The BIGGEST LIES You've Been Told About Diet & Nutrition That Are Killing You! | Dr. Chris Palmer | Transcription

Note: This transcription is split and grouped by topics and subtopics. You can navigate through the Table of Contents on the left. It's interactive. All paragraphs are timed to the original video. Click on the time (e.g., 01:53) to jump to the specific portion of the video.

Introduction

Intro (00:00)

This woman in front of me, my patient, her life is decimated now. Her life is decimated now. She's in my office week after week sobbing, begging me for help, begging me to give her something that will make her pain go away. And I'm like, this diet might work. Like, I've given her dozens of pills already and they haven't done shit. If this diet might help her, why not try it? So that particular woman that I'm thinking of actually became hypomanic on the Atkins diet, meaning it took her from a super dark place to she was very excited, very happy. She was so she was a little too happy because I've read your book. I know where this is going and I've been meaning to ask you about that.

Exploring Mental Disorders And Metabolic Brain Disorders

AWFUL/MDT v Work for Some (00:51)

So just to give people markers, so you were struggling. And you were in a depressive state. You start coming out of it, but for other reasons when you get diagnosed with the metabolic disorder, it ends up even clearing that up even more. So you start trying it on yourself. You try it on other people and your family. You try it on patients. It's working for a lot of them. I don't know if it worked for everybody, but it works for a lot of them. We don't yet understand exactly what the mechanism of action is, but then since I know from reading the book that there are people, there are cells that are under firing and there are cells that are over firing. If it moves people from under firing into over firing, how do we know this is a good thing? Like, isn't becoming hypomanic a sign that we actually haven't solved the fundamental problem?

All Mental Disorders Are Metabolic Disorders of the Brain (01:44)

It is. So at the end of the day, I am arguing that all mental disorders, and we may need to get into defining what is a mental disorder, but I'm arguing all mental disorders are metabolic disorders of the brain. And as you just said, what that means, it can mean a lot of different things, depending on the developmental age of the person. So a fetus growing in utero is going to have different consequences than an adult who might have different consequences than a very elderly person who is 10 years from death. But for most adults, the two primary things are that metabolic compromise to brain cells can result in underactivity and overactivity. And actually, the exact same cell can do both. I have very sound scientific reason to believe that the same cell could be underactive 90% of the time and overactive 10% of the time. And that will result in different mental symptoms. But at the end of the day, it's really an issue of balance. I know that sounds like so eastern medicine of me, and I'm really kind of a western medicine kind of guy, but it really is about balance in the brain that neurons need to fire when they are supposed to fire and they need to abruptly and acutely stop firing when called to stop firing. And if they are sluggish in getting going, that is a problem. If they are sluggish in stopping, that is a problem. And so it's about attaining balance. And so anytime you introduce a treatment like a dietary intervention or an antidepressant or an antipsychotic or electroconvulsive therapy, anytime you introduce a treatment that plays a powerful role in metabolism, you run the risk of overshooting or undershooting. And if you overshoot or undershoot, you're going to get new symptoms. And the beauty of this theory is that at least for me, as a clinician and a scientist, it helps me not panic when I see that. If somebody starts getting hypomanic, I don't panic anymore. I have a very clear vision of what's happening. Overall, it's a good thing. It means that I'm delivering more energy to that person's brain, that their brain is not yet healthy enough to manage that energy appropriately. That's interesting.

The Science of Mitochondria (04:46)

So take me into the cell now. So we, for people that don't know what mitochondria are, I think it will be a very helpful primer. I've talked about it a fair amount on the show. Long time viewers listeners will have heard me refer to it as the powerhouse of the cell. But your book goes into detail much more than that. Why do people think it's a powerhouse and why do you think it's far more than that? So mitochondria being the powerhouses of the cell is based on the fact that mitochondria take most of the food. They're really the only utilizer of oxygen and human body. We need to breathe. We need to breathe in oxygen, breathe out carbon dioxide. That's mitochondria. Mitochondria are using that oxygen and churning out carbon dioxide at the end of the day. They are doing the processes that result in that. So this is really fundamental stuff to living organisms. It defines life itself in many ways. And there's no doubt mitochondria are powerhouses. They do those things. But the research over the last 20 years, primarily in the metabolic health field, but also in the aging field. So researchers who are trying to figure out what causes premature aging, how can we slow it or delay it. There's been an explosion of research on mitochondria and all of the functions they do. Some cancer researchers are highly focused on mitochondria. And then in the neuroscience and mental health fields, this dates back to at least the 1980s. In the 1980s, we had the first mitochondrial theory of autism. And in 2000, we got the mitochondrial theory of bipolar disorder. And since then, we've had mitochondrial theories of lots of chronic mental disorders. But it also applies to things like Alzheimer's disease and Parkinson's disease. So quick summary of what else do mitochondria do? They are primary regulators of neurotransmitter production and release, including key neurotransmitters like dopamine and serotonin and GABA and glutamate. They are primary regulators of steroid hormone production and release. So this includes cortisol, estrogen, testosterone, progesterone. They are primary regulators of inflammation. They play a direct role in turning it both on and off. They are primary regulators of epigenetics. In fact, one study found that they are responsible for the expression of at least 60% of the genes from the cell nucleus. Mitochondria? Mitochondria. So mitochondria are producing lots of the signals that play a role in the function of cells. So mitochondria are producing something called reactive oxygen species. Mitochondria are producing ATP. But they also play a role in how much ADP and AMP are in the cell. Those levels, the levels of ATP to ADP to AMP, play profound roles in cell function and cell health and gene expression. Mitochondria play a role in the levels of calcium in a cell. Talsium is important to turn cells both on and off. Also plays a role in gene expression. Mitochondria are the primary regulators of calcium levels in a cell. Yeah. So first of all, this is so radical. I'm getting too nerdy. This is incredible. We're actually going to keep going deep. But I had never heard anybody talk about mitochondria as being that multidimensional before. And I've really looked into this stuff. And so this is part of what freaked me out reading your book is you're very clear in the book. I'm not saying any of this stuff for the first time, but I'm the first one pulling it all together. And so I had never heard of mitochondria talked about is anything other than you've referred to it as a power cable. You usually hear about it called a battery, but I thought that was interesting. So they are the power cable. But you said that's actually not the most accurate way to think about them. If you're going to use an analogy, use the analogy of a motherboard in a computer. And that's when I was like, what? Like, I've just never heard that before. So once you begin understanding the like way back history is we at one point were a single cell organism that consumed the mitochondria inside of the cell. So when you think of mitochondria as like its own living thing with its own DNA, it is its own bacteria that's you've taken inside the body and you begin to understand are we really humans as we think about it? Or are we this fascinating collection of bacteria? And when you begin to understand that from your microbiome to the biome on your skin and your mouth and inside of your cells, you have all these different bacteria doing all this different stuff to have intelligence might not be the right word. But that's where you begin to realize, oh my god, it now I begin to understand how it could be possible that all these very disparate things, which don't feel like they could be connected with my lay person's brain anyway, just they felt too disparate that once I understood how much mitochondria is involved in that if you begin to break that machinery through diet, we're going to need to go into why that ends up breaking it. So I actually don't understand that part. But then it's like, okay, if this really is the motherboard and you do something that disrupts the motherboard, now you understand why it will sketch out your entire personality. And that blew me away. I did not realize even to the point where, and this I think is what you were just saying, that mitochondria themselves will produce hormones, but they also have receptors for hormones. So they're like communicating to each other with all of these mechanisms that I think I represent a lot of people in that I imagine it's still in that homonculoid way where there's like a guy in my brain and you know, my brain is like dictating all these functions. When in reality it's hyper-distributed, it's happening at the level of cell and they're communicating back and forth with these different messengers. Is that all accurate? The one thing I'm going to correct is that diet is the primary or only factor that can harm mitochondria. So the most important message that I want to make sure people don't come away with is that Chris Palmer is saying poor diet is the cause of all mental illness.

Moving away from a blanket statement (11:43)

How are you not saying that? This is so interesting. I'm not saying that at all. And at the same time I am saying diet plays a powerful role in mental illness. Diet plays a powerful role in mitochondrial health, but it is not the only thing that plays a role. The reason that is so critically important is because I can think of hundreds of examples in which people might develop a mental illness completely unrelated to diet. Somebody could be traumatized. Somebody could have a horrible traumatic abusive childhood. Somebody can have a hormonal imbalance. Somebody can smoke cigarettes. Somebody can do hallucinogens, lots of hallucinogens, and marijuana, and develop a psychotic disorder. None of those are diet related. People are consuming other things or other problems are occurring in their body, and they can develop chronic crippling mental disorders as a result. Women, hormones, postpartum, postpartum everything, postpartum depression, postpartum anxiety, postpartum psychosis, postpartum mania. Those are real things. It's not because women changed their diet. It's not because women started eating more carbs at the end of their pregnancy, and that or somebody gave them a box of chocolates, and they ate those chocolates, and that is what caused their postpartum psychosis. It's not that simple and we can't make it that simple. The reason this theory is so overwhelmingly exciting to me is because number one, if you understand the science of mitochondria, you can understand all of the symptoms of mental illness and all of the associations that we have known about for decades. You can begin to understand neurotransmitter imbalances, hormonal imbalances, gut microbiome issues, all sorts of things, underactive, overactive brain regions. By understanding mitochondria, you can understand the phenomenon of mental illness, but much, much more importantly, or equally importantly, I guess, it's equally importantly. When you look at all of the things that can adversely affect mitochondrial function, like the things I just mentioned, they're all well-established risk factors for mental illness. So what I'm saying in a nutshell is mitochondrial dysfunction ultimately is the cause of mental illness. If you ask the big picture question, well, what causes that? Diet is one of the things that can cause it, and I'm happy to go into the details and weeds on that if you want, but it's not the only thing that can cause it. Trauma can cause it. Alcohol use can cause it. Marijuana use can cause it. Poor sleep can cause it. High level of stress, hormonal imbalances, insulin resistance, all sorts of things that we know play a role in mental illness are known to directly impair mitochondrial function. And that can result in all of the metabolic and mental disorders that we know of. So if you can take any one of those risk factors, childhood trauma, people who have a lot of trauma in childhood are more likely to develop a mental disorder, which one, all of them, all of them. It's not just post-traumatic stress disorder, they're also more likely to develop depression, anxiety disorders, personality disorders, bipolar disorder, schizophrenia, alcoholism, opioid addiction, they're more likely to develop every mental disorder. Was that part of your first clue that they had to have some similar underlying cause?

Recognized that mental illness starts at the cellular level (15:59)

It wasn't the first clue. This was kind of like, as I dove deeper, you know, in order to create this theory, I had to dive really deep into cell biology and mitochondria and mitochondrial function and all of the cutting-edge research that's going on with them. But at the same time, I had to go out and see the forest from the trees and test my hypotheses, test my theory. I had to like make it work. And it, trust me, I didn't do it overnight. The first iteration did not make sense. The first iteration, I quickly found flaws in the way I was thinking about it. Flaws in the theory. But I kept going back to the, not to the drawing board, but I kept going back to refine it. Well, let me see if I can understand this in a different way. Let me see if I can add just one level of complexity to the theory to make everything fit. What was some of the first roadblocks that you ran into? You know, the biggest roadblock that I ran into initially was the fact that psychiatric medications, many of them, cause metabolic harm. We have lots of pills that we use that cause massive weight gain, but they work. Is that why it was a conundrum? They cause diabetes, they cause cardiovascular disease, and they reduce symptoms of mental illness. And when I recognize that, I quickly recognize, nobody's going to believe this. This theory is crap. It's dead. There's no way I can responsibly make this claim given that the pills we give are causing metabolic problems. That doesn't make sense because I'm not going to go down the rabbit hole of conspiracy theorists and say all the trials are fraudulent. None of the medicines actually work because as a clinician, I know that's not true. I've seen the medications work. I have used them and I have seen them work. And yet, as I'm developing this theory, I have to be able to explain, well, then why would a metabolic toxin or a mitochondrial toxin, which some of our medications are? Why would that reduce symptoms? That is what ultimately led me to refine and understand these two dichotomous states of metabolically compromised cells, both under active and over active. So one cell, when it's metabolically compromised, requires energy to work. And if it doesn't have enough energy, it's not going to work as well. That's the underactivity. Most people get that. If a car doesn't have enough energy, it's just not going to go as fast or it may not go at all. Or maybe parts of it won't work. Under active functions all make sense. The hyper-excitability, hyperactivity did not make sense initially. But as I began to understand all of the complex roles of mitochondria, the fact that they are sequestering calcium to turn the cell off. And that if they fail to do that in an efficient manner, that cell will become hyper-excitable. That was the thing that blew my mind, that really got to the heart of it. But again, so I didn't stop there. I then step back and say, "Let's see the forest from the trees." Test your theory, Chris. Test your theory. You should be able to test it with common sense already established observations. If that's really true, if that's really true, think of all of the situations you can think of in which mitochondrial function is abruptly impaired. And then ask yourself, are those situations associated with brain hyper-excitability? Meaning, does it increase your risk for a seizure? And lo and behold, it works. Oxygen deprivation can cause seizures. Carbon monoxide poisoning. Carbon monoxide poison, oxygen deprivation, are very specific assaults to mitochondria because mitochondria are the only things using oxygen. If somebody doesn't have enough oxygen, or if somebody gets carbon monoxide poisoning, all sorts of symptoms can emerge, including all sorts of mental symptoms. They can start hallucinating. They can get them paranoid. They can get depressed. They can have brain fog. They can have all sorts of things. But they can also seize, which is an unequivocal example of hyper-excitability. But then I went to mitochondrial toxins, arsenic, lead, cyanide. These well-known toxins are all targeting mitochondria. That is their mechanism of action. That is how they are toxins. The truth is hitting your career goals is not easy. You have to be willing to go the extra mile to stand out and do hard things better than anybody else. But there are 10 steps I want to take you through that will 100x your efficiency so you can crush your goals and get back more time into your day. You'll not only get control of your time, you'll learn how to use that momentum to take on your next big goal. To help you do this, I've created a list of the 10 most impactful things that any high achiever needs to dominate. And you can download it for free by clicking the link in today's description. Alright, my friend, back to today's episode. And if you look at the consequences of poisoning with those, seizures are a possible consequence. So once again, acute poisoning of mitochondria can result in hyper-excitability of the brain. I could go on and on and on. But needless to say, I didn't go into this lightly. So I did my best to test this theory in every which way I could with available evidence to see does it even fit? Like I'm presenting a picture. That's the way I think about a theory. So the way I think about developing a theory is that every research study is a piece of the puzzle. The puzzle has to create a picture, a coherent picture that makes sense. It has to. And the reason it has to is because humans exist. We exist and we have flaws and we have mental illness and we have mental health and we have all of it. The fact that it's working tells me there must be a coherent explanation and it's our job to figure it out. So in my mind, creating a theory is about taking all of the relevant research that we have, all the studies that are all pieces of the puzzle and just putting them together. But what I've had to do is rearrange some. I've had to take pieces of the puzzle from the obesity world and pieces of the puzzle from the metabolism world and pieces of the puzzle from the aging world and all of the pieces of the puzzle from the mental health world. And only then could I put it all together to create one coherent picture that actually allows us to make lots of predictions in the way that I just said. Well, oxygen deprivation can cause essentially every mental symptom and seizures. Why? Why is that? Carbon and oxide poisoning can do the same. Arsenic poisoning can do the same. Why? It's not serotonin. It's not carbohydrates. So why? And when you understand the science and you see the forest from the trees, you can then actually start to use simple interventions like low carbochiodines to help people heal from sometimes life-threatening devastating brain disorders and other health conditions. Okay, so you just made a leap that I couldn't follow. So we're looking at all of the different things that could cause somebody to seize up.

Why did you do these experiments in the first place (25:08)

That tells you we can throw it into a hyper excited state. So now you've solved for the I know I can be under and I know I can be over, so I need to find that balance in the middle. You look at all of the things that cause mental illness and all of them keep coming back to basically perturbations in oxygen and that points you to the mitochondria. So you're looking at all the different ways that this goes wrong and you're seeing at that point that the only thing that it could be is mitochondria. The thing that led me down this path is a serendipitous finding. So it was not only that I was noticing that the ketogenic diet or low carbohydrate diets could help people with depression and anxiety, but it was in 2016 when I had a patient with schizoaffective disorder who had been my patient for eight years, was tormented by his illness, had tried 17 different medications, they did not stop his symptoms. He had seen numerous other mental health professionals and basically our field said well he's just got a really bad illness and he's gonna live a second-class life essentially. We're really sorry, we don't know what to do.

Will getting your blood sugar perfectly regulated eradicate mood disorders (26:34)

He asked for my help to lose weight. I decided to try the ketogenic diet. At that point I have no no conception whatsoever that this is going to do anything for his illness because he's got schizoaffective disorder. That's very different than depression and anxiety, but it's a good weight loss tool. I'm gonna help the guy lose weight. He wants to lose some weight. I'll help him lose some weight. Within two weeks I'm noticing the powerful antidepressant effect. I'm thinking wow it's even happening for him and he's got a really bad illness. He's got this horrible debilitating schizophrenia bipolar thing. The thing that upended everything that really set me on this journey was about two months in. He spontaneously starts reporting his hallucinations are going away, his paranoid delusions are going away. He starts to realize that they aren't true and probably never had been true. This man has now lost 160 pounds and kept it off, so the weight loss thing goes well six years later, almost seven years later now. He, but he was able to do things he hadn't been able to do since stem dysagnosis. He was able to go out in public and not be paranoid, perform improv in front of a live audience, move out of his father's home. It was that story that began in 2016 that completely shattered everything I knew as a psychiatrist and actually forced me back to your initial question. Why? What was the mechanism of action? Initially I was like who cares? It works. It's not my job to figure it out, whatever. Nobody's going to take this seriously. I need to stay on the down low with this anyway. I'm a Harvard physician. I cannot be talking about the Atkins diet for mental health. Nobody's going to take that seriously. They're probably going to take away my license. They'll fire me from my job. I don't need any of that in my life and I'm just going to shut up about this. I'm going to lay low. When I saw it put essentially schizophrenia into remission, at that point I knew I can't stay quiet about this. This is two important millions, millions of people's lives are devastated. I can't shut up about this. I cannot keep this quiet. At the same time I knew but I have to have science. Nobody's going to believe me. I already can hear them laughing. I have to figure out how and why would this work? I went on this journey. The godsend for me was that the ketogenic diet is actually an evidence-based treatment for epilepsy. It can stop seizures even when meds don't. We use epilepsy treatments in psychiatry all the time. I'm like, "Oh, that's a nice gift. I've got all these decades of neuroscience that I'd never known about. Nobody had ever told me the ketogenic diet stop seizures. I had trained in psychiatry and neurology. Nobody ever told me that." But I quickly figured it out. Then I went on this deep dive to understand the neuroscience of that. But at the same time, I'm trying to also piece it together with, "Wait, this doesn't make sense because it made my metabolic syndrome go away. How did that work? What does that have to do with mental illness?" It helps hundreds of thousands if not millions of people lose weight. What does weight loss have to do with mental illness?

Why do you advocate for the Ketotarian Diet in certain cases of bipolar (30:33)

It helps people with type 2 diabetes put their type 2 diabetes in remission off medications. What does that have to do with mental illness? Quickly, I realized I have a lot more work to do. I have to understand how the hell does this keto diet work for obesity and diabetes and epilepsy and all these other things. How can I pair that together with the science of the mental health field? Initially, the cursory review leads you to neurotransmitters and inflammation and hormones and other things. That's just all the vague, non-specific garbage we've been spewing out for decades that gets us nowhere. I realized, "No, those are insufficient explanations because they don't deliver actionable new treatments that actually restore people's health or lives. I need to go deeper than neurotransmitters. What is causing the neurotransmitter imbalances? Why do those neurotransmitter balances change? Why do they change from day to day, from hour to hour? Because people who have hallucinations aren't hallucinating every day 24/7. They're hallucinating some of the time, not all of the time. How can I understand this? All of that led me to mitochondria and then the more I unraveled and learned about mitochondria, the more I was like, "Oh my God, this is connecting not just the dots of why would the keto diet help my patients, but this is connecting the whole cricket mental health field. I'm like, this is impossible. What is the mechanism of action though? I can round it to it regulates. It turns off and it's supposed to turn off and it turns on when it's supposed to turn on, but why? I think the easiest answer I can give you to the big picture question that you're asking is like, what exactly is happening? Why are different people having different symptoms? The first thing I want to say is if this sounds like too much of a leap for people, I just want to point out type two diabetes is supposed to be one in one distinct illness.

Type 2 affects the nations (33:00)

Some people with type two diabetes get by just fine with diet and exercise and otherwise don't have any unreal otherwise related health conditions. Other people at the extreme end with type two diabetes not only have their type two diabetes for which they take massive doses of insulin to try to control their still uncontrolled blood sugars, but they're also having heart attacks, brain problems, eye problems, nerve problems, gastrointestinal problems, liver problems, kidney problems, and all sorts of problems. We know all of those things are related to type two diabetes. So why does one person have all of those things? And the other person seemingly has a very mild illness. It's a metabolic problem. There are lots of factors that go into it. Some people with a metabolic problem can have very mild symptoms that are localized in specific ways. Other people can have wild out of control metabolic dysfunction. This wreaking havoc on their entire body. So that is just fact today, at least the way most people think about type two diabetes. It's a metabolic disorder and it can have widespread consequences on the whole human body, including the brain. So when I think about metabolic dysfunction in the brain, what I'm really thinking of is specific brain cells or brain circuits that either have insufficient mitochondria or the mitochondria that are there are somehow defective. And for people with chronic mental disorders, it is one of those two things. Insufficient mitochondria and or defective mitochondria that are not performing their tasks. And what that means is that those brain cells or that those brain circuits are then going to become underactive or overactive, which can then result in symptoms that we call mental illness. The environment, however, plays a role. So you have these cells that are vulnerable. That's the way I think about them. These are vulnerable cells. They're not dead. They're still alive. They're still trying to do what they can do. But they're malfunctioning intermittently. So what would make them malfunction more? And what would allow them to function normally? The beauty of this theory, again, is let's just look at all the risk factors for symptom exacerbations of mental illness. If a person is eating a good diet, well-rested, non-stressed symptoms are going to be low or absent because the demands on those cells aren't great and or there are lots of available resources because this person is not stressed. As soon as you apply a metabolic stress to this human being, in the form of, I'll give three, but there are lots of others, sleep deprivation, really crappy diet and or high levels of stress or trauma, as soon as you do that, those are all assaults on metabolism broadly, not just the brain. So if somebody already had a heart attack last year, they are at higher risk of having another heart attack when they are sleep deprived, when they experience high levels of stress or trauma, or when their diet is way off. But likewise, people with mental disorders who have metabolic brain dysfunction, same deal. So with the heart attack, it's hearts of the heart or the arteries that feed the heart that are going to start to quote unquote malfunction or possibly the immune system cells that are going to, you know, and the coagulation cells that are going to coagulate something is going wrong under those stressful situations and the same deal in the brain that when the brain, when the, when the human being is stressed in these obvious known predictable ways, it causes a stress response, essentially. And a stress response means that metabolic resources, energy, food, oxygen are actually going to the defense system of the human organism. And that means less metabolic resources are available to all of the other cells in the body. Most of the cells get by okay because we have reserve capacity. We have health, we have metabolic health, if you have resilience, they're going to be okay. But if you have some brain cells or brain circuits like the anxiety cells in your brain when you had an anxiety disorder, those cells are vulnerable. Under good times, they're going to function fine. And that means you're not going to have symptoms of anxiety. But if somebody stresses you, your anxiety is going to go through the roof in a disproportional way. Like, so, you know, this is where the stigma of mental illness comes from. Because then people think, well, you know, that was a pretty mild stressor. Why are you freaking out? Why are you hyperventilating over that stupid stressor? And that's where the stigma comes from. Because all the normal people are saying, well, I can manage that. The teacher gave us an assignment. Yeah, it's a little stressful, but big deal. But you're hyperventilating and having a panic attack over it. Like, God, get a little grip, take some deep breaths. Yeah, there's a meme on the internet that is brutal. And it was, there was a student in class, the teacher called on him. And after 30 seconds, he said, I'm not dumb. I'm just panicking. And I was like, whoa, yeah, that is, that's rough. That to your point about the stigma, mental illness, that it, one, it seems to be ratcheting up now that more and more, that that meme is a meme because so many people can relate to a small stressor causing them to panic. And so there's a lot of things that can cause these problems. You name three, I think those three are pretty profound. So you've got poor sleep, poor diet, trauma, and stress trauma. When you work with people, because the book really focuses on the diet, does the diet have a disproportionate soothing impact? And if it does, I have a guess why. But is that true? That the diet is just the thing that disproportionately sort of brings that the tax on the metabolic system down. The diet, you know, I think a lot of people, I really did not mean to focus in the book.

Does keto have more of an effect? (40:39)

Really interesting. I really did not. But a lot of people reading the book will come away with the ketogenic diet is the new thing I read about them. Because they already know the other stuff. They already know, don't, you know, get good sleep. Yeah, we already knew that. Avoid trauma and stress. Yeah, we already knew that. Um, uh, don't use drugs and alcohol, uh, hormonal imbalances. Yeah, yeah. Um, everybody knew that. I spent so much time in the book going through all of those known things. Because again, this is a new theory. I had to show that all of our existing knowledge fits into it. Everything that we already know to be true fits into it. But to answer your question, why that does the diet play a special role in any of this? I would argue that the ketogenic diet or fasting states or fasting mimicking states in particular play a profound role in healing. And the reason is not because carbohydrates are the villain. The reason is because fasting is the saving treatment. Now because of its impact on mitochondria. So one thing we haven't talked about is, um, mitophagy. So for people that know, uh, top of G where the cells are programmed cell death. So the cell didn't die accidentally. We see that it's deformed or it's not performing the way that it should. There's enough stress on the body that we go in, we break it apart and we shuttle those off. Fasting or fasting mimicking diets, as I understand it trigger my top of G where the mitochondria that are malfunctioning, those are broken apart to make way for new mitochondria. And that, if I understand it again, that the liver, which is actually making the key, the liver mitochondria, which is making the ketones has to up ramp to keep up with the demand to make the ketones. And so now you're up regulating the production of your mitochondria. So you have basically put a, a hormetic stress on the body through fasting or fasting mimicking that says, Hey, hey, we have to go anything that's malfunctioning. It's got to be taken apart. And we have to also generate more mitochondria, new mitochondria. And this might be where we start to get into the more holistic view of what you're talking about.

Dave the perfect lifestyle for building a healthy brain. (43:10)

Because you talk about exercise in the book, talk about sleep, sun exposure. What is that perfect milieu to use a fancy word? What does that perfect lifestyle look like? What is up, my friend, Tom bill you here. And I have a big question to ask you, how would you rate your level of personal discipline on a scale of one to 10? If your answer is anything less than a 10, I've got something cool for you. And let me tell you right now, discipline by its very nature means compelling yourself to do difficult things that are stressful, boring, which is what kills most people, or possibly scary or even painful. Now, here is the thing, achieving huge goals and stretching to reach your potential requires you to do those challenging, stressful things, and to stick with them even when it gets boring, and it will get boring, building your levels of personal discipline is not easy. But let me tell you, it pays off. In fact, I will tell you, you're never going to achieve anything meaningful unless you develop discipline. All right, I've just released a class from impact theory university called how to build ironclad discipline that teaches you the process of building yourself up in this area so that you can push yourself to do the hard things that greatness is going to require of you. Right, click the link on the screen, register for this class right now, and let's get to work. I will see you inside this workshop from impact theory university. Until then, my friends, be legendary. It's all the common sense things that people know with the exception of a fasting mimicking diet. So, you know, again, the medical field right now says that's dangerous and reckless and Jillian Michaels doesn't like it. So lots of people hate the ketogenic diet. Lots of people in society here that it's dangerous and toxic. But all of the other things that milieu is all the common sense things that people already know. And one of the pieces of feedback that I've been getting since the book came out from people is, I'm already doing all of that, Dr. Palmer. And I went on your keto diet and I'm not cured. So what's the deal? And when I talk to them, I say, "Okay, do you smoke cigarettes or vape?" Well, yeah. Do you drink alcohol? Well, yeah. Do you take benzos or anti-psychotic medications that impair your metabolism? Well, yeah, but my doctor prescribes them. How's your sleep? Oh, well, I can't sleep. That's the problem. It's not that I'm not trying to sleep. I'm trying to sleep, but I'm not sleeping because I can't sleep. So I take more pills, but they don't always work. And then I say, "So you really think you're doing my treatment when all of these basic common sense milieu, common sense lifestyle strategies that I've already outlined in the book and why they are all harmful and why they are going to prevent you from recovering. You're not doing any of them because you, because what? You thought the keto diet was going to be the cure all? In the context of you poisoning your brain and liver with massive doses of alcohol, in the context of you smoking and vaping nonstop throughout the day, in the context of you not sleeping, you just thought the keto diet was going to just poof, like magically fix everything, like what planet are you living on? And you clearly didn't read or comprehend the book. And so it's unfortunate because I know people are desperate and people want quick fixes and people want simple answers. They want, but just the one thing, Dr. Palmer, tell me the one thing that I need to do to cure my schizophrenia. And the point I have tried so hard to make in the book, you can get better. You can get rid of your schizophrenia. I really authentically believe that. You can get rid of your depression. You can get rid of your anxiety. You really can. I'm not lying. I'm not making it up. I have seen it countless times. I know it works. I know it can work. But if you're looking for a one size fits all simple solution, just do the keto diet for three months and that'll fix you up. It's not that simple. Does that mean I'm saying it's super complicated and impossible? No, you can think about your sleep. You can think about removing all the toxins that you're putting into your body. You can think about stress reduction practices. You can think about, you know, all of those things, maybe spending some time outside or spending some time with human beings instead of always on your screen. You can think about these other things. It's not going to be news. You're going to have heard it a million times. But if you're not doing it, you're not doing the treatment. Yeah. Everybody does want the very simple answer. There's no doubt. And the good thing about your theory though is at least it draws a connection between all of this.

Can you reverse autism or prevent it? (48:19)

There's only one thing that you have to address. It's just you have to address it in a dozen different ways. Talk to me about autism. This is one of the more interesting sort of side comments that I've heard you make. And my real question is, can you reverse autism or is it just avoidable from somebody getting it? Because you said, depending on when you encounter the metabolic distress that warps your mitochondria, it will have pretty profoundly different effects. So if you have disturbed mitochondria as a kid or in utro, that's going to play out in your brain development. When autism first people started saying like, "Oh, diet can impact it." It was like, man, people coming after you with billy clubs, even for bringing it up. So I'm not sure where the current state of the art is, like how crazy a question that is. But is this something that can go into remission? Or is it just, here's how you avoid somebody getting it in the first place? Yeah, it's a really important question. And I've had some critics come out with that particular example. Because again, they're taking away the simple message. Dr. Palmer is saying that poor diet is causing all mental illness. And that's why I kind of inserted, no, that's not what I'm saying. And autism is the perfect example of this. So autism is a neurodevelopmental disorder that occurs either in utro or early in life. Some children infants appear to be perfectly neurotypical early in life for like the first year or two. They get an infection, for instance, and within three months of that serious infection start showing signs of autism spectrum disorder. So, and we have clear ways to understand all of that. So a lot of people are going to say, well, what does this have to do with metabolism or mitochondria? So the first thing I want to point out is I am not at all the first to be claiming that metabolism and mitochondria play a direct role in the cause of autism spectrum disorders. The first mitochondrial theory of autism dates back to 1985. So this is, I do not at all, try to claim credit for the other pioneering researchers have done this. Researchers have looked at the brains of people with autism spectrum disorders and have noticed all sorts of metabolic and mitochondrial problems, low levels of ATP and brain cells, higher levels of brain inflammation, higher levels of reactive oxygen species, other things. So all of those point to weight, this is a metabolic or a mitochondrial problem. For those who don't know, rates of autism have skyrocketed in the last 40 years. Over the last 20 years, rates have tripled. Whoa, 20 years tripled the rate of autism. A lot of people are like, well, that can't possibly be true. Well, the researchers who are studying it and the people who are doing the household surveys are saying it's true. So either keep your head in the sand and be in denial about it or open your eyes to this is happening. One of the global kind of observations that I just want to make that we haven't overtly stated is that we have a skyrocketing mental health crisis in the world. How do we know this isn't just an increase in diagnosis and it's always been this way and we're just now diagnosing it more? I think the primary source of information would be looking at the household surveys where researchers funded primarily by the United States government go door to door to a random sample of households throughout the United States, ask the people who answer the door, a series of long list of questions about mental health conditions and make estimates of how many people are suffering from different mental disorders. The rates are increasing. They're particularly increasing in the young population. A much harder, kind of variable that is indisputable is the rate of death from mental illness, which we probably, the most comprehensive figure that we have is something called the deaths of despair, which includes suicides, but also overdoses on drugs and alcohol. That rate has doubled over the last 20 years in the population. That's really brutal. The rate has doubled. People aren't faking their deaths. They're not whining and complaining. So there's a lot of skepticism about mental health because there's no objective tests and everybody thinks, oh, everybody thinks they've got autism these days. Everybody's just complaining about being autistic because they want sympathy. Well, guess what, folks? The rates are really skyrocketing and we can't keep our heads in the sand. So how can we understand that in the context of the brain energy theory? If the brain energy theory is really true, how can we understand that? And what I would say is I will share a couple of observations, but the most important ones. Women who are giving, who are pregnant, if they are obese and also have poorly controlled diabetes, such as gestational diabetes, they have a three to fourfold increased risk of having an autistic child. If you are a man with obesity, compared to a man who is a healthy weight, the obese man has doubled the risk of having an autistic child. So people are asking this question, where the hell is all this autism coming from? That's impossible. Autism is supposed to be genetic. Well, look at statistics like that. Look at some common sense observations. Is obesity increasing in our population right now? Are the rates of diabetes increasing in our population right now? Does this apply to childbearing women? Does this apply to men who are about to become fathers? So to get very clear in concrete with my theory, so people who are overweight or diabetic are more likely to have autistic children, why? Why? What I'm arguing is that people who are overweight or diabetic have a mitochondrial problem. They have a metabolic problem somewhere in their brain or body. That is what is causing their obesity, and that is what is causing their diabetes, or their insulin resistance, that obesity and diabetes are symptoms. Obesity and diabetes are not causes. They are symptoms. They are symptoms of metabolic derangement somewhere in the body or brain. And that means that these people already have a mitochondrial problem somewhere in their body or brain. That mitochondrial problem is getting transferred to their gametes. Those gametes are going on to create a child. That child is at higher risk. Again, this is not absolute. It's not double the risk. It's not the majority of overwhelming majority of children born to obese women are not autistic, but it increases the risk because you're increasing the risk of transmitting a mitochondrial problem or a metabolic problem or an epigenetic metabolic problem to that child, and that then results in a problem. The other strong possibility, so that's gametes, and maybe some epigenetic signals, but the other strong possibility in particular with the women, because the women are not only contributing an egg, the women are growing this child. And that means that the women's hormones play a role in the growth and development and neuro development of this child. That means a woman's stress levels play a role. That means a woman's diet is playing a role. Levels of glucose and her bloodstream are getting into that fetus.

Fat, Calories, And Their Impact On Disorders

Can we fix autism? (57:36)

That is affecting that fetus's development. To go back to your other question, so can we fix autism? Autism is a neurodevelopmental disorder. What that means is that the primary symptom of autism, there are really two buckets of symptoms. One bucket is social skills impairment or social skills differences. That people who are autistic relate to other humans in a different way. They might have trouble interpreting nonverbal social cues, for instance. The other bucket is that by definition, they have to have some kind of OCD symptoms as well. So if we focus on the social skills, social skills are hardwired into the human brain. We are all hardwired to develop appropriate social skills. As parents, we are hardwired to transmit this information to children. Children are hardwired to get this information, store this information, and utilize it effectively. Meaning, I have to get mom and dad to do what I need them to do to take care of my needs and make sure I don't die. Meaning, when the child is old enough to start going out to school or to playground, I have to figure out how to navigate all of these other human children and get along with them, or at least not be bullied and teased by them, or navigate conflict. If they've got a ball and I want the ball, how do I manage that situation? Those are being acquired over time. You come out of the womb and you've got those skills. You don't actually have those skills at all. So a metabolic assault at any point in the timeline of the acquisition of those skills could impair the acquisition of those social skills and result in what we call an autism spectrum disorder. How does that relate to mitochondria and metabolism? Mitochondria are critical to neurodevelopment. They are critical to the differentiation of cells, and they are critical to something called neuroplasticity, so the branching of neurons to create new connections and synapses with others. They are critical to those processes. So if a fetus or a young child has impairment in mitochondrial function, those areas of the brain that are supposed to be acquiring social skills may be impaired, and that may result in them not getting them. The challenge with reversing that or correcting that is that if I take an extreme case, give me a 30-year-old person who is autistic now, can I change their autism? Can I make it go away? Can I somehow help them acquire social skills that are neurotypical? My strongest guess is no. And the reason I say no is because neurodevelopment has windows of opportunity. They're called neurodevelopmental windows. The window opens, and then parts of the brain grow and thrive and branch out and connect and do all sorts of things, and then the window closes. You don't get to go back and redo it. So my strong guess is that social skills actually do undergo neurodevelopmental windows and that humans need to acquire these skills in the right ways at the right times. Now the caveat to that is it does not say that neuroplasticity is impossible. So neuroplasticity is could we get the brain to somehow form those connections that are missing? Could we get that to happen? It's conceivable to me, but it probably will not be a simple intervention. It won't be going keto for three months and that'll fix you up. That's not going to do it. The ketogenic diet might even play a role. We've had studies of the ketogenic diet for autism. They can correct some of the cognitive problems. They can certainly correct the seizures that often accompany autism. They can also correct some of the mood disorder symptoms that can accompany autism. So they can have a powerful treatment role for quality of life and ability to function, but for the most part, most of the studies have not found any improvement in social skills, which is the reason I say what I just said, which is I think the developmental window closed and it wasn't enough. The interventions that I think could work are if we prime the brain for mitochondrial biogenesis and mitophagy, so we're going to try to get rid of old defective mitochondria and we're going to try to increase the number of mitochondria in brain cells. If we do an intervention like the ketogenic diet, but maybe some supplements, maybe even mitochondrial transplantation that's happening nowadays, that means there's all sorts of possible interventions that I could conceive. How do you give somebody a mitochondrial infusion on a transplant? How? That researchers are working on it. There's an IV drip and they're primarily focused on people with very rare mitochondrial disorders. The challenge with mitochondrial transplantations, you have to get the mitochondria in the right cells in the right way. Exactly. So most people have heard of stem cell transplants? Yep. Stem cells are one of the primary donators of mitochondria to metabolically impaired cells. Interesting. Everybody thinks stem cells are all about, "Oh, you get a brand new cell and it'll just replace the bad defective cell." Stem cells are actually going around connecting, creating these little nanotubes with other cells, metabolically compromised cells, and transferring healthy mitochondria into these defective cells. That is one of the primary roles of stem cells. So it could be stem cell transplantation to spread some healthy mitochondria around, so there are ways to do it. So back to autism. If I do this intervention, I'm priming the human brain, the human body for neuroplasticity. Let's rev up mitochondrial biogenesis. Let's rev up my toffee. I would much rather use it, do it using natural methods like a diet or exercise or something else as opposed to injecting stem cells in one location. The reason is because the body is really good at healing itself. We just need to give it a chance. It knows what to do. If we inject stem cells into a specific part of the brain, maybe those stem cells are needed there, but maybe they're needed somewhere else that we don't even know about. Also, if you don't fix a problem, it's just going to revert back. If we do this neuroplasticity priming treatment, at the exact same time, we have to deliver the training for social skills. This human being would need intensive immersion on how to interact in a neurotypical way. Social skills are both about biology and brain circuits, but also about the acquisition of those skills. Somebody has to teach that human being. Those skills. We know this from Romanian orphans. Romanian orphans were probably born relatively healthy for the most part, but they were left in cribs, never picked up, never touched by other humans. Many of them had horrible, horrible neuropsychiatric outcomes as a result. All sorts of neurological problems, all sorts of mental disorders as well, including autism, dramatically high rates of autism. I don't think about that as, well, they had a mitochondrial problem from mom and dad, or maybe those parents who gave their kids up for adoption were all overweight or diabetic. That's not the way I'm thinking about it. The parents gave the child up for adoption. That child probably had a chance at a normal life and normal neurodevelopment, but because they were so neglected and so maltreated and not given the ability to learn how to be human, they did not acquire it. I think that's it though, because that feels like it would be the world's most stressful environment. Going back to your earlier statement, it's not just going to be diet. There's going to be a whole host of things. I've heard you talk about this before, the orphans at some point start banging their heads against their crib just to feel something. No one's touching them. That is an unimaginable amount of stress, especially since I know about the whole idea of failure to thrive, where if you don't touch and cuddle and love and infinite, may just die. Lisa Feldman Barrett said something to me, which I thought was utterly fascinating. We have a nature that requires nurture, because she was like, "You have to stop trying to tease these two things apart.

We have a nature that requires nurture (01:08:02)

Like they're just inextricably connected." And hearing about the Romanian orphans, that was the first thing that came to mind, which is the amount of dysfunction you're going to get when you have biology that's screaming out for interaction that, "Hey, I am programmed to learn through this interaction. Touch, love, affection, cues, close up, your face, my face. I do this. You respond in this way." And cool. Now my brain wires in. I've got it. I've figured all this out. And if you don't have that, it is just trauma. There's no doubt about that. Trauma is a huge part of it and stress is a huge part of it. When an infant is screaming at the top of his or her lungs, it is highly stressful when they are not picked up. It is highly stressful to that infant. Stressful that day I was trying to do more on an airplane. So there's no question that those children have massive trauma, massive stress responses, and probably malnourishment and all sorts of other things that we're playing a role in their neurodevelopment. We do have research though. Some people hate this research, especially animal rights people, but there is research on monkeys that supports what I've said. That researchers took groups of monkeys, fed them normally, but deprived them of maternal love and support and all sorts of problems in the world. That is a very interesting part of our biology, the way that we're so interconnected, and how far down the mammalian train that goes. I want to talk about obesity. So I imagine that some of the pushback that you get, especially when it comes to autism, is, "Hey parents, you're increasing the likelihood of your child being autistic just by being obese." But I also heard you say that there was recently an obesity conference where the brightest minds in the field of obesity were like, "We don't actually know what causes obesity." And I thought you were going to be like, "That's laughable." But you were like, "Actually, yeah, we don't." "Ah, how is that possible?" So here's my overly simplistic prior to reading your book, "Take on all of this obesity anyway." Obesity is largely driven by what you're doing to your microbiome based on what you eat. Certainly sleep because of all its massive impacts on metabolism, light exposure, and then diet. And if you said, "Tom, I need you to mess somebody up and make them obese," but you can either affect their sleep, affect their sun exposure, affect their stress, or affect their diet. I'll take diet every time, and I'm going to fuck them up. Oh my God, so predictably. And I would say I will do exactly one thing. I'm going to get them to eat ultra processed food that's high in sugar. And if you let me do that, and if you won't let me ultra process the food, then I'm just going to go with things that are high in sugar. And I will win every time. I will be able to metabolically dysregulate them and to a very distressing degree. Because of that, I feel like we know what causes obesity. So let me push back a little bit just to ask for clarification, because this is such a contentious issue. So ultra processed food, high in sugar, how exactly in your mind does that cause obesity? I'm the latest of laypeople ever, but I love to spout off. So I'm going to give my answer to you. So the reason that I'm going to highly process things is I need to damage the molecules that your cells are going to be made of. So the easiest one is trans fats. Not the only, there's going to be a whole host of things, but that's the one I understand the best. So you take a fat molecule, which is normally nice and flexible and squishy, through frying it basically, you make it rigid and stiff, but your cells are still going to uptake that fat. So now you're making your cells brittle. You talked earlier about, hey, we have these metabolically damaged cells, and I'm just going to call them vulnerable. So I'll say the same thing is happening. When you're ingesting these highly processed foods, you literally are what you eat.

calories in + calories out is the correct model for metabolism. (01:12:46)

Your cells are made up of the things that you intake. So one is that I'm now changing the structure of the molecules that are going to make up your cells and not in a way that the body is used to dealing with. And so brittle cell membranes is one example of I'm sure a whole host of things. Then what you eat is going to be largely impacted by what you absorb. What you absorb is going to be largely based on your microbiome. And by the way, the just level of inflammation that I can get by breaking the epithelial lining of your gut, which is only a cell thick. So all I have to do is get bacteria in there that's going to claw that away, break those junctions. Now I can actually get partially digested food into your bloodstream, get your body to attack itself with an autoimmune response. All hell is going to break loose. Also by getting the sugar into your bloodstream, I'm obviously raising your glucose. I'm spiking the shit out of your insulin. And now I'm just assaulting your body and your glucose levels, sugar molecules stick to things in your blood. So now I'm creating all of the metabolic disaster that is having a gummy system. I know I'm giving this in like the least scientific description possible. You're doing great. So now I'm fucking up your arteries. I'm creating a inflammatory response in your body. I'm from the elevated glucose levels, from the things crossing the barrier in your gut. And in all of that, I'm also making your cells insulin resistant. So they're trying desperately to pull the sugar out of your bloodstream because the difference between a normal person and a diabetic is a quarter teaspoon of sugar in your blood. So while the sugar is very useful, like you said in the beginning, it's all a balance. If you have too little sugar, you're going to have seizures and you're dead. If you have too much sugar, you basically burn alive from the inside. So can't have either of those. You need to have everything in the sweet spot. But now I'm making your fat cells essential, any cell that's going to use glucose. I'm making it insulin resistant. So insulin is trying to get the sugar into those cells. But the cells like fuck off. Like there's just too much. So now it's staying in my bloodstream. All the things that people know about a type 2 diabetic where they're losing their eyesight because the sugar is basically burning the eye to pieces, losing their limbs. You get neuropathy of the nerve endings that can even feel the fact that they're effectively getting the corrosus of their limbs and they end up having to be cut off. So while I get that I'm not giving that from a scientific standpoint, it's you can demolish the body pretty fast just by spiking glucose now because I know that the calorie in calorie out people are in the comments right now just lighting me on fire. I will say that yes, if you have somebody reduce their calories enough, even if they're eating sugar, they won't manifest all of the symptoms as quickly. But I still think they're going to be metabolically dysregulated. I am going to guess, and this is a guess, that I could still especially somebody developing. I can fuck up their brain even by reducing their calories. So they're not getting fat, but I can completely disrupt their the appropriate functioning of the brain by just inundating them with trash when they're a kid, even if I'm keeping their calorie count low. I don't think that obesity is the only sign that something is going wrong. I think that obesity is probably adaptive in that your body is just like, fine, fuck, like I'll pull this all out of the bloodstream. I will cram it into your fat cells. And so getting obese, you might be better off getting obese. It might actually delay some of the symptoms of a bad diet. So that is why I feel like it is way complicated.

Fat incorporates in your brain. It gives you fatigue, develops ADD and ADHD. (01:16:50)

I understand that. And I am grossly oversimplifying. But because if I want to mess you up, I really only need the lever of your diet. At some point to me, it's like I get in the purest of pure ways. We don't understand maybe that all the mechanisms of action, but at a blunt force trauma, like if you just let me just give me control of sugar, and I will completely ruin somebody, or get them healthy or there's so many micro things that we would also need to take care of. I get I can't completely solve all the problems. Man, if you let me control sugar, I'm going to go a long way. And if you let me control processed and sugar, I've got you covered, I think. I don't disagree at all with anything you said, anything you just said. I also don't disagree with the solution. Get rid of sugar, get rid of ultra process. I actually think in the way that you describe like these toxic fat molecules can be incorporated into your cell membrane. I think the real money is to focus on mitochondria. And I know people will call me a mitochondria, or they will call me crazy, or they will think I'm obsessed with the real answer, or they'll think I'm delusional, or whatever. The reason is because mitochondria actually control the regulation of blood glucose. It's so crazy. Hearing you talk about it, mitochondria basically does everything. Yeah, when I was developing this theory, I actually felt that way. And when I started looking at what are different things that can poison the human body quickly, and what is their mechanism of action? What is their precise mechanism of action? Yeah, I listed them before. Arsenic, cyanide, others, Tylenol poisoning. What exactly is happening? All of those poisons target mitochondria. Tylenol targets mitochondria? Tylenol targets mitochondria. Alcohol targets mitochondria. Alcohol poisoning is due to mitochondrial disruption in impairment. And so when somebody dies of alcohol poisoning, the cause of death is poisoning the mitochondria. Is it because they can no longer process oxygen? What? So at the end of the day, initially I was like, too, I was like, this can't be. Am I just seeing mitochondria everywhere I look? Maybe I'm going crazy?

Fat that causes cardiovascular disease and kidney disease. (01:19:45)

What is going on here? When you take a step back, when you look at the big picture of life, cells in the human body are all there to perform a function, but they all need nutrients. They need nutrients to replace the parts that need to be replaced and/or create energy in the form of ATP. Without nutrients, you're dead. I'll define oxygen as a nutrient as well. Oxygen is part of the process of making energy. And essentially at the end of the day, what I'm saying is that in order to understand why cells in the human brain or body malfunction, we have to go all the way to the basics of biology, which is every living cell at the end of the day depends on metabolism or energy. And it's the only way to connect the dots. But like obesity researchers have zeroed in on mitochondria in specific brain circuits that control appetite and feeding behaviors. And they've looked at what causes those neurons to turn on or off. It's mitochondria. When they look at the cells in the pancreas that release insulin, what causes the cell to actually release the insulin? What is the critical signal? That causes insulin to get released, mitochondria. Mitochondria are actually sensing the amounts of glucose, creating reactive oxygen species and response. And that sets off a cascade that results in the release of insulin. And then mitochondria respond as the glucose levels come down. Stop, you know, either make more ROS or less ROS or whatever they're doing. And that then results in the pancreas not releasing insulin. And so on one hand, it's enormously complex. To say it's mitochondria, some researchers are going to be like, well, duh, big deal. So what? But on the other hand, it is a major leap in the mental health and metabolic health field. Because guess what we could do? Number one, we can look at a lot of our treatments that are causing mitochondria toxicity. And we can start using those very sparingly and try to get people off those and try to allow people to heal and recover. That's a huge thing that I'm actively doing with lots of patients. So I think we need an abrupt wake up call in the mental health field because I do think we are doing harm to people long term. But even in the food supply, there's so much debate. What's causing the obesity epidemic? Oh, everybody's just overeating delicious foods. It's the calories. It's the calories. They're eating more calories. That's what it is. There was a huge study that just did an assessment of the entire food supply in the United States from the 1970s to the present. And they actually calculated how many calories are in this entire food supply divided by the number of people in the population. And the researchers concluded the calorie consumption of the United States population has not significantly changed. Really? Over the last 30 years, the calorie consumption has not significantly changed. Calories of our food supply is being largely stable. And obesity rates have skyrocketed. Shocked by that. What that means is that the metabolic rate of the human population is going down. And what does that mean? What do I mean when I say the metabolic rate? I mean the mitochondria and the human species is being poisoned.

Fat that builds up in your body. (01:24:29)

What are the likely culprits? Ultra processed foods. High amounts of sugar and other artificial ingredients. But we need to look at environmental toxins, the microplastics, and all of the environmental toxins, the forever chemicals that are accumulating in our fat cells and our brain cells. Those might be poisoning mitochondria. Lots of small pilot studies have strongly suggested they are. And if we're poisoning the mitochondria, it means that the metabolic rate is going down. So yes, calories in, calories out, energy balance. Yeah, sure, if you're into physics and that means anything to you, sure, that still applies. But what I'm arguing is that the obesity epidemic is likely because the metabolic rate of the human species is being poisoned. That's really, really interesting. I want to push on that. So earlier we talked about that a cell could be either underactive or overactive. So why isn't that that metabolism can go either way? Either as it gets poisoned, it dials up or as it gets poisoned, it dials down. Why is it only getting dialed down? Or am I missing something and then some people, it really is going up. So the going up and going down is not metabolic rate overall. So what I'm saying, what I'm arguing for the brain cells is that if you have, let's say you only have 60% of the healthy mitochondria needed for a brain cell to function properly. 60%. So that cell, if we do a neuroimaging study on it, will have something that we call glucose hypometabolism, meaning that it is not producing enough ATP from glucose, the primary energy source. Why? Because it doesn't have enough healthy mitochondria. And that could either be because the total number of mitochondria is decreased and/or the number of healthy functional mitochondria has decreased. That cell will have insufficient ATP, low metabolic rate, lower metabolic rate. It doesn't have enough ATP. As a consequence of not having enough ATP, it can become underactive, which again is intuitive to most people. But at the same time, that 60% ATP cell can become hyper-excitable. You can think about it as this frail, vulnerable cell that's spasming, if that helps, if that analogy helps. So it's like the elderly person who has really weak muscles and those muscles begin to spasm. That is hyper-excitability. The muscle is not strong. The hyper-excitability doesn't mean too much metabolism. It actually is still too little metabolism, but it results in erratic activity of the cell. And once you understand that it's mitochondria, then you have to ask that big picture question, "What the hell is going on then?"

Challenging Weight Loss And Dietary Myths

It is impossible to lose weight by reducing calorie intake or increasing activity. (01:27:55)

Why do we have skyrocketing rates of all these diagnoses? The easiest soundbite answer is because we are somehow poisoning mitochondria and human species. Where could the poisoning be occurring to result in obesity? It could actually be occurring in several places. Two easy answers are the brain because the brain, brain circuits control eating behaviors. Brain circuits tell you when you are full. Brain circuits tell you when you are hungry. If those brain circuits have impaired mitochondrial function, it means that those brain circuits aren't going to function normally. If they're not functioning normally, it means that person is going to feel hungry when they should otherwise not be feeling hungry because it's just not working right. It's underactive. And could it become overactive or could other circuits become overactive? Absolutely. And that might help us understand something like binge eating disorder. The other thing that some of these brain circuits do is change metabolic rate in response to eating. So when you, you know, we all over eat at some point or another. We all over eat at Thanksgiving. And usually our metabolism burns off that excess. We actually might feel hot or we might get more fidgety or we might want to just go out and take a walk or something to feel better. Or we have a suppression of appetite and we wake up the next day and we still feel full or stuffed and we just eat a smaller meal and it all balances out. My wife will actually sweat through the sheets if she overeats. I just get fatter, which really that's interesting. So that's interesting. So she's got, she's got a system that's going to stimulate her mitochondria to produce heat that, that sense you've got too many calories going around, get rid of them. We don't literally be able to wring out her shirt. We don't want to store it as fat. Let's burn it off. Just burn it. Because mitochondria produce heat in the human body. That is where heat is produced. And but the other location that we could have a problem for obesity is in the fat cells themselves. So fat, you know, there are three kind of buckets of fat cells that a lot of people have heard of.

Different types of fat in the body (01:30:33)

There's white fat, which is bad, bad white fat. There's brown fat, great, good, good brown fat. Brown fat is good for you. Because it's kicking off heat, it has more mitochondria. That's what makes it brown, right? And then there's beige fat. And the only difference between those types of fat is the number of mitochondria in the cell. Brown fat has a higher density of healthy mitochondria. White fat has a very low density of mitochondria. And what I fear might be happening is that some of these environmental toxins that I mentioned are lipophilic, meaning they tend to go to places where there's a lot of fat in the human body and stay there. That means two locations primarily fat cells and the brain. Unfortunately. So if the mitochondria and fat cells are being poisoned, it means that they are going to have a harder time sensing signals to release that fat and then actually releasing the fat. Because the mitochondria actually are involved in the process of releasing the fat from the fat cell. So that fat cell is going to become dysfunctional or underactive in particular in its capacity to release. It may still be able to receive nutrients and store them. But when called for it may just be a little sluggish and releasing. And that may then stimulate hunger that then drives the person because it may stimulate lower blood sugars or something else. And then that may stimulate the person to go and eat. But at the end of the day, what you said is correct. We had this obesity conference. World renowned obesity experts. Many of them have their strong opinions. Someone below Carver's work. It's carbohydrates. Carbohydrates are causing the obesity epidemic.

Dietary arguments the government (01:32:38)

We just got rid of other people. I mean, you know all the arguments and everybody's just as passionate. The vegans will say it's animal sourced foods. They're causing the obesity epidemic. If we just got rid of animal sourced foods, everybody would be fine. And they're winning. They're argument right now, politically at least. They are running the dietary guidelines. They are in control. Yeah. What does that make you think feel? Not specifically that. It won't even make you take a position on that. But it makes me really unnerved when I think about the government being in control of what we can and can't eat. That is really scary to me. I think the thing that is criminal is that the people who make the decisions about what the health and wellness of the United States population should be. The overwhelming majority of them have very strong ties to commercial enterprises that make ultra processed foods. And so they settle on simplistic arguments like energy balance. It doesn't matter if you're getting your 200 calories from a piece of salmon or a donut. It's 200 calories. Calories of calorie. EBM. It's basic physics. Doesn't matter what you eat. As long as you're counting your calories, you can be just fine. So maybe one easy place to start would be to actually make it a rule, make it a law, whatever it needs to be. That number one, only health care professionals are going to sit on these committees and only health care professionals who have zero conflicts of interest over the last 10 or more years can sit on the committees. And if you want to work for big food, if you want to work for big pharma, that's great. But you don't have any business in making dietary recommendations for the health and wellness of the entire population of the United States. Given that you have clear bias, that may sound extreme to some people that the clearest example is, I mean, tough school of nutrition came out with this kind of list of foods that are healthy for you and foods that are not healthy for you. And they include brand name cereals on their list. Lucky charms is good for you. Lucky charms is better for you than eggs. Lucky charms is better for you than whole milk. Lucky charms is better for you than cheddar cheese. Interesting. With dietary advice like that, it's really that surprising that we have an epidemic of obesity and diabetes and mental illness and other health problems in our population. I mean, I actually do believe that is criminal. It's not criminal for those people to make money off of big food and big pharma if they want to be consultants. Go ahead. Do it. But you shouldn't be issuing guidelines as though they are unbiased guidelines. You just shouldn't. Brand name foods have no place in dietary guidelines and recommendations. They just don't. I mean, obviously it's infuriating. It's heartbreaking. I don't know how to get. I don't know how we get through to the politicians that need to make those decisions.

Chris's thoughts on diet (01:37:17)

Let's start by telling them what is your breakdown of a good ketogenic diet. So for somebody that struggles, whether it's anxiety, depression, schizophrenia, obviously see your doctor, obviously don't stop taking your meds without medical supervision, all of that. But how do you do that particular diet well? So it really depends on the condition that I'm treating. I know this is frustrating for some people. Again, people want one size fits all solutions. So you got to be able to be flexible and modifiable. As a rule of thumb, rule number one is exactly what you've already said. Get rid of the shit food. Have real whole foods. Foods that are great grandparents heard of and consumed. If your great grandparents did not hear of or consume this food thing, then don't eat it. If it comes in a box with fancy packaging and a plastic insert, it's probably not on the healthy food list. Great grandparents could have been consuming Coca-Cola that had cocaine. No, don't drink that. It's not, again, all sorts of exceptions to the rules I'm going to say. But eat real whole food. Start there. For some people, that's enough. And I really mean that. For some people, that's all they have to do. They don't have to be counting calories. They don't have to be managing carbohydrates or protein or anything else. They just get rid of all the junk. Eat real food. I mean, that's the whole paleo or other kind of food dietary movements that what they're based on is let's just eat real food. And for some people, that's enough. If you then want to restrict carbohydrates, start to get rid of all grains, flowers. Through all of this, I should have said get rid of all sugar. Sugar, artificial sugar, sugars, artificial sweeteners. I'm now based on one animal study. I am now going to say get rid of artificial sweeteners. So one animal study came out in one of the nature magazines, making nature journals recently showing the aspartame, which is an artificial sweetener, can cause anxiety in mice and causes anxiety in mice. And then those mice can transmit that propensity for anxiety to their children. Their children can transmit the propensity for higher rates of anxiety to their children. That's bananas. And the researchers used normal amounts of aspartame that a normal human being who's drinking lots of diet soda would consume. Yeah, we were talking before. They weren't poisoning them with ridiculous, massive doses of aspartame. That was my big breakthrough with my anxiety was I was drinking diet monster. And I always feel bad throwing them under the bus because I love diet. I loved drinking it. But man, oh man, did it give me anxiety. So there you go. Yeah, as soon as I cut it out, I'd say drop by 70%. Research just support that. And but unfortunately it's resulting in epigenetic changes. That can persist. So and again, but the good news, what's in charge of epigenetics? Hyacondria primarily. How can so can we do interventions that will influence them? Yes. So back to your question. What other diet? So get rid of all sugars, sweet things. You saw fruit, everything else, if you're doing a paleo diet, you can have potatoes if you're doing a paleo diet. You can fry those potatoes in olive oil. You can have delicious foods. It's not like I'm saying you can't have delicious foods. You can have delicious foods. They won't taste delicious when you're giving up your ultra processed foods. They won't taste delicious when you're giving up your diet monster. They will you'll be like, Oh, but I'm hooked on my diet monster. I need my diet monster. And yet my anxiety is almost gone. And then if you go to Keto, you know, the first step for people with anxiety or depression is just get into any level of ketosis. Do blood monitoring, do urine strips, do something, look for an objective biomarker of ketosis. I don't care what level you're at. See if that does the trick for you. It might. For some people, it does. For people that I work with who have serious chronic debilitating mental disorders, like bipolar disorder or schizophrenia, I've universally found low levels of keto, like a ketogenic diet is not effective. That's what I found. Maybe I'm wrong. Maybe I don't have enough of a sample population. Maybe there are people out there that would respond beautifully to low levels of ketones from a ketogenic diet. What are you calling low? 0.5 to one? Like less than one. So when I use this diet for people with serious mental disorders, I usually tell them I want blood ketones greater than 1.5. Ideally, I'm looking for 1.5 to like 4.5. Can they get there without caloric restriction? I have found to get north of one. I'm going to be restricting my calories. So the two strategies that you're going to use to get there are either caloric restriction and or well, or three strategies and or carbohydrate restriction. So the more carbs you restrict, the more likely you'll be in ketosis and or higher fat. So you are a thin person. If you wanted to get ketones of 3.0, blood ketones of 3.0, you would have to consume a very high fat diet. Whereas somebody who's a beast does not need a lot of fat in their diet. Interesting. So part of it is that when people first start a ketogenic diet, they can get sky-high ketones. Usually within weeks or months, they will come down. Is that because they get more efficient at using the ketone? So it's not as readily available in the blood. I'm going to say this. My answer is speculative. I don't know that anybody really knows for sure the real answer to that. And I don't know that we have research studies that clearly go from A to B to C to D to clearly establish what is causing it. I do think one one possibility is that the body does just get more efficient at using ketones. The much more likely possibility in my mind is that insulin resistance is dramatically improved. When people have high levels of insulin resistance, it means that a lot of the cells in their body are metabolically compromised and would qualify as having glucose hypometabolism. So if we actually looked at the amount of ATP in their cells, it would be reduced compared to a healthy cell. And we call it glucose hypometabolism because they're the primary fuel source is glucose. So those cells are actually all sending out distress signals saying feed me, send some more fuel, send more glucose. We're dying here. What are you doing? Liver, liver, get on the job, send up some glucose. When you first start the ketogenic diet, this is where a keto adaptation can be problematic. Those cells is like pulling the rug out from under them. They're struggling already. And now you're plummeting your glucose levels and your insulin levels. And so those cells are really going to struggle after that. And that is the keto adaptation phase that a lot of people will say, oh, it's kind of bad for weight loss. When I use it in people with mental health conditions, I can see symptoms get worse before they get better. And it's all the way. It's depression can get worse, anxiety can get worse, psychosis can get worse. I know that now. I'm not going to be afraid of it. It's got to be managed safely. So that means with a clinician, like I know how to do that. I'm educating the patient. I'm talking with the patient. We're coming up with a safety plan. We're doing all of the things that we need to do. But I'm not going to freak out if on day two they're saying my psychotic symptoms are getting worse, Dr. Palmer. I'm going to say, yeah, we talked about that. Remember a million times. This is part of the plan. And how are we going to let's implement the plan now? But insulin resistance will be improved over time. And as insulin resistance is improved and you're feeding these cells ketones, the cells are going to kind of establish normality or metabolic health. And at that point, they're not going to be sending out distress signals of send more food, send more nutrients. And those signals are not only stimulating glucose or fat mobilization from fat stores, those signals are also stimulating ketosis. They're stimulating the mitochondria in your liver to produce ketones. Because your brain cells in particular are calling for ketones.

Link Between Symptoms And Diet

Symptoms and diet (01:47:32)

And so as those cells become healthier, they're not going to send out those signals. And ketone levels may go down for that reason. And I don't consider that a problem. Because at that point, the symptoms are probably going to be better. And the person's going to say, I feel great. And that's when even some of my patients, you know, especially after a year or two, if their symptoms are in full remission, they start to dabble. And what can I get away with? Can I eat some fruit? Can I have a little, can I have some carrots which are higher in carbs and other vegetables? Can I, can I, can I get away with a potato? And what will happen? And, and it's always just a work in progress. I mean, sometimes they can get away with it. And we're like, that's great. And I see that as a huge celebration. It's like, wow, you're maintaining, you're achieving more metabolic health. Your brain and body are able to tolerate even more carbohydrates. You're not getting symptomatic. This is wonderful. And if their symptoms start coming back, it's like, well, it's too soon. Lifestyle makes such a difference, man. Where can people follow you to fine tune their own lifestyle? So the easiest place is brain energy.com. You can follow me on social media from there. You can sign up for a newsletter, all sorts of things. Click here now to learn the foods you need to avoid at all costs. Shall we drop acid? We're, we already did, right? We'll see where it takes us. I love the title of the new book. Not quite as much as I actually love the book itself though, but the title sets us up. It really makes a subject.