This week we revisit a great episode of Solving Healthcare with Dr. Laura Buchanan and Dr. Matt Calkins. We jump into the world of metabolic health, particularly using a low-carb ketogenic diet as a potent tool for countering metabolic disorders like type 2 diabetes and obesity. We also explore Laura and Matt's personal journeys and experiences as they advocate for and uncover the potential of low-carb ketogenic strategies in promoting metabolic well-being. Throughout the conversation, we shine a light on their accomplishments, their obstacles, and their dedicated efforts to educate and inspire their peers within the medical community.
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Speaker 1 (00:00):
The views expressed in the following program are those of
the participants and do not necessarily reflect the views of
Saga nine sixty am or its management.
Speaker 2 (00:11):
Turned my music. Ha ha ha, sure I do. I'm
from the streets where the fuck procrastination. Welcome back Solving
Healthcare Rady Yo with doctor Kay. It's been great a
couple of weeks here covering a lot of wicked content,
(00:32):
and today we are going back and talking low carb
keto with two doctors, young doctors, doctor Lord Buchanan and
doctor Matt Culkins. They are in Salem, Massachusetts, and what
they're doing is changing the boogie, folks. They're changing that boogie.
What makes me so excited about what these guys are
(00:54):
doing is they are reversing people's type two diabetes. They
are putting it into remission through low carbon ketogenic approaches,
and they are an inspiration and teaching young docs to
do the same. Like often you're hearing some more isolation
(01:15):
isolated docs doing these things, like doctor Trow, doctor Jason Fong,
older docs. But this is the first time we're talking
about new physicians. They just finished their training. You're here.
They also have a new baby, James. You'll hear him
throughout the podcast, a little six week old, beautiful boy.
(01:35):
What got me excited to talk with these guys is
that it's the next generation. And if they're seeing what
we're talking about, the lack of talking about root cause,
the lack of talking about nutrition as a tool to
be able to reverse these conditions, then there's hope, folks.
There's hope for a broader future, and we will get
(01:59):
there with the helps of with the help of these folks.
And this is what gets me super stoked, super excited,
And yeah, I really, I really think this is something
to highlight before jumping into this week's episode. I got
a chance to comment earlier about ozembic on the news
(02:21):
recently about the complication of delayed gastric emptying, and I
think it would be worth to highlight what that looks
like from an ICU perspective or an ICU doc perspective. So,
what you've seen on the news is a lot of
aniseesiologists when they're seeing their patients for their operation, their
their stomach is full, and sometimes what happens is you
(02:42):
asp it, meaning contents in your stomach going to your lungs,
and that happens during an operation, you would not be
able to complete the operation. Potentially you might not get
enough oxygen your system, needing to go on a respirator
for a longer period time landing in ICU, and that
could be serious. And I think it's an important point
(03:06):
to raise that this is another concern of taking a
medication like those epic and highlights that there's not a
one or a single medication one person can take that
will solve all the problems, Like there isn't a magic pill.
There are consequences and risks that you have to think about.
(03:27):
And with that complication, there are things you could do.
We could have an extended fasting period, you could give
medications that might cause the stomach to empty, you might
come awful zempic as an example, prior to your operation.
But I do think it's another thing to think about
when we're talking about these medications. And this is why
(03:48):
we highly encourage folks to not only if you are
taking the med but continue to work on lifestyle modifications
so that you have a more sustained impact, a more
sustained change in your life. Because you come off ozempic,
you're going to gain that weight you're on ozembic. You're
(04:09):
losing muscle mask because just your intake has diminished, so
that not only are you losing fabri, you're also losing muscle.
So all these things I think you want to try
and mitigate, but also create an environment where you will
be able to sustain if the weight loss impacts life long.
(04:29):
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reboot dot CO. I am excited because this might be
the youngest group of docs that we've had on the
show now that I think about this, and this really
excites me because it points towards an optimistic future when
it comes to metabolic health. We got doctor Lord Buchanan
and doctor Matt Calkins in the mix. Welcome on the show.
Speaker 3 (06:56):
Thanks for having its great to be here.
Speaker 2 (06:59):
And we got little James. He's not in the you
can't see him in the picture right now, but they
have a six week old which always warms my heart
as a dad of three three boys. You guys got
you got some work to do, you know what I mean,
a few years down the road. But I'm really I
just want to say out of the gate, I'm really
proud of you guys for taking on this idea of
(07:22):
reversing metabolic disease, reversing type two diabetes. And it takes some, honestly,
some courage because there's a lot of opposition or resilience
and resilience needed to to to take that on. So
number one, I want to commend you, but maybe we'll
start start with Laura, like what got you into this space?
(07:43):
Like what what made you curious about? What made you
want to learn more about it?
Speaker 4 (07:48):
Yeah, so make a long story a little bit shorter.
And during medical school, I we had our two week
nutrition elective, basically their curriculum that, unfortunately, I think, like
a lot of medical school nutrition curriculums, leaves you with
not much to take away as far as how can
I practically help my patients? And so I started During it,
(08:12):
you were taught some things about oh, saturated, that's going
to kill you, some old kind of standard dogua in
addition to the classic vitamin deficiencies. So I started reading
a ton of just doing a lot of research on
my own. Being A title is his big fat Surprise,
Jason Bunes, The Obesity Code, Gary Tops.
Speaker 3 (08:30):
I mean just kept going.
Speaker 4 (08:31):
Then started Withsting Low Carbon D podcast and was really
angered almost by just feling like we were being told
a lot of partial truths. And from there I got
a continuous glucose monitor in the fourth year of medical school,
and that really opened my eyes. I love the story
(08:51):
Matt and I were eating these healthy oatmeal cookies, low sugar,
high fiber, skyrocketing, and my sugar plosted two hundred and
I've been doing that every day for over a year.
Speaker 3 (09:01):
Yeah, terrible, And so my eyes were opened.
Speaker 4 (09:05):
And as soon as residency started, I was practicing low
card for my patients and we both have been low
card since then.
Speaker 2 (09:14):
Amazing, amazing. What about and what about you, Matt, Like,
how did you come into this landscape.
Speaker 5 (09:20):
Relatively the same thing as Laura. We met in medical school,
so we really shared the same interest in metavalk health.
For me, there's a in medical school they teach you
that all metabal diseases are chronic and progressive diabetes, obesity.
You're going to be on medications, you're going to increase
the medications, You're going to have it the rest of
(09:41):
your life, and you're eventually going to get the end
organ complications from that, whether that be the amputations.
Speaker 3 (09:46):
Or the dialysis.
Speaker 5 (09:47):
And it's really hard to be motivated to want to
to basically take care of the metaval health of a
patient in such way. I actually decided to go into
emergency medicine. Is at emergency medicine is a fantastic specialty,
and as a medical student, you can't not love it
because you do all the exciting fun things. And then
(10:07):
as a resident, I was an resident and intern, and
I realized that that's not where I wanted to be.
I felt so far downstream pulling people out of the stream,
and you could be one hundred miles up the stream
telling people not to jump in. So I made the
switch to actually family medicine because I realized that what
(10:28):
we were told in medical school, it's kind of the
lazy way out. If you use medicine. If you use
if that's the only tool in your toolkit. These diseases
are chronic and progressive. However, if you can help patients
realize what they need to do is to improve their lifestyle.
We both use low carb ketogenic diets, then it is
(10:50):
not a chronic, progressive disease. You put these diseases into remission.
People do it every single day. They get off of
their medications. They don't ever have the complications. The last
twenty four hour shift I was in the hospital and residency,
I had to admit a patient at two am with
an advertizing fasciatis from a diabetic footloud and that is
something that I never want to have happen for anybody else.
Speaker 2 (11:10):
Ever.
Speaker 5 (11:10):
Again, that's my vision in life is too is to
shut down every pedetary OAR except for.
Speaker 3 (11:16):
Bunyans in the country, Like there should.
Speaker 5 (11:18):
Never there should never be a pedietary emergency operating room
procedure at two o'clock in the morning.
Speaker 2 (11:27):
Oh man, you speaking my language? Like I love the
perspective of being emerged doucins and and seeing the end
stage of all these conditions. It's similar. I mean, it's
kind of a similar story for me with the from
the nice perspective. Yeah, by the time we see them,
it's it's too late. And trying to educate folks on
(11:50):
how they can avoid seeing someone in the emerge or
seeing someone like myself in the intensive care unit is
absolutely empowering. And I'm curious in terms of well, I'll
go to a Laura here, when it came to being
in residency and applying the low carb ketogenic approach to
(12:12):
your patients, was it was it well received? How did
what was the opposition like with your preceptors, because obviously
you have to run and buy them right, So what
was that experience Like, Yeah.
Speaker 4 (12:24):
So I'll do both kind of the hospital setting and
then also the clinic setting. So in the clinic setting,
initially there was definitely some pushback. I would get fasting
insulin labs sometimes see peptides.
Speaker 3 (12:36):
If I had.
Speaker 4 (12:37):
Someone on insulin, I wanted to make sure save for
them to ty trate completely off. And I would get
pushed back saying, why you were in these labs, this
isn't standard of care. And I would explain my reasoning,
some of the background science behind it, and they would
actually be really interested and they wouldn't necessarily agree, but
they're like, Okay, you know you have good logic.
Speaker 3 (12:57):
Go for it.
Speaker 4 (12:58):
And so after I had several patients whose A one
seeds were above twelve thirteen, fourteen, and I would not
treat them with this sulne. I would treat them with
a keeogenic diet and they would actually in three six
months come back with A one seeds around six, around seven.
And when the preceptors would see those results, there is
no question. I mean at that point they were like, Wow,
(13:21):
this is incredible, How like how's this happening without medicine?
And so the more that I just spoke to people
and let them see the results rather than try to
argue just only with piers of paper about it. Here's
of paper about it. Just let them see it. I
starting less pushback. Same thing with calcium scans and kind
of explaining my logic about the benefit of knowing someone's
(13:42):
calcium score and helping further stratify them. Initially there was pushback,
but in the end people were all about it, and
in fact, people would start coming up and asking me, Hey,
do you think I should get a calcium score on
this person or do you think they could come off
with this medication because we're we want to do this
low carb diet. So it was really cool to see
that switch in the mindset of not everybody, but a
(14:04):
lot of people.
Speaker 2 (14:05):
We'll be right back on Solven Healthcare Radio with Doctor K.
You're listening with doctor Laura Buchanan, doctor Matt Culkins.
Speaker 6 (14:27):
Stream us live at SAGA nine sixty am dot.
Speaker 5 (14:30):
C A.
Speaker 2 (14:37):
Is to listen to Solven Healthcare Radio with Doctor K.
Just to explain for the calcium score, it's basically looking
at your risk of cardiobascular disease. And yeah, and so
(14:58):
I that a better experience than I would have anticipated.
Speaker 3 (15:02):
Laura.
Speaker 2 (15:02):
If I'm being honest, but I do think there's a
leadership lesson there for creating changes. You do it at
a micro level, and if you lean on action, it's
way more likely that you'll you'll see some change as
opposed to as shes as Laura mentioned, like just giving
them the paper. You know, there's only so many like
(15:23):
you could dissect through a paper and criticize it to
the ninth degree, and often that's enough, not enough to
create change. But if people are seeing it with their
own eyes, you're creating that change at a micro level.
That could be quite powerful. And Matt did you did
you have similar experience as well, like when it came
(15:44):
to implementing it into your practice.
Speaker 5 (15:47):
Minimal to not at all. I think that's one of
the most important takeaways from physicians, providers, allied health professionals
that are listening to this is that if you're going
or a fight for something you know is right for
your patients. In our case, it was the key to
JENK diet to improve metabolic health, which is not yet
widely adopted, even though there's a lot of emerging evidence.
(16:10):
The small battles that you fight and the small battles
that you win will make it that much more easier
for when the next person comes through in your footsteps.
So by the time Laura was a year ahead of
me in residency, she paved roads for a full year
before I got into failing medicine my intern here and
it was basically already done. I could order the insulins
(16:32):
so I could more easily counsel patients on their full
risk of metabal disease, and nobody ever, really, nobody bad
an I at that calcium scans for the full risk stratification.
I actually got a lot of our co residents to
do it now and there, because if you look at
the AHA guidelines in America, there's a large swap of
people you can get them on in order to help
(16:53):
them decide what.
Speaker 3 (16:54):
We need to do about their risks.
Speaker 5 (16:55):
So these are things that in the moment it's really hard,
and I'm not going to discount there have been a
lot of people who have been put through a lot
of hardships to do what they know is right. I
hope it's a consolation to those that are going through
that now that you're you're helping the next generation, which
is helping patients.
Speaker 2 (17:17):
Absolutely, Like I can't emphasize how exciting this is to
hear like this next generation of docs that are creating
that change, that see the light. I still I'm still curious,
Like what There's something in you? Right, There's something because
like say, in your class, Laura, was there anybody else
(17:37):
that was looking at low carbon keto and looking at root?
Cause was there any like did you feel like you
were an army of one or were you like, did
you like have like a battle cry world? A few
of your colleagues were like, yeah, let's do this.
Speaker 4 (17:51):
We had at least one other friend who he would
dive down all the rabbit holes with us, the into
the bottom of the research. You know, what is the
underlying path of physiology. And we love going toe shops
and just working for hours on this stuff with him.
I'll be a shout out Dustin Anderson if he listens
to this, shout.
Speaker 2 (18:12):
Out to da Dustin Anderson changing the boogie. We love
your big guy.
Speaker 3 (18:17):
Yes.
Speaker 2 (18:18):
No, Like I said, that's exciting to me because it's like,
if I were to be honest with you, like when
we started to make this show four years ago, now,
oh my god, this was kind of the you were
like the target audience. If I was being honest, like
the young up and coming docs that can that are
(18:39):
open to change, because I often I find like my
age or older, they're pretty resistant to change. But it's
powerful because your colleagues will see it, and now you're
impacting the lives of your patients. You're like, I'm sure
even your nurse colleagues that you see in clinic, their
eyes must be like wide open when you guys are
(19:01):
in the mix.
Speaker 4 (19:02):
Yeah, I mean when you have a patient come in
to see who's lost sixty pounds and then the nurse
obviously knows is that because they're checking their weights and
seeing them before and after, and then they asked me
about it, I'm like, oh yeah, they went keto. The
A one C also dropped six points and that is
really powerful and so the message does definitely spread that way,
(19:23):
which is great to see. The other thing that is
super exciting. So one of our other colleagues and good
friends who during residency was actually very passionate about this
stuff as well as got her a metabolic health practitioner
through the SMHP as well. She is now faculty and
she has actually with us created a metabolic health elective
(19:44):
for residents to take and the first residents are now
taking it this week actually, so that is incredibly exciting
and I think this is how things grow.
Speaker 2 (19:54):
That is incredible. So what does that elective look like?
Do you know? I'm doing it to put you on
the sport.
Speaker 4 (20:00):
So you spend a couple of days doing just lectures
that Matt has actually created.
Speaker 3 (20:05):
Some of those lectures a little bit on the.
Speaker 4 (20:07):
Dietary guidelines, how we got here, how some of the
research that shows red meat you know quote causes cancer,
the flaws and that research and analyze how to properly
analyze that research and epidemiology, logical studies. And then you
have you go work with the prevalent of cardiologist. You
go to the obesity medicine weight loss specialty clinic here
(20:30):
at our facility, and then you spend a little bit
time with her. She has her own personal kind of
weight loss clinics she'll do with patients for metabolic health
as well.
Speaker 3 (20:40):
And I think that's that's.
Speaker 4 (20:44):
So it's a little bit of asynchronous learning with the lectures,
a few point papers to read and analyze, and then
going through a few of those other clinics.
Speaker 5 (20:54):
Yeah, I think the beauty of the elective is that
you'll this is a low car ketogenic diet attending, but
you'll also rotate through with some of the physicians that
are that practice in some of the older models. But
I think the beauty of where we're at today in
twenty twenty three is that over the past five years,
(21:17):
the published data we have about ketogenic diets to reverse
or put into remission metabolic disease has exploded, and we've
never really been in this situation before. I think before
before let's say twenty fifteen, there wasn't really a lot
you could you could hang your hat on. But now
we have doctor Trow's pilot program, twelve patients. They improve
(21:38):
their A one C but I think it was one
point five points or two points and lost twelve kilograms.
Doctor David Unwin in the UK and all comers type
of clinic in the NHS system, if you live in
the footprint of a GP practice, you have to go
to that practice. Forty percent of his patients with type
two diabetes said yes, and of those that had diabetes
(21:59):
for less than a year, he'd put I believe it
was seventy to eighty percent into remission just from them
saying yes and going.
Speaker 2 (22:06):
On a keto diet.
Speaker 5 (22:07):
You have the Verta Health two year data. And then
we also had the awesome opportunity to rotate through doctor
Eric Westman's clinic that's the Duke Duke Keto Medicine. And
he always says at every at the end of every
single one of his talks, he's like, if you want
to come see how I do it, all you got
to do is ask, and I implore people to when
(22:27):
you hear this, take them up. We both rotated through
with him for a week in residency during one of
our electives, and it was it was an amazing experience.
Speaker 3 (22:35):
And I just got it.
Speaker 4 (22:36):
I have to his data. So I took notes on
all of the patients. We saw thirty five return patients.
There was thirteen hundred pounds of weight loss, one hundred
and fifty inches off of waste circumference, and thirteen medications
were stopped. And this age range was thirty five to
seventy eight years old.
Speaker 2 (22:54):
Wow. Yeah, Wow, it's a good point. You make mat
about the data, the data. More and more data coming
through that gives it gives it teeth, as you know,
that's obviously the first level of of of of data
(23:14):
people want to see it's like studies to be able
to create some change, but I often say it's not enough,
you know the the in terms of trying to create changes,
as we talked about earlier. So I'm curious from your perspective,
like you're your involvement with H I always get the
acronymic h M s P s M yeah, m hm
(23:40):
hm HP is like it sounds like you're you're you're
doing some special things. So like, what what is what
are some of the things that you're doing with H
oh my god, s M HP.
Speaker 5 (23:52):
Yeah. I'm the chair of the Resources Committee for the SMHP.
This was a professional organization founded in twenty ninety that
seeks to promote evidence based medicine regarding a low card
ketogenic diet. And we have basically an accreditation where you
can get a meta BALK, you can be a MEDVALK
health practitioner. We have physicians as members pas, MPs, any
(24:15):
health coaches, Allied Health Professionals rgis. Everybody who's interested can
be a member on the Resources Committee. My goal is
to do essentially what Laura did for me.
Speaker 2 (24:27):
I want to.
Speaker 5 (24:28):
Create resources for one provider to take to their clinics
and say this is what I want to do, and
I want to give them other resources to easily implement
using low card ketogenic diet. So currently we have a
sample of a low carb ketogenic diet page that's based
on Eric Westman's famous Page four. Basically, it's a one
(24:50):
sheet handout that can have everything that a patient can
eat unlimited amounts of or certain amounts they have to
reduce or medicate our foods that they should stay away from,
like by carb foods that they're doing a low carb diet.
I have other handouts on there that basically has the
data we just talked about that if it can be
a conversation starter with the administrators of a clinic. Two
(25:12):
things we're working on probably the two biggest projects at
the moment. We're looking to get accm accredited, which just
means we would be able to offer AMA American Medical
Association Category one credits for CMME continuing medical education, which
would be huge Because we now have low Carb FOCA
affiliated with the SMHP, we have Low Carb San Diego
(25:34):
which is starting here in a few weeks, and we
also have a new journal, so we have the Journal
of metabolc Health and this is a journal where people
can submit case reports, case series, bench research, clinical research,
anything that has to do with metabolc health. And you
can help disseminate evidence based medicine to the world. And
(25:54):
this is a low carb patogenic friendly paper. So the
addition of CEM the end of that is also incredibly helpful.
The last thing we're trying to do is create kind
of like what they had at our residency. Just created
a nutrition curriculum that if you are a medical student
or a resident, you can sign up to take a
two or four week asynchronous nutrition curriculum where you learn
(26:18):
about a low carbon ketogenic diet. Is to supplement whatever
they learn in.
Speaker 3 (26:23):
Or whatever they don't learn in medical school or residency.
Speaker 2 (26:25):
We'll be right back on solving healthcare Radium with doctor
k You're listening with doctor Laura Buchanan and doctor Matt Culkins.
Speaker 1 (26:32):
Out of the Night into the WATA. We pushed the
boat from sure breaking and the stillness of the No Radio,
No Problem stream is live on Sagay ninety sixty am
(26:53):
dot C a.
Speaker 2 (26:56):
R named Jewels Fast one and one named Jewels Fast
One Slow Move. We are back on SOLFI and healthcare radio.
What a great way of providing people with the resources
to make informed decisions, because yeah, I mean clearly this
(27:17):
is what people need. And and I'm curious, along with
the diabetes reversals, do you guys get into a little
bit about like the low cop keto with other medical conditions,
Like I don't know if you guys have been interested
in Chris Palmer's work and and so on, so I'm
(27:40):
curious to hear where your heads are at with that.
Speaker 4 (27:41):
Yeah that I love Chris Palmer's work, his book Brain Energy,
Highly recommend everyone read it the results. A lot of
the time when I see patients and clinic, we are
focusing maybe other diabetes or maybe they're coming to see
me for weight loss. But what is amazing and happens
so commonly is they tell me, oh, I stopped my
(28:04):
reflux medication. I have one patient who got off of
nine medications for maybe four different medical conditions, and that
was all through the keithogenic diet. So that was one
intervention off of nine medications. And I have patients still
me my anxiety has never been better, their depression symptoms
are improving. So that's kind of on Chris Palmer. The
mental health benefits that we see from lifestyle changes and
(28:27):
from the ketogenic diet specifically. And I haven't specifically worked
with patients who had schizophrenia or bipolar in this area,
but the data. They published a paper on thirty one
individuals who had refractory mental illness to from schizo effective
disorder bipore major depression and were hospitalized, and their results
(28:52):
were staggering. Oh I'm going to forget the statistics, but
the number of individuals who go off of medications and
then actually went from it's the global severity Index. Yeah,
global severity index that went from very severe to.
Speaker 3 (29:10):
None was huge.
Speaker 5 (29:12):
Complete remission.
Speaker 4 (29:13):
Yeah. And so that so not only are we seeing
complete remission of diabetes, high blood pressure, reflux so good,
we are seeing refractory mental illnesses meaning they've been on
numerous medications and it failed and are hospitalized because of
it getting going into remission.
Speaker 3 (29:30):
And that is incredible.
Speaker 2 (29:31):
One hundred percent. That to me is Yeah. I got
to see Chris Palmer speak at well Carved Denver about
the impact of mental health in terms of going to
ketogenic diets, and that was, for lack of a better word, enlightening.
And it makes sense like you know, like when you
(29:52):
think of information, uh being a driver of many diseases,
no reason to think that same information that we're seeing
impatience is not happening in their in their in their brain.
And and so it's and it's just pretty it's powerful
to think of what you eat or how you eat
(30:14):
can impact impact your your health to that level. And
I mean it's a motherly statement. Like a lot of
our I don't know parents, grandparents would probably say, clearly,
you got to think about what you eat. But it's
not something we we talk about at all in medicine.
Like I was surprised you got two weeks of like
(30:35):
for us, I think it was a day or two hours.
It's two hour lecture nutrition. Yeah, yeah, No, it's interesting.
Speaker 5 (30:43):
I think the I think the tide is slowly turning.
The medical schools and residencies know now how important nutrition
is for metaball health. It's just a little bit misguided,
uh in terms of how they go about teaching it.
For everything that they key to genic diet basically improves
or ameliorates. Eric Westman says it best at almost in
(31:06):
every single one of his talks. He says it's so unbelievable.
It's unbelievable. And that's kind of when you start talking
to people about, hey, we can reverse or put these
diet like diabetes into remission. Oh and by the way,
there's new data that shows that it helps with mental owns.
But by the way, there's a case series that shows
that actually helps with anorexia.
Speaker 3 (31:23):
And believe in RVOSA.
Speaker 5 (31:25):
I actually was talking to somebody in an attending workroom
about the kogenic diet and somebody not in the conversation
turned to me and said, I was I was harming
patients by recommending the ketogenic diet they were going to
have eating disorders, and there has never been any data
for that. I just think there's for how much good
(31:46):
data we're having now, there's still this massive amount of
inertia in medicine at large too. At least not allow
other providers to offer this. In my opinion, everybody should
say should have the opportunity to say no to a
kid Jack did, at least yearly if they have any
sort of underlying mental health or metabolic disorder that could
(32:07):
be improved by it.
Speaker 2 (32:09):
Man informed decision, what's a showed decision making informed decision
like I want to cuss there for a second, but
I don't want to cuss in front of James here.
But like, it actually pisses me off if I'm being frank,
that we have so much bullheadedness in our profession, Like
(32:30):
I like, I saw a lot of it during the pandemic.
Like I mean, I don't know if you know mus story,
but this wasn't on my radar at all. I didn't look.
You know, I did a little bit of fasting for myself.
But then when I saw the amount of metabolic disease
for COVID patients as an icy you talk like literally
(32:52):
I did. And I say this in every talk I
give about metabolic health to this day. I've yet to
take care of a healthy person, like a completely healthy person.
They could have been pre diabetic and people will say,
like there were no medications, yeah, but you know what
they were the b and I was thirty five, like
it was. There was still there's risks there. And even
(33:14):
our patients that were in their twenties, most of them
were approaching if not more than three hundred pounds. That
I doubt that you know that we that we saw.
So I think the amount of resistance to change in
our profession, frankly just gets me, like it upsets me.
(33:35):
And I once again commend you guys for for taking
this on because it's it's not easy. Like if it's
not easy when you're at times going to be the
lone wolf talking about many of these issues. But getting
back to that point though about shared decision making a
it's that's always the out for young docs or nurse
(33:57):
practitioners whoever. If you say to your patient and you know,
this is what I know about ketogenic diets, this is
what other options are in terms of the medications are
starting you on insulin, but this would be my recommendation.
These are the risks, these are the benefits. How do
you feel about that? And adding and if they're willing
(34:20):
to take the quote unquote risk of going on a
ketogenic diet for whatever reason and they're competent, well you're covered,
like as long as you're clearly articulating what the pros
and the cons are and and so I know there's
a lot of resistance amongst young docs, like when you're
dealing with your supervisors and stuff, but I'm telling you,
(34:44):
as a seasoned doc, like this is the approach. If
you think that something is remotely controversial. You're just upfront
with the patients and you have that shared model for
making a decision. But yeah, I sorry for the rant,
but it's a trigger for me.
Speaker 3 (35:03):
It's such a good point.
Speaker 4 (35:03):
And I, you know, I was the clinic experience had
of going back a bit was amazing and after just
pushing through a little bit of walls, it was great.
In the hospital, unfortunately it's not the same and maybe
that's because of Oh I guess. I think there's many
factors that play there, but there is one particular instance
(35:24):
that just stands out, and I think this is we
need to fight for our patients, and sometimes you won't
win the fight, but at least you can try. And
we had I was working on the pediatric floor. We
had a twelve year old admitted with new type two
diabetes with an allecy of twelve. And in the morning
we had to give him a lot of extra insulin
following breakfast because the sugars were sky high after already
(35:47):
giving him a large amount of insulin overnight, and it
was because he had pancakes and syrup for breakfast, and
so I during rounds, I asked my attending I said, hey,
can we put him on a low carb diet?
Speaker 3 (36:01):
Dam Bain's no.
Speaker 2 (36:06):
Welcome on the show, thank you.
Speaker 4 (36:08):
So so I asked for you put him on a
low carb diet and the attending was like, are you
trying to kill him? I cause a heart attack? And
I looked at it and like, no, his sugars are
really high and we're having these a lot of extra insulin,
so we wouldn't have to do that if we put
on low carb. And then I, you know, I said,
I think actually the data doesn't support that the low
carb diet is actually going to cause a heart attack.
(36:31):
And he said, well, what are you going to give him,
because I don't want to give him back. It's like, well,
we can do higher protein then, and the attending said,
so you're going to kill his kidneys, and I just
I was very respectful and kind of talked. I was like,
I'd actually think the data supports that in people who
are perfectly healthy kidneys, high protein is actually going to
cause me harm. And we went back and forth a
little bit. The rest of the room with the other
(36:51):
residents and the fellow's dead silent. It was, you know,
kind of awkward. Little in turned me and the attending
going back and forth. Unfortunately, the attendee one and the
kid got all the cards he wanted and lots of
insulin for the rest of hospitalization. But I think if
you should still fight for your patients, and maybe at
some point, maybe I put a little something in the
(37:14):
back of his head that made him start second guessing
or thinking about things another way.
Speaker 2 (37:19):
Absolutely, next time the mats of the world grew that
rotation and said the exact same thing. Then as he's
starting to realize, like, yeah, you're being foolish and closed
minded and not rational, I I, yeah, it just makes
me want to Yeah, that would be that would be infuriating.
(37:45):
Any other kind of myths that you often have to
address when it comes to low carb or keto like
definitely the I mean, as you mentioned the kind of
the worry about about fats. I don't hear too much
about the protein side, but I'm just wondering, is there common,
uh misconceptions that you often have to address.
Speaker 4 (38:08):
I get asked about kidney stones quite a bit and
then gout the data. I mean, in the burn of
health to your study, there is no kids cases of
kidney stones or gut flares, even in individuals who had
gout previously. I personally have had many patients who have
had history of kidney stones as well as gout who
have never had any issues once they go on a
ketogenic diet. I do monitor, you know, uric acid levels
(38:32):
and just monitor a little bit more closely, but I
have not had issues there.
Speaker 3 (38:38):
I think.
Speaker 5 (38:39):
I think one of the most egregious is the belief
that people will go into keto acidosis from a ketogenic
diet unless you have some profoundly underlying issue or you
get acutely ill with like a gastronritis. I think it
just shows a severe lack of the underlying knowledge from
the physiology of of what a ketogen that does. Ketosis
(39:01):
is completely normal and natural for a perfectly metabolically healthy person,
especially overnight. You can measure key tones in the morning
and they could and should be zero point three to
zero point five on a fingerstick. So it's something that
people go into every night. But I think a lot
of the concerns about the kit deject diet just comes
(39:22):
from a place of inertia from like the seventies and eighties,
and then largely ignorance nowadays, because, like I said, with
the new data we have, we're truly an evidence based
society of medicine. Then people should be reading this data
and they should be realizing, Hey, the adverse events in
the VERDA health study are low, and people are getting
(39:44):
off of their insulin and doctor Trow's program An Unwin
and Eric Westman is publishing all of these randomized control
trials about low carb versus other dietary patterns, and low
CARB's doing great. But I mean, it's been out there
for five years now, and it takes about on average
ten years for us and to change, so we just
need to keep plugging a way.
Speaker 3 (40:03):
Yeah, I'm sorry.
Speaker 4 (40:05):
One more is the red meat causing cancer because people
go keto and you get all this red meat and
the data on that. I don't know if you've gone
into the epidemialogic studies before, but basically, if you look
at food frequency questionnaires and they give one of you
eat in the past year basically, and I've taken.
Speaker 3 (40:23):
One of these before.
Speaker 4 (40:23):
It took me forty five minutes, and it's comical to
go through and maybe you get three of those over
the course of a decade, so you have three time points,
and then it's like, how many hamburger patties have you eat?
And what they don't figure out is how many when
you eat those hamburger patties. Are you having a large
fry a milkshake, are you having the buns? Or am
(40:44):
I at home cooking for myself eating a hamburger patty
that I made with maybe some broccoli on side, or
maybe I just had three hamburger patties and nothing else.
So they don't control for any of that. And then
the actual absolute numbers, even if you trusted the data,
are tiny, and so it's really unfortunate that that is
(41:04):
such a large concern and propagated by a lot of
organizations still and even the WHO who warns about process
needs and Redney Company cancer being a potential persinagion.
Speaker 2 (41:18):
We'll be right back on Solven Healthcare Radio with doctor k.
You're listening with doctor Lord Buchanan, Doctor Matt Culkins. You
must better do your job and grown up there would
sell me grown up? Then I take that's told the
thing hopefully it's so nuts.
Speaker 4 (41:32):
I take the sip for that.
Speaker 2 (41:33):
Yet I want to be I take the hit of
that that stuff.
Speaker 1 (41:37):
We really what's the stream us life?
Speaker 6 (41:40):
At Saga nine sixty am dot c as.
Speaker 2 (41:49):
Yah. I'll feel with Israel lies wrapped the bout against
God by you listen to Solven Healthcare Radio with Doctor King. Yeah,
I must say at a personal level, I agree with
you in terms of the study analysis, those like those
aren't like when you have to go through memory and
the association of typical foods that they might have on
(42:10):
top of that, like it does not put it this
way for those listening. I still eat my red meat
in abundance.
Speaker 5 (42:19):
Yeah.
Speaker 2 (42:19):
They had who Ribby stakes yesterday, yo, and I got
some for lunch today, just a little bit of leftover.
I'm gonna hit that up and I and it's just
something that to me. You also got to think of
the benefits too, Like, I don't know if you guys
have had any any change in heart or thoughts about
protein intake. There's been a bit of a movement and
(42:42):
whether you were low carb or not like it in
terms of how important protein intake is. And I must say,
over the last I don't know, twelve to eighteen months
putting this on my radar, I've definitely amped up my
protein intake. I feel like this is an excellent hack
for folks to optimize their health.
Speaker 3 (43:03):
Yeah, I'm right there with you.
Speaker 5 (43:04):
Yeah, I h the I think the two things we
don't do a great job talking about in medicine in
terms of disease states would be one cyclopedia and two
social isolation. Social isolation is this whole other concept that
as you get older it's just harder to connect with people,
and then you basically you don't have a lot of
interaction with other people. But sarcopenia is I.
Speaker 2 (43:26):
Think muscle loss by the way for Golden English, So yeah.
Speaker 5 (43:30):
And it can be associated with diseases like you could
have like COPD and things like that, or you could
just have muscle wasting as you get older. And if
you're living into your seventies and you don't have the
muscles to do what you want to do, that is
that is a large that is a large burden on
somebody in my opinion.
Speaker 2 (43:50):
So I'm the same way.
Speaker 5 (43:52):
I actually started increasing substantially my protein intake about the
same time you did, and I put on actually a
couple extra pounds of muscle and started lifting heavier in
the gym too, And I've never felt better. And I
think that extra bit of muscle you can put on
when you're able to do it because everybody gets injuries
and you're going to be on vacation and there are
you know, you can't always do what you want to
(44:13):
do in terms of sustaining your metal health. The muscle
that you can build, when you can build it can
sustain you through those times when you can.
Speaker 2 (44:22):
M Yeah, to me, it was a big hot We
had ten naming on the show. You was talking about
is protein to energy expenditure ratio PE ratio, And it
was just one of these. The whole time I'm hearing
them talking, I'm like, this makes way too much sense.
Like the idea of definitely the muscle genesis, like the
(44:46):
maintaining muscle or increasing muscle mass, which even as from
a diabetes perspective, great sulker of glucose, great way of
managing insulin sensitivity. But then talk about the satiation like
being fuller, talking about you're less likely to go towards
(45:07):
crappy foods when you're fuller. It just weighed wagh too
much sense And and for me, yeah, similar thing. I
put on about maybe two three pounds since really ampened
up my protein. So I go, well, all us so
like zero point seven to one, what am I saying
(45:28):
grand per pound where I at least where I go
for and I, yeah, I love it. I love it
and sometimes I won't lie though it is sometimes challenging
to go to meet your requirements, like I have to
to have to add a shake or a bar. But yeah,
I I've never felt better since since implementing that.
Speaker 5 (45:52):
I really at the end of the day. I think
that's that brings up one of the other great points
is that dietary chain are an iterative process.
Speaker 3 (46:01):
So just because you had a study that showed that.
Speaker 5 (46:05):
There was no improvement in the outcomes after a dietary intervention,
so one of my least our most frustrating comments and
least helpful comments in medicine is, well after five years,
everybody's the same anyways, Like when you do dietary studies,
that's not a problem of the diet, it's the problem
of the intervention, and you have to figure out how
(46:27):
to deliver interventions. How are you going to tweak that
diet to get it more sustainable?
Speaker 2 (46:31):
You got it?
Speaker 5 (46:31):
Do you increase the protein to one point five grams
per kilogram? Do you have the closer follow up? Like
with doctor Trow, they have the health coaches. The touch
points are immense continuous glucose monitors as well for you
gives you any diets you can basically like having a
health coach in your pocket. Actually you can eat something
on a low carb diet pattern and know immediately whether
(46:53):
that meal fit in your dietary pattern and you can
use that for the next meal. So the find that
protein is higher protein can be helpful is I think
it's an amazing breakthrough. Like if people if I had
a crystal ball and if somebody is going to eat
higher protein and that's going to keep them from gaining
(47:14):
the weight, which is going to keep them from diabetes,
which is going to keep them from the footing amputation,
I'm on board. There are so many eating patterns that
are completely like reasonable that if that can be prevented,
so iterative process. We're getting better at this all every
single day, and it's all about tweaking the intervention to
(47:34):
the patient.
Speaker 4 (47:35):
And I think something that is so awesome about what
Troe has created is helping or is addressing, really food addiction,
because that is another thing that's just not discussed or
talked about, and as you Matt mentioned, it's a problem
in the intervention. Not a problem that the patients aren't
being able to follow the advice. It's the advice is
(47:56):
either wrong or it's you're just not good enough. So
eat less movement or a perfect example doesn't hardly help anybody.
But with Tron, what he's created with having our wonderful
health coaches, the front desk, get the touch points, an
app where you can have asynchronist learning, a community where
you can have a chat that people all the time
are talking and get help now, so people can put
(48:19):
in to get help now chat and immediately twenty people
or more might respond and say.
Speaker 3 (48:24):
What did you do in this scenario?
Speaker 4 (48:27):
Because it is life, a lot of stress and things
just happen, and it's when things are really stressful or
when stuff just hits the fan, that's oftentimes when people
end up just swinging through the drive through or going
to get that ice cream that makes you feel better,
give the dopamine rush from the unhealthy food. So it's
being able to help and intervene at that really stressful point.
(48:50):
I think that is so critical and what hopefully we
can get more and more clinics and more providers and
people doing to try to help patients from ever going
way far off track.
Speaker 2 (49:00):
It's the psychological opponent is way underrated, Like we don't
I don't think we draw enough attention to it. And
then it's once again you're not really diving into it
in medical school. But it's it's a huge aspect of
overeating and I think having that support system and having
(49:22):
the tools as as when doctor Troll was on on
the show talking about alternative alternative options for when you
want that, whether chips or what have you, like, it's
so so good, like it's it's it really is where
we where we need to go. This has been awesome,
(49:45):
Lauren Matt. I really am excited about the future when
I hear you guys, and I hear your passion and
hear about your involvement with s m HP A and
really trying to be leaders and I mean I shouldn't
even say that you are leaders, that's where you are, uh,
(50:07):
And so I just really want to commend you for
all the work you guys have been doing. If people
want to learn more about any of your initiatives, s
m HP, how do how do people how do people
hit hit you up?
Speaker 5 (50:20):
Yeah?
Speaker 4 (50:20):
So people can just go to the s m hp
dot org. Uh to go to that website and access
to a ton of great free resources. And then I'm
on Twitter and Instagram, although with James I can't take
a step back, but at large you can m D.
And then we have a substack called Aging successfully dot
substack dot.
Speaker 5 (50:40):
Com and I'm on Twitter at Matt Calkins MD as well,
though I've also taken a smitch of a step back
during my parental lead.
Speaker 2 (50:48):
Amazing, amazing, great work you guys, and thank you so much.
Speaker 4 (50:52):
And one other if you just go to doctor trou
dot com that way, if you've got any interest in
what we have to offer as well, so.
Speaker 2 (51:02):
Good, Thank you so much you guys. This is a
lot of fun. Thank you for what you do well.
I hope you guys enjoyed that episode with doctor Laura
U Cannon and doctor Matt Culkins. You heard where you
could hit them up. We are super proud of these guys.
I want to thank our sponsors Betterhelp dot com, largest
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(51:23):
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(51:44):
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(52:05):
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(52:27):
at quadcasts. Can leave any comments at Quadcast nine nine
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We constantly want to improve on the show's content. Don't
be shy. This was Luscious Solve It Healthcare Radio with
Doctor k Peace. I remember seeing you when spaghetti strap
it snapsack hel stop by your own fact.
Speaker 5 (52:46):
When I seen it, I was like, damn girl, so
you have a.
Speaker 1 (52:49):
Man, buddy, No radio, no problem. Stream is live on
Saga ninety sixty am dot CA.
The views expressed in the following program are those of
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Speaker 2 (00:11):
Turned my music. Ha ha ha, sure I do. I'm
from the streets where the fuck procrastination. Welcome back Solving
Healthcare Rady Yo with doctor Kay. It's been great a
couple of weeks here covering a lot of wicked content,
(00:32):
and today we are going back and talking low carb
keto with two doctors, young doctors, doctor Lord Buchanan and
doctor Matt Culkins. They are in Salem, Massachusetts, and what
they're doing is changing the boogie, folks. They're changing that boogie.
What makes me so excited about what these guys are
(00:54):
doing is they are reversing people's type two diabetes. They
are putting it into remission through low carbon ketogenic approaches,
and they are an inspiration and teaching young docs to
do the same. Like often you're hearing some more isolation
(01:15):
isolated docs doing these things, like doctor Trow, doctor Jason Fong,
older docs. But this is the first time we're talking
about new physicians. They just finished their training. You're here.
They also have a new baby, James. You'll hear him
throughout the podcast, a little six week old, beautiful boy.
(01:35):
What got me excited to talk with these guys is
that it's the next generation. And if they're seeing what
we're talking about, the lack of talking about root cause,
the lack of talking about nutrition as a tool to
be able to reverse these conditions, then there's hope, folks.
There's hope for a broader future, and we will get
(01:59):
there with the helps of with the help of these folks.
And this is what gets me super stoked, super excited,
And yeah, I really, I really think this is something
to highlight before jumping into this week's episode. I got
a chance to comment earlier about ozembic on the news
(02:21):
recently about the complication of delayed gastric emptying, and I
think it would be worth to highlight what that looks
like from an ICU perspective or an ICU doc perspective. So,
what you've seen on the news is a lot of
aniseesiologists when they're seeing their patients for their operation, their
their stomach is full, and sometimes what happens is you
(02:42):
asp it, meaning contents in your stomach going to your lungs,
and that happens during an operation, you would not be
able to complete the operation. Potentially you might not get
enough oxygen your system, needing to go on a respirator
for a longer period time landing in ICU, and that
could be serious. And I think it's an important point
(03:06):
to raise that this is another concern of taking a
medication like those epic and highlights that there's not a
one or a single medication one person can take that
will solve all the problems, Like there isn't a magic pill.
There are consequences and risks that you have to think about.
(03:27):
And with that complication, there are things you could do.
We could have an extended fasting period, you could give
medications that might cause the stomach to empty, you might
come awful zempic as an example, prior to your operation.
But I do think it's another thing to think about
when we're talking about these medications. And this is why
(03:48):
we highly encourage folks to not only if you are
taking the med but continue to work on lifestyle modifications
so that you have a more sustained impact, a more
sustained change in your life. Because you come off ozempic,
you're going to gain that weight you're on ozembic. You're
(04:09):
losing muscle mask because just your intake has diminished, so
that not only are you losing fabri, you're also losing muscle.
So all these things I think you want to try
and mitigate, but also create an environment where you will
be able to sustain if the weight loss impacts life long.
(04:29):
All right, let's jump into a word from our sponsors.
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(06:14):
they get out of this rut when it comes to
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(06:35):
reboot dot CO. I am excited because this might be
the youngest group of docs that we've had on the
show now that I think about this, and this really
excites me because it points towards an optimistic future when
it comes to metabolic health. We got doctor Lord Buchanan
and doctor Matt Calkins in the mix. Welcome on the show.
Speaker 3 (06:56):
Thanks for having its great to be here.
Speaker 2 (06:59):
And we got little James. He's not in the you
can't see him in the picture right now, but they
have a six week old which always warms my heart
as a dad of three three boys. You guys got
you got some work to do, you know what I mean,
a few years down the road. But I'm really I
just want to say out of the gate, I'm really
proud of you guys for taking on this idea of
(07:22):
reversing metabolic disease, reversing type two diabetes. And it takes some, honestly,
some courage because there's a lot of opposition or resilience
and resilience needed to to to take that on. So
number one, I want to commend you, but maybe we'll
start start with Laura, like what got you into this space?
(07:43):
Like what what made you curious about? What made you
want to learn more about it?
Speaker 4 (07:48):
Yeah, so make a long story a little bit shorter.
And during medical school, I we had our two week
nutrition elective, basically their curriculum that, unfortunately, I think, like
a lot of medical school nutrition curriculums, leaves you with
not much to take away as far as how can
I practically help my patients? And so I started During it,
(08:12):
you were taught some things about oh, saturated, that's going
to kill you, some old kind of standard dogua in
addition to the classic vitamin deficiencies. So I started reading
a ton of just doing a lot of research on
my own. Being A title is his big fat Surprise,
Jason Bunes, The Obesity Code, Gary Tops.
Speaker 3 (08:30):
I mean just kept going.
Speaker 4 (08:31):
Then started Withsting Low Carbon D podcast and was really
angered almost by just feling like we were being told
a lot of partial truths. And from there I got
a continuous glucose monitor in the fourth year of medical school,
and that really opened my eyes. I love the story
(08:51):
Matt and I were eating these healthy oatmeal cookies, low sugar,
high fiber, skyrocketing, and my sugar plosted two hundred and
I've been doing that every day for over a year.
Speaker 3 (09:01):
Yeah, terrible, And so my eyes were opened.
Speaker 4 (09:05):
And as soon as residency started, I was practicing low
card for my patients and we both have been low
card since then.
Speaker 2 (09:14):
Amazing, amazing. What about and what about you, Matt, Like,
how did you come into this landscape.
Speaker 5 (09:20):
Relatively the same thing as Laura. We met in medical school,
so we really shared the same interest in metavalk health.
For me, there's a in medical school they teach you
that all metabal diseases are chronic and progressive diabetes, obesity.
You're going to be on medications, you're going to increase
the medications, You're going to have it the rest of
(09:41):
your life, and you're eventually going to get the end
organ complications from that, whether that be the amputations.
Speaker 3 (09:46):
Or the dialysis.
Speaker 5 (09:47):
And it's really hard to be motivated to want to
to basically take care of the metaval health of a
patient in such way. I actually decided to go into
emergency medicine. Is at emergency medicine is a fantastic specialty,
and as a medical student, you can't not love it
because you do all the exciting fun things. And then
(10:07):
as a resident, I was an resident and intern, and
I realized that that's not where I wanted to be.
I felt so far downstream pulling people out of the stream,
and you could be one hundred miles up the stream
telling people not to jump in. So I made the
switch to actually family medicine because I realized that what
(10:28):
we were told in medical school, it's kind of the
lazy way out. If you use medicine. If you use
if that's the only tool in your toolkit. These diseases
are chronic and progressive. However, if you can help patients
realize what they need to do is to improve their lifestyle.
We both use low carb ketogenic diets, then it is
(10:50):
not a chronic, progressive disease. You put these diseases into remission.
People do it every single day. They get off of
their medications. They don't ever have the complications. The last
twenty four hour shift I was in the hospital and residency,
I had to admit a patient at two am with
an advertizing fasciatis from a diabetic footloud and that is
something that I never want to have happen for anybody else.
Speaker 2 (11:10):
Ever.
Speaker 5 (11:10):
Again, that's my vision in life is too is to
shut down every pedetary OAR except for.
Speaker 3 (11:16):
Bunyans in the country, Like there should.
Speaker 5 (11:18):
Never there should never be a pedietary emergency operating room
procedure at two o'clock in the morning.
Speaker 2 (11:27):
Oh man, you speaking my language? Like I love the
perspective of being emerged doucins and and seeing the end
stage of all these conditions. It's similar. I mean, it's
kind of a similar story for me with the from
the nice perspective. Yeah, by the time we see them,
it's it's too late. And trying to educate folks on
(11:50):
how they can avoid seeing someone in the emerge or
seeing someone like myself in the intensive care unit is
absolutely empowering. And I'm curious in terms of well, I'll
go to a Laura here, when it came to being
in residency and applying the low carb ketogenic approach to
(12:12):
your patients, was it was it well received? How did
what was the opposition like with your preceptors, because obviously
you have to run and buy them right, So what
was that experience Like, Yeah.
Speaker 4 (12:24):
So I'll do both kind of the hospital setting and
then also the clinic setting. So in the clinic setting,
initially there was definitely some pushback. I would get fasting
insulin labs sometimes see peptides.
Speaker 3 (12:36):
If I had.
Speaker 4 (12:37):
Someone on insulin, I wanted to make sure save for
them to ty trate completely off. And I would get
pushed back saying, why you were in these labs, this
isn't standard of care. And I would explain my reasoning,
some of the background science behind it, and they would
actually be really interested and they wouldn't necessarily agree, but
they're like, Okay, you know you have good logic.
Speaker 3 (12:57):
Go for it.
Speaker 4 (12:58):
And so after I had several patients whose A one
seeds were above twelve thirteen, fourteen, and I would not
treat them with this sulne. I would treat them with
a keeogenic diet and they would actually in three six
months come back with A one seeds around six, around seven.
And when the preceptors would see those results, there is
no question. I mean at that point they were like, Wow,
(13:21):
this is incredible, How like how's this happening without medicine?
And so the more that I just spoke to people
and let them see the results rather than try to
argue just only with piers of paper about it. Here's
of paper about it. Just let them see it. I
starting less pushback. Same thing with calcium scans and kind
of explaining my logic about the benefit of knowing someone's
(13:42):
calcium score and helping further stratify them. Initially there was pushback,
but in the end people were all about it, and
in fact, people would start coming up and asking me, Hey,
do you think I should get a calcium score on
this person or do you think they could come off
with this medication because we're we want to do this
low carb diet. So it was really cool to see
that switch in the mindset of not everybody, but a
(14:04):
lot of people.
Speaker 2 (14:05):
We'll be right back on Solven Healthcare Radio with Doctor K.
You're listening with doctor Laura Buchanan, doctor Matt Culkins.
Speaker 6 (14:27):
Stream us live at SAGA nine sixty am dot.
Speaker 5 (14:30):
C A.
Speaker 2 (14:37):
Is to listen to Solven Healthcare Radio with Doctor K.
Just to explain for the calcium score, it's basically looking
at your risk of cardiobascular disease. And yeah, and so
(14:58):
I that a better experience than I would have anticipated.
Speaker 3 (15:02):
Laura.
Speaker 2 (15:02):
If I'm being honest, but I do think there's a
leadership lesson there for creating changes. You do it at
a micro level, and if you lean on action, it's
way more likely that you'll you'll see some change as
opposed to as shes as Laura mentioned, like just giving
them the paper. You know, there's only so many like
(15:23):
you could dissect through a paper and criticize it to
the ninth degree, and often that's enough, not enough to
create change. But if people are seeing it with their
own eyes, you're creating that change at a micro level.
That could be quite powerful. And Matt did you did
you have similar experience as well, like when it came
(15:44):
to implementing it into your practice.
Speaker 5 (15:47):
Minimal to not at all. I think that's one of
the most important takeaways from physicians, providers, allied health professionals
that are listening to this is that if you're going
or a fight for something you know is right for
your patients. In our case, it was the key to
JENK diet to improve metabolic health, which is not yet
widely adopted, even though there's a lot of emerging evidence.
(16:10):
The small battles that you fight and the small battles
that you win will make it that much more easier
for when the next person comes through in your footsteps.
So by the time Laura was a year ahead of
me in residency, she paved roads for a full year
before I got into failing medicine my intern here and
it was basically already done. I could order the insulins
(16:32):
so I could more easily counsel patients on their full
risk of metabal disease, and nobody ever, really, nobody bad
an I at that calcium scans for the full risk stratification.
I actually got a lot of our co residents to
do it now and there, because if you look at
the AHA guidelines in America, there's a large swap of
people you can get them on in order to help
(16:53):
them decide what.
Speaker 3 (16:54):
We need to do about their risks.
Speaker 5 (16:55):
So these are things that in the moment it's really hard,
and I'm not going to discount there have been a
lot of people who have been put through a lot
of hardships to do what they know is right. I
hope it's a consolation to those that are going through
that now that you're you're helping the next generation, which
is helping patients.
Speaker 2 (17:17):
Absolutely, Like I can't emphasize how exciting this is to
hear like this next generation of docs that are creating
that change, that see the light. I still I'm still curious,
Like what There's something in you? Right, There's something because
like say, in your class, Laura, was there anybody else
(17:37):
that was looking at low carbon keto and looking at root?
Cause was there any like did you feel like you
were an army of one or were you like, did
you like have like a battle cry world? A few
of your colleagues were like, yeah, let's do this.
Speaker 4 (17:51):
We had at least one other friend who he would
dive down all the rabbit holes with us, the into
the bottom of the research. You know, what is the
underlying path of physiology. And we love going toe shops
and just working for hours on this stuff with him.
I'll be a shout out Dustin Anderson if he listens
to this, shout.
Speaker 2 (18:12):
Out to da Dustin Anderson changing the boogie. We love
your big guy.
Speaker 3 (18:17):
Yes.
Speaker 2 (18:18):
No, Like I said, that's exciting to me because it's like,
if I were to be honest with you, like when
we started to make this show four years ago, now,
oh my god, this was kind of the you were
like the target audience. If I was being honest, like
the young up and coming docs that can that are
(18:39):
open to change, because I often I find like my
age or older, they're pretty resistant to change. But it's
powerful because your colleagues will see it, and now you're
impacting the lives of your patients. You're like, I'm sure
even your nurse colleagues that you see in clinic, their
eyes must be like wide open when you guys are
(19:01):
in the mix.
Speaker 4 (19:02):
Yeah, I mean when you have a patient come in
to see who's lost sixty pounds and then the nurse
obviously knows is that because they're checking their weights and
seeing them before and after, and then they asked me
about it, I'm like, oh yeah, they went keto. The
A one C also dropped six points and that is
really powerful and so the message does definitely spread that way,
(19:23):
which is great to see. The other thing that is
super exciting. So one of our other colleagues and good
friends who during residency was actually very passionate about this
stuff as well as got her a metabolic health practitioner
through the SMHP as well. She is now faculty and
she has actually with us created a metabolic health elective
(19:44):
for residents to take and the first residents are now
taking it this week actually, so that is incredibly exciting
and I think this is how things grow.
Speaker 2 (19:54):
That is incredible. So what does that elective look like?
Do you know? I'm doing it to put you on
the sport.
Speaker 4 (20:00):
So you spend a couple of days doing just lectures
that Matt has actually created.
Speaker 3 (20:05):
Some of those lectures a little bit on the.
Speaker 4 (20:07):
Dietary guidelines, how we got here, how some of the
research that shows red meat you know quote causes cancer,
the flaws and that research and analyze how to properly
analyze that research and epidemiology, logical studies. And then you
have you go work with the prevalent of cardiologist. You
go to the obesity medicine weight loss specialty clinic here
(20:30):
at our facility, and then you spend a little bit
time with her. She has her own personal kind of
weight loss clinics she'll do with patients for metabolic health
as well.
Speaker 3 (20:40):
And I think that's that's.
Speaker 4 (20:44):
So it's a little bit of asynchronous learning with the lectures,
a few point papers to read and analyze, and then
going through a few of those other clinics.
Speaker 5 (20:54):
Yeah, I think the beauty of the elective is that
you'll this is a low car ketogenic diet attending, but
you'll also rotate through with some of the physicians that
are that practice in some of the older models. But
I think the beauty of where we're at today in
twenty twenty three is that over the past five years,
(21:17):
the published data we have about ketogenic diets to reverse
or put into remission metabolic disease has exploded, and we've
never really been in this situation before. I think before
before let's say twenty fifteen, there wasn't really a lot
you could you could hang your hat on. But now
we have doctor Trow's pilot program, twelve patients. They improve
(21:38):
their A one C but I think it was one
point five points or two points and lost twelve kilograms.
Doctor David Unwin in the UK and all comers type
of clinic in the NHS system, if you live in
the footprint of a GP practice, you have to go
to that practice. Forty percent of his patients with type
two diabetes said yes, and of those that had diabetes
(21:59):
for less than a year, he'd put I believe it
was seventy to eighty percent into remission just from them
saying yes and going.
Speaker 2 (22:06):
On a keto diet.
Speaker 5 (22:07):
You have the Verta Health two year data. And then
we also had the awesome opportunity to rotate through doctor
Eric Westman's clinic that's the Duke Duke Keto Medicine. And
he always says at every at the end of every
single one of his talks, he's like, if you want
to come see how I do it, all you got
to do is ask, and I implore people to when
(22:27):
you hear this, take them up. We both rotated through
with him for a week in residency during one of
our electives, and it was it was an amazing experience.
Speaker 3 (22:35):
And I just got it.
Speaker 4 (22:36):
I have to his data. So I took notes on
all of the patients. We saw thirty five return patients.
There was thirteen hundred pounds of weight loss, one hundred
and fifty inches off of waste circumference, and thirteen medications
were stopped. And this age range was thirty five to
seventy eight years old.
Speaker 2 (22:54):
Wow. Yeah, Wow, it's a good point. You make mat
about the data, the data. More and more data coming
through that gives it gives it teeth, as you know,
that's obviously the first level of of of of data
(23:14):
people want to see it's like studies to be able
to create some change, but I often say it's not enough,
you know the the in terms of trying to create changes,
as we talked about earlier. So I'm curious from your perspective,
like you're your involvement with H I always get the
acronymic h M s P s M yeah, m hm
(23:40):
hm HP is like it sounds like you're you're you're
doing some special things. So like, what what is what
are some of the things that you're doing with H
oh my god, s M HP.
Speaker 5 (23:52):
Yeah. I'm the chair of the Resources Committee for the SMHP.
This was a professional organization founded in twenty ninety that
seeks to promote evidence based medicine regarding a low card
ketogenic diet. And we have basically an accreditation where you
can get a meta BALK, you can be a MEDVALK
health practitioner. We have physicians as members pas, MPs, any
(24:15):
health coaches, Allied Health Professionals rgis. Everybody who's interested can
be a member on the Resources Committee. My goal is
to do essentially what Laura did for me.
Speaker 2 (24:27):
I want to.
Speaker 5 (24:28):
Create resources for one provider to take to their clinics
and say this is what I want to do, and
I want to give them other resources to easily implement
using low card ketogenic diet. So currently we have a
sample of a low carb ketogenic diet page that's based
on Eric Westman's famous Page four. Basically, it's a one
(24:50):
sheet handout that can have everything that a patient can
eat unlimited amounts of or certain amounts they have to
reduce or medicate our foods that they should stay away from,
like by carb foods that they're doing a low carb diet.
I have other handouts on there that basically has the
data we just talked about that if it can be
a conversation starter with the administrators of a clinic. Two
(25:12):
things we're working on probably the two biggest projects at
the moment. We're looking to get accm accredited, which just
means we would be able to offer AMA American Medical
Association Category one credits for CMME continuing medical education, which
would be huge Because we now have low Carb FOCA
affiliated with the SMHP, we have Low Carb San Diego
(25:34):
which is starting here in a few weeks, and we
also have a new journal, so we have the Journal
of metabolc Health and this is a journal where people
can submit case reports, case series, bench research, clinical research,
anything that has to do with metabolc health. And you
can help disseminate evidence based medicine to the world. And
(25:54):
this is a low carb patogenic friendly paper. So the
addition of CEM the end of that is also incredibly helpful.
The last thing we're trying to do is create kind
of like what they had at our residency. Just created
a nutrition curriculum that if you are a medical student
or a resident, you can sign up to take a
two or four week asynchronous nutrition curriculum where you learn
(26:18):
about a low carbon ketogenic diet. Is to supplement whatever
they learn in.
Speaker 3 (26:23):
Or whatever they don't learn in medical school or residency.
Speaker 2 (26:25):
We'll be right back on solving healthcare Radium with doctor
k You're listening with doctor Laura Buchanan and doctor Matt Culkins.
Speaker 1 (26:32):
Out of the Night into the WATA. We pushed the
boat from sure breaking and the stillness of the No Radio,
No Problem stream is live on Sagay ninety sixty am
(26:53):
dot C a.
Speaker 2 (26:56):
R named Jewels Fast one and one named Jewels Fast
One Slow Move. We are back on SOLFI and healthcare radio.
What a great way of providing people with the resources
to make informed decisions, because yeah, I mean clearly this
(27:17):
is what people need. And and I'm curious, along with
the diabetes reversals, do you guys get into a little
bit about like the low cop keto with other medical conditions,
Like I don't know if you guys have been interested
in Chris Palmer's work and and so on, so I'm
(27:40):
curious to hear where your heads are at with that.
Speaker 4 (27:41):
Yeah that I love Chris Palmer's work, his book Brain Energy,
Highly recommend everyone read it the results. A lot of
the time when I see patients and clinic, we are
focusing maybe other diabetes or maybe they're coming to see
me for weight loss. But what is amazing and happens
so commonly is they tell me, oh, I stopped my
(28:04):
reflux medication. I have one patient who got off of
nine medications for maybe four different medical conditions, and that
was all through the keithogenic diet. So that was one
intervention off of nine medications. And I have patients still
me my anxiety has never been better, their depression symptoms
are improving. So that's kind of on Chris Palmer. The
mental health benefits that we see from lifestyle changes and
(28:27):
from the ketogenic diet specifically. And I haven't specifically worked
with patients who had schizophrenia or bipolar in this area,
but the data. They published a paper on thirty one
individuals who had refractory mental illness to from schizo effective
disorder bipore major depression and were hospitalized, and their results
(28:52):
were staggering. Oh I'm going to forget the statistics, but
the number of individuals who go off of medications and
then actually went from it's the global severity Index. Yeah,
global severity index that went from very severe to.
Speaker 3 (29:10):
None was huge.
Speaker 5 (29:12):
Complete remission.
Speaker 4 (29:13):
Yeah. And so that so not only are we seeing
complete remission of diabetes, high blood pressure, reflux so good,
we are seeing refractory mental illnesses meaning they've been on
numerous medications and it failed and are hospitalized because of
it getting going into remission.
Speaker 3 (29:30):
And that is incredible.
Speaker 2 (29:31):
One hundred percent. That to me is Yeah. I got
to see Chris Palmer speak at well Carved Denver about
the impact of mental health in terms of going to
ketogenic diets, and that was, for lack of a better word, enlightening.
And it makes sense like you know, like when you
(29:52):
think of information, uh being a driver of many diseases,
no reason to think that same information that we're seeing
impatience is not happening in their in their in their brain.
And and so it's and it's just pretty it's powerful
to think of what you eat or how you eat
(30:14):
can impact impact your your health to that level. And
I mean it's a motherly statement. Like a lot of
our I don't know parents, grandparents would probably say, clearly,
you got to think about what you eat. But it's
not something we we talk about at all in medicine.
Like I was surprised you got two weeks of like
(30:35):
for us, I think it was a day or two hours.
It's two hour lecture nutrition. Yeah, yeah, No, it's interesting.
Speaker 5 (30:43):
I think the I think the tide is slowly turning.
The medical schools and residencies know now how important nutrition
is for metaball health. It's just a little bit misguided,
uh in terms of how they go about teaching it.
For everything that they key to genic diet basically improves
or ameliorates. Eric Westman says it best at almost in
(31:06):
every single one of his talks. He says it's so unbelievable.
It's unbelievable. And that's kind of when you start talking
to people about, hey, we can reverse or put these
diet like diabetes into remission. Oh and by the way,
there's new data that shows that it helps with mental owns.
But by the way, there's a case series that shows
that actually helps with anorexia.
Speaker 3 (31:23):
And believe in RVOSA.
Speaker 5 (31:25):
I actually was talking to somebody in an attending workroom
about the kogenic diet and somebody not in the conversation
turned to me and said, I was I was harming
patients by recommending the ketogenic diet they were going to
have eating disorders, and there has never been any data
for that. I just think there's for how much good
(31:46):
data we're having now, there's still this massive amount of
inertia in medicine at large too. At least not allow
other providers to offer this. In my opinion, everybody should
say should have the opportunity to say no to a
kid Jack did, at least yearly if they have any
sort of underlying mental health or metabolic disorder that could
(32:07):
be improved by it.
Speaker 2 (32:09):
Man informed decision, what's a showed decision making informed decision
like I want to cuss there for a second, but
I don't want to cuss in front of James here.
But like, it actually pisses me off if I'm being frank,
that we have so much bullheadedness in our profession, Like
(32:30):
I like, I saw a lot of it during the pandemic.
Like I mean, I don't know if you know mus story,
but this wasn't on my radar at all. I didn't look.
You know, I did a little bit of fasting for myself.
But then when I saw the amount of metabolic disease
for COVID patients as an icy you talk like literally
(32:52):
I did. And I say this in every talk I
give about metabolic health to this day. I've yet to
take care of a healthy person, like a completely healthy person.
They could have been pre diabetic and people will say,
like there were no medications, yeah, but you know what
they were the b and I was thirty five, like
it was. There was still there's risks there. And even
(33:14):
our patients that were in their twenties, most of them
were approaching if not more than three hundred pounds. That
I doubt that you know that we that we saw.
So I think the amount of resistance to change in
our profession, frankly just gets me, like it upsets me.
(33:35):
And I once again commend you guys for for taking
this on because it's it's not easy. Like if it's
not easy when you're at times going to be the
lone wolf talking about many of these issues. But getting
back to that point though about shared decision making a
it's that's always the out for young docs or nurse
(33:57):
practitioners whoever. If you say to your patient and you know,
this is what I know about ketogenic diets, this is
what other options are in terms of the medications are
starting you on insulin, but this would be my recommendation.
These are the risks, these are the benefits. How do
you feel about that? And adding and if they're willing
(34:20):
to take the quote unquote risk of going on a
ketogenic diet for whatever reason and they're competent, well you're covered,
like as long as you're clearly articulating what the pros
and the cons are and and so I know there's
a lot of resistance amongst young docs, like when you're
dealing with your supervisors and stuff, but I'm telling you,
(34:44):
as a seasoned doc, like this is the approach. If
you think that something is remotely controversial. You're just upfront
with the patients and you have that shared model for
making a decision. But yeah, I sorry for the rant,
but it's a trigger for me.
Speaker 3 (35:03):
It's such a good point.
Speaker 4 (35:03):
And I, you know, I was the clinic experience had
of going back a bit was amazing and after just
pushing through a little bit of walls, it was great.
In the hospital, unfortunately it's not the same and maybe
that's because of Oh I guess. I think there's many
factors that play there, but there is one particular instance
(35:24):
that just stands out, and I think this is we
need to fight for our patients, and sometimes you won't
win the fight, but at least you can try. And
we had I was working on the pediatric floor. We
had a twelve year old admitted with new type two
diabetes with an allecy of twelve. And in the morning
we had to give him a lot of extra insulin
following breakfast because the sugars were sky high after already
(35:47):
giving him a large amount of insulin overnight, and it
was because he had pancakes and syrup for breakfast, and
so I during rounds, I asked my attending I said, hey,
can we put him on a low carb diet?
Speaker 3 (36:01):
Dam Bain's no.
Speaker 2 (36:06):
Welcome on the show, thank you.
Speaker 4 (36:08):
So so I asked for you put him on a
low carb diet and the attending was like, are you
trying to kill him? I cause a heart attack? And
I looked at it and like, no, his sugars are
really high and we're having these a lot of extra insulin,
so we wouldn't have to do that if we put
on low carb. And then I, you know, I said,
I think actually the data doesn't support that the low
carb diet is actually going to cause a heart attack.
(36:31):
And he said, well, what are you going to give him,
because I don't want to give him back. It's like, well,
we can do higher protein then, and the attending said,
so you're going to kill his kidneys, and I just
I was very respectful and kind of talked. I was like,
I'd actually think the data supports that in people who
are perfectly healthy kidneys, high protein is actually going to
cause me harm. And we went back and forth a
little bit. The rest of the room with the other
(36:51):
residents and the fellow's dead silent. It was, you know,
kind of awkward. Little in turned me and the attending
going back and forth. Unfortunately, the attendee one and the
kid got all the cards he wanted and lots of
insulin for the rest of hospitalization. But I think if
you should still fight for your patients, and maybe at
some point, maybe I put a little something in the
(37:14):
back of his head that made him start second guessing
or thinking about things another way.
Speaker 2 (37:19):
Absolutely, next time the mats of the world grew that
rotation and said the exact same thing. Then as he's
starting to realize, like, yeah, you're being foolish and closed
minded and not rational, I I, yeah, it just makes
me want to Yeah, that would be that would be infuriating.
(37:45):
Any other kind of myths that you often have to
address when it comes to low carb or keto like
definitely the I mean, as you mentioned the kind of
the worry about about fats. I don't hear too much
about the protein side, but I'm just wondering, is there common,
uh misconceptions that you often have to address.
Speaker 4 (38:08):
I get asked about kidney stones quite a bit and
then gout the data. I mean, in the burn of
health to your study, there is no kids cases of
kidney stones or gut flares, even in individuals who had
gout previously. I personally have had many patients who have
had history of kidney stones as well as gout who
have never had any issues once they go on a
ketogenic diet. I do monitor, you know, uric acid levels
(38:32):
and just monitor a little bit more closely, but I
have not had issues there.
Speaker 3 (38:38):
I think.
Speaker 5 (38:39):
I think one of the most egregious is the belief
that people will go into keto acidosis from a ketogenic
diet unless you have some profoundly underlying issue or you
get acutely ill with like a gastronritis. I think it
just shows a severe lack of the underlying knowledge from
the physiology of of what a ketogen that does. Ketosis
(39:01):
is completely normal and natural for a perfectly metabolically healthy person,
especially overnight. You can measure key tones in the morning
and they could and should be zero point three to
zero point five on a fingerstick. So it's something that
people go into every night. But I think a lot
of the concerns about the kit deject diet just comes
(39:22):
from a place of inertia from like the seventies and eighties,
and then largely ignorance nowadays, because, like I said, with
the new data we have, we're truly an evidence based
society of medicine. Then people should be reading this data
and they should be realizing, Hey, the adverse events in
the VERDA health study are low, and people are getting
(39:44):
off of their insulin and doctor Trow's program An Unwin
and Eric Westman is publishing all of these randomized control
trials about low carb versus other dietary patterns, and low
CARB's doing great. But I mean, it's been out there
for five years now, and it takes about on average
ten years for us and to change, so we just
need to keep plugging a way.
Speaker 3 (40:03):
Yeah, I'm sorry.
Speaker 4 (40:05):
One more is the red meat causing cancer because people
go keto and you get all this red meat and
the data on that. I don't know if you've gone
into the epidemialogic studies before, but basically, if you look
at food frequency questionnaires and they give one of you
eat in the past year basically, and I've taken.
Speaker 3 (40:23):
One of these before.
Speaker 4 (40:23):
It took me forty five minutes, and it's comical to
go through and maybe you get three of those over
the course of a decade, so you have three time points,
and then it's like, how many hamburger patties have you eat?
And what they don't figure out is how many when
you eat those hamburger patties. Are you having a large
fry a milkshake, are you having the buns? Or am
(40:44):
I at home cooking for myself eating a hamburger patty
that I made with maybe some broccoli on side, or
maybe I just had three hamburger patties and nothing else.
So they don't control for any of that. And then
the actual absolute numbers, even if you trusted the data,
are tiny, and so it's really unfortunate that that is
(41:04):
such a large concern and propagated by a lot of
organizations still and even the WHO who warns about process
needs and Redney Company cancer being a potential persinagion.
Speaker 2 (41:18):
We'll be right back on Solven Healthcare Radio with doctor k.
You're listening with doctor Lord Buchanan, Doctor Matt Culkins. You
must better do your job and grown up there would
sell me grown up? Then I take that's told the
thing hopefully it's so nuts.
Speaker 4 (41:32):
I take the sip for that.
Speaker 2 (41:33):
Yet I want to be I take the hit of
that that stuff.
Speaker 1 (41:37):
We really what's the stream us life?
Speaker 6 (41:40):
At Saga nine sixty am dot c as.
Speaker 2 (41:49):
Yah. I'll feel with Israel lies wrapped the bout against
God by you listen to Solven Healthcare Radio with Doctor King. Yeah,
I must say at a personal level, I agree with
you in terms of the study analysis, those like those
aren't like when you have to go through memory and
the association of typical foods that they might have on
(42:10):
top of that, like it does not put it this
way for those listening. I still eat my red meat
in abundance.
Speaker 5 (42:19):
Yeah.
Speaker 2 (42:19):
They had who Ribby stakes yesterday, yo, and I got
some for lunch today, just a little bit of leftover.
I'm gonna hit that up and I and it's just
something that to me. You also got to think of
the benefits too, Like, I don't know if you guys
have had any any change in heart or thoughts about
protein intake. There's been a bit of a movement and
(42:42):
whether you were low carb or not like it in
terms of how important protein intake is. And I must say,
over the last I don't know, twelve to eighteen months
putting this on my radar, I've definitely amped up my
protein intake. I feel like this is an excellent hack
for folks to optimize their health.
Speaker 3 (43:03):
Yeah, I'm right there with you.
Speaker 5 (43:04):
Yeah, I h the I think the two things we
don't do a great job talking about in medicine in
terms of disease states would be one cyclopedia and two
social isolation. Social isolation is this whole other concept that
as you get older it's just harder to connect with people,
and then you basically you don't have a lot of
interaction with other people. But sarcopenia is I.
Speaker 2 (43:26):
Think muscle loss by the way for Golden English, So yeah.
Speaker 5 (43:30):
And it can be associated with diseases like you could
have like COPD and things like that, or you could
just have muscle wasting as you get older. And if
you're living into your seventies and you don't have the
muscles to do what you want to do, that is
that is a large that is a large burden on
somebody in my opinion.
Speaker 2 (43:50):
So I'm the same way.
Speaker 5 (43:52):
I actually started increasing substantially my protein intake about the
same time you did, and I put on actually a
couple extra pounds of muscle and started lifting heavier in
the gym too, And I've never felt better. And I
think that extra bit of muscle you can put on
when you're able to do it because everybody gets injuries
and you're going to be on vacation and there are
you know, you can't always do what you want to
(44:13):
do in terms of sustaining your metal health. The muscle
that you can build, when you can build it can
sustain you through those times when you can.
Speaker 2 (44:22):
M Yeah, to me, it was a big hot We
had ten naming on the show. You was talking about
is protein to energy expenditure ratio PE ratio, And it
was just one of these. The whole time I'm hearing
them talking, I'm like, this makes way too much sense.
Like the idea of definitely the muscle genesis, like the
(44:46):
maintaining muscle or increasing muscle mass, which even as from
a diabetes perspective, great sulker of glucose, great way of
managing insulin sensitivity. But then talk about the satiation like
being fuller, talking about you're less likely to go towards
(45:07):
crappy foods when you're fuller. It just weighed wagh too
much sense And and for me, yeah, similar thing. I
put on about maybe two three pounds since really ampened
up my protein. So I go, well, all us so
like zero point seven to one, what am I saying
(45:28):
grand per pound where I at least where I go
for and I, yeah, I love it. I love it
and sometimes I won't lie though it is sometimes challenging
to go to meet your requirements, like I have to
to have to add a shake or a bar. But yeah,
I I've never felt better since since implementing that.
Speaker 5 (45:52):
I really at the end of the day. I think
that's that brings up one of the other great points
is that dietary chain are an iterative process.
Speaker 3 (46:01):
So just because you had a study that showed that.
Speaker 5 (46:05):
There was no improvement in the outcomes after a dietary intervention,
so one of my least our most frustrating comments and
least helpful comments in medicine is, well after five years,
everybody's the same anyways, Like when you do dietary studies,
that's not a problem of the diet, it's the problem
of the intervention, and you have to figure out how
(46:27):
to deliver interventions. How are you going to tweak that
diet to get it more sustainable?
Speaker 2 (46:31):
You got it?
Speaker 5 (46:31):
Do you increase the protein to one point five grams
per kilogram? Do you have the closer follow up? Like
with doctor Trow, they have the health coaches. The touch
points are immense continuous glucose monitors as well for you
gives you any diets you can basically like having a
health coach in your pocket. Actually you can eat something
on a low carb diet pattern and know immediately whether
(46:53):
that meal fit in your dietary pattern and you can
use that for the next meal. So the find that
protein is higher protein can be helpful is I think
it's an amazing breakthrough. Like if people if I had
a crystal ball and if somebody is going to eat
higher protein and that's going to keep them from gaining
(47:14):
the weight, which is going to keep them from diabetes,
which is going to keep them from the footing amputation,
I'm on board. There are so many eating patterns that
are completely like reasonable that if that can be prevented,
so iterative process. We're getting better at this all every
single day, and it's all about tweaking the intervention to
(47:34):
the patient.
Speaker 4 (47:35):
And I think something that is so awesome about what
Troe has created is helping or is addressing, really food addiction,
because that is another thing that's just not discussed or
talked about, and as you Matt mentioned, it's a problem
in the intervention. Not a problem that the patients aren't
being able to follow the advice. It's the advice is
(47:56):
either wrong or it's you're just not good enough. So
eat less movement or a perfect example doesn't hardly help anybody.
But with Tron, what he's created with having our wonderful
health coaches, the front desk, get the touch points, an
app where you can have asynchronist learning, a community where
you can have a chat that people all the time
are talking and get help now, so people can put
(48:19):
in to get help now chat and immediately twenty people
or more might respond and say.
Speaker 3 (48:24):
What did you do in this scenario?
Speaker 4 (48:27):
Because it is life, a lot of stress and things
just happen, and it's when things are really stressful or
when stuff just hits the fan, that's oftentimes when people
end up just swinging through the drive through or going
to get that ice cream that makes you feel better,
give the dopamine rush from the unhealthy food. So it's
being able to help and intervene at that really stressful point.
(48:50):
I think that is so critical and what hopefully we
can get more and more clinics and more providers and
people doing to try to help patients from ever going
way far off track.
Speaker 2 (49:00):
It's the psychological opponent is way underrated, Like we don't
I don't think we draw enough attention to it. And
then it's once again you're not really diving into it
in medical school. But it's it's a huge aspect of
overeating and I think having that support system and having
(49:22):
the tools as as when doctor Troll was on on
the show talking about alternative alternative options for when you
want that, whether chips or what have you, like, it's
so so good, like it's it's it really is where
we where we need to go. This has been awesome,
(49:45):
Lauren Matt. I really am excited about the future when
I hear you guys, and I hear your passion and
hear about your involvement with s m HP A and
really trying to be leaders and I mean I shouldn't
even say that you are leaders, that's where you are, uh,
(50:07):
And so I just really want to commend you for
all the work you guys have been doing. If people
want to learn more about any of your initiatives, s
m HP, how do how do people how do people
hit hit you up?
Speaker 5 (50:20):
Yeah?
Speaker 4 (50:20):
So people can just go to the s m hp
dot org. Uh to go to that website and access
to a ton of great free resources. And then I'm
on Twitter and Instagram, although with James I can't take
a step back, but at large you can m D.
And then we have a substack called Aging successfully dot
substack dot.
Speaker 5 (50:40):
Com and I'm on Twitter at Matt Calkins MD as well,
though I've also taken a smitch of a step back
during my parental lead.
Speaker 2 (50:48):
Amazing, amazing, great work you guys, and thank you so much.
Speaker 4 (50:52):
And one other if you just go to doctor trou
dot com that way, if you've got any interest in
what we have to offer as well, so.
Speaker 2 (51:02):
Good, Thank you so much you guys. This is a
lot of fun. Thank you for what you do well.
I hope you guys enjoyed that episode with doctor Laura
U Cannon and doctor Matt Culkins. You heard where you
could hit them up. We are super proud of these guys.
I want to thank our sponsors Betterhelp dot com, largest
online canceling platform. You got to check out better help
(51:23):
dot com backslash Solving Health. Can you get ten percent
off check out Element? This is what I use anytime
I got to use some exercise post exercise. When I'm
fasting sugar free electro likee drink they're balling. Go to
drink Element dot com backslash Quadcast and get your free
sample pack. That's drink Element dot com backslash quodcast. Also,
(51:44):
make sure to check out our twenty eight day Reboot course.
Those that are trying to get into the health kick,
We keep it simple, highly effective ways such as increasing
your protein intake, getting your ten thousand steps in, turning
off your screens an hour before bed to enhance your
all these steps that we do together to try and
improve our health and wellness. Check out twenty eight Day
(52:05):
Reboot dot co dot co. That's twenty eight Day Reboot
dot co. You want to learn more about what we
throw down, go to Doctor Quadro dot ca A. And lastly,
if you want to sign up for our newsletter, that's
Quadcast dot substack dot com. Quadcast dot substack dot com.
Connect with us on Twitter, Instagram, YouTube, Facebook, TikTok threads
(52:27):
at quadcasts. Can leave any comments at Quadcast nine nine
at gmail dot com. We'd love to hear from you.
We constantly want to improve on the show's content. Don't
be shy. This was Luscious Solve It Healthcare Radio with
Doctor k Peace. I remember seeing you when spaghetti strap
it snapsack hel stop by your own fact.
Speaker 5 (52:46):
When I seen it, I was like, damn girl, so
you have a.
Speaker 1 (52:49):
Man, buddy, No radio, no problem. Stream is live on
Saga ninety sixty am dot CA.
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