of social media. And one thing academia is terrible at is standing up and translating our results, our data, you know, the science, into stories around the science that actually attract people's attention and start discussion. So what ends up happening is, quote, unquote, this is how I'm going to put my, like, you know, prudish academic hat on for a minute. The influencers take over the space. Right? But that's important because a lot of academics aren't standing up to translate themselves. So I find it interesting to engage in what you can call a game. But it's just like the ecosystem we now live in of engagement tactics. How can you attract people's attention, you know, with things that are flashy on the outside but actually lead them to much more deep nuance? So we can start exploring these things together in a way that's motivated more by curiosity than and a love of the science than just the incentive structures that be. And we can get into that. But what I'm referring to is right now the spotlight of medicine science shines where there's a business model. So say where pharmacology can make money, that's just where the attention goes because there's a business model around it. So these are all complicated things. But the Oreo versus statin study was my first attempt at saying look, how can I raise the discussions that I think are important using the tools at my disposal. And it was quite successful.

So one other question about the Oreo thing, speaking of helpful, how would that advise someone in terms of making dietary decisions or how would that impact health in some way for someone to know the link between carbohydrate intake and cholesterol in these so called lean mass hyper responders?

That's an excellent question, Ben, and I'll tell you why it's an excellent question is you know what made the study so provocative was we all agree Oreos are not a healthy food. I would say most of us at least, and most people would say that lowering LDL is a good outcome. So what was implicitly presented was unhealthy intervention, but good outcome. And that's a paradox. Now I don't place any judgment value on statins, Oreo cookies or LDL in the study. But in trying to resolve this paradox, people are very uncomfortable sitting with like a cognitive dissonance. So they pass their own value judgment. That's what made this provocative. But actually what I want to highlight and what I want to challenge people is there's actually a lot we don't know. We don't know, for example, if this LDL response in people like me is even dangerous. We are collecting those data, but we don't have it yet. So it brings us to really what the definition of medicine or what the art of medicine is. And it's sometimes making really difficult decisions and individual risk benefit analyses with imperfect or incomplete information. And that's the situation we have here. And what we should do with that is chase the questions to get better information. So we're doing that currently. But I'll tell you how this unfolded from a clinical perspective, which was not that. As some people speculated, I turned Oreo cookies into a health food and now they're being sold for cholesterol lowering.

I mean, maybe if you made some kind of like a cookie with shilajit coloring and colostrum cream cheese filling or something like that.

I don't know. I mean like people joke around like you're tricking people into cookies being healthy. I'm like, no, like real adult would believe that, but hopefully. And if they do, then you can thank me and natural selection. But aside, what ended up happening was the purpose of this was to amplify discussion around research. So I started getting a flood of emails and direct messages from clinicians who said, hey, actually like the science here is really interesting. I didn't know about this population of patients before this. Now it's on my radar and I'm using the physiology, my now new knowledge of the physiology, which I became aware of, I being the physician, because of the Oreo vs. Statin experiment to treat my patients. So say patients who they're fine introducing say 50 to 100 grams of carbs, that's not necessarily metabolically challenging for them who have this response. And so what they can do is basically drug sparing approaches. So rather than having a patient say, oh, we're going to put you on statins for life, just give them a sweet potato. And in some patients that is as or more effective and better tolerated. So it's just about acquiring knowledge to then make more informed and individualized decisions. So if anything, the irony here is this experiment ended up probably causing a lot more LDL and Apple B lowering because clinicians and patients who were interested in that then became aware of the physiology and used other carb sources to do so. Fruits, starches, whatever, it works with any carb. The reason I did Oreos is because I knew it would amplify the discussion around it because Oreos are just a sexy food.

Oh yeah, absolutely, Absolutely. It's a pattern interrupt. And actually it makes me, I'm largely ketogenic. My cholesterol hovers around 200. It kind of makes me want to go out and try a little self experiment myself. Although I probably will go the sweet potato route.

Oh, if you actually want to collect data on yourself just for that purpose, do it with a quote unquote healthier carb. I put my body on the line for science, so hopefully people don't have to. Although I will mention after I did this, there were several doctors, including seniors to me at Harvard Medical School who are also lean mass hyper responders. There are quite a few who did replicate it with Oreos. So it's been done more than once.

You wrote something on substack. I follow your subset, by the way. And you wrote something that I wanted to ask you about today. This is actually one of the reasons I wanted to interview you today. It's about seed oils. And you basically said that the general consensus on seed oils is that if seed oils, plant fats and omega 6s are fragile, prone to oxidation, and generate harmful carcinogenic products, they're bad. And then the other quote is, the elites have misled us. And as it turns out, animal fats like tallow are the health food, whereas omega 6s are unhealthy and to be avoided at all costs. So my question for you is, what do you think about that consensus? And this is kind of a big question when you've also noted a large body of human evidence, including observational and randomized controlled trial data, suggests increasing polyunsaturated fatty acid intake is associated with and or results in better cardiovascular disease outcomes. So let's open that can of worms because I know you've written a lot about this and there's a lot of nuances. So what's going on with seed oils right now?

So first I'll just say I think at least one of those quotes was me intentionally being comedically hyperbolic, as in, I don't believe this, but this is the narrative. So, Right. This is one of those terms. As soon as people hear seed oils, their brain shuts off and they're like, I've decided what I'm going to think and I'm not going to listen anymore. And if you're not saying the narrative I like, then I'm going to troll you. But let's start at the beginning. So step one is defining what we're even talking about, because seed oils is actually something with a really poor definition. Some people hear it and think we're talking specifically about hyper industrialized processed vegetable oils. You know, the kind you see the reels going, conveyor belt in the plastic containers. That's one category. Then there's this logic creep, this domino chain where they're like, well, what's harmful about it? One thing that's harmful about it is the fragile omega 6. And so then omega 6, polyunsaturated fat. So just to define our terms, you have fats, they go into unsaturated and saturated. Among unsaturated, there's monounsaturated, like olive oil type fats, then polyunsaturated, which includes omega 6, kind of like nuts and seeds. And then omega 3 is like fatty fish. It's an oversimplified umbrella diagram, but there you go. So people vilify this Omega 6, which is found in the quote unquote, seed oils. There's a little bit of rationale for that because one, an imbalance in your omega six to three ratio. So very high omega six levels correlate with and may even cause inflammation.

So. So high omega 6 levels relative to omega 3s, like the ratio or just high omega 6 levels, no matter what your omega 3 levels are at.

Good point. So the ratio. And this actually leads to another logical fallacy because if you look at the literature again and you look at not just circulating levels, but also tissue levels like in fat tissue, a lower Omega 6 to 3 ratio associates with better outcomes. So from that, what you might conclude is, well, you want a lot of Omega 3 and very little Omega 6. But if you dig a little deeper, you actually find that both Omega 3 and Omega 6 levels, when they're higher, associated with better outcomes. One way we can explain that is it's not that Omega 6 are bad per se. Omega 3 are just better. So the denominator drives that, that association. But taking a step back, I would say in general, those highly impross, those highly processed, you know, industrialized oils, I would put in the category of generally harmful. You can do better. Omega 6 is as a broad category. So now talking less processed, think about like walnuts. Walnuts have like 10,000 milligrams per ounce of omega 6. Is that harmful for you? I would argue no, not generally. And one huge nuance this is, I think goes beyond just omega 6 and seed oils. And just something that needs to be emphasized is when we're talking about anything you ingest, it's not just an intrinsic property of the thing, let's say the Omega 6, but also how it's interacting with the host, you. So let's take two extremes. If you're someone eating a westernized diet and you have obesity, let's say you ingest a bunch of omega 6. What happens? Your body has a very highly like, say oxidative environment. Literally your fat cells are spitting out enzymes like ones called myeloperoxidase, that oxidize fat. So you're in this state where you're actually prone to oxidize and damage the fat, which Then can perpetuate poor outcomes. Let's take another extreme. Say you're lean and insulin sensitive and you're very low carb. Then what happens? Well, there are multiple things that can happen to that Omega 6 that you ingested. It can actually be turned into compounds that are cardio protective, so converted into like hormone molecules. It can be converted into ketones. Actually PUFAs, omega 6 are very ketogenic. So like as a health hack for me, if I want to boost my ketone levels, even keeping my carbs and protein the same, I can just swap saturated for polyunsaturated fats. They swap butter for like, you know, sesame seed oil or walnuts and my ketones will go through the roof.

Interesting, huh? Okay, that, that's actually, that's actually notable that that's a little like double click bookmark. But sesame oil can be a ketogenic fatty acid. That's interesting.

Very ketogenic. And again, there's more nuances because if you're eating like say sesame seeds, the whole product is inclusive of antioxidants that protect the natural omega 6. And you can do this if you actually look at the graphs. I can send you one of the graphs. If you look at just the extracted Omega 6 linoleic acid, it can get oxidized a lot. But then you add in the antioxidants that are present in sesame and they protect the fat against oxidation so the oxidation levels go down. So I know there's a lot of jargon here. What I'm really saying is like the interaction with the host and how you consume the fatty acid matter, eating it in a whole form, say sesame, like walnuts, probably not harmful. If you're healthy metabolically, you're going to use that omega 6 very differently than somebody who's metabolically unhealthy. So omega 6 aren't bad. Highly processed industrialized oil I think are quite harmful on balance and you can do better. But I think there is too much fear about Omega 6 broadly because of the exaggerated perspective on quote unquote seed oils.

Yeah, I think that is important from a definitive standpoint. Let's say someone hears that all too common headline nowadays. Avoid seed oils like the plague. Ruthlessly avoid seed oils. Seed oils are bad for you and they are a healthy host. Right. They're a lean person. And I know there's some other factors we can get into later. I think I even heard you mention cold plunging might be protective. And, and they think, okay, well there's gotta be some seed oils that I could consume. You've already mentioned that. Something like heavily fried foods like McDonald's french fries. Probably there's better options than that. But what are some seed oils or seed oil sources that you think are kind of like unfairly vilified that people are currently cutting out of their diet and potentially missing out on the Cardioprotective benefits of Omega 6s.

I wouldn't even, let's even set aside making a claim about cardio protectiveness. Let's just say like things that might even be harmful. I see people cutting out, you know, nuts and seeds, like whole nuts and seeds, say walnuts, pecans, tahini. I love tahini. You can make a lot of nice dressings with that. I see people even getting very granular about things like, well, what is the exact PUFA breakdown of like my grain fed versus grass fed beef? Now by all means, eat grass fed beef, pasture raised beef, maybe for ethical reasons more than anything else. But is there actually going to be a difference on your health based on like a slight skew in Omega 6 levels? Probably not. I even see people go so far as to avoid like sardines or like Omega 3 resources. This is at the extreme end, but it does occur because they're like, well, this is a polyunsaturated fat and it's, you know, fragile, therefore I should avoid it. Which goes to tell you how far people have slipped down this like logic creep chain of PUFAs are bad for you because they're fragile. Which is a very sticky narrative. And I just want to pocket that in like, think about all the sticky narratives. A big one was fat makes you fat. That was the whole low fat era where saturated fat clogs your arteries. Polyunsaturated fats are fragile and prone to oxidation is actually in the same category. It's a sticky, easy concept that people adhere to, but it's a gross oversimplification. So my two cents. Yeah, don't eat like hyper processed oils and like plastic clear containers that have been heated and reheated. But don't fear Omega 6 as a category either. In fact, it can be used strategically for reasons I just mentioned.

What if someone were going to start eating more seeds and nuts and be a little less fearful of Omega 6s? But they're going through the airport, you've probably seen this, and they're buying the packaged seeds and nuts and it says something like vegetable oil, safflower oil, canola oil as an additive to the nuts. Do you get concerned at all about what you see in Even some of these so called healthy packaged foods.

As far as added oils, I would say it's one of those categories where it's probably not the worst thing in the world, but it is suspicious and you can probably do better. So when it comes to like nuts and seeds, I would say as best you can get raw nuts and seeds, there's no health benefit to having like the coatings other than maybe they'll be delicious. I will like provide a disclaimer here. I almost exclusively eat raw nuts and seeds, except there's one brand other like salt and vinegar pistachios that do have a little bit of sunflower oil on them and they're just so good. So everybody has a guilty pleasure. It's not about being perfect. I would say if you're optimizing health. Yeah, don't get the processed version.

I want to know a little bit more about some of these host factors and some of the things that might make sources of omega 6 fatty acids more likely to be unhealthy. But there's a term that I think might confuse a lot of people, Linoleic acid. That's used a lot of times during the seed oil or omega 6 conversation. What is linoleic acid?

For our purposes, you can almost think of it as synonymous with Omega 6. So to review our fat hierarchy, you have fats as a category and then you have unsaturated fats, which means they have double bonds and saturated fats. Each of these has actually a lot of things within them. Let's focus on unsaturated fats. Therein you have monounsaturated, so one double bond like oleic acid and olive oil. And then you have polyunsaturated omega 3 and omega 6. The predominant omega 6, like the vast majority in the diet is linoleic acid. So for simplicity purposes, omega 6, linoleic acid, kind of synonymous. There are other omega 6s, but they occur in much lower frequency.

All right, got it. I'm going to rapid fire a few at you then related to omega 6 fatty acids and seed oils heating. You go to this whole food salad bar and says whatever cold expeller pressed canola oil. I'm assuming there's a difference between that and whatever the fried oils that they're using at a fast food joint. But what do you think about when it comes to consuming seed oils that have been heated? Where do you draw the line?

I would not consume seed oils that were heated. One thing that is true is that these are fragile fats. It doesn't mean they're bad, but it means you have to treat them with care. And the heating causes damage to the fats. It can cause, you know, the oxidation, the transformation into harmful byproducts. To give you just a case in point about how much variation there is if you take two different nuts. So walnuts are super high in omega 6, about, like I said, 10,000 milligrams per ounce. Macadamia nuts are very high in monounsaturated fat, which is less fragile. Still more fragile and saturated, but less fragile. So if you were to roast an equal amount of walnuts and macadamia, I think it's at 150 Celsius for like 20 minutes, you end up with 30 times the oxidized fats in the walnut. So that just gives you an indication of how relatively fragile these fats are. So I would say I would avoid high omega 6 fats that have been heated.

Okay. So if I've got the sesame oil you talked about, that'd be maybe like an addition to a cold salad dressing bottle of macadamia nut oil. I could use something like that for cooking.

Yeah. I will draw a little exception for toasted sesame oil. This is really getting into the weeds. But sesame is a weird outlier. Even people that are very anti seed oil say, like Tucker Goodrich, admit sesame is kind of like an oddball. When you heat the sesame oil, there are actually antioxidants that the heat bio transforms them into even more protective forms, some of them, so you don't end up with that much oxidation. So a little toasted sesame oil as a dressing oil, I think is fine with that exception. I wouldn't heat high omega 6 oils, and I would preserve them for like omega 6 foods. Kind of like toppings, dressings. You want to crumble some walnuts on like a salad with like, some nice rook for cheese, which, and this is a fact, peer reviewed fact, is the best cheese. Yes, probably.

Okay, all right, well, thank you for not ruining Asian food night for everyone. Okay, how about the additives like you hear a lot about? Oh, there's these harsh chemicals that are used to extract the seed oil. So even if it doesn't have, you know, bad properties in the Omega 6 itself, there's all these other chemicals that get added in during the extraction.

Yeah.

What's your take on the whole, like, chemical extraction processing piece?

I would say precautionary principle. So it's true, like, people were like, oh, well, you know, it's processed with hexane until you end up with Hexane in the oil, and hexane is a neurotoxin. Those are each true, but it's. I've never heard of a single case of hexane poisoning from like a seed oil. So the question then becomes, what's the burden of proof? And what I mean by that is if you are holding someone to, like, claim, hey, this compound present in these doses is proven to be harmful, you might not get those data. However, if you're operating more on the precautionary principle and saying, hey, this isn't probably an ideal thing to have, not even just the hexane, but like, as a composite and, and it's easy enough to avoid without much risk, then I would say avoid it. So there are additives that, some of which either are additives or generated during the heating process that are thought to be carcinogenic, harmful. I would not go so far to say, like, this is going to cause neurotoxicity, but I would say, what's the cost to avoiding it? And really the only cost I can possibly think of is that these hyper processed oils are probably going to be cheaper on balance. So if, like, you actually have a very limited food budget and you know, you're, you're in a situation of like, poverty, then this will become an issue just because, like, buying a nice olive oil can be expensive. That's a whole nother kettle of fish. So I would say, barring that limitation, I can't think of any single reason why you would ever choose this processed heated oil that contains these potentially harmful additives, even if it's not proven without a shadow of a doubt.

Okay. Okay, got it. That's clear. With omega 6 fatty acids. You mentioned obesity, adiposity potentially being an endogenous factor that could contribute to oxidation and make them potentially more harmful. I've also heard something similar about sunlight, particularly UVA and UVB radiation. Like if you have a high seed oil intake or a high intake of omega 6 fatty acids, that you get more skin damage if you go out in the sun. What's your take on that?

I'm not aware of literature that proves that's the case, but I wouldn't discount anecdotes. So I've heard the same people, like, I cut out seed oils and now I don't sunburn. I think it's very plausible that at a high level these get incorporated into your skin and therefore you become more prone to, like, skin damage. It's an interesting hypothesis. I haven't seen any definitive evidence on it, but I Guess this is a good point to interject when you're listening to someone and you're trying to evaluate if they're an expert. Generally the best mark of an expert is not what they know, but how they can delineate. Hey, these are the limits of knowledge, and here's why. So there are certain ideas. This is one of them, where it's like, hey, we don't have these data. At least that's the best of my awareness. But also one of the reasons we don't have these data is because who is motivated to actually do the study? So this happens with food studies all the time, or like food researchers. Like, I can't make certain definitive claims because the research is impractical or too expensive to do. And there's not a business model that is driving the research. There are a lot of questions I'd love to answer, but it might require a $20 million feeding study. Who's funding that? Basically nobody wants to. So it's difficult sometimes to talk about these topics because people are always shifting the burden of proof and not like, clearly alienating. Like, what evidence do we have and what can we actually fairly conclude from that? So, sorry, I went off on a tangent, point being plausible, but I don't know of any evidence proving it's the case.

Okay, now, now, besides something like obesity or a high omega 6 to omega 3 ratio, would there be other predisposing factors inside of somebody or as a part of their diet that might cause more oxidation of omega 6 fatty acids?

Yeah, I mean, I think the best way to go about it is to look at like metabolic markers for metabolic health. Because obviously a BMI is very weak man's proxy. So if you have elevated inflammation and HSCRP or oxidative stress markers, that's probably a signal. And that's also going to correlate with dietary patterns like high sugar intake. So, you know, if you're having a high sugar, high omega 6 diet, that's probably not a good combination. To give kind of just an example of how, like, intricate this gets. I mentioned earlier that fat cells secrete certain compounds that oxidize fatty acids. So literally unhealthy enlarged fat cells, some of which sit around blood vessels. It's called peri. Peri. Around vascular, perivascular. So around blood vessels, adipose tissue, fat. Let's go. These enzymes. One's called myeloperoxidase. And it's really scary, but also fascinating because it exists outside the blood vessel and inside. So inside the blood vessel, one thing it's doing is causing oxidation of lipids. So, like, you get oxidized LDL particles because this molecule is in the bloodstream, but then outside of blood vessels, it's doing other things. So it decreases generation of healthy hormones. One's called adiponectin. It's kind of like yoga for blood vessels. So it makes your blood vessels stiffer. It also decreases, like, thermogenesis and brown fat activity. So what you're basically getting here, and I hope people get how cool this is, is like in obesity, enzymes generating. That's creating like a metabolic pincer maneuver to leverage the omega 6 fats to harm blood vessels in that condition of ill health.

Okay.

And people don't need to understand everything I'm saying to take a step back and be like, wait, the narratives that were told, oh, seed oils aren't harmful, there's no evidence of that, or seed oils are terrible, are grossly oversimplified. And you don't. You don't need to, like, understand all the biochemistry to just take a step back and be humbled by that biology. Because I think there's a lot of value in just doing that. Because I think it is a treatment for the frustration that arises from these simplified, polar opposite narratives. And trying to figure out. This is always what I'm trying to do. Not necessarily successfully, but trying to figure out those quotes you presented at the beginning. How do we take contradictory and discordant data and try to make sense of it in a way that is nuanced? And we could do this all day in like, you know, journal clubs among academics, but in a way that the general public can start to understand. And it's not necessarily sexy and appealing, but I do get the sense, and I want to know if you get the same sense, Ben, that there is actually a lot of hunger for discussions like these where people are like, wow, that actually makes a lot of sense. Maybe I only got like 30% of it first round, but things are progressively clicking. I think people like being challenged with the details.

Yeah, a discussion slightly lower on the dogmatism scale, for sure. Okay, so what about cold exposure? I briefly mentioned it. I think it might play a role. Based on what I've seen you write, is there any evidence that doing something like cold exposure could help with, I guess, less omega 6 oxidation?

Yeah, well, this is another level of complexity. Not all oxidation is bad, so.

Yeah, good point.

So basically what happens with cold exposure, and this has been shown in human controlled trials, is it causes some Omega 6 to be converted into these Signaling hormones. I think one's called 12, 13 di h o m E that do things that are cardio protective so actually decrease. One thing is called perivascular fibrosis. Terms aren't important. Basically there are lifestyle interventions. Cold exposure is one of them, which can bias your metabolism to turn the substrates, the, you know, raw materials you're giving it, including omega 6, into healthy compounds that like, are hormones that will help your heart. That's the high level. Just this idea that be it, you know, exercise or cold exposure or light exposure, all these things change your metabolism in ways to take the raw products you're ingesting and put them down different pathways. Because that's all what it's about. Like how is your body partitioning what you're taking in? It's not what you eat, it's how your body uses what you eat. And so this is one example. Yes, cold exposure can cause some omega 6, I don't know what proportion to be turned into hormones that help the heart.

Yeah. And lest everyone rush out for their 20 minute, 33 degree cold plunge, do you recall or do you know if there was any dose response or if there was anything in terms of temperature or time or anything like that?

I'm trying to remember the trial. So the trial covered in over a year ago and I think it was a 39.4% increase in this compound. I forget the method. I think it was two hours. But not like in a cold plunge. I think it was near shivering threshold.

Okay.

If I recall all these things, I've read hundreds of papers since then, but it was something like that.

Yeah, like a girl, like a cold air exposure type of thing.

It could be that total sidebar. But I just didn't experiment. Sardine dieting was kind of like popping off. And I did a sardine diet, which is obviously very high in omega 3. And one of the weirdest things that happened that I totally didn't expect was I became like cold resistant to a bizarre extent. Like, I'm walking around in Boston in the winter, it's 30 degrees, and I can just take my shirt off and I'm like, I'm not cold at all. And it was so bizarre, I just needed to go on a little rabbit hole.

Wow, that's kind of cool. It's like, it's like the doctrine of signatures. Eat a lot of fish and you start to develop thermoregulatory mechanisms like that of a fish.

There's actually literature that omega 1 of the omega 3 derivatives is called I apologize for all these jargons. Scientists aren't very creative. 12 hepe is made by brown fat. It's an omega 3 derivative. And it acts at brown fat, kind of like is released and then signals back. It's called autocrine signaling. But also at muscles it increases thermogenesis and it increases like glucose disposal into muscle tissue. So I'm kind of piecing, I'm taking a leap of logic here because this is like basic science data that oh, omega 3s can be turned into this hormone that increase thermogenesis. And I only found this though because I had this weird personal experience when I like hyper loaded on mega threes. In fact, When I did Omega 3 testing the Omega quant, my Omega 3 levels broke the scale. I became like fatty acid levels of a dolphin. But it was just the most striking, bizarre phenomenon where I just wouldn't get cold. Anyway, I have a letter on that as well. All this ends up in my newsletter generally, all these.

Okay, yeah, your newsletter is great, by the way, but. And if you're listening BenGreenfieldLife.com Nicknor Norwitz N O R W I T Z I'll link to Nick's newsletter and some other resources. Nick, speaking of fish, we talked about this ratio. Could someone theoretically, let's say they just don't have access to a lot of quality fish. They maybe don't like sardines. What about fish oil? Could someone just up their intake of fish oil to get their omega index their percentage up and improve that ratio?

I would say in a word, yes, omega 3 supplementation becomes a little bit complicated. I don't know that I want to go too far down the rabbit hole on this, but what I would say at a high level is it works, but there are still benefits to having actual fatty fish. So in terms of the forms of omega 3, and I don't just mean like EPA and DHA, the fatty acids have different carriers. So, you know, sometimes they come in a triglyceride form. If you get like a fatty acid supplement, like a Nordic Naturals, which is great, that's going to be the form. It doesn't cross into the brain as well. It also isn't packaged with protective forms of say selenium. So there's a little bit of an oddity in the literature where there's good data on, you know, fish intake being protective, safe for the brain and not as good literature for omega 3 supplementation. I wouldn't discount it. And I'll have an article coming up specifically on this because there are now particular forms of omega 3 that are being generated with this knowledge in mind. But I would say if you really don't like fish. Yes, do an omega 3 supplement. And yeah, I'm not going to go down the rabbit hole, but if you go to the my newsletter, I'll have a little bit more information on the different forms of omega 3s, the different carriers and what you want for different outcomes. But Generally an omega 3 supplement will skew your peripheral ratio so like not in the brain towards a better omega 6 to 3 ratio.

Yes. Okay. It's been a little bit one sided in terms of the multisyllable scientific terms spewing. So I'll throw one in here. 4 hydroxy nonenol. I don't know if I'm pronouncing that properly. 4 hydroxy nonenol. I believe it's abbreviated for HNE. That's another one that you hear talked about in relation to seed oil intake as something that somehow contributes to chronic disease. Seed oils are chock full of this stuff. What's the deal with 4H&E?

Yeah, I would say it's one of these derivatives of processed seed oils for which there's a decent amount of literature that it's harmful, carcinogenic, genotoxic. Again, this isn't like you have a walnut and it's loaded with this stuff. But I would say yeah, if you're eating like you know, processed soybean oil or like oil that's been in a fryer, you're gonna get dosed up of this stuff. And all these things, I believe I'm correct on this can just be made endogenously as well. So kind of speaking at a broader class, maybe people have heard of advanced lactation end products. You can quantify these like outside the body. So if I fry a bunch of bacon, it's loaded with age. And if you have like a stack of pancakes with syrup doesn't have much ages. But all that syrup and sugar is going to make a lot of ages in the body. So again, your hormone, your hormonal metabolic milieu really matters for H and E. Probably harmful. No, it is harmful, but I wouldn't worry about like natural sources of omega 6 because of that.

Okay, so don't go to IHOP frequently if you're concerned about 4 Hnes.

In other words, I just wouldn't go to IHOP frequently IF you want to.

All right. As much as we like whipped cream and strawberries, so this is really interesting on seed oils and obviously there's A lot of nuances here. This is why I wanted to get you on the show. Everything from simple things like the amount of thermal stress that you might have to your level of adiposity, to the nature of the seed oils and the processing and heating versus the more natural source such as, say, walnuts. You know, the idea of your omega 6 to omega 3 ratio. One last thing regarding seed oils, any influence here? And this is kind of, you know, a little bit of a throwback to what you were saying about Oreos in terms of macros. Anything in terms of, in the literature, carb percentage, protein percentage, fat percentages, overall, affecting any potential impact Omega 6s might have on the body.

Not that I'm aware of. Like, direct literature. Again, if you're skewed towards higher glycemic low diets, like more sugary carbs, I would bet strongly that that would negatively affect how your metabolism is handling high omega 6 foods. That is my high level perspective.

Okay, you. I think we're going to be a doctor at one point, and then you kind of like pivoted into public health education, into content production. Like, psychologically, is it weird for you not to be practicing medicine, or is that something you didn't really see yourself doing originally?

Thank you for asking that question. So I grew up always planning to be a clinician. Both my parents are physicians. Obviously, I went to medical school. I applied to medical school. So generally when you do that, that's the intent you have. It wasn't until, you know, my last year or two of medical school that I even started contemplating doing something else. It's actually pretty taboo to not even apply to residency. So it was something that I thought a long time about. And I spoke with a lot of my advisors because in past generations, people haven't had the opportunities that were presenting themselves to me. And what I ultimately decided was, you know, medicine is evolving. And there's a niche, I think, that needs to be occupied with people who are medically trained and academics who position themselves as like, communicators to the general public. And I was getting such amazing feedback from members of the community about how my education was helping them that I thought, you know, this is what I love doing. Like, I would go, this is like, in my last year of med school, I would be like, you know, rounding on patients, and my mind would just be a little bit trapped elsewhere with the science. And then when I had like a day off, I'd be up at like 5am like, reading cell science in Nature. And I was all excited And I realized I really wanted to want to have a calling for medicine. And I think it was something I convinced myself that I had because it's a profession that I have the deepest respect and admiration for. But as I went through the process, you know, and made friends where I could see, like, they got up every day excited about clinical care, I just. I didn't have that same passion for that practice. What I had was a passion for getting up reading and learning and teaching about the science. So I decided, I think my skill set and where I can have the most impact is one, in science communication, and then two, in using that platform to empower people with information, empower people with their own data, go into the private sector, entrepreneurial sector, and also research. So one thing I think most people can agree on is food, nutrition, metabolic health. They're underemphasized when it comes to scientific research. And that's because we do not have a good business model around them. There's a good business model around drugs, not around metabolic health research. And the fact of the matter is, having a public presence and a profile and platform like I'm trying to build gives you the connections to help really get this research fired up. So now I'm talking with some very wealthy philanthropists to get money. Like, we're talking five, $10 million for major projects that could change the course of medicine and healthcare. And it's not even that these are going to be governed by me in particular, but I feel like I can act as a bridge. I've identified some incredible labs, and I'm like, hey, I can help design, ideate, but I can bring in resources to get the research done that will actually change clinical care. So I've decided to commit myself to this alternative path. It was a big risk, but now, honestly, I get up every day and I just. I couldn't be happier. And the way I would position it, it's not that I abandoned medicine or, like, you know, quit the system to, like, attack it from the outside, but that medicine is a team sport and you need to find your position on the team. I think I have a particular skill set that lends itself to something different. And then I'll leave the clinical care right now to my friends and colleagues who thrive on that. So I'm exploring. I'm a young person just trying to figure out my life like anybody. But candidly, that is the process I've gone through. It was not an easy decision, but I definitely think it was the right decision for me.

Yeah, well, you're A great teacher. Phrases like adiponectin is yoga for the vasculature highlights that. And for those of you listening, Nick's content is great. Great follow on Instagram, YouTube, Substack. I'll link to all of his channels@BenGreenfieldLife.com NickNorwitz N O, R, W, I T, Z Twitter, too, or X. So, Nick, thank you so much for doing this. You're an incredible resource. I'm happy you're doing what you're doing, if that counts. You definitely help guys like me dig through the science a little bit better. So I appreciate you, man.

I appreciate it. There's one more thing I have to say. It's been bothering me this entire time that I've not noticed. Has anybody told you you look very much like Kit Harrington? I don't know if it's a haircut in the beard right now. Like who? Kit Harrington. Jon Snow.

I don't know who that is. No, I don't know who that is.

All right, look it up anyway.

All right, I'll Google it later.

All right, everybody watch the video version of this. And just, like, look at your face. Look at it.

All right, I'll check it out.

Ken Tarrington.

If you have comments, questions, feedback, or want to pipe in on whether or not I look like Ken Terrington, go to the show notes@bengreenfieldlife.com nicknorowitz and until next time, I'm Ben Greenfield. And ignore it. Signing out. Have an incredible week.

Do you want free access to comprehensive Show Notes, my weekly roundup newsletter, cutting edge research and articles, top recommendations from me for everything that you need to hack your life and a whole lot more. Check out BenGreenfieldLife.com it's all there. BenGreenfieldLife.com See you over there. Most of you who listen don't subscribe like or rate this show. If you're one of those people who do, then huge thank you. But here's why it's important to subscribe like and or rate this show. If you do that, that means we get more eyeballs, we get higher rankings, and the bigger the Ben Greenfield Life show gets, the bigger and better the guests get and the better the content I'm able to deliver to you. So hit subscribe, leave a ranking, leave a review. If you got a little extra time, it means way more than you might think. Thank you so much.