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
  • Joe takes Carlson’s fish oil
• 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)
  • To grow your own broccoli sprouts use this kit with these seeds
• Even a single sauna session has been found to improve depressive symptoms

Intro

• Check out these Podcast Notes from Rhonda’s last appearance on Joe’s podcast
• Follow Dr. Patrick on Twitter and Instagram
• Check out the Podcast Notes from her podcast

BPA

• 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
    • For more on a FMD, check out these Podcast Notes
  • 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
  • Magnesium
    • 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 if 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
  • For us at Podcast Notes, hands down, when it comes to a brand of NR, we can’t recommend Elysium Basis enough (use the code “podcast45” at checkout to receive $45 off a semi/annual subscription). We, Matt and Yoni, have been researching the company and trying Basis out for the past 3 months. Basis is a proprietary formulation of crystalline NR and pterostilbene that supports cellular health by increasing and sustaining NAD+ . Elysium Basis is the only NR supplement we’ve found that has run gold-standard clinical trials, owns their own supply chain (which means metals, other molecules, etc don’t get in your supplement), and they continuously test the product for stability long after it hits the “shelf.” In short, it’s effective AND safe.

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