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我曾是高碳水化合物饮食的坚定支持者，甚至在《跑步法则》(The Lore of Running)一书中大力推崇运动员摄入大量碳水化合物以提高运动表现。然而，33年的高碳水饮食最终导致我自身健康状况恶化，让我不得不重新审视这一观点。亲身体验让我明白，高碳水化合物饮食的危害远比我们想象的严重。

如今，我深信胰岛素抵抗是大多数慢性疾病的根源，包括糖尿病、癌症和痴呆症等。长期高碳水化合物饮食会导致胰岛素抵抗，进而损害身体多个器官，最终引发各种慢性疾病。我的父亲死于糖尿病，这种痛苦的经历更坚定了我要揭示高碳水饮食危害的决心。

我坚信，及早发现并逆转胰岛素抵抗是至关重要的。 而改变饮食，特别是采用低碳水化合物饮食，是逆转这些疾病的关键。过去，我们常说改变“生活方式”，但现在我认为，营养才是关键。

我28岁时就已出现胰岛素抵抗，但当时身材苗条，每周跑步超过100公里，并未意识到问题的严重性。直到60岁，我才出现明显的糖尿病症状。通过转向低碳饮食，我成功逆转了20年的衰老迹象，恢复了年轻时的活力和运动能力。 这段经历让我更加确信低碳饮食对改善代谢健康具有显著效果。

如何判断自己是否处于胰岛素抵抗的早期阶段？ 我建议关注以下几点：

对于已经出现胰岛素抵抗或糖尿病的人来说，降低碳水化合物摄入量至关重要。 但需要注意的是，降低碳水化合物的速度要循序渐进，并密切关注自身反应，特别是空腹胰岛素水平。 糖瘾是低碳饮食失败的主要原因之一。 克服糖瘾，才能更好地坚持低碳饮食。

我的日常饮食以肉类、鱼类、乳制品、鸡蛋、坚果和少量蔬菜为主。 这种饮食方式让我不再渴望甜食，血糖控制也得到了显著改善。

关于补充剂： 我定期服用多种维生素，包括维生素A、B、C、D、E，尤其重视维生素D3和K2的补充，因为它们对维持血管健康可能具有重要作用。至于其他补充剂，例如肌酸，我个人认为其效果并不显著。

关于运动： 长跑并不能完全避免胰岛素抵抗。我个人认为，随着年龄增长，应减少长跑，增加力量训练、柔韧性训练等，以保持肌肉量，增强身体机能。

关于我的“审判”： 我因在社交媒体上分享低碳饮食的观点而被医疗机构起诉，这场长达四年的官司最终以我的胜诉告终。这场官司不仅让我承受了巨大的压力，也让我更加坚信，我们需要打破传统饮食观念的束缚，重新审视现有的医疗体系，并警惕制药行业对医疗领域的控制。

改变需要勇气，更需要行动。 我希望我的经历能够帮助更多人认识到低碳饮食的重要性，并积极采取行动，改善自身的代谢健康，拥有更健康、更长寿的人生。

Coming up on the Ultimate Health Podcast. So for 33 years, I promoted the carbohydrate diet and it took me to get sick. And when I got sick and felt fat and lazy and couldn't run properly, I was ready for change.

And that's the moment. The moment you're ready for change, then all this information suddenly makes sense. Type 2 diabetes and these other chronic diseases are reversible if you catch them early enough. If you are telling diabetic patients to eat anything but a low-carbohydrate diet, that is malpractice. That is gross malpractice.

Hello and welcome to the Ultimate Health Podcast, episode 564. I'm Jesse Chappas and I'm here to take your health to the next level. Each week I'll bring you long-form conversations with health and wellness leaders from around the world. This week I'm chatting with Prof. Tim Noakes. Prof. Noakes is a researcher, educator, and author. He is well known for challenging common and old paradigms and the discipline of exercise physiology.

Prof Noakes has published more than 750 scientific books and articles. He's been cited more than 16,000 times in scientific literature.

Prof. Noakes has won numerous awards over the years and is the author of several books on exercise and diet. Highlights of our conversation include, what is the root cause of chronic disease? A high carb diet leads to diabetes. Do carbs actually make you run faster? Does berberine impact the microbiome? And the pharmaceutical industry's control over medicine. I

As always, if you'd prefer to watch versus listen, this full conversation is available over on YouTube. You can get there by going to ultimatehealthpodcast.com slash YouTube. After you're done watching, be sure and subscribe. You don't want to miss any of the action.

If as you're listening to this, you can think of somebody right now that could benefit from the information, please share the episode with them and help them out. Thank you so much. Without further ado, here we go with Prof. Tim Noakes. In your opinion right now, the most important medical condition is insulin resistance. Let's start out talking about why this is.

The reason is because insulin resistance is the cause of most of the chronic diseases. And so most people living in Western society today are at risk of dying of one of numerous related conditions, diabetes, cancer, dementia, etc. And they're all linked to this condition of insulin resistance. So insulin resistance in the face of a high-carbohydrate diet damages the body in many different ways.

And that can affect your brain, affect your kidneys, affect your heart, etc., your arteries. And so these are the chronic diseases that happen, and they happen over a period of time. So insulin resistance develops progressively, and if one eats a high-carbohydrate diet for decades and one is insulin resistant, then the long-term consequences are the diseases we mentioned.

And the reason I'm particularly interested in it is because my dad died of diabetes, and it's one of the cruelest ways to die. And if you have diabetes, which is now so prevalent, if you have diabetes, you are going to die from the condition. And people simply don't understand. They think that you can continue to abuse your body for decades, and then suddenly it'll all be fine if you do something later on, if you take medication.

And the reality is that's not going to work. So what the message to the population is type 2 diabetes and these other chronic diseases are reversible if you catch them early enough. And what you need to do to reverse them is to change. We used to say it was lifestyle. And now I believe it's your nutrition is the key that you have to change.

All right, starting to put the pieces together here. We have carbs at the top. People are eating too many carbs, causing insulin resistance, which is at the root of all these chronic diseases, including type 2 diabetes. But before we move forward, let's get into specifically what insulin resistance is.

Okay, so my opinion is that humans are designed to eat high-fat diets, high-fat, high-protein diets. So either by design or by evolution, and don't worry which you choose, humans seem to be very good at burning fat and protein and metabolizing it, and very poor at coping with carbohydrate.

So if we go back a long enough time, we find that humans were eating high-fat, high-protein animals. And then, unfortunately, we ran out of those animals. We killed them off. And so now we had to add something else. And so we started eating carbohydrates. But for the evolutionists, that occurs 18,000 years ago. So if you follow the evolutionary story,

Humans start eating meat four million years ago, three million years ago, and we only add in carbohydrates in the last 18,000 years ago. So that becomes the problem because our body's not designed for this high-carbohydrate story. Now, the reason why I am involved in this whole story is because I wrote a book called Law of Running, and in this book,

It says you must eat as much carbohydrate as you possibly can. Every moment you must just stuff your body with carbohydrates because that's going to make you run faster and further. And I've followed the literature and I thought I was being scientific, but I didn't realize that the evidence that was being proposed and marketed to us had never been properly tested. No one had tried to disprove it. So everyone said, yes, when you run fast, you've got to burn lots of carbohydrate.

So for the last two or three years, I've been working with a group in Pennsylvania, and Philip Prince is the head of the department. And we've tested this hypothesis. And to make a long story very short, we showed that we could not find any difference in the response to diet, whether it was a high-fat or high-carbohydrate diet, in people running any distance down to one mile. And even we went as low as 800 meters.

And what we did, which was extremely novel, was we measured the metabolism of these athletes when they were running 800-meter repetitions. And we found the highest rates of fat oxidation ever measured in history in humans.

Now, why was this important? Because it completely disproves the current teaching, which is that once you get to a high intensity and the number is 85% of your maximum, you can't burn fat anymore. You have to burn carbohydrates. And we found the highest rates of fat oxidation ever measured. And so what this tells us is there's no particular reason why your muscles should burn carbohydrates. So then the question becomes,

So why do you burn carbohydrates? Because remember, we're eating so much carbohydrate and we're told it's good for us. Well, it's a good idea we should know why we're eating it. And it is true that the brain needs some carbohydrate, but the liver can produce all the sugar, glucose you need for your brain. You don't need to feed yourself that carbohydrate.

Now, if you look back, and this is one of the papers we published, oh gosh, 20 years ago. But when you're young and you're committed to something and you don't look, and we found that 40 to 50% of the energy of the athletes we were looking at when they were at rest was coming from carbohydrate. But now, isn't carbohydrate the jet fuel that you spare so you can run fast? So why are you burning it at rest? And there's only one answer. And this is where…

My brain is, and we've got the evidence for it, you're burning it because you want to regulate your blood glucose concentration. So now this comes back to your question of insulin resistance. The human body is clearly designed to keep its blood glucose as low as possible. And you do that best if you're not eating carbohydrate. But the instant you put carbohydrate in your body, the body says, okay, this is something of a crisis.

We must regulate the glucose and get it down back to normal as soon as possible. So within minutes of taking carbohydrates, you switch off your liver producing glucose. The liver reduces its glucose production. And that tells you something. That tells you the liver has been warned, don't produce any more glucose. We've already got far too much. And the next thing you do is you dump that glucose into your muscles because that's a nice place where you can dump it.

And so what we have said in the past, like in this book, Law of Running, the reason why you must take carbohydrates, fill your muscles with glycogen and glucose so you can run fast, no, you mustn't do that because that's a harmful process. You don't want that process to happen. So my opinion now is that the body is poorly adapted to manage carbohydrate. However, the diet that we're eating today from the moment the child is born,

they're exposed to high carbohydrate diets. And now every few hours, the body has to assimilate this glucose because it wants to keep the glucose as low as possible. And it's in that process that it eventually fails. And that is the development of insulin resistance. Insulin resistance is simply the inability to get rid of that glucose and store it without over secreting too much insulin.

So what happens originally, you can secrete lots of insulin and it drives the glucose into the liver, into the muscles, and you burn the excess or you turn it into fat. So that's the options. And that works well until you get to 30 or 40, when all of a sudden the insulin isn't as effective. And so your blood glucose stays high for longer and your blood insulin levels stay high for longer.

And then that insulin starts acting on other tissues. And that's when you start to become inflamed. You put on belly fat and you put on fat in your liver. You put fat in the pancreas and in your skeletal muscles. And that then is what we call the metabolic syndrome. So the metabolic syndrome is the indication that you're in trouble because you're insulin resistant. The body's really struggling to control your blood glucose level. So whenever you see someone

who's obese, most of them, what that body is telling you is this person is struggling to regulate his or her blood glucose concentration. And so it's logical. What's the solution? Well, don't tax the body to do what it can't do. It can't do, it can't store that glucose, so don't give it glucose. So that's how I try to summarize it now.

that your body doesn't need carbohydrate. You can do very well without it. But if you are going to eat lots of carbohydrate, most of us will become insulin resistant and then get the consequences, which is the obesity, the metabolic syndrome, and all those diseases we spoke about.

And where this becomes really tricky is the fact that this builds up over so many years. And you mentioned the obese person. At that point, it's very obvious that when they get that symptom, that they have insulin resistance. But what about that person who genetically or they're on that continuum, say a decade or two,

where they're building up insulin resistance and things are going awry behind the scenes, but they don't know anything's happening. And I'm a classic example because it turns out we did experiments on myself and another runner in about 1978, and we were really interested in studying ketosis. Can you believe it? In 1978. And we discovered that it was when you reduced your carbohydrate intake, we could show marked ketosis.

So what we did was we took the two of us and we ran for two hours on the treadmill when we were eating high carbohydrate diets or low carbohydrate diets. And we'd eat low carbohydrate diets for about two or three days. And we get this massive ketosis. But we also measured our glucose and insulin levels. And mine were through the roof. When I ate the high carbohydrate diet, my glucose was elevated, but my insulin was five times normal. But the point I'm going to make now is,

is my body mass index was 21. I was lean and I was running 100 kilometers at least a week and I was running marathons. So here I was thinking I'm in perfect health

But the data was showing that it was quite a complete opposite. And I mentioned my father died of this disease, and that's where I got my insulin resistance from. I just made it worse by loading up on carbs. So at 28, I'm profoundly insulin resistant, but I don't understand what it means. And I continue to eat a high-carbohydrate diet for the next 38 years. And then, only then does it become apparent I've got type 2 diabetes.

And I was never grossly overweight. I was overweight, but never grossly overweight. And when I look back, I can see that shortly after those experiments, in about the next five or 10 years, my health started to deteriorate. My running ability got worse. I got progressively fatter.

And everything changed. And I didn't know what was it. There was something wrong. I didn't feel as good as I did 10 years younger, but I didn't know what it was. And eventually after 20 years, you just say, well, it's aging. What happened was when I went on the low carbohydrate diet, I reversed my aging 20 years. I got back to running what I was doing 20 years earlier. So that and the high carbohydrate diet was very damaging for me.

So I use that as an example of how insulin resistance can be there on a genetic basis. I think I have it on a genetic basis. And then it's made worse. And some people…

Eating a high-carbohydrate diet, maybe you've got worse genes, they will develop type 2 diabetes at the age of 40. It took me until I was 60 to show the real symptoms of the disease. So the extent of your insulin resistance tells you how quickly you're going to get the diabetes if you're eating a high-carbohydrate diet.

Your example there is a perfect highlight of what I was getting at. The fact that at least at one point in your journey, when you're running all those miles or kilometers and you were thin, you had no idea that behind the scenes, things were falling apart. So the obvious question for people that are tuning in right now, how do I know if I'm in that camp of 10 to 20 years where things are falling apart, they're having a higher moderate carbohydrate diet, but they still feel okay. Yeah.

How do they know what's going on? Like, how do they get the baseline to figure out where they're at on that spectrum? Well, I think the first thing is obviously to check your weight. If your weight starts rising, that's insulin resistance. And I'll explain that a little bit later, but that would be the first thing. And I should have noticed that.

For example, I would run races. I'd eat lots of carbohydrates, run the race, and then you'd rest for a week or a month, and my weight would just go like this, just like that. It would really explode. And that's because I was coping with the carbohydrates when I was running. If I ran two hours a day, I could get to my optimum weight on the diet that I was eating.

Now I live on that diet and I don't have to run two hours a day to maintain my weight. So that was the trouble. I was burning that carbohydrate. So I'm putting it in and I'm burning it and that prevents me from getting fat. But as soon as I stopped burning the fat, just went mad. Okay, so that's the first thing. Any drift up in your weight, you shouldn't put on any weight after the age of 18.

It should be the same weight from 18 to 80, but maybe two kilograms or three kilograms. But anything beyond that, that's not right. But the key measurement is your fasting insulin level. So that's if you have a blood sample drawn in the morning when you haven't eaten for 12 to 16 hours.

And that fasting insulin must be below six units. Now, essentially, no one has a value below six units unless they're eating a low carbohydrate diet. So once your value starts getting above six, in time, I know that you will become pre-diabetic and diabetic. So the normal values, we're told, is from five to 20. That's nonsense.

It's five or six. And we know that from our studies that when athletes get their insulin levels below six, their metabolism is totally different than when it's above six. The cutoff is remarkable. So once you get it below six, then you have all these benefits. But if it's above six, you don't get the benefits of the low carbohydrate diet. So that's the first thing.

measuring your fasting glucose is a waste of time because that only goes wrong after 30, 40, 50 years. So my fasting insulin was fine all those years. It was amazing. But then it slowly started to rise. But when I told you I was profoundly insulin resistant, my fasting glucose was very low. It was about 60 to 70, which is fantastic. Those are American units. It was fantastic. So then you see, I looked at the glucose. I'm not diabetic, but my insulin was

Five times too high. Why? Because it was getting rid of the glucose. And it could only get rid of it by having such a high value. So this first is insulin. And ultimately, your glucose will follow and it will start to rise. But that might be 20 or 30 years later. So if people would measure their fasting insulin, we would know that the majority of people are at risk of future diabetes. But we could detect it then.

and then you would change to a lower, you would start reducing your carbohydrate intake and try to keep that insulin as low as possible, and you would be fine. What next happens is that your blood glucose starts to rise. The fasting level may be okay, but during the rest of the day, it might be elevated. And we measure the effects of that on the red blood cells. So if the glucose is elevated, it damages the red blood cells. And the percentage of the red blood cells that are damaged

is a measure of how high the glucose is. And that's called the HbA1c test, glycated hemoglobin. And once that goes above 5.5, you're pre-diabetic. You'll never be told that. You'll be told the value below 5.5 is fine. 5.4 is perfect, 5.5 is fine. And they'll watch it and it'll go to 6, and then it'll go to 6.5. Oh, it's 6.5, all of a sudden you have diabetes. No, you had diabetes when the value was 5.5.

but you didn't pick it up early enough. So that would be the second value. And then the other things are your blood pressure starts to rise, your blood triglycerides start to rise, your HDL cholesterol starts to drop. Those are the classic markers of insulin resistance. So if you look at all of those variables, you get an idea of how seriously insulin resistant you are. But I don't think it matters. You know, it's not by degree. You just, if your insulin's elevated, you've got to take steps right there and then.

And then continuing this diabetic story even further for a type two diabetic, their metabolic machinery is broken, their insulin, you know, it continues to build up, build up and try and regulate that glucose. Eventually, it can't do that the glucose goes up, you go see your doctor, and oftentimes you're prescribed insulin. So then you're putting more problems into the mix, injecting that further elevating your insulin and continuing to break your metabolic machinery.

Yeah, correct. So now you ask the question, why would doctors use insulin to treat a disease of insulin excess? And the answer is because when insulin was discovered as active in diabetes in 1921, no one could actually measure the glucose in the blood, the insulin in the bloodstream. So they assumed that all people with diabetes have too little insulin.

And it was very true if you're what we call a juvenile-onset diabetic, which was the main cause of people. They were the ones who were dying. The youngsters were dying from lack of insulin. And so everyone got labeled as lack of insulin. And so the older people who, like me, who were a bit overweight and insulin-resistant, we got insulin as well because no one knew.

And then only in the 1970s was it possible to measure insulin. And the surprise was the people who looked at it, the first thing they measured was insulin in older diabetics. And gosh, it was elevated. And they were shocked. So gosh, why should the insulin be elevated? And then that changed everything. But by then, the insulin is the easiest way to get the glucose down.

So we just measure the glucose and we give you insulin and your glucose goes down and everyone's happy. But early on, they realized with young diabetics who type 1 diabetics who have no insulin, they noticed that these people didn't live long, that the more insulin you gave, the more problems they had.

And so that, tragically, you know, one of my great friends was in type 1 diabetic, insulin-dependent diabetic, from the age of 14 when we were at school together. And he was the first person in our group to get dementia. And that's typical of what would happen from excessive insulin injecting because they didn't know it those days. And he changed his diet too late to influence the outcome.

So there we have it. We give insulin, but that's not the solution, but to remove the problem, which is the carbohydrates. And not to mention the whole aspect of taking insulin is going to further drive that glucose into cells, and you're going to continue to put on weight. Indeed. And insulin now is acting on all the tissues. So the muscle cells and the liver may be profoundly insulin-resistant.

but the other tissues aren't. So the fat storage capacity, which is insulin stimulating, is not a problem. And insulin is probably carcinogenic. And so those cells that might be wanting to become cancerous, they're getting this continual stimulus of insulin. And there's growing interest in insulin resistance as one of the major predisposing causes of cancer in the long term. So all the other tissues upregulated.

by this excessive insulin. And it's not helping the ones that are resistant because they're not going to respond appropriately. Coming back to your story, you talked about that period of time when you were having a high-carb diet, but you're running a lot and you're burning through those. I'm not sure how things panned out over time. We know that you ended up breaking your metabolic machinery over time.

But what I'm getting at here for the young person who is very active and consuming a lot of carbs, we already know from a performance aspect, it's not going to increase performance. But are they okay for a period of time? If they're using that fuel on a regular basis, they're young, their metabolic machinery is good.

What do you think about that specific case? So I'll tell you that in the studies we did of these, we had relatively well-trained athletes could run 24 kilometers in under 20 minutes. So they could run

five kilometers under 20 minutes, four kilometers, four minutes a kilometer. So they were better than 88% of all runners in North America and across the world, I think, that if you expanded it. So these were, they weren't the best athletes in the world, but they were in the top group of recreational athletes who trained 80 kilometers a week or something like that. And of the 10 that we studied on the high-fat diet and the high-carbohydrate diet, remember they went on the high-carb and then they went on the high-fat diet,

When they were on the high-fat diet, no one, not one, was pre-diabetic. They were absolutely perfect. When they went on the high-carbohydrate diet without weight gain, no weight gain, no increase in calories, and no reduction in training, three of them, that was 30%, became pre-diabetic. We could identify the pre-diabetes. So there you go. That's one of the best examples we have. It's actually the first study showing

that the ultra-processed high-carbohydrate diet that we're eating is the cause of the diabetes because we controlled for absolutely everything else, but we didn't control for the diet. The diet changed, obviously. We see it all the time, people telling us that they become pre-diabetic or diabetic having eaten this high-carbohydrate diet. You must remember that

People look at the Tour de France and they say, oh, but Tour de France cyclists don't get fat with age. And they probably because they're so highly selected. You have to remember that if you look at Tour de France cyclists, I mean, there are billions, well, there are hundreds of, well, there are many millions of cyclists and you get 120 or 140 survive and become selected as the Tour de France cyclists. They are absolutely unique.

compared to the group that they start from. And that's the reality. And they may be totally different. They may be able to eat high-carbohydrate diet all their life and not get diabetes. But you can't reflect what their experience is to the average person. The average person is like me, and that amongst that group, the majority will become diabetic if they eat high-carbohydrate diets. Yeah. So let's just remind you that every time you take carbohydrates and you secrete insulin,

then you are eventually that's going to run out. The system is going to wear out and that will be prediabetes and type 2 diabetes. Okay. Let's take the example of somebody along the continuum of beginning insulin resistance all the way to type 2 diabetes. You can pick where we want to start there, but they start to lower the carbs. How does that metabolic machinery change as they do that?

Okay, so that's a very good question because normally, so we can exist in two modes. We can either be carbohydrate burners or we can be fat burners. And if you look, talk to athletes, they'll tell you, oh yes, you can become a fat burner, but you've got to run 100 miles a week or whatever, 160 kilometers a week. And that is absolutely not true. All you have to do is cut the carbs and you become a fat burner, well, not overnight, within four or five days.

All you have to do is lower your muscle and liver glycogen content that carbohydrates stores. And we showed that in other studies in the 1980s, 1990s, that if you start exercise with low muscle glycogen, the body says, thank goodness, now I can burn what I'm meant to burn, which is fat. And you burn fat. And the experiments we did, we tried to override that and we couldn't.

We injected glucose to try and get the body to take the glucose. Yeah, take this glucose. Said, no, I'm going to burn the fat. And only when we raise the blood glucose could we shut off fat metabolism a little bit. So that's how the body's designed. It's designed to keep the muscle glycogen low, keep the blood glucose low, and burn fat. That's the one model. And that's the model we get into when we

cut carbs for 48 hours or 72 hours. Within 72 hours, you get into that state of just burning fat and then you're burning ketones. So that's the ketogenic lifestyle. And the argument is that that's this lifestyle that humans developed because we didn't have access to food all the time. We didn't have refrigerators. We didn't have fast foods.

We killed animals, we ate them, then the food went, well, then we had to find more food sometime. And so there was a period of fasting. What's happened now is that obviously we're eating carbohydrates three or four meals a day and you're getting this swing. So the moment you take your carbohydrate, the body says, crisis, get rid of the glucose, burn it, use it, burn it up or distribute it into the muscles or the liver.

and or store it as fat until the glucose gets back to normal. Then it's, oh my goodness, thank goodness, we've got your glucose back. But unfortunately, your insulin is still high. Cortisol and other hormones are all high, so they can have their long-term effects. And what the body is wanting to get rid of that glucose so that the next time you insult it, you can dump the glucose back into the muscles.

So the way exercise helps is it manages to just keeps the liver, sorry, the muscle glycogen a little bit lower. And so you burn more fat. But the only way to burn fat ideally is to avoid the carbohydrates. So that's the two ways humans live. They either have carbohydrate burners or they're fat burners. And all the evidence, absolutely all the evidence is that the fat burners are doing metabolically much healthier.

And all the problems we talk about, the hypertension, the high cholesterol, the low HDL, the high triglycerides, the abnormal glucose, they don't occur to the same degree in people who are fat adapted and burning fat. They occur almost exclusively in the group who is carbohydrate addicted and eating, just eating too much carbohydrate.

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That's correct. But it turns out you really have to take a lot of carbohydrates to get it stored as fat. Somehow the body can assimilate quite a lot of glucose. But I'm currently looking at what happens in these experiments because what's happening now is that industry wants to sell you as much carbohydrate as it possibly can. So they're driving the message that you need 120 grams of carbohydrate every hour that you exercise. It doesn't matter if you go on a 5K run

or you do the Ironman, you must get in your 120 grams per hour. Maybe that's a little bit of an understatement. Maybe they haven't targeted the 5K runners quite yet, but it'll come. So, because I wrote this other book about how the industry forced us to believe that you have to drink lots because of the serious problem of dehydration. And they generated this problem of overhydration. And what they've done now is to generate the problem of overeating carbohydrates.

And when these experts come along and they say, okay, where did that carbohydrate go to? They can't find it in the body. It's hiding somewhere. And I'm not joking. If you're taking in 120 grams of carbohydrate an hour, about 60 grams an hour goes missing. It's not traced. And it's probably sitting in the gut somewhere. So the gut might actually decide, well, I'm only going to take in so much carbohydrate. We'll leave the rest in the gut for later digestion or something.

So those are the issues that if you overstuff the body with carbohydrates, it'll do everything possible to get rid of it or not to assimilate it. So just to be clear here, if we go low carb and we deplete the glycogen, will the body make sugar through gluconeogenesis to build back the glycogen?

How does that piece work? - Yeah, okay. So my point is that you don't need the glycogen. Okay, so, with one exception. But you don't need the muscle glycogen. That you can burn fat. So you don't have to worry about that. We've done experiments and we studied liver and liver glycogen metabolism, muscle glycogen metabolism in people who are fat adapted. And we showed that their muscle glycogen is about half the normal.

And that would be the excess that the liver's producing. So the liver's still producing excess that it's being used. And these people were eating very little carbohydrate, 25 to 50 grams a day. But they weren't eating nought grams a day. If they were eating nought grams a day, maybe the muscle glycogen would be even lower. But no one's really tested that. So you don't have zero glycogen. You have half the normal that you would have.

Okay, in that case, they're still eating low-carb though, so would part of that glycogen be coming from the diet and part of it from the liver? Correct, correct. Now, the problem, which we've also identified recently, which for some reason has gone missing, when you exercise, even in a fat-adapted state, you burn little carbohydrate, but you burn less and less carbohydrate the further you run or exercise.

With one exception, the glucose in the bloodstream, which is coming directly from the liver, because you're not ingesting anything, that goes up during exercise, which is paradoxical. You'd think that the one thing you want to protect is make sure you don't burn too much blood glucose, but the body doesn't choose to do that. It protects the muscle from burning glucose, but it doesn't, sorry, it protects the muscle from burning glycogen,

but it doesn't stop the muscle burning glucose and the brain burning glucose. So as you're running along, a point will ultimately be reached. And this has to happen in everyone. If you are fat adapted or not fat adapted, you will run out of glucose in the bloodstream ultimately, if you're not ingesting some glucose.

So the liver will produce a lot of glucose and it'll cover most emergencies and most cases. But if you're on a low carbohydrate diet and you want to run for five or six hours, some people will drop their blood glucose and that will affect their running performance. But that's the extreme. And they can completely reverse that or prevent it by just taking a little bit of glucose to help the liver get over that problem.

Having said that, we do know of some super adapted athletes who can cycle all day without taking any carbohydrates. So their liver has upregulated its gluconeogenesis to such an extent that it can cover all the glucose that that body requires during any type of exercise. But I warn that that's not common.

Most people on the low-carbohydrate diet, for example, doing the Ironman, would need some carbohydrate after four or five hours. And if it is below four or five hours, say somebody's running a marathon at a relatively quick pace, do we have a lot of research showing the difference in performance between somebody eating a high-carb diet versus low-carb? Because the way I understand it,

It's still common knowledge in the running world to carb load and do what you wrote about in your book there that you showed us earlier. So, and you talked about early on the research you did of performance and how performance wasn't depleted, at least in the lower carb group. But I'm curious the other way around, improved performance. So let's go, you know, all the way from, I think you mentioned 800 meter before, 800 meter all the way to a marathon. Yeah.

Is there a performance increase on low carb? And how many people are adopting this diet? Okay, so that's the question I'm looking at at the moment. I'm trying to explain why does carbohydrate make you run faster? Because if you look at the studies, there's no question that people who take carbohydrates either before or during will generally perform slightly better than when they don't. But I've given you one explanation already.

that if you're not going to take carbohydrates during the race, you will reach a point where your blood glucose level will drop and then your performance will be impaired. Why? Because the brain needs glucose and it's not stupid. The brain, if it loses glucose, it's going to get damaged and you lose brain function. If I drop, if your glucose drops and stays low for three, four, five minutes, you could be in trouble. You could have brain damage.

So the brain's too clever. It says, listen, I'm not going to allow you to run fast if you're not going to give me some glucose to keep my brain working. So I'm going to slow you down. And that's what happens. You slow down. And then eventually you start walking because the brain said, okay, I can only keep your blood glucose level at this low, very low level if you walk. So that's what the brain does to keep you safe.

If you carbohydrate load before a marathon, your glucose will be higher during the marathon than if you don't. And that's the reason is because you filled your liver with glucose. And the first experiment showing glucose had an effect, what did they have to do? They had to starve the athletes for 12 hours to 14 hours. Because in the laboratory, you'll never get anyone to do more than about three hours exercise. So you've got three hours to exhaust the glucose or the glucose stores in the body.

and it takes you three hours to make the liver run out of glucose in highly trained athletes. But if you just feed them the breakfast or make sure they carbohydrate load before, they will be okay for the three hours. So all our research is based on the three-hour model. And then we try to extrapolate that to the Ironman, et cetera, and it doesn't really work. So-

The reason why athletes will tell you, but I perform better if I'm carbohydrate loaded, is because I believe they protect their blood glucose levels for longer. And so they don't become what we call hypoglycemic. The blood glucose level doesn't form. And that's the easiest explanation. And that's what the science shows. When people try and prove it, that's what they find.

And the irony is, you see, in the first studies where they used, they looked at muscle glycogen and they said that muscle glycogen determines everything. The reality is, was on the low carbohydrate diet, the blood glucose levels dropped like this. They dropped to nowhere.

And they ignored that. They said, no, no, that's blood glucose. We don't have to worry about blood glucose. That's 1960s research. We're 1980s researchers. We look at muscle glycogen. And they completely ignored what had happened to the blood glucose because on the low-carbohydrate diet, the liver was depleted. So these people are going to run out of glucose earlier. So they are going to stop exercising earlier. But you can't say that's absolutely because they ran out of muscle glycogen.

You have to exclude the possibility that the liver was involved. And so, unfortunately, people didn't bother about that. They just ignored it. Whereas the quickest way to stop an athlete running is to drop their blood glucose. They will stop very, very quickly. And if you give them glucose, they'll continue. And it can't have been because the glucose has been burned by the muscles. It has to be that your blood glucose has become elevated. So,

To answer your question, if you did enough experiments and you had enough people, you could get the variation. And the people who started exercise with more liver glycogen and less liver glycogen, and those started with less liver glycogen, would benefit by carbohydrates during a marathon. And those who started with more glycogen in the liver wouldn't benefit from carbohydrate ingestion. I must just say that this very moment in Pennsylvania,

My colleagues, Dr. Prince and his team, we're looking at what's the minimum amount of glucose you need to prevent hypoglycemia. And we're going to see if we just change the blood glucose, we can maintain the blood glucose in the one group and we're allowed to fall in the other, what happens? Because if we keep the glucose just like that, you don't influence metabolism. You don't influence how quickly the muscle glycogen is being burned. So we're hoping to show that

that just by keeping the blood glucose normal, you improve performance without altering whole body metabolism. You're just supporting mainly brain function. So that's the story. But unfortunately, what happens in science is like I wrote in this book, there's a model. I mean, I didn't understand it at the time. I now understand it. We develop a model and a model then determines what you believe. So if you believe muscle glycogen is crucial, then you'll say carbohydrates are everything.

So what we had to try to show is that muscle blockage isn't everything. You don't need it. And then the model breaks down. And then diet, actually diet means nothing. Athletic performance is not influenced by diet, at least the carbohydrate-fat ratio. You can eat what you like. Eat lots of fat, eat lots of carbohydrate. Your performance will be unchanged. All right. I'm going to step away from performance, at least for a bit here, and come back to the layperson.

And I'm curious, somebody who has quote unquote abused their body over the years and had either a moderate or high carb diet, and they're somewhere along that continuum we talked about earlier of insulin resistance to all the way to type 2 diabetes, how is their metabolic machinery affected? If they adopt what we're going to talk about, continue to talk about today, going low carb,

Over time, does everything correct itself? Or because they push the boundary, someone like you, we can use you as an example, who, you know, you became type 2 diabetic over time and not realizing, because you were there and now you're back here, does your metabolism function differently even to today? Yeah, okay. So I have to use a drug metformin to keep my glucose in the ideal range.

If I were running two hours a day, because I'm very low carbs, probably 25 grams maximum a day. If I was running two hours a day, I wouldn't need the metformin. I would be burning that extra carbohydrate. But unfortunately, my body can't get rid of that excess carbohydrate. Even 25 grams a day is too much. And it's almost right, but it's not perfect. So I'm not 100% normal.

And that's because I started to change the diet too late. At the age of 60, it was too late. So if you were, let's say you were pre-diabetic, like those three people in our study of 10, they were 100% normal when they ate the low carbohydrate diet, 100% normal. You could never have said that they were diabetic.

It's only when they push the carbs to 200, 300 grams a day that it becomes apparent. So they would be the next group. That would be the group who are, it's sort of completely reversible in the terms that if they cut their carbs to, let's say, 150 grams, they're going to be fine. They don't have to go to 25 grams. If they went to 25 grams, they'd be fine, but they don't need to. So I think that's the point.

is the longer you wait and abuse your insulin-regulating system, the less carbohydrate you can eat and still maintain normal metabolism. So it's a very individual thing, and people have to understand, it literally is, the cutoff point is remarkable.

I've just reviewed a paper that was published probably a year ago, when they suddenly noticed that if you put people on a low carbohydrate diet, they took people, let's say, I can't recall the date, 150, 250, 350, 450, 500 grams. They noticed that you had to get right down to 150 or lower before you noticed the metabolic change. And these are athletes.

And that's the point. The instant response is so great and the instant is so powerful that until you get it down to those values I said of six units, it's as if you could have 60 or six, doesn't make much difference. You've got to get below 60 and then below six, and then you start noticing a difference metabolically. So I think that answers your question. Yeah, it sounds like there's a lot of difference person to person.

And the true way to test because of that is to test your fasting insulin as you make changes and make sure it's below that baseline level. Yeah, that's correct. And so then you could find out how much carbohydrate you can eat and still keep your insulin below six units. And for some people, it might be 150 grams.

And for some people, it might be 250 grams. I've not seen that, but it's possible. But for people like myself, it's got to be 25 or 20 grams a day to get it below that value. My insulin, by the way, is about two. So my insulin is two, but I still have to take metformin to keep the glucose in the normal range. And unfortunately…

a lot of people will probably stop without testing the insulin and just get their weight down to where they feel good about it, which isn't, as we talked about before, the whole story. That can be deceiving. Yeah, absolutely. So the insulin is the problem. We focused on glucose as the problem because we could measure glucose and we couldn't measure insulin. And that's why we focused on glucose.

And sadly, even the glucose isn't properly understood that you've got to get the glucose down below 6.5 or in the five to six range and keep it there all day. And that's people are not taught that one that at all. All right. Given the caveat, now we know it's going to be dependent on the individual. But for a person who wants to start today, cutting down the carbs,

Do you have a baseline number for everybody? Is it 50 grams a day, 100 grams a day to start and then to test down the line? Okay, so now I'm going to throw another curveball, a big curveball. That's what we've discovered. And it was not my discovery. It was obvious to others that the real problem for people adapting low carbohydrate diet is sugar addiction and food addiction.

And that's why the diet fails or succeeds on whether or not you control your sugar addiction. Because sugar addiction is just as bad as all the other addictions, in fact, probably worse. So when we tell people to start reducing their carbohydrate intake, a lot of them say, but does that mean I can't eat sugar? I'm not going to do it. Or I'm not going to drink alcohol. No, I can't do it.

So that's the first problem, that you've got to get over the sugar addiction even before you start worrying about the carbohydrates. And addiction behavior treatment is difficult. It's extremely difficult. So depending on the degree of your sugar addiction, you may need help. I was fortunate because I was raised in the 1950s and

And sugar hadn't really become so popular. And we only had allowed to have sweets once a week. I was so fortunate. So but I became sugar addicted. I was a profound sugar addiction, particularly with the drinks during marathons. I mean, I just love those drinks. And when you finish, you have more.

And it took me a year to get over the sugar addiction. I did it by first going straight to fat and protein diets, eating all the foods I love and getting rid of all processed foods. That was easy to get rid of that sugar. It wasn't so easy to get rid of the sugar in the drinks or the coffee or tea. And that took me 14 months. And all I did was I just slowly reduced the amounts. And eventually I was taking so little, I said, well, why are you still taking it?

And now I have no desire to taste sweet. If I taste sweet, I'll spit it out. So you can re-educate your taste. So that's the first thing you have to do is you just got to assess to what extent are you sugar addicted and start addressing that one. And then at the same time, if you want to, you literally start reducing from 400 to 350 to 300.

We had one guy who was an athlete and he went from about 350 to 50 and he couldn't get out of bed in the morning. He said, something's gone wrong. And we pushed him up to 150. He was perfect. So we've just got to be careful. There probably is a lower limit that most people can tolerate. And you just go move slowly down. And that's the way to do it. But the sugar, that has to be

You have to try to get rid of that. You can't really moderate that. If you understand that, you can moderate a little bit, but ultimately it's got to go completely because otherwise you just go back to looking for the sugar. So you ask the question. The point is most people probably listening to this are eating 300 to 500 grams of carbs a day. You don't go from 300 to 20 unless you're diabetic like me.

And then you feel so much better because your diabetes is suddenly reversed. You say, my gosh, I feel so amazing. There's no way I'm going to eat those carbs again. But if you aren't like that, you should just do it slowly. 50 grams a week, 100 grams a month, whatever. Just reduce it slowly. Because remember, this is the diet. This is the eating plan. It's not a diet. The eating plan you're going to follow for life. So there's no rush to get there. Just get there slowly and adapt. Let your body adapt to it.

Let's come back to the sugar versus carbs piece. Yeah. How do you separate those or do you when you're looking at, say, like putting sucrose in coffee and tea? You talked about the addictive nature of sugar versus, say, a loaf of bread. Is the addiction different? And how do you look at those two foods impacting the body? Is it the same? Yeah.

So I believe that there are people who have got a wheat addiction as well. So the one that is well-defined and is probably accepted as a sugar addiction, and that's obviously sucrose, as you've indicated. But I do suspect that there may be other carbohydrate addictions, and one of them might be wheat. So I wouldn't speak to that one.

But I suspect you can tell I had a bread addiction. I mean, I would just eat loads of bread every day. I would come home from work and I would start eating bread and my wife would say, I'm cooking this lovely dinner. And I would say, no, I'm hungry. It wasn't. I was addicted. I had to have the bread.

Well, I've seen you in a lecture post this great graphic that shows when we consume carbs, you had two different arrows that pointed to two different outcomes there, or at least the next step. One being cuing the hunger in the brain, and the second being spiking insulin. So we can't negate the fact that when we have carbs…

there is this cascade in the body that makes us hungry. - Absolutely correct. And ultimately, you have to treat the hunger. And so you have to find the diet that will allow you to eat fewer calories without being hungry. That's the whole basis of everything. So you can only lose weight if you find the diet that satiates you, but still provides the nutrients that you require.

And that, it turns out, is always a low-carbohydrate diet. Or at least as far as I know, for the vast majority of people, it's a low-carbohydrate diet. You mentioned the fact for you, at this point, it's 25 grams a day of carbs, which is basically nothing. An apple is 14 grams right there. So…

What does a day look like for you? How do you keep it so low? Because, you know, eventually, well, of course, I'm a lot older and I'm not running marathons anymore. So my total calorie intake is a lot reduced. So I just eat meat, fish, dairy, eggs, nuts, and the occasional vegetable. And those are the foods that I eat. That's it. And

And I love eating those foods. So I don't have any cravings. I have no desire to eat sweet stuff. I used to walk into the supermarket and I would get hungry. And, you know, you'd think, oh, gosh, I need some of that and I need some of that. I can walk into this. I honestly do not get hungry walking through a supermarket and buying food. I have no desire to eat. And that wasn't the case before.

So that's probably a good test is if you can go through the supermarket in the middle of the day when you should be hungry and not feel any hunger. So it's a slow process, but ultimately after a few years, it becomes a very complete swamp. You mentioned the fact that at this time you're on metformin. Is there anything in the natural realm supplement-wise that you've tried to substitute that would have a similar effect?

Or is metformin just working for you and you're happy there? Yeah, berberine is very effective. It's a little more expensive and I buy it when I have it, when I have access to it. I have to order it through the doctors and so on. It's much more convenient to get metformin. And so if my control is reasonable or good, I just stick with the metformin. So berberine, many people prefer berberine to metformin.

But there are studies showing metformin reduces cancer risk. And it's supposedly one of the safest drugs. It does have a problem that it interferes with vitamin B12 metabolisms. I have vitamin B12 injections on a regular basis, and I suspect that that's important. But it is one of the safest drugs that there are. And I'm the world's worst. I hate taking medication. So

But I've convinced myself and I've been taking it for 10 years now. So I'm happy that it's working. One of the things I was recently cued on to by Dr. William Davis is the fact that when you take berberine, it actually impacts the microbiome and kills some of the microbes. Have you heard anything about that? Or how do you think about the microbiome when it comes to health and well-being? The microbiome is really interesting because it's…

One of my people, a relative of mine, or a relative by marriage and so on, he started working on the microbiome. And I asked him, but how can you know when you've got trillions of bacteria, how can you know what you're actually measuring is real? And that's the problem. So that's the first thing is that how do you know what you're measuring is representative of what's happening in the gut?

The first point. The second point, in any new measurement in science, you have to be very careful that it actually means anything. For example, creatine, as a sports scientist, creatine came in 30 years ago. And for a period, everyone thought creatine was the answer. And today, we realize it doesn't really make much difference.

Heart rate variability. So you've got a heart rate monitor. Heart rate variability was going to tell us how you should train. 20 years later, they got the technology, but they couldn't find a disease for it to treat. That's the issue. And so that's what you have to understand. When new technology comes along, you've got to be very cautious because in the end, it may be meaningless.

And what concerns me is that when I read the literature on the microbiome, and this is, again, I haven't studied it in depth, but what I immediately noticed was that if you were a vegan doctor and you were studying the gut, you would say that this vegan diet gives you the right microbiome. If you were a carnivore, you'd say this carnivore diet gives you the perfect microbiome. So everyone was fulfilling their own wishes and they were finding what they wanted to find.

And so I tended to discount it until we've got really good evidence for it. I've no question it's important, no doubt, but I'm not so sure that we know what is the perfect microbiome for every single individual. That's the proviso. So I would say that if your whole body response is improving, then that might be the microbiome is making a major contribution.

But to actually study the microbiome and say that you must eat the carnivore diet because it gives you this microbiome, I'd say, no, you need to eat the carnivore diet because it gives you these benefits. Or conversely, if you believe veganism, you must eat vegans because it does this, that, and the other. And the microbiome it gives you is fine. That's part of the picture. But I don't think one should separate the two. So you've talked about berberine being a supplement that you take periodically. Yes.

And you mentioned creatine and how basically at this point there's no value in taking that. Are there any supplements that you're taking on a regular basis along with your low-carb diet? Yeah, I take all the vitamins A, B, C, D, E. And of those, I think the benefit for D3 and K2 is…

I suspect there's some value in the D3 and K2 keeping the arteries clean. It's still early days, but I've read enough to think that there's something. What really influenced me was the book by Weston Price. When he went through all these populations in the 1930s, isolated populations, eating diets very similar to mine. They only ate meat, fish, vegetables.

dairy, and other things. Like if you were in the Pacific Islanders, you had coconuts. And if you went to the Outer Hebrides in Scotland, where they had incredibly healthy people living in these isolated communities, eating fish and oats, and that's it. And yet they survived and they were flourishing. They had perfect anatomy, their teeth were perfect, yet they were eating a very, very

a very refined, not refined, a very confined diet. But he thought that there was something in some, particularly milk, he thought that was provided things because he found each community had one special food that they ate. And he called that the factor, I forget what it was, factor X or something. And it turns out that they were most likely vitamins. That's point one. And point two, there are some studies now showing that

that heart disease patients given multivitamins as a controlled study did better than the group taking the intervention, the pharmaceutical intervention. So there is just enough evidence to suggest that we probably could do with some vitamins. And having said that, there's clear vitamin D, you need to have a high vitamin D concentration in your blood. That's clearly protective against a whole lot of stuff.

And I just say, well, there might be some other vitamins that are helpful. I noticed my blood glucose control, I can change it if I take a lot of vitamins for a period that my glucose control becomes marginally better. It's a marginal bit, but I measure that as, okay, something's changing in a positive way. We will never know. We will never know whether you should take vitamins or not. We will never know whether the low-carbohydrate diet

it reduces heart disease rates because the studies are too complex. You've got to take a lot of people and study them for a long time and they've got to stick to the diet and they're not allowed to do anything else different but the diet. We can't do that. So it's all speculation and we've all just got to look at the totality of the evidence and see what works out.

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Given you are so close, have you ever played around with that? Or is there a reason you don't go all the way carnivore? Is it just for diversity in the diet? Or how do you feel about carnivore? Oh, I'm very supportive of it. I think you need to go on a carnivore diet if you've got an allergy to vegetables. And there are a lot of people who can't process vegetables because they contain lectins and all sorts of other things. And I suspect that some people have an allergy to certain of the proteins.

I was definitely intolerant of wheat. And I would get infections, chronic infections, sinus infections, and which would then go into my lungs. I haven't had anything in 10 years since I stopped. So I think there are allergies that you don't get if you eat meat. So I've seen too many people cure themselves completely of serious illnesses by just cutting out all vegetables.

But I literally have one squash a week or some asparagus or some things like that once a week. So does that make me non carnivore? I don't know. It was a lot of dairy and I do occasionally drink milk. So does that make me non carnivore? I'm not sure. But it's technically I am almost carnivore. And it's just that I do occasionally have vegetables.

And does your wife eat the same way you do? I could see how for a lot of couples who are going to make a dramatic shift in diet, like we're talking about today, you know, they may have kids or a wife that's eating standard. And of course, we're all on different journeys and we can all, if we want to change, we can all change at our own rate. But is that something that you've both embraced together? We're both very similar. She does eat a few of the odd bread and odd cakes and so on.

But she's not insulin resistant, so she can afford to. She's not diabetic, pre-diabetic or insulin resistant. And she's lean and without needing to be low carbs. But for our main meals, it's always we fish or meat or chicken or eggs. So the main meal is always the same for both of us. - As you talk about fish, it gets me thinking about omega-3s and different fats.

Is fish something you're including on a regular basis because of that? Do you ever take an omega-3 supplement? Fats are a really controversial topic right now. I'm curious how you think about those. The omega-3, omega-6 ratio, is that of concern to you? I think it's very important. And I think it's underestimated. And so what I've done is we've cut out, obviously, all vegetable oils.

and we don't have them and we do eat fish regularly and hopefully that's going to give us enough omega-3. I never took the supplements because I'm concerned that they could be oxidized. You know, I just don't know how do they protect against oxidation. So I haven't pushed that. I'd rather eat natural sources and try to make sure that the meat that you eat and the milk that you eat, drink comes from pasture-raised animals. That's not always easy, but

that probably is the best way you can do it. - Talk more about that quality piece when it comes to food, pasture raised, organic. How important is that for you and for people to consider? - Okay, so I think your diet can be improved, it can always be improved, and it just depends how far along the road you're going. I mean, I would love to live on a farm where I raise my own animals.

Then they were fully pasteurized. But it's impractical to find that at the moment. I think it would be really nice if we knew exactly that the food, we knew where it was coming from. However, eating meat versus, for me, eating meat versus eating a high carbohydrate diet, that's the major change I need to make. We can then refine it from there.

But I'm not going to kill myself if I have to eat a piece of meat which I don't think was pasture-raised. I still think the benefit is there compared to what were you eating instead of it. And as long as I'm not eating the carbohydrates, I'm going to prefer the meat and the fish

but obviously I would prefer to eat pasture-raised animals, but it's not always practical. How do you feel about intermittent fasting? So my great friend Jason Fung, who is the authority on fasting, and he uses it to treat diabetes, and he says it's easier because you don't have to worry about food because you're avoiding food. And I think that that's really interesting, but he's an expert, and it's more difficult probably to start on intermittent fasting

you need a lot of support. So, however, I absolutely agree. I think it's very, very important because that's the nature of the way humans used to eat. And that's what we're trying to do is always get back to our past and the way we used to eat. So the beauty of intermittent fasting is if you can intermittent fast, you're probably fat adapted. Because if you're not fat adapted, it's unlikely that you'll cope with intermittent fasting.

because you'll start to get hungry, you're not burning fat, you're burning carbs, and you'll start to get the need to eat more carbs. So to me, a person who can intermittent fast and doesn't need to eat for 18 hours or 24 hours is much more metabolically healthy than before they could do that. So I think intermittent fasting is a marker of metabolic flexibility.

And it's an indication that you're already getting there. Your body's already adapted properly. And then the fasting makes it even better. So most of the people that I deal with or know eat one meal a day, and that would be an equivalent to intermittent fasting. And so that's what I definitely promote. I promote one meal a day that you eat in an 8-12 hour period, and then you don't eat for the rest of the time.

- Wait, I wanna make sure I understand that correctly. One meal within an eight to 12 hour period. So is all the calories within one meal or is it spread out? - Yeah, you could snack as well. But again, remember that my calorie consumption is quite low now. And so I can easily fit it into one meal and plus one other snack later on. But that would be a meaty snack or a cheesy snack.

So then I can get the catapult. I mean, if you're a world-class athlete, it might be difficult to fit it all into one meal. But for the person who's struggling, who's overweight, and who's trying to lose weight, the key is to don't think you have to eat three times a day. That's a disaster. That's a disaster waiting to happen. You've got to get it down to two or one meal a day. And then you get the fasting coming with that.

One of the myths in the health and wellness space that seems to prevail even to this day is saturated fat and the fear of that. And for people that are going to be cutting down their carbs, naturally they're going to include more animal products. Their saturated fat percentage of their diet is likely going to go up. Is that at all a concern for you or how do you feel about saturated fat? So saturated fat, all it means is it's stable. That's all it means. Yeah.

Saturated fat is stable, and that's why it's incorporated in the cells, cell linings, because it's stable. If you eat unsaturated fat, like polyunsaturated fats, vegetable oils, they're unstable, and they destroy the cell lining, and they cause all sorts of inflammatory responses. So when I changed my diets, I started reading the literature and

then realized that the case against saturated fat was completely and utterly bogus, completely bogus. And so you may remember that I went through a trial for promoting this diet. And I described that in this book, Real Food on Trial, which gives the story of how the diet dictators tried to destroy top scientists.

And what happened was I had two years during, four years, but two years to present my case. And I went through the literature and I wrote a series of columns and I wrote the whole story down. It was just nonsense. There's never been any evidence that saturated fat causes disease. It's always been evidence it's carbohydrates that are doing it and the refined, particularly ultra-processed foods.

But unfortunately, the industry, my industry, medicine, makes a lot of money out of telling you that saturated fat raises your cholesterol and causes heart disease. Well, the evidence is absolutely the opposite, that saturated fat's got nothing to do with arterial disease. It's all related to insulin and glucose and diabetes. And one of the things we do, my foundation does, is we teach physicians all around the world

And one of the ladies who's on our current teaching program is a vascular surgeon in Los Angeles. And we asked her, so why would you want to do this course? She said, because I operate on these arteries. And she said, I can tell you one thing. It's got nothing to do with cholesterol. It's all diabetes.

and I'm tired of cutting off legs and trying to fix up arteries, when you know that in a year's time, that artery is going to be as diseased as before, because it's the diabetes that is causing the arterial disease. And the moment you cut saturated fat out of your diet, you're putting yourself in a high carbohydrate situation, which is what's really going to destroy your arteries. And medicine knows that, because we treat all these diabetic patients for arterial disease.

But then if you ask a medical student, what causes arterial disease? Oh, it's high cholesterol diet. But hold on, this patient lives in a poor community in Cape Town. They eat sugar most of the time and bread and a high carbohydrate diet. Where's their fat coming from? Because fat's expensive. Oh, doc, I'd never thought of that. We had one of our professors who trained a few years ahead of me, goes to the Mayo Clinic,

becomes a world authority on statin drugs to lower your cholesterol. He comes back to Cape Town and he gives a lecture. Now, of course, he's the visiting honored person bringing slides, being the expert. And he tells us that the reason why we've got so much heart disease in Cape Town and the poorer people is because they're eating too much fat. Our research group studies what these people are eating, the poor people eating in Cape Town. It's sugar and bread. That's what they eat.

And if they get arterial disease, it's got nothing to do with saturated fat. That's how ignorance, that's the extent of the ignorance. This afternoon, before we spoke, we were discussing on later's program, I was talking to a doctor from Ethiopia. He says diabetes is rampant in Ethiopia. Heart disease is rampant in Ethiopia. He said, what are they eating? Well, it's a traditional, more vegetarian type diet because meat's too expensive.

So the truth is all out there. It's got nothing to do with saturated fats. But the industry managed to fool the world. And they took me to court to try to make me shut up by saying that cholesterol has got nothing to do with heart disease. Well, it's interesting because as you're talking there, it gets me thinking about the fact when it comes to diabetes…

mainstream will accept the fact that it damages vasculature in the eyes and people have trouble with wound healing in the feet and the legs. But then when it comes to the heart, we blame it on saturated fat. So it's just this incongruency of the root of the issue. And I mean, if you go to a renal unit where they treat people on dialysis, in this country, 80% of the patients are diabetic.

And the renal disease is caused by arterial in the very small arteries in the kidney. That's what causes the problem. So it's a specific type of disease and it's specific to diabetes and it causes all this kidney failure. It's an arterial disease. It may be in the kidney, but it's an arterial disease. But they can't put the two together. And because if you do that, then you're questioning the cholesterol theory and that makes you a conspiracy theorist.

I was called a cholesterol denialist. I describe it in here, the cardiologists in my town. Noakes is a cholesterol denialist. We've had enough of AIDS denialists in Africa, and now he's a cholesterol denialist. What is a cholesterol denialist? I mean, that's… You've touched on plant-based diets a couple of times there.

Have you seen anybody successfully adopt a low-carb diet while staying plant-based? Yeah, certainly some people have reported that they have benefited from it. And so I accept that. And there are people who claim that a zero-fat diet can also reverse diabetes.

But I want to see the evidence. The evidence comes from some very shady studies done, I think in the Philippines or somewhere, there was some sort of guru who started promoting this zero fat diet. And when I was starting running, there was a guy called Pritikin in the States who was promoting a zero or very low fat diet. And

Ultimately, he committed suicide, and whether that was because of the low-fat diet or whatever, but it never took off. Except, sadly, Senator McGovern, who was driving the 1977 dietary guidelines, was a fan of Pritikin, and he promoted this low-fat diet for all Americans and as a consequence for all the world. And he was very strongly influenced by Pritikin.

And so Pritikin's stamp still exists around the world. So it is true that there are claims that a zero-fat diet can reverse diabetes, but I can't see how it works. I just, I can't see the mechanism because a zero-fat diet is a high carbohydrate, very high carbohydrate diet, and that must stimulate insulin and that ultimately must cause problems.

I was in an interview with another very famous podcaster in America. I won't mention his name. And he believes he went from low carbs to low fat and higher carbohydrate and said he lost a lot of weight and it cured his glucose, improved his glucose. So I believe that, but I don't know how applicable it is to the general population. It definitely sounds scary to me considering the fact the brain is predominantly fat and the

neurons are covered in fat as well. It just doesn't seem to make sense. No, I agree with you. I wouldn't want to do that because dementia is a real issue. And it seems to me that dementia is strongly linked to a fat-free diet or a diet low in protein. And the other thing about a low-fat diet, I worry about osteoporosis as well. It's interesting, I was watching yesterday the

The King of England was walking and marched while walking. They were walking together with the Prime Minister or the President of France. And the President of France is a very upright man. And it's clear to me that he does body, he does weight training because he's got a lovely arched back and his head sits straight above his spine. There's none of this. But if you compared him to the older King, you see the older King was like this.

And he doesn't have to be like that. Even though he's my age, he doesn't have to look like that. And I worry that when I look around at people my age, that's what I look for. I look for the presence of this fixed, rigid position and osteoporosis. Because the professor who advised me to eat a low-fat diet died of advanced osteoporosis. And no one questioned, hold it, you've eaten this almost fat-free diet.

And you get osteoporosis, you know, could it have been linked? No one questioned that. Up until this point, we've talked about exercise predominantly from an endurance perspective. When it comes to insulin resistance, regulating blood sugar, we should get into the aspect of resistance training, putting muscle on the body and how that makes us more insulin sensitive. So how do you look at that for your own lifestyle and using that as a buffer?

And is this even a good thing? Thank you very much. Obviously, exercise is a good thing, but I mean, to use that as a buffer. Yeah, I think that's a great question. So all my, I ran 70 marathons, or including some ultra marathons, and I still got type 2 diabetes. And so clearly, that's not going to, we're not going to protect. And in fact, there's a study recently published about a month ago on the metabolic health of marathon runners, and it wasn't great, which is,

you know, surprising. So because I would have expected it to be. From my personal experience, unquestionably, if I run, my glucose control is easier. There's no question. If I run for the next 24 hours, my glucose control will be better than if I hadn't run. And I think that's because I've emptied my muscle glycogen. However, I also do weight training and I've got much more upper body strength and

decent back and strength and so on. So I put on at least three or four kilograms of muscle and I'm sure that's helpful. But ironically, it's not as effective for my glucose control as is running. So that may be just me, but that's what I observe. However, what I do know is that I get as much benefit from weight training now as I did from running when I was 20 or 30. I feel as good

And I enjoy it as much. And I think my health has benefited hugely because I think that at my age, you cannot lose muscle. You've got to keep the muscle and running doesn't do it. Running doesn't do that. And so I think that weight training, once you get over 60, it's time to cut back on the running and increase your high intensity training.

including weight training and also flexibility and gymnastics and so on. Those are crucially important. Earlier, you talked about your court case and the whole multi-year process that was for you. And it all started with a tweet. I think at this point, it'd be interesting to get into what went on there and how that changed the trajectory of everything you're doing today. Yeah.

No, that's absolutely interesting. I mean, it gave me another career, which is fantastic. It extended my career for another 10 or 20 years. So in retrospect, I laugh about it now, but it was awful at the time. So what happened was that I changed my diet. I announced it in an article I wrote, and I lost all my funding. That just disappeared. And I became the pariah. And by chance, we also wrote a book called The Real Meal Revolution.

What happened was a friend of mine and his friend ran the length of the Greater Wall of China, which is, I forget now, it's 5,000 miles or 5,000 kilometers, but they had to run a marathon a day for 100 days. So that tells you it's 42,000 kilometers or 26,000 miles. It can't be 26,000 miles. It's 2,600 miles.

That sounds even too far. But anyway, it was a long way. And halfway through the run, they're in outer Mongolia and they're running out of food. So the locals tell them, you're only going to finish this if you eat pork fat. So they were fed pork fat and they finished it. So when they came back to Cape Town, they said, well, why don't we write a textbook or a book, cookbook on high fat diets for athletes? And they said, would you write the four words? So I said, I started, I thought, sure, I'll do it. And then

I was starting to get attacked. So I decided, well, actually, I'm going to put something solid in this. So I put 25,000 words about the benefits of the low-carbohydrate diet and the fact that saturated fat doesn't cause heart disease. And the book went ballistic. It just sold more than most books ever in South Africa, huge amount, was extremely successful.

And as a consequence of that, people now suddenly heard about this thing, this low carbohydrate, high fat diet. And they went to their dieticians and they said, but this guy in Oaks is saying you must eat more fat. What are you saying? Oh, you can't eat fat because you're going to get arterial disease. Because that's what my training tells me. That's what the dieticians are telling him. So the dieticians got very, very concerned. And I gave a talk in Johannesburg and six of them came along and they taped everything I said.

And at the end of the talk, they placed a question, which I'd never heard before, and I had nothing to do with that. They did not say a thing. They said, Dr. Noakes, what about breastfeeding? And something about high-fat diet, high-carbohydrate diets. I forget what it was. But it was completely, I wasn't talking about breastfeeding. Not at all. So where did it come from? So then, about a week later,

A lady asked me a question in which she asked what we call a wee question. And it said mothers and babies. It didn't say me and my son. It said mothers and babies. And the question was, can mothers and babies eat high fat diets or does it cause colic and wind in the baby? So I responded because I thought, well, it's kind of, it's not likely to happen because it's

The baby's only getting healthy breast milk. And then I said, the key is to wean your child, or wean baby, the key is to wean on a high-fat, low-carbohydrate diet. But I didn't say LCHF diets, or I didn't say real foods. Sorry, I said low-carbs, high-fat diet. If I'd said real foods, they couldn't have complained.

But because I said LCHF, they said, oh, but this is a ketogenic diet and ketones kill the brain. They kill the baby, which is, of course, the opposite because the developing brain of the neonate requires ketones. Ketones are absolutely crucial. That's why children are born fat and they convert that fat into ketones and the ketones cross the blood-brain barrier and develop the brain. So the lady who complained hadn't a clue. So anyway, she put in a complaint that night that I tweeted it.

And it was seven words, and it became the most expensive tweet in history because it cost me a lot of money, but it also cost the opposition a lot of money. So anyway, I was reported, and the Health Professional Council took it up. But their goal was to shut all doctors from speaking on anything they didn't want them to talk about. It was just an excuse. We'll use it on diet with NERCS, but if we can shut him up,

then no doctor will be prepared to say anything about anything in public in future. So it became a free speech issue. And so we went to court for 28 days over four years. And eventually we won on everything. There were 10, 13 decisions. We won all 13 decisions. And so I was declared innocent and that what I said was correct. And it was not unscientific or whatever. I can't remember the details.

So I won the case and it was so funny because the response of the dieticians was, he may have won the case, but that doesn't change anything. We're still teaching what we've always taught. And they've continued to teach that, which is sad. Because what I know now is that if you are telling diabetic patients to eat anything but a low carbohydrate diet, that is malpractice. That is gross malpractice. And…

It's such a pity because they're harming so many people. You touched on this earlier. It sounds like the resistance to what we're talking about today all comes down to money. Oh, absolutely. Absolutely. So I became very friendly with Greg Glassman, who started CrossFit. And he emailed me and asked me, would I come talk in America about the waterlogged story?

And I said, but why? I mean, this has got nothing to do with gyms and weight training and so on. And he said, no, you were one of the first to tackle industry and show how they distorted the science. And it turns out that CrossFit, the evidence was presented in a scientific paper, and it originally had nothing to do with injuries.

And the editor of the journal said, I'll only publish this article if you include negative effects of CrossFit. Can you believe it? So anyway, so then they got 20 people who supposedly got injured from CrossFit. And Greg looked at it and he said, this is fake. Those are not the injuries that you get in CrossFit. Because he's a tough guy, he said, I'm taking you all to court. And he took it to court, the editor said.

of the journal, the company that publishes the journal, the person who wrote the article, and then all the 20 people who were supposedly injured. He said, “They come into court because we want to see what injuries did they have.” It turned out they didn't have injuries. So it was all fraudulent, and he won the case. Now he's focusing on promoting this idea that a lot of the science is falsified. So that was

What I learned, and then when my child began, he kindly sent his experts out here to see who was behind it. They discovered that there was an organization called the International Life Sciences Institute, which is a front for the food industry and pharmaceutical industry, that many of the people who evolved against me were members of ILSE or position holders in ILSE. Then he showed the influence ILSE had in South Africa.

not just in South Africa, but around the world. And that, of course, has since been exposed. So that made me realize that this was not just a single dietitian in South Africa who got angry with me. Well, given this situation, what's it going to take to break through with this information and to have actual real change in the mainstream? You know, that's the question that I ask myself almost daily, and people ask me that question. And

Let me give you an example of how complex the story is. The High Court in Pretoria, South Africa, recently passed a ruling that the documentation that the South African government had to sign with the pharmaceutical industry regarding vaccinations, they got access to that. And the only country where that access was got. So they got the documents that the South African government had signed,

signing off the amount of money they were going to pay to the pharmaceutical industry to get the vaccines. And then in the small print, it says that in essence, that by signing this, you accept that there's no evidence that this vaccine is safe, that it has been subjected to long-term safety studies. So we were told that this vaccine is safe and effective by government that knew it wasn't or knew it had never been tested.

That's what we're fighting against. When people see that and they say the absolute lies that are being sold to us, they might start questioning about nutritional advice. But until that happens, we're in real trouble. The problem is if I'm the professor or I'm the dean of medicine at a university, it doesn't matter whether it's in America or South Africa,

My university, my department, or the medical faculty can only run because of the support it gets from the pharmaceutical industry. Anytime I stand up against the pharmaceutical industry, as I did, I had to be got rid of because I was a threat to that relationship. And so the only way the medicine will become independent is when it breaks that linkage to the pharmaceutical industry. But when that's going to happen, I don't know. The head of the Noakes Foundation, she was at…

a local diabetes endocrinology meeting last week. She said she didn't hear any science, not one paper of science. All it was this insulin versus that insulin in diabetic patients. And these are the outcomes. No one's questioning how do you use insulin? Should it be used? Et cetera. All the stuff we've talked about that doesn't get spoken about. But

there was lots of support from the pharmaceutical industry that sells insulin. That was everywhere. So that's the reality. The question is, how long can they keep going? Being a conspiracy theorist, there's a possibility that they've gone too far with the vaccine and that the harm that has been caused could bankrupt the vaccine manufacturers. And that might take out one or two pharmaceutical companies.

And then that has a knock-on effect because then the medical schools, where are they going to get their money from if it's not coming from the pharmaceutical industry? So it's interesting times. And I think the public are a lot more wary about the medical profession today than they were because some of them are realizing that we were misled about the need for all the interventions that were put on us for this so-called COVID pandemic.

And people may start questioning. And the more evidence that they see for wrongdoing, the more likely it will be to change. And I think medicine has taken a big blow because the profession was very supportive of the lockdown and all these other things. And now people are realizing there was never any evidence that we needed to go that far. But we destroyed countries, we destroyed individuals, we destroyed lives.

We've destroyed people's income generation by doing all these things. Coming back to your message and what we've talked about primarily today with the diet being the biggest piece and then exercise and other details, the good news in all of this is that people can take this information in and apply it on their own. With what you're talking about today, it's not like you have this drug people need and you need FDA approval and

You're sharing this information. It's powerful. People can shift on their own and make these changes. And now with the internet and things spreading the way it does, I'm sure the work you're doing and coming on shows like this and sharing all that knowledge you've accumulated is just such a powerful way for creating change. Yeah, thank you. And that's why we do it.

And, you know, I'm just one of hundreds of dedicated doctors. And I must tell you that they're the most interesting group I've ever dealt with. Low carbohydrate, dietitians, doctors, psychologists. They're the most interesting group because they're the mavericks. You know, they've seen through the system. And you have to be very courageous to be the maverick because almost all of them have been censored in some way and their careers have been influenced. So,

They're a remarkable group. And the message just grows and grows and grows. I mean, even last week, I was approached by people who want to do new ways of getting this information out. And they formed a collection of all the top social media people who are promoting the low-carb diet. I'm not one of them, but they've got these people. And they

When you look at the reach of these people, it's astonishing. They're reaching millions of people every day. So they realize that the market is there. It's just got to be properly serviced. And once we get those people working together, and then who knows how far it's going to spread. Also, people need to be ready to change.

So for 33 years, I promoted the carbohydrate diet and it took me to get sick. And when I got sick and felt fat and lazy and couldn't run properly, I was ready for change. And that's the moment. The moment you're ready for change, then all this information suddenly makes sense. Well, I want to commend you as somebody that was in that other polar opposite field of nutrition than you are today.

to be willing to make that shift. And again, it comes from a personal place, your own health degrading. But you've done all this work and you had your running book you showed us earlier and you've gone against everything that you were promoting before. And I think that just gives you an extra layer of credibility and your message just lands in such a real way because you've been willing to

adapt and change your message as you've learned new information. No, thanks, Jesse. That's very kind of you to say that. You know, the irony is that I will never suggest that my trial was a simple thing. And, you know, you can read the book. It was really tough. You know, when you have the whole profession against you and remarkable beauty as you learn who your friends are, because your friends, the real ones come to you.

And I had these two lawyers who are the top lawyers in South Africa. And they came and they said, Tim, this is serious. This is important. We're going to defend you at no charge, no cost. Without them, I couldn't have afforded what we did. It was astonishing. Now, those are the people, and they are now my dearest friends. But I lost a lot of people who left me and people I trained and thought were honorable. They disappeared because their careers were on the line.

If they associated with me, they would be in trouble with the people they worked with. And that's how the shaming works. It spreads virally through the community. One of the professors told me, he was told, you do not talk to Nogues because he's bad news. That was the message that was sent out amongst the professors of the University of Cape Town. I mean, it's remarkable. You're not allowed to think for yourself.

So anyway, it was tough. We got through it. And it was amazing because I now got this other career in looking again back at carbohydrates and exercise. And so I'm having a fabulous time writing a definitive article on carbs and exercise. And literally what I told you earlier came to me about a month ago, that this carbohydrates

is the thing that you protect and you've got to keep your glucose down. And that's the failure of that system that leads to pre-diabetes and diabetes. It came to me literally a month ago and it's taken 40 years for me to see it. But there it was, when I looked at the research we'd done, it's all there, but no one had put it all together.

Well, Professor Noakes, you've been doing amazing work in the world for a lot of years. I'm sure you're going to continue to do that. I want to thank you for coming on the show and sharing so much knowledge with me and the audience. We're going to link up your website, your foundation, your social media, everything in the show notes. And I just want to thank you so much again for the work you're doing and for coming on the show.

Well, that's so kind of you. And it's been an honor and a privilege to be on your show and allowing me to speak for so long. That's really kind of you. And thank you for the way you directed the discussion. I think it's, hopefully it will be very valuable for many people and help drive our message that we want to get out. And thank you for what you do for this, for all of us as well. Much appreciated. And again, it's been a privilege to be with you.

And my pleasure too. Thank you, Professor. Thank you so much. I really enjoyed that chat with Prof Noakes. I hope you did too. Let me know what you thought of it over on Instagram. You can tag Ultimate Health Podcast. You can take a screenshot of the players who are listening. Be sure and tag me so I can connect with you over there.

For full show notes, head over to ultimatehealthpodcast.com slash 564. There's links to everything we discussed today and so much more. Be sure and check those out. Have an awesome week. I'll talk to you soon. Wishing you ultimate health.

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目录

低碳水 Tim Noakes 教授

Deep Dive

Tim Noakes：从高碳水饮食倡导者到低碳饮食的坚定支持者

蒂姆・诺克斯教授谈碳水、胰岛素抵抗与慢性疾病

胰岛素抵抗：多种慢性疾病的根源

胰岛素抵抗的本质：人体与碳水的 “不匹配”

胰岛素抵抗的隐匿性：看似健康的 “隐患”

如何判断自身胰岛素抵抗状况

糖尿病治疗中的误区：胰岛素的过度使用

低碳饮食如何改变代谢机制

碳水的代谢路径：从储存到转化

低碳饮食对运动表现的影响

低碳饮食能否逆转代谢异常

开始低碳饮食的建议：从克服糖瘾开始

糖与碳水的成瘾性及对身体的影响

诺克斯教授的日常饮食

补充剂与健康：诺克斯教授的选择

对生酮饮食和肉类为主饮食的看法

脂肪与健康： omega-3 与 omega-6 的平衡

间歇性禁食的价值

饱和脂肪的争议：并非健康威胁

植物性低碳饮食的可能性

运动与胰岛素抵抗：耐力运动与力量训练的作用

诺克斯教授的诉讼经历：为科学发声

医药行业的影响与医学的未来

传播低碳饮食知识的力量

个人转变的力量与信息传播的意义

总结

目录