Dietary Diversity or Carnivore: Which Fuels Better Health, Longevity, and Performance? Dr. Shawn Baker & Joel Greene Debate

Joel Greene [00:00:00]: Diversity in the diet actually allows us to enjoy the benefits of animal foods and completely nerfs any potential liabilities. And it doesn't even have to be a ton. It's just some. Some diversity in the diet. So that's what I would offer.

Ben Greenfield [00:00:13]: Yeah, that's interesting. Shawn, you gotta start dipping your steak in oatmeal?

Dr. Shawn Baker [00:00:16]: Well, probably not oatmeal. I mean, as I said before, you know, and certainly I appreciate Joel's perspective on this...

Ben Greenfield [00:00:26]: All right, it is debate time. I've got two guys who I really respect on the show today. Two guys who are not only very well-versed in the realm of nutrition, but also physical beasts in their own rights. One of my guests, Dr. Shawn Baker, absolutely humiliated me with the overhead double kettlebell press competition at the last health event I was at. I think you hit 40 reps, Shawn. And then I came back and hit 41, and then you had to show me up. So, like right before the conference ended, you dropped in and did 42 and my shoulders were already toast. So good job.

Dr. Shawn Baker [00:01:08]: I did, I ended up doing like 54.

Ben Greenfield [00:01:10]: Oh, geez. It's even worse.

Dr. Shawn Baker [00:01:12]: Yeah, but I mean, you know, I outweigh you by, what is it, 60 pounds or something like this? It's not quite fair, but it was a little—yeah, it was a little...

Ben Greenfield [00:01:19]: Yeah. And then you have a background as a pretty competitive rower. I mean, that, that's, that's the, the main sport that you're known for being really successful in, right?

Dr. Shawn Baker [00:01:28]: Well, yeah, I mean, I've got some world records on the rowing machine, but I mean, I like, I used to do powerlifting, I did strong man. I did professional rugby, I did Highland Games—world champion at that. So, I mean, yeah, I mean, I've got a lot of strength background, so, I mean. Yeah, I mean, even though I'm—I think Joel and I are close to similar age, I turn 58 next month. And so, you know. Yeah, I mean, I've been.

Dr. Shawn Baker [00:01:48]: You know, strength is definitely something that I've cultivated over the—damn near 50 years I've been...

Ben Greenfield [00:01:54]: Yeah, yeah. And not, not just a, not just a meathead. You're an orthopedic surgeon. You're a world leading authority in treating disease with medical nutritional therapy. You're a best selling author on Amazon. And so you're definitely somebody who is, who is both physically and mentally crushing it in the fitness and health game. And then I've also got Joel. Joel, I don't know how much you row or how much you overhead kettlebell press, but you're pretty fit yourself. I know you have your own approach to staying in shape, but what's your primary mode of fitness these days?

Joel Greene [00:02:33]: Right now it's track and field. So I'm training for a master's this year and just doing a lot of time on the track.

Ben Greenfield [00:02:40]: Okay, cool. What's that mean, masters?

Joel Greene [00:02:43]: That means you're old.

Ben Greenfield [00:02:44]: Yeah, well, I mean, well, I know what it means. What, what event is that?

Joel Greene [00:02:49]: 200 meters.

Ben Greenfield [00:02:50]: Okay. All right. 200. Wow. Cool. And, and Joel's been on the podcast a few times. You guys might have heard me interview him about his book, the Immunity Code. We've talked a lot about dietary diversity.

Ben Greenfield [00:03:01]: He does a lot of work in the nutritional world. He's the creator of the Immunity Code and his book, the Immunity Code and the way you can find anywhere fine books are found. And Shawn, remind me the name of your book. I'm blanking now.

Dr. Shawn Baker [00:03:15]: My book is very simple. It's called the Carnivore Diet. You know, it was obviously a bunch of meathead stuff, but I just, you know, I just added Joel because, you know, as I turn 60, one of my goals is to do some running and some sprinting and stuff like that. And so I looked at 100 meter, 400 meter and, and you know, like sub six minute mile, you know, and I'm just curious, what, what is your target for the 200 meter and what age class are you going to be in? Are you gonna—obviously you're going to be, what, mid-20s or something like that? I'm guessing on times, but I don't know where you're going to be.

Joel Greene [00:03:45]: Yeah, I mean, I have a goal. I don't even want to say it. But...

Dr. Shawn Baker [00:03:50]: You gotta say, you gotta say so you can manifest, so you can hold you accountable when you don't get there. That's why I've done it. All right, I said I'm going sub 13 in the hundred and sub 60 in the 400. So I got, so I either gotta put up or shut up now, so...

Joel Greene [00:04:03]: Yeah, I, I, I'm shooting for sub 24, so we'll see. We'll see.

Dr. Shawn Baker [00:04:08]: What, what age group would that be in at 60? At 60. Okay. That's, that's because a world record is not far from that at 60, if I'm not mistaken. Is that correct?

Joel Greene [00:04:19]: No, that is a world record.

Dr. Shawn Baker [00:04:20]: Yeah, it is a world record. What, what body weight are you going to be at when you do that?

Joel Greene [00:04:25]: Don't know. That's a big question. So I've run my best times historically, like under 200 pounds. And I'm about 220 right now, so I got to come down about 20 pound.

Dr. Shawn Baker [00:04:34]: Going to say, like Noah Lyles weighs 154, you know. Yeah, you know, it's not, it's not a big man sport. You know, I'm, I'm coming down from 260. I'm, I'm, I woke up this morning at 244, and so I probably, I, I suspect I'll be in the 230s when I'm able to, capable to do some of these things. Just, you know.

Ben Greenfield [00:04:50]: You know, you mentioned your book, by the way, Shawn, the Carnivore Diet. That's what, that's actually why I wanted to get you guys on together because.

Dr. Shawn Baker [00:04:56]: Ya, sure.

Ben Greenfield [00:04:57]: You know, when I've talked with, when I talk with Joel in the past, he's very much been into the idea of dietary diversity. The Carnivore diet, I would say, is, is less diverse than, than many diets. And I, I wanted to have a little discussion here about your guys's approach and why you approach things the way that you do. Now, of course, the awkward part about a three way like this is somebody gets to go first and describe what they eat or what they, they recommend folks eat and why. So I don't know if you guys just want to shoot a hand up, arm wrestle, run, or we just pick, flip a coin.

Dr. Shawn Baker [00:05:35]: Well, mine's simpler. So I'll, I'll, I'll go.

Ben Greenfield [00:05:37]: No, go, go for it. Shawn, fill us in.

Dr. Shawn Baker [00:05:39]: As a physician my goal is to get people healthy. Right. I, I, I generally, I'm not necessarily out here saying that every human needs to be a carnivore or going to a carnivore diet. I've never said that. I'll never say that. What I say is I get people that have autoimmune conditions, they might have depression, they might have, you know, some gut issues, and just out of experience, out of practical results, we see pretty good results with that. You know, and I tell people do this for three months, six months, and then, and then where you go from there, if you want to get a tattoo and say you call yourself carnivore Carl, whatever, that's, that's, that's whatever if you want to do that.

Dr. Shawn Baker [00:06:13]: I think that my personal diet, I've been doing it for about eight years. I mean, I eat pretty much a Carnivore diet. I mean, I eat steak every day. I've got a ribeye steak, I'll eat After this meeting here in a little bit.

Ben Greenfield [00:06:23]: Yeah, definitely get. Definitely get into the details of what the carnivore diet looks like for you, because now it's, you know, so it's. I see different versions of it from different people. So I want to hear what yours is.

Dr. Shawn Baker [00:06:33]: Yeah, I mean, it's. It's mostly red meat. I mean, that's just the reality of what, you know, because obviously, if you're not having carbs, you need fat, and red meat just has higher fat than, you know, white meat does in many cases. So I eat a lot of red meat. I'll do some eggs from time to time. I'll do a little bit of dairy products here and there, seafood, things like that. It's mostly animal products. And that's probably legitimately 99% of my diet.

Dr. Shawn Baker [00:06:56]: Every once in a while, and I mean, every once in a while, we're talking like a couple times a year, I'll just have something off the. You know, this is not. I mean, like, I was in Ecuador a couple weeks ago. My son had his birthday party. We were on a boat. They cooked a cake. I had a piece of birthday cake, you know, but, you know, it's. You know, it's.

Dr. Shawn Baker [00:07:12]: It's not a normal feature of my diet. You know, I pretty much am legitimately eating meat every day, pretty much all the time. And for me, it works well. You know, and. And I, you know, like I said, it's not that I necessarily think that plants are trying to kill you like some of the other folks in this community. It's not that necessarily. I think that everybody needs to do that. But, you know, as an older guy, I just know when I don't eat like this, I don't feel as good.

Dr. Shawn Baker [00:07:37]: And I mean, I. I've tried over and over again. And, you know, I don't think meat is killing people. I don't think it's causing heart disease. I don't think it's causing cancer. So that's what I do personally, what I recommend for people. And we have a company, as you mentioned. I'm this.

Dr. Shawn Baker [00:07:51]: I'm the chief medical officer and co founder of a company, Rivero Health Digital Healthcare Company. We got a bunch of positions that put people on various diets. Sometimes it's carnivore, sometimes it's not. A lot of times it's generally more lower carb. We have to eliminate things that people have issues. We've collected data on thousands of patients to see what affects people with different conditions. And we kind of tailor it, to that, to that particular need and then we adjust based on the patients sort of outcome and so.

Dr. Shawn Baker [00:08:18]: But yeah, I mean, I've been one of the largest champions of the Carnivore diet. In fact, this diet was not called Carnivore until I wrote the book. It was called like zero carbs.

Ben Greenfield [00:08:25]: Yeah, yeah, I don't think you got that popular until you were on the Rogan show talking about it.

Dr. Shawn Baker [00:08:28]: Yeah, sure. I mean, you know, where we have access to the Internet and social media and I mean, I'm by far not the first doctor that ever talk about this. I mean, you can look at John Rollo in the 1700s talking about all meat diets for diabetes and James Salisbury in the 1800s and you know, what's his name, Blake Donaldson in the 1930s. I mean this has gone over and over again. This is not new. So I think it is a therapeutic diet. I think it is something that used as an intervention tool. Now again, the, the controversy I'm there, Joel will talk about is what happens if you do it long term.

Dr. Shawn Baker [00:09:02]: Are there some, some significant detriments or potential things? And I'm interesting to have what he has to say and I've got some, my own perspective on that. And I think like I said, you know, I don't want to say all humans are different. I mean, we all are, but I mean we're all, we all basically share the same physiology and biology. It's not like some of us can eat grass and some of us can eat, you know, wood chips. I mean, we all get eat basically from the same, same, you know, selection of food. But yeah, that's what I do.

Ben Greenfield [00:09:31]: Yeah. And before I ask Joel about his dietary approach, Shawn, you mentioned that, that your diet works for you and that's worked for many of your patients. How would you describe the reason why, you know what I'm saying? Like in terms of any underlying medical or biological reasons why you would feel better on a carnivore diet versus others. Like, what do you suspect is going on there?

Dr. Shawn Baker [00:09:55]: Well, I mean, I mean, I think there's some commonalities all that, I mean, I think most of us, I'm sure Joel will agree that the American diet, standard American diet's garbage. I mean we got, we have 70% off to ultra processed food for our kids and some are similar for the, for the adult. So you clearly get all that crap out of there. So you're not poisoning yourself as much. So that's helpful. High quality bioavailable nutrition. I mean, protein is obviously better. I mean, there's, there's, there's. It's not a coincidence that the essential amino acids we need as humans are found in the exact ratios. We need them in meat. I mean, it's. This is not a coincidence. There's a reason for that. I think that meat is generally tolerated pretty well by the gut. And I know, Joel, have some, you know, input on the gut particularly, but that's what I see. I think, you know, I think when we, when we talk about gut dysfunction, whether it's dysbiosis or, you know, gut hyperpermeability or however you want to describe that the diet seems to be helpful. I mean, there's a lot of data that comes out of Europe that supports that. They've done a lot of testing on this where they showed that gut permeability is improved on this diet. I think the, the. A lot of people, even though we got a lot of fat people in this country, they're, They're. They're malnourished. I mean, they're undernourished. Malnourished in, in many things. And, you know, if we look at, if we look at why do we eat as human beings? I mean, what is the whole purpose of eating? We have to obtain essential amino acids, essential fatty acids. We have to have an energy supply. So that's. Carbs are fat, as far as I'm concerned. Vitamins, minerals, and then arguably water. I mean, those are the essentials for life. And if we don't have those things, you know, we eventually get sick and die. Now, how you decide to get that, there's a lot of opinions on that. I mean, carbs taste good. They're an easy source of nutrition or energy for. I think, I think the main benefit of carbohydrates, Carbohydrate, specifically... We're talking about the glucose monosaccharides, disaccharides, you know, glycogens and things like that, or starches, rather, is energy. Right. And then you can argue around fiber or not. And I know this is probably where we'll have some, Some level of contention here. I would argue that fiber is not an essential nutrient. If it were, I would long be dead. You could be conditionally beneficial. I don't know. I don't disagree with that. But I mean, that's, you know, that's kind of why I think, you know, I mean, it is what it is. I mean, and again, I'm not so... I'm not so... I don't believe I know everything. I don't think anybody does. And, you know, I, I still think of the body as largely a black box. I mean, we have inputs and we have outputs, and there's a lot of things we know about the human body, but what we know is probably would fit in a thimble full of what we don't know. And we're always discovering new things, and the things we think they're accurate in 1990 are not accurate in 2010, and so on and so forth. And so we have this incredibly complex machine. And all I do is I like, what are the results? You know, and again, you know, I tend to say, well, I don't know what's going to make me live longer. I don't think anybody really knows. I do know I can get people that are sick and make them healthy, which is pretty cool. I mean, I think that's. As a physician, that's a high bar. I mean, we, you know, that's a, that's a, that's a good thing. And, you know, worrying about am I going to live to 100 or am I going to get this disease at 80 or not, I don't know. I don't know if, I don't know if we can really know that.

Ben Greenfield [00:13:06]: Yeah, yeah. It certainly reduces a lot of dietary confusion for people who are trying to shift from a standard American diet to say, hey, this is one food group or there's just a couple of food groups that you can eat. And I know that certainly helps people out mentally as well.

Dr. Shawn Baker [00:13:19]: It provides a high degree of satiety for many people. And this is a problem if you tell me, " Hey, don't eat cookies and cake all day long." Okay, great. What do you want me to eat instead? " Well, eat some, eat some cardboard." And you know, low fat cardboard. Doesn't work very well. A lot of people are hungry and they're like, f that, man. I can't do this. I can do it for three or four days and I'm, then I'm, you know, I'm face down in a bowl full of Ben and Jerry's, you know, three days later.

Ben Greenfield [00:13:43]: So, yeah, so. So, Shawn, you're eating a lot of meat, occasional dairy and eggs, very, very occasional slice of birthday cake. Joel, what's your diet look like?

Joel Greene [00:13:56]: Yeah, so first of all, I think we're, we're, we're in. We're probably more on page with each other than not for the most part. I've been an early, longtime advocate of animal foods. Wrote some articles back in 2007 referencing like the Chico studies on the benefits of grass-fed beef. I don't want to put words in your mouth, but I would venture to say we probably both agree that meat's essential in the diet. Like you have to have meat in the diet. When you look at what happens when people don't have meat in the diet, long term you see problems you can't fix typically. I mean, you see a lot of problems. So I think we would agree on that. I've also been a big advocate of dairy over the years. I've taken a lot of heat for that, actually. A lot of people are like, you're in the back pocket of the dairy industry. And it's like, no, I've just read the research, man. It's just. And I've seen it in person, you.

Dr. Shawn Baker [00:14:50]: Know, I wish I could get in the back pocket of one of these places, man.

Joel Greene [00:14:53]: Me too.

Dr. Shawn Baker [00:14:53]: The meat industry owes me a lot of money.

Joel Greene [00:14:56]: Yeah, I wish, I wish I was in the back pocket. So I've been. In fact, I was in, I was an early guy back in the mid-2000s going into nutrition facts.org and you know, arguing with Dr. Michael there about eggs and things like that. So, so I, I think we're on the same page in that animal foods are essential in the diet. And I would think we're probably also would agree that keto diet. And also I want to kind of just mention that in my opinion, the way that the carnivore diet is executed for most people is, is really a keto diet. It's a keto diet based on animal foods. And under that umbrella you can also make the assertion that it's also an elimination diet. So it's a keto diet that's an elimination diet based on that. And I think there's a lot of utility to it. I think that keto diets are very, very useful. I think carnivore diets are extremely useful. So in fact, I was on Mark Bell's podcast in 2018 and he asked me what I thought about them and I said I think they're very useful. I just, I don't think that they are the way for life, but I think they're intervention based diets that can be extremely useful. So, so I think we would agree on all that. I think, I think we're on the same page with all that stuff.

Ben Greenfield [00:16:10]: And by the way, Joel, just real quick, before you move on, when you say the, the carnivore diet, an animal based Keto diet, I assume you're saying that there are not appreciable amounts of glucose that one can metabolize from an all me diet.

Joel Greene [00:16:32]: You're going to see the same endpoints, I think the way that it's executed with most people, which is that you're going to get into ketosis, you're going to see, you know, very similar effects to keto diet. And I don't know, Maybe you disagree, Dr. Shawn, but that's kind of how I would see it.

Dr. Shawn Baker [00:16:44]: Yeah, I mean, I think many people can and do. It doesn't always have, you know, again, it depends on pretty much how much protein you're consuming in many ways. And you know, like, for me, I mean, there's a lot of days where I'm consuming 300, 400 grams of protein, which is a ton of protein, you know, again, big guy, but that doesn't necessarily lend itself so much to ketosis as somebody who's pushing the envelope and now, now they're 80% fat by calorie and they're consuming a, you know, a more moderate amount of protein. So it, it does depend a little bit on your goals. And most people that come to this diet are doing it for some health reason or perhaps to lose weight. And, and that, that often holds true, what you're saying.

Joel Greene [00:17:21]: Yeah, so, and so, just so, just. Yeah, I think they can be very useful. I'm not, this isn't the classic, like, you know, meat is bad, plants are good, plants are good. This isn't that. This is, this is more, I think, where we differ. And the way that I eat is I basically try. I have seen that there's a, there's a, we're in this era of aligning with nature. So that's light and dark, heat and cold, biohacking, all that stuff.

Joel Greene [00:17:45]: And I've just looked at this enough to see that there's a rhythm of eating that takes place in nature and the constraint is scarcity. And scarcity drives you to eat foods out of your preference, even though you're always in the process of seeking animal foods. And you watch these survival shows like Alone or Naked and Afraid, or in fact, I'm doing some survival courses this year and I'll probably film it just so you see. But so in the process of looking for nutrient dense animal food, you tend to eat anything that's edible. And so you eat out of your preferences forced by scarcity. And so scarcity has this very unique effect. It drives diversity into the diet. And I'm of a belief that diversity actually is a protective mechanism.

Joel Greene [00:18:26]: So opposed to these sort of like. And I don't think you've really been one of these guys, but other people have been sort of in this, well, you know, plants are bad and here's all the reasons why, blah, blah, blah, blah, blah. I actually think there's synergies between the two. I think that either done too much creates. And again to your point, we don't have perfect knowledge. We don't 100% know anything really. So we're talking about something that doesn't have 30, 40 years of, you know, meta review studies to say, you know, oh, well, beyond any doubt, we can see this, this and this. So we're projecting into the future all with the same goal.

Joel Greene [00:19:05]: We all want lasting health, we all want what's sustainable and real. And I would just argue that too much of either side of that debate creates probabilities of outcomes that we don't want and that the synergy between plant and animal foods actually protects you from both. So my diet is really pretty simple. I lean more towards foraging kind of looking foods on one day and then the next day I'll do feasting foods looks very keto carnivore and there's overlap between the two. So it's never, rarely exclusively, you know, vegan one day and plants the other. It never really looks like that there's overlap. But I would just say that it's nutrient dense, diverse and balanced. That's how I would describe it.

Joel Greene [00:19:47]: And I think that's the difference between where we're at and when it comes to the carnivore diet. Again, I think it's very useful short term and you know, in a bell curve, not everybody's going to respond the same, so. But long term, I would say there are potential liabilities that are worth going over, worth looking at, worth enumerating, which have to do with the impact on the gut. Should we be really running beta oxidation as a way of life and beta.

Ben Greenfield [00:20:20]: Oxidation, meaning fat burning?

Joel Greene [00:20:22]: Yeah, yeah. Ketosis. Beta oxidation, all that. Yeah, I would offer, it's pretty that, that I would offer the bobbi probably not designed to try and do that. When you, when you look at what happens when you try and do that, it's not a hundred percent, but I think there's things that are worth looking at in terms of what happens when you try and run beta ox, as when you try to rely on the liver to make glucose forever. I would say there's concerns, just things to look at things, to kind of run down the list of. And you know, it's up to each person what they want to do. But I think, I think there's potentially some long term liabilities that are worth looking at. So...

Ben Greenfield [00:20:59]: So when, when you say there's some long term liabilities, particularly with oxidation, are you, or beta oxidation, are you talking about like, you know, Because I've seen some people like Jay Feldman, who champions this idea of the. He has an energy hypothesis in which he argues that excess fat oxidation can somehow inhibit, I believe, NAD recycling enzymes. Is that what you're referring to, Joel?

Joel Greene [00:21:27]: Not, not specifically, but just to lay it out briefly, it's this. So in order to be sustainable, you would have to have a sort of a, an even one to one input between beta oxidation and the TCA cycle. Okay, so that's not what you tend to see over time. What happens over time is that the ability of beta oxidation to produce Acetyl-CoA outstrips the power of the TCA cycle to metabolize that for a number of different reasons, converging from several different angles. And again, this isn't like a hundred percent. We don't 100% understand this stuff. But just as a point of discussion, it's worth talking about. Which would be the first problem you get into is that when you have high protein diets in the presence of high fat, the issue you're going to get into is when amino acids get catabolized, they are going to, you're going to get an accrual of intermediates in the Krebs cycle.

Joel Greene [00:22:36]: So you're going to get an accrual of Sustenyl-CoA, you're going to get an accrual of other intermediates. And what can happen from that is that inhibits citrate synthase, which inhibits citrate production in the TCA cycle. So the net of it is an incomplete oxidation. You get a mismatch between beta oxidation and the TCA cycle. And so what happens is intermediates accrue. The ones that we need to concern ourselves with are Acyl-Carnitines. So Acyl-Carnitines are your energy intermediates from beta-ox going into TCA cycle and they tend to occur in the mitochondria. It's stressful.

Joel Greene [00:23:12]: So the body has tons of backup mechanisms that kicks them out into the serum and then in the serum, number one, it's measurable. So you can measure for specific types of Acyl-Carnitine. So this is something that you can actually Take a look at. But the issues you see from that, number one, is that that breaks the glucose transport chain, so it spins up. Tumor necrosis factor alpha breaks IRS-1 in the glucose transport chain. But there's other problems. So you have very specific Acyl-Carnitines, so you have two Hydroxy-Methyl-Carnitine, that's a thrombosis promoter, so it promotes blood clots and its effects are far reaching. It takes a long time to see anything from that.

Joel Greene [00:23:54]: So that's just one angle that's coming at the TCA cycle. But then you have the liver to take into account. So what happens is the longer you're running beta-oxidation, you need oxaloacetate to, to metabolize all that, all of the Acetyl-CoA that's coming out of beta-ox. And normally you get that from glycolysis and you get it from a salvage pathway from citrate. But what happens is you're seeing an overall dampening of the TCA cycle, which is necessarily, not necessarily a good thing. And so what happens is the liver kicks in and then starts making Ketones and makes Oxaloacetate. And so for a while everything's good. But over time, what tends to happen is that the longer the liver's asked to be in Gluconeogenesis, a couple things happen.

Joel Greene [00:24:40]: Number one, you start to cannibalize Oxaloacetate in the liver and you also begin to see peripheral Insulin resistance in the muscle. And so you have this sort of multi pronged attack on the TCA cycle where over time what, what seems to be the case, or at least is worth considering, is that you get incomplete oxidation of fatty acids. Ketosis seems to make up for that for a time. But then long term you start to see the accumulation of intermediates, Propionyl CoA, Sustenyl CoA, inhibition of Citrate, accumulation of Acyl-Carnitines, and all of these things combined just kind of bring us to looking at this. Like quite possibly it could be that the body's a flex fuel system and it's meant to run on both. And when you try and run it on too much of either, it's probably not good. And so, yeah, that's something worth discussing.

Ben Greenfield [00:25:44]: What do you, what do you think about that, that metabolic theory? Shawn? Sorry, you, you were probably jumping in already.

Dr. Shawn Baker [00:25:49]: What's that? I mean, I, you know, I learned the Krebs cycle like six times through my medical career and you always forget it because it's just. But I mean, I, I guess I would say okay, so we have this sort of speculative, mechanistic sort of belief that this might happen and then it should show up as some sort of clinical outcome. And so what, what would be, what would be the predictive negative clinical outcome? And are we actually seeing this? I mean, Ben Bickman just post published a paper the other day, interestingly enough, about uric acid. And we know that high levels of uric acid certainly are associated with Gal, but it also has cardiovascular implications. And so we see that uric acid would rise. And somebody said, well, you're eating all this meat, uric acid might go up. And in some cases it does. But the other thing he demonstrated, now this is in vitro, is that if you add ketones to uric acid to, to, to cultured cells, instead of the normal uric acid associated increase in things like tumor necrosis, Factor Alpha and IL6 and some of the other inflammatory cytokines, it was blunted, it was basically negated.

Dr. Shawn Baker [00:26:46]: So again, you have to put this mechanistic theoretical concern into the context that we're talking about. And again, without long term, randomized, you know, prospective studies on human beings, to me it just becomes speculative. And I would like to say, how do we demonstrate these concerns are actually going on and we just don't know. I mean, I can't even get a damn carnivore study. I mean, I've had, I've had several case reports. We've had inflammatory bowel disease, we've had case reports on anorexia. We've had case reports on mental health disorders. We've got one coming out, coming out on multiple sclerosis.

Dr. Shawn Baker [00:27:19]: I'm working with the South Dakota Cattleman's group to get something on diabetes. So again, I would say any criticisms, good or bad or, or supposed benefits of the carnivore diet, we just don't have studies on. And I mean, again, I, I get the mechanistic speculation. Does it actually hold up? I don't know. Maybe. Maybe you'll be 100, right, and we'll find this out. I just think it's too premature to sort of really say that. And again, again, I tell people, hey, if the diet ain't working for you don't do it, I'm not religious about it.

Dr. Shawn Baker [00:27:50]: I'm like, hey, if your results are not what they need to be, go do something. I'll go do Joel's diet, go do a vegan diet, do Mediterranean diet, whatever. So that's kind of been my approach. I, I really. And there's a lot of people out there, you know, there's these longevity gurus, and I'm like, well, show me. Show me the money. Where's the results? I mean, you can speculate all you want, but because, you know, we saw this thing with, like, rapamycin and metformin. Everybody's taking this, and then all of a sudden, everybody's ditching it.

Dr. Shawn Baker [00:28:15]: Five years later, like, well, that didn't really work out. You know, all the mice are getting skinny and dying. Maybe that rapamycin wasn't the best thing. So, again, I don't. I don't doubt that what the facts that you're saying are true, and that's a potential concern. Are there other mitigating factors? Is it showing up? I mean, one of the concerns, like, I see around, like, carnivore diets. Yeah, maybe TMAO is going to be a big issue. It's like, well, what.

Dr. Shawn Baker [00:28:38]: What drives TMAO? Well, gut dysbiosis and kidney failure definitely cause high levels of TMAO. Is that the same thing as you get from eating carnitine and choline, which clearly have benefits in the body? And so it's like, what is the reason for the elevation? You know, is it physiologically appropriate or is it physiologically inappropriate? And so you have to say, you know, maybe, you know, maybe the metabolites are accumulating. Maybe that's an issue. Maybe ketosis is protective. Maybe some other component. Maybe the carnitine and meat has some effect on the, you know, the TCA cycle.

Dr. Shawn Baker [00:29:11]: I don't know. So we'll have to see what happens in the long term. So I. I'm never going to be the guy saying carnivore is going to make you live longer or prevent you from getting heart disease. I just don't know. I think it's. I think it's premature to speculate.

Ben Greenfield [00:29:22]: Yeah. I think two. Two points that Shawn raises real quick, Joel, I would love to hear your take on are potential mitigating factors of, you know, this. This constancy of beta oxidation that you would be concerned about with the carnivore diet. With one of the primary mitigating factors Shawn brought up was elevated ketone bodies. And then probably an even kind of bigger elephant in the room is do these mechanistic scenarios that you describe actually have any fleshing out in epidemiological studies or actual manifestation of any type of chronic disease in humans?

Joel Greene [00:30:02]: Yeah. So to your second question. And by the way, Dr. Shawn, welcome. Well put. What. What I would offer is, you're right. We don't have Perfect knowledge.

Joel Greene [00:30:13]: This is something that I bring up sort of as a, as a concern. It's something to look at. I would offer. It's measurable. So you can, you can actually measure 2 methylbutyryl carnitine and it's a marker of metabolic distress. They test kids for it for metabolic disease. You see it with prolonged fasting. There's sub evidence that you can see it with prolonged keto diets.

Joel Greene [00:30:35]: And so it's, it's something actually you can. If you're on a carnivore diet and you concern you could probably go, go just test for 2 methylbutyryl carnitine. Test for that Aceyl Carnitine. In terms of Ben's question, is there any data? Actually yeah, there's a handful of, and probably what I'll do is just make this available in the post show notes for anybody that wants to look at it Ben

Ben Greenfield [00:30:58]: Just email me anything you got me include in the show notes.

Joel Greene [00:31:01]: There's a number of studies that have been published looking at kind of this time inversion of fact with. Related to protein intake where scientists have speculated that... In fact there's a paper entitled high protein intake ameliorating or elucidating insulin resistance or inducing insulin resistance. And the mechanisms that they're speculating in there have to do with this. They're looking at why do we see these profound improvements short term with insulin sensitivity and all this stuff on keto-carnivore diets.

Joel Greene [00:31:32]: But then long term there does seem to be evidence that we're seeing the exact opposite happen. And it really has to do with some. A framework that I would offer is missing which is the impact of time and the basic forces that take place over time which is the accumulation of something, the degradation of something, the attenuation of something, the compensation of something. And so over time things can begin to accrue that sort of U shape, curb the benefits into the negative zone. And so, so when it comes to looking at protein, excessive protein intake or high protein intake and insulin resistance, that's exact where this stuff comes out of. And I'll make it available.

Dr. Shawn Baker [00:32:15]: Yeah, well you know, like I said, I know we've seen things like for instance like branch chain amino acidemia as being concerning, you know, where are we getting these branch chain amino acids. Well the assumption would be hey well you know, obviously dietary protein would be a good place for that. But it turns out it was. It's kind of a reverse causation thing that we see that cells are actually being damaged and break down, leak these, these branch chain amino acids in the bloodstream. So we get this amino acidemia. It's not exactly what you're talking about. Often see these, you know, again, I, I, I hesitate to put too much value into any kind of serum marker. And whether it's, whether it's LDL cholesterol or many other things, just because I know there's so much one, there's so much dynamic variability in measurement.

Dr. Shawn Baker [00:33:00]: You know, like I said, for instance, I did a little experiment back in February this year where I, you know, I had a total cholesterol meter, which is considered very accurate. You know, it's, it's supposed to be within 95 accuracy. And I tested my total cholesterol on a Sunday. It was 154. Yay. Good. It's all perfect. No one would complain about that.

Dr. Shawn Baker [00:33:21]: Most doctors be happy with that. And then I basically didn't eat for 18 hours and I worked out, tested the next day. It was 350, 345. Went up 200 points in 18 hours. That's my total cholesterol. And then the question was, which measurement is valid?

Ben Greenfield [00:33:34]: That's the opposite of what you want to do. By the way, if you're giving blood for, for an insurance evaluation.

Dr. Shawn Baker [00:33:41]: Those things, I mean, you, you can, yeah, I mean, there's, I mean, you know, Dave Feldman has shown, you know, and many others, if supplements show that you can, you can kind of play with your cholesterol, make it go where you want. And so whether these, you know, these carnitine metabolites in the blood are problematic and they probably are in certain population. But then you got to say, you got to specify to the population of, of interest. And I would say, I mean, you might be able to show that's associated with some negative outcome, cardiovascular disease, mortality, whatever it might be in the general population. But until you actually test it in the population with concern, I kind of have to say, is it really relevant? You know, and I, and I know we're all human beings, but I do think that when you're running a ketogenic metabolism, it's kind of different. I think a lot of the reference ranges may not apply. A lot of the RDA requirements are clearly, they're different. I mean, we know that, you know, people eating a lot of phytic acid grains and legumes, their zinc requirement goes up, and when you're not consuming that, it's down So, I mean, I just.

Dr. Shawn Baker [00:34:40]: I just caution making generalizations about individual populations when that individual population is not being tested. Hopefully we'll get some of that. But at the end of the day, like I said, I'm. I'm very much. How do you define health in the first place? And I think Joel and I are both on the same page. Let's be able to function. Right. And Ben, you would, you would agree if I can run and jump and sprint and do things in my 50s and 60s, well, I'm better than 99 of the people, and probably not definitely, but probably I'm going to have a longer health span than these other folks.

Dr. Shawn Baker [00:35:12]: But whether my, you know, whatever level you want to put in the blood is, is this or that, it may be predictive, but I'm somewhat, somewhat skeptical.

Ben Greenfield [00:35:22]: Yeah, Joel, one thing I didn't hear you talk too much about was this idea of ketones being potentially protective against this, you know, traffic jam in the Krebs cycle that Shawn brought up. Do you think there's anything to that idea?

Joel Greene [00:35:38]: I don't know...

Dr. Shawn Baker [00:35:41]: Neither do I. I'm just saying speculatively. There are lots of likely compensatory mechanisms. You know, it's just like. Like, just meat in general. I mean, look at all these supplements we get from meat that are great. Carnitine, creatine, carnosine, all of them have had tremendous mitigating effects for any. Like, if you say, like, well, you know, meats are associated with cardiovascular disease because of saturated fat, which I think is quite honestly false. But then you say, well, what about the carnitine to meat, what about the creatine in meat? What about the carnosine in meat? All which have been shown to have net positive effects, and just.

Dr. Shawn Baker [00:36:10]: So does it mitigate this? And, you know, when the average American gets most of their saturated fat from baked goods and processed foods and only 3% of it comes from unprocessed red meat, it's like, well, wait a minute, what are we talking about here?

Joel Greene [00:36:21]: You know, I think it's worth mentioning because what we're talking about here, very often you hear sort of couched in these definitive, like, good or bad sort of scenarios. And in my experience, what I've seen is that the same diet can work very differently on the same person at different points in time. And so I think it's very important to point out that a given thing at a given point in time can work wildly different at different points in your life. So in saturated fats kind of come under that, where, when you look at get saturated fat intake, and there's all this research on people in their 20s, 30s, whatever, and absolutely no effect whatsoever. But that same person pushed them forward 30 years, and they're facing the inevitable decline of the cardiovascular system. Everybody goes through where the glycocalyx is destroyed, the Nox enzymes are hyperactivated, and there's an accumulation of things that we really don't want. Oxy sterols, things like that. Saturated fats can have a very different effect on the same person.

Joel Greene [00:37:25]: So I just think it's important to kind of introduce that reality, which is that time changes the equation for just about everything.

Dr. Shawn Baker [00:37:34]: Yeah, I don't disagree with that. I mean, and I think, you know, the longer you can preserve the function of what you had when you're in younger, when you say you're 20. Let's say 20 is the peak of human physical health. And very. Well, maybe it may be a different number, but, you know, and as we, you know, we eventually slow down, as you know, I mean, it's harder to run a sub 24 at 60 than it was at 20. I mean, that's, that's just a reality.

Joel Greene [00:37:57]: Significantly.

Dr. Shawn Baker [00:37:58]: Yeah, but, but I mean, you know, and again, I'm not here to talk about, like, you know, when I. My approach to. Is not diet in isolation. I tell people, hey, you got to sleep well, you gotta. You gotta not be sedentary. You got to get out there and exercise. You got to get some sunshine. All those types of things that I think all of us would probably agree upon.

Dr. Shawn Baker [00:38:16]: So it's like, you know, how do you. How do you mitigate it? You know, and again, it's. There is a lot of relativism here. It's like, well, compared to what? You know, if you compare to the average person's diet at 50, you know, either of our diets likely to be far superior to that, you know, quite honestly. And so it's kind of like, you know, it's kind of like, well, which one's the best? I don't know. Who knows? I mean, you know, I mean, obviously we could stick some twins and lock them up in a metabolic ward for 30 years and see what the outcome is. It's not. No one's going to fund that.

Dr. Shawn Baker [00:38:44]: It's never going to get done. But so it's. It's almost like, well, it's speculative and, and fun to talk about. And, and, you know, I'm. I'm sure, you know, I, I don't think Joel's gonna go. Come, come away from this eating a carnivore diet. And I probably am not going to eat whatever diet he's promoting. But at the same time, it's, it's interesting to talk about and I think it's, you know, but, but at the end of the day, I think we have to, we have to be able to sort of back up whatever claims we're making with some hard clinical endpoints.

Dr. Shawn Baker [00:39:13]: And I just don't make the claims because I'm like, I don't know. I really just don't know. I mean, and I tell people going in, I don't know if carnival is going to make you live any longer or shorter. And I don't think I'll ever know that. But again, I'll go back to, as a physician, if you got Crohn's disease, I think I can get you, I think I can significantly improve your quality of life with this. And that's, that's what I come from, basically.

Ben Greenfield [00:39:33]: Well, you know, Joel, being a self professed guinea pig, I believe may indeed try carnivore diet after this. Yeah, I interviewed Paul Saladino. I did for 12 weeks.

Ben Greenfield [00:39:41]: And I, I had a carnivore diet. I included blueberries and honey. I don't know if that totally breaks it, but I've felt great. I just got bored after 12 weeks.

Dr. Shawn Baker [00:39:51]: Yeah.

Ben Greenfield [00:39:52]: However, you did bring up one thing, Shawn. When you were describing your diet, you mentioned the relative lack of fiber and you said that you thought Joel might disagree with you on your take on fiber. Joel, do you have any thoughts on the fiber piece?

Joel Greene [00:40:08]: Oh, yeah, yeah, yeah. Pretty significant. Yeah, sure. We'd probably wildly differ on this one. I think it's, and I think it's fun to talk about. I think fiber is essential. I think that when you look at the, the four main mechanisms which, without which no one, no one is going to have lasting health, that would be the cardiovascular system, that would be the immune system, that would be insulin function in the microbiome. You got anything wrong with any one of those, you're not going to be healthy, period.

Joel Greene [00:40:33]: End of story. So when you, when you and I've come at this problem, just looking at it, to reverse engineer it, when you begin to look at that problem, there, there are some very prominent suspects in there. Number one is the gut immune axis and the central role of bifidobacteria in there. So we don't have to speculate. We know that children, when the immune system is being developed, have mostly bifidobacteria in there. We know that it's bifidobacteria that really for the most part takes the lead role in setting the human immune system, which is just important. We also know that old people in poor health have very different profiles of species of bifidobacteria in there versus super healthy people who live sanitarians who live very long, they have different profiles of bifido and it's pretty consistent. So I would offer there's no real and lasting health without optimal bifidobacteria for most humans.

Joel Greene [00:41:29]: And mechanistically it's pretty easy to see. It's involved with dendritic function, antigen sampling, T-cell ratios, all kinds of stuff. And when you reverse engineer, how do you feed that? There's five ways. There's resistant starch, there's dairy, there's berry phenols, there's cruciferous vegetables, inulins. So that's how you feed bifidobacteria. So just based on that alone, just that alone, there seems to be a really good case for those things to be in the diet of most humans. And when you look at epidemiology and when you look at disease states, like checking every box down the line, you see, wow, yeah, Parkinson's, low bifido, asthma, low bifido on down the line, obesity, low bifido, all one after another, numerous, numerous different pathologies all related to low bifido.

Joel Greene [00:42:24]: In fact, my friend Dr. Christine Bashara published a study post Covid looking at bifidobacteria level and the vax. And there's another doctor who's done this. And consistently what you see is bacidobacteria is wiped out and it correlates to long Covid. So there's a very good case that optimal levels of bifidobacteria are essential for most humans. And when you break down how you feed that, it makes a really good case that you need to have those types of foods in the diet just to accomplish just that. But I would take it a step further and I would offer that when you look at what the colon needs. So let me also back up a little bit and talk about the gut as a complete system. So I believe that just looking at the gut, you can see nature's design.

Joel Greene [00:43:18]: So when you look at the small intestine, it's perfectly fed by animal foods, it's perfectly fed by aminos, it's perfectly fed by those. And then when you look at the, at the large intestine at the colon, it seems to be best fed by Sacralytic fibers. That seems to be the thing that gives you the highest percent probability of getting where you want to go. And so it seems that just looking at the structure that nature has provided kind of a template to see, wow, diversity really is kind of the way this is set up to feed. And when you try and make the reverse argument and you go, no, you can feed the colon perfectly from amino acids and protein you have, you run into six, seven massive problems. Okay? The first problem you run into is you're going to alkalize the colon. So we've been under this diluted belief that cancer cannot grow in an alkaline environment. That's just complete rubbish.

Joel Greene [00:44:07]: You will get cancer with an alkaline colon. You're going to drive alkylated carbonyls, not coincidentally. So the ph in the colon needs to be roughly 6.7. When you feed high, very high protein diets with no fiber, you alkalize the colon. This is borne out by lots of carnivore adherence who've published their stuff, their, their stool results and their colon and their stools are alkaline. So that's a major cancer promoter. And it is so easily solved, it's so ridiculously easy to solve that you just add a little bit of fiber in the diet, you push the ph back down. What you find with colon cancers is that the ph of the proximal colon is, is different from the distal colon.

Joel Greene [00:44:46]: The distal colon is where the ph goes higher and that's where all your colon cancers are. So that's a massive problem. You're going to alkalize the colon. That's, that's non trivial. But the bigger problem really gets down to when you begin to trace your butyrate pathways down, and you look at the bacteria that make butyrate from amino acids, and then you look at the bacteria that make butyrate from sacralytic fibers.

Ben Greenfield [00:45:13]: Sorry, sorry, Joel. Just real quick, sacrolytic fiber, quick definition for people who might not, not know what that is.

Joel Greene [00:45:18]: Just plant stuff. Plant stuff, yeah. So when you look at the end products, they're radically different. Radically different. And, and that's, that's important. So what you see when you ferment, and keep in mind the way you make butyrate is bacteria eat those things and ferment metabolites. So it's the bacteria doing the heavy lifting, the bacteria that ferment fibers. Generally speaking, you're gonna get two things.

Joel Greene [00:45:47]: You're gonna get antioxidants and you're gonna get propionate. Butyrate acetate, and you're gonna get them in the right ratios, and that's what you get. Now, the antioxidants is no small thing because the inner lining of the colon is highly oxidizing, and it's very easy to push it over the edge. So you need a steady supply of antioxidants in there to keep that from happening. What you see with a lot of gut dysbiosis is this just completely inflamed lining. And because you lose the reductive potential, what you find with bacteria. There's a word for when bacteria ferment protein. It's called putrefaction.

Joel Greene [00:46:23]: And you can prove it. You don't need to take my word. Just take a steak, leave it out for four days, and then come back and what you're smelling is called putrefaction.

Ben Greenfield [00:46:31]: Or smell a fart on an elevator at a bodybuilding show.

Joel Greene [00:46:38]: So what you find is that the end products from the fermentation of aminos. And it's been shown for a number of years now that roughly 12 to 18 grams of Aminos reach the colon every day. Okay. And when they ferment, there's two things to keep in mind. Number one, the bacteria that ferment, those tend to be pathogenic things like fusobacteria. Like, there's been studies showing that very high meat consumption will drive fusobacteria. And if you have fusobacteria, you're going to get cancer, like, literally guaranteed.

Joel Greene [00:47:11]: When I was at Quest working with some of the really great minds, they had there, one of the brightest guys of all, Dr. Steven Witherly, we were looking at some microbiome assays, and he goes, oh, yeah, yeah, fusobacteria, man, that guy's going to get cancer every single time. So there have been studies showing this, because what you're doing is you're competitively disadvantaging bacteria that otherwise solve that problem. So your end products from the bacterial fermentation of amino acids, you're going to get propionate, acetate, butyrate, but you get them in much smaller amounts. So keep in mind, the amount of substrate you have to work with is much smaller. You're only getting about roughly 12 to 18 grams a day to work with, so your overall levels are decreased. But then on top of that, instead of antioxidants, you get ammonia, and then on top of that, you get branched chain fatty acids. So that's a problem. Branched chain fatty acids.

Joel Greene [00:48:05]: You don't really see too much with fiber fermentation, but you see them increase over time with amino fermentation. The problem with that is they have both beneficial and negative effects and you tend to see the beneficial effects up front and the negative effects long term. Branched chain fatty acids are a very poor source of food for the colonocytes. They can use them for energy, but it's not ideal. And they tend to be, generally speaking, you can look at, you can measure this, you can measure branched chain fatty acids in the stools and they tend to correlate with gut dysbiosis. So the end products from one versus the other are wildly different and they accrue over time. So you begin to see this accrual over time of ammonia, you begin to see the accrual of toxic metabolites from fermenting.

Joel Greene [00:48:51]: And you know, it's fair to say there's a ton of benefits of the carnivore diet, but there's a ton of pathology that I've seen which is I have pages of testimonials of people and it's always the same story. It's, and it's, and by the way, it's not just limited to the carnivore diet, it's every diet done to an extreme. So I want to make that clear up front. But it's, but particularly the carnivore diet, same story, which is, yeah, I did that for a number of years, it worked really well, but then this went wrong and now I've got insulin resistance or dysbiosis and I can't fix it. Can you help me? And that story is pretty consistent. And what this again speaks to is that the same diet works differently at different points in time. And the mechanisms involved are the mechanisms of time accumulation, degradation of the gut lining, all this stuff. So I would just say that trying to run the colon off of amino acid fermentation is not a long term solution. It's really best meant to run off fibers. That's what I would offer.

Dr. Shawn Baker [00:49:52]: Yeah, interesting. Yeah. You know, and it's interesting when we look at like comparative anatomy, you know, different species, animals, you know, we look at, you know, our fermentation capacity as a human, it's, I think generally, you know, the amount of hardware we have dedicated, the amount, the amount of amount of anatomy that's dedicated to that for fermentation, around 17% to 18% of our gut, total gut surface area, chimpanzees, 45%, gorillas 60%, obviously they have a much higher, higher plant based diet that makes sense for them. And then you compare that and it's very similar like cats and dogs. Cats and dogs are around 15%. So we have this kind of small capacity to ferment, ferment fiber to and certainly to obtain any kind of energy from that. It's estimated between 4% and 10% of our calories could come from fiber fermentation which is, you know, maybe up to 200 calories if you're eating a 2000 calorie diet today. Interestingly, say people with say like conditions like familial polypoposis where they have these adenomatous polyps which if not treated ends up in an average life expect to be about 42 years of age as they get all these polyps in their colon.

Dr. Shawn Baker [00:50:59]: So they often end up with a colectomy. And those people that undergo colectomies live basically as long as everybody else. They have a normal lifespan without their colon, without really the microbiome, really. So you, we talk about the essentiality of the microbiome. I would point you to collectomy patients that live long, you know, normal life expectancy. So you got to say, okay, it's a, it's an important thing while it's there, how effective is it? You know, if you say well you're a lot more likely to develop colorectal cancer because you have a particular bacteria species 100% I would, I would call into question the validity of that particular claim saying everybody with this bacteria is going to get colon cancer because I don't know that I would be born out. The other thing I would say is that, you know, they just published a study out of Europe on carnivore diets and, and gut diversity but microbiome diversity and they found really no difference.

Dr. Shawn Baker [00:51:51]: I mean it's pretty much same alpha diversity, same beta diversity. Now I don't know if the specific metrics you're talking about with regard to bifido were looked at, but generalize, the diversity is not that much of an issue. I see a lot of people with gut issues going carnivore and to your point, it might be a, you know, a short term solution for a long term term problem. And maybe down the road people are developing issues. I don't know, I see a lot of people doing it long term. I don't necessarily see that, you know, all the time. There's a lot of things that affect our gut microbiome outside of what we just eat. I mean, God, the temperature, the time of the year, the, the, you know, what are the, what are the things we're exposed to, whether we have A cold or not.

Dr. Shawn Baker [00:52:28]: Our microbiome is very, it's very plastic in a way. And as you know, I mean you can take an antibiotic and whole things changed. And so, I don't know, I mean, it could be, it could be that stuff again. I, I still think maybe it's speculative. I, I, I will certainly be the first one to admit there are people that do carnivore for a period of time and it stops working for them for whatever reason. And it could be that, it could be one of a thousand other reasons, quite honestly. And my response is, you know, maybe make some adjustments, doesn't work, go do something else. I mean, again, I'm not religious about this type of thing.

Dr. Shawn Baker [00:53:00]: I'm just, just, again, I just don't have the confidence and maybe it's because I lack understanding or knowledge in this, but I just don't have the confidence to make big proclamations that this or that is either unsustainable or sustainable. You know, I mean, we'll see, I mean, we'll see what it goes. But I mean, I think it's good, it's good, it's good to discuss this and bring this up because if there's something you can do to mitigate a problem, I don't care if somebody adds a fiber supplement to their diet, it helps them, good for them. You know, I would still admit that I don't, I would still argue that it is not essential in the sense that if I don't have, I'm going to die. Now, you might say it's conditionally beneficial. It might, it might decrease your risk for this or that negative outcome, which may be true, but it's not essential. I mean, otherwise I would be, I mean to me an essential thing is, you know, if I don't eat protein, how long can I go without eating protein before I drop dead? How long can I go without oxygen without dropping dead? Those things to me are essential. I think it's conditionally beneficial.

Dr. Shawn Baker [00:53:54]: And clearly most of the epidemiologic research out there shows a clear association between fiber consumption and every good outcome, mortality, cardiovascular disease, cancer risk and all that type of thing. And some of that says, well, you know, there's clear studies that show that a high fiber diet is clearly associated with better socioeconomic status, general overall better health outcomes. And you know, like Tommy Wood, Lucy Mailing's paper from, from, you know, 2021, looking at the metabolic flexibility of the gut, maybe you've read that paper again, talks about what you said. Proteins can seem to serve as an adequate source of short chain fatty acids, whether it's propionate or acid, you know, acetate or things like that. Butyrate can certainly come from ketone bodies. We know that beta hydroxybutyrate is very easily reversed into butyrate, which is considered beneficial for the gut, the energy for the gut, perhaps maintaining the gut mucosis. So, yeah, I mean, I would say certainly, I think that concern is valid. Does it play out for 10% of the population, 90% of the population? I don't know.

Dr. Shawn Baker [00:54:58]: I'm still, like I said, we're still learning here.

Ben Greenfield [00:55:01]: It seems to me, just, just real quick, it seems to me like, like Shawn, besides implying that more rich people have kale smoothies, is that that there's a certain amount of adaptability and that potentially someone consuming a long term carnivore diet might actually experience some kind of a shift in gut bacteria from these other sources of say, like butyrate or perhaps, you know, dairy that that person might be eating that would still allow their body to adapt and not experience an increase in the risk of chronic disease or say something like colon cancer by eating a carnivore diet.

Dr. Shawn Baker [00:55:36]: Well, I mean, let me just, you know, jump in on that real quick before Joel responds because, you know, the risk factor for colorectal cancer, there are, there, there are many, you know, obesity is a huge one. Right. You know, chronic underlying inflammation. If you have a chronic inflammatory bowel disease like colorect, like Crohn's disease, risk goes way, way up. You know, so I mean, we're seeing those risk factors, obesity, you know, inflammation and others go down significantly. Diabetes, you know, these things go, these generally get better on carnivore. And so if we say, you know, there's, there's, let's say there's 50 risk factors for colorectal cancer. And you know, the carnivore diet increases 2 of them, but mitigates 42 of them.

Dr. Shawn Baker [00:56:16]: What's the net effect here? So again, I, I, that's why when we focus on one mechanistic pathway to the exclusion of the other 150, sometimes it leads us to the wrong conclusions.

Joel Greene [00:56:29]: Yeah, so first of all, I would agree, I'm not a, a huge fan of reductionism. I think you've, you've probably said it differently, but I'll, I'll say the same thing, which is that we're moving into the future, which is we're moving into the unknown. And I look at it kind of like a game of golf. It's like when you're playing golf, you want to minimize risk, maximize your return. So everything comes down to percent probabilities of things, percent likelihoods of things moving into something unknown. And so when you look at these mechanistic underpinnings, 1, 2, okay, whatever. But when you begin to stack them, 3, 4, 5, 6, 7. In my, in my opinion, It's certainly worth being aware of.

Joel Greene [00:57:12]: It's certainly worth saying, particularly in the things we're talking about. So some tidbits. What's interesting to me about colectomy is that what you see post colectomy, you see pouches form in the small intestine and the bacteria that were in the colon relocate into the small intestine. And so the analogy would be it's kind of like you're running a business out of your house, your house burned down, and then you move into your cousin's house and it's cramped. It's not necessarily the same thing, but. But you're still in business. And so it, it points to the possibility that you might be able to get by without the colon, but you probably can't get by without the bacteria that were in the colon.

Joel Greene [00:57:52]: And they just find a way. We shouldn't be surprised that the body's incredibly adaptable. That shouldn't surprise anybody. What I think is interesting, though, is the relocation of the colon bacteria into the small intestine. And it seems to be that the small intestine takes on the function that the colon used to have. So that's very interesting. The other thing is ketone bodies. To my knowledge, that's been shown in a petri dish, but it's never been shown in vivo in the human body.

Joel Greene [00:58:20]: And I would probably be highly doubtful because ketone bodies just tend to bypass the gut and go in the serum. Serum. So nobody's ever shown me a mechanism where ketone bodies go from the blood, go from the serum, and then just pop into the gut when they need it. It's very, very different. So I would be suspect that that actually takes place. Maybe it does. We don't 100 know. No one knows.

Joel Greene [00:58:43]: But I would believe there's more reason to think that doesn't happen just, just based on the way ketone bodies allocate themselves.

Dr. Shawn Baker [00:58:51]: So, yeah, I mean, I would say that, you know, the colonocytes are, well, they're. They're well vascularized, and so that crosses from. From the other side. So it goes into the colonocyte and it nourishes a colonocyte and that thing. And I think because some of the argument is the ketone bodies or the, the butyrate specifically among other short chain fast is actually nourishing from the, from the gut side to the, to those cells. And I think that of course they're, they're vascularized so they're getting some of that from that way. So that would be my assumption. The other, the other thing that's interesting and I, I, I think this is interesting because you mentioned, you know, putrefaction is occurring in the gut.

Dr. Shawn Baker [00:59:25]: We're, you know, causing things like cadaverine and some of these other compounds that come when protein gets in the gut and we putrefied, which is. You mean putrefaction sounds disgusting because you know, it's putrid. It's the same process but you know, with carbohydrates now it's called fermentation. It's just a name. But there's interesting studies looking at you know, for instance, plant based proteins like soy. Like there's a study out there showing that soy, the protein that gets into the colon from soy is actually higher from, than from beef. So again, you're still getting protein into the gut through plant based sources, whether it's soy or some others. And soy might, you know, the example I have.

Dr. Shawn Baker [01:00:06]: So you're still getting some level of putrefaction that's occurring. It's just the amino acids are now coming from plant sources rather than animal sources. And again, on a, on a, you know, gram for gram paste. Now again, if you're eating more, if you're eating 500 grams of protein a day. Yeah, that, that, that difference is probably going to be overwhelmed by the, the, the sheer amount that you're consuming. So again, to your point of truly high protein diets, and I certainly have been guilty of that eating you know, 500 grams of protein in a day. And, and, and so we don't, we don't know. I mean like I said, it's, it's interesting to say.

Dr. Shawn Baker [01:00:39]: But yeah, it's, you know, interesting discussion.

Joel Greene [01:00:42]: What I would offer on that, that to my mind it seems to be kind of like I, you know, I can't, I can't see why not to do it is that there have been quite a few studies actually that have shown this was Lou, Lou showed this in 2016, several other studies that have shown this that all of the, we can make a list of issues that happens when you're just trying to run the gut on protein. And, and there's, there's a number of issues. You can alkalize the colon, you can feed fusobacteria, you can make metabolites that we don't want to make. All this stuff all that's nerfed, 100% nerf. Just by adding a little bit of fiber in the diet, it shifts the locus of fermentation, prevents things like nitroso compounds from being formed. It's just completely nerfed. So to my mind, if there's no negatives and only benefits, then you get all the benefits of meat and none of the negatives. I don't know why not to do it would be my response to that.

Dr. Shawn Baker [01:01:31]: Yeah, I mean, fair if there truly are no negatives. The only problem with, I see with that is I do see people that fiber is a net negative for them. So I mean it's just symptomatically and even after a period of adaptation. So yeah, you're absolutely right. I'm like, if there's all upside, no downside, then yeah, why not? But then the question is, what happens when there's a downside? Then you have to sort of weigh those odds in there. And I, you know, I mean, I get people that are eating a healthy diet. They're eating meat and they're eating some vegetables and no junk food and no sugar and you remove the vegetables and they just get better. I don't know why.

Dr. Shawn Baker [01:02:02]: I mean, I mean, I can speculate as to why, but it is what it is. And so I have to say, at least accept that, at least for some people, that is a concern, either acutely or. And then what happens chronically. And I will tell you, you know, as a physician, what I do is I take people. We don't put everybody on a carnivore diet with our company, by the way. Some people we do, but then we generally tell them your issue has resolved. Maybe it's been three months, six months, a year, whatever it is, we would encourage you to attempt to add some things back in and see how it goes. And you have to, you have to be kind of, you know, sort of selective on how you do that and so on and so forth.

Dr. Shawn Baker [01:02:36]: And for the, the vast majority of the people that have ever done a carnivore diet, I would say 90 of them probably end up carnivorous or they're carnivore plus whatever. A little bit of fruit, a little of that. So again, from a long term sustainability, I'm not going to be the guy here saying that carnivore is the best thing for Everybody on the planet, everybody should be doing it. It's the best diet ever. I don't say that, I won't say that. But I, but I will sure as hell say way it can be used as a therapeutic tool. And we should be, we should be definitely exploring more of that. And then if somebody wants, like I said, if someone wants to do it long term, you know, good for them.

Dr. Shawn Baker [01:03:11]: They're the pioneer, they're, they're the astronauts and we'll see what happens out of that. Maybe, maybe it'll turn out that I'm totally right or, or maybe I got lucky and I'm gonna live to 150 and be like Dave Asprey and claim that I'm gonna live to 180. And even without my 300 supplements a day or whatever, whatever not nonsense is being prop, you know, pushed out there about that stuff. We'll just have to see what time and I don't know that I'll keep doing it. I mean the honest and just to be consistent, if I get to a point where I start feeling like garbage, I'm gonna change. I'm not going to put up with that. You know, like I said, I got a lot of goals, I got a lot of things to do, I got to run fast. You know, it's like all that stuff you got to do.

Ben Greenfield [01:03:46]: Yeah, that's a good point, Shawn. And that's actually because I know we're getting close to running up against time. That's kind of, kind of leads to. The question I want to ask both of you is kind of a closing question. Joel, based on what you learned from Shawn today and the discussion here, would you ever eat a carnivore diet or some type of relatively un-diverse diet, maybe with the inclusion of some of the things that Shawn does like eggs, dairy, etc, just to do a short term stint and see how your body feels.

Joel Greene [01:04:15]: Oh, absolutely. Yeah. I think, as I said up front, I, I think the carnivore diet can be extremely useful as an intervention. There's, there's, there's, we have no disagreement on that whatsoever. In fact, the process of taking people from intolerances and getting them back to where they have diverse diets, we're not even in disagreement on that. So I've done a carnivore diet for periods and you know, absolutely, you can quantify that. There's benefits to it. So I think it's important also to point out that when, when we talk about dietary diversity, we don't mean the four food groups.

Joel Greene [01:04:54]: What I talk about in my. My new book, The Way is that there are identifiable patterns of eating in nature, and we need to replicate all of them. So then there's four, primarily. One is that you just go hungry. And going hungry always goes with foraging. So in the process of trying to get some game, you go hungry and you're eating whatever you run across. Mushrooms, just anything. Okay.

Joel Greene [01:05:16]: Foraging and fasting have always gone together, and. And they are synergistic, and they're beneficial. Then there's feasting. Feasting means you, you know, you. You got a trout, you got a deer or something, and you just. You eat until you can't eat anymore. Then there's a season of abundance. And so in the context of dietary diversity, what a season of abundance looks like is, you know, you kind of eat the same thing for a period of time.

Joel Greene [01:05:40]: You know, it could be whatever three months, six months. And that fits within dietary diversity. It's just the diversity comes in nature by scarcity. So eventually you run out of the thing and you got to go find something else. So I'm not opposed to, you know, these types of things at all. It's my big thing, I think, over the long term is that there are synergies between foods. Example, you know, oats get vilified a lot, but a benefit of oats is that they actually clear ammonia from the gut. So just by adding a little bit of oats into the diet with Carnivore, you're mitigating a potential liability.

Joel Greene [01:06:15]: And, and there's no harm to that. They actually sharpen insulin sensitivity. Another one is there've been some research showing that adding roughly about 50 grams of grains into the diet per thousand calories increases muscle synthesis rates with high protein. So that high protein, together with some grains, your muscle synthesis rates improve. Um, and on and on. You can. You can kind of find these synergies that, that show that diversity in the diet actually allows us to enjoy the benefits of animal foods and completely nerfs any potential liabilities. And it doesn't even have to be a ton.

Joel Greene [01:06:49]: It's just some. Some diversity in the diet. So that's what I would offer.

Ben Greenfield [01:06:53]: Yeah, that's interesting, Shawn. You guys start dipping your steak in oatmeal.

Dr. Shawn Baker [01:06:56]: Well, probably not oatmeal, but I mean, as I said before, you know, and certainly I appreciate Joel's perspective on this, and, you know, if I get to a point where there is some sort of clinical concern for me whether it's, you know, and, and, you know, to me, it has to be a legitimate clinical concern. I know some people say we're waiting too long, you know, maybe because I just don't know about, you know, how I, how I relate specific facts as to what they translate in down the road. But I certainly am open to change my diet and I will. I mean, I certainly, if I get to a point where I like, I don't feel like I'm feeling good, I don't feel like I'm as good as I can be, I will, I would not hesitate to change at all. And maybe it'll be adding some small amount of, you know, plant food carbohydrate in there, you know, because they taste good. I mean, I don't, I mean, I still like freaking chocolate cake. I'm not saying that's the health food, but I mean, I still like the way fruit tastes. I still like, like a lot of these things.

Dr. Shawn Baker [01:07:46]: I don't find them disgusting, I don't find them evil in any way. But you know, the question for me is, you know, what's, what's optimal for me? And right now I feel like I'm doing pretty good. I mean, like I said, just, I'm, you know, I'm the damn rowing machine. I'm one of the fastest guys in the world at 50, 57, I'm beating 20 year olds still. So that to me is a pretty good metric. You know, I mean, there's other things you can measure. And just because you're fit and in shape and athletic doesn't mean you're healthy. I mean, it kind of does.

Dr. Shawn Baker [01:08:13]: I mean, I, I, when people say, oh, just because you're in shape, you're not healthy, I'm kind of like, yeah, that's kind of, I mean, most people that are sick are fat guys on the couch going to the cath lab. You don't see a lot of world class athletes. When you do, you hear about it because it's such a rare event. So I mean, you know, it depends on, you know, how you, how you define health and how I define health and what make what's important for me. But if I get to a point where it doesn't make sense, I'm not opposed to it. As I said, I already, I, I'm not religious about this diet in any way, shape, shape or fashion. You know, do I get to a point where, and to Joel's point, I totally do totally agree. At least in the near historical context, yes, there were seasons.

Dr. Shawn Baker [01:08:50]: There's always seasons. I mean, there's berries in my backyard. I Live in Washington, there's blackberries. August, September, my blackyard's full of blackberries. I could certainly do that. I do think, you know, I mean, from an evolutionary perspective, the farther we go back, I think things are a little bit different. You know, I mean, a lot of our, A lot of our observations on foraging strategies are based on modern populations, relatively recent population, people we can observe in nature. Hadza, Bolivians, whatever, whatever.

Dr. Shawn Baker [01:09:18]: And that, that may have been a very different scenario. Went back when, when, you know, mammoths were everywhere and there weren't that many of us and we could kill them pretty easily. And, you know, you take down a mammoth and you got food for, you know, you got abundant abundance and surplus of food for. For several months, likely. So it's not that hard to. To get that. So anyway, but I am open to it for sure.

Ben Greenfield [01:09:38]: Guys, I know we got a lot of people listening. We're going to be interested in following you. Shawn's book is the Carnivore Diet. Like I mentioned, I'll link to all his socials, everything he does in his website, in the show notes. Joel wrote the immunity code. He's been on the podcast a few times. I'll link to him and all of his stuff on the show notes.

Ben Greenfield [01:09:57]: Fellas, I learned a ton. I'm sure a lot of other listeners did as well. So thank you so much for coming on and having a friendly little chat about meat and beyond. I appreciate you guys.

Joel Greene [01:10:09]: Likewise. Thank you, Dr. Baker. Thank you, Ben.

Ben Greenfield [01:10:12]: All right, thank you, Mr. Green, Dr. Baker. I'll talk to you guys later.

Dr. Shawn Baker [01:10:16]: Thanks, guys.

Ben Greenfield [01:10:18]: Do you want free access to comprehensive show notes, My weekly roundup newsletter, cutting edge research and articles, topic top recommendations from me for everything that you need to hack your life and a whole lot more. Check out BenGreenfieldLife.com it's all there. BenGreenfieldLife.com See you over there. Most of you who listen don't subscribe, like or rate this show. If you're one of those people who do, then huge thank you. But here's why it's important to subscribe like and or rate this show. If you, if you do that, that means we get more eyeballs, we get higher rankings, and the bigger the Ben Greenfield Live show gets, the bigger and better the guests get and the better the content I'm able to deliver

Ben Greenfield [01:11:03]: A quick thing, most of you who leave a ranking, leave a review if you got a little extra time, like or rate this show. Thank you so much.