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Diet Doctor podcast #40 — Ted Naiman

763 views Add as favoriteProtein is not the enemy. In fact, Dr. Naiman says it’s hard to imagine anyone eating too much protein. What about longevity, mTOR, and gluconeogenesis? Dr. Naiman says there is no evidence to suggest that these are concerns on a hole devised low-carb, high-protein diet. In fact, it’s quite the opposite — he believes we need to worry about the risks of too little protein in our diets.

In addition, I think you’ll enjoy hearing about Dr. Naiman’s passion for efficient exert. Although we may not all end up with his impressive physique after precisely 15 instants of practise, he shares his approach to helping his patients adopt a short, healthful life-long exercise routine. Dr. Naiman’s experience may not match the classic LCHF approach, but he construes success with his patients and am willing to share that message.

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Table of the information contained

2:16 Welcome, Dr. Ted Naiman

2:50 Ted’s transition from vegetarian nutrition to low-toned carb

9:20 Becoming a low-carb doctor after residency

9:59 Low carb and keto according to Ted 12:44 Body adjustment on low-pitched carb 14:55 Protein intake based on RDA 17:08 How unwarranted amounts of protein changes longevity, mTor and gluconeogenesis 22:53 How insulin opposition responded by too much protein uptake 25:55 Several great benefits of protein 29:06 Ted’s explanation of healthy metabolism with a low-fat high-carb diet 31:28 Distinguishing the sources of protein 35:52 Collagen and protein add-on in medical position 41:24 High intensity exercise and cardio exert 48:00 Does employ obligate people hungrier? 49:40 A epoch in a life of Dr. Ted Naiman 54:10 Where to find Dr. Naiman?

Transcript

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Dr. Bret Scher: Welcome back to the Diet Doctor podcast with Dr. Bret Scher. Today I’m joined by Dr. Ted Naiman. Now Dr. Naiman is a primary care doctor here in Seattle and he has his own story about how he transitioned from mainly vegetarian Adventist life both with family and in medical institution to learning about the benefits of low-carb lifestyle.

Continue reading the full transcript

But what separates Ted from sort of your median low-carb doctor, median low-carb enthusiast, is he is not so much in the clique of the low-carb high-fat. Ted is really big on protein and the importance of protein and it’s amazing how protein as a macronutrient can be so contentious. Now remember we don’t chew fattens, we don’t eat proteins, we snack real foods, but the percentages matter.

And there’s this concern, this fear about getting too much protein. So discovering Ted’s perspective is very interesting from the standpoint because it’s a send that we don’t hear a great deal of and is still contentious some of it, but I think it’s a great perspective. Now he’s also known as the utilization chap. If you’ve seen his before-and-after photos he’s rent, I signify this guy is built and fit.

Not super bulky, but equip and trimmed, enormous bend mas mass and he does it on 15 minutes a day of exercising which makes a lot of people sorrowful and upset with him, but he sacrifices us some of his secrets and some of his tips about how to achieve that and most importantly how to get it on safely for people who maybe don’t have any experience in practise.

Now let’s be honest not everybody is going to get the results he has, but the importance of exercise, how it contributes to health is still a crucial concept and maybe doesn’t get enough emphasis because although employ were not able to be the keto weight loss, there are some other constituents about maintaining lean muscle mass and concentration that can be very important for health and recovering from chapters where you may have struggles with your state.

So we talk about that, we talk a little bit about Dr. Ted as the doctor and as the person or persons. He’s got a very relaxed approach to things, a very relaxed attitude that hopefully you will appreciate. If you miss the full transcripts, go to DietDoctor.com. Otherwise enjoy this interview with Dr. Ted Naiman.

Dr. Ted Naiman, thanks so much better for attaching me on the Diet Doctor podcast today.

Dr. Ted Naiman: Thank you for having me, it’s an honor.

Bret: It’s great to have you here. Now in the world countries of low-carb, in social media, you’re sort of known as the protein person and the exercising guy. But it wasn’t always that case, right? I listen some fibs about your upbringing and your background and … very different. I mean, you were brought up in an Adventist tradition and you went to school at Loma Linda which is a Seventh-day Adventist school, which is sort of the contrary to high-pitched protein and low-carb.

So tell us about your change about what you learned growing up in that type of environment and how your thought process differs and how that vary happened.

Ted: Okay, sure, so yes I was raised in an Adventist tradition and Adventists of course are famous for being vegetarians. And my upbringing is why you now basically animal fatty and cholesterol and saturated overweight was really terrible and the goal is to eat as numerous weeds as possible and so I had this really healthful nutrition on paper where I was devouring lots of whole particles, and you are well aware, time mostly lots of whole-wheat and that kind of thing and it was supposedly the healthiest food.

And then I went to Loma Linda Medical Center and of course Loma Linda is this notorious blue-blooded zone where everybody is vegetarian and it’s sort of an Adventist vegetarian Mecca and I just- well, my personal experience was that I was never in a really great shape. My body composition was not that huge, I was not that healthy, I had a lot of issues, I had a really bad eczema and I had a really bad body composition and I didn’t feel specially health at all.

And so what I pointed up realizing is that diet doesn’t matter. Diet is not a big deal because now I am munching the healthiest food you perhaps could and I’m in really bad shape. So clearly diet is not that important. And frankly even though Loma Linda is, a you know, diet based institution, they’re very big into diet and life-style even there my teach was basically, okay if somebody’s having a bad state sequels it’s mostly genetic.

If you’re obese, it’s genetic. If both your mothers are obese, there’s 80% chance you’re going to be obese. If you have type 2 diabetes it’s mostly genetic because your parent was diabetic or your grandparent. And so I got this training that oh yes diet is important, you are able to never snack meat, but at the same time if you get a bad sequel, you are able to blame it on your genetics and you should just feel sorry for people who are overweight or diabetic.

They can’t help it because their parents were overweight or diabetic. So you do the best you can and you time give them more and more remedies. So this is my mindset … is like okay diet is important. Almost from a religious point of view you should not eat swine and you’ll be health. And then if anything bad happens to you it’s really just bad genetics.

Bret: So when you started your rehearsal that was still the mindset you had when you were attend patients one after the other after the other.

Ted: Well, this was my mindset in medical school and in my first year of internship. So I did my internship in South Carolina which was just the diabetes and obesity capital of the country at the time and I participated exactly a ton of pathology, just like every diabetic complication you can imagine, precisely over and over again.

So here I am in residency with this clinic with simply tons of diabetes pathology and everybody is slowly getting worse, coming fatter and more diabetic and amputations and blindness and kidney failing and the whole thing. And genuinely I’m just there feeling sorry parties, because I meditate, wow, you are well aware, such bad genetic … You only can’t overcome that, right? It’s not your omission, you’re just suffer that highway.

And then truly it was a patient of mine who came in one day and wow, he’d lost 30 pounds and his blood sugar was totally normal. And he was just telling me I feel great and I asked about … I said,” What did you do? You have to tell me what you did so I can tell everybody else to do the same thing .” And this guy plucks out a fake of the Atkins book and he said,” I went on this Atkins diet where I exactly didn’t dine carbs and bam … I feel superb .”

And that blew my recollection because never had I saw someone go on a vegetarian food and have this superhuman conversion. This was my firstly experience with diet as a huge lever for health and it was a big deal.

Bret: Were you interested like jump in right away or were you still like,’ yeah, but that can’t really be health … I’m sure there’s something to that that’s more concerning ‘? Did you like withstand it right away because of your qualify or are you open right away? Ted: Oh no, I was like this is the coolest thing I’ve ever seen … I was so excited. And I will never forget what happened to me.

I went to my coaches in residency and I was like, look at this guy, he lost all this force, his blood sugar is down, his blood pressure is down, his A1c is down, he lost a bunch of value, he looks like$ 1 million. And they look back me and “theyre saying”, “What happened to his total cholesterol?” And I hadn’t really paid any attention to it and so I searched it and I was like, well it did I predict come up 20 tops.

So I was crestfallen and my coaches were like,” Good job, Naiman …” He probably had a heart attack in the parking lot. And you are basically going to kill people .” And they told me under no circumstances could I recommend this diet and this was just a bad meaning. So that was the flicker, you now, and then in residency we are required to do a research paper and I started experimenting basically macronutrients and health.

And that was about 20 years ago and you know back then it was a lot harder to do research but I located all this evidence that people are eating direction more carbohydrates than they probably should. And I’ve been doing this low-carb thing now for 20 years.

Bret: So was it that residency knowledge that compiled you deepen personally? They may have tried to prevent you from helping your patients that highway, but you did you help yourself that style straight off in residency?

Ted: Yeah emphatically I want I personally had a big state changeover from going on a low-carb diet. I was clearly skinny fat, I was never really fat-fat, but I definitely lost about 20 pounds and my body composition increases were enormous and my before-and-afters were not that spectacular but it felt dramatic to me.

Bret: Well, that’s important, I intend how you feel there’s one thing. We do a lot of, you are well aware, look at the difference visually, but how you feel is even more important than that significant differences visually. So once you got out of residency and got into practice, did you really hit the ground running as a low-carb doctor, applying that as an intervention right away in people?

Ted: Yeah, I’ve basically been recommending carb control for my totality 20 time occupation now and initially it was really under the radar because I was worried about this total cholesterol. I make who knew what was going to happen … this has got to be bad, right? But, you are well aware, thankfully, as go goes on thanks to things like Diet Doctor, the legitimacy is definitely increasing and it’s a lot easier to practice low-carb medicine.

Bret: Yeah, enormous to hear. Now you used the words ” low-carb” in “low-carb medicine” and that frequently is used interchangeably with ketosis in ketogenic prescription I guess you could say. But they’re not always the same. So do you draw a line in differentiating them in when you would use one or another or the benefits of one of the other? Just afford us an idea of how you participate the difference between low-carb and keto.

Ted: Right … I don’t really use the word keto because I’m not telling anyone to track ketone grades. It doesn’t seem to be super necessary. And I know that anyone who is restricting carbs even below about 100 g a date is going to be at least in a light-headed ketosis, you are well aware, off and on. And so I don’t really- I see it on a range or continuum and for me just plain old-time low-carb is good enough because it does imply a significant amount of ketosis and so …

For me … the favourite keto diet for me has kind of evolved into something where you’re just going out of your room to eat a ton of solid and drive you ketone positions up as high-pitched as is practicable and I is of the view that at a certain point that becomes more bad than good. And so I don’t really focus on ketone heights or make sure you ate fairly solid to be in extreme ketosis all the time. So I just like the carbohydrate controls surface of keto.

Bret: It’s a fascinating discussion because it seems like there are some people who need to get into ketosis to break down railings and move forward and some people are going to thrive on a lower carb not were concerned about ketosis and trying to find who is in what tent can time happen with self-experimentation, but it sounds like for most people or pretty much everybody you’re not even really that worried about something it. You say simply cut the carbs down about 100 g and you’re going to improve.

Ted: Right, right, and the reality is that everyone envisages of ketosis as some sort of binary switch, but it’s just a slow gradual continuum from attaining minuscule extents of ketones to making a whole bunch of ketones and all these biological processes are happening at all times in everyone.

So everyone’s generating a tiny extent of ketones at all times. And then as you curb more and more carbohydrate or give more vigor your ketone ranks go up and it’s because it’s on a range. I don’t really say right now you’re in ketosis and then, you know, an hour last-minute, oh now you’re not in ketosis. It’s just I don’t like thinking about it in this binary fad.

Bret: How about the adjustment process? I want it seems like for some people they certainly have to make a rush to help their body kind of flip a permutation like you said and then they can sort of back off and go in and out of ketosis, but to get into it for a first time and learn your form to get off of all that glucose and carbohydrate that you’ve been burning for so long, that maybe it takes a little bit more of situations of extreme step than merely 100 g of low-carb.

Have you found that to be the case at all?

Ted: Well I anticipate yes fat adjustment is a huge big deal and that’s very real and you really have to upregulate the ability to run your totality metabolism off of overweight and I think that’s a gradual and gradual process and you’ll know a great deal of people who tell you that they can’t perform athletically as well as they could for several months after endorse a low-carb diet, precisely because you are slowly up-regulating the ability to generate a knot of ATP from overweight at a high enough rate.

And actually I feel like this is unrelated to time obliging ketones. So like I could take anyone off the street and just tell them to not gobble carbs for 16, 18, 20, 24 hours and they are going to be fully generating ketones.

But they’re going to feel dreadful and they’re going to be starving and their exert recital “il go to” nosedive and now you’re talking about the process of fatty adaptation which to me is totally different than simply realise ketones which honestly anyone on any high-pitched carb diet is able to not feed carbs for 16 to 24 hours, and they’re in ketosis. So to me it’s not about … it’s not so much better about the ketones. It’s more about solid adaptation and doing better, loping your entire metabolism off of fat.

Bret: And so much better of this has to do with our insulin degrees and our glucagon degrees and that ratio and being able to train our mas to have lower insulin ranks, which is required for ketosis. And not putting paroles in your lip, but it seems like of the two, lower insulin and higher ketones, you would be much more interested in time are concentrated on the insulin and forgetting about the ketones … would that be accurate?

Ted: Correct, I means for me I believe the ketones come along for the ride.

Bret: Yeah, so when it comes to a low-carb diet or a ketogenic food, how to formulate it, in what percentages is sure to vary from person-to-person. And one of the biggest areas of controversy is protein. We kind of all concur you restriction the fat … Sorry, we all agree you restriction the carbohydrates and then you chewed the proper extent of protein and you can fill in the rest with fat. So the discussion comes around what is the proper amount of protein.

And it’s in such an interesting discussion and going back to the RDA, you know, the recommendations of the daily allowance of protein, you check wanders out there from 10% of your calories to 0.8 g per kilogram, to 0.3 g per pound, which is really a small amount of protein, but somehow that’s the recommended daily allow. So help us understand what this RDA of protein measures and how it can be so small compared to what we were used to.

Ted: Right, so the RDA is just a bare absolute minimum where below which you’re going to be only abjectly insufficient. And the RDA in no way suggests how much protein you should eat. It’s just how much protein you should never ever, ever, ever depart below. So that’s a really important concept. It’s almost impossible to eat “too much protein”.

You basically can’t make love. So it’s very, very possible to not chew fairly protein and have protein dearths which is horrible and very severe and you will actually die. So the RDA is just there to tell you what to not croak below. In no way does that suggest how much you should be eating.

Bret: Yeah, and I think that’s such an important point because when we talk about the RDA for vitamin A or vitamin D or Omega threes or whatever, the calcium and vitamin C, it’s sort of accepted that it’s a minimum. But somehow when we talk about protein certain nutritional fornication have turned that into a peak; you shouldn’t go above it. But it was never proposed that highway.

Ted: It was never purposed that lane and I really don’t even know where that comes from.

Bret: So then there is some legitimate expressing its concern about what if we are eating too much protein. So I guess it can come from three different perspectives. One is longevity- the concern that too much protein injures longevity, lower proteins improves longevity. Two is this almost mythological stimulant of mTOR and how is that affected with protein.

And three is ketogenesis, you are well aware, with gluconeogenesis and kicking you out of ketosis. So let’s take each one of those individually starting with the last one- gluconeogenesis. It’s a big word, mostly causing new glucose in your mas from something else, and often from protein. Is it awfully? Does it happen?

Ted: Gluconeogenesis is constantly occurring and your liver is obligating every bit of glucose you ever need all the time, 100% of the time whether you’re eating carbs or not. And gluconeogenesis is demand driven. If you are required to more glucose you’ll time more gluconeogenesis. But it’s not supplying drive, so snacking extra protein does not increase gluconeogenesis.

Bret: But then you participate all these reports of people who are following a ketogenic nutrition and they increase their protein intake and their ketones disappear or decrease. So what’s the cause there?

Ted: Yeah I signify I think you will suppress ketones if you chew more protein, that’s absolutely true.

Bret: So I guess your point would be then, since I’m not worried about something a ketogenic diet, I don’t care if gluconeogenesis is happening and ketones are going down. As long as you’re still following carb restraint you’re still be healthy and health trumps ketosis. Would that be an adequate statement for -?

Ted: Absolutely.

Bret: Okay. So people who are on carnivore diets and chewing much higher levels of protein, any concerns there with getting too much?

Ted: Not genuinely, I necessitate, you know, mostly even in even in medical circles up to 35% protein seems to be fine. Nobody’s seen any problems with protein tiers that high-pitched. And hunter gatherers were eating at least 19 to 35% protein in their diet and so I don’t really receive any problem from carnivore foods. Frequently an average person on a carnivore diet is feeing about 30% protein and in no way do I think that’s too much.

Bret: And what about these principles of mTOR? mTOR being very important nutrient sensor and growing stimulator in our form. Without it being stimulated we would not grow we would not develop muscles, but with it being energized too much, there’s concern that it’s going to movement abnormal cadre growth, so cancer cadre swelling. How do you wrap your manager around the concerns of mTOR with too much protein?

Ted: I think that there is definitely this sort of Yin and Yang to anabolism and catabolism and you have to go back and forth and you have to have some of each and you have to have feasting and you have to have fasting.

And my suggestion is just keep insulin pulsatile, you know, by simply not snacking all the time and I think you’ll probably be fine. I’m not convinced that eating more fat and less protein is going to be longevity benefit to anyone … You know what I make? And I know this is controversial and I am a big fan of Dr. Rosedale and a great deal of people other fantasize, you are well aware, if you can just squeak by with the very lowest amount of protein you’re going to live longer.

But I don’t think we have any data in humans to support that at all. And honestly, you know, look at elderly people in America. American adults age 70 to 79 chew 66 g of protein a daytime and 247 g of carbohydrate. So I really don’t think protein limited is that profitable because those people are curtailing a inferno parcel of protein and their outcomes are not consequently that great on average.

Bret: Yeah, routinely we talk about protein from snacking too much standpoint, but what’s not has spoken about fairly is how the requirements probably go up even higher as we age and the risk of sarcopenia and not having fairly muscle mass and tumbles and faultings. Do you think that can be almost completely abolished with multiplication protein uptake?

Ted: Absolutely, I represent the reality is the stronger you are the longer you’re going to live, the lot more muscle mass you have, the longer you’re going to live. Descends are one of the biggest murderers of elderly people and if you’re curb protein for some sort of theoretical longevity help that’s never been demonstrated in humen.

You’re mostly risking some very real osteoporosis and sarcopenia for some theoretical longevity assistances that simply haven’t been demonstrated. So I think it’s a horrible sentiment. You know, Valter Longo, all of his data is from mice and we have zero human data to support protein restriction. So until I encounter some sort of data in humans I’m probably not going to restrict protein.

Bret: Yeah, longevity data is such a minefield because you know you need 30, 40, 50 years studies to really prove it. So it’s trying to draw best agreements from the data that’s there and a great deal of hours that can come from overstating the quality of the evidence and the subscribe that you have for your opinions.

Ted: Right, it’s bad.

Bret: It’s bad … good summary. And then there’s the issue of how our bodies respond to protein depending on our insulin sensitivity. And I had a great talk with Prof. Ben Bikman who likes to talk about research from Dr. Cahill and others showing that our insulin and glucagon fraction and our insulin response to protein is very different depending on our baseline metabolic state and insulin sense.

So do you witness any concerns in someone who is fairly insulin resistance at baseline, crusading with metabolic disorder, who hasn’t really gone a handle on it hitherto, devouring too much protein then because of the insulinogenic replies from it?

Ted: No, I actually have bigger concerns about that person eating unrestricted quantities of fatty, because they’ve clearly run out of adipocyte storage and that’s why they are insulin resistant. So “youve been” don’t have any place to make overweight if you’re acutely insulin resistant and what the hell is often do in the hospital as you know prior to bariatric surgery for example, we set person on a protein giving modified fast, where they are eating nothing but protein and just curbing nonprotein force.

And these people generally lose a ton of weight genuinely rapidly and their insulin predisposition dramatically improves even though they are just eating a cluster of protein. So I actually think that’s optimal. I think if you’re insulin resistant you are clearly internally over fat and you don’t have a lot of chamber to accumulate any kind of energy glucose or fatty and in that setting you might want to merely eat protein a la the medical protein sparing modified fast.

I’ve seen cases do that and have pretty good results. So I don’t think- I’m not saying is optimal to precisely devour protein but I’m saying that I don’t think it’s actively bad. I would have no concerns about that.

Bret: The clarity of insulin resist are able to obtain very difficult peculiarly distinguishing insulin resist and hyperinsulinemia. But I think there’s clear there’s a physiological regime where you’re insulin resistant in the muscle cells in the liver, but not in the fatty cells; you’re still storing plenty of solid. Insulin is working there, you are preventing lipolysis, increasing fat storage, but you’re sort of peripherally insulin resistant.

And I wonder if that would be different, because you said when you are insulin resistant you have nowhere else to give fat but clearly parties are coming fatter and insulin resistant. So I wonder if there’s a differentiation we need to draw there about defining insulin opposition better rather than exactly exerting one covering call of insulin defiance.

Ted: Absolutely and the reality is that your other tissues get insulin resistant before your solid cells do and the reality is that insulin opposition is this worst-case situation where anything bad you could get from insulin you are getting and good-for-nothing good. And so yeah, I is in agreement with that but even in that preparing I don’t see snacking protein as being a problem. I would still be more concerned about non-protein energy.

Bret: Interesting. Now some of the other benefits about protein, we talked about preventing sarcopenia and maintaining lean muscle mass, but beings have this concept that as long as I’m eating protein, I’m going to gain muscle. Is it that simple?

Ted: It actually is that simple if you are on a low-pitched protein nutrition. Like there are numerous studies where people were given a higher amount of protein in their nutrition and literally gained lean mass only sitting on the couch. Like literally you will increase your lean mass by only ingesting more protein especially initially if you’re coming from a lower protein food, which is very interesting.

Bret: Yeah, that is really interesting. And then there’s also the concept of satiety and feeling full and less hungry and a good deal of people in the low-carb and keto life talk about fatty. You feed your solid to suppress your thirst. But there are actually some studies showing that if “theres going” from 15% to 30% of your calories from protein, you dramatically reduce your appetite and increase your satiety.

So if you are going- and again I approximately hate talking about about macros, because we don’t eat protein, we don’t eat solid … we chew nutrient and it’s a combination of both. But if you’re going to put your finger on one macro or one particular area that affects satiety the best … would you pick protein?

Ted: Okay, first of all we know that protein is far more satiating than carbs or obesities in everybody, lean and obese; I convey this is basically a medical actuality. So protein provides the most satiety and we also have studies in a low-carb setting showing that 30% protein destroys 15% protein for everything: hunger, organization form, satiety, triglycerides, insulin, HDL … anything you can measure, 30% protein is better than 15% protein, even in a very low-carb setting.

So I desire like 30% protein nutritions. I convey this is kind of, you are well aware, Hunter gatherer diet territory and I like to look at every food through an evolutionary lens. So if I had to pick a percent for everyone to be eating, it would probably be 30% protein. If you’re not eating any carbohydrates that’s roughly equal grams of protein and fatty.

That would be one-to-one grams of protein and solid. Menus that are one-to-one grams of protein and fatty “couldve been” eggs, would be ribeye steaks. So mostly your steak and eggs sphere is various kinds of a 30% protein diet and I love that. I adoration that so much more than some keto diets that are 10% protein and 90% fat. I have just a big problem with those diets.

Bret: And what if some of us are doing well though? Someone feels better, they are reversing their diabetes, they’re losing force and their markers are improving. Do you still have sort of theoretical longer-term concerns or do you think as long as all their markers are improving and they are feeling well, okay, it works for them. I really wouldn’t recommend it blanketly for everyone.

Ted: Oh no, I can’t argue with success. If someone is doing well, that’s great. I have patients who are very successful on extremely high carb low-fat nutritions as well and if it works for you, I certainly can’t insist with that.

Bret: So again a sort of a bimodal dissemination. So with the force beginning, if you are having a very low-fat higher carbohydrate food, there are some reports that those people can be metabolically healthful, which sort of is completely contrary to everything “were talking about” in the low-carb high-fat world. So how do you explain that?

Ted: It’s pretty easy; it’s carbs and fattens together that are the problem. So if you go low on one or another, you’re going to be fine. Low-carb employments huge, low-fat works for some people, usually people who started out thin. Low-carb and low-fat and high-protein projects spectacularly well for all your bodybuilders and your bikini models and your aesthetic jocks out there.

So you go low-toned in one of those two and you’re pretty much okay. And that’s how it uses. And then we know that the combination of the two is what’s really driving the obesity epidemic. It’s carbs and fats together, this is a huge dopamine rewarding to your ability so all your obesogenic meat are high in carb and fat together, it’s your doughnuts, it’s your cookies, it’s your muffins, it’s your … mostly your broiled potato with butter and your bagel with ointment cheese and your candy tables … it’s this combination that’s bad.

So if you can get either one certainly low-spirited, you’re home free. Of track I prefer a low-carb approach, but that’s how these higher carb foods are working.

Bret: Interesting though how the baseline metabolic health is going to have a big impact on who can actually get away with a higher carb low-fat.

Ted: Exactly, so if you’re thin initiated with, low-fat is going to work great for you, because most organization obesity comes from dietary overweights. If you’re just not munching solid you’ll keep thin. On the flipside if you’re paunch initiated with, you’re going to be much better off with a low-carb approach, because carbohydrate dismiss fatty oxidation so much. So if you have a bunch of solid you want to burn, you really want to get the carbs low-grade. So I agree with you, it kind of depends on your basic starting point.

Bret: And the quality of carbs as well because if you’re following a high carb low-fat diet but still of refined carbs or high-pitched fructose I think you’re still going to run into trouble, so aspect does still matter, it’s important to emphasize.

Okay, so let’s get back to protein now for a few seconds, the quality of protein, because you identify different sorts of assertions about flower protein versus animal protein. So expecting we can agree on the amount of protein we require, how about the quality and the source of protein of where it’s coming from? Do you understand a big differentiation there?

Ted: I sure do and here’s how it operates. All of these proteins are broken down into amino acids before they’re even sucked so on some grade you’re getting the same amino acids either way and so why should it even matter, who charges, right?

But the reality is that plant foods are different than animal nutrients and they have a different essay of amino acids and they are less terminated for animal health, you know what I want? So like leucine, lysine, methionine, tryptophan, some of these crucial amino battery-acids that your body truly needs and is really looking for from your nutrition are much lower in plant foods than in animal foods.

So it’s just a medical point that you have to eat more of a plant protein to get the same amount of- a full amino battery-acid profile that you get from animal nutrients. And this is a really- if you’re a bodybuilder for example and you are getting protein from P protein or rice expenditure or hemp protein, or one of these plant-based roots everybody knows you have to eat about 30% or 40% more to get all the amino battery-acids you need to build muscle that you get from whey protein or egg white protein or some sort of animal-based protein.

So there’s definitely a higher quality to animal proteins. And that’s, if you’re looking at exactly the pure protein, then there’s also absorbability, so a good deal of the plant proteins are locked up in this fiber matrix and some of it is not getting absorbed. And so you’ve got bioavailability in the G.I. pamphlet and then you’ve got incomplete sketch of amino acid. So the animal meat are mashing the plant food.

Bret: So patently beings survive as vegans and there are plenty of vegan athletes who are doing very well, so it’s not that they can’t get it. They’re going to have to work harder, feed more calories and not have as bioavailable protein to get the same amount. So they’re going to have to exactly increase more carbs and more calories that go along for the ride to get the same amount of protein.

Ted: Correct and actually not very many people know this, but a super, super low-protein diet will actually give you a whole new level of leanness, simply because the cost of weight gain goes up exponentially as protein goes down. So if you can get your protein intake down below maybe 5% today, you’re very, highly lean because your body can’t open to build any kind of mass at all. Unfortunately and this is how like the 30 bananas a day nutrition wield, your fruitarian nutrition might be 5% protein, your potato spoof are very small in protein.

You’re going to actually lose weight and get thinner, but a great deal of what you’re losing is lean mass. And so you’re literally going to have lighter parts, your brain’s going to be lighter, your bone and muscles will be way lighter, so there is this like extreme low-protein approach that you typically are presented in the vegan world like the McDougall starch solution and this is you know extremely high carb, but it’s very low-fat, it’s very low-protein, and it “works” for time weight loss, but I don’t know if you really want the osteopenia and the sarcopenia that is definitely going to come with along that.

Bret: Yeah, perfect speciman of what the scale of assessments says and weight loss is not necessarily the same as health. And interestingly there are some prominent vegans who have said, yeah, you can lose weight with heroin and cocaine, but I am not going to recommend that to my patients. And they do that, “theyre saying”, in reference to low-carb diets, but it seems like they should probably be saying that in reference to this very low-protein food.

Ted: Yes, exactly, I wholly concur.

Bret: And then of course the nutrients that come along with the different sources of protein. You know, higher nutrient availability in the animal proteins compared to the plant proteins … again not that you can’t get them, but things like vitamin D and B12 and even heme cast-iron and zinc and of course DHA, I make all those are really fairly deficient in weed proteins.

Ted: Absolutely and the reality is you need you know at least 25 factors and minerals to run your mas and be healthy and weeds are absorbing these minerals from the clay but they are limited as to how far their roots can reach. So they will absorb a certain amount of minerals, but swine go around and chew a knot of different seeds and they bioaccumulate minerals, they bioaccumulate and bio-magnify nitrogen and minerals.

So as you go up the food chain, as you go up the trophic levels from weeds to herbivores, to carnivores, you identify higher and higher bioaccumulation and concentration of micronutrients like minerals and nitrogen and protein. And the reality is the higher you go up the food chain, the higher the nutrient density of the menu you’re munching, it’s just a scientific happening. That’s why animal foods are always higher in protein and micronutrient density than plant food … point.

Bret: Yeah, it attains gumption. So another thing that’s gotten favourite lately talking about protein is collagen. Sort of like a certain specific, very specific type of protein. So much so that people are recommending collagen pills and collagen complements. Where do you stand on the subject of collagen and how that fits into a healthful nutritional decoration?

Ted: You know, I adoration nose to tail eating, because it acquires ability to me from an evolutionary attitude and I do think that that’s a good way to look at anything when it comes to diet, is through an evolutionary lens and so it would make sense to eat collagen and connective tissue and the whole animal snout to tail.

On the flipside every bit of protein you devoured is just broken down into amino acids before you even absorb it into your organization. So I’m never telling anyone,” oh my gosh, you have to go out and feed X pounds of collagen a date exactly to get enough glycine”, because mostly if you’re eating, you know, ground beef or an egg, or if you’re eating any kind of approximately whole animal menu source, you’re going to get plenty in my opinion.

So I never tell anyone to make supplements, I think it’s not really- If you have the extra money for collagen augments, I would say just go out and buy some high-quality animal informants, like you know, only try to eat the whole cow, you know what I mean?

Bret: Yeah , now the snout to tail, we say it a lot, but a lot of people have a hard time doing it. Either psychologically they’re hesitating to make love or they have a hard time finding organ meats or, you are well aware, true-blue snout to tail nature nutrients. What are some practical tips-off you can give people on how to incorporate more of the notions of nose to tail eating?

Ted: Sure, first of all anytime you’re ingesting an part organism you’re getting this nose to tail form phenomenon. So like ingesting an egg for example would be spectacular, because you’re eating the entire organism. Or munching big fish, or dining the whole thing- mussels, clams, oysters, shellfish, small fish like sardines, you are eating the entire creature, you’re getting all the connective tissue, you’re eating all the cartilage and the bones.

Ground beef , is not simply it’s the most cheapest protein you can get, but there’s tons of connective material and material hurl in there. So I like eggs, I like ground beef, I like ingesting seafood in its entirety, like clams and oysters and mussels and that sort of thing.

Bret: That’s an interesting perspective because most people when they contemplate snout to tail, they repute I need to eat liver, I need to eat kidney, and psyche and nature, but you are saying , no, let’s focus on other organisms, but the whole organism. That’s a good perspective.

Ted: Yeah, I imply candidly I never eat liver, I never eat any part meat, but I’m eating the heck out of- can I say ” heck” on this podcast?

Bret: You can say-

Ted: I snack the heck out of eggs and sardines and oysters, I eat that substance all the time.

Bret: I feel keto and low-carb is very ruminant in flesh focus, so it’s a good view that there is a lot of other sources out there that are really good beginnings that we could still focus on. Now what about protein adds-on?

You briefly touched on P protein augments versus whey, versus egg white augments and protein shakes and we listen a lot about beings, you are well aware, taking extra protein, those shakes. I know you are a protein proponent, but do you encounter a difference in again a better quality, in the needs and requirements of real food protein versus protein shakes and adds-on?

Ted: Absolutely, honestly I don’t like protein augments, I’m not a huge fan of whey powder. Whey is actually this byproduct to the cheese-making process. It’s just a cast-off, it’s an unsolicited cast-off of cheese-making. They used it to simply feed it to boars or they just used it to fertilize soil with it or throw it away literally. And then person figured out you could evaporate and dry it and sell my shares to bodybuilders for like 50 horses a tub.

So I’m not a huge fan. You get behavior more satiety with real menu than imbibing nutrient. So you mostly never want to drink your calories. You also- the hurrying at which the protein is delivered to your arrangement is probably better if you’re eating a steak instead of drinking whey protein.

So I commonly don’t tell anyone to ever by protein solvents. I frequently don’t recommend them. And for me it’s more like an emergency level thing, like if you really don’t have time to eat, you might want to grab something like that. But it’s not my first choice.

Bret: Got it. So transitioning a little bit away from protein now to what you are also known for, is the exercise guy, but not just any practise; you are known as like the 15 minute do accommodate, do ripped, exercise guy. And I’ve heard lots of people say, I’m so upset with you, that we are able to have the physique, “youve had” … and be as fit as you are and merely 15 instants. And I think is important to realize not everybody will have that response.

Not everybody is going to be able to be you with 15 hours of effort. But tell us your general concept when you approach cases of how to implement exercise, the importance of exercise and specifically what the different types of rehearsal translate to maximal health.

Ted: Got you, okay, so there is really mostly two different types of activities. There’s resist usage and then there’s cardio workout. And you are getting specific are taking advantage of these. When you’re doing fight usage you’re trying to get more lean mass, you are trying to get more muscle and it’s remarkable for state.

Like the more muscle “youve had”, the highest your glucose tolerance or carbohydrate forbearance, the longer you’re going to live literally. And the same thing with cardio you’re mostly putting a stress on your person, a hormetic stressor that’s going to make it better later. Also a cardio you’re sapping muscle glycogen and after you deplete muscle glycogen your solid oxidation goes through the ceiling and your insulin sensibility goes through the roof.

Your glucose disposal croaks practice up and so you get all these massive health benefits. Expending glycogen from your whole body is a massive like metabolic reset. I like people to do two forms of exercise, cardio and defiance, and I like high-intensity exercise because it’s more time efficient. You can always trade intensity for duration when it comes to exercise.

In other terms you could do a time of all that 20 second sprint times and you’re basically going to get the same benefits you get from time moving for an hour or two. So the idea is you always can trade intensity for term.

So I like beings to do the highest intensity they can generate on some sort of cardio that could be merely hop hunkers, climbing up and down, that could be doing jumping jacks, it could be jumping rope, that is likely to be merely sprinting, that could be running up flights of stairs. You’re trying to maximize your intensity output to deplete glycogen and ramp up your fatty oxidation and it’s really, really good for metabolism.

On the muscle resistant slope the goal is to generate the highest tension you can possibly get in your muscles for as long as possible and it simply makes perhaps 30 to 60 seconds to max out on a situated of pull-ups or push-ups or any kind of pushing or attracting or leg category activity. So I have this is something that, really, really tiny protocol where you’re basically doing a propagandizing resistance practice, like a push-up, a attract fighting rehearsal, like a rower or pull-up, a leg resist utilization like a squat and you’re doing them all to failure mostly which might exclusively make 30 to 90 seconds.

And the goal is you send a signal to your muscles that they are inadequate the way they are and they have to be stronger or you’re going to die. So you did a super high-intensity default character used to work which might take just a few minutes and you actually get this adaptation where you have more muscle the next day.

And I just think everyone should be doing this; it’s so important to put pressure in your muscles this method and increase the headroom of how much work you’re capable of- you’re just going to live longer. I convey look at people in the ICU who are in berthed for two weeks and then they can’t even march. You now, we have to send beings to physical regiman to walk up a flight of stairs after precisely lying in bed for two weeks.

And as important as diet is, you really start recognise how important generating tension your muscles is if you’ve ever had your leg in a shed or you’ve been in berthed for two weeks or something … I mean your body exactly falls apart so rapidly. In a course it’s just as important as diet in my opinion.

Bret: That’s a great view on that. It’s not all about sporting execution, it’s not all about how much you can benchpress or squat, but it’s about being able to regain your part after a severe setback like that and the better starting point you have, the easier it’s going to be to regain function. So it is just like the key to your activity curriculum then is to failure.

Ted: Intensity, yes utterly.

Bret: Now what about someone who can’t even do a push-up or you are well aware, can’t even do a pull-up, like how do they even get started when they are starting from such a sedentary baseline?

Ted: Right, it’s all on a range. So you start with something that’s easier like a wall push-up. If you can’t do a push-up, you start with a wall push-up. You do all push-ups to failure. A week last-minute now you can do a push-up on the back of the couch or on a kitchen countertop.

Once you’ve done that long enough you can do push-ups on a … off of a terrace and then pretty soon you’re doing knee push-ups and then you’re doing regular push-ups and then you’re doing diamond push-ups and then you are doing one limb push-ups and then you’re just the strongest person anybody knows. And this is just sluggish gradual advancement from precisely oh my gosh, I can’t even do one wall push-up to as high-pitched as you want to go.

Bret: Yeah, that’s a good point about adapting it to the person and getting-

Ted: Progression … it’s progression. You start super easy, simply you are well aware, get in the door with one wall push-up and then just take it from there.

Bret: Now about rest periods? Is this something that you do or you recommend your patients do every day or do you think since you’re going to failure you need a day or two for residual and retrieval before croaking again? What does your timeframe look like?

Ted: So there’s kind of three variables when it comes to exercise: there’s ferocity, there’s frequency and then there’s capacity. I like maxing out severity because it’s the most time efficient. Then when it comes to frequency and capacity I likewise like frequency because it’s more time efficient as well.

So I like high pitch perhaps daily, perhaps every other day, so I’m often recommending beings do that kind of rehearsal if not daily perhaps every other day, but the magnitude is so low-toned that you’re just not going to be over-trained, you know what I signify? It might make you two minutes to thump absolute failing multiple times on a draw utilization and you are definitely going to be able to recover from that in one or two days.

Bret: And what about the concept that people are sometimes afraid of exercise because it spawns them thirsty? It kind of opens them an excuse to eat more and sort of the mental side of things that exert can then sort of harpoon weight loss, lodging to a nutritional planned.

Ted: Well, the interesting thing here is that if you’re doing low-spirited intensity steady-state cardio, let’s say you’re just lightly running for an hour or two, yeah you’re probably going to be hungrier after that and you might overshoot and devour more.

But for anybody out there who’s done a high-intensity exercise protocol, where you do Tabata sprints, you know, sprint as hard as you are able to for 30 seconds, respite for 30 seconds, one thing you’ll notice after that is you are just absolutely not starving because your blood sugar goes up a fair quantity, you get this release of glycogen, glucose from the liver, and a great deal of parties notice that they are actually little hungry after they do this.

And I encourage people to try this … if you’re hungry try doing a 30 second leap diddly-squat Tabatas: jump up and down as many times as you are able to in 30 seconds, rest for 30 seconds, do it again for 30 seconds, respite again for 30 seconds.

Do a couple of cycles of that and see how hungry you are afterwards. A mint of beings are just really not ravenous. So I’m not consider that high-intensity exercise is going to automatically start parties hungrier and stir them eat more. I think it’s exactly the opposite.

Bret: Yeah, I think that’s a great level. I know it from my dates training for triathlons, you know, going for long bike goes and long runs I was starving subsequentlies, but doing a good hard 30 minute seminar at the gym- completely different-

Ted: Yeah, utterly.

Bret: And I make a lot of people be understood that. We’ve heard a lot about the thinkings of Dr. Naiman and tell us now about Ted … Ted the family man, Ted the day in “peoples lives”. What does it looks a lot like for you? How these state theories you apply to your everyday life and your family life?

Ted: Right, so I’m married I have a beautiful wife and a beautiful 12 -year-old daughter and so we have this wonderful little family and the whole family is really into diet and activity. My daughter’s going to the gym and working out and my bride is really careful with her nutrition and everybody is healthy and joyous. And then I’m a primary care doctor at one of the biggest medical cores in Seattle, so I basically simply punch a clock there and experience patients and it’s very rewarding, I have a really great patient population, so I cherish my work.

This diet exercise thing is kind of a diversion but I’m lucky enough to be able to incorporate it into my job as well. So I’m really grateful; the pastime and the personal health journey and the job all sort of align in the same direction. And then exactly on a personal level I’m addicted to Ultimate Frisbee, like I exactly basically live to play Ultimate, it’s one of my favorite things ever. I am a bassist so I’ve played in a lot of parties and done a great deal of local music vistums in Seattle kind of stuff. And that’s kind of me on a personal level.

Bret: Multiple ranks to Dr. Ted. Now I don’t have daughters, I have two sons, but I can imagine a teenage daughter might be a challenge in terms of wanting to instill these healthful attires, specially when she’s out on her own social circles and she wants to fit in and she wants to assert her independence … and I suspect I shouldn’t just say daughter; that can happen with any girl truly.

So are you starting to see any of that creep up with your relationship or you are wanting your daughter to keep up with these healthy garbs?

Ted: Oh, you are well aware, my daughter’s 12 and of course her real destination is mostly- she’s ready to move out and get her own lieu and she recognise her mothers are just insane. So the practice we handle it is at home we just surround- the kids are encircled with healthful nutrient, like you know, here’s our healthful food, we’ve got tons of steak and eggs, we have tons of flesh and we have tons of veggies and we have tons of low-spirited sugar fruit and it’s just like good nutrient everywhere. Slews of good food.

But then when she goes out, we don’t inhibit her at all. We just tell her to eat whatever she requires. And it genuinely intent up kind of working out, because, you know, she’ll go to a birthday party and ingest birthday patty and then she’s like,” That was kind of sweet .” And she kind of gets to the point where she looks around and she looks at what parties are eating and she’s like,” Are they really going to eat that ?”

So candidly it’s just like lead by example. She ensure how her parents eat, she sees the nutrient that we have at home, she’s free to do whatever she demands and it seems to work out … at least so far.

Bret: You certainly have a laid-back approach that seems to work because you lead by example, and I think that’s so important. The other date my son was in a residence where there was this big buffet with all these candies and cookies and sugareds and he asked if he could have a cookie and we said, sure everybody is having cookies … whatever, we’re not going to fight about it now and let you do it.

And then he went back for a second cookie, and then he went back for a third cookie and then later that night he was complaining of how his belly was bothering him. I was privately very happy but he said,” Why didn’t you stop me from going back for more cookies ?” And that was a great opportunity to have this discussion … it’s not our job to tell you what to do. It’s our job to educate you and register you the course and help you stir your own decisions. And sometimes you have to let beings fall to learn.

And maybe it was the same thing with the birthday cake, right? She realise,’ that was pretty sweet, perhaps I didn’t need it ‘, but it’s that recognizing that,” Wow, look at the behavior people are eating “. Because in our society we don’t want to be ordinary.

Like the normal in society is broken and downwards and so you nearly have to be abnormal and stand out which can be hard for babies. So I like your approach, it’s a relaxed approaching, it seems to be working and hopefully is continuing to work.

Ted: Yeah I’ll restrain you announced.

Bret: Keep us announced! Well, it was very good to get a slice of physician Naiman and also Ted as the person and see how you walk the saunter and talk the talk for sure. I know you’re very active on social media, on Twitter and Facebook and you have a website so tell us how people can find you to learn more.

Ted: I have a little Facebook group, Burn Fat Not Sugar and a website and I am pretty active on there so it’s pretty easy to track me down.

Bret: And if anybody is in the Seattle area and craves a great primary care doctor … They know where to turn, right?

Ted: Absolutely.

Bret: Great , thank you, it’s been a pleasure having you on the Diet Doctor podcast.

Ted: Thank you for having me, I appreciate it.

About the video

Recorded at Low Carb USA in Seattle, May 2019, published in February 2020. Host: Bret Scher. Sound: Dr. Bret Scher. Editing: Captur4 Project

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