 So, welcome to the Dr. Gundry podcast. You know, I've seen a lot of interesting diet trends over the years, but the one we're going to be talking about today is definitely one of the most unique. Now, it's been around for many iterations for well over 150 years, so this is not new. And I do want to emphasize that because we're going to dive into that. But it's probably the most controversial diet out there right now. What I'm talking about is the carnivore diet, where the only thing you eat is meat. Whether you think that sounds delicious or whether you think that sounds crazy, my guest today is here to argue that it's actually a great way to eat. So he's Dr. Paul Saladino, and on today's episode of the show, he and I are going to have a friendly debate about this meat-only diet. Is it the best diet ever for weight loss? Or is it just another potentially dangerous dietary fat? So stay tuned, because you don't want to miss this. So Paul, welcome to the show. Thank you. It's great to be here. So I want you to tell the listeners about you, and what kind of medicine do you practice? So I'm a classically trained MD. I went to medical school at the University of Arizona and trained with Andrew Weil there prior to medical school. I was a cardiology PA, so I've been in medicine for a long time, and I have just finished my residency at the University of Washington. So I'm a traditionally trained doctor. My residency was in psychiatry. I'm quite interested in the way that food affects mental health and the growing burden of mental health in the world. And I'm also a functional medicine physician. So I'm certified by the Institute of Functional Medicine. So I'm a functional medicine practitioner, completed my residency in psychiatry, and I'm a classically trained medical doctor. So though people may imagine these ideas of a Carnivore diet to be a little bit crazy when they first hear about them, I think there's a lot of really interesting things here, and I'm excited to talk to you about it. So a guy who went to medical school where Andrew Weil, one of the ultimate kind of plant-based guys, to have you talk about a Carnivore diet, wow, what a brain twist, but you're a psychiatrist, so you're used to twisting brains. I think that that's what it's about. I mean, when I met you at PaleoFX, you said something that was really cool, and you said, you know, I didn't get to be where I am by having a closed mind, and I thought that was so cool. Like, you're an open-minded guy. I think that we have to be always challenging our paradigms and asking questions, and that that's how we're going to push the field forward. I think that as physicians, it's important that we're at the forefront of asking these questions and sort of helping people understand what's safe and what's not. But I think that unless we ask questions and really consider the foundations that we're making our paradigms on, then we are not going to move the field forward. So this is a really interesting topic. Yeah, you know, I show a slide of General Patton, and Patton said, if everybody's thinking alike, then somebody isn't thinking, and I totally agree with that. OK, so define a carnivore diet for me. A carnivore diet is essentially a whole foods animal-based diet. It includes no plant materials. So we're eating, I would argue, like our ancestors would eat. If you're in the savanna or you're in Europe and you're hunting and you kill a deer or a buffalo, carnivore diet is eating animals nose to tail. There's no plant material in a carnivore diet for the reasons that we will talk about the plant toxins. So all of the animals, so muscle meat, organs, connective tissue, bones, brain, it also includes all animals. So fish, shellfish, you know, things like this, birds, but no plant material on a carnivore diet. Eggs? Eggs, yes. So what made you decide to try a carnivore diet? So I got interested in a carnivore diet about a year ago, and it had to do with my training and the fact that perhaps you've experienced the same thing. But throughout the, you know, 14, 15 years that I've been in medicine now, I've generally been disappointed in what I've seen in terms of patients getting well and being able to correct their disease at the root. And so as people will know or maybe not, functional medicine is a type of medicine that starts to ask questions around the why. And the why behind the why and really trying to get to the root cause of an illness. And so what interested me about medicine was what was causing disease. And that's what I've been sort of obsessed with throughout my career. That was why I went back to medical school after I'd been practicing as a PA in cardiology. And that's why I started to look into integrative medicine and trained with Andrew Weil and then got interested in functional medicine. And what I basically realized was that mainstream Western medicine is not great at asking questions around what is causing an illness and what's at the root. And so that has been my constant process is what is at the root? What is at the root? And I just haven't been able to understand what that is until I started thinking about diet. And so I've been thinking about diet for a number of years now. And, you know, I think that food is such a huge contributor to health and disease, perhaps one of the biggest. It's not the only thing, but it's a big one. We put a huge amount of food in our bodies every day, kilogram of quantities of food into our bodies. That's all molecular signals that affect the immune system that affect us at a biochemical level. They're full of nutrients and anti nutrients, all kinds of things. And so it's been this sort of gradual evolution, trying to understand how humans were best evolved to eat, how humans were best adapted to eat. In the introduction, you said that the carnivore diet's been around for 150 years. I would argue the carnivore diet's been around for three and a half million years, and I'll tell you guys why. But it's been around for a long time. Having said that, I think that I got interested in the carnivore diet because I saw that people were getting better in incredible ways. First with Jordan Peterson and his daughter, McKayla. And then as I dug into it, I saw thousands and thousands of cases of people with recalcitrant autoimmune disease ranging in a variety from rheumatoid arthritis to inflammatory bowel disease to even psychiatric disease, which I would characterize as autoimmune. I think that most psychiatric disease has been incorrectly characterized as a neurotransmitter deficiency when, in fact, there's immunologic activation in the brain. So I think of myself as a physician that's interested in understanding what is causing inflammation and autoimmunity. And when I started to see what was happening with the carnivore diet, I was very interested in this. And I just dove in, I started exploring, why is this happening and what is this about plant toxins? Because as many of your listeners may experience, when I first heard about this, I thought that's pretty wild. That's a little too far out there. And I really had to dig into it and understand the science and the evolutionary basis and the notions of plant toxins and the notions of fundamental human biochemical nutritional needs to really start to put the pieces together for myself. The other thing I'll mention here is that a lot of times when people think about a carnivore diet, they think it's only meat. And you said that in the introduction, but it's not meat only. We're eating animals nose to tail. So this is essentially we are trying to eat animals the way our ancestors would have eaten animals. We don't just eat steaks. That's not my plan for people to eat a carnivore diet. And if you look at the nutritional basis of a carnivore diet, which I'm sure we'll get into, if you eat an animal from the nose to the tail, that means eating muscle meat and organ meat, connect the tissue, fat, all of these good parts of the animal. Then you're going to start to see that you get all the nutrients that a human needs. And once I understood that, like once I really thought about this from a basic perspective, it all clicks for me and I decided to try it myself. And that basic premise that I understood or realized, which has been echoed by people before me was that if we look at human nutrition, eating animals nose to tail provides all of the nutrients that a human needs in the most optimal, bioavailable forms in the right ratios without any of the plant toxins. And I thought, well, that maybe it actually makes sense. So it was that idea that people were getting better in incredible ways. And there are so many stories of incredible healing transformations of people changing their diet, especially with a carnivore diet or a nose to tail carnivore diet, resolving these incredibly severe psychiatric illnesses. So that really struck home for me too. Yeah, I think that's a great point in my in the Plant Paradox book and in my lectures, there's some really good animal studies that you can, for instance, inject lectins, my favorite subject, into the perineum of rats and mice, and they will get so anxious and depressed that they will cower in the corner of their cage, not explore their environment, not look for food. And from a plant standpoint, that's a pretty good defense mechanism against being eaten. And so I think you're right. I personally feel that so much of depression and anxiety is coming out of the gut and is coming from leaky gut and a lot of the plant toxins that are designed to make us not eat these guys. They they were here longer than us. Couldn't agree with you more. And there are tons of toxins even besides the lectins. There are oxalates and this this whole realm of plant pesticides, you know, the chemicals that plants make beyond lectins, you know, all the all the alkaloids and even the polyphenols are defense chemicals that people don't really realize. Can you restate what you think about polyphenols? So polyphenols are very interesting. And there's a lot of different polyphenols. But I think that if we look at plant foods, we need to remember that polyphenols are not made for humans. They're often plant defense mechanisms. They are plant toxins or they are used as colorings or pigments and plants. But what we know about polyphenols is that they're often compounds that don't even participate in plant metabolism. Tanins are a great example. Tanins inhibit digestion in animals. So we see and we see this time and time again with polyphenols that have been much touted for health, whether it's resveratrol or curcumin. When we actually look into the data, resveratrol has pretty much repeatedly failed in human trials and has shown many negative effects. It decreases androgen precursors. It's been shown to create thrombocytopenia, potentially modulate the immune system in negative ways by affecting T-helper 17 cells. Curcumin is much the same. There are over 120 failed randomized double blind placebo-controlled trials with curcumin. And then if we actually look at what curcumin is doing in the rest of the body, it can interfere with a potassium channel called the HERG channel. It can affect DNA replication and inhibit topoisomerases, which are DNA repair and unwinding enzymes. So this gets back to the idea that in my opinion, polyphenols are, they're from a different operating system than humans. And if we look at the whole body, they often have these negative effects elsewhere in the body. Though we may be able to sow benefits, these hormetic, these molecular-hormetic benefits sometimes, we have to look at the whole body. And what we see is because they're a different operating system, they often are dangerous for humans. And I would argue net negative. And they don't do anything unique. All the effects that we are claiming are beneficial from polyphenols we can achieve in other ways, whether it's turning on longevity genes like ser 2 and 1s. We know we can do that with ketosis. Curcumin is often used as an anti-inflammatory and I would say, well, why are you trying to get rid of inflammation without understanding what the cause of the inflammation is? So we don't need curcumin to not have inflammation in our bodies. And in some settings, reactive oxygen species, oxidative stress are needed for proper molecular signaling. We don't want to get rid of that completely. So that's my stake on polyphenols. I would submit that we're looking at the wrong thing. I happen to think it's the bacterial metabolism of these polyphenols into more active compounds that are important, including active 8s or 1s. So I think if we paid more attention to the gut microbiome and what they're doing, maybe you'd have a different opinion. But you've got a totally different gut microbiome than I do. And so may the best man win. We should compare. We should compare. We should compare our gut microbiota. Well, personally, I think that we're looking at the wrong gut microbiome. I think most of the things are happening in the small intestine in us. And that set of microbiome is yet we haven't been able to characterize well yet. I think we will eventually, but just having somebody send something into you biome or one of the other groups, biome, that's kind of the end product. And that, as you and I probably would both agree, shifts on a daily basis, depending on what we're eating. When my first book came out years ago, Dr. Gundry's Diet Evolution, which was bought by Random House, who had done all the South Beach books and all the Adkins books. And in the first part of that program was actually a high protein diet. And then I through the stages, I went more and more introducing plants. But my editor wanted me to introduce grains and beans as part two of the diet. And I said, you don't get it. Both Adkins and South Beach took away all these carbohydrates and then in phase one and then they reintroduced them. And then everybody gained weight and all their symptoms came back. And what did they say to do? Oh, well, go back to phase one and eliminate all these carbohydrates again. And I said, don't you get it? It was these plant materials that they were putting back in that was causing the problem in the first place. So I mean, the banding diet took away carbohydrates, you know, the Adkins diet took away all of these diets took away carbohydrates. My contention is that they were taking away the major plant defense carbohydrates out of their system. And I think one of the things that you and I just from the start, so we remain friends is, I mean, this is the ultimate elimination diet, in my opinion. Now, the ultimate elimination diet is Stop Eating, which is actually very effective, but it is the ultimate elimination diet that you are getting rid of all these plant toxins. Now, this is a good step off. So you're not saying that you can go out and eat factory raised meat, factory raised pork and have a wonderful time. I hope you're not saying that. No, that's not my intention to promote that. I think that the quality of the food we are eating and the ethics which with with which the animals that we're eating are treated are very important. And so I'm an advocate for eating grass fed pasture raised meats that are organic, the best meats that people can afford. And we know that things like glyphosate, you know, which is also known as Roundup and other pesticides can bioaccumulate in the food chain. And, you know, all of the ethical environmental arguments aside, we'll have to do a second podcast to talk about the environmental stuff. We know that grass fed agriculture is actually net carbon negative. There was something that came out recently with white oak pastures saying that they're reducing the amount of carbon in their environment because the soil becomes so much more rich and nutrient full that it can actually sequester more carbon. So for so many reasons, the nutrition of the animals that we're eating, the lives of the animals that we're eating and the greenhouse gas emissions, the sort of overall balance, I'm not an advocate for factory farming. I think people should be aware of the quality of the foods they're eating. I think glyphosate is a big deal. We can't ignore the fact that grain fed animals are probably going to bioaccumulate that in the grains they're eating. Yeah, that's absolutely true. And I think that's one of the really scary things that we need to pay more and more and more attention to is that, you know, Roundup is sprayed on almost everything as a desiccant for harvesting and nobody's washing this stuff off before it's fed to our animals, nor is it washed off before it's put in our bread, our cookies, our crackers, our cereals. And I think 20 years from now, we'll look back and we'll, holy cow, maybe all of this was a glyphosate problem and we'll find out. At least a big portion of it is. I mean, I saw posted on social media today that in these sort of plant based burgers, these impossible burgers have like eleven times the amount of glyphosate of some of these other plant based burgers. So there are certain plant based burgers that are particularly just riddled with these pesticides. So people shouldn't think that, you know, like by eating fake meat, they're going to avoid this either. So. No, that's true. And in fact, you know, one of the burgers I won't mention recently changed their formula to get rid of gluten containing foods. Imagine that a healthy plant based burger that had gluten. It's like, really? All of them, they're all bad in my opinion. Yeah. So many of them are based on pea protein, which I think you and I would probably agree would not be high on our list of plant material to consume. So many lectins. No good. OK. All right. So great. We're starting at a mutually agreeable place. All right. So a lot of my listeners and me are very skeptical of the idea of only eating meat. So I want you to come on. Give us a pitch for why we really ought to switch to a carnivore diet. OK. So here's the deal. Like I said a few minutes ago, if we think about this from the beginning, there are a number of arguments. There are biochemical arguments, there are nutritional arguments, and there are evolutionary arguments. Let's just start with the evolutionary arguments briefly. And the evolutionary argument is that humans have been eating a primarily meat based diet for 3.5 million years. And there's evidence for this in the fossil record. There's evidence that probably what had to happen to change our brains from an Australopithecus type animal, which is a primate like animal to a homo genus animal like homo habilis or homo erectus was the consumption of a large amount of meat, very nutrient dense food, which provided all of these sort of special nutrients, these fat soluble vitamins, omega 3s, DHA, EPA, which really most people believe allowed our brains to grow. Primate evolution preceded human evolution for 20 plus million years. We know that eating lots of vegetables doesn't grow a brain because primate brains pretty much stayed the same size, you know, 300 milliliters, something like this 300 ccs. Some some primates have larger brains, but for the most part, over 20 million years of primate evolution, the brain remained the same size eating primate diets. And then something really important in human evolution happened about three million years ago when Australopithecus became homo erectus and we started to walk more upright and our brain exploded in size. It went from 300 to 600 to 800 to 1000 ccs. And then in the last, you know, maybe 800,000 years, our brain went from 1000 ccs to 1500 ccs. So our brains have been growing and we know that with these growing brains comes increased complexity of processing and human intelligence, higher development of structures and increased neural networks. And I think there's a very clear argument that this was animal foods, that animal foods allowed this to happen. And then if we go back and we actually look at fossilized remains, we can look at stable isotope studies from Neanderthals and contemporary Homo sapiens, even 70,000 years ago. What we see is that the amount of nitrogen in that collagen is so high that it's higher than other known carnivores at the time. These are really compelling studies to suggest that 70 to 80,000 years ago, our Homo sapien ancestors, as they were moving up from Europe into Europe, moving up from Africa into Europe and contacting the Neanderthals were they were both eating a lot of meat, perhaps almost entirely meat. I would argue that humans are facultative carnivores. People often want to compare us to obligate carnivores and say, well, clearly humans aren't carnivores because we don't look like lions and tigers and, you know, our teeth aren't the same and our guts are not the same. And we don't have claws. We don't have claws. Well, most of us don't have claws. You know, nobody that I've seen, we've got some aspects in our mouth and our, you know, our stomachs are pretty darn acidic. But we have become, I would argue, a facultative carnivore. And what that means is that animal foods provide the ideal nutrition for humans, but we can eat plants if we need to during times of survival, starvation, if animal foods are not around. So it's this really incredible adaptation. So those are kind of the evolutionary arguments. The biochemical arguments around are around the plant toxins. The idea that if you start to look at plants, you realize no plant wants to get eaten. And we can talk about fruit a little bit later. That's a separate category, but no plant wants to get eaten. Plants are rooted in space. They can't move and plants and animals have been co-evolving for 450 million years. And if you really look into botany, it's so amazing, the things that plants have evolved to discourage animals and insects from eating them. And there's been this sort of this war going back and forth. It's an arms race throughout 450 million years of evolution. But I would argue that humans are not very well adapted to plant toxins because we've mostly been eating animals for the last 3 million years. So would you, when you say meat, would you include fish and shellfish in the definition of meat? Absolutely, absolutely. Yes. And I think it's very clear that our ancestors have been eating those foods throughout our evolution based on where we were. But yeah, I think there are some very unique benefits. And when I am, when I am discussing a carnivore diet with people, one of the things I talk about is where are you getting your omega 3 fatty acids from? Like are you eating a source of fish? Are you eating a source of iodine? You know, do you have a seafood source? Or are you eating egg yolks or bone marrow? You know, but I definitely think we need to think about all these compartments of the animal and make sure we're getting omega 3 fatty acids and iodine and those are primarily found in seafood but are found in some parts of the animal. We just have to think like, well, if you're not eating bone marrow, I think people should probably be eating salmon roe, you know, salmon eggs are one of my favorite things. So that brings up an interesting point. There's a study just published this morning out of Denmark that you may have not seen yet looking at Danish consumption, whether they're eating animal meat versus fish and particularly low level fish, not tuna, things like anchovies, herring, mackerel and looking at their health outcomes and they find a definite, at least in this study, correlation between the more fish that they eat and the less meat that they eat, the better their overall health. Could we discuss that idea? Absolutely. So I think that let's talk about research and epidemiology. So if we're thinking about epidemiology, there's experimental and non experimental epidemiology. And I think that this is an issue that doesn't really get really fleshed out as much as it should in these sorts of podcasts. Most of what we're talking about here is non experimental epidemiology, which has traditionally just been called epidemiology, right? These are population studies where they're doing food frequency questionnaires and either retrospective or prospective studies, but this is epidemiology. And I think when we're looking at epidemiology, sometimes it's all we've got. But it's really, really important that people like you and I help people understand the nuance of this because it can be misinterpreted in so many ways. And it's really easily confounded, meaning that there are all sorts of factors that can be influencing these studies that don't really tell us that these two things are linked. What we're looking at here are associations and correlation does not always mean causation. Sometimes correlation can be an indication of causation. But usually, ideally, these studies generate hypotheses that are then tested in interventional studies. Unfortunately, as you and I both know, nutritional studies that are interventional are very rarely done. So in my opinion, we're really only building the car halfway or partway with these studies, you know, these these non-experimental epidemiology studies. To give people a little more background here, I'll just note that the majority of studies, if not every single study, and that's a broad statement, but I'll back it up here, that suggests that animal, excuse me, that it suggests that plant-based diets, vegetarian diets are beneficial to people in terms of longevity or health outcomes are non-experimental epidemiology. And we really have to dig into this and understand that there is a bias there called healthy user bias that is very difficult to account for. And that is my argument for many of these studies that show in non-experimental epidemiology that red meat is less beneficial or is detrimental to health, that for the last 70 years, most of the Westernized world has been told, red meat is bad for you. So who eats red meat? People that also smoke, people that exercise less, people that are of lower socioeconomic status, depending on whether it's considered to be a valuable thing in terms of prestige or not. People that are rebels, these are the James Deans of Denmark who are eating red meat. You know, these are the guys who are saying, ah, I don't care about your recommendations, I like my hamburger. Well, is it the hamburger that's not beneficial for them? Or is it the fact that they're not exercising or not seeing their family or not doing things, not going to the doctors often they should be in getting regular screening? This is the unhealthy user bias, I would argue that's been associated with red meat. And again, this is all just theory and this is why these studies need to be followed by interventional studies. The other thing I would say is that if we look in Asia, there's so much interesting epidemiology in Asia that shows the reverse trend repeatedly. And I would argue that Asia is such a good illustrator of the fact that healthy user bias is a play in the Western world. In Asia, meat is associated with royalty. Meat is associated with people who have lots of money and it's seen as an affluent thing to eat meat. So what do we see in the studies in Asia? The people that eat the most meat live the longest and the best. So if we are starting to look at epidemiology, we just need to balance westernized epidemiology that may be confounded by healthy user bias or unhealthy user bias with quote unquote Asian or Eastern epidemiology that may not have those same biases because if you look at Asians, man, they love meat and they live a long time and the people that eat the most meat live the longest. So I can just hear T. Collin Campbell, one of my critics screaming at this podcast right now, saying how how dare you say that people in Asia who eat the most meat live the longest because the China study as interpreted by T. Collin Campbell showed the exact opposite. What say you? Unfortunately, I fear that T. Collin Campbell may have done a little bit of cherry picking of his statistics and multiple people have have done re analyses of his data and shown the same thing many, many times. So this is the problem with non experimental epidemiology is that I don't believe any of the people doing this data are have poor intentions or nefarious ways. I just think that as humans, we always have a bias, right? And it's very important to realize that everybody just wants people to be healthy and happy. But when we look across the data, it's very often conflicting, suggesting, ah, this isn't the best way to study this, you know, it gives us an idea. And I think the non experimental epidemiology can generate hypotheses. But then what we really need is interventional studies. And there's a few interventional studies with me, which we can talk about. But we really need the interventional studies to really clarify this, because like I said, if you look at Asian epidemiology, and there are big studies, which I'm happy to send you. I'm sure you're aware of them that say, man, people in Asia that eat more meat live the longest and, you know, Hong Kong has one of the longest life expectancies on the planet. 85 years, they eat a pound and a half of meat a day on average. So the I would say that T-colon Campbell statistics a little shady, unfortunately. And that's where it all gets kind of confounded. And it's just we really need to dig into it with careful detail. Okay, so let's go to another hotbed of low fat veganism. Esselstyn's work out of the Cleveland Clinic. Now, let's take the Cleveland Clinic work on TMAO and the effect of choline and carnitine on our gut microbiome in making this fairly nasty compound called TMAO, which their research and others is implicated in coronary artery disease. So they've done human studies of exposing vegans to meat and carnitine. And luckily, according to them, they have a microbiome that won't make TMAO. Whereas if we give normal people meats or choline in eggs, and carnitine, a major component of meat, they will produce large amounts of TMAO. What say you to that? So TMAO is a very interesting compound and I fear that we will disagree strongly on this one. If we look at TMAO, I am extremely skeptical of the research regarding TMAO, especially with regard to meat. I feel like meat, choline and carnitine have been unjustly vilified in this situation. If we look at fish and vegetables, those things also make TMAO. And in fact, many fish have 40 times more TMAO preformed in the fish than you would make from an equivalent amount of choline and carnitine coming from meat in red meat. And so this to me is a huge glaring paradox. How can we say that TMAO is beneficial when it's from fish and vegetables and it's harmful when it's from red meat? That doesn't make any sense to me. And I've never heard any proponent or anyone that has any concern about TMAO actually be able to answer that. So I would say to vilify choline and carnitine is just really to take aim at some of the things which make us healthy humans. The story doesn't add up to me in any way shape or form. I'm not convinced at all. And I revel in my choline and carnitine and I think that the literature around choline for naffle D and carnitine for depression is extremely convincing. And the other thing I'll add is that if we look at guts of people who are carnivores, I've often seen that people who are carnivores don't have TMAO producing bacteria either. So this is fascinating. I have because I have a lot of carnivores that I work with and I am part of a lot of carnivore groups. I've been sent tons and tons of carnivore you biomes and almost invariably if people are eating a clean carnivore diet knows to tail, they don't even have any TMAO producing bacteria. So this kind of gets back to the other thing like is TMAO really bad? What's the whole story? And then guts are very individual, right? And what you just because they're saying, Oh, a mixed diet is going to have a TMAO producing bacteria. Well, I think this is another thing that I'll put as context for this whole discussion. Mixed diets are not carnivore diets, right? We'll see that later as we continue the conversation, the way that humans react to protein on a carnivore diet or in ketosis totally different than when people are on mixed diets. And I think that we see different gut microbiota often in people who are not eating mixed diets. And so it's one thing to say red meat is bad for you in the setting of other junk food. It's another thing to say red meat is bad for you in and of itself, right? It's like, don't blame the meat for what the bread did. It's all this kind of nuance in the nutritional world. So what I like to do is I like to paralyze my gut bacteria so that they won't make TMAO by giving them butanol and olive oil, balsamic vinegar and red wine. And to the Cleveland Clinic's credit, they said, you know, wait a minute, the Mediterranean diet where they eat a lot of fish, they eat a lot of meats, they eat a lot of salamis, preserved meats, they don't have a lot of heart disease. What's going on here? And they, you know, to their credit realize that this compound butanol paralyzes the enzymatic system of bacteria so that they can't make TMAO. So maybe I can have my cake and eat it, too. Don't I wonder. No cake, cake, you can have your cake as long as you have olive oil in there. Exactly. You're making olive oil cake like from our book. No, I think it's interesting and there are all of these nuances around. We just don't understand the microbiome well enough. And I think that we need to study this. And but generally what I've seen is, yeah, I don't think it's an issue in general, nor do I think people should be limiting choline and carnitine. And who knows if there are other molecules like, you know, like these butanol molecules that the DMV that can that can change the gut flora or maybe there are things in meat that can change the gut flora because it's an incredible phenomenon. People with carnivore guts don't seem to have this TMAO producing bacteria in large numbers either. And I might add that I have two lifetime vegans in my practice and they're in their late 70s. And we measure TMAO in everybody. And we adjust their diet. These people run TMAOs and this may not mean anything to our listeners of over 150. And normal TMAO on the Cleveland Clinic scale is less than six just to give people an idea. And we've retested them multiple times. We sent it to the Cleveland Clinic. They say we don't believe it. It's impossible. And there it is. So I mean, that's what I was saying, you know, there's evidence that vegetables produce TMAO as well. So it probably whether or not TMAO is a is a harmful compound remains to be seen in my opinion. But I think it also talks to the context of the gut microbiome. And, you know, there's I we can get into that or save it for another podcast, like we're probably doing it. Yeah, we're probably going to do another one because I want to do one last thing before we go. So you know, my good friend, Walter Longo at USC says we dramatically overeat protein. We don't need as much protein as we need. I test my patients for IGF one every three to six months. There's pretty interesting evidence that the lower IGF one goes, the longer and better we're going to live. And one of the ways to raise IGF one is, as you know, animal protein. The other way, of course, is sugar molecules. So what do we do about this? One of the ways to raise IGF one is perhaps animal protein in the setting of a mixed diet. So what do you think my IGF one level is? Take a guess. Well, first of all, how old are you? I'm 41. 41. So, you know, you could have if you wanted up to about 250 and still be normal. But I but I hope it's around 100. It's about 120. So most of the carnivores I test for IGF one are around 120, which is significantly lower than people on mixed diets who are not even carnivores. So I think this brings back the idea of context. And the context that I'm talking about here is that IGF one can be triggered by a lot of things. But I think that the response of the body to protein is very different when we are in ketosis than it is on a mixed diet. And this we see this with insulin as well. The main problem I would argue with aging is insulin sensitivity. It's not protein. I would argue that protein is so valuable for people long term. We see this in terms of sarcopenia, adequate protein for bone health, that people should eat a lot of protein as they age. I'm sure you're familiar with Longos 2014 study where he looked at the NHANES data. And there were some funny findings because in the younger group protein didn't look like it was very good. But in the older group, protein was associated with so many better outcomes, right? So again, this gets back to the notion that non-experimental epidemiology is maybe not the greatest. But in that study echoes something that we see throughout all orthopedic literature, we need adequate protein to build muscle. And we need lean muscle mass to avoid sarcopenia. We need lean muscle mass for bone health. These are super important things to limit protein out of fear of mTOR is to misunderstand the contextuality of the way these nutrients affect humans. So I would say that them, but I have argued with Dr. Longo that that data actually to me suggests that what happens as you get older, the sarcopenia is from damage to the gut wall lining and leaky gut. And that's why you need more protein because the gut becomes more inefficient at absorbing protein. And I've shown in my patients that if I seal their gut and actually cut back their protein, their albumin production will go up and their total protein will go up. What's the image is the gut in the first place? Exactly. I totally agree with you. See, there is commonality here. But I think that we need to interpret protein in the context of metabolism. Ketogenic diets, I think fat-based metabolism has been shown to be so beneficial. And if we're thinking about longevity, it's so interesting to note that ketosis, ketogenic diets mirror caloric restriction in terms of their molecular mechanisms. Absolutely. I think the sirtuin genes, these genes all get turned on with beta hydroxybutyrate. So when we're thinking about this, we're thinking, wow, ketosis, fat-based metabolism mimics caloric restriction without any of the bad parts of caloric restriction. So I would argue we can eat adequate, we can eat robust protein, get all the good micronutrients that are in animal foods and not over-trigger IGF-1 at all when we're doing fat-based metabolism. But the context is totally important. And it's really important to say meat, I believe, has been vilified because people are eating meat with potatoes, or people are eating meat with bread. And we need to separate these two out. And when we do that, what we see is that meat is incredibly healthy for humans. And it doesn't cause, you know, all of these problems with IGF-1 or aging or any of these other issues. Are you worried about advanced glycation end products? Absolutely, yes. I think all humans need to be worried about advanced glycation end products. And I think that as we see cooking any food creates advanced glycation end products, whether it's animal foods or plant foods, it all creates advanced glycation end products. And advanced glycation end products are like the browning on food. So if you brown toast, that's advanced glycation end products. We also get acrylamide from cooking carbohydrates. So yes, I think that people should be aware that cooking any food is going to create some things which humans need to detoxify. In meat, there's polycyclic aromatic hydrocarbons and heterocyclic amines. Our bodies are able to detoxify that. And if we're going to cook meat, I recommend either sous vide, which I got Ben Greenfield interested in. He's now posting about his sous vide all the time, or just lightly searing on the outside of the meat and not overly browning or charring your meat. And I think in that way, you will avoid the majority of AGEs. Now, again, I don't think people should be cooking in oil because it's going to create more AGEs. And I don't I'm not a big fan of bacon for that reason because it's cooked in its own oil and all these things. So I think we should definitely think about advanced glycation end products. Now everything we cook is going to have AGEs. Meat is going to have polycyclic aromatic hydrocarbons, heterocyclic amines as well. I think people should be aware of that. How about a pressure cooker? A pressure cooker is a great idea. That's a fantastic idea. You know, bone broths and soups and, you know, stews. Yeah, absolutely. All right. So one last thing. Great carnivores usually eat the abdominal contents and often leave the meat behind. And even our hunter-gatherer contemporaries like the hanzas, when they slaughter an animal, as you probably know, they will eat the intestinal contents. They will squeeze out all the green stuff that these animals have been eating. Not only smear themselves with it, but eat it. What about the concept that we need to get some maybe digested plant material into us that the animal protein, per se, wouldn't deliver? I don't think so. If you look at the actual nutritional biochemistry and I'll back up there and say that I agree that carnivores eat the abdominal contents, but usually they go for the organs. Usually they go for the liver and other things. And then they may or may not eat the abdominal contents, depending on the actual animal. But they generally, when they're going for the abdominal contents, they're going for the organ meat, which is kind of the idea of the nose-to-tail eating the importance of those organs. But if you really just look at the nutritional biochemistry, I have never found any nutrient that's in plants that people can't get from nose-to-tail animal foods in a more bioavailable form in the right ratios. So I don't think so. And animal foods are the most nutrient dense foods on the planet and we really don't need anything in plants. There's nothing valuable there that we can't get through animals. All right. So, you know, a lot of people are going to be listening. They said, but wait a minute, fruits and vegetables are essential for human health. And certainly primates have been eating leaves and they certainly been eating fruits and were, you know, a higher level primate. So don't we need those things? Come on. We don't. This is what's incredible. And that kind of goes back to our evolutionary arguments, you know, 20 million years of primate evolution, eating fruits and vegetables didn't grow a big brain, you know, they didn't, they didn't change. But it was when we started eating animals and a lot of animals that we became human. Now, I think that if you look now, fruits and vegetables for two different categories, if we look at fruit, I think you can make a clear argument that fruit is not beneficial for humans. I mean, fructose, insulin resistance, like this is not a beneficial thing. I've kind of jokingly said that fruit is like plant pornography. It's just it looks all sexy and nice on the tree, but that's plants using us. That is not a long term relationship with fruit. You know, there is no long term value there. That is a seductive thing. The plant is getting you to move its seeds around. It tastes good. But there's no real benefit there. And the vegetables again, these are the parts of the plant that we don't that the plant doesn't want us to eat. So no, we don't need those things. And we didn't have time. We'll have to do a part too. But people always say, oh, I need, I need vegetables for fiber, for nutrients or for polyphenols. And I would say, nope, there's no benefit to fiber in plants that's been shown repeatedly through numerous studies. In fact, it harms a lot of people. There's no unique nutrients and plants we can get everything we need in such high bio availability in animals. And the polyphenols, I would argue, redundant and in many cases dangerous. I think that there's clear evidence that the polyphenols and plants can reduce digestion. Tanins actually inhibit digestion of proteins. So polyphenols can inhibit our digestion. Plants don't make polyphenols for humans. They make polyphenols either as defense mechanisms or as pigments. So no, I think it's pretty clear that fruits and vegetables not needed at all for optimal human health. And the other thing is that we can get adequate glutathione optimal antioxidant status with living a radical life. You know this cold heat, you know, go jump in a cold lake, heat exercise sunlight. These are the hermetics that we need. I believe we don't really need molecular hermetics when we have environmental hermetics and the studies show the same thing. If you look at the fruit and vegetable intervention studies that have been done, they've done from four to 10 weeks with pounds and pounds of fruits and vegetables. And they have a no vegetable group and a vegetable group. And what they see that no vegetable group is eating no fruits and vegetables for 10 weeks. What do they see at the end? No difference in markers of DNA damage or oxidative stress between the two groups suggesting there's really no interventional, there's no experimental evidence that we get any real benefit from fruits and vegetables. You know, fructose is one of the best mitochondrial poisons out there as far as I'm concerned. And it just, it breaks everybody's heart when I say that. And they say that's not true. And I publish it. And my critics say, but that's still not true. Well, look, here's the data. You know, I didn't make this stuff up. Oh, well. Oh, well. All right. Well, very good. Well, this has been a great discussion. And we will have to have you back because we've only scratched the surface here. I realize it's actually, I think for our listeners and viewers, it's it's a deep dive. But we'll probably go down the rabbit hole even more because this has become a very interesting topic. And I'd love to. Okay. Where can they find you and learn about your work? So I have a podcast myself. It's called Fundamental Health. I'll have to have you on. Okay, maybe we'll continue the discussion there. Yeah, yeah, you can come on my podcast. It's called Fundamental Health with Paul Saladino MD. Most of my work can be found at paulsaladinomd.com. And the great irony of this whole discussion is that my last name has salad in it. So my last name is spelled S-A-L-A- D-I-N-O. But the other thing that I tell people is that my last name also has dinosaur in it, or at least dino. So I have both. So it's salad dino, S-A-L-A-D-I-N-O. paulsaladinomd.com. There you can find links to my newsletter, my social media. I'm at paulsaladinomd. And on Twitter, I'm MD Saladino. And I've got a YouTube under paulsaladinomd. All right, it's time for our audience question. And this one comes from Rolando on YouTube asks, are bugs okay to eat on the plant paradox diet? Wouldn't they have had some place in our diets? And you're absolutely right. Almost all diets worldwide have a fairly large percentage of bugs in their diet. And there's absolutely nothing wrong with bugs in your diet. In fact, I have some cricket flour in my pantry that I use. Personally, I put it in my smoothie when I'm using it. You can also bake with it. There's some interesting ways to hide this. Bugs are an important part of diet. In fact, one of the things that got me interested in bugs is that a very famous observation was made at the Washington Zoo back in the 1920s. And I wrote about this in my first book, Dr. Gundry's Diet Evolution. They brought a bunch of marmoset monkeys from South America who are obligate frugivores. All they eat is fruit. And they fed them fruit. And these monkeys did not do well. They didn't reproduce. And a young zoologist at the zoo said, you know, we're giving them fruit that basically we buy at the grocery store. And the fruit that these guys are eating out in the jungle is full of bugs. In fact, chimpanzees have been observed by Jane Goodall to take a bite of fruit and look at it and then throw it on the ground. And she found that the ones that were thrown on the ground didn't have any bugs in it. And so they introduced 6% animal protein into the diet of the marmoset monkeys to make up for these insects that they weren't getting in their diet. And lo and behold, they thrived and they actually began to reproduce. And it was one of the things that really compelled my argument that were a great ape and even great apes have to have some animal protein in their diet. So that's a great question. And, you know, chimpanzees will take little sticks and go into termite mounds and get the termites. And believe it or not, even hummingbirds who all they do is drink sugar water will actually go after gnats and little bugs crawling on leaves because they have to have a source of animal protein. All right, Paul, thanks a lot and we'll talk again. You've been watching the Dr. Gundry podcast and we'll see you next week. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher or wherever you get your podcasts because I'm Dr. Gundry and I'm always looking out for you.