The Keto Code with Dr. Steven Gundry: Rational Wellness Podcast 258
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Dr. Steven Gundry discusses how to Unlock The Keto Code with Dr. Ben Weitz.
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Podcast Highlights
2:14 Dr. Gundry recommended a keto version of the plant paradox diet in one of his previous books for certain patients, though this was not a pure keto diet. Dr. Gundry previously believed that ketones are used in mitochondria to generate energy and that ketones make mitochondria more efficient and that you lose weight because you get less energy production out of less fuel and you become an efficient fat burner, which is why you lose weight. Now he has figured out that that is the opposite of what happens in ketosis.
4:11 Mitochondrial uncoupling. The original ketogenic diet started in 1930 at the Mayo Clinic as a way of treating childhood seizure disorders. The original ketogenic diet was 80% fat, 10% carbohydrates, and 10% protein. In the 1990s we discovered that you could give kids MCT oil, medium chain triglycerides, and achieve the same results as a high fat diet. Dr. Cahill and Dr. Owen showed that even at full ketosis, the brain only gets 60 to 70% of its energy needs met by using ketones and 30 to 40% of the fuel needs of the brain are still glucose. So even at full ketosis, the brain’s needs, aren’t met by ketones. What ketones are doing is signaling the mitochondria to protect themselves and become less efficient at producing energy, which is known as mitochondrial uncoupling. During Oxidative phosphorylation, we couple oxygen molecules with protons to produce adenosine triphosphate (ATP) to drive energy production. When mitochondria uncouple, this produces heat and neurons love heat and they operate more efficiently at higher temperature. Also, if you like the mitochondrial dysfunction theory of Alzheimer’s disease, then protecting mitochondria with uncoupling sounds like a really good idea.
10:20 Mitochondrial uncoupling would seem to run contrary to survival, since uncoupling is telling the body to waste energy and not having enough energy or starvation was one of the biggest threats to survival for thousands of years. Here is a paper to read about mitochondrial uncoupling: Brand MD. Uncoupling to survive? The role of mitochondrial inefficiency in ageing. Exp Gerontol. 2000 Sep;35(6-7):811-20. doi: 10.1016/s0531-5565(00)00135-2. PMID: 11053672. The author, Dr. Brand explains in this paper that if you are starving to death, you need to protect the mitochondria because if the mitochondria die, you are done. Ketones also signal the mitochondria to make more of themselves via mitogenesis.
Dr. Steven Gundry is a cardiovascular surgeon who has changed his focus to a Functional Medicine/Integrative approach. He is the director of the International Heart and Lung Institute in Palm Springs and the founder and director of the Center for Restorative Medicine in Palm Springs and Santa Barbara. He is the best selling author of Dr. Gundry’s Diet Evolution, The Plant Paradox, The Plant Paradox Cookbook, The Plant Paradox Quick and Easy, The Longevity Paradox, and his latest book, Unlocking The Keto Code. Dr. Gundry can be reached through his website, DrGundry.com or by calling his office at (760) 323-5553.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.
Hello, Rational Wellness podcasters. Our topic for today is whether or not to keto and why with Dr. Steven Gundry. The keto genetic diet is one of the more popular diets in the functional medicine world. Being recommended for weight loss, diabetes, cancer, neurological diseases, like Alzheimer’s and a number of other conditions. But the ketogenic diet is a very controversial, and now we have Dr. Steven Gundry weighing in with what his take is on the keto diet. Dr. Steven Gundry does not really need an introduction, but he’s a heart surgeon who has changed his focus to nutritional and preventative medicine. He is now internationally known, having made hundreds of TV appearances, and he’s all over the internet. He’s the director of the International Heart and Lung Institute in Palm Springs and the founder and director of the Center for Restorative Medicine in Palm Springs in Santa Barbara. He’s the bestselling author of Dr. Gundry’s Diet Evolution, The Plant Paradox, The Plant Paradox Cookbook, The Plant Paradox Quick and Easy, The Longevity Paradox, and his latest book Unlocking The Keto Code, which you can see to the right of Dr. Gundry. Dr. Gundry. Thank you so much for joining us today.
Dr. Gundry: Hey, thanks for having me. Appreciate it.
Dr. Weitz: So you’re one of the most prolific doctors in the functional medicine world, though I guess you have a ways to go to catch up with Mark Hyman, who has 11 books and Deepak Chopra who has 25.
Dr. Gundry: I know, I just keep trying to catch them. I’m working hard at it.
Dr. Weitz: So Dr. Gundry, at one point you recommended a version of the ketogenic diet, what you called the keto based intensive care program in your Plant Paradox book, but you’ve changed your view on the keto diet. Can you tell us why that is?
Dr. Gundry: Well, if you actually look at the plant paradox, the keto version of the plant paradox diet, that diet that I recommend has a lot of what would appear to be carbohydrates that would be against the traditional ketogenic diet, and yet it worked extremely well in my patients. When I was writing my last book, The Energy Paradox, I like to back up what I say and recommend with science, whether it’s my research or others, and I was trying to explain how ketones are used in mitochondria to generate energy. And so I, like many people talking about ketones, was convinced that ketones were making mitochondria more efficient, that they were able to get more energy production out of potentially less fuel, and that you became an efficient fat burner, and that’s why you lost weight. And in fact, when you look at the literature, human literature, primarily based out of Harvard and the NIH, you find that in fact, that’s exactly the opposite of what happens in ketosis. And so I said, son of a gun, this goes against everything most people have talked about, and I need to go down this rabbit hole and find out what the heck are ketones doing, if they’re not the world’s greatest fuel and if they’re not actually making your mitochondria efficient fat burners, and that’s actually what the book is about.
Dr. Weitz: Yeah. Everybody really focuses on the brain and how ketones are… The brain works so much better when it can work off of ketones instead of glucose. And this is often recommended for patients with Alzheimer’s as Dr. Dale Bredesen includes it in his program and for patients after concussions. So why doesn’t the brain work well with ketones?
Dr. Gundry: Well, the original ketogenic diet started in 1930 at the Mayo Clinic as a way of treating childhood seizure disorders. And that was before Phenobarbital and Dilantin, and they found that… Actually it was almost stumbled upon. They found that children who were having so many seizures, that they basically didn’t eat, because they were in this post ictal state, their seizures went away. And then when they started eating again, when they kind of woke up, their seizures came back and people said, Gee, when these kids aren’t eating, they’re in ketosis, they’re making ketones and maybe it’s the ketones that were stopping these seizures and are there other ways to make ketones? And in fact, a very restricted carbohydrate diet or a very high fat diet makes people make ketones. So the original ketogenic diet was 80% fat, 10% carbohydrates and 10% protein. And lo and behold, kids on this diet actually had a remarkable diminution in seizures. So the initial thought process was that ketones suppressed seizures. Now, when drugs came out, the ketogenic diet for seizures pretty much fell by the wayside. It had a resurgence in the 1990s when it was found that you could give kids MCT oil, medium chain triglycerides, and achieve the same results as a high fat ketogenic diet, but give these kids more carbohydrates and more proteins and anyone who has children and now grandchildren know it’s pretty hard to deprive kids of carbohydrates. And in fact, it’s pretty hard to deprive adults of carbohydrates. So when people started looking at, well, what in fact were ketones doing that suppressed seizures, results particularly out of Harvard with Dr. Cahill and Dr. Owen showed that even at full ketosis, the brain only gets 60 to 70% of its energy needs met by using ketones and 30 to 40% of the fuel needs of the brain are still glucose.
So even at full ketosis, the brain’s needs, aren’t met by ketones. Are ketones doing something different than just being a fuel source? And it turns out that in fact, it is something different, and ketones are actually signaling molecules and they actually signal mitochondria to protect themselves at all costs and to actually tell mitochondria to become more inefficient at producing energy than efficient at producing energy. And this is actually something that’s been known about since the late 1970s in that ketones and other substances that I talk about in the book, actually tell mitochondria to uncouple oxidative phosphorylation. Briefly what that means, and I wish there was a better term, but it’s in the literature and we’re going to use it. Normally we… Oxidative phosphorylation, we couple oxygen molecules with protons to produce adenosine triphosphate to drive energy production. And that’s oxidative phosphorylation. That coupling can be stopped or diminished by what are called uncoupling proteins. And it basically is like a pressure cooker. Pressure cooker is great at cooking food fast, but if the pressure gets too high, the pressure cooker blows up. So you have to have a way of popping off that pressure with a pressure release valve. Making energy is really damaging to mitochondria and mitochondria should have a pressure release valve. Then it turns out these are opening pressure release valves with uncoupling proteins. And it turns out that ketones uncouple mitochondria, and prevent damage to mitochondria. And if you like the mitochondrial dysfunction theory of Alzheimer’s disease, for example, then protecting mitochondria with uncoupling sounds like a really good idea. Now we’ve known about mitochondrial and coupling again for a very long time. It turns out that when mitochondria are uncoupled, one of the side effects is producing heat and neurons actually love heat. They operate at a much higher temperature and operate more efficiently at higher temperature. So one of the exciting findings of the effective ketones on the brain is not so much that they’re great fuel, but they tell mitochondria to uncouple, to protect themselves in the brain and produce heat in the brain. And it’s actually the heat effect that makes neurons relax and work better. Kind of fun.
Dr. Weitz: Wow. Kind of interesting. It would seem at first blush, when you think about this uncoupling concept, you’re telling the body to waste energy. And if you think about evolutionary survival, the biggest threat to survival was not having enough energy, starvation, and the last thing you’d want to do is inefficiently waste energy.
Dr. Gundry: That’s exactly right. At first blush, that seems like the stupidest thing you could do. But I was profoundly influenced by a paper that was written by a PhD, by the name of Martin Brand in 2000. [Brand MD. Uncoupling to survive? The role of mitochondrial inefficiency in ageing. Exp Gerontol. 2000 Sep;35(6-7):811-20. doi: 10.1016/s0531-5565(00)00135-2. PMID: 11053672.] And I really recommend everyone, your listeners and viewers to pull up this paper, it’s an easy read. It’s called Uncoupling to Survive, and Dr. Brand argued, and there’s subsequently tons of papers that prove he was right, that if in extremists, if you are starving to death, you’ve got to protect the mitochondria, which make energy from damage. Because if the mitochondria die, you’re done and you will waste every last resource to protect mitochondria. You’ll waste muscles, you’ll waste anything to protect mitochondria. So he argued that mitochondria should be told by ketones to uncouple waste fuel so that they don’t have to work so hard. That’s number one. Now that sounds dumb.
But the second thing is mitochondria are told by ketones to make more of themselves, mitogenesis. And the cool thing about mitochondria is they have their own DNA, and so mitochondria can divide within a cell without the cell dividing. And the example I like to use is let’s suppose we have a dog sled up in Alaska and we have one dog pulling the sled. Now, the dog could pull the sled, but you’re not going to go very fast and you’re not going to go very far before the dog gets tired. Suppose we add five more dogs to that one dog, and we have a 6 team dog sled.
Now you’re going to go a lot faster, you’re going to all go a lot farther, but you now got six dogs to feed instead of one dog to feed. And so you’re actually going to require more food. So the example is correct. What happens with ketosis is we tell each individual mitochondria to work less hard to protect itself, but to add more mitochondria, to share the workload. And when you start looking at that, one of the things that Brand showed was if you look at super old people who are thriving at 105, they have the most uncoupled mitochondria compared to anybody else.
And I bring up the example of birds. There’s a fun theory of aging called the cost of living hypothesis. And the cost of living hypothesis has been around for nearly 100 years, actually 100 years. And that is in general, the faster your metabolic rate, the shorter your lifespan and the slower your metabolic rate, the longer you live. And in general, that is pretty applicable. The exception to that rule is birds. Birds are remarkably small, but birds can live an incredibly long time. A parrot can live 80 to 100 years, a hummingbird in captivity, which was one of the highest metabolic rates there is. Hummingbird’s hearts can beat a thousand times per minute and hummingbirds in captivity can live 10 years. So what the heck is happening with birds, it turns out that birds have incredibly uncoupled mitochondria, and that explains the mystery of why these little creatures can live a very long time because they’re mitochondria are protected.
Dr. Weitz: So I’m thinking that some of the proponents of the ketogenic diet and especially those who promote ketones as a source for energy, they might argue when the studies show that the brain can only get 70 or 60% of its energy from ketones, that might be because those people are not used to using ketones for fuel. They’re not keto adapted and that if they were to be using a ketogenic diet for a longer period of time, that they would be more efficient at using ketones.
Dr. Gundry: Well, that research has been refuted by Cahill and Owens in human volunteers who are keto adapted.
Dr. Weitz: Oh, okay.
Dr. Gundry: And interestingly, so in ketosis, after about three days of ketosis, the muscles of humans actually prefer using ketones as a fuel, but as time passes muscles begin to much prefer free fatty acids. And in fact, keto adapted individuals only 30% of fuel from muscles come from ketones, the rests come from free fatty acids in glucose. Now that’s in absolute counter distinction to Vogel and Phinney’s results in human athletes that shows that there is a keto adaption period of up to two weeks, but with Owens and Cahill’s results, if muscles are using ketones as their preferred full at three days, we ought to see the exact opposite of what Kenny and Vogel say. And in fact, that’s not the case. And in racewalkers who are keto adapted, we know that racewalkers actually burn much more oxygen to sustain their ability than if they’re using carbohydrates as a fuel. So human studies actually suggest that much of what we believed about the ketogenic diet just isn’t based on human facts.
Dr. Weitz: I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.
For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.
Dr. Weitz: In your book, Unlocking the Keto Code, one of the things you talk about is intermittent fasting or time controlled eating as one of the keys to getting the benefits of keto without necessarily doing keto. And every time I have a discussion of this concept, I always find it so interesting because when I got into doing nutritional counseling over 30 years ago, I recall having a lot of women clients and they all skipped breakfast and they had a light lunch and they ate a large dinner and the mantra was you’re overweight because you skip breakfast and it’s important to eat within an hour of waking up and you have to eat a meal or snack every three hours or your blood sugar’s going to be going crazy and you’re going to store fat. And so the key was to have a meal, a snack, a meal, a snack, a meal, a snack. And that was the only way. And that would actually… Eating had a fat burning effect, and that was the only way you’re going to lose weight. And the worst thing you could do is to skip breakfast. And now the key to health is skipping breakfast.
Dr. Gundry: Yeah. It’s funny when you look at hunter gatherers, then there are a few of them left. Hunter gatherers, don’t eat breakfast. There’s no storage system for food. There’re no refrigerator.
Dr. Weitz: You don’t have Frosted Flakes.
Dr. Gundry: No. They have to find breakfast. And most of these guys don’t eat until 10 or 11 o’clock in the morning when they’re out finding something, picking a berry or getting a tuber. And it turns out when you look at the history of breakfast, breakfast is really a modern invention. It was actually started in the industrial revolution in the late 1800s. And what happened, nobility got breakfast, because they had servants, and they had breakfast in bed. Churchill had breakfast in bed every day. But when people had to go to work in factories, what would happen is that men went to work in factories and men would go to work, they didn’t get a lunch break, they didn’t get breaks and they’d work all day and come home late at night. So women would give men before they went to the factory food and they work all day without, and then come home late at night and have their next meal.
And it was actually interestingly enough, the Ramadan diet. Ramadan you eat before sunrise and you don’t eat or drink again until after sunset. And so that’s where breakfast actually came from. The idea of fueling because you weren’t going to eat for a very long time. And it wasn’t until the Kellogg brothers invented Kellogg’s Cornflakes in the early 1900s that they’re advertising acumen actually convinced Americans, and then the world that breakfast is the most important meal of the day. And you ought to actually start your day with a predigested meal. And Kellogg’s cornflakes were actually first advertised as the world’s first predigested meal that would go instantly to work. And boy advertising works miracles.
Dr. Weitz: So what are some of the other keys to unlocking the keto code? I know you talk about polyphenols.
Dr. Gundry: Yeah. Let me just give one more example about the power of intermittent fasting. And so there’s an Italian athlete study that I’ve talked about in the book that I think really is important for all of us, particularly in sports and medicine. So they took Italian cyclists and they put them on a training table. Everybody had to eat the same thing for three months. All they changed was the time of eating. So one group of athletes had breakfast at eight o’clock in the morning. They had lunch at one o’clock in the afternoon and they had to finish dinner at eight o’clock at night. So a 12 hour eating window. The other group of athletes, same food. Had breakfast at one o’clock in the afternoon, had lunch at four o’clock in the afternoon and then had to finish dinner at eight o’clock at night. A seven hour eating window.
They followed them for three months, the group with the seven hour eating window, lost weight, even though they were eating the exact same amount of calories as the group with the 12 hour eating window, which didn’t lose weight. And the group with the seven hour window had identical performance on the bikes, but they’re insulin like growth factor, which most of us use is one of the best markers for mTOR activation, and aging plummeted in the group in the seven hour window and it didn’t change a bit in the 12 hour window. So it shows the power. Now why did this happen? It’s bec-
Dr. Weitz: And by the way, if you took that seven hour window and instead of 12 to eight, if you made it eight to four, would it have made a difference?
Dr. Gundry: Great question. And the question is the length of time that somebody is actually making ketones. So that’s a great question. Normally, if we have metabolic flexibility and sadly the average American does not have metabolic flexibility, even people with normal weight, only 50% of people have metabolic flexibility. And just to define our terms, metabolic flexibility is the ability of mitochondria to either use sugar as a fuel or use free fatty acids or ketones as a fuel. And we should be able to go back and forth literally instantaneously, almost like a hybrid car. If you’re overweight, 88% of people have no metabolic flexibility and if you’re obese, 99% of people have no metabolic flexibility. So going back to metabolic flexibility, if you have that and you stop eating, you finish dinner, you begin to make ketones about eight hours after you stop eating by 12 hours, you’re really beginning to ramp up ketone production.
So let’s look at the athletes. The 12 hour guys are just coming into their beginning sweet spot of making ketones and then boom, they eat and their ketone production stop. The guys who are eating breakfast at one o’clock in the afternoon now have an additional, basically five hours of ketone production. So they’re getting signaling from those ketones for another five hours. So to answer your question, if we started eating at eight o’clock in the morning and then stopped at two o’clock in the afternoon, we could get the same benefit as long as we aren’t eating the rest of the time.
And in fact, when I was writing the energy paradox and I’ve tried this with patients, I’ve toyed with people and I’ve done it myself, Hey, I want you to eat breakfast and lunch and then stop. Our lifestyles, particularly if we’re raising a family or if we’re married, for instance my wife and I kind of see each other from five o’clock on and that’s family time. Right. And so it’s so impossible in our culture to push away from the dinner time. That is just hard to do. But to answer your question, yeah, you can do it and it’ll work.
Dr. Weitz: Yeah. That’s kind of what I do in my program three days a week, I eat my last meal at 02:00, but partially because I’m working till 08:00 and it’s easier for me not to eat anyway.
Dr. Gundry: No, it’ll work fine. Just our culture is really hard.
Dr. Weitz: Right. The family dinner. So let’s talk about some of the other ways to unlock the keto code. Polyphenols, which are these phytonutrient rich fruits and vegetables. A lot of people describe them as antioxidants.
Dr. Gundry: They’re not. Yeah. And I joke about this in the book. For years, I’ve had the pleasure of presenting papers at the International Congress of Polyphenols, which usually meets every year in Paris. The last two years, it hasn’t met for obvious reasons. And the organizer of this conference is a doctor by the name of Marvin Edeas. Years ago I was talking to him and he actually opened a conference one year, this is literally 12 years ago. And he said, those of you who are here thinking that polyphenols are antioxidants, you may leave the room right now because I don’t have enough time to catch you up on what polyphenols actually do. And I went, what, what? Of course they’re polyphenols. What about the ORAC, the oxygen radicals absorbing capacity. And he says that has nothing to do with anything. And I go, well, teach me. I actually grabbed him backstage and went teach me.
Dr. Weitz: Durk Pearson and Sandy Shaw are turning over in their graves. [I apologize that they are still alive]
Dr. Gundry: Yeah. I said, teach me. He said they have no antioxidant capacity. And mitochondria have only two antioxidants, which I go into the book. And this was actually a revelation to me. There are only two antioxidants that work in mitochondria. One of them is shocker and it’s melatonin, the sleep hormone and I spend a lot of time in the book trying to convince people, the melatonin is not a sleep hormone. And number two, it’s glutathione, and these are the only two antioxidants that work in mitochondria. So if polyphenols aren’t antioxidants and I can assure you, they’re not, then what the heck are they doing? Why do they have a beneficial effect?
Dr. Weitz: Don’t they contain vitamin C and other nutrients that are antioxidants?
Dr. Gundry: Sure. But vitamin C is not an antioxidant that actually works in mitochondria. In fact too much vitamin C can be a prooxidant in mitochondria. Vitamin C is useful for recycling glutathione into glutathione after it’s been oxidized. But vitamin C has no place in mitochondrial antioxidant. So what the heck are polyphenols doing?
Dr. Weitz: So you’re saying vitamin C can serve in the antioxidant capacity, but not in mitochondria?
Dr. Gundry: Exactly. Exactly. Yeah. That’s not where it works. So same with vitamin E. It’s not an antioxidant in mitochondria. So what’s fascinating is plants have their own mitochondria. They’re called chloroplast. And again, we talk about oxidative phosphorylation, mitochondria take oxygen combine it with protons from carbon and make ATP and carbon dioxide. Those are the byproducts plants work exactly in opposite. They take carbon dioxide, they take photons from sunlight and they produce oxygen and glucose, the exact opposite. So these chloroplasts believe it or not, sunlight is very damaging to these mitochondria.
Dr. Weitz: [inaudible 00:31:10]mitochondria also produce reactive oxygen species.
Dr. Gundry: Correct. And those are what glutathione and melatonin are for.
Dr. Weitz: Oh, okay.
Dr. Gundry: To absorb that damage.
Dr. Weitz: I thought those were free radicals, the vitamin C and the other antioxidants would[inaudible 00:31:29].
Dr. Gundry: No, not in mitochondria.
Dr. Weitz: Okay.
Dr. Gundry: Not in mitochondria. Mitochondria only have two antioxidants. One of the things that shocked me when I was writing the energy paradox is that plants make melatonin, and you go, what the heck? Plants don’t need to go to sleep. What the heck is melatonin doing? Well, plants use melatonin to protect their mitochondria. Plants also use polyphenols to protect their mitochondria by uncoupling their mitochondria to prevent damage. What are polyphenols? So all of us have seen polyphenols every fall. As soon as the chlorophyll in leaves goes away, we see all these beautiful yellow, orange, red, magenta, purple colors in the leaves. Those are the polyphenols that the plant has produced to protect its mitochondria by uncoupling them. When we eat these polyphenols, we don’t absorb them very well, quite frankly, but our microbiome loves them. They’re actually a prebiotic food for our microbiome. The microbiome then transformed those polyphenols into absorbable compounds. And the cool thing is that we then uncouple arm mitochondria from those polyphenols effect. It’s literally… Every time I talk about this, I start singing the Circle of Life from the Lion King. It’s like we eat the plants and we die and then we feed the plants and it’s a circle of life. And it’s hilarious. And it turns out that’s why these plant polyphenols are so good for us because they uncouple mitochondria.
Dr. Weitz: Your favorite polyphenol foods?
Dr. Gundry: Well I’m, I’m famous for saying the only purpose of food is to get olive oil in your mouth and olive oil is rich in polyphenols and surprise, surprise olive oil’s actually very rich in melatonin. The richest source of melatonin in food is actually pistachio nuts by far. Red wine has melatonin, coffee has melatonin, tea has melatonin. So these were produced by plants to protect their mitochondria, amazingly, not to put them to sleep.
Dr. Weitz: What do you think about A, taking supplemental polyphenols and B, what about the idea of using high dose melatonin? Typically we recommend small doses of melatonin often in sleep products or for patients having trouble falling asleep. But a lot of times 20 milligrams of melatonin might be used in a patient that’s putting together an integrative program to help them with their cancer therapy. And some people advocate really high, even higher dosages of melatonin for some longevity effect.
Dr. Gundry: Right. In fact, I profile in the book… I’ll just tell you an interesting story. I have a 17 year old female Labradoodle, big dog, 85 pounds. A year and a half ago now she couldn’t pee, strained to pee, took her in to the vet, get an ultrasound. The vet comes out and said, Gosh, I’ve got… Sorry to tell you. She has inoperable bladder cancer. I want to send her to an oncologist and we need to start her on chemotherapy, or we can put her into sleep right now. And I’m going well, shoot. I know a lot about cancer. I treat a lot of cancer patients. I’m going to put her on my program. So I put her on a lot of uncoupling agents, which included… She takes 48 milligrams of melatonin a day. She takes-
Dr. Weitz: Did you come up with that number?
Dr. Gundry: Well, so in my patients, I use up to 100 milligrams of melatonin in my cancer patient.
Dr. Weitz: Really?
Dr. Gundry: Yeah. Now you got to start slow. You got to build them up. But yeah, I’ll use 100 milligrams. So-
Dr. Weitz: Now where did you get that number from?
Dr. Gundry: Research.
Dr. Weitz: Okay.
Dr. Gundry: Yeah. There’s actually some surprising research that looks at high dose melatonin in at least slowing cancer progression. And if you like the metabolic dysfunction theory of cancer, which I like a lot, normally, as you know, we rely on mitochondria to produce ATP and they’re incredibly efficient at making ATP. One molecule of glucose will give you 32 molecules of ATP if you use mitochondria. On the other hand, fermentation, glycolysis is the other way of making ATP. But one molecule of glucose will only give you two molecules of ATP with fermentation. What’s odd, and this is what fascinated Otto Warburg was cancer cells, for some obscure reason, you couldn’t quite figure out why, prefer to use fermentation to make ATP. He thought it was because mitochondria had a defect that they couldn’t make ATP and so the cancer cell fermented to make ATP. Subsequently, we know he was wrong that mitochondria can make ATP in cancer cells, but cancer cell chooses to use fermentation. You’re old enough to remember the original computers where we all ran Microsoft, and when something was going wrong with your computer, it would shut down or you’d shut it down and then it would come back on and it would say operating in safe mode.
Dr. Weitz: Oh, of course.
Dr. Gundry: Remember?
Dr. Weitz: Oh, I remember having a DOS system.
Dr. Gundry: Oh yeah, exactly, that was MS-DOS. So you could do a few things in safe mode, but until you figured out what you screwed up, it would operate there. So there’s this fascinating theory of cancer that I like a lot. That if the cancer cell… If the cell thinks that it’s damage, it will go into the primordial operating system prior to mitochondria. And the primordial cell before engulfing mitochondria bacteria, there’s a thing called contact inhibition where normally, in a high organism like us, when one sells growing and it runs into another cell, it stops growing because the… Nope, you can’t go any farther.
Primordial cells do not have contact inhibition. So if it’s growing and runs into another cell, it just keeps growing, and that’s a characteristic of cancer. So the theory is what’s happened is the cancer cell is operating in safe mode in this primordial system. And if you like the metabolic dysfunction theory of cancer, if you can get mitochondria back online, then the cancer cell can revert back into its normal operating system. And this is what I see in my patients and I see in my dog. Pearl is now a year and a half out. She pees like a race horse. She takes 48 milligrams of melatonin a day and along with a number of other mitochondrial uncouplers.
It’s not the placebo effect. I can assure you. Pearl doesn’t know she’s not supposed to have cancer anymore. And it’s rather humorous when I met with the oncologist actually two months into this and she said, Wow, she has inoperable bladder cancer and we can get her on chemotherapy this afternoon. And I said, well, no, no, no, you don’t understand. She’s peeing fine now, and don’t you want to know how I did it? And she said, oh this is just temporary. She’s not going to make it. I said, well, let’s suppose it’s temporary. How long do we have? She said, well, weeks. And I said, well, what’s a chemotherapy going to do for us. She said, oh, I can give you six months. And I said, well, then what happens? And she said, well, going to run out of effectiveness.
Well, so that was a year and a half later, and about a year into this, I called her office and said, Hey, the dead dog is still around. Would you like to know how I did it? And the receptionist said, Oh, yeah, I’ll go talk to her, and came back, said, no, the doctor doesn’t want to know. Have a nice day. Okay. Okay.
Dr. Weitz: Kind of like when you first met Big Ed, right?
Dr. Gundry: Yeah. That’s exactly right. You know, you can’t see unless your eyes are open. And I was blessed I guess, because I was a researcher all my life, going, this makes no sense. How did you do that? This is impossible, and how the heck you do that? And it turns out Big Ed has taken a ton of polyphenols. And as you know, at Gundry MD, one of the things that made me famous at Gundry MD is these polyphenol containing compounds. So now-
Dr. Weitz: That’s interesting. I’ve talked to some of the leading proponents of that metabolic theory of cancer, like Dr. Thomas Seyfried and Nasha Winters, and of course they all recommend a ketogenic diet.
Dr. Gundry: Sure. And sadly, we know that the ketogenic diet clearly has some positive effects, but when you actually look, cancer cells can actually use ketones as a fuel. So then you go, well, wait a minute, this goes against Warburg’s thoughts. So there’s a different effect that ketones are having, and that is this mitochondrial uncoupling. And I think, yeah, the ketogenic diet should absolutely be a part of a cancer therapy. But I think there’s more here to uncover, and that’s among other things where melatonin looks very interesting because it is, again, one of the two mitochondrial antioxidants.
Dr. Weitz: Any other key nutrients you use in your cancer protocol?
Dr. Gundry: Yeah. So I actually use a lot of uncoupling agents. I use sulforaphane, which is a broccoli extract. I’ll use turmeric as part of this… Which is, believe it or not an uncoupling agent. Interestingly enough, low dose NSAIDs, non-steroidal anti-inflammatories are actually uncoupling agents. And I write about in the book. When I first wrote The Plant Paradox, one of the things that was very obvious from pharmacologic research is that NSAIDs, like Ibuprofen, like Naproxen, Aleve, are incredibly damaging to the lining of the gut. They’re literally like swallowing hand grenades.
Dr. Weitz: And kidney stress.
Dr. Gundry: Oh yeah. And kidney stress. And it turns out that the pharmaceuticals knew this. In fact, I’m old enough to remember when these were introduced in the mid 1970s and they were prescription only, and they came with a warning that you could only prescribe these for two weeks because they were so dangerous. The pharmacologic literature is full of these papers. And now of course they’re the lightest selling over the counter drug there is, and people eat them candy, there’s children’s Advil. So when I was writing this book, I went back to that literature and I go why are these guys so damaging? And it turns out that these things are such potent mitochondrial uncouplers that at contact to the wall of the gut, they uncouple the mitochondria so aggressively that the cells die and that’s what creates the damage.
So you start going, huh, oh, maybe a little dab will do you. And in dog bladder cancer, use Pearl’s example, there was a sudden discovery of a very standard NSAID called Feldene, which is still around. Dogs with bladder cancer were given Feldene for pain relief. And surprisingly about 30% of dogs on Feldene had a spontaneous remission of their bladder cancer. And you go, wait, spontaneous remission of bladder cancer on Feldene? What’s the mechanism? And sure enough, it’s uncoupling mitochondria. So Pearl’s on Feldene and yeah, it’s cheap. So there’s a bunch of tricks. Okay.
Dr. Weitz: Cool.
Dr. Gundry: Yeah.
Dr. Weitz: I have to have another discussion about cancer. Maybe a few more things about the keto code. You know, I love your recommendation for reverse juicing. That’s very creative. I usually just tell patients to make a smoothie instead of juicing, but-
Dr. Gundry: Yeah. And I actually wrote about this in my first book, Dr. Gundry’s Diet Evolution, years ago. And so juice is really the most nasty, awful fructose laden stuff that you can eat, but fruits are loaded with polyphenols. And everybody’s got a juicer. I’ve got a Jack Lalanne Juicer. So what I like people to do is buy some organic fruit, preferably in season, and juice it, throw the juice away and take the pulp and then put it in goat yogurt or sheep yogurt, or put it in a smoothie or get a silicone ice cube tray and put it in the ice cube trays and freeze it and then throw it in. You can make ice cream out of it. I do goat yogurt ice cream with these polyphenols several times a week.
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Dr. Weitz: So goat milk, is it less allergenic? Is that why?
Dr. Gundry: Great question. Yeah. It turns out that goat milk traditionally is called mother’s milk because goat milk actually has almost identical properties and proteins and fats as human milk. Cows milk has absolutely no relationship. So that’s part of it. But interestingly, if you look at cultures with extreme longevity, in fact, three of the blue zones, they’re real longevity comes from the fact that their goat and sheep herders, and that they eat a lot of goat dairy products, goat yogurt, goat cheese, sheep cheeses, sheep yogurt. And part of the reason is that MCTs are instantly turned into ketones in our liver and those ketones uncouple their mitochondria. So these guys have got uncoupled mitochondria just by having goat and sheep herds. But-
Dr. Weitz: Interesting. I remember we had a functional medicine meeting with Dr. Bastani, and he said that camel milk was actually the least allergenic type of milk.
Dr. Gundry: Yeah, that’s true. It’s really pretty hard to find camel milk. Donkey milk is also-
Dr. Weitz: It just so happened, some guy stood up who was there, who’s like a distributor for camel’s milk.
Dr. Gundry: Yeah. No, you can find it. Absolutely. Yeah.
Dr. Weitz: Let’s see. Fermented foods. You’re big on fermented foods. And most people recommend fermented foods because of the fact that they contain probiotics.
Dr. Gundry: Yeah. And that’s actually… Yes, they do contain probiotics, but most of those probiotics are actually destroyed by gastric acid and never make it into our digestive system. But what’s exciting is that fermented foods contain short chain fatty acids, which are like butyrate, like acetic acid, which is vinegar, and propionic acid. And it turns out that these short chain fatty acids are mitochondrial uncouplers and that’s actually how these foods work. That’s why apple cider vinegar, there’s no magical mystical way that it helps you lose weight. It actually is a potent mitochondrial uncoupler, and the more you uncouple your mitochondria, the more you literally do a caloric bypass on your mitochondria and you’ll waste-
Dr. Weitz: Because you’re wasting energy instead of using it to store fat.
Dr. Gundry: Yeah. Yeah. You’re wasting fuel. That’s kind of cool.
Dr. Weitz: And you like hot and cold therapy as well.
Dr. Gundry: Yeah. And again, it all kind of comes down to the same common denominator, cold therapy uncouples mitochondria, hot therapy uncouples mitochondria via heat shock proteins. I did a lot of research as a heart surgeon into heat shock proteins in protecting the heart.
Dr. Weitz: Most in the longevity world talk about these things as being stressors that have a hormetic effect.
Dr. Gundry: That’s because we thought that’s what they did. But now we have an actual underlying mechanism, which is mitochondrial uncoupling that explains hormesis. Yeah. I used to talk about hormesis all the time as that which doesn’t kill me makes me stronger. But now we know that everything that we classified as hormetic stressors actually uncouple mitochondria, and you’re right, you can overdo this uncoupling. And we talked off camera about this miracle weight loss drug in the 1930s, which was called 2,4-Dinitrophenol, DNP, and DNP was discovered because back in World War I, munition factory workers in France and Germany were noted to be incredibly skinny and eating huge amounts of food to keep their weight on, and they were always running a temperature. And after the war, researchers said, Hey, there’s compounds in munitions, one of which is called 2,4-DNP, that increases the metabolic rate. And that explains why these guys were so thin and they were running a temperature.
So a couple researchers at Stanford says, holy cow, we’ve got the ultimate weight loss drug. And so they actually wrote… 100,000 prescriptions for DNP were written in the 1930s. And it was miraculous, low dose DNP, you could lose a pound a week, high dose DNP, you could lose five pounds a week. Think about that. And you go, wow, that’s a miracle. Well, like any miracle, these people started running temperatures. They started developing thyroid issues. They developed cataracts. And this was actually before cataract surgery. And I make a joke, this is so great, but you can’t see yourself in your skinny dress because you’re blind. And then there were deaths. And so the FDA, the newly formed FDA in 1938, one of their first act was to ban DNP as a drug. And so we now know in 1978 it was discovered that DNP was actually the first known oral mitochondrial uncoupler, and that’s actually how it worked.
Dr. Weitz: And the reason it was dangerous because it uncoupled too much.
Dr. Gundry: Too much. Correct. It was uncoupling, but it wasn’t making extra mitochondrial to take up the slack. Yeah. And I talk about it in the book, a little dab will do you.
Dr. Weitz: Right. If people don’t quite understand this concept, if you completely uncouple your mitochondria, you no longer produce energy and this is not compatible with life.
Dr. Gundry: Exactly. Yep. That’s exactly right. There’s a Goldilocks rule. There’s a sweet spot where a bit is really good for you. Too much, you’re right, you’re dead.
Dr. Weitz: Now you also recommend polymines such as found in aged cheese. And I would say cheese is probably not on the list of health foods these days too much.
Dr. Gundry: Well, it turns out goat and sheep, cheese and aged cheeses ought to be one of the top foods in health lists and cheese has been maligned. I’ve maligned cheese in the past and I’m willing to say I was wrong, but-
Dr. Weitz: Saturated fat causes heart disease, right?
Dr. Gundry: Yeah. Not. You know that there are multiple theories of heart disease. I particularly do not like the cholesterol theory of heart disease. But if you like the cholesterol theory of heart disease, you got to oxidize-
Dr. Weitz: The entire cardiovascular profession is built around that concept.
Dr. Gundry: Yeah. And again, we always have to be willing to take a second or third look at our beliefs. And we always have to question conventional wisdom, including our own, as I talk about in my dedication. You always got to question your own beliefs and be willing to change.
Dr. Weitz: I find it interesting that you like MCTs, medium change triglycerides, which are often recommended as part of a ketogenic diet and some people put them in their coffee. But you don’t like MCTs from coconuts, which is where most people get them from.
Dr. Gundry: No, I like MCTs from coconuts.
Dr. Weitz: Oh, okay.
Dr. Gundry: But I don’t like coconut oil.
Dr. Weitz: Oh, okay.
Dr. Gundry: The problem with coconut oil is, yeah, it has a few MCTs, but coconut oil… The other saturated fats in coconut oil actually impair mitochondrial function, unfortunately. So there’s a difference.
Dr. Weitz: Which saturated fats are…
Dr. Gundry: So it turns out that there’s… Lauric acid is actually not as good as people think it is. Stearic acid is fairly benign in terms of cholesterol, but the big long chain saturated fats actually impair mitochondrial function. And I have a whole chapter that I won’t bore people with about how fats work, but there are great saturated fats and then there are not so great saturated fats.
Dr. Weitz: So the story about saturated fats you’re saying is don’t lump them all together and let’s separate out 12 chain, 18 chain, 22 chain, et cetera, and are having different properties.
Dr. Gundry: Correct. And there’s some exciting, new, very long chain saturated fats and some odd chain saturated fats that I go into. There’s a new one, recently discovered called Carbon 15, which is an odd chain saturated fat, which is present in milk products. But it turns out it’s an essential fat that we had no idea it was essential. And work actually out of the US Navy Dolphin Project actually identified this. I talk about it in the book. It’s a fun read. Yeah. There is an essential Carbon 15 fat that we didn’t know.
Dr. Weitz: And outside of milk, for those of us who don’t consume milk, where else can you get it?
Dr. Gundry: You can actually get it, and I have no relationship with this company. There’s a company called Fatty15.com. Cute name. And you can get it as a little capsule. It’s quite inexpensive. And yeah, so you don’t have to have milk to find Fatty 15.
Dr. Weitz: All right. So now I got to add the omega 15s to my omega 3s and my omega 7s.
Dr. Gundry: Yeah, yeah, yeah. Yeah. So check it out it, and it’s actually a wonderful website. And again, I literally have no relationship with them. It’s just a fascinating story that I talk about in the book.
Dr. Weitz: Great. So there’s been a great discussion, Dr. Gundry, thank you so much. And closing thoughts and how can people find out about your programs?
Dr. Gundry: Well, so they can find me at drgundry.com. My supplementary food company is gundrymd.com. I’ve got the Dr. Gundry Podcast, wherever you get your podcasts. I’ve got two YouTube channels I’m on Instagram and Facebook. And hopefully I show up in everybody’s email every day, talking to them and waving at them, or hopefully when you’re surfing the web, I’ll pop up and say hi, hopefully.
Dr. Weitz: Thank you.
Dr. Gundry: All right. And thanks a lot for having me. Appreciate it.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica, Weitz Sports Chiropractic and Nutrition clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.
