2 Keto Dudes

In this, the longest 2KD episode yet, Carl and Richard interview Nina Teicholz, author of "The Big Fat Surprise," an award-winning book that exposes the politics, bullying, and other malfeasance that led to the suppression of dozens of real randomized trial studies (with real humans - not mice) to determine the danger of eating saturated fat. Guess what the results of all these trials show? You guessed it. Eating saturated fat does not increase the risk of heart disease. Not only that, but eating a well-formed high-fat low-carb diet (ketogenic) is protective against heart disease, diabetes, and many other modern ailments. The Big Fat Surprise was named "Science Book of the Year" in 2014 by The Economist.

Carl Franklin and Richard Morris try to get to the bottom of why everyone is so afraid of the ketogenic diet, of eating fat, and lowering carbs. Feeling they talk about themselves entirely too much, Carl and Richard turn to the fans this week for stories of ketophobia, both in themselves and others. The dudes also talk to one Carrie Thompson, who has been eating a ketogenic diet for 18 years. Guess what? She's not dead. In fact, she's a model of perfect health. What's up with that?

Ivor Cummins joins Carl and Richard to talk about markers of disease. What should you test for? How do you interpret your results? This is often the first decision one makes when considering a lifestyle change to improve your health. Are there better tests you can do for heart disease risk? (hint, yes!) Errata: Richard said his CAC results post on Facebook were shared 48 times, but it's now been 55 times ... 57 times ... 59 times ... ummm many many times.

Carl and Richard look back on 4 months of keto and reveal what they consider to be optimal eating patterns based on their own experience, the science to back it up, and the experience of others they've met on the journey. Not to be missed.

Carl Franklin and Richard Morris talk about the science behind heart disease, a component of cardiovascular disease. What is it? When did it start becoming a real problem? How did it happen? Does a ketogenic diet help mitigate it? Of course, the entire discussion is based on solid science, which they have provided links to. Errata: Richard mentioned the "number needed to treat" or (NTT) for statins is 141. But that is incorrect. The Number needed to treat to save one life for someone who has heart disease is 83. You need to treat 83 people over 5 years with statin therapy to save one life. The NTT to save one life for someone without prior heart disease is 8 because no lives would be saved no matter how many people without heart disease took statins. Carl mentioned that Mahler's bread is only 1 net gram of carbs per slice. There is some controversy around this. Some labels show 5 net carbs and some (including the label on my own loaves) show 1 net carb. We'd like to get to the bottom of this mystery!

Carl and Richard confront the dreaded plateau, the reason that most people fail on the low-carb diet. In a word, patience. Your body will fight to keep you at your set weight. Maybe it's your gut microbes tugging at your brain. Maybe it's your mitochondria afraid to move on... whatever it is, the dudes have some suggestions and experience to share.

Carl and Richard interview Tom Seest. Tom is a software developer from Illinois. In 1999 he injured his back falling down stairs. He was always active before the injury, completely stopping all exercise after. He put on weight. A LOT of weight. He estimates he was over 500 pounds. He started an Atkins diet in 2009 and was down to 490 by the end of 2010. He tried various combinations of low-carb, low-fat and low-calorie diets. In April, 2011 he took his first bike ride and went 2 miles. By the end of the month he was up to 20 mile rides. Since then he's logged 21,700 miles, and has cycled all over the US and in many other countries. He managed to drop 200 pounds with a combination of diet and exercise. In January, 2015 he started a ketogenic diet and has taken off an additional 90 pounds! We talk to Tom about his experiences coping with his situation. Errata: Carl mentioned that the fat you eat has no effect on insulin. This is effectively true but technically false. Dietary fat does raise insulin ever so slightly, but the effect is negligible. However, we strive to be accurate!

Carl and Richard discuss Ketones. What are they? How are they produced? Are they safe? How can we effectively measure our ketone levels? Does it actually matter? All of these questions and more are answered on this episode of 2 Keto Dudes. Errata: We said we'd talk about consuming ketones but we never did. There is evidence that the mere presence of ketones in the blood stream is beneficial for controlling some kinds of cancer (listen to the cancer show from last week) however, taking ketones isn't a short cut to ketosis. It's like instead of going for a run you just cover yourself with sweat. The process of burning fat and creating ketones is where the magic happens. Carl mentioned that mitochondria are organelles in _every_ cell in the body. But there are some cells like red blood cells that lack a mitochondria - which is why they can only ferment glucose for energy and are unable to use fat for energy. Richard said that the Romans discovered that fasting cures epilepsy, but apparently a Greek doctor in the roman empire name Galen of Pergamon was just the first to write down that the Greeks had originally discovered the link noting thati n the book "Epidemics," Hippocrates describes the case of a man whose epilepsy was cured with drastic diet and fasting. Erasistratus, a Greek anatomist and royal physician under Seleucus I Nicator of Syria stated, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."

Carl and Richard talk to prostate cancer-survivor and friend, Mark Miller. In no way do we intend to claim that the ketogenic diet can cure cancer, but there has been interesting research that shows a correlation between eating a ketogenic diet and reduced tumor size. There's more to the story, and more interventions cited as well. We let Mark tell his story. A note to parents, we do talk about sexual function in this show.

Are you new to the Ketogenic diet, or maybe just kicking the tires? Carl and Richard interview Carl's daughter, Emmy, who has been only doing keto for 21 days. This is a good show to listen to if you're completely new to this way of eating and would like a thorough review of what to expect, as well as some first-hand testimony.

Carl and Richard discuss alcohol, how it is metabolized, particularly by those eating a ketogenic diet. They discuss the carbohydrate content of typical drinks, and share a couple yummy keto-friendly cocktail recipes. Errata: Richard said he'd had 3 Bottles of Moët before the show - but it was actually 3 GLASSES of Moët. Also Richard said he didn't know of research substantiating Alcohol inhibiting gluconeogenesis and 5 minutes after we finished recording he found one from Hans Krebs (linked below). Update: May 11, 2016: Carl did an n=1 study on himself by following a 22/2 intermittent fasting pattern for 3 weeks. He ate only dinner, but had drinks with and after dinner. The result was a big plateau. No major weight loss. He then did a 2 day fast and started eating his one meal at lunch time (with no alcohol) saving the drinks for the evening. The results were positive. He started losing a pound a day. His hypothesis: When you drink alcohol your liver stops metabolizing food and focuses on the alcohol. Once all the calories are extracted from the alcohol the liver goes right back to metabolizing food, but now your caloric intake has increased and some of the calories from the food will not be used, and some of the fat will be stored in the fat cells. By giving the body time to process the food intake, you allow the liver to do it's job. More fat gets burned. By the time you introduce alcohol a bigger chunk of your lunch has already been metabolized.

Carl Franklin and Richard Morris research the elusive cholesterol. Is it bad? Good? Why so much bickering? The results may surprise you. Also, Carl got his blood work results after 2 months on the ketogenic diet. There's great news. As far as potentially bad news, that's what was discussed. You guessed it. Cholesterol. Errata: Richard referred to the units for fasting insulin being pico IU, but the correct unit is “microunits per milliliter” (mcU/ml or mIU/ml). Richard also mentioned that the Norwegian Hunt 2 study followed 5,000 individuals for 10 years, but it was actually 50,000 individuals for 10 years. Note: Converting Cholesterol divide mg/dl by 38.67 Note: Converting Triglycerides divide mg/dl by 88.57 When first published on April 11, 2016, this show was linked to episode 8. If you find yourself here because of that, just re-download it. We fixed the problem. Sorry for the inconvenience.

Carl and Richard discuss Type 2 Diabetes. How does one get it? Is it reversible? How does it differ from Type 1 Diabetes? How does the medical establishment tell you to manage it? What does the standard recommended diet for Type 2 diabetics look like? These are all questions Carl and Richard tackle on this week's 2 Keto Dudes. Errata: Richard said that a study showed that people with an HbA1c under 8.5 might still be able to see a reversal with an intervention that lowered serum triglycerides - the study was "Very-Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiologic Changes in Responders and Nonresponders" and the non-responder group (no reversal of pancreatic burnout) had an HbA1c of 8.4% ± 0.3, the responders (reversal of pancreatic burnout) had an HbA1c of 7.1% ± 0.3 - so if glucose control turns out to be the discriminator the cut off may be between 7.4% and 8.1%.

This week Richard Morris and Carl Franklin talk about sweeteners other than table sugar, the good and the bad. Errata: Carl mistakenly said that he had an insulin response to the Truvia brand sweetener (Erythritol + Stevia), but in fact it was the Fructevia brand, which combines fructose with Stevia.

Today Richard and Carl geek out on Protein. So much of what they do is separating fact from fiction, and this episode is no different. Did you know that excess protein turns into glucose? Of course, there is science to back all of this up. Good thing the dudes have learned to harness their OCD for the powers of good! Eratta: Carl mentioned that sugars like glucose and fructose trigger an insulin response but only glucose does. Fructose doesn't require insulin to be metabolized. Richard mentioned that after 6 months of keto he was left with "massive" muscles, this is in relation to the muscles he thought he totally didn't have before he started keto.