Dr. Chris Palmer: Diet & Nutrition for Mental Health
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Welcome to the huberman lab podcast, where we discuss science and science space tools for everyday life. I'm Andrew huberman and i'm a professor neurobiology and opened ology at stanford school of medicine today. My guest is doctor Chris palmer.

Doctor Chris palmer is a medical doctor specializing in psychiatry at harvard medical school. He is the world expert in the relationship between metal bolic disorders and psychiatric disorders. He treats a variety of different conditions, including psychosis, including schizophrenia a as well as attention deficit, hiper activity disorder, obsessive compulsive disorder, anxiety disorders and depression, among others.

He is best known for understanding the relationship between how metabolic and these various disorders of the mine interact. And indeed, today he describes not only his own fascinating journey into the field of, but also his clinical and research experience using diet, that is, different forms of nutrition in order treat very psychiatric disorders. He described some remarkable case studies of individuals and groups of people. We've achieved tremendous relief from the types of psychiatric disorders that I just mentioned a few moments ago, as well as new and emerging themes as to how metabolic and the mind interact to control things like obesity. Indeed, he raises the hypothesis that perhaps obesity, in many cases, is the consequence of a brain disfunction, as opposed to the consequence of a meta diffunce that then impacts the brain.

During today's episode, he shares with us his overriding hypotheses about the critical roles that might a construal function and this function play in mental health and mental illness, and how various particular types of diet, ranging from the kito generic diet to modify ketogenic diet and even just slight adjustments in carbo hydroid intake, can be used in order to change my doctoral function and bring relief for very psychiatric illnesses. He also had relates the essential and important theme that various diet interventions, including the key to generic diet, we're not first developed for sake of weight loss, but rather were developed as treatments for neurological conditions such as epilepsy. Today, he shares with us how the foods that we eat alone and in combination, and how fasting, both intervention, fasting and more lengthy, fast, can interact with the way that our brain functions to strongly control the way that we think, feel and behave.

What's wonderful is that doctor palma not only explains the science and his clinical expertise, but also points to various action measures that people can take in order to improve their mental health. I'd like to mention that doctor palma is also the author of a terrific new book. The title is brain energy, a revolutionary breakthrough in understanding mental health and improving treatment for anxiety, depression, O, C D, P, T, S D and more.

I've read the book, and IT is a terrific read. I came away from this book with a much evolved understanding of how the very atrix disorders that I just described, as well as adhd, emerged in people. And IT has completely revised my understanding about the possible origins of various psychiatric disorders and the best ways to treat them, including both with medications but also with nutritional approaches.

If you'd like to learn more about doctor palmer's work and the book, please go to Chris palmer, md dot com. We also provide links to the book into his website in our showing te captions. Before we begin, i'd like to emphasize that this podcast is separate from my teaching and research roles at stanford.

IT is, however, part of my desired effort to bring zero cost to consumer information about science and science related tools for the general public. In keeping with that theme, i'd like to thank the sponsors of today's podcast. Our first sponsor is element.

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Chris, doctor palmer, thank you for being here. Thank you, Andrew, for having me. I have a lot of questions for you.

And i'm really excited about this topic because I think most people know what mental illnesses, or they have some idea what that is. Most people have some idea what nutrition is. Fewer people certainly know how closely those things can interact. And I think everybody y's familiar with the feeling of a food or the injections of a food, making them feel good in the short we need a food that takes delicious to us, that we associate with something nice.

And we feel good mentally and physically, whether when we eat something that gives us food poisoning, or maybe even something that just doesn't taste that great, or that we associate with a bad experience, we feel less good in the short term. But I believe that very few people understand or are familiar with the fact that nutrition and our mental health interact in this very intimate, maybe even calls away. And that is something that occurs over long periods of time, meaning what I ate yesterday, the day before, maybe even ten years ago, could be impacting the way that my brain and body are making me feel now. So if you would, i'd love you to just tell us about, no, but that the history, in particular your history with expLoring the relationship between nutrition and mental health, and then we can dive into some of the more particulars of key eric diets versus other diets and some of the truly maculate findings that you and others are are coming up with um based on real patients and real experiences of people who suffer and then find relief by altering their nutrition.

Sure you know I the story really starts with my own personal story and uh uh I don't need to go into great detail but uh to set the stage when I was a kid I definitely had mental illness started with A C D A series of events happened in my family. My mother had a horrible kind of psychotic c break um and all sorts of adverse childhood events for me. He and I were actually homeless together for a while.

Um I went on to have subsequent depression, suicide, all sorts of things the one hour another I pulled myself together um and got through medical school actually did quite violent medical school got an award for being one of top students and then was doing my internship and residency harvard and and at that point in time I was diagnosed with meta lic syndrome so had high blood pressure, horrible lipids and prediabetes and I was doing everything right. Supposedly I was on a low fat diet and I was exercise regularly. And year after year my doctor kept telling me diet and exercise.

I kept asking him what diet, what exercise I was doing, everything he kept telling me to do, everything was getting worse. My bd pressure kept going higher. And and at some point he'd trying of said, you've got ta have to go on medication. I need to put you on something for your credibility, something for your cluster and something for your blood pressure. Three pills out out of the gay and i'm like, i'm only .

my twice where .

you overweight? No, technically no. I had A, I had a gut.

So you know, that's a sign of in some resistance I know now I didn't know then but um and he actually kind of lean dinner one point instead you know, do your parents have diabetes? Yeah do your parents have high blood pressure? Yeah the parents over way yeah oh, i'm really sorry.

It's genetic um basically your screwed. It's your jeans. You just have to buy the bullet and take meds and as a physician I knew what that man I knew that I mean my twenty is if i'm already on three meds for melik syndrome, i'm gonna screwed by the time i'm forty or fifty, and i'm probably gonna having heart attack.

And, uh, and i'd heard through the rumor, male, that the atkins diet could somehow help people improve their classical and prediabetes. I actually didn't really believe that. I was highly skeptical and know, I believe everything I was taught in medical school. Why would why would my professors lie to me that they knew what they were talking about?

Low fat diet was the thing to do um and the kinds diet was clearly dangerous and reckless and but I had been trying the medical dogma for years and IT wasn't working for me and so for whatever reason, I decided this is going to be my last attempt at something different and then i'll just bite the bullet and go on bed so I tried the accs diet. I did my own special version of that. I still avoided read me because I was terrified of read me. You know, I tried to do a healthy version, which is probably more like the south beach. I know this was before the south beach I was invented, but um within three months my metal abc syndrome was completely gone .

to blood pressure Normalized, lipid ds Normalized, did you wait change? Or is that you mention that you are a healthy weight, but that you .

had a bit of abdominal? I lost the abdominal and I probably lost about, you know, ten pounds through this process, and but everything got Normal. And when I went back to my doctor, he was shocked. He actually said, what the holiday doing .

during the time before you switch to this new diet, how was your mental health, if you don't mind me asking, because this sound like you, you're very clear that there was metal bolic syndrome, or you are headed IT towards more severe meta lic sync. Me, you mention ocd. I actually familiar with this. As a kid, I had a low level kind of treat grant, and probably obsessive still to some extent, although not blown clinically diagnosed ocd. So I can relate somewhat, if you're willing, what was the context of of all that before and after this nutritional switch?

So before the nutritional switch, I was still struggling with low grade depression. And O C D A I um again, IT wasn't necessarily interfering with my ability to function because I was functioning at a high level. I mean, anybody looking from the outside, you're a top student.

You just got into one of the most competitive actually at that point. IT was the most competitive residency program in the country for sketch. So they would have looked at me and said, you're fine, but I wasn't I was actually on medications.

I was trying different medications, trying to figure out how how feel Better, how to stop obsessing so much, how do not be so depressed um and I found that those medications. They they actually came with more side effects for me than benefits that was on project for a long time IT totally messed up my sleep. And then the psychiatrist was like, you need pills to help you sleep now.

And i'm like, that doesn't that's not really resonating very well with me. And i'm now as syria rist. I'm in my psychiatric residency and i'm thinking, you know what? That's just not sitting well with me that you're going to prescribe more and more meds for all the side effects that you're causing.

And yet, at the same time, I wanted to feel Better, and I was learning chemical imbaLances. This is what we do to get rid of depression and no CD. You're supposed to take your pills.

And so I was taking my pills. I was in psycho therapy. I had been psychotherapy on an offer years. Um I had received much more intensive treatment when I was Younger and that was essentially worthless for me. IT actually probably just causes harm at the .

end of the day.

Psychoanalysis, various psychotherapy, not psychoanalysis persae, but some of them more psychoanalytical oriented psychotherapy has actually hospitalized at one point um uh had been put on lithium and amid premium, which is a cycle hanted a present and other things and they are they were actually horrible. They were horrible. They did nothing beneficial for me.

Um I gave them a decent amount of time to work. I really wanted to feel Better. Um so at the time that I tried this diet, I certainly wasn't impaired in the same way.

I wasn't struggling that much, but I was still have these low grade symptoms, was trying to feel Better. And the thing that was the most striking to me after doing the diet for three months was not the fact that my meta lic syndrome was gone. That was my goal.

And IT was a you seemingly maculate achievement, because I got rid of everything with one dietary change. But the thing that I noticed was dramatic improvement in my mood, energy, concentration in sleep. I for the first time in my life, I started waking up before my alarm lin off and feeling rested.

That never happened to me before. I, I was meticulous about planning when my alarm went off and how many times I could push the snooze button in order to be on time for wherever I needed to be, whether was school or the hospital or whatever. Um I had A I had a good system.

I was never late for anything but a that was shocking to me that I felt so good. And you know, one of the things that i've often said, the people prior to the diet, I always felt like there are two types of people in the world. There are half and have nots.

There are these happy puppy people who just are so positive and you've got energy and they have these the saying, they like to work hard and play hard. And I always understood working hard. I totally got that because I was a hardworking er and I understood the value of hard work.

And you know, you got to do something useful with yourself. But I never understood who the hell wants to play hard. Like who's got energy for that? Like, aren't you tired from working so hard? How on earth do these people have energy to go and play hard? And I assumed that they were just part of the half in the world and they were just lucky and privileged. They either had good genetics or maybe they had good, good childhood's or good parents or something something that I .

didn't have the kids with .

genuine smiles in the year .

books ah where the rest the rest and by the way, I really appreciate you sharing some of your personal story because I think IT is very important for people to hear and understand that people like yourself who are extremely high functioning and accomplished, that the road was from everything i'm hearing and understanding very choppy internally at times and that you've overcome a lot in order to get there.

And also have um been going through what sounds like a very long iterative process of trying to figure out what works and what doesn't work to finally arrive at a solution and then make that the basis of much of the work that you're doing today for other people. I think it's very important because I think many people share with you this notion that there are are the two groups a happy group and and faded to be unhappy group. And IT speaks to the fact that your story rather speaks to the fact that what we see is not always what's going on internally with people, and that this notion of there just being two groups, the happy or the haves and have nots, can't be the way that IT works.

And there are probably many more people suffering than we realize and that there is an important need for tools to overcome that suffer. So I really just here even early in our discussion, I just want to extend genuine thanks because um so much of what I hear from people is no questions about health and mental health and YSL health but that clearly point to the fact that many people are strugling to varying degrees and even the people who are in this category of great childhood and and happiness could do far Better for themselves and then also for other people. So thank you for that.

I I want to know at the point where you realized that nutrition can play a profound role in how you feel and Operate in a large number of domains. You are still a student or a resident at that point, as a resident at that point, did you decide that you were going to explore this in a professional context? not.

yes. okay. So what what was the journey forward into the the work that you're doing now?

So so the next step was that I just had friends and family who saw me, saw that I had improved my health, saw that I lost some weight pretty easily um in particular remember, like my sister and sister in law, they would got really pissed me one thanksgiving because I could resist all the pumpkin and apple pie and everything else they were like, how that how are you doing that? How are you resisting all of this food? And I said, I don't crave IT anymore.

I don't want IT. I'm fine. I'm just i'm having turkey and Green beans and and that's good enough for me so I got them to do the diet.

And they too noticed dramatic improvement in their moods and energy and sleep and anything else. So within a few years, I I like the primary thing I noticed is this powerful enter depression effect. And now i'm, you know, an attending physician.

I've got all these patients in my clinical practice with treatment resistant mental illness. I'm an eternity care hospital, so I almost never get somebody off the street with their first episode of depression out of the gate. As part of my career, I get treatment resistant mental disorders, so I get people who've already been to six plus psychiatrists, therapists.

They've usually tried dozens of different medications. They're been in decades of psychotherapy. They've often had E, C, T. And other things, and nothing's working. And i'm thinking, you know, what were kind of out of options for these other people, and this diet is having this really powerful anti depression.

Of fact, I think i'm gonna try IT and just see if any of my patients are game to try IT to see if that might help them. sure. ugh. I did didn't help everyone, and not everybody was interested and were able to do IT. But but some of the ones who are able to do IT ended up having a remarkable and powerful enter depressing effect.

One woman actually became hypomanic within a month, and SHE had been depressed, pretty much non stopped over five years, chronically depressed, suicidal, in and out of hospitals and I saw her become hyper manic and i'm thinking, wow, this really is a powerfully and to the present effect like this is amazing this is like a medication but Better because IT actually is working for her and um but I laid low at that point because at that point we didn't have many clinical trials of the safety or efficacy of the actions diet for even weight loss or diabetes that loan any mental disorders and so I really actually felt like i'm on the french here and this is not going to be met with with praise by anyone. So i'm just got to lay low and to offer IT to patients. And a and I I went along the way up until twenty sixteen.

Um IT may just ask about the diet. We say act in diet. So this is low to zero starch, a low carbon hydrate diet, certainly low sugar yes. And was IT traditional actions or were you tailor oring IT to the individual patient depending on their psychiatric symptoms, whether not they were overweight or not overweight?

Um i'm assuming you're not a nutrition, so how did you prescribe a nutrition plan for your patients? And what was involved in making sure that they had heard to that? Maybe even some of the things you've observed in terms of who was more willing to try this or not try this, any observations or and even data.

So early on I was winging IT. You know, the the first few patients IT was try this actions, diet. I wanted see key tosa. So I was going for key tone.

So they were pricking their finger and they were doing .

a blood ketone test. I didn't know about blood d key tone monitors if they existed back then. So I was we were using your own step.

which are not quite as accurate but still useful as a general guide from what I understand. Is that right?

Absolutely ay. And so so I was strongly recommending the patients achieve urinary key to sis. And the interesting thing is I noticed a pattern that when they were trying to diet and not getting key tones, they often did not get a clinical benefit. IT was once they got indicate tos, that I began to notice the clinical benefit and um that the powerful and present effect.

So probably any nutrition plan, A K diet that elevated key tones in the urine to the point where you would say this person is in key tos where they would say i'm in kito us. That was a step in the right direction, independent of like exactly what they were eating or not eating to get there and including fasting that time, probably fasting wasn't as popular. Now thanks to the incredible work, I think it's incredible.

And he is a former colleague. And I know there's a lot of controversy about fasting, but I think for many people, fasting is a powerful tool for others, it's a less useful tool, but of such an panda and others. But fasting certainly will limit your cover hydro intake and get you into guy tos is correct. Did you have any patients fast or do you intermit and faster?

I did so and and we had I had patients who did what actions had called a at fast where they eat primarily fat um so they either fast and or they eat primarily fats to try to get into a state of key tosa. So for some patience, IT was actually quite easy to get in tiki toa, especially overweight and obese patients. They have a lot of fat stores on their body. And actually limiting carbon hydrate usually results in high levels of key toes for them.

And they probably feel Better to, I imagine, because when we limit our starch intake, we started to agree a lot of water people can get some pretty quick weight loss that even though they may not be, fat loss makes them feel literally little lighter and maybe a little more energetic.

Is that absolutely. And um and as the years went on, you know, the field was advancing. More research was coming out. People were getting a little more sophisticated with blood key tone monitoring, with different versions of key to gene diets. And I was of valve, my practice.

Um the thing that completely up ended everything that I knew as a psychiatry though, was when I helped the patient in twenty sixteen lose weight. So this was a patient, thirty three year old man with schizo effective disorder. He'd been my patient for eight years now. Could you clarify .

for me what schizo effective disorder is? I am not a clinician, but as I recall, it's like a low level of his zophernes. So there might be some auditory fluctuations. If I met this person, I might think they're kind of different and quite weird, but they would not seem necessarily but the scarily to me to typically to other people and I mean that with with respect, of course but often times people skip free and can seem just like you don't even know how to interact with them because their world seems so altered um because they have all these so called paul ve symptoms of these nations and they are talking of people that no one else can see that that .

is that schizo effective. So no, actually so skidoo effective is the same as schizophrenia centrally. The only difference is that schizophrenia a with superimposed mood episode.

it's actually more severe than IT can be OK.

So I A card, so skip effects disorder is essentially schizophrenia and plus the mood pisos .

may the one thing is gets a typo.

is a typo is the low grade kind of mild paranoia, you know, kind of eccentric beliefs and other things? Okay, so I I focused out.

I have my nominal clatter backwards, gets a type, is the coin at lower low level skills of any or schizoid like skids effective is as full blown .

schizophrenia plus full blown, usually by polar.

And now it's absolutely clear through the thank you for that reminder.

No, no worries. So so this may had skidoo effective disorder. He had, he had daily auditory cino. He had paranoid delusions. He could not go out in public without being terrified.

He, uh, he was convinced that there are these powerful families, that they had technologies that can control his thoughts, they could broadcast his thoughts, thought that people, they were trying to hurt him, they had targeted him for some reason. He wasn't quite sure why he had some suspicions and beliefs about maybe when he did this bad thing when he was eleven years old. That's why they decided to target him. This man was tormented by his illness, tormented IT, ruined his life. He had already tried seventeen different medications, and none of them stop his symptoms, but they did cause them to .

gain a lot of weight. These are medications, as I will call for, sees a friend, that classical ones are dopamine cept or blockers cause people the huge increases in process. And that's why sometimes men will get breast development. And they'll put on a lot of way, be at make or movement disorder, make you feel like I have to imagine, given how good most things that releases dopamine make us feel, that blocking dopamine e receptors with antipsychotics .

makes people feel lousy, horrible and uh and and it's a huge chAllenge in our feel because a lot of patients don't want to take them and uh and then you get these rebound effects if patients are on them for several months and then they stop them called turkey, they can get wild. This psychotic and ill end up aggressive for hospitalized or sometimes dead. So so that's him.

He was three hundred and forty pounds, and for whatever reason, he gets IT in his head. I never get to a girlfriend if I don't lose some weight. He also recognizes, I never get a good girlfriend because i'm a loser.

I'm schizophrenia ic. I live with my father. I know I have nothing going for me, but I could at least try to address one of these awful, horrible things about myself, and maybe I could lose some weight.

So he asked for my help. For a variety reasons, we ended up deciding to try the cute tonic diet. Now, at this point, I have no anticipation that the pediatric diet is going to do anything for his psychic c symptoms, because this man has kiss of effective disorder.

That's not depression. Depression is very different. They're totally different disorders. So he decides to give them a try within two weeks.

Not only does he start losing weight, but I begin to notice this dramatic anti depression effect. He's making Better eye contact. He's smiling more.

He's talking a lot more. I'm thinking, like what's gotten into you? Like you're coming the life like you i've never heard you talk this much.

I've never seen you so excited erb present or alive. I haven't changed his mind at all. The thing that up ended, everything that I knew as a psychiatrist, was sixty eight weeks in.

He spontaneously starts reporting, you know, those voices that I hear all the time. They're going away and he says, you know, you know how? I always thought that there were all these families who were controlling my thoughts and out to get me, and they had targeted me.

And I think I know we've been talking about that five years. We can talk about that again. He says, you know what? I now that I think about, I don't think that's true.

And now that I say, that sounds kind of crazy IT probably never was. I've probably had schizophrenia all along like everybody's been trying to tell me and I think it's going away. That man went on, he's now lost one hundred and sixty pounds and captured after this day.

He was able to do things he had not been able to do since the time of his diagnosis. He was able to complete a certificate program, is able to go in public, can not be paranoid, he could. He performed, improve in front alive audience.

At one point, he was able to move out of his father's home and lived independently. And that. Completely blew my mind as a psychiatry, and I went on a scientific journey to understand what in the health just happened.

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And they'll give you a year supply of vitamin d 3k two again， that's athletic Greenstock comm slash huberman en to get the five free travel packs and the year supply of vitamin d 3k two。 I have a couple of questions. First of all, did he stay on any kind of antibiotic or other medication? If so, where the dosages adjusted? Excuse me, while undergoing this remarkable transition because as we know, it's not an neither or medication or nutrition changes that can be both.

And then other questions. One of the hearts, you know, I think about someone with skills, effective disorder, whose suffering from all the source of things that you described, how does somebody like that organized themselves in order to stay on a key to generic die? And I say this with all the seriousness in the world.

I think there are a lot of people who do not have schizo type or schizo fecal disorder who have trouble they claim and hearing to a kidgin ic diet. It's not the easiest diet and certainly in in its extreme form at first, it's not the easiest diet to to stick to. So how did he do IT? This sounds like a remarkable individual um and i'd also like to just know your general thoughts about um adherents to things when people are back on their heels mentally, how get motivated and stick to something. So the questions were medication yes or no, if yes, dose adjusted yes or no. And if people are suffering from depression or full blown psychotic c episodes, how does one ensure that they continue to add here to a diet?

So in terms of medications, he has remained on medication. So early on, I wasn't adJusting anything. I was disbelief and shocked that this was happening.

I didn't know what was going on. Over the years, we have slowly but surely tried to taper him off his mads. He has been on meds for decades.

He started medications when he was a Young child. His brain is is developed in response to all sorts of psychiatric medications. And IT has not been easy to try to get him off.

So we are we continue to try to get him off medication. And it's chAllenging and difficult. And I just want to say for any listeners, IT is getting off. Your mads is very difficult and dangerous and you need to do IT with supervision with the um a mental health professional or describer um because this is dangerous when people produce their much too much they can get wildly symptomatic.

This is that true for depression as well?

It's true for any psychiatric medication that the brain makes out aptamer in response to psychic c medications. And when you when you stop them called turkey, uh, you some people are fine, but I wouldn't I wouldn't recommend finding out because i've seen patients when they stopped enter the presence. I've seen patients get fluidity, depressed and suicidal.

Within three months, I had one patient almost quit her job because SHE became convinced that, you know, well, my life sucks and it's all because of my boss. And I know that she's just, you know, horrible human being and she's abusing me. And I was like, wow, wow.

W I think this is related to your medication change. We got her back on our meds within three days. SHE said, oh my god.

I can't believe that happen. Like, I almost quit my job. And that would have been the most ideological and irrational decision i've ever made in my entire life.

But somehow IT seem so real to several days ago. And now that i'm back on this medication. And IT doesn't mean that he needs the mad, but IT doesn't mean that he needs the mad.

That means that mads need to be adjust that very safely and cautiously and gradually. So that's the medication piece. The adherence ance peace was not easy for humor for other patients.

It's very rare that I have a patient who I can say, do the key to genet comes, see me in three months and let me know how go on that. That almost never happens. That has happened, I think, on two occasion.

But that is, if I understand correctly, what perhaps not you, but many psychiatrists do with medication. It's here's your prescription. Let's talk in in, yes, a month, three months.

So that's a variable that is probably worth us expLoring a little bit here as the conversation continues. absolutely. You know that frequent contact and making microprocessors or micro o adjustments to medication or nutrition could be meaningful.

absolutely. So with that, with this particular patient, you know early on, he was actually pretty here. And I was seeing a once a week ah and so I could do a lot of education.

I was wearing him. I was checking his key ones. I was checking his blue cose levels that point. I had a blood keystone monitor in my office so I knew whether he was compliant or not, which is so beneficial in doing clinical work and researched on this diet is the only diet or within seconds I can have an object biomarker of compliance or non compliance .

uh uh such a key point and again brings to mind for me the parallel with medication. I mean a patient can say they're taking their medication and unless you're in a hospital setting where somebodies checking under their tongue and you know all of this that they very well could not be taking IT or taking more.

And um you and I both know that blood draws for newer transmitter or levels are complicated because you want to know what's in the brain and what's functional in the brain. So and we have to imagine that most people, they are prescribed drugs for any number of different psychiatric conditions, are not giving blood every time they talk to their psychiatrists, psychologists. No.

no. And when we've looked at you know on that front, when we've looked at studies of compliance, the the majority of patients are at least somewhat non compliant with prescription medications. It's not on purpose.

It's it's forget they forgot they take IT at night. They were out late. They were off their routine.

They forgot to brush their teeth because that's when they take their mads. And so because they, you know, I was so late, they just crashed when they got home. They forgot to take their meds.

Happens all the time. If it's a medication that people take more than once a day than non compliance, rates are much higher because it's just easy to forget. So it's not that people are willfully you disobeying their doctors or anything else. Just hard to remember to take mads consistently everyday when you say .

um measuring key tones. I want to drill into this a little bit IT because IT does seem that the presence of key tones and somebody being correctly in key tosa turns out to be the key variable certainly in your book. That's what I one of the major take away.

Although there are many important takeaway um that people get into key tos, do they have to stay in key tos? So for ces i've followed the I don't any longer but i've tried in the past the so called sick t ky ogen ic guide where every third fourth day yet some pasta rice at sara um and that not that was interesting as an experiment but to stay in key tos, what sort of blood levels of key tones do you like to see in your patients? What is the range that you think most people could uh, aspire to?

So IT really depends on the patient and what i'm treating quite honestly. So and I don't think every patient needs the key to genetic diet. For some patients, simply getting rid of junk food can make a huge difference in a mood disorder, for instance.

So a junk food, meaning highly processed food, they could last on the a very long time.

highly proceed foods that are usually high in both sugar, carbon hydrate and carbs and fats. Those seem to be the worst food that combination high sugar, high fat um seems to be the worst combination from meta lic health. And long behold, we've got emerging data that suggests that strongly suggest it's also bad for mental health.

Depression and anxiety are the most common mental disorders until we have the best of data for those disorders. But we actually have a lot of data with even bipolar disorder. And because sopha nia, that instant resistance, in particular an instant signaling in the brain, is impaired in people with chronic c mental disorders kind of across the board, all the way from chronic anxiety, depression to bipolar, schizophrenia and even alzheimer's disease.

We know that patients with all of these disorders have impaired glue cos metabolism and the the instant signal system in the brain, which is different than instant signals in the prophet um IT seems to somehow possibly be playing a all so so to step back from that. So for some patients, I might just want to decrease glue coast and instant levels, and I can do that by getting rid of sweets. For other patients like patients with schizoid effective disorder, schizophrenia, bipolar disorder, especially if its chronic, i'm using IT as a brain treatment um then I do want a kito gene diet and I usually want reasonably high levels of blood key tones. Usually for for depression I want to see at least greater than probably zero point eight little more for for psychotic disorders and bipolar disorder, I usually want to see levels greater than one point five. That's what i'm shooting for if at all possible um and um so yeah I that I I think that's what I go for yeah so and so I didn't mean to imply .

that you people need to be in key tosa in order to see some mental health benefits from changing their diet. You make very clearing your book and will go into this in more detail that avoiding insulin resistance, reversing insulin resistance and essentially trying to reverse what. Earlier described as of this meta lic syndrome, which is a bit of different things, is the target.

And for some people, getting rid of highly processed foods and focusing mainly on non processor minimum proceed foods will really help for others. Going straight to the full bonito genre guy will be a most benefit. I'd like to back up a little bit in history and get to something which I find incredibly interesting, which is epilepsy in the long standing use of geology, guy in fasting to treat epilepsy.

And the reason I want to rewind to that point in history is that I think that for a lot of listeners and people out there who are familiar with how changing your diet or changing your exercise can positive ly impact sleep and wait in all these things, and that cades into feeling Better. That makes perfect sense. But for a lot of the world, still, the idea that changing or using nutrition as a dissection tool or as a treatment tool to understand and treat mental illness is still a kind of horrendous idea that to them, that kind of falls in. Okay, well, that's like a woo science or something like that. Obviously your board certified physician and psychiatrists, arguably one of the finest medical schools in the world ever, medical school, you know, know him in the stanford side knowledge, we acknowledge our .

east coast of the west cost.

When I got to talk.

I can talk that argument could .

go back and forth the number of times you this is you're a serious clinical and serious scientist and your serious thinker. But for a lot of people out there, the notion of using diet, they immediately think, oh um well, that makes perfect sense or I think there's a category of people who think, well, yeah, didn't actions die of a heart attack you know I hear that a lot. So like that was crazy.

You know like people immediately discarded the kin's diet for that reason um which I do think is storing the baby out with the bath water. But it's an interesting thing nonetheless. Then I think that the majority of people sit in the middle and just want to see science and medicine come up with treatments that work.

And I had to say i'm very a relieved to hear what you said earlier, which was you never said that people should come off their medication and just become going a kito Jenny guy and everything will be cured. You're certainly not saying that no. And rather, you're saying, if I understand correctly, that nutrition needs to be considered one of the major tools in the landscape of effective tools and that IT can be very effective evidence by the the story that you share IT. And there are many other stories in there as well um of truly maculate transformations. So let's talk about epilepsy and how the key to generic diet is not just used for epilepsy, but is one of the oldest, if not the oldest, examples of the use of nutrition to treat a condition of the nervous system that can be incredibly debilitating, even deadly yeah.

And the reality is that this literature in this clinical history and all of the research we have with the god's, and that I needed to do the work that i'm doing, otherwise I would have been discredited on day one. Chris palmer claiming a dietary change can influence schizophonia schizo fecal of disorder. That's impossible.

And he is a quack. But the thing that immediately got me credibility was I didn't focus on IT as a diet. I did a deep dive into the epilepsy literature.

So the kiloton ic diet, unbeknown ced to most people, was actually developed one hundred years ago. Twenty twenty one, buy a physician for one, and only one purpose to treat epileptic sy. IT wasn't developed as a weight last diet.

IT wasn't developed as the the diet that all human beings should follow. And the reason that was developed is because of this long standing observation since the time of that, fasting can stop seizure. Now, fasting is not a healthy diet.

Fasting is the process of no diet. But, and so we now understand a tremendous amount of science. Most people think going without food is bad, and they equated with starvation.

But in fact, when we go without food, IT causes tremendous shifts in metallism, both brain and body metabolism, and IT puts the body into a mode of autocad and conservation of resources and all sorts of things that a that are beneficial to human health. And this is why fasting has been used as a therapeutic al intervention in almost every culture and almost every religion for millennia. But but for the most part, that was all thought to be religious floor.

That that was just crazy talk. And those those stupid people wait back, then thought god cured everything. And so they fasted. They just assume that they were getting Better. Well, in one thousand nine hundred and twenty one, one physician used min fasting on a child with seizure and found that, oh, well, we hold this religious folklore stuff has up to IT IT actually worked. The problem with fasting is that you can only fast for so long before you started to death, and that's not a very effective treatment.

And this child was ingesting water, correct? Just a food elimination.

food elimination. So, no special diet. So IT was. But the problem with fasting for epilepsy is that as soon as people start eating a Normal diet again, their seizures usually come right back, often times with the tensions.

And so I can be a good short term intervention. Um you know the the faster can take a few days because I can take a few days to get key tos and then you can get some relief from chronic seizures. But it's not a good long term treatment because again, people will starve to death as soon as they start eating, just come back.

So I was actually doctor russel wilder at the male clinic who developed the kidney diet with one and only one purpose he wanted to see, can we mimic the fasting state using this special diet to see if IT might stop seizure long term and no one be hold? IT worked, you know, early results were extraordinary, ily positive. Fifty percent of patients who use the kitchen nic diet became serious free, and another thirty five percent have a fifty percent of greater reduction in their seizures frequency. So about eighty five percent efficacy rate.

Sorry to interact. I didn't mean to do that there. The IT was IT just for pediatric epilepsy or for adult epilepsy as well.

So back in the one thousand nine and twenty years, we didn't have many anti epilepsy treatments and a lot of adults were struggling as well. So they were using IT on anybody who would do the diet um by the one thousand nine hundred and fifties pharmaceuticals were coming out and we had many more anti compulsory treatments and there's no question they work for a lot of people that's great.

And taking a pill is so much easier than doing this diet. So the diet pretty much fell out of favor and nobody was using IT from the one thousand nine and fifties, about the seventies. But long behold, even to this day, people with epilepsy, about thirty percent don't respond to the current treatments that we have available.

Thirty percent will have treatment resistant epilepsy, which means they continue to have seizures no matter how many anti convultions are taking. Even if you've had brain surgery, IT just doesn't stop their seizures. And so in the one thousand nine seventies, the key genetic was reported at john hopkins for these treatment resistance cases.

And low and behold, IT works not for all of them, but IT works in about, about one third, become seizure free. And these are, people have tried everything and nothing's working. So one third becomes season free.

Another third get a clinical benefit, meaning a fifty percent of greater reduction in their season frequency. And the other third IT doesn't seem to work. It's not always clear if that's because of noncompliance or if that's because the dies just not working. But about a third, a third, the third session freedom production and seizures were just doesn't work.

Um and so the reality the god sent for me is that we have decades of neuroscience research on the eugenic diet and what he is doing to the brain, we know that the eocene diet is influencing the transmitter or levels, in particular glue mate, gaba a density, IT changes, calcium channel regulation uh, and calcium levels, which is really important in the function of cells uh IT changes gene expression IT IT reduces brain information IT changes the got microbial and there got microbial a huge topic right now and there are some researchers who argue that is the primary benefit of the gigi c diet is changing. They got microbiome in beneficial ways. Um so it's doing a lot of things.

IT obviously improves instant resistance, lowest blue SE levels, lowest inland levels, which improves instant signaling. The key for my research that i've outlined, the real magic, is that this diet stimulate tes two processes that relate to my a country. It's stimulates the process called my top gy, which is getting rid of old and effective medical ria and replacing them with new ones. And IT also stimulates a process called mitic construal biogenesis, which means that after people have done the key to gene diet for a while, months or years, many of their cells in their bodies and brains will have more medical ria, and those might will be healthier. And I believe that is the reason the key to genetic diet is such a powerful treatment, not only for epilepsy, but also for people with chronic mental disorders.

Would you want in listening off a few of the mental disorders? And I know this is not meant to be inside ball, but we should distinguish between psychiatric disorders and neurological a symptoms and diseases. The fields of psychiatry, neurology, hopefully someday will just emerge. But for instance, typically, if somebody is presenting with something that looks like alzheimer's dementia, the talk to neurologist, where, as if somebody is presenting with symptoms schizo nian bipolar, talk to psychiatrists. But if you wouldn't mind wearing a dull hat, could you just quickly list off some of the neurologic and psychiatric disorders for which key to gene, or not to say, nutrition changes have been shown to improve symptoms of significantly? And the way we can dive into a couple of these as well as get more deeply into these two very interesting aspects of medical construal function and repair in turn.

Noh, yeah. So the fuel, you know, in terms of nutritional psychiatry to broad field and is in its impending y is the real answer. If you're looking for random ze control trials documenting efficency in large numbers of patients with these disorders, we don't have them.

They're under way now, but we don't have them yet. What we do have our case studies. We have a lot of mechanistic um science papers by some of the leading neuroscientist and syria sts in the world and neurologists in the world kind of outlining.

This is everything we know that the eugenic dites doing. These are the problems in the brains of people with these chronic mental or neurological disorders. So we know that they should work, but but the disorders range from chronic depression.

Two, we've got, we've got a trial underway for P, T, S. D. We've got one actually decent pilot trial from the national institutes of health for the key to gene die for alcohol use disorder of all things.

And we can go into that a little more. We've got a couple of pilot trials of the key generic diet for alzheimer's disease. We've got and those are anomie controlled trials.

We've got case studies of the keoghs diet for chronic depression, bipolar disorder in schizophrenia. A the largest study that we've got in that mental health sphere is a pilot study of thirty one patients admitted to a french hospital. The twenty eight of those patients were able to do the diet and stay on the diet ah.

So ten percent off the back non compliant couldn't do the diet. So we need to include that. But of the twenty eight patients who were able to do, and these are twenty eight patients with treatment resistant mental disorders, chronic depression, bipolar and schizophrenia, a um of the patients we were able to do, the key gene diet, hundred percent had at least some improvement in symptoms.

Forty six percent had a mission of illness, remission of illness that does not happen with current treatments, and sixty four percent, I think were discharged on less medicine and they went into the hospital on so IT wasn't that the the people were prescribing more medicine and not why I was, they were being discharged on less medication. We got at least again, lot of the hard core scientists who got to say, show us the random zed controlled trials with hundreds of patients. And we've got five randomized control trials under way now funded primarily through philanthropy.

Um I can tell you that you know we've talked about that one index patients, but at this point, I have now treated dozens of patients and i've heard from hundreds of patients who been treated by other clinicians, researchers or have just hurt from patients from around the world who have shared stories of complete remission of long chronic mental disorders like byo AR disorder in schizophrenia. Off of psychiatric made some of them, not all of them, but some of them are able to get off all psychiatric mads and remaining remission. Again, I think I didn't say this before, but it's really important to mention for people who might be unfamiliar with the mental health field and it's connection with epilepsy.

The reason that is such an important connection is that we use epilepsy treatments in psychiatric patients every day in tens of millions of people. So a lot of people don't know this, but i'm a list of some names that a lot of your listeners may have heard of, and they probably know them as psychiatric drugs. But in fact, these are epytus y drugs, dep code text, lamictal top, max neuron ton or gaba, enton volume cleophon, xanax.

Those are all medications that stop seizure. And many of them were developed initially for scissors. But we in the mental health field quickly steal them and start using them in tens of million to people, even if they're off label.

So that means we don't have research studies documenting that they are of. But we go ahead news of anyway, because the reality is far too many patients aren't getting Better with the F, D, A approved treatments that we do have to offer. So psychiatrists are just winging in some cases, and we're just throwing whenever we can add them.

And we absolutely include apples sy treatments. So in many ways, using the key ogen ic diet as a treatment for serious mental disorders is nothing new at all. It's an establish evidence based treatment for epilepsy.

We use evidence based treatment for evolution sy across the board for a wide range of mental disorders. And so in many ways, that's all i'm doing with the other genc diet. IT just happens to be a diet.

I love IT. I love IT. And I should say I love IT because we had a guest on her early days of the podcast, is a colleague of mine at stanford, is a bioengineer in a psychiatrist, phenomenal scientists and psychiatrist called days off in the last year prize, and so so on and so forth.

He made of a really important point, which should have been obvious to me, but wasn't until he said IT, which was, you know, the psychiatrist has tools, just like the surgeon has tools, but the tools are language and observing behavior. Know, those are the disease tools for what's going on, and someone is brain. And then as a neuroscientist, you are familiar with the neurotransmitters ors and ur modulators. And you mentioned that, you know, then there are these tools of of altering brain chemistry, which are of the sorts of drugs you just listed off for anti depression or antiseptics, that fall into these major bins of adJusting dopamine or adJusting serotonin or some combination of doping, serota, appan effort, Denny, and on and on and on. And IT seems to me it's it's an incredible field, but that the field is still very much in its infancy that IT wasn't about one hundred years ago that um people were measuring bumps on the head as a way to diagnose a phonology and um that they're still so much to learn.

And so when I hear you say, you know adJusting nutrition or putting people into a key to generic state or even just eliminating highly processed sugars, that said, a ticking care of metabolic syndrome me and then observing tremendous relief in uh clinical syndromes of uh or symptoms rather of psychiatric disorders, IT makes perfect sense to me is yet another dissection tool and A A tool for altering brain chemistry. I think that if I think about the landscape of is our sociology out there of, again, IT seem to be these bins, like a third of people saying, of course, you died and exercise and social connection and limiting stress like that. That's the good stuff.

That's the stuff that we know really works. And then about thirty of people are server unclear. And then a third people think, well, if it's not a prescription drug, then IT just has no place in medicine.

And hopefully, that's changing. And certainly, the work that you're doing is this can be important in that, that transition that I think we will see. I'd like to talk about. My thai gy and my okra biogenesis. I think most people learn that the might the country are the energy um factories of cells and that indeed they are um as an error number entities.

What I know about them is that they are present everywhere in neurons, not just in the so called cell body, but you can find my a country, and in the further little bits of neurons. And neurons can be quite big, very large, in fact, meters long or more, in some cases, in some species, including, depending on all somebody is, could be many meters or several meters rather. And that meta contrary, to do a lot of stuff besides just produce energy, because I think people hear my a country energy and they think, oh, so these patients felt Better.

They lost way, they have more energy and then they're doing Better. But here we're talking about remission of auditory hu cino people feeling H A suicide, then changing their diet and feeling like life is something they can deal with them maybe even function extremely well and at set up. So maybe you just talk about my contrary for a moment and then talk about these two major effects. What are some of the other things that might a country are are important for um in neons and um and maybe other cells of the brain because as a access point for all this, I think you would be great if people could learn little about a country of biology.

Yeah no, it's so I guess the first thing that i'll say is that you know this field is one of the most cutting edge fields in medicine right now um twenty years ago or so. I think the majority of research scientists thought of my teenage a is nothing more than little batteries. They they take food in oxygen, turn to in the atp, and that's really important.

Yeah, we get that. But there is little batteries that all they are. And so one of the reasons that this work is so important is, is is, is because that combines cutting at research in the metaphor c old and the aging field, and we can start to pair IT with the mental health and neurological health field.

So ma andria, you know, one one scientists gave me this analogy. He said, if you think of the cell is a computer, a lot of people think of my to country as the power cord to that computer, because they're providing the power, and they are, in fact, the power cord to that computer. But actually the real function is the motherboard of that computer so much.

The country are directing and allocating resources throughout a cell that is their primary function, and then they happen to be powerhouses as well. And so to to give some clear examples, might a country a play a direct role in the production and release and regulation of some really key neural transmittals, including serotonin doping glute master coin? Um those are pretty powerful neuro transmit yeah .

I would call those. I would consider those. I know you listed more than three, but um the expiry colors of neurotransmitter, any one of those in access or efficiency is going to have profound negative effects on a nervous system or it's gna alter the way that people in animals feel, think, move yeah member at a and so .

as part so my country are providing both some of the building blocks, if you will, for some of those molecules, there are part of the crib c ric acid cycle. Some the, some the intermediate products actually go into making those new transmittals. Much more importantly, ma congress provide the energy for the production of those neurotransmitter ors.

And fascinatingly, meter contract are directly related to the release of neurotransmitters. Atp alone is not enough. They've been some research studies that have actually found that might a country a move along the members of the s to release batches of vehicles of neurotransmitter res and that if the market country are removed from the sens and researchers flood that cell with ATP, no, transmittals usually are not getting release.

Might the country are doing other things? We don't entirely even understand what all they're doing or how they're doing IT, but they're doing other things than just providing the power. Another really important example is that mia contra are actually the primary regulators of epigenetics, if you look at any one factor.

So one study actually found that they are responsible for the expression about sixty percent of the genes in a cell. And so in that, a country do this through a lot of ways that have been known for years, and sometimes decades. So my, a country are directly related to the levels of reactive oxygen species.

Es in ascl. They are managing calcium regulation in cells. And we know that those things play a role in epigenetic expression. We know the levels of A T P, A D P or A M P also play a role, and maa country are doing those things. But IT turns out my a country actually doing much more sophisticated things than even those in terms of gene expression.

My a country a at least play a role in all of the aspects of the human stress response so when humans are stressed either physically or psychologically, uh you know there are several things that happen um increased court as all increase a gentle in or alin uh inflation tion and gene expression in particular in the hypocrite s occa r with the stress response. And one group of researchers actually genetically modified my country country in four different ways and found that all of the stress response, all those four buckets of distress response, were impacted in one way or another, implying that my country are somehow playing a role in those. In terms of IT, the rolling court is all we know that madani actually have.

The end I required for the sentences is of steroid hormones. So that includes court is all estrogen test stone and protest some names that maybe everybody heard of and uh so that means that if ma korea are in short supply or disfunctional, the production of those hormones may become deregulated. Um might the country play a direct role in information and they turn the inflaming system both on or they they at least play a role in turning the inflammatory ory system both on and off.

I think i'm not to be able to quote the exact study and author, but one paper in cell actually identified my content is the key regulator in turning certain inflammatory cells off and that when you inhibit mdc country function, those cells don't turn off. The mini contro levels of reactive oxide species are a key signaling process to turn in for motor's process of. Another study found that macrophages so after vages are an important mune cell to play a ruling healing.

If you cut yourself, your, your body will get, send information way and a, and send a new until that way to try to heal your skin. And macro pages play an important role in that healing. One group of researchers try to figure out how do macrophage res know to switch between the different phases of wound healing because micro phaidon different things in the different phases of wounds healing.

And the conclusion of all of their research was that its my country, I mia condition are sending the essential signals that changed the state of the macrophage res to induce these different phases of wound healing. So so i've just talked about neurotransmitters, hormones, epigenetic expression, inflation tion. For anybody familiar with the mental health field, they know these are like some of the key variables that researchers have been struggling with for decades, trying to figure out how do these fit together.

We know that all of the those buckets can be disrupted in people with mental disorders, and our field has struggled to understand. But how do they fit together? How can we make sense of this disruption? And I believe once you understand the science of medical dia, you can actually connect all of the dots of the mental illness puzzle.

Super interesting little sub seller a goodies. these. My country are, I, I, I come from a field where people are often divided into l lumpers and splitters. And i'm somewhere in between. For those of you don't know, lumpers are people that like to make things really simple.

List of no more than three functions or dividing brain areas into no more than three splatters of people that like to subdivide into a ton of detail. There's a history of scientists being splitters in order to be able to name things after themselves because there's more territory to go around if you're splitting than if you're on something. Um but we are doing neither here.

What what i'm hearing is that might a country a in addition to being important sources of energy production and output in cells, which of course they are probably have other rules and that maybe may be someday, what we call my data will actually be two or three different little subcellular organ's. Like there may be little bits in there there control gene expression, and little bits in there that are controlling no transmit production, at least for now that the name is ma contra. And thank you, by the way, for illustrating some of the other things that they do because um in the landscape of science education and often times people think, okay, energy production, they'll be a picture of cartoon of the country.

I like flexing its muscles. People go to energy, medical, my my country and they all think, oh no, there are just sort of like a dumb jock portion of the cell, right? They're not doing anything sophisticated.

And everything you listed off is that they are doing many sophisticated interactive things within sales. So I think how things cartoon in disgust actually has an impact, and not just on the general public, but on the medical field and on the science fields. Anyway, that's more science ology. But now that everyone is well aware that my country are doing a large number of very important things, a very regulated way, let's talk about my topic, you know, a few years ago, because a nobel prize was given for auto fogy, sometimes called auto fag.

Look, people you can say, either way, people know, hopefully, what IT means is more important, which is the goblin up of one's own cells that are the injured um and this idea of autofocus cells, ua being eaten up or within a system, nervous system, other system um has come up again and again. I actually wasn't aware that my top gie could be such an important leaver. So tell us about mythology, which I have to resume, is the um intentional or not gobble up of medical a presubscribed them with newer healthier metadata that .

right IT is so in in many ways my topic is a subset of autofocus. But IT is it's got its own name because that is specific to my deAndrea. There do appear to be some unique regulators of biology compared to autocad more broadly.

Might a country actually are playing A A role in autofocus self? Um and this makes sense because one of so the global picture of autofocus stimulated by fasting states or fasting myrick states, so when your body senses that you don't have enough food, IT actually honkers down and starts to recycle dead old parts in this kind of carefully orchestrated way. And IT takes them to lice zones, they get degraded.

And then those degradation products get used for either energy or to build new things. Ontology is always occurring um at a low level, but you can really hyper stimulate the process through fasting calorie restriction, fasting mimicking diets, other things. And this is why fasting and invest. You know calorie restriction is so kind of such topics in the medical field now is because we they've been shown to induce longevity. And we think it's probably through that process that you you're stimulating the body to um IT kind of become lean and conservative in terms of its allocation of resources in the body doesn't just destroy the healthiest tissue along with the old dead stuff that has these processes that identify the old defective parts for and they go first. And that's what's beautiful about the whole thing, and that's why fast thing is so important.

So my topic um we know plays a really important role because um so there's this term called my a country this function which some researchers are actually wanting to get rid of and move away from because as you just said, might the country do so many different things in different my country, even within the same cell may very well be specializing in different tasks and might a country from one cell to another or sometimes doing very different things like not all my a country can produce court is all that specific to specific cells um where those genes are getting turned on so it's not like all of the country are producing court at all. Just the ones in your drill land for rent since are producing court is all um but there is this term by a control this function and IT has long been known for decades that mia construal this function is associated with everything that ells us essentially. So in the nineteen fifties we had a theory of aging that was based on reactive oxygen species and that essentially and that's where all the inflation tion is bad for you comes from and where .

all the um noise about anti oxidant yeah like in the nine years old like IT contains any oxidation. Not to say anti oxidant are bad, but they are certainly not to be all in all of health.

They are not. But that's exactly where that research came from, is that researchers were narrowing in on these reactive oxygen species are highly, highly correlated with all of the diseases of aging and poor health outcomes. Turns out there also highly, highly correlated with all mental disorders.

Interesting way. And so researchers use the anti accidents to see if, well, maybe if we can stop somehow, take these reactive and species will improve health outcomes, doesn't seem to work. But the one thousand nine seventies, our understanding of my, a country and the role in the production of reactive accident species expanded.

And that LED to the medical theory of aging. So in the one thousand nine seventies, we have this macro theory of ageing based primarily and exclusively unreactive oxyde species. Fast forward a couple of decades that was disproven because we now know reactive accident species aren't all bad.

They actually serve a signaling process. There are a Normal part of human functioning and the other function. So they're not all bad, but we still know high levels of reactive oxygen species are bad for you.

Fast forward to just I think, maybe last year with this expanded role of all of the different things might are doing. So David and clare, uh, publish a paper in one of the cell journals, I think, uh, saying that, oh, my country are actually the unifying link of everything that we know about aging. My country, you are the cause, or defective media, genia, or defective my, a country of function.

Might a country of this function is possibly the unifying cause of aging and all of the aging related disorders? Um so my topic is trying to address all that is trying to say, okay, this is bad. We don't want defect of my country up. And how can we get rid of old ones or defective ones and replace with new ones? And I think the most powerful signal and tool that we have right now is, in fact, related to die IT. It's calorie restriction that is the oldest, truest kind of best proven way to prevent aging in a wide variety of animal species fasting and intimate and fasting and again, you can only do those things for so long and then fasting mimicking diets um can also stimulate this process of biology.

Before we talk about mobile genesis, if and I certainly accept the idea that might actually a are extremely important in physical health and mental health, as for me is is a straight forward conclusion at this point based on what you said, whatever had elsewhere, eeta and if various diets, including kitto Janet diet, including fasting, reducing sugar and ticket seta, can assist in my doctoral function and my topgi, and that at least one of the levers by which diet can positively impact mental health and physical health, can we conclude that there's something special about low blood glue cose in the brain, right? I mean, that the sort of common pathway of all of those things, fasting kito genesis for some people, maybe they, maybe some people managed have great insulin management.

So just removing sweets, you refined sugars know, brings down their blood lue coast level substantially. They don't need to go on a kioto ic diet in order to relieve a low level depression or something like that. Seems like the the common theme here is that glucose levels in the brain need to be reduced, which for me is surprising because neurones love glue cose.

I mean, there are some really nice studies, one that I can think of um recently, those published neuron. If you just look at the tuning of a neuron, how well a the brain represents some visual image in the environment in terms here, we can just generalize and saying more action potentials, more electrical signals from the non generally correlate with Better high fidelity representation. It's like of have everyone time someone says shout and then someone shouts.

The neuron is like the one responding to the the order. And these neurons, just when there's high glue coast, they are faithful representatives of what's out there in the world. But then when you fast in animal, they become less faithful representatives of what's out there.

And yet, when i've done internet and fasting, and I do a kind of modified version of IT, my mental clarity is far Better than when i've had a big ball of pasta, probably, for other reasons, relate to serotonin and and trip to fan. And so I think for the typical listener they are after, imagine it's got to be a little confusing, right? We hear neurons love glue cose.

They live on glue cose. And here we're saying, let's deprive them of some glue cose, or let's just bring glue cose levels down, or let's switch the fuel source of the brain from glue coast to key tones. And now the brain really works the way it's supposed to.

So this raises a little bit of a just so stories, questions like, why would you be the case that neurons love glucose and yet if there's too much glucose around they become sick and of course with any um why would I be story as I would say you know I wasn't consulted at the design phase and i'm going to pursue the sun either. And then if any of us say that we are, then we are probably the patients that need evaluation. So I think there's a name for that, right? There's a illusions, right? okay.

And you have my first correct clinical assessment of myself. So how do I get my head around this, right? You've got me sold on mother country, and not that I needed to be sold.

But that's an easy. Like, yes, yes, absolutely. The idea that diet can impact mental health and physical health, yes, absolutely.

By way of my contra, at least in part. great. But then neons love glue cose. So what's going on or what do you think is going on?

I am not convened. The glucose is the real story. Glucose may in fact be a symptom. So we know that, we know that parts of the brain, you know, there is there been a couple of studies that just came out in last couple of weeks.

I think documenting that actually extra sites in hyper Thomas play a key role in glue cose regulation throughout the body and um and IT appears to be a meta lic role, which in my mind implies that the might a country in those extra ascites are probably playing a key role because we know might a country play a key role in sensing glucose levels. They play a key role in the release of insulin from the pancreas. But my contra in the brain is also playing a role in kind of balancing how much glucose is around and.

So it's it's a difficult question because I think in some cases, high glue cose levels are actually a symptom of meta lic disfunction somewhere in the body, your brain. And when I think about what what does that mean? In my mind, most of the evidence currently is pointing to mia construal disfunction somewhere in the body or brain that is the most likely cause of that this regulation of glue cose levels um but we know that if you consume massive amounts of junk food, sugar and other things that you can get, this regulation of glucose levels. The canon rim though, is that that's not a universal response. And what about .

the typical person? Like, i've never really like junk food that much. Maybe as a kid, I can recall IT like in Candy, but I was a sandwich for lunch person for a long time.

And as i've changed that out for salad, and maybe a small piece of meat with my salad or something like that, I feel far Better during the day, far more alert. But I do eat carbo hydra. I eat starches, typically night, but I tend to do some very hard training at some point during the day.

So I imagine I have some like agent re pack. Okay, that to me, I only mentioned that because I not in ketosis. As far as I know, I haven't brought the strips.

I haven't the blood glucose today, so what about the the typical person who's an omnivore eating, you know, some rise, some pasta, pasta salads know people that they are eating, not junk food, massive amounts of sugar, but have blood glucose and kind of moderate range. Do you think? And here, feel free to speculate. Do you think that those people might feel far Better or even a little bit Better if they were in a lower glucose state? And I asked us because I think there are a lot of people out there who suffer from full blown depression, but there are also a lot of people who suffer from like moodiness and feeling not so great sub clinical depression .

burn out as well I would call IT yeah .

and just feeling like some days they are great and the other days they feel lousy for reasons they don't understand yeah um and those make for less dramatic case studies. And yet I have to assume that that description will net a large traction of the general public.

So the way that I kind of break this field, and i'm probably getting too nerdy right now, but I kind of a break this field in the cause, what's the actual root cause? And water effective treatments, and I really see them as two separate things, just because the key to gene diet is an effective treatment does not imply that the cause of the problem was eating carbo hydrate. And I think that's a really important distinction.

There are many people who disagree with me on that. There is no doubt about IT. And everybody's heard people say sugar is the cause of everything that else. You our carbs are the cause of everything that else. If everybody does a low carp diet or architectonic diet, and then they go to so IT must be sugar, that was the cause.

I don't see IT as clearly black and White, is that the calorie restriction, kidger ic diet, carbon hydrate restriction, are inducing metabolite changes in the brain and body. And regardless of what the person was eating, they are inducing metabolite changes that can be really beneficial to brain health. So let me, let me just give a clear black and White example of this.

And then and then I can speak to the broader topic that you brought up about, just the general population. The easy example of the key ogen ic diet being an effective intervention for somebody who was not following a about diet is an infant with epilepsy. There are lots of infants who have uncontrollable seizure.

They are drinking breast milk. To the best of our knowledge, that is the primary most beneficial food source in infant could be consuming. Now some might say, well, maybe the mother's, but whatever that I don't buy that the mother's breast milk is, in fact, the the, the optimal food source for that.

Yet that input is still seizing. If we put that infant on a kito genc dia, a lot of those infants seizures will stop. IT doesn't mean that the cause of the infant seizure was about diet, but that means a dietary intervention can change brain metabolic and improve symptoms in that person.

So going to your broader question about adults modern day, the real answer, you know, there was just this conference in london, the royal college of obesity medicine, or something like that does not not the name, but it's something along these lines, the conclusion of that conference that invited the greatest minds in obesity medicine. The overarching conclusion of that conference was we don't know what causes obesity. It's really important that we sit with that. We don't know what causes obesity.

They don't think access chloric can take beyond once daily meta ball needs is causing obesity.

Some will argue that but and and so some will say, yes, it's all energy baLance, but why do we have an epidemic of obesity?

Well, that's that's the anguissola .

dollar. G, some will say it's all the junk food, but we had junk food in the one thousand and seventies when I was growing up. I grew up on cool aid, twinkies and condos and homes. And h i'm retouching.

i'm retouching the madman series now. I love that series, and i'm retouching IT. And I happened to know someone who worked on that.

So as they research everything for the props and the costumes already, but right down to diet, and you look at the the diet was terrible as mostly yes, there is was a lot of excessive amounts of drinking and cigarette smoking but the diets were terrible IT was prepackaged oos IT was frozen dinners I mean, that really came to prominence in the seventies and eighties um but even in the fifties and from what i've been reading, even in the thirties and forties, you know people were not eating grass fed meat and brazil nuts with a little bit of broccoli. Rabbi on the side does not the typical intake. Um so something something out there or maybe multiple things are at play to increase obesity.

And at the end of the day, I believe some will call this speculative, but I actually think we've got a tremendous amount of evidence that continues to point in this direction. I believe that my a angry are the key to the obesity epidemic, that there is something in our environment. So that is either our food, environmental toxins, stress levels, tour, sleep, not getting adequate sunlight, whatever you want to speculate on all, all of the above, all of those things are known to impermanent the country of function. And if, if, if parts of your brain that regular metabolic and that regularly eating behaviors are not metrology healthy, IT means that they will not stop you from eating or IT means that your metabolic will not rise to the chAllenge of ten donuts, because some people can eat ten donuts and go on staying thin and healthy.

Although I I totally agree, though, I would just like to say that IT seems to me that compared to when I was growing up, and again, I ve run the statistics, there are fewer and fewer of those individuals around now, just as when I was growing up, I was one or two kids in class that were quite overweight, and then there were some that were mildly wait, but most were of healthy weight. Nowadays, that's dramatically altered.

The landscape is dramatically altered in the other direction. Um IT is rare when I encountered one of those can eat anything type people. I know when he's actually an employee at stanford, he's in our media team at stanford and this guy when I take him to launch, it's like the his son is a early seventy and he can eat and he he's incredibly he exercises a little bit, but he's one of these mutants that just can eat and eat and eat and his lean and he's vital and he's its its wild and he's an expensive launch. But those people are seen rare and even those kids are now and they're getting increasingly rare.

And and that that leads me to think IT may be a genetic factors in the woman environment so that kids are actually coming out predisposed to obesity.

Well, let me ask you about that because I had a note here to ask this later, but i'm going to interpret you now in order to capture this moment. My understanding is that, well, as everyone knows, we inherit DNA. We get genes from both our parents and they mix. Although there are incredible data from Kathy do lox lab at harvard and showing that we actually have entire regions of our brain that Carry neurons that are of purely of moms or of dada's DNA depending on the brain region this is a wild finding and um but it's accurate and this has actually been known about in in terms of hedging of disease that that maternal DNA DNA from mom jeans from our mother not to place blame on mothers at all by understanding is that the might a construal DNA come exclusively through the maternal side is that true?

So it's a great question and that i've been ask before. And yes, schistus sts are known for blaming mothers. Some might say that i'm like trying to redo that whole thing. Could blame mothers again.

know the data or the data. I'm not trying to blame mothers, your mothers playing essential role um in in everything. Um but if if IT is true that ma conry are the linchpin of all this and maternal DNA is what determines the construal DNA, I think it's an .

important place. It's an important question and the answer is unequipped no, that's not the way. Well then so .

indications for anyone that was asserting that.

And so let me explain IT. So might a country I have thirty six genes under themselves. Thirteen of those genes code for some of the medical rial machinery of making A T, P. And the other thirty six play roles in epigenetic regulation, play roles in whole body metabolic and other things. But so that is what you're inheriting from your mom, is the my condition.

And those thirty six genes, for the most part, but the majority of proteins that make up might a contra over, I think thirteen hundred genes that make up country are actually encoded in the nuclear D N. A. And so you inherit a copy from both your mother and your father.

So the majority of people who have made a construal defects or might rare ma on real diseases actually could inherit IT them from either mom or dad because I can be a defect in um the nuclear genes that code for proteins that make up my the contra the much bigger issue when so when I talk about my construal disfunction being a primary driver of mental illness, meta lic illness, it's not that people inherit IT a defective might a condition or might a contra from mom and then that just ruins their life forever. That's actually not the way IT works. The beautiful thing about this theory is that IT connects all of the risk factors that we already know, play a role in mental health, but also meet abla health, sleep disruption in pairs.

Might the countries, and might the countries function? Stress, high level of stress and trauma impair my central function. Drug and alcohol use alcohol, tob tobacco, definitely in terms of the smoke and, uh, marijuana, T, H C, in particular, all impair my country al .

function T H C directly or the the smoke um and didn't .

those studies have been done and they so might a country actually have cb one receptors right on them? And uh and various researchers, a couple of studies from nature actually documented this, said that the market country will C B one receptors are primary um uh kind of primary points of the influence of marijuana on human behaviors and affects. So um because when they remove C B one receptors and animal models, these changes don't happen.

So the C B one receptors um you we've got some large studies of adolescence who use a lot of marijuana. And the areas where the meta country have the greatest number of C B one receptions are areas of their brains that actually are atrophy or shunk compared to Normal healthy controls. So that means their brain tissues aging premature is shrinking premature.

I um but the C B one receptors on my country also seemed to play a role in the memory impairment that can be induced from my, from A T H C. And they also play a role in a the kind of lack of motivation, the behavioral a motivation state uh from T H C. Now again, for people who want to chance, that's what they're looking for.

They don't want to remember anything, they don't want to think, they want to be spaced out, they want to relax. That's great. Um but it's important that they know that they're actually harming the other country in their brain cells and that although there's always an opportunity to repair my a country a and always an opportunity to stimulate biogenesis, you can get that back. But if you keep doing that chronically, you're probably not helping your overall mental or medical health.

Yeah, i've glad you read up. T. C. We didn't episode on canvas. We also did one on alcohol. Probably lost some friends from that one. I mean, when you look at the data, it's very clear i'm i'm not arguing that people dislike the effects of these compounds when they take them.

But IT is clear that least to me, based on the data that regardless of what people have read about red wine, that not drinking any alcohol is going to be healthier than drinking alcohol, that the threshold for alcohol and justice before people start to negatively impact their health is about one, two per week. And then T, H C, because of the very high concentrations of T, H C that are present in a lot of products, now raping and smoking T H C, and even edibles that IT IT can be problematic. You mentioned adolescence, said you know previous position of brain atrophy psychosis at in any case um because you mentioned alcohol because IT is a commonly used substance.

I heard you give a talk in which I think I have this right in which alcohol can disrupt the way that the brain uses fuels of all kinds, which may disrupt one's response to alcohol, make alcohol seem um more uh a rewarding to those that drink alcohol a drinking alcohol makes alcohol more rewarding to the brains, alcohol a drinkers. But that is also might alter glue co s metabolic, that basic alcohol is not good for our brains. Do have that correct.

You do have that correct.

okay? What happens if you taken alcoholic or somebody that just drinks up, you know, two to four nights a week, a couple of drinks, which I think is pretty common out there, and you put the mona edo gene die as that experiment been done.

that experiment has been done and IT LED by none other than a woman named nura voca who is one of the leading nor scientists um and addiction researchers in the world he is the director of the national institute drug abuse she's been hot on the trail of metal abc abNormalities in the brains of people with alcohol use disorder which I will just referred to as alcoholic because that's what everybody knows that is um so she's been hot on this trail for many, many years and and as you said, IT turns out that um the reward pathways in particular are metabolite compromised in alcoholic and the medal of compromise essentially and a not all means they aren't getting enough fuel from blue coast.

The interesting thing is that when people drink alcohol, your liver converts alcohol into a molecule called asset that acid travels up to the brain and fuels brain cells, in particular some of these reward pathway cells more than others and um so chronic alcoholics have this chronic deprivation of energy in these cells. And so nor of ala and other researchers that national institutes of health did a study in which they they set out to see if we can change this brain metabolic and alcohol lix. Will that affect clinical symptoms of alcoholism and will IT do anything, you know, that clinically useful? And so they actually did a randomized control trial, admitted alcoholic to a detox unit.

Half of the patients got a kito generic diet, the other half got the standard american diet. Then everybody else, all of them got the same detox protocol. The patients who got the kilogram ic diet required fewer benzo days of pins for their d talks.

Despite that, they had fewer withdraw symptoms from the alcohol. They reported fewer cravings for alcohol. And the researchers did bring scans, which showed improved brain metabolism in these key areas they were looking at.

And their brains showed produced levels of neural information, which was also something they were really interested in. And so that one study says to us that even though most people would think alcoholism has nothing to do with diet, alcohol is just drinking too much. It's a matter of willows, or is somebody who is addictive, you know, they ve got an addictive personality and it's that simple.

You come out of the whom with an addictive personality. And those people are, you know, novelty seekers and they're impulse sive. And they have no patients. They have no discipline. They can't sustain you know, any kind of rewarding experience .

or childhood. There's a there's a yes story there, which there very well.

maybe but and there maybe and but what that research study strongly suggest, again, yes, maybe we need larger controlled trials. But this is one of the neuroscientists in the world who's hot on this trail. This is what he believes and this is what I believe is that we can correct the brain metaphoric defects from chronic alcohol use.

We might be able to help people be sober um and give them a fighting chance or give them an edge up or pull a liver that we can use in their favor for their benefit. There's one cautioned all of this research that I really do on a highlight. And so now I am going to get hate mail e from all the kito community okay?

I mean in time is I admire you for talking about nutrition at all, because in time uh one talks about nutrition, you're going to hate mail from somebody. But um so .

the the caviar to all of this is that is part of the research that those researchers were doing. They actually wanted to see what will happen to alcohol levels if an animal consumes alcohol while on a kio gene diet. So they didn't do this in humans yeah, this is a fairly easy study to do.

So i'm hoping somebody will do this study soon. But they, they instead put rats, half of them, on a standard diet and half of them on a key to gene diet, and then they expose them to the exact same amount of alcohol. The right to were on the kidney diet had a five fold increase in blood alcohol levels. Five fold increase.

meaning they drank more or IT was meta zed.

Was meta zed differently? They, the rats, got the same amount .

of alcohol. So for people out there who are key to gently and chocolate, but we are not alcoholics, please, alcoholics, please do something about IT because it's so detrimental. But I guess, does this mean that they can drink less in order to get the effect of alcohol that burst? People are .

seeking cheap dates, cheap data. What you call that a, you only need to half drink instead of three drinks.

I would think the kito community would thank you for this unless they have a stake in the, the alcohol industry。

The reason that I, the reason that I put IT as a caution is that if anybody is struggling with alcoholism, and thanks, hey, I need a net job. I need to leave the pool because i'm really struggling to give this stuff up. I just find myself going back. And if you're telling me my brain metabolism is my stop and this might help IT, i'm all in favorite of that. And yes, that's what the researchers are pursuing, and that's what i'm saying with the following caveat that if you relax while on the kito gene diet, you Better not drink the same amount of alcohol that you think you can drink .

um to be deadly IT IT could .

be deadly and and or I could be really yet deadly to you or someone else because unfortunately, a lot of times when people drink, they get behind the wheel and they think that they can handle two drinks safely and they they think, well, you know, I can go out for dinner and have two glasses of wine and drive home safely. I know myself, if you go to a kidney diet, please don't drive with the same two drinks because that means your blood alcohol level, if it's, if IT models, anything that we found in the right study, your blood alcohol levels maybe five times higher than they would Normally be, and that means you are really wasted and you're probably not safe to be driving.

Probably the same is true for drink on an empty stomach right now. It's a very important point. And then thank you for raising that. I mean, I hear this a again about my cona, about blood blue coast.

I you mention exercise, and for those of you that earlier exercise are a non neuron cell type in the brain, a glial cell type that my post I advisor was known for our popular zing, the modern science of glia, which include exercise. And i'd be remiss, I didn't say that they do. They are considered the cells that hold everything together in the brain and are kind of passive observers. But they do many things actively there.

I think now people appreciate the exercise as at least as important as the neurons um and certainly for disease they are often implicated in warding off of disease at at a everything that you're telling me about the fact that the brain can regulate things that are happening in the body meta lisp, IT set, organ health, obesity IT set up to me as a neuroscientist, that's not surprising all of IT just screams hypothetic hypothetic hypothalamus. Here you're telling me it's regulating these bases. Al functions like metabolism. It's regulating how much we crave things. And of course, hypothalamus volte in motivation, in craving. There are other areas, other areas that bring too, of course, but I would imagine that someone otto or has mapped out where the, you know, the receptors for all this business are in the brain and and you know and guess that raises the question of when one goes on a kito generic or low blood lucas diet, or fast, as anyone observe changes in the brain, as anyone at neuroimaging of humans and their brains are, are their conditions of ingesting one diet or another, whether not their psychiatric sufficing from a psychiatric disorder or not. And we think that I would think that's .

where that the goal is. We do have some of those study. So and you've the you know when you do in your imaging study, you can measure a lot of different thing. So one thing with a pet scan, you can measure glue cos metaphysical.

So A A researcher er Stephen canada is doing that research in particular in all timer's disease patients um and altimeters to these models that in humans um and that's because we know that um yes again A A A common finding and patients with alzheimer disease is this blue coast hype boomed habilis m some people are attributing IT to insurance signaling impairment, and so some people are calling at type three diabetes. The end of the day, I think the clearest signal that we have is that cells aren't getting enough energy from blue coast as a fuel source. That is something that I think I can confidently say that's backed by numerous research studies.

There's debate in the research field about whether that's premier, a primary driver of the illness I happen to believe IT is. And I if you ask the question why why would sells not be getting enough fuel from glue? Cos you have to focus on my a country because they are the ones producing the fuel from that glue code. So you somehow you have to implicate my country a in that process somewhere another um others will say no, that's just you know a side effect of whatever is causing alzheimer's disease. But so Stephen good name has done studies where he even gives key on supplements.

This is our liquid ketone esters. So yeah keystone .

asters or keystone sault and IT has actually found that these brain metabolism deficits can be corrected at least short term by giving a key tone supplement.

Is this um in the context of people also interesting some carbon hydras? I I confess I i've tried the key to generic guide. I proud I did IT wrong. This was years ago and then the sick ky og ic guide.

But in the last year, so i've started using liquid key town asters, but I and I do eat some carbon yo da tes each day, usually in proportion to how much I intensity exercise I am. Those liquid key tone esters, for me, at least subjectively, I feel like greatly increase my energy levels in my ability to focus mentally. And they improve my sleep. This is my observation, tracking some data, but just again, subjectively. So in this example, are you talking about people taking key to nesters or ketone salts on a backdrop of a kito generic diet or on the backdrop of a more typical diet?

So he's done both. So he's done um he's on studies where patients aren't doing anything special with the diet, so they're eating whatever they Normally eat, absolutely non key to genc, giving them a keystone salt or ester and then noticing immediate direct changes in the metabolic of these metabolically compromised brain cells by as measured by pet imaging. Um these are not household pets.

by the way, I sorry at where you have to just be positive on emission tomography, not pets although i'm sure that there are people out there who have the their dogs or cats or whatever you know the kangaroo, whatever you might own on geog ET guys okay.

So right. So he's actually moved further. He's done a pilot trial in a nursing home actually where he did not put the patients on a kito anet diet. He simply reduced carbon hydrate consumption at breakfast and lunch. They still got the same dinner as everyone else, and simply reducing carbon hydrate consumption at breakfast and lunch resulted in cognitive improvement in in a statistical ally, significant way in some of those subjects.

I love that result. I'm sorry. I just have to highlight this. I am a huge believer in you directing carbo hde rates to specific portions of the day when one needs to be less focused and alert and yet can replenish gygax en limiting carbo hydrates tes most of the time during the day for me has been a game changer in terms of maintaining alertness. That said, i'm not aware that I have you know angering coding of decline. But then again, I would people around .

me may argue that let me say you are Andrew huberman there is no way you have though you didn't know me as the man were also sewed I plenty .

of flaws and experiments well over three thousand documented by people very close me so um but this is very interesting. I I think in the context of everything we've been talking about because could IT be that supplementing with liquid key tones or prescribing liquid key ones to people who are chAllenged with mood disorders or things that sort could be beneficial even if they are not willing or able to add here to a kito genc diet?

That is the million dollar tion right now. And we don't have good trial data to say yes or no. My speculation, my hunch, having tried that clinically with patients is IT doesn't seem to work.

It's not the same thing. My the bigger reason for my feeling confident in saying that is that we've had keystone salts and esters available for over the right now. We have tens of thousands of children and adolescence who are following a street ridiculously strict category diet to control their epilepsy. Those kids would love to be off the key to genet diet. Their parents would love to have them off.

And no cake, no ice.

There is not one case report of any child controlling his, her seizure using exogenous key tones without also doing hydra diet. I just find IT hard to believe that at least some of those people haven't tried IT out to see. I do know some patients with bipolar disorder and even schizophrenia a who are doing extraordinary well on a ketogenic diet.

They have tried to switch off the kidgin ic diet using exogamous key tones. Their symptoms came back. And so they they found that IT just wasn't effective.

And again, those are anecdotes, my scientific speculation about why is is because the key to genetic diet is actually not necessarily about key tones themselves, key onto one of a multifamily story there. And so when people do a key ogen ic diet, they're also improving. They're lowering glue coast levels, they're improving insurance signalling. They are ramping up.

Might a condron biogenesis in particular in the liver because ma contact actually make key tones? That's where they're made and they're primarily made in the liver mda. So when somebody is on in a fasting status on a kioto ic diet, their liver might dandrik go through the roof because they are being called the action.

It's like, hey, bodies and starvation mode get to work. And so the medical dia, the cell senses we need more medical ria to process fat, to turn IT in the key tones. So those key tones can get up to the brain and keep the brain fuel.

Because fed assets can fuel the brain. Only key ones can. Now, so my sense is the and the got microbiome changes and everything, the changes in hormones. So if you're eating a lot of donuts and drinking a bottle of key tones, the donuts are going to prevent your body from lowering glue cose levels.

You're still going to have the high glue cose levels from the donor, you still going to probably have the impact insulin signal, you're probably still going to possibly have some information from the inflammatory effects of that food. Um and and so just drinking key tones alone won't be enough. I think I think for people who are metall icc healthy and include you in that, I think key tones can play a really beneficial role.

No doubt. I think exogenous key tones may, in fact proven valuable in clinical use for patients who maybe can't follow a super strict diet that maybe could do a low carb diet. And then given the research is happening with alcohol use disorder, I could imagine a situation, here's the million dollar like, you know, tip to whoever wants to go out and get this. If IT actually turns out to be true, I could imagine the same scenario where we use exchange as skitters with alcoholic, and that every time they have a severe craving for alcohol, they drink key tone instead.

which sort of taste like alcohol. The key on ester, when I take them, I drink them straight. Someones up, put them in salter. And i'm not a big drinkers I mention I might have an ali drink every once in a while I just don't ever crave IT i'd just do IT every maybe I think twenty twenty was the last time I A drink alcohol and so obviously i'm not a good represented example um but the key tones taste good to me and they obviously don't get you drunk just they do seem to um flick on my alertness pretty quickly. The I my understanding is that they are the brain's preferred fuel source, meaning they are going to be the first fuels used by the brain in when there's a behav of fuels available, there's glucose in my bloodstream, there's circulating liquid key tones. Key tones would be used first or preferentially.

Is that true? I think it's a complex question. Means some some researchers that we have suggest that there are brain areas or brain cells that require glue costs and cannot use key tones.

So one hundred percent of the brain cannot be fuelled with key tones as far as we can tell. So there are some areas that require glue cos. And that's probably the reason we have Lucy o genesis to keep the body going and keep the brain going no matter what.

Um but when key tones are available, especially key tones are high. Um the way I think about IT is not that key tones are like the preferred fuel source and glue cos goes to the way side. But the way I think about IT is that you have a range of cells with varying degrees of meta c health.

And some of those cells are going to be extraordinary healthy with appropriate, healthy, abundant by the country. And those cells are probably going to continue to use glue costs of fuel source. But if key tones happen to be there, sure, we'll use that to like why not but the real money is metabolite compromised tissues um whether its brain cells or other tissues that but we're talking about the brain.

So if you ve got medical likely compromised brain cells because it's not across the board, like with alzheimer brain scans, there are specific regions that are more metabolically compromised than others. And that's why we see patterns of atrophy in specific brain regions, is because those regions are diss functional metabolite for whatever reason. And we can get into why that might be.

But but my thing is that if you've got to meet about like a compromise so that cell is sending out a distress signal, that cell is calling resources from the body, like, feed me, give me something. And if IT can't use glue cose effectively, IT is going to suck up those key tones and then start running on all cylinders or closer to IT. And and that that process is so critical because what that means is that if that cell was barely getting by on sixty percent of its real atp requirement, IT means that IT doesn't have enough energy for maintenance and repair functions. As soon as you give that cell a hundred percent energy or close to IT, even if you get IT up to ninety percent of its preferred energy amount, um IT can start to repair itself I mean, that's the beauty of the human body and living organisms is that they have a priority list of what they're going to do and and if they if that cell senses that there are defective molecules, defective proteins in the cell that need to be replaced um once IT gets enough fuel, IT will start repairing itself and doing that work .

that makes sense. Thank you for that clarification. Like to talk about alzheimer's and age, really a cognitive decline generally. I know many people out there are just terrified of losing their memory for the obvious reasons, memory sets context that set a. And many people have relatives that suffer from alzheimer's is are other forms of dementia.

I've heard that the key organic diet and diets like IT can be very effective for helping to offset some of the symptoms of alzheimer's and atrial econic decline. In fact, I even have A A friend I won't out him by institution, whose the chair of cardiology, who contacted me of all people, asking whether or not I was aware of any studies or whether not I knew of anybody who had benefit from kidgin ic diet for alzheimer's. And I, why don't you ask of your colleagues and neurology? But his response was really interesting.

He said, there is there many books out there for the general public? There are a lot of online discussions about this. There are a lot of assertions about this in some animal studies, but again, these are his words.

There are very few, if any, controlled clinical trials expLoring the role of the kio generic guide for the treatment or reversal of alzheimer and atrial coding of decline. I'm hoping that statement was incorrect or soon will be incorrect because those trials are ongoing. But he said that, you know, the people are the most popular for telling us about the important role and positive role of being in keetz.

As for alhama. For some reason, they just won't do a clinical trial, and that's been frustrating to the community. So this is a very educated, very accomplish person whose a position of heart medicine as opposed to something else related to the brain.

But what is the story there? And and for good and sake, why aren't their clinical trials kito? Janet died.

And although I don't expect you to have the to be responsible, that fact but good goodness, I I would think this would be like the obvious thing for N H. Amon studying section, you know, but not for these sorts of experiments. Why isn't money just balancing into this area based on all the anodos evidence that people are talking about?

So we've got a couple of small pilot clinical trials. The best one was a random zed controlled trial. I think IT only included twenty six subjects, something like that randomized to twelve weeks of a low fat diet, ten week washout, twelve weeks of genet diet.

Some of the participants got kiddo first and then love at. Other participants got low at then kiddo. And that trial actually found that when patients were in kitta, they had statistically significant improvement in activities of daily living and quality of life, and they did have improvement in cognitive function.

But I didn't reach statistical significance. That improvement did not. We've got other trials. We've got several animal models showing that the key to gene diet can improve bio markers of alzheimer sees in alzheimer's models, so I can reduce blacks and tangles, can even improve cognitive impairment in animal models. We've got and we've got a couple of other small I trials of cute genetic diet in humans showing that in improves biomarkers compared to say, the low fat diet or the american heart association diet. So we've got those I think one of the biggest chAllenges that i'll just share openly, you know and this is i'm somebody who's pretty passionate about this research and I believe that has a lot of potential um but you know john hopkins researchers attempted to do exactly this kind of a study uh, all zeier patients kited generic diet versus the I think an american academy of aging or something like that diet is the control diet which recently .

has starches in there. I think that's the key very above whole in some potatoes .

um and they spent, I believe, over three years they screened over thirteen hundred thousand thirteen hundred people who expressed interests. The end of the day, I think they only got twenty seven people to enroll in. Only fourteen of those people completed the study despite that. What they found was that the subjects who achieved key tos had cognitive improvement. But people on study section are gonna look at a study like that and say, even if the science is there, if you can't get people to do this diet, why would we spend money on researchers trying to get people to do this diet?

I should mention study section is this uh closed door panels of forty years. So people that they're many of these panels um different different divisions of the national institutes of health use different panels and then grants are evaluated. And in a very small because of the size of the federal budget for research, a very small percentage, usually about ten percent of these studies are funded.

The rest don't generally don't end up happening. That is very informative. What you just describe IT is very informative because now IT makes sense to me that there's no conspiracy. It's not like big pharma I don't think is trying to suppress trials of a key to generic um diets on alzheimer's is because I would imagine the first thing that farmer would want to do is to see that study done so they didn't have to.

And then the moment they would IT was done, if IT showed a positive effect, they probably want to isolated the molecule and wrap IT up in something that people take right. So I don't think there's any active suppression by farmer. I think farmer would probably be cheering from the sidelines because they could capitalize on IT because ultimately, the studies are on my scientists, but the treatments are generally dot out by pharmaceuticals ands or were in your physician.

So I don't believe there's a conspiracy there are that is very interesting and kind of amazing given our discussion of earlier, which is that you had a patient that was having schizophrenic symptoms who may just stay on the diet. So is there something special about alzheimer's patients and people they agree cognitive decline brazenly there, very dependent on others to cook for them and shop for them. I think that this is a almost perfect controlled environment for getting .

the study done. I think that is the key issue. So again, I got patients.

I get patients with bipolar disorders. Kizer hania extraordinary ly impair people to do this diet and stay with IT. But it's because i'm providing like a weekly session for them.

And and I imagine this study did not provide that kind of intensive support. So I think, you know, in the pilot trial that I described to you, they actually got, I think, over ninety percent compliance with the different dietary interventions. So some of IT is going to be dependent on the research group.

And is the research group understand that this is not it's not like prescribing appeal here. Take this pill and take IT every day and come back in three weeks um and even then, we don't know for sure of the patient took the pill every day. We just assume they took pill every day and studies say they probably didn't. But so I think when we think about a dietary intervention, we need to think about more intensive support and education.

And that support could be a health wellness coach IT could be a dietician IT could be education of the family IT might even be providing them with dietary like meals um that maybe for six months, we actually provide them with heaven ic meals um once a week, put him in your freezer, your microwave um when needed to make this diet is easy, endure as possible. Because if we can get people to do the diet, if we can get them through the first couple of months, most people can learn how to do this diet. More importantly, I didn't mention this before, but the number one reason I am so successful at getting patients to stay on this diet for years, it's because of the consequences to them when they go off of IT.

That is the reason I can get schizophrenia ic patients and bipolar patients to do this diet, whether other people can't get, and everyday human being to do IT for weight loss, because the weight loss patient doesn't experience devastating tormenting symptoms when they break the diet. Often times they are rewarded. They they eat something they really enjoy and they get a little bit of a dopamine rush from IT and they in the off the races or like i'm a ah i've already cheat IT i'll cheat again.

I'll get back on IT someday and they never get around to IT my patience when they go off to die at. They start allusion inc. Within forty or twenty four, forty eight hours.

And they quickly realized that was a really stupid thing to do. That piece of cake was not at all worth the torment that i'm experiencing now. So they get back on the diet.

I suspect with all heim's disease, we might notice something similar. These people, some of these people have very mild symptoms. So maybe they won't have that kind of a reinforcement negative reinforcing kind of experience.

But I think some of them will. Some of them recognize that they are impaired, cognitive timely. And if this diet could help them remember Better, if this diet could help them function Better. And again, as with the pilot, al showed his activities of daily living. That means these people are able to go to the bathroom on their own.

They're able to get themselves dressed, whether they need to help with those things before those are actually really important things to both the patients and the caregiver and um and if they go off the diet and then quickly revert into a more symptomatic state, that might be reinforcing enough for them to figure out away to do the diet on their own. And if we think about you know if this really is an effective intervention, and yes, we need longer trials, larger trials all back because there there are plenty of stories in the medical field where pilot trials looked really spectacular and promising and then larger trials just failed to show the benefits. I believe, based on all the science of metabolism, metai a glue cose, hypo metabolism, all of that, I believe the science makes this an obvious treatment that has real potential. So now people will call me buyers, that's fine. I got my buyers.

No, based on clinical observation and extensive clinical observation at that, I think biases that are simply because we want to feel a certain we believe something are worth worth critical. But um bias based on observation here I should mentioned that you know most of what we know about human memory was Sparked by one patient, a famous H M I think was in living in harvard medical in one of the hospitals around there, many hospitals on long wood campus.

But um one patient of in the reason why you associate the hip campus with memory is because we knew that hm hip campus was damaged intentionally damaged for a python y treatment, right? So this idea that everything has to be a randomized clinical trial to me is crazy. I mean, of course, that's a gold standard and its essential, but there's so much information in textbooks, medical textbooks in particular, that are gleaned from single patient case studies or from three patient neurostimulator the brain or something of that sort.

So to me, i'm still perplexed to you know why the why there's this insistence on only one form of evidence clearly what you're doing, the important worth that you're doing clinically and in the research side and and in public communication is is assistant ness. I have a question about or more of a statement slash question about the key to generic diet based on everything that we've talked about. Seems to me that the key to genet diet for weight loss is a very interesting aspect of the diet, as is intervention fasting for weight loss, even though IT might just be by a way of chloric restriction that occurs with fasting, but then in some ways, that the effects of the key to and a guy on weight loss are a bit of a decoy for most people.

That's where their mind goes. This person lost x amount of way. Maybe that made them feel Better. Maybe that actually made them underweight. I think you ve talked about IT, for some people can actually bring the underweight, but i'm glad that .

we got the .

chance to dive into the description of key gene, die for epilepsy because IT really is a medical intervention that has a side effect of weight loss or could be used to treat obesity and induce weight loss. But it's really about far more than that. And that raises a question for me, which is know we ve been talking about the key to generic died as one thing.

But i've heard you discuss this before where you know just as a physician will prescribe different dose dosage ranges of a given drug, you can prescribe different postage ranges of a nutritional plan. A diet is not one thing. It's not necessarily zero carbo hydrates or one hundred grams or fifty grams IT depends on the patient and a lot of other factors.

I've heard you list off everything. Classic kiddo. Maybe you could just briefly tell us what that typically is because I think most people think eating IT means eating a lot of meat and not carbo hydrates, but might not be that fasting.

And then some of the other you mention actions earlier. We don't have to go into each of these in detail. I know in your book, you talk about not just the science and clinical background but also some action onal steps that people could consider so they can refer their for more detail.

But for somebody who lets say is depressed, they've had some rounds of depression. Maybe they are on into presence, maybe not, and they want to try something like this. Obviously, this has to be done in concert with a physician observing all this.

But what is the typical thing that you probe with first, just like with the drug you'd might probe with twenty million grams of a drug, what's your typical pro initial dietary intervention probe? Terrible languages, I realized, and criticizing myself for that. But I think people get the idea.

The the real answer is that I I don't have a one size fits all recommendation for any person. So the first thing that i'm going to assess with the patient is what symptoms are they having, what is their current diet like and what are they willing to do? I tried to meet them more.

There are out. So uh, if somebody you know and I want to point out, like you mention the all meat version of this diet, which is often referred to you as the car of war diet, very controversial. There is no doubt that exists.

And for some, some people swear by they swear that they've tried other versions of cutolo ic diets, and only when they went to a carnivore diet did they get benefits. But there are vegetarian and vegan virgins of the key to gene diet. So in my mind, this is not at all about the diet wars of animal source versus plant source foods.

It's about inducing a state of key to sis, which is mimicking the fasting state. That is what it's about. And you can do that by not eating anything by fasting and or innovate fasting and you get your results.

So no diet is a is a key to genetic diet. So it's not about the foods or the types of foods that you're eating. It's about inducing a state of ketosis. The first variable i'm going to look at when I recommend this or prescribed this is the person's current weight.

If if somebody y's obese or adverse to somebody whose then i'm going to use different dietary strategies for those two situations in the obese patient, they have tons of fat stores on their body already. Usually IT is a goal of theirs to tap into some of those. And they'd like to lose some weight if they're gonna try a key to gene diet for brain health anyway. And so i'm going to a use that so that person really the diet is carbon hydrate restriction, and that usually is a sufficient intervention.

both simple carbon hydrates tes meaning sugars and fotos also .

fractus definitely. So no added sugars essentially um you can have added natural sweeteners like stevia. Among fruit, you might use artificial sweeteners. I'd probably years after of doing this, i'd probably recommended steer away from them if you can because I think they tend to stimulate cravings for pie card foods.

Um so if you can kind of get through a couple of weeks without um sweet things, your cravings for those will go down and it'll make the diet easier and a little more sustainable. But let's say you can have your artificial sweeteners, if that's what you really want. Some going to say less than twenty grams of carbs a day for those people.

They can have all the protein they want. They can have vegetables and they can have all the fact they want. But I got to push fat on those people. I got to tell them eat a lot of fat at the same time because I want to use the fat on their body as the fat source, at least early on.

Are you encouraging healthy fats like mono and saturated fat like olive yary, encouraging people to um eat the less butter etter?

I I I tend to, I tend to encourage, again, a wide range of fans, and it's to depend on the person. A lot of times people come to me with very specific ideas, but i'm going to attend to encourage all of oil, avocados, nuts, which are usually considered, even by the american hard association, healthy sources of fat.

The the more controversial thing are things like coconut oil or coconut cream, which the american heart association might say is not a healthy fat. I kinda disagree with that and don't think it's unhealthy at all, actually. And when you look at the epidemiology ical studies of saturated that causing heart disease or causing adverse outcomes at best IT maybe crees your risk ten to fifteen percent at best.

How much coking oil can people adjust anyway before they um either developed area no joke or or just or get tired of coconut il that anyway your point is taken but that you can eat meat if they like meat or you can eat eggs or if they don't like meat ex they could eat sardines or things that sort I mean I personally can ah I cannot even stomach like the word sardine have nothing in the actual fish but um that's just mean but obviously people have I say this because people have different preferences， right? Yes, stake.

but i'm not and i'm to go. And again, there are vegan sources of protein that people can eat champagne and you know other things. So um that's the obese person is carb restriction is the primary initial phase. The thin person is going to needed a lot of fat because they don't have a lot of fat stores on their body.

And if I want them in key tos, clinical key tos, i'm going to have to feed them fat so that the person that i'm going to say, make sure you get in avocados, olive il butter, maybe a heavy cream. So heavy cream is delicious. It's a delicious way to get your fats. And and I have one patient who just drinks IT straight to just try to get IT in.

get like i'd never had an appetite for sweets. I, I absolutely love savery fatty food. When I was in high school, I was, I was dense.

I was able to do this. But I I used to drink half and half. Sometimes I wake up with a mild night .

and drink IT just because a day so so good IT doesn't good. So to push away from half and half and toward heavy whipping crane and and so you can that up, you can freeze IT IT turns in the ice cream, you can add vanilla, you can add coco powder, you can add all sorts of things and you you're after the races with shakes and ice cream moose and all sorts of things that you can have um with any of these patients.

The beauty of this diet is I have objective biomarkers. I'm gona have them measuring key tones and i'm going to adjust the diet based on their state of key toes, handle the clinical benefits that i'm looking for if it's an average person who is not currently under psychiatric care, not taking prescription medicines, but is saying i'm burned out, i'm exhausted. I want some of that brain energy that Andrew huberman s talking about.

He talks about feeling good. I want some of that. I'm probably actually get to recommend the protocol you describe, which is let's see if we can just carb strict for a while um and see if that produces clinical benefit.

I have one. He's not even been a patient, just somebody who read my blog. I didn't tell him anything and he came away from IT saying he was ready to start an anti depress or an anti depression for his anxiety at rony.

Anxiety, trying meditation was trying all sorts of things. Nothing, nothing. Those things weren't enough.

He was ready to go on prescription medicine. He really nearly copy at the book. He took IT upon himself without consulting with me to restrict carbon hyrax alone.

He did not go ketogenic. He is a vegetarian. He restricted carbs within three weeks, said, I don't need prescription medicine.

I can't believe how much Better I feel. And all I did was cut out some of the high car woods in my diet. So I think for some people, IT can be that simple. For people with serious mental disorders.

They are chronically depressed if they are on lots of prescription, mads, if they're disabled by their symptoms and certainly if bipolar or have schip, rena or something, those are the people I really do want them to work with a medical professional, because meds may need to be adJusting they really need of. They need a real shot at this diet. It's not like weight loss.

Weight loss, everybody wins IT. And either you're successful or you are you you look on the internet or you read a book or you do you know even the colleague that you mentioned, he's probably just reading who knows whether it's credible information or not and just winging IT and seeing whether IT works or not. For people with serious mental disorders, I want you to treat IT like you have eileen sy, because you do have a serious brain disorder like it's impairing your ability to function in the world.

It's impairing your health and happiness. You deserve a competent medical treatment. And we have that, we have a hundred year evidence base. We've got dieticians who know this like the back of their hand. They can monitor your level of key toes.

They can help, they can help look for writing and neutral deficiencies that can be a consequence of the dial and make sure that you're not developing those. They can help tweet the diet if needed. They can give you ideas. If you're getting bored with eggs every morning, they can give you ideas for what else you might have. And you know, if you're using IT to treat a serious disorder, I think you need serious help.

Couple of questions a little more detailed, but I think a lot of people have this on their mind. Is IT ever the case that you prescribe somebody the ketogenic ic diet in conjunction with intermit and fasting? So ek, do but eat between the hours of whatever, eleven A M and eight pm, or something like that. That's the first question.

absolutely. so. And at one patient with type two diabetes and chronic depression, and he will try to follow the cute genc diet, and sometimes his blood chargers are still very high, and sometimes I will ask him to do either intermet fasting or even a three or four day water fast.

And IT is shocking when he does a three or four day water fast. You know the first day or two feels like crap. I'll just say up front, don't do IT if you you got an important meeting or business trip er and like don't .

be so this is just consuming water, this just consuming water. No black coffee.

Um I usually tell me, me can have plane black coffee or tea um but .

you have mercy 哎呀哎呀。

i have a tiny answer mercy but but when he does that， his blood sugars plumet in a good way like his blood sugars are Normalizing. But the last time he did IT, he actually got to seven days at one point. And he said, I feel great.

I want to keep going. I can't believe that i'm not hungry, but i'm not hungry at all. I don't miss food at all. And at seven days I kind of cut the court. I like, no, no, where does you ve got to eat?

Well, I find IT really interesting that the international fast hse controversial um at some level, but as to whether or not it's just beneficial by way of clerk restriction, because that is one way to achieve ve clerk restriction, whether that has additional benefits.

But um i'm very interested in the neural side of IT and IT does seem that the fasted state can start to take on its own rewarding properties where people get dopamine release, not from eating as most everyone does, but from abstaining from food. Now this can be logic. And in the sort of example of an era xi and rosa, which is both know is the most deadly psychiatric illness. But for non annex X I, I think it's interesting to note that eventually not eating can have its own rewarding properties to IT that aren't just relate to weight loss, but in the short time feeling, in other words, feeling really good by way of obtained for meeting. Yes, yes.

Well, and that's actually IT. IT raises an important risk that I haven't mentioned yet, but at least in psychiatric patients, but even in some patients who just use the key to diet for weight loss, I have seen definite hypomania. 嗯。

so low. So these are people aren't sleeping very much there. Um are they also getting kind of a delusional thinking they're going to run for president?

no. So so the distinction between hypomania and mania. So mania, you might become psychodeviant delusion.

Mania, by definition, is problematic. It's causing a problem in somewhere another. And if if you have psychotics, symptoms is definite, called mania.

For bin mania, hypo, omani, for Better or worse, is something every human being probably craves. So IT is, IT is feeling extraordinary good. It's getting by on less sleep.

But you don't need to sleep. Who needs sleep? I've got things to do.

I am. My brain is running on all cylinders. I feel so creative. We've been in lots of famous people through the ages who have been bipolar, probably bipolar, and some of their most productive periods of time, whether it's art or creating scientific models or what have you were probably during hypomanic episodes.

So what do you do in that case? I mean, I am obsessed with getting sufficient quality sleep. It's a kind of repeating theme in our podcast and many of my social media posts and um I always recommend behavioral tools first then uh you know exercise, viewing sunlight at at other appropriate times, avoiding late night artificial light exposure that are um and occasionally for people who are doing all that and still struggles, sleep supplementation.

Um one of the things that i've seen some data on is that for people who are following a low carbon hydrates diet that in oat all in particular can be helpful for getting IT to sleep probably because it's a bit of an as a bit of an antianxiety effect. But personally, there are other things out there too. The magnesium ms will generally do that.

A hot bath will do that too for that matter. But what you're talking about is people who are going a day and a half without sleep or they're just know, two hours of sleep at night. I have.

So the worst case I saw was actually a mental health professional who didn't recognize that initially he went six months with two to four hours of sleep every night because .

they were on a kito generic.

He was on a kito generic diet, was getting on two to four hours of sleep every night. Did not initially recognize that this was a problem. He was feeling great.

He was feeling that kito high, and he was actually waking up. And I get four A M going for ten to twenty mile runs most days. He finally stopped that he did like diet after about six months because he said, I can't maintain my weight so i'm losing .

too much way so I do mean to dropped. So what you was just think there some social media personalities, so with nutrition might be hypomanic um let you do the clinical evaluation um so what does somebody doing that case? So I I don't know that i've ever been hyman ic.

As I mentioned earlier, unless i've done a very high intensity work out early in the day and I need to replenish carbon hydras, I typically eat meat, fruit and vegetables throughout the day, minimum amount of fruit, but some. And then at night I switch to mainly carbon hydrate. That really helps me sleep. If planes glackens stores, I sleep really well.

Wake up the next morning, repeat and of course, this goes against a lot of the dogma that, oh, you're not super sing carbo hundred late in the day and this is what works for me um and so and so I do IT for somebody like this mental health professional who was hypomanic. Would going off the key to genetic guy entirely be the best idea? Or could IT be that adJusting when they their carbon hydrate would be advantageous in order to make sure that they felt alerting greater in the day, maybe not hypoxic, but then, uh, you know, where could have a four to eight hours tonight sleep, as opposed to a two to four hours night, which is really very little sleep? Not can be healthy. It's not healthy. And even if you can do IT and feel great, I imagine that the brain is suffer .

and and and the body is suffering and your .

friends and family yourself.

the body is repairing ing itself with sleep and so yeah it's uh um the you know if it's somebody whose is a not a patient, they're not a mental health patient. They're not using the hydro enc diet is a mental health treatment. They're simply doing IT for whatever.

Um I actually start with everything you've just outlined. Let's start with behavioral measures first and the first and intervention is education. You need at least six hours of sleep a night period, end of story.

That's non negotiable. If you're not getting at least six hours of sleep a night, we need to consider this a problem. So figure out a way to get six hours of sleep.

For some people, that's enough. Just the education. They they don't get out of bed at three A M. IT might take him an hour to fall back to sleep. They fall back to sleep. For most people, if you can get three nights of decent sleep in a row, the typo mania goes away IT IT is that is the way to extinguish IT.

And and then they still go on feeling are high from IT if you great, the brain feels good um in terms of memory, concentration, motivation, all of those things but they're not hypomanic anymore. Um and then I might use supplement melatonin, others others that you mention, magnesium is a big one. And for for some I will recommend exactly what you're doing.

Eat some carbid rates in the evening before you're going to bed, either have them met dinner and then wait a few hours before you're going to go to bed or have them right before you're going going to go to bed just to try to calm your body down and uh get IT going for when i'm using this is a clinical intervention, especially with patients with serious mental illness. Um I actually want them in a state of key osa long term, so i'm not going to do the car by intervention and can try all the other ones. But if they still can't sleep even with supplements over the counter supplement, then i'm probably GTA go with prescription.

Sleeping medicines is a temporary stop gap to try to get them three to seven days of decent sleep that usually breaks the hypomanic cycle and then they stay on the kidney diet because IT ends up resulting in all of these other improvements that i've described. They their illness can sometimes going to full remission. Um so is IT lotos trason .

as a first first line prescription, I would not use transit.

I would actually specifically avoid resident interest because it's an entered the present and they're already hyper manic and I certainly don't want to to push that further. So as long as that somebody without a history of addiction, i'm going to a use a venal days APP. Um or either you know commonly called the z medicines for sleep zala dam or ambient or something like that .

tap into the opposite path. G i'm probably .

I usually start with something like a something like that um probably out of them because it's shorter acting um and again, i'm only looking to use a short term. I let them know that up front. We're looking for three to seven days of decent sleep and then we're going to try to get them off that medicine. And usually people are off to the races and can sustain at well .

a question about hormones. Many of the huberman lab podcasts le listeners will ask anytime we're talking about something like exercise or a drug treatment or or behavioral treat, people say, what about the menstrual cycle? How is that impacted by this? And how does this impact how does the menstrual cycle impact its efficacy? Y it's set a um carbo hydrates uh and color c restrictions have been implicated in different um interact are known to interact with the underground system.

Um so what do you do if you have a patient who um is depressed or could have psychotics symptoms? Es, but IT let's go with depression because that's probably a bit more familiar to most people and then they're on a low carbon hydrates or full kito generic diet, but their menstrual cycle cease. How do you deal with those adjustments? And I guess we going to spend this conversation to say, what about male fertility also? Because sub chloric diets seem to improve.

My understanding is that sub maintenance collate diets, the weight loss diet will improve testa ostrom exogenous ratios in males that are obese. But for someone that's not obvious to go on a sub color c diet that I can start to improve just to les and probably not make render them in ford al, but i'm certainly adjust that whole access. So what about interactions between key tos diets at sea and the underground system?

The real answer is I don't think anybody knows and there's not a one size. It's all answer because i've seen i've seen examples and I am aware of science to back up polar opposite conclusions. So the first general observation that i'll make, I know so many couples, husband's and wives, boyfriends and girlfriends, had a sexual couples who have tried the key generic diet till lose weight together.

an end of on the baby.

No, almost almost univerSally, the men have a much easier time with IT than the women. Um it's it's not across the board, but I know so many examples where the women say I couldn't tolerate that diet IT IT did not make me feel Better IT actually make me feel worse. And I think in those cases that probably does relate to hormones.

I'm aware of animal models of mice, in particular giga diet and mouse models. One researcher shared with me the thing that was striking is that the female mice never got pregnant on the other genetic diet. Where's the mice on the standard diet? Were just having babies, right? And laugh, and I was just shocking. The difference on the surface that makes sense, the kiloton ic die is mimicking the fasting state. Women who are trying to reproduce should not be fasting.

If your body isn't a fasting state, IT probably does not want to to expand resources, meta lic resources, calories, nutrition and other things to creating a baby because you're very life is being threatened by coton coat faster or starvation that even though the category diet is a sustainable non starvation diet, we're really using that diet to trick the body and the thinking that IT is in a fasting or starvation state. And so just from a kind of evolutionary stance that makes sense, that women's bodies may actually have significant changes in hormonal status to prevent pregNancy, because a woman should not be having a baby when she's starving to death. Um I know of examples of women who are the opposite though, who have benefited dramatically and tremendously from the eugenic diet, have put sis of rena bipolar disorder to the remission.

And I do actually know of one case, at least one case, a woman in feral SHE in her husband had been trying for three years, no pregNancy SHE went kito within four months SHE was pregnant. How do I make sense of that? I don't know.

And unfortunately, I don't think we really have good control data on what does the teenage diet do to male hormonal systems. What does the kiosk c diet do the female hormonal systems. But you know, clearly, I think changes are happening and I I don't have a way to protective, at least if somebody else has great insights. I welcomed them, but I haven't seen them published.

It's a terrific answer because when things are all over the place and by directional, depending on one circumstances, the other, I think IT IT screams for controlled studies and and more descriptions of case studies and an anecdotal data too. So I think it's it's an excEllent answer. IT also calls to mind the important public service announcement that um because of these by directional effects that you describe, please don't use fasting or the key to Janet diet as a reliable form of contract action.

yes. Please doubt .

I have a final question, which release is something that is very much um starting to get buzz now and maybe more so far, people that hang out in the twitter space or the nutrition space. But um there's a new class of drugs that I think initially were developed to um treat diabetes but are now being evaluated for their efficacy to a obesity. And these are the semi lutie drugs that are involved in.

They tap into these glucagon related pep G L P one pathways and as as A A story that we've talked to a little bit on the podcast before, but many people, I imagine, probably haven't heard that conversation. I would just simply like to know what you think about these drugs. They obviously adjust the way that glucose inland are managing energy um both in the body in the brain and can produce weight loss the that to me when I look at the data yeah it's impressive but um a good you know a good logical shift in diet exercise could achieve similar weight loss but a lot of people just won't do that. So the question I have is um what are your thoughts on sea blue tide and um other glp? I think I might have said gt before, excuse me, glp one related compounds and do ever prescribe be these in conjunction with these dietary shifts because IT seems to me they would fall right in with the catoche of other approaches that you have available.

The real answer is, I am not at all an expert on these medications, but what are your .

thoughts about them? I mean, they seem to be weight lost drugs, and not unlike the fen fen drugs over the nineties that then were banned because a few people didn't handle them well.

They are and um you know and um we had fan fan and even before that in the ninety fifties and sixties and seventies dexedrine and ampt, my mother's little help was yes, was the treatment of choice for women across the united states to keep their swim figures and we created addicts and all sorts of problems, but they were widely used in probably millions of women because they .

work um because they kill appetite.

They kill appetite. the. My overall thoughts are this. There is zero doubt in my mind that the obesity epidemic is a threat to human health and potentially the human species.

If IT keeps going at the rate is going, IT is a threat to our species. We have to figure out what on earth is happening and what can we do about IT. These medications in early studies are highly effective over a year too. That's promising. I am worried though that we're not attacking the root cause of obesity.

And if we're not, if if the room cause of obesity ends up being some kind of poisoning of the metal bolic machinery in the brain or body, and I would argue that probably relates to my to concentrate health and my country of function. I have every reason to believe that taking a medication that helps you lose weight may not be addressing that problem, and therefore may not be addressing all of the negative health consequences of what we call obesity. I actually, so obesity in and of itself, we know that excess fat can become inflamed, ory and can cause problems in and of itself.

But I actually see obesity as a symptom. I C. Obesity as a symptom of meta lic arrangement in the body or brain. And that is why people become obese and that if we're really going to get anywhere, we need to identify what is causing that netbook arrangement using a symptomatic treatment like A G L P one. You know, medication, to the best of my knowledge, is not addressing that core problem and we're just ignoring IT.

Maybe i'll be wrong and maybe this will be the wonder drug that saved the human species, and everybody will be thin and healthy forever and ever. I'm not hopeful because we've desert. We've had so many promising drugs come along.

Fan fan, dex, other things, we've had so many promising drugs. And at the end of the day, when you try to muck with human metabolism using a single processed molecule man made, I can't think of even one example where it's. Where it's been great for large numbers of people.

I mean, certainly manufacturing instant is life saving for people with type one diabetes. So that would be an example. But giving mass of doses of inland to people with type two diabetes actually a doward spiral I would match. Others see people with type two diabetes control their diabetes through diet and lifestyle. And that might be a cute on a diet, or low carb diet, or exercise, or good sleep, or all of the other thing, all of IT.

I'd much rather see that because when people try to control their type tu diabetes with a molecule, even though it's a natural molecule incident, we know that that results in really poor health consequences, results in higher rates of cardiovascular disease, higher rates of mental disorders, higher rates of premature mortality. Do I think G, L, P, one, you know, molecules are going to be different now I don't have any reason think they are going to be. So that would be buying two cents. But we'll see.

Time will tell. Time will tell. Meanwhile, I want to thank you for doing what is, without question, pioneering work. I mean, again, i'm not a clinic, but i've been around the space long enough to know that indeed, there there are no wonder drugs. There are drugs that certainly can help deviate symptoms and some individuals.

But that lifestyle, and in the case of you're work in particular in the discussion today, diet and the ketogenic guide in particular, um it's clear can have incredible effects, more acute effects in some individuals and positive effects and others that might not be of the same magnet de. But none's are extremely important. So I half of myself and listeners and and certainly just on behalf of everybody out there, because everyone does need to be concerned about mental health issues, whether not they have them in in their family themselves or otherwise, because they impact everybody.

Truly want to thank you for doing the word that you're doing because he really is pioneering and its brave. And I can see now based on our discussion why IT would work, you given us a lot of hints into the underlying mechanisms that suggest as to why IT would work, and you've given us examples as to how IT has worked in patients that you've worked with. And this field is expanding fast.

I think this is an area of psychiatry and medicine in general, meaning behavior, nutritional interventions, that is expanding very fast. So thank you for being brave and for taking this on and doing IT in such a structured way and for communicating IT here today and with the general public through your book in your online, we will certainly point people in the direction of those valuable resources. Thanks so much. I really appreciated.

Thank you, Andrew, for being brave and having me on so and a pleasure for a great conversation. Thank you for joining me for .

my discussion with doctor Chris palmer. I hope you found IT to be as an informative, actionable and exciting in terms of the various treatments that we can now think about when considering treatments for psychiatric disorders. Once again, if you're interested in his work or his new book brain energy, I encourage you to go to his website.

That's Chris palmer, md. Dot com. You can also find the book brain energy by Chris palmer on amazon and other sites where books are sold, and we provide links to the book and to doctor promotion website in the show.

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