125-Q&A with Dr Vincent Buscemi

He's a practicing dentist and he has a podcast called the Dr Vincent Bouchemi Survival Guide for Dentists . I'm not sure how I can help dentists survive , but we had some interesting conversations and I hope you enjoy it . Please also check out other podcasts from Dr Bouchemi on his website and let us know how you like this format .

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And now , please enjoy this conversation with Dr Vincent Bouchemi .

He's a physician and medical school professor at both UCLA and USC , focusing on applied science of health , longevity and consciousness . Robert is not your typical mainstream run-of-the-mill physician , although he writes in his newly released book the Lies I Taught in Medical School that he is part of the establishment .

That is probably the only thing I have to disagree with Robert on . He is an independent thinker . He's looking at the literature . He's finding ways to live the best life possible . Robert , I can't thank you enough for the amazing interview . Guys , you're going to love this and I'll talk to you guys soon .

Tony , I was in Disney World last week considering handing out your book to every person that was at that park .

I went and saw my doctor , I was put on prescription medicines for all of them and that would be the end of story . Except those chronic diseases were diseases that my father had gotten and he died from them . But he was in his 80s , almost 90 , when he died and I was much younger . I still had kids in elementary school .

I'm thinking , wow , this isn't going to end well If I'm getting these diseases now which killed my father . So basically I was forced to reexamine what my beliefs were and what I was teaching and what many people still believe and are still teaching in medical schools . And this isn't any original research I did .

I just basically went back to the peer-reviewed articles and tried to educate myself as best as possible and I realized there was a lot of change in our understanding of chronic diseases and in particular the diseases that I had and the role that one , how they were related by common underlying metabolic factors and how the prescription drugs that I was given and that

I had prescribed for people actually didn't . They treated the symptoms , but they didn't really have much effect on the progression of the disease the root cause , if you will . And so I looked dove even deeper , and there's a lot of work about how these diseases can be reversed and as metabolic conditions can be reversed with lifestyle choices .

So I looked very , very long and hard at the lifestyle choices I was making . I completely changed my diet , my sleep , my exercise , my stress and , long story short , I went back in to see my doctors and they couldn't believe it . They said what's going on ? What happened ?

You know , basically , you're cured of these diseases and you don't need to be on these medicines anymore . So I've now become interested in helping other people understand this and not fall into the same situation that I was in .

And unfortunately , this message isn't very widely known and there are a lot of things that are still being taught in medical school and many of my colleagues still accept that I believe are incorrect and that I disagree with . Now .

But if , once the evidence comes in , if the evidence says that drinking Diet Coke every day will make me healthy , I'm going to start ordering it by the case . But I don't think that's the evidence supports that now . But as scientists , we just have to look at the evidence , and sometimes the evidence is not clear and intelligent .

People can have different viewpoints on a given situation , but for me it's pretty powerful and compelling that I think there's some basic things that are being overlooked and , as a result , a lot of people are being harmed by this , and I don't think anyone will disagree with the fact that our health is out of control . Obesity and overweight rates are unprecedented .

Never in the history of the world have there been so many overweight and obese people , never have there been so many type 2 diabetics . That happened about 10 years later and that is increasing now .

And then we're seeing increasing rates are going to be coming from heart disease , cancer , alzheimer's disease and all the metabolic conditions hypertension that are , in my opinion , are all linked by some serious underlying metabolic situations that are being overlooked by the health care system as it is .

Even One of my chapters in my book I talk about a disease called non-alcoholic fatty liver disease that when I went to medical school didn't even exist . If someone got damaged to their liver and fatty liver changes , it was due to alcohol by and large .

There were some other things that could do it , but it was basically you assume they were drinking and it was alcoholic fatty liver disease . But in 1980 , a new form of liver disease appeared , this non-alcoholic fatty liver disease , which today is the number one cause of liver transplants and liver failure worldwide .

The medical establishment is unclear on how to treat it . They're not sure what it's due to . They think it's due to maybe lose weight , as the recommendation from standard approaches for fatty liver . It may get better .

But I think there's very strong evidence that we cite in the book from people like Robert Lustig at UC San Francisco who did controlled trials and kids with fatty liver and they were able to reverse it in a matter of weeks by changing their diet and removing an interesting toxin in the diet that's handled , not surprisingly , by the liver through similar pathways that

alcohol , which is also a toxin ethanol is handled by the liver and , not surprisingly , this non-alcohol toxin is the cause of many , many cases of non-alcoholic fatty liver disease it's used . In 1980 spiked upwards as our diets changed and we began using more and more of this in our diet . At least there's reasonable associative evidence that these are correlated .

High fructose corn syrup .

When it exceeds certain levels , certain very low levels , it needs to be detoxified , and the detoxification organ is the liver . The liver handles fructose . When we eat large amounts of fructose , it goes to the liver and causes fatty changes in the liver .

To your point , high fructose corn syrup was essentially developed in the 1980s and all the soda makers famously switched from cane sugar to high fructose corn syrup for the Coca-Cola and Pepsi . I hope they're not sponsors of your show . Unfortunately they're not Similarly all the junk foods switched from .

The majority of them switched from cane sugar to high fructose corn syrup . The reasons are one high fructose corn syrup has a longer shelf life it lasts indefinitely , basically . The second thing is it's a liquid . Cane sugar will crystallize in foods and it'll be crunchy after a while .

You may not want your hostess Twinkie to be crunchy if the cane sugar crystallizes . The most important thing , and the pernicious financial incentives behind this whole thing , is that the government actually subsidizes the production of high fructose corn syrup by its massive corn subsidies , as well as subsidies for other junk food materials .

Corn is heavily subsidized , so that high fructose corn syrup is actually cheaper than an equivalent amount of cane sugar . One reason why junk food is so inexpensive is because our tax dollars are used to subsidize it . The money comes back into the system on the healthcare side when people go in and need treatment for their diabetes and money flows back in .

It flows out for the subsidies on these .

The endocrinologist may not talk to the liver specialist , or the Alzheimer's doctor , who deals with a brain fog and the early Alzheimer's disease , may not talk with the endocrinologist , even though increasingly , alzheimer's disease is strongly linked to diabetes and metabolic disease . It's now called type 3 diabetes because of that association .

Anyway , in the medical system there's not a lot of cross-talking and learning from other people . There are also pernicious financial incentives . Some are conscious and unconscious and some are , I'm sad to say , intentional or people are aware of them . There are strong financial incentives to prescribe certain types of drugs .

The American Heart Association still recommends vegetable oil or canola oil as being heart healthy , when there's a very large amount of evidence suggesting that it's not . American Diabetes Association recommends eating foods for diabetics with moderate sugar content in which they say that's okay , just quote cover it with insulin .

This is not a good approach and it makes the type 2 diabetes worse . It's very complicated . It's much easier to prescribe a statin or to give someone metformin or insulin for their type 2 diabetes in what modern medicine has for an office visit of seven minutes or so in some cases .

Things that I had to do to change my lifestyle were very challenging lifestyle changes . They affected how I slept , all different kinds of things that couldn't really be communicated to me necessarily in a seven-minute visit .

In fact , when I was diagnosed with one of my diseases , which was hypertension , which almost half of adult Americans have anyway , and I was prescribed a blood pressure medicine , on the way out the door the guy said , even though I wasn't overweight , I said is there anything I could do about this ? He says , yeah , exercise more and lose weight .

I go okay and don't eat salt , which is the common medical advice . In the book we talk about how hypertension is strongly linked to metabolic disease . It's one of the symptoms of metabolic syndrome .

In fact , by going on a diet that reverses metabolic disease , one of the symptoms which I certainly had and it's a common symptom that people have even days after starting a metabolically healthy diet is to get lightheaded because the hypertension goes away very quickly . To your question , there are many different things .

You go to a hospital and you say , hey , we have a program just like Virta Health does , and other people have shown in controlled trials that type 2 diabetes is carbohydrate intolerance .

If you remove carbohydrates from the diet , the type 2 diabetes will go away and people won't need insulin , they won't need metformin and you can basically get them off these things . The problem is hospitals are businesses . The number one . Surgery is a cash cow for hospitals , just like radiology is .

But surgery especially the number one driver for amputations , which is the big surgery , is type 2 diabetes . The number one driver for blindness is type 2 diabetes . The number one driver for renal failure and consequently renal dialysis , which people in renal failure will require , is type 2 diabetes .

That's why some of the biggest supporters for the American Diabetic Association , which recommends eating diets that make your diabetes worse , are companies whose business is dialysis . I'm not saying it's all a big conspiracy , but I'm saying there are numerous incentives that are not necessarily aligned for , ultimately , the health of the patient .

I wish that were true , but it's not necessarily always that way . I don't think people wake up and say we're going to harm the patient , but the incentives align sometimes so that I believe people are harmed by the way medicine is being practiced today .

How do you start to reverse that ? With diet . What kind of diet should I be eating to live a long life and look healthy like you do ?

we're inundated with junk food . All around us , is junk food everywhere , and junk food , because of the content of the food , drives obesity , drives hypertension , drives type 2 diabetes and drives these metabolic abnormalities . I mean , there's a great quote .

Somebody said that if we all stopped eating any food that wasn't available 150 years ago , most of us would have a significant improvement in our health , and if you think about that , that's probably true . But what does that say about our current food supply today ?

I mean , my mom was a dietitian so I was raised in trying to eat healthy foods , but it's just the foods that I was taught was healthy , and even today , even more so . All the junk foods that we're inundated with really contribute to the situation for all these diseases that we're facing , and that was the other wake-up call that I had .

My diseases were hypertension , pre-diabetes , I had joint pain , gout , arthritis , and it seemed like these were all very different diseases than what I've been taught . Joint pain is very different from hypertension , which is very different from diabetes .

But what I'm learning , I think the evidence now is showing with the most recent research , there's a common underlying cause for these this metabolic dysfunction driven by junk food , among other factors . And if we reverse the junk food and the metabolic disease , then all these chronic diseases not only stop their progression , but we can actually reverse them .

And another thing changing my thinking I used to think that diabetes was something some people got , some people didn't get . It's kind of like maybe I got it from my parents or maybe I didn't . But there's some interesting data now that changed my mind on that .

If you look at a large populations of non-diabetic adult Americans , like the Framingham study or the NHANES data , if you plot the markers for diabetes risk , which is called hemoglobin A1C I don't know if you've ever talked about that with your audience , but that's a marker for glucose damage to the red blood cells and the higher it is , the more the damage .

And once it passes 6.5% , then the doctor will diagnose you as , yes , you're diabetic , and then I can start charging for the visit . I can prescribe insulin , I can prescribe metformin . There are different things you can do that kick in , but below that I'm not diabetic , so I can't charge that . But what happens is , over time .

A fascinating thing happens in non-diabetics that is almost all of us . The average HA1C increases the older we get . So my thinking has changed . What I think of now is diabetes and this insulin resistance .

It's like gray hair , In other words , if we live long enough and we don't die of something else , we will all become type 2 diabetic over time as our HA1C creeps up . So what does that mean ?

It just means that for most people , it's probably a good idea to adopt lifestyle and eating habits that protect you from diabetes , as if you were at risk for diabetes , Because I believe that most of us there are a few people who manage not to be insulin resistant , but on the average , most of us our HA1C grows up the older we get , and we're on that path .

On the other hand , which includes sugar or refined carbohydrates like starches and bread and cereals and things like that , actually are not required . They're actually populations of humans that survive without eating any carbohydrates . To speak of , they're basically carnivores , like some Inuit populations in the Maasai and Africa who just drink blood and milk from animals .

People have made the interesting observation that if you have type 2 diabetics and you put them on a diet with very , very low carbohydrates what's called a ketogenic diet or even a carnivore diet the diabetes goes away . That's the trick there . Back to your question . Personally , my hemoglobin A1C this marker was going up and I was diagnosed with pre-diabetes .

I changed my diet and I got rid of essentially all the refined carbs and the sugar . They're carbohydrates , none of the things like . They're non-digestible carbohydrates and vegetables and stuff . Those are really not bad . You don't absorb them or anything .

The really ones to watch out for , the ones that spike your insulin or spike your glucose , and those are refined carbohydrates , starches and then sugars . I do avoid those . I'm in ketosis most of the time , which means my body has switched from burning glucose to burning ketones , which I think is a healthier way to be . I certainly feel better .

My mind's a lot clearer . I don't get that brain fog that I used to get when I ate a lot of junk food which is high in carbohydrates .

What I'm talking about , Dietary ketosis , is just what happens . If you fast and you don't have any food intake . Your body starts burning fat , which is a good thing because you lose weight . Most of us can afford to lose a little weight . Or if you have a low carbohydrate diet , there aren't carbs to burn to make glucose .

Then your body uses fat in the diet to make glucose itself and also ketones , but most of the energy is produced by ketones . One of the original treatments for epilepsy from 2000 years ago from seizures was to just have the patient stop eating . When you stop eating , your body goes into ketosis , as we said with fasting .

The ketogenic diet is a reliable treatment for many , many kinds of epilepsy . That's still used to this day . There are children and adults that are put on a ketogenic diet , that essentially live their entire life on a ketogenic diet without consequences .

It's not like they get a bunch of heart attacks or anything , chris Palmer , who you may have had on your show . He's a psychiatrist from Harvard Medical School just wrote a book called Brain Energy where he takes patients who are very sick psychiatric patients hospitalized for visions and voices and manic depressive symptoms and he puts them on a ketogenic diet .

Not all of his patients , but some of his patients have dramatic reversals of their mental illness to the point that they can actually go off all meds and leave the hospital . In fact I was just talking to him about it and he said yeah . I said how do you know it works for your patient ? He goes well . I have one patient at home .

He says he knows when he's eating junk food or he has carbs in his diet because the voices start coming back and talking to him again when he eats potato chips or something . Similarly , to jump to another disease , heather Sandison is a great Alzheimer's researcher who she has nursing homes that treat Alzheimer's patients , unlike most nursing homes .

People who go to her nursing homes for Alzheimer's disease get discharged because they get better and they go home . One of the foundational elements is everybody's on a ketogenic diet . At the nursing home I say come on , how do you know that ketosis works for your Alzheimer's patients ? Do you have evidence ?

There's published evidence from Dale Bredes and others , but she relayed an interesting anecdote . She said yeah , well , for some people it's really dramatic . For example , mr Jones over there . When he's in ketosis and his grandchildren come into the room , he smiles and hugs them and knows all their names and interacts with them normally .

When he eats some junk food or goes out of ketosis he basically can't remember their names anymore and doesn't even recognize them when they come into the room . It can be that dramatic .

These ketogenic diets that correct metabolic disease can also reverse hypertension . They can also reverse type 2 diabetes and they can also , of course , reverse obesity . That's why people have six-pack abs who are on ketogenic diet , because all this subcutaneous fat tends to go away . That's a great question .

Why aren't more of our colleagues out there shouting this from the roof ? I started this about four years ago and I've been in ketosis and I'm a ketogenic diet now for four years . Sure , I miss the sugar , I miss the bread and the sweets that I used to exist on all the time , but I'd rather live to see my grandchildren .

I've been able to substitute things that I never used to eat , like butter or meat with fat on it and a lot of avocado guacamole dip . Personally , I started fasting , so I eat one meal a day . I don't count calories at all and I just have my one ketogenic diet , my meal , my low-carb diet , once a day .

I eat as much as I want pretty much anything I want , as long as it doesn't have carbs in it or seed oils . I'm a happy camper .

It's not even clear that serum cholesterol is a big factor for heart disease risk . Half of people coming with heart attacks have normal cholesterol . But to your question , it depends on the doctor . If they're not educated and the cholesterol is high , they'll say you need to be on a statin , even though my calcium score is zero my CT calcium score .

There's a lot of education and a lot of acceptance that has to be out there . You have to find a doctor who has read these articles and is familiar with Chris Palmer's work and other people's work in a ketogenic diet .

I recommend his podcast . I recommend his book . He's getting great exposure , but I think some of the things in his book I disagree with .

When you include other causes of death , taking a statin has no effect on the overall death rate on people . In other words , taking a statin in a population , it may lower the risk of heart attack a very small amount , but something else happens to the death rate with other people so that it makes up for it . What could that possibly ? Bleep ?

As you say , the suicide rate goes up . Other things related to mental health issues which may be tied to cholesterol . At the end of the day , nobody knows , peter or Tia may be right , we may be right , who knows ? We're still learning this stuff . That is real cost and concern . That the statins .

You may not die of a heart attack , but it changes other things in your body so that you at least on a population-wide study , the people who take statins die at a higher rate from other things , which doesn't make any sense at all . One could imagine mechanisms for it .

It was a small population , a small number of people over a short timeframe . There's a lot of challenges to get through the evidence . Then talking about pernicious incentives there's a lot of money coming in to do research on statins to prove that they work . There's very little money coming in to do research proving that statins don't work .

But we just have to be open-minded , look at the literature and talk to other people about it , like we're doing now .

Almost all cancer cells do that . What happened , though , was in the 1950s , with the genetic revolution . Everybody saw genetics as the solution for medical problems , rather than metabolic science . Otto Warburg was a metabolic scientist . A lot of the metabolic science was lost during World War II , when the Germans and Europe was just in complete disarray .

Fast forward to 1950, . Everyone began doing research on genetics and how genetics could play a role in cancer . Fast forward 40 years later . 50 years later , the Human Genome Project , where the goal was to sequence the human genome and understand the master blueprint for disease . We did that famously beautifully . In the 2000s , everyone said , wow , this is great .

Now cancer is a genetic disease due to mutations . All we need to do is we sequence the human genome . Now let's just sequence the cancer genome . In other words , take a bunch of cancers , all different types , sequence them , find out what mutations they are and then design drugs for them , like Glewak or Herceptin . They're different drugs .

You could design that specifically target certain mutations and then we'll treat all cancers and game over . What happened ? There was a second human genome project that never got any publicity . That ended about 2010 . It was called the Human Tumor Genome Project . What happened was , briefly , as they sequence , they just did what we said .

They sequence a number of thousands of human cancers . What they found was extremely disappointing . There were mutations in these cancers , but there were no consistent mutations . In other words , the same cancer in one patient compared to another patient , the same cell type had different mutations . In fact , the same cancer in the same patient had different mutations .

In fact , the same cancer in the same location in the same patient , the same lump tumor , had different mutations . Whatever was happening , they appeared to be completely random and there wasn't like a single driver mutation . Despite the fact that there were certain oncogenes that are driver mutations that have been discovered .

They unfortunately are not the rule and most cancers have random mutations . This led to a great disappointment in the early 2010s about our approaches to cancer , even though Richard Nixon started the war on cancer in the National Cancer Institute in the 1970s . Sadly , overall , we're not winning the war on cancer . You could even say cancer is winning .

It's caused people like Thomas Seyfried and others to take a look at metabolic drivers for cancer , specific metabolic things . It appears , as evidenced by back to the ketogenic diet , using that as a tool to switch our metabolism to ketosis and turn down metabolic illness .

For certain types of cancers , particularly glioblastoma multi-forming , which is a brain cancer that Teddy Kennedy died of and other people have died of , they've had dramatic results using ketosis on that type of cancer and now they're beginning to use ketogenic therapy as an adjunct to basically all types of cancer . The work's very exciting .

The final answers aren't in , but there's promise that turning down glucose metabolism by switching ketones . We know tumors are highly glucose metabolic . The idea may be to starve those and it's probably not that simple . It's simple a thing , but there does appear to be some effect in certain types of cancers by these metabolic strategies , these ketogenic diets .

Since there have been no harmful effects from it , it's not like oh , it makes the cancer worse . A lot of people are making the argument that well , maybe we should start doing this on a broader scale , with all patients who are cancer patients or in recovery . It doesn't do any harm and there's evidence that it helps at least some of them .

With a ketogenic diet , if you're eating meat , wouldn't that still feed the cancer cells ?

It's a master survival protein and it basically senses glucose , tell cell to grow . If there's no glucose , it tells cell to repair and do autophagy . There's a lot of evidence I mean it's not even evidence . It's known that cancers work by growing . Turning mTOR on to this growth state drives cancers .

There's evidence that drugs that block mTOR , this protein , and turn it off , drugs like rapamycin , are actually FDA approved to treat cancers . It just so . It turns out they also treat heart disease and Alzheimer's disease . Research they're doing and many other things . But turning down mTOR for cancer appears to be a very , very powerful signaling thing .

So glucose , insulin , igf-1 , all turn mTOR on and presumably drive cancer . So by metabolically turning mTOR down and as it turns out , protein in the diet doesn't affect mTOR . So it's mainly glucose that drives mTOR up . Protein is a very , very slight effect .

So if you want to get the maximum signaling effect on mTOR with lifestyle is with getting rid of glucose and turning down your insulin , or you can take rapamycin or probably do both if you really want to .

Now , if I have a broken arm , ketogenic diet may help me repair , but I'll need to go to a hospital , get a cast and set the bone . If I have a congenital heart valve , like a bicuspid aortic valve , ketogenic diet probably isn't going to do anything . I need surgery to replace the valve . I need things , so certain things traditional medical care does .

Now a ketogenic diet or a metabolic health strategy ? Certainly no one will argue . Getting rid of junk foods is going to help everyone for everything , but , to your point , for these chronic diseases that occupy most of our healthcare dollars and most of us 90% of us are going to die of .

Those , interestingly enough , are driven by common metabolic factors that can be influenced by the junk food we eat and exercise and sleep and stress .

So if we had one takeaway from this hour interview , what would you tell the audience ? What's the biggest point you want them to know ?

They made my symptoms better , but they didn't change the underlying disease . So for me , the take home message was that lifestyle really , really matters and we get to choose every day what we put in our mouth when we eat . And it does make a difference , probably more than most of the medicines we take .

I'll be glad to give you the link here , but they can go to my website and you're welcome to download a sample chapter , either an audio form or a PDF of the first chapter , and you can see if it interests you .

If you find this to be on the value , please hit that like button to subscribe to support the work that we do on this channel , and we take your suggestions and advice very seriously , so please let us know what you'd like to see on this channel . Thanks for watching and we hope to see you next time .