Siobhan Huggins & Dave Feldman - Transcript


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Originally published at: https://ketowomanpodcast.com/siobhan-huggins-dave-feldman-transcript/

This transcript is brought to you thanks to the hard work of Trish Roberts.

Welcome Siobhan and Dave to the Keto Woman podcast. How are you doing today?

Great. Thank you for having us.

Very excited and happy.

And how are you feeling about the conference? We're nearly at an end and I'm starting to feel a bit deflated. Getting a bit sad about leaving everyone. What have been your best bits?

Oh my goodness. For me it was getting a chance to see.... I've really been impressed with the advancement on, especially the cardiology front. Brett Scher and Nadir Ali are cardiologists that are really breaking ground and addressing a lot of these tough topics head on. And I'm really glad to see that. I really enjoyed Paul Mason's presentation as well. And again, I'm kind of biased, but I feel like it's a very critical question that a lot of people have. In many respects sort of the one key question because as far as being concerned in terms of mortality in the ketogenic diet... I mean, people aren't worried about keto rash or cramps in their legs as much as they are of, if they're going to die of heart disease. And so I'm glad there was a lot of focus here on it and they were really good talks.

Yeah. One thing I've been really excited about this time was just the level of excitement and hope. Not only in Low Carb Denver, but also CarnivoryCon. There's a lot of developing stuff, a lot of people talking about just getting healthier. One thing in particular that I enjoy is just the level of excitement from the doctors because one thing that Brett has talked about in the past is doctor burnout, where they're trying and they're trying and they're trying, and it's the same for the patients. Like nothing they're doing is working, and it just hits them hard. And to see care providers and doctors and coaches and stuff, just happy and excited to be able to help people is just exciting.

I've been speaking to quite a few Type 1's, and they were really excited about that presentation yesterday as well with Nadia Ali and Brett Scher. They really seemed to get a lot from that.

Well Type 1 is especially challenging because I feel like the science is so strong for a ketogenic diet with Type 1s. There could be a case - and I believe somebody was doing a fairly good job of this - I think it was Sarah Hallberg who was saying, there are these three different ways to address diabetes and that she was speaking more to diabetes Type 2. For Type 1... I try not to be a specific diet advocate, but in particular for Type 1, it's kind of comparable to epilepsy in that you really should find a way to manage bringing down total carbohydrates because of how much you know. You know how much insulin you're going to need to manage it, and your body has an enormous challenge in trying to regulate it. And so for me that's not as close of a call.

Yeah. Especially because lately more and more we're finding type ones that are transitioning into Type 2s. Like their dietary management is just so poor that they're becoming insulin resistant, which is just complication on top of complication, and it has to be really difficult for them.

So you two are both known for doing crazy experiments. What have you been up to lately?

Gosh, where to begin? I guess if I were to say what the last set of experiments are, they were to do carnivore. And one thing I didn't get a chance to talk about in the presentations, but I feel like it's kind of a little more appropriate for a podcast....for all of the kinds of experiments I've done and for the controversy they've garnered, nothing came close to my mentioning I was going to do a carnivore experiment. I got a whole lot of people both jumping in on the positive and negative side. It had enormous attention and this I found to be pretty odd because my ketogenic diet, I'm normally having close to 75 to 80% animal based products.

So getting all the way to 100% I thought would be, to use the euphemism, a nothing burger. Probably it would feel like keto to me. Probably no one would care. I couldn't have been more wrong about that. Not only was there a lot of pushback on the outside, but I was thinking, gosh, I hope there really is going to be good data given there's not...given how much I'm having to put up with to make this happen. And sure enough, I found that if I went on carnivore I did in fact see a lot of effects that really kind of blew me away. As you know, a lot of the data I just go and get it myself. That's the value of N of one, is when you're the N, you get to find out how much things people have been telling you really pan out.

And in the case of carnivore, I really can't say there were a number of symptoms. I would say both advantages and symptoms that turned out to be worthy of mentioning. A lot of them most of your followers probably already know. My appetite was much more satiated and in fact I just thought less about food. I didn't think about planning for food and so forth. And that was very liberating. A little less time in the bathroom...make of that which you will. I really found that I enjoyed meat a lot more specifically when meat was my main target; which was good. That said...

You think it would potentially be the opposite..that you get bored with it?

As I was about to say, that said, I haven't done a really long-term carnivore experiment, but in both that first one I did and in a second one that I did just recently, I do get bored of food choices. But it seems as if it's in the process of subsiding before it is, that I end up ending the experiment. So it could very well be that if I were doing carnivore for say, three months, that I would actually find, oh, okay, I'm really getting into animal products only. It's working out for me.

Yeah. And that's actually exactly what I found. I've been doing carnivore for almost a year and a half I think - since October 2017 - and I definitely found... I thought I would get bored going in, but it was the exact opposite. My excitement for food went from absolutely zero to just excited about every single meal. Happy while eating. Satisfied after the ambiguity and appetite I was experiencing with keto went away. It's absolutely clear when I'm hungry and when I'm not. And after all this time, am I bored? No, absolutely not. It's more enjoyment than I've ever experienced from food. Ever.

I actually want to prod you into what really should be the experiment you should talk about because it is one of your most recent experiments and it relates to carnivore. It's your raw week.

Yeah, so I've been having a...I think it's a pre-existing issue with low folate, and I think it's pre-existing because even in my Standard American Diet days, I was having symptoms of numbness and tingling in my fingers. And actually right before I started keto, I had a numbness and tingling in my toe that was not going away. And that was actually a big motivator for keto because like in my head it was like diabetes or something. But obviously that wasn't it. I was also experiencing shortness of breath, even just like sitting and doing nothing like we're doing right now, it would just be like breathing normally, but feeling like there's just not enough oxygen. And eventually I got tested, B12 and folate, and folate was like rock bottom, like 2.8. Normally low carbers I see like levels of 10. So clearly that's pretty abnormal, especially because there's research indicating that with low carb diets folate goes up, even with the same intake. Amber discussed at CarnivoryCon that this relates to gut bacteria and things like that.

And I decided to try supplementing for a while. So I did that while I was out of the country for three months and the symptoms did subside, but I wanted to see if I could find some other way to fix the issue. And I was like, hey, if you cook meat, you lose water content and folate is a water soluble vitamin, so if I just don’t cook it, maybe I’ll get more folate that way. It was just a random thought. So I decided to do a full week of raw meat only, and I was doing that while at Amber’s house before the conference. So it was like raw chuck roast, raw beef heart. Not really any organs then, except for the heart, because I didn’t want that to confound. I just recently got my labs back and my folate was 18. Granted, that could be still coming down from the supplementation even though I’d stopped it several weeks before that.

But this is definitely something I want to look at further because if that’s all I need to do to fix it...

Can you tell them what the reference range is?

So the reference range I think is like under 3 is a clinical deficiency, and then up to, I think it’s like above 28. Just say it’s above 28 and you’re out of range.

And your prior tests?

My prior test was 2.8, and then 3.1 for another one, and then it went out of range when I was supplementing. And now it’s 18. So it’s very interesting. And while I was eating raw, I experienced something very similar at the beginning of carnivore, where when eating pork I was getting like this feeling of just absolute happiness and excitement while eating...like a borderline euphoria. And that eventually faded over time. And that’s why I was eating pork so much. It’s actually something I’m kind of known for on social media.

Pork and cream cheese.

Pork and cream cheese was my go to. But I was getting the same feeling with raw meat and in my head it’s like, maybe there’s something in here I need. It’s not very scientific, but it’s something I want to pay attention to because it’s not ignorable for sure.

Well, it's using your first and most important meter. Because I can never say this enough times, for as much as we like to experiment and measure methodically, the one meter you should never lose touch with is, how you feel. Never. And I think that if you're feeling good around the clock...and I always put it that way, as in 24/7 you're just generally feeling good. Not having rushes. Not having feeling good briefly, and then having a crash. But if you're feeling good around the clock, that's very valuable information and you want to be very mindful of what you're doing and how this came about.

And presumably you've seen an improvement in those things.

Yeah, like the symptoms haven't come back. Nothing. No tingling or shortness of breath. I've been running all over the place and been fine. And so it's definitely something I want to continue. Although I do have another experiment coming up that will be not as fun. I want to dig a little deeper into lipoprotein(a) because I did some fasting, and then high calorie, and then baseline diet, high calorie, and it seemed to be tracking with fat intake. So I want to explore that a little bit more. Probably as soon as I get back home. And that'll be with a high carb, low fat diet.

Yuck.

I agree. Especially because... I mean to be honest I don't like plants that much regardless of what they are. It's just soul sucking to eat them. But I really, really want the data.

That's going to be a real shock to your system surely, after all this time.

Yeah. I want to give it a good length of time just to make sure there's not any transition, so it'll probably be multiple weeks paying very close attention to how I feel. Because when I was following the Standard American Diet, I had depression and it was pretty bad. So that is one thing that I'm concerned about, and I'll have my parents on standby, like warning them ahead of time, watch out for anything. Please let me know if I'm acting weird and I'll just stop because that's not anything I'm messing around with.

And as we would advise to anybody else considering N of 1s, you always want to be prepared to cancel an experiment if it's not working.

Absolutely. There is nothing shameful in that. Absolutely nothing. You have to take care of yourself first and foremost.

And on that note, while I was doing the white bread and processed meat experiment, which was also a high carb, low fat diet, and my continuous glucose monitor was just constantly showing me the alps, if you will. I was very irritable. It was probably one of the most difficult times that I've had as far as maintaining control of my emotion. And Siobhan would joke toward the end - though not entirely joking.

I was not joking.

That she might have to take time off soon if I was going to continue the experiment too much longer. So if I'm experiencing the same thing on the other side, I'll let you know.

Yeah, I would appreciate that.

It's a challenge though because in approaching an experiment like this, you do want to do your best to keep your own biases in check. So I intend to every time I do an experiment, even if I'm going out of keto, to try to experiment with something like this, I try to maintain the best outlook for what the experiment could be, and not let anything trip me up. And I will say, there are experiments where I've had carbs and not fat, and it did not have a negative impact on my mood. This last one was one of them. And of course, I'm going to be hoping the same for you as well.

Yeah. And one thing I'm going to do to try and mitigate that...because the problem with lipoprotein(a) is it's an acute phase reactant, meaning if there's inflammation it goes higher. So I'm actually trying to go out of my way to avoid that. And one of the ways I'll be doing that is going with the whole food based approach. So it'll be a very simple sweet potato, lean meat type of thing. And I'm hoping that'll help mitigate part of the mood issue, because I think part of that was largely due to insulin resistance and things like that. So hopefully that'll help and I can coast through easy and just be bored, and that'll be the worst of it.

And do you think the kind of carbs you had in this experiment where you were feeling irritable, played a part?

Oh yes. Michael Eades did a really great presentation not too long from that, to really emphasize, how a food is processed can matter for how it impacts your system. And he was going into not just your insulin, but also a number of other factors. I certainly have speculated on for some time when I like to call speed of entry...how fast things that you're consuming, food stuffs that you're consuming, can get into the vascular system. And particularly we've found a lot of ways through refinement that I speculate, can kind of trick our enterocytes to some degree. As I say over and over again, we've had a lot of practice as a species with protein, fat and very fibrous carbs. This is sort of a brand new paradigm where we've actually found ways to get, say, glucose inside of our bloodstream within minutes.

That just wasn't really that possible before, not at these scales, right? And given that, it doesn't surprise me that I've now done - in one year's time - I've now done four different experiments that had to do with carbohydrates. First one being the skittles experiment from last year. Then I did the weight gain experiment where as the standard American diet. Then I did the white bread and processed meat experiment. And then a very recent one was the added dextrose experiment. All four of them have character to themselves in both how I was feeling about it. What I saw for the difference in my continuous glucose monitor and aftermaths.

And ironically of all of those experiments, the shortest of them was the added dextrose experiment. It was only four days long. It was a total of 75 grams of dextrose added to each meal. So a total of 225 per day. It was the highest my glucometer had ever gone. And afterwards I had cravings like I had never had post any other experiment. I actually really wanted sweets. So I had a whole bunch of keto junk food, but I kept trying to figure out a way to just get my head space out of it. It wasn't until I went into the second version of the carnivore experiment that I was really able to reset. These things really weigh on me as to how much other people may be dealing with the same things. And I do believe, again, it's not just carbs, it's the nature of those particular things that I was eating.

Yeah, I agree. I was about to bring that up. We do see anecdotally that some people who are consuming liquid fats habitually - not just bulletproof coffee, but I've also seen an example of bone broth with butter melted into it - they can sometimes come back with really weird lab results, or weight stalls, or weight gains, and for the lab results it tends to be high triglycerides and it's like I'm following really strict keto, but my triglycerides are really high. I don't know what's going on. And it's on our list for people who have high triglycerides on low carb, are you consuming liquid fats? And I think it's the same issue. It's the speed of entry that's the problem.

Yeah, there's definitely something in that. I mean it makes sense logically as well, doesn't it?

Well, I mean I think the best way to think of it is we're having a conversation all the time. Our digestive tract is having a conversation that's spoken in hormones, spoken through signals through the vagas nerve. These are practiced over 2.5 million years, right? And for Homo sapiens, we're talking what, 200,000 years, I want to say. This is very long. It's very common. There are all sorts of refinement that's happened for how that system works, and now we're throwing that all up in the air entirely. And so the signalling things like your leptin response, probably the dosage that was actually in your vascular system at the point where that was getting activated was so much smaller than it is on the Standard American Diet. So, so much more is inside, and that's why people could have cycles where it's not just a hypoglycemic but also hyperglycemic. I doubt any of our ancestors were dealing with this.

Yeah. And I just want to clarify that I don't think this is a problem for everyone, but I definitely do think it is a potential problem because while I was losing weight, I was drinking the bulletproof coffee. And so it's not everyone for sure, but I do think it's important for people to realize that if they're having issues, it's something to think about because it can just be helpful to know what could be contributing to potential problems and then they can kind of figure it out and go from there.

And let me just add, I think one of the worst excuses to be having liquid or refined forms of fat is that you're trying to "fill your macros". Oftentimes people are trying to hit a percentage that they've heard is the keto percentage. I'm happy for family and friends to get into things like keto treats in the beginning to get into things like bulletproof coffee if they find that it satiates them away from carbohydrates to some extent. But I actually get a little bit frustrated with them if I feel like they could have a coffee that isn't bulletproof and it's not something that they necessarily need to have and they feel that they need to add it in order to hit their fat macros for the day. If you're trying to add energy for the purpose of meeting these macros, I highly discourage it.

I agree. And people finding ways to add things like MCT oil just because they've heard they should be adding it. But for what reason?  It always comes down to these real whole unprocessed foods and if you stick to those in majority, it's very difficult to go wrong, isn't it?

Well, I do want to nitpick a little because I actually do take issue to the whole process debate, because there are plenty of processed foods that we eat that are perfectly healthy.

That's very true. Bacon...

Cheese and salami and stuff like that. I think what I would like people to focus on is the metabolic effect of what we're eating and the better we can understand that process, the better we know... I don't react well to this. I react well to this. I can have bulletproof coffee be perfectly fine. Everything looks good. I feel good. I'm full from that. And then some people have the complete opposite reaction. And so I think that's what I try and focus on is the effect of what we're eating. Because what else would you care about in the end?

It gets back to whether you have a problem or not.

Yeah, exactly.

If you're having fat shakes and fat bombs and you're still running record marathons and so forth, then you probably aren't listening to this part of the advice anyway, right? And I'm not going to tell that person, oh, you're wrecking your life. If you're happy 24/7 - getting back to that first meter - and you don't seem to have any issues with your personal goals. You know, your weight's at the right weight and you don't have any stalling. You don't have any disease states that's arising. Whatever you're doing is probably good. Probably is. That said, if you want my top list of suspects. If you find that your weight's stalled. If you find that you're not feeling good, I start with how fast are you getting food into your body? Because that is stored energy ultimately and your own hormonal system to be able to turn on those regulators like leptin to be able to tell you you're done, that's got to happen soon enough for you to then limit the amount of food that you're eating.

Yeah, and I think this would actually apply to carnivore as well because I've noticed that people seem to sometimes think that because I follow a carnivorous diet, I'm recommending it to other people. And sometimes I think if there's evidence behind something they're experiencing, and carnivore could potentially help based off of anecdotal data that we have, I'll mention it, but a lot of the time I don't. And I think that's because if you can eat plants and be happy and feel healthy and feel energetic and great - why would I tell you to do anything else? That's just silly. Obviously you can try it and see if you feel even better, but then if you do that and find, whatever, I miss my vegetables then go eat them.

And you mentioned you were getting quite a lot of pushback and extreme reactions to carnivore experiments. Was it along those lines or something different?

Yeah, so some people even within the keto community, some big wigs for that matter. Some would say that it's unsustainable environmentally. Some would say that actually there's still a number of issues with nutritional completion. Certainly there are a lot who are concerned, even eating nose to tail, that you don't get enough nutrients. All of these things, again, me being an N of 1, I like to go get my own data. I like to go see for myself. I know that I am going to be getting very wide spectrum testing and so I'll have a fairly good idea of what I feel like the data's going to look like, even if it's just in the short term. And that I'm going to find more meaningful than what anybody tells me, truly. Because a lot of times, even what I'm telling myself turns out to be wrong, the blood work is the most important.

Oatmeal was an interesting topic in your CarnivoryCon presentation.

Yeah. So that presentation focused a lot on an area that I'd been excited to explore because I was considering - and truly I still am considering - I would like to do a plant based diet for around four to six weeks because I feel like that would give it the best shot. And if I went for that period of time, I need to figure out what diet I could eat that I would feel was nutritionally complete enough. And, believe it or not, I landed on Michael Greger's Daily Dozen which I was showing in my presentation. It actually came pretty close to hitting all the stuff that I wanted to hit. But amino acids was pretty tough. And even with all of the different samples that I had put together, I found that oatmeal was really the primary source of the amino acids I was looking for. So then it was like, okay, well maybe I can just pump up oatmeal in particular, and then I found that it needed to be at least a pound and a half dry. So a pound and a half dry, which means...

I'd struggle with that. Just eating it consistently.

Yeah, so before adding water....Right, it's like its so much oatmeal. And where I was going with that whole talk was that, amino acid composition - like if we were to take each of us and enzymatically break us apart to where we just have this bucket of the mixed amino acids, there's around 23 of them associated with the human body. Well we're pretty close to the other animals who are making a lot of the same proteins from the same amino acids, that I was basically pointing out that amino acids are kind of like the toner for our proteins that proportionality speaking, it makes sense why it is that those would end up being comparable to each other.

Whereas if you go to the plant kingdom, how surprised could you be that there'd be some amino acids that would be highly lacking while others were way over the top, right? And that's what I found is that sure enough, while I was checking out, just trying carnivore, a nine ounce ribeye steak covered all my amino acids. A nine ounce chicken breast covered all my amino acids. Salmon, all my amino acids. It was crazy. And the other food compilation I put together - there was a dozen - really took about a pound and three quarters and didn't quite get me there either.

To lower the tone of it…it's no surprise that there's a difference in toilet activity really. When you come down to it, the more nutrient dense it gets for your needs, the less waste there's going to be. Whereas if you got to bulk it up with pounds and pounds of carbs...

Yeah, to be sure I'm going to... I have two very good vegan friends who I spoke of in the conference. What they would want to say is, well, okay, sure; but how much environmentally did it take to make that cow or to make that chicken and so forth. These are all, I think, valid things to bring up as long as it's within that sphere. I think you've got to still separate though the two. You've got to talk about the topic of nutrition and it should stand on its own for nutrition. I lauded those people in the vegan movement who are trying to move towards more nutrition completion because I think it's something that we should all be striving for. Again, if I had a vegan friend, just like Siobhan was saying, if they're all into plants for that matter and they're meeting their nutritional needs, why would I tell him to do anything differently if they're happy?

I think you mentioned this in the presentation. The point is if you're going to do it that way and I'm the same. If you want to do it that way, that's fine. It takes a lot more work and effort, and being methodical about it, and working out exactly what you need to eat, and the variety of what you need to eat, to get those things you need. Whereas it's a lot easier just to throw a steak in the pan.

It's actually a really massive gap. Again, I really want to be even handed about it, but I would just love if there was a lazy nutritionally complete vegan diet that's whole foods plant based. Because I really think I would have already been doing it by now. I would've just started acclimating to whatever that was, but I wasn't able to find a way to reach the vitamins, the minerals and the amino acid completiveness that I was seeking. And I didn't even need it to be perfect. I just needed to be close enough to where I could say I did a good shot at doing a plant based diet and here's what it looked like. Not that I was going to change any minds in either sides of the movement, but because I want really good information. I wanted to see, hey, what does Dave Feldman look like on a nutritionally complete plant based diet?

And as I told my wife, I think I could pull it off if I just had a vegan cook in the house. And by the way, I'm not totally ruling that out. If it eventually gets to the point where I can rope somebody in to make all my vegan meals to be able to make it to that level, then I would do it. But as far as like me planning it, cooking it on my own, no. Yes, it's just, its way easier to throw a ribeye steak onto the grill. I don't have to do that much more past that point. It's kind of daunting.

Yeah. I can actually back that up because I first heard Amber discuss carnivore at that first Ketofest where I met Dave actually. And after that I started... I was already working a full time job and then pretty much all of my free time after work was studying, helping Dave, talking to Dave, figuring out all this stuff, and so anywhere I could cut out time that I didn't need to be spending, I was doing that. And that's a large reason of why I started carnivore in the first place because it's like, picking these vegetables of what I want to eat and cooking them and preparing them and chopping them, while I could just throw, you know, mostly pork on a baking sheet, stick it in the oven, heat up some cream cheese and eat it, and then be done in like 15 minutes. It's just no comparison. And understandably though other people do enjoy cooking. Like my dad enjoys cooking. I'm not one of those people.

Nor me.

Not even close.

No, I must admit, I'm not overly tempted by vegan, but I can remember when I interviewed Carrie Diulus, and she made it sound really interesting and tasty. But the effort that goes into it, and for me in France, just the lack of availability of ingredients, if I was to do vegan keto, it would be so boring.

I know. If I could make things that were three ingredients and as fewer steps as possible, that's what I want.

Now, Carrie if you're listening, if you cook for me and Dave, we will come over, have a little vegan keto retreat, get blood work all together.

100%.

It'd be fun.

Carrie Diulus, by the way, is one of my favorite people in the keto movement. And she actually has a tough job because she is vegan - vegan keto - so she's kind of straddling two worlds that are at battle with each other. And God bless her, she's doing such good work, and not just for Type 1 diabetics - she's Type 1 diabetic - but also for those people who are emerging who want to do a vegan diet, that's ketogenic.

Absolutely. I have utmost respect for her approach and what interested me was that she landed there through self-experimentation via carnivore actually, and found that vegan keto was how her body felt the best.

Yes. And I think that's a valuable lesson to take away. Because once again, if you're really good scientist, you've got to keep from falling into your own biases. And so I would hope that if I had a family member that was in the same spot and I had them trying carnivore as the multiple removal diet, and they were still having problems, so we could figure out if they were the next Carrie Diulus, and move them over to vegan. Because whatever works is what we want to hope you can find, but part of that is remaining open minded the whole time.

Yeah. I just want people to be happy and healthy and that's all I really care about.

What about coffee?

Coffee's a fun topic for us. First of all, I should just say that it's been annoying to me only from a studying aspect, as in it kind of came on to my radar really, and I want to say maybe a year and a half ago, but very loosely. And one of the experiments that haunted us a bit - actually, you weren't as involved at that time, but you did know her, was a gal by the name of Brenda Zorn who I'm sure you know well. She had gone on a steak only diet before carnivore was even as big as it is now. And there was a lot of battling and a lot of internet rancor about it. But while she was on it, one month later she got her blood work, and her triglycerides are sky high. They were 500 and she didn't have those kinds of triglycerides before being on keto.

Well, I tried to reassure her that probably it was temporary. Because at those levels, if you're metabolically healthy, you can probably correct them quickly - that's a lot of what this research shows. But sure enough it ended up tapering down. The only other thing she was having than steaks, was coffee. And ironically I asked her if at the beginning of the experiment if she could actually go without the coffee for lack of confounders, and she said there was just no way. And then brought up lots of euphemisms of things that would happen to me if I tried to make her. So that was the very first time it kind of came onto the radar. And the reason I started asking on occasion whenever somebody would come with high trigs and it didn't make sense. And by it didn't make sense is, we do expect people who when they go on a low carb or a carnivore diet, that typically triglycerides will be low in HDL will be high. Triglycerides being low, like say under a hundred would be ideal, but at least under 120 or 130, and HDL being high, typically 50 or above.

Now when triglycerides end up being above 150, but HDL is also high, let's say 50, 60, 70. That's curious. And we have two suspects when that happens. The most common one is they didn't actually do a fully fasted blood test. We recommend that that you fast for 12 hours or more, preferably 12 to 14 hours is the nice spot we would like you to be in. Water only. No coffee. Now if they've done that - if in fact they definitely fasted for that period - our next question is do you drink coffee? And if they drink coffee, then our next suspect is that it could be a coffee sensitivity which we have seen with a number of carnivores. Not the majority of them. Don't throw anything at your iPod right now, but a fraction of them do appear to have high triglycerides. We had somebody - Sean Brennan - who actually did a very extensive N of 1, showcasing this with himself that looks very compelling.

He was trying different types of coffee while intermittently having no coffee and when he had no coffee, his triglycerides were low. When he had coffee his triglycerides are high. Whether it was filtered or not, French press or even decaf.

So it's the coffee itself. It's not the caffeine.

That's what we think. I mean to be sure it's an N of 1 - as always, we like to get reproduction by other people who may have this coffee sensitivity to see what it looks like. And to be fair, our original No of 1 ended up coming back, ended up doing a very extensive experiment and it didn't work the second time around.

So Brenda actually did a... I believe it was a six week experiment where she did a baseline test just eating her normal diet, coffee included. Then she included coffee for two weeks. So steak only, coffee, normal amount of exercise, not within a couple of days leading into the test, but otherwise. And then she did no coffee and we didn't see the same triglyceride increase. But CarnivoryCon gave me some additional ideas because they were talking about phytotoxin - toxins found in plants and I'm wondering maybe it has something to do with gut permeability. I don't think we really have any idea at this point. It's definitely interesting though and definitely would like to see more people trying it out if they're curious. If they suspect it, it's pretty easy to test. Usually what people end up doing is they just subtract coffee for two weeks, go water only, and then retest and then they'll come back and see it dropped from like 296 to under 100.

It's really a remarkably high number of people that we see correct their surprisingly high triglycerides by either making sure that they're at least 12 hours water only fasted, and/or eliminating coffee for like say 7 to 10 days. We usually like to say 10 days if possible. And that suggests there may be some phenomenon here. I do, by the way, have some new ideas I have to talk to you about, particularly since I've kind of come to realize a couple of other things since Michael Eades talk that may be relevant.

Hmmm...mysterious.

Yeah, we'll talk.

They're looking at each other secretively. I would hazard a guess though that if you found you got some pushback from carnivore, the pushback you're likely to get from suggesting people give up coffee, it's going to go off the charts.

You have no idea. I always feel like I have to hold my hands up in defence as any objects are going to be flown my way. You know what's fascinating to me, is coffee I feel like is one of those quiet addictions. People don't realize just how addicted they are until you're even just suggesting that they go without it. And then there's almost like a visceral reaction people get. This is the worst part...anecdotally speaking, the people who seem to have the coffee sensitivity anecdotally seem to be the ones who are the most attached to coffee.

I can see the logic in that though.

Yeah. It does make me wonder if you look a little deeper, one of the fascinating things you find out about is it's an adenosine aggravator. But that typically is talked about as far as the brain goes, not so much as to what would be happening in the vascular system. Which is why I kind of assumed it wasn't really that big of a deal. There really hasn't been a lot of presentations and some work sent my way that has me like... I feel like I could spend a week just on looking at how coffee affects the human body. It turns out there's really a lot of things it can impact. So all of these things have me quite curious.

Yeah, and to note, I don't have this reaction, and Dave has asked me before...would you be willing to go without coffee? And I was like, yeah, sure, whatever.

But you'll do anything it seems.

But she doesn't have a coffee sensitivity, that's her point.

I would be thrilled if I did because then I could just test it, test it, test it, test it, test it, test it, over and over and over until I could figure out what it was.

Then probably give it up.

Neither Dave nor I have figured it out. And it's worth mentioning we don't know if there's an increased risk from this rise in triglycerides - we just don't have the data on it. And so really I think it's up to the individual, but it is worth noting, I've never actually seen a case of something that increases fasting triglycerides that is anything that you want to have around.

But what's good for the goose is good for the gander. We don't want to make the statement that we know for sure that this could be problematic. All things considered, I just say I don't feel comfortable with it.

Yeah, and that's kind of what we go with. People have to decide for themselves if they're comfortable with it or not. And it's just part of being honest here.

I'm interested in the behavioral side of it. After talking to Amber about how much liquid I intake, and I know a lot of that is just habit. I'll have a coffee and then I'll go make another coffee, and another coffee, and then my tea for the rest of the time. And I've been interested in doing a carnivore experiment again - really strict meat, eggs, salt. That's it. But extending that out to just water - meat, eggs, salt, water - just to see...because having tried it before, the more restrictive you get with the food - as you've noticed - your appetite goes down and cravings go down, and all that stuff. I'm just interested to see...I don't dislike water at all, but I don't think I'll have the same behavioral issues as I do with coffee and tea. I think I'll only drink it when I need to - when I'm thirsty.

I definitely do still drink water out of habit, but I also drink other things. And I actually have tried to go water only before, but the first time I did end up successfully quitting diet soda, which is fantastic for me.

Same here.

Not because I have seen any hard evidence on any harm, but I didn't like the feeling of being addicted to it. But going water only the first time resulted in really severe carb cravings, which I've never actually had before. And it got so severe, I was like texting Dave, like nearly in tears, like what do I do? And his response was to go have a cup of coffee if it's that bad.

And it changed it, right?

Yeah, immediately after I had that cup of coffee, the carb cravings were gone and it wasn't even like, oh, a carrot. It was like I was at the store and it was like, they sell donuts, you should buy like five donuts and just binge eat all of them. It's like, what the heck is going on? So it's very clear that coffee does have an effect on me and I don't know what it is. It wasn't that I was under eating, I was eating more than normal just to try and keep this stuff at bay. And then I actually tried again recently because I had heard on the Carnivore Cast - if you've ever listened to it - Amber had been talking about how she had had withdrawal symptoms and she supplemented with L-Tyrosine, which is a type of amino acid. I was like, all right, I'll try this again, I'll see if I can induce the cravings again and then do a clean break where I add the coffee back in, and then try a break again with adding the L-Tyrosine, and see if I can get rid of it.

I stopped after three days but only because it was making me really hungry, and I was also simultaneously trying to work on my presentation for CarnivoryCon and I was like, I'm not doing this right now, I just don't have the head space for eating more than I usually do as well as trying to work on this presentation. So I'll definitely come back to that. It's not at the top of my priority list, but mostly just because I have like six other experiments I have ahead of that.

But I do actually want to express this. This is another observation of patterns that I certainly see a lot. It seems people are chronic soda drinkers are typically not the big coffee drinkers, and vice versa. A lot of people I know would say, oh yeah, you know what? I only drink water Dave. I mean, except for coffee. But it's almost like a throwaway line. And this is where I find the visceral reaction that I do. And I'm like, oh, well why don't you try just doing water only and cutting out the coffee, and then sit up straight. There's an alarmed look as though, oh no, no, no, I can't. Okay, well then you know, you haven't quite hit water only, and it's okay, you still have an attraction to coffee. It's almost as intensive as what my prior sweetened drink attraction was.

I was a chronic soda drinker my whole life. Truly tried - this isn't hyperbole - probably six times in the last five years to really give up soda. And that includes after I went keto and I was having diet soda. My cravings for sweetened solids went down, but my cravings for sweetened drinks didn't. And I kept wondering how much of that was truly habit. Sure enough, while it could be a podcast of its own, and I'm sure Siobhan’s tired of hearing me talk about it, but it's an area of great fascination for me. I finally figured out what I need to do in order to accomplish going to water only. So now every beverage I have is water. Full stop. Since May 1st of last year. So I'll probably come up to a year pretty soon actually.

Yeah. And this is actually something I've talked about a lot with Dave because I had the same exact experience of trying to quit soda, trying to quit soda, trying to quit diet soda after I went keto, and it was like nothing would work. It was like this horrible addiction and I really didn't like it. And so he went water only and I was like, okay, maybe that'll work for me. And even though I didn't keep the coffee out and stick with water only permanently, it did work to quit the diet soda, which I consider a huge win. And the funny thing for me is I don't have the same addiction reaction to coffee. I don't have the same addiction reaction to sparkling water or whatever.

So I'm mostly okay with keeping those in for the short term. And it's just fascinating how different the response is because if I go to a coffee shop and it turns out they're closed, it's like, yeah, whatever, I'll just go do something else. But with the diet soda, it was like this visceral disappointment at not being able to have it, and then the anticipation, and then the satisfaction. And then shortly after that, the anticipation again.

Panic if there aren't enough left in the fridge and it's a Sunday and you can't buy anymore.

Yeah. I really would love to figure out what that is because I don't think it's necessarily the sweetener. I don't think it's necessarily the carbonation.

There's some kind of a fix effect.

Yeah, definitely.

There's some kind of a key satisfaction that does seem to be quantitative in nature. During the time...people also knew me before I started the water only challenge, that I would obsess about the subject a lot and really break it down. I even got to the point where I would kind of break it out into what the phases of joy were. So, for example, at the point where I knew I was going to go get one, I had a reward effect just in knowing that I was going to go get one. And that oftentimes felt like the biggest effect of all. That now the plan was in place, I would say, be walking across the street to the grocery store and, oh, it was just going to taste so good. And that had a euphoria all on its own before me even having one sip of it. And then as I drank it, I oftentimes wouldn't drink it all at once, like chug it. It would be kind of a nursing it, sipping it slowly, et cetera.

And then there was sort of an aftermath. An aftermath that seemed for me to last about two hours. Around two hours of almost as if I was still sipping on it. But it's a fresh memory of joy and therefore there was this kind of euphoria in the aftermath. And that to me was something that I found to be so fascinating because here you are, you're having an experience that you could say stretches out over two and a half, three hours from this one drink. From this one 20 ounce bottle.

I've always found with that, but with other sweet things. I remember it with ice cream - was that anticipation and that climb, that mounting up to the top. That actually when I started eating it, I realized I was back on the way down. That high point was actually before it even went in my mouth I found.

I think that happens a lot of times especially with things you've determined that you're going to cheat. Like if you were going to break a commitment. The excitement of breaking the commitment is almost greater than when you're breaking the commitment. Like you're almost in the process of eating this food. You're like, you know, I didn't really need to eat this even though this is off my diet, and I decided to do this, right? But I try to bring this up for people to kind of realize it. If right now I were attempting you with a donut, and you really didn't want the donut, and I was like, this is great donut. Telling you we're all going to have one, and you really felt like you wanted to have one, and then you went, all right. And at that point you committed to going ahead and cheating. You're like, you sure you're going to...

And in that moment you're getting excited about it, and then I go, no I was just kidding, I'm not going to let you have that donut, I'm going to be mindful. I'm going to be careful. You would actually feel this kind of frustration and resentment towards it, as opposed to relief that I just now prevented you from breaking your commitment. That's what's so fascinating to me is I think that a lot of that initial joy is relief from indecision. You were being tempted with something that you weren't so committed to that you could ignore it, and you were sitting there teetering for so long that it took that moment where you said, okay, I'm going to go ahead and commit to this direction - it's just the easier one - that you actually felt a release.

Is that part of what you were saying...you said the only thing that worked - with repeatedly trying to give up the soda, and then the diet soda - was the only thing that worked...just going to water only.

Yes. So I will unpack this for a second just because you're curious. Basically every time I tried to quit I had that which I would replace it with. So either I had say sparkling ice, which was another kind of sweetened drink or sweetened tea that I'd sweetened with stevia or just club soda. I'd rationalize, okay, well you know, its sparkling fizzy water, so I'll still feel somewhat entertained. But there was a problem with every single time I did this; my head space was still applying the attempt to go seek this out. To seek out these other replacement beverages. And therefore, even if I was drinking more water, it didn't change that the water was disappointing because I could have been having the club soda. And so then I would still be...we'd be going to different restaurants and I would care whether or not they could serve a club soda or not.

And let's say I go there and I said, could I get club soda? And no, we don't actually have club soda, would you just like water? And I'd like, yeah. But I'd be disappointed. So what I needed to do was I needed to find a way to remove beverages as a source of joy. Only when I could do that could I remove them as a source of disappointment. So that sounds almost too easy to accomplish. But that's exactly what happens. And I like to use smoking as an analogy. You don't smoke, right?

I used to.

Oh, you used to smoke. Okay. So when you'd gone a long period of time without smoking, it's not so much that you would think, oh, this inhale is a wasted inhale. I could be inhaling smoke, right? But on some very tiny level...actually kind of is, because you had a bodily function that you now apply to the source of joy, right? Well, if you think about it, drinking is a bodily function that's being applied to a source of joy because we now have drinks that make it entertaining. I needed to change my drinking to be just like my breathing. So if it's not a source of joy, it's not a source of disappointment. It just is.

Yeah. And I wanted to make a point because the big problem with me is it would result in this cycle. For me, eating is a huge source of joy and excitement and pleasure and it's all good. But after I've eaten, that's it. I'm not hungry anymore. It stops there. It doesn't turn into this cycle of eating and excitement like what I had before. And it was actually a rule that I had very early on into keto which is, if something was resulting...if I ate something immediately after eating that thing, if I just wanted more of it, it was out. Immediately. Not allowed in my diet. And so that included fruit of any kind, even low carb, berries, nuts and stuff like that. And it's just because if something is hijacking my appetite like that, or my mind like that, I didn't want it anywhere near me. Like I think you've mentioned before, there are moderators and abstainers. I'm a hardcore abstainer. If I can't moderate, you don't deserve to be anywhere near me. And so the diet soda was definitely the hardest of those. But really satisfying.

In my opinion, there are very few actual moderators. I think most people in order to truly quit something, need to completely cut it out. And to Siobhan's point, I've actually given this advice before myself in that, if I find I will eat something - not that I can eat something or even that I desire to eat something, but that I will - then that is something I need to be mindful of. What is it that activates me to go ahead and eat something when I'm not hungry? So by the same token, I would say the same thing with beverages. What gets you to drink something when you're not thirsty? Because a lot of the soda I was drinking, I wasn't drinking when I was thirsty.

Exactly it. That's what I was thinking. That was my instinctive feeling that just taking it down to water; I would only drink it when I actually needed it

And that was always the pitch to myself long before I was into keto and nutrition or any of that, going all the way back to my twenties I kept thinking, if there's one habit that I could feel confident was a net health gain, I'm pretty sure that it would be to just drink water only. That anything I'd be drinking that wasn't water was probably worse for me on balance. Even if it was a "vitamin water". Probably anything that I could get from a beverage, I'd be better served getting from food. So if I could just flip a switch...and I had actually said this to Siobhan before I pulled this off...if I could flip a switch and just drink only water, that's what I'd like to do. And so I'm so happy to have found that actually it's easier than it's ever been. Each month it actually gets easier than the month before. It's like, great, now I don't even think about it.

And it's so fascinating because this seems to be - this type of cyclical reaction to things seems to be - very individual because I've heard people having the same struggle with dairy, and I was like, hey, maybe that's me. I'll quit dairy for a month and see. But even before that I would have cheese in the fridge for like a month, and I just wouldn't touch it except for an occasional meal. And then after that I was like, I don't want any more of this. And I did go a whole month without dairy and I was like, this is nothing. I don't even care. Even after that I didn't really go back to eating that much dairy. So, for me that's a non-issue, but then for other people they're like, I can't have cheese in the house. I can't have it anywhere near me because I'll just eat it even if I'm not hungry.

And I really wonder, is this a different physiological reaction to the food? Is it a psychological reaction to the food. Is it both? I'm really curious what drives that? Because it does seem to be pretty individual.

It comes back a lot to addiction I think. Abstaining, moderating and just those emotional reactions to food or drinks. What's next on the cards for experiments? Siobhan, you mentioned high carb, low fat.

Sweet potato and lean meat. Not Looking forward to it, but hopefully the data is good. I have a whole ton I want to do after that. Pork with L-Carnitine because I've seen a drop in Lipoprotein(a) with beef. And then maybe some more fasting experiments. I want to get a cardio check, which is a home cholesterol meter and do some fasting with day to day or even hour by hour readings. Just lots of fun stuff.

And how long have you got to torture yourself with the high carb?

I think probably two or three weeks just to give it a fair amount.

I look forward to watching that one. What about you Dave?

Well, so there are two experiments. One that's the top secret experiment that Siobhan knows about, but I think it's less likely it'll be in the very near future. There's one that I would like to do that I may be able to pull off even within a week or two, of total time of the experiment - which is I'd like to do my baseline and then the intervention be the addition of insoluble fiber. So I'd like to see what that would do with my blood work. Obviously there's lots of speculation on that. But all of that said, I'm very reluctantly coming to grips with the fact that I am human, and that apparently I may need to de-emphasize my experimenting for a little while because there are some larger responsibilities that are coming onto the scientific front with some bigger players. And I guess I could...this may be the first podcast I mention this...I may have a book coming out in the near future.

How exciting.

Yes. My hope is it will be sometime late summer, or the fall. We'll see because me being me, I'm sure I'll be obsessively editing it a lot.

I know all about obsessive editing.

And I better be one of the first ones to get a signed copy.

Oh, I think you've got an in.

So perhaps you could leave us with a top tip.

I think for mine, it would be to pay really close attention to yourself. You know, if something is changing your behavior in a way that you're uncomfortable with, it might be something to think about. And unfortunately that does include coffee for some people, not everyone, but also food habits. People, just try and pay attention to yourself and see what sort of impact things in your life are having, because you never know what sort of impact removing it could have. How about you Dave?

I'm going to extend my invitation that I gave at the talk today, which is that I really want anybody listening who likes the work we're doing to consider being one more contributor. Don't underestimate your contribution to also be a citizen scientist, because as I said in the room, every one of us is. Every one of us are conducting an N of 1 experiment and we actually are pretty interested in how the outcome of that experiment goes. Well you may learn something quite valuable that can help you out, but why not go ahead and help out everybody else as well.

Good point. And where do we need to go to do that?

Cholesterolcode.com is of course the site we manage and we put up a lot of our materials there. We do also invite people to come to the Cholesterol Code Facebook group -a lot of people are networking there. And of course for those who are Lean Mass Hyper Responder - having LDL of 200 or more; HDL of 80 or more; Triglycerides of 70 or less or thereabouts - may want to strongly consider a special Facebook group we have for Lean Mass Hyper Responders.

Fantastic. Thank you very much for sharing your time with me. It's been a great pleasure, especially to do it with you here in the same room, face to face, and to have shared this wonderful conference with you both. As well as CarnivoryCon of course, which was amazing, wasn't it?

Yes, it was. Thank you for having us.

Yeah, wonderful. Thank you.

Thank you.