The Joe Rogan Experience #1178 – Dr. Rhonda Patrick


Key Takeaways
  • The carnivore diet seems to improve autoimmune disorders. Why?
    • It mimics calorie restriction and fasting
    • The diet replenishes the immune system through apoptosis
    • It produces changes in the microbiome
  • Dr. Patrick has many concerns about the carnivore diet
    • People on the diet are most likely not getting the micronutrients they need (like vitamin E, vitamin C, and folate)
    • “At the end of the day, there’s no data” – Going on a carnivore diet may be harmful long term
    • By not eating vegetables, you’re missing out on key fiber that the gut needs
  • Genetics determine if you are likely to experience a placebo effect
  • Fish oil (Rhonda recommends this brand) increases dopamine in the prefrontal cortex
  • Sleep is one of the ways you clear away amyloid plaques (which develop and cause dementia) in the brain
    • During sleep you squirt cerebral spinal fluid into the brain which clears out the plaques and other junk
  • Rhonda loves this ketone ester from HVMN
    • When taking it, she experiences a decrease in anxiety (it got her to a blood ketone level of about 4.5 mmol in about an hour) and a feeling of “being present”
  • We all need to up our sulforaphane intake (found in broccoli and brussel sprouts)
  • Even a single sauna session has been found to improve depressive symptoms
  • Rhonda’s son is 13 months old,
    • She’s very cautious about exposing him to any BPA in plastic
  • Boiling water, and putting it in plastic, increases the amount of BPA that leeches into the water 55 fold
  • Animal studies have shown that BPA exposure has negative consequences on the endocrine system, and these negative consequences can be passed to multiple generations
  • A single exposure to BPA can disrupt insulin sensitivity 
  • Typically we excrete BPA through urine and sweat
  • While pregnant, Rhonda made sure not to consume any water from plastic bottles due to the concern of exposing her son to BPA
  • If you keep using a bottle with BPA, as the bottle ages, more BPA leeches out in the liquid
    • This includes baby bottles, as well as plastic water bottles
On Kids
  • Joe has an 8 and 10 year old
  • “If you know how to be happy, your kids will take on your behavior patterns”
Air Pollution
  • Living in a major metropolitan area, like NYC, can shorten your life from the air pollution
    • There are compounds in air pollution, like benzyne, which are carcinogens
  • Exposure to air pollution can increase the risk of stroke, heart attack, and Alzheimer’s disease
  • One study compared the happiness of runners after going for a run in nature vs. a metropolitan area
    • Runners who ran in nature were far happier after their run
  • You also have to be mindful of brake dust pollution
The Carnivore Diet
  • “The diet could be dangerous without any long term evidence or scientific studies’
  • The diet does seem to improve autoimmune disorders
    • Why does it work?
      • Calorie restriction and fasting have been shown to allow for significant improvements in autoimmune diseases
        • People eat less when they eat a high protein diet
          • You have less insulin production, which changes your leptin and ghrelin levels (the satiety and hunger hormones, respectively), which causes you to eat less
        • Studies show that when people are given the same food every single day, naturally they start to eat less, and calorie restrict themselves
      • It replenishes the immune system through apoptosis
        • While fasting, or just calorie restricting to very low levels, entire cells are cleared away through a process known as apoptosis
        • During a 72 hour fast, animal studies show you can clear away about 30% of the immune system and replenish it with brand new healthy immune cells
        • Organs shrink during the fasting, and then re-expand when you eat
        • Autoimmune cells may be selectively killed off first, and replenished with non-autoimmune cells
      • It produces changes in the microbiome
        • The microbiome has been linked to autoimmunity in things like arthritis and multiple sclerosis (MS)
          • One study showed that when people with MS fasted every other day for 7 days, they experienced profound changes in the gut microbiome
          • They grew gut bacteria which produce more butyrate (this is a short chain fatty acid which gut cells love – it’s good for them), which helps the immune system produce for T-regulatory cells
  • There are negative changes, in terms of the gut microbiome that occur when following a carnivore diet
    • People that go from a high fiber, to a high protein (or carnviore diet), will tend create an environment in the gut that allows for the presence of more bacteria that ferment amino acids (like putrefactive bacteria)
      • Why is this not desirable? – Some species of putrefactive bacteria have been linked to colon cancer
        • These bacteria create genotoxic agents known as putracine and cadaverine which damage the DNA inside colon cells
      • By eating fiber/vegetables along with meat/protein – this promotes the growth of lactic acid producing bacteria (bifiodo, lactobacilius etc.) , which limits limits the growth of putrefactive bacteria
  • There are other ways to cure or help autoimmune issues, without going on such a restrictive diet
    • Do a prolonged fast 1x a quarter, depending on how severe the issues are
    • Do a fasting mimicking diet (FMD) once per month
    • One study showed that going on a ketogenic diet for three months, also improved symptoms of autoimmunity
  • “At the end of the day, there’s no data” – Going on a carnivore diet may be harmful long term
More of Rhonda’s Concerns with the Carnivore Diet
  • Rhonda has concerns about micronutrients (check out these Podcast Notes where Rhonda talks more about micronutrients)
    • Micronutrients (30 particular vitamins and minerals) are essential
      • They run our metabolism, are involved in making neurotransmitters, etc.
      • 22% of all enzymes in your body require a micronutrient to function
      • You don’t make micronutrients in your body, so you have to get them from your diet
      • How are RDAs of micronutrients set?
        • First, the EAR (estimated average intake) is looked at – you look at a given population, and determine how much of a given micronutrient the population needs so that 50% of the population has adequate levels
        • The RDA is set from that, 2 standard deviations above
        • For each micronutrient it’s different
        • “RDAs are set to prevent acute disease, but what about promoting optimal health”
    • Many micronutrients are much more concentrated, and easy to get, from plants
      • The biggest one of concern is vitamin C
        • Vitamin C is important for making collagen, converting dopamine to norepinepherine (important for the fight or flight response), and is an antioxidant
          • Scurvy happens when you don’t have enough vitamin C for collagen production (this is thought to be about only 10mg/day – it doesn’t take much)
          • So people on a carnivore diet are probably getting enough Vitamin C to prevent scurvy. but perhaps not enough to cover all the other things vitamin C is required for
        • Vitamin C has two forms – ascorbic acid (the reduced form – aka the antioxidant) and an oxidized form (dehydroascorbic acid)
        • The RDA for vitamin C is 90 mg/day for men and 75 mg/day for women
          • It’s been shown in guinea pigs, there are biological differences (even 10 fold) into how much vitamin C they required
      • Vitamin E is also a concern
        • Vitamin E helps recycle vitamin C and vice versa
        • It’s an antioxidant, but is also important for maintaining cell integrity – it’s located inside the cell membrane and prevents normal oxidative processes from happening there
        • The RDA is 15 mg
        • Nuts are the best source (almonds) of vitamin E, and sardines
      • Folate too…
        • Folate plays an important role in making new DNA
          • So low levels of folate, can lead to DNA damage – this is very hard to measure, and you don’t even know it’s happening
        • Enzymes to repair DNA damage require magnesium
        • Beef liver is a great source of magnesium
    • If you lack micronutrients…
      • There are enzymes that are required to prevent and repair DNA damage, and then there are enzymes that require a micronutrient to prevent short term disease
      • If there’s only so much of a micronutrient around, it will be used for the latter
  • What is you just ate a bunch of organ meat to get the micronutrients you’d be missing from vegetables?
    • You can do it – but it’s difficult, and most people probably won’t do it
  • By not eating vegetables, you’re missing out on key fiber that the gut needs
    • “We evolved eating plants”
    • There’s all these other things present in plants that people following a carnivore diet are missing out on – falvonoids, polyphenols, phytochemicals, etc.
    • You’re missing out on SULFORAPHANE
      • Broccolli sprouts are the biggest source, but it’s also present in brussel sprouts
      • Sulforaphane activates a variety of enzymes which help get rid of potentially harmful compounds in the body
      • Humans given sulforaphane extract show an increase of glutathione (a master antioxidant) in the brain – it plays a huge role in preventing brain aging 
      • Sulforaphane has been found to improve symptoms of autism
    • There are literally so many beneficial things that come from eating vegetables – too many to mention
      • “Why would you want to eliminate a massive source of bioavailable nutrients” – Joe
Fasting and the FMD
  • Dr. Valter Longo has shown that fasting prior to chemotherapy allows cancer cells to be much more prone to cell death
    • Why? – Healthy cells increase their stress response pathways when you’re fasting (more heat shock proteins, more antioxidants etc.), and cancer cells can’t do this
    • Therefore, healthy cells are more resilient to the cancer treatment
  • Once Rhonda has stopped breast feeding her son, she plans to start regularly doing some long term fasts (2 days minimum)
The Nocebo Effect is Real
  • Genetics determine if you are likely to experience a placebo effect
    • The gene that is important in determining whether you will experience placebo vs. nocebo, also controls the degradation of dopamine 
      • So people who are more likely to experience a placebo response, have more dopamine in the brain
      • People with less dopamine, are more likely to experience the nocebo response
    • The gene SNP is called COMT
      • Gene SNPs are single nucleotide polymorhisms – it’s a slight change in the sequence of DNA in a certain gene makes it function a little differently
  • You can increase serotonin with 5-HTP and L-Tryptophan (which converts to 5-HTP), but is there anything that increases dopamine?
    • Fish oil (Rhonda recommends this brand) increase dopamine in the prefrontal cortex
      • Some schizophrenics are prescribed a very high dose (3-6 grams a day) of fish oil because their dopamine is lower in the prefrontal cortex, which is associated with he negative symptoms of schizophrenia
      • Rhonda takes capsulized fish oil from a friend who makes it in Norway – she takes 5-6 grams a day (6 pills for her)
        • It’s not available in the US yet
      • Joe takes Carlson’s fish oil – he takes 3 tbsp.a day (not sure of dose)
The Ketogenic Diet
  • Joe is favorable of it, but he eats too much meat (elk) to stay in ketosis
  • Joe asks if exogenous ketones (aka exogenous BHB (beta-hydroxybutyrate)) are beneficial for the gut in any way, since butyrate is good for the gut
    • The same thing with being in ketosis, you’ll have BHB molecules in your blood
    • If you aren’t familiar with the ketogenic diet, long story short, your body converts the fat you eat (and stored body fat) into ketones (aka BHB)
    • Short answer – we don’t know how similar BHB is to butyrate, so it’s tough to say
  • Exogenous Ketone Supplements
    • Joe uses Kegenix
    • Rhonda has tried the ketone ester from HVMN
      • She experienced a decrease in anxiety (it got her to a blood ketone level of about 4.5 mmol in about an hour) and a feeling of “being present”
        • Perhaps the glucose in her brain is being spared for other things besides “worrying”
        • Sulforaphane also does this for her
          • Joe suggests the perfect pre podcast meal – the HVMN ketone ester and a salad contain broccoli sprouts (which are loaded with sulforaphane)
      • She’ll often take it before doing a podcast, or a big talk
      • It lowers her blood sugar levels pretty dramatically, so once the ketones ware off (after a couple of hours) she crashes, since she doesn’t follow a ketogenic diet regularly
        • If she was already in ketosis, this wouldn’t happen
        • Perhaps the crash could also be mitigated by consuming the HVMN with a higher carb meal
More on Sulforaphane and Broccoli Sprouts
  • To grow your own broccoli sprouts (which are high in sulforaphane) use this kit with these seeds
  • Brussel sprouts also contain sulforaphane
  • Freezing your broccoli sprouts increases the sulforaphane content
  • You can’t cook the sprouts – the enzyme that converts the precursor into active sulforaphane is heat sensitive
  • You can put mustard seed powder on brussel sprouts, sauteed kale, or broccoli sprouts to increase the absorption of sulforaphane
    • The mustard powder has the active enzyme that converts the precursor in the sprouts/kale into sulforaphane
  • Avamacol – this is a sulforaphane like supplement
    • “The best in the US”
  • Rhonda says Prostaphane is better, but it’s hard to get in the US (it’s made in France)
    • Rhonda has been taking 3 pills/day, each pill is 10mg with food
Alzheimer’s Disease
  • There’s a gene that increases the risk for Alzheimer’s Disease if you have one copy of it (ApoE4)
    • You get 2 copies of every gene – 1 from mom, 1 from dad
    • 1 copy of this ApoE4 increase the risk 2-3 fold, 2 copies increases the risk 10-15 fold
    • The gene also increases the chances of a poor outcome if you have any kind of traumatic brain injury (TBI)
  • Sleep is one of the ways you clear away amyloid plaques (which develop and cause dementia) in the brain
    • During sleep, your brain swells, and you squirt cerebral spinal fluid into the brain which clears out amyloid plaques and other junk
    • “If you have ApoE4. but you’re getting good quality sleep, you have the same risk as someone who doesn’t have APOE4”
  • You also clear out amyloid plaques through an APOE mediated mechanism
    • APOE4 does it 20 fold less efficiently
  • People with ApoE 4 will benefit from eating fish
  • DHA (in fish oil and fish) plays an important role in enhancing amyloid clearance, decreasing tau tangles, and regulating glucose uptake into the brain
    • Tau tangles form inside of neurons and disrupt microtubule transport (the neuron’s system for transporting fatty acids to the synapse)
  • Rhonda advises to consume DHA supplements in the phospholipid form for increase absorption
    • Fish contains DHA in the phospholipid form, but it’s even more abundant in fish roe (eggs) (30-70% of DHA found in the roe is in phospholipid form)
    • Rhonda orders salmon roe
      • They often have flying fish roe in Asian grocery stores
    • Fish oil is DHA is triglyceride form – this is a close second to the phospholipid form, you just need more of it in a sense
  • Amyloid plaques form outside neurons in the extracellular space and can disrupt synapse formation
    • Why do they form? – A protective mechanism against viral, bacterial infections
  • Can you consume too much fish oil?
    • Be careful of oxidized fish oil (this happens if it’s too old)
Niacin and NAD
  • Rhonda doesn’t supplement with niacin
    • It’s been shown to lower LDL-C
  • Niacin is a precursor for NAD (which you can increase during fasting)
  • Joe takes Elysium
    • Rhonda stopped taking it while breast feeding, she was taking 250 mg/day previously
The Sauna
  • Is there a difference between infrared and standard?
    • Much of the scientific studies detailing the benefits involve the dry sauna
    • Rhonda thinks the standard saunas are better, because they get hotter (and hotter quicker), which allow you to produce more heat shock proteins (HSPs) and get more of the benefits
  • The real benefits come when you get to 180 degrees
    • 180 degrees for 20 minutes is the sweet spot
  • One study showed sauna use 4-7 times a week improved cardiovascular related mortality by 50% (and Alzheimer’s Disease risk is reduced by 67%)
    • 3-4x a week, this improved by 24%
  • Even with one sauna session, blood pressure improves, C-reactive protein (an inflammatory biomarker) drops, and vascular compliance increases
  • Frequent sauna use increases mitochondrial biogenesis and allows for improvements in mitochondrial function
  • Using the sauna before a workout has been shown to reduce DOMS (delayed onset muscle soreness) – they don’t specify for how long to use the sauna pre workout
  • Even a single sauna session has been found to improve depressive symptoms
    • Hyperthermia (and exercise) activates IL-6 (it’s an inflammatory cytokine) like crazy
    • The greater the production of IL-6, the greater the reduction in depressive symptoms
      • This is the same thing released from muscle tissue after exercise
          • In response to this, the body has an anti-inflammatory effect
          • Giving people NSAIDS (nonsteroidal anti-inflammatory agents) prior to a workout, blunts IL-6 production, and many of the benefits of exercise are negated (like improved insulin sensitivity)
      • For more on this check out these Podcast Notes
      • There are studies that show hot yoga improves depressive symptoms
  • Heat stress causes the release of beta-endorphins in the brain (same with exercise)
  • Dynorphin is upregulated during heat stress
    • Dynorphin serves to cool you down
    • It’s is responsible for what one might call, a dizziness feeling, at the tail end of a sauna session – that feeling of “oh god, I have to get out”
    • Dynorphin binds to kapa opioid receptors in the brain
      • This causes a feedback response in other opioid receptors in the brain (mu opioid receptors) which bind to beta endorphins
      • Once your are past the dizziness/dysphoric feeling from dynorphin release, you feel really good
        • Why? – More mu opioid receptors are binding to beta endorphins
        • This explains the lasting “feel good” effects from sauna use throughout the day
The Float Tank
  • Joe has one in his studio, he tries to do it 2-3 times a week
  • He’ll often do it in the morning, sometimes for 2 hours
Random Yet Important
  • Exercise has been shown to change the microbiome in a positive way independent of diet
    • Fasting does the same thing
  • Joe gets his blood checked every 6 months
  • 300 grams of brussel sprouts a day increased blood glutathione plasma levels by 1.4 fold
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