Kind: captions
Language: en
this woman in front of me my patient her
life is decimated now
her life is decimated now she's in my
office week after week sobbing begging
me for help begging me to give her
something that will make her pain go
away
and I'm like this diet might work like
I'm giving her dozens of pills already
and they haven't done [ __ ] if this diet
might help her why not try it
so that particular woman that I'm
thinking of actually became hypomanic on
on the Atkins diet
meaning it took her from a super dark
place to she was very excited very happy
she was so she was a little too happy
because I've read your book I know where
this is going and I've been meaning to
ask you about that so just to get people
markers so you were struggling and you
were in a depressive State you start
coming out of it but for other reasons
when you get diagnosed with
um the metabolic disorder it ends up
even clearing that up even more so you
start trying it on yourself you try it
on other people in your family you try
it on patients it's working for a lot of
them I don't know if it worked for
everybody but it works for a lot of them
yep we don't yet understand exactly what
the mechanism of action is but then
since I know from reading the book that
there are people there are cells that
are under firing and they're cells that
are over firing If It Moves people from
under firing into over firing
how do we know this is a good thing like
isn't isn't becoming hypomanic a sign
that we actually haven't solved the
fundamental problem
it is so at the end of the day I'm
arguing that all mental disorders and we
may need to get into defining what is a
mental disorder but
I'm arguing all mental disorders are
metabolic disorders of the brain and as
you just said what that means it can
mean a lot of different things depending
on the developmental
age of the person so
a fetus
growing in utero is going to have
different consequences than an adult
who might have different consequences
than a very elderly person who is 10
years from death
um but
for most adults
the
the two primary things are that
metabolic compromise to brain cells can
result in under activity and
overactivity
and actually the exact same cell can do
both
I have very sound scientific reason to
believe that the same cell could be
under active 90 of the time
and overactive ten percent of the time
and that will result in different mental
symptoms but
at the end of the day it's really an
issue of balance
I know that sounds like so Eastern
Medicine of me and I'm really kind of a
western medicine kind of guy
but it really is about balance in the
brain that neurons need to fire when
they are supposed to Fire and they need
to abruptly and acutely stop firing when
called to stop firing and if they are
sluggish and getting going that is a
problem
if they are sluggish and stopping that
is a problem and so it's about attaining
balance and so anytime you introduce a
treatment like a dietary intervention or
an antidepressant or an antipsychotic or
electroconvulsive therapy anytime you
introduce a treatment
that plays a powerful role in metabolism
you you run the risk of overshooting or
undershooting
and if you overshoot or undershoot
you're going to get new symptoms
and
the beauty of this Theory
is it at least for me as a clinician and
a scientist
it helps me not panic when I see that
somebody starts getting hypomanic I
don't panic anymore
I have a very clear vision of what's
Happening
overall it's a good thing it means that
I'm delivering more energy to that
person's brain that their brain is not
yet
healthy enough to manage that energy
appropriately that's interesting so take
me into the cell now so we for people
that don't know what mitochondria are I
think it will be a very helpful primer
I've talked about it a fair amount on
the show
long time viewers listeners will have
heard me refer to it as the PowerHouse
of the cell but your book goes into
details much more than that
um why do people think it's a Powerhouse
and why do you think it's far more than
that
so mitochondria being the powerhouses of
the cell is based on the fact that
mitochondria take most of the food
they're really the only utilizer of
oxygen in human body like everybody we
need to breathe we need to breathe in
oxygen breathe out carbon dioxide
that's mitochondria mitochondria are
using that oxygen and churning out
carbon dioxide at the end of the day
they are doing the processes that result
in that so this is really fundamental
stuff to living organisms it defines
life itself in many ways
um
and there's no doubt mitochondria are
powerhouses they do those things
but the research over the last 20 years
primarily in the metabolic health field
but also in the Aging field so
researchers who are trying to figure out
what causes premature aging how can we
slow it or delay it
um
there's been an explosion of research on
mitochondria and all of the functions
they do
some cancer researchers are highly
focused on mitochondria
and then in the neuroscience and mental
health fields this dates back to at
least the 1980s
in the 1980s we had the first
mitochondrial theory of autism and in
2000 we got the mitochondrial Theory by
polar disorder and since then we've had
mitochondrial theories of lots of
chronic mental disorders but it also
applies to things like Alzheimer's
disease and Parkinson's disease
so
quick summary of well what else do
mitochondria do
they are primary regulators
of neurotransmitter production and
release including key neurotransmitters
like dopamine and serotonin and Gaba and
glutamate
they are primary Regulators of
steroid hormone production and release
so this includes cortisol estrogen
testosterone progesterone they are
primary Regulators of inflammation they
play a direct role in turning it both on
and off they are primary Regulators of
epigenetics in fact one study found that
they are responsible for the expression
of at least 60 percent of the genes from
the cell nucleus mitochondria
mitochondria so mitochondria are
producing lots of this signals that play
a role in the function of cells so
mitochondria producing something called
reactive oxygen species mitochondria are
producing ATP
but they also play a role in how much
ADP and amp are in the cell those levels
the levels of ATP to ADP to amp playful
profound roles in cell function and cell
health and gene expression mitochondria
play a role in the levels of calcium in
a Cell calcium is important to turn
cells both on and off also plays a role
in gene expression mitochondria are the
primary Regulators of calcium levels in
the cell yeah so first of all this is so
such a radical limit I'm getting too
nerdy this is incredible we're actually
going to keep going deep but I I I had
never heard anybody talk about
mitochondria as being that
multi-dimensional before and I've really
looked into this stuff and so this is
part of what freaked me out reading your
book is you're very clear in the book
I'm not saying any of this stuff for the
first time but I'm the first one pulling
it all together and so I had never heard
of mitochondria talked about as anything
other than then you've referred to it as
a power cable you usually hear about it
call the battery but I thought that was
interesting so they are the power cable
but you said that's actually not the
most accurate way to think about them if
you're going to use an analogy use the
analogy of a motherboard in a computer
that's when I was like what like I've
I've just never heard that before so
once you begin understanding the the
like Wayback history is we at one point
were a single-celled organism that
consumed the mitochondria in inside of
the cell so when you think of
mitochondria as like its own living
thing with its own DNA it is its own
bacteria that's you've taken inside the
body and you begin to understand are we
really humans as we think about it or
are we this fascinating collection of
bacteria and when you begin to
understand that from your microbiome to
the biome on your skin in your mouth and
inside of your cells you have all these
different bacteria doing all this
different stuff to have intelligence
might not be the right word but that's
where you begin to realize oh my God it
now I begin to understand how it could
be possible that all these very
disparate things which don't feel like
they could be connected with my
layperson's brain anyway just they felt
too disparate that once I understood how
much mitochondria is involved in that if
you begin to break that Machinery
through diet we're going to need to go
into why that ends up breaking it
because I actually don't understand that
part but then it's like okay if this
really is the motherboard and you do
something that disrupts the motherboard
now you understand why it will sketch
out your entire personality
and
that blew me away I I did not realize
even to the point where and this I think
is what you were just saying that
mitochondria themselves will produce
hormones but they also have receptors
for hormones so they're like
communicating to each other yes with all
of these mechanisms that I think I
represent a lot of people in that I
imagine it still in that homunculoid way
where there's like a guy in my brain and
you know my brain is like dictating all
these functions when in reality it's
hyper distributed it's happening at the
level of cell
and they're communicating back and forth
with these different Messengers
is that all accurate the one thing I'm
going to correct
is that diet is the primary or only
factor that can harm mitochondria
so the most important message that I
want to make sure people don't come away
with
is that Chris Palmer is saying poor diet
is the cause of all mental illness how
are you not saying that this is so
interesting I'm not saying that at all
and at the same time I am saying diet
plays a powerful role in mental illness
diet plays a powerful role in
mitochondrial Health but it is not the
only thing that plays a role the reason
that is so critically important is
because I can think of hundreds of
examples in which people might develop a
mental illness completely unrelated to
diet somebody could be traumatized
somebody could have a horrible traumatic
abusive childhood somebody can have a
hormonal imbalance somebody can smoke
cigarettes somebody can do hallucinogens
lots of hallucinogens and marijuana and
develop a psychotic disorder those
things are none of those are diet
related
people are consuming other things or
other problems are occurring in their
body and they can develop chronic
crippling mental disorders as a result
women hormones postpartum
postpartum everything postpartum
depression postpartum anxiety postpartum
psychosis postpartum Mania those are
real things it's not because women
change their diet it's not because women
started eating more carbs at the end of
their pregnancy and that or they
somebody gave them a box of chocolates
and they ate those chocolates and that
is what caused their postpartum
psychosis
it's not that simple and we can't make
it that simple
the reason this theory is so
overwhelmingly exciting to me
is because
number one if you understand the science
of mitochondria you can understand all
of the symptoms of mental illness and
all of the associations that we have
known about for decades you can begin to
understand neurotransmitter imbalances
hormonal imbalances gut microbiome
issues
um all sorts of things under active
overactive brain regions so by
understanding mitochondria you can
understand the phenomenon of Mental
Illness but much much more importantly
or equally importantly I guess it's
equally importantly
is when you look at all of the things
that can adversely affect mitochondrial
function
like the things I just mentioned
they're all well established risk
factors for mental illness
so what I'm saying in a nutshell is
mitochondrial dysfunction ultimately is
the cause of mental illness and if you
ask the big picture question well what
causes that
diet is one of the things that can cause
it and I'm happy to go into the details
and Weeds on that if you want but it's
not the only thing that can cause it
trauma can cause it
alcohol use can cause it marijuana use
can cause it poor sleep can cause it
high levels of stress hormonal
imbalances insulin resistance all sorts
of things that we know play a role in
mental illness are known to directly
impair mitochondrial function
and that
can result in all of the metabolic and
mental disorders that we know of
so if you you can take any one of those
risk factors childhood trauma
people who have a lot of trauma in
childhood are more likely to develop a
mental disorder which one
all of them
all of them it's not just post-traumatic
stress disorder they're also more likely
to develop depression anxiety disorders
personality disorders bipolar disorder
schizophrenia alcoholism opioid
addiction they're more likely to develop
every mental disorder was that part of
your first clue that they had to have
some similar underlying cause
foreign
it wasn't the first clue this was kind
of like as I
as I dove deeper
you know in order to create this Theory
I had to dive really deep into cell
biology and mitochondria and
mitochondrial function and all of The
Cutting Edge research that's going on
with them but at the same time I had to
go out and see the forest from the trees
and test
my hypotheses
test my theory I had to like make it
work
and it trust me I didn't do it overnight
the first iteration did not make sense
the first iteration I quickly found
flaws in the way I was thinking about it
flaws in the theory
but I kept going back to the not to the
drawing board but I kept going back to
refine it well let me see if I can
understand this in a different way let
me see if I can add just one level of
complexity to the theory to make
everything fit what was some of the
first roadblocks that you ran into
you know the biggest roadblock that I
ran into initially was the fact that
psychiatric medications many of them
cause metabolic harm
we have lots of pills that we use
that cause massive weight gain but they
work
is that why it was a conundrum they
caused diabetes they cause
cardiovascular disease and they produce
symptoms of mental illness and when I
when I recognize that I quickly
recognize nobody's gonna believe this
this theory is crap it's dead
there's no way I can
responsibly make this claim
given that the pills we give are causing
metabolic problems that doesn't make
sense because I'm not going to go down
the rabbit hole of conspiracy theorists
and say all the trials are fraudulent
none of the medicines actually work
because as a clinician I know that's not
true I've seen the medications work
I have used them and I have seen them
work
and yet as I'm developing this Theory I
have to be able to explain well then why
would a metabolic toxin or a
mitochondrial toxin which some of our
medications are why would that reduce
symptoms and that is what ultimately led
me to
refine and understand these two
dichotomous states of metabolically
compromised cells both under active and
overactive
so one cell when it's metabolically
compromised requires energy to work
and if it doesn't have enough energy
it's not going to work as well that's
the under activity most people get that
if a car doesn't have enough energy it's
just not going to go as fast or it may
not go at all or maybe parts of it won't
work under active functions all make
sense
the hyper excitability hyperactivity did
not make sense initially
but as I began to understand all of the
complex roles of mitochondria
the fact that they are sequestering
calcium to turn the cell off
and that if they fail to do that in an
efficient manner that cell will become
hyper excitable that was the thing that
blew my mind that really got to the
heart of it
but again I so I didn't stop there I
then step back and say let's see the
forest from the trees test your theory
Chris
test your theory you should be able to
test it with common sense already
established observations if that's
really true
if that's really true
think of all of the situations you can
think of in which mitochondrial function
is abruptly impaired
and then ask yourself are those
situations associated with brain hyper
excitability
meaning does it increase your risk for a
seizure
and lo and behold
it works
oxygen deprivation
can cause seizures
carbon monoxide poisoning
carbon monoxide poison oxygen
deprivation are very specific
assaults to mitochondria because
mitochondria are the only things using
oxygen
if somebody doesn't have enough oxygen
or if somebody gets carbon monoxide
poisoning all sorts of symptoms can
emerge including all sorts of mental
symptoms they can start hallucinating
they can give them paranoid they can get
depressed they can have brain fog they
can have all sorts of things but they
can also seize which is an unequivocal
example of hyper excitability but then I
went to mitochondrial toxins arsenic
lead
cyanide
these well-known toxins are all
targeting mitochondria that is their
mechanism of action that is how they are
toxins the truth is hitting your career
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description alright my friend back to
today's episode
and if you look at the consequences of
poisoning with those
seizures are a possible consequence so
once again
acute poisoning of mitochondria can
result in hyper excitability of the
brain
I could go on and on and on but
needless to say I didn't go into this
lightly so I did my best to test this
theory in every which way I could with
available evidence
to see does it even fit like I'm I'm
presenting a picture
that's the way I think about a theory
so the way I think about developing a
theory is that every research study is a
piece of the puzzle
the puzzle has to create a picture a
coherent picture that makes sense
it has to
and the reason it has to is because
humans exist we exist and we
have flaws and we have mental illness
and we have mental health and we have
all of it the fact that it's working
tells me there must be a coherent
explanation and it's our job to figure
it out
so
in my mind creating a theory is about
taking all of the relevant
research
that we have
all the studies that are all pieces of
the puzzle and just putting them
together
but what I've had to do is rearrange
some
I've had to take pieces of the puzzle
from the Obesity world and pieces of the
puzzle from the metabolism world and
pieces of the puzzle from the Aging
world
and all of the pieces of the puzzle from
the mental health world
and only then could I put it all
together to create one coherent picture
that actually allows us to make lots of
predictions in the way that I just said
well oxygen deprivation
can cause essentially every mental
symptom and seizures why
why is that
carbon monoxide poisoning can do the
same arsenic poisoning can do the same
why
it's not serotonin
it's not carbohydrates
so why
and when you understand the science
and you see the forest from the trees
you can then actually start to use
Simple interventions like low carbo keto
diets to help people heal from sometimes
life-threatening
devastating brain disorders and other
health conditions okay so you just made
a leap that I couldn't follow so we're
looking at all of the different things
that could cause somebody to seize up
that tells you we can throw it into a
hyper excited state so now you've solved
for the I know I can be under and I know
I can be over so I need to find that
balance in the middle you look at all of
the things that cause mental illness and
all of them keep coming back to
basically perturbations in oxygen and
that points you to the mitochondria so
you're looking at all the different ways
that this goes wrong and you're seeing
at that point that the only thing that
it could be is mitochondria the the
thing that led me down this path is a
serendipitous finding so it was it was
not only that I was noticing that the
ketogenic diet or low carbohydrate diets
could help people with depression and
anxiety but it was in 2016 when I had a
patient with schizoaffective disorder
who had been my patient for eight years
was tormented by his illness
had tried 17 different medications they
did not stop his symptoms
he had seen numerous other mental health
professionals
and basically our field said well he's
just got a really bad illness and he's
gonna live
a second-class life essentially we're
really sorry we don't know what to do
he asked for my help to lose weight
I decided to try the ketogenic diet at
that point I have no
no conception whatsoever that this is
gonna do anything for his illness
because he's got schizoaffective
disorder he that that's very different
than depression and anxiety
but I'm like but it's a good weight loss
tool I'm gonna help the guy lose weight
he wants to lose some weight I'll help
him lose some weight
within two weeks
I'm noticing the powerful antidepressant
effects I'm thinking wow it's even
happening for him
and he's got a really bad illness he's
got this horrible debilitating
schizophrenia bipolar thing
um
and the thing that upended everything
that really set me on this journey was
about two months in he spontaneously
starts reporting his hallucinations are
going away his paranoid delusions are
going away he starts to realize that
they aren't true and probably never have
been true
this man has now lost 160 pounds and
kept it off so the weight loss thing
goes well six years later
almost seven years later now he
but he was able to do things he hadn't
been able to do since some of his
diagnosis he was able to go out in
public and not be paranoid
perform improv in front of the live
audience move out of his father's home
it was that story that began in 2016.
that completely shattered everything I
knew as a psychiatrist and actually
forced me
back to your initial question why what
what was the mechanism of action
initially I was like who cares it works
it's not my job to figure it out
whatever nobody's going to take this
seriously I need to stay on the down low
with this anyway I'm a Harvard physician
I cannot be talking about the Atkins
diet for mental health nobody's going to
take that seriously they're probably
going to take away my license they'll
fire me from my job I don't need any of
that in my life and I'm just gonna shut
up about this I'm gonna lay low
when I saw it put
essentially schizophrenia into remission
at that point I knew I can't stay quiet
about this
this is too important millions millions
of people's lives are devastated
I can't shut up about this I cannot keep
this quiet
and at the same time I knew that I have
to have science nobody's going to
believe me
that I already can hear them laughing
I have to figure out how and why would
this work
and so I went on this journey
the godsend for me was that the
ketogenic diet is actually an
evidence-based treatment for epilepsy
it can stop seizures even when meds
don't
and we use epilepsy treatments in
Psychiatry all the time so I'm like oh
that's a nice gift I've got all these
Decades of Neuroscience that I've never
known about nobody had ever told me the
ketogenic diet stop seizures I had
trained in Psychiatry and neurology
nobody ever told me that but I quickly
figured it out and then I went on this
deep dive to understand the Neuroscience
of that
but at the same time I'm trying to also
piece it together with but wait this
doesn't make sense because
it made my metabolic syndrome go away
how did that work and what does that
have to do with mental illness
it helps
hundreds of thousands if not millions of
people lose weight what does weight loss
have to do with mental illness
it helps people with type 2 diabetes
put their type 2 diabetes and remission
off medications what does that have to
do with mental illness
so quickly I realized
I have a lot more work to do I have to
understand well how the hell does this
keto diet work for
obesity and diabetes and epilepsy and
all these other things and how can I
pair that together with the science of
the mental health field
and very quickly you know initially the
cursory review leads you to
neurotransmitters and inflammation and
hormones and other things
but that's just all the
kind of
vague non-specific garbage we've been
spewing out for decades it gets us
nowhere and I realized no I no that's
those are insufficient explanations
because they don't deliver actionable
new treatments that actually restore
People's Health or lives so I need to go
deeper than neurotransmitters what is
causing the neurotransmitter imbalances
and why do those neurotransmitter
balances change why do they change from
day to day from hour to hour because
people who have hallucinations aren't
hallucinating every day 24 7. they're
hallucinating some of the time not all
of the time so how can I understand this
all of that led me to mitochondria
and then the more I unraveled and
learned about mitochondria the more I
was like
oh my God
this is connecting
not just the dots of why would the keto
diet help my patients
but this is connecting the whole
freaking mental health field I'm like
this is impossible what is the mechanism
of action though is it like I can round
it to it regulates and so it turns off
when it's supposed to turn off and it
turns on when it's supposed to turn on
but why
I think the easiest answer I can give
you to the big picture question that
you're asking is like what exactly is
happening why are different people
having different symptoms
um
the first thing I want to say is if this
sounds like too much of a leap for
people I just want to point out type 2
diabetes is supposed to be one and one
distinct illness
some people with type 2 diabetes get by
just fine with diet and exercise and
otherwise don't have any unreal
otherwise related health conditions
other people at the extreme end with
type 2 diabetes not only have their type
2 diabetes for which they take massive
doses of insulin to try to control their
still uncontrolled blood sugars but
they're also having heart attacks brain
problems eye problems nerve problems
gastrointestinal problems liver problems
kidney problems and all sorts of
problems
we know all of those things are related
to type 2 diabetes
so why does one person have all of those
things
and the other person seemingly has a
very mild illness
it's a metabolic problem there are lots
of factors that go into it some people
with a metabolic problem can have very
mild symptoms that are localized in
specific ways other people can have wild
out of control metabolic dysfunction
this wreaking havoc on their entire body
so that is
that is just fact today at least the way
most people think about type 2 diabetes
it's a metabolic disorder
and it can have widespread consequences
on the whole human body including the
brain so when I think about metabolic
dysfunction in the brain
what I'm really thinking of is specific
brain cells or brain circuits
that either have insufficient
mitochondria
or
the mitochondria that are there are
somehow defective
and for people with chronic mental
disorders it is one of those two things
insufficient mitochondria and or
defective mitochondria that are not
performing their tasks and what that
means is that those brain cells or that
those brain circuits
are then going to become under active or
overactive
which can then result in symptoms that
we call mental illness
the environment however plays a role so
you have these cells that are
vulnerable
that's the way I think about them these
are vulnerable
cells they're not dead
they're still alive they're still trying
to do what they can do
but they're malfunctioning
intermittently
so what would make the the malfunction
more
and what would allow them to function
normally
the beauty of this Theory again is let's
just look at all the risk factors for
symptom exacerbations of mental illness
if a person is eating a good diet well
rested non-stressed
symptoms are going to be low or absent
because the demands on those cells
aren't great and or there are lots of
available resources because this person
is not stressed
as soon as you apply a metabolic stress
to this human being
in the form of I'll give three but there
are lots of others sleep deprivation
really crappy diet and or
um high levels of stress or trauma
as soon as you do that those are all
assaults on metabolism broadly not just
the brain
so if somebody already had a heart
attack
last year they are at higher risk of
having another heart attack
when they are sleep deprived when they
experience high levels of stress or
trauma or when their diet is way off
but likewise people with mental
disorders who have metabolic brain
dysfunction same deal
so with a heart attack it's parts of the
heart or the arteries that feed the
heart that are going to start to quote
unquote malfunction or possibly the
immune system cells that are going to
you know and the coagulation cells that
are going to coagulate or something
something is going wrong
under those stressful situations and the
same deal in the brain that when the
brain when the
when the human being is stressed in
these obvious known predictable ways
it causes a stress response essentially
and the stress response means that
metabolic resources energy food oxygen
are actually going to the defense system
of the human
organism
and that means less
metabolic resources are available to all
of the other cells in the body
most of the cells get by okay
because we have Reserve capacity we have
how if you have metabolic Health if you
have resilience you're gonna be okay
but if you have some brain cells or
brain circuits like the anxiety cells in
your brain when you had an anxiety
disorder those cells are vulnerable
under Good Times they're going to
function fine and that means you're not
going to have symptoms of anxiety but if
somebody stresses you
your anxiety is going to go through the
roof
in a disproportional way like so you
know a lot this is where the stigma of
mental illness comes from
because then people think well you know
that was a pretty mild stressor why are
you freaking out
why are you hyperventilating over that
stupid stressor
and that's where the stigma comes from
because all the normal people are saying
I I can manage that the teacher gave us
an assignment
yeah it's a little stressful but big
deal but you're hyperventilating and
having a panic attack over it like God
get all the grip take some deep breaths
yeah there's a meme on the internet that
is brutal and it was there was a student
in class the teacher called on him and
after 30 seconds he said I'm not dumb
I'm just panicking
and I was like whoa yeah that is uh
that's rough that to your point about
the stigma of mental illness that it one
it seems to be ratcheting up now that
more and more that that Meme is a meme
because so many people can relate to a
small stressor causing them to panic and
so there's a lot of things that can
cause these problems you name three I
think those three are pretty profound so
you've got poor sleep poor diet trauma
and stress trauma
when you work with people because the
book really focuses on the diet does the
diet have a disproportionate soothing
impact and if it does I have a guess why
but
is that true that the diet is just the
thing that disproportionately sort of
brings that the tax on the metabolic
system down
the diet
I think a lot of people I really did not
mean to focus in the book really I
really did not but a lot of people
reading the book Will Come Away with the
ketogenic diet is the new thing I read
about because they already know the
other stuff they already know don't you
know get good sleep yeah we already knew
that avoid trauma and stress yeah we
already knew that
um uh don't use drugs and alcohol uh
hormonal imbalances yeah yeah
um everybody knew that
I spent so much time in the book going
through all of those known things
because again this is a new Theory I had
this show that all of our existing
knowledge fits into it everything that
we already know to be true fits into it
but to answer your question why the does
the diet play a special role in any of
this I would argue that the ketogenic
diet or fasting States or fasting
mimicking States in particular play a
profound role in healing
and the reason is not because
carbohydrates are the villain
the reason is because
fasting is
the saving treatment
now because of its impact on
mitochondria so one thing we haven't
talked about is
mitophagy so for people that know
autophagy where the cells are program
cell death so the cell didn't die
accidentally we see that it's deformed
or it's not performing the way that it
should there's enough stress on the body
that we go in we break it apart and we
shuttle those off
fasting or fasting mimicking diets as I
understand it trigger mitophagy where
the mitochondria that are malfunctioning
those are broken apart to make way for
new mitochondria and that if I
understand it again that the liver which
is actually making the key the liver
mitochondria which is making the ketones
has to up ramp to keep up with the
demand to make the ketones and so now
you're up regulating the production of
your mitochondria so you have basically
put a a hermetic stress on the body
through fasting or fasting mimicking
that says hey hey we have to go anything
that's malfunctioning it's got to be
taken apart and we have to also generate
more mitochondria new mitochondria and
this might be where we start to get into
the more holistic view of what you're
talking about because you talk about
exercise in the book talk about sleep
sun exposure what is that perfect milieu
to use a fancy word what does that
perfect lifestyle look like what is up
my friend Tom bilyu here and I have a
big question to ask you how would you
rate your level of personal discipline
on a scale of one to ten if your answer
is anything less than a ten I've got
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boring which is what kills most people
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requires you to do those challenging
stressful things and to stick with them
even when it gets boring and it will get
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all right I've just released a class
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legendary peace out
it's all the common sense things that
people know with the exception of
a fasting mimicking diet so you know
again the medical field right now says
that's dangerous and Reckless and
uh Jillian Michaels doesn't like it
uh so lots of people hate the ketogenic
diet
lots of people in society hear that it's
dangerous and toxic
um but all of the other things that
milia is all the common sense things
that people already know and one of the
pieces of feedback that I've been
getting since the book came out
from people is I'm already doing all of
that Dr Palmer
and I went on your keto diet and I'm not
cured so what's the deal
[Music]
and when I talk to them
I say okay do you smoke cigarettes or
vape well yeah
do you drink alcohol well yeah
do you take benzos or antipsychotic
medications that impair your metabolism
well yeah but my doctor prescribes them
how's your sleep oh well I can't sleep
that's the problem it's not that I'm not
trying to sleep I'm I'm trying to sleep
but I'm not sleeping because I can't
sleep so I take more pills but they
don't always work
and then they say so you really think
you're doing my treatment
when like all of these basic Common
Sense milia Common Sense lifestyle
strategies that I've already outlined in
the book and why they are all harmful
and why they are going to prevent you
from recovering you're not doing any of
them because you because what you
thought the keto diet was going to be
the cure-all
in the context of you poisoning your
brain and liver with massive doses of
alcohol
in the context of you smoking and vaping
non-stop throughout the day in the
context of you not sleeping
you just thought the keto diet was gonna
just poof like magically fix everything
like
what planet are you living on and you
clearly didn't read or comprehend the
book and so
it's unfortunate because I know people
are desperate and people want quick
fixes and people want simple answers
they want what but just the one thing Dr
Palmer tell me the one thing that I need
to do to cure my schizophrenia
and the point I have tried
so hard to make in the book
you can get better
you can get rid of your schizophrenia I
really authentically believe that
you can get rid of your depression you
can get rid of your anxiety you really
can
I'm not lying I'm not making it up I
have seen it countless times I know it
works I know it can work but if you're
looking for a
one-size-fits-all simple solution just
do the keto diet for three months and
that'll fix you up it's not that simple
does that mean I'm saying it's super
complicated and impossible no you can
think about your sleep you can think
about removing all the toxins that
you're putting into your body you can
think about stress reduction practices
you can think about you know all of
those things maybe spending some time
outside or spending some time with human
beings instead of always on your screen
you can think about these other things
it's not going to be news you're going
to have heard it a million times but if
you're not doing it you're not doing the
treatment
yeah everybody does want the very simple
answer there's no doubt and the good
thing about your theory though is that
Lisa draws a connection between all of
this there's only one thing that you
have to address it's just you have to
address it in a dozen different ways
talk to me about autism this is one of
the more
interesting sort of side comments that
I've heard you make and my real question
is can you reverse autism or is it just
avoidable from somebody getting it
because you've said depending on when
you encounter the metabolic distress
that warps your mitochondria it will
have pretty profoundly different effects
so if you have Disturbed mitochondria as
a kid or in utro that's going to play
out in your brain development yes how
like when when autism first people
started saying like oh diet can impact
it it was like man people coming after
you with billy clubs even for bringing
it up so I'm not sure where the current
state of the art is like how crazy a
question that is but is this something
that can go into remission or is it just
here's how you avoid somebody getting it
in the first place yeah it's a really
important question and I've had some
critics come out with that particular
example because again they're taking
away the simple message die Dr Palmer is
saying that poor diet is causing all
mental illness and that's why I kind of
inserted no that's not what I'm saying
and autism is the perfect example of
this so autism is a neurodevelopmental
disorder that occurs either in utero or
early in life
some children infants appear to be
perfectly
neurotypical
early in life for like the first year or
two
they get an infection for instance
and within three months of that serious
infection start showing signs of autism
spectrum
disorder
um so and and we have clear ways to
understand all of that
so a lot of people are going to say well
what does this have to do with
metabolism or mitochondria so the first
thing I want to point out is I am not at
all the first to be claiming that
metabolism and mitochondria play a
direct role in the cause of autism
spectrum disorders the first
mitochondrial theory of autism dates
back to 1985. whoa so this is I I do not
at all try to claim credit for the other
pioneering researchers have done this
researchers have looked at the brains of
people with Autism Spectrum disorders
and have noticed all sorts of metabolic
and mitochondrial problems low levels of
ATP and brain cells higher levels of
brain inflammation higher levels of
reactive oxygen species other things so
all of those point to wait this is a
metabolic or a mitochondrial problem
for those who don't know rates of autism
have skyrocketed in the last 40 years
over the last 20 years rates have
tripled whoa
20 years triple the rate of autism
a lot of people are like well that can't
possibly be true well the researchers
who are studying it and the people who
are doing the household surveys are
saying it's true
so either keep your head in the sand and
be in denial about it or open your eyes
to this is happening
one of the global kind of observations
that I just want to make that we haven't
overtly stated
is that we have a skyrocketing Mental
Health crisis in the world how do we
know this isn't just an increase in
diagnosis and it's always been this way
and we're just now diagnosing it more
I think
I think source of information would be
looking at
um
looking at the household surveys
where researchers funded primarily by
the United States government go door to
door to a random sample of households
throughout the United States
ask the people who answer the door a
series of long list of questions about
mental health conditions and make
estimates of how many people are
suffering from different mental
disorders the rates are increasing
they're particularly increasing in the
young population
a a much harder
Med kind of variable that is
indisputable is the rate of death
from mental illness which we probably
the most comprehensive
figure that we have is something called
the deaths of despair
which includes suicides but also
overdoses on drugs and alcohol
that rate has doubled over the last 20
years God damn in the population that's
really brutal the rate has doubled
people aren't faking their deaths
they're not whining and complaining so
there's a lot of skepticism about mental
health because there's no objective
tests and everybody thinks oh everybody
thinks they've got autism these days
everybody's just complaining about being
autistic because they want sympathy
well guess what folks the rates are
really skyrocketing and we can't keep
our heads in the stand so how can we
understand that in the context of the
brain energy theory if the brain energy
theory is really true how can we
understand that
um and what I would say is I will share
a couple of observations but the most
important ones
women
who are giving who are pregnant
if they are obese
and also have
poorly controlled diabetes such as
gestational diabetes
they have a three to four-fold increased
risk of having an autistic child
whoa if you are a man with obesity
compared to a man who is a healthy
weight the obese man has double the risk
of having an autistic child whoa so
people are asking this question where
the hell is all this autism coming from
that's impossible autism is supposed to
be genetic
well look at statistics like that
look at some common sense observations
is obesity increasing in our population
right now are the rates of diabetes
increasing in our population right now
does this apply to
childbearing women does this apply to
men who are about to become fathers so
to get very clear and concrete with my
theory so people who are overweight or
diabetic are more likely to have
autistic children
why
what I'm arguing is that people who are
overweight or diabetic
have a mitochondrial problem they have a
metabolic problem somewhere in their
brain or body
that is what is causing their obesity
and that is what is causing their
diabetes or their insulin resistance
that obesity and diabetes are symptoms
obesity and diabetes are not causes they
are symptoms they are symptoms of
metabolic derangement somewhere in the
body or brain
and that means that these people already
have a mitochondrial problem somewhere
in their body or brain that
mitochondrial problem is getting
transferred to their gametes those
gametes are going on to create a child
that child is at higher risk again this
is not absolute it's not it's double the
risk it's not the majority of
overwhelming majority of children born
to obese women are not autistic
um but it increases the risk because
you're increasing the risk of
transmitting a mitochondrial problem or
a metabolic problem or an epigenetic
metabolic problem to that child and that
then results in a problem the other
strong possibility so that's gametes
and maybe some epigenetic signals but
the other strong possibility in
particular with the women because the
women
are not only contributing an egg the
women are growing this child
and that means that the women's hormones
play a role in the growth and
development and neurodevelopment of this
child that means a woman's stress levels
play a role that means a woman's diet
is playing a role levels of glucose in
her bloodstream are getting into that
fetus that is affecting that fetus's
development
so to to go back to your other question
so can we fix autism
autism is a neurodevelopmental disorder
and what that means is that you know the
primary symptom of Autism they're really
two buckets of symptoms one bucket is
social skills impairment or social
skills differences
um that people who are autistic
relate to other humans in a different
way
they might have trouble interpreting
nonverbal social cues for instance
um
the other bucket is that by definition
they have to have some kind of OCD
symptoms as well
so if we focus on the social skills
social skills are hardwired into the
human brain
we are all hardwired to develop
appropriate social skills
as parents we are hardwired to transmit
this information to children
children are hardwired to get this
information store this information and
utilize it effectively
meaning I have to get Mom and Dad to do
what I need them to do to take care of
my needs and make sure I don't die
um meaning when the child's old enough
to start going out to school or the
playground I have to figure out how to
navigate all these other human children
and get along with them or at least not
be bullied and teased by them or
navigate conflict if they've got a ball
and I want the ball how do I manage that
situation
um those are being acquired over time
it's not you know you come out of the
womb and you've got those skills you
don't actually have those skills at all
so a metabolic assault at any point in
the timeline of the acquisition of those
skills could impair the acquisition of
those social skills and result in what
we call an Autism Spectrum Disorder how
does that relate to mitochondria and
Metabolism mitochondria are critical to
neurodevelopment
they are critical to the differentiation
of cells and they are critical to
something called neuroplasticity so the
branching of neurons to create new
connections and synapses with others
they are critical to those processes
so if a if a fetus or a young child has
an impairment in mitochondrial function
those areas of the brain that are
supposed to be acquiring social skills
may be impaired and that may result in
them not getting them
the challenge with
reversing that or correcting that
is that if if I take an extreme case
give me a 30 year old person who is
autistic now
can I change their
autism can I make it go away can I
somehow help them acquire
social skills that are neurotypical
my strongest gas is no
[Music]
and the reason I say no is because
neurodevelopment has Windows of
opportunity
they're called neurodevelopmental
windows and the window opens
and then parts of the brain grow and
Thrive and Branch out and connect and do
all sorts of things and then the window
closes
you don't get to go back and redo it
so my strong guess is that social skills
actually do undergo neurodevelopmental
windows and that humans need to acquire
these skills in the right ways at the
right times
now
the caveat to that is it does not say
that neuroplasticity is impossible
so neuroplasticity is could we get the
brain to somehow form those connections
that are missing could we get that to
happen
it's conceivable to me
but it probably will not be a simple
intervention it won't be go on keto for
three months and that'll fix you up it
that's not going to do it
the ketogenic diet might even play a
role we've had studies of the ketogenic
diet for autism
they can correct some of the cognitive
problems
they can certainly correct the seizures
that often accompany autism they can
also correct some of the mood disorder
symptoms that can accompany autism so
they can have a powerful treatment role
for quality of life and ability to
function
but as far for the most part most of the
studies have not found any Improvement
in social skills
which is the reason I say what I just
said which is I think the developmental
window closed
and it wasn't enough the interventions
that I think could work or if if we
Prime the brain
for mitochondrial
biogenesis and mitophagy so we're going
to try to get rid of old defective
mitochondria and we're going to try to
increase the number of mitochondria in
brain cells
if we do an intervention like the
ketogenic diet but maybe some
supplements maybe even mitochondrial
transplantation that's happening
nowadays so I mean there's all all sorts
of possible interventions that I could
conceive how do you give somebody a
mitochondrial infusion not a transplant
how that
um
researchers are working on it this is an
IV drip and they're primarily they're
primarily focused on people with very
rare mitochondrial disorders the
challenge
transplantations you have to get the
mitochondria in the right cells in the
right way exactly so so most people have
heard of stem cell transplants yep
stem cells are one of the primary
donators of mitochondria to
metabolically impaired cells
interesting
everybody thinks stem cells are all
about oh you get a brand new cell and
it'll just replace the bad defective
South
stem cells are actually going around
connecting creating these little
nanotubes with other cells metabolically
compromised cells and transferring
healthy mitochondria into these
defective cells that is one of the
primary roles of stem cells so
so it could be stem cell transplantation
to spread some healthy mitochondria
around so there are ways to do it
so back to autism
if I do this intervention I'm priming
the human brain the human body for
neuroplasticity let's rev up
mitochondrial biogenesis let's rev up
mitophagy I would rather and I
you know I would much rather use it do
it using natural methods like a diet or
exercise or something else as opposed to
injecting stem cells in one location and
the reason is because the body is really
good at healing itself we just need to
give it a chance it knows what to do
if we inject stem cells into like a
specific part of the brain maybe those
stem cells are needed there but maybe
they're needed somewhere else that we
don't even know about also if you don't
fix a problem it's just going to revert
back yeah
but
so if we do this neuroplasticity kind of
priming
treatment
at the exact same time we have to
deliver the training for social skills
this human being would need intensive
immersion
on how to interact
in a neurotypical way right
because
social skills are both about biology and
brain circuits but also about the
acquisition of those skills somebody has
to teach that human being interesting
those skills so we know this from like
Romanian orphans
were probably born relatively healthy
for the most part but they were left in
cribs never picked up never touched by
other humans
and
many of them had horrible horrible
Neuropsychiatric outcomes as a result
um and all sorts of neurological
problems but all sorts of mental
disorders as well including autism
dramatically High rates of autism
and I don't think about that as well
they had a mitochondrial problem for Mom
and Dad or maybe those parents who gave
their kids up for adoption were all
overweight or diabetic that's not the
way I'm thinking about it
the parents gave the child up for
adoption that child probably had a
chance at a normal
life and normal neurodevelopment but
because they were so neglected and so
maltreated and not given the ability to
learn how to be human
they did not I think that's it though
because that feels like it would be the
world's most stressful environment so
going back to your earlier statement
it's not just going to be diet there's
going to be a whole host of things
because I've heard you talk about this
before and the orphans at some point
start banging their heads against their
crib just to feel something no one's
touching them
that is an unimaginable amount of stress
especially since I know about the whole
idea of failure to thrive where if you
don't touch and cuddle and love an
infinite may just die yeah so Lisa
Feldman Barrett
said something to me which I thought was
utterly fascinating we have a nature
that requires nurture because she was
like you have to stop trying to tease
these two things apart like they were
just inextricably connected
and hearing about the Romanian orphans
that was the first thing that came to
mind which is uh the amount of
dysfunction you're gonna get when you
have biology that's screaming out for
interaction that hey I am programmed to
learn through this interaction touch
love affection cues close up your face
my face I do this you respond in this
way and cool now my brain wires in I've
got it like I've figured all this out
and if you don't have that it is just
trauma it is there's no doubt about that
trauma
is a huge part of it and stress is a
huge part of it when an infant is
screaming at the top of his or her lungs
it is highly stressful
when they are not picked up
it is highly stressful to that infant
stressful as everybody else around too
um more on an airplane
um but uh so
there's no question that those children
had massive trauma massive stress
responses and probably malnourishment
and all sorts of other things that were
playing a role in their neurodevelopment
we do have research though some people
hate this research especially animal
rights people but there is research on
monkeys
that supports what I've said
that researchers took groups of monkeys
fed them normally
but deprived them of maternal love and
support
and
um
and all sorts of problems ensued
yeah that is uh it's a very interesting
part of our biology the way that we're
so interconnected and how far down the
mammalian train that goes
I want to talk about obesity so I
imagine that some of the uh pushback
that you get especially when it comes to
autism is hey parents you're increasing
the likelihood of your child being
autistic just by being obese
but I also heard you say that there was
recently an obesity conference where the
brightest Minds in the field of obesity
were like we don't actually know what
causes obesity
and I thought you were going to be like
that's laughable but you were like
actually yeah we don't
how is that possible like so here's my
overly simplistic prior to reading your
book take on all of this obesity anyway
uh obesity is largely driven by what
you're doing to your microbiome based on
what you eat uh certainly sleep because
of all its massive impacts on metabolism
uh light exposure and then diet and if
you if you said Tom I need you to mess
somebody up and make them obese but you
can either affect their sleep affect
their sun exposure affect their stress
or affect their diet I'll take diet
every time and I'm gonna [ __ ] them up oh
my God so predictably and I would say I
will do exactly one thing I'm going to
get them to eat Ultra processed food
that's high in sugar and if you let me
do that and if you won't let me Ultra
process the food then I'm just going to
go with things that are high in sugar
and I will win every time I will be able
to metabolically dysregulate them and to
a very distressing degree
because of that I feel like we know what
causes obesity so how so let me let me
push back a little bit just to ask for
clarification because this is such
a contentious issue yes so Ultra
processed food high in sugar how exactly
in your mind does that cause obesity
okay so I'm the layest of laypeople ever
but I love to spout off so I'm gonna
give myself uh so the reason that I'm
gonna highly process things is I need to
damage the molecules that your cells are
going to be made of so the easiest one
is trans fats not the only there's going
to be a whole host of things but that's
the one I understand the best so you
take a fat molecule which is normally
nice and flexible and Squishy uh through
frying it basically you make it rigid
and stiff but your cells are still going
to uptake that fat so now you're making
your cells brittle you talked earlier
about hey we have these metabolically
damaged cells and I'm just going to call
them vulnerable so I'll say the same
thing is happening when you're ingesting
these highly processed foods you
literally are what you eat your cells
are made up of the things that you
intake so one one is that I'm now
changing the structure of the molecules
that are going to make up your cells and
not in a way that the body is used to
dealing with and so brittle cell
membranes is one example of I'm sure a
whole host of things then what you eat
is going to be largely impacted by what
you absorb what you absorb is going to
be largely based on your
microbiome and by the way the just level
of inflammation that I can get by
breaking the epithelial lining of your
gut which is only a cell thick so all I
have to do is get bacteria in there
that's going to claw that away break
those Junctions now I can actually get
partially digested food into your
bloodstream get your body to attack
itself with an autoimmune response all
hell is going to break loose also by
getting the sugar into your bloodstream
I'm obviously raising your glucose I'm
spiking the [ __ ] out of your insulin and
now I'm just assaulting your body and
your glucose levels sugar molecules
stick to things in your blood so now I'm
creating all of the metabolic disaster
that is having a gummy system I know I'm
giving this in like the least scientific
description
so now I'm [ __ ] up your arteries I'm
creating a inflammatory response in your
body I'm from the elevated glucose
levels from the things crossing the
barrier in your gut
and in all of that I'm also making your
cells insulin resistant so they're
trying desperately to pull the sugar out
of your bloodstream because the
difference between a normal person and a
diabetic is a quarter teaspoon of sugar
in your blood so while the sugar is very
useful like you said in the beginning
it's all a balance if you have too
little sugar you're going to have
seizures and you're dead if you have too
much sugar you basically burn alive from
the inside so can't have either of those
you need to have everything in the sweet
spot but now I'm making your your fat
cells essential any cell that's going to
use glucose I'm making it insulin
resistant so insulin is trying to get
the sugar into those cells but the
cell's like [ __ ] off like there's just
too much so now it's staying in my
bloodstream all the things that people
know about a type 2 diabetic where
they're losing their eyesights because
the sugar is basically burning the eye
to Pieces losing their limbs you get
neuropathy of the nerve endings it can't
even feel the fact fact that they're
effectively getting necrosis of their
limbs and they end up having to be cut
off so while I get that I'm not giving
that from a scientific standpoint it's
you can demolish the body pretty fast
just by spiking glucose now because I
know that the calorie in calorie out
people are in the comments right now
just lighting me on fire I will say that
yes if you have somebody reduce their
calories enough even if they're eating
sugar uh they won't manifest all of the
symptoms as quickly but I still think
they're going to be metabolically
dysregulated I'm going to guess and this
is a guess that I can still real
especially somebody developing I can
[ __ ] up their brain even by reducing
their calories so they're not getting
fat but I can completely disrupt their
um the appropriate
functioning of the brain by just
inundating them with trash when they're
a kid even if I'm keeping their calorie
count low I don't think that obesity is
the only sign that something is going
wrong I think that obesity is probably
adaptive in that your body's just like
fine [ __ ] like I'll pull this all out of
the bloodstream I will cram it into your
fat cells and so getting obese you might
be better off getting obese it might
actually delay some of the symptoms of a
bad diet
so that is why I feel like it is way
complicated I understand that and I am
grossly oversimplifying but because if I
want to mess you up I really only need
the lever of your diet
at some point to me it's like
I I get in the purest of pure ways we
don't understand maybe that all the
mechanisms of action
but at a blunt force trauma like if you
just let me just give me control of
sugar and I will completely ruin
somebody or get them healthy ER there's
so many micro things that we would also
need to take care of I get I can
completely solve all the problems but
man if you let me control sugar I'm
gonna go a long way and if you let me
control processed and sugar
I've got you covered I think
I don't disagree at all with anything
you said anything you just said
I also don't disagree with the solution
get rid of sugar get rid of ultra
process
um
I actually think
in the way that you describe like these
toxic fat molecules can be incorporated
into your cell membrane
I think
the real money
is to focus on mitochondria and I know
people will call me a mitochondria act
or they will call me crazy or they will
think I'm a that's the real answer or
they'll think I'm delusional or whatever
the reason is because
mitochondria actually control the
regulation of blood glucose that's so
crazy
hearing you talk about a mitochondria
basically does everything
yeah when I was developing this Theory I
actually felt that way
and when I like started looking at what
are different things that can poison the
human body quickly
and what is their mechanism of action
what is their precise mechanism of
action yeah I listed them before
arsenic cyanide others Tylenol poisoning
like what exactly is happening
all of those poisons Target mitochondria
Tylenol targets mitochondria Tylenol
charges mitochondria alcohol targets
mitochondria alcohol poisoning is due to
mitochondrial
disruption and impairment
and so when somebody dies of alcohol
poisoning the cause of death
is
poisoning the mitochondria is it because
they can no longer process oxygen what
so so at the well so at the end of the
day initially I was like two I was like
this can't pop this can't be am I just
like seeing mitochondria everywhere I
look like maybe I'm going crazy like
what what is going on here
when you take a step back when you look
at the big picture of life
cells in the human body
are all there to perform a function
but they all need nutrients
they need nutrients to create replace
the parts that need to be replaced
and or create energy in the form of ATP
without nutrients
you're dead
we can I'll Define oxygen as a nutrient
as well oxygen is part of the process of
making energy
and
essentially at the end of the day what
I'm saying is that in order to in order
to understand
why cells in the human brain or body
malfunction
we have to go all the way
to the basics of biology
which is every living cell at the end of
the day depends on metabolism
or energy
and it's the only way to connect the
dots
but like obesity researchers have zeroed
in on mitochondria in specific brain
circuits that control appetite and
feeding behaviors and they've looked at
what causes those neurons to turn on or
off
it's mitochondria
when they look at the cells and the
pancreas that release
insulin
what causes the cell to actually release
the insulin what is the critical signal
that causes insulin to get released
mitochondria mitochondria are actually
sensing the amounts of glucose creating
reactive oxygen species and response and
that sets off a Cascade that results in
the release of insulin
um
and then mitochondria respond as the
glucose levels come down
stop you know either make more Ros or
less Ros or whatever they're doing and
that then
results in the pancreas not releasing
insulin and so on one hand
is enormously complex
to say it's mitochondria some
researchers are going to be like well
duh
big deal so what
but on the other hand
it is a major leap
in the mental health
and metabolic health field
because guess what we could do
number one we can look at a lot of our
treatments that are causing
mitochondrial toxicity
and we can
uh start using those very sparingly
and try to get people off those and try
to allow people to heal and recover
that's a huge thing that I'm actively
doing with lots of patients
um so I think we need an Abrupt wake-up
call in the mental health field because
I do think we are doing harm to people
long term
but even in the food supply there's so
much debate what's causing the Obesity
epidemic oh everybody's just overeating
delicious foods it's the calories it's
the calories
they're eating more calories that's what
it is
there's a huge study that just did an
assessment of the entire food supply in
the United States
from the 1970s to the present and they
actually calculated how many calories
are in this entire food supply
divided by the number of people in the
population
and the researchers concluded the
calorie consumption of the United States
population has not significantly changed
really over the last 30 years the
calorie consumption has not
significantly changed
calories of our food supply is relating
largely
stable
and obesity rates have skyrocketed
shocked by that what that means is that
the metabolic rate of the human
population is going down
and what does that mean what do I mean
when I say the metabolic rate I mean the
mitochondria and the human species is
being poisoned
what are the likely culprits
Ultra processed foods high amounts of
sugar and other artificial ingredients
but we need to look at environmental
toxins the microplastics and all of the
environmental toxins the forever
chemicals that are accumulating in our
fat cells in our brain cells
like those might be poisoning
mitochondria
lots of small pilot studies of
strongly suggested they are
and if we're poisoning the mitochondria
it means that the metabolic rate is
going down so yes calories in calories
out energy balance yeah yeah sure if
you're into physics and that means and
anything to you sir that still applies
but what I'm arguing is that the Obesity
epidemic is likely because the metabolic
rate of the human species is being
poisoned
that's really really interesting uh I
want to push on that so earlier we
talked about that a cell could be either
under active or overactive
so why isn't that that metabolism can go
either way either as it gets poisoned it
dials up or as it gets poisoned it dials
down why is it only getting dialed down
or am I missing something and then some
people it really is going up
so the the going up and going down is
not metabolic rate overall so what I'm
saying what I'm arguing for the brain
cells is that if you have let's say you
only have 60 percent
of the healthy mitochondria needed for a
brain cell to function properly
60 percent
so that cell if we do a neuroimaging
study on it
we'll have something that we call
glucose hypo metabolism
meaning that it is not producing enough
ATP from glucose the primary energy
source
why because it doesn't have enough
healthy mitochondria and that could
either be because the total number of
mitochondria is decreased and or the
number of healthy functional
mitochondria has decreased
that cell will have insufficient ATP
low metabolic rate
lower metabolic rate
it doesn't have enough ATP
as a consequence of not having enough
ATP
it can become under active which again
is intuitive to most people
and at the same time that 60 ATP cell
can become hyper excitable
you can think about it as this frail
vulnerable cell this spasming
if that helps if that analogy helps no
very much so
um so it's it's like the elderly person
who has really weak muscles
and those muscles begin to spasm that is
hyper excitability
the muscle is not strong the hyper
excitability doesn't mean too much
metabolism it actually is still too
little metabolism that it results in
erratic activity of the cell
and once you understand that it's
mitochondria then you have to under then
you have to ask that big picture
question what the hell is going on then
why do we have skyrocketing rates of all
these diagnoses
the easiest sound bite answer is because
we are somehow poisoning mitochondria in
the human species where could the
poisoning be occurring to result in
obesity
it could actually be occurring in
several places
too easy answers are the brain
because the brain brain circuits control
eating behaviors brain circuits tell you
when you are full brain circuits tell
you when you are hungry if those brain
circuits have impaired mitochondrial
function it means that those brain
circuits aren't going to function
normally if they're not functioning
normally it means that person is going
to feel hungry
when they should otherwise not be
feeling hungry
because it's just not working right it's
under active
um
and could it become overactive or could
other circuits become overactive
absolutely and that might help us
understand something like binge eating
disorder
the other thing that some of these brain
circuits do is change metabolic rate in
response to eating
so when you you know we all overeat at
some point or another we all overeat at
Thanksgiving
and usually our metabolism Burns off
that excess we actually might feel hot
or we might get more fidgety or we might
want to just go out and take a walk or
something to feel better
um or we have a suppression of appetite
and we wake up the next day and we're we
still feel full or stuffed and we just
eat a smaller meal and it all balances
out my wife will actually sweat through
the Sheets if she overeats I just get
fatter which really that's interesting
deeply distressed so that's interesting
so she's got she's got a system that's
going to stimulate her mitochondria to
produce heat
that sense you've got too many calories
going around get rid of them you'll
literally be able to wring out her shirt
we don't want to store it as fat let's
burn it off just burn it because
mitochondria produce heat in the human
body that is where heat is produced
um
and but the other location that we could
have a problem for obesity is in the fat
cells themselves
so fat you know there are three kind of
buckets of fat cells that a lot of
people have heard of there's white fat
which is bad bad white fat
there's Brown fat grade good good Brown
fat Brown Fat's good for you because
it's kicking off heat has more
mitochondria that's what makes it brown
right and then there's beige fat and the
only difference between those types of
fat is the number of mitochondria in the
cell
Brown fat has a higher density of
healthy mitochondria
white fat has a very low density of
mitochondria and what I what I fear
might be happening is that you know some
of these environmental toxins that I
mentioned are
lipophilic meaning they tend to go to
places where there's a lot of fat in the
human body and stay there
though that means two locations
primarily
fat cells
and the Brain
unfortunately
so
if
the mitochondria and fat cells are being
poisoned
it means that they are going to have a
harder time sensing signals to release
that fat
and then actually releasing the fat
because the mitochondria actually are
involved in the process of releasing the
fat from the fat cell
so that fat cell is going to become
dysfunctional or under active in
particular in its capacity to release it
may still be able to receive nutrients
and store them but when called for it
may just be a little sluggish and
releasing
and that may then stimulate hunger
that then drives the person because it
may stimulate lower blood sugars or
something else and then that may
stimulate the person to go and eat
um
but
at the end of the day what you said is
correct we had this obesity conference
world renowned obesity experts
many of them have their strong opinions
some of the low carbers were it's
carbohydrates carbohydrates are causing
the Obesity epidemic if we just got rid
of it other people I mean you know all
the arguments and everybody's just as
passionate
the vegans will say if animal sourced
Foods they're causing the Obesity
epidemic if we just got rid of animal
sourced Foods everybody would be fine
and they're winning
their argument right now politically at
least they are running the dietary
guidelines they are in in control yeah
what does that make you think feel not
not specifically that I won't even make
you take a position on that but it makes
me really unnerved when I think about
the government being in control of what
we can and can't eat that that is really
scary to me
I think the thing
that is Criminal
is that the people who make the
decisions
about what
the health and wellness of the United
States population should be
the overwhelming majority of them have
very strong ties to commercial
Enterprises that make Ultra processed
foods
and so
they settle on simplistic arguments like
energy balance
doesn't matter if you're getting your
200 calories from a piece of salmon
or a donut
it's 200 calories
a calorie
ebm it's basic physics
doesn't matter what you eat as long as
you're counting your calories you can be
just fine
so maybe one easy place to start
would be to actually just make it a rule
make it a law whatever it needs to be
that number one only Healthcare
professionals are going to sit on these
committees
and only Healthcare professionals who
have zero conflicts of interest over the
last 10 or more years
can sit on the Committees
and if you want to work for big food if
you want to work for big Pharma that's
great but you don't have any business in
making dietary recommendations for the
health and wellness of the entire
population of the United States
given that you have clear bias
that that may sound extreme to some
people that the clearest example is I
mean Tufts
tough School of nutrition came out with
this
kind of list of foods that are healthy
for you and foods that are not healthy
for you
and they include brand names cereals on
their list
Lucky Charms is good for you Lucky
Charms is better for you than eggs wow
lucky charms is better for you than
whole milk
Lucky Charms is better for you than
cheddar cheese
interesting with dietary advice like
that
it really that surprising
that we have an epidemic
of obesity and diabetes and mental
illness and other health problems in our
population
I mean I actually do believe that is
Criminal it's not criminal for those
people to make money off of big food and
big Pharma if they want to be
Consultants go ahead
do it
but you shouldn't be issuing guidelines
as though they are unbiased guidelines
you just shouldn't
brand name foods have no place
in dietary guidelines and
recommendations they just don't
I I don't I
I mean obviously it's infuriating
it's heartbreaking
I don't know how to get I don't know how
we get through to the politicians that
need to make those decisions let's start
by telling them what is your breakdown
of a good ketogenic diet
so for somebody that struggles whether
it's anxiety depression schizophrenia
obviously see your doctor obviously
don't stop taking your meds without
medical supervision all of that but how
do you do that particular diet well
so it really depends on the condition
that I'm treating I I don't I know this
is frustrating for some people again
people want one-size-fits-all Solutions
so you gotta be able to be flexible and
modifiable
as a rule of thumb
rule number one is exactly what you've
already said get rid of this [ __ ] food
have real Whole Foods foods that are
great grandparents heard of and consumed
if your great grandparents did not hear
of or consume this food thing then don't
eat it if it comes in a box with fancy
packaging and a a plastic insert
probably not on the
healthy food list
um
you know great grandparents could have
been consuming Coca-Cola that had
cocaine and so on no don't drink that so
it's not you know again we've got like
all sorts of exceptions to the rules I'm
gonna say
um but eat real whole food start there
for some people that's enough
and I really mean that for some people
that's all they have to do
they can they don't have to be counting
calories they don't have to be managing
carbohydrates or protein or anything
else they just get rid of all the junk
eat real food I mean that's the whole
paleo you know or you know other kind of
food dietary movements that what they're
based on is let's just eat real food and
for some people that's enough
if you then want to restrict
carbohydrates start to get rid of all
grains flowers
through all of this I should have said
get rid of all sugar sugar
artificial sugars artificial sweeteners
I'm now based on one animal study I am
now going to say get rid of artificial
sweeteners
so one animal study came out in one of
the nature magazines Make nature
journals recently showing that aspartame
um which is an artificial sweetener
can cause anxiety in mice and causes
anxiety in mice
and then those mice can transmit that
propensity for anxiety to their children
Jesus their children can transmit the
propensity for higher rates of anxiety
to their children that's bananas
and the researchers used normal amounts
of aspartame that a normal human being
who's drinking lots of diet soda would
consume
yeah they were talking before they
weren't poisoning them with ridiculous
massive doses of aspartame that was my
big breakthrough with my anxiety was I
was drinking diet monster and I always
feel bad throwing them under the bus
because I love Diamond I loved drinking
it but man oh man did it give me anxiety
so there you go yeah as soon as I cut it
out I'd say drop by 70 research to
support that and
um but unfortunately it's resulting in
epigenetic changes Jesus that can
persist
so and again but the good news
what's in charge of epigenetics
mitochondria primarily
how can so can we do interventions that
will influence them yes so back to your
question what other diets so get rid of
all sugars sweet things
you still have fruit everything else if
you're doing a paleo diet
um you can have potatoes if you're doing
a paleo diet you can fry those potatoes
in olive oil you can have delicious
foods it's not like I'm saying you can't
have delicious foods you can have
delicious foods they won't taste
delicious when you're giving up your
Ultra processed foods they won't taste
delicious when you're giving up your
diet monster they will you'll be like oh
but I'm hooked on my diet monster I need
my diet monster and yet my anxiety is
almost gone
um and then if you go to
Keto
you know the first step for people with
anxiety or depression is just get into
any level of ketosis
do blood monitoring do urine strips do
something look for an objective
biomarker of ketosis I don't care what
level you're at see if that does the
trick for you it might for some people
it does
for people that I work with who have
serious chronic debilitating mental
disorders like bipolar disorder or
schizophrenia
I've universally found low levels of
Ketone like a ketogenic diet is not
effective
that's what I found Maybe I'm Wrong
maybe I don't have enough of a sample
population maybe there are people out
there that would respond beautifully to
low levels of ketones from a ketogenic
diet what are you calling low 0.5 to 1
like less than one
um the so when I use this diet for
people with serious mental disorders I
usually tell them I want blood ketones
greater than 1.5 ideally I'm looking for
1.5 to like 4.5 can they get there
without caloric restriction I have found
to get north of one I'm going to be
restricting my calories
so the two strategies that you're going
to use to get there are either caloric
restriction and or well or three
strategies
and or carbohydrate restriction so the
more carbs you restrict the more likely
you'll be in ketosis
and or higher fat
so you are a thin person
if you wanted to get ketones of 3.0
blood ketones of 3.0 you would have to
consume a very high fat diet
whereas somebody who's obese does not
need a lot of fat in their diet
interesting so part of it is that when
people first start a ketogenic diet they
can get sky-high ketones usually within
weeks or months they will come down
is that because they get more efficient
at using the Ketone so it's not as
readily available in the blood
I'm gonna say this my answer is
speculative I don't know that anybody
really knows for sure the real answer to
that and I don't know that we have
research studies that clearly go from A
to B to C to D to clearly establish what
is causing it
I do think one one possibility is that
the body does just get more efficient at
using ketones the much more likely
possibility in my mind is that insulin
resistance is dramatically improved
when people have high levels of insulin
resistance
um it means that a lot of the cells in
their body are metabolically compromised
and would qualify as having glucose
hypomatabolism so if we actually looked
at the amount of ATP in their cells it
would be reduced compared to a healthy
cell
and uh and we call it glucose
hypomatabolism because they're the
primary fuel source is glucose
so those cells are actually all sending
out distress signals
saying feed me
send some more fuel
send more glucose
we're dying here what are you doing
liver liver get on the job send up some
glucose
when you first start the ketogenic diet
this is where a keto adaptation can be
problematic those cells is like pulling
the rug out from under them
they're struggling already and now
you're plummeting your glucose levels
and your insulin levels and so those
cells are really going to struggle after
that and that is the keto adaptation
phase that a lot of people will say oh
it's kind of bad for weight loss when I
use it in people with mental health
conditions I can see symptoms get worse
before they get better and it's all the
way it's depression can get worse
anxiety can get worse psychosis can get
worse
I know that now I'm not going to be
afraid of it it's got to be managed
safely
so that means with a clinician like I
know how to do that I'm educating the
patient I'm talking with the patient
we're coming up with a safety plan we're
doing all of the things that we need to
do but I'm not going to freak out
if on day two they're saying my
psychotic symptoms are getting worse Dr
Palmer I'm going to say yeah we talked
about that remember a million times then
this is part of the plan and how are we
get let's implement the plan now
um but uh
insulin resistance will be improved over
time
and his insulin resistance is improved
and you're feeding these cells ketones
the cells are going to kind of establish
normality or metabolic health
and at that point they're not going to
be sending out distress signals of send
more food send more nutrients
and those signals are not only
stimulating glucose
or fat mobilization from fat stores
those signals are also stimulating
ketosis
they're stimulating the mitochondria in
your liver to produce ketones because
your brain cells in particular are
calling for ketones and
um and so as those cells become
healthier they're not going to send out
their signals and Ketone levels may go
down for that reason and I don't
consider that a problem
because at that point the symptoms are
probably going to be better and the
person is going to say I feel great
and that's when even some of my patients
now especially after a year or two if if
their symptoms are in full remission
they start to
dabble and what can I get away with can
I eat some fruit
can I have a little can I have some
carrots which are higher in carbs than
other vegetables and I know it can I can
I can I get away with a potato
and what will happen and
um and it's always just
a work in progress I mean sometimes they
can get away with it and we're like
that's great and I see that as a huge
celebration it's like wow you're
maintaining you're achieving more
metabolic health
your brain and body are able to tolerate
even more carbohydrates you're not
getting symptomatic this is wonderful
and if their symptoms start coming back
it's like well it's too soon
lifestyle makes such a difference man
where can people follow you to fine-tune
their own lifestyle
so the easiest place is brain energy.com
um you can follow me on social media
from there you can sign up for a
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here now to learn the foods you need to
avoid at all costs shall we drop acid or
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takes us I love the title of the new
book not quite as much as I actually
love the book itself though but the
title sets us up it really makes a
subject