Ketosis and Fasting - The Only Tool Your Doctor Will Never Use

For fitness and Paleo Diet aficionados—and perhaps regular STEM-talk listeners—Robb Wolf is the type of esteemed guest who needs no introduction. Many people already know him by his best-selling book, “The Paleo Solution: The Original Human Diet,” (http://amzn.to/2gB6N4c) or his top-ranked podcast by that same name. (http://robbwolf.com/podcast/)

But what some people may not know is that Wolf also started the world’s first cross-fit affiliate gym; that he’s raising his young daughters on a paleo diet—which may account for their mouths having a similar phenotypical expression as hunters and gatherers; and that nicotine—yes, nicotine—can actually be good for you (just not delivered by cigarette) in some contexts.

STEM-Talk Host Dawn Kernagis and IHMC Founder Ken Ford talk to Wolf about these and other fascinating insights in this episode.

Wolf hailed from a relatively unhealthy family, which pushed him towards discovering good health on his own terms. A keen interest and aptitude in science (he was a biochemistry major at California State University-Chico) set Wolf on the path of evolutionary medicine.

He began thinking seriously about pre-agricultural diets in response to his mother’s poor reaction to her consumption of grains, legumes, and dairy. Since that time, Wolf has become an expert, researcher, and self-experimenter of the Paleo Diet. His expertise has led him to become a review editor for Journal of Nutrition and Metabolism; co-founder of The Performance Menu, a nutrition and athletic training journal; and co-owner of NorCal, one of Men’s Health magazine’s top thirty gyms in America. He is also a consultant for the Naval Special Warfare Resiliency Program.

Wolf recently gave a lecture entitled “Darwinian Medicine: Maybe There IS Something to This Evolution Thing” at IHMC: https://www.youtube.com/watch?v=qga4A3vnXmg

2:10: Dawn reads iTunes review entitled “No Bro Science Here” from someone nicknamed “Leafy Sweets:” “Science-based interviews with experts, post-docs and department/lab heads on relevant topics. No Bro Science here!  Interesting discussions relevant to one’s well-being and interests.”

3:46: Dawn welcomes Robb and Ken.

4:10: “I was raised by two well-meaning, but quite ill parents. Both of them smoked, neither of them exercised, both of them developed Type-2 Diabetes pretty early in their lives, and I’m not really sure why…but somewhere along the line I suspected that if I ate better and exercised, that I could maybe have a better outcome.”

5:00: “They really kind of acquiesced all their health to the medical establishment, and I went just as opposite that vector as you can possibly imagine.”

5:30: “I had a pretty good interest in science in general… I got into an organic chemistry class (in high school) and loved it like I had never loved anything before, and actually discovered that I had an aptitude for spinning molecules in my head and thinking about bonding and stuff like that.”

6:55: After his degree in biochemistry, Wolf considered medical school, but he had some personal health problems. That’s when, “The evolutionary approach to health/medicine got on my radar.”

7:28: Plus, he says, “Academia seemed to move at glacial speeds.” “Around 2000-2001, I found this weird thing called Cross-fit. I opened a gym, and it happened to be the first cross-fit affiliate in the world, and I opened a second one (the fourth in the world) … That was kind of the medicine that I wanted to practice. I got to talk to people about sleep, food exercise; and build community.”

9:15: Wolf describes his entry into evolutionary medicine: He was vegan, he was not sleeping and he had moved to Seattle, into a tiny basement where he didn’t see the sun for several months. He had a lot of gastro-intestinal problems, as did his mother, whose rheumatologist told her she was allergic to grains, legumes and dairy.

10:47: Around 1998, Wolf learned about the Paleo Diet through the work of Arthur De Vany and Loren Cordain (who would become Wolf’s mentor). Lauren had written a paper called “Cereal Grains: Humanity’s Double-edged Sword.” (http://www.directms.org/pdf/EvolutionPaleolithic/Cereal%20Sword.pdf)

12:00: Dawn asks about the “contemporary collision between foods we’re wired to eat and what we find on the shelves of local supermarkets.”

12:15: Wolf responds: “We’re set up for failure. I half-jokingly say that if you live in this modern environment and you’re not diabetic and broken, then you are kind of screwing up. You’re not paying attention to your evolutionary history.”

12:45: “We have limitless caloric input. We don’t need to expend effort to obtain these items. We have limitless palate options.”

15:00: Wolf’s short definition of the Paleo Diet: “You’re generally not eating a much in terms of grains, legumes, and dairy. You eat everything else: meat, fruit, roots, shoots, vegetables.”

16:27: He also cautions against the trendy uptake of the diet: “Paleo became this thing where people were asking: ‘Is this Paleo or not?’ instead of ‘Is this a good item for me?’”

17:00: Wolf decries the use of the term “Paleo,” which was used early on in the anthropological literature to describe the diet.

17:25: Wolf says that he has been low-carb for a long time; he currently eats 100-150 grams of carbs a day. “I’ve really enjoyed ketogenic diets in the past. That’s where I get my best cognition from.”

17:35:  “I am playing again with a ketogenic diet again because I am being leaned on by folks like you (Ford) and some other people to see if I can fuel my Brazilian Jujitsu activity.”

17:49: He can eat lentils, beans and corn…but not gluten. “I am highly reactive to gluten and gluten-like grains.”

18:45: Wolf discusses the role of genes in what we ought to eat, and the gut microbiome in modifying those genetics…He cites the studies of the Weizmann group in Israel, in which 800 people were given a sub-cutaneous glucose monitor and then fed a battery of meals. “The glycemic response was all over the map.”

20:00: “One person would eat a banana and have virtually no blood glucose response …Another person would eat a banana and get into nearly diabetic ranges… It’s clear in my mind that there’s massive variation in folks, and that a one size fits all approach is really, really problematic.”

21:00: Ken comments: “It would be surprising to me if Northern Europeans and Kitavans would both be ideally suited to eat exactly the same diet, particularly for genetic reasons, but also for gut microbiome reasons.”

21:50: Dawn asks if anyone has looked at the impact of ancestral diets on people doing manual labor jobs or professional athletes—since our ancestors were more active than we are.

22:00: Robb answers that most of the studies have been done in disease populations, such as people with cardiovascular disease, Type-2 Diabetes, insulin resistance or stage I/II renal disease.

23:43: “Both coaches and elite performers tend to be ahead of academia in empirically figuring out what works well.”

23:55: The Paleo way of eating has reached the Navy’s Special Warfare community.

25:05: “In college, most of us had some sort of horrific diet like pizza and beer for months on end and it didn’t kill us, so my greasy car salesman pitch is why don’t you give it [the Paleo diet] a shot for a month and see how you look, feel and perform; do blood work before and afterwards and see how it works.”

26:30: Dawn asks if an obese individual following a cleaner, healthier diet is enough to shift his/her phenotype to a healthier place.

27:11: “I think for the optimum human experience we need some sort of vigorous physical activity at least occasionally.”

28:00: “Ketogenic diet plus fasting can actually mimic a lot of the physiological processes that we see with exercise, but I’m not sure how much mileage we can get out of that. There’s some indication that a ketogenic diet and intermittent fasting can enhance certain elements of our metabolism, like mitochondrial density [along with] pro-apoptotic and autophagy benefits.”

28:50: “We need periods of relative abundance and some scarcity, and that is then sending signaling that is possibly most consistent with health and longevity.”

29:10: Wolf discusses who food and the metabolic byproducts of food and exercise are often signaling molecules. “There’s an expectation for a certain type of cadence and beat to our physical activity and nutrient intake, and if we get out of step with that, then I think that we’re pre-disposing ourselves to a transcriptome that may be pathogenic at some point.”

30:00: Commercial break: STEM-Talk is an educational service of the Florida Institute for Human and Machine Cognition, a not-for-profit research lab pioneering ground-breaking technologies aimed at leveraging human cognition, perception, locomotion and resilience.

31:15: Dawn asks about studies comparing unprocessed, whole-food diets to comparable Paleo diet.

31:46: Robb cites a Lynda Frassetto study comparing the Mediterranean and Paleo diets. (http://jn.nutrition.org/content/early/2016/04/20/jn.115.224048.) The two groups were fed at a level so they would not lose weight. It was hard to get the Paleo group to eat enough food so they would not lose weight. Absent weight loss, they saw dramatically improved blood lipids and systemic inflammatory markers in the Paleo diet group.

34:26: Dawn talks about being vegetarian for 22 years, an emotional decision rooted in growing up on her grandparents’ farm during the summer and being uncomfortable eating what had been killed and that she had helped raise. “When I was seventeen, my grandfather told me who I was eating at the dinner table. So I called it quits…. But a lot of us are interested in the Paleo diet.” She asks about recommendations for vegetarians interested in the Paleo Diet.

36:08: Robb says, “If we’re doing eggs and dairy, it really is pretty easy to make that work. Properly prepared legumes are a great background, primary energy source; lots of coconut, coconut oil; cheese and butter.”

37:38: One possible caveat for those on vegetarian diets is to avoid a monochromatic dietary pattern. We need to be better about rotating foods in and out, like eggs.

39:50: At Wolf’s house, he does 90 percent of the cooking. His wife, who is Italian, was vegan when Wolf met her—and he impressed her with his cooking. She switched to his diet.

41:22: We really don’t eat much in the way of gluten. Many people think it’s just a fad. I’ve spent twenty years studying this from an immunological perspective, and there are a lot of folks that benefit from gluten free.

42:05: The preponderance of what they eat is sweet potatoes, fruit, fish, seafood; both of Wolf’s little girls eat homemade sauerkraut, homemade kimchi; liver.

42:22: His kids’ dentist has noticed that the kids have a lot of space between their teeth—and broad jaws, a notable phenotypic expression. This likely means they won’t have crowding of their teeth. Wolf attributes this to their nutrient-rich diet. On the contrary, lower nutrient-dense foods cause a shortening of the dental arch and crowding of teeth. “That would kill us were it not for modern dentistry.”

45:10: Still, his kids express the same attraction to sweet foods as everyone else. “We have to find some way …so that we aren’t on the losing end of food intake.”

45:48: Ken comments that the neuro-regulation of appetite is currently of huge interest and asks Rob to discuss it.

46:11: In the last fifty years, there have been a lot of macro-nutrient wars such as those between high and low carbs. “At the end of the day, what we want to see is some ability for people to eat an appropriate amount for their energetic needs and not much more/less. [It] boils down to the neuro-regulation of appetites.”

47:10: “The state of ketosis is incredibly satiating, and seems to be disproportionately so relative to caloric intake.

47:22:  “One takeaway that I would love for folks to noodle on is that within medicine and dietetics, there is only one disordered eating that they acknowledge, and that is trying to limit palate options in some way. If you show up eating a big gulp and Twinkies — you are good to go.”

48:00: In every study that’s ever been done comparing the American Dietetics recommended diet with the vegan diet, or the high protein diet, etc. … the diet that fails consistently is the moderate, don’t-exclude-any-food-groups diet.

49:42: Ken asks Robb how he felt in ketosis initially, post-adaptation period.

51:22: Robb says when he first clicked into ketosis, around 1998, “It was amazing. I had incredible mental focus. I could go hours or even days without eating. It just didn’t phase me at all.” He was also very active at the time, doing gymnastics and Brazilian Capoeira.

54:30: Robb says exogenous ketones are “reasonably impressive.” Ketone salts give him GI upset. He is getting ready to play with ketone esters. He mixes MCT oil with soy lecithin and nut butter (as a carrier.) That mitigates his GI problems.

59:30: Robb comments on the cultural tendency to over-train. “We hold elite athletics on a pedestal. We assume their training should be emulated, and I haven’t seen that to be the case. And I see a lot of people break themselves as a consequence of that. Endurance athletes especially are neurotic about training.”

1:01:40: Ken comments: “Marathon running has been a sacred cow, and a symbol of personal virtue…We hear more and more of negative consequences associated with long-term, extreme endurance activities.”

1:04:12: Commercial break: STEM-Talk is an educational service of the Florida Institute for Human and Machine Cognition, a not-for-profit research lab pioneering ground-breaking technologies aimed at leveraging human cognition, perception, locomotion and resilience.

1:04:50: Robb used to recommend high dose Omega 3 supplements. Now he recommends getting as much of it from your diet as you can, with deep water fish that are smaller on the food chain such as mackerel and sardines.

1:06:40: He says Omega 3s are “highly reactive poly-unsaturated fats: if we dump that into an already inflamed individual, that could be a disaster.” In certain people, other issues need to be tackled first before using Omega 3s as an adjunctive therapy.

1:08:30: Ken says nicotine gum seems to provide focus and a productivity boost, especially during activities demanding focus such as writing a book.

1:09:09: Robb started researching nicotine when he was giving talks on sleep, nutrition, alcohol and nicotine for the Navy SEALs. He found that nicotine enhances dopamine status; and is beneficial for gastrointestinal issues. The culprit (i.e., cigarettes) is the delivery system.

1:11:03: Robb tried nicotine gum, about which he says: “It was a whole other layer of peeling back the fog, and the focus. Plugging into the matrix for 45 minutes to an hour. I shared this information with the SEAL community. The flight docs just wanted to barbeque me alive.”

1:11:54: He recommends lozenges and gum, not cigarettes.

1:13:55: Dawn says her dad smoked when he did fine-scale modeling.

1:14:27: Ken comments that nicotine is among the most addictive drugs in common use.  Nicotine has a 90 percent addiction liability (90 of 100 people would become addicted). Opiates are 50 percent; and alcohol, about 10 percent. With nicotine, there is not much of a list (unlike for opiates and alcohol) of societal or personal health hazards.

1:16:45: But one should probably be cautious regarding nicotine in cold weather. Robb once did long bow hunting in very cold weather and chewed nicotine gum, and because of the vascular constrictive effects, he went from being completely comfortable to his hands and feet turning into blocks of ice.

1:17:17: If you’re prone to Raynaud’s disease, nicotine would not be a good idea; or in a situation where your extremities need to be warm, it’s not a good idea.

1:18:04: Robb talks about the Lazy Lobo Ranch and the work of Allan Savory, who developed a process to reverse desertification by using smartly controlled grazing animals.

1:19:15: Robb moved to a three-acre ranch in Reno. Comments that Nevada used to be a giant grassland.

1:20:58: He uses a mob grazing technique with electric fencing. Because animals are bunched up tight, they compete to eat everything. The before/after photos of this piece of desert land are just stunning.

1:23:14: Allan Savory makes the point that one third of all the land masses on the planet are grasslands; this is amenable for growing grass/animals, and we’ve shied away from using these areas in these ways.

1:24:15: “I think there’s a real opportunity to produce lots of food, address some soil carbon issues, and heat sinks and water utilization. When you re-establish these grasslands, the water doesn’t just run off; you don’t get flooding. It actually re-fills aquifers.”

1:25:11: Ken says, “Allan Savory is a person that more people should know about and pay attention to.” (http://savory.global)

1:25:49: Robb’s new, upcoming book, “Wired to Eat,” is looking at the evolutionary biology story again. “The thing that seems to pop up again and again is sense of guilt and failure of morality around eating.” He diffuses that in the front of book.

1:28:24: “My hope is that both on a cognitive level and an emotional level people can plug into this and understand: ‘I’m not a failure because this stuff is hard.’” The back part of book contains a 30-day re-set for the neuro-regulation of appetite and getting your insulin in line. The final chapter is titled ‘Hammers, Drills and Ketosis: The Only Tool Your Doctor Will Never Use’. A carpenter wouldn’t argue about whether to use a drill, saw or ax — they each have specific and well-appreciated purposes. Ironically in medicine, the use of ketosis and fasting as tools is a controversial topic.

1:30:20: The book will be out in March or April, 2017. Amazon is taking pre-orders. (http://amzn.to/2hqfJJE)

1:30:46:  Dawn asks about the genesis of Robb’s popular podcast. At first, the podcast was about answering questions from the audience and over time he shifted the podcast to an interview format. Currently, Dobb is thinking about adding a “news round-up” section to the podcast.

1:33:19: Dawn and Ken thank Robb for the interview and his recent IHMC lecture, available for viewing at: https://www.youtube.com/watch?v=qga4A3vnXmg

1:34:38: Dawn and Ken sign off.