 Thank you so much. I really appreciate your patience. And I just want to thank you all for being here. It's such an honor to be presenting at this year's ancestral health symposium here at all places, Harvard, hey? I'm talking about a topic that's been just a little bit controversial within the genre. And I know that there's been a lot of talk about what role carbohydrate should or shouldn't play. And I'm here to make just a little bit of a case for why I think a ketogenically adapted way of eating makes more sense from both a physiological perspective, human physiological perspective, as well as an evolutionary perspective. There we go. So even though we could go back and start talking about ice age humans and the critical role that nutrient and energy dense fats played in more climatologically challenged portions of our evolutionary history, I think it makes sense to really start talking about dietary fat from the standpoint of more neopaleolithic cultures, just to highlight the fact that it doesn't have to be cold out or extreme in some way in order for fat to be playing a critical and fairly central role to the human diet. Now, all primitive and traditional cultures revered and coveted sources of dietary fat. The Plains and Northern Indians used Pemican over which entire wars were fought. The Laps, Simeon, Siberians valued reindeer fat. Marsh Arabs and Berbers valued camel fat. The Canadian tribes relished moose fat. Coastal Salish tribes used zulacan grease on pretty much everything. Inuit aged large amounts of seal walrus and whale fat. The Enos of Northeastern Canada coveted caribou fat. Aborigines sought out emu fat in any other kind of fat they could get their hands on. The Maasai consumed lots of high fat raw milk and the list goes on and on and on. And according to the work of nutritional pioneers, such as Weston Price, mental and physical illness were virtually completely unknown in these cultures. And additional sources of dietary fat and fat soluble nutrients included things like egg yolks, organ meats and sex fish heads and shellfish as well as some nuts and seeds. So it's really clear that fat played a very, very important role in early diets. Now, these diets would also have been especially rich in fat soluble nutrients and according also to nutritional pioneers like Weston Price, pretty much 10 times more than what our diets actually include today. And I think that's something that's not only overlooked but something overlooked when we're discussing these things from a macronutrient perspective. But these critical fat soluble nutrients, they use intracellular signaling pathways that initiate or modify our gene expression. They play really, really important roles. And they've been shown to have this direct effect on gene transcription. So they have a uniquely powerful role to play. And I think an argument could be made for why dietary fat might be even more important to us now than it was in our distant past, based on that alone. Now, here's something else that's also underappreciated and under discussed, that large mammals are basically designed to obtain the majority of their caloric intake from fat. And despite being our most herbivorous cousins, gorillas actually obtain a minimum of 65 to 70% of their daily caloric intake from short chain saturated fatty acids, butyric acid, from bacterial fermentation of the dietary fiber that they consume. So they're actually getting almost no calories from carbohydrates per se. They're relying on these things. And even ruminants that supposedly are eating a carbohydrate-based diet obtain 70 to 80% of their caloric intake from the same short chain saturated fatty acids, not carbohydrates. And also compared to large body daves, we have this enhanced capacity to digest and metabolize higher fat diets. RGI tract, with its expanded small intestine and reduced large intestine, is quite different from that of chimpanzees or gorillas. We've got like 25% of the lower GI tract of the colon of say a chimpanzee, which supposedly are closest cousin. And this is consistent with the consumption of what is termed in the literature a high-quality diet, which is basically a diet high in animal-sourced food, particularly protein and especially fat. So of course, your brain actually runs better on fat. The brain makes up maybe two to 5% of your total body weight, well maybe a little less if you happen to be a politician, but it uses a whopping 20 to 30% of our total caloric intake, which is massive. We were literally born to rely on dietary fat as our primary source of fuel. There's an author in the Journal of Neuroscience Research here that states that once the onset of suckling takes place, ketone bodies become the major fuel for brain development. In the textbook Basic Neurochemistry, the authors state that, quote, cerebral utilization of ketones is increased more or less in direct proportion to the degree of ketosis. Significant utilization of ketone bodies by the brain is normal in the neonatal period. The newborn infant tends to be hypoglycemic, but becomes ketotic when it begins to nurse because of the high fat content of mother's milk. Notice they're not saying the baby starts burning sugar for brain fuel as soon as the lactose shows up. No, they're saying that the brain becomes ketotic when it begins to nurse because of the high fat content of mother's milk. And apart from coconut oil and palm kernel oil, the richest natural source of medium chain fats, the most ready source of ketones is human breast milk. So fat and ketones play essentially central roles in the optimal composition and function of the human brain. So fat, roughly, you know, fat in general makes up roughly 80% of the human brain and nervous system by dry weight. Now, roughly 50% of this is saturated fat, evil saturated fat, right? 11% evil arachidonic acid. About 25% of the fatty acids making up the human brain is stochosohexanoic acid, this elongated omega-3, a storage form of omega-3 found in animal-sourced foods. Fully 25% of your body's entire repository of cholesterol is found in your brain and it sure as heck needs to be there. Your brain cannot function without optimal cholesterol levels and without a good deal of it. According to the respected ketone researcher, Dr. Richard Veach, ketone bodies from dietary fats in ketogenic diets may not only treat but also prevent Alzheimer's disease. And ketones are also an abundant and stable and steady source of fuel, even in the absence of regular meals. That's assuming a state of ketogenesis and a state of well-adapted of healthy keto adaptation. Now, according to this article in the American Journal of Physiology, quote, a ketogenic state results in a substantial 39% increase in cerebral blood flow and appears to reduce cognitive dysfunction associated with systemic hypoglycemia in normal humans, okay? This isn't just for sick people. Human brain growth is completely dependent on dietary fats, particularly the 20 and 22 chain carbon fatty acids, DHA and ducosexinoic acid and arachidonic acid, in other words, dietary animal source fats. And humans allocate, of course, a substantially larger share of, you know, much larger share of our energy budget to our brains than do other primates and other mammals. So, getting our energy from something like starchy roots and tubers during early evolution would really have required extensive cooking. We can't make use of the starches and roots and tubers without extensively cooking them. And, you know, when we heat those things, the starch granules, you know, swell and then they disrupt from the cell wall and then they become available to action by our digestive enzymes. But even so, even with cooking, the energy value of these foods are considerably less than animal source foods. And things like fruit would have only been seasonly or climatically available to us. And, you know, compared again to the large-bodied apes, we have this enhanced capacity to digest and metabolize higher fat diets. And it's one reason why we have a gallbladder and it certainly appears to what we are designed to do. And again, without this metabolic adaptation, homo sapiens could not have evolved such a large brain. Never would have happened. So this is very cool, I think. This is a plot of relative brain size versus relative diet quality for 31 primate species, including humans. The enhanced enhanced diet quality essentially means more protein and especially fat. And the quote from the study is here that primates with higher quality diets for their size have relatively larger brain size. Humans represent the positive extremes for both measures, having large brain-to-body size and a substantially higher quality diet than expected for their size. So here we are, way out on this limb of our family tree. And nobody else even comes close. From the journal, Prostagland is Luca Trines and Essential Fatty Assets, another article written by Richard Beach. The effects of ketone body metabolism suggest that ketosis may offer therapeutic potential in a variety of very different and common and rare disease states. The large categories of disease for which ketones may have therapeutic effects are, number one, diseases of substrate insufficiency or insulin resistance. Number two, diseases resulting from free radical damage. And number three, disease resulting from hypoxia. That's covering a lot of bases. And also there's ample evidence of ketogenic diets, specifically offering benefit in type one and type two diabetes. Metabolic syndrome, neurological impairment of all kinds. Autoimmune disorders, cardiovascular disease, Parkinson's disease, epilepsy, kidney failure, brain cancer and other forms of cancer, as well as even heart failure. My question is, why wait till you get sick? You know, there's no real evidence that a well-adapted ketogenic state is harmful in any way and it provides such a rich range of benefits. In this article in Pediatric Neurology, the evidence suggests that the ketogenic diet has neuroprotective properties in diverse models of neurodegenerative disease. Again, why wait? This particularly interesting and exciting to me article from the British Journal of Cancer States, quote, if the anti-tumor effects of restricted caloric intake are associated with reduced glucose levels and glycolytic energy, a question arises as to what role elevated ketone levels might have in CT2A management. We suggest that ketone body metabolism while providing normal brain cells with an alternative high energy substrate also reduces the inflammatory activities of tumor-associated host cells. Ketone body metabolism reduces oxygen-free radicals, enhances tolerance to hypoxia, and may prevent organ dysfunction from inflammatory processes. Hence, a shift in energy metabolism from glucose to ketones will enhance the bioenergetic potential of normal brain cells on the one hand while reducing tumor cell growth and tumor inflammatory properties on the other hand. I ask you, why wait? From the article by George K. Hill and Richard Veach in the transactions of the American Clinical and Climatological Association, the authors state that D, beta-hydroxybutyrate, the principal ketone and starving man displaces glucose as a predominating fuel for the brain, decreasing the need for glucose synthesis in the liver and kidney, and accordingly spares its precursor, muscle-derived amino acids for all you athletes out there. And recent studies have shown that D, beta-hydroxybutyrate, the principal ketone, is not just a fuel, but a superfuel, more efficiently producing ATP than either glucose or free fatty acids. Also, ketone levels, beta-hydroxybutyrate, during the neonatal, or not neonatal, during nutritional ketosis, decrease mitochondrial reactive oxygen species production, in other words, free radical activity. And this increases, and it also increases antioxidant activity. Ketogenic diets reduce levels of systemic inflammation, high-fat, low-carbohydrate diets decrease serum triglycerides associated with cardiovascular disease and diabetes. I mean, is there anything they can't do? Do you like muscle? Well, a well-formulated ketogenic diet and well-adapted ketogenic state, and these are the key phrases, they'll spare lean tissue mass by sparing protein from being utilized or converted to glucose and utilized for energy during hypoglycemic states. It also improves your efficiency of protein utilization, reduces nitrogen excretion, and it provides better maintenance of and even increases circulating branch chain amino acids, leucine, isoleucine, and valine. And as there's less of a need to use them as fuel while operating in a ketogenic state. And by the way, the main driver of muscle protein synthesis is not insulin, but the availability of essential amino acids in particular leucine. Also, if you're wanting to consume sufficient protein, if you can consume sufficient protein after a workout, adding extra insulin-provoking carbs is not going to improve your anabolic response. So this study was just published at the beginning of last month, and I just thought I'd throw it in. The aim of this study was to investigate the influence of very low carbohydrate ketogenic diets on explosive strength performance. The conclusion that they came to was that they demonstrated that using a very low carbohydrate ketogenic diet for relatively short time period can decrease weight, body weight, and body fat without negative effects on strength performance in high-level athletes. So some of this has been debated about high-level athletes and whether you need carbs for that. The evidence seems to be showing not. Also, using, do you like energy? Using ketones for fuels again, provide you with a greater amount of ATP, and particularly with beta-hydroxybutyrate, most efficiently produced ATP for energy over glucose or fatty acids. The human body doesn't store much more than a couple thousand calories of glucose at any given time, and even the leanest person in this room has more than 20 times that amount of energy stored as body fat that is totally available to you if you happen to be in a well-adapted ketogenic state. Isn't that a much more efficient way for us to be? And by the way, fat oxidation or fat burning is actually suppressed for days after high-carbohydrate meal, not just immediately following when insulin levels are elevated. So the less we indulge in those carbs and the more efficiently we maintain that fat burning potential for longer, obviously glucose has its place. It's our version of rocket fuel that we use to help us deal with emergencies or extreme exertion, right? But that's what we have glycogenolosis and gluconeogenesis for. In the metabolic fuel duel between glucose and ketones, there just isn't much of a contest between which ought to be your primary choice. Now for just a moment, consider the role that carbohydrates and fats have strictly from the energy that they provide us with. Obviously, we're much more than just a heat engine, we're a complex metabolic chemical factory, but nonetheless, permit me this analogy relating to metabolic fuel. If you had to heat your house using nothing but a wood stove, what kind of fuel is going to work best for you? Well, carbs are basically analogous in this metaphor to kindling on our metabolic fires. So your whole grains, beans, brown rice, sweet potatoes, et cetera, as the complex carbohydrates we're supposed to be basing our diet on according to the US Department of Agriculture's Food Pyramid, these can be viewed more or less as twigs on that metabolic fire. White potatoes, bread, cereal, white rice, sugary snacks, and all of that are basically the equivalent of throwing paper on that metabolic fire. In fact, white potatoes, white rice, and those pesky supposedly safe starches and cereal can do this even faster than table sugar, so we can really get that to being like confetti. And of course, alcohol, particularly the sweeter alcoholic beverages and even wine and beer, and this includes stuff like sugary beverages, juices, sports drinks, and all of that are really the equivalent of putting lighter fluid or gasoline on that metabolic fire. So if you had to heat your home using nothing but kindling, you could do it, you could do it. And lots of people do it every day. In fact, probably 99% of America does this every day. But you'd be basically sitting, you'd have a stool pulled up in front of this little wood stove here. You'd have this shoved up here with the doors open. You'd be grabbing handfuls of twigs and paper, squirting lighter fluid on there. You'd be have a constant preoccupation with where that next handful of fuel was coming from to keep that fire going. And what's that metabolically, metaphorically equivalent result? Basically it's a constant preoccupation with carbohydrate-based foods and snacking. I mean, carbohydrates and carbohydrate-based diets basically make us hungrier. Monsanto's gotta love that. What's the alternative? Consider the considerable advantages of using that nice big fat log, in other words, fat on that metabolic fire. Is that primary source of fuel? Fat burns aerobically. In other words, it works most efficiently for 99.99% of everything you do during a given day that requires breathing. It burns in a more prolonged and sustained manner, even in the absence of regular meals. It can be stored much more efficiently and drawn upon as energy reserves for a much longer period of time and it needs way less frequent replenishment. You're not a slave to that wood stove. And I, for one, prefer not to be a slave to my wood stove all day. Consider two the survival advantages of a fat-based metabolism for primitive ancestors, not to mention us, I'm just saying. So while we're at it, consider these other advantages. Fat to our primal physiology means survival and nothing is more fundamental than survival. The hormone leptin, a key part of that, has a primary role to play as a fat sensor and endocrine coordinator. And carbohydrates like dietary sugar and starch basically scream at leptin. They cause it to surge and much more easily dysregulate. While fat, on the other hand, speaks a language that leptin much more readily understands and it calmly assures it that, hey, hunting is good. And that can allow for much more ready access to those fat stores for energy. It's likely to hoard those fat stores. So very low carbohydrate ketogenic diet is also longevity-hancing. It's anti-aging. It minimizes the need for insulin and also the undesirable end to our activation. Something else to consider here is that cancer, folks, is an epidemic problem. Certain to escalate in the future. And we've got Fukushima now. It's bound to get worse and not better, a lot worse. The primary source for fuel for cancer cells is glucose. Ketones don't feed cancer cells. The more ketogenic you are, the less friendly your internal environment is going to be to cancerous processes. And also eating a fat-based nutrient-dense, ketogenically adapted diet, that's you're moderating your protein intake, you're restricting sugar and starch, you're eating as many of the fibrous vegetables and greens as you either like or can tolerate. That's the least expensive approach. Anybody notice that the economy's not doing so well? It's the least expensive approach to eating optimally well in existence without ever having to be hungry or feeling deprived. So here's what's the formula for reliably inducing and maintaining a ketogenic state? By definition, a state of ketosis means having blood ketone levels between one to three millimollars, okay? In order to get the levels above one millimolar, this typically requires a consumption of less than 50 or 60 grams of carbohydrates in a day. Now, carbs are found in way more than just starchy roots and tubers and sugary foods. You're gonna need to allow for, you know, five to 10 grams from protein-based food. It's five to 10 grams, or 10 to 15 grams from fibrous vegetables, five to 10 grams from nuts or seeds, five to 10 grams from fruits, five to 10 grams from other sources. So in a state of full or maximum ketosis, our requirement for glucose is no more than 120 to 130 grams in a given day. And if you keep your carb intake below 50 to 60 grams, it's really easy for your liver to make up for that deficit, you know, with, say, another 60 to 70 grams without dropping you out of ketosis. This isn't hard. The other trick, and it's a rather important one, is that you need to restrict your protein intake to no more than about 25 grams or so in any given meal, or less than that. And, you know, roughly three ounces of meat fish or eggs in a single meal, and each ounce of meat has roughly about seven grams of protein, and the eggs generally have six or seven grams of protein in them. So it's a rough formula. I go into that a little bit more in my book in a little more detail. Or you can follow this formula. Every day you should eat something from each of the five basic food groups, fried blubber, boiled blubber, stewed blubber, baked blubber, and raw blubber. And folks, here's your thought for the day. No diet will remove all the fat from your body because your brain is entirely fat. Without a brain you might look good, but all you could do is run for public office. George Bernard Shaw, thank you. Moral of the story, that is where it's at. And there you go. So if you have any questions, please go to my website, sign up for my newsletter, or you can read my book. I still have a small handful of them left. Thank you so very much. Let's take some time to ask a few questions until we have our next presentation set up. If you would use this so that, thank you. Okay. I feel like a lounge singer here. Give them the speaker, or if you can sit right there too. You can sit right up there. All right, cool. Thank you. Nora? Yeah. Are we gonna allow us to ask some questions? Hi. Hi. How are you doing? I have a question. You said many times that a well-adjusted ketogenic diet. Right, because it takes time for your body to switch over from a primary dependence on glucose to a primary dependence on fat. There are enzymatic conversions, and things that need to happen for your body. If you've been, depending on sugars, your primary source of fuel throughout your life, your body doesn't switch over instantly that easily. It just, you know, my experience, it seems to take anywhere from like three to six weeks, generally for a person to become well-adapted, and some of that depends on your degree of addiction to the carbs and what kinds of reactions you're having. But, and there are things that you can do and things that you can take to help support that transition a little bit, you know, more painlessly. You know, some people, and actually quite a lot of people, just make that transition. I mean, it was a matter of a couple days, they're already feeling better. And other folks seem to struggle a little bit more, but it's well worth the effort. And then, does that mean that, is there something one needs to do once you are adjusted to maintain a well-adjusted ketogenic diet? Relying on fat is your primary source of fuel and avoiding sugar and starch to the degree that you can. And lastly, is there any known drawbacks to entering a ketogenic state and then going back to a more carbohydrate-oriented diet and then back to ketogenic? Well, you end up going back to, you know, certainly a more glycating way of living, you know, and a more insulin-disregulating way of living. The other thing is too, you might, so much depends on how metabolically dysregulated you were before you went ahead and made this transition in the first place. I think there are people that are sort of kindled for metabolic dysregulation, and they're either genetically predisposed or they're predisposed from a lifetime of metabolic abuse to dysregulating very, very quickly. And so I think what you find when you get ketogenically adapted is that when you fall off that wagon, and you're, you know, a lot of people do, it's way more noticeable. I mean, it's sort of like a clean windshield effect, you know, where you just suddenly really feel slammed where before you could handle eating that dessert and now it's like, oh my God, it just wiped you out. So I think people find, they notice the consequences more if they sort of fall off that ketogenic wagon. Thank you. You're welcome. Nora? Yeah. I'm hiding over here. Oh, hey, hey, how you doing? I'm obviously a huge fan, and I've got, you know, the big fat poster. The biggest thing I hear people come up with, I'd love to have you address that. There are two things. Number one, the thyroid issue. Yeah. Number two, the insulin resistance issue. Insulin resistance issue. It's going to be on a ketogenic diet, tends to potentially increase insulin resistance. And that's been brought up several times. I don't know what universe it increases insulin. It's going to improve insulin sensitivity. There's just no question about that. And in terms of the thyroid issue, I think Ron Rosdale did a great job of putting that to rest yesterday during the, you know, the safe starches panel. You know, the changes that the thyroid undergoes are just enhanced efficiency changes. There's nothing pathological about it in the least. And the big problems that, you know, you hear in the blogosphere people running into with that are just, I haven't really run into it. Okay, I'm sorry, we've got to break now. Thank you.