Low Carb International All Stars - Q&A 1st Session

[Music] good afternoon everyone uh we're officially starting the q a session at the moment um my name is daron scherr i work with paul mason people on your screen really need no introduction to you professor tim knox from south africa dr gary fettke who's really from another country he's from tasmania rod taylor who's down in melbourne and paul taylor paul mason who's organised this whole conference so it's just the first thing is paul thank you so much for uh for organizing what it really has been a wonderful session so far and we're looking forward to watching the rest of the videos now guys if you can send through some questions on the live chat we'll get through as many of them as we can tim you and paul were just chatting there about some of the you know the conspiracy theories and unfortunately this is actually not conspiracy theory it's true conspiracy so do you want to um maybe give us a little bit of a summary of where you think we're up to right now yeah thank you darren and hell welcome to everyone this morning uh it's this morning in cape town maybe a little bit later in australia yeah um you know when i gave the lecture i gave it on the basis of what i've been researching for the last about nine months or so which of course follows a lot of other research but it became very clear to me that the idea that cholesterol causes heart disease is completely bogus it was found guilty without ever being put on trial it was just accepted and ansel keyes was the first guy who who hid the data and there have been something like 30 or 40 other attempts to prove that cholesterol causes heart disease and low fat diets reverse heart disease and they've essentially all failed and no one has really taken the time to say well they've all failed so therefore surely we should move on to something else and one in my talk i tried to draw attention to was the fact that it it's not that whether it's saturated fat is associated epidemiologically with heart disease it's not but that's not the issue because well i it's it's not associated but if even if it were there's so much other evidence that we should be focusing on and i wanted people to focus on on all the other evidence and and what i show and what nina taishol show and gary talbs show is that the the problem was that in the 1960s there were two it seems like tim may frozen so we'll wait a couple of seconds to see if we can get him back um dorian that's just proof that there's a transmission uh every time you start speaking out about it these silent forces rise up and uh try and shut us all up but luckily when we hand the baton from one to each other um gary i'm actually going to ask you the next question if you don't mind um i know you've got it and every time we i mean everything in nutrition i've said you know we've taken for granted it's a paradigm it's what we're taught every single topic i've actually touched upon just collapses like a house of cards whether it's cholesterol sugar carbohydrates fiber salt fasting being dangerous all of them just keep collapsing when you under put them under scrutiny and that's what this group has done over a long period of time now is just more and more scrutiny the whole myths about diabetes being caused by you know fat it's just it's all absolute nonsense or non-science but um yeah that's right i was just continuing on from tim there look i i think we all agree with you um there are specific questions on the q a and i might um ask you about this one do you have a thought process on seed oils versus fructose if is one worse than the other how are they different in in terms of causing insulin resistance so you cut out for the first half of that question it's something versus fructose seed oils sorry tim you you dropped out for a little while so we've uh we've moved on but i will come back to you to get the rest of that answer if you don't mind sure thanks darren all right so gary you know you you've got an interest in seed oils as well as an nc as an inc as an interest in fructose well i think it's in my talks on inflammation you know and i only ever describe what i call a model or a hypothesis of inflammation based on nutrition and it can't ever be proven it can't ever be disproven but effectively i describe it as the combination of glucose like refined carbohydrates fructose and polyunsaturated seed oils have come together in a perfect storm and in a nutshell i describe it that the sugar and the carbs and the fructose are the kindling of a fire and the polyunsaturated oils are the match and as tim was alluding to in the discussion beforehand you can have high consumption of carbohydrate and get away with it you might develop obesity you might develop diabetes it might develop some insulin resistance because of that ongoing glucose and carbohydrate load compounded by fructose and it's affecting the liver but when you add in the seed oils then that they're prone to oxidation and the trouble is that the fat in our body whether or not it's intracellular whether it's in the cell membrane the mitochondrial membrane every single structure of our cells that contains fat is the amount of fat in it is determined by a dietary intake over a period of time and so where we were 50 100 years ago we had very very low levels of the polyunsaturated oils in our body particularly the linoleic acid which is the omega-6 we now have 20 to 30 percent depending on which way you measure of the fat in our bodies is linoleic acid or omega-6 which is prone to oxidation and i think that's the runaway trait so the three things sugar refined carbs and polyunsaturated oils but one of the kickers for me was in 1972 there was a great article but related to the polio pathway so we know fructose is bad we know the glucose over long amount but if we have excessive carbohydrate in our diet and if we are insulin resistant then the polyol pathway instead of converting three percent of glucose to fructose is actually 40 percent so when we up that up that polio pathway that 30 conversion of all glucose to fructose is just a massive of inflammatory tissue that hits the body and i think that's that's the big problem again the carbs the sugar that's the kindling that's the fuel source for it but until we actually put in those industrial seed oils into the equation and the amounts we've done that's that's that's inflammation and inflammation sits under every single component of health or disease probably all right thanks gary paul i know um you've been doing a lot of research there's a lot of people that are promoting you know mediterranean style diets and having lots and lots of olive oil and monounsaturated oils can you just give us a little bit of your thoughts on that because i know you don't think that they're necessarily all as safe as what they're made out to be um now i can't hear you paul we need somebody with sign language next to you maybe so uh i think it all comes down to what your competitor is and if you're comparing a poison um to an even worse poison then it's going to come out smelling of roses and i think this is essentially what the story is done with the mediterranean diet and the way i see it is become a halfway house for trying to bridge the gap between the two camps between those who are absolutely scared petrified of saturated fat and those people who absolutely love seed oils and i think i have to appreciate the uh i guess the urge of you know these two groups to try and meet in the middle but at the end of the day one of these groups is right and having a consensus opinion around the mediterranean diet is false science the reason that seed and vegetable oils are so bad is as gary said they have a tendency to oxidize their chemical structure means they have a double bond which means that they they generate oxidative stress oxidative compounds we ingest them we actually absorb them into our body and we can actually see them directly cause fatty liver and other things like this and olive oil is a seventy percent oleic acid which is a monounsaturated which means it has a single double bond prone to this oxidative stress it means it's not as bad as the polyunsaturated but in no way is it as good as the saturated fats so when i actually went looking at the literature for the miraculous benefit of seed oil and olive oil it's simply not there we can demonstrate that as a part of a healthy diet it's healthier than a standard western diet but that really doesn't prove much it's an incredibly low bar tim do you have any thoughts on this yeah i think that that's very brilliantly concisely explained by paul i think what what i never knew until a few months ago was that the mediterranean diet was developed by walter willett at a conference in 1992 1993 he simply plucked it out the air and then developed the the walter willett pyramid a mediterranean pyramid and essentially he said that you had to take meat out of the diet so you're only allowed to eat meat once a month you replace the animal proteins with with other beans and and things like that and then you added olive oil and that was it and it was at a in a period of time when greece italy were struggling because the olive oil industry was failing and they needed to make it more popular so they organized a series of conferences at which the top scientists nutrition scientists in the world went to europe went to the mediterranean countries and had these conferences and they were supported by other people sorry i think you've lost me again no no keep going okay so they were supported by by writers and journalists who would then go home and report on these fabulous mediterranean diet and if that if the journalists didn't report positively they then got kicked off their the group and that's how the mediterranean diet became very popular it was completely commercially driven and as paul said there wasn't any evidence to support it and he's absolutely right it's a halfway house but it's it's really sad because i see recently there's a studies on individual responses to carbohydrates and the guys use the mediterranean diet as their standard and i and asked why and they said no that's the standard of care mediterranean diet is a standard of care for all patients i said where's the evidence and there is no evidence and so so paul's completely correct the there is no significant evidence that the mediterranean diet or however constructed is more healthy for us than than any other diet maybe then the american diet the standard american diet but but not above anything else tim paul right everyone i have a favorite question when i'm told about the benefits of the mediterranean diet i say well what is the mediterranean diet and because the mediterranean it's quite a big sort of ocean and i'll see you sorry and you know it is it is it a portuguese diet is it an israeli diet an egyptian diet it is completely fabricated with different food sources sure there may be an agenda but nobody and i realized willett came up with this sort of contribution but when you ask other researchers what the mediterranean diet is they don't describe what will it described yeah and so it is a complete myth again it just falls over on the very first question so when people say i follow the mediterranean guy so what is it and which part of the mediterranean are you talking about and so again it's i don't know how to debunk it any more than the fact that it's more non-science all right thank you rod i'm going to ask you a question you've been doing low-carb for a very long time and one of the leaders in the field really do you think supplements are necessary if you're eating low-carb foods i suspect not duron i mean we've managed for thousands of years without having supplements so i don't see a particular role i do hear things like magnesium is very low in our soils because of our agricultural methods and as a consequence maybe there are things that we could supplement to advantage and that's that's the only one i know so i'm not sure but um just for good measure i do take a a small dose of magnesium every day but i'd be interested in other's thoughts on this one um well anybody want to make a comment there any of the other panelists i'll take take the dietitians association uh lined a well-constructed fully supervised diet plan including veganism by your dietitian will supplement and manage everything perfectly well which is complete not a bs um but i actually think if you're tip to tail and you have a a wide variety of low carb foods you don't need supplementation but i completely agree with you right about the magnesium being deficient most fertilizers in the soil have got potassium and potassium binds irreversibly to magnesium and therefore if you can't get the magnesium into your grass you can't get the magnesium into the food and if you look at the price of magnesium supplements in the last 10 years they've just gone up and up and up at the chemists in the supermarket so obviously a lot of people are taking it do you have to have it um i took it for a few years i haven't had any for about five you know three or four years now but i i it's there in theory paul um one of the other questions from the live chat here is about patients after having had bariatric surgery now i know you've seen a lot of patients who have had bariatric surgery and then about five years later they tend to put a huge amount of the weight on again because they haven't changed what they're eating and then they come to you with all sorts of deficiencies um have you sort of got a little thought bubble of the typical things you see in those patients oh we've lost you again paul back on now so it really depends on the type of uh bariatric surgery they've had if they have a sleeve gastrectomy that probably leads to significant degrees of nutrient deficiencies you impair the secretory capacity of the some of the gut and if you have impaired acid secretion then that means you can't dissociate a lot of nutrients from the amino acids that come in this is why proton pump inhibitors cause b12 magnesium and calcium deficiencies amongst other things so i actually like to do a complete nutrient screen on those patients and you'll often find odd things so had one patient who actually had a microacetic anemia that ended up being due to copper deficiency i've had patients who come in with subacute combined degeneration which is a neurological condition because of profound b12 deficiency so the problem is not just that the surgery doesn't work and the patients don't lose weight but they often end up with these terrible nutrient deficiencies that would normally only see in strict vegans or populations like this and it's truly damaging to their health did you want to come up here there on the vitamins as well sorry tim sorry can i just put in there y'all so as a diabetic i've actually found that magnesium and zinc improve slightly my glucose control so i've just speak i mean i've been studying my glucose for years and there's no question that when i take magnesium and think glucose control is slightly better i mean it's a few millimeters it's always that way if i stop taking the glucose control gets slightly worse i do take vitamin d3 and k2 because i just think that they may have a role in coronary artery disease prevention and blood forming also so i take perhaps a few more more vitamins and minerals than other people do but at least i find i convince myself that there's a role for for me and with my diabetes whether it's scientific or not i don't know but i'm a you know an experiment of one so i look at myself and see what happens cool so one thing that i think is not discussed and gary alluded to it previously was nutrient depletion in soil and it's not just magnesium there's multiple micronutrients that we don't even think of there was one study they did in australia that looked at the nutrient density of soil in the 1940s and they compared it then to the same soil from the same locations in the 1990s 50 years later and they found that some nutrients had actually dropped down by about 75 and i can assure you that when you speak to farmers they're not replenishing all of those nutrients in the in the soil and this should concern you know everybody across the whole spectrum from vegan vegetarians carnivores you know omnivores what have you ever this actually impacts everybody and i've got no doubt that monocrop agriculture our modern agricultural techniques are largely to blame but the trouble is that every food that comes from that land be it an animal-based food or a plant-based food is effectively nutrient-deficient compared to what it was 50 years ago and remember this data was from the 1990s and now we're 30 years later again 30 years more of nutrient depletion with you know hydroponic setups and things like this we've really um i think occasionally i flip-flop a little bit between whether i think supplements are a good idea but there certainly are a couple of key ones which i think can be beneficial but i would always recommend against fish oil supplements again just because any oil understand that fish oil is highly polyunsaturated it is even more prone to oxidation than omega-6 fats and immediately out of the bottle or out of the capsule it's oxidized if you want your omega-3 supplements then get it from fresh food the definition of rotten food rancidity is oxidation of oil so if your fish is fresh then the omega-3 fats are not oxidized and if you're having pasture fed beef that too contains omega-3 so you don't have to be having salmon every day or sardines every day so just natural is best but sometimes it's not always possible all right thanks paul um tim there's been a few fairly primitive prominent fitness bloggers who you know say go they're very pro keto for quite a period of time and then all of a sudden they do a 180 degree turn and go vegetarian or vegan saying that their insulin resistance got worse when they had been on keto for a period of time do you have any comments for us for those people yeah i think we must distinguish it between pathological insulin resistance and physiological insulin resistance so pathological insulin resistance is what i have and or and i share that with all people with type 2 diabetes in that it doesn't matter what diet we we eat our diabetes will always be there or if we we can put it into a high fat we remain profoundly insulin resistant is that in this profound state of insulin resistance we simply can't tolerate more than 25 grams of carbohydrate per day so our body can cope with 25 grams a day without requiring enormous amounts of insulin and distributing the carbohydrate into our muscles and our liver so that's pathological and you're not going to improve it it's there for life it's only going to get worse by eating a high carbohydrate diet physiological insulin resistance however is quite different that's when a person is completely normal that they have not got type 2 diabetes their blood glucose control is perfect when they take carbohydrates their glucose spikes but they've got sufficient insulin and the tissues are sufficiently insulin sensitive that the carbohydrate can be distributed into the tissues quite rapidly it's the adaptive complications if we put them on a high fat diet their glucose tolerance will become worsened so now if we were to to do a glucose tolerance test they would have to secrete more insulin and their glucose would go higher but it's not material because they're eating so little carbohydrate anyway that they're not hypersecreting insulin all the day and they're not exposing themselves to high glucose so it's not a problem as i've indicated only becomes a problem when you have pathological insulin resistance so i think people have to make that distinction it's a terribly terribly important distinction and i and you're quite correct that people use that as an explanation why you shouldn't go on a high fat diet but the point is once you're on a high fat diet you're not hyper secreting insulin your blood glucose is better and even if your insulin resistance it's it's not a problem i want to just make the final point that that people don't die of diabetes they die of its management and so if you have insulin resistance and diabetes and you eat 25 grams of carbohydrate a day you should be spared most of the complications of type 2 diabetes we can't say you're going to be spared all of them but we can say that you will probably be spared most of them because your insulin glucose levels are going to be low most of the time and that's what's important so having type 2 diabetes making your insulin resistance even worse but not eating carbohydrate is the key to the management insensitive and you go on a high fat diet you're going to get lots of benefits but you probably weren't going to get diabetes in any case so the fact that you become slightly more insulin resistant it's all physiological it's all easy to explain and it's not going to cause long-term disease all right thank you um so a a question from rachel here for those who want to monitor their metabolic health is it best to look at the fasting insulin the hba1c or both and can you just tell us what are the levels indicative of insulin resistance so paul maybe you could take that one for us well i think the fasting insulin was one that uh ben actually ben bickman covered in his uh lecture and he uh believes a level of six and that's actually very close to the level the threshold which i use i actually use a threshold of five so we probably read some similar literature there funnily enough i think it's important though to not discount the fact that the fasting insulin doesn't tell you anything about how the body handles a glucose load dynamically so i think if you have the option of doing a craft test that's always useful i find that hba1c can be useful to track progress over time in somebody who's poorly controlled but it has an incredible amount of variables for instance if somebody has a an iron deficiency state that will artificially elevate their hbo1c or if they've got an autoimmune state where their red blood cells are under autoimmune attack that will artificially lower the hbo1c and we often there's so many other factors that can impact hbo1c i personally prefer a couple of key things that are done on standard blood tests and metabolic health triglyceride to hdl ratio fasting glucose and fasting insulin will give you an indication in most everybody and then certainly if there's any doubt at all if anybody's in the gray zone then there's a heck of a lot of other tests that we can do to find the nuance on things a little bit more all right thank you very much um so another question i'll go ahead gary broad you deliver function tests and monitor your alt in particular yeah absolutely alt is an amazing thing um so basically you've got a liver cell and it's got this enzyme in it that particular chemical called alt if the liver is under stress that's sick of dying the liver cell will basically burst option and the alt will leak into the blood we can detect this on a bloodstream so it's a very good marker for liver health and the interesting thing is this is a perfect case of moving the goal posts a lot of people you go to your doctor the doctor looks at the blood test and says oh it falls inside the reference range it's not in bold or it doesn't have a star you get a big tick so but unfortunately these reference ranges are set as statistical parameters they reflect 95 percent of the population so they're basically the values that you could 95 of the time expect a person from the street to fall within it has no bearing to optimal health it's just a purely statistical measure so in the 1950s the upper threshold for alt was 25 or 30. and now in some laboratories it's over 40. so the simple fact is that as our population has gotten less metabolically healthy rather than say guys we've got a problem whatever we're doing is not working we've just shifted the goal posts but alt is one of the single best market and absolutely i do do alt and it is very very useful and it's incredibly responsive to healthy diets gary um being from tasmania the local salmon farming uh is probably not too far away from from where you are um i don't know if you've had a chance to go down there but i read an article not so long ago about all the nasty stuff that's fed to the the farmed salmon and that's why a lot of the omega-3 to six ratios and nutrients in the salmon are changing have you got uh any local knowledge uh for us uh from down there well being warned doran and paul i used to come from a place called sydney which is it used to be started as a penal colony so just remember that guys the this has been looked at not just in tasmania but uh internationally um the the omega three omega six ratios of pasture fed uh meets wild um uh salmon wild fish versus those that are farmed and the majority when you say all those toxic things that are fed to them absolutely right it's called grain you know a grain products so the moment you introduce that you do increase the omega-3 omega-6 ratios um in a detrimental fashion but it's it's very small it's very small i'd rather you have said we have grain fed meat or grain-fed fish than having the grain so the ratios are a bit poorer than the wild fish and the white and the pasture fed meats but they're still better than the vast majority of meats uh sorry of other products that fit into those food pyramids and the food guidelines so not everyone can afford to have pasture fed meats i'd rather you have meats that are that or and fish that are than to not have them now rod there's been a few uh comments uh on the chat about the uh ethics of eating or farming meat versus the ethics of farming um grains and other plant sources have you got any thoughts on us on that for us i can't hear you rod hopefully hopefully that's better um yes this is this is a big question um around sustainability it's a big question around plant-based eating versus animal uh animals included in the diet uh yeah yeah this this this is a complicated one i think ideally um i'm personally a believer in uh including animal products in our diet um because i think that's a much more complete diet with all the uh all the nutrients that are required so that's that's my bias to start with sustainability is an issue for both animal based agriculture and plant-based agriculture by eating grass-fed meats and i mean grass grass fed and grass finished then we avoid the problems that we have for industrial methods of feeding uh animals towards uh prior to um yeah at the end of their lives so lots of issues in here but uh if we can use regenerative agriculture methods uh then i think that's a great way to addressing uh sustainability for what i believe is is a better diet there are also problems with grain-based agriculture there are a lot of negatives that go into that in terms of things that are added to the soil herbicides and pesticides and the like and there is also damage to animals small animals in harvesting this is a huge question to rod but thank you uh that's a little take on uh on some of the issues that i see thank you tim i'm going to actually flick that across to you and in a country where there are a lot of poorer people who can't necessarily access the meats and proteins can you give us some guidance as to how they can make their country healthier yeah thanks doran because that that was something that concerned us and i have a small little foundation and that's one of the questions we've tackled and we developed a program called the eat better south africa campaign where we went into poorer communities in my town of cape town south africa and we wondered could we make these people healthier by eating a diet that they could afford and we were able to produce a diet for three australian dollars a day that was healthy and com complied with a low carbohydrate diet and the focus was on tinned fish egg dairy produce they generally have access to lots of vegetables that's pretty freely available and they then found ways to get hold of saturated fat from the more wealthy shops where they cut the fat off and and throw it away and so there were ways that they could render that fat and then use it so on three australian dollars a day we were able to show dramatic improvements in all the risk factors that metabolic risk factors that we've discussed that paulus discussed earlier within a period of six weeks and the the change was quite dramatic because these were people who are marginalized because they're in south africa and you know south africa's history they were marginalized and they'd never had control of their own lives and it reflected in what they were eating and once they took control of what they were eating the benefits were quite remarkable you know we had um so it seems that we've lost him there again i'll take on from tim um i was lucky enough fortunate enough invited to speak with tim at the first lchf summit in cape town one of the most profound moments for all of us as speakers was actually traveling into the couple of the settlements um we had a day trip in there scary living conditions but they had an open market and in that open market was a wide range of offal that you would not you would struggle to find any well australian us [Music] marketplace so they had lots of liver lots of lung heart they had goats heads which a lot of us might find offensive but they were eating tip to tail and that was readily available in their open markets and you didn't find you know great big steaks and minced meat but and that awful which is paramount with full of nutrients and having the bones was actually really it was available in settlements apart from the fact that every um advertising sign was coca-cola so you didn't see anything apart from coca-cola signage but you know and tim i don't know if you've heard any of that but thank you once again it was an incredibly eye-opening experience for all of us that came across just to see an open market so in those settlements very poor very um clean you know but but they but they had their ability to get food which was actually very nutrient dense so paul bringing it back to australia we have an incredible problem with our indigenous population with their insulin resistance diabetes and all the complications and i know that you did some work looking at the original native diets that that were they were eating and what happened if you went back to those diets so do you want to give a little bit of a comment on that and then the second part of the question if you want to just talk to me a little bit about omega three to six ratios as well please yeah so essentially there's a uh some research that was done um by a a researcher who obviously had a bias towards the food pyramid um and they had actually looked at what happened if they took uh groups of uh indigenous australians the aborigine back to their native diet for a period of time and what they actually found was that they had an incredibly rapid reversal of diabetes um in a matter of weeks they were officially reversed now the researchers conclusion did not reflect that at all so to actually understand that so you actually i went to the studies and i actually calculated their macronutrient intakes and i actually discovered that it was actually a relatively low carbohydrate diet um actually tending quite a very high protein diet so tending towards the more carnivorous diet actually that would see now so the traditional diet when i went through and looked at the historical literature they would eat foods like wichita grubs which are very fatty they would actually if they killed a kangaroo and the kangaroo was too lean they wouldn't even drag it back to camp that would just be left for the dogs and the dingos if they if they killed a wallaby the fat that that ate first they would um disembowel the animal and not eat the fat around the kidneys first so they really prioritized similar to what amber talked about they had a priority of their natural intake for fatty foods and this natural diet rich in fatty foods and protein rapidly reverse diabetes now uh to the second part of your question about the omega six to three ratio i say there's a few comments about uh omega-3s and sixes and stuff like this and i think that there's a little bit of a misunderstanding people think that the ratio in and of itself is inherently important and that's what confers your health status if you have a high omega 63 ratio that's bad i actually think the reverse i well i don't think omega 6 is a good but i believe the only deleterious thing about omega 6's is the fact that when the way we ingest them is that they're associated with a lot of oxidized products so if we had omega-6s coming from fats and grain-fed animals even those omega-6s are not necessarily going to cause us harm because we worry about sixes we say well that can lead to arachidonic acid and that's the precursor for a lot of inflammatory substrates icosanoids and so on and so forth however this conversion from arachidonic acid to these inflammatory substrates only happens if you have an inflammatory trigger and indeed we've actually seen in research that if you go on a low carb diet the amount of arachidonic acid can actually increase and that simply reflects that less of it is being converted into these downstream problems so i would ask people to not focus too much on the three to six ratio but just to make sure if you are eating sixes make sure you're having sixes from healthy foods and it's not oxidized so um there's a lot of people that talk about not eating chicken because chicken's very high in omega 6 relatively speaking is that is it a problem eating chicken no i don't i don't believe it is now this does nothing to remove the need that the body has for omega-3 so it doesn't mean that you get away from having a bit of fish or pasta raised meats or something like that from uh you know to make sure that you're still meeting your essential fatty acid needs but i don't think there's inherently wrong and i actually agree with gary it's better if the animal eats the grains than we do i don't believe that grain-fed animals are you know particularly problematic for most people so some people may benefit from sourcing organic foods cleaner foods pasteurized foods and things like that but when finances come into it if the best you can afford is a chicken then it's absolutely fine to eat the chicken tim i'm going to ask you another question but did you have any comment about that as well he's frozen okay we'll come back to him um gary rod any comments about that are you back tim did you hear um paul's comments about the chicken yeah i did i don't really have anything to add to that thank you okay so so the the question then is um in the lean mass um hyper responders they they get a very um significant increase in ldl could you give us your thoughts on on what that um is there any worry about that in those people uh who's that directed to i thought we would start with tim if you don't mind i think that following on what gary and paul have been saying it's the oxidized cholesterol that's the problem that's that's what we need to be worried about and so if you have a high cholesterol but you're eating a diet that's not going to cause that cholesterol to become oxidized then then that's not a problem uh you know there's so much evidence that that high cholesterol is protective in many conditions that we need to remember that but in my talk i also focused on the mr fit data and it showed that the variance between a low cholesterol and a high cholesterol the mortality difference is absolutely immaterial it's it's completely as i've said it's immaterial and so so that the other point i made in my talk which i hope gets across is that that diet has never been shown to be a determined of blood cholesterol concentrations in a population so that for an individual the many factors that drive cholesterol up or down that are completely unrelated to diet and we've just completely ignored those factors because if you put people in a laboratory for six weeks or so you can definitely lower their cholesterol if you give them a high polyunsaturated fat diet which now we know is toxic for the reasons that gary and paul have spoken about but in a population the cholesterol completely unrelated to what people are eating so to my in my way of thinking that disproves the both the lipid and the dietary hypothesis because it shows you can't predict if someone has heart disease how can you relate back to diet when the diet is going to be so variable in the population and not driving their cholesterol values anyway so i have yet to see any evidence that increasing your blood cholesterol on the start is going to be dangerous if it's oxidized ldl cholesterol yes then it's going to be a problem but otherwise it's not and the only way you're going to get oxidized ldl cholesterol is from an inflammation and eating the grains and polyunsaturated fats that that gary and and paul were talking about so therefore is it useful to actually monitor people's levels over time no no i don't think anyone should ever have the ldl cholesterol measured and particularly not women because it's then used as an excuse you know you know how bad we are in medicine i tell patients that if you have a coronary antigen if you have a cholesterol measured you're going to have a coronary angiogram and if you're going to have a coronary angiogram you're going to have coronary artery a stent or a coronary artery bypass surgery there are certain things in medicine you don't do and and coronary artery coronary artery invasive resist operations are probably one of them in most cases and stenting is another one but it all starts with cholesterol and if you measure your cholesterol you're going to go down a pathway that is not proven to be beneficial to your health long term and particularly in women there's absolutely no evidence in the published literature that cholesterol has anything to do with coronary artery disease in women and so that that's terribly important because people use this model the the key ancel keys model that cholesterol causes heart disease and then they just apply it men women old people young people everyone's the same and that's simply not true so there are much better tests to determine your health and those are the ones that paul described for insulin resistance and metabolic syndrome that's what we should be focusing in on thanks tim that's fantastic gary you wanted to make a comment look i think we're going to stop utilizing using the terms of cholesterol and ldl uh in the standard testing of ldl it's actually a subtraction equation it's got it's it's a it's not actually a measure of anything in the standard test that's done and when you realize that the ldl particles are a spectrum of particles of which the small dense ones are probably the ones most likely to oxidation and for one of a better term the big fluffy ones that are floating around our carriers it's no wonder when we actually improve our health profile dietary but the big fluffy carriers are fine and the small damaging ones are reduced the only way to effectively measure that nowadays is to do a lipid subfraction analysis so in 2019 even the american cardiologists association said they should drop the ldl measurement and to ignore it and so the major units in the world that are now studying cardiac risk factors remember nobody's ever died from cholesterol nobody's ever died from an ldl particle it's only ever at the best dissociation data so the big units now are now doing lipid subfraction analysis and so if anyone's got questions about and certainly before they take on a lifetime of statins they should request a lipid subfraction analysis in australia it's about eighty dollars depending on where you have it done incredibly cheap test and i've had a couple of cardiologists say to me that if would i stop screwing with their head because i've got patients of mine that go to the season with an elevated cholesterol elevated ldl they want to put them on a statin and then they come along at the same time with the lipid subfraction analysis and it's completely undermined their thought process and i've got a couple of cardiologists have come around to our you know our paradigm based purely on that lipid subfraction analysis very useful test available in most western countries and i realize it's not everywhere but it's don't don't start a statin until you've proven it go ahead tim yeah can i just say that in my talk i started with that thing that we don't know the cause of coronary artery disease we simply don't know the cause and it's not cholesterol because i made the point that if you treat peach patients with something that will lower their cholesterol by 30 you essentially don't do very much to their risk for coronary artery disease if after if cholesterol was the cause you would reverse the disease and it would not appear and that has never been shown conclusion is we know the reasons for people developing heart disease and gary's spoken about them the lipid subfractions are a reason but they're not the cause and you really need to understand that and also i referred to the mr fit trial at length which was this incredible study where they took the people at the highest possible risk for coronary artery disease they modified all their so-called coronary risk factors which are not risk factors they are reasons for developing the disease they are not the cause and nothing happened the only benefit was to stop smoking so that's the basis that's the evidence base on which we giving all our nutritional advice about lowering cholesterol we don't know the cause we know that cholesterol is not the cause but we don't know what the reason the causes of coronary artery disease are so the whole discipline of cardiology is based on on falsehood which has not been scientifically shown and we have to get the people to understand that that it's it's the only factors that we think might be linked to coronary artery disease are insulin resistance high carbohydrate diets and diets high in polyunsaturated fats that's the best guess we have at the moment but it's still a guess but it's a lot better than the cholesterol guess paul i know you've been following the lipid subfractions for quite some time and i know your thoughts have changed over time can you give us where you're at right now with the patients that you're treating with the patterns of the subfractions well i guess my i think my thoughts are essentially the same in terms of modified ldl is the ldl that potentially is atherogenic let's see uh if we have a healthy what we call a native or a physiological ldl population that does a job it's there for a reason but if that gets damaged in any way and that becomes the small dense stuff um then that potentially can get deposited on the inside of the walls the interesting thing that i've been learning is that uh there's multiple stresses that all come down under the heading of glyco oxidation so sugar damage through glycation oxidation damage and eventually the formation of what we call advanced glycated end products and these are actually uh synergistic processes so the initial question you uh you posed today was the relative uh deleterious nature of say fructose versus seed oils or sugar versus seed oils in actual fact they work synergistically together to harm us so this process of forming these advanced glycated end products first of all requires glycation and the second phase of that process is strongly not solely but strongly driven by oxidation stress and i've noticed that say a state of hemochromatosis which is associated with increased oxidative stress has increased oxidation of ldl i've noticed that if somebody has a very high diet that's high in olive oil this has been a very uh interesting thing for me i noticed that you end up with a slightly modified ldl population and often eliminating olive oil from the diet and replacing it with more saturated fats will then lead to normalization of that ldl peak into that normal native physiological curve so it's this uh this understanding that it's the balance of glyco-oxidative stress through a number of causes and number of inputs and i feel i'll probably um should put a shout out there for the coronary artery calcium score i'll be there some questions coming up and there'll be a very upset irishman if we don't mention this essentially the the ldl subfraction is actually a fantastic tool for seeing uh whether the ldl currently in your circulation has the potential to contribute to atherogenic plaques but it doesn't tell you about history and i think the coronary artery calcium score is a very very good indication of giving us an idea of your overall cardio vascular risk and i think it's certainly got much better predictive potential than any blood marker we could do and certainly if i have any um any shadows of doubt about somebody's risk then i have a low threshold for requesting a coronary artery calcium score so look we're going to wrap up in a couple of minutes if i could ask everybody and i'm going to start with rod and finish with tim to try and give us 30 to 45 seconds i guess of just some advice that you might give to somebody and it doesn't have to be about anything specific just something a little thought of yours that you a useful tip that you found something to do with low carb over the the years i mean rod you've spoken to tens of thousands of people run lots of conferences uh any just you know a little bit of a thought process that somebody could could take be useful if they're thinking about keto or low carb type lifestyle yeah well essentially what we eat is very important and we've got to be very careful to minimise processed foods we also want to know how we're traveling we want to have long and healthy lives and to that extent we want to speak to people healthcare professionals who understand nutrition and the roles of the whole food nutrition that we're talking about so it's important to find to find out all you can it's important to find people to help you along the road it's important to get metrics done including the coronary artery calcium score which paul's just alluded to for those as we you know reach a certain age so for a long healthy life uh these are some of the things we need to do thanks uh rod gary do you want to go next for us two things um to explaining the whole concept i talk about a wood fire you've heard a lot of people heard me talk about it into a wood fire you've got a choice of putting kindling branches or logs the kindling burns hot and fast and requires opening and shutting the door a lot and into our cells they require acetyl coa and you've got a choice of putting carbohydrates proteins or healthy fats and if you put in the carbs you're going to be opening and shutting the door that's called insulin resistance over a long period of time so put in your branches and logs it'll burn slow and steady and all of a sudden you've avoided healthy health issues in summary lchf by definition is eating fresh local seasonal food that doesn't come in a cardboard box or a plastic bag and doesn't have a label on it so if that's if that's ever considered dangerous then we're all in deep bottom because that's all we're advocating fresh local seasonal food and the other two analogies i try to get through to my patients every day and it seems to work in getting the message across i know that lchf works but the message is what we're trying to get across thank you great paul look uh so i might uh let somebody else go first because i've just got an announcement or two um to finish this off with as well uh all right well look but before i go to tim carl franklin's in the background and he's been doing a fantastic job so tim why don't you give us your your words of wisdom and i'll let paul wrap things up after that but thank you all for being wonderful panelists and answering the questions yeah thanks darren and thanks for thanks everyone for allowing me to participate it's been very illuminating and i've learned a substantial amount from everyone today so thanks very much for that okay so i was the original guy who promoted the high carbohydrate diet which which almost killed me and i then realized that i was on the road to disaster and managed to change and all i can say is that i have absolutely no doubt that the most important change you can do in your life is to eat the low carbohydrate diet it is it is crucial and it's it's vital for our profession to acknowledge that and to start promoting it and not to continue making people unhealthy by promoting diets that are profoundly unhealthy and are now known to be unhealthy so my message is very simple get into the low carb lifestyle because it's going to change your life and improve your health dramatically and there is nothing that is as powerful as a low carbohydrate diet to improve health medicine has found nothing that is superior to that so that's my message and thanks again for allowing me to participate in this remarkable conference really truly words of wisdom and i think that's very important so paul why don't you wrap up for us uh before we go back to the live stream well i think that the more i look into this it health is more than just one isolated macronutrient or micronutrient it's the whole package and it's it's diet and i was absolutely fascinated with tim's talk talking about how early in history we started having deviations from a natural diet how early these polyunsaturated fats actually come in you know over 100 years ago it's a lot later than you know we tend to think about these things in terms of the 1970s but this has been going on for a long long time and the closer we get back to uh evolutionary style diets i think the better health we have and it's not just diet but it's an evolutionary style in lifestyle so something like sun exposure which here in australia we're almost allergic to we've got a quite a strong public health messaging against all sun exposure certainly some sun exposure can be dangerous but sun exposure at the right time of day and the shoulders of the day when the sun's low in the sky actually appears to be quite healthy we probably don't promote an active lifestyle enough we probably don't promote enough activity we certainly don't promote sleep enough and it's all of these pillars you know we need to have good relationships good sleep good good exercise good diet it takes all of them to be healthy and certainly with my patients it's not just a conversation about how many grams of carbs you're having that that's just such a minor part of being healthy as a person um just with regards to i'd like to thank everybody who's participated today everybody's been incredibly generous with their time and their effort in terms of putting all the lectures together and providing the content and uh thank you tim it's uh as i said earlier it's a combination of uh an editorial by yourself and by peter bruckner that was really quite um formative for my journey so i'd like to thank everybody for being involved all right thanks very much everyone thank you everyone guys thank you thank you [Music]

Channel: Low Carb Down Under

Views: 60,329

Keywords: Low Carb Down Under, LCDU, www.lowcarbdownunder.com.au, Low Carb International All Stars, #LowCarbAllStars, Timothy Noakes, Doron Sher, Low Carb Doctors, Gary Fettke, @fructoseno, Rod Tayler, Paul Mason, Noakes Foundation

Id: yywNw9hH2B4

Length: 59min 13sec (3553 seconds)

Published: Sat Dec 26 2020