Keto Saved My Life — The Future of Metabolic Medicine | Nick Norwitz PhD MD

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I often say the most remarkable thing about my story is it's not at all unique.
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People suffering with chronic diseases to become desperate to try something that's out of the mainstream and then it works, and then you're left bothered about why nobody told you about this before.
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Welcome back to the Health Longevity Secrets Show, where we push the limits of human potential and unlock the secrets to our health and longevity with your host, Dr.
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Robert Lovkin.
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In this episode, Dr.
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Nick Norwitz, a PhD in human metabolism and a freshly minted Harvard MD, shares how disease nearly ended his career before a specific diet put him in complete remission.
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We dive into why evidence-based doesn't always mean best care, how wearables and CTMs are rewriting the rules of diagnosis, and while why tools like keto, fiber, fermented foods, and even GLP1 medications can radically change the future of metabolic and brain health.
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Stick around for some great tips.
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And now, please enjoy this week's episode.
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Hey Nick, welcome to the program.
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Thanks for having me, Rob.
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Nice to be here.
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It's it's so uh as I was saying offline, it's so great.
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I've you know followed you for a long time.
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It's it's always it's always great seeing someone that you respect and follow and uh learn from to finally meet if if only it's from Zoom from California to Boston, but still that's that works.
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And you're you're one of the uh you know, you know, you you're truly a leader in the metabolic space as your you know your degree show and everything.
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And and uh before we jump in though, you you have an interesting story that um that our listeners may not have heard yet.
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Maybe you could start off with that and just kind of uh tell us how you came to be interested in this area and become so passionate about it.
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Thanks.
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Thanks for the generous intro.
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Uh it feels weird being referred to as like a leader in the space.
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I feel like I'm just getting my lift off, but I guess that'll come come in my story.
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So um for those who you know don't know me, don't know my name, my name is Nick.
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I'm a 29-year-old living in Boston, Massachusetts.
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I just finished up my time at Harvard Medical School and have somehow found myself in this metabolic health space.
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So, how did I get there?
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Well, I grew up in a um a medical and scientific household.
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Both my parents are actually academic physicians, both MD PhDs.
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And I always loved science.
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I always held the highest respect for medicine.
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So it was just kind of the default that I would practice my exploration of science through the practice of medicine.
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So I always envisioned becoming a physician and becoming an academician, a scientist.
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So, you know, MD for sure, maybe a PhD.
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And so as I was going into finish up college, I went to college at Dartmouth and Hanover, New Hampshire.
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And then going on to grad school, I went to Oxford for my PhD in human metabolism, in particular brain metabolism, before going to medical school at Harvard.
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At the end of college and at the beginning of graduate school, I was really struggling with inflammatory bowel disease.
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So specifically ulcerative colitis.
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For those who don't know, apologies for being graphic, but people get IBS like tummy troubles, constipation diarrhea, and inflammatory bowel disease a little confused to be clear about what I was experiencing in my everyday life.
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Bloody diarrhea a dozen plus times per day.
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I was deteriorating physically, and because of the uncontrollable nature of the disease, um, the pain and ultimately the malnourishment that resulted from just not being able to eat well, I started to really deteriorate.
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So I went from being a pretty competitive athlete.
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Even at age 17, I was a sub-three marathoner.
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I was setting like push-up records in high school and was very academically inclined to being pretty not only frail physically, but withdrawn socially and not struggling academically in the I'm having trouble choosing the right answer on an exam, kind of struggling, but academics become really hard when you can't like sit for an exam because you're worried about having to run to the bathroom streaking red, or um, you know, just being able to spend enough time in lab because you're having medical emergencies.
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So when I was in grad school, I was in the hospital a lot, at least at the beginning.
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So I was really losing a lot of myself.
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Um, and while all my opportunities were nice on paper, I was just like deteriorating as a person.
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Um, that brought me to a place of desperation.
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I think a lot of people have been there.
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I don't need to talk about what it was like, but anybody who's been there has a loved one who's been in that kind of space, headspace, knows that you're willing to try anything.
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So I got to this point where I diverted from the mainstream and what is quote unquote evidence-based.
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We can get into, you know, why I put quotes around evidence-based later if we have time.
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But uh I started trying different things, not out of expectation, but of desperation.
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And eventually I found a ketogenic diet was tremendously impactful for my inflammatory bowel disease and overall quality of life.
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So I went into remission clinically based on biomarkers, based on biopsies on my colonoscopy and complete remission, like my disease was gone.
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That allowed me to finish up my PhD and go to medical school and complete medical school.
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So sorry, I'm being long-winded, but the point is that personal experience really framed how I went through my graduate level studies and how I went through medical school.
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And what I started to notice was that my story arc was patterned.
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I often say the most remarkable thing about my story is it's not at all unique.
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People suffering with chronic diseases to become desperate to try something that's out of the mainstream and then it works.
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And then you're left bothered about why nobody told you about this before.
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So I'm gonna kind of leave it there as to how I got interested in this space.
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I'm not leaving with a chip on my shoulder or salty.
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I have a little bit of a different perspective, but that is what originally drew me in to metabolic health, ketogenic diet, health span, longevity, and looking at the science through a very different lens than I ever could have imagined.
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And and if your your journey is is really unique.
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You know, you you like you said you your PhD at Oxford in in essentially metabolism-related things, and then and then to one, you know, top medical school uh finishing a medical education, Harvard Medical School.
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And so I guess the the question, what how are those different in changing your views of metabolic health as you went through those?
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And uh, you know, I've got a 16-year-old daughter who's asking me, hey, daddy's a doctor, shall I go to medical school?
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Shall I go to science and study this or that?
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What how is that how has that experience informed your your view through the process?
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And if you had to do it again, what would that look like?
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Yeah, that's a very good question, an important question to ask, and a difficult question to answer.
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Um you know, for me, I think the thing that that caught my attention most about medical school is observing what was not taught and what was not cared for.
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And the kind of things that you know I got up and read about in the pages of Nature's Cell, Cell Metabolism Science is omitted from medical school.
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And it's not omitted because I, you know, the instructors don't think it's important.
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It's omitted because of I think the larger incentive structures that determine what is modern conventional medicine.
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Let me unpack that a little bit more.
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I am not the kind of person that will promote conspiracy theories around big pharma wanting to make us sick.
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I don't think there's malintent in the medical system, the pharmaceutical industry, etc.
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I think the problem's a little bit more complex in that we have a particular business model in medicine that is predicated on this idea of pills and procedures are reimbursable and make money.
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So there's an industry to develop these.
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And some of these can be life-saving.
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It's really amazing what we can do in certain circumstances, particularly acute care circumstances.
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But that does leave a large deficit around the metabolic health diseases that are plaguing society.
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And so I think the reason the metabolic health interventions that might be so efficacious for metabolic health, autoimmune inflammatory diseases don't get a lot of play is because the most powerful interventions are not necessarily the most lucrative ones.
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And so one thing I want to point out and unpack is that quote-unquote evidence-based care is not actually optimal care.
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And what I mean by that is let's take my experience as an example.
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A ketogenic diet saved my life.
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I can't point you to any randomized controlled trial saying, hey, a ketogenic diet's good for inflammatory bowel disease.
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Because they've never been conducted.
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So it's not that it's not efficacious, it's that the study's never been done to check the box to make it standard of care.
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Why has the study never been done?
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Because to do it well is a$10 million study that's very difficult to conduct, and nobody wants to fund it because nobody's gonna make money.
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It's not because they're evil, it's just because the spotlight of biomedical sciences and what eventually becomes medical standard of care is directed by incentive structures and a business model.
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And so I had a very different perspective on what evidence-based care is going through medical school, given my experience, than what I imagined it to be before.
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Because I imagined it to be like, you know, what it sounds like, this great virtue signal, the best care.
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And I realized it wasn't that.
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And I think I became really bothered by that fact, not angry at anybody, just sad, because that circumstance sets us up for what we have, which is a metabolically sick population that's not getting healthier because we're not looking for the solutions in the right place.
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And we're not looking for the solutions in the right place because the current business model doesn't incentivize that.
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So I do think there's a solution, and this is where I'm very optimistic, which is exactly what we're doing here.
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With the rise of public access to information and social media, which has its pros and cons, you don't have to wait for something to become a conventional standard of care to gain access to tools that can literally save lives.
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So that really changed my passion, uh, redirected me towards, you know, getting the research done and communicating about it.
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Now, I guess my answer to the question, how do I see medicine?
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I see medicine as an evolving team sport.
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And my position on that team, I feel, is more situated towards exploring and developing the research and communicating that research, more so than necessarily sitting one-on-one with a patient in a clinic, which is what I imagined when I was 15.
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Um So, yeah, that's my answer.
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Yeah, I mean, I I think you and I are on the same page on that.
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I've I've heard people say, and I've I've experienced this with my my colleagues practicing medicine, is that that doctors are doctors really don't make us healthy.
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They just make us less sick, you know, and uh doctors are very busy managing disease.
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And these chronic diseases that you mentioned begin so many years beforehand that that opportunity for prevention really isn't taken advantage of by doctors just because they don't have the time and the business structure is not set up for it.
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There's no reimbursement.
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So I'm I'm with you.
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This is such an exciting time.
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This whole new field where people at home draw their own blood, you know, and they they send it off, they follow markers, and they get healthy, even though they're not maybe they haven't crossed the border for being sick yet, but they're you know, they're they're making themselves healthier and healthier and healthier.
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This wellness movement is is so exciting.
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Do you how do you are you on the you what's your take on that?
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I think it's incredibly uh cool how people are being empowered with their own data.
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You mentioned like, you know, testing your own data at home, biomonitoring.
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I think that biofeedback, having your data in your own hands and combining that with education is incredibly powerful.
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I really have seen it transform lives.
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And I think as the wearable biohacking, whatever term you want to use, space is evolving, we're just gonna have more and more tools for people.
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Um, I was just talking with, I don't know if you know Michael Snyder at Stanford.
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He's sure, yeah, of course.
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Yeah, leader, a leader in um in advanced uh multiomic testing.
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But some of the work they're doing, just to kind of give an example of how this is evolving, um, they were looking at different causes of diabetes.
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Now, people might not be aware, um, there are kind of four primary causes of uh even type 2 diabetes: muscle insulin resistance, liver dysfunction, beta cell dysfunction, and incretin dysfunction, so GLP1.
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Now, the reason I'm bringing this up is because in each individual who has like prediabetes or diabetes, there's usually a dominant underlying pathology.
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And based on which of those four is dominant in that individual, the effective treatment structures are potentially going to be different.
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Um, so if you have muscle insulin resistance, you know, building up muscle mass might be not as powerful, and different drugs might work as opposed to, say, somebody with uh beta cell dysfunction, and you also might be responsive to different foods.
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We can go down the rabbit hole on that.
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But the reason I bring it up is because if you think about how rudimentary our testing is for like diabetes, like what's your after blood sugar?
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All right, diagnosis or oral glucose tolerance test.
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And you just take, you know, a time point, a single time point.
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But what they did in their research, and there are many more like this, is they did like state-of-the-art testing to figure out, okay, in one cohort what the underlying pathologies were.
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Then they used machine learning and big data sets, uh, attached continuous glucose monitors to people, which now is you know over-the-counter available.
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And through the machine learning algorithm, the AI basically could decode a pattern from the shape of the glucose curve, not the point at two hours, but like exactly how it rose and fell and dipped at different points, and see within that the underlying pathology with pretty good sensitivity and specificity.
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So the reason I bring this up is because this kind of technology in the coming years is going to be built into like phone apps.
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So you can have a DEXCOM on your arm, eat some grapes, and not only will it say, hey, your blood sugar went up, but it's gonna say, hey, your blood sugar went up.
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And the exact shape of this curve tells me that your type of diabetes is primarily caused by beta cell dysfunction, not muscle insulin resistance.
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And that means you should do XYZ with precision.
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Like that is where we're going.
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And that's cool.
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That, yeah, that is so so exciting.
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Yeah, yeah.
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Shout out to Mike Schneider, his company.
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He's done some of his companies, the one with uh the multiple blood tests, uh, 500 metabolomic markers is exciting.
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Anyway, he's gonna be on the podcast coming up.
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So we'll we'll get to hear it from him.
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But that is that is so exciting.
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Back to your back to your thing with the um inflammatory bowel disease.
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I mean, the um uh you you basically um you you published a case series on ketogenic diet slash carnivore, and I assume it's the ketogenic part, not necessarily the carnivore part, but yeah, about anyway, about for IBD.
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Um which what did you learn from that?
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Yeah, uh again, this is occupying the space of there isn't good RCT level evidence.
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So we do the best we can with the resources we have.
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Resources I have are pretty minimal, but what I can do is say, hey, are there other people like me?
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What are their stories?
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And also, does this make sense physiologically?
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So effectively what we did is we collected um patient cases from 10 patients who had uh originally attest to having put their disease into remission with a carnivore or ketogenic diet.
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We can get into why carnivore skew in a moment.
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And then we didn't just take their word for it, um, but we went and we made sure they had a clinical diagnosis of inflammatory bowel disease confirmed on colonoscopy, so Crohn's or colitis.
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And then we did, you know, a formal medical case history, um, did dietary records, including prospective dietary records.
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So, you know, we tried to do this all by the book and get as much detail as possible.
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And basically, we were able to document that in these self-selected cases, they were pretty incredible stories like mine of reversal or at least complete remission of inflammatory bowels.
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These people that had been on many harsh medications, some people that have had, you know, parts or even their entire colon removed, and even that wasn't efficacious.
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And then they changed their diet and they went into remission.
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And, you know, we shared some quotes in the case series about patients talking about their own experience, but people talking like, I'm literally a different human being now.
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Like, I suffered with this disease for so many years, and then I changed my diet, and I become a new person.
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I have like a new light in life.
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And we were focusing on that case series on inflammatory bowel disease, but it's a pattern we see recapitulated again and again and again in the literature.
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A big trial just came out of Ohio State for ketogenic diets for depression in college students.
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Again, the same pattern.
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Um, just to briefly speak about the mechanisms.
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So, you know, we have clinical narratives saying this potentially can work.
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It makes sense physiologically too on many levels.
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So, first of all, there's the elimination aspect.
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There's probably a component of like you just eliminate certain things from your diet, and that might be therapeutic.
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Fiber actually might be one of them.
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We'll talk about that in a minute.
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But also ketones are very healing.
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They're anti-inflammatory, including in the gut, um, and they help with stem cell renewal in the gut.
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So you're reducing inflammation and an inflammatory bowel disease, um, changing macrophage polarity, helping with, you know, the intestinal stem cell niche, stem cell renewal.
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All this is in the literature.
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And then there may be an additional benefit therapeutically of fiber elimination in ulcerative colitis and Crohn's disease.
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It's actually known, it's not talked about, but uh it's pretty well known that fiber elimination is therapeutic in um treatment-resistant cases of Crohn's disease, particularly pediatric.
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So if kids aren't resistant, they'll put them on these fiber-free liquid diets.
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In about 60 to 85% of cases, the kids go into remission.
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And the reason it's not talked about more is because it's assumed to be quote unquote unpalatable and unpleasant.
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But it's funny because this is actually like conventional care medicine, eliminating fiber, not in the ketogenic sense in that particular case, but putting two and two together, you take fiber elimination and keto, you could have a high-fat carnivore diet.
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And setting aside the stigma that comes with that quote unquote extreme diet, there's just a lot of biological rationale for thinking, hey, this could be very powerful in inflammatory bowel disease.
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And I just want to head off the criticisms on that, which is at no point did I say, hey, that means carnivore is best for all humans, or hey, carnivore is like the best for longevity.
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I didn't say that.
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But when you're talking about particular disease conditions and treatments, you need to like specifically talk to that disease state.
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So my interest in writing that case series was to kind of raise the questions could ketogenic and carnivore diets really be life-saving in inflammatory bowel disease in particular, which uh it's a pretty ability-heading in addition, I can tell you from experience.
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But yeah, the the the the whole idea of um ketogenic diets or being in ketosis, it's it's uh fascinating how you know, like you say, inflammatory bowel disease.
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Well, uh depression, uh, Alzheimer's disease, cancer, diabetes, heart disease, you know, there there's evidence almost almost any of the chronic diseases, there's an advantage to being in ketosis as a basic, basic metabolic mechanism.
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Before we talk about that, let's just define if somebody wants to be in a healthy diet, what does a ketogenic diet mean for you?
00:20:53.920 --> 00:20:55.599
Or what is how do they know?
00:20:55.759 --> 00:20:59.359
I mean, urine ketones are not that reliable after.
00:20:59.519 --> 00:21:04.079
So what if if I want to be in a healthy ketogenic diet, what should I do?
00:21:04.720 --> 00:21:12.000
So um the first thing I like to say is ketogenic diet or the ketogenic diet, it's a papiv of mine, is a misnomer.
00:21:12.240 --> 00:21:14.240
There is no the ketogenic diet, right?
00:21:14.400 --> 00:21:30.480
Because unlike other diets that are defined by you know the source of the food, like you know, plant-based from plants, animal-based from animals, Mediterranean, presumably from the Mediterranean region, a ketogenic diet is just defined by the metabolic state of ketosis.
00:21:30.799 --> 00:21:35.039
So it's perpendicular to other diets because it's defined by a metabolic state.
00:21:35.359 --> 00:21:39.359
So practically speaking, it does mean you need to keep your carbohydrates low.
00:21:39.440 --> 00:21:49.599
There are different thresholds, it's gonna depend on your age, body size, activity level, but I would say below 25 grams of net carbs is probably a ketogenic range.
00:21:49.759 --> 00:21:52.240
You can measure that with a finger stick.
00:21:52.400 --> 00:21:56.160
They do have breath meters and urine sticks, they're not as good.
00:21:56.240 --> 00:22:02.480
And the urine sticks, to your point, will only last and or work for the First, you know, several weeks to months.
00:22:02.640 --> 00:22:04.799
But I would say a finger stick, it's not very painful.
00:22:05.039 --> 00:22:08.000
In fact, it's a little fun tip: don't go in like the middle of your finger.
00:22:08.079 --> 00:22:11.920
If you go to like the side of your thumb, it's usually less painful.
00:22:12.079 --> 00:22:14.160
There's less sensors there, so you barely feel it.
00:22:14.319 --> 00:22:22.960
I have no affiliation, but I use keto mojo, and you just kind of want to test the same time every morning, maybe an hour after waking before eating, and see where your ketone levels are at.
00:22:23.039 --> 00:22:29.680
Targeting a level above 0.5 millimole is generally the threshold for what's called nutritional ketosis.
00:22:29.920 --> 00:22:39.039
So if you're achieving that, which you can do by eating below 25 grams of carbs per day for most people, then you are, you know, ketogenic.
00:22:39.119 --> 00:22:42.240
You're on a ketogenic diet that can mean very different things for different people.
00:22:42.559 --> 00:22:46.559
Can be carnivore, can be vegan, can be anything in between.
00:22:46.880 --> 00:22:52.799
So my job here is not to be prescriptive on like what that looks like for any individual, but that's a ketogenic diet.
00:22:53.119 --> 00:23:00.480
And for people who don't have access to keto mojo or other specific ketone monitors, let's say I'm wearing a CGM.
00:23:00.640 --> 00:23:10.559
If I keep my glucose really flat with no spikes at at all, uh, is that an indicator that I'm I've I'm very few carbs, right?
00:23:10.720 --> 00:23:10.880
Yeah.
00:23:11.680 --> 00:23:14.559
I would say I'll probably intuit it more off the carb count.
00:23:14.640 --> 00:23:18.799
I'm saying if you're below 25 grams, you're probably going into ketosis.
00:23:19.440 --> 00:23:24.160
A glucose level doesn't necessarily indicate ketosis.
00:23:24.400 --> 00:23:30.319
Um I wouldn't also like things can spike glucose that can actually promote ketogenesis in the longer term.
00:23:30.400 --> 00:23:35.839
So say you do like a hard workout, your glucose is going to spike, or you go in a sauna, your glucose is going to spike.
00:23:36.000 --> 00:23:40.000
Um, but that won't necessarily hinder your ketogenesis over the long term.
00:23:40.079 --> 00:23:43.759
Now, if you're doing HIIT exercise, the ketones will go down for a moment.
00:23:44.000 --> 00:23:48.720
But I I wouldn't suggest trying to figure out if you're in ketosis off of a CGM.
00:23:49.440 --> 00:23:53.440
So so ideally we want to be in this healthy metabolic state.
00:23:53.519 --> 00:24:00.720
We want it low carbs, we want to be in ketosis, um uh seed oils, yes or no?
00:24:00.799 --> 00:24:05.039
Or do you want to weigh in on the oh that's we need like six hours to talk about that.
00:24:05.200 --> 00:24:11.759
I think actually about uh I want to I want to delve into it a little bit at a high level because I think it's a very misunderstood area.
00:24:11.920 --> 00:24:16.640
Uh actually, I just got out of a three and a half hour debate with Paul Saladino on Denny Jones around it.
00:24:16.720 --> 00:24:25.839
So people who listen to that, but at a high level, I think the first question we need to ask about, I mean somebody says seed oils, is what are we actually talking about?
00:24:26.160 --> 00:24:42.480
If we're talking about highly processed industrialized oils that have been heated, refined, have chemical additives to them, and have been put into like a you know clear plastic bottle on the shelf, basic logic, precautionary principle would say you probably can do better.
00:24:42.720 --> 00:24:46.240
And I'll say what'll happen is the fats can get damaged.
00:24:46.480 --> 00:24:54.000
Um, you know, there can be chemicals that have been added to these oils that can actually damage your body.
00:24:54.240 --> 00:25:10.000
But the reason I want to caution against the whole seed oil fear-mongering broadly is because what I see in social media is this inappropriate logic domino chain where a lot of the focus is placed on omega-6 fats.
00:25:10.319 --> 00:25:15.039
So sometimes seed oils and omega-6 are talked about interchangeably.
00:25:15.119 --> 00:25:18.400
So polyunsaturated fats include omega-3 and omega-6.
00:25:18.720 --> 00:25:23.200
People have heard maybe omega-6 linoleic acids talk about as quote unquote inflammatory.
00:25:23.440 --> 00:25:27.119
If you look at the literature, uh it's not that clear-cut.
00:25:27.519 --> 00:25:36.319
I mean, higher levels of omega-6, including higher tissue levels, actually associate with better outcomes and lower levels of inflammation.
00:25:36.799 --> 00:25:55.519
I'm not saying you should go eat 10 handfuls of walnuts, but I just want to raise the idea that it really depends what you do with these omega-6 and linoleic acid, both outside the body and inside the body.
00:25:55.759 --> 00:25:57.359
Have they been heated and refined?
00:25:57.519 --> 00:26:01.200
If you're eating them, what is your metabolic state?
00:26:01.440 --> 00:26:13.440
So, for example, if you have obesity, your fat cells make certain enzymes, one's called myeloperoxidase, that can oxidize fats and polyunsaturated fats, as compared to somebody who's leaner.
00:26:13.519 --> 00:26:18.720
So, say obesity might be a more omega-6 susceptible state, as can aging.
00:26:18.960 --> 00:26:23.519
And then there are lifestyle interventions that can change the fate of omega-6 when you eat them.
00:26:23.599 --> 00:26:38.000
So, for example, if you expose yourself to cold, your brown and beige fat turns omega-6, particularly linoleic acid, into a compound called 1213 Di HOME, which actually has anti-aging properties on the heart.
00:26:38.160 --> 00:26:40.160
It fights against perivascular fibrosis.
00:26:40.240 --> 00:26:45.279
This is in human trials they've shown that you can increase levels of this with cold exposure and that they decline with age.
00:26:45.440 --> 00:26:49.200
We don't need to go into the molecular details about all the different fates of omega-6.
00:26:49.839 --> 00:26:55.039
The high-level point is omega-6 not bad per se.
00:26:55.759 --> 00:26:57.519
Theoretically, could you overdose it?
00:26:57.599 --> 00:27:01.680
Maybe, but don't fear walnuts, tahini, whole natural foods.
00:27:01.920 --> 00:27:05.119
Highly processed industrialized oils, you can probably do better.
00:27:05.279 --> 00:27:11.119
I like cooking with ghee and avocado oil and then dressing with olive oil or maybe some sesame oil.
00:27:11.279 --> 00:27:12.799
Um, but yeah.
00:27:13.359 --> 00:27:16.559
So be before we leave ketosis in general, the diagnosis.
00:27:16.640 --> 00:27:20.640
So I'm I'm having a key uh metabolically healthy diet.
00:27:20.720 --> 00:27:25.039
I'm in ketosis, I'm low carb seed oils, maybe, maybe not.
00:27:25.200 --> 00:27:28.079
We'll see, well, avoid the highly industrialized ones.
00:27:28.160 --> 00:27:28.240
Yeah.
00:27:28.480 --> 00:27:33.680
Highly and fried foods, certainly the high temperature things and all that.
00:27:33.839 --> 00:27:35.119
So we'll leave that.
00:27:35.359 --> 00:27:40.880
What about adding on um intermittent fasting or extended intermittent fasting?
00:27:41.039 --> 00:27:42.480
I'm already in ketosis.
00:27:42.640 --> 00:27:46.000
What is there any added value to that metabolically?
00:27:46.319 --> 00:27:48.319
I think they go hand in hand.
00:27:48.480 --> 00:27:53.200
So intermittent fasting or time restricted feeding can naturally enhance ketosis.
00:27:53.359 --> 00:27:57.680
Um, also, if you're already low carb keto, then you're very good at burning body fat.
00:27:57.920 --> 00:28:01.440
So it should be a lot easier to time restrict feeding.
00:28:01.599 --> 00:28:09.599
So, for example, I do, you know, either an 18-6 or a 16-8, which means basically my feeding window is six or eight hours on average per day.
00:28:09.920 --> 00:28:13.359
I like that more because I don't really feel like eating in the morning.
00:28:13.440 --> 00:28:15.279
I want to be light when I have my workout.
00:28:15.359 --> 00:28:20.799
And I it's just easier and nicer to have two large meals rather than like this snacking and grazing bit.
00:28:20.880 --> 00:28:23.680
So I actually think they pair together very nicely.
00:28:24.079 --> 00:28:32.480
Um, and there's very little disadvantage, except maybe for those people who really struggle to get in enough protein, but that's pretty rare.
00:28:32.559 --> 00:28:38.319
Maybe for like older women who for some reason can only tolerate like 20, 24 grams of protein per meal.
00:28:38.559 --> 00:28:44.160
But for the most part, two meals a day, eight-hour feeding window, it's pretty doable.
00:28:44.319 --> 00:28:47.680
Longer-term fasts can just get you into deeper ketosis.
00:28:47.839 --> 00:28:53.039
There probably are some additional uh ketone-independent benefits.
00:28:53.119 --> 00:28:57.440
So biomolecules that go up when you just restrict overall food intake.
00:28:57.680 --> 00:28:59.759
You know, it's it's a cost-benefit analysis.
00:28:59.920 --> 00:29:03.039
If you fast for seven days, you're gonna lose some lean mass.
00:29:03.200 --> 00:29:15.599
So if you're like a very lean person already with not a lot of fat or muscle to lose, I'd probably say it wouldn't be my preference to do a whole week-long fast, but they can be done safely.
00:29:15.759 --> 00:29:24.480
Um, and so prolonged fast for like, you know, a day or two, if you enjoy them, probably do have some additional benefits, but they're not a must if you don't enjoy them.
00:29:24.640 --> 00:29:25.440
That's what I'd say.
00:29:25.599 --> 00:29:31.440
They're like life lot, lifestyle flexibility, and uh nice little metabolic challenges.
00:29:31.759 --> 00:29:32.559
Yeah, yeah.
00:29:32.799 --> 00:29:39.519
In the in the break, we were talking about your uh interest in um neurodegenerative diseases.
00:29:39.599 --> 00:29:50.160
I mean, the the ketogenic diet helps the whole spectrum of metabolic disease, which for many cases neurodegenerative disease has a strong metabolic component, we're finding out.
00:29:50.319 --> 00:29:54.000
So talk about your interest in that and uh what you're doing there.
00:29:54.400 --> 00:29:54.799
Yeah.
00:29:54.960 --> 00:29:59.599
No, my my PhD was actually on the particular topic of ketones in neurodegenerative diseases.
00:29:59.680 --> 00:30:02.960
So I'm somewhat well read uh well read on them.
00:30:03.200 --> 00:30:04.960
Maybe my brain's not working now.
00:30:05.200 --> 00:30:08.640
Um there's so much we could talk about.
00:30:09.519 --> 00:30:12.720
I mean, here's what one one question while you're thinking.
00:30:12.880 --> 00:30:24.640
Um uh people always ask about exogenous ketones, and certainly for Alzheimer's disease, famously with Mary Kelly and others who've written anecdotally about, you know, Mary Newport.
00:30:25.759 --> 00:30:26.559
Uh Newport, yeah.
00:30:26.720 --> 00:30:27.759
Sorry, not Mary Kelly.
00:30:27.839 --> 00:30:28.960
Yeah, Newport, yes.
00:30:29.119 --> 00:30:30.960
My Alzheimer's is kicking in.
00:30:31.119 --> 00:30:40.079
But how how exogenous ketones work, seem to work for some patients, not all patients, but some patients with Alzheimer's disease, just like ketogenic diets do.
00:30:40.400 --> 00:30:50.400
Whereas it going a little bit different, but similar, mental health, talking to Chris Palmer and and others in that space.
00:30:50.640 --> 00:30:55.359
I specifically ask them about ketogen about exogenous ketones, and they go, no, it doesn't work.
00:30:55.920 --> 00:30:57.599
You have to do it from a diet.
00:30:57.759 --> 00:31:01.519
It was interesting that that it I wonder why that is.
00:31:02.000 --> 00:31:08.319
I think, okay, so the diet has a ketogenic diet has particular benefits over exogenous ketones.
00:31:08.640 --> 00:31:13.359
One benefit will be higher overall levels of ketones in terms of steady state.
00:31:13.440 --> 00:31:17.839
Because when you take an exogenous ketone, for the most part, it spikes it and then it drops back down.
00:31:18.079 --> 00:31:23.519
So, say, for example, when you're sleeping, levels are going to be low if you're on a mixed diet having exogenous ketones.
00:31:23.680 --> 00:31:30.720
Um, in addition, there's other components of the diet that just might be beneficial in addition to just the ketones themselves.
00:31:30.880 --> 00:31:36.880
You're shifting your entire metabolic state or it's more of a fat-based metabolism rather than just adding on a biomolecule.
00:31:37.119 --> 00:31:46.559
Um and that said, I do think that there are benefits that can be uh exerted from exogenous ketones alone.
00:31:46.799 --> 00:31:53.599
I think in terms of correcting or supplementing for a metabolic deficit in glucose metabolism, there can be benefit.
00:31:53.839 --> 00:31:59.279
So, in manifest Alzheimer's disease, generally glucose metabolism is very impaired.
00:31:59.519 --> 00:32:10.160
So, giving an exogenous ketone source or something like coconut oil or MCTs that help make more ketones that are very ketogenic, it can improve symptoms in cognition, at least acutely.
00:32:10.400 --> 00:32:13.839
To what extent it's protective, it's not exactly clear.
00:32:14.079 --> 00:32:16.799
And the same could be true in things like depression.
00:32:16.960 --> 00:32:22.160
I mean, ketones are anti-inflammatory, you reduce neuroinflammation, and that can have direct effects on cognitive health.
00:32:22.319 --> 00:32:30.000
In fact, certain cytokines, inflammatory molecules in the brain, themselves operate as neurotransmitters and can change mental states.
00:32:30.079 --> 00:32:38.400
So ones called, for example, IL-17, itself acts in the brain, it's an inflammatory molecule as a neurotransmitter that turns up uh anxiety.
00:32:39.359 --> 00:32:43.200
But yeah, I do think more broadly the ketogenic diet would have benefits.
00:32:43.279 --> 00:32:46.079
So I'll give you an example in mental health.
00:32:46.160 --> 00:32:50.160
A new paper just came out in, I think it was nature, about autophagy and depression.
00:32:50.480 --> 00:32:57.359
One of the really interesting things they found was there's a brain region called the lateral habenula, and it's kind of the depression center for the brain.
00:32:57.440 --> 00:33:08.079
And what happens is in depression, the cellular recycling process of autophagy gets turned down in this brain region, and that leads to a buildup of particular receptors.
00:33:08.319 --> 00:33:11.279
The receptors in question that build up are called glutamate receptors.
00:33:11.359 --> 00:33:15.759
Glutamate is the excitatory neurotransmitter in the brain, it's like the gas pedal.
00:33:16.000 --> 00:33:23.440
So effectively, what happens is you're putting the gas pedal down on the depression center of the brain, and feelings of despair just get turned up.
00:33:23.759 --> 00:33:30.400
Interestingly, um, a lot of different medications in humans that we know help treat depression.
00:33:30.480 --> 00:33:40.000
So ketamine, selective serotonin and reuptake inhibitors, SSRIs, um, they actually converge on this pathway, even though they act through distinct mechanisms.
00:33:40.079 --> 00:33:42.559
They do converge on this pathway, which is interesting for many reasons.
00:33:42.720 --> 00:33:45.440
But point being, I think there's probably human relevance.
00:33:45.599 --> 00:33:55.519
The reason I bring all this up is because fasting or ketogenic diet, things that lower your insulin level tend to modulate and increase autophagy.
00:33:55.680 --> 00:34:02.880
So it could be a way of stabilizing basic processes like that in the brain to help treat mental health disorders, neurological disorders.
00:34:03.119 --> 00:34:11.760
Um I think the best use case for ketones will be as topping off on top of a ketogenic or low carb diet.
00:34:11.920 --> 00:34:16.000
So if you want really high ketones, you can't just restrict carbs.
00:34:16.159 --> 00:34:18.960
You probably need to restrict protein and go on a very high fat diet.
00:34:19.119 --> 00:34:20.239
And that can be pretty hard.
00:34:20.320 --> 00:34:30.639
Like a three to one or a four to one ketogenic diet, so three grams of uh fat for every one gram of protein plus carb or four to one, it's very difficult to do.
00:34:30.880 --> 00:34:36.800
So imagine instead of doing that, doing a 1.5 or a two to one and then adding on exogenous ketones as kind of a booster.
00:34:36.960 --> 00:34:38.800
I think that's probably the best case for them.
00:34:39.039 --> 00:34:39.599
Oh, that's good.
00:34:39.760 --> 00:34:40.320
Yeah, interesting.
00:34:40.480 --> 00:34:43.199
Yeah, that's a great strategy uh for that.
00:34:43.440 --> 00:34:47.760
Jumping, jumping back, quick follow-up question to fiber before we leave that.
00:34:47.920 --> 00:34:52.800
Um, obvious, uh obvious benefits, inflammatory bowel disease, it makes sense, you know.
00:34:52.880 --> 00:34:56.320
Um fiber elimination, yeah.
00:34:56.639 --> 00:34:58.880
Getting rid of fiber for those patients.
00:34:59.119 --> 00:35:06.480
What's your what's your position on fiber and gut health for everybody else as far as metabolic disease?
00:35:06.880 --> 00:35:15.360
I think if you're gonna go with the most people most of the time approach, fiber from Whole Foods, most people most of the time, I think is gonna have a net benefit.
00:35:15.519 --> 00:35:20.320
I am not anti-fiber by any measure, despite me not eating a lot of fiber.
00:35:20.559 --> 00:35:28.159
My issue comes in with the blanket and umbrella statements of it's, you know, everybody needs it, and more is better.
00:35:28.480 --> 00:35:31.519
I'm not for those platitudes.
00:35:31.840 --> 00:35:49.920
I think rather than focusing on like net fiber amount, I would say for most people, most of the time, having a diversity of fiber sources, because fiber is a tremendously diverse set of biomolecules is probably where you're gonna reap the most reward.
00:35:50.079 --> 00:35:53.599
And also adjust to tolerance, adjust to tolerance.
00:35:53.840 --> 00:36:04.960
So, you know, if eating a lot of fiber is causing you GI upset, maybe back off and consider you know, what dose is appropriate for you and what other interventions might be helping you achieve the outcome that you're interested in.
00:36:05.119 --> 00:36:15.039
So, for example, if you're interested in microbiome diversity and anti-inflammatory effects of plant-based foods in particular, you're better off focusing on fermented foods than fiber.
00:36:15.280 --> 00:36:27.039
So a study came out of the, I think it was Sonnengaard 2021, I believe, out of Stanford, um, looking at fermented foods versus um or fiber in uh people.
00:36:27.199 --> 00:36:37.360
And what they found was fiber was anti-inflammatory in most people, not a huge effect on microbiome diversity, but it was pro-inflammatory in a subset.
00:36:37.519 --> 00:36:40.320
So there are pro-inflammatory responders to fiber.
00:36:40.480 --> 00:36:45.599
Now, to add a level of nuance, these people were the people that at baseline had lower microbiome diversity.
00:36:45.679 --> 00:36:47.920
So it's possible you could train up your microbiome.
00:36:48.239 --> 00:36:49.840
A little bit more complicated than that.
00:36:50.000 --> 00:36:55.199
But um they found fermented foods basically had a universally anti-inflammatory effect.
00:36:55.440 --> 00:37:01.679
So, you know, if you're thinking about foods for gut health, I would say start off with uh low sugar fermented foods.
00:37:01.840 --> 00:37:13.039
Kimchi, kefir, natto, things like that, uh fermented pickles are going to be the biggest bang for your buck before you just go like smash a head of broccoli.
00:37:13.360 --> 00:37:13.920
Microsoft.
00:37:14.800 --> 00:37:16.800
That sounds great advice.
00:37:16.960 --> 00:37:40.960
The um switching around a little bit out here, um we're in California and uh Jam had just came out a few months ago, I guess, with an article uh or they mentioned that uh at least one study numbers showed that uh the number of obese and overweight people, which is most people, most adults in America, were actually decreasing slightly.
00:37:41.039 --> 00:37:43.760
The first time in 40, you know, 40 years.
00:37:44.000 --> 00:37:53.519
It might be an artifact, it may be, you know, sample size, all sorts of things, but they attributed it possibly to um GLP1 agonists.
00:37:53.599 --> 00:37:55.199
You know, we're out in Ozempic country.
00:37:55.280 --> 00:37:57.599
What's your take on this really controversial topic?
00:37:57.760 --> 00:38:08.559
Obviously, they're proven, you know, they're they've shown effectiveness for obesity and and type 2 diabetes, and there's a growing list of other indications that are seemingly unrelated, right?
00:38:08.800 --> 00:38:14.400
You know, fatty liver disease and and you know sleep apnea and all how does it all fit into metabolic health?
00:38:14.559 --> 00:38:15.840
Where do you stand on that?
00:38:16.320 --> 00:38:18.960
So GLP1s are interesting.
00:38:19.119 --> 00:38:25.599
Uh the first thing I'll say is the data are compelling, not just for obesity, but for other uh health conditions.
00:38:25.760 --> 00:38:31.440
Um, and there probably is a lot of promise for microdosing uh and pathways that we don't fully understand.
00:38:31.599 --> 00:38:40.400
So, for example, we now know, at least in animal models, GLP ones inhibit an enzyme that generates the uh amyloid oligers that are toxic in Alzheimer's disease.
00:38:40.480 --> 00:38:42.800
Not the plaques, but the actual toxic oligomers.
00:38:43.039 --> 00:38:43.599
Different point.
00:38:43.840 --> 00:38:51.679
Point I'm making is are these cool drugs and a pretty impressive medical innovation that I think are a good tool that should be deployed?
00:38:51.920 --> 00:38:52.559
Yes.
00:38:52.880 --> 00:38:58.639
My caveat to that is we can't lose sight of the forest for a tree.
00:38:58.800 --> 00:39:13.519
So I think where the metabolic health, low carb, wellness community, whatever you want to call it, gets irritated is when they feel that society is saying, hey, this is a silver bullet, nutrition and diet is too complicated, too hard, don't worry about it.
00:39:13.760 --> 00:39:16.239
And I want to just point out these things aren't mutually exclusive.
00:39:16.320 --> 00:39:22.800
So, my opinion is the best possible use case for GLP1s is as a catalyst for lifestyle change.
00:39:23.039 --> 00:39:24.239
I'll give you an example.
00:39:24.480 --> 00:39:28.639
We now better understand this phenomenon of food noise.
00:39:28.880 --> 00:39:39.679
Some people might have experienced it, some people, you know, might not have intensely, but this like food chatter in your brain when you try to restrict and avoid and make healthier food choices, those foods that are your compulsion.
00:39:39.920 --> 00:39:43.119
And we know that different people have different, you know, food noise volumes.
00:39:43.199 --> 00:39:53.599
And if your food noise volume is turned up too high, in the modern food environment, it could be very, very difficult to stick to a healthy, you know, lifestyle plan.
00:39:53.760 --> 00:39:58.559
Now, imagine if I could turn down the food noise knob in your brain.
00:39:58.639 --> 00:40:10.639
So you could just make a smarter choice so that when you're at the office and somebody brings in donuts, you can't do much about it, you have that moment of lesser food noise to say, hey, hey, I'm not gonna have that donut.
00:40:10.800 --> 00:40:15.199
I actually prepare by bringing some hard-boiled eggs and avocado and eat that instead.
00:40:15.519 --> 00:40:19.039
So one thing GLP ones do is they turn down the food noise.
00:40:19.199 --> 00:40:21.519
We actually know how this happens in the brain.
00:40:21.599 --> 00:40:24.000
There was a paper in science on this particular topic.
00:40:24.239 --> 00:40:32.880
I can send it to you if you want, but the idea that it decreases pre-in increases pre-ingestion satiety, fancy term for turns down food noise.
00:40:33.119 --> 00:40:34.400
So think about that for a minute.
00:40:34.559 --> 00:40:39.920
You're giving somebody a tool that then enables them to make a smarter, healthier lifestyle choice.
00:40:40.079 --> 00:40:43.039
So I think that needs to be more of the conversation around GLP ones.
00:40:43.199 --> 00:40:44.719
Are they incredible metabolic tools?
00:40:44.880 --> 00:40:45.280
Yes.
00:40:45.519 --> 00:40:54.719
Are they being deployed at a population level for their optimal use case to be a catalyst for lifestyle change?
00:40:55.039 --> 00:40:55.360
No.
00:40:55.599 --> 00:41:01.599
I was gonna say I don't think so, but I've sat in enough weight loss clinics to know that I think the deployment could be better.
00:41:01.760 --> 00:41:02.880
So that's my answer.
00:41:03.119 --> 00:41:07.920
Good tool could be used more responsibly.
00:41:08.239 --> 00:41:09.280
Yeah, fascinating.
00:41:09.360 --> 00:41:12.960
And so much we have to learn about all these metabolic pathways.
00:41:13.039 --> 00:41:24.639
Well, like GLP1s, the idea that they uh through dopamine pathways in the brain, not only turn down food noise, but also, you know, half the people lower their alcohol use, you know.
00:41:25.440 --> 00:41:33.280
Um, you know, all the addictions, shopping, porn, gambling, people start to go down, and junk food too, and other things.
00:41:33.360 --> 00:41:34.639
But it's it's fascinating.
00:41:34.719 --> 00:41:42.000
They're, you know, at some level, they're they're changing the motivation and the satiety center in a broad sense, like you say.
00:41:42.480 --> 00:41:52.639
They're a tool like any other, and I think one thing that the metabolic health space needs to get on board with, and I think a lot of people already are, although the most extreme voices usually get the loudest mics.
00:41:53.119 --> 00:41:55.039
We celebrate people getting healthier.
00:41:55.280 --> 00:41:57.840
If you use GLP1s as a tool, that's not cheating.
00:41:58.000 --> 00:42:00.320
That is, you have used a tool at your disposal.
00:42:00.559 --> 00:42:03.280
You use a ketogenic diet, use a plant diet, plant-based diet.
00:42:03.360 --> 00:42:03.760
I don't care.
00:42:03.840 --> 00:42:12.800
If you get healthier, if you take control of your life through whatever tools you have at your disposal, in an ecosystem that is built to put obstacles in front of you, that's awesome.
00:42:13.039 --> 00:42:16.800
So I don't want people to feel discouraged about exploring it as an option.
00:42:16.880 --> 00:42:18.400
It I don't think it's required.
00:42:18.480 --> 00:42:24.639
I don't think it's a sign-on for life kind of thing if you don't want it to be, but it's a tool that people should not be ashamed to use.
00:42:24.960 --> 00:42:25.679
Yeah, yeah.
00:42:25.760 --> 00:42:34.880
And like you say, the the sort of metabolic health space, a lot of the people in it are in the lifestyle space, which I certainly support and I'm a big fan of.
00:42:34.960 --> 00:42:42.400
But the the fasting thing about GLP1s, if you don't change your lifestyle and you take GLP1s, you will get sicker.
00:42:42.480 --> 00:42:53.280
You know, if you don't lift weights and you don't uh you know add protein, you will you will develop uh weight loss and sarcopenia rather than just a healthy weight loss, you know?
00:42:53.679 --> 00:42:56.639
Yeah, they're powerful medications with side effects.
00:42:56.800 --> 00:43:04.960
And I think any discussion of, you know, pharmacotherapy deserves acknowledgement of the risks and benefits.
00:43:05.119 --> 00:43:13.440
And depending on what space you're in, I think it's overinflated with discussions about risks or benefits of GLP1s, again, depending on what space.
00:43:13.599 --> 00:43:21.199
There are other areas where I think we do need to be more responsible by talking about the risks, but that's another kettle of fish.
00:43:21.360 --> 00:43:27.599
Actually, no, I will I will open this Pandora's box, even though we don't have a lot of time for it, because we were speaking about GLP1s.
00:43:27.840 --> 00:43:33.440
Um, there was a trial out, I don't know if you heard me talking about it, on uh statins and GLP1s.
00:43:34.079 --> 00:43:37.440
And this is one of those things that just shocked me.
00:43:38.239 --> 00:43:39.760
Not because of the metabolic effect.
00:43:39.840 --> 00:43:40.800
It actually is quite intuitive.
00:43:40.880 --> 00:43:45.519
Basically, there's a human uh control trial that found statins slash GLP1 levels.
00:43:45.599 --> 00:43:47.920
Again, we're talking about GLP1 receptor agonists.
00:43:48.079 --> 00:43:59.599
The fact that the most profitable drug class in history, not GLP1 receptor agonists, statins, slash GLP one levels like in half in humans, and it doesn't get talked about is shocking.
00:44:00.559 --> 00:44:01.760
For obvious reasons.
00:44:01.920 --> 00:44:06.000
People listening can put two and two together if they're a human adult with a few brain cells.
00:44:06.239 --> 00:44:10.400
And that is not to say you need a GLP1 if you're on a statin.
00:44:10.480 --> 00:44:11.840
And it's not to say statins are even bad.
00:44:11.920 --> 00:44:27.280
It's just to say, hey, these drugs have effects that are potent biologically, and we should have a full conversation about what these are so that people can make informed decisions and so that they have the opportunity to offset them if they can.
00:44:27.360 --> 00:44:35.840
So in this particular trial, they actually had a solution for offsetting the GLP1 smashing effects of statins that had to do with bioacid supplementation.
00:44:36.159 --> 00:44:36.800
Different topic.
00:44:36.960 --> 00:44:41.679
But point being, there's a lot of very silo conversations and imbalanced conversations.
00:44:41.760 --> 00:44:47.119
If you're taking a medication, it's a very high chance it's going to have both benefits and risks.
00:44:47.280 --> 00:44:52.320
And it's up to you to figure out how that risk-benefit analysis falls for you.
00:44:52.800 --> 00:44:54.320
To the pro, to the con.
00:44:55.280 --> 00:44:56.960
Usually it's clear, not always.
00:44:57.360 --> 00:44:57.920
Great message.
00:44:58.079 --> 00:45:02.480
And the the whole idea of personalization of all these things, like type 2 diabetes, four different types.
00:45:02.639 --> 00:45:04.079
Like, you know, that's important.
00:45:04.159 --> 00:45:07.920
And we're not doing that now nearly enough that we we should.
00:45:08.079 --> 00:45:10.559
And hopefully, more and more in the future, we're going to see that.
00:45:10.719 --> 00:45:12.239
We're almost out of time.
00:45:12.480 --> 00:45:19.199
Maybe we'll maybe just end with like, what are you most excited to publish or build next?
00:45:19.280 --> 00:45:23.039
Or is there anything we didn't talk about that you want to hit in the last couple of minutes?
00:45:23.360 --> 00:45:24.079
Oh, yeah, no.
00:45:24.159 --> 00:45:25.840
Uh, a million and one things.
00:45:26.000 --> 00:45:32.480
As I mentioned, I like I'm a few months out from medical school and it's been an absolute whirlwind, involving a couple companies, building up my social media base.
00:45:32.559 --> 00:45:35.440
Right now, I'm having the most fun on Substack.
00:45:35.679 --> 00:45:49.199
So if people want to check me out on OnePlace, they can find me Nick Norwitz on any social last name, N-O-R-W-I-T-Z, but my Substack, um, you can find it at staycuriousmetabolism.com is where I hit the most data as it comes out.
00:45:49.360 --> 00:45:54.639
So I'm generally up very early in the morning reading cell science nature and then trying to communicate it in fun ways.
00:45:54.800 --> 00:45:59.920
So, you know, there's some new papers on very odd amino acids that can fight age-related muscle loss.
00:46:00.079 --> 00:46:04.559
There was this new study that blew my mind out of nature on how stress makes glucose in the body.
00:46:04.719 --> 00:46:14.960
So literally a direct hot wire from the brain to the liver when there's stress saying, hey, liver, turn up glucose-generating enzymes, is actually kind of crazy.
00:46:15.119 --> 00:46:21.599
The methodology they use is beautiful, like injecting viruses into animals that can go travel up neurons and they glow.
00:46:21.760 --> 00:46:23.679
So like inject it into the liver.
00:46:23.840 --> 00:46:28.639
And if it is connected directly to the brain, you will see a glowing green signal in the brain and they show that.
00:46:28.800 --> 00:46:30.719
So it's the kind of science I review.
00:46:30.800 --> 00:46:32.000
At least three times per week.
00:46:32.079 --> 00:46:34.079
I'll have a deep dive on some new science.
00:46:34.239 --> 00:46:36.239
So stay curious, metabolism.com.
00:46:36.320 --> 00:46:38.960
I love engaging with people, but uh you can find them pretty much anywhere.
00:46:39.039 --> 00:46:39.840
I'm trying to spread.
00:46:40.320 --> 00:46:40.800
It's great.
00:46:40.880 --> 00:46:42.159
Let me sneak one last question.
00:46:42.239 --> 00:46:44.400
It is out of the box, out of the blue.
00:46:44.639 --> 00:46:46.159
How are you most excited?
00:46:46.239 --> 00:46:51.679
Well, how do you how do you use generative AI, large language models, agents most in your work?
00:46:51.760 --> 00:46:56.239
Or what do you see the the what are you most excited about that for the asset?
00:46:56.639 --> 00:46:59.280
Yeah, for me, it's very helpful for ideation.
00:46:59.360 --> 00:47:05.920
So I'm not that great with AI, but I'll use Chat GTP to like, you know, expedite my process.
00:47:06.000 --> 00:47:10.079
So what I'll do is like I'll read a paper and I'll like auto-dictate a script.
00:47:10.159 --> 00:47:11.760
And then I'll just put it into Chat GTP.
00:47:11.840 --> 00:47:14.159
I won't ask it to write it for me, but I'll ask for feedback.
00:47:14.320 --> 00:47:22.159
And ideation is like, hey, is there a better hook here that can like resonate with a layperson or an analogy or like a fun title?
00:47:22.320 --> 00:47:24.559
And so I help it helps me with my ideation.
00:47:24.960 --> 00:47:34.079
Um, all the legwork and the reading and then like the original drafting is me, but just in like cleaning it up, I think it's very good for a feedback buddy at this point in time.
00:47:34.320 --> 00:47:38.239
I I don't think it's like I wouldn't use it to like write original stuff.
00:47:38.320 --> 00:47:41.760
I think one of the issues is it's pretty bad about like scientific citation.
00:47:42.159 --> 00:47:44.400
Um but yeah, we'll see.
00:47:44.559 --> 00:47:49.440
Also, as I build up my team, I mean, one thing to know in medicine and science is like it's a team sport.
00:47:49.599 --> 00:47:51.760
You know what you're good at, you know what you're not good at.
00:47:52.079 --> 00:47:53.760
Tech is not necessarily my thing.
00:47:53.840 --> 00:48:00.719
So my goal is to build a team of people who can say, hey, now there's this new AI tool, you know, let's play with that.
00:48:00.880 --> 00:48:01.760
So sometimes it's fun.
00:48:01.840 --> 00:48:04.559
Like I have a voice clone that'll read my newsletters if you go there.
00:48:04.719 --> 00:48:06.480
You can click in, there's like AI Nick.
00:48:06.800 --> 00:48:08.320
There's 11 labs for that, I think.
00:48:08.480 --> 00:48:09.280
No affiliation.
00:48:09.360 --> 00:48:11.199
But uh yeah, it's pretty cool.
00:48:11.280 --> 00:48:13.199
And I think you need to become savvy with it.
00:48:13.360 --> 00:48:15.599
I'm not super savvy with it, but I like to explore.
00:48:15.920 --> 00:48:19.360
Be careful, don't let it take over and start doing all your stuff.
00:48:20.159 --> 00:48:20.480
I know.
00:48:20.880 --> 00:48:21.360
AI Nick.
00:48:21.760 --> 00:48:23.039
People can usually capture that.
00:48:23.280 --> 00:48:30.159
There's some big influencers, I won't name names, but somebody pointed out they put up like a an image and they're like, this reference is wrong.
00:48:30.239 --> 00:48:31.840
And it was a PubMed idea.
00:48:31.920 --> 00:48:34.960
Like that was just not a paper.
00:48:35.119 --> 00:48:39.280
Uh and it's because like they clearly used AI and it hallucinated.
00:48:39.440 --> 00:48:47.360
Uh, I know of this individual, and this seems very R for them, but something like that can end up creating a big embarrassment.
00:48:47.440 --> 00:48:52.880
And there's very little recovery once it's clear you're using AI to generate your science because it does hallucinate science.
00:48:53.039 --> 00:48:55.599
So I'd be I'll be cautious about that.
00:48:55.760 --> 00:48:56.719
No worries.
00:48:57.039 --> 00:48:58.800
This has been wonderful, Nick.
00:48:58.880 --> 00:49:02.480
Uh getting to know you a little bit better, and thank you for spending time with us.
00:49:02.559 --> 00:49:07.199
And I'm looking forward to uh great things with you and connecting again in the future.
00:49:07.440 --> 00:49:08.400
Thank you so much.
00:49:08.639 --> 00:49:10.079
Appreciate you having me.
00:49:10.639 --> 00:49:16.639
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Can I start?
00:50:31.519 --> 00:50:32.159
Is it recording?
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It's already recorded.
00:50:33.360 --> 00:50:34.320
Oh, sorry.
00:50:35.039 --> 00:50:38.800
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