All right, welcome back, team, to the Building a Lifelong Athletes podcast. Thanks so much for stopping by. I really appreciate it. We have another chance to meet it. My name is Jordan Rennicki, and I'm a dual-board certified physician in family and sports medicine. The goal of this podcast is to keep you active and healthy for life. Through actual evidence-form education. Today, we're cutting through the noise on a topic that's really exploded on social media, and that's the carnivore diet. And we're seeing these massive sweeping claims from a lot of people about it being a panacea for everything from rapid weight loss to resolving autoimmune conditions. To improving your jaw structure and teeth, there's so many claims out there, it's hard to know what is real. But the world is a complex place, right? So, what I'm trying to do today is separate the scientific fact from the internet hype. And look at what's actually going on. So that's what we're going to look at today. And as always, I am never doing this in an intention to try to demean or belittle someone's. Preferred dietary pattern. And really, essentially, that's what it comes down to. This is someone's preferred way of eating for one reason or another. And there's a lot of vitriol on the internet saying, you know, if, oh, if you're a carnivore, I can never treat you because of this. I mean, it's very weird. The victory people have for people in the Carnivore space. And so I'm trying to be as objective as possible. At the end, I'll sprinkle in kind of my thoughts on things, but I'm just trying to go through what it is because I've had someone come up to me and Are on the internet and say, Hey, I'm a physician and people are talking about this. What is it? So, I'm trying to do a deep dive here to better understand and give people an understanding of what this diet and lifestyle kind of entails, what they're looking for, and what their underlying belief system is. And so First and foremost, let's define our terms, right? So, the carnival diet isn't one single protocol, right? So, it's kind of a spectrum of different diets. So, the one core principle, though, is a partial or complete exclusion of foods derived from plants. Typically, in a true, true carnivore, it means no fruits, veggies, grains, legumes, nuts, seeds, all that, all that stuff is eliminated, right? So, the fundamental rationale is the belief. That plant foods are potentially harmful or toxic, right? So, proponents talk about anti-nutrients like lectins, oxalates, and phytates. The theory is that these compounds might provoke gut irritation, might lead to Intestinal permeability or leaky gut and trigger systemic inflammation or autoimmune responses. So, from their perspective, it's framed as the ultimate elimination diet to remove potential dietary. Irritants. So they're saying, hey, we're going to remove everything that could be a cause of problem. Meat seems to be non-irritive. They say it doesn't affect the brush border, doesn't affect Uh, leaky gut, so they can eliminate everything, and this is the preferred human diet. That's generally where they're going. And first, let's talk about the strict carnival diet. This is the version most people think of, right? So, it permits all forms of animal flesh, whether that's beef. Pork, poultry, fish, seafood typically will also include and encourage things like organ meats. Also may include eggs and sometimes low lactase dairy like Butter or hard cheeses. Butter is pretty much always included on these. You can see people cooking and eating butter straight up, but it's a very, very low carb or zero carbohydrate approach, high protein and high fat regimen. Obviously, you can split things around and move your fat and protein depending on that, but a lot of times the split is anywhere from 60 to 80% fat, 20 to 40 percent protein. So, a lot of fat, a lot of protein, no carbohydrates. And all plant-based foods, even coffee and tea, are strictly forbidden. So, this is kind of the strict. Carnivore diet. The most extreme, even more extreme than that, is the lion diet. And this consists solely of ruminant animals, so animals like beef or lamb, and you can also have salt and water. So, ruminant means they have a stomach that is specifically four-chambered and it's thought to digest tough plant matter better. And so, that's where they're coming from. So, no poultry, pork. Fish, seafood, eggs, or dairy, just straight up beef or lamb, salt and water. You know, other people talk about condiments in terms of seasonings and other stuff. And it's a little, you know, there's lots of variability inside the actual carnival diet, but. Line diet, pretty strict, just eating beef, lamb, salt, and water. That's it. And for this one, the main purpose and where it came from is kind of a short-term therapeutic intervention, not necessarily a long-term strategy. For some people, they are eating this and doing this long term, but the idea is behind it. And the hypothesis is that cutting dietary inputs to the least immunologically reactive foods helps those people with severe autoimmune conditions. So. This was popularized by Michaela Peterson, who credits it with resolving her severe autoimmune arthritis. So she says she went on this diet and it fixed everything and got her better substantially. And so, this is the line diet. There's a book all about this and stuff. And so that's kind of where it came from saying, hey, how do I resolve this severe autoimmune condition that we had? From a clinical standpoint, its utility is. Specifically, an end-of-one diagnostic tool, right? So, symptom relief may simply demonstrate a sensitivity to an eliminated food rather than proving that it's from this all-me diet, right? So, when you say, hey, this worked for someone, that's wonderful. Like, and that's one thing all the time. We see this in the carnivore communities. People had drastic improvements in their life. I mean, drastic improvements. And then they get belittled by people on the internet saying, well, yeah, but it's still just eating meat. So, I mean, completely removing the context that they're debilitated, and then all of a sudden they're not anymore. And so, but that being said, This restricted, restricted diet, it's hard to know, and all these things is kind of a spoiler. Is it the all-meat diet that's eating it, or is it they, what did they remove that kind of guy? And so, kind of Maybe refrain success from meat cures disease to like extreme elimination can reveal food sensitivities, and then that helps you get better. And once again, does it really matter for these people who feel better? Probably not. It doesn't really matter to them. They're saying, hey, I feel better, and that's all that matters. But this is kind of my heuristic on this: hey, this is a huge and a very, very big elimination diet. You know, people talk about elimination diets, they go to the other side of things, too, right? They come, some people completely remove meat from an elimination diet, and they have success there as well. So, but Here, this is lineite, very, very restrictive. Then we have an animal-based diet, which is kind of represents a significant evolution, signaling kind of a retreat from the excluding all plant material. This is kind of becoming more popularized. Kind of a hybrid model popularized by Paul Saladino. It's still centered on meat. He calls it a meat-based or animal-based diet, centered on meat and organ meats, but reintroducing low-toxicity plant foods. Specifically, he talks about fruit. Raw honey and raw dairy products in addition to other animal foods that we talked about. And so this does is kind of a big shift in the carnivore community, right? So specifically. Going from, oh, like, hey, only meat to like, actually, we can add in some things and still have the benefits. And so it's kind of giving a little bit of ground there. And it's reintroducing fruit and honey, addresses concerns about long-term ketosis. Like electrolytiman imbalances, cramping, or impaired athletic performance for some people. And yeah, so it kind of gives people a little option of not necessarily having a zero carb approach, having some different things. But still, trying to keep it as quote unquote, you know, low toxicity is kind of the idea behind it. That's where this comes from. And so, let's take a step back, though, real quick, and look why this diet has had such a compelling narrative, right? It's a powerful blend of evolutionary anthropology. Historical anecdotes, and a modern rebellion against established nutritional science. And so it's really caught on and really just blown up. Here's the evolutionary argument, right? So the central pillar is an appeal to our evolutionary history, right? So the argument is that humans evolved as apex predators and Kind of were geared for a diet of meat and animal fat. That's the big thing. And then the agricultural revolution came and is framed as a mismatch shift. So, right. Causing this chronic disease, meaning, hey, we were never meant to eat this, we weren't supposed to be agrarian, we're supposed to be apex predators and eat meat. So, but then, agricultural revolution, it's way easier to get food when you just grow it as opposed to go have to go hunt it, and so that kind of led to our chronic disease. On top of that, we also have an idea and a theory that there's an expensive tissue hypothesis, which kind of posits that there's a metabolic trade off. To evolve large, costly brains, our gut had to shrink, necessitating a move away from bulky plant matter to energy dense animal protein and fat. And modern gut anatomy supports this potentially with talking about a smaller colon and elongated small intestines, similar to omnivores. This is not an area of extratis of mine by any means, but this is the arguments that they're talking saying: hey, that our guts recognize people who are probably better with eating more animal-based products than the guts of animals that eat more plant-based. And so. Obviously, the evidence is often oversimplified, saying, Hey, look at these things, we therefore have to be perfect for this. It's kind of a leap to go from meat was essential to evolution to an unsubstantated claim that Hey, actually, an all-meat diet is optimal, and that's like what we're seeing. There's lots of thesis. And if you look at the overarching evidence, it seems like most people, anthropologists and biological anthropologists, classify humans as. Adaptable omnivores, not necessarily obligate carnivores. So, obligate carnivore means like, hey, you have to eat me. That's what we're made to do. Whereas omnivores can eat a multitude of things, right? And so, once again, this is not my area of expertise. I'm not pretending. I'm sure someone can correct me in the comments. Um, but this is, I'm just once walking through like what the overall beliefs and the research that I've done. They're saying, hey, like, actually, our evolution has told us that this is a perfect human diet. And I've seen that claim online as well. This is the perfect human diet for everybody, it's what we're made for. You know, they support people also. Look at the Inuit tribes, they eat nothing but whale blubber and meat and fat, and they're fine and thriving. But then, you know, spoiler, and look at the other side of things where people eat a lot of plants in other areas and also thriving. So, once again, This is not my expertise. I'm not going to pretend to be an expert in this, but this is the argument that we say, like one of the arguments that you see online. On top of that, we also had taking a little back looking at history. This isn't necessarily a new invention, right? So, this isn't the first time we've ever seen it before. It's been in or around for the last 150 years documented. In the 1870s, there was a physician, Arlalo Catani, who prescribed an all-animal diet for people with diabetes in the pre-insulin area. So that's what he said. Hey, like, you have diabetes, we don't have insulin, like this can be cured diabetes. Obviously, not necessarily type one. Like, that's not necessarily going to be the best thing in the world. That's going to unfortunately lead to bad outcomes. But. Saying, hey, we can try this thing. And other examples are: there were Arctic explorers in the earliest 20th century. He observed, once again, the robust health of the Inuit on almost exclusively animal-based diet and said, hey, that can happen. And then so, to counter skepticism, he underwent a year-long medically supervised all-meat diet at a you know, supervised by a hospital, and physicians were surprised to find him in such excellent health at the end. And so this is, once again, not a new idea. Obviously, this wave of it is definitely new, but it's been around for hundreds of years now talking about people eating this. In the modern movement, though, this diet really exploded into mainstream around 2018. It was fueled a lot by social media, right? This is like the first dietary trend that's like been huge on social media. I bet if Atkins had social media back in the day, this would also be very similar to that. But this was fueled by public figures, specifically like I mentioned before, Jordan Michaela Peterson, saying, you know, how the lion diet helped heal Michaela's autoimmune disease. And a kind of a cornerstone of anecdotal evidence. So, and I say anecdotal evidence, what I mean by that is people telling their story, saying, Hey, this is what happened to me, and this is what happened. And I'm not saying that disparagingly, saying, Hey, it's anecdotal versus research. That's all we really have right now. So, anecdotal: I don't mean that in a bad way, but that's just really where we're at. And so, social media, though, in this situation is kind of an ideal ecosystem, right? So, it's a shock factor. We know that we all click on things that are crazy. So, when someone says, I eat only meat. That's a big thing, right? And you show pictures of massive plates of meat and steaks, provides these strong visual hooks. And so, really, it kind of really exploded. On top of that, There's also another core appeal of rebellion against the establishment, meaning, hey, traditional dietary guidelines, look how much of a scam they are. And this kind of tapped into public distrust of the official dietary guidelines. And this is like perfect timing as well, because, right, over the past, I don't know, five years, lots of stuff has happened in the world. There was lots of distrust in the government, and you know, big organizations and whatnot. So, kind of really, I Went all there. And then, but the big thing I think they do fantastically well is it offers a message of hope for those who feel failed by conventional medicine. And that is for sure. Right, conventional medicine, what I've traditionally practiced in before, is yeah, you meet people all the time who hey, they've tried this, they've tried this, and it hasn't worked. And we say, I don't know, and kind of shoulder shrugging. And we have a Ton of people. I say all the time: we have people here, you know, on one side of a chasm, say, Hey, this is where they are, and this is what we know. But then in the middle, we have this big gap, and that's like Probably where most people live is that we don't really know everything yet. We have a lot to learn. And so we have a huge community of people who said couldn't get any help from conventional medicine. Turned to this, had life-changing results, and they say, Hey, from that, raving fans. And big anecdotes and stories are very, very powerful, right? Like, humans love stories, and so when we hear Success stories, then man, that really kind of catches on. And then you add that in fuel of social media, and it's really kind of the perfect storm for this taking over. And that's why we see it so much on social media, but very, very intriguing for sure. And so, I do want to talk about who is kind of talking about this online, right? So, who are the main medical voices you'll see promoting these diets online, right? A common thread is that a lot of these are physicians who've reported significant personal health improvements. From the diet, which then catalyzes their advocacy, and so these are just the main voices. Once again, I'm not saying anything about what I believe or whatnot, it's just more of these are the voices that you will see and kind of run across as well. So, we'll start first year. Uh, Sean Baker. This is often considered the most visible and influential populizer of the modern carnivore diet. He has a background as an orthopedic surgeon and was a pretty high-level rower as well. He has his own YouTube channel, social media, all that stuff. And he's a big, strong dude. Like, if you look at him, he's a big, strong dude. And he has a lot of advocacy for the carnivore diet and A lot of times, anti-the mainstream nutritional science, which is, you know, kind of contradicts, you know, he's saying what's going on here, nutrition science is wrong, and then go there. So that's one voice that you'll see commonly. Another voice you'll see is Paul Saladino. So he has a background in psychiatry. Initially, he was a proponent of a strict carnivore diet. He used to be carnivore MD as handle, and he's kind of moved to Paul Saladino. He since evolved his position to an animal-based model, which reintroduces fruit, honey, raw dairy, as you mentioned. And he said the big rationale for his shift was his own experience with electrolyte issues, cramping. And just kind of on this long-term diet, he felt this is a better fit for him. So he's kind of been one who he's still in that animal-based community, obviously, a big voice on social media, but isn't a strict carnivore anymore. But so he's kind of introduced this whole animal-based seed. We also have Ken Berry as well. He's a family physician by training. He has practiced in Tennessee for a while and he saw a lot of chronic disease there. And that kind of helped him get in this low carb space. He was low-carb initially, and then kind of on the carnivore here. He once again has a very, very, very big social media. I think he has like millions of followers on social media. And so he's another voice you may or may not see. And then another one is Anthony Chaffee. Background in neurosurgery, I believe, in Australia, where he was a resident for a while. He was a former high-level rugby player as well. So, strong, once again, another strong fit dude. And he's a proponent of a very strict version of Carnivore, been practicing it for many years. And he kind of talks about the and emphasizes the evolutionary arguments and has the idea that plants contain harmful defense chemicals. That's kind of where he stands. But my guess is, if you're watching this episode or you're seeing this podcast, you've probably seen them in some way, shape, or form because they have way, way, way bigger social media followings than I do. And yeah, those are kind of the main voices. There's obviously lots of other ones out there, but those are the big ones that we consistently see. And so now it's time to get into the claims, right? So advocates for this say that Carnivore is the answer for a wide variety of modern health problems. And I want to objectively kind of catalog these benefits with their proposed mechanism. Then we'll kind of present arguments as they're made by the proponents and then critically evaluate the evidence and where we're at. First things first is metabolic health. So, the claim is that the diet induces rapid and significant weight loss without hunger. So, people can eat carnivore, they're eating just fat and protein, and they don't get hungry. That's really, really what a lot of people say. And they also claim it's a powerful tool for improving glycemic control with adherents reporting reduced need for their diabetes medications or even getting off specifically. And how does this happen? Well, the mechanism mainly is inducing ketosis. A lot of times, we think about it. Obviously, if you eat too high of a protein diet, you may not get any ketosis if you're eating more. Fat ketosis is easier to get into, but when you get into ketosis or this low, low carbohydrate diet, it forces the body to switch from its primary fuel of glucose to fat. On top of that, how this may be working is that you have enhanced satiety from protein and fat, right? So, leading to a spontaneous reduction in calorie consumption. And on top of that as well, we know that we're probably going to have pretty stable glycemic control by removing all dietary carbohydrates. Eliminating blood glucose and insulin spikes kind of staying flat. And so, this is the big one. I mean, this is like undeniable that, like, when you eat this way and you know, eat keto or low carb, like you shed weight for most people, not everybody. It's perfectly. You're able to do it, you know, especially today with all the keto junk out there. If you just keto garbage nonstop, you may not lose weight. But at the end of the day, what's happening here is predominantly an enormous reduction in calories, right? So people don't just lose. 120 pounds by eating the same amount of calories, right? They're definitely reducing their calories. And that's like the main way they're doing it. Any strict diet will do that, right? Any strict You know, restricted diet will decrease calories. And so, but here we are definitely doing that. And when you lose a massive amount of weight, it leads to good outcomes for metabolic things. We have wonderful weight loss, good for blood sugars, good for blood pressure, all those things. And so, but that is one thing here: the metabolic health, a big reason people take this. And then next, moving on to autoimmune conditions. So there are, this is probably the most dramatic claim than the most impressive claims that you hear from people. So people who've Use these diets, report profound improvements or complete remission of conditions like rheumatoid arthritis, psoriasis, inflammatory bowel disease, all these things. And the proposed mechanism behind is that an elimination of plant-based immuno triggers is what's happening. So essentially, plants have these plant defense chemicals or anti-nutrients, and that It's those things that are underlying causing the issues that people have, these autoimmune conditions, leading to that leaky gut, leading to inflammation, all those issues. And the idea kind of compounds also that, once again, all your intestinal lining, it's. Messed up, and then you have gut permeability. All these things trigger an issue with your immune system. So, this leads to an immune response that we don't want. And by removing all those things, We have that, and I think there's no denying this is a really, really important thing to talk about: is people claim to have incredible results. And I don't say claim as like, oh, I don't believe it. Like, I clearly believe someone who said, Hey, I was on these meds, and no, I'm not. I believe that. And the question is, though, is it coming from removing everything, or is it just one specific thing that really bothers them? We don't necessarily know, but people are having a lot of success on the internet. And that's what they're talking about here from the autoimmune claims. Next, they talk about neurologic effects. Some people, followers of the diet, describe significant improvement in mental clarity, focus, and sustained energy. Also, reduction in mood disorders like depression and anxiety. And this one is going to be a lot harder to actually get to the bottom of in terms of mechanism-wise. You know, some people propose that maybe you're getting a stable amount of glucose. In the body, eliminating glucose spikes, which may lead to energy and mental clarity, that's still to be sussed out. Also, people say, hey, when you're eating this way, you have a high intake of brain-specific nutrients for meat like vitamin B12, iron, and zinc. That may be helpful. This is going to be hard as well. Also, when you lose a lot of weight, are you going to improve your mental clarity focus? But people do seem to say when they're on a low-carb diet, they feel like locked in mentally. And so that's just something to consider there. And now, this is kind of where we have to understand and kind of apply a critical lens to this, right? So, the reported benefits may be driven by more of what the diet eliminates than what it exclusively includes. Right, so that's once again. This is me playing devil's advocate right now, saying, Hey, do we know this? The carnival diet removes all ultra-processed foods, refined carbohydrates, added sugars, and you know, they're a big thing on like seed oils or anything that's not animal-based, so, pretty much all those things. These are probably huge staples of an American diet, right? But we know that a lot of these things, in terms of specifically the processed foods, refined carbohydrates, added sugar, all those things are strongly linked to obesity, metabolic dysfunction, and inflammation, right? So. Consequently, it's exceptionally difficult to disentangle the specific effects of consuming only meat from the benefits of ceasing a poor quality modern diet. So moving from the standard American diet to any diet Will give you some improvements, right? I've heard incredible stories of people eating their regular diet, switching to a plant-based diet, to a Mediterranean diet, to a keto diet, to a whatever have-you diet, and having drastic improvements. And so These improvements are highly confounded. What I mean by confounded is there's a lot of things going on, a lot of things are changing at once. And so we have to kind of think about that lens. Is it actually this diet? Is it what is actually entailed in the food itself? Or is it what we've eliminated in the process? And, you know, it's. Spoiler alert, we don't know, but that's kind of the underlying question that everyone really has. Okay, so now that we know the what and the why, let's dive into what we actually know from a scientific perspective, right? So, when we evaluate the carnivore diet, we're immediately confronted with an unfortunate situation where we pretty much Have a vacuum of evidence. The diet's extraordinary claims stand in stark contrast to the near-total absence of high-quality scientific research. Once again, I'm not saying that the improvements people are having are not real, I'm just saying that the data we have is lacking, that's for sure. And where are we on this spectrum? Well, unfortunately, we have, I could not find a single randomized controlled trial looking at the carnivore diet. You know, first of all, you have to stop back and say, okay, this is a pretty new diet, so that's understandable. Two, Pretty hard to do RCT on someone who, like, randomize. How do you randomize someone into a carnival group? It's like you're going to know if you're eating meat or not eating meat. So, I'm not saying this is the fault of anything. I'm just saying this is hard to do because. We are missing these RCTs, right? That's kind of our gold standard. It's hard to determine causality of anything that's said that we can place it just on the diet. So, RCTs. The thing behind them, why they're so helpful, is because we can eliminate everything but one variable, hopefully, and then if something changes, we can say, Yep, it's probably just that variable. Whereas dietary interventions in general are very hard to study, and so this is going to be very, very challenging. And once again. The current evidence is composed almost entirely of anecdotal reports, self-selected surveys, and case reports, and it would be categorized as very low-quality evidence. And once again, that's not me attacking the evidence, that's just saying where we're at. The academic world, you'd say, Hey, you know, meta-analyses, RCTs, kind of work down the case things, and then you know, case reports. That's kind of where we're at is that lower quality evidence. That's not to say that improvements and how people feel, I'm not trying to diminish those. But that's where we're at. And this is another thing I see a lot on the internet: people say, I don't care. Like, look at all the stories. Look at all the stories. Like, I've gotten this one, I've done other studies looking at peptides or whatever. People say, look at the stories, Jordan. Like, clearly, this works. And my answer is always: that's wonderful. I'm so glad they're working, but how do we know it's because of that thing and not a placebo effect or whatnot? But either way, neither here nor there. The study is We hope that more research is coming. I'm sure they are. I know people are into this, but currently, it's not a very robust data set. And there are some big ones that are out there. There was a Harvard study from 2021. It was a cross-sectional survey of over 2,000 adults on the diet for at least six months, and there were definitely limitations as participants recruited primarily through pro-carnivore social media platforms. So these people were carnivore already saying, volunteering for a study to say, hey, look how good this has been for me. The findings, though, were that overwhelmingly self-reported outcomes were positive, with high satisfaction with significant health improvements as well. There was, once again, a limitation as well. Selection and survivor bias is a massive issue as it attracts those who've already had a positive experience. And exclude those who probably stopped or moved on and something that didn't work. And other limitations include self-reported data, which is recall bias, and the lack of a control group. But we have data points here now saying, hey, we have A lot of people saying, hey, this has really worked for me. So that's kind of the first thing. On top of that, we had another German study in 2025, which was small, so 24 participants, but included pre and after diet or on-the-diet blood panels, which is great. So The findings were the participants reported subjective improvements, but the objective blood data was mixed, potentially concerning for some people. Statistically significant and striking increases in lipids, essentially, specifically LDL, were observed in the group as a whole. The median LDL cholesterol rolls from 156 before the diet to 256 after. And it kind of highlights the clinical paradox and what we see a lot here: where patients feel surveillantically better. But some lab markers may look worse from traditional metrics. And so, this is like really where the carnivore community and traditional medicine like buttheads. This is like the big thing. I think nobody's going to disagree: like, hey, you've lost a ton of weight. You've. Gotten off your diabetes meds, you've gotten your antihypertensive medications, like great, great, great. That's all great. It's right here, like the lipids. This is where, like, the big, big question that everyone's going to talk about. So, we'll talk a little bit more about that later. There was also a paper out there, a case series for patients with inflammatory bowel disease, and reported on 10 patients with IVD who achieved remission on a very low-carb diet. And the findings were clinical improvements reported as universal across all 10 cases. And one striking case showed a fecal calprotectin, which is an inflammatory marker, decreasing from 4,000 to about 9, which is normal, meaning, hey, a really big decrease in inflammation, which is wonderful. As a case series, can't prove causation of this diet, but definitely represents a strong signal of biological plausibility for future research. So this is wonderful. And so now this is where kind of our clinical hat comes on, right? So while evidence for benefits is sparse, the potential harm is. Unknown right at this time, right? We don't really have much data. And so we kind of have to weigh powerful anecdotal stories and reports of benefits, balance it versus potential risk in terms of cardiovascular disease, which we'll talk about more. This is kind of where we have to sit. And so, as I mentioned before, the most immediate and significant concern for most people is the impact on cardiovascular health, specifically their lipids. The diet is exceptionally high in saturated fat and dietary cholesterol, which we know can increase LDL or atherogenic lipoproteins or APO-B. And so, high saturated fat intake is known to increase that. We know that. And, you know, the question here is: what role does LDL play in heart disease? Right. So, we'll talk about that in a second. It definitely elevates LEL. And the idea in the traditional medical establishment views this as kind of competing risks, right? So a patient might normalize their blood glucose. And improve their blood pressure, but elevate their LDL to potentially dangerous levels, or according to ACC and HA guidelines, high enough where you probably should be on a medication. And so. There's this trade-off of metabolic risk for potentially long-term cardiovascular risk. Like, that's what everyone's trying to balance and understand. Like, we don't know these patients. We've never seen these people before who go on these low-carb diets and have really high numbers. Like, long-term, are they going to be fine? That's like really inactive. Area of research right now. And that's what we're looking for. But that's really why, and I'm trying to bridge the gap here. This is why the online community people say traditional medicine knows nothing. And traditional medicine says these carnivore people are crazy. And it's like, this is where we sit in the middle. This is the big crux of everyone. So What happens here? Like, how do people get these numbers in their LDL way through the roof and say, doesn't matter? It's fine. Because you will look at people online and they say, hey, it doesn't matter at all. Like, higher, the higher the LDL, the actual, the better. I've seen people verbatim say that. And. For a while, people just said, Hey, like, it must be fine. Like, I feel good. My other numbers are good. Like, it must be fine. Then they started using, you know, trail start HDL ratio, saying that as long as that's fine, that's more important than your LDL. And they really didn't have any sort of idea behind their mechanism until some scientists came out and introduced something called the lipid energy model. So it proposes that on a very low-carb diet. The body traffics a large amount of fat for fuel, and these LDL particles are interpreted as the emptier transport vehicles in this high-turnover fat-based energy system. A lot of times they're saying LDL is not a sign of pathology, but it's actually just a remnant saying, hey, we're moving cholesterol using it efficiently. That's why it's so high because we need it to carry a lot of things. That's with the general idea saying, hey, how we can kind of put together and say, hey, why is it okay to have a high LDL? This is the justification for that thing. But I will say this model is definitely a hypothesis. It's very early on, and it stands in direct opposition to decades of traditional cardiovascular research, right? So it definitely offers a plausible mechanistic explanation. But provides no real long-term clinical outcome to prove that this LDL elevation is benign. They're saying, hey, and traditionally, on top of that, in this lipid energy model, people will say that, hey, Heart disease is caused by inflammation. And they say LDL, yeah, yeah, yeah. We know cholesterol is in there, but it is inflammation and endothelial damage. That's the big thing. And if you have. Rock solid blood sugar, no issues there, no spikes of glucose, and your blood pressure is fine, then like you can't damage endothelium, and then you can't have inflammation. Your inflammation will be down, so therefore, you will not have heart disease. That is another unsubstantiated claim saying, hey, this is what's going on. And there's definitely data in terms of like LDL is not one for one. And I think that's, you know, traditional medicine saying, like, it's only LDL are probably missing the boat. And then people saying that, hey, it's only inflammation. Might be missing the boat as well, but this is where we live, right? Right now, we have the traditional medicine saying this and these people saying something else. And so a lot of people are stuck in between saying What do I do? What do I do? I have other videos discussing that, so I'm not going to go in that here. But that's where we, this is the big, the biggest crux of the issue. I think if we had no issue in our LDL, if we had perfectly normal blood lipids, everyone would be like, fine, man, you do you. Like, you do carnivore, not a problem. But because we have such drastically elevated LDL, people start to get worried saying, What are we missing? Could this be bad? And so, this is where we're at, and this is why I want to talk to you about that specifically On top of that, people also worry about nutritional adequacy, right? So eliminating entire food groups can lead to potential nutritional deficiencies. You know, they don't have any dietary fiber in here, which I thought to be important for digestive health and gut microbiota. People on the diet will say otherwise, saying, Hey, actually, I've never felt better without it, but traditionally, it's a turn from our traditional idea. Also, vitamin C can be difficult to get at the recommended daily allowance level through just meat alone. Also, things like potassium, magnesium are found in lower concentrations in meat. Also, calcium and folate, specifically vitamin B9, primarily sourced through leafy greens. And so there's a lot of potential nutritional gaps. People say, hey, Well, you need to supplement, or you need to take, you know, more organ meat. So, there are options, and people say ways to get around there. Um, but that's that's one justification that they say, and one concern people have on top of that. People say, hey, you're actually missing out on all the beneficial qualities of plants. So, plants can have these anti-nutrients, but they also have positive things like polyphenols and flavonoids, which seem to be helpful. And so, once again, more people just like head scratching, saying, Well, what are we doing? And is this bad? And a lot of we don't knows, but this is where it's coming from. And what's the long-term consequences? Like, unknown, right? We have no idea. So, long-term outcomes, we worry about, you know, think about gut microbiome, a diet devoid of fiber. Can this cause a huge shift in your microbiome? Probably will. Is that going to be negative long term? We're not sure that's what we're looking for. Kidney function, as well as another one. High-protein diets can increase the metabolic load on the kidneys. And with those who have preexisting kidney disease, it may accelerate decline. So that's the one thing that you have to look out for. I think it's pretty well known that if you have a healthy kidney, high protein loads don't seem to be an issue. But if you have protein issues or kidney issues, that can lead to worsening of that with a high-protein diet. Also, people talk about like a cancer risk. A large body evidence links high long-term consumption of red and processed meat with an increased risk of colorectal cancer. And you know, in this diet, people say you can eat whatever you want. Like, you can eat hot dogs. That's not a problem. That's certainly a processed meat. Is that going to lead to issues? Once again, we're going to see down the line, but these are the traditional, like, this is the reason people are worried about things. And this is why I wanted to just have this presentation, to just present it and say, We don't know, but here it is, and so we can kind of all just talk. But protein here, we're also going to talk about some other things from a science perspective. So I want to get a little nerdy here. There's a Fundamental trade-off between potential, potential growth, and longevity, or this diet and longevity. So people talk about long longevity and eating. There's some research talking about animal protein, it can activate cellular pathways like mTOR and IgF-1, which are essential for like building muscle, which is great. So, eating protein is great for muscle protein synthesis. That's great. But the paradox is while robust activation of mTOR is good for building muscle. Some people say chronic lifelong upper regulation of this can lead to the same pathways that are linked to accelerated aging. And a systematic review concluded that high animal protein diets are excellent for hypertrophy, but potentially. Could lead to these issues down the line. Once again, nobody's done like a long-term study on this, but these are more mechanisms for why people are kind of concerned about this. So increased mTOR lifelong, is that a bad thing? That's the question in the trade-off we have. I think most people say, Well, I'll deal with that problem later. I'm taking this because I don't feel good and I want to feel better now. But I'm just bringing up all both sides of the arguments here. I know that's a lot of stuff. I want to bring it back here to a 20,000-foot view and talk about the big rocks, right? The most important practical takeaways from this thing. So, first of all, the evidence is unfortunately weak, right? So, the diet's Populated is built on a foundation of success stories and potentially just biased survey data, right? So there's no RCTs out there to validate its efficacy and establish long-term safety. So any claim of causality. Is unfortunately scientifically unsubstantiated. Once again, that is just me talking science saying, like, from a science perspective, we can't know. Not to diminish the improvements that people have very clearly had on this diet and feel passionate about. And so. I'm just saying we unfortunately don't have the data behind it. You know, and all of nutritional epidemiology and studies are challenging, but you know, compared to like a Mediterranean diet or something, or even a ketogenic diet, we have a lot more evidence on there. We just don't have that quite yet. Hopefully, we'll get some, but we're not quite there. From the benefits, we are certainly getting benefits for some people, for a lot of people, I should say, for a lot of people. So, what is causing that? If I had to guess, probably from elimination, not necessarily inclusion, meaning, hey, it's just the meat you eat, like, it's the meat. And eliminating the things that are probably getting the positive effects are highly confounded, right? So it's difficult to disentangle from simply eliminating ultra-processed foods, refined sugars, and losing weight, right? Its utility, though, with some autoimmune issues, may be due to its function as an extreme elimination diet, probably not necessarily because it's the optimal diet, but we're moving something that's bothering them and causing this and getting better. So, something is working for these people. What is it? Is it the meat or is it eliminating something? We don't know. If I had to guess, it's probably elimination, but we will see and find out. So, the other takeaway is the unclear cardiovascular risk. People will say that, hey, I've improved everything else. I'm okay with taking that risk. And that's certainly fine. But for me, this is like the central clinical paradox. This is why when you go to your doctor's office and you're on carnivore. They doctors go bananas, like, oh my gosh, what's going on? It's because of this, this traditional thought that, hey, actually, this LDL or APOB, like having it elevated, we worry about that. And I think it's pretty interesting this conversation, right? So the proponent-led lipid energy model. Can justify the elevations in LDL saying, hey, this is why we believe it's not an issue. Unfortunately, it's not supported by long-term outcome data, and it opposes the general weight of the evidence that we've had from years and years. Where do I sit on this? Like, this is one of the other videos on this as well, but this is like the biggest question for me. Like, I really don't care what anybody eats. And even, like, that's all I care about, but this is like the biggest crux: what are we doing long-term-wise? And that's, you know, we have lots of discussions online and whatever. Funnel, you get you know, funneled down, you know, whether it's the traditional medicine or carnal, like they complete opposites, and nobody wants to talk to each other. Nobody will recognize that, hey, maybe there's some talk back here, and I think that's very unfortunate. That's where it is. And then nutritional risk, as I talked about before, you know, no fiber here, maybe low potentially in vitamin C, folate, potassium, magnesium. All those things we worry about long term. What happens? We don't know. We have no idea. We're also limiting protective and positive components from plant products. Does that matter? Who knows? But we're going to find out down the line, and that's what we're looking at. And based on the current evidence, is this a high-risk intervention? Like, well, it's one of those potential high-risk. We don't necessarily know, right? It potentially. Have the people who feel better, right? So we have risk-benefit ratio. Some people say, like, traditional medicine, this is an unfavorable risk-benefit. Like, I'm not worth that. And so when I'm the words on the screen here, I'm not necessarily saying this is my opinion on this. Wholeheartedly, but this is like traditional medicine saying, Hey, like, this is a high-risk thing. We have no idea what's going on, but we have these people over here feeling better while cardiovascular markers are getting worse, and like that's the biggest concern. It's potentially clashes against all things, requires, you know, people think it requires medical supervision for electrolytes, all those things. And so, this is why there's a lot of concern from people saying, hey, like, We should check your lipids, your kidney function, your inflammatory markers, your electrolytes, all those things. So, like, I think it's just generally a good idea: work with someone if you're going to do this. Like, let's work together and we'll figure it out and kind of go from there. And I say that to people all the time: that's If you're going to do something, whether it's anabolic steroids or whatever, talk with someone, find someone you're comfortable with who will do it. And obviously, if someone comes to me and like, I want to take anabolic steroids, I'm like, that's probably not a good idea. I don't think I'll do that. If someone comes to me and says, I want to try a carnivore diet, I say, okay, I want to have a conversation, right? And that kind of takes me to my next slide here. It's like, we're going to have a conversation. The big thing is, I want you to see the whole person. The last thing I want to mention is that I want people to understand why someone would do this diet, right? I think. I don't think this is a lot of people's first choice, right? I don't think most people are like, hey, I'm going to eat nothing but meat for the rest of my life. Like, most people find themselves here because of some issue in their life that's debilitating to them, whether that's their weight, whether it's an autoimmune condition, whether that's diabetes, who knows? These people have been trying to do what is right for them for a long time and fail. And they found something that is actually having success for them and their family. And they feel like it's changed their life, right? So, if something changes your life, you want to tell people. Right, you want to like you want to evangelize, you want to spread the gospel, saying, Hey, this is good for me, and this sort of works. And it's a perfect match with social media as well, right? So, but I see so much online rhetoric where people are getting vilified for what they eat. And although I see it on both sides, it really bothers me, right? So, people saying who are in the Carnivore community say, oh, there's, you know, they'll call people like vegan or, you know, whey, you know, soy boys or whatever, and say, oh, they look at the plants. And the other side of people saying, oh, they're, you know, smooth-brained people just eating carnivore. And like, it doesn't. Why are we doing this, guys? Like, it's so stupid. We're so polarized these days and we can't agree on anything. And we speak such hatred because, like, why? Because if we disagree with someone on how they eat, that's crazy. So, I. My approach to this, generally how I do it, if someone comes to me, I lay out not a 40-minute podcast like I'm doing now, but I lay out the risks and benefits saying, hey, like, this is absolutely someone can try. These are the risks of what's going on. We don't know the long-term outcomes of the cardiovascular outcomes. We don't know nutritional deficiencies. Like, we don't know any of these things long-term. You know, yes, we've had some people who say, I've been doing this for 20 years and there's no problem with me. Guess what, man? People who smoke cigarettes all day, every day and don't get heart disease, but we know that's still not a good idea. So we can't just rely on that. So I just, I'm honest with people. I'm honest and say, hey, I don't know. This is what we're looking for. But I let people know I care about them specifically, like them as a person, more than I care about any ideology in a diet. And say, hey, if we can work together, that's fine. I would still want to see things right and evaluate them and look at them and make sure that. Our electrolytes are good, that our kidney function is good. I would look specifically at lipids. I would still look at things and say, Hey, if you're going to do this, if you're going to say, Hey, forget that, I'm going to look at only my triglyceride HDL ratio, like. Do I think that's the best marker? No, but I'm saying, okay, if we are, then we got to have that locked in, right? So, also looking at our blood pressure and our blood sugar, all those things. So, working with someone, that's how I would think about it: if we're going to have. One potentially unmitigated risk factor, then we got to make sure everything else is locked in. And I think that's probably a fair and reasonable thing to take. You know, I also have an issue. I see people saying, I would never take care of someone who's caring more. Like, I can't agree with them, so I can't take care of them. I'm like, dude. It's like if you have someone who smokes, you're like, I don't agree with them smoking, but you're going to like not take care of them. It's crazy to me. So, but I see that out there. And I just want to bring that up. Are there some non-negotiables? Like, if someone's like, I'm going to do this, I'm not going to, yeah, then maybe it's, I won't do it. But I think. I think if someone understands all the risks and benefits of any dietary intervention or medical intervention, whether that's medication or whatnot, and they want to proceed, then that's their decision, right? And that's kind of where we sit. And I think that's the biggest thing that we see is that for whatever reason, we have this overreach of people saying, hey, I don't want to do this. Like, I'm not going to touch this because you're not doing the way I want to do. And yes, in traditional medicine, we were taught that, hey, when your elders is high, Then we want to treat it this way. And we have these people saying, No, no, no. And ultimately, all I care about every single day is that you are well informed. If you, as a patient, are well informed and can make a rational decision. Then let's do it. I'm totally fine with that. Do I think there are many other ways to do things? Yeah, that's the beautiful thing. Do I think this is the perfect human diet? I mean, I mean, no, I don't think it is. I think you can see lots of people can have lots of benefits from different diets, but At the end of the day, it's working with an individual, right, and understanding them and then understanding their risk. We are terrible at understanding risks as humans. And so you look at all the risk factors and say, okay, someone might say, I'm willing, I'm willing to leave my LDL high. I'm okay with that because my blood sugar is better, my blood pressure is better. My, you know, everything else in my life, my obesity is everything's better except for that one number. I'm fine with that. And that's the case. And we just don't know what that's going to do long term. Do we think it's a potential risk factor? Yeah, we do. And I think most traditional medicine would say that, yeah, like having elevated APOB is probably problematic long term, potentially, but is a personal risk. And I'm not going to yell at someone or say, like, hey, you're a worse person because of this. It's just a personal choice. That being said, I do, do, do, I need them to believe and understand the risks, right? I do think there are real risks potentially that we don't know about. And so I want to be honest with people because that's a big thing. In silos, In the Carnivore community, you'll just see people time and time again saying, Oh, it doesn't matter. It doesn't matter, it doesn't matter, it doesn't matter, and like just getting pushed off if anyone says, Well, what about this? And they just kind of say they can't be. Whereas this side says, like, oh, that you know, that's an issue, that's an issue. So, once again, it's finding middle ground. It's where I live in the gray. That's what I do. But this has been a longer run, it's because it's a very, very hot topic, and I want to talk about it. That is going to be it for today. Thank you so much for listening. If you enjoyed this, it would mean the world to me if you either shared this with a friend or left a five-star rating on your podcast platform or choice or subscribed on YouTube. Or just like text it out or share with someone. That'd really, really be helpful. But that's going to be it for today. Now get off your phone and get outside. Have a great rest of your day. And we'll see you next time. This podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat, or prevent any condition. The information presented here was created with an evidence-based approach, but please keep in mind that science is always changing, and at the time of listening to this, there may be some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified healthcare provider for questions regarding any medical condition.
