Doctor Makes His Case for the Carnivore Diet to Heal Chronic Gut Conditions and Shares What We Know and Don't Know About High Cholesterol with Dr. Shawn Baker

This episode dives deep into the carnivore diet, exploring its potential to address chronic gut conditions and the controversies surrounding high cholesterol management.

1. Improvement in Gut Health: Many individuals with chronic gut issues may experience significant improvement within three months of adopting the carnivore diet.
2. Cholesterol Misconceptions: Common beliefs about the dangers of dietary cholesterol and fats are challenged, suggesting a need for a more nuanced understanding.
3. Dietary Impact on Autoimmune Diseases: The carnivore diet can potentially mitigate symptoms of autoimmune diseases by reducing inflammation and healing the gut.
4. Scientific and Anecdotal Evidence: Dr. Baker provides both scientific data and personal testimonies to support the benefits of the carnivore diet.
5. Controversies and Criticisms: The episode addresses the ethical and scientific controversies surrounding the carnivore diet, especially in relation to traditional dietary guidelines.

1: Introduction to the Carnivore Diet

Dr. Baker discusses the basic principles of the carnivore diet and its application as a therapeutic tool for chronic illnesses. Dr. Shawn Baker: "Many diseases originate from the gut, which interacts most with our external environment."

2: Cholesterol and Health Misconceptions

The conversation shifts to cholesterol's role in health and the common misconceptions that surround it. Dr. Shawn Baker: "The science that suggests red meat causes chronic diseases is incredibly poor."

3: Personal Stories and Data

Dr. Baker shares stories from his practice and data collected from thousands of diet adopters, highlighting the diet's profound effects on health. Dr. Shawn Baker: "Improvements are not just anecdotal; they're statistically significant in large datasets."

4: Addressing Criticisms

Critiques and ethical concerns about the carnivore diet are discussed, with counterpoints based on recent research. Dr. Shawn Baker: "It's unethical not to study the diet given its potential benefits."

1. Consult a Healthcare Provider: Before starting the carnivore diet, particularly for those with chronic conditions, consulting with a healthcare provider is crucial.
2. Start Gradually: Transition to the diet gradually to monitor how your body responds.
3. Monitor Health Markers: Regularly check blood markers and health indicators to ensure the diet's suitability for your health needs.
4. Be Mindful of Source Quality: Opt for high-quality, unprocessed animal products to maximize the diet's benefits.
5. Stay Informed: Keep abreast of the latest research and discussions about the diet to make informed choices.

This episode is brought to you by Cozy Earth, Fatty15, and Lifeforce.

With all the diets out there, determining which one is the right fit is often confusing. Today’s guest offers hope for individuals who may be feeling tired, weak, or dealing with gut challenges and explains why the carnivore diet offers simplicity and reduces inflammation at the root of many of today’s diseases.

Today on The Dhru Purohit Show, Dhru sits down with Dr. Shawn Baker to discuss the carnivore diet. Dr. Baker shares what the diet entails, who can benefit the most from implementing it, and the latest research on what we know and what has yet to be discovered. Dr. Baker also shares his journey to discovering the diet, why many people have seen significant healing and weight loss on the diet and common challenges found within the standard American diet. Dr. Baker gives us insight into the difficulties with the current healthcare system and shows us how personalized medicine is the future of care.

Dr. Shawn Baker is the Co-Founder of Revero, an orthopedic surgeon, a leading authority on treating disease with medical nutritional therapy, an Amazon best-selling author, world champion athlete, international speaker, podcast host, and consultant. He introduced the zero-carb elimination diet to the world and wrote the best-selling book on Amazon. His personal experience with optimizing health and interacting with thousands of patients has shown powerful results in treating and reversing many chronic diseases.

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Dr. Shawn Baker

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Drew
Doctor Sean Baker. Welcome to the podcast. You know, I'm curious if I brought you a handful of patients as a physician, and I said, okay, this individual is dealing with severe gut issues. This person's dealing with an autoimmune condition that they haven't been able to get to the root of. And I said, doc, put these guys on a carnivore diet for 30 days, not too dissimilar.

About eight years ago, you put yourself on a 30 day carnivore diet. What do you think would happen to these individuals? I think many of them would notice some improvement. You know, again, I don't think this is something that every single person needs to do or should do, but in those particular situation, gut issues and autoimmune disease, I particularly see a lot of improvement with that. And I think if we look at where many diseases originate, I think the gut is clear.

Doctor Sean Baker
You know, you think about how we interact with the external environment, most people don't realize. We think, you know, we think our skin. Our skin is how we kind of contact the world. And the reality is our skin is designed to keep stuff out, right? I mean, our skin is waterproof.

We don't want things coming in. Whereas our gut, the surface area of our gut, and most people don't realize this, but from our mouth, our esophagus, our stomach, our intestines is all external to our body. That's actually outside of our body, and most people don't realize that. And so that surface area is about the size of a tennis court when you think about how much surface area is in the gut, and it's designed to actually bring things in. If it didn't bring things in, we would starve to death.

Right? And it's designed to absorb things, and that absorptive capacity is modifiable by what we put into it. So, really, the biggest interaction we have with the external environment is through our gut. 70% of our immune system is located in our gut for that very reason, because it's so proximate to the external environment. And so that's why I think a lot of the disease that is influenced by our environment is largely directed to our gut.

I know he had somebody talking about indoor air pollution and lungs, and the lungs are also the way we interact with these things, but our gut is even bigger than that. I would say within 30 days, people would probably start to feel better. Certainly with the gut issues, a lot of people's guts. When you stop, I'll be so bold to say, stop poisoning yourself. You get better.

And it, again, depends on what their baseline diet is. If you take somebody that's eating the standard western diet or the standard american diet, which is just absolute trash, they're gonna clearly get better. Now, depending on what their baseline is, it may, it may or may not have as big of an impact. But clearly, many, many, many people use a carnivore diet to improve these types of issues. And that's how I promote it.

I don't promote it as all humans need to do this, or we, you know, we are inherently carnivorous. It is a. I think humans exist on a spectrum. You know, there are people that clearly mostly meet that all the way to, people that are fruitarians, for instance, and they still exist and they're alive. So clearly you can do that.

But I use it as a therapeutic protocol. I usually tell people three months is more realistic to see if you're going to get a benefit. And the reason I say that is because I had collected data on about 12,000 people doing this, and we kind of said, you know, at what point did you notice significant improvements for XYZ conditions? And by three months, most people saw a pretty significant inflection point where they started to see significant enough improvements to where they could say if it's actually working or not. Because I think, you know, the downside is it doesn't work.

The upside is it might potentially change that person's life significantly for the better. There's a lot of ideas about what the carnivore diet is. Maybe somebody read an article, they saw a very brief video on social media. But give our audience a sense, like, what are those individuals? You mentioned you had 12,000 people fill out this survey as part of your community.

Drew
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Doctor Sean Baker
It's entertaining. It's entertaining. You know, I think it's for entertainment purposes, but you can learn some things. And by the way, I love your content. It's very entertaining.

Well, I think you have to, you have to provide some entertainment. So you can get people interested, so they'll watch. You could have the great, the greatest message in the world. You can be one of the smartest, most intelligent, insightful people. But if your message is boring, no, no one's going to pay attention.

So you have to do some of that stuff just to get an audience in there. But I think that what, it's not. And you see these people eating, you know, like, I'll use the liver king as an example. I mean, this guy's out there eating raw liver and raw testicles and acting like a caveman. It's, it doesn't, it's not that.

It doesn't need to be that. I mean, it's simply people are eating whole nutritious, you know, unprocessed food, and it happens to be animal products. So things like, uh, you know, and I certainly do this. I mean, a lot of red meat, a lot of, uh, beef in particular. I eat steaks almost pretty much every day.

Uh, eggs are often on the menu. Things like seafood, uh, really, anything that really is, you know, it's kind of funny. They had a face or parents is on the menu for, for, for this particular diet. I know that would upset some people to describe it that way, but that's a reality. Dairy products, you know, can be on the, on the diet, although some people struggle with that.

So I think it's one of those kind of gray areas for people. But that's basically it. Now, some people will, like, season their food, you know, these, some spices and some seasonings. For some people, like an autoimmune person, that might be problematic. But for the majority of people, let's say somebody just wants to lose 20 pounds or they're diabetic or something like that.

Those things are certainly possibilities. And it's, you know, I have a company called Rivero. It's a digital health company. We're nationwide, and we don't put everybody on a strict carnivore diet. I mean, some people need it and we'll use it in that situation, but I think there's capacity to have some level of flexibility there.

And what's going to happen long term, most people that will do a carnivore diet will end up doing some level of compromise down the road. I mean, that's just a reality. 90% of the people end up being, you know, when they do it, they obtain some success. And I see this all the time. I see people say Crohn's disease.

And we have a nice article ready to go that we're waiting on the Harvard Irb to approve so we can get this published. But we get people with, say, inflammatory bowel disease, which includes Crohn's disease or ulcerative colitis. We put them on a carnivore diet, they heal their gut, their symptoms get better, all their markers of inflammation go down. They feel better than they have in years. Maybe they get off the biologic drugs that they're on, and then over time, maybe a year later, they are able to start including other foods back in there.

And, in fact, I encourage people to do that. Quite honestly, I'm not. I'm not religious about this diet. I don't think it is. You know, I think that's unhelpful to be that way.

And I just ultimately want people to get as healthy as they can, whatever is sustainable for them. And I find that a lot of people do this because they've been told that meat, particularly red meat, is so bad for us. You know, it's killing us. It's causing heart disease and cancer and now diabetes, which, again, the science that would indicate that is incredibly poor, unfortunately. And that's the message that's gotten out there.

And so once people do this and they experience, they're like, well, how can something that's supposed to be so bad for me, something I've heard my whole life is bad for me, literally bring me to the best health I've ever been in my life? It just doesn't make sense. And I think that's because, you know, we haven't really properly studied that. And I think that's something that I am working tirelessly behind the scenes to get some of these studies published, it's hard. It's hard, I got to tell you, getting funding and then getting it through, like I said, even the struggles we're having, getting it through an institutional review board, I mean, we've got.

We've got a. A case series of ten people, clearly, with biopsy proven colonoscopy, proven Crohn's disease, clear intervention of a carnivore diet, clear resolution. Again with biopsies and colonoscopy showing disease is gone. And the IRB is, like, dragging their feet. They don't want to publish it because it goes against the sort of, I don't know, the narrative we've been sort of told to believe.

Drew
Well, we're going to get into the controversy in a little bit. And how one researcher that you've mentioned has said that the carnivore diet is so dangerous that it's unethical that they could actually even do a study on it. We'll get to that in a second. But let's pull on this thread about the gut and the carnivore diet. So is it that the carnivore diet is adding in a lot of good, maybe some things that we're missing, or is it that the carnivore is removed diet is removing a lot of the bad, the standard ultra processed diet that so many people are eating, or is it the combination of those?

Both. And can you give us some examples? Yeah, I mean, I think it's clearly both. I mean, you know, I think the standard diet is so bad that any relative diet compared to that is going to be an upgrade. Whether it's a mediterranean diet, whether it's a vegan diet, whether it's a carnivore diet.

Doctor Sean Baker
We clearly see people that start with this sort of standard american junk food diet, which unfortunately now 71% of our diet in the United States now is something like that. Is ultra processed food even higher in kids? 30% of our kids are now pre diabetic, 25% of them are obese, which is just insane. So moving away from that is clearly helpful. And I see that.

I see a lot of people that are critical of this diet, and they'll say, well, the only reason you got better is because you removed the junk food and you, you know, you replace it with a whole food. And I think that's part of the reason, clearly. But I get people that were on whole food, clean diets, and yet they still improve depending on their condition. And so I think part of it is the nutritional bioavailability. I mean, we know clearly.

I mean, here's an interesting, and this is a little bit controversial because fiber has been so lauded as this super nutrient, even though it's not essential. You know, you're supposed to eat 25 to 30 grams a day. That's what they recommend. And we look at what fiber is doing, and observationally, epidemiologically, people that consume more fiber tend to have better outcomes. That's clear across the board.

Now, I suspect that is because it's a marker for diet quality. You know, you think about it, if I eat all this acellular processed food, if I'm eating cakes and cookies and potato chips, I'm getting very little fiber in the diet. When I compare that to, say, someone who's eating fruits and vegetables and whole foods, that's clearly a better diet quality. So I think that's a lot what it has to do. But interestingly, there's a nice study from, from back in, I think, 1978, interestingly, where they looked at high fiber versus low fiber diets.

And what they found was those people on a high fiber diet actually excreted through their waste products, their stool, twice as much protein, twice as much fat, twice as much carbohydrate. So you're actually losing nutrition, which is not a very effective way or efficient way to nourish yourself. But like, for instance, 2018 study from Stanford showed that people that have major depressive disorder and depression is so pervasive these days, I think something like 25% of the population is on some sort of mental. Is diagnosed with some sort of mental health disorder, which is just shocking. One in four people that we run into in the United States has a mental health disorder which does not bode well for a happy society.

And you think about it, every fourth person you run into has got some sort of mental health issue. That's a problem. The odds of those people colliding is quite high. But back to the Stanford study. People with low levels of carnitine were statistically much higher, like three times higher to have depression.

Now, where do you get carnitine now? Carnitine, we can. We can manufacture some in our body. It's not essential, but if we're not consuming it, it tends to be low. Where can you get carnitine from?

Almost exclusively from animal products. I think it's kind of interesting. I think asparagus has a small amount. It's like the only plant product we can get carnitine, or one of the few. But animal products, red meat in particular, is something that's very high in carnitine.

So that's one example. We also look at things like iron deficiency, zinc deficiency, or I should say relative deficiencies. And again, those things are higher or more bioavailable when you eat things like meat, again, those things have a tremendous impact on our mental health. You know, there's just numerous of these things that are. That are available.

The other thing is, I think that we see that insulin levels are often associated with disease states. You know, if you can, you can literally go to any scientific search and you type in hyperinsulinemia, which is too much insulin in the body, and literally any disease, and you're going to find an association, whether it's cancer, dementia, diabetes, obesity, heart disease, on and on list goes on and on. And so a carnivore diet generally is pretty reliable at bringing high levels of insulin down. So a lot of people see improvements in that. So there's, there's a number of things going on physiologically.

I mean, just like you would imagine. I mean, there's. There's so many, you know, reactions that occur in our body on a daily basis. There are millions of them. So anything, any.

It's kind of, you know, it's kind of interesting because everything affects everything, you know, and it's so complex. But when you start feeding yourself good quality nutrition, I have not seen, literally, it's been surprising. Almost every disease I've seen, someone, you know, present with has been improved by improving their quality of nutrition, which I don't think is a controversial statement. The controversial statement is, what do you mean by improving their nutrition? Because some people say, oh, my God, you're eating a lot of meat, saturated fat.

That's awful. Other people would say, hey, you're removing all the garbage. You're providing high quality protein, you're providing a lot of essential nutrients. You think about, why. Why do we eat?

I mean, why are we required to eat? I mean, a lot of people eat because they're bored or they're stressed out or they're. The guy on the tv told them to eat. I mean, that's why a lot of people eat for the wrong reasons. But what do we have to do?

What do we have to obtain from nutrition? Well, we have to obtain essential amino acids. There are essential fats. We have a requirement for energy, vitamins, minerals, and then, arguably, water. And a carnivore diet provides that in a very, very nice way without the additional things that might be potentially harmful for us.

Drew
Do you find, especially with this big community that you have behind you that's tried the carnivore diet, do you find that most people find their way to this because they are hurting in the sense that they're sick, their gut is messed up, something is wrong, and then they're looking for a therapeutic solution to get better? Or, uh, and maybe what percentage of people are coming saying, look, I feel pretty good, but I want to feel better? Yeah, I think, and I think rightly so, the majority of people that have tried this, you know, because you think about it, there's so many good foods out there, right? I mean, I mean, I still get it. I mean, I like, I like foods.

Doctor Sean Baker
I always like those things. I mean, why would you give up something that provides you, you know, some level of pleasure if you didn't have to? I mean, most people won't make a change unless there's some level of pain. You know, there's got to be a pain point to get people to change for most, most of the time now, there's a small percentage of people say, hey, I want to just see if I can level up in some way in some regard. And, you know, does that help?

For some of them, it does. Some people will say, head to the diet. I was already healthy. It didn't make much of a difference. And that's why I tell people, hey, there's no reason to try it.

The vast majority of people, and I think rightly so, were people that were legitimately sick. In fact, the majority of people that do this are, tend to be older people, you know, young people in their twenties. You know, like when I was in, when I was, when I was in my twenties, I felt pretty good. And I just imagined if I could magically transport myself today at, you know, nearly 58 years of age back to my twenties, I wouldnt listen to me. Theres no way, you know, go away, old man.

You dont know what youre talking about. But I mean, its clearly and rightly so, people that are sick that need to do this. And I think that's what I get joy in as a physician. I mean, it's exciting for me to have somebody with, say, Crohn's disease, where they're literally going to the bathroom with bloody diarrhea 20 times a day on the verge of getting their colon removed, and they say, hey, I want on the diet. And not only do I not need surgery, but it's completely gone.

I'm completely healthy. Or somebody who had such severe depression that they were suicidal and now they're like, I have a normal life again. Those things to me are so exciting, and that's why I continue putting this message forth and being such a vocal proponent. Granted, like I said, it's not the only reason why people can get healthy, but it clearly has been uniquely beneficial where many other things have not been tried and not been helpful. Set the stage a little bit with your story.

Drew
What was the pain that you were in that had you try many other diets before you got to trying carnivore for 30 days? And take us through your experience of what you went through in that 30 day challenge. Yeah, so, I mean, this is so when I did that, this was 2016. So we're in 2024. So eight years ago now.

Doctor Sean Baker
Prior to that, I was a, I don't know, 42, 43 year old orthopedic surgeon. I was a very accomplished athlete. I just won a world championship, so called the Highland games, where you put on kilts and throw stuff. So I was a big, strong athlete, and I just professional rugby player. I played professional rugby, and then I'd done high level power.

I've set some national records in powerlifting, and I've won world championships and rolling. So I've done a lot of sports where I've competed at a very high level. And I remember being in my early to mid forties and sitting there going, you know what? I feel old. I don't feel very good.

And I didn't like that because I was like, well, I'm a doctor. I should be able to figure this out. I'm a hard working athlete. I shouldn't feel this way. And yet I did.

And so the only piece that I felt that I hadn't fully maximized was my nutrition. And so I was probably at that time, 290 pounds. I mean, for perspective, I'm about 260 right now, so about 30 pounds heavier. Not that I was obese, but I was heavier than I probably needed to be. I needed to be for the sports I was competing at because, you know, at six foot, 5290, I was kind of on the smallish side for highland gains.

These guys are six, 7340 pounds. You have to be very big to throw these things far. So I. But I didn't want to be that heavy anymore. And, you know, I could see I was becoming metabolically unhealthy.

I mean, this is just inevitable what happens if you're that big for that long in many cases. And so I decided I would do what I thought was the right thing at the time. I ate a low fat diet. I ate a lot of vegetables. I ate a lot of lean protein.

I worked out like a maniac even harder than I was. I remember I was getting up at 04:00 in the morning, jumping rope 3000 times before I had to go to work to go do surgery on people. And then I would at lunch in my clinic days, I'd work out during the lunch hour and then come home at night. I put my kids to sleep, do another couple thousand jump ropes. And I did this for about three or four months.

And I lost, in the course of three months, something like 50 pounds. And I was very lean, but I was miserable. I was literally, like, hungry. The nurses at the hospital said, hey, we like the fat doctor Baker way better because you're kind of an asshole. So it's literally like, you know, starving.

I realized that that was not something I could do sustainably over the course of time. And so I started looking at this time. I think the paleo diet was was in vogue. And so I was kind of attracted to that. And I did that for about a year or two, and I felt a little better.

And then I kind of got into the low carb literature and some of the popular media and some of the books, tried that for a while, went on a ketogenic diet for a period of time. And the interesting thing for me was, in my career, I was doing, as a surgeon, I was doing a lot of things like knee replacements and hip replacements. And one of the struggles we had was we had a lot of obese people that were wanting these surgeries. And obese people, unfortunately, are at higher risk for a number of complications, blood clots, infections, poor rehab outcomes. And so as a community of surgeons, we all kind of got together and said, hey, we're not going to operate on people if they're above a certain BMI class without a significant attempt to have them lose weight because the complications aren't worth it.

And there was no sort of guidance. It wasn't like, hey, do this. It was just like, get your patients to lose weight. We're like, I don't know, how am I going to do that? Some people said, you know, we had a bariatric surgeon that was doing gastric bypass, but there was no way he could keep up with the demand of the number of patients we had.

So that wasn't a realistic option. And so I, at the time, because I was on a low carb diet, started trying that with my patients. And what I was seeing is, you know, not the majority of them wouldn't try it. About 20% would do it. But the ones that would do it, I found, as I would bring them back about two weeks later, I'd say, hey, how you doing with the diet?

What's going on? A high percentage of them were started telling me, hey, you know what? My knee that we're supposed to be operating on doesn't hurt anymore. And to me, that was like, wow, that's weird, you know, because I've got your x ray, and your knee looks like garbage. It looks like a dog's been chewing on it, right?

I mean, it's, you know, clearly you need surgery, but one of the prime indications for surgery is pain. And they're like, they're no longer in pain. And so to me, you know, I'd done thousands of surgeries by that time. It was more exciting to me that these people didn't need their surgery anymore than the fact that, hey, I get to do another operation. And so that sort of set me on this weird course.

And I started asking the hospital, I said, hey, guys, I would like to spend, I don't know, like one afternoon a week just kind of talking about diet. Nutrition and the resounding no. That I got was just shocking to me. They were like, no, we're not paying you for that. Your job is basically, you're telling me what my job was, was to, you know, take people to the operating room, do surgery on them, and, you know, consequently make a lot of money for the hospital because that's how they make money.

Drew
Be productive, right? Be productive and make money. We don't want you talking about lifestyle. So that frustrated me, and I ended up, you know, eventually walking away from that type of stuff. But.

Doctor Sean Baker
But during that journey of me being low carb, I ran into this, what I thought were nutty group of people just eating meat. I thought they were nuts. I literally, because that's what you think. They called it a zero carb diet at the time. This is before it was even named the carnivore died.

And I just kind of out of morbid curiosity, I was following, I remember I was on a Facebook group, which people laugh at Facebook. It's so stupid, right? Social media again. I remember watching these guys. I was like, this is weird.

I was asking questions and, you know, I mean, some of the results they were putting up and objective results. They had pictures before and after. They had, you know, lab values before and after. It piqued my curiosity enough to where I tried it myself because I was already kind of in this low carb state of mind. And this is, like I said, 2016.

And I remember I had a small following on Twitter. I had like 3000 followers. And most of them were like, medical types and things like that. People that were interested in kind of low carb nutrition. I said, hey, I'm going to try this all meat diet for 30 days.

Clearly, I'm going to die at the end of this, but what's going to kill me? I remember I ran a poll, I said, is it going to be, my heart's going to clog up my. I'm going to die of scurvy or my colon is going to fall out from lack of fiber, right? We don't kind of had a laugh with that. So I did it for 30 days.

And, you know, the first seven, eight days, I felt kind of not great. I didn't feel bad, but wasn't great. I remember I had some mild headaches, probably I was dehydrated in retrospect. But by about three two, three weeks in, I was like, well, I feel pretty good. And I was strangely satisfied with just eating steak and eggs, which I thought was weird because, you know, in the past, I was, I like to eat.

You know, you can imagine you don't get to be a 300 pound human without liking to eat. And I was a guy that would go, you know, I go to a restaurant, I said, let's get two or three appetizers. Maybe I'll have two or three entrees. And, oh, I can't decide between the red velvet cake and the cheesecake. Hell, just give me both, right?

I mean, that's. That had been my way of eating for years because I spent, you know, 25 years weighing 280 pounds as a big, strong athlete. So I could eat, I could put away a lot of food. And at this time, I was like, you know what? I'm pretty satisfied with this.

I'm not even hungry. Which was, to me, kind of revolutionary because I was like, I'm not constantly thinking about food. So I did that for 30 days. Felt really good. And then I said, well, the experiment's over.

I'm going to go back to my regular, healthy, omnivorous diet. And I did that. And within 24 hours, I remember my gut started feeling bad. I started getting some back pain, and I just didn't feel as good. And I was like, you know what?

All things being considered, I'd rather feel good. I don't really care about, you know, the fact that this diet is strange or weird. I just rather feel like I feel good. And within two months, I remember I had really bad quadriceps, tendonitis in my right quadriceps. I remember I was squatting.

I was doing a 500 pound squat one time, and I felt a little tear, like I partially tore my tendon. And that had bothered me for ten years. I couldn't sit like this for a long period of time because my knee would always hurt. It would prohibit me from training sometimes because it was too painful. And within two months.

And as an orthopedic surgeon, I know how to treat tendonitis, or how we're supposed to treat tendonitis. I knew all the little tips and tricks, and I had tried all those things that never went away. So I kind of resigned myself as someone who was approaching 50 years of age at that time. I think it was 40. No, I was already 50 at that point.

That's just being 50. That's what being old is like, right? I see it all the time. It's normal. Two months after that, it went away and it's never come back since, which is kind of.

Kind of cool to me. So that really got me thinking. And then I noticed that I was competing. As I mentioned, I was doing this kind of rowing, this crazy sport, this competitive rowing, where you just get on a rowing machine and push as hard as you possibly can for a set period of time or distance. And I had already.

I was already at a level where I was setting american records on that at 49 for the 40 plus age group. So I turned 50 and I was on this diet, and within about four or five months, my power output went up by something like 10%, which is at that level, it's kind of unheard of. It's like taking Usain Bolt going from nine five to nine two. I mean, it was like a huge leap in power, which, again, was also very shocking to me. So at that point, I was pretty impressed with my results.

And so somehow I convinced 100 people online at time, on Twitter to try it for 90 days. And we actually collected data. I called this the. Because everybody was saying, well, it's just n equals one. It's fine for you, but it's not applicable to the population.

So I said, well, let's get a bunch of people out here and call this n equals many. You know, instead of n equals one. It was n equals many. Got 100 people to do it for 90 days. And we actually built a little website to track the data.

And what we found was that among those hundred people, the average weight loss was about 14 kilos. So about 30 pounds. They lost about 8 cm on their waist. Their average heart rate, resting heart rate went down by ten beats per minute. And then everything.

Subjective. Sleep, digestive health, mental health, you know, joint health, sexual health, everything got better. So I thought that this is really, really kind of interesting and weird. You know, I was like, I wouldn't have expected that. And so that's.

This is probably September of 2017 at this point. And then I think at that point, Joe Rogan picked it up and kind of messaged me, hey, would you like to come on this show and talk about it? And at that point, I was like, yeah. You know, I didn't realize how influential he was at the time. Cause I didn't really pay attention to podcasts and stuff.

So I kind of drove up to his place in woodland Hills at the time and just kind of hopped in there and had a discussion. And then all of a sudden, you know, obviously, it kind of gets a little bit overblown. And then all of a sudden, I had a lot of people start asking me, questioning and following me. I had a lot of vegans that didn't like me at that point. I remember all of a sudden I'm like the Hitler to the vegans, you know, it was funny how that, how that transpired so quickly.

And all I'm doing is saying, hey, look, this is my observation. I'm seeing people get healthy eating this crazy all meat diet. And I think it's fascinating and interesting and kind of cool stuff and I'm excited about it, but a lot of people didn't like it, apparently. So that's, you know, and then, so now we're some seven years later and I've been just astounded by the thousands, 10,000 probably into the hundreds of thousands of people now that have tried it with, in many cases, very, very positive results, which I think is, I think it's just cool. I think it's fun to see that.

Drew
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Right. You're advocating that there's this strong therapeutic approach that you've seen in hundreds now, thousands of individuals, and you want people to pay attention to it and maybe question some of the assumptions that they had about various aspects of why they thought the carnivore diet, or even just meat in general, is dangerous. Now, with all that being said, you've also been very public that 95%, 90, 95% of your diet is pretty much beef. And I actually don't even know if you add salt to it or if you don't add salt to it. Do you add salt?

Doctor Sean Baker
I do. You add a little salt? Yeah. It tastes better. Occasionally.

Drew
You'll have some eggs. Right. You'll have some, uh, some other, uh, proteins inside of there as well. But beef is the main one from the outside. Somebody could look at that and say, wow, that seems, like, very strict.

How have you decided to practice the carnivore diet in that version that you're doing right now? Yeah, I mean, it's something that I don't think a lot about nutrition anymore. It's kind of weird in a sense that I don't. I don't really, you know, because in the past, it was, you know, you spend so much time thinking about food. You eat lunch.

Doctor Sean Baker
What am I gonna have for dinner? You think about new recipes and new restaurants, and you're. You think about how much time and effort is put into feeding yourself, and so that that's something that I don't even really think about anymore. It's like, yeah, when I have a mistake, it's not even a question for me. It's like, how many?

Maybe. Maybe that's the biggest decision point I have at this point. But I, you know, a lot of people. That sounds so boring. I mean, literally, for me, I enjoy every meal.

It's not like I'm sitting down to eat a plate of, you know, some. I don't know what would be so, like, like cauliflower, if I had eat plain cauliflower. Can you? I don't know. How do people do this?

They can eat raw cauliflower with anything on there. It tastes like sawdust to me. But. But, yeah, I mean, my diet is, is generally beef based. I'd say for sure.

It waxes and wanes a little bit sometimes. You know, like, if I go out of town and it's not available, I'll eat eggs, I'll eat fish. I'll eat some dairy products and things. Like that every once in a while. Like I said, I'll have a piece of cake.

You know, I'm just like, effort. I'll have a piece of cake. It's not, it's not to me, it's not, like I said, it's not a religion. Now, generally, I don't want that stuff, which is really cool because it's like, you know, it's not that I don't get to eat that stuff. I'll eat whatever I want whenever I want to.

It's just, I don't really want to. Which I think is very liberating because a lot of people say, oh, it's so restrictive. But I. But to me, it's more freeing because I literally don't feel compelled to eat all this, you know, quite honestly, garbage that's out there. And it's.

I just don't desire it, which in many people find that to be incredibly freeing. You know, we have this new sort of thing, these new drugs out there, these ozempics, GLP one agonists, where people think for the first time, I don't feel literally like I have to eat this stuff because we have such a problem with, you know, I think this is a real issue. Food addiction. I think there's, you know, clearly people with eating disorders, whether it's binge eating disorder, night eating disorder, or just food addiction, which is estimated to affect about 14% of the population. And, you know, these people are constantly sort of controlled by food and their cravings.

And when that goes away, it is incredibly, incredibly liberating. And so that's how I feel. I just don't. I don't really worry much about nutrition. I know.

I know. You know, if you think about every animal on the planet, how many of them are walking around with apps telling them what to eat, I mean, we see people that were like, oh, I need. I need to get my macros or add up my micronutrients, or they're on some sort of crazy plant. Maybe they're tracking themselves with some sort of tracking device, and no other animal on the planet does that or needs to do that. And I think humans shouldn't be any different.

I mean, there should be a diet where you don't have to think much about it or just eat until you're good. And I literally eat until I'm full, and I don't eat again until I'm full again. And it maintains me in what I think is a reasonably good level of health. I want to talk about weight loss for a second, you mentioned that a bunch of the people in your community, the average weight loss when individuals went on this 30 day program, so it. Was like 14 pounds, 14 kilos.

Drew
14 kilos. So about 30, 30 pounds. Wow, that's a lot, right? What is it about the carnivore diet that you think is playing such a significant role in those individuals that have weight to lose and primarily, like, the reshaping of their body composition? Because it sounds like they're probably, you know, keeping their muscle, maybe in some cases adding some muscle, but losing some fat.

Is it that they're getting so much protein, and protein is so satiating, or is it that they're just not getting this ultra processed foods, which are so addictive that cause you to eat more of them? Or is it some combination of those and something else? Yeah, I think. I think. I think both those things are important.

Doctor Sean Baker
You know, again, with the ultra processed food, we know that consumptive ultra processed food literally rewires our brain to desire more of it. And I think the food engineers know this, and I think they've known that for decades now. I actually had a gal who was employed as a food chemist, and she set her job, and she worked for one of these major food corporations for like 30 years, was to make food as addictive as possible. And she felt really bad about it. She felt horrible about it, because she realized that she's been part of this horrible thing that's really destroyed much of our population's health.

But when you think about, you point out satiety. And that's an important concept, because this is how these GLP one drugs work, for instance. In many ways, it is very satiety provoking in the sense that the way I tell people do it, you know, like people ask me, well, how much should I eat? Well, I say, eat enough. Eat enough beef or steak and eggs so that you don't want a cupcake or a pizza or whatever, whatever that problem food might be.

And when people will do that, they'll often find that they, they become so satiated. And you are right that, you know, the protein is typically higher than most diets. Not. Not if you're on a bodybuilding diet. You may be, you know, kind of equivalent.

You know, the average American consumes between twelve and 16% of their calories come from protein. I think that's not enough for most people. I think that's the problem with that, is it drives you to consume other foods. So a carnivore diet, typically 20% to 40% protein for most people, depending on how they practice it, protein itself is metabolically more challenging to break down in energy. So about 20, up to 25% of our protein calories are just thermically used up just to process it.

So that's clearly part what's going on there. As we talked about, like for instance, with beef, things that stimulate GLP, one naturally in our body, protein does monounsaturated fat, which most people don't realize beef is the biggest fat in beef, is actually monounsaturated fat. We hear about how, you know, how because we always hear about the saturated fat, but it's, and it's there, but it's actually the second most prevalent fat in beef. So I think the monounsaturated fat, the protein from beef provides this significant satiety benefit to where a lot of people will find that they're not hungry, they don't eat as much. And that can be a problem.

A lot of people under eat on the diet and they end up run on the problems with not being able to consume it enough. And so that's an issue that some people have. So I think that's going on. I think the fact that it is, despite what some people might say, it is incredibly gentle on the gut. You think about how we're designed as human beings.

I mean, our gastric ph is literally 1.51 to 1.5. That is more acidic than a lion's gut. Believe it or not, a lion runs around two to three. It's on par with scavenging animals. So like vultures and hyenas and things like that.

And the thought evolutionarily was that early hominids were actually scavengers. And because we would find maybe a lion had killed a zebra and they leave about, on average, there's studies in Africa that show that a lion will leave about 25 kilos of meat behind after they're done. So humans went through there, probably picked off the scraps that had been sitting out for who knows how many hours. So they obviously would have been contaminated with bacteria. And so we had to develop a very acidic gut to deal with that.

And so there's all this talk about the microbiome and how important that is. But you don't need a microbiome, literally, to digest meat because it's all absorbed before it even gets to the microbiome. So it's interesting, a lot of people are trying to dial in their microbiome through probiotics and prebiotics and pro prebiotics and all these things because what we're seeing is this fermentation that's occurring by the microbiome. But, you know, so you have to. So in order for you to effectively consume all this plant food, the microbiome has to be dialed in or you have problems, you have digestive problems.

You don't need that for meat. In fact, there are people. So the most compelling argument I can make for this, and there's, there's, well, there's a couple. But there are people out there that don't have a colon, right? Because we hear about your microbiome losing your colon, and it ferments all its food.

It's really important you get these short chain fatty acids, like uteric acid. Well, why is it that people that don't even have a colon, you know, lost their colon due to diverticulitis or colon cancer or Crohn's disease, can live a normal full life to normal life expectancy without even having a microbiome? Because you don't really need it. Humans have, like, if we compare a human to a other primates, like, for instance, a gorilla can get something like 60% of its calories from the fermentation of fiber in its gut. A chimpanzee can get like 45%.

Humans can get around 4%. So we have a very diminished capacity to absorb calories from things like fiber. It's like a tiny amount, like some people estimate maybe at most 200 calories a day. And that's clearly not enough to run, run a human being. So it's, you know, kind of how we're designed from a hardwire, from a hardware standpoint.

You know, if we want to use like the variable microbiome as a software package, we're hardwired to consume meat. We can do it very easily, very efficiently, and in the context of all species that have ever been on earth. So every animal that has other swam, flown, or walked on earth, something like 85% of them have been carnivorous. Why? Because it's an easier, it's a more efficient way to digest and absorb nutrition.

You think about if I were going to build a brick house and I had a pile of bricks over here, and I had some straw and mud over here, it'd be more efficient to use the bricks that are already formed. And that's the same analogy to animal, you know, if I'm made up of animal cells, right? And all the components that make up that, and I need that to continue to maintain that, to grow that. The easiest way to get that would be to consume direct animal cells, rather than. Rather than consuming the straw in the mud, I just want to consume the bricks.

And that's why it's much more efficient that way. So it's a more efficient way of eating, you know, as food prices go up. And this is interesting, you know, how many of us, how many of us have experienced a time where we go, we want to be super healthy and we go buy all this organic fruits and vegetables, we put them in our fridge, and then two days later, you pull the strawberries out and they're all covered in mold. Got to throw them away, right? Man, that's a waste of money.

And then, as I pointed out earlier, all that fiber that you're consuming, much of the nutrition actually ends up being flushed down the toilet. So you're literally, like, wasting money consuming all this stuff, whereas with meat, you're absorbing, almost all of it gets absorbed. So it's more efficient. And in fact, many people end up, they find on themselves eating way less on this diet. They actually end up spending less money because people, meat is so expensive and so on and so forth.

And true it is relative to, you know, cereal, I mean, but cereals literally devoid of nutrients. That's why I gotta fortify it, you know, that's why we have these fortified cereals, because they're so nutritionally devoid. And the fortification, you know, isn't even absorbed to the degree that we think they are. So anyway, you know, there's people that. Are listening and they're like, I like this guy.

Drew
He is making sense. Like, okay, this doesn't sound like crazy. Help our audience understand, because a lot of them are not in this world of maybe being super aware of the carnivore diet. Maybe they've heard of it a little bit. Why is it that the carnivore diet ends up being one of the most controversial diets that are out there?

And secondarily, I mentioned this earlier, why is it that some researchers, or at least one researcher at Stanford University, said that the diet is so controversial, it's so unethical, that we can't even run a study to see if it works or if it doesn't work, give an overview of that? Well, again, obviously it goes counter to everything we've heard about for the last 50, 60, 70 years in nutrition. If we go back to the origins of, say, the American Dietetics association, this goes back to 1917. Most people don't know it was founded by a woman named Lena Cooper and one other person. And Lena was a staunch 7th day Adventist and 7th day Adventist religiously are kind of vegetarian.

Doctor Sean Baker
They just don't like red meat. They think it's. They think red meat leads to sexual deviancy, masturbation and lust and adultery. This goes back to guys like John Harvey Kellogg and, you know, these folks that believe that meat was one of the drivers of sinfulness. And so we have that baked into the origins of nutrition.

And then we couple that with what happened when Dwight D. Eisenhower, President Eisenhower had his heart attack back in the 1950s. And so they were looking for a reason, and that's where they came with this diet heart hypothesis. So we've been sort of immersed in this belief that meat is the enemy in many ways. And there are a lot of associational studies out there.

Like, for instance, Harvard University just did one earlier this year saying that the consumption of red meat was associated with, like, a 62% increase in the risk of diabetes. And the problem with that study, as there are many, is they said, well, you know, we're going to call red meat. Lasagna is red meat, and sandwiches are red meat and McDonald's hamburgers are red meat. And we're not going to account for how much sugar was consumed. And, oh, by the way, obesity is not going to be something we control for.

It's like when you're picking out obese people and saying they're more likely to have diabetes and blaming it on the red meat. Well, I said, well, it's because red meat makes you fat. And, you know, I'm sitting here saying, well, wait a minute, I got people that go on red meat diet and they lose 200 pounds. It doesn't make you fat. You know, it's the overconsumption of whatever that tends to do that.

But I mean, as far as, like, you know, Professor Chris Gardner at Stanford, you know, he says it's unethical to study this diet. You know, and I'm like, well, right now there are literally hundreds of thousands of people who are doing it. I think it's unethical not to study it, in my view. So we've got that sort of interesting thing, you know, because there's people that are so convinced that they are correct without, you know, it's. It's, you know, it's one of these things where kind of this, you know, trust the science thing that we went through.

And it's just like, if you say you trust the science, you can't question the science. It's not very scientific. And so this is something that is very much threatening to people because they have built careers saying, that I know that I'm right or I'm mostly right, and all of a sudden you have something that says you're completely wrong. That's offensive to a lot of people. And they don't want to.

They don't even want to acknowledge that in a way, but you can't. You know, it's interesting, there's this sort of, you've heard the term evidence based medicine, I'm sure. And does anyone know where that comes from? Interestingly, that came from a guy by the name of Professor Gordon Guyett. Now, Gordon is a professor at McMaster's University in Canada.

And back in the early 1990s, he was a internal medicine residency director at that institution. And he was frustrated that the way medicine was being practiced was that guys were saying, well, I don't know. My patients seem to do better when I do this. And there was no real science behind that in sort of developing the way we think about things. And so he came up with this concept called evidence based medicine, which he actually coined that term back in 1991.

There's a paper by him that you can find, and his entire career since that time has been, how do we evaluate the strength of evidence? Is this a good study? Is it a bad study? What can we learn from this? Because quite honestly, a lot of studies out there are kind of worthless.

I mean, in fact, probably most of them are, to be honest. And he was involved in a huge study in 2019 looking at red meat. He was a senior author. It was 14 other authors from around the world. And they basically said the evidence that shows that red meat causes heart disease, cancer, or any other disease is so weak and so poorly done that it is basically something we can literally ignore.

You can continue to eat as much meat as you want. That's what we know at this point. And I think that's a fair assessment of what we really know. I mean, you can point to, I can certainly pull up studies that will show you that red meat is beneficial in this regard. It doesn't cause these things, as can many people show studies that show the opposite.

But the reality is we just don't know. And I get people asking me, well, is this going to shorten your life? And I'm like, I have no idea. I have no idea. And I don't think anybody does.

And I think this is, to me, this is sort of almost arrogant in a way, to say that the mediterranean diet is going to make me live to 100 or the vegan diet or even the carnivore diet. I think that's wrong, because we have no way of really knowing that, no way of testing that. So at best, you're speculating. And so what I am more concerned about, and I've said this over and over again, I mean, clearly, I'm 100% certain that I'm wrong about something. I just know that.

I mean, there's no way I'm not. What I do know and what I see every day is I can take someone who is sick and suffering, and I can provide an intervention, perhaps a carnivore diet, and I can make them so they're no longer sick and suffering. And I think that is so incredibly important and powerful. Rather than worrying about, am I going to get heart disease, you know, five years prematurely, or am I going to die of cancer, or am I not going to make it to 100? Which I think is all just guesswork and not particularly.

The farther you get away from today and tomorrow, the less accurate you are. The weatherman can't predict the weather in five years. There's just no way they're lucky if they get it right tomorrow. In many cases, it's the same thing with medicine and anything else. Again, if we focus on, as physicians and healthcare providers, of actually doing what we're supposed to do, it's taking someone sick and getting them better, rather than maybe putting them on some drug for the rest of their life in order to prevent something.

Who knows what it is? I mean, I think. I think the healthcare system, and I'm going off on a tangent here, but I think the healthcare system is incredibly poorly incentivized. I mean, we have this just really perverse system at this point, you know, where patient well being is almost an afterthought at this point. I mean, if it's not profitable, you think about the drug companies.

If it's not profitable, they're never going to develop it. There was an interesting, Goldman Sachs did a really nice study on, is it profitable to cure disease? And they came out resoundingly with, the answer is, no, it's not. It's literally not profitable to cure disease. And so that's kind of where we're at with the healthcare system and the pharmaceutical industry.

Drew
You know, I was asking you, why is it so controversial? You gave a great overview. I'd love to pull on some of those threads that you mentioned. You know, the primary researcher you mentioned, I forgot his last name. Chris Gardner.

Chris Gardner. He was also, if anybody is familiar with the Netflix documentary the Twins study, where they took twins. They had one of the twins follow a vegan diet, they had the other group of twins follow, essentially, like an omnivore ish diet they didn't control for calories. They just kind of let people ate whatever they want. And the paper was published.

Again, these are researchers from Stanford. And the Netflix documentary came around around the same time. And the big sort of caption from that study and the documentary was, look how much healthier the vegan diet is because these individuals, the twins, again, twins, because they have the same genetics on each side, they lowered their LDL cholesterol. And that's often the argument that you're hearing from individuals who are in the evidence based camp and also individuals that are in the plant based or vegan camp, which is, hey, we know from these large observational studies that LDL is associated, over time with atherosclerosis, heart disease, the number one killer of men and women that's out there. So anything that we can do to lower the LDL of individuals is going to be a beneficial thing.

Now, I'd like you to talk about, like, why is that not the complete story around LDL, from your perspective? Yeah. And again, I'll be very clear. This is from my perspective, because if you talk to the average cardiologist, most physicians will say, yeah, lowering LDL is a good, good idea for most people. And I think for most people, it's probably not a bad idea, to be honest.

Doctor Sean Baker
And so when you. When you use that as a primary outcome metric, and again, that anytime we're using biomarkers, whether it's ldl, whether it's blood glucose, whether it's, you know, serum potassium or whatever you want to put in there, it's not a clinical endpoint that's often meaningful. You know, I. And so I think, you know, just. Just back to that Netflix documentary, the other thing that was probably of interest is the people that went on the plant based act clearly lost muscle or failed to put on as much muscle, which to me, is a clinically important marker when we're talking about various markers of disease, LDL cholesterol or total cholesterol or apoB, or however you want to just divide it up or think about it, is clearly a risk factor for cardiovascular disease in my mind, you know, based on the evidence I've seen.

But I do think it's a dependent variable, and I think. I think there's. There's emerging evidence, and certainly some evidence has already been published that shows that, you know, for instance, there's a huge study that Mortensen did in 2022. Look out of Denmark, where they showed that people that had high LDL cholesterol versus low LDL cholesterol had no difference in outcomes with regard to cardiovascular disease, like heart attack, strokes, need for revascularization. If they had a CAC score, which is a calcium score of zero, which means that there is another dependent variable.

And what would drive a high CAC score? Well, things like diabetes, things like smoking, things like chronic inflammation, hypertension. So I think you have to look at it globally. And I think, you know, it's lazy medicine just to focus on one variable and say, hey, you come in with high cholesterol in my clinic, you're going to leave with a script. I mean, that's a product, really, of the healthcare system.

Again, when physicians have 510 twelve minute visits, they don't have time to take a comprehensive look at what's going on. They base everything on a lab value. You get that it's becoming more and more of that. In fact, medicine is going to increasingly, as providers replaced by AI algorithms, you're going to see less and less physician interface, where, because drug companies would just love to get all the drugs in your hands, and we'll see that. But with regard to LDL, as you know, Matt Budoff, who's a cardiologist here in UCLA, is working on a particular study that looked at people with very, very high cholesterol.

We're talking total cholesterol of seven, 8900 points, you know, LDL cholesterol five, 6705 years at least in that period of time, all on a sort of a higher fat ketogenic diet. And what they're, what they found on their baseline data after five years was that they were at no increased, they had no increased level of plaque in their arteries and someone who had low cholesterol with the same level of health. So that's interesting. You know, that Dana study that I had mentioned found that 60% of the people that had familial hypercholesterolemia, that's this, is this genetic high cholesterol. Those people did not have advanced heart disease compared to anybody else.

So there's obviously, I use the analogy of if I wanted to start a fire and what do I need to start a fire? Well, I need something to burn, some wood, right? I need an oxygen rich environment and I need a spark. And if I don't have any one of those three things, the fire doesn't happen. So I can have all the logs in the world.

But if there's no oxygen and no spark, it's just going to sit there. Right. So I kind of look at that as that is your LDL cholesterol is that it's the wood, but if you don't have the fire, if you didn't, if you don't have the oxygen rich environment, then it may not do anything. And so again, I think more and more data is pointing that way, that it's a dependent variable, I think, where there's more to come, you know, particularly as Matt Buddha and hopefully other people replicate, replicate his work, that we can see that, because I don't, you know, I'm not interested in having a heart attack, you know, and as someone who I don't have really high cholesterol, I mean, I know there's some people that do that, and I think here's another interesting bit of information. So there was a great meta analysis.

It was just published in January this, this year by a guy named Adrian Sotomota out of Monterey Tech. He was previously, he was a PhD from Oxford. They did 41 randomized control trials, and they did a meta analysis on that and said, what is driving high cholesterol in these people in a low carb state? And overwhelmingly, what they found was it was if they were very lean, if they were obese, they didn't have high cholesterol. If they were very, very lean, though, they had high cholesterol, which fits into something called a lipid energy model.

And I think you maybe if you had Dave Feldman on here, you guys talked about it. So it clearly lines up with that. I mean, we see, for instance, like certain drugs, like there's these drug classes called SGLT, two inhibitors. Basically what happens is they're diabetic drugs, and you end up peeing off all the glucose. So it makes you get rid of all your glucose, and it lowers the risk of heart disease.

But guess what else it does? It raises your LDL cholesterol. And despite the fact that it raises your ldl cholesterol, your heart disease risk goes down. So again, there's a lot of other things that are at play here. And to say it's just all black and white and just a knee jerk reaction.

Everybody on, everybody that has ILDL needs to be on a drug is probably harming some percentage of the population. You know, certainly, I mean, because, you know, the average doctor visit, this is a problem. Doctors are used to dealing with sick people, and most of the data we have are on sick people that have heart disease. What about somebody who's healthy and fit and physically active and doesn't have diabetes or prediabetes or, you know, chronic inflammation or hypertension. Are they acting a little bit differently?

I think the answer is yes. But again, studies are forthcoming on this, so I don't want to push too hard on that. So I tell people, if you have high cholesterol and you're on a low carb diet, a ketogenic diet, a carnivore diet, you shouldn't ignore it. You should get some more information, maybe get some imaging, maybe get some sequential imaging where you check it, you know, year one, year three, and see where you're going in that direction so it can help you make decisions. Well, I'm somebody that fell into that camp.

Drew
I've had higher lDl, higher apob. I think my apob at the highest was like 190 when I tested it a few years ago. And then I made some dietary changes, and still it was elevated. So I got, and I searched a little bit, and through a friend, I ended up connecting with a cardiologist, doctor Michael Twyman. I don't know if you've heard his name before.

Doctor Sean Baker
Yeah, I've interviewed him. Yeah, yeah, he's a great guy. He's been on this podcast a couple of times. And through that process, and especially me falling into the camp of being indian, south asian, in America, we have the highest risk of any ethnic minority of having heart disease. There's literally a entire center at Stanford University called the South Asian Heart Disease center that's, you know, dedicated to, like, researching this.

Drew
All the Indians that live up there, and the tech money and the donations, and they've had all these different theories. Is it genetics? Do we have smaller arteries? Is it this? But it's very clear now, since that institute's founding, there's a lot more awareness that, especially for indian, south asian.

South Asians who tend to be under muscled, skinny, fat, have insulin resistance, that those things all play in a role, not that these other things may not have a factor, genetics, etcetera, but the lifestyle components, being very sedentary, play a major role. So I got some imaging done, because LDL APOB, these are all guesses, and they're proxies. So I got advanced CCTA scan done. I got a particular one done. It's an AI imaging scan.

The clearly scan. Yeah. Familiar with it, yeah. And the results came back, and I was a little bit nervous about what it was going to say, and it showed that I had incredibly clean vascular health. In fact, Doctor Twyman told me that it's the cleanest for anybody in my age group, that he's seen for a male, I think he's seen a female.

And I even went to a vegan cardiologist to get a second opinion. Doctor Joel Kahn, who I think you know Joel. Yeah, he had been, he had been referred to me. I've known Joel through a few different, you know, groups that I'm part of in the industry. And somebody said, you know, well, you should show it to Joe as well, too, because, you know, Joe has seen more clearlies than a lot of people that are out there.

And he told me that it was the second cleanest that he's seen next to his own. I guess he puts a lot of attention into that. So he was bragging a little bit about that, which, which, great. You know, I'm happy for anybody who has a good, clearly scan. So that left me feeling that even though my APOB was high and even though my LDL has been high, because I'm a hyper reabsorber, I got some further genetic testing done.

I'm not. I don't have familiar familial hypercholesterolemia, but I'm a hyper reabsorber of cholesterol. So there could be reasons why my body is just producing or keeping more of that sort of lipids in the system, but it put a lot of my concerns to rest, that I generally eat very clean. I've been on a mission as a former recovering sort of vegetarian and vegan, growing up to add lean muscle mass, to work out more, to improve and, uh, up the protein intake in my diet now. And I felt that largely, I was heading in the right direction, but that there was these individuals, I would say from just seeing my LDL, my OPB, that, hey, I'm worried, but now getting some of that imaging done, and, you know, unfortunately, this is out of pocket.

You know, I think my test cost about $2,000 in the interpretation, so it's not accessible to everybody, but that price will come down over a period of time. And it goes back to this idea that you have, which is we're going to be guessing a lot less, and instead we're going to have more, especially when it comes to heart health. We're going to have better and more available imaging that's going to tell people the individual answer to is their diet healthy for them, and are they heading in the right direction? And I think that I just wanted to share that personal testimonial, because, number one, I'm excited about what's coming down the pipeline, and number two, my APOb, I haven't been testing it for. I didn't know about it.

And a lot of my clinicians that I was working with, it didn't know about it prior to about like eight years ago. So I don't have data on it, you know, seven years ago and further than that. Eight years ago and further than that. But I feel like that'd be a long enough time of having it that we should see, you know, some advanced plaque, soft plaque, and hard plaque buildup. And, of course, I'll continue to monitor it over time.

Have you gotten some of this imaging done yourself? You've mentioned you've have high cholesterol, high ldl. I don't know if you even know your APOb number. Have you gotten some of this imaging and what has it told you about your own health? Yeah, I got a.

Doctor Sean Baker
Well, I got a coronate scan a few years ago. It was zero. So, I mean, again, it's not as precise as the clearly or ct angiography, but, you know, my. Again, my. I'm not as lean.

I mean, my bmi is. I'm obese by bmi. I mean, obviously, I've got a lot of muscle mass on me, but so I don't tend to run as high of an LDL cholesterol as some others do. Now, if I get leaner. And it was kind of interesting, I did a real interesting experiment back about two months ago where I checked my total cholesterol at a certain point, and it was 154, which is low, right?

I mean, it's like, most cardiologists would be happy at that number. And then I fasted for, like, 18 more hours, and I. And I exercise and I rechecked it, and it went up from 154 to 345 in under 18 hours, which shows you how dynamic these numbers. So that, to your point, why are we guessing what numbers it can fluctuate dramatically over the course of even, you know, 24 hours. So, you know, I, like I said, I had my imaging done with, with the CAC score, which was zero.

I look at my Vo two max. I basically put up for my age, world class numbers with Vo two max, which is another proxy for cardiovascular function, because as you pointed out, and I think rightly so, we need to look at things that actually matter over time. Like, if my ldl can change 200 points in 24 hours, you know, what can't change that much in 24 hours is how much fat I have on my body. You know, I mean, it's just like, these are things that actually are, to me, more clinically useful. I mean, I think literally, a simple measuring tape where you can take a waist to height measurement provides you more information on a person than a slew of lapse can in many cases.

So there's some things that we sort of over rely on these labs which change. Like, even, for instance, vitamin D. Most people don't know this, but vitamin D can vary 30% throughout the day. It's like, I'm worried about my vitamin D link being low. What time did you take it?

So when you know how much diurnal variability is in a particular lab, you start to say, well, how important is that if it can change so much? So I like things like that imaging you had that clearly is a great study. I think blood pressure is a pretty reason, can be a pretty reasonable metric if it's measured correctly. I think body composition is huge, as you point out in India, where there are more diabetics and people with cardiovascular disease in largely any place in the world. I mean, they just went through the most populous country in the world right now.

They've surpassed China recently. So you've got that. And as you know, in India, 30% of the population is vegetarian. And even the ones that eat meat don't eat that much. It's like five kilos a year.

So it's not a. Even in the households that eat. It's like a small. Well, you know, better. It's like a once a week maybe minimal thing for many people, and yet they have tremendous levels of diabetes and heart disease.

So you gotta. You gotta ask the question, why is that? Why? Why do we have so many people with heart disease that barely eat much meat, and yet we're gonna blame it on that here. You know what I like about your approach, Sean, is that you're saying very clearly on your end there's certain things that you don't know.

Drew
So it's very clear that these observational studies show that over the long haul, and if you take somebody like a Peter Attia or a Simon hill who's been on this podcast before, they'll say, listen, over the long haul, you are gambling by having your LDl higher or your APOB higher. And do you really want to put yourself at risk? And based on all the data that we have out there from these observational studies, now, if I understand correctly, and you correct me if I'm wrong, I'm just recapping for our audience. You're not throwing that out. You're saying, yeah, these.

These large observational studies do show that. Now, a couple things are, you know, are those individuals that have high ldl? Are they healthy? No, it's the general population. And most of the general population is unhealthy, so they also have insulin resistance.

They're obese often or overweight. They have other factors that are there. Now, sometimes I've heard these individuals say, well, a lot of that is controlled for, and I'm not smart enough to know the answer around that. But then further, you're saying that if we actually look at a population that is truly healthy and if we use maybe more, some of this more advanced imaging, we actually don't know the answer to, is that a problem over time? And then, more importantly, if you do lower your LDl extremely low or your total cholesterol extremely low, or your aPob, is there something that you're potentially sacrificing?

Can you talk about that for a second? What do you think could be sacrificed if people continue on this threat of going very extreme, of wanting to lower their lipids to the lowest level possible? Yeah, it's interesting. There are advocates out there that will say they want their LDL cholesterol like 20, which is what a newborn infant is born with. Now, mind you, a newborn infant hasn't eaten any yet.

Doctor Sean Baker
And so it's like this is the only time in our life. You know, there's interesting studies that looking at breastfeeding infants, and they look at their total cholesterol, and within 13 weeks, the average infant who breastfeeds will have a total cholesterol between 180 and 250. So high. Relatively high, much higher than these people would want you to have, you know, probably double. Why that?

And so why is that? Are we saying now that breastfeeding is dangerous for human beings? Perhaps. I mean, it's kind of one of those interesting things. I mean, again, if we're talking about associations, we know that low cholesterol is associated with higher rates of, or can be associated with higher rates of depression, violent behavior, suicide, infection, some types of cancer.

So there are some perhaps long term issues around dementia. So there are potential problems. Now, people will point to certain studies and say, well, we've excluded that. Again, most of those are industry funded studies which have a clear conflict of interest. When you have a drug manufacturer tells you that our studies show this drug is safe and effective over the long term, you can almost always rely on those guys to over promise and under deliver.

I mean, that historically is what happened. So you tend to, not to be conspiratorial here, but I mean, I think there's some of that going on and I think that if, for instance, and I tell people, look, you gotta do what's right for you if you have cause. I talk to people all the time. I interview people almost on a daily basis where it's like they've had some awful, awful disease. Maybe they've had Ms, multiple sclerosis, and they're bed bound, and now they've been on this higher fat, maybe a carnivore diet, and now their MS plaques are going away.

They are now able to participate in life. Maybe they got their job back to them. When I asked them, what about if your risk for heart disease is increased? What do you say to that? They said, you know what?

I would rather risk that than go back to where I was. As physicians, you can't just make the decision for people. They have to be able to decide what makes sense to them. And certainly you can offer that some people, like, they don't want to change your diet, because a lot of people like, I like my diet. I don't want to change it.

I was on a whatever diet. You want me to be on a cardboard based, you know, low fat diet. And I didn't, I just, I didn't feel good. I didn't do well. I've bad gut issues and so on and so forth.

And so for those people, they're not going to go back to that. They're not going to make the lifestyle alterations because they feel so much better. You might offer them some sort of lipid lowering therapy, whether it's a statin, whether it's, you know, PCSK nine inhibitor, what any of these other, you know, ZD, any of these other drugs out there. And I think, you know, I certainly tell people that's an option for you if you want to do that. Now, assuming there's no side effects, that you don't have issues with that many people do have the side effects.

Many people just patently don't want to be on these drugs. For whatever reason. They don't trust the pharmaceutical industry. They don't like the fact that they have to be on drugs. They don't like the fact that they're dependent on someone else for their health.

I mean, this is one of the nice things about diet in general is like, you can, you can kind of wean yourself off the dependency of the healthcare system, because when you are literally diagnosed with a chronic disease, let's say you're diabetic and you need a doctor to refill your, whatever your metformin or any other drugs that you might be on, you become disempowered in many ways because you are now dependent upon some other individual. If they feel like it, or if they decide to, or if they deem it's necessary to provide you this drug. Whereas if you get away from that and you're like, look, I've got within my own capabilities. I can. I can change my life so I can eat a certain way, I can dial in my sleep.

I can not be sedentary. I can exercise. I can maybe find a supplement or something like that. Then you become empowered, which is, a lot of people don't want to give that up. I know this is kind of a little wandering a little bit, but I think that with regard to, and I'll say it again, with LDL cholesterol, I think most people out there, it's a significant risk factor for.

And, you know, if you're talking about population level health, yeah, probably makes sense. I mean, well, interestingly, we have, on a population, brought our average total cholesterol down from around 220 to 200 over the last 30 or 40 years. And the incidence of disease has not decreased. I mean, cardiovascular disease has not gone down. Now.

Cardiovascular mortality has gone down because we've gotten better at treating it. Of course, there's a confounder of smoking. Back in 1954, 45% of Americans smoke. Today it's around 13%. So you can't ignore that factor.

And then going back to Dwight D. Eisenhower, you know, when he had his heart attack, well, it must have been the fat, but he was smoking three packs a day. And they kind of, this is back in the fifties when they thought smoking was so healthy for us. So it's kind of one of those things that there's a lot of moving parts here, you know, a lot of. Folks that are listening today, and even you and me individually, in our own health journey, we're trying to make the right decisions for our own health.

Drew
And every week we're getting exposed to new information every day in many instances. You mentioned you had Doctor Michael Twyman on. He's the cardiologist that I work with. I've interviewed him, and I've been very transparent with my audience that I'm trying to make the right decision at looking at all these things. And from what I've understood and sort of internalized from his content, is that, okay, you have shots on goal, let's say, Apob, and these particulates which play a role in, uh, cardiovascular disease, atherosclerosis.

And more importantly than that, in his sort of explanation, is our endothelial health? How strong is the endothelial health? How strong is endothelial function, which is a byproduct of, are you producing enough nitric oxide? Because that plays a huge role into it. Are you avoiding the main things that damage the endothelium, things that oxidize it?

Um, are you avoiding being exposed to chronically bad air, which largely comes from indoor air, off gassing, smoking, things like that? Are you, um, living a sedentary lifestyle and not producing enough nitric oxide? Are you drinking and, you know, smoking a lot? Are you doing these things that are damaging the endothelium that would allow these particulates to sort of get wedged in and then plaque to be built around them? So diet is one component, because we're looking at the.

The total amount of lipids that are there, which seem to be playing some role, but then there's also the endothelium. Is that your understanding as well, too, or do you have any comments on that? Yeah, sure. So, I mean, and that's a good analogy because you got shots on goal and you got the goalkeeper, right. If you got a good goalkeeper, maybe those those shots don't get through.

Doctor Sean Baker
And so I think that obviously, like anything, you know, like a hormone and a receptor, you have to have both to have the effect. There's obviously the proteoglycan content. So there's little proteoglycans that can reach out and grab and help us to endocytose some of those cholesterol molecules. And so that proteoglycan is affected by hyperglycemia, it's affected by hypertension and those types of things. Again, it's even at the most basic level, there are multiple factors that go into that.

And so to your point, let's say I have the cleanest diet in the world, but I'm still exposed to environmental toxins through the air. I'm still exposed to maybe chronic sleep issues or something. So there's other things you have to dial in. So if you're going to, quote, unquote, roll the dice with I'm on this low carb, carnivore ketogenic diet run with high ldl cholesterol, which, you know, that's up to you if you want to do that. Have you dialed in those other factors, too?

Because you may still be at higher risk due to compromised endothelium from indoor air pollution or chronic stress or. And stress, I think, is underplayed on how incredibly important it is with regard to the development of cardiovascular disease. And some people would estimate maybe even 30% of our risk is associated with chronic stress. And some people, how do you mitigate that? Let's say you live in an awful situation.

Let's say you live in a crime ridden, impoverished area. So there's other factors here that you have to take into account when you're going to roll that dice. And so I tell people, I'm comfortable in my own health decisions, what I want to do, but I'm not going to make it for you. I think you need to be, you know, aware of what your overall picture is, because I know, I know enough about myself to where I'm saying, hey, I'm comfortable with this, but I'm not going to make that decision for somebody else. The same way I'm not going to tell somebody, you need to be on a medication, you need to lower your drugs in all cases.

Because, again, as you mentioned, there are other reasons where that might be a net detriment. Like I said, if we just talk about lifestyle measures, let's say I know that if I eat a low fat cardboard diet, I'd have lower ldl cholesterol today than I. Than I would if I didn't, however, I might have more gut issues, I might have more inflammation, I might have more joint issues, my quality of life might be worse. And it's not a trade off that I'm willing to have. I mean, ultimately, none of us are getting out of here alive.

At some point, we're all dead. And it's like, well, I remember I had this discussion with this one vegan doctor one time, and I said, and he was talking about the potential risk of a meat based diet, you know, yeah, you're more likely to have heart disease, disease or cancer or something like that. And I said, well, what do you think vegans are dying of? And he looked at me, well, I mean, it was on Twitter. So he kind of paused and he said, I think it's like skiing accidents.

And I was like, you got, come on, man. Skiing accidents? Really? So I actually looked it up and there's some data on this so called epic Oxford study where they had, it's in the sub, you know, the subtables where you can look at it, you can find it. And the number one cause of death among vegans and vegetarians is heart disease and cancer, just like everybody else.

So, you know, one way, I think they had a little more cancer and a little less heart disease. So what, would you rather die? I know it's a morbid topic but I'm like, honestly, I wouldn't mind dropping dead of a heart attack at 90, you know, just boom, like that if I had to. Again, you want to live as long as possible. You ask, you know, like, you ask somebody, like I've seen in my life, I've had the opportunity to meet a lot of hundred year olds, and most of them I was like, I don't want to live to be a hunter, if that's the situation.

Because in my experience, it was all these literally demented old ladies in a diaper with a broken hip. And I'm like, that's what a hundred is. I'm good. I don't need that. Now, obviously, if you start seeing robust, vigorous, because this is, you know, I know a lot of people are interested in longevity and all these various longevity gurus, and I think it's a great sort of place to be because there's, you don't get a money back.

There's no money. Money back guarantees. There's no accountability. It's like, yeah, you do whatever. Take my supplements or my expensive program and you're going to live longer.

It's like, well, how do you know that? So when we have 120 year old people walking around that are vigorous and jacked and tan and getting after it, I'll start paying attention to that. But until then, I'm kind of like, let's fix it here. And now. We have a hard enough time with that.

You know, if you just walk around, you know, the streets of LA, you'll just see how many sick people with chronic disease. If it's mental health or obvious, clear physical health, it is an enormous problem. You know, you mentioned the here now, and I think one of the most exciting things in this space of carnivore keto low carb that's happened in the last, like, especially three years, has been this explosion of some of the world's top psychiatrists. Harvard, Stanford, these other institutions that are literally reversing severe mental health conditions. Bipolar disorder, type two bipolar disorder, severe schizophrenia, and not just in young people, older people, too.

Drew
Severe depression, anorexia, severe anorexia. And they're largely doing it through diet. And some of these doctors have gone so far to say, like Doctor Georgia Ead at Harvard, who's been running a lot of these studies and working with patients saying that meat is actually a superfood and it's one of the most important parts of their protocol to help patients heal. When you look from the outside and, you know, some of these people, how excited are you about this conversation that's happening specifically for these dietary interventions for mental health? Yeah, I mean, it's tremendous.

Doctor Sean Baker
And it's one of the more common, because mental health has become so, mental health disorders have become so pervasive. It's one of the more common things I see get better. And you're absolutely right. Schizophrenia, depression, you know, bipolar disorder, I've seen Tourette's syndrome. My goodness, I've seen PTSD, all these things that I've been seeing for years.

And one of the problems is, you know, we've always talked about low carb diets in the context of weight loss and diabetes primarily. But I'm like, there's so much more here. In fact, I would be so bold as to say that good nutrition will affect every single disease process out there. I think. I mean, it always makes sense to me because somebody will ask me, what about this disease?

I say, my pat response is improving. Nutrition is always going to be a good idea. I don't care what it is, whether it's end stage cancer or dementia, if you can improve that person's nutrition, you're going to see some benefit. And, you know, let's just extend this over even to addiction. I see people with alcoholism, with tobacco addiction, with drug addiction go on one of these diets, and literally they say, I lost a desire to smoke cigarettes.

I lost a desire to drink alcohol. So I think nutrition, you know, and that old saying is, you know, food is medicine. There's really a lot of truths that, and the fact that Georgia EADs and others that have been talking about this. I've known Georgia for eight or nine years now talking about this stuff in a more sort of open way, because even five years ago, if you talked about the fact that nutrition impacted depression, people would get angry about it. Oh, you don't know my trauma.

It's all about trauma, and nutrition is not going to have a role there. Well, I mean, the brain is an organ, like the heart is, like, the liver is, like the kidneys are. They're all affected by nutrition. And if you're not nourishing your brain correctly, it's not surprising that you have these, these issues. And so it's exciting to see.

I'm really, really hopeful. I know, like the Bozuki family, you know, with metabolic minds, I and her husband, I mean, that video game Roblox, they're billionaires and they're their son, I think Matt was diagnosed with severe bipolar disorder. He put it in remission with a ketogenic diet. So I think we're going to see more sort of directed that way, hopefully more research, but hopefully more clinicians that'll get on board with this. And I think this is part of it goes to, part of the problem with the healthcare system in general is when I was practicing orthopedics, I mean, I would line up, I get my morning schedule and I have 50 patients to see, 50 patients in an eight hour clinic.

Not to mention I have to see my Pa's patients too, if they brought somebody had a question. So I'm seeing maybe 60, 65 patients in a day. You can't provide good health care doing that. And that's just how the system's set up. And so if we can have a system set up where we can facilitate the utilization of these nutritions rather than just writing prescription, because it's so easy just to write a prescription, they've got that so streamlined, it's so automatic.

I mean, it's built into the emrs here. Hit that button. I mean, it's going to be literally what we're going to see with healthcare, in my view, and my prediction is you're going to have people that will interact with some sort of terminal, it won't even be a, won't even be a doctor. They might be able to stick their finger and get a blood sample that will be analyzed very rapidly, a diagnosis will be made and a Amazon drone will drop a drug off at your house later that afternoon. I think that's where healthcare is going in a lot of ways and we already see that.

You know, there's a lot of these drugs you can get over on the Internet. So that's going to happen. And the physicians will be in the background maybe signing off. Maybe one physician will do this on maybe 5000 people, you know, a week or something like that, some ridiculous number. And what you're talking about the nutrition side requires, unfortunately, a lot of time and a lot of support.

And I think that's what we lack in healthcare. We put all this money into technology and the latest drug, and yet what may provide even more benefit is just actually getting people, you know, on the right lifestyle, with the right nutrition, with the right level of support. And that's, you know, like I said, our company, Rivero is done. That's why I set it up. I'm so frustrated with, I, even if I want to do the right thing, I have nowhere to turn.

I can't do it. I can't, you know, like I said, my hospital is actively saying, don't do that because we lose money. So to turn that around and provide the resources for people to actually get that type of care is real important because, you know, our, with our thing, we have a physician that oversees it, oversees the care, but we have a coach talking to that person every single day in many cases. And that's, for some people, that's what's needed, you know, particularly somebody that's really struggling with implementing this stuff. And, gosh, I mean, if I, you know, I know, I don't know if you know who Callie means is, but I know he has a company where he's actually, you know, enabling people to write food as prescription, true medicine.

So I think that's. I think there's going to be a dichotomy. I think there's going to be some people that just give me the drugs, and I don't need the doctor in the way because a lot of people, you know, you go on these little doctor rating things, and some of the people really are excited and give high marks for doctors that are very responsible of getting them drugs really quickly. I don't have to wait for my refills. My doctor always gives me a refill, and that's a good doctor.

And I'm like, man, I think it'd be better if your doctor could get you off the drugs. That would be real cool. But no, there's people that are just, you know, like I said, you see these little memes where you got pills and surgery and the lines out the door, and you got one person saying diet and lysosome and no one's at his counter. So I think that's going to change. So I think enough people are becoming frustrated with the clear, really lack of results.

I mean, you know, you think about how many drugs are there for these chronic diseases. The more drugs there are, the diseases never go away. It's not like we've put these diseases, you know, where they don't exist anymore. They're just, they're more prevalent. The more diabetes drugs there are, the more diabetics we have, which is kind of disturbing.

Drew
You know, something on that note, have you heard of or read the book sickening? It's John Abrams. I'm familiar with John Abrams work. I've seen a couple of his interviews. I have not read his book, though.

One of the core opening lines in the book is a super inconvenient truth that most people, let alone their primary care doctor, knows about. So your own doctor doesn't know about this is that whenever we hear that a drug had peer reviewed and research and a panel looking at it. The peer review team that actually reviewed that drug never got access to the actual data, right? They only saw a summary, a sanitized summary of the data on that drug from the drug company itself. Right?

Doctor Sean Baker
Because it's proprietary data, they don't want. To share it because all the study data is proprietary, including with the jab that we all went through and were being told to take. And when you understand that, you can understand. How is it that something like a drug like Vioxx could get out there for ten years and lead to an excess of 50,000 additional deaths before it was ended up taking off the market, is because drug companies have an incentive to put out their version of the story, even to the peer reviewers. And the peer reviewers tried to push back.

Drew
At a certain point in time, all the journals got together and said, we need to change this. We need access to the raw data. And unfortunately, right after they published their open letter a few months later, September 11 happened, and the whole national conversation was focused on something else and terrorism, and the issue just kind of got swept under the rug. And ever since then, it's never really been brought up, except for in a few circles where people would look at it and say, that's conspiratorial. What are you talking about?

All these journals and doctors and researchers have our best interests at heart, and we have to understand that they have their. Their selves, their executive team, and their shareholders best interest at heart. That doesn't mean that there aren't good people that are there, but the incentives are designed to tell a particular story. So there's shouldn't be surprised when we find out that certain drugs that we thought were safe or didn't have certain side effects come out and end up having major issues or don't end up working as well as lifestyle. Many drugs don't actually have to be tested against lifestyle interventions.

So what happens when you actually look at lifestyle interventions? Well, lifestyle interventions, the diabetes prevention trial, which is another study, uh, that was, uh, government funded, that John Abrams talks about in his book, he showed that when you compared metformin just being on that, to having a study set that was on metformin and dietary and lifestyle changes, and then just dietary and lifestyle changes with the appropriate coaching that was there. The population that did the best when it came to type two diabetes was the group that got the education and the support and made the dietary changes. So, in that instance, when doctors are presented with the full data, they can actually see that no patients actually want to make these changes, they just don't have the support. And obviously, that's a bigger conversation of how we need to change healthcare.

But unfortunately, a lot of doctors are left with the message because they just get the sanitized data from the drug companies that patients don't want to do any work. They just want the magic pill. And so just give them this drug that will make everything better. Yeah. And it's, you know, as you probably are aware, I mean, it's like these journals, these medical journals.

Doctor Sean Baker
I mean, that's something like 40% of their incomes comes from the drug company buying their reprints, their pre prints, so they can hand out to the doctors. So it's even the journals themselves are, you know, Marcia Angle, who sat on the. Was a chief editor at New England Journal of Medicine for so many years, basically said, I can no longer in good conscience support this because I know it's basically, it's such bad corruption in that whole system. There's a famous quote of her talking about. I wrote that in my book.

Actually don't remember the exact quote right now, but that's kind of where it comes from. And so, yeah, I mean, we've got. I think I saw stat where since 2010, something like 14,000 FDA approved safe and effective drugs have been pulled from the market. That's a high number, 14,000 of them. You know, and that's.

That's all these drugs that are, you know, one of the. I saw a funny little meme. Somebody put any drug that's making billions of dollars will always be safe and effective. And I think that some of that's true. I mean, like, I used to prescribe viacs.

It was a good. It worked with inflammation, with people's knee pain. It literally worked pretty well. But, I mean, again, the company withheld the data that they knew that it was causing excess cardiovascular disease. So that was something that they clearly knew about.

And these companies, they'll make their 10, 20, 50, maybe in the case of things like statins, trillion dollars. And then at some point, when enough people are harmed and when physicians actually realize that there's actually harming enough people, when enough people die, it gets pulled from the market and they pay some slap on the wrist $2 billion fine, which is, you know, pocket change for these companies. So it's kind of. It's kind of an interesting, sad situation that we have. So, I mean, and I'll see that with.

I think with these GLP one drugs that are out there, we're going to see something similar. You know, they'll make, whatever, hundreds of billions of dollars, and then eventually they'll have to, you know, shift it, change it, go on to the. And this. Kick it down to the next drug. Oh, that one didn't work very well.

But guess what? The, this new one. And we, it's just like, I don't know if you remember the Charlie Brown, the peanuts cartoon. Every year Lucy would put the football out there and pull it from Charlie Brown, and every year he'd fall for it. It's like the same thing.

We just keep falling for the same thing over and over. Company. These drugs have been fined, guilty of clear fraud, are still back in action. They're still out there. No one goes to jail.

They pay some slap on the wrist fine, and they keep as is, because our whole system is basically, the politicians are basically being. I mean, for every single member, sitting member of Congress, there are three federal lobbyists that are lobbying these guys. Think how much power they have. It's crazy. With all that being said, you have a telemedicine company, right?

Drew
And I'm sure there's still some times you guys will bring in some prescription drugs. You might have people on testosterone. You might have people in some instances, as you're balancing out their health, you might bring in a statin or statin like, you know, drug that is helping them decide, you know, if they want to roll the dice in one direction or not. I've been very transparent with my audience, even though I have virtually no soft plaque and no hard plaque in my clearly scan, and we'll link to it in the show show notes below. My cardiologist walking us through that and everything, I've decided that I don't want to have, even though I'm doing all the lifestyle stuff, long term, high apob, the way that it is.

So I decided to start on azettomide. Right. So I think both you and I would say that there are some great drugs that are out there, and people should have individual choice of whether or not they want to participate. And there are some, you know, people that are genuinely trying to make things that move society in the right direction. Of course, antibiotics, you know, helped society probably the most out of any drugs.

Antibiotics helped the most, and that was obviously lifesaving for us as a. As a species. So always like to put stuff in context, which I know you're really good at doing. You know, I want to come back to the carnivore diet as we're winding down here for a second. You know, at the beginning of the interview, you mentioned that the vast majority of people that find themselves in this position where they're looking at what some people would say is a very extreme diet from the outside.

And by all measures, it is very extreme compared to the ultra processed food standard american diet. But by design, because it works, they're looking for a therapeutic intervention to help them with severe eczema, severe gut issues, autoimmune conditions, and as we mentioned, in many cases, severe mental health issues that are there. Some of our audience is going to find themselves nodding their head along and saying, you know what? I'm in that camp. Maybe I need to do a little bit more research and maybe I need to subscribe to your channel, which they definitely should.

We'll have the link below for the other group of people that are saying that. Sure. You know, there's some things that I want to tweak. I might have a little bit more joint pain or I might have a little bit of belly fat that I want to do. I want to do a little bit of body recomposition.

What are some lessons or themes they can learn from the carnivore diet? If you say one, two and three takeaways, that if they're not ready or they don't feel like they need to go on as quote unquote extreme of a dietary intervention cause their health issues aren't that bad, what are a few lessons that they can learn from the carnivore diet that they can incorporate? Yeah, so I think that protein is quite important. I think that's, you know, whatever, you know, even if you're on a vegan diet, guys, don't listen to the guys that say don't eat a lot of protein because that's just a disaster, which. Is less and less every year.

You have less and less vegans, I feel every year are advocating for the low protein. Right. Even doctor Gareth Davis, who I debated recently, wrote a book called Protein Aholic where he was demonizing protein. He says, you know, I've kind of walked that back a little bit. So I think he's even really, as a guy who's now in his fifties, it's like, it is incredibly important to retain lean functional mass.

Doctor Sean Baker
And I think, you know, I think that's something that I'm really interested in, and I'll be talking about a lot more as time goes by. I think that, you know, not constantly eating is important. I think in my view, the fact that we eat from 07:00 a.m. to 10:00 p.m. three meals a day plus three or four snacks a day is a disaster for us metabolically.

So I think maybe, perhaps some level of intermittent fasting for some people. I know there's people that are critics that say, well, it's all about calorie restriction. Whatever gets you there so you don't over consume energy, whether it's protein or fat. Sorry, carbohydrates or fat. That's incredibly important.

I think that, you know, gosh, just avoid the ultra processed stuff. I know there's people that say, well, you know, protein powder is ultra processed and so on and so forth. But I mean, generally, if you generally cut out ultra processed foods from your diet, you're going to do better. I think. I think most people are going to do that.

Now, the problem is, what are you replacing it with it with? I mean, I have found that it is really hard to be successful on a diet where, number one, you don't like the food, or number two, you're hungry all the time. That just is not sustainable over the long haul. So you've got to find something that you enjoy that nourishes you properly and, you know, keeps you relatively satiated. Otherwise, you're just going to be in there eating, you know, Ben and Jerry's and Oreo cookies.

And that's, and that's just not appropriate. I think, obviously, alcohol is not a, it's not a health food. I mean, obviously, minimize that. People ask me, what's the best alcohol? And I say, well, what's the best, what's the best bat to hit yourself over the head with?

Doesn't really matter. Still a problem. I think that just other lessons and I think it's not. I think the important thing, like I said the other day, the best nutritional advice I could give somebody is to get stronger. And I know that's kind of counterintuitive, but I'm like, you think about that.

What do you mean by that? Well, eat in a way that's going to allow you to feel good to where you can get out there and do the things that are necessary, the strength training. So protein is important, non inflammatory foods, and you can figure it out yourself. What? Here's an interesting sort of observation.

Many of gone to bed, we wake up the next morning and we're like, oh, my, you know, my elbow is really hurting. I wonder what I did if I slept on it wrong. Or maybe it was that, you know that tennis game I played three days ago. Well, maybe it was a chocolate cake you had for dessert last night. If you start thinking about how food impacts you in ways outside of, you know, my stomach's rumbling.

But, I mean, there are, there are so many ways that a meal can actually impact this that we don't even associate with. I mean, I clearly see people all the time, they'll go off a diet and all of a sudden all their joint pain will come back. That's real. I used to, I used to dismiss that when I remember I was, you know, seeing some lady in my clinic as an orthopedic surgeon, and she said, you know, every time I eat gluten, my knee hurts. I thought she was crazy.

I thought he was a little crazy lady. I'll just kind of, yeah, let me just, let me just look in your knee with a scope. We'll figure this out. It turns out there's a lot of truth to that, that there's a lot of things going on that actually impact us, and our diet impacts us in much more ways than we think. So that, so pay attention to that stuff.

I think that as far as, you know, finding something that, you know, is easy. I mean, the thing about a carnivore diet is its so simple. You dont have to think, I mean, its like, its so easy. My dog could do it and my dogs do it, by the way. I mean, its, you know, nutrition should not be hard.

And if you find yourself constantly obsessing and calculating about your diet, rethink where youre at. It shouldnt be that hard. It should be very fairly intuitive. It should be fairly easy. You dont have to eat gazillion foods.

I mean, and you think about in the context of the time we've been on earth, it's only recently, I mean, you see some of these food recommendations where it's like, you need a little of this and a little of this and a little of this to have a complete diet. I'm like, those things don't even grow on the same continent. How would that have even been humanly possible prior to modern refrigeration and transportation? So it's like, nutrition can be a lot simpler than it is. And you can kind of think about, obviously, there's some genetic differences in all of us.

You know, if you live in the tropics, you have more access to stuff. But if you lived in, like, my ancestry is northern Europe, I mean, there's not a lot of mangoes growing around in northern Europe. It wouldn't been, wouldn't have been accessible to me. So I think it's something to realize that one animal products are incredibly beneficial. They're, they're more efficient.

They provide tremendous nutrition. Most people don't realize this is a nice study by Stephen van Vliet out of Utah state, formerly out of Duke. Meat has all kinds of phytonutrients in it, which most people don't realize that it's got something like 70,000 unique nutritional compounds in beef. And so some of them are polyphenols and tannins and all these various quote unquote healthy plant compounds. So they're actually in meat.

So it's kind of interesting. I'm a huge believer in that. I've been, like, snacking on these maui nui beef sticks from wild venison. Have you tried those before? I have, yeah.

When I was there, I was in Hawaii for talk a few years ago, and they, that company was actually there. Yeah, those are great. I love that. Like, the deer eat wild, and we can get access to that. Obviously, there's this growing movement of regenerative agriculture where the cows and other animals are eating a lot of different things.

Drew
So I'm a big believer. Final question here. Do you think that you were born to be one of the leaders in the carnivore movement because your dad traumatized you by sneaking onions and vegetables into your meatloaf? And so you were so traumatized as a young kid, and you hated vegetables so much that this was the only path that was there for you? Yeah, that's a funny story.

Doctor Sean Baker
I remember my dad, and it was kind of funny when I asked him about that years and years later, because I would sit at the table, and my parents were like, you're not getting up till you finish your meal. Don't waste food. Sit there. And I hated onions with a pat. I still do, unfortunately.

And they were in there, and I'm sitting down there eating this. Well, not basically not eating, staring at this cold piece of meatloaf that had been there for like, 3 hours. And my dad was just like, you know, just eat this stuff. And what's the problem? I said, I don't like onions.

He goes, well, you can't even taste them. And I said, well, dad, if you can't taste them, why'd you put them in there? He was like, well, shut up, kid. And then I asked him years later about that. He goes, you know, I didn't really like vegetables either, but I just felt that you had to eat them, and that's why I forced you to do that.

So maybe. Maybe that's why. No, I think it's kind of funny. I would have never in my life predicted, you know, if you had asked me ten years ago, I'd be this crazy diet. Write a diet book and be an advocate for this crazy, wacko, bizarre diet.

Never in a million years I would. I would have ever thought that. I mean, it's just not who I was. But it's kind of funny how life takes you in these different, different directions. I've had kind of a really, you know, circuitous route through life, which has been taking some fun detours.

But maybe that was it. Maybe that's why. I mean, I literally don't like vegetables, so that makes it easier for me. But, yeah, I guess I was born to do this, perhaps in that way or traumatized into doing it. Well, the thing I appreciate about you is that, you know, you were very clear you don't like vegetables, but you're not saying that everybody else out there has to stop eating this.

Drew
I actually really do like vegetables. Not generally completely raw by themselves in large amounts. It's usually with a little bit of butter, oil, salt, other ways to make them palatable. But I enjoy vegetables. I do like onions, although my wife doesn't like me eating onions.

But I really appreciate that. You know, I mentioned to you that we've never really done an episode with just one individual on the carnivore diet, largely because I feel that I have a little bit of stewardship with my audience that I'm not excited about having somebody on that's telling them that, you know, broccoli or eating a little bit of spinach here and there is going to kill them. And I felt like when I found your content a few years ago and have seen the way you communicate about it, it just felt really balanced. But you still are firm in your beliefs, and you're willing to share those beliefs. So, Doctor Sean Baker, I want to thank you for coming on the podcast.

How can people follow you? And also, who's a good fit for this telemedicine company that you have? Yeah, so the company's called Rivero Rev E r o.com. and so we're licensed in all 50 states, and we currently are treating anybody with cardiometabolic disease. So obesity, diabetes, hypertension, metabolic syndrome, autoimmune conditions, inflammatory conditions, that's where our focus is right now.

Doctor Sean Baker
We'll probably expand, I'd like to see us expand into mental health in the next few years, but for now, that's where we're at. So anybody that fits that description, that wants a doctor that is not afraid to let you eat meat, for one, and will work with you that need support because our coaches do a wonderful job with that of reaching out and, you know, in many cases, contacting you every single day. As far as where I'm located, I have a YouTube channel as well. Sean Baker, MD. I'm on Instagram at Shawn.

So it's s h a w n, Baker Baker. And then the number 1967, which is when I was born. And then I'm on Twitter at sbakermdash. So those are the major places you can find me. Amazing.

Drew
Well, they get educational content, some snarky content, too, in a fun way. You'll laugh a little bit, you know, but I want to acknowledge you and appreciate you for doing all the work you're doing to advocate for people who are hurting. At the end of the day, you are a physician. You see people who are hurting. You're trying to give them options and solutions, some of them that have worked for you, a lot of them that work for also your community.

And I want to acknowledge you for being on that journey and, of course, for coming on the podcast day. Well, Drew, thanks for having me on and let me share with your audience.

Hi, everyone. Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already subscribed, just hit the subscribe button on your favorite podcast app.

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