Bad Science and Diet Lies Keep Feeding Obesity: Gary Taubes with Dave Asprey : 778

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You're listening to Bulletproof Radio with Dave Asprey. Today is going to be awesome because I have my very favorite all time science journalist on the interview for you today. This is a guy who got famous in keto circles. Before keto was a thing with a book called Good Calories, Bad Calories, which for me is the high mark of science books to be able to not waste one word in a book like that. A great thinker and leader in understanding low carb, understanding keto, understanding sugar. He's also known for a book called the Case Against Sugar. And if you're a longtime listener, you might remember episode 223 where he talked about the bad science in public health, which has only gotten worse. Researching healthy diets, what gut bacteria does, and how to experiment on yourself. And Gary has released one of his infrequent and always epic new books, and this one's called the Case for Keto. And he just explains straight up how the way we think about obesity has led to 60 years of controversy and these diet wars about calories and basically the end of it. Why I always felt ashamed when I weighed 300 pounds, because I did what was supposed to work and it just doesn't work. And he tells us why. Also, side note, before we officially welcome him to the show, Gary actually introduced me to the very first agent who represented me for my first book a lot of you probably don't even know about called the Better Baby Book, which took five years to write, was all about fertility. And it was a phone call and an email that he placed that really set me in motion as an author. So, Gary, welcome back.

Dave, it's good to be here. Thank you.

What made you have to write another book now?

Okay, well, we have not won this battle. What I'm doing this book, I think of this as a grassroots movement. The whole world of people who were struggling with their weight or struggling with their blood sugar and were doing exactly what they were supposed to be doing and it wasn't helping. And when I started writing about this 20 years ago, there might have been a dozen doctors in the US or maybe in the world who were prescribing low carb, high fat or keto diets. Half of them had written diet books like Mike and Mary, Dan Eades and the Sugar Buster guys, and Agatston with the south beach diet, and Ted Naiman and not enough. You know, Atkins was still alive and that was it. And if you did this and you lost 60 pounds, you would go see your cardiologist, and your cardiologist would tell you you were crazy, even though you were 60 pounds lighter. So now, 20 years later, we've got a few tens of thousands of physicians out there who are prescribing these diets, and we've got dieticians who are being won over and nutritionists who are slowly being won over. And it's a slow slog. And we're still fighting the establishment. As you've said, the bad science has not gone away or gotten better. And so we have to keep getting this message out there and as it evolves. What I wanted to discuss was how that. How it had evolved, and I wanted to put it all in context. So it is, you know, the book started off with the title how to Think about how to Eat. Actually, even before that, I wanted to call it In Praise of Fad Diets. Just the reason it sort of struck me, I talk about this. I was being interviewed for a BBC documentary and all they wanted to hear from me was, why did people do fad diets? And why were there so many fad diet doctors out there? And why did the diet book sell so well? And I was literally doing the interview and I thought, why do people do fad diets? Because the conventional wisdom doesn't work. You know, you do exactly what you're told to do, and all it does is keep you fat and make you hungry and you feel bad about yourself because you blame yourself for failing. And, you know, any reasonable person in that circumstance is going to look for another approach. And the other approaches are the approaches being peddled by fad diet doctors, some of whom have happened to have gotten it right. So. So anyway, I wanted to explain sort of how we got into this crazy naivete, this idea that people get like, you weighed 300 pounds because you ate too much, which is the bedrock conventional. That's the Newton's laws of obesity science. And it's insane. And then I wanted to explain sort of what the alternative should have been, which is, you weighed 300 pounds because you had a, you know, a hormonal disorder going on in your body. You were storing fat rather than burning it for fuel. That's a fuel partitioning problem. And anyway, so, you know, there are a lot of. As the bad science in the nutrition community has evolved and as the, you know, having to live with this inane idea that this obesity is an energy balance idea that obesity researchers kept adding in the philosophy of science, you'd call them epicycles, like one stupid idea after Another so that they could justify continuing to believe what they had always believed, despite all evidence, that it's complete and utter failure. Among that evidence being the obesity epidemic and the diabetes epidemic. And, you know, so this was an opportunity to me to sort of unravel all of those epicycles, throw them out, bring us down to the essence. And then I interviewed about 120 physicians out there and another 20, you know, personal trainers, nutritionists, dietitians, a dentist who's a smart guy. And I got to ask them what their challenges were and what they were learning about prescribing these diets and what they were seeing in their clinics.

I. I remember really well when the bulletproof diet, which involves cyclical keto, not eating sugar, not eating bad fats, stuff that you very. Are very familiar with. And someone, I think it was the New York Times or maybe the Telegraph, they're saying, well, how do you. How do you know this isn't just another fad diet? I'm like, guys, we're going on 50 years of starting from the year I was born, Robert Atkins published a book, and yet I was fat, because no one listens except for these brief periods. So if this is a fad diet, and fad diets last for 50 years, then, yes, it's a fad diet. But I'm pretty sure keto is not going away because it's the only thing that works well.

And this is the thing. And first off, it's not 50 years. It's actually in five years, it'll be 200 years. There you go.

From banting.

No, even before banting, it goes all the way back to this Frenchman, Brillatte Savarin. So Brillat Savarin. He's a lawyer in Bon Vivant. He likes to live and he likes to eat, and he's struggling with his weight also. So he quits his law firm and he travels around and he writes about eating. And he puts together this book called the Physiology of Taste, which has been in print since 1825. Not that many nonfiction books other than the Bible, and make that claim. And in it he says, look, I talked to 500 people, all of them struggling with their weight. And they all, you know, if somebody's obese, then they're going to tell me, they love potatoes, they love bread, they love pasta, they love rice. These are the foods they can't live without. These are the foods we fatten animals with.

Shocking.

And sugars make everything worse. So in 1825, sugar was still hard to come by, and sugary Beverages like basically you might get a lemonade at a cafe because they could put some sugar in water and stir it up and add lemons, but other than that. So he didn't think of sugars as a major problem because if you got people not to eat grains, then they wouldn't eat pastries and they wouldn't get the sugar. But anyways, that's it. It's always been there. There's always been this idea that if you don't want to get fat, you had to avoid carbs. And I use this in the book. Ultimately, the low carb, high fat, ketogenic way of eating is a way of eating that. And I use Brillat Savron's 195-year-old phrase, more or less rigid abstinence from, he said flours and grains, or fecula, which is another word for it that has gone out of style in the past 200 years. But that's it.

Wow.

The fad diet is, is the low fat diet that was introduced in the 1960s that was supposed to be a way to prevent heart disease and then became an obesity diet. It had never been tested. It had never been tested for obesity. It required lowering fat and adding back carbs. So when the nutrition community starts to embrace a low fat diet for heart disease, they transform carbohydrates from something that every woman knew was fattening. This was the first line of a British Journal of Nutrition article in 1963, Every woman knows carbohydrates are fattening. Which they did. And then by like 1985, 22 years later, they're heart healthy diet foods. And the personal health reporter in the New York Times is writing a best selling diet book telling us all to eat pasta because. Because even though we used to think it was fattening, it turns out it's not. And they never tested, nobody thought, let's do a clinical trial comparing these. So the carbohydrate is fattening idea was left to the diet book doctors, the Atkins and Tallers and Eads and all these people who stumbled on it on their own and said, hey, when I tell people not to eat fattening foods, they don't get fat anymore. That's it.

What do you think when you hear the words the French paradox, that's one.

Of those epicycles, you know. So you've got this theory that fat causes heart disease, right? And then you have a country like France where they live on. They don't even, really didn't even eat chicken in France, right? They Ate duck.

You'd soak your chicken in pork fat and then you'd eat it.

Yeah, foie gras and cheese and eggs. And I lived in Paris for two years. There were two of the best years of my life, I have to admit. And every morning for breakfast, I had eggs and bacon in the cafe because that's what they were serving. So how do you explain a low level of heart disease in that population? Well, you say it's a paradox, so you don't have to say maybe our hypothesis is wrong and there's a low level of heart disease in Sweden. I lived in Switzerland doing my first book for nine months. Geneva was not my favorite city, but two of their staple foods, the two foods that the Swiss are famous for, cheese fondue and a dish called raclette, which is melted cheese on a plate with cornichon, onions and pickles. Corny shell are pickles. Anyway, so this is it. Anytime you come upon contrary data, you just assume that this is, you know, you write it off as a paradox. You never have to consider that your hypothesis is wrong.

I used to. After I lost the weight, I was really angry for a few years. I'm like, I was so lied to. I had a chip on my shoulder and I think I'm over that. I'm now just mostly incredulous. But I would call it the American paradox, which is, why don't Americans eat like French people to get thin? It's not that hard because it seems to work for them. Instead of like, oh, clearly it's because of the wine. Let's drink more wine. I'm like, guys, that's not going to work either.

Well, that's the thing you add. You say that it's all because of the red wine. I mean, it's just, it's anti science. There are layers and layers of bad science. Yeah. You start off with an assumption that you can't even test and experiment, and then you assume it's true. And then whenever you just keep layering these again, these epicycles on top of it or spinning them around, and then you end up with what you call a multifactorial complex disorder that's clearly so complex, maybe it can't be solved. Anyone who says there's a solution is clearly deluding themselves or selling something. And maybe you just have the wrong paradigm.

Do you ever feel a little bit of pride when you look around and like, there's tens of thousands of doctors talking about the keto diet? You were one of the first and most science based Voices writing about this. I mean, back in 2007, your big book came out, but I mean, I consider you to be one of the big guys who first planted the modern seeds of this. When you go to bed at night, you're like, all right, I help these 10,000 plus doctors get there.

When I'm feeling bad about myself and I need to prop up my ego, I, you know, this is going to sound hubristic and I don't mean it to, but I. The book I've always wanted to write is about good science and bad science. So I spend a lot of time when I'm not watching Netflix or Amazon prime with my wife and wishing that kids would just go to bed already. I spend a lot of time reading memoirs of scientists and looking for where they talk about how they do their science and what they think is good science and bad science. And so I read Darwin in his memoirs.

Wow.

At the end of the memoirs, he talks about how many books, he talks about how many books he's published, how many different foreign language editions there are of their books. He does everything but talking about his Amazon numbers. And then he talks about the mantra that he repeats to himself over and over and over again when he gets criticized or feels like people aren't taking his work seriously. And the mantra was something like, I've done all that one man can do. No one could ask for anything more. And I thought, you know, I'm no Darwin as my high school guidance counselor. But what he said was, you're no I. But, but, you know, you just. See, you know, at some time you have to remind yourself that. And I said this, even I did this misguided debate with young neuroscientist named Guilline, whose first name I'm not going to say because I. I remember when you did on the debate, and I still can't remember how to pronounce it because correctly it's either.

He spells it wrong. That's why.

So at one point I just said, jesus, you. You clearly think that I have done an enormous amount of damage in the world by raising these issues and implying that the mainstream medical community, you know, God forbid, might have made a mistake, and a tragic one in this case. But you and I both know we're both bombarded by emails. We get emails daily saying, look, I went on keto diets and I went on low carb, high fat diet. And for the first time in my adult life, I was able to achieve and maintain a healthy weight without feeling like I was starving myself to Death. And, you know, there's always, I don't know. He didn't find those observations meaningful. I do. I mean, there's clearly, as you put it, we've. Well, I talk about in the book the conversion experience. So you had a conversion experience. Right. This was a Malcolm Gladwell phrase from his first. In 1998, he wrote an article on obesity called the Pima Paradox. And he asked the same questions I asked when I wrote about obesity for the New York times magazine in 2001. But the difference was, was in those three years I had David Ludwig to follow at Harvard and Eric Westman to follow at Duke. And I could see that there was really respected establishment physician researchers who were taking seriously the idea that carbohydrates were fattening. And for a diet to work, you shouldn't have them in it. But Gladwell talked about the conversion experience in diet books. You know, every diet book doctor tells his story first about how he was getting fatter or diabetic or growing five arms or turning green or whatever it was. And nothing he did helped. And he followed the advice. And then he went to the depths of the local medical school library. And from there he emerged with the secret formula that he's now going to give you because it cured him. And the fact is, all these physicians went through that. And it was either one of two phenomena. Either if you're doing family medicine or internal medicine or pediatrics in America, you're dealing with the negative sequelae of obesity, diabetes, hypertension, metabolic syndrome, insulin resistance. That's what you're confronted with. And you're telling your patients how to eat because that's how the American Heart Association, American Medical association says we should do when they're not getting any better and you're just managing disease, you're either confronted with your patients getting fatter and more diabetic. That was the case with, like Eric Westman and one of his patients does Atkins against his will. He does Atkins, he gets healthy and his cholesterol profile gets better. And Eric Westman is open minded enough to say, wow, this is interesting. This goes against everything I believe. Maybe I should look into it. Exactly what you want your doctor to do. So some of them did that and some of them were getting heavy themselves. And so they couldn't blame their patients for not taking their advice because they knew they were taking their advice. Right. And there's some of them are vegans and vegetarians and some of them are world class athletes. You know, my former partner, Peter Attia at Nusi is a prime example. I mean, Peter's an exceedingly smart physician.

Yeah, he's great.

He's doing everything he was supposed to be doing, right? Working out three, four hours a day, swimming from LA to Catalina and back, and he's just getting fatter.

It's so frustrating.

But the problem is you have to have a weight problem to understand that, Right. If you're thin and you're doing everything right, then there's nothing to learn. There's no conflict between your expectations and reality. So there's no learning. And science starts with the observation of something that conflicts with what you believe it should be. So you have a hypothesis about how the universe works, and you see something that doesn't fit that hypothesis, and now you have to generate a new hypothesis.

Okay, Gary, you've got it all wrong. If there's something that disagrees with what you believe, you suppress it via orchestrated censorship and commercial interests. I mean, come on, I don't know what century you're living in this old science you speak of.

And cognitive, they never discount the fact that nobody wants to admit they were wrong.

Yeah.

It's also, you know, I thought about a lot about this when we were running, when Nusi was up and running, and we were dealing with these researchers, particularly the collaboration at Columbia University, which has some of the leading obesity and diabetes researchers in the world, that we were working with, you know, regularly on this experiment. We would meet with them every three months. And one of them in particular just kept getting fatter and fatter over the course of the three, four years that these meetings went on. And you knew that when he was in college, he was about 6 foot 3. He was within a month of being my age. And I could bet you when he was in college, he weighed 160 pounds, and maybe he was up to 220 by the time, you know, we were doing these experiments. A lot of it was gut. And I kept arguing that he should do, you know, like, just he should understand the phenomenon of going into ketosis, being on a ketogenic diet. Because that's kind of what we were studying. We were asking a scientific question, and we were using a ketogenic diet to ask that scientific question. But I said, you're clearly gaining weight. Try the diet as an experiment, just so you can understand this phenomena of sort of gaining weight, regardless of what's happening to your, you know, what you're eating and how much you're exercising. And then suddenly it's like you flick a switch and the weight starts to go away. I couldn't get him to do it. I couldn't get him even to try. And he would always, he would write me these long, thoughtful, I mean, apparently thoughtful explanations for why it would be unscientific to do an N of one experiment. And I thought so much about this. And the problem is, it's like we attend different churches. So you and I attend the church of sort of carbohydrates and insulin. That's what we drive weight gain. They attend the church of energy balance. That's the Newton's law of obesity, is you get fat because you consume more energy than you spend. There's no more fundamental, fundamental law in the obesity community than that. And everyone you know believes that. And everyone you know worships at that altar. And everyone you know in your field has built up their career based on that belief system. All the epicycles I talked about that. You have to add to that belief so as to continue to maintain that that's what the research that these people do. And you yourself have moved to the top of your field based on the sort of respect you've garnered from all these people believe exactly what you believe. This is like the essence of groupthink. And everyone you know, the people you respect think the way you do. That's why you respect them. You think they're smart because you agree with each other. I mean, we think we're smart because we agree with each other. It's sad, but it's true.

That's human.

If now, if you're going to change the way you think now, you're going to go to a new church where everybody you know goes to the old church, and you're going to start proselytizing about some new religion when everyone you know believes the old religion, there's nothing, there's virtually nothing to gain other than the pursuit of truth and reliable science and helping your patients and all that stuff. But that's indirect. As far as yourself, it's almost impossible for people to make that conversion. And the only way you could do it is if you have the courage, if you're getting so heavy or so diabetic that now you're sort of. Your health is more important than what you believe to be true.

You know, what I would love to be able to do is to be able to sneak some xenoestrogens into the holy water at the Church of Calories, because I've got academic literature from agriculture that says if we put xenoestrogens in cow's ears, they get fat on 30% less calories. And if that is possible, the calorie thing is bullshit. And it, that one outlying thing says there must be something else possible. And the fact that people look at me and say, you didn't lose weight on a low carb diet because you couldn't have lost weight. And I'm just scratching my head going like, are these alternate universes we live in?

You know, there's a lot of. The funny thing is the obesity research community is overwhelmed with examples like that. So, you know, from the very first animal model of obesity, the very first one, one of the two most famous animal models of obesity are the two. The two most famous are the ventromedial, hypothalamically lesioned mouse or rat. Pick your rodent. So bmh, lesioned animals, and then the obe obi mice. That led to the discovery of leptin to every other animal model of obesity. But including these two, those animals will get obese even when you half starve them. So by half starving them, I mean, you measure the amount of energy that a lean animal eats, you cut it in half, and that's what you give to your obese animal model. And you'll end up, if you grow this mouse from, you know, when it's a pup, upward, you'll end up with an obese mouse that's half the size of the lean animal, but it's full of fat. And these studies have been sitting there in plain view. You know, the Churchill quote about some people, you know, stumble over the truth and they just pick themselves up and hurry on like it never happened, these studies. I just, I spent the winter interviewing obesity researchers for what? The ones who would still speak with me, which is about half of the community, and those are the half that are so uninterested in what a science journalist says that they've forgotten what I've written in the past. But I would ask them, look, you know, you've got all these belief systems about how whatever gene you've discovered or molecule you've discovered affects appetite and how it tells the animal whether it's eating too much or not. But here you've got your very own animal model that will get obese even when it's half starved. What does that tell you about the relevance of what the appetite, if you can starve it and it still gets fat. And they would say, well, that's an interesting question. You've been in this field for 30 years, professor, and I ask you basically to explain a fundamental observation of the field and the response is that's an interesting question or I hadn't thought of that. And these are very smart people. And that's the sort of power of a religious dogma like calories and energy balance.

I have a book on fasting that comes out a couple week after years and with good luck both of our books will be on the New York Times list at the same time. And certainly I know you're suspect yours will be higher. I'm not worried about being higher, but yours is worthy of being on the New York Times list because of the quality of your writing and what you have to say. And I'm saying that very seriously. The idea that we have this kind of religious filter in people's brains. It seems like if keto is a problem when you start saying fasting, that's even worse because now you're going to be starving and if you don't eat six times a day you'll go into starvation mode and then you'll die and all that kind of stuff. So I almost was hesitant to write about that. Which goes hand in hand with keto. It doesn't have to be keto. It can be kind of a little bit keto sometimes, depending on what you eat when you come out of the fast. But it's. It's like just bumping up against an immense mountain of belief systems that are based on false assumptions. I mean, are you hopeful that we're moving in the right direction?

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Well, I do think, I mean, we are moving in the right direction. There are forces that are working against us. Like I said, when I started this 20 years ago, when I got into this 20 years ago, there were a dozen physicians prescribing these diets. Now they're, my rough estimate is a few tens of thousands. And my support for that is there's a Facebook group of women physicians in Canada who are eating low carb, high fat diets. And last I looked, we about nine months ago there were 4,000 women physicians in Canada. So I'm assuming there are 4,000 male physicians in Canada who are also doing it, at least maybe more. And I don't know how many have stopped doing and didn't, you know, disengage from the Facebook group. You don't know those things. But from that I think we can reasonably guess a few tens of thousands worldwide, minimally. That's a, that's, that's a positive thing. I just spoke this morning with Arjun Panasar and Charlotte Summers. This is for a book I'm doing on diabetes alone. And they started Diabetes. Well, Arjun started Diabetes.co.uk in the UK and so this was. Arjun was studying machine learning and artificial intelligence when his grandfather was diagnosed with type 2 diabetes and his grandfather didn't know what to eat. So Arjun said, you know, let me sort of crowdsource it online. I'll build a program where people with diabetes can go online and talk about what they eat, what kind of what works and what doesn't. And now between their various, you know, arms of their online empire, they have 1.7 million members.

Wow.

And what came out of what works and 10% of the type 2 diabetics in the UK, 18, I think they said 18% of the type 1 diabetics. And what came out of it was what works as a low carb diet, the opposite of what they're being told to eat by their physicians. And this was not, they went into it with no bias. Arjun just wanted to know, tell me what you're eating and tell me what your numbers are. And because of that, the way the National Health Service works is involved. So there are these forces we don't even see in a day to day notion, day to day, moment to moment that are working to communicate this. And this is one of the phenomena I talk about in the book for every physician whose patients get healthier doing low carb diets. If those patients see any other doctor, there's a likelihood after a while those doctors will say, geez, I noticed you lost 60 pounds. Yeah. It's funny that going back to a story Arjun told me, Arjun found us are worthy. They've been working with this physician, David Unwin, in the uk, and David Unwin has a practice with a lot of diabetics. And about 15 years ago or 10 years ago, I forget what the date was, he realizes that he has a woman he's been seeing in his practice who he hasn't seen for two years. So they contact her and they say, you should really come in for a checkup, an exam, because you've got diabetes. And she shows up and she's lost so much weight that he doesn't recognize her and her diabetes has apparently gone away. And she's on diabetes.co.uk.com so she's changed the way she ate because she's been looking at what all these other tens of thousands becoming hundreds of thousands of people are doing that are making them healthy. And she wanted to be healthy too. So, you know, and then David being, you know, doing what Eric Westman did in the us, looks at her and says, this is fascinating. So he gets on diabetes.co.uk, he signs up and he's the first for physician or healthcare professional to ever sign up for it. Even though they now have like 100,000 members and they have to contact, the first time they ever talk to him is they have to apologize because they assumed he was a troll. They'd never confronted a physician with an open mind before.

There's a lot of anger. I didn't see a doctor for four years. I was really pissed in my late 20s. My, like, you guys have no clue what you're talking about. You think I'm sneaking Snickers bars and I'm doing what you said and I'm just weak and tired and hungry and all that. And that's part of it too, is fixing that rift between people and doctors, because most doctors really do want to help. They just didn't have the information. And at least now it's out there. I think any doctor who reads any of your books is going to have to at least scratch their head and say, maybe there's two ways to lose weight.

Well, that's the thing when I'm. When I'm writing and with the title. So originally I told you I wanted to call this in Praise of Fad diets. But that was never gonna fly with my editor. That was my fantasy. Then it was. And I think I have a chapter called still called In Praise of Fat Diets. Then it was how to think about how to eat. That was my wife's suggestion. I thought that was terrific. Because basically the idea is we've been getting lean people's diet advice. So lean people do what the authorities tell them to do, and it works for them. And then they say, well, it keeps me thin. Clearly, it'll keep me thin.

It works until they get cancer. Yeah, there's that.

Yeah, yeah, yeah, yeah, it works for them. In the short term, we don't know what's going on long term, so we don't have those trials. So, you know, we need to accept is that those of us who gain weight easily are different from those people who aren't. I mean, this is one of my revelations in doing this work that I told you Newton's law of obesity is you get fat because you're taking more calories than you expend. And that means the difference between a lean person and an obese person or some. If you have two kids who are both 17, you know, 18 years old, and they're both relative, relatively lean, and one goes on to become obese and the other stays lean, the difference is the one who went on to become obese ate more than he expended and the lean person didn't. So that's the fundamental. That's the only. If these researchers thought about it, which they don't, but if they did, they would conclude that the difference between a person who gets fat and a person who stays lean is just how much they eat and exercise. Nothing. No physiological difference, no hormonal differences, no fuel partitioning differences in the body, no insulin differences, or pick your hormone. It's just how much you eat and exercise. So this is insane. And what we need to understand is that those of us who fatten easily, we can't eat what lean people eat, because if we do, we'll be fat, hungry, tired, grouchy. And then when we go in to see the doctors, they'll accuse us of cheating on the diet because we're still heavy. That's one of the epicycles. If someone stays heavy and they're doing what you tell them to do, and they say you're doing what you tell them to do, then they're lying to you. And, I mean, this is built into the literature. 1930s, you could find doctors documenting that their overweight pediatric patients are lying to them about their diets and therefore they just lack willpower. So anyway, all this has to be rejiggered. You have the right paradigm. Obesity is a hormonal disorder. So hormonal dysregulation of fat accumulation and the link to diet is through insulin. So you minimize insulin and you could do it by fasting for long periods of time or intermittent fasting. You could lengthen this time that you're mobilizing fat rather than storing it, which is the time that your insulin levels are low and you can lose the weight you stored.

One of the things I came across in my anti aging book was that chronically low insulin was linked to higher all cause mortality. And chronically high insulin is. Is also linked to all cause mortality. So I feel like there's gotta be some Goldilocks zone, which is like, when do you need to be keto and when do you need to be low or even moderate carb, but not necessarily full on keto? I mean, are you keto all the time? Like without.

I've never measured. I've never. And this book, by the way, despite the title, the Case for Keto is a case for carbohydrates being fattening and the diet where you abstain from carbohydrates. If you abstain completely, if you abstain from carbohydrate rich foods, you're probably going to be in ketosis.

Yep. It's possible to eat like 100% protein and not get there. But most people, over time, you're going to get into keto.

Yeah. So it's sort of. That's the. You know, my editors like the title. Keto's a buzzword. I didn't fight it. But ideally this was how to think about how to eat. If you're one of these people who fattens easily, which is the way they used to. If you know that you put on fat easily, so easily that sometimes or all the time it seems you can't stop it from happening, then knowing the mathematics, obesity people are supposedly. I read memoirs of people's writers struggling with obesity. Like Roxanne Gay's got this heartbreaking memoir called Hunger. Tommy Thompson, one of the great titles ever. The Elephant in the Living Room.

That is a great title.

In both cases, they say Tommy weighed over 400 pounds and Roxane Gayweigh probably weighed over 400 pounds. They both talk about knowing the mathematics of obesity, which means if they like can somehow eat 500 calories less every day than they used to be, they'll lose a pound a week and they won't. It doesn't work like that. It's not about math. It's about knowing the endocrinology of obesity, the effect of hormones on fat storage and metabolism.

One of the things that happened after I, I met some of the early low carb people because of the anti aging nonprofit group that I run, you actually came and spoke probably before. Good calories, bad calories. This had to be like 2005, 2006. You wrote the book. I didn't launch Bulletproof until 2010. The, the blog. And I said, all right, I'm going to test this thing. I'm going to eat 4,500 calories a day. I'm going to stop exercising and I'm going to restrict my sleep to less than five hours a night. And then at the end of the month, I should gain whatever the math would work out to. But 10 or 20 pounds of fat. And I'm pretty sure I'm controlling my insulin. I'm probably only going to gain three pounds. And I lost three pounds. I was getting sick of eating too much food, which is not good for you. I don't recommend it. But I was forcing myself to eat more than I wanted to and I was either losing weight or maintaining weight. My energy levels were up, I felt good. And that was one of the early blog posts I made. And it was also kind of stress testing the principles of the diet that I developed, which has keto at its core, but it also don't eat inflammatory fats and don't eat inflammatory vegetables and stuff like that that are still hotly debated by various people. And I think if you hadn't have written so convincingly and the good calories, bad calories, I probably, probably wouldn't have done that experiment that really cemented for me, okay, I got this. And I mean, to this day, I can still put on fat like no one's business, but I can eat a hundred grams of carbs a day as long as I have the right carbs and I don't gain any fat. And if I wanted to lose a little bit of fat, I'd just eat 70 grams. Or maybe I go keto for a week. But it's not hard. There's no pain. I just remember the struggling and the suffering and just the intense hunger and all that crap. It doesn't been a part of my life for so long. I, you know, I don't want to go back to that ever. And every time I see someone who's you Know, really overweight. Everyone knows they're overweight when they are, they're trying to do it. They haven't had access to, you know, your books and just to this whole body of knowledge. And you see them sitting there drinking a diet soda just like I used to and going, man, it's not going to work. It just won't.

And then, yeah, I remember sitting when we were doing this experiment with NuSI, the Nutrition Science Initiative. So we would have meetings quarterly in Bethesda, Maryland, next to NIH at this DoubleTree Hotel. And after one of the meetings I was sitting, having dinner before I was leaving for the airport and I was sitting in this lousy little restaurant they had next to this family of four that was staying in the hotel. And it was a mother and a father and maybe a third 13 year old lean daughter and a 15 or 16 year old obese daughter and the mother and the father are eating normal meals and the 13 year old was eating a normal dinner and the 16 year old girl with obesity was eating like a low fat, mostly planned vegetable plate with maybe 400 calories for dinner. And it was hard and hating it. I know, hating her sister and her sister's probably hating her because she's not, you know, I just, you could see the burden of this obesity and then starving herself on something that ultimately wasn't going to work because it wasn't fixing the problem. And the problem wasn't too much food or too much fat. It was in effect, any carbohydrates for her.

Wow.

And you know, I want to reach out to, and I have tried to like Roxane Gay. This wonderful, heartbreaking book just came out, why we, what we don't talk about when we talk about fat by a young woman who weighs, I think she said, 340 pounds and her struggles and the burden and the social ostracization and the psychological issues. And you could see her struggling to eat healthy. Right. Which to her means low fat foods and skinless chicken breasts.

Yeah. If you're empathetic, you feel a lot of compassion for them, especially if you've seen it so many times or if you've lived it. It's one of the things that gets me up in the morning is I don't want anyone to go through, I went through starting around 16 through about 25, because man, it is a miserable existence. And you think it's your fault.

Yeah, I know that's a fact. And, but you know, the weird thing is we're perceived, still perceived even by these People as quacks.

I always like that because I'm not a medical doctor. So if you call me a quack, you're promoting me to the field of physicians and I'm not even licensed. I'm like, thanks, Stephen Barrett. I love you, brother. By the way, that guy runs Quack Watch. He's a total quack himself.

Yeah, no, I agree. I've had headaches for explain to me that I don't rate being a quack because you need to be an MD to be a quack.

And it's like, okay, it was on my bucket list, Gary, to be listed on Quack Watch. It really was. Every doctor I know who's made a difference has been attacked by quackwatch. And when the USA Today used Stephen Barrett to discredit what I was doing, I'm like, yes, this is like a serious career life moment. I finally, you know, I made the list of big time people who make a difference.

So now I'm going to have to go look to see if like what am I? Chop liver? I don't get on the list. Although I do try to be relentlessly honest about what we know and what we don't. To me, that's the essence of good science is never over interpret the data. So as long as you say exactly what you can defend and nothing more than you're relatively safe. So even in this book I'm arguing we can, we can't say that you're going to live longer if you go on a ketogenic diet because we don't have that evidence. What we know is you're going to get healthier. We've got clinical trials and hundreds of thousands or millions of anecdotes that in the short term this is going to make you healthy in the short term, and there are certainly people who can keep it up for life. It's funny, writing about diabetes means writing about Richard Bernstein of Dr. Brad Bernstein's Diabetes solution. And like Bernstein was diagnosed at age 12, which was 72 years ago and he's been on his diet since early 70s, which was so 40 plus years and it hasn't killed him yet. So that's a good sign that we might just be, you know, it is indeed not a clinical trial, but it's a good sign. Sign.

It's a good sign. Well, speaking of good signs, I'm seeing lots of people interested in your new book and I certainly enjoyed getting early access to it. And I think you have a special gift for explaining things in a way that's that's really accessible and is just full of integrity. And I want to thank you again for the last 20 years of work and for continuing to be on the case in this case, the case for Keto. And I want any anyone who's listening to this. If you appreciate good writing, having things spelled out well for you with a hundred percent just certainty, I will tell you Gary is a better science writer than I am. I've been on Gary. I've been on the monthly New York Times Science Bestseller list. It was the highlight of my career as an author and it was a big honor. But I am nowhere near the science author you are. So I'm just telling you guys, you need to read the case for Keto. Even if you are to see I know Keto works. There's stuff in there that you don't know that you want to know because you don't have to be in ketosis all the time. You don't have to be on a zero carb diet. But understanding the mechanisms and the mechanics, it's hard to do. And reading a book that makes it easy to understand is very difficult. And this book is worth your time. And Gary, thanks for being back on Bulletproof Radio. Just keep doing what you're doing. I absolutely love your work.

Okay, Dave, thank you. You have made my day and now I'm going to go have a Bulletproof coffee.

All right, it's a deal.

It's a deal. Okay, thanks.

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