Metabolic Mind

In this conversation, Dr. Matthew Budoff, a preventive cardiologist and researcher from UCLA, challenges conventional beliefs about cholesterol and heart disease. He reveals surprising findings from his study on individuals on a ketogenic diet, where elevated LDL and ApoB levels did not predict plaque progression. Some participants with LDLs over 500 showed no plaque, while existing plaque was a better indicator of risk. Dr. Budoff advocates for personalized approaches to cardiovascular risk assessment, reshaping the conversation around diet and heart health.

There’s been a lot of buzz—and confusion—about the new Keto-CTA study, examining plaque progression in Lean Mass Hyper-Responders (LMHRs).Much of the social media debate has centered on whether high LDL on keto is safe or dangerous, driven largely by how to interpret the supplemental table comparing this study to others on LDL and plaque progression.In this episode of the Metabolic Mind Podcast, we sit down with Dr. Matthew Budoff, a world-renowned cardiologist, cardiac CT researcher, and the study's lead investigator, to discuss the the supplemental table, what the plaque markers mean, and how this fits into the discussion of high- vs -low-risk plaque progression.In this episode, we cover:✅ What PAV (Percent Atheroma Volume) is, what it actually measures, and why it matters✅ Why a 50% increase in plaque may sound scary, but can be deceiving✅ The difference between “treatment-naive” and “treated” participants✅ What the Miami Heart Study comparison reveals about keto, LDL, and plaque✅ Why LDL alone may not tell the whole story about heart disease risk✅ How some high-risk individuals may still benefit from statins and other therapiesThis study doesn’t answer whether keto causes heart disease or not. Instead, it shows that high LDL on a ketogenic diet is not a reliable predictor of plaque progression across all individuals. What is predictive? The presence of existing plaque.💡 Key takeaway: Relying on surrogate markers of heart disease, like LDL and ApoB, is not the best way to assess heart disease risk in all populations.If you're concerned about how elevated LDL may be affecting your heart health, the best next step is to speak with your doctor about cardiac imaging to directly assess plaque and gain a clearer picture of your individual risk.Expert Featured:Dr. Matthew BudoffX: https://x.com/budoffmd?lang=enhttps://lundquist.org/matthew-budoff-mdResources Mentioned:Plaque Begets Plaque, ApoB Does Nothttps://www.jacc.org/doi/10.1016/j.jacadv.2025.101686CMEs Mentioned:Managing Major Mental Illness with Dietary Change: The New Science of Hopehttps://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616Brain Energy: The Metabolic Theory of Mental Illnesshttps://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

In this engaging discussion, Dave Feldman, an engineer and CEO of the Citizen Science Foundation, challenges conventional wisdom about LDL cholesterol. He reveals fascinating insights from his latest study, showing that lean mass hyper-responders on ketogenic diets can exhibit elevated LDL without increased heart disease risk. The conversation delves into the importance of ApoB over LDL, the complexities of cardiovascular health, and the necessity for individualized risk assessments. Feldman's work encourages a reevaluation of how we view cholesterol in relation to metabolic health.

Dr. David Unwin, a pioneering NHS physician from the UK, has successfully guided over 150 patients to drug-free remission from type 2 diabetes through a low-carb ketogenic diet. He discusses the revolutionary potential of this approach, the importance of real-world data in changing medical practices, and the resistance he faces from traditional healthcare systems. Unwin also highlights the power of sharing patient success stories to inspire others and the role of social media in public health advocacy. His insights offer hope for those struggling with metabolic health.

Not all medical research is created equal, so how do we know which studies to trust?The phrase evidence-based medicine (EBM) is often misunderstood and misused. What does it truly mean to rely on evidence in clinical decision-making?Dr. Gordon Guyatt, the father of the term evidence-based medicine, explains how to assess scientific studies, understand the strength of different types of evidence, and apply findings to clinical decisions.Want to make better-informed health decisions? This interview will help you learn how to critically assess medical evidence for yourself. In this conversation, Dr. Guyatt breaks down:✅ Why some studies are more trustworthy than others✅ The limitations of observational studies in nutrition and medicine✅ How the GRADE framework categorizes evidence from high to low certainty✅ How to critically assess nutrition and mental health research✅ The importance of patient values in clinical decision-makingAs new chronic disease treatments emerge from rapidly evolving research, understanding the quality of evidence is more important than ever. The ability to distinguish robust data from weak correlations isn’t just a skill—it’s essential for making informed, effective decisions in patient care.#MetabolicMind #EvidenceBasedMedicine #MedicalResearch #NutritionScience #GRADEMethod #HealthDecisionsExpert Featured:Dr. Gordon Guyatt, MDResources Mentioned:Core GRADE WorkshopCMEs Mentioned:Managing Major Mental Illness with Dietary Change: The New Science of Hopehttps://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616Brain Energy: The Metabolic Theory of Mental Illnesshttps://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Dr. Kirk Nylen, a neuropharmacology expert and Managing Director at Baszucki Group, shares groundbreaking insights on the ketogenic diet's potential for improving pediatric mental health, particularly in children with bipolar disorder. He discusses two ongoing studies: CABIN, a multi-site trial assessing ketogenic therapy, and a real-world pilot study by CMHRC. The conversation emphasizes the urgent need for innovative solutions as youth mental health issues rise, highlighting how ketogenic interventions could enhance treatment options for clinicians.

Can you safely taper off psychiatric medications? And what are the potential harms of long-term psychiatric care?Laura Delano spent years as a professional patient, navigating psychiatric diagnoses, multiple medications, and a life defined by treatment.In this interview, Laura discusses her 13-year experience as a psychiatric patient, the impact of long-term medication use, and how she took control of her health to successfully taper off multiple psychiatric drugs.Now, as the founder of Inner Compass Initiative and author of Unshrunk: A Story of Psychiatric Treatment Resistance (available March 18, 2025), she’s dedicated to helping others navigate informed choices about psychiatric medications, diagnoses, and withdrawal.💡 In this episode, we cover:✅ Laura’s personal story of polypharmacy and its effects✅ The impact of long-term psychiatric medication✅ The challenges of tapering and withdrawal✅ How Laura has rebuilt her life beyond medications✅ How Laura built a nonprofit to support others on the same path✅ The role of diet, lifestyle, and community in mental health recovery✅ Why informed consent is crucial for psychiatric treatment decisions✅ The mission of Inner Compass InitiativeLaura’s new book Unshrunk: A Story of Psychiatric Treatment Resistance is available March 18, 2025.⚠️ Trigger Warning: This conversation includes discussion of suicidality and a suicide attempt. Please take care when watching.#MentalHealth #Psychiatry #Deprescribing #PsychiatricMedication #Tapering #MetabolicPsychiatryExpert Featured:Laura DelanoResources Mentioned:Inner Compass Initiativehttps://www.theinnercompass.org/Laura’a New Book: Unshrunk: A Story of Psychiatric Treatment Resistancehttps://www.amazon.com/Unshrunk-Story-Psychiatric-Treatment-Resistance/dp/1984880489The Challenges of Going off Psychiatric Drugshttps://www.newyorker.com/magazine/2019/04/08/the-challenge-of-going-off-psychiatric-drugsCMEs Mentioned:Managing Major Mental Illness with Dietary Change: The New Science of Hopehttps://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616Brain Energy: The Metabolic Theory of Mental Illnesshttps://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Brain Energy and metabolism appear to play critical roles in the development and treatment of psychiatric disorders like bipolar disorder, depression, and schizophrenia. And emerging research suggests that our gene expression influences how our brain uses energy, thus linking the fields of genetics and metabolism.In this episode, Dr. Harry Pantazopoulos, Associate Professor in the Department of Psychiatry and Human Behavior at the University of Mississippi Medical Center, joins Dr. Bret Scher to discuss fascinating new research into the relationship between gene expression and metabolism in serious mental illness.Dr. Pantazopoulos’ study reveals a fascinating insight: while metabolic dysfunction is a common feature of serious mental illnesses, each condition exhibits its own distinct patterns of altered gene expression that impacts metabolic function. This suggests that the underlying metabolic dysfunction in mental illness arises through different mechanisms unique to each disorder.In this interview you will learn: The benefits of studying metabolic function and gene expression of the amygdala Which genes show altered expression in each mental illness, and how these changes affect metabolism How shifting the brain’s energy source from glucose to ketones could offer a promising way to address changes in metabolic gene expression How these study findings could translate to targeted clinical careAlthough these findings are not yet ready to directly influence clinical psychiatric care models, they provide a critical foundation for future research aimed at tailoring metabolic therapies to the unique needs of each individual.Expert Featured:Harry Pantazopoulos, MDLinkedIn: https://www.linkedin.com/in/harry-pantazopoulos-04460413/X: @HarryPantazopo1Studies Mentioned:Transcriptomic Analysis of the Amygdala in Subjects with Schizophrenia, Bipolar Disorder and Major Depressive Disorder Reveals Differentially Altered Metabolic PathwaysDifferentially Altered Metabolic Pathways in the Amygdala of Subjects with Schizophrenia, Bipolar Disorder and Major Depressive DisorderCMEs Mentioned:Managing Major Mental Illness with Dietary Change: The New Science of HopeBrain Energy: The Metabolic Theory of Mental IllnessFollow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Is psychiatry stuck in the 19th century? For decades, psychiatry has relied on trial and error but is there a better way to provide precise, personalized, and preventative treatment?Dr. Alexander Niculescu, professor of psychiatry at the University of Arizona and CEO of MindX Sciences, is at the cutting edge of transforming psychiatry into an objective, data-driven field. With blood tests evaluating specific biomarkers, doctors may now be able to measure mental health, better understand symptoms, and predict which treatments will work best.In this conversation, Dr. Niculescu explains how his research is helping reshape how we diagnose and treat mental illness allowing for a more personalized approach and potentially better outcomes. He shares research demonstrating how utilizing biomarkers can allow practitioners to better understand the current state of a patient’s mental health to assist in prevention and tailor both medications and lifestyle interventions for better outcomes.In this episode, you’ll learn:Why psychiatry is still practiced like 19th-century medicine and how to modernize itHow blood tests can pinpoint the right treatment for a patient including lifestyle interventions, medication choice, and dosingHow blood tests can identify the nuanced difference between mental illnesses like depression and bipolar disorder at a biological levelWhy these tests could be more reliable than genetic testingHow early screening could help prevent serious mental illnessThe future of personalized lifestyle recommendations for mental healthAt Metabolic Mind, we believe mental health care must evolve to incorporate metabolic interventions alongside innovative diagnostic tools. Our vision is a future where the metabolic health of every individual is assessed and addressed with evidence-based interventions, leading to improved mental health for all.Expert Featured:Dr. Alexander Niculescuhttps://mindxsciences.com/https://www.linkedin.com/in/alexander-niculescu-md-phd-b460a75/Studies Mentioned:Special Report: Precise, Personalized, and Preventive Psychiatryhttps://doi.org/10.1176/appi.pn.2024.12.12.27CMEs MentionedManaging Major Mental Illness with Dietary Change: The New Science of Hopehttps://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616Brain Energy: The Metabolic Theory of Mental Illnesshttps://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Is it possible for ketogenic therapy to significantly reduce schizoaffective symptoms in 2 weeks? What about putting symptoms into complete remission in 6 weeks?Licensed Mental Health Counselor Nicole Laurent joins Dr. Bret Scher to discuss her newly published case series showcasing the dramatic improvements in individuals with schizoaffective disorder using ketogenic metabolic therapy.In this interview, Nicole shares:The life-changing stories from the patients and their familiesHow she collaborated with healthcare teams to ensure better outcomesHow she determines the right type of ketogenic diet for each patientThe role of nutrient deficiencies and supplementation in treatmentHow medications were handled and her perspective on medication changes with ketogenic therapyThe profound transformations in her patients’ lives, including returning to school and regaining independenceThese stories offer hope and add to the growing evidence that ketogenic therapy can help individuals struggling with mental illness.Want to hear more real-life experiences of people reclaiming their mental health through metabolic therapy? Hear from our community of experts by experience, including their challenges, setbacks, and successes on the path to recovery at metabolicmind.org/think-smart.Expert Featured:Nicole Laurent, LMHChttps://mentalhealthketo.com/Founder and Medical Director of Mental Health KetoX: @KetoCounselorLinkedIn: https://www.linkedin.com/in/nlaurent/Instagram: mentalhealthketo/Studies MentionedKetogenic metabolic therapy for schizoaffective disorder: a retrospective case series of psychotic symptom remission and mood recoveryhttps://doi.org/10.3389/fnut.2025.1506304CMEs MentionedManaging Major Mental Illness with Dietary Change: The New Science of Hopehttps://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616Brain Energy: The Metabolic Theory of Mental Illnesshttps://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/About us:Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.