HD on Boundless Health Podcast…Again


I love talking to Dr. Bret Scher, Preventive Cardiologist extraordinaire and host of the Boundless Health Podcast.  He recently had me on his show for the third time and – as usual – this was a wide-ranging conversation.  I wonder if he’ll continue to invite me, as he’s been killing it with some A-list guests recently.  Not sure exactly where I fit into that mix, but for now, I’m happy to chat with him whenever called upon.

Allow me to tempt you with just a few of the topics we explore in this episode:

  • My (early) personal experience with time restricted feeding (TRF) and what I hope to gain.
  • What I think about non-physician engineers like Dave Feldman and Ivor Cummins (both recently interviewed on the BH Podcast – you should definitely listen to these) tackling cholesterol and glucose metabolism, respectively, from novel angles.
  • The problem with making the ketogenic diet the “standard of care” for diabetes.
  • Why I think that smart people are stupid about their healthcare.

You can access the episode by searching for the Boundless Health Podcast using your favorite podcast app, you can click on this, or if you don’t like that, you can click here.  One of the methods should get you there.  As always, feel free to come back and comment after listening.  Enjoy!

By reading this site, listening to the podcast, and/or interacting with me in the Comments, you agree to abide by my Disclaimer.


7 Replies to “HD on Boundless Health Podcast…Again”

  1. Interesting podcast. I would caution you not to fall too far down the Insulin fairy/LCHF/fasting, rabbit hole for which Dr. Scher seems to have grabbed a pom pom. LCHF has been around for over a hundred years and is reinvented by the latest salesmen/guru’s every 10 years or so.

    Most obesity experts agree on two things for LONG TERM healthy weight management – real food and adherence. The second is key, if you don’t enjoy your life while you’re losing the weight, its coming back on.
    Its astounding how many smart people think that lowering insulin is required for weight loss, while completely ignoring the insulinogenic effects of protein (whey, beef, etc). Tim Noakes is an example of a brilliant man who is now seeing science through his own personal conformational bias

    Evidence based nutrition and lifestyle advice is ridiculously boring and does a lousy job of selling books and driving sales.
    – Eat real foods, mostly plants
    – Get adequate sleep/improve sleep hygiene
    – Move more, find something you enjoy, be consistent, weight bearing activity is also very important.
    – Be part of a community, laugh, be social, take vacations, etc.
    – Find a physician, nurse, or dietician to help keep you accountable and provide guidance.

    Oh, and if you’re still looking to bulk up, eat more. You’re welcome.

    1. Crusty, I love the way you think (and the way you write), and we agree on most points you make about diet and lifestyle. I can’t speak for Dr. Scher, though I think it’s fair to say he is more enthusiastic in general about the LCHF approach to food than I am. However, I like the ketogenic diet for diabetics, if they find it sustainable, as the improvement in glycemic control, weight, and other metabolic parameters can be truly impressive in a very short period of time (a la the Virta Health data). Though diabetic people could achieve similar results through a more measured and balanced approach to diet, the problem is they just don’t – in my world, at least. I do think there is something unique about cutting out starches in the diet that truly cuts cravings for more of said starches and sugars, and helps break a cycle of overfeeding for many folks who can stick with the KD.

      I don’t think I’m in danger of falling too far down the rabbit hole, but then again, it’s hard to be objective about oneself, so I promise to be careful! As you heard on the podcast, I am midway through a 3-month self-experiment with time-restricted feeding, not to lose weight, but to perhaps improve insulin sensitivity and increase autophagy. How helpful has it been for me? I don’t know yet, but I like the medical journal data I’ve read so far, which is why I decided to try it. One thing I have found, now that I’ve kind of figured out how to get enough calories in on fasting days: not eating breakfast has completely knocked out the major hunger I used to have mid-morning, which feels liberating. Could I have achieved the same result by eliminating all starch and fruit from breakfast and eating pure protein and vegetables? Probably, but time is limited on work days and I don’t always have time to cook a protein and vegetables. So I think I may continue TRF long-term, but we’ll see!

      In any case, I love your sensible approach to wellness. Thanks for the comment.

  2. Hi Crusty. I appreciate your comments, especially about the evidence based nutrition and lifestyle advice. That is exactly what I wrote my book about, Your Best Health Ever. And you’re right. That advice does not sell a lot of books! No question you are correct in the core principals of sustainable health. The fascinating part comes in when people are already insulin resistant and metabolically unhealthy. For some of them, a ketogenic diet may be the best solution, at least to help them overcome their metabolic syndrome/insulin resistance/diabetes, and then they will do much better on a real foods diet after that. I am a strong believer that everyone is an individual. For some of those individuals, KD is a great way to go. For some it is not. But at a minimum, I believe a LCHF/KD needs to be part of the medical conversation. One more tool in the tool kit. Thanks again for your comment.

    1. Bret, I agree that the KD can be a useful tool in the tool kit. However, I do worry about diabetics using it for awhile and then trying to transition back to a less restrictive eating strategy. My concern is that they will have been “treating” their IR, but not “curing” or “overcoming” it. So when they try to eat more starch, even healthier starch, they will find that they are back in a cycle of hyperinsulinemia and back on the path toward hyperglycemia and diabetic complications. So while I am not advocating that all diabetics eat ketogenically (I believe they will fail), I am saying that the ones who do should probably try to stick with it long-term, perhaps just building in some “cheat” days or weeks into each year, so they can still enjoy a beautiful baguette every now and then.

      1. Agreed! I think the word “cure” is an interesting one, and maybe “in remission” is better. The tendency to become insulin resistant or even full blown diabetic will likely always be there. It can be kept in check with lifestyle, but not sure we can think of it the same way we can cure an ear infection. Great point!

    2. Hi Dr. Scher. I did read (and enjoy) your book as recommended by HD. I also enjoy your podcasts.
      I agree that LCHF is a tool to be used as appropriate and ideally recommended by knowledgeable professionals. As far as I know, we still don’t have any long term data, or population studies on health outcomes for individuals who have followed a KD/LCHF diet for decades. We have an animal model that seems to imply a potential age accelerating effect of a high protein diet (MTOR pathway, IGF-1). I’m concerned when i see patients putting butter or MCT oil in their coffee, have bacon wrapped steak for breakfast, yet exhibit real fear around eating a handful of carrots, a tomato, or a mandarin orange.

      HD, I’m also very intrigue by the potential effect of TRF on increasing autophagy. I feel its a valid strategy for potential health optimization (versus disease treatment).
      I spent 5 years working in an integrative cancer centre (which, as you can imagine HD, led me to massively dislike alternative medicine). Fear sells, A LOT. The one think that i will share anecdotally (with some ongoing clinical trials to potentially support this), I found a significant decrease in chemotherapy side effects achieved via TRF/fasting 24-72hrs. I collected over a hundred case reports that one day I should get around to writing up.

      The Virta Health group publication is interesting. I would have preferred to see a longer duration study, a control group, and the research carried out by individuals not directly tied to Virta Health. In many regards it reads somewhat like the magic joint formula ads that are in my local Thursday flyer, sounds too good to be true, but you still can’t help but call the 1-888 number. I don’t have a horse in the diet race but at least this study was longer, and published in a respectable journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/ .

      Thanks for the discussion.


      1. Hi Crusty. Great comments. The protein issue is a fascinating one. The main difference between KD and Atkins is that KD is (or at least is “supposed” to be) low carb, high fat, moderate protein, where as Atkins was high fat and high protein. Obviously everyone does it differently, but I agree with you. Keeping up with the veggies, minimizing all other carbs, liberalizing the fat, and maintaining moderate protein seems like the best template. But we are all individuals and thus the approach will vary.

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