1 00:00:02,000 --> 00:00:07,000 Downloaded from YTS.BZ 2 00:00:02,043 --> 00:00:04,295 (no audio) 3 00:00:08,000 --> 00:00:13,000 Official YIFY movies site: YTS.BZ 4 00:00:10,468 --> 00:00:12,721 (no audio) 5 00:00:18,476 --> 00:00:20,729 (no audio) 6 00:00:28,945 --> 00:00:33,950 (pensive music) (heart beating) 7 00:00:34,242 --> 00:00:35,826 (dramatic music) 8 00:00:35,827 --> 00:00:36,910 - [Newscaster 1] Heart disease, 9 00:00:36,911 --> 00:00:39,163 still the single leading cause of death, 10 00:00:39,164 --> 00:00:40,706 the number one killer. 11 00:00:40,707 --> 00:00:43,625 - [Newscaster 2] The number one killer in the US. 12 00:00:43,626 --> 00:00:46,587 - [Emily Kaplan] We're spending so much money 13 00:00:46,588 --> 00:00:49,214 and yet the outcomes are all worse. 14 00:00:49,215 --> 00:00:50,466 - [Historic Clip] Heart disease has become 15 00:00:50,467 --> 00:00:52,551 the most frequent cause of death. 16 00:00:52,552 --> 00:00:53,385 - [Historic Clip 2] Cardiovascular ailments 17 00:00:53,386 --> 00:00:55,596 continue to take American lives. 18 00:00:55,597 --> 00:00:58,223 - [Historic Clip 3] You can reduce the risk of heart attack 19 00:00:58,224 --> 00:01:01,186 if you eat a diet low in cholesterol and saturated fats. 20 00:01:02,103 --> 00:01:04,438 - [Dr. Bret Scher] We're still taught that high-fat diets 21 00:01:04,439 --> 00:01:08,192 cause heart disease because they raise LDL cholesterol. 22 00:01:08,193 --> 00:01:09,526 - [Dr. Brian Lenzkes] We would talk about cholesterol 23 00:01:09,527 --> 00:01:12,154 being bad. Higher cholesterol is gonna clog your veins. 24 00:01:12,155 --> 00:01:14,615 - Is that what we should be focusing on the most? 25 00:01:14,616 --> 00:01:17,367 And I think, no, it absolutely is not. 26 00:01:17,368 --> 00:01:19,453 - [Dr. Tro Kalayjian] The only reason to focus on 27 00:01:19,454 --> 00:01:21,790 cholesterol is because we have drugs. 28 00:01:23,625 --> 00:01:24,834 There's no other reason. 29 00:01:25,877 --> 00:01:30,882 - More drugs, more illnesses, and it's not working. 30 00:01:31,049 --> 00:01:32,508 [Dr. Paul Saladino] It's a broad failure of the 31 00:01:32,509 --> 00:01:35,052 medical system, I think. It's just the paradigm is wrong. 32 00:01:35,053 --> 00:01:36,512 - [Tro] You go to the medical literature, 33 00:01:36,513 --> 00:01:40,724 it's all on flimsy data based off of a sick population. 34 00:01:40,725 --> 00:01:43,560 (dramatic music) 35 00:01:43,561 --> 00:01:45,896 [Dr. Arthur Agatston] cholesterol was not a good predictor 36 00:01:45,897 --> 00:01:48,065 of who's gonna have a heart attack. 37 00:01:48,066 --> 00:01:49,358 [Dave Feldman] Now is our chance. 38 00:01:49,359 --> 00:01:52,278 This one study could change everything. 39 00:01:53,988 --> 00:01:57,950 These people could finally help us crack the code. 40 00:01:57,951 --> 00:02:00,410 [Dr. Thomas Dayspring] I'm sorry, that's not ethical. 41 00:02:00,411 --> 00:02:01,995 [Dr. Gil Carvalho] Incredibly reckless. 42 00:02:01,996 --> 00:02:03,789 No regard for human life. 43 00:02:03,790 --> 00:02:05,374 - I feel like I've underestimated 44 00:02:05,375 --> 00:02:07,543 the wind that's in front of us. 45 00:02:07,544 --> 00:02:11,171 - If we think high LDL in everybody is equally concerning, 46 00:02:11,172 --> 00:02:15,051 if that's wrong, then we've been wrong for a very long time. 47 00:02:16,261 --> 00:02:18,930 (heart beating) 48 00:02:25,311 --> 00:02:26,270 (pensive music) 49 00:02:26,271 --> 00:02:27,771 - [Dave] All over the world, 50 00:02:27,772 --> 00:02:30,817 people are looking for ways to live a healthier life, 51 00:02:32,318 --> 00:02:34,611 free from medication and disease. 52 00:02:34,612 --> 00:02:38,448 (plane engine roaring) 53 00:02:38,449 --> 00:02:40,993 I have traveled so many places 54 00:02:40,994 --> 00:02:44,247 to get some of these stories from people like me, 55 00:02:46,416 --> 00:02:48,792 people who suffered, sometimes for decades, 56 00:02:48,793 --> 00:02:50,169 with chronic illness, 57 00:02:50,170 --> 00:02:52,880 and then, in what seems like a miracle, 58 00:02:52,881 --> 00:02:56,175 a simple change in diet turns it all around. 59 00:02:56,176 --> 00:02:59,178 [Dr. Nick Norwitz] My symptoms all improved dramatically. 60 00:02:59,179 --> 00:03:02,014 - [Dave] Many people lowering or getting off medication, 61 00:03:02,015 --> 00:03:03,849 finding relief from pain. 62 00:03:03,850 --> 00:03:05,559 [Dr. Jen Unwin] It really did change my life. 63 00:03:05,560 --> 00:03:08,061 It literally felt like the lights had come on. 64 00:03:08,062 --> 00:03:10,481 - [Dave] They have hope again, life again. 65 00:03:11,316 --> 00:03:13,775 So many people have found their solution 66 00:03:13,776 --> 00:03:15,069 in a Ketogenic diet. 67 00:03:17,614 --> 00:03:19,907 [Matt Baszucki] I was surprised at first that 68 00:03:19,908 --> 00:03:21,366 just changing my diet 69 00:03:21,367 --> 00:03:25,455 had such a night and day effect on my mental health. 70 00:03:26,623 --> 00:03:27,497 - [Dave] There's new hope 71 00:03:27,498 --> 00:03:29,583 for the reversal of mental illness. 72 00:03:29,584 --> 00:03:33,378 - It's almost like a different existence. 73 00:03:33,379 --> 00:03:35,839 - [Dave] The resolution of eating disorders. 74 00:03:35,840 --> 00:03:37,257 [Michelle Hurn, RD] I'd never been able to go that long 75 00:03:37,258 --> 00:03:38,508 without eating 76 00:03:38,509 --> 00:03:40,844 or without, like, obsessing about it and thinking about it. 77 00:03:40,845 --> 00:03:43,305 - [Dave] The reversal of Type 2 diabetes 78 00:03:43,306 --> 00:03:45,390 and safe management of Type 1. 79 00:03:45,391 --> 00:03:48,101 - [Alison] His diabetes is completely under control. 80 00:03:48,102 --> 00:03:49,811 - [John] He just looks healthy. 81 00:03:49,812 --> 00:03:51,313 [Robyn Dobbins] Every day is just a better day. 82 00:03:51,314 --> 00:03:52,523 There is hope. 83 00:03:53,399 --> 00:03:55,943 And that is what I want everyone to know. 84 00:03:55,944 --> 00:03:57,027 - That was my story, 85 00:03:57,028 --> 00:04:01,114 and it's a story I've seen tens of thousands of times. 86 00:04:01,115 --> 00:04:03,200 - [Dave] I wish the story ended here. 87 00:04:03,201 --> 00:04:04,034 (dramatic music) 88 00:04:04,035 --> 00:04:06,370 - A new report from the American Heart Association 89 00:04:06,371 --> 00:04:08,747 is shedding light on the risks associated 90 00:04:08,748 --> 00:04:10,749 with some popular eating plans. 91 00:04:10,750 --> 00:04:12,918 - [Dave] The problem is modern medicine believes 92 00:04:12,919 --> 00:04:15,879 that Ketogenic diets can also kill us. 93 00:04:15,880 --> 00:04:18,006 - These diets that were very low in carbohydrates 94 00:04:18,007 --> 00:04:19,675 raise the risk for bad cholesterol, 95 00:04:19,676 --> 00:04:21,593 and that is a risk factor for heart disease. 96 00:04:21,594 --> 00:04:24,096 - If you have that much fat, the bad cholesterol goes up, 97 00:04:24,097 --> 00:04:26,014 increasing your risk of heart problems. 98 00:04:26,015 --> 00:04:27,224 - There's an assumption 99 00:04:27,225 --> 00:04:30,143 that if someone starts a Ketogenic diet, 100 00:04:30,144 --> 00:04:32,437 automatically you increase your risk of heart disease. 101 00:04:32,438 --> 00:04:34,398 And that really is unfounded. 102 00:04:34,399 --> 00:04:35,440 - [Dave] Most people on Keto 103 00:04:35,441 --> 00:04:37,402 see little change in their cholesterol, 104 00:04:38,403 --> 00:04:41,697 but surprisingly, it's the leanest, healthiest individuals 105 00:04:41,698 --> 00:04:44,367 who can see their levels go up, a lot. 106 00:04:45,285 --> 00:04:47,244 - The cholesterol went through the roof. 107 00:04:47,245 --> 00:04:49,788 - My LDL is way up. 108 00:04:49,789 --> 00:04:51,581 - It was the highest I've seen it. 109 00:04:51,582 --> 00:04:53,583 - I was in the best I've ever been in, 110 00:04:53,584 --> 00:04:57,045 yet one lab number was saying that this was bad. 111 00:04:57,046 --> 00:05:00,299 - I just knew how good I felt when I was low carb, 112 00:05:00,300 --> 00:05:02,134 but I did freak out a little. 113 00:05:02,135 --> 00:05:03,510 - I was really afraid. 114 00:05:03,511 --> 00:05:05,679 I was really scared. 115 00:05:05,680 --> 00:05:08,307 - [Dave] Modern medicine believes there's no debate. 116 00:05:08,308 --> 00:05:11,226 These people are a heart attack waiting to happen. 117 00:05:11,227 --> 00:05:12,978 - Straight out, LDL cholesterol 118 00:05:12,979 --> 00:05:16,148 causes heart disease and stroke. 119 00:05:16,149 --> 00:05:19,860 - LDL cholesterol is causative, without a doubt. 120 00:05:19,861 --> 00:05:23,530 - LDL causes heart disease, without question. 121 00:05:23,531 --> 00:05:25,741 You'll have more heart attacks and more strokes. 122 00:05:25,742 --> 00:05:28,035 - A lot of times LDL is described 123 00:05:28,036 --> 00:05:30,871 as though it is the disease. 124 00:05:30,872 --> 00:05:32,080 If you have high LDL, 125 00:05:32,081 --> 00:05:34,416 it's as good as if you already have heart disease, 126 00:05:34,417 --> 00:05:37,252 or at least that it's right around the corner. 127 00:05:37,253 --> 00:05:39,463 But what if modern medicine is wrong? 128 00:05:39,464 --> 00:05:40,297 - [Dr. Laura Avery] Would you like to see your heart 129 00:05:40,298 --> 00:05:41,882 in three dimensions? 130 00:05:41,883 --> 00:05:43,842 - [Dave] What if this isn't a medical problem 131 00:05:43,843 --> 00:05:45,761 but a scientific opportunity? 132 00:05:45,762 --> 00:05:46,678 - [Dr. Avery] Well, we have the 133 00:05:46,679 --> 00:05:48,347 anterior descending artery here. 134 00:05:48,348 --> 00:05:51,892 - Why not just go ahead and study these folks? 135 00:05:51,893 --> 00:05:54,436 - That's one of the fascinating things about Dave. 136 00:05:54,437 --> 00:05:56,646 He's an outsider who came in 137 00:05:56,647 --> 00:05:59,567 and is starting to sort of upend medicine. 138 00:06:01,152 --> 00:06:03,236 - [Dave] My story began when I saw my own cholesterol 139 00:06:03,237 --> 00:06:04,988 skyrocket on this diet 140 00:06:04,989 --> 00:06:07,283 and I became obsessed with finding out why. 141 00:06:08,159 --> 00:06:10,619 But I'm not a medical professional. 142 00:06:10,620 --> 00:06:12,829 I've gathered hundreds of blood tests 143 00:06:12,830 --> 00:06:14,790 and I tracked everything I consume. 144 00:06:14,791 --> 00:06:17,168 But I don't work for a lab. 145 00:06:18,169 --> 00:06:19,711 I've authored peer-reviewed papers 146 00:06:19,712 --> 00:06:21,296 to share these discoveries. 147 00:06:21,297 --> 00:06:22,130 - [Emcee] Well, then, Dave, 148 00:06:22,131 --> 00:06:23,799 please come and tell us more about it. 149 00:06:23,800 --> 00:06:25,217 (attendees applauding) 150 00:06:25,218 --> 00:06:26,218 - And now I'm spearheading 151 00:06:26,219 --> 00:06:28,345 a highly controversial research study 152 00:06:28,346 --> 00:06:30,013 with a team of doctors and PhDs 153 00:06:30,014 --> 00:06:32,557 across multiple institutions. 154 00:06:32,558 --> 00:06:34,434 But I'm not a trained researcher. 155 00:06:34,435 --> 00:06:37,270 I'm an engineer chasing this medical mystery 156 00:06:37,271 --> 00:06:39,189 around the world and seeking an answer 157 00:06:39,190 --> 00:06:40,482 for the countless individuals 158 00:06:40,483 --> 00:06:43,235 who rely on Ketogenic diets for their health. 159 00:06:43,236 --> 00:06:45,904 I need for what they're experiencing 160 00:06:45,905 --> 00:06:47,615 to tell the story for us. 161 00:06:48,533 --> 00:06:51,660 And that's what's exciting, getting to see how different 162 00:06:51,661 --> 00:06:53,078 each of the locations are, 163 00:06:53,079 --> 00:06:55,455 but yet how common the phenomenon is. 164 00:06:55,456 --> 00:06:58,000 This isn't to say the Ketogenic diet is a panacea. 165 00:06:58,876 --> 00:07:00,168 It's not for everyone. 166 00:07:00,169 --> 00:07:02,003 It's certainly not for every medical condition. 167 00:07:02,004 --> 00:07:05,799 But for some medical conditions and for some individuals, 168 00:07:05,800 --> 00:07:08,343 it seems to be a lifeline. 169 00:07:08,344 --> 00:07:10,387 And yet they have this one problem. 170 00:07:10,388 --> 00:07:12,305 They see this extraordinary increase 171 00:07:12,306 --> 00:07:14,266 in their LDL cholesterol. 172 00:07:14,267 --> 00:07:16,810 Why not just go ahead and find out, 173 00:07:16,811 --> 00:07:18,270 are they at a higher risk? 174 00:07:18,271 --> 00:07:19,271 (gentle music) 175 00:07:19,272 --> 00:07:20,981 - [John] He's throwing strikes. 176 00:07:20,982 --> 00:07:22,899 - We really need to have an answer, 177 00:07:22,900 --> 00:07:25,694 not just for the adults, but also for the children, 178 00:07:25,695 --> 00:07:29,406 who might have a medical reason 179 00:07:29,407 --> 00:07:31,534 to be on a very low carbohydrate diet. 180 00:07:32,743 --> 00:07:34,661 And they deserve it from us. 181 00:07:34,662 --> 00:07:38,206 - 91. 182 00:07:38,207 --> 00:07:41,251 (texts whirring) 183 00:07:41,252 --> 00:07:43,753 (lighthearted music) 184 00:07:43,754 --> 00:07:45,797 - [Dave] Worldwide, the leading causes of death 185 00:07:45,798 --> 00:07:47,174 are chronic diseases. 186 00:07:47,175 --> 00:07:48,758 You already know these well, 187 00:07:48,759 --> 00:07:51,511 heart disease, stroke, Type 2 Diabetes, 188 00:07:51,512 --> 00:07:53,264 Alzheimer's, and kidney disease. 189 00:07:54,098 --> 00:07:56,516 A key driver of most chronic diseases 190 00:07:56,517 --> 00:07:58,685 is chronically elevated insulin. 191 00:07:58,686 --> 00:08:01,605 And a major contributor to chronically elevated insulin 192 00:08:01,606 --> 00:08:05,692 is the over-consumption of sugar and refined carbohydrates. 193 00:08:05,693 --> 00:08:09,112 Ketogenic diets, often referred to as Keto, 194 00:08:09,113 --> 00:08:12,908 restrict carbohydrates to less than 5% of daily calories. 195 00:08:12,909 --> 00:08:15,035 They include high amounts of healthy fats 196 00:08:15,036 --> 00:08:17,412 and a moderate amount of protein. 197 00:08:17,413 --> 00:08:20,290 Studies on Keto diets show that they can reduce insulin, 198 00:08:20,291 --> 00:08:22,709 normalize blood sugar, promote weight loss, 199 00:08:22,710 --> 00:08:24,336 and restore metabolic health. 200 00:08:24,337 --> 00:08:26,630 And yet every physician I've met on this journey 201 00:08:26,631 --> 00:08:30,133 was taught that Keto diets cause high cholesterol, 202 00:08:30,134 --> 00:08:33,386 and high cholesterol causes the number one killer, 203 00:08:33,387 --> 00:08:34,804 heart disease. 204 00:08:34,805 --> 00:08:35,972 - Just cholesterol is bad. 205 00:08:35,973 --> 00:08:37,641 It causes heart diseases. 206 00:08:37,642 --> 00:08:39,226 - We would talk about cholesterol being bad. 207 00:08:39,227 --> 00:08:41,144 Higher cholesterol are gonna clog your veins. 208 00:08:41,145 --> 00:08:43,605 The assumption was just, well, everyone knows 209 00:08:43,606 --> 00:08:45,023 that the cholesterol is the problem. 210 00:08:45,024 --> 00:08:45,858 Enough said. 211 00:08:47,443 --> 00:08:49,529 - But what is cholesterol? 212 00:08:51,239 --> 00:08:52,781 cholesterol is an essential molecule 213 00:08:52,782 --> 00:08:55,283 found in every cell in the human body. 214 00:08:55,284 --> 00:08:56,619 We cannot live without it. 215 00:08:57,537 --> 00:08:59,204 In fact, whatever cholesterol 216 00:08:59,205 --> 00:09:01,122 we don't get from the foods we eat, 217 00:09:01,123 --> 00:09:03,083 our liver will make on its own. 218 00:09:03,084 --> 00:09:04,418 And the liver is not alone. 219 00:09:05,294 --> 00:09:07,337 Nearly every cell in the human body 220 00:09:07,338 --> 00:09:09,090 can synthesize cholesterol. 221 00:09:10,466 --> 00:09:13,885 cholesterol is essential for building your cell membranes. 222 00:09:13,886 --> 00:09:15,762 It also helps your liver make bile, 223 00:09:15,763 --> 00:09:17,974 which is needed to digest the foods you eat. 224 00:09:19,100 --> 00:09:21,142 cholesterol also plays a starring role 225 00:09:21,143 --> 00:09:22,894 in the central nervous system, 226 00:09:22,895 --> 00:09:25,523 ensuring your brain communicates well with your body. 227 00:09:26,524 --> 00:09:28,608 It also helps synthesize vitamin D, 228 00:09:28,609 --> 00:09:30,402 which supports your immune system, 229 00:09:30,403 --> 00:09:33,447 and sex hormones like testosterone and estrogen. 230 00:09:35,533 --> 00:09:38,535 So if every cell in our bodies needs cholesterol 231 00:09:38,536 --> 00:09:40,036 and we can't live without it, 232 00:09:40,037 --> 00:09:42,706 how did it become the villain of modern medicine? 233 00:09:42,707 --> 00:09:44,583 Well, here's an interesting fact. 234 00:09:44,584 --> 00:09:46,876 Most studies that show an association 235 00:09:46,877 --> 00:09:49,296 between elevated cholesterol and heart disease 236 00:09:49,297 --> 00:09:51,464 are looking at general populations 237 00:09:51,465 --> 00:09:55,885 who are, let's face it, generally unhealthy. 238 00:09:55,886 --> 00:09:58,221 - There was a recent study that showed 93% 239 00:09:58,222 --> 00:10:01,933 of the American population has suboptimal metabolic health. 240 00:10:01,934 --> 00:10:02,851 93%. 241 00:10:02,852 --> 00:10:04,102 So then the question becomes, 242 00:10:04,103 --> 00:10:06,021 well, would that same evidence 243 00:10:06,022 --> 00:10:08,648 translate to a metabolically healthy population 244 00:10:08,649 --> 00:10:11,359 or a population who's in Ketosis? 245 00:10:11,360 --> 00:10:13,069 And we don't have that evidence, right? 246 00:10:13,070 --> 00:10:15,697 That population has not been studied. 247 00:10:15,698 --> 00:10:19,034 - What if we back out high insulin? 248 00:10:19,035 --> 00:10:23,538 What if we back out obesity, diabetes, pre-diabetes? 249 00:10:23,539 --> 00:10:26,666 What if we take a look at healthy people 250 00:10:26,667 --> 00:10:30,670 and see if cholesterol matters the same? 251 00:10:30,671 --> 00:10:32,839 - What if high cholesterol 252 00:10:32,840 --> 00:10:35,091 in healthy people on a Keto diet 253 00:10:35,092 --> 00:10:36,886 is telling us a different story? 254 00:10:39,138 --> 00:10:41,891 (texts whirring) 255 00:10:44,518 --> 00:10:47,062 (keyboard clacking) 256 00:10:47,063 --> 00:10:52,068 This is the kind of thing I like to be eating, or this. 257 00:10:52,276 --> 00:10:54,819 (lighthearted music) 258 00:10:54,820 --> 00:10:56,237 Now you might be like, 259 00:10:56,238 --> 00:10:59,949 "Huh, how many photos of food do you have?" 260 00:10:59,950 --> 00:11:01,242 Good question. 261 00:11:01,243 --> 00:11:06,164 About, I don't know, this many. (laughs) 262 00:11:06,165 --> 00:11:08,500 I've been pretty much a nerd my whole life. 263 00:11:08,501 --> 00:11:11,336 And I liked playing with Legos. 264 00:11:11,337 --> 00:11:14,297 I liked reading comic books. 265 00:11:14,298 --> 00:11:15,716 I liked playing video games. 266 00:11:18,386 --> 00:11:20,887 I liked playing around with programs 267 00:11:20,888 --> 00:11:24,392 and writing little games for myself and my friends. 268 00:11:26,060 --> 00:11:28,353 I like building things. 269 00:11:28,354 --> 00:11:30,313 I remember I really impressed my dad one time 270 00:11:30,314 --> 00:11:33,983 'cause I built a transmission for a Lego car. 271 00:11:33,984 --> 00:11:35,777 And it was fun. 272 00:11:35,778 --> 00:11:39,322 Just the building and the constructing of things 273 00:11:39,323 --> 00:11:41,117 is enjoyable. 274 00:11:42,159 --> 00:11:45,412 But here's one of the things about all engineers. 275 00:11:45,413 --> 00:11:49,583 We actually spend more time taking things apart. 276 00:11:50,584 --> 00:11:52,752 I've been taking photographs of my food 277 00:11:52,753 --> 00:11:54,129 and lot of these metrics 278 00:11:54,130 --> 00:11:58,092 for coming on to eight years in a couple of months. 279 00:11:59,260 --> 00:12:02,429 I'd just always be sure that my hand was in the shot, 280 00:12:02,430 --> 00:12:04,556 but usually I'd have, like, my fist nearby 281 00:12:04,557 --> 00:12:06,308 so you could get a sense of volume. 282 00:12:07,393 --> 00:12:09,018 - [Jennifer Isenhart] Why do you do this? 283 00:12:09,019 --> 00:12:10,688 - I wanted to track all my food 284 00:12:12,148 --> 00:12:16,151 so that I had the data to match with the blood work I do. 285 00:12:16,152 --> 00:12:18,946 And I have a perfect record of everything I've consumed. 286 00:12:20,239 --> 00:12:21,072 - [Jennifer Isenhart] How many photos 287 00:12:21,073 --> 00:12:23,742 has Dave taken of you versus food? 288 00:12:23,743 --> 00:12:25,744 - (chuckles) Well, I think if anybody 289 00:12:25,745 --> 00:12:26,703 looked through their phone, 290 00:12:26,704 --> 00:12:30,790 they'd think that something was very, very off, 291 00:12:30,791 --> 00:12:34,753 because there are far more pictures of his food, 292 00:12:34,754 --> 00:12:36,546 his food and his fist. 293 00:12:36,547 --> 00:12:39,090 - I even have a lot of gestures. 294 00:12:39,091 --> 00:12:41,426 While the hand enclosed 295 00:12:41,427 --> 00:12:44,179 is what's showing up shot after shot, 296 00:12:44,180 --> 00:12:48,558 I actually have some things like this gesture. 297 00:12:48,559 --> 00:12:50,560 What this means is I decided 298 00:12:50,561 --> 00:12:52,772 to start eating two hot dogs without a bun. 299 00:12:53,898 --> 00:12:56,608 But an open hand means that I stopped. 300 00:12:56,609 --> 00:13:00,153 And that's because these hot dogs were gross. (laughs) 301 00:13:00,154 --> 00:13:02,489 - Being the engineer geek that he is, 302 00:13:02,490 --> 00:13:04,240 he just has a different way of thinking, 303 00:13:04,241 --> 00:13:08,119 that maybe somebody who spent their entire life in medicine, 304 00:13:08,120 --> 00:13:10,955 than how they would think in their thought process. 305 00:13:10,956 --> 00:13:12,248 - The more I could take things apart 306 00:13:12,249 --> 00:13:13,625 and see how they worked on the inside, 307 00:13:13,626 --> 00:13:16,044 the more I became fascinated. 308 00:13:16,045 --> 00:13:18,338 And nowhere did I become more fascinated 309 00:13:18,339 --> 00:13:21,133 than with code, with programming. 310 00:13:22,092 --> 00:13:24,219 (lighthearted music) 311 00:13:24,220 --> 00:13:27,555 As early as I can remember, I loved software. 312 00:13:27,556 --> 00:13:30,850 Eventually, I'd be writing my own code, starting businesses, 313 00:13:30,851 --> 00:13:33,895 and building platforms with teams of engineers. 314 00:13:33,896 --> 00:13:37,774 I love technology, and technology loved me back. 315 00:13:37,775 --> 00:13:40,068 But it came at a cost. 316 00:13:40,069 --> 00:13:42,821 Like my fellow developers, my diet was terrible 317 00:13:42,822 --> 00:13:43,655 and my blood work 318 00:13:43,656 --> 00:13:45,907 was showing higher and higher glucose levels, 319 00:13:45,908 --> 00:13:47,951 suggesting I was developing diabetes, 320 00:13:47,952 --> 00:13:49,328 like most of my family. 321 00:13:50,412 --> 00:13:54,249 Finally, in 2015, I decided to do something about it. 322 00:13:54,250 --> 00:13:56,918 The low-carb diet was steadily rising in popularity, 323 00:13:56,919 --> 00:13:59,170 especially for treating diabetes, 324 00:13:59,171 --> 00:14:01,422 which made a lot of sense to me. 325 00:14:01,423 --> 00:14:04,384 And when I cut back on carbohydrates, it worked. 326 00:14:04,385 --> 00:14:06,344 Not only did my blood sugar come down, 327 00:14:06,345 --> 00:14:09,097 I dropped 30 pounds, my energy levels increased, 328 00:14:09,098 --> 00:14:12,308 my sleep improved, my running improved. 329 00:14:12,309 --> 00:14:16,229 Everything got better, except one thing, 330 00:14:16,230 --> 00:14:18,357 one thing that could not be ignored. 331 00:14:19,650 --> 00:14:22,026 I remember that day like it was yesterday. 332 00:14:22,027 --> 00:14:27,032 I remember it because that one 8 1/2 by 11 piece of paper 333 00:14:28,284 --> 00:14:30,368 completely changed my life. 334 00:14:30,369 --> 00:14:33,788 (foreboding music) 335 00:14:33,789 --> 00:14:37,877 I just kept looking at those labs completely mystified. 336 00:14:38,836 --> 00:14:40,962 (foreboding music) 337 00:14:40,963 --> 00:14:42,255 I kind of wanted a second opinion. 338 00:14:42,256 --> 00:14:43,632 Maybe it was a lab error. 339 00:14:45,384 --> 00:14:47,845 So why not just get my blood work all over again? 340 00:14:48,846 --> 00:14:49,721 In the meantime, 341 00:14:49,722 --> 00:14:52,056 I'm trying to learn everything I can about cholesterol. 342 00:14:52,057 --> 00:14:54,559 But I have no background in medicine or research 343 00:14:54,560 --> 00:14:58,354 so I'd just get frustrated and then depressed. 344 00:14:58,355 --> 00:15:00,399 And my appetite had fallen off. 345 00:15:01,400 --> 00:15:03,359 But I kept thinking, that's actually a good thing. 346 00:15:03,360 --> 00:15:05,737 If my appetite's fallen off, guess what? 347 00:15:05,738 --> 00:15:10,116 I'm eating less fat, and especially less saturated fat. 348 00:15:10,117 --> 00:15:12,076 Because if I'm eating less saturated fat, 349 00:15:12,077 --> 00:15:15,246 my LDL should drop, right? 350 00:15:15,247 --> 00:15:16,414 But that's not what happened. 351 00:15:16,415 --> 00:15:17,374 Not at all. 352 00:15:18,959 --> 00:15:21,002 The second test was two weeks later. 353 00:15:21,003 --> 00:15:25,089 Instead of dropping, my LDL jumped up, a lot. 354 00:15:25,090 --> 00:15:27,133 It climbed another hundred points. 355 00:15:27,134 --> 00:15:31,596 And suddenly a lot of my fear became fascination. 356 00:15:31,597 --> 00:15:35,642 I knew, I knew right then, there's way more to this story. 357 00:15:35,643 --> 00:15:38,227 It's not as simple as it's just fat or saturated fat 358 00:15:38,228 --> 00:15:41,397 because this was literally the first experiment 359 00:15:41,398 --> 00:15:43,275 that I didn't even intend to do, 360 00:15:44,401 --> 00:15:47,111 yet I was doing it. 361 00:15:47,112 --> 00:15:50,865 I was finding out that the thing that I was told 362 00:15:50,866 --> 00:15:52,701 was driving up my cholesterol, 363 00:15:53,953 --> 00:15:57,372 it couldn't have been all there was to the story. 364 00:15:57,373 --> 00:15:59,707 There had to be more. 365 00:15:59,708 --> 00:16:02,543 And at that point it, it turned into a full obsession. 366 00:16:02,544 --> 00:16:03,962 (dramatic music) 367 00:16:03,963 --> 00:16:06,673 So I started taking pictures of my food all the time, 368 00:16:06,674 --> 00:16:08,883 and that allowed me to have a tighter record 369 00:16:08,884 --> 00:16:11,886 of where my food matched with my lipid levels, 370 00:16:11,887 --> 00:16:14,806 because at the same time, I'm getting constant blood tests 371 00:16:14,807 --> 00:16:16,265 and tracking my cholesterol, 372 00:16:16,266 --> 00:16:18,559 then comparing it to my food intake. 373 00:16:18,560 --> 00:16:21,270 So I could actually see these changes in real time. 374 00:16:21,271 --> 00:16:23,773 And the very first pattern that emerged 375 00:16:23,774 --> 00:16:26,526 was this inversion pattern. 376 00:16:26,527 --> 00:16:29,320 My baseline LDL is still high on Keto, 377 00:16:29,321 --> 00:16:33,241 but, get this, my numbers can swing dramatically 378 00:16:33,242 --> 00:16:35,743 based on what I eat on a daily basis, 379 00:16:35,744 --> 00:16:38,162 and not the way we might think. 380 00:16:38,163 --> 00:16:40,707 When I consumed less food on Keto, 381 00:16:40,708 --> 00:16:44,669 including less saturated fat, my LDL jumped higher. 382 00:16:44,670 --> 00:16:47,672 When I consumed more, my LDL dropped. 383 00:16:47,673 --> 00:16:49,132 That was the first signal. 384 00:16:49,133 --> 00:16:50,842 The first signal was, wait, wait, wait, 385 00:16:50,843 --> 00:16:53,094 these levels are super dynamic. 386 00:16:53,095 --> 00:16:56,347 All I need to do is track my food, 387 00:16:56,348 --> 00:16:59,350 take a higher frequency of these tests, 388 00:16:59,351 --> 00:17:00,476 and then see if that feedback 389 00:17:00,477 --> 00:17:01,769 gives me meaningful information. 390 00:17:01,770 --> 00:17:02,603 And it did. 391 00:17:02,604 --> 00:17:05,690 It was giving me meaningful information in real time. 392 00:17:05,691 --> 00:17:07,275 In just the span of a few months, 393 00:17:07,276 --> 00:17:11,571 I was already wanting to go to the next low carb conference, 394 00:17:11,572 --> 00:17:13,364 and knock on their doors, and say, 395 00:17:13,365 --> 00:17:14,741 "Look, guys, you've gotta check this out. 396 00:17:14,742 --> 00:17:16,076 You've gotta look at this." 397 00:17:18,829 --> 00:17:21,289 (lighthearted music) 398 00:17:21,290 --> 00:17:23,958 It's my very first low carb conference. 399 00:17:23,959 --> 00:17:25,376 And I brought my laptop with me, 400 00:17:25,377 --> 00:17:26,794 which had the data in it. 401 00:17:26,795 --> 00:17:28,421 And it had the graphs. 402 00:17:28,422 --> 00:17:31,507 - The thing was that it was our very first event, 403 00:17:31,508 --> 00:17:33,676 and I was spinning like a top, 404 00:17:33,677 --> 00:17:36,220 and he kept getting in my face with his laptop. 405 00:17:36,221 --> 00:17:37,055 You know, like, "Look at it." 406 00:17:37,056 --> 00:17:39,682 And I was saying, "Yeah, Dave, thanks, but, you know..." 407 00:17:39,683 --> 00:17:41,142 "No, no, no, like..." (laughs) 408 00:17:41,143 --> 00:17:42,727 He was so passionate about it. 409 00:17:42,728 --> 00:17:45,605 - And all I had was eight blood tests at that time, 410 00:17:45,606 --> 00:17:48,274 but it showed this inversion pattern. 411 00:17:48,275 --> 00:17:49,817 And I started talking to them 412 00:17:49,818 --> 00:17:51,737 about what I thought it might be. 413 00:17:52,988 --> 00:17:57,575 And they all looked at me like I was an alien. (chuckles) 414 00:17:57,576 --> 00:17:58,993 - But the most astounding thing to me 415 00:17:58,994 --> 00:18:00,620 was everybody was coming to me saying, 416 00:18:00,621 --> 00:18:03,039 "Have you met that gentleman 417 00:18:03,040 --> 00:18:04,957 who's walking around with a laptop?" 418 00:18:04,958 --> 00:18:07,960 And he's got this graph and he's showing everybody 419 00:18:07,961 --> 00:18:10,463 you can adjust your LDL and your cholesterol 420 00:18:10,464 --> 00:18:13,091 by what you eat on a daily basis. 421 00:18:13,092 --> 00:18:16,595 - Yeah, I'm sure I came off as, you know, a bit kooky. 422 00:18:17,513 --> 00:18:21,474 Regardless, though, it didn't change how passionate I was 423 00:18:21,475 --> 00:18:24,811 about making sure that they could understand 424 00:18:24,812 --> 00:18:26,938 just how dynamic these levels were. 425 00:18:26,939 --> 00:18:29,357 - The usual we think about lipids and lipoproteins 426 00:18:29,358 --> 00:18:31,109 is on the order of months. 427 00:18:31,110 --> 00:18:32,360 Now here's Dave who comes along 428 00:18:32,361 --> 00:18:34,028 with his end of one experiment and says, 429 00:18:34,029 --> 00:18:35,655 "In a matter of days, 430 00:18:35,656 --> 00:18:38,283 I can radically change my cholesterol." 431 00:18:39,660 --> 00:18:42,161 We've not talked about that in lipidology. 432 00:18:42,162 --> 00:18:43,663 - If anybody has any questions, 433 00:18:43,664 --> 00:18:46,207 feel free to post them here in the chat. 434 00:18:46,208 --> 00:18:47,917 The more I shared my discoveries, 435 00:18:47,918 --> 00:18:50,044 the more people started paying attention. 436 00:18:50,045 --> 00:18:52,463 - Dave is a software engineer 437 00:18:52,464 --> 00:18:54,340 who got ridiculously interested 438 00:18:54,341 --> 00:18:57,009 in self experimentation, nutrition. 439 00:18:57,010 --> 00:18:58,261 - I wanna thank Dave Feldman, 440 00:18:58,262 --> 00:19:00,263 an engineer who came into this field. 441 00:19:00,264 --> 00:19:02,390 - Dave Feldman, I think it's extraordinary 442 00:19:02,391 --> 00:19:03,975 that we've got an engineer. 443 00:19:03,976 --> 00:19:07,436 - Dave Feldman noticed that when he went on a low carb diet, 444 00:19:07,437 --> 00:19:08,271 his LDL- 445 00:19:08,272 --> 00:19:10,439 - Dave Feldman is someone you'd wanna have on too. 446 00:19:10,440 --> 00:19:12,692 - Dave Feldman, who's been a guest on the podcast- 447 00:19:12,693 --> 00:19:14,819 - I respect Dave Feldman. 448 00:19:14,820 --> 00:19:17,572 - Dave Feldman, who's been on the podcast. 449 00:19:17,573 --> 00:19:19,115 - I mentioned a guy named Dave Feldman and he was- 450 00:19:19,116 --> 00:19:21,909 - And Dave Feldman is an engineer 451 00:19:21,910 --> 00:19:23,620 who stumbled onto this mystery. 452 00:19:24,913 --> 00:19:26,706 - And that's how it all started. 453 00:19:26,707 --> 00:19:28,040 They all thought I was a little crazy, 454 00:19:28,041 --> 00:19:32,170 which maybe I am because I put my engineering career on hold 455 00:19:32,171 --> 00:19:35,591 and jumped full time into the world of science. 456 00:19:37,301 --> 00:19:40,761 (texts whirring) 457 00:19:40,762 --> 00:19:43,849 (lighthearted music) 458 00:19:45,434 --> 00:19:47,685 It's fascinating because now 459 00:19:47,686 --> 00:19:49,562 I'm connected with all these people 460 00:19:49,563 --> 00:19:51,314 who experienced the same thing I did. 461 00:19:51,315 --> 00:19:54,400 It's like they're echoing back the same story, 462 00:19:54,401 --> 00:19:58,237 where they feel like they found the fountain of youth. 463 00:19:58,238 --> 00:20:00,448 All these things improved and there's a lot of people 464 00:20:00,449 --> 00:20:02,533 who are getting medical benefits 465 00:20:02,534 --> 00:20:04,994 from dropping their carbohydrates way down, 466 00:20:04,995 --> 00:20:07,789 but you've got this one thing, this one thing. 467 00:20:09,082 --> 00:20:11,125 (doorbell ringing) 468 00:20:11,126 --> 00:20:14,503 I have to know, I have to know if this is a problem. 469 00:20:14,504 --> 00:20:17,715 Because it's the only one, it's the only one I can see. 470 00:20:17,716 --> 00:20:18,550 Alison? 471 00:20:20,427 --> 00:20:21,260 - Hi. 472 00:20:21,261 --> 00:20:22,094 - [Dave] Hello. 473 00:20:22,095 --> 00:20:22,929 - How are you? 474 00:20:22,930 --> 00:20:24,305 Come on in. 475 00:20:24,306 --> 00:20:26,265 I've landed in Pennsburg, Pennsylvania 476 00:20:26,266 --> 00:20:27,767 to meet 10-year-old Johnny. 477 00:20:27,768 --> 00:20:29,352 Hey. 478 00:20:29,353 --> 00:20:30,937 Tell me a little bit about Johnny. 479 00:20:30,938 --> 00:20:32,188 What kind of kid is he? 480 00:20:32,189 --> 00:20:36,067 - So Johnny is all boy. 481 00:20:36,068 --> 00:20:38,653 (laughs) I'm gonna start with that. 482 00:20:38,654 --> 00:20:40,697 He's very, very active. 483 00:20:42,157 --> 00:20:44,408 - Do a full windup, all right? 484 00:20:44,409 --> 00:20:46,411 You could go slow, slow with the windup. 485 00:20:47,746 --> 00:20:50,414 He turned 10 last April 486 00:20:50,415 --> 00:20:54,001 and he played with 11 and 12 year olds. 487 00:20:54,002 --> 00:20:55,002 And some of those 12 year olds 488 00:20:55,003 --> 00:20:57,755 actually were almost 13 year olds. 489 00:20:57,756 --> 00:20:59,840 And he didn't miss a beat. 490 00:20:59,841 --> 00:21:02,760 - Like, I think I can do like 50 miles per hour, 491 00:21:02,761 --> 00:21:05,221 like, right-handed. 492 00:21:05,222 --> 00:21:07,182 I sure (indistinct) 12 year olds too. 493 00:21:08,141 --> 00:21:09,809 - [Dave] Last year, Johnny was diagnosed 494 00:21:09,810 --> 00:21:11,269 with Type 1 diabetes. 495 00:21:11,270 --> 00:21:14,355 His condition requires vigilant blood sugar monitoring 496 00:21:14,356 --> 00:21:15,940 and insulin therapy. 497 00:21:15,941 --> 00:21:19,193 - [Alison] This is .5 units of R insulin. 498 00:21:19,194 --> 00:21:21,696 He'll get this right before he eats breakfast. 499 00:21:21,697 --> 00:21:23,072 - [Dave] Insulin injections are crucial 500 00:21:23,073 --> 00:21:24,907 for individuals with Type 1 diabetes 501 00:21:24,908 --> 00:21:27,576 because their bodies don't produce insulin, 502 00:21:27,577 --> 00:21:29,078 a hormone needed to regulate blood sugar. 503 00:21:29,079 --> 00:21:30,330 - [Alison] There you go. 504 00:21:31,248 --> 00:21:32,331 - [Dave] Without insulin, 505 00:21:32,332 --> 00:21:33,874 glucose builds up in the bloodstream 506 00:21:33,875 --> 00:21:35,419 to dangerously high levels. 507 00:21:36,336 --> 00:21:38,629 Injections of insulin unlock the cells, 508 00:21:38,630 --> 00:21:40,966 allowing them to absorb glucose properly, 509 00:21:41,800 --> 00:21:44,052 keeping blood glucose levels normal. 510 00:21:45,762 --> 00:21:47,847 But the amount of insulin Johnny requires 511 00:21:47,848 --> 00:21:50,309 is greatly affected by the foods he eats. 512 00:21:51,143 --> 00:21:54,103 - Type 1 diabetes, the mantra has always been 513 00:21:54,104 --> 00:21:55,980 eat whatever you want, eat your carbs, 514 00:21:55,981 --> 00:21:57,732 and cover it with insulin. 515 00:21:57,733 --> 00:21:59,483 - [Announcer] Your child will still be able to eat 516 00:21:59,484 --> 00:22:01,736 all of his or her favorite foods. 517 00:22:01,737 --> 00:22:02,903 - Because with Type 1 diabetes, 518 00:22:02,904 --> 00:22:05,114 the risk of too low of insulin 519 00:22:05,115 --> 00:22:07,366 is as great as too high of insulin. 520 00:22:07,367 --> 00:22:10,995 And that's unfortunately why, in the long run, 521 00:22:10,996 --> 00:22:12,830 they tend to do pretty poorly, 522 00:22:12,831 --> 00:22:17,084 because the treatment guidelines are very lax 523 00:22:17,085 --> 00:22:19,086 about how aggressive to be. 524 00:22:19,087 --> 00:22:23,257 - I can have a cupcake and get insulin for it and be okay. 525 00:22:23,258 --> 00:22:25,843 - That's what they kept saying, feed him what he wants, 526 00:22:25,844 --> 00:22:27,595 you dose accordingly. 527 00:22:27,596 --> 00:22:30,848 So I have pictures of him, like, in the hospital bed 528 00:22:30,849 --> 00:22:35,353 with his IVs and he's shoveling pancakes covered in syrup. 529 00:22:35,354 --> 00:22:38,439 - That's the highest his blood sugar has been 530 00:22:38,440 --> 00:22:41,567 since we knew he had Type 1 diabetes. 531 00:22:41,568 --> 00:22:43,986 The last night in the hospital under their care, 532 00:22:43,987 --> 00:22:47,615 I think it was over 300 milligrams per deciliter. 533 00:22:47,616 --> 00:22:51,702 But he didn't like being on that rollercoaster. 534 00:22:51,703 --> 00:22:54,580 - That rollercoaster of glucose gets too high, 535 00:22:54,581 --> 00:22:56,874 you need insulin, but then it can get too low and you have 536 00:22:56,875 --> 00:22:59,460 the hypoglycemic effect. - Correct. 537 00:22:59,461 --> 00:23:02,004 - If I was living, like, that high carb diet, 538 00:23:02,005 --> 00:23:04,215 like, I would have to take a lot of insulin, 539 00:23:04,216 --> 00:23:06,926 it'd bring me up and then when I started low carb 540 00:23:06,927 --> 00:23:08,386 it got perfect. 541 00:23:08,387 --> 00:23:09,970 (upbeat music) 542 00:23:09,971 --> 00:23:13,265 - So we buy our eggs from a local farm. 543 00:23:13,266 --> 00:23:14,975 - [Dave] The entire family went Keto, 544 00:23:14,976 --> 00:23:17,895 cutting out simple carbohydrates like bread, pasta, 545 00:23:17,896 --> 00:23:19,897 cereal, and sugary sweets. 546 00:23:19,898 --> 00:23:21,982 - So Johnny at 10 years old, 547 00:23:21,983 --> 00:23:25,361 hardly requiring any insulin because he's on a Keto diet, 548 00:23:25,362 --> 00:23:28,864 his path is going to be much clearer, much smoother, 549 00:23:28,865 --> 00:23:32,118 and much better controlled than the alternative. 550 00:23:32,119 --> 00:23:33,494 - [Dave] Fewer carbs on his plate 551 00:23:33,495 --> 00:23:35,788 means less glucose in his bloodstream, 552 00:23:35,789 --> 00:23:39,375 making Johnny less reliant on injected insulin. 553 00:23:39,376 --> 00:23:41,752 - [John] An hour and a half after breakfast 554 00:23:41,753 --> 00:23:44,046 and he's sitting at 78, 555 00:23:44,047 --> 00:23:46,924 which is pretty healthy blood glucose 556 00:23:46,925 --> 00:23:48,343 for a child or anybody. 557 00:23:49,678 --> 00:23:53,722 - [Alison] So I keep our extra insulin in this fridge. 558 00:23:53,723 --> 00:23:57,102 We get it every month and I just put it away. 559 00:23:58,895 --> 00:24:00,521 - [Dave] Before the discovery of insulin, 560 00:24:00,522 --> 00:24:03,732 a diagnosis of Type 1 diabetes was a death sentence. 561 00:24:03,733 --> 00:24:05,985 Children with the disease became emaciated 562 00:24:05,986 --> 00:24:08,154 and slowly starved to death. 563 00:24:08,155 --> 00:24:10,281 When insulin was discovered in the 1920s, 564 00:24:10,282 --> 00:24:13,033 it revolutionized the treatment of Type 1, 565 00:24:13,034 --> 00:24:15,870 but dosing insulin was a new frontier 566 00:24:15,871 --> 00:24:18,372 and there were no tools like blood glucose meters 567 00:24:18,373 --> 00:24:20,332 to monitor the results. 568 00:24:20,333 --> 00:24:23,252 - In the old days, individuals were being given 569 00:24:23,253 --> 00:24:26,505 what I call industrial doses of insulin. 570 00:24:26,506 --> 00:24:28,424 - Richard Bernstein is a pioneer 571 00:24:28,425 --> 00:24:30,218 in the realm of diabetes care. 572 00:24:31,303 --> 00:24:36,015 Born in 1934, he developed Type 1 at the age of 11. 573 00:24:36,016 --> 00:24:37,600 How old are you Dr. Bernstein? 574 00:24:37,601 --> 00:24:38,767 - 89. 575 00:24:38,768 --> 00:24:40,186 - 89. (chuckles) 576 00:24:40,187 --> 00:24:43,481 - When I got diabetes, my parents were told 577 00:24:43,482 --> 00:24:48,487 that my lifespan would be 30 years from the onset. 578 00:24:50,030 --> 00:24:52,615 So I'd live to be 41. 579 00:24:52,616 --> 00:24:54,284 - (sighs) Wow. 580 00:24:55,243 --> 00:24:57,953 Many of Bernstein's contemporaries would die young. 581 00:24:57,954 --> 00:25:00,372 Early insulin therapy was a miracle cure, 582 00:25:00,373 --> 00:25:02,625 but young patients on high insulin doses 583 00:25:02,626 --> 00:25:05,085 developed early atherosclerosis. 584 00:25:05,086 --> 00:25:07,505 Most died from heart attacks and strokes 585 00:25:07,506 --> 00:25:10,674 within 20 or 30 years of starting therapy. 586 00:25:10,675 --> 00:25:14,386 So one of the things that's emerged with insulin therapy 587 00:25:14,387 --> 00:25:19,183 for Type 1 diabetics is it's connection with heart disease. 588 00:25:19,184 --> 00:25:22,269 - The connection with heart disease was very profound. 589 00:25:22,270 --> 00:25:25,064 - [Dave] Gary Taubes is an investigative science journalist 590 00:25:25,065 --> 00:25:27,942 who has researched the history and treatment of diabetes. 591 00:25:27,943 --> 00:25:32,112 - By the 1960s, the research is saying insulin itself 592 00:25:32,113 --> 00:25:37,117 in high doses is atherogenic, it causes atherosclerosis. 593 00:25:37,118 --> 00:25:38,285 - [Dave] Bernstein was determined 594 00:25:38,286 --> 00:25:40,538 to avoid those complications. 595 00:25:40,539 --> 00:25:44,583 - Okay, this is the first blood sugar meter. 596 00:25:44,584 --> 00:25:47,586 It was used in emergency rooms 597 00:25:47,587 --> 00:25:50,339 to tell the drunks from the diabetics at night 598 00:25:50,340 --> 00:25:53,050 when the labs were closed (chuckles). 599 00:25:53,051 --> 00:25:54,718 - [Dave] Originally trained as an engineer, 600 00:25:54,719 --> 00:25:56,679 Bernstein hacked the bulky monitor 601 00:25:56,680 --> 00:25:59,265 so he could run it off batteries, carry it with him, 602 00:25:59,266 --> 00:26:01,183 and continuously track his blood sugar. 603 00:26:01,184 --> 00:26:04,812 - So he becomes the very first person in the world 604 00:26:04,813 --> 00:26:07,732 to start measuring his blood sugar at home 605 00:26:09,401 --> 00:26:10,901 multiple times a day. 606 00:26:10,902 --> 00:26:13,028 - I was the only one in the world 607 00:26:13,029 --> 00:26:15,990 who was checking his blood sugar all day long. 608 00:26:15,991 --> 00:26:19,868 - Literally patient number one for blood sugar monitoring. 609 00:26:19,869 --> 00:26:21,120 And he comes up with this idea 610 00:26:21,121 --> 00:26:23,289 that he calls the Law of Small Numbers, 611 00:26:23,290 --> 00:26:26,292 which is the way physicists and engineers think, 612 00:26:26,293 --> 00:26:30,671 that small inputs have predictable effects. 613 00:26:30,672 --> 00:26:33,716 So if he keeps the input, the carbs small, 614 00:26:33,717 --> 00:26:36,010 he can keep the insulin doses small. 615 00:26:36,011 --> 00:26:40,264 And now he could kind of keep everything under control. 616 00:26:40,265 --> 00:26:43,601 - I finally had normal blood sugars. 617 00:26:43,602 --> 00:26:48,397 I walked into this taking 200 units of insulin, 618 00:26:48,398 --> 00:26:51,942 and today I take about 20 units, 619 00:26:51,943 --> 00:26:54,528 about a 10th of what I was taking then. 620 00:26:54,529 --> 00:26:57,072 - [Dave] Bernstein went back to school in his 40s 621 00:26:57,073 --> 00:26:59,617 to become a medical doctor. 622 00:26:59,618 --> 00:27:01,368 Adding MD after his name 623 00:27:01,369 --> 00:27:03,704 would open more doors for publishing his discoveries 624 00:27:03,705 --> 00:27:05,497 in medical journals. 625 00:27:05,498 --> 00:27:06,915 But even so... 626 00:27:06,916 --> 00:27:09,209 - Letters of rejection. 627 00:27:09,210 --> 00:27:10,461 - He sent it out to journals, 628 00:27:10,462 --> 00:27:13,088 got very nice rejection letters back then 629 00:27:13,089 --> 00:27:17,509 saying this is a good idea, but you're not a typical person 630 00:27:17,510 --> 00:27:19,178 and nobody else is ever gonna wanna monitor 631 00:27:19,179 --> 00:27:21,472 their blood sugar five times a day. 632 00:27:21,473 --> 00:27:26,478 So Bernstein's revelation that you can control the disease 633 00:27:26,770 --> 00:27:29,355 with small doses of insulin 634 00:27:29,356 --> 00:27:32,107 and control blood sugar almost perfectly 635 00:27:32,108 --> 00:27:35,736 without carbohydrates would be left behind. 636 00:27:35,737 --> 00:27:39,073 - Wow, it just seems so straightforward though. 637 00:27:39,074 --> 00:27:41,033 If carbohydrates are what gets converted 638 00:27:41,034 --> 00:27:43,160 to glucose in our body 639 00:27:43,161 --> 00:27:46,372 and if you've got a condition 640 00:27:46,373 --> 00:27:48,374 where you have difficulty regulating it, 641 00:27:48,375 --> 00:27:50,250 why not just have less carbohydrates? 642 00:27:50,251 --> 00:27:52,211 - Well, there's something 643 00:27:52,212 --> 00:27:55,839 that's now called the cholesterol Myth. 644 00:27:55,840 --> 00:27:57,508 - Okay, so remember how, 645 00:27:57,509 --> 00:27:59,510 in the early years of insulin therapy, 646 00:27:59,511 --> 00:28:02,262 people with Type 1 diabetes were dying young 647 00:28:02,263 --> 00:28:04,515 from heart attacks and strokes? 648 00:28:04,516 --> 00:28:06,558 At the time, some researchers blamed it 649 00:28:06,559 --> 00:28:08,352 on high doses of insulin, 650 00:28:08,353 --> 00:28:11,772 but other researchers blamed it on high cholesterol. 651 00:28:11,773 --> 00:28:15,067 Dr. Bernstein calls this the cholesterol Myth 652 00:28:15,068 --> 00:28:17,653 because he observed that reducing insulin 653 00:28:17,654 --> 00:28:21,615 reduces diabetic complications like heart disease. 654 00:28:21,616 --> 00:28:24,034 When did you first find out that Johnny 655 00:28:24,035 --> 00:28:26,746 had something going on with his cholesterol? 656 00:28:28,331 --> 00:28:31,417 - That was at his one year labs. 657 00:28:31,418 --> 00:28:33,419 - [Dave] And this brings us back to Johnny. 658 00:28:33,420 --> 00:28:36,672 Johnny's insulin is under control and he's thriving. 659 00:28:36,673 --> 00:28:38,882 But like so many I've met who are very lean, 660 00:28:38,883 --> 00:28:40,676 and athletic, and go low carb, 661 00:28:40,677 --> 00:28:43,721 Johnny's cholesterol went through the roof. 662 00:28:43,722 --> 00:28:45,597 - I was hysterical. 663 00:28:45,598 --> 00:28:46,807 I called my husband. 664 00:28:46,808 --> 00:28:49,601 I was just like, "Ahhh, we're doing everything right. 665 00:28:49,602 --> 00:28:51,603 Why is this happening?" 666 00:28:51,604 --> 00:28:52,896 He's like, "Calm down. 667 00:28:52,897 --> 00:28:53,731 It's okay. 668 00:28:53,732 --> 00:28:55,399 Like, breathe." 669 00:28:55,400 --> 00:28:56,525 - Timeout. 670 00:28:56,526 --> 00:28:58,986 Of course Johnny's parents and his medical team 671 00:28:58,987 --> 00:29:00,279 are freaked out. 672 00:29:00,280 --> 00:29:02,489 His LDL cholesterol isn't just high, 673 00:29:02,490 --> 00:29:05,117 it's 640 milligrams per deciliter. 674 00:29:05,118 --> 00:29:08,620 That's well over six times the recommended level. 675 00:29:08,621 --> 00:29:10,164 Johnny's cholesterol is on par 676 00:29:10,165 --> 00:29:12,250 with kids who have a rare genetic disease. 677 00:29:13,334 --> 00:29:17,755 It's called Familial Hypercholesterolemia, or FH. 678 00:29:17,756 --> 00:29:19,965 FH impairs the absorption of LDL cholesterol, 679 00:29:19,966 --> 00:29:22,634 causing a massive buildup in the bloodstream. 680 00:29:22,635 --> 00:29:26,180 In its rarest form, FH can cause heart attacks and death 681 00:29:26,181 --> 00:29:27,639 in young children. 682 00:29:27,640 --> 00:29:31,268 This condition is often marked by fatty deposits on the skin 683 00:29:31,269 --> 00:29:34,480 and is considered the strongest case for the hypothesis 684 00:29:34,481 --> 00:29:38,400 that LDL cholesterol independently causes heart disease. 685 00:29:38,401 --> 00:29:40,527 But it's unclear how much of the risk 686 00:29:40,528 --> 00:29:43,739 is related to the genetic disease itself. 687 00:29:43,740 --> 00:29:46,658 Regardless, the association between LDL cholesterol 688 00:29:46,659 --> 00:29:48,535 and heart disease in this condition 689 00:29:48,536 --> 00:29:53,081 is a major reason why Johnny's medical team is so concerned. 690 00:29:53,082 --> 00:29:55,251 So now the difficult question. 691 00:29:56,127 --> 00:29:57,586 How do you know for sure 692 00:29:57,587 --> 00:30:00,214 if you're doing the right thing for Johnny? 693 00:30:00,215 --> 00:30:02,132 - I feel sometimes, just looking at him, 694 00:30:02,133 --> 00:30:05,427 he looks like so much healthier 695 00:30:05,428 --> 00:30:08,555 than any other kid his own age. 696 00:30:08,556 --> 00:30:10,265 I know that's kind of naive, 697 00:30:10,266 --> 00:30:13,268 to think that nothing wrong is going on inside, 698 00:30:13,269 --> 00:30:16,230 but I tell you that all the time, he just looks healthy. 699 00:30:16,231 --> 00:30:18,607 - I'm hoping that maybe one day 700 00:30:18,608 --> 00:30:22,736 there'll be a doctor that can help us, 701 00:30:22,737 --> 00:30:25,656 you know, at least with what we should do, 702 00:30:25,657 --> 00:30:27,950 the proper test to get done to make sure 703 00:30:27,951 --> 00:30:30,410 that everything is okay with him. 704 00:30:30,411 --> 00:30:33,581 (lighthearted music) 705 00:30:35,834 --> 00:30:37,042 - Here's an important point. 706 00:30:37,043 --> 00:30:39,127 Johnny doesn't have genetic FH. 707 00:30:39,128 --> 00:30:41,797 He wasn't born with these levels. 708 00:30:41,798 --> 00:30:44,842 Like me, he only started to see high cholesterol 709 00:30:44,843 --> 00:30:48,804 when he went on a Ketogenic diet to manage his diabetes. 710 00:30:48,805 --> 00:30:51,014 He also has minimal body fat 711 00:30:51,015 --> 00:30:53,309 and is extremely lean and athletic. 712 00:30:54,519 --> 00:30:55,686 And high LDL cholesterol 713 00:30:55,687 --> 00:30:58,063 wasn't the only thing we had in common. 714 00:30:58,064 --> 00:31:00,649 We also had high HDL cholesterol, 715 00:31:00,650 --> 00:31:03,443 often referred to as the good cholesterol. 716 00:31:03,444 --> 00:31:06,322 And low Triglycerides, a measure of fat in the blood. 717 00:31:07,407 --> 00:31:10,075 High HDL cholesterol and low Triglycerides 718 00:31:10,076 --> 00:31:12,160 are markers of good metabolic health 719 00:31:12,161 --> 00:31:14,204 and are associated with a low risk 720 00:31:14,205 --> 00:31:16,373 of cardiovascular disease. 721 00:31:16,374 --> 00:31:20,085 I continued to see this triad of high LDL cholesterol 722 00:31:20,086 --> 00:31:23,422 alongside high HDL cholesterol and low Triglycerides 723 00:31:23,423 --> 00:31:27,093 in other lean, metabolically healthy people on a Keto diet. 724 00:31:28,595 --> 00:31:32,139 Finally, in 2017, I wrote an article in my blog 725 00:31:32,140 --> 00:31:35,893 where I named this profile Lean Mass Hyper Responder. 726 00:31:35,894 --> 00:31:37,604 The responses were staggering. 727 00:31:38,771 --> 00:31:41,231 Hundreds of people, then thousands of people 728 00:31:41,232 --> 00:31:43,942 from different countries all around the world. 729 00:31:43,943 --> 00:31:45,944 (lighthearted music) 730 00:31:45,945 --> 00:31:49,364 Identifying this phenotype proved a major breakthrough. 731 00:31:49,365 --> 00:31:51,867 But the big unanswered question remains. 732 00:31:51,868 --> 00:31:53,827 Will these high levels of LDL cholesterol 733 00:31:53,828 --> 00:31:56,580 cause plaque to build up in their arteries 734 00:31:56,581 --> 00:31:57,623 or is there something different 735 00:31:57,624 --> 00:31:59,417 about Lean Mass Hyper Responders? 736 00:32:00,418 --> 00:32:03,879 For that matter, is there something more they can tell us 737 00:32:03,880 --> 00:32:06,466 about cholesterol and its role in heart disease? 738 00:32:08,885 --> 00:32:11,638 (texts whirring) 739 00:32:13,556 --> 00:32:15,599 - You know, when you see your LDL come back 740 00:32:15,600 --> 00:32:17,894 in the 300s, 400, 500s, 741 00:32:19,562 --> 00:32:22,064 and you're a medically literate person, 742 00:32:22,065 --> 00:32:23,983 the reaction always is, 743 00:32:26,152 --> 00:32:28,987 like, I can just, it's the facial expression. 744 00:32:28,988 --> 00:32:29,905 It's the double take. 745 00:32:29,906 --> 00:32:32,824 Like, is this an error? 746 00:32:32,825 --> 00:32:34,034 What's going on here? 747 00:32:34,035 --> 00:32:35,661 This is something that you only see, 748 00:32:35,662 --> 00:32:37,204 especially levels in the 500s, 749 00:32:37,205 --> 00:32:40,415 in very rare genetic conditions. 750 00:32:40,416 --> 00:32:41,625 This is the famous building 751 00:32:41,626 --> 00:32:42,834 that there are all the pictures of- 752 00:32:42,835 --> 00:32:45,629 - [Dave] Nick Norwitz is a medical student at Harvard. 753 00:32:45,630 --> 00:32:47,547 He first noticed his LDL spiking 754 00:32:47,548 --> 00:32:48,882 when he got his blood work back 755 00:32:48,883 --> 00:32:51,176 after starting a Ketogenic diet. 756 00:32:51,177 --> 00:32:53,053 (gentle music) 757 00:32:53,054 --> 00:32:55,722 Nick went Keto to treat his ulcerative colitis, 758 00:32:55,723 --> 00:32:57,057 an inflammatory bowel disease 759 00:32:57,058 --> 00:32:59,685 that causes ulcers in the gut. 760 00:32:59,686 --> 00:33:03,188 Symptoms of ulcerative colitis include severe abdominal pain 761 00:33:03,189 --> 00:33:04,773 and intestinal bleeding. 762 00:33:04,774 --> 00:33:05,983 - Basically, I went from having 763 00:33:05,984 --> 00:33:07,651 absolutely no dietary restrictions, 764 00:33:07,652 --> 00:33:08,860 in fact I was known as the guy 765 00:33:08,861 --> 00:33:10,862 who would basically be the garbage disposal, 766 00:33:10,863 --> 00:33:12,114 I'd eat anything, 767 00:33:12,115 --> 00:33:14,199 to really not being able to eat much of anything 768 00:33:14,200 --> 00:33:17,494 without having negative reactions. 769 00:33:17,495 --> 00:33:21,749 - I think the scariest thing about his ulcerative colitis, 770 00:33:22,750 --> 00:33:25,085 for me at least, was seeing him lose weight. 771 00:33:25,086 --> 00:33:27,713 I mean, he lost a dramatic amount of weight. 772 00:33:27,714 --> 00:33:29,631 He lost about 20% of his body weight, 773 00:33:29,632 --> 00:33:32,718 and he's already, you know, a very lean young man. 774 00:33:32,719 --> 00:33:34,177 - [Dave] Over the course of two years, 775 00:33:34,178 --> 00:33:36,221 Nick went from athletic and energetic 776 00:33:36,222 --> 00:33:39,850 to dangerously thin, going in and out of the hospital. 777 00:33:39,851 --> 00:33:41,268 He was so sick and weak 778 00:33:41,269 --> 00:33:43,812 he considered dropping out of medical school. 779 00:33:43,813 --> 00:33:45,564 At the lowest point of his illness, 780 00:33:45,565 --> 00:33:47,441 he ended up in a palliative care ward 781 00:33:47,442 --> 00:33:49,526 surrounded by dying patients. 782 00:33:49,527 --> 00:33:52,487 - Yeah, it was a little bit terrifying. 783 00:33:52,488 --> 00:33:54,614 (somber music) 784 00:33:54,615 --> 00:33:57,576 - So that was the point at which I started finagling 785 00:33:57,577 --> 00:34:00,704 with lifestyle and particularly diet. 786 00:34:00,705 --> 00:34:02,205 And you know the punch the line to the story 787 00:34:02,206 --> 00:34:03,749 was I eventually tried Keto 788 00:34:03,750 --> 00:34:07,754 out of a large degree of desperation and zero expectation. 789 00:34:08,796 --> 00:34:11,382 And my life changed like that. 790 00:34:13,301 --> 00:34:16,136 It was shocking to see what a potent effect 791 00:34:16,137 --> 00:34:17,847 the Ketogenic diet had on my life. 792 00:34:18,973 --> 00:34:22,851 Within a few days, I was feeling remarkably better. 793 00:34:22,852 --> 00:34:25,353 My energy was back. 794 00:34:25,354 --> 00:34:27,856 My symptoms all improved dramatically, 795 00:34:27,857 --> 00:34:29,107 and my inflammatory markers 796 00:34:29,108 --> 00:34:31,276 had dropped to completely normal. 797 00:34:31,277 --> 00:34:33,988 I think they dropped like sixfold within a week. 798 00:34:34,989 --> 00:34:38,158 So, you know, that was a light bulb moment for me. 799 00:34:38,159 --> 00:34:39,659 Even then, I was a little bit anxious, 800 00:34:39,660 --> 00:34:41,412 you know, that it wouldn't hold. 801 00:34:43,289 --> 00:34:46,500 But it's been over four years and it's holding. 802 00:34:46,501 --> 00:34:48,126 - We're gonna leave a little bit on there. 803 00:34:48,127 --> 00:34:49,294 - [Nick] It really has changed my life 804 00:34:49,295 --> 00:34:53,840 and I think given me the life back that I was hoping for. 805 00:34:53,841 --> 00:34:57,969 - Nick is interesting because he got into Keto 806 00:34:57,970 --> 00:35:00,013 because it became the one thing he could do 807 00:35:00,014 --> 00:35:02,474 to help his symptoms with ulcerative colitis. 808 00:35:02,475 --> 00:35:07,437 And that ironically is what would ultimately lead him to me, 809 00:35:07,438 --> 00:35:10,357 because given how lean and how fit he is, 810 00:35:10,358 --> 00:35:12,901 that meant he was likely gonna develop 811 00:35:12,902 --> 00:35:15,112 the Lean Mass Hyper Responder phenotype. 812 00:35:15,113 --> 00:35:16,238 And eventually he did. 813 00:35:16,239 --> 00:35:18,323 - And on my first lipid panel, 814 00:35:18,324 --> 00:35:20,325 which was taken very shortly 815 00:35:20,326 --> 00:35:22,327 after I started a Ketogenic diet, 816 00:35:22,328 --> 00:35:25,247 my LDL jumps well over threefold. 817 00:35:25,248 --> 00:35:28,376 It had gone from around 90 to well over 300. 818 00:35:29,544 --> 00:35:32,713 Subsequent tests found that it went up even higher. 819 00:35:33,965 --> 00:35:35,842 It's peaked at the mid-500s. 820 00:35:36,801 --> 00:35:38,760 - [Dave] Nick Dove into the medical literature, 821 00:35:38,761 --> 00:35:40,095 but he found few answers 822 00:35:40,096 --> 00:35:41,471 as to why he would experience 823 00:35:41,472 --> 00:35:44,141 such a hyper-response in his cholesterol. 824 00:35:44,142 --> 00:35:46,601 So he did what any modern medical student would do. 825 00:35:46,602 --> 00:35:48,311 He hit the internet. 826 00:35:48,312 --> 00:35:51,022 - And it wasn't long before I got into the trail 827 00:35:51,023 --> 00:35:54,234 of this quirky engineer in Nevada 828 00:35:54,235 --> 00:35:57,362 who had put up a blog post about this phenotype 829 00:35:57,363 --> 00:36:00,198 in which people who are lean and athletic go low carb 830 00:36:00,199 --> 00:36:02,993 and their LDL goes through the roof. 831 00:36:02,994 --> 00:36:05,203 Their HDL also goes up and the Triglycerides drop. 832 00:36:05,204 --> 00:36:06,538 And I looked back on my lipid panel, 833 00:36:06,539 --> 00:36:09,750 I'm like, "Well, this is me." 834 00:36:10,585 --> 00:36:12,669 - Isn't it just striking 835 00:36:12,670 --> 00:36:14,713 how little curiosity there really is 836 00:36:14,714 --> 00:36:17,090 for at least wanting to get under the hood 837 00:36:17,091 --> 00:36:18,758 and understand this better? 838 00:36:18,759 --> 00:36:21,053 - When you have a question, 839 00:36:22,096 --> 00:36:24,639 a really authentic question, 840 00:36:24,640 --> 00:36:27,727 and you're told it's off limits, 841 00:36:29,270 --> 00:36:31,021 at least for me, it makes you a lot more hungry 842 00:36:31,022 --> 00:36:33,732 to, like, go after that question. 843 00:36:33,733 --> 00:36:35,984 The idea that this is a scientific taboo 844 00:36:35,985 --> 00:36:38,028 but actually also a legitimate scientific question 845 00:36:38,029 --> 00:36:39,779 is very enticing for both of us, 846 00:36:39,780 --> 00:36:41,865 combined with the fact that it actually has the potential 847 00:36:41,866 --> 00:36:43,158 to help a lot of people. 848 00:36:43,159 --> 00:36:44,576 - [Dave] So Nick and I teamed up, 849 00:36:44,577 --> 00:36:47,204 along with Dr. Adrian Soto-Mota and many others, 850 00:36:47,205 --> 00:36:49,331 and we begin publishing papers together. 851 00:36:49,332 --> 00:36:51,458 (dramatic music) 852 00:36:51,459 --> 00:36:55,712 - True science is human being exercising their curiosity 853 00:36:55,713 --> 00:36:57,839 and poking things to see what happens 854 00:36:57,840 --> 00:37:00,175 and then trying to make sense of it. 855 00:37:00,176 --> 00:37:01,635 That's true science. 856 00:37:01,636 --> 00:37:03,721 - When you keep poking at that question 857 00:37:04,722 --> 00:37:05,680 and there's no good answer, 858 00:37:05,681 --> 00:37:06,973 that's the question you wanna pursue. 859 00:37:06,974 --> 00:37:08,475 And if people get defensive about that question, 860 00:37:08,476 --> 00:37:10,477 that's a question you really wanna pursue. 861 00:37:10,478 --> 00:37:12,687 - We are presented with this opportunity, 862 00:37:12,688 --> 00:37:15,440 this scientific opportunity that's never existed before, 863 00:37:15,441 --> 00:37:16,691 where we actually pulled off 864 00:37:16,692 --> 00:37:21,697 getting this one variable of interest, LDL, all by itself. 865 00:37:24,158 --> 00:37:25,534 It's scientific manna 866 00:37:26,494 --> 00:37:28,328 that you could actually get the variable of interest 867 00:37:28,329 --> 00:37:30,873 all by itself at super high levels 868 00:37:32,083 --> 00:37:34,251 alongside low cardiovascular risk. 869 00:37:34,252 --> 00:37:36,670 - Yeah, it's a natural experiment. 870 00:37:36,671 --> 00:37:39,256 - And yet there's so much controversy 871 00:37:39,257 --> 00:37:42,759 just in our pursuing research on this, 872 00:37:42,760 --> 00:37:44,886 which, to me, baffles me. 873 00:37:44,887 --> 00:37:45,763 It's crazy. 874 00:37:47,640 --> 00:37:51,017 (texts whirring) 875 00:37:51,018 --> 00:37:53,812 So this is just a general example? 876 00:37:53,813 --> 00:37:58,191 - Yes, this is somebody who has severe atherosclerosis. 877 00:37:58,192 --> 00:37:59,234 - [Dave] Dr. Matthew Budoff 878 00:37:59,235 --> 00:38:01,236 is a cardiologist and researcher. 879 00:38:01,237 --> 00:38:03,363 He's conducted hundreds of clinical trials 880 00:38:03,364 --> 00:38:06,032 and published over 1,500 peer-reviewed papers 881 00:38:06,033 --> 00:38:07,325 on his findings. 882 00:38:07,326 --> 00:38:08,827 - This is the left artery. 883 00:38:08,828 --> 00:38:12,038 Dark means that there's soft plaque. 884 00:38:12,039 --> 00:38:14,207 White means there's calcified plaque. 885 00:38:14,208 --> 00:38:15,709 You can see dark and white. 886 00:38:15,710 --> 00:38:19,337 So this person has just a lot of atherosclerosis. 887 00:38:19,338 --> 00:38:22,299 - [Dave] Dr. Budoff uses high resolution computerized x-rays 888 00:38:22,300 --> 00:38:26,261 to produce detailed 3D images from inside the body. 889 00:38:26,262 --> 00:38:28,513 - And we can take a look at the individual arteries 890 00:38:28,514 --> 00:38:32,142 and compare it and contrast it to the last study we just saw 891 00:38:32,143 --> 00:38:33,893 that had severe disease. 892 00:38:33,894 --> 00:38:35,353 This is the right coronary, 893 00:38:35,354 --> 00:38:40,150 nice, smooth, big pipes and no disease seen. 894 00:38:40,151 --> 00:38:42,652 So I started working with cardiac CT 895 00:38:42,653 --> 00:38:45,113 early in my career in the early '90s. 896 00:38:45,114 --> 00:38:48,366 And my boss told me back in 1991 897 00:38:48,367 --> 00:38:50,452 this is gonna be the mammogram of the heart, 898 00:38:50,453 --> 00:38:53,830 that we're gonna do these scans in middle aged people, 899 00:38:53,831 --> 00:38:55,832 see who has plaque and who does not, 900 00:38:55,833 --> 00:38:57,667 who needs treatment and who does not, 901 00:38:57,668 --> 00:38:59,210 and base everything on that, 902 00:38:59,211 --> 00:39:01,463 just like we do a mammogram for breast cancer. 903 00:39:01,464 --> 00:39:04,132 - Yeah, we called it the mammogram of the heart. 904 00:39:04,133 --> 00:39:06,134 And we knew it reflected 905 00:39:06,135 --> 00:39:08,470 the total amount of atherosclerosis. 906 00:39:08,471 --> 00:39:09,971 - [Dave] In the early 1990s, 907 00:39:09,972 --> 00:39:12,640 Dr. Arthur Agatston, Dr. Budoff, 908 00:39:12,641 --> 00:39:14,434 and their cardiology colleagues 909 00:39:14,435 --> 00:39:17,145 rallied around a brand new x-ray machine. 910 00:39:17,146 --> 00:39:19,814 For the first time, it was ultra fast enough 911 00:39:19,815 --> 00:39:23,443 to take clear images of a live, beating human heart. 912 00:39:23,444 --> 00:39:25,153 - And it froze the motion of the heart. 913 00:39:25,154 --> 00:39:28,865 So for the first time, you could actually see the heart. 914 00:39:28,866 --> 00:39:31,868 It showed that there was a lot more coronary calcium 915 00:39:31,869 --> 00:39:35,622 in people with coronary disease versus those without. 916 00:39:35,623 --> 00:39:37,791 - [Dave] But the high price and radiation exposure 917 00:39:37,792 --> 00:39:40,627 of ultra-fast scanners made adoption slow. 918 00:39:40,628 --> 00:39:43,880 Fast forward 30 years and both the price and exposure 919 00:39:43,881 --> 00:39:45,757 have come down dramatically. 920 00:39:45,758 --> 00:39:49,178 Yet still, coronary calcium scans are under-utilized. 921 00:39:50,054 --> 00:39:53,431 A more advanced scan known as a CT angiogram 922 00:39:53,432 --> 00:39:57,560 adds contrast dye injected into the blood of the patient. 923 00:39:57,561 --> 00:39:59,938 This allows researchers like Dr. Budoff 924 00:39:59,939 --> 00:40:03,274 to see both the calcified and soft plaque 925 00:40:03,275 --> 00:40:06,569 for a more complete picture of their heart disease risk. 926 00:40:06,570 --> 00:40:07,987 - And then we can rotate around 927 00:40:07,988 --> 00:40:09,490 to the right side of the heart 928 00:40:10,408 --> 00:40:13,535 and measure the right coronary artery through here. 929 00:40:13,536 --> 00:40:15,495 And then this is the right coronary artery 930 00:40:15,496 --> 00:40:18,039 with a moderate to severe stenosis. 931 00:40:18,040 --> 00:40:21,042 It gets narrow and then opens back up like an hourglass. 932 00:40:21,043 --> 00:40:22,502 That's a stenosis. 933 00:40:22,503 --> 00:40:24,337 This person will probably need to get a stent 934 00:40:24,338 --> 00:40:26,965 or bypass surgery at some point. 935 00:40:26,966 --> 00:40:28,633 - CT angiography is great 936 00:40:28,634 --> 00:40:31,719 because beyond looking at something like a marker, like LDL, 937 00:40:31,720 --> 00:40:33,847 you're actually looking at the physical presence 938 00:40:33,848 --> 00:40:35,932 of the disease itself, 939 00:40:35,933 --> 00:40:37,934 for that matter, whether it's there at all. 940 00:40:37,935 --> 00:40:39,310 And this gave me an idea. 941 00:40:39,311 --> 00:40:41,855 What if we recruit a hundred Lean Mass Hyper Responders 942 00:40:41,856 --> 00:40:44,441 who rely on Keto diets for their health 943 00:40:44,442 --> 00:40:46,276 and who see extraordinary increases 944 00:40:46,277 --> 00:40:48,194 in their LDL cholesterol? 945 00:40:48,195 --> 00:40:50,071 We just scan their hearts. 946 00:40:50,072 --> 00:40:53,741 We just go ahead and look inside to find out, 947 00:40:53,742 --> 00:40:56,077 do they have plaque in their arteries? 948 00:40:56,078 --> 00:40:58,955 - Honestly, I mean, as just a reflex, 949 00:40:58,956 --> 00:41:00,665 as a preventive cardiologist, 950 00:41:00,666 --> 00:41:05,671 somebody walks into my office with an LDL of 250 or 300, 951 00:41:05,963 --> 00:41:08,923 I'm looking for the prescription pad. 952 00:41:08,924 --> 00:41:12,760 - [Dave] So why not just study them, look inside and see? 953 00:41:12,761 --> 00:41:14,137 The plan is simple. 954 00:41:14,138 --> 00:41:17,265 We scan everybody at the beginning of the study. 955 00:41:17,266 --> 00:41:19,560 And then a year later, we do a follow-up scan. 956 00:41:20,686 --> 00:41:23,605 Then we can do a comparison between the two. 957 00:41:23,606 --> 00:41:25,064 There's only one catch. 958 00:41:25,065 --> 00:41:27,192 - There's no money without industry 959 00:41:27,193 --> 00:41:29,861 and there's not an industry for Ketogenic diet. 960 00:41:29,862 --> 00:41:33,198 We don't have big pharma here to fund the trial. 961 00:41:33,199 --> 00:41:36,451 - So I decided to try something different. 962 00:41:36,452 --> 00:41:41,457 I had officially announced the Citizen Science Foundation. 963 00:41:42,041 --> 00:41:44,709 And I was a little scared, honestly. 964 00:41:44,710 --> 00:41:47,378 I didn't know how much money we would get or wouldn't get. 965 00:41:47,379 --> 00:41:49,506 - Yeah, so for me, this was a first. 966 00:41:49,507 --> 00:41:51,925 I haven't worked with other crowdfunding studies. 967 00:41:51,926 --> 00:41:55,595 - But I knew I needed at least $50,000. 968 00:41:55,596 --> 00:41:59,390 Yes, if you could donate, any amount helps. 969 00:41:59,391 --> 00:42:03,186 (lighthearted music) 970 00:42:03,187 --> 00:42:07,232 As that study announcement was made, 971 00:42:07,233 --> 00:42:10,527 I was heartened to see that tens of thousands of dollars 972 00:42:10,528 --> 00:42:11,945 were coming in. 973 00:42:11,946 --> 00:42:14,782 (numbers chiming) 974 00:42:16,033 --> 00:42:16,866 I went ahead and said, 975 00:42:16,867 --> 00:42:20,078 "Look, but what I really want is 200,000." 976 00:42:20,079 --> 00:42:23,581 At $200,000, that would give me $2,000 977 00:42:23,582 --> 00:42:24,999 per Lean Mass Hyper Responder, 978 00:42:25,000 --> 00:42:27,043 which is what I figured I would need 979 00:42:27,044 --> 00:42:29,337 for the study idea I had in mind. 980 00:42:29,338 --> 00:42:30,171 Hi, guys. 981 00:42:30,172 --> 00:42:34,717 I am humbled, to say the least, to share this news, 982 00:42:34,718 --> 00:42:36,219 that once our contributor pool 983 00:42:36,220 --> 00:42:38,805 reaches a hundred thousand dollars, 984 00:42:38,806 --> 00:42:40,807 there's an anonymous donor that has made clear 985 00:42:40,808 --> 00:42:43,685 that they will be matching it dollar for dollar. 986 00:42:43,686 --> 00:42:48,691 They will be contributing a hundred thousand dollar match. 987 00:42:48,816 --> 00:42:51,025 (numbers whirring) 988 00:42:51,026 --> 00:42:54,404 (explosions popping) 989 00:42:54,405 --> 00:42:55,238 We did it. 990 00:42:55,239 --> 00:42:59,492 We managed to crowdfund a clinical study. 991 00:42:59,493 --> 00:43:03,162 And that just doesn't happen these days. 992 00:43:03,163 --> 00:43:05,623 That's just not something you see. 993 00:43:05,624 --> 00:43:07,208 And thank goodness 994 00:43:07,209 --> 00:43:09,168 because now we're really getting the data. 995 00:43:09,169 --> 00:43:11,379 We're just making it happen ourselves. 996 00:43:11,380 --> 00:43:13,047 And who better to lead the study 997 00:43:13,048 --> 00:43:16,426 than one of the pioneers in high resolution heart imaging, 998 00:43:16,427 --> 00:43:18,553 Dr. Matthew Budoff himself. 999 00:43:18,554 --> 00:43:19,971 - I think this is remarkable. 1000 00:43:19,972 --> 00:43:21,472 I think it's a wonderful model. 1001 00:43:21,473 --> 00:43:23,766 I think you can answer a lot of great questions. 1002 00:43:23,767 --> 00:43:25,977 And I think crowdfunding has done wonderful things 1003 00:43:25,978 --> 00:43:26,978 outside of science. 1004 00:43:26,979 --> 00:43:29,105 I'm not aware of too many models of it 1005 00:43:29,106 --> 00:43:31,232 funding scientific studies, 1006 00:43:31,233 --> 00:43:33,776 but we now need crowdfunding 1007 00:43:33,777 --> 00:43:36,988 to answer some of these clinical questions about diet. 1008 00:43:36,989 --> 00:43:38,656 (dramatic music) 1009 00:43:38,657 --> 00:43:40,575 - [Dave] So it's happening. 1010 00:43:40,576 --> 00:43:44,245 The fully funded Lean Mass Hyper Responder Study is a go. 1011 00:43:44,246 --> 00:43:46,873 All 100 participants will be evaluated here, 1012 00:43:46,874 --> 00:43:49,626 at the Lundquist Institute's Cardiac Wellness Center 1013 00:43:49,627 --> 00:43:51,669 in Southern California. 1014 00:43:51,670 --> 00:43:54,130 Frank Caputo traveled all the way from New York 1015 00:43:54,131 --> 00:43:55,173 to participate. 1016 00:43:55,174 --> 00:43:56,174 - I enrolled for it. 1017 00:43:56,175 --> 00:43:57,258 They picked me for it. 1018 00:43:57,259 --> 00:43:58,343 How are you today? 1019 00:43:58,344 --> 00:43:59,260 - Good, how are you? 1020 00:43:59,261 --> 00:44:00,428 - I'm good. 1021 00:44:00,429 --> 00:44:01,262 Scan day. 1022 00:44:01,263 --> 00:44:05,099 And I'm hoping that this changes the science going forward. 1023 00:44:05,100 --> 00:44:07,685 - [Dave] Back Home, Frank works as a landscaper. 1024 00:44:07,686 --> 00:44:10,188 He started Keto five years ago. 1025 00:44:10,189 --> 00:44:12,398 - [Frank] I do work a very physical job, 1026 00:44:12,399 --> 00:44:15,151 have a lot of inflammation throughout my days. 1027 00:44:15,152 --> 00:44:16,402 I needed a change, 1028 00:44:16,403 --> 00:44:19,405 so I challenged myself to try this diet out. 1029 00:44:19,406 --> 00:44:21,366 Immediately, I started feeling better. 1030 00:44:21,367 --> 00:44:22,659 - [Dave] Frank qualified for the study 1031 00:44:22,660 --> 00:44:26,954 because after he started Keto, his LDL cholesterol spiked. 1032 00:44:26,955 --> 00:44:30,625 - LDL was last we checked, it was about 238. 1033 00:44:30,626 --> 00:44:34,630 Prior to being on the diet, it was at about 73. 1034 00:44:35,589 --> 00:44:39,801 So it is what they consider a hyper response 1035 00:44:39,802 --> 00:44:41,969 to the diet, the LDL. 1036 00:44:41,970 --> 00:44:44,180 - [Dave] Frank's other blood work all looks good. 1037 00:44:44,181 --> 00:44:46,265 His blood glucose and Triglycerides are low 1038 00:44:46,266 --> 00:44:49,394 and his HDL is high, which are all indicators 1039 00:44:49,395 --> 00:44:50,896 of excellent metabolic health. 1040 00:44:52,189 --> 00:44:53,606 As a participant in the study, 1041 00:44:53,607 --> 00:44:56,734 Frank must test his ketone levels daily. 1042 00:44:56,735 --> 00:44:59,737 This number is proof that Frank is keeping his carbs low 1043 00:44:59,738 --> 00:45:01,155 and maintaining his Keto diet. 1044 00:45:01,156 --> 00:45:03,825 - And this is the extent of the fat burning mode 1045 00:45:03,826 --> 00:45:05,076 that I'm in right now. 1046 00:45:05,077 --> 00:45:06,160 - [Dave] Along with blood work, 1047 00:45:06,161 --> 00:45:08,538 Frank will undergo two CT angiograms, 1048 00:45:08,539 --> 00:45:09,831 one at the beginning of the study 1049 00:45:09,832 --> 00:45:12,041 and another one year later. 1050 00:45:12,042 --> 00:45:14,961 The images taken here could change our entire understanding 1051 00:45:14,962 --> 00:45:18,756 of Ketogenic diets, cholesterol, and heart health. 1052 00:45:18,757 --> 00:45:21,551 - [Frank] I'm hoping this changes the medical protocol, 1053 00:45:21,552 --> 00:45:24,637 where instead of them immediately putting you 1054 00:45:24,638 --> 00:45:27,265 on a statin for the rest of your life 1055 00:45:27,266 --> 00:45:29,350 because they see a high LDL, 1056 00:45:29,351 --> 00:45:31,269 they're sending you for a heart scan 1057 00:45:31,270 --> 00:45:33,062 and they're seeing if there's any calcium 1058 00:45:33,063 --> 00:45:35,356 that's built up in your arteries. 1059 00:45:35,357 --> 00:45:38,234 - Very soon, Frank and 99 others 1060 00:45:38,235 --> 00:45:40,153 will help us find some answers. 1061 00:45:40,154 --> 00:45:43,240 (lighthearted music) 1062 00:45:44,533 --> 00:45:46,325 (texts whirring) 1063 00:45:46,326 --> 00:45:49,328 (upbeat music) 1064 00:45:49,329 --> 00:45:53,791 To understand how LDL cholesterol can jump so high so fast, 1065 00:45:53,792 --> 00:45:56,586 you need to understand what happens inside the body 1066 00:45:56,587 --> 00:45:58,838 when you restrict carbohydrates. 1067 00:45:58,839 --> 00:46:00,506 The human body has what you might call 1068 00:46:00,507 --> 00:46:02,300 a hybrid energy system. 1069 00:46:02,301 --> 00:46:05,428 We can use glucose for fuel, which comes from sugar, 1070 00:46:05,429 --> 00:46:07,513 starches, and simple carbohydrates, 1071 00:46:07,514 --> 00:46:10,475 and our bodies can run on fat. 1072 00:46:10,476 --> 00:46:12,643 When your primary fuel is fat, 1073 00:46:12,644 --> 00:46:16,190 you enter a unique metabolic state called Ketosis. 1074 00:46:17,191 --> 00:46:19,984 A variety of eating patterns can induce Ketosis, 1075 00:46:19,985 --> 00:46:23,446 including carnivore, omnivore, vegetarian, 1076 00:46:23,447 --> 00:46:25,990 and there's even plant-based Keto. 1077 00:46:25,991 --> 00:46:28,994 The key to Keto is restricting carbohydrates. 1078 00:46:30,037 --> 00:46:33,122 Carbohydrate restriction drops glucose stores in the liver 1079 00:46:33,123 --> 00:46:37,627 and shifts energy demand over to using more fat for fuel. 1080 00:46:37,628 --> 00:46:39,462 - So if we're eating high carbs, 1081 00:46:39,463 --> 00:46:41,547 we're using glucose for energy. 1082 00:46:41,548 --> 00:46:43,925 If we're eating low carb, we're in Ketosis, 1083 00:46:43,926 --> 00:46:45,426 all of a sudden our body switches 1084 00:46:45,427 --> 00:46:47,428 and we're burning predominantly fat 1085 00:46:47,429 --> 00:46:50,181 or fatty acids to create energy. 1086 00:46:50,182 --> 00:46:53,267 - But here's the thing, and this explains a lot, 1087 00:46:53,268 --> 00:46:56,646 glucose is soluble, like this table sugar. 1088 00:46:56,647 --> 00:46:58,356 It mixes easily in the blood 1089 00:46:58,357 --> 00:47:00,734 because the blood is water-based. 1090 00:47:02,528 --> 00:47:04,320 But shipping fat around in the bloodstream 1091 00:47:04,321 --> 00:47:06,697 is an extremely difficult problem to solve. 1092 00:47:06,698 --> 00:47:07,907 Why? 1093 00:47:07,908 --> 00:47:10,243 Well, you know how oil and water don't mix. 1094 00:47:10,244 --> 00:47:13,163 It's the exact same thing with fat in the blood. 1095 00:47:14,122 --> 00:47:18,251 Like this oil, fat will clump together. 1096 00:47:18,252 --> 00:47:20,711 It doesn't mix well with the blood. 1097 00:47:20,712 --> 00:47:23,173 So how does the body solve this challenge? 1098 00:47:24,007 --> 00:47:26,425 Well, the body makes these little containers 1099 00:47:26,426 --> 00:47:28,845 to ship lipids through the bloodstream. 1100 00:47:28,846 --> 00:47:30,638 They're a bit like submarines. 1101 00:47:30,639 --> 00:47:33,099 And the lipids are effectively the cargo 1102 00:47:33,100 --> 00:47:34,809 that rides inside. 1103 00:47:34,810 --> 00:47:38,646 Altogether, they're a complex of lipids and proteins, 1104 00:47:38,647 --> 00:47:41,357 appropriately called lipoproteins. 1105 00:47:41,358 --> 00:47:43,276 Never heard of a lipoprotein? 1106 00:47:43,277 --> 00:47:45,319 Well, actually, you probably have. 1107 00:47:45,320 --> 00:47:48,447 The most legendary is called LDL, 1108 00:47:48,448 --> 00:47:50,993 short for Low Density Lipoprotein. 1109 00:47:52,452 --> 00:47:54,996 And here's where we see the connection to cholesterol, 1110 00:47:54,997 --> 00:47:57,039 because the fat we burn for energy 1111 00:47:57,040 --> 00:48:01,752 is just one kind of lipid that rides inside lipoproteins. 1112 00:48:01,753 --> 00:48:04,213 There are other lipids that catch a ride as well, 1113 00:48:04,214 --> 00:48:08,050 such as fat soluble vitamins, A, D, E, and K. 1114 00:48:08,051 --> 00:48:11,095 And yes, the most famous lipid that ride-shares 1115 00:48:11,096 --> 00:48:15,391 with fat around the body is, you guessed it, cholesterol. 1116 00:48:15,392 --> 00:48:17,935 And that brings us back to the Keto diet. 1117 00:48:17,936 --> 00:48:20,688 When we're fueled more by fat than glucose, 1118 00:48:20,689 --> 00:48:23,566 it makes a lot of sense why we would need to ship 1119 00:48:23,567 --> 00:48:25,484 more of this fat around in the blood 1120 00:48:25,485 --> 00:48:27,737 inside these lipoproteins. 1121 00:48:27,738 --> 00:48:30,156 More lipoproteins circulating in the blood 1122 00:48:30,157 --> 00:48:33,576 means more cholesterol in circulation as well. 1123 00:48:33,577 --> 00:48:37,538 To be sure, this is a high-level simplified explanation, 1124 00:48:37,539 --> 00:48:39,040 but it's the basic premise 1125 00:48:39,041 --> 00:48:41,292 for what we call the Lipid Energy Model, 1126 00:48:41,293 --> 00:48:44,211 and it's the phenomenon we believe we're seeing often 1127 00:48:44,212 --> 00:48:46,423 in lean people on a very low carb diet. 1128 00:48:47,341 --> 00:48:51,469 Okay, but are there any studies supporting this? 1129 00:48:51,470 --> 00:48:52,678 (upbeat music) 1130 00:48:52,679 --> 00:48:53,804 Randomized controlled trials 1131 00:48:53,805 --> 00:48:56,599 are considered the gold standard in research. 1132 00:48:56,600 --> 00:48:58,684 In a broad analysis of 41 RCTs 1133 00:48:58,685 --> 00:49:01,729 that included people on low carb and Keto diets, 1134 00:49:01,730 --> 00:49:05,274 we see, indeed, the leanness of participants 1135 00:49:05,275 --> 00:49:07,610 prove strongly predictive of the change 1136 00:49:07,611 --> 00:49:09,612 in their LDL cholesterol. 1137 00:49:09,613 --> 00:49:12,698 The leaner they were, the more likely and higher 1138 00:49:12,699 --> 00:49:15,284 their LDL cholesterol would go. 1139 00:49:15,285 --> 00:49:18,704 Conversely, those with higher body mass were more likely 1140 00:49:18,705 --> 00:49:21,082 to see their LDL stay the same 1141 00:49:21,083 --> 00:49:23,752 or even decrease on a low carb diet. 1142 00:49:26,546 --> 00:49:29,048 This could explain why most people on Keto 1143 00:49:29,049 --> 00:49:31,801 do not see an increase in LDL cholesterol, 1144 00:49:31,802 --> 00:49:35,137 because most people adopt the diet to lose weight. 1145 00:49:35,138 --> 00:49:38,099 So they start out at a higher body mass. 1146 00:49:38,100 --> 00:49:41,185 But in recent years, we are recognizing the power of Keto 1147 00:49:41,186 --> 00:49:43,479 for treating all kinds of medical conditions, 1148 00:49:43,480 --> 00:49:45,231 including mental health. 1149 00:49:45,232 --> 00:49:47,566 For these reasons, we're seeing more lean 1150 00:49:47,567 --> 00:49:49,902 and normal weight people switching over to Keto. 1151 00:49:49,903 --> 00:49:52,238 And it's when lean people 1152 00:49:52,239 --> 00:49:54,907 go on these very low carbohydrate diets 1153 00:49:54,908 --> 00:49:58,120 that we can see their cholesterol levels rise, a lot. 1154 00:49:59,746 --> 00:50:01,580 (texts whirring) 1155 00:50:01,581 --> 00:50:04,251 (pensive music) 1156 00:50:05,210 --> 00:50:06,711 (keyboard clacking) 1157 00:50:06,712 --> 00:50:07,753 - [Robyn] Hello. 1158 00:50:07,754 --> 00:50:09,463 - Hi, Robyn, (laughs) how are you? 1159 00:50:09,464 --> 00:50:10,631 - I'm very well, thanks. 1160 00:50:10,632 --> 00:50:11,507 How are you? 1161 00:50:11,508 --> 00:50:12,341 - Good, good. 1162 00:50:12,342 --> 00:50:15,386 Robyn is a mom, a wife, and a woman who's suffered 1163 00:50:15,387 --> 00:50:18,806 from the debilitating depression of Bipolar disorder. 1164 00:50:18,807 --> 00:50:21,642 - I was basically comatose all day long. 1165 00:50:21,643 --> 00:50:23,477 I set an alarm in the morning to wake up 1166 00:50:23,478 --> 00:50:26,647 and take the kids to school, go home, go back to bed, 1167 00:50:26,648 --> 00:50:30,026 set an alarm to remember to wake up to get them. 1168 00:50:30,027 --> 00:50:32,403 - [Dave] Bipolar disorder is a mental health condition 1169 00:50:32,404 --> 00:50:34,488 characterized by severe mood swings 1170 00:50:34,489 --> 00:50:37,950 that include manic highs followed by depressive lows. 1171 00:50:37,951 --> 00:50:39,452 - Everything was just gray. 1172 00:50:39,453 --> 00:50:42,038 There was no joy in life. 1173 00:50:42,039 --> 00:50:44,915 And I'm doing all of this during a time 1174 00:50:44,916 --> 00:50:46,333 were my children are little. 1175 00:50:46,334 --> 00:50:49,128 Like, I should be sitting on the floor with them 1176 00:50:49,129 --> 00:50:52,214 and playing with whatever toys they're playing with. 1177 00:50:52,215 --> 00:50:55,509 But instead, I'm just kind of perched on a couch 1178 00:50:55,510 --> 00:50:56,927 and just watching. 1179 00:50:56,928 --> 00:50:59,680 Like, I can see life is happening, 1180 00:50:59,681 --> 00:51:02,892 but I'm not participating in that life. 1181 00:51:02,893 --> 00:51:06,020 - It would become a decade-long struggle. 1182 00:51:06,021 --> 00:51:08,064 Robyn cycled through numerous doctors 1183 00:51:08,065 --> 00:51:09,523 and various medications, 1184 00:51:09,524 --> 00:51:12,568 drugs that sedated her and caused weight gain, 1185 00:51:12,569 --> 00:51:14,695 making it difficult to do daily tasks 1186 00:51:14,696 --> 00:51:16,655 and help raise a family. 1187 00:51:16,656 --> 00:51:19,451 What are some of your earliest memories of your mom? 1188 00:51:20,702 --> 00:51:24,998 - To be honest, I don't have a lot of them. 1189 00:51:26,208 --> 00:51:28,292 I think I would ask her to play with me 1190 00:51:28,293 --> 00:51:32,005 and she would just sit in her bed and she wouldn't get up. 1191 00:51:33,590 --> 00:51:37,301 - There was a lot of, for them, tears, a lot of crying, 1192 00:51:37,302 --> 00:51:39,678 a lot of uncertainty. 1193 00:51:39,679 --> 00:51:44,684 But for me, a lot of, I don't know how to stop this. 1194 00:51:44,768 --> 00:51:46,143 And it was miserable. 1195 00:51:46,144 --> 00:51:47,729 It was absolutely heartbreaking. 1196 00:51:48,730 --> 00:51:50,898 - [Dave] Nearly a billion people on the planet 1197 00:51:50,899 --> 00:51:53,609 now have a psychiatric condition serious enough 1198 00:51:53,610 --> 00:51:56,237 that it interferes with their daily life. 1199 00:51:56,238 --> 00:51:58,864 This startling increase in mental health disorders 1200 00:51:58,865 --> 00:52:02,284 coincides with the rapid decline in the quality of our diet. 1201 00:52:02,285 --> 00:52:03,786 For the past 75 years, 1202 00:52:03,787 --> 00:52:05,663 we've thought of mental health conditions 1203 00:52:05,664 --> 00:52:07,665 as chemical imbalances in the brain 1204 00:52:07,666 --> 00:52:09,501 to be treated with medications. 1205 00:52:10,544 --> 00:52:13,546 But the field of psychiatry is experiencing a transformation 1206 00:52:13,547 --> 00:52:15,548 in how it views these conditions, 1207 00:52:15,549 --> 00:52:18,092 recognizing that most mental disorders 1208 00:52:18,093 --> 00:52:22,471 may in fact be metabolic disorders affecting the brain. 1209 00:52:22,472 --> 00:52:23,973 - There is a very strong connection 1210 00:52:23,974 --> 00:52:25,224 between metabolic and mental health, 1211 00:52:25,225 --> 00:52:26,976 just as there is a very strong connection 1212 00:52:26,977 --> 00:52:27,977 between metabolic health 1213 00:52:27,978 --> 00:52:31,272 and just about every aspect of health. (laughs) 1214 00:52:31,273 --> 00:52:32,356 - [Dave] Dr. Georgia Ede 1215 00:52:32,357 --> 00:52:34,150 and a growing group of psychiatrists 1216 00:52:34,151 --> 00:52:36,610 say that Ketogenic Metabolic Therapy, 1217 00:52:36,611 --> 00:52:39,238 which is structured around a Keto diet, 1218 00:52:39,239 --> 00:52:41,240 offers promising new hope. 1219 00:52:41,241 --> 00:52:44,660 - And for some people, it can be life-changing. 1220 00:52:44,661 --> 00:52:47,121 - [Dave] Dr. Chris Palmer, a Harvard psychiatrist, 1221 00:52:47,122 --> 00:52:49,415 says the Ketogenic diet can work 1222 00:52:49,416 --> 00:52:51,250 even when medications fail. 1223 00:52:51,251 --> 00:52:53,085 - It doesn't work for everyone. 1224 00:52:53,086 --> 00:52:56,213 But I think the thing that has been really disruptive 1225 00:52:56,214 --> 00:52:58,424 to the field and quite exciting 1226 00:52:58,425 --> 00:52:59,466 is that the Ketogenic diet 1227 00:52:59,467 --> 00:53:03,345 can sometimes have dramatic benefits 1228 00:53:03,346 --> 00:53:06,974 for people with Bipolar disorder, schizophrenia. 1229 00:53:06,975 --> 00:53:09,643 - There's still some debate on exactly how Keto diet 1230 00:53:09,644 --> 00:53:11,520 improves brain function, 1231 00:53:11,521 --> 00:53:13,689 but one prominent theory points to the change 1232 00:53:13,690 --> 00:53:15,108 in fuel sources. 1233 00:53:16,026 --> 00:53:18,819 High consumption of sugar and refined carbohydrates 1234 00:53:18,820 --> 00:53:21,071 can flood the body with so much glucose 1235 00:53:21,072 --> 00:53:23,532 that it causes an energy overload, 1236 00:53:23,533 --> 00:53:26,035 making cells malfunction throughout the body 1237 00:53:26,036 --> 00:53:28,538 and causing cells in the brain to malfunction too. 1238 00:53:30,040 --> 00:53:31,582 A Keto diet switches the body 1239 00:53:31,583 --> 00:53:33,792 over to burning mostly fat for fuel. 1240 00:53:33,793 --> 00:53:37,296 A portion of this fat is converted to ketones. 1241 00:53:37,297 --> 00:53:40,507 Even in the midst of a glucose-induced energy crisis, 1242 00:53:40,508 --> 00:53:42,968 ketones can fuel the brain. 1243 00:53:42,969 --> 00:53:45,429 - I think that may be responsible for this phenomenon 1244 00:53:45,430 --> 00:53:48,974 that we often see in patients who begin a Ketogenic diet. 1245 00:53:48,975 --> 00:53:51,268 Sometimes in as little as three days, 1246 00:53:51,269 --> 00:53:53,646 people will say things like, 1247 00:53:53,647 --> 00:53:55,481 "I feel like my brain, 1248 00:53:55,482 --> 00:53:57,609 you know, the lights just switched on." 1249 00:53:59,236 --> 00:54:00,277 - A revelation. 1250 00:54:00,278 --> 00:54:01,445 - I just felt amazing. 1251 00:54:01,446 --> 00:54:03,322 - My energy is through the roof. 1252 00:54:03,323 --> 00:54:05,157 - I'd never felt like that before. 1253 00:54:05,158 --> 00:54:07,869 - Everything was in color and sounded amazing. 1254 00:54:08,745 --> 00:54:09,954 - You get the picture. 1255 00:54:09,955 --> 00:54:10,829 And get this. 1256 00:54:10,830 --> 00:54:13,457 In 2022, scientists in France 1257 00:54:13,458 --> 00:54:16,043 used a Ketogenic diet with 28 patients 1258 00:54:16,044 --> 00:54:19,213 who had been hospitalized for severe Bipolar disorder, 1259 00:54:19,214 --> 00:54:22,091 major depression, or schizophrenia. 1260 00:54:22,092 --> 00:54:25,010 In less than a year, nearly half of the participants 1261 00:54:25,011 --> 00:54:27,554 achieved full clinical remission. 1262 00:54:27,555 --> 00:54:29,682 That means they no longer meet the criteria 1263 00:54:29,683 --> 00:54:31,267 for mental illness. 1264 00:54:31,268 --> 00:54:35,646 - And that is so exciting and powerful 1265 00:54:35,647 --> 00:54:38,607 because our existing treatments right now 1266 00:54:38,608 --> 00:54:41,277 usually don't restore people's health. 1267 00:54:41,278 --> 00:54:44,405 - You know, doctors who've been treating Bipolar disorder, 1268 00:54:44,406 --> 00:54:48,659 schizophrenia, major depression for years and decades 1269 00:54:48,660 --> 00:54:50,619 have said they never thought 1270 00:54:50,620 --> 00:54:54,498 they would see complete remission with nutrition alone. 1271 00:54:54,499 --> 00:54:55,624 - In addition to his work 1272 00:54:55,625 --> 00:54:57,710 as a cardiologist and lipidologist, 1273 00:54:57,711 --> 00:55:01,171 Dr. Bret Scher is the medical director at Metabolic Mind, 1274 00:55:01,172 --> 00:55:04,508 a nonprofit organization that promotes metabolic therapies 1275 00:55:04,509 --> 00:55:06,010 to improve mental health. 1276 00:55:06,011 --> 00:55:08,887 - But what I've seen in the past year and a half 1277 00:55:08,888 --> 00:55:11,098 by being the director of Metabolic Mind 1278 00:55:11,099 --> 00:55:12,975 is stories left and right 1279 00:55:12,976 --> 00:55:15,853 of people completely putting their Bipolar disorder 1280 00:55:15,854 --> 00:55:18,147 into remission with a Ketogenic lifestyle. 1281 00:55:18,148 --> 00:55:21,358 And that's remarkable, the way it has changed their lives, 1282 00:55:21,359 --> 00:55:24,028 the way it's changed their family's lives. 1283 00:55:24,029 --> 00:55:27,197 - It's almost like a different existence. 1284 00:55:27,198 --> 00:55:29,033 I don't even know how to describe it. 1285 00:55:29,034 --> 00:55:30,409 - [Dave] After a five-year struggle 1286 00:55:30,410 --> 00:55:32,494 with treatment-resistant Bipolar disorder 1287 00:55:32,495 --> 00:55:33,787 that left him homeless 1288 00:55:33,788 --> 00:55:36,248 and wandering the streets of Los Angeles, 1289 00:55:36,249 --> 00:55:40,044 out of desperation, Matt Baszucki tried Ketogenic therapy. 1290 00:55:40,045 --> 00:55:42,713 He says it healed his brain. 1291 00:55:42,714 --> 00:55:44,256 - Not only did my mood stabilize, 1292 00:55:44,257 --> 00:55:46,008 but everything just fell into place. 1293 00:55:46,009 --> 00:55:49,803 So I could play chess again, I could work full-time. 1294 00:55:49,804 --> 00:55:53,515 I was exercising, and I was lifting weights, 1295 00:55:53,516 --> 00:55:54,558 and I had energy. 1296 00:55:54,559 --> 00:55:57,144 And everything seemed to fall into place 1297 00:55:57,145 --> 00:55:58,062 when I went on Keto. 1298 00:55:58,063 --> 00:56:02,066 - And people have no idea that what they eat 1299 00:56:02,067 --> 00:56:04,777 can cause mental illness. 1300 00:56:04,778 --> 00:56:07,571 - [Dave] Eric Rogers suffered from severe depression 1301 00:56:07,572 --> 00:56:08,614 and thoughts of suicide. 1302 00:56:08,615 --> 00:56:12,368 He adopted a Keto diet to address his pre-diabetes. 1303 00:56:12,369 --> 00:56:14,203 Not only did his metabolic health improve, 1304 00:56:14,204 --> 00:56:16,580 his depression faded away. 1305 00:56:16,581 --> 00:56:18,874 - I felt it initially fairly quickly, 1306 00:56:18,875 --> 00:56:22,586 but it's just been a continual gradual improvement 1307 00:56:22,587 --> 00:56:27,592 to where, yeah, the last seven years, no mood issues at all. 1308 00:56:28,676 --> 00:56:30,928 - Like, kind of blown away 1309 00:56:30,929 --> 00:56:35,058 that I just don't really experience symptoms anymore. 1310 00:56:36,059 --> 00:56:36,892 - [Dave] Lauren Kennedy 1311 00:56:36,893 --> 00:56:38,894 struggled with Schizo Affective Disorder 1312 00:56:38,895 --> 00:56:40,104 for more than a decade. 1313 00:56:40,105 --> 00:56:41,980 It's a serious mental health condition 1314 00:56:41,981 --> 00:56:44,858 that combines the psychosis of schizophrenia 1315 00:56:44,859 --> 00:56:47,486 with the mood disorders of Bipolar. 1316 00:56:47,487 --> 00:56:48,779 But earlier this year, 1317 00:56:48,780 --> 00:56:51,073 she began working with her psychiatrist 1318 00:56:51,074 --> 00:56:52,992 to implement Ketogenic therapy. 1319 00:56:53,827 --> 00:56:55,744 - I have been using medical Ketogenic therapy 1320 00:56:55,745 --> 00:56:57,579 to treat my Schizo Affective Disorder 1321 00:56:57,580 --> 00:56:58,956 over the last five months, 1322 00:56:58,957 --> 00:57:01,458 and honestly I'm kind of blown away 1323 00:57:01,459 --> 00:57:04,837 by how effective it has been in eradicating my symptoms. 1324 00:57:04,838 --> 00:57:06,672 I have thoroughly documented this process 1325 00:57:06,673 --> 00:57:09,007 on my YouTube channel, Living Well With Schizophrenia, 1326 00:57:09,008 --> 00:57:11,468 if you want to learn more about my experience. 1327 00:57:11,469 --> 00:57:14,263 I think I already feel fine on 10 milligrams, 1328 00:57:14,264 --> 00:57:18,642 so kind of planning to try going completely off. 1329 00:57:18,643 --> 00:57:20,018 - People who have schizophrenia 1330 00:57:20,019 --> 00:57:22,813 usually have lifelong disorders. 1331 00:57:22,814 --> 00:57:24,815 They have lifelong suffering. 1332 00:57:24,816 --> 00:57:28,777 Any treatment that can reduce symptoms 1333 00:57:28,778 --> 00:57:33,783 or even put symptoms into remission is a godsend. 1334 00:57:34,951 --> 00:57:37,870 - You may have noticed the name of our channel has changed. 1335 00:57:37,871 --> 00:57:40,205 It's gone from Living Well With Schizophrenia 1336 00:57:40,206 --> 00:57:43,251 to now Living Well After Schizophrenia. 1337 00:57:44,794 --> 00:57:49,799 I don't struggle with my symptoms of schizophrenia anymore. 1338 00:57:51,092 --> 00:57:55,429 And so I hope that setting an example that it is possible 1339 00:57:55,430 --> 00:57:59,183 can be seen as a new kind of beacon of hope 1340 00:57:59,184 --> 00:58:01,226 for people who may be experiencing 1341 00:58:01,227 --> 00:58:03,188 similar challenges or illnesses. 1342 00:58:05,857 --> 00:58:07,900 - [Robyn] Let's go with red. 1343 00:58:07,901 --> 00:58:09,985 This is where it gets interesting. 1344 00:58:09,986 --> 00:58:14,156 Because I had no indication, no idea, 1345 00:58:14,157 --> 00:58:18,076 no information at the time to let me know 1346 00:58:18,077 --> 00:58:21,371 that mental health could be affected 1347 00:58:21,372 --> 00:58:24,500 in any way, shape, or form by diet. 1348 00:58:24,501 --> 00:58:26,628 - [Dave] Ironically, it was the desire 1349 00:58:27,837 --> 00:58:30,797 to lower her cholesterol that led Robyn to try Keto diet. 1350 00:58:30,798 --> 00:58:34,301 Within six months, Robyn dropped 50 pounds. 1351 00:58:34,302 --> 00:58:37,763 At first, her cholesterol levels trended downward. 1352 00:58:37,764 --> 00:58:40,557 And something remarkable happened to her mood. 1353 00:58:40,558 --> 00:58:42,392 - I said to Matt, 1354 00:58:42,393 --> 00:58:45,479 "I think my mental health is getting better." 1355 00:58:45,480 --> 00:58:47,356 - There was a joy in her 1356 00:58:47,357 --> 00:58:51,236 that I hadn't seen in a very, very long time. 1357 00:58:52,153 --> 00:58:53,362 (lighthearted music) 1358 00:58:53,363 --> 00:58:54,531 - I felt excitement. 1359 00:58:55,365 --> 00:58:59,952 And I just said, "You know what, I need to see 1360 00:58:59,953 --> 00:59:04,831 if I can live my life without this medication." 1361 00:59:04,832 --> 00:59:07,584 We went to the doctor and we told him what was going on. 1362 00:59:07,585 --> 00:59:10,170 And she agreed and said, 1363 00:59:10,171 --> 00:59:13,173 "Yes, let's titrate you off your medications." 1364 00:59:13,174 --> 00:59:15,968 So that's exactly what we did. 1365 00:59:15,969 --> 00:59:16,802 And I have not been 1366 00:59:16,803 --> 00:59:19,930 on any mental health medications ever since. 1367 00:59:19,931 --> 00:59:21,682 - [Dave] Wow. 1368 00:59:21,683 --> 00:59:23,725 Robyn achieved full remission. 1369 00:59:23,726 --> 00:59:26,228 She no longer suffers from Bipolar. 1370 00:59:26,229 --> 00:59:27,271 And it's holding. 1371 00:59:27,272 --> 00:59:28,814 It's been seven years now. 1372 00:59:28,815 --> 00:59:30,732 Robyn has reconnected with her children 1373 00:59:30,733 --> 00:59:32,859 and is healing her relationships. 1374 00:59:32,860 --> 00:59:36,154 - [Robyn] Before life was gray, now it's full of color. 1375 00:59:36,155 --> 00:59:40,034 That joy that I knew existed, I now feel. 1376 00:59:40,994 --> 00:59:43,036 - [Matt] I just look forward to everything. 1377 00:59:43,037 --> 00:59:44,746 That is in the bulls-eye. 1378 00:59:44,747 --> 00:59:46,665 - That's totally a miss. 1379 00:59:46,666 --> 00:59:48,917 - [Matt] 'Cause this is what it's supposed to be. 1380 00:59:48,918 --> 00:59:51,837 This is what our life is supposed to be. 1381 00:59:51,838 --> 00:59:55,090 - There's hope, and it just takes one little change. 1382 00:59:55,091 --> 00:59:56,800 You did a good job throwing axes. 1383 00:59:56,801 --> 00:59:57,634 - Thank you. 1384 00:59:57,635 --> 01:00:00,137 - [Dave] But now that Robyn has regained her mental health, 1385 01:00:00,138 --> 01:00:03,056 she has also become more and more lean. 1386 01:00:03,057 --> 01:00:05,350 - Well, that's where the irony starts. 1387 01:00:05,351 --> 01:00:08,312 I started this whole process of eating low carb 1388 01:00:08,313 --> 01:00:10,897 to drop my cholesterol 1389 01:00:10,898 --> 01:00:14,985 and then suddenly my cholesterol starts shooting up. 1390 01:00:14,986 --> 01:00:19,281 - Robyn saw her LDL cholesterol climb to 360. 1391 01:00:19,282 --> 01:00:23,827 Suddenly, she faced a very real and difficult decision. 1392 01:00:23,828 --> 01:00:27,998 Should she abandon a diet that has given her her life back? 1393 01:00:27,999 --> 01:00:31,293 - Modern lipidology says abandon the diet quickly, you know? 1394 01:00:31,294 --> 01:00:34,004 This is the worst thing that could ever happen to you. 1395 01:00:34,005 --> 01:00:38,467 And yet we see so many people improving their lives, 1396 01:00:38,468 --> 01:00:39,760 improving their metabolic health, 1397 01:00:39,761 --> 01:00:41,720 improving their mental health. 1398 01:00:41,721 --> 01:00:44,890 And abandoning it could lead 1399 01:00:44,891 --> 01:00:48,185 to some potentially really negative outcomes. 1400 01:00:48,186 --> 01:00:51,772 So it's tough to figure out what to do. 1401 01:00:51,773 --> 01:00:54,149 Robyn, it's so good to see you again. 1402 01:00:54,150 --> 01:00:55,108 How are you? 1403 01:00:55,109 --> 01:00:56,109 - I'm doing really well. 1404 01:00:56,110 --> 01:00:57,361 How are you? 1405 01:00:57,362 --> 01:00:59,738 - [Dave] Robyn turned to Dr. Tro Kalayjian. 1406 01:00:59,739 --> 01:01:02,532 He specializes in low carb nutrition. 1407 01:01:02,533 --> 01:01:04,451 - Of course, you being the great doctor that you are, 1408 01:01:04,452 --> 01:01:08,914 you asked me, would I go on a statin, and I refused. 1409 01:01:08,915 --> 01:01:10,874 But instead of being like all the other doctors 1410 01:01:10,875 --> 01:01:13,710 and considering me a noncompliant patient, 1411 01:01:13,711 --> 01:01:16,505 you worked with me on some ways 1412 01:01:16,506 --> 01:01:18,674 that we could try to get around that. 1413 01:01:18,675 --> 01:01:21,927 - We saw your famous Wonder Bread study 1414 01:01:21,928 --> 01:01:25,180 and we knew of other people in my clinic 1415 01:01:25,181 --> 01:01:26,807 who had improved their cholesterol 1416 01:01:26,808 --> 01:01:30,268 by adding back carbohydrates. 1417 01:01:30,269 --> 01:01:33,105 - What Dr. Tro just mentioned is a key premise 1418 01:01:33,106 --> 01:01:34,940 of the Lipid Energy Model. 1419 01:01:34,941 --> 01:01:37,901 I demonstrated this in my most popular experiment. 1420 01:01:37,902 --> 01:01:39,695 (lighthearted music) 1421 01:01:39,696 --> 01:01:42,364 I called it the White Bread Experiment. 1422 01:01:42,365 --> 01:01:44,241 In it, I lowered my cholesterol 1423 01:01:44,242 --> 01:01:46,576 more than 200 points in a week 1424 01:01:46,577 --> 01:01:50,122 by adding white bread to my otherwise Keto diet. 1425 01:01:50,123 --> 01:01:51,206 The experiment reveals 1426 01:01:51,207 --> 01:01:55,002 just how tightly linked cholesterol is to metabolism. 1427 01:01:55,837 --> 01:01:57,087 Many people who eat Keto 1428 01:01:57,088 --> 01:01:59,923 have replicated variations of this experiment. 1429 01:01:59,924 --> 01:02:03,552 It can dramatically and swiftly affect cholesterol levels. 1430 01:02:03,553 --> 01:02:06,471 And any simple carbohydrate will work. 1431 01:02:06,472 --> 01:02:10,851 It can be white bread, sweet potato, or... 1432 01:02:10,852 --> 01:02:13,812 (chiming) 1433 01:02:13,813 --> 01:02:15,731 - Five months ago, I started an experiment 1434 01:02:15,732 --> 01:02:18,109 to see which would lower my cholesterol more, 1435 01:02:19,318 --> 01:02:22,572 statin therapy or Oreo cookies. 1436 01:02:23,948 --> 01:02:25,741 - [Dave] Nick made the provocative choice 1437 01:02:25,742 --> 01:02:28,326 of adding 12 Oreo cookies per day, 1438 01:02:28,327 --> 01:02:30,412 about a hundred grams of carbs 1439 01:02:30,413 --> 01:02:33,457 to his otherwise low carb Keto diet. 1440 01:02:33,458 --> 01:02:35,083 He compared that to six weeks 1441 01:02:35,084 --> 01:02:37,377 of high intensity statin therapy. 1442 01:02:37,378 --> 01:02:39,880 The results are stunning. 1443 01:02:39,881 --> 01:02:42,799 The addition of Oreo cookies was twice as effective 1444 01:02:42,800 --> 01:02:47,012 at lowering Nick's LDL in less than half the amount of time. 1445 01:02:47,013 --> 01:02:48,221 But why? 1446 01:02:48,222 --> 01:02:50,807 Well, remember, according to the Lipid Energy Model, 1447 01:02:50,808 --> 01:02:54,936 the main driver of LDL cholesterol in people on Keto diets 1448 01:02:54,937 --> 01:02:58,523 is a drop in glucose stores in the liver. 1449 01:02:58,524 --> 01:03:00,400 This shifts energy demand 1450 01:03:00,401 --> 01:03:03,403 toward using mostly fat-based fuel. 1451 01:03:03,404 --> 01:03:06,156 But even a small reintroduction of carbohydrates 1452 01:03:06,157 --> 01:03:08,617 can refill those glucose stores. 1453 01:03:08,618 --> 01:03:10,911 And when glucose is easily available, 1454 01:03:10,912 --> 01:03:12,996 it dramatically drops the need 1455 01:03:12,997 --> 01:03:15,791 to ship fat fuel in the blood, 1456 01:03:15,792 --> 01:03:18,335 resulting in a sudden and significant drop 1457 01:03:18,336 --> 01:03:19,670 in LDL cholesterol. 1458 01:03:20,838 --> 01:03:23,298 So did it work for Robyn? 1459 01:03:23,299 --> 01:03:28,094 - So every day, actually, the very first meal of my day 1460 01:03:28,095 --> 01:03:30,431 was one sweet potato. 1461 01:03:31,265 --> 01:03:32,224 - [Dave] For three months, 1462 01:03:32,225 --> 01:03:34,684 Robyn added one sweet potato per day 1463 01:03:34,685 --> 01:03:36,312 to her baseline Keto diet. 1464 01:03:37,396 --> 01:03:40,398 - Lo and behold, the numbers are all trending downwards 1465 01:03:40,399 --> 01:03:42,818 where they're supposed to trend downward. 1466 01:03:42,819 --> 01:03:45,779 And we're seeing success. 1467 01:03:45,780 --> 01:03:47,823 But the first thing that happens to me 1468 01:03:47,824 --> 01:03:51,701 when I wake up in the morning, and this is a big sign to me, 1469 01:03:51,702 --> 01:03:54,579 it's like a blaring me on blinking sign, 1470 01:03:54,580 --> 01:03:56,624 is I can't wait to go back to bed. 1471 01:03:58,251 --> 01:04:00,919 I said, "I think my depression's coming back." 1472 01:04:00,920 --> 01:04:03,839 - [Dave] Dr. Tro and Robyn tried scaling back the dose, 1473 01:04:03,840 --> 01:04:06,967 cutting down to half a sweet potato per day, 1474 01:04:06,968 --> 01:04:08,093 then a quarter. 1475 01:04:08,094 --> 01:04:11,221 But still, her symptoms of depression lingered. 1476 01:04:11,222 --> 01:04:12,639 - It was not getting better. 1477 01:04:12,640 --> 01:04:15,433 Even that quarter of a sweet potato, 1478 01:04:15,434 --> 01:04:17,644 I was not in a good mental state. 1479 01:04:17,645 --> 01:04:20,730 My family was very aware of what was going on, 1480 01:04:20,731 --> 01:04:22,607 and they were telling me, 1481 01:04:22,608 --> 01:04:24,276 "Mom, it's hard to be around you." 1482 01:04:24,277 --> 01:04:26,695 "Mom, you're angry again." 1483 01:04:26,696 --> 01:04:30,615 It wasn't worth it to me to drop that number 1484 01:04:30,616 --> 01:04:32,242 and ruin the relationships 1485 01:04:32,243 --> 01:04:35,161 that I was really very new to forming 1486 01:04:35,162 --> 01:04:36,914 with my family members. 1487 01:04:37,874 --> 01:04:40,333 And so we eventually just stopped. 1488 01:04:40,334 --> 01:04:41,918 (gentle music) 1489 01:04:41,919 --> 01:04:44,421 - [Dave] Robyn's experience speaks to a larger issue. 1490 01:04:44,422 --> 01:04:47,966 For many people, the Keto diet is a lifeline, 1491 01:04:47,967 --> 01:04:51,345 and adding back carbohydrates is simply not an option. 1492 01:04:52,221 --> 01:04:55,432 - [Robyn] What's important to me is my overall health 1493 01:04:55,433 --> 01:04:56,474 and the relationships 1494 01:04:56,475 --> 01:04:59,185 that I'm trying to rebuild with my children. 1495 01:04:59,186 --> 01:05:02,480 And I can't do that if I am eating that way. 1496 01:05:02,481 --> 01:05:05,066 I've lived that life, I know what that life feels like, 1497 01:05:05,067 --> 01:05:07,528 and I never want to go back. 1498 01:05:11,949 --> 01:05:14,826 (keyboard clacking) 1499 01:05:14,827 --> 01:05:18,371 (foreboding music) 1500 01:05:18,372 --> 01:05:20,123 - So to be coming from the outside, 1501 01:05:20,124 --> 01:05:21,833 raise money for a study like that 1502 01:05:21,834 --> 01:05:24,378 to pursue a question that you're just curious in, 1503 01:05:25,880 --> 01:05:27,964 I'm trying to think of a word more powerful than admirable, 1504 01:05:27,965 --> 01:05:29,758 but it's incredibly admirable. 1505 01:05:29,759 --> 01:05:31,885 - Today, today is the day. 1506 01:05:31,886 --> 01:05:35,473 We're going to Lundquist, so this is it. 1507 01:05:36,474 --> 01:05:37,725 - He's swimming upstream. 1508 01:05:39,602 --> 01:05:41,186 And he's had to scrap and fight 1509 01:05:41,187 --> 01:05:42,729 just to get a couple hundred thousand dollars 1510 01:05:42,730 --> 01:05:43,731 to do these studies. 1511 01:05:44,982 --> 01:05:48,276 - Today we get to see the first hundred heart scans 1512 01:05:48,277 --> 01:05:49,111 from the study. 1513 01:05:51,405 --> 01:05:54,325 It's taken seven years to get to this point. 1514 01:05:55,326 --> 01:05:56,160 Big day. 1515 01:05:59,288 --> 01:06:02,708 - [Sharon] For Dave, it's truly a passion project for him. 1516 01:06:04,794 --> 01:06:08,380 It's something that he feels very strongly about. 1517 01:06:08,381 --> 01:06:12,217 This is not about money, or fame, or fortune, 1518 01:06:12,218 --> 01:06:13,176 or anything like that. 1519 01:06:13,177 --> 01:06:16,347 It has always been about helping other people. 1520 01:06:17,473 --> 01:06:19,557 - I'm kind of nervous, man. It's been so long to come up 1521 01:06:19,558 --> 01:06:21,268 to this exact moment (indistinct). 1522 01:06:22,228 --> 01:06:26,732 So, Dr. Budoff, our hundred baselines are here, right? 1523 01:06:28,150 --> 01:06:31,236 So let's look. 1524 01:06:31,237 --> 01:06:32,070 - Sure. 1525 01:06:32,071 --> 01:06:37,076 So just going through the population that we studied, 1526 01:06:37,118 --> 01:06:38,827 you can see a pretty nice spectrum, 1527 01:06:38,828 --> 01:06:41,621 going from about 200 LDL all the way up to somebody 1528 01:06:41,622 --> 01:06:42,914 who looks like they're approaching 1529 01:06:42,915 --> 01:06:46,209 about 600 milligrams per deciliter. 1530 01:06:46,210 --> 01:06:49,546 So this is kind of the big money shot. 1531 01:06:49,547 --> 01:06:51,549 More than half had zero plaque. 1532 01:06:52,550 --> 01:06:56,803 53% had absolutely no plaque detectable. 1533 01:06:56,804 --> 01:06:59,055 The vast majority have either no 1534 01:06:59,056 --> 01:07:02,350 or minimal atherosclerosis. 1535 01:07:02,351 --> 01:07:03,935 - I just couldn't believe my eyes. 1536 01:07:03,936 --> 01:07:08,941 The total plaque score can go from 0 to a maximum of 45. 1537 01:07:08,983 --> 01:07:12,277 And yet everyone in the study is a nine or below. 1538 01:07:12,278 --> 01:07:15,822 Not one person even made it to 10. 1539 01:07:15,823 --> 01:07:19,325 This is actually, this is really good, 1540 01:07:19,326 --> 01:07:20,285 right? - Yeah. 1541 01:07:20,286 --> 01:07:23,038 Staying zero is still the predominant number 1542 01:07:23,039 --> 01:07:26,124 and the median is still zero for the overall cohort, 1543 01:07:26,125 --> 01:07:29,294 even as we trended higher in age. 1544 01:07:29,295 --> 01:07:30,670 - This is big. 1545 01:07:30,671 --> 01:07:33,965 The average age of our participants is 55. 1546 01:07:33,966 --> 01:07:37,093 At 55 years old, it's very common to see plaque 1547 01:07:37,094 --> 01:07:38,970 developing in the arteries, 1548 01:07:38,971 --> 01:07:42,182 and yet most of our participants have no visible plaque 1549 01:07:42,183 --> 01:07:44,225 on these initial scans. 1550 01:07:44,226 --> 01:07:48,146 Add to that, they've been Keto for an average of 4.7 years. 1551 01:07:48,147 --> 01:07:49,689 That's almost half a decade 1552 01:07:49,690 --> 01:07:52,610 at these sky high levels of LDL cholesterol. 1553 01:07:53,652 --> 01:07:57,697 - Yeah, no, I think this is really, really incredible data. 1554 01:07:57,698 --> 01:08:00,075 I think the expectations 1555 01:08:00,076 --> 01:08:02,285 when we see LDL cholesterol 1556 01:08:02,286 --> 01:08:06,081 of 200, 300, 500, 600 1557 01:08:06,082 --> 01:08:09,542 is that the coronaries are gonna be coated in plaque, 1558 01:08:09,543 --> 01:08:11,294 that there's gonna be a lot of blockages, 1559 01:08:11,295 --> 01:08:12,462 that we're gonna be thinking about, 1560 01:08:12,463 --> 01:08:16,091 should we be calling the cardiac surgeon for bypass surgery? 1561 01:08:16,092 --> 01:08:18,593 And that's not what we saw. 1562 01:08:18,594 --> 01:08:20,470 - I just really appreciate this, Matt. 1563 01:08:20,471 --> 01:08:24,015 Like, there's literally epileptics that write me, 1564 01:08:24,016 --> 01:08:26,392 and severe Type 1 diabetics. 1565 01:08:26,393 --> 01:08:30,188 And, you know, the first time I'm hearing a toddler, 1566 01:08:30,189 --> 01:08:32,983 her parents are considering getting her brain surgery. 1567 01:08:34,610 --> 01:08:37,195 And she was thriving on a Ketogenic diet. 1568 01:08:37,196 --> 01:08:38,905 The pediatrician was pushing back and saying, 1569 01:08:38,906 --> 01:08:39,906 "Well, there's no point 1570 01:08:39,907 --> 01:08:43,368 if she's gonna, like, have a heart attack in 10 years. 1571 01:08:43,369 --> 01:08:46,621 I wanna be able to give her that answer from our data. 1572 01:08:46,622 --> 01:08:48,331 - We will, we will give 'em the answer. 1573 01:08:48,332 --> 01:08:49,207 - Yeah. 1574 01:08:49,208 --> 01:08:50,750 So thanks. 1575 01:08:50,751 --> 01:08:53,503 Thanks to you, and your team, and everybody. 1576 01:08:53,504 --> 01:08:54,337 - That's great. 1577 01:08:54,338 --> 01:08:56,881 And we just pursue wherever the science takes us. 1578 01:08:56,882 --> 01:08:59,135 And we, you know, come in with open minds 1579 01:09:00,010 --> 01:09:03,471 and try to see which way the, 1580 01:09:03,472 --> 01:09:06,057 you know, the science pushes us. 1581 01:09:06,058 --> 01:09:07,684 - Yeah. 1582 01:09:07,685 --> 01:09:09,978 (texts whirring) 1583 01:09:09,979 --> 01:09:11,479 (dramatic music) 1584 01:09:11,480 --> 01:09:14,900 (plane engines rumbling) 1585 01:09:17,486 --> 01:09:19,738 - Here we are, London town. 1586 01:09:20,865 --> 01:09:23,616 There's a lot of low carbers here. 1587 01:09:23,617 --> 01:09:25,785 And that means, of course, a number of 'em 1588 01:09:25,786 --> 01:09:27,663 are gonna have some high cholesterol. 1589 01:09:28,539 --> 01:09:30,290 We've traveled all the way across the pond 1590 01:09:30,291 --> 01:09:32,500 to London, England to meet with members 1591 01:09:32,501 --> 01:09:34,335 of the Public Health Collaborative. 1592 01:09:34,336 --> 01:09:37,213 The PHC is a nonprofit health organization 1593 01:09:37,214 --> 01:09:39,757 that advocates for the use of low carb and Keto 1594 01:09:39,758 --> 01:09:43,261 to reverse metabolic disorders like Type 2 diabetes. 1595 01:09:43,262 --> 01:09:44,888 Sam Feltham is the president 1596 01:09:44,889 --> 01:09:47,640 and he's been closely following our research. 1597 01:09:47,641 --> 01:09:52,271 - The LDL issue, really one of the biggest objections 1598 01:09:53,105 --> 01:09:57,025 to implementing low carb in all aspects, 1599 01:09:57,026 --> 01:10:00,529 whether it be cardiovascular disease, or Type 2 diabetes, 1600 01:10:02,323 --> 01:10:04,365 and everything else in between. 1601 01:10:04,366 --> 01:10:08,995 So Dave's work is vital in overcoming that. 1602 01:10:08,996 --> 01:10:10,872 So I'm really excited about it. 1603 01:10:10,873 --> 01:10:13,626 (dramatic music) 1604 01:10:15,252 --> 01:10:16,544 - [Jennifer Isenhart] Why do you travel all over the world 1605 01:10:16,545 --> 01:10:18,088 to meet these people in person? 1606 01:10:19,423 --> 01:10:21,007 - I think there's just no substitute. 1607 01:10:21,008 --> 01:10:25,303 Like, really coming to meet people directly, 1608 01:10:25,304 --> 01:10:28,599 you get to know their story directly. 1609 01:10:29,683 --> 01:10:30,767 While we're here, 1610 01:10:30,768 --> 01:10:33,728 we'll actually be chatting with Dr. Jen Unwin. 1611 01:10:33,729 --> 01:10:34,562 Jen. 1612 01:10:34,563 --> 01:10:35,855 - Welcome. 1613 01:10:35,856 --> 01:10:36,689 - [Dave] How are you? 1614 01:10:36,690 --> 01:10:37,607 - Pretty good. 1615 01:10:37,608 --> 01:10:38,858 - I'm just so excited 1616 01:10:38,859 --> 01:10:40,985 to finally be discussing this with her. 1617 01:10:40,986 --> 01:10:44,864 And of course she has extraordinarily high levels of LDL. 1618 01:10:44,865 --> 01:10:47,533 You don't just have high cholesterol, 1619 01:10:47,534 --> 01:10:49,994 you have what I think many would consider 1620 01:10:49,995 --> 01:10:51,788 extremely high cholesterol. 1621 01:10:51,789 --> 01:10:52,664 - Mm-hmm. 1622 01:10:52,665 --> 01:10:54,207 - I myself was very surprised 1623 01:10:54,208 --> 01:10:58,878 that her levels were up there, at around 600. 1624 01:10:58,879 --> 01:11:02,215 And she's voluntarily having it at those levels 1625 01:11:02,216 --> 01:11:04,301 in order to work with her food addiction. 1626 01:11:05,427 --> 01:11:07,887 - I'm a carb addict. (laughs) 1627 01:11:07,888 --> 01:11:11,474 If I up my carbohydrate, I lose all balance with my diet 1628 01:11:11,475 --> 01:11:15,937 and I start overeating and then putting on weight. 1629 01:11:15,938 --> 01:11:17,730 - She's exactly the kind of person 1630 01:11:17,731 --> 01:11:20,733 who drives me to continue this research. 1631 01:11:20,734 --> 01:11:23,152 I'm sure many colleagues would say, 1632 01:11:23,153 --> 01:11:26,072 "Why not just go ahead and bring the carbs up a little bit 1633 01:11:26,073 --> 01:11:29,118 if that can bring the cholesterol down a lot more?" 1634 01:11:29,994 --> 01:11:31,703 Why wouldn't you consider that? 1635 01:11:31,704 --> 01:11:34,914 - What I've learned, like you, through self experimentation, 1636 01:11:34,915 --> 01:11:38,584 is that I'm better when I keep the carbs really low. 1637 01:11:38,585 --> 01:11:40,086 And I think that's why 1638 01:11:40,087 --> 01:11:42,213 my cholesterol's gone up over the years, 1639 01:11:42,214 --> 01:11:44,132 because there's a nice balance 1640 01:11:44,133 --> 01:11:48,261 between feeling well mentally, 1641 01:11:48,262 --> 01:11:50,096 not doing that sort of weight cycling. 1642 01:11:50,097 --> 01:11:54,892 It's just that sort of stability is so invaluable to me, 1643 01:11:54,893 --> 01:11:56,437 that mental stability. 1644 01:11:58,480 --> 01:12:00,983 I might not even swap that if you told me 1645 01:12:02,776 --> 01:12:05,528 that I'm going out earlier. 1646 01:12:05,529 --> 01:12:07,405 I might even keep that. 1647 01:12:07,406 --> 01:12:11,409 - Dr. Jen follows a nearly 100% animal-based diet 1648 01:12:11,410 --> 01:12:13,453 with fresh eggs from her own chickens 1649 01:12:13,454 --> 01:12:16,415 and grass-fed lamb from a pasture just down the road. 1650 01:12:17,499 --> 01:12:20,460 She's been eating this way for more than a decade. 1651 01:12:20,461 --> 01:12:23,130 You're eating a lot of these livestock, 1652 01:12:25,090 --> 01:12:27,300 predominantly meat-based diet. 1653 01:12:27,301 --> 01:12:28,134 - [Jen] Yeah. 1654 01:12:28,135 --> 01:12:30,054 - It's resulting in you having high cholesterol. 1655 01:12:30,971 --> 01:12:34,557 And this, as natural as it feels, 1656 01:12:34,558 --> 01:12:36,601 must therefore be killing you, right? 1657 01:12:36,602 --> 01:12:40,104 - (laughs) Yeah, no. 1658 01:12:40,105 --> 01:12:42,065 (Dave and Jen laughing) 1659 01:12:42,066 --> 01:12:42,899 No. 1660 01:12:42,900 --> 01:12:47,488 So, you know, I feel better physically and mentally at 59 1661 01:12:48,822 --> 01:12:52,617 than I did in my 20s when I was eating a high sugar, 1662 01:12:52,618 --> 01:12:55,244 high processed food diet. 1663 01:12:55,245 --> 01:12:56,704 - [Dave] Dr. Jen is not alone. 1664 01:12:56,705 --> 01:12:59,624 New research is bringing to light the benefits of Keto 1665 01:12:59,625 --> 01:13:02,251 for a variety of eating disorders. 1666 01:13:02,252 --> 01:13:05,171 (pan sizzling) 1667 01:13:05,172 --> 01:13:08,174 - Then there was kind of this constant, like, battle. 1668 01:13:08,175 --> 01:13:09,384 You know, I felt like I was standing 1669 01:13:09,385 --> 01:13:10,843 on the sidelines of my own life. 1670 01:13:10,844 --> 01:13:12,845 Like, I couldn't really participate, you know? 1671 01:13:12,846 --> 01:13:14,931 'Cause I always had, like, all these thoughts 1672 01:13:14,932 --> 01:13:16,099 running through my head. 1673 01:13:16,100 --> 01:13:17,892 - [Dave] Michelle Hurn was just 12 years old 1674 01:13:17,893 --> 01:13:20,478 when she was diagnosed with Anorexia nervosa, 1675 01:13:20,479 --> 01:13:23,022 a potentially deadly eating disorder. 1676 01:13:23,023 --> 01:13:26,192 She suffered from constant racing thoughts about food 1677 01:13:26,193 --> 01:13:27,944 but struggled to eat. 1678 01:13:27,945 --> 01:13:30,446 She became so thin her parents sent her 1679 01:13:30,447 --> 01:13:32,073 to an inpatient care facility 1680 01:13:32,074 --> 01:13:34,992 where the medical team put her on an IV feeding tube 1681 01:13:34,993 --> 01:13:38,204 and force-fed her foods that would help her gain weight. 1682 01:13:38,205 --> 01:13:40,373 - The number one ingredients of tube formulas 1683 01:13:40,374 --> 01:13:44,460 are maltodextrin, soy protein, corn syrup, canola oil, 1684 01:13:44,461 --> 01:13:47,547 these really highly inflammatory ingredients. 1685 01:13:47,548 --> 01:13:49,632 And so, you know, you're taking somebody 1686 01:13:49,633 --> 01:13:52,510 who, you know, clearly had starved themselves 1687 01:13:52,511 --> 01:13:55,888 for several months, super damaged GI, 1688 01:13:55,889 --> 01:13:59,392 and immediately dripping, you know, all of this sugar 1689 01:13:59,393 --> 01:14:01,269 and oil in their system 1690 01:14:01,270 --> 01:14:03,980 while having them eat the standard American diet. 1691 01:14:03,981 --> 01:14:05,273 You know, we were eating cereals, 1692 01:14:05,274 --> 01:14:07,400 and breads, and pastas, the food pyramid. 1693 01:14:07,401 --> 01:14:08,860 - The focus of treatment 1694 01:14:08,861 --> 01:14:10,653 always seems to be about the weight. 1695 01:14:10,654 --> 01:14:12,280 Eat your shakes. 1696 01:14:12,281 --> 01:14:14,031 Eat your chocolate shakes, and your chocolate cake, 1697 01:14:14,032 --> 01:14:15,700 and your cookies. 1698 01:14:15,701 --> 01:14:19,454 I mean, it's a real thing that people aren't able to leave 1699 01:14:19,455 --> 01:14:22,206 an inpatient treatment center until they eat their cookies. 1700 01:14:22,207 --> 01:14:23,916 - It didn't take long for, 1701 01:14:23,917 --> 01:14:26,335 I had all kinds of problems in the facility. 1702 01:14:26,336 --> 01:14:30,423 I had severe anxiety, you know, depressed. 1703 01:14:30,424 --> 01:14:32,091 I was, like, shaking. 1704 01:14:32,092 --> 01:14:34,802 I had massive GI issues, diarrhea, 1705 01:14:34,803 --> 01:14:37,763 then constipation, lots of pain. 1706 01:14:37,764 --> 01:14:39,015 And, you know, you're often told, 1707 01:14:39,016 --> 01:14:40,391 like, it's in your head, you know? 1708 01:14:40,392 --> 01:14:41,726 It's in your head. 1709 01:14:41,727 --> 01:14:46,355 (laughs) It was a very difficult time. 1710 01:14:46,356 --> 01:14:48,065 - [Dave] Michelle eventually gained enough weight 1711 01:14:48,066 --> 01:14:49,484 to check out at the care facility, 1712 01:14:49,485 --> 01:14:52,403 but she struggled with anxiety and nutrition 1713 01:14:52,404 --> 01:14:55,239 throughout adolescence and into adulthood, 1714 01:14:55,240 --> 01:14:57,950 even contemplating suicide for a time. 1715 01:14:57,951 --> 01:15:00,328 Then out of sheer desperation, 1716 01:15:00,329 --> 01:15:04,123 she tried a low carb, high animal protein diet. 1717 01:15:04,124 --> 01:15:05,500 In a matter of weeks, 1718 01:15:05,501 --> 01:15:08,794 her anxiety around food started clearing up. 1719 01:15:08,795 --> 01:15:10,546 - If you're thinking about eating disorders 1720 01:15:10,547 --> 01:15:13,633 as purely like a psychiatric illness, 1721 01:15:13,634 --> 01:15:15,343 like, you can't ask somebody 1722 01:15:15,344 --> 01:15:18,304 with a dysfunctional relationship with food 1723 01:15:18,305 --> 01:15:20,806 to eliminate a food group or give up a food group. 1724 01:15:20,807 --> 01:15:24,310 Like, that in theory, like, makes sense. 1725 01:15:24,311 --> 01:15:26,896 But what I want people to understand 1726 01:15:26,897 --> 01:15:28,272 and what I'd want more dieticians 1727 01:15:28,273 --> 01:15:30,399 and medical professionals to understand 1728 01:15:30,400 --> 01:15:33,611 is Anorexia is not just a psychiatric illness. 1729 01:15:33,612 --> 01:15:36,447 It has a metabolic component to it, you know? 1730 01:15:36,448 --> 01:15:39,534 And that's the one thing that we've missed. 1731 01:15:39,535 --> 01:15:42,078 I mean, Anorexia has the highest mortality rate 1732 01:15:42,079 --> 01:15:44,288 of any psychiatric disorder. 1733 01:15:44,289 --> 01:15:48,251 So if people can eat in a way, 1734 01:15:48,252 --> 01:15:49,877 you know, that provides their body 1735 01:15:49,878 --> 01:15:52,088 with all the nourishment they need, 1736 01:15:52,089 --> 01:15:54,674 and they feel calm, and they can participate in their life, 1737 01:15:54,675 --> 01:15:56,884 I would say that's not restrictive. 1738 01:15:56,885 --> 01:15:58,094 That's freedom. 1739 01:15:58,095 --> 01:16:00,805 - And I think a lot of food addicts would stay the same. 1740 01:16:00,806 --> 01:16:04,976 It's really priceless, that freedom from cravings 1741 01:16:04,977 --> 01:16:09,730 and compulsions to eat, which I've suffered. 1742 01:16:09,731 --> 01:16:11,440 - [Dave] Both Dr. Jen and Michelle 1743 01:16:11,441 --> 01:16:13,359 have dedicated their lives to helping others 1744 01:16:13,360 --> 01:16:14,860 with eating disorders, 1745 01:16:14,861 --> 01:16:16,988 Michelle as a registered dietician 1746 01:16:16,989 --> 01:16:18,656 who supports Ketogenic nutrition 1747 01:16:18,657 --> 01:16:20,491 for treatment of Anorexia 1748 01:16:20,492 --> 01:16:24,078 and Dr. Jen in her practice as a psychologist. 1749 01:16:24,079 --> 01:16:28,040 - I'm dedicated now to this work around food addiction, 1750 01:16:28,041 --> 01:16:29,584 educating people about that 1751 01:16:29,585 --> 01:16:33,129 so that they understand that it's a real condition, 1752 01:16:33,130 --> 01:16:35,840 and helping them to learn to manage it. 1753 01:16:35,841 --> 01:16:38,134 - But what about the cholesterol? 1754 01:16:38,135 --> 01:16:40,595 Both women are Hyper Responders. 1755 01:16:40,596 --> 01:16:44,724 Soon, Dr. Jen will visit her cardiologist to find out, 1756 01:16:44,725 --> 01:16:46,684 is she trading good health today 1757 01:16:46,685 --> 01:16:48,520 for a heart attack tomorrow? 1758 01:16:50,731 --> 01:16:53,483 (train rumbling) 1759 01:16:55,068 --> 01:16:56,902 I think one of the benefits of traveling 1760 01:16:56,903 --> 01:16:59,740 and showing that this is everywhere, 1761 01:17:00,616 --> 01:17:04,785 in all ethnicities, and in all ages, and all genders, 1762 01:17:04,786 --> 01:17:09,750 that it's a phenomenon that needs to get looked at. 1763 01:17:10,125 --> 01:17:12,376 I think when people can see that, 1764 01:17:12,377 --> 01:17:14,295 particularly when all kinds of people can see 1765 01:17:14,296 --> 01:17:16,213 all kinds of people are affected, 1766 01:17:16,214 --> 01:17:17,382 that makes a difference. 1767 01:17:19,801 --> 01:17:21,344 (texts whirring) 1768 01:17:21,345 --> 01:17:24,388 (dramatic music) 1769 01:17:24,389 --> 01:17:25,682 Okay, so you're recording? 1770 01:17:29,436 --> 01:17:32,147 This is absolutely gonna be one of the best days of my life. 1771 01:17:33,815 --> 01:17:35,608 There's been a big development. 1772 01:17:35,609 --> 01:17:38,319 Dr. Budoff's team is preparing our study for submission 1773 01:17:38,320 --> 01:17:40,446 to the American Heart Association. 1774 01:17:40,447 --> 01:17:42,907 The goal is to present a summary of our research 1775 01:17:42,908 --> 01:17:45,576 to the AHA's Scientific Sessions, 1776 01:17:45,577 --> 01:17:47,828 one of the most important cardiology conferences 1777 01:17:47,829 --> 01:17:49,205 in the world. 1778 01:17:49,206 --> 01:17:50,373 - Tomorrow, yeah. 1779 01:17:50,374 --> 01:17:51,290 - Tomorrow, wow. 1780 01:17:51,291 --> 01:17:53,042 Okay, so this is really it. 1781 01:17:53,043 --> 01:17:56,588 All the work, all of the push, this is the moment. 1782 01:17:58,256 --> 01:18:00,216 I wasn't just thinking it, I could feel it. 1783 01:18:00,217 --> 01:18:01,051 This is it. 1784 01:18:02,010 --> 01:18:04,720 This may be some of the most novel data 1785 01:18:04,721 --> 01:18:07,723 in the field of cardiology in decades. 1786 01:18:07,724 --> 01:18:11,519 Dr. Budoff has prepared a comparison between 80 participants 1787 01:18:11,520 --> 01:18:14,105 in our Lean Mass Hyper Responder Study 1788 01:18:14,106 --> 01:18:16,482 and 80 from the Miami Heart Study, 1789 01:18:16,483 --> 01:18:18,693 a separate study that includes many 1790 01:18:18,694 --> 01:18:20,403 who are also metabolically healthy 1791 01:18:20,404 --> 01:18:23,614 but have average levels of LDL cholesterol. 1792 01:18:23,615 --> 01:18:25,241 For the first time ever, 1793 01:18:25,242 --> 01:18:27,576 we'll see how the plaque levels in our group 1794 01:18:27,577 --> 01:18:31,455 compare to a healthy matched control group. 1795 01:18:31,456 --> 01:18:33,165 Are you excited about this data? 1796 01:18:33,166 --> 01:18:34,208 - Yeah, no, I'm very excited. 1797 01:18:34,209 --> 01:18:35,167 I'm looking forward to it. 1798 01:18:35,168 --> 01:18:37,878 I'm pretty confident that we'll be able to present it 1799 01:18:37,879 --> 01:18:39,338 as a late-breaking clinical trial. 1800 01:18:39,339 --> 01:18:41,257 Obviously, we have to wait to see 1801 01:18:41,258 --> 01:18:42,925 what the American Heart says about it, 1802 01:18:42,926 --> 01:18:46,011 but I think it's robust data, it's prospective, 1803 01:18:46,012 --> 01:18:47,138 it was blinded. 1804 01:18:47,139 --> 01:18:50,891 This is very exciting data and I think very powerful data. 1805 01:18:50,892 --> 01:18:52,810 - This is a pivotal moment. 1806 01:18:52,811 --> 01:18:54,854 Our data and this comparison 1807 01:18:54,855 --> 01:18:58,315 have the potential to influence the world of cardiology. 1808 01:18:58,316 --> 01:19:02,570 As much as I'd like to have been that protagonist 1809 01:19:02,571 --> 01:19:04,156 who knew he was right all along, 1810 01:19:06,324 --> 01:19:09,745 you don't know until it's right there staring back at you. 1811 01:19:13,081 --> 01:19:14,082 Okay, alright. 1812 01:19:14,916 --> 01:19:15,959 We've got a busy morning. 1813 01:19:20,881 --> 01:19:22,923 We've come to Philadelphia, Pennsylvania 1814 01:19:22,924 --> 01:19:26,260 for the American Heart Association's annual conference. 1815 01:19:26,261 --> 01:19:27,553 This is where cardiologists 1816 01:19:27,554 --> 01:19:29,346 and lipidologists from all over the world 1817 01:19:29,347 --> 01:19:31,432 come to learn the latest science, 1818 01:19:31,433 --> 01:19:35,561 except we've just learned our science won't be presented. 1819 01:19:35,562 --> 01:19:36,855 I'm just beside myself. 1820 01:19:38,148 --> 01:19:38,981 I couldn't sleep. 1821 01:19:38,982 --> 01:19:41,692 I couldn't get over 1822 01:19:41,693 --> 01:19:45,446 that this was happening. 1823 01:19:45,447 --> 01:19:47,948 The American Heart Association has a long history 1824 01:19:47,949 --> 01:19:50,743 of pushing back against low carb and Keto. 1825 01:19:50,744 --> 01:19:52,745 I suspected they might downplay our data, 1826 01:19:52,746 --> 01:19:56,415 but honestly I never expected this. 1827 01:19:56,416 --> 01:20:00,127 I can't think of a single better example 1828 01:20:00,128 --> 01:20:03,506 of what we're up against, frankly, 1829 01:20:03,507 --> 01:20:07,092 than the American Heart Association's Scientific Sessions 1830 01:20:07,093 --> 01:20:11,765 rejecting our abstract of 160 people. 1831 01:20:12,849 --> 01:20:16,852 Groups of 80 compared with CT angiography, 1832 01:20:16,853 --> 01:20:18,646 that gets rejected. 1833 01:20:18,647 --> 01:20:20,940 But they're accepting a case report abstract 1834 01:20:20,941 --> 01:20:25,946 on a single person who already had advanced heart disease, 1835 01:20:27,405 --> 01:20:29,615 then having a heart attack, 1836 01:20:29,616 --> 01:20:33,578 and emphasizing that it's a Lean Mass Hyper Responder. 1837 01:20:34,913 --> 01:20:37,623 Why not at least accept both? 1838 01:20:37,624 --> 01:20:39,875 I'm dumbfounded, honestly. 1839 01:20:39,876 --> 01:20:41,085 - Very disappointing, for sure. 1840 01:20:41,086 --> 01:20:43,963 I thought it would be accepted at American Heart. 1841 01:20:43,964 --> 01:20:46,382 But, you know, we'll never know for sure 1842 01:20:46,383 --> 01:20:48,468 what kept it from the meeting. 1843 01:20:49,970 --> 01:20:52,304 (rhythmic music) 1844 01:20:52,305 --> 01:20:53,222 Thank you very much. 1845 01:20:53,223 --> 01:20:55,724 It's certainly a pleasure to be here with everybody. 1846 01:20:55,725 --> 01:20:57,351 - [Dave] Fortunately, it didn't take long 1847 01:20:57,352 --> 01:20:59,019 before another cardiology conference 1848 01:20:59,020 --> 01:21:02,565 recognized the value of this new and exciting research. 1849 01:21:02,566 --> 01:21:04,692 - So we undertook this study 1850 01:21:04,693 --> 01:21:08,863 to look at this interesting population of patients 1851 01:21:08,864 --> 01:21:13,325 who go on a carbohydrate-restricted Ketogenic diet 1852 01:21:13,326 --> 01:21:18,163 and end up with very high LDL cholesterol. 1853 01:21:18,164 --> 01:21:19,832 The Lean Mass Hyper Responders 1854 01:21:19,833 --> 01:21:23,460 had an LDL of 272 milligrams per deciliter. 1855 01:21:23,461 --> 01:21:27,424 And when we compared them to patients with more normal LDLs, 1856 01:21:28,717 --> 01:21:31,385 mean LDL of 123, there was no difference 1857 01:21:31,386 --> 01:21:33,846 in coronary plaque burden. 1858 01:21:33,847 --> 01:21:35,431 - [Dave] It's incredible. 1859 01:21:35,432 --> 01:21:36,849 When you compare the two groups, 1860 01:21:36,850 --> 01:21:39,476 there is no statistically significant difference 1861 01:21:39,477 --> 01:21:41,103 in total plaque score. 1862 01:21:41,104 --> 01:21:44,398 In fact, ours are trending slightly better. 1863 01:21:44,399 --> 01:21:47,693 In spite of having sky high levels of LDL cholesterol, 1864 01:21:47,694 --> 01:21:49,278 the Lean Mass Hyper Responder group 1865 01:21:49,279 --> 01:21:52,489 has essentially the same low level of plaque. 1866 01:21:52,490 --> 01:21:54,325 - But I'll just conclude by saying 1867 01:21:54,326 --> 01:21:56,619 there is no correlation, in this study, 1868 01:21:56,620 --> 01:21:59,622 between LDL cholesterol and plaque burden. 1869 01:21:59,623 --> 01:22:02,458 So with that, I'll stop and thank you all very much. 1870 01:22:02,459 --> 01:22:04,668 (attendees applauding) 1871 01:22:04,669 --> 01:22:07,380 - That was fantastic. (laughs) 1872 01:22:11,760 --> 01:22:13,636 I don't know how much more I could've liked it. 1873 01:22:13,637 --> 01:22:16,931 And the response from the audience 1874 01:22:16,932 --> 01:22:19,058 was kind of what I was expecting. 1875 01:22:19,059 --> 01:22:20,976 - We are seeing these people in clinical practice 1876 01:22:20,977 --> 01:22:23,145 and it makes us feel very uncomfortable 1877 01:22:23,146 --> 01:22:24,104 when somebody walks in with this. 1878 01:22:24,105 --> 01:22:26,440 So would you recommend 1879 01:22:26,441 --> 01:22:28,233 that we're supposed to just ignore the LDL 1880 01:22:28,234 --> 01:22:29,568 and not treat them if they walk in? 1881 01:22:29,569 --> 01:22:30,819 - No, no. 1882 01:22:30,820 --> 01:22:33,238 So I would say get a calcium score. 1883 01:22:33,239 --> 01:22:36,075 If we have great data that a calcium score of zero 1884 01:22:36,076 --> 01:22:38,619 does not induce long-term risk, 1885 01:22:38,620 --> 01:22:40,412 I would say get a calcium score. 1886 01:22:40,413 --> 01:22:42,539 Going as fast as I can, George, I promise. 1887 01:22:42,540 --> 01:22:44,083 Huge amount of interest. 1888 01:22:44,084 --> 01:22:46,085 Rapid fire questions. 1889 01:22:46,086 --> 01:22:48,170 (Matthew sighing) 1890 01:22:48,171 --> 01:22:49,964 - They had to cut off the questions 1891 01:22:49,965 --> 01:22:51,131 because there were just so many. 1892 01:22:51,132 --> 01:22:54,051 - I think it was eyeopening for a lot of people. 1893 01:22:54,052 --> 01:22:54,886 - Yeah. 1894 01:22:55,762 --> 01:22:56,595 This is it. 1895 01:22:56,596 --> 01:22:59,139 I mean, we're across the dotted line now. 1896 01:22:59,140 --> 01:23:01,475 - Wow, what a revelation. 1897 01:23:01,476 --> 01:23:03,727 - Earth-shaking in the world of health. 1898 01:23:03,728 --> 01:23:05,437 - Will the findings of a new study 1899 01:23:05,438 --> 01:23:08,440 make us rethink everything we know about LDL cholesterol? 1900 01:23:08,441 --> 01:23:09,525 - The video I posted 1901 01:23:09,526 --> 01:23:11,402 is already up to a hundred thousand views. 1902 01:23:11,403 --> 01:23:14,822 I don't think I've ever had anything this viral. 1903 01:23:14,823 --> 01:23:17,950 - The data that I've been talking about is finally in. 1904 01:23:17,951 --> 01:23:20,744 - Even after four years, most of these people 1905 01:23:20,745 --> 01:23:23,956 do not have a progression of atherosclerosis. 1906 01:23:23,957 --> 01:23:26,083 - And that's also getting a little spicy. 1907 01:23:26,084 --> 01:23:27,960 A number of people are getting pushback too. 1908 01:23:27,961 --> 01:23:29,670 - A lot of people now are feeling that it's okay 1909 01:23:29,671 --> 01:23:32,381 to chug endless amounts of saturated fat 1910 01:23:32,382 --> 01:23:35,134 and increase your LDL to 500. 1911 01:23:35,135 --> 01:23:36,635 - So the research that Dave is doing 1912 01:23:36,636 --> 01:23:40,431 with Dr. Budoff and others is absolutely groundbreaking 1913 01:23:40,432 --> 01:23:43,392 because medicine has never looked at this in this way. 1914 01:23:43,393 --> 01:23:46,562 Whatever it shows, we need to know what is going on 1915 01:23:46,563 --> 01:23:49,148 in this particular patient population. 1916 01:23:49,149 --> 01:23:51,066 And then that will hopefully lead to more research, 1917 01:23:51,067 --> 01:23:53,861 and more experience, and more research, and more experience. 1918 01:23:53,862 --> 01:23:55,779 And that's how science progresses. 1919 01:23:55,780 --> 01:23:57,448 That's how medicine progresses. 1920 01:23:57,449 --> 01:23:58,991 - It's new territory, 1921 01:23:58,992 --> 01:24:03,204 but the territory I was aiming to get to. (chuckles) 1922 01:24:04,330 --> 01:24:05,622 (texts whirring) 1923 01:24:05,623 --> 01:24:09,501 (lighthearted music) 1924 01:24:09,502 --> 01:24:11,503 When it comes to risk factors for heart disease, 1925 01:24:11,504 --> 01:24:14,381 is it possible that we've been missing the forest 1926 01:24:14,382 --> 01:24:16,008 for the trees? 1927 01:24:16,009 --> 01:24:17,259 Is it possible 1928 01:24:17,260 --> 01:24:20,179 that we've been hyper-focused on LDL cholesterol 1929 01:24:20,180 --> 01:24:24,308 when the major culprit is chronically high insulin? 1930 01:24:24,309 --> 01:24:26,769 Our processed food culture provides an overabundance 1931 01:24:26,770 --> 01:24:28,896 of refined carbohydrates and sugar. 1932 01:24:28,897 --> 01:24:32,441 The blood sugar spikes caused by over-consuming these foods 1933 01:24:32,442 --> 01:24:35,235 wreaks havoc on our metabolism. 1934 01:24:35,236 --> 01:24:36,320 This causes our bodies 1935 01:24:36,321 --> 01:24:39,198 to release ever higher amounts of insulin. 1936 01:24:39,199 --> 01:24:40,365 Chronically high insulin 1937 01:24:40,366 --> 01:24:42,577 is a major risk factor for heart disease. 1938 01:24:43,578 --> 01:24:46,246 Take a look at this analysis of one of the largest 1939 01:24:46,247 --> 01:24:49,374 and longest health studies ever conducted. 1940 01:24:49,375 --> 01:24:50,793 The Women's Health Initiative 1941 01:24:50,794 --> 01:24:53,378 examined more than 160,000 women 1942 01:24:53,379 --> 01:24:56,590 over a period of more than 20 years. 1943 01:24:56,591 --> 01:24:58,175 This analysis found the condition 1944 01:24:58,176 --> 01:25:00,552 with the greatest risk factor for heart disease 1945 01:25:00,553 --> 01:25:02,055 is Type 2 diabetes. 1946 01:25:02,972 --> 01:25:05,307 People with Type 2 increase their risk 1947 01:25:05,308 --> 01:25:09,478 of developing heart disease by more than tenfold. 1948 01:25:09,479 --> 01:25:11,105 Those with metabolic syndrome, 1949 01:25:11,106 --> 01:25:13,482 which is a cluster of metabolic disorders, 1950 01:25:13,483 --> 01:25:16,568 have more than sixfold greater risk. 1951 01:25:16,569 --> 01:25:17,611 The biological marker 1952 01:25:17,612 --> 01:25:19,571 with the highest risk factor for heart disease 1953 01:25:19,572 --> 01:25:21,448 is insulin resistance. 1954 01:25:21,449 --> 01:25:23,534 Insulin resistance occurs in people 1955 01:25:23,535 --> 01:25:25,744 who have chronically high levels of insulin, 1956 01:25:25,745 --> 01:25:27,996 like in Type 2 diabetes. 1957 01:25:27,997 --> 01:25:30,040 No other marker even comes close. 1958 01:25:30,041 --> 01:25:33,127 By comparison, elevated LDL is associated 1959 01:25:33,128 --> 01:25:35,963 with a very small increased risk. 1960 01:25:35,964 --> 01:25:39,967 - Insulin resistance is responsible 1961 01:25:39,968 --> 01:25:42,761 not just for diabetes and heart disease 1962 01:25:42,762 --> 01:25:45,639 but all chronic diseases of the West. 1963 01:25:45,640 --> 01:25:48,058 And if you're not measuring insulin levels, 1964 01:25:48,059 --> 01:25:50,227 you're missing the boat. 1965 01:25:50,228 --> 01:25:52,563 - [Dave] Yet insulin is rarely tested, 1966 01:25:52,564 --> 01:25:54,523 even though insulin resistance 1967 01:25:54,524 --> 01:25:57,943 has the strongest association with the biggest killer. 1968 01:25:57,944 --> 01:25:59,653 What is routinely tested 1969 01:25:59,654 --> 01:26:02,197 in physician offices all around the world? 1970 01:26:02,198 --> 01:26:03,031 cholesterol. 1971 01:26:03,032 --> 01:26:05,784 - There've been lots of theories about why the focus on LDL, 1972 01:26:05,785 --> 01:26:09,163 and one is because we have a drug that we can give, 1973 01:26:09,164 --> 01:26:12,457 that is, you know, quote, unquote, easy to take, 1974 01:26:12,458 --> 01:26:15,085 easy to give, easy for the doctors, 1975 01:26:15,086 --> 01:26:17,629 as opposed to lifestyle changes, 1976 01:26:17,630 --> 01:26:19,756 which is what improves metabolic health, 1977 01:26:19,757 --> 01:26:22,092 which takes more time to talk about, 1978 01:26:22,093 --> 01:26:25,637 which is, for many people, harder than taking a pill. 1979 01:26:25,638 --> 01:26:27,514 I mean, that's really where the focus should be, 1980 01:26:27,515 --> 01:26:30,350 but unfortunately I think our modern day medicine 1981 01:26:30,351 --> 01:26:35,022 is not very good at addressing lifestyle interventions 1982 01:26:35,023 --> 01:26:37,192 as opposed to pharmaceutical interventions. 1983 01:26:40,195 --> 01:26:43,198 (keyboard clacking) 1984 01:26:44,407 --> 01:26:47,076 (pensive music) 1985 01:26:49,078 --> 01:26:51,121 - [Dave] The final data is finally here 1986 01:26:51,122 --> 01:26:53,165 and I'm driving to meet Dr. Budoff. 1987 01:26:53,166 --> 01:26:55,752 I've waited eight years for this moment. 1988 01:26:57,462 --> 01:26:59,922 Dr. Budoff is ready to show me a comparison 1989 01:26:59,923 --> 01:27:02,799 between the first and the final set of scans. 1990 01:27:02,800 --> 01:27:04,509 - Take a look. 1991 01:27:04,510 --> 01:27:07,304 - [Dave] It's hard to even describe how much effort it took 1992 01:27:07,305 --> 01:27:09,056 to get to this very moment. 1993 01:27:09,057 --> 01:27:11,809 (pensive music) 1994 01:27:13,478 --> 01:27:16,355 - (sighs) Alright, one more try. 1995 01:27:16,356 --> 01:27:21,360 - It's definitely been a roller coaster of seven, 1996 01:27:21,361 --> 01:27:23,487 however many years it's been. 1997 01:27:23,488 --> 01:27:26,365 He just keeps pushing through all of the ups and downs 1998 01:27:26,366 --> 01:27:27,824 and the days where he just feels 1999 01:27:27,825 --> 01:27:30,577 like he wants to just give it up 2000 01:27:30,578 --> 01:27:33,580 and move on to something else. 2001 01:27:33,581 --> 01:27:37,919 He always just looks towards the people that he's helping. 2002 01:27:40,546 --> 01:27:42,631 - [Matthew] All right, Dave, sorry. 2003 01:27:42,632 --> 01:27:43,465 - No worries. 2004 01:27:43,466 --> 01:27:45,134 - [Matthew] Promise, this should work. Alright. 2005 01:27:47,804 --> 01:27:49,721 - A lot of people can come up with a hypothesis, 2006 01:27:49,722 --> 01:27:52,266 but what he's done is he's followed it through. 2007 01:27:52,267 --> 01:27:54,142 For someone with no medical training, 2008 01:27:54,143 --> 01:27:56,478 no medical degrees, no research training, 2009 01:27:56,479 --> 01:27:59,106 to have partnered and built this amazing team 2010 01:27:59,107 --> 01:28:01,024 that contribute to the medical literature 2011 01:28:01,025 --> 01:28:03,819 is substantial, and really deserves notice, 2012 01:28:03,820 --> 01:28:04,945 and would be remarkable 2013 01:28:04,946 --> 01:28:07,281 for any, you know, seasoned researcher. 2014 01:28:07,282 --> 01:28:08,657 But he's an engineer. 2015 01:28:08,658 --> 01:28:11,536 He's completely on the outside and he's created all this. 2016 01:28:12,578 --> 01:28:13,412 - And we're in business. 2017 01:28:13,413 --> 01:28:15,248 All right, so here's the data. 2018 01:28:16,082 --> 01:28:18,250 So this is a sum of all of the vessels 2019 01:28:18,251 --> 01:28:20,252 and the severity of the plaque. 2020 01:28:20,253 --> 01:28:23,630 Overall, very, very excellent data, 2021 01:28:23,631 --> 01:28:26,508 with about 90% of patients showing no change 2022 01:28:26,509 --> 01:28:28,510 over the course of a full year. 2023 01:28:28,511 --> 01:28:29,345 - Wow. 2024 01:28:30,430 --> 01:28:33,307 The data is better than I ever expected. 2025 01:28:33,308 --> 01:28:38,145 90% of our participants show little to no change in plaque. 2026 01:28:38,146 --> 01:28:39,688 That means most people 2027 01:28:39,689 --> 01:28:43,317 who started with zero plaque a year ago stayed at zero. 2028 01:28:43,318 --> 01:28:46,236 - Vast majority, 90% plus, 2029 01:28:46,237 --> 01:28:48,697 are in that range of no progression, 2030 01:28:48,698 --> 01:28:51,075 which is a great place to be. 2031 01:28:51,993 --> 01:28:54,536 - [Dave] Overall, remarkable results. 2032 01:28:54,537 --> 01:28:56,330 But there are a few outliers. 2033 01:28:56,331 --> 01:28:59,791 Six people showed significant plaque progression. 2034 01:28:59,792 --> 01:29:02,294 But even then, the numbers don't line up 2035 01:29:02,295 --> 01:29:04,421 the way modern medicine would predict. 2036 01:29:04,422 --> 01:29:06,006 There is no correlation 2037 01:29:06,007 --> 01:29:07,674 between the levels of LDL cholesterol 2038 01:29:07,675 --> 01:29:09,634 and the progression of plaque. 2039 01:29:09,635 --> 01:29:12,804 In fact, some people with the highest LDL cholesterol 2040 01:29:12,805 --> 01:29:15,474 developed no plaque at all. 2041 01:29:15,475 --> 01:29:16,641 And take a look at this. 2042 01:29:16,642 --> 01:29:19,728 Six people actually show regression. 2043 01:29:19,729 --> 01:29:22,689 - [Matthew] We did see six people with regression. 2044 01:29:22,690 --> 01:29:25,359 So six people had less plaque. 2045 01:29:25,360 --> 01:29:26,818 - This is incredibly exciting. 2046 01:29:26,819 --> 01:29:30,989 Six people had less plaque at the end of one year. 2047 01:29:30,990 --> 01:29:34,785 At these levels of LDL cholesterol, that's unheard of. 2048 01:29:34,786 --> 01:29:38,121 For years, I've wondered if that's even possible. 2049 01:29:38,122 --> 01:29:39,664 - We wouldn't expect it. 2050 01:29:39,665 --> 01:29:41,541 And if we did, that would be a new learning 2051 01:29:41,542 --> 01:29:42,918 that we try to understand. 2052 01:29:42,919 --> 01:29:46,338 - If you saw regression with LDL levels 2053 01:29:46,339 --> 01:29:50,550 in the 2-300 range, that better be front page news 2054 01:29:50,551 --> 01:29:53,595 because that would be remarkable. 2055 01:29:53,596 --> 01:29:55,931 - [Dave] To independently confirm these findings, 2056 01:29:55,932 --> 01:29:58,266 we sent the same scans to an outside group 2057 01:29:58,267 --> 01:30:00,394 for a separate analysis. 2058 01:30:00,395 --> 01:30:03,438 Heartflow is one of the most thoroughly validated platforms 2059 01:30:03,439 --> 01:30:05,899 in cardiovascular research. 2060 01:30:05,900 --> 01:30:07,651 Their results broadly matched 2061 01:30:07,652 --> 01:30:11,738 Dr. Budoff's semi-quantitative and quantitative analysis. 2062 01:30:11,739 --> 01:30:15,034 The median change in plaque volume remains low. 2063 01:30:15,993 --> 01:30:17,494 And look at this. 2064 01:30:17,495 --> 01:30:21,207 Heartflow shows more than 30 participants with regression. 2065 01:30:22,208 --> 01:30:25,419 Plaque regression has been visually verified 2066 01:30:25,420 --> 01:30:27,629 by Dr. Budoff's team directly. 2067 01:30:27,630 --> 01:30:32,300 Multiple participants have less plaque in their second scan, 2068 01:30:32,301 --> 01:30:36,388 people like Mark, Craig, Kathleen, and Lyle. 2069 01:30:36,389 --> 01:30:39,474 In spite of high LDL cholesterol, 2070 01:30:39,475 --> 01:30:42,727 all four of you actually saw regression. 2071 01:30:42,728 --> 01:30:44,146 How did that make you feel? 2072 01:30:44,147 --> 01:30:46,648 - That was refreshing news. 2073 01:30:46,649 --> 01:30:48,859 - Thrilled of course, over the moon for myself. 2074 01:30:48,860 --> 01:30:49,734 - I was happy. 2075 01:30:49,735 --> 01:30:52,362 - I'm happy with it 'cause I love the Keto diet 2076 01:30:52,363 --> 01:30:53,572 and I wanna stay on it. 2077 01:30:53,573 --> 01:30:56,617 - Do you feel this study will affect clinical care? 2078 01:30:57,452 --> 01:30:58,285 - I do. 2079 01:30:58,286 --> 01:31:02,497 I think for those patients with a hyper response of LDL 2080 01:31:02,498 --> 01:31:04,249 in the setting of a Ketogenic diet, 2081 01:31:04,250 --> 01:31:07,043 I think that this should have a change in management. 2082 01:31:07,044 --> 01:31:09,838 I can't imagine even a cardiologist 2083 01:31:09,839 --> 01:31:12,382 who would say this is inappropriate 2084 01:31:12,383 --> 01:31:13,885 to let you be on this diet. 2085 01:31:14,927 --> 01:31:17,680 (dramatic music) 2086 01:31:19,599 --> 01:31:21,766 - This is something that should be interesting to everyone. 2087 01:31:21,767 --> 01:31:23,560 Even if that only applies to one patient, 2088 01:31:23,561 --> 01:31:24,811 you still have to ask the question, 2089 01:31:24,812 --> 01:31:26,397 well, what the heck is going on? 2090 01:31:29,775 --> 01:31:33,069 - Okay, Jen, so you had your CT scan. 2091 01:31:33,070 --> 01:31:35,780 - [Dave] For decades, doctors viewed LDL cholesterol 2092 01:31:35,781 --> 01:31:37,782 as the go-to marker for heart disease. 2093 01:31:37,783 --> 01:31:38,867 - And obviously this was done 2094 01:31:38,868 --> 01:31:42,996 because your cholesterol is massively high. 2095 01:31:42,997 --> 01:31:45,665 - [Dave] But today, cardiologist can now see 2096 01:31:45,666 --> 01:31:47,459 a much clearer picture of your risk 2097 01:31:47,460 --> 01:31:49,294 with high resolution heart scans. 2098 01:31:49,295 --> 01:31:50,462 - There's no calcium in there 2099 01:31:50,463 --> 01:31:52,339 and there's actually no plaque either. 2100 01:31:52,340 --> 01:31:53,590 You can see there's nothing. 2101 01:31:53,591 --> 01:31:54,841 - [Dave] Sure enough, 2102 01:31:54,842 --> 01:31:57,552 Dr. Jen Unwin has no detectable plaque. 2103 01:31:57,553 --> 01:31:59,846 - Two negative calcium scores five years apart 2104 01:31:59,847 --> 01:32:01,515 whilst continuing your current lifestyle, 2105 01:32:01,516 --> 01:32:05,894 with a cholesterol of 751 milligrams per deciliter, 2106 01:32:05,895 --> 01:32:08,104 and you've got no coronary artery disease. 2107 01:32:08,105 --> 01:32:09,397 So you don't need statins. 2108 01:32:09,398 --> 01:32:10,232 - Thanks very much. 2109 01:32:10,233 --> 01:32:11,066 - Alright. 2110 01:32:11,067 --> 01:32:11,900 - Yep. 2111 01:32:11,901 --> 01:32:13,693 - So it kind of flies in the face 2112 01:32:13,694 --> 01:32:15,654 of what you'd think should happen 2113 01:32:15,655 --> 01:32:18,073 and what the GP thought would happen. 2114 01:32:18,074 --> 01:32:19,449 - Well, and the fact that I've been doing this 2115 01:32:19,450 --> 01:32:22,035 for 10 years and there are still no symptoms, 2116 01:32:22,036 --> 01:32:23,454 and I'm an older person, 2117 01:32:24,705 --> 01:32:26,748 I guess I'd take that as reassuring. 2118 01:32:26,749 --> 01:32:30,418 (lighthearted music) 2119 01:32:30,419 --> 01:32:33,713 - All those vessels look really open and excellent, 2120 01:32:33,714 --> 01:32:35,924 lots of blood flow to all of your heart here. 2121 01:32:35,925 --> 01:32:36,758 - Right. 2122 01:32:36,759 --> 01:32:38,677 - [Dave] Despite what Nick is learning in medical school 2123 01:32:38,678 --> 01:32:41,638 about the consequences of high cholesterol, 2124 01:32:41,639 --> 01:32:43,306 his heart scan is clean. 2125 01:32:43,307 --> 01:32:47,602 - My LDL has been over 500 for years 2126 01:32:47,603 --> 01:32:50,064 and my coronary arteries are absolutely perfect. 2127 01:32:50,898 --> 01:32:52,148 - I definitely think Nick is gonna help 2128 01:32:52,149 --> 01:32:53,316 with shifting the paradigm 2129 01:32:53,317 --> 01:32:56,486 because he has extremely high levels of LDL. 2130 01:32:56,487 --> 01:32:57,862 He is getting scanned. 2131 01:32:57,863 --> 01:33:00,866 He's turning that around and putting it into the literature. 2132 01:33:01,701 --> 01:33:05,328 I think nothing quite hits home for people 2133 01:33:05,329 --> 01:33:09,207 like other people who are sharing their own experience 2134 01:33:09,208 --> 01:33:11,210 and especially their own data. 2135 01:33:14,380 --> 01:33:16,464 Johnny and his parents finally found a doctor 2136 01:33:16,465 --> 01:33:19,467 who supports Keto for the management of Type 1 diabetes. 2137 01:33:19,468 --> 01:33:22,929 - The Type 1 diabetics that manage their disease 2138 01:33:22,930 --> 01:33:26,182 with a low carb approach or a Ketogenic approach, 2139 01:33:26,183 --> 01:33:29,102 in general, I've seen faring significantly better 2140 01:33:29,103 --> 01:33:31,730 along every metric, every metric. 2141 01:33:31,731 --> 01:33:34,482 - [Dave] Dr. Bilal Mannan is also keeping a close eye 2142 01:33:34,483 --> 01:33:35,859 on Johnny's heart. 2143 01:33:35,860 --> 01:33:39,070 - We're just going through slices of his heart 2144 01:33:39,071 --> 01:33:42,907 and we see that it's all completely clean. 2145 01:33:42,908 --> 01:33:47,412 - I think it brings us a little bit of, you know, peace 2146 01:33:47,413 --> 01:33:51,124 with the situation, just knowing that his heart is okay 2147 01:33:51,125 --> 01:33:53,418 and we're just keeping an eye on it. 2148 01:33:53,419 --> 01:33:56,589 (lighthearted music) 2149 01:33:57,465 --> 01:34:01,968 - Okay, Robyn, so we're gonna review here your CAC. 2150 01:34:01,969 --> 01:34:03,178 - [Dave] Adding back carbohydrates 2151 01:34:03,179 --> 01:34:04,971 brought down Robyn's cholesterol, 2152 01:34:04,972 --> 01:34:07,807 but it also brought back her symptoms of Bipolar. 2153 01:34:07,808 --> 01:34:11,728 She's choosing instead to stay Keto and monitor her heart. 2154 01:34:11,729 --> 01:34:14,773 - And each of your arteries are completely clean. 2155 01:34:14,774 --> 01:34:18,401 There's no evidence of any calcified plaques there. 2156 01:34:18,402 --> 01:34:22,238 - It was a huge relief to get that back. 2157 01:34:22,239 --> 01:34:23,531 And it's a zero. 2158 01:34:23,532 --> 01:34:25,033 There's nothing going on in there. 2159 01:34:25,034 --> 01:34:27,160 - Nothing beats the physical detection 2160 01:34:27,161 --> 01:34:28,453 of the disease itself. 2161 01:34:28,454 --> 01:34:29,287 - No. 2162 01:34:29,288 --> 01:34:31,039 If there was a medicine that was found 2163 01:34:31,040 --> 01:34:33,792 that would've helped me with my Bipolar disorder, 2164 01:34:33,793 --> 01:34:36,211 I may not have ever gone down this path. 2165 01:34:36,212 --> 01:34:38,214 There wasn't one, and here I am. 2166 01:34:40,299 --> 01:34:42,676 (keyboard clacking) 2167 01:34:42,677 --> 01:34:44,719 - If the CAC had been zero, 2168 01:34:44,720 --> 01:34:48,765 I wouldn't feel a need to take lipid-lowering medicine. 2169 01:34:48,766 --> 01:34:50,475 But it wasn't zero. 2170 01:34:50,476 --> 01:34:52,352 - [Dave] Eric reversed suicidal depression 2171 01:34:52,353 --> 01:34:54,729 and metabolic syndrome with Keto, 2172 01:34:54,730 --> 01:34:56,773 but he fears that for many prior years, 2173 01:34:56,774 --> 01:34:59,234 his standard American diet caused damage. 2174 01:34:59,235 --> 01:35:03,113 Eric's coronary artery scan did show moderate calcification. 2175 01:35:03,114 --> 01:35:06,282 - And the doctors I talked to said take the medicine, 2176 01:35:06,283 --> 01:35:09,703 and if you tolerate it, it's hedging your bets. 2177 01:35:09,704 --> 01:35:11,746 You're doing everything you can with lifestyle, 2178 01:35:11,747 --> 01:35:15,959 but let's hedge your bets and lower your LDL a little bit. 2179 01:35:15,960 --> 01:35:19,754 And as long as it's asymptomatic lowering, no side effects, 2180 01:35:19,755 --> 01:35:21,923 I'm good with that. 2181 01:35:21,924 --> 01:35:23,466 - [Dave] Eric plans to remain Keto 2182 01:35:23,467 --> 01:35:25,427 for his mental and metabolic health 2183 01:35:25,428 --> 01:35:27,095 and take cholesterol-lowering medication 2184 01:35:27,096 --> 01:35:29,013 for the foreseeable future. 2185 01:35:29,014 --> 01:35:30,640 Many experts in the low carb community 2186 01:35:30,641 --> 01:35:32,183 agree with this approach. 2187 01:35:32,184 --> 01:35:34,978 - If they think they're a Lean Mass Hyper Responder 2188 01:35:34,979 --> 01:35:37,689 and they have a lot of plaque, you treat 'em. 2189 01:35:37,690 --> 01:35:39,190 - In a non-healthy environment, 2190 01:35:39,191 --> 01:35:41,943 I think people still need to be very cautious about LDL. 2191 01:35:41,944 --> 01:35:44,696 And for those patients who have metabolic disease, 2192 01:35:44,697 --> 01:35:46,114 coronary artery disease, 2193 01:35:46,115 --> 01:35:48,116 I still believe that lowering LDL 2194 01:35:48,117 --> 01:35:51,911 is very important in that context of heart disease 2195 01:35:51,912 --> 01:35:54,456 or a lack of metabolic health. 2196 01:35:54,457 --> 01:35:57,584 - Almost every doctor we've interviewed for this documentary 2197 01:35:57,585 --> 01:36:00,837 has a similar position to Doctors Agatston and Budoff 2198 01:36:00,838 --> 01:36:02,797 for this exact situation. 2199 01:36:02,798 --> 01:36:04,841 They say if you have high LDL cholesterol 2200 01:36:04,842 --> 01:36:08,136 and poor metabolic health or existing heart disease, 2201 01:36:08,137 --> 01:36:09,763 you may wanna consider taking steps 2202 01:36:09,764 --> 01:36:11,766 to lower your LDL cholesterol. 2203 01:36:12,641 --> 01:36:15,310 But they also agree metabolic disease itself 2204 01:36:15,311 --> 01:36:18,396 is a far greater risk to heart health. 2205 01:36:18,397 --> 01:36:20,482 There's just no comparison. 2206 01:36:20,483 --> 01:36:23,693 - We should look at a lot of different things as doctors. 2207 01:36:23,694 --> 01:36:27,906 But if you back out metabolic syndrome 2208 01:36:27,907 --> 01:36:31,743 and you look at just cholesterol in the absence of disease, 2209 01:36:31,744 --> 01:36:34,078 in the absence of family history, 2210 01:36:34,079 --> 01:36:37,040 it's like it almost doesn't matter. 2211 01:36:37,041 --> 01:36:38,666 - [Dave] And what about me? 2212 01:36:38,667 --> 01:36:40,543 Well, remember earlier when Dr. Budoff 2213 01:36:40,544 --> 01:36:41,961 showed this heart scan? 2214 01:36:41,962 --> 01:36:44,297 - This is the left anterior descending. 2215 01:36:44,298 --> 01:36:48,009 Nice, smooth, big pipe and no disease seen, 2216 01:36:48,010 --> 01:36:51,638 so this is a nice, clean study. 2217 01:36:51,639 --> 01:36:53,556 - [Dave] Yeah, that was me. 2218 01:36:53,557 --> 01:36:54,390 - It's very simple. 2219 01:36:54,391 --> 01:36:56,643 If you have a patient who is a Lean Mass Hyper Responder, 2220 01:36:56,644 --> 01:36:59,646 their LDL is very high, just get a calcium score. 2221 01:36:59,647 --> 01:37:02,106 If the score is zero, we have great evidence 2222 01:37:02,107 --> 01:37:04,025 that there's no short-term risk 2223 01:37:04,026 --> 01:37:06,069 to having high LDL cholesterol. 2224 01:37:06,070 --> 01:37:07,946 And you may be able to derive the benefits 2225 01:37:07,947 --> 01:37:10,073 of the Ketogenic diet 2226 01:37:10,074 --> 01:37:12,493 without the harms of the high cholesterol. 2227 01:37:15,579 --> 01:37:18,165 (gentle music) 2228 01:37:19,834 --> 01:37:21,627 - [Alison] Wow, isn't it beautiful? 2229 01:37:23,212 --> 01:37:27,465 We are at the office of Dr. Bernstein. 2230 01:37:27,466 --> 01:37:29,050 Okay, give a little knock. 2231 01:37:29,051 --> 01:37:31,177 We can't wait to meet him. 2232 01:37:31,178 --> 01:37:32,887 - One of you is Johnny. 2233 01:37:32,888 --> 01:37:34,514 - Yeah. - Are you Johnny? 2234 01:37:34,515 --> 01:37:39,018 - I wanna thank him for all of his teachings, 2235 01:37:39,019 --> 01:37:43,106 my son's health, and for getting us off the roller coaster 2236 01:37:43,107 --> 01:37:44,149 that we were on. 2237 01:37:45,526 --> 01:37:46,819 Thank you so much. 2238 01:37:47,903 --> 01:37:51,614 - I have to tell you why I feel such inspiration from him. 2239 01:37:51,615 --> 01:37:52,741 He was an engineer. 2240 01:37:54,660 --> 01:37:57,078 But the establishment wasn't listening to him 2241 01:37:57,079 --> 01:37:58,705 until he became a doctor. 2242 01:37:58,706 --> 01:38:00,456 So he was willing to go the extra mile 2243 01:38:00,457 --> 01:38:02,041 to bring this solution 2244 01:38:02,042 --> 01:38:05,128 to so many amazing folks like yourself. 2245 01:38:05,129 --> 01:38:08,047 - We're so incredibly honored to be here, 2246 01:38:08,048 --> 01:38:10,341 to be able to say thank you in person. 2247 01:38:10,342 --> 01:38:13,636 - And so I hope 2248 01:38:13,637 --> 01:38:16,140 that I can bring the other part of the solution. 2249 01:38:17,725 --> 01:38:21,060 - It takes somebody with completely fresh eyes, 2250 01:38:21,061 --> 01:38:23,438 but some scientific background, 2251 01:38:23,439 --> 01:38:26,107 in Dave's case, engineering, 2252 01:38:26,108 --> 01:38:28,569 that would take this, and run with it, 2253 01:38:29,403 --> 01:38:31,905 and not be influenced 2254 01:38:31,906 --> 01:38:35,533 by the more traditional medical community. 2255 01:38:35,534 --> 01:38:37,744 - I would compare him to Richard Bernstein 2256 01:38:37,745 --> 01:38:40,413 because he was an engineer who got into medicine, 2257 01:38:40,414 --> 01:38:41,497 had a new way of thinking, 2258 01:38:41,498 --> 01:38:44,293 to now running a major study, 2259 01:38:45,377 --> 01:38:48,797 and a very important study that would never have happened 2260 01:38:50,090 --> 01:38:51,800 if his cholesterol hadn't gone up. 2261 01:38:52,760 --> 01:38:53,593 - [Dave] For decades, 2262 01:38:53,594 --> 01:38:55,720 modern medicine has assumed high cholesterol 2263 01:38:55,721 --> 01:38:58,890 on a low carb diet is dangerous for everyone. 2264 01:38:58,891 --> 01:39:01,768 Today, new data is showing us that the story 2265 01:39:01,769 --> 01:39:04,437 is much more nuanced, offering new hope 2266 01:39:04,438 --> 01:39:07,357 to countless people who rely on Keto for their health. 2267 01:39:07,358 --> 01:39:10,402 - If they wanna do it, that's smarter than not doing it. 2268 01:39:11,779 --> 01:39:14,405 I recommend being healthier than not healthy. 2269 01:39:14,406 --> 01:39:18,409 - For me, it was the difference between having a life 2270 01:39:18,410 --> 01:39:19,661 and no quality of life, 2271 01:39:19,662 --> 01:39:22,538 from being able to pursue a career in medicine 2272 01:39:22,539 --> 01:39:24,499 and not being able to pursue a career in medicine. 2273 01:39:24,500 --> 01:39:27,835 - People need to understand what they eat 2274 01:39:27,836 --> 01:39:30,338 affects everything in their body. 2275 01:39:30,339 --> 01:39:33,925 - It's so hard in our current food environment 2276 01:39:33,926 --> 01:39:36,135 to stay on this low carb journey. 2277 01:39:36,136 --> 01:39:37,845 So we need to all support each other, 2278 01:39:37,846 --> 01:39:39,555 have the right information. 2279 01:39:39,556 --> 01:39:44,311 - I hope doctors won't tell their patients 2280 01:39:45,229 --> 01:39:48,231 who feel good for the first time in 20 years 2281 01:39:48,232 --> 01:39:49,774 that they need to stop doing Keto 2282 01:39:49,775 --> 01:39:52,151 because their LDL is 20 points higher. 2283 01:39:52,152 --> 01:39:53,445 That's insane. 2284 01:39:54,363 --> 01:39:57,490 - I've seen what a Ketogenic diet can do. 2285 01:39:57,491 --> 01:40:00,952 I want people to be given this as an option initially 2286 01:40:00,953 --> 01:40:04,497 because it's hard to be hopeless. 2287 01:40:04,498 --> 01:40:06,457 I want that message to get out there. 2288 01:40:06,458 --> 01:40:07,458 - Hi, everybody. 2289 01:40:07,459 --> 01:40:11,254 Welcome to (indistinct) success story. 2290 01:40:11,255 --> 01:40:12,755 - People are now coming out of the woodwork, 2291 01:40:12,756 --> 01:40:14,632 sharing their stories. 2292 01:40:14,633 --> 01:40:17,677 So, yeah, I think there's a paradigm shift happening, 2293 01:40:17,678 --> 01:40:18,845 but we're at the very beginning of it, 2294 01:40:18,846 --> 01:40:21,014 and I can't wait to see what happens next 2295 01:40:21,015 --> 01:40:24,225 because the way this can improve people's lives. 2296 01:40:24,226 --> 01:40:27,687 - Truth-seeking is not just science. 2297 01:40:27,688 --> 01:40:29,523 It's actually a part of human nature. 2298 01:40:30,441 --> 01:40:31,983 And I'm thankful for how many people 2299 01:40:31,984 --> 01:40:34,152 have put in their own elbow grease 2300 01:40:34,153 --> 01:40:36,946 to just help us get to the answer. 2301 01:40:36,947 --> 01:40:39,365 - Well, I'll take the side of science every time. 2302 01:40:39,366 --> 01:40:41,492 - That's where the data led you. 2303 01:40:41,493 --> 01:40:43,119 - That's the answer the data gave us 2304 01:40:43,120 --> 01:40:45,705 and that's the answer that I see in front of me. 2305 01:40:45,706 --> 01:40:47,206 And if we do another study 2306 01:40:47,207 --> 01:40:50,001 and, you know, can prove something different 2307 01:40:50,002 --> 01:40:51,294 or supplement that, 2308 01:40:51,295 --> 01:40:53,588 then then the message may change over time. 2309 01:40:53,589 --> 01:40:56,382 But that's gotta be led by the science and the outcomes, 2310 01:40:56,383 --> 01:40:57,759 not by our personal beliefs. 2311 01:40:57,760 --> 01:41:00,845 And I think a lot of times, even in medicine, 2312 01:41:00,846 --> 01:41:04,557 it's personal beliefs that rule the moment, 2313 01:41:04,558 --> 01:41:07,561 and that might just be the human flaw in all of this. 2314 01:41:08,937 --> 01:41:10,688 (punching bag thudding) 2315 01:41:10,689 --> 01:41:11,856 - [Dave] In the end, 2316 01:41:11,857 --> 01:41:14,108 no one can take ownership of your health like you can. 2317 01:41:14,109 --> 01:41:14,984 - [Supporter] You got this. 2318 01:41:14,985 --> 01:41:17,654 (gentle music) 2319 01:41:21,533 --> 01:41:25,120 For me, that meant digging deeper into the science. 2320 01:41:26,622 --> 01:41:29,624 And if there's anything I can now say from experience, 2321 01:41:29,625 --> 01:41:32,877 it's that the science is never settled. 2322 01:41:32,878 --> 01:41:37,883 (gentle music continues) (birds chirping) 2323 01:41:41,428 --> 01:41:45,015 (birds chirping continues) 2324 01:41:47,851 --> 01:41:50,604 (rhythmic music) 2325 01:41:56,527 --> 01:42:00,114 (rhythmic music continues) 2326 01:42:04,368 --> 01:42:07,955 (rhythmic music continues) 2327 01:42:12,501 --> 01:42:16,088 (rhythmic music continues) 2328 01:42:20,509 --> 01:42:24,096 (rhythmic music continues) 2329 01:42:28,517 --> 01:42:32,062 (rhythmic music continues) 2330 01:42:36,358 --> 01:42:39,945 (rhythmic music continues) 2331 01:42:43,490 --> 01:42:46,784 (rhythmic music continues) 2332 01:42:46,785 --> 01:42:49,872 (lighthearted music) 2333 01:42:54,459 --> 01:42:58,338 (lighthearted music continues) 2334 01:43:02,426 --> 01:43:06,346 (lighthearted music continues) 2335 01:43:10,475 --> 01:43:14,396 (lighthearted music continues) 2336 01:43:18,483 --> 01:43:22,404 (lighthearted music continues) 2337 01:43:26,408 --> 01:43:30,329 (lighthearted music continues) 2338 01:43:34,458 --> 01:43:38,378 (lighthearted music continues) 2339 01:43:42,424 --> 01:43:46,345 (lighthearted music continues) 2340 01:43:50,390 --> 01:43:54,311 (lighthearted music continues) 2341 01:43:58,398 --> 01:44:02,319 (lighthearted music continues) 2342 01:44:06,490 --> 01:44:10,993 (lighthearted music continues) 2343 01:44:10,994 --> 01:44:13,247 (no audio)