LowCarbUSA Podcast

Arthur Agatston, MD, attended New York University School of Medicine. He did his internal medicine training at Montefiore Medical Center at the Albert Einstein College of Medicine and his cardiology fellowship at NYU. He spent a year on staff at NYU while training to best combine both academic medicine with clinical practice. He then moved to the Mt. Sinai Medical Center in Miami Beach, associated with the University of Miami School of Medicine, and later became the director of the Mt. Sinai Non-Invasive Cardiac Lab.  He continued to pursue his practice and research in the field of noninvasive cardiac diagnostics, specifically in the areas of echocardiography and transesophageal echo and began lecturing regularly and published articles in academic journals on topics such as aortic stenosis, pericarditis, and hypertrophic cardiomyopathy.

Arthur and his colleague Warren Janowitz, MD, a radiologist, did early work on quantifying calcium in the coronary arteries as a measure of arteriosclerosis (as a predictor of heart attack and stroke). He is one of the developers of the electron beam tomography scan, or EBT, a screening method used to detect coronary artery disease and other diseases. EBT scans for this purpose are given a score on the "Agatston Scale," to gauge the severity of the disease.

He talks here about the early days and how the Agatston Score came about and we look forward to seeing him in August,2021 at the LowCarbUSA - San Diego, 2021 event which will BE IN PERSON AGAIN!!

William Schumacher Found when he adopted a keto diet he was like me and did not miss bread at all but what he did miss was really good crunchy chips (or crisps as they are called in various other regions).  Uprising Foods is on a mission to rebuild and reformulate the staple categories of food that are so fundamental to many, if not most, people's perception of core foods. They set out to develop something that was made from quality clean ingredients and vey low in carbs that had a high nutritional value and did not compromise on taste. Turns out they actually started with bread  because they wanted to address the product that most people found psychologically hardest to give up.  They call it their "Sour Dough" cube.  It's inspired by the sour dough concept but made predominantly from nuts and seeds.  Now you can make French Toast and grilled cheese and all the things you were used to pre-low carb lifestyle.  More importantly the rest of the family who are maybe not low carb with you (yet) can enjoy it just as much.

Then came the chips (crisps) which was nearest and dearest to his heart.  He really missed that crunch!  This sensation of crunch that so many people really desire. It took them a year to come up with something that delivered the crunch they were looking for.

You can find out everything you need to know about getting these super foods in your home by visiting their website here.

I was introduced to Emily Fletcher by Robb Wolf after I was talking with him about my issues with traumatic brain injury and he said the Ziva meditation method that Emily has developed totally changed his life.  He describes it now as Life Before Ziva and Life After Ziva.  Before actually talking to her, I got her book, Stress Less, Accomplish More and immediately became aware of the fact that although we are always talking these days about the fact that it is not just a diet, but rather a lifestyle change, that we need to embrace.  And a big part of that is to develop effective strategies to deal with stress so that we limit the deleterious effects of excessive cortisol and other stress related hormones in our bodies.  So even though I was still a little skeptical of the efficacy of meditation, I thought it was worth investigating further and so I set up this talk with Emily.

She has done great things by learning about meditation in detail (including a 3 year period in India) and then developing a whole new practice which she calls the Ziva technique.  The important thing that sets the Ziva technique apart from others is the fact that it teaches us to be self sufficient and enables us to be able to do it anywhere, in an airport, on the train, anywhere (just not while we're driving).  There no reliance on funky positions or meditation apps that have become so popular these days.  After talking with her I agreed to enroll in her online course which teaches the technique (very effectively, I might add) over a period of 2 weeks.

I have to say that I have not seen or noticed any big changes (as some people have experienced) but I do find that I look forward to the meditations so that must mean something?  I literally go to bed at night looking forward to the fact that I get to meditate as soon as I wake up.  I have always slept well so it is hard to judge if it has helped me in that respect and the LowCarb Lifestyle already results in massive improvements in cognitive function and mental health so it is hard to say now whether there is an even greater improvement since I started with Ziva.  If I look at it, I have noticed small things like a couple of times I have remembered things that I wouldn't normally expect myself to remember (because of the TBI).  The other day I was in Costco and came around the corner into a massive checkout queue and I just stood there patiently and waited my turn.  Normally I would have imploded (Pam will attest to that) and I didn't even become aware of it until I got back to the car and thought, "Wow, that didn't even stress me out, maybe this Ziva thing does work!"  I believe that we are the sum of all things in our life so adding in a practice that seems to make me happy and is probably drastically reducing my stress levels is a good thing to keep in place.

You can learn more about Emily's online course here.

This was such a good chat!!  Michelle Hurn was a Registered Dietitian working in a hospital setting and trying to get ready to qualify for the Olympic Marathon team.  As she started to increase her training everything started to shut down.  She was breaking out in cold sweats and developing severe muscle pains and it got to a point where she couldn't even run 2 or 3 miles.  Eventually she came to the conclusion that she just couldn't run anymore which was devastating for her.  Then she came across the ketogenic diet and as she started researching it she learned how much evidence there was showing the efficacy of reducing carbohydrate intake in treating diabetes and, even more surprising to her, in improving mental health.  She read more and more anecdotes of people feeing infinitely better after adopting the diet. After further research she actually decided to try out a pure carnivore diet for a month to see what happened.  Not only did she start to feel better almost immediately, she noticed that the chronic anxiety she had faced her whole life disappeared.

This made her really angry at the healthcare system that had not taught her any of this as a dietitian.  She decided to spend any time she had writing about it and trying to teach people about it.  She was so frustrated that she was not able to tell people in her work setting about it and so eventually she decided she needed to get out of that environment and establish herself in a position where she could help people. Her book is called The Dietitian's Dilemma and is a great read.

It's always such a pleasure to catch up with Robb Wolf.  He's such a humble, wise man.  This time we got to speak about the latest project he finished up working on recently, 'Sacred Cow', the book and movie project he helped on enormously.  We spoke to Diana Rodgers in a podcast a couple of episodes back and the project was her brain child but Robb got very involved right from the start as he is so passionate about it.  They went to great pains and have done such a magnificent job at representing the science so accurately that none of the would be haters in the vegan community have dared to try to discredit the book since they would get egg on their faces if they tried.  So much so, in fact that they don't even mention the book.  It's like any publicity is good publicity and they don't want anyone even knowing the book exists.

It's an awesome read and, as we say towards the end of the podcast, watch the movie and then get the book.  You won't regret it!

Dr. James Muecke is an ophthalmologist who was nominated as Australian of the Year in 2020 for his ongoing humanitarian work in helping to prevent blindness in impoverished communities in many places around the world.  About a year ago, however, he became aware of the potential of reversing type 2 diabetes by restricting carbohydrates in the diet.  Suddenly there was a way to prevent people going blind from diabetes complications instead of having to do surgery to try to save the sight afterwards.  He is using his platform as Australian of the Year to help spread this message and hopefully help reduce the number of people losing their sight due to complications from Diabetes.

He has released a few videos on the subject, including one called 'Blinded By Sugar'.  In that video he recounts the story of one of his patients who goes to bed one evening after saying good night to his wife and in the morning he wakes up blind in both eyes.  Since then this man has undergone nine amputations due to gangrenous toes and feet as a result of his diabetes.  He has finally seen the light and is an advocate now for the low carb diet and he hopes to save many people from going through what he has had to go through.

You can catch 'Blinded by Sugar' here.

Diana Rodgers is a Registered Dietitian, a farmer, an author, a filmmaker and a mom!  We talk to her about her new book, and movie, Sacred Cow.  The book goes into great detail about the science behind her rigorous defense of the beef industry with respect to the animal cruelty argument, the fear mongering around red meat causing cancer, cow farts (well belches, actually) destroying the environment and also the sustainability aspect.  The movie could never cover most of what is covered in the book and so focuses mainly on the sustainability component.

She was actually just working on writing the book with Robb Wolf, but the vegan community came out with yet another propaganda movie and she decided that we badly needed a rebuttal movie and so she put the book project on hold and started raising funds and working on a movie project.  In this interview we talk about how the movie, and especially the book, tackle environment, nutrition and ethics as those are the three main reason why people are anti-meat.  She says "Not only are you harming your health, but you are killing these beautiful animals and caw farts are destroying the environment, right?!  So it's the trifecta of evil that cows represents."  That is why she is so passionate about correcting all the misinformation out there and fighting back against those who would disseminate said misinformation (extremely effectively, I might add).

If you want to learn more about Diana's amazing work or even contribute in some way you can find her at the links below:

Movie Website:  https://www.sacredcow.info/
Instagram:  @sustainabledish
Her Website:  https://sustainabledish.com/

Two years ago, Dr. Andrew Oswari, a family medicine doctor practicing integrative medicine, was experiencing what most doctors are currently experiencing, depression and disillusionment due to their lack of ability to help any of their patients with chronic illnesses get better.  Ongoing progression of the conditions and escalating medications are the order of the day.

In the January of 2019 he was tested and the results came back with an HgA1c of 7.4 and he says we was devastated.  He felt there was no way he could be diabetic since he practiced what he preached about diabetes to medical students coming through his practice.  He had happened to notice previously that one of his patients who came in regularly for a certain treatment was losing weight and he would ask her how she was doing it.  When she replied that it was by adopting the keto diet, he just blew it off but this time, in the February of 2019, when she talked about keto he paid attention.  He said he joined a Facebook group to learn about it since there was no other way to find out how it worked, especially not in medical circles.

Within 2 weeks all sorts of things happened.  He just felt great, his daily headaches which he used to attribute to the stress of the job had vanished.   His irritable bowl syndrome which he thought he was stuck with for life disappeared.  "I had gone low carb just to lose weight and hopefully cure my diabetes and all these things happened", he says.  He learned about how this lifestyle could potentially address so many conditions and he immediately started contacting some of his patients with these chronic conditions, including one with cancer, and he says he has never looked back.

He started looking up where he could get some training and came across LowCarbUSA^®.  He found all the training we had in our partnership with the Nutrition Network and proceeded to do every module they had to offer.  That has stood him in good stead when the new non-profit, The Society of Metabolic Health Practitioners (The SMHP) launched in mid-December they had a number of pathways defined to achieve accreditation and one of those includes a number of the Nutrition Network Modules.  So Andrew became one of the first practitioners to get accredited with the SMHP and he now has the right to display the SMHP Accredited badge and use the credentials MHP after his name.  So he is now Andrew Oswari, MD, MHP.  He wrote an essay as part of his submission for SMHP Accreditation and it was so inspiring that I have provided a link to it here.

Andrés Rosales and Mauricio Moel are two youngsters from Mexico, studying at Harvard, who decided that there was a huge gap in the meal replacement market for a very strict, clean, keto version.  They wanted medical practitioners who were using therapeutic carbohydrate deduction as an intervention in their practice to feel comfortable recommending it to their patients to use as a convenient replacement to take to work, or to somewhere where they did not think a keto option would be available, or even just if they didn't feel like cooking.  They formed a board of advisors from many of the high profile doctors and personalities in the low carb space to help make sure that this product delivered everything it promised.  Anyone embracing the ketogenic lifestyle can, and surely will, use one of these shakes as a convenient meal replacement but it was important to Andrés and Mauricio that the medical community saw it as a tool. 

This product is now shipping for you to try today :) here.

Edit: an apology form Nick - "Apologies to everyone. At 34:30 I made a false statement when I said HMG-CoA reductase inhibition could inhibit ketone production directly. It is not the RLE in ketogenesis. There are indirect mechanisms potentially at play, but that enzyme is downstream of the divergence point in ketone and cholesterol metabolism. I was questioning the thought as it came to mind and regret the impulsive speculation. My sincerest apologies. That's embarrassing."

What a treat to spend some time with Nick Norwitz PhD.  He just graduated from Oxford with a PhD in neuro-metabolism and now he is about to embark on his MD at Harvard.  But this is not about his academic achievements, impressive as they are, rather it is about his immense battles with numerous chronic conditions that led him down the path to discovering keto.  When he was younger he never put on weight and was as carefree as most kids are until the end of high school when he started to develop osteoporosis, which was super weird for a male of his age.  By the end of college he developed ulcerative colitis.  He went to Oxford to pursue his PhD and had a huge flare up soon after arriving ending up in a hospital in a strange country where no one knew what was wrong with him.  So he started doing a bunch of research and he voraciously consumed scientific papers about carb reduction and the ketogenic diet and, although still skeptical, he decided to go for it. Within a week his colitis disappeared.  So he titrated off his meds over time and feels confident that his colitis is gone.  He is totally excited about this to the point that he is worried about getting expelled from Harvard for calling out his professors on this stuff.

We went on to talk about the new Society of Metabolic Practitioners (SMHP), a non-profit in which Nick is very active and even ended up in a pretty scientific discussion about cholesterol.  We made mention of his new YouTube testimonial video he put out and he talked about his book and referred to a bunch of papers so I have put a few interesting links down below here.

I have wanted to sit down and chat with David and Jen Unwin for the longest time so this was a real treat.  We start out by hearing briefly how he first came to learn about Low Carb, and that was through a patient who went off and reversed her diabetes on her own.  When she saw him again she literally scolded him for not every telling her that starch was really just sugar in the body and she basically asked if he was even qualified!  When I pointed out that he was never taught that stuff during his studies at university, I was amazed by his answer, "That is No Excuse!!  As a doctor I should have know that.  I was caught with my pants down".  She apparently learned all everything from an online group of about 40,000 people who were all teaching each other about this and when he tried to join the group to learn more they would not let him in initially because they thought that if he was a doctor then he must be a troll.  They literally investigated him in his practice before they allowed him in, but since then he and Jen have gone on to help them to develop an online program which has helped over 460,000 people so far.

What a brilliant discussion with two genuinely caring and humble doctors who are helping to change the world!

You can find that famous chart on the teaspoons of sugar under the Resources tab on this website.
You can link to David's latest paper he was talking about here.

After bursting onto the scene with Good Calories Bad Calories in 2007, Gary Taubes has gone on to write many books that have managed to make it into the mainstream and not get pigeonholed in the Keto or Low Carb genre which, let's be honest, is still pretty small as communities go.  It's because of this that I am particularly excited about this new book of his, 'The Case For Keto' (available on Amazon here).  Our main focus at LowCarbUSA^® has always been to not preach to the choir but rather to try to reach people who have not yet discovered the wonders of approaching metabolic health with lifestyle interventions instead of drugs.   

What's also interesting to me is that for the first time, Gary has strayed a bit from pure science.  Pretty much the second half of the book is practical insights and advice on how to be successful on this diet (we hate to call it that but let's leave it at that for now).  His comment to me was that once we convince people that they need to consider this change, we need to make sure they do it right!  Another deviation from the norm for him is that he has made it personal.  He describes himself as one of those people who 'fatten easily' and so, for the first time, he  is making himself vulnerable and putting it out there that he is not just preaching from his ivory tower but providing you with tools to come down and fight side by side with him in the trenches.

We discussed the purpose of his book at length and he says he is hoping to reach a bunch more physicians and hopefully persuade them to at least take a really hard look at this as an option.  I really hope he achieves his dream!

What a fascinating discussion with Dr. Ben Bikman about what Insulin Resistance really means.  He makes this statement towards the end but I would like to highlight it right here at the start, "We should be studiously avoiding dogmatic thinking and constantly be checking what we think we know, lest we become that which we have grown to despise in those who are very antagonistic towards a low carb diet."

There has been quite  lot of chatter around recently about what it means and whether or not Insulin Sensitivity is something we should be striving for or not. I agree with his take on it that it is extremely desirable for most of our cells and organs to be Insulin Sensitive and it is that insulin sensitivity and the absence of chronic hyperinsulinemia that leads to all the amazing benefits in metabolic health that we see with carbohydrate reduction.

We discuss his thoughts on where insulin resistance starts and he is quick to point out that this is opinion of how it based based on his knowledge of the biochemistry and basic logic.  It becomes really clear as the discussion continues about how important an enzyme insulin really is to our existence.  It's only when we become chronically hyperinsulinemic that trouble starts to surface.  At one point he talked about how in a type 1 diabetic where the beta cells in the pancreas are not producing insulin but the alpha cells are producing glucagon like crazy because there is no insulin to downregulate it.  So the liver is making more and more glucose under the effect of the glucagon.  He also explained that injecting insulin does not have the desired dampening effect since really high levels of insulin are required at the alpha cells to have the desired effect.  Since the beta cells are right next to the alpha cells in the pancreas, the levels of insulin right there at the site of production are high enough, but injected insulin is never in high enough concentrations to be effective by the time it reaches the pancreas.  So there is some research going into the idea that type 1 diabetes is just as much a disease of glucagon excess as it is of insulin deficiency.  Dr. Roger Unger has shown that there are other therapies like somatostatin and even leptin which can be administered to turn off glucagon production and you can possibly solve the type 1 diabetes without insulin at all.

I sat down with Dr. Adele Hite to talk about the imminent launch of the nonprofit Society for Metabolic Health Practitioners (SMHP).  She has been instrumental in helping us to get to this point.  Back in 2018 she worked with the panel of advisors that we put together to oversee the development of the Clinical Guidelines for therapeutic carbohydrate restriction.  We published them on our LowCarbUSA^® site at our Seattle event in May, 2019 and they have been embraced by the community.  However it was never really the ideal home for these guidelines and through numerous discussions with Dr. Tro Kalayjian, it became clear that  what we really needed was a dedicated nonprofit entity for practitioners.  So I went off and established a nonprofit called the SMHP and put a Board of Directors in place and built a website and by the time this podcast airs, we will be live at https://metabolicpractitioners.org/.

You can help is to get this going by engaging on the website and an social media:
Website:    https://metabolicpractitioners.org/
Facebook: https://www.facebook.com/TheSMHP
Twitter:    @TheSMHP
YouTube:  The SMHP
Instagram:  @TheSMHP

Pam talks to Dorian Greenow, Founder of Keto-Mojo which produces a meter to measure blood glucose and blood ketone levels.  When they first launched, at our LowCarbUSA^® San Diego Event in 2017, they had already managed to bring the cost of the test strips down to 25% of the cost of the other available strips at the time.  But he has never been satisfied with that and is constantly striving to bring the cost down further and also to try to get it certified for use in many other countries around the world.  In order to achieve this he has needed to change manufacturers which has bought with it many challenges. 

With this change he has managed to reduce the cost of the meter by about 30% and the cost of the strips down by 20%.  More than that, the old strips came in batches of 50 which came in a vial.  Once that vial was opened, the clock starts ticking and after 6 months those strips expire and you have to open a new vial.  Now the strips are individually wrapped so there is no 6 month expiry problem.   However it means that they will eventually run out of stock of the old strips for the old meters and so he has been offering people the chance to upgrade to the new meter just for the cost of the new strips.

You can learn more about, and view all those videos Dorian was talking about on the Keto-Mojo Site.

I first came across André Obradovic while I was working my way through the Advisor Training Course from the Nutrition Network.  What stood out immediately that it wasn't a doctor or scientist trying to teach me something about the benefits of carbohydrate restriction or the LCHF lifestyle but rather about coaching and teaching people and how to effectively help them to understand why they might need to make a change.  André calls himself a performance coach so I guess performance, in this case, is about how effective a doctor might be in communicating with the patient.  What I also found fascinating was that even though the talk was pitched at a practitioner with respect his or her patient or client, it applied equally well to anyone trying to get through to a friend or family member.  For those of us struggling to get the message through to friends or family, there is so much here to help us.

During the talk he mentions the Wheel of Life Tool.

He also talks about his free app.  You can find it in your app store under Andre Obradovic.

Adam Pike was one of the lawyers involved in the successful defence of the charge against Prof. Tim Noakes for replying to a lady on Twitter about the best way to wean a baby.  Since then Adam has presented a talk on ethical behaviour of medical professionals on social media for the Nutrition Network, which is a spin-off from the Noakes Foundation.  I had a fascinating chat with him about what constitutes ethical behaviour on social media and we discover how the behaviour of Prof. Noakes did not constitute unethical behaviour (which is why he was exonerated) whereas the behaviour of Claire Julsing-Strydom, who was instrumental in bringing the charge against him, and the ADSA did in fact behave unethically in a number of ways in the aftermath of that fateful tweet and yet no charge was ever brought against them.

We then went on to talk about how protected a practitioner might be if they are to disseminate advice on therapeutic carbohydrate restriction and the LCHF lifestyle.  We are working really hard to establish an alternative Standard of Care (SoC) for this.  Part of that effort is to establish a non-profit called the Society of Metabolic Health Practitioners (The SMHP) which is due to launch shortly.  You can learn more here.  But until that happens, how protected is a doctor who advises their patient in this way.  What Adam said was really interesting.  If a doctor provides care that goes against the accepted SoC but they can show that they based their decision on solid evidence then they would still be able defend themselves in court if it ever came to it.  Patient autonomy (or informed consent) is also critical here.  As long as the patient is fully informed of all the options available with all the supporting evidence and they then make a decision on their course of treatment, no harm can be done and the doctor is protected.  That is just critical knowledge that all doctors should have.

Vyvyane Loh is a board certified internal medicine nd obesity doctor who started out in obesity practice and found herself taking patients off medications which was very different from what she had been taught in her training.  She feels she was very lucky to get exposed to  it early.  Down the road she measured her own A1c levels and found them to be high, around 6.4.  Her doctor looked at her and seeing that she was not overweight, told her she could not explain it and told her not to worry about it. 

That really bugged her so she started digging into it more.  Then her friend encouraged her to start the Atkins diet with her and she decided to try it.  Literally 2 days after she started all her symptoms she had previously attributed to irritable bowl syndrome disappeared.  She was flabbergasted and could not understand how she had not known about this and why she and her colleagues were not telling their patients about it.

She has reversed her own diabetes trend and is now committed to taking this to her patients and also in helping to reach the more impoverished communities who aren't exposed to this information as easily.

We have partnered with Restore Health to launch a comprehensive mentoring Program for embracing a low carb lifestyle.  This program is available to everyone, but we are finding that it has become a very powerful tool for practitioners.  Once they are able to get their patients to understand that they need to change their lifestyle in order to address their metabolic health issues, this proves to be a very helpful tool to help those patients to actually implement the changes.  The program addresses not only the concept of reducing carbs in their diet, but it shows them how to achieve huge metabolic benefits by doing Dr. Ben's SMaRT™ exercise program which only requires 15 minutes twice a week, literally.  They also teach strategies to improve sleep and reduce stress.

In the end, most people providing feedback on the program have told us that they found the access to a live coach was the best part of all. Having someone they can turn to with questions and to hold them accountable seems to be a huge plus!

You can learn more here.

We caught up with our friend Andrew Berger again after almost a year.  Andrew suffers with Type 1 Diabetes and found himself with terrible blood glucose control, the onset of diabetic retinopathy and was about 75 lbs overweight.  We met him for the first time at the LowCarbUSA^®- San Diego 2019 event.  At that point he had been on a keto diet for about 7 months and was down about 40 lbs and his blood sugar control was way better.  He met Dr. Ben Bocchicchio at the event and learned about the metabolic benefits of his '15 minutes - Twice a Week' workout philosophy.  So he started with that the next day and around about the same time started dabbling with the carnivore diet.  We saw him again about 6 weeks later and he had lost another 5 inches on his waist and he looked great.  We did a podcast interview with him at that stage (go check out Episode 15) and talked about all his successes.  Well, since then he has taken it to the next level.  He as introduced intermittent fasting, and even some extended fasts and the results have been spectacular.  He is looking amazing, his blood glucose control is the best it has ever been.  His glucose runs in the 80s to 90s most of the time and his A1c has come down to and astounding 4.9.  He is now off his insulin pump and is back to injecting himself with insulin.  He is down from about 100 units a day to numbers in the teens (and even down to just 3 units during his extended fasts).  He is experimenting with less powerful, slower acting (and cheaper) insulin options to try to get his life to a point where he is stable 24/7.  We are so excited to follow him on this journey.