#12 - A Surgeon's View of the Carnivore Diet
SUMMARY KEYWORDS
carnivore, diet, eating, people, meat, low carb, fiber, salt, low carb diet, constipation, electrolyte, physicians, studies, bowels, bowel movements, couple, healthy, question, keto, health
SPEAKERS
Jack Heald, Dr. Philip Ovedia
Jack Heald 00:00
Welcome back. We're doing this particular podcast early in the morning, Dr. Oh, it's good to talk to you. How you doing today,
Dr. Philip Ovedia 00:08
I'm doing great jacket to be back with you.
Jack Heald 00:10
I want to talk today about chapter seven in your book. Because, first of all, it's just interesting, I think, for anybody who wants to get healthy. And also because you go, you go to a place that I'm interested in knowing more about, and that's carnivore so let's talk, take us through your evolution from where you started this journey with with what was a good calories, bad calories by Gary Taubes correct that right? So So take us from there, the evolution of your diet from there to now.
Dr. Philip Ovedia 00:46
Sure thing, jack, and as you, you know, alluded to, it was an evolution and it continues to change to this day. So, going back now, about four years is when I first came across Gary Taubes and good calories, bad calories in the case against sugar. And the change that I made at that time was initially to go gluten free and to eliminate sugar from my diet as much as possible. And that's
Jack Heald 01:16
what you and that was kind of the pivot point for you. That was when that was when the weight started to come off and stay off. Is that right?
Dr. Philip Ovedia 01:27
Correct. You know, I would say, while that wasn't the first time I had success in losing weight, that was the first time I had success in keeping weight off, you know, past a couple of months. So I, you know, did that and more so than the actual diet and the weight loss that record, you know, resulted from that, that spurred my interest to look into the whole topic of nutrition more. And I started doing more of the research and, you know, combination of reading scientific articles and reading books and listening to podcasts, and, you know, really got involved in what I would call the low carb nutritional space, and certainly came across, you know, more and more influencers, influencers, in that space, both physicians and non physicians.
Jack Heald 02:20
Well, real quick, just just as a sidebar, if you got two or three, that were particularly influential for you,
Dr. Philip Ovedia 02:29
sure, I would say you know, on the physician side of things, Dr. tro collation. And Dr. Brian Lenski is who co host, the low carb MD podcast, which, you know, is a podcast sort of geared towards physicians, at least, it was at the beginning, it's now gone into a much larger audience. And they they were very instrumental in, you know, bringing on guests, as well as their own personal thoughts and practices around this. They're both family physicians, who have, you know, changed their practices to center on nutrition and preventative efforts. So
Jack Heald 03:07
that link that one in the in the show notes? Yeah, I highly recommend
Dr. Philip Ovedia 03:11
that. And then, you know, I would say Dr. David unwoven, who's a general practitioner in the UK, has been very influential as well, he has done a lot. He has actually published, you know, a lot of his data on how he has, you know, had significant diabetes reversals and lowering costs in the patients that he takes care of with diabetes and other health conditions. So he's been another big influencer. There are guys like Dr. Finney and Dr. Volek, who, you know, are some of the have done a lot of the seminal work a lot of the seminal lab, you know, clinical studies on low carb and then ultimately got involved in starting verta Health which has now published you know, very impressive data showing their reversal of diabetes utilizing a low carb nutritional approach.
Jack Heald 04:12
Alright, didn't mean to cut you off path there, but I thought that would be interesting to our listeners, go ahead.
Dr. Philip Ovedia 04:18
I think that certainly has so you know, as I started learning more and more about low carb, it you know, kind of evolved from, you know, just eliminating sugar and going gluten free to what I would call, you know, formal sort of keto, where I was really tracking macros and you know, measuring my blood ketone levels at that point, and really trying to kind of dial in, and then I would say probably the next big evolution was discovering the information. You know, the concerns around processed fat, vegetable and seed oils was another big Kind of revelation for me. As you know, many people out there are probably aware, these things like, you know, canola oil have been promoted as being heart healthy. And you know, there were scientific studies put forward, showing that they help to lower your cholesterol, and therefore, they're going to be beneficial, and that those would be the healthiest fats to consume. And as I started to dig into information more, and realize that not only are they probably not helpful, but there's a very good chance that they're actually harmful. That was another big step for me eliminating those processed vegetable and seed oils from my diet. So that brought me to what I would kind of call clean keto, where I was really only doing you know, coconut oil, avocado oil, olive oil, and animal fats, but still pretty high fat, low carb, you know, keto measuring, tracking, macros, and measuring ketosis. And I got to a point then, that I was exceedingly low carb, probably under 20 grams of carbs a day. And I was feeling pretty good. And then I heard this orthopedic surgeon by the name of Shaun Baker, on the Joe Rogan podcast, and he was talking about the carnivore diet. And I'm sure you know, many people listening to this are familiar, but basically, the carnivore diet is that you only eat animal products. So meat, dairy, seafood, essentially. And you therefore, basically eliminate carbohydrates completely, you know, there's very small amounts of carbohydrates in some of the animal foods and some dairy products, but you're essentially eliminating carbohydrates. And honestly, that sounded crazy at first, but I started to think about it and I'm like, Okay, I'm only eating like very little amounts of carbohydrates currently, you know, do I think that those are really essential, or those are, you know, benefiting my health, the small amount of vegetables that I'm eating, and I, you know, looked into it more, and I started hearing about people who had been on this very long term. You know, going on decades, I came across the historical sort of reports of the carnivore diet. Most Famous is a scientist explorer by the name of Vilma Steffensen, who had kind of embedded himself with, you know, the Inuits and survived over a year on just, you know, they essentially just whale blubber, but a carnivore diet.
Jack Heald 07:48
I like to biohack but I think I'm gonna draw the line. Yeah,
Dr. Philip Ovedia 07:52
very interesting. But you know, this was, you know, in the 1920s 1930s. And he comes back to New York City where he lives. And he's returns to kind of the standard diet of the time, and he noticed he felt a lot worse than he did when he was with the Inuits. And so he actually did a study. He and one other gentleman, were actually, inpatients it was basically considered at Bellevue Hospital at the time, for about a six month period, doing strictly carnivore diet, having their bloodwork monitored, all of this stuff, and, you know, showed that it was a very healthful way to eat and showed improvement in all his markers at the time, you know, when was this? This was in the 1920s 1930s Wow. And he had a couple of books that he wrote, you know, very interesting reading as well. But, you know, you start to see the history and then I, you know, that, that brings you to the, all the ancestral tribes, you know, and, you know, that are out there that basically survive on carnivore diets as well. And, you know, the, I guess the biggest revelation from all this was that it is possible to survive on a carnivore diet, we do not need carbohydrates, we do not need vegetables, to, you know, to survive as humans. So I made that leap of faith then I said, Let me try it, you know, for a couple of months and see what happens. So this brings us to march of 2019, that I went cart full carnivore. And I would say the two biggest improvements that I noticed, first one was immediate. So I had had persistent trouble with inflammation, specifically plantar fasciitis in my right foot. And, you know, at this time, I was doing a fair amount of running, I had run a half marathon. I had done I remember actually, the day, the last day of non carnivore I had run a 10k. And I always had this trouble with plantar fasciitis. On my right foot I would get up every morning I would you know get out of bed and for about 10 minutes my right foot would hurt until I sort of worked it out and I had done all the physical therapy stretches exercise is everything that's recommended for plantar fasciitis had stopped running you know change shoes all of that nothing helped my third day on carnivore I got out of bed I put my foot down and it didn't hurt and I'm like huh that's interesting you know maybe it's just a fluke and you know it the pain did not come back again and early on when I was doing carnivore in those first few months and I would stray and I would have something you know and again we're not talking like I was downing a whole cake or anything
Jack Heald 10:44
or like your ringtone
Dr. Philip Ovedia 10:46
thank you I would have a you know few bites of something that was non carnivore I would start to feel some pain in my right foot and I could tell that information was coming back so that was the most
Jack Heald 10:58
no like like how long did it take to feel the impact of carbs
Dr. Philip Ovedia 11:07
early on it was pretty much right away like if I had something that day you know the next morning I would feel some pain in my foot it was nowhere an hour yeah within hours and it was nowhere near the original level that it was but I could start to kind of feel some inflammation down there so for whatever reason why you know that's where I had some inflammation and it went away on carnivore and it's never come back again. Wow. On the long term you know now that I've been married to a carnivore for coming up on you know, almost three years here I stick with it because it's just the easiest way of eating for me to maintain I don't have to track anything I'm not you know, worried about macros. I'm not measuring you know, ketone levels I kind of know I'm in ketosis because I'm not eating any carbs but I don't really worry about it and the Shopping is easy you know I literally the rare times I go to the supermarket it's a quick lap around the outside you know I pick up some meat some seafood some dairy, some eggs and I'm out most of my shopping honestly is not done in the supermarket you know I tend to get a half side of beef from a local farmer every few months and I get some seafood from you know one of the local seafood shops and you know and that's you know, I'll oftentimes go to the farmers market and get some you know fresh eggs from the farm and and that is the majority of what I eat and food preparation is easy I grab something out of the fridge or the freezer I throw it in a pan for a few minutes typically I'm not worried about recipes and all this planning very little waste I noticed I don't you know throw at people who you know buy a lot of produce certainly are used to you know some of the spoils and you throw it out and and there's a lot of packaging and all this so it's just interesting that it's at a low what I say now is I think a lot less about food than I used to and it just it's not a constant you know thought in my mind what am I going to eat what am I going to eat I gotta go get this to prepare you know this recipe or these types of things.
Jack Heald 13:21
I remember I remember you talking about this was several episodes ago where you're talking about food that keeps you hungry so that's a big change
Dr. Philip Ovedia 13:30
yeah that's a huge change I mean I eat as I've said before I typically eat once maybe twice a day and not because I'm restricting myself just because I'm not hungry more than that you know I get hungry once or twice a day and I eat you know when
Jack Heald 13:48
so you you're you're a thoracic surgeon as I understand it some of these surgeries can can go on for hours and I know that that is a a mentally and I would well certainly a mentally demanding job and I would expect physically demanding as well. How are your energy levels?
Dr. Philip Ovedia 14:11
Yeah, my energy levels are great and you know I can make it through those long surgeries a lot better than I used to and realize you know, I was 15 years younger when I started my career and I you know obviously going through my training you know 20 plus years ago and I can honestly say now I feel better you know if I have a long surgery and like I said some of my surgeries end up being eight to 10 hours sometimes. And at the end of that you know, I feel just fine and I'm not hungry You know, I can go that time without eating. And I used to you know, kind of finish up a lawn case and you know, kind of make the Beeline to the cafeteria because I was starving and now you know I finished up the case and I you know Take care of whatever work I need to do and, and whenever I happen to get, you know, around food that's acceptable again, which, by the way is usually not in the hospital, right? I, you know, I eat when I, when it's convenient, and you know, maybe I'm feeling a little hungry, maybe I'm not it just and so I have a lot more energy, I have a lot more mental clarity. And many people who do low carb, and and especially, you know carnivore, notice that. And for whatever reason, you know, it just seems one of the sort of myths that persist is that your brain needs sugar, to you know, your brain works on sugar. And the reality is, is that the brain seems to work much better when the body is in ketosis and burning fat instead of, you know, burning sugar is its primary fuel.
Jack Heald 15:57
I know evolutionarily, that certainly would make sense simply because for 99.999% of our history, the bulk of our diet would have been stuff we'd hunted and killed. And being able to eat ripe fruits or berries would have been a rarity rather than something that was available all the time. So it makes sense that our bodies evolved to, to process protein and fat as to keep us going rather than rather than carbs. I understand that, from an evolutionary standpoint, but there's just something that's, it's kind of jarring to hear a testimony about it to hear, hey, I actually do this. Here's my actual experience. I'm fascinated by it. So I want to ask a couple of questions about contrary indication so so how would a person know that you shouldn't be trying a carnivore diet?
Dr. Philip Ovedia 17:08
Well, so you know, that's a very interesting question, because I get asked a lot, you know, about contraindications, or downsides of the carnivore diet. And, honestly, I struggle to come up with any, you know, because every sort of perceived contraindication, let's say, to the carnivore diet, you know, meat is going to harm your heart, or meat is going to harm your kidneys. You know, there are a couple others that are, you know, pretty common Lee put out there. And when you really dig into the science behind any of those claims, none of them, you know, none of them turn out to be well founded in the scientific literature. And then, you know, the personal experiences that go along with carnivore as well. You know, almost every disease that is supposedly, you know, that that carnivores that eating, a lot of meat will worsen, I can find reports of people with those diseases, saying that they've improved their conditions with the carnivore diet, you know, and it, that's what kind of keeps me where I am, you know, as a, as a primarily carnivore way of eating, because my personal experience has been positive. I interact with a lot of people, you know, my clients, and then, you know, on the various, you know, forums and websites around carnivore diet, who report similar things that they've had great experience with it. You alluded to, you know, ancestrally, and, you know, from an evolutionary standpoint, this is the diet that we primarily evolved as humans on. And I can go back through the scientific literature, you know, and find a lot of evidence to support the carnivore diet and support, you know, eating a primarily meat based diet. And the only evidence that really speaks against it is really lousy scientific studies that have come out in the past, you know, 40 to 50 years. So, you know, and like I said, those studies are all, you know, associational studies, they, they, you know, look at what people are eating overall, and try and pull out one particular element the meat and tie that to bad outcomes. But the reality is that over the last 40 to 50 years when people have been eating, you know, when people report that they eat meat, that is mostly in the context of, let's say, a hamburger, which is fried oftentimes in vegetable and seed oils, is eaten With a bun and all the toppings, and the side of french fries, fried and, you know vegetable and seed oils, and oftentimes a soda, you know, sugar sweetened beverage that's drank with it. And so that all gets put in, but all that the bad effects get attributed to our meat. And the reality is, is that the meat is probably the healthiest part of that, you know, kind of meal that I just went through. And so there really is no good scientific evidence that isolates meat as a risk factor for any of these diseases. And, you know, but I remain, I will say that, even though I've been on this diet for, you know, almost three years, and I know the 1000s and 1000s of people who, you know, have had success with it. I remain skeptical, and I'm always on the lookout, and you know, people who follow me on Twitter, we'll see some of my interactions, you know, if someone can send me good evidence that, you know, eating a carnivore diet, or eating large amounts of animal products is bad for our health. I want to see that data, you know, but you know, I will, because obviously, I have a personal interest in this is what I am doing personally. So if it's harmful, you know, no one should be more interested in that than me. And thus far, I have not seen any evidence to, you know, to say that. So, getting back to your original question, are there any contraindications to a carnivore diet, I really cannot come up with any, I do caution people that, you know, it needs to be done in a certain way. If you have a lot of medical conditions like diabetes, and heart disease, or kidney disease, you probably should be working with a knowledgeable physician to do it, rather than just doing it on your own. But I really, you know, I guess I actually do have one recent thing that I was introduced to that would be a contraindication. And there was a very rare disease called alpha gal syndrome, that there is a particular type of tick, that a bite from that tick has been shown to stimulate an allergic response, essentially, to some of the proteins that are in meat. And this syndrome can actually, you know, cause people to be allergic to meat, essentially. And that is one, it's very newly described. It's very rare. I, you know, I, within the past year or two became aware of its existence. It's kind of fascinating to me from a scientific standpoint, and that I would say, is perhaps the one contraindication that I've ever found to a carnivore diet.
Jack Heald 22:51
Okay, let's let me ask you about I actually thought this was going to be a short episode and and, Boy, was I wrong. I've got so many questions. One of the things I've heard, and I get, I haven't done this myself. So I don't know that this is a fact. But we hear all the time that you need fiber in order for your bowels to function properly and keep things moving well. And one of the things I've heard about full carnivore is your constipation, let's just cut to the chase constipation. Talk about that, please.
Dr. Philip Ovedia 23:34
Sure thing. So the experience of most carnivores is that they move their bowels less often. So you know, we have come to expect I would say people on you know, sort of a standard American diet or even, you know, people in a healthy, let's say, a Mediterranean or, you know, even a vegan vegetarian diet, we have come to x, we've been told that it's normal to move your bowels every day or multiple times a day. And my personal experience on carnivore and again, the experience of lots of people on carnivore is that, that doesn't happen. You know, I would say I average two to three bowel movements a week. Okay, but understand that that's different than constipation. Constipation is when you have a essentially, you know, an accumulation of backup. That's usually associated with pain and discomfort. I just, I just moved my bowels less often, but they're normal bowel movements. They don't take extra effort or straining. And, you know, basically what I attributed that to is that the food that I am eating, my body is fully utilizing. You know, fiber, understand that our bodies basically do not yet digest fiber, it passes through our digestive system. This was, you know, thought to stimulate You know, keep the bowels healthy by keeping things moving through. But you know, the reality is, is that if you're eating food that your body is fully utilizing, and there's a lot less white waste products being made, I would view that as a good thing. The myth around needing fiber comes from a couple of different places. It actually, you know, when you really trace it back through the scientific literature, it, there was a scientist, and I forget his name. And this is like, early 19 hundred's and he was, you know, studying one of the tribes, I believe it was, you know, in Africa, and he was just so impressed by their bowel movements, like he thought they had a perfect shape and amount and this and that he was very impressed. And he figured out that it was, there was some high fibrous plant, you know, that was local to the area that they ate a lot of. And so, you know, he basically said, Look at these guys, they're eating all this fiber, they're having all these great bowel movements, you know, much better than we have, you know, back in civilized you know, Europe or America. And it This all started the myth, basically that fiber was necessary to have healthy bowels. When you look at the, when you look at the site,
Jack Heald 26:20
I'm just laughing because there are so many of these stories about these commonly accepted truth in air quotes. Yeah, it has its that actually has its roots in either bad studies, no studies, apocryphal studies, I'm just it's, I we I keep running into this and it's it laughs maybe I'm laughing so I don't cry.
Dr. Philip Ovedia 26:53
Yeah, it really, you know, this is the stuff you start to figure out when you look into this. So there was a very good study done an interventional study done on what we call idiopathic constipation, so people who were struggling with constipation, you know, and they had painful bowel movements, and you know, all the things that goes along with true constipation. And they gave these people fiber supplements, and it made it worse. So the data shows that increased fiber does not correlate to, you know, good bowel habits, or good health overall. And again, you know, when you look at the studies that are purported to show that fiber is beneficial to our health, overall, what you realize is that, you know, the people that are on high higher fiber diet, or eating less of the bad stuff, so the fiber, the fibrous foods, you know, vegetables primarily, is in substitution of, you know, basically crap, processed junk food. And so it looks like those people are doing better because they're eating fiber, but they're not really doing better, because they're eating fiber, they're doing better because they're eating less bad stuff, and they're having the fiber instead. So, you know, again, the scientific studies don't support the fact that you need fiber, the personal experience of myself and all of the carnivore community out there is, is that fiber is in no way essential to health, and you can live a perfectly normal life without consuming any significant amounts of fiber.
Jack Heald 28:33
Wow. I really didn't expect it to be that clear cut, I thought I thought there was going to be a whole lot of nuance around this, this question. Okay, so now I do have a little bit of experience that is behind this next question. I've, I've done a keto diet off and on for several years. And one of the things that I've experienced is cramping, muscle cramps, and it might just be genetic and my dad suffered from masti muscle cramps most of his life. And, you know, I, I often wake up in the middle of the night with nasty cramps in my, my lower body. And somewhere I heard, you know, my, my highly scientific results here, that whatever, vitamins, minerals, whatever, that we need to keep our muscles from cramping are absent, or at least not in sufficient quantities in a keto diet. I realized I sound like a complete idiot here. But can you address that?
Dr. Philip Ovedia 29:51
Sure, you know, and again, very common question that comes up and very common, you know, concern that's raised and The cramping, the muscle cramping that occurs with low carb diets in general, you know, keto, carnivore, really all the low carb diet seem to be primarily related to electrolytes, right, so the salt, the minerals, like you said that we eat. And I would say there is probably you know, there are a couple of factors in play here, the one pretty clear factor that we know is that when you're eating less carbohydrates, your insulin level drops, insulin we've talked about in the past is sort of a master hormone in your body. And one of the many effects that insulin has is it causes your kidneys to basically retain salt. And so when your insulin level drops, basically, you start to, you know, the kidneys start to flush out a lot more water and a lot of salt. And this is, you know, some of the initial, you know, rapid weight loss that we see with people that go on a low carb diet is that they're just getting rid of a lot of water weight. But anytime water is being, you know, released by the kidneys, they're salt that's going with it. So, you know, one can very quickly become salt depleted on a, especially when they first start a keto diet, or a low carb diet, I should say. And so you need to replace that white by taking salts, and that's one of the many things you know, that I do with my clients is making sure that their electrolyte intake, high quality, sea salt is usually what I recommend. And then magnesium seems to be the other element. And also realize that many of us are deficient in these, you know, electrolytes and elements to start with, you know, and without getting too deep into it, you know, for many reasons, our food supply has become deficient, or we've been told to restrict our intake of salt, the salt, I tend to consume report poor quality salts that don't really have the electrolytes and the minerals that we need. So, you know, it's led to a vicious problem, but most of those issues around cramping, I find get corrected with proper electrolyte supplementation. And they also over time, again, your body adjusts. And so for instance, you know, I don't need to, I don't do the rigorous sort of electrolyte supplementation, now, three years into the carnivore diet four or five years into low carb dieting, that I needed to, you know, at the beginning of this experience,
Jack Heald 32:42
this is very helpful for me, this, this is really very helpful for me. Okay, um, those are my questions. Are there other things that I should be asking about? that we need to know,
Dr. Philip Ovedia 32:56
I think the other important aspect of the carnivore diet that, you know, needs to be mentioned is that it it is probably the best elimination diet that people can do. And, you know, so when I talk to my clients, and you know, they're trying to optimize their health, oftentimes, I will propose the carnivore diet as an elimination slash reset diet. So you know, it is pretty clear that meat, salt and water is kind of the minimum, you know, that humans can survive on
Jack Heald 33:31
what about coffee and whiskey because that's pretty important for what
Dr. Philip Ovedia 33:34
Yes, indeed and we can talk about that a little bit but you know, if you're trying to figure out what bad food what foods might be triggering your various health problems, one of the most useful aspects of the carnivore diet is that it is the best elimination diet that you can do so you can put yourself on you know, very basic carnivore meat salt water, for you know, let's say, three months and see how you feel. I give you know, I tell people this is going to reveal to you how good you can actually feel. And then you can use the carnivore diet for instance as a baseline to start adding back in foods. Right intentionally Kayla
Jack Heald 34:16
Peterson did that yes, exactly how she healed herself
Dr. Philip Ovedia 34:20
I guess correct. And for people with autoimmune conditions in particular, you know, that is an especially powerful use of the carnivore diet. And finally, you know, again, as I go through in my book, you know, I don't say that the carnivore diet is the only way to be metabolically healthy. You know, I go through in my book, how you can be metabolically healthy on literally everything from vegan to carnivore and you know, a couple of things in between, like keto and paleo and and, you know, Mediterranean type diets, right. So, but I think it is an important tool that we do not utilize enough You know because of the fears because of the myths truths that have been, you know, around meat in general and around the carnivore diet in particular, it doesn't get utilized as much as I think it should and I think it can be a very useful tool but again, I I'm not out here saying everyone needs to be on a carnivore diet you know, I don't think that one right diet for everyone and the diet changes over time for everyone so carnivore might be a useful tool at some point in your experience, and you know, it may or may not be something that you need to stick with long term.
Jack Heald 35:39
Okay, one last question. How long Oh, it's probably a series of questions. Now how long have you been mostly carnivore?
Dr. Philip Ovedia 35:49
So I started in March of 2019 Wow, we're doing this and no October 21 so two and a half years
Jack Heald 35:58
and you don't see any reason to change?
Dr. Philip Ovedia 36:02
I really don't you know, it's the best I feel. I'm happy with the way I eat you know, I eat when I'm hungry. I eat until I'm full and I enjoy all the food that I eat. I don't feel deprived I don't you know, feel like I'm starving myself and so I really don't have a good reason to go back you know to not continue to eat this way and that's the bottom line for me.
Jack Heald 36:28
All right, well, I think this has just been killer. This has been for me has been very very eye opening and educational. I would just want to remind our listeners they can follow you on Twitter at I fix hearts please visit Dr. Vedas website as well. Aveda heart health, that's o v A di a heart health.com he's got a telemedicine practice if you need help with these metabolic get with your metabolic health. He's the guy to talk to and I guess if you're around the Memphis area head, you need to have your chest cut open. You're also the guy to talk to, but let's let's hope that's not gonna happen. All right. Well, this has been the stay off my operating table podcast with Dr. Philip Aveda. I'm your host, Jack Heald. We'll talk to you next time.