The power of protein - With Dr. Eric Westman



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power of protein

The power of protein with Dr. Eric Westman, Dr. Mary Dan Eades & Dr. Mike Eades

Dr. Eric Westman: Hello, everyone! Welcome. It’s my great pleasure to be here with Dr. Mary Dan and Dr. Michael Eades. What a thrill! I’m Dr. Eric Westman. I’m a professor of internal medicine at Duke University, past president of the Obesity Medicine Association, and still in practice, loving how we can reverse metabolic disease, and improve people’s lives in a medical setting without medications.

In 1998, when two patients came to me at the VA Hospital in Durham, North Carolina, they lost weight without me doing anything. I had sent all my patients to the dietitian, and no one seemed to have lost weight, but these two people came to me having lost over 50 pounds on their own. Can you imagine the nerve? They didn’t need a doctor. I asked them what they did. They politely told me that they read a book, and the book was written before I was born, and that really got my goat. I started learning, and so I went to read the books that they had read, and one was Protein Power that you guys wrote. I was trying to learn on my own without any nutritional training, without training in weight loss, which is the norm even today among doctors.

What I’d like to do is start with how you got into this. What I finally learned is that you had the clinic experience, which I required if I was going to learn from somebody. I wanted to learn from another doctor. Please tell us how you got involved in this, where your practice was, and how long you practiced, because I think that’s just a wonderful story.

Dr. Michael Eades: I had been thin all my life and then all of a sudden in my early to mid-30s, I just exploded into obesity. I wasn’t morbidly obese or anything, but I was way larger than I wanted to be and than I ever had been. I started trying to fiddle with my own weight loss. I ended up working full-time as a doctor. At the time, we had developed one of the first chains of what are now called “urgent care centers” anywhere in the country. We had four of them. At that time, there was some hostility with the medical community because they thought we were stealing patients. Anything new in medicine is automatically greeted with hostility. We had these four clinics. They had just turned out to be a full family practice clinic where you didn’t need an appointment. I was working in one; she (Dr. Mary Dan) was working in one. A couple of other doctors we had worked in the others. And then we filled in with other locum tenens and doctors. During this time, I had all of a sudden gained a lot of weight. So I started. I got one of these fasting programs that you could do in the clinic, and I went on it myself, and I lost all this weight.

When I read all the materials that came with it, it said that it was reminiscent of Dr. Atkins’ book, which I’d read years before, the first. When I saw that, then at the end of the thing, it said, you need to go back on a low-fat, high-carb diet. I thought, “What nonsense. If this works so well, the front end, why wouldn’t it continue to work?”

Meanwhile, I went back to a regular whole-food diet. But during this whole thing, patients had seen me lose weight, and they wondered how I did it and wanted to do it. I said, “I can help you,” and started working with them and feeling my way through it. That’s the beginning of it. Once I switched myself over to this whole-food, low-carb diet, I thought, why do you need all the shakes and everything? Let’s just go on a low-carb diet. And so I started putting people on low-carb diets. This was when everybody was scared to death of cholesterol. And so that, of course, is the first question on everyone’s lips: “What’s going to happen to my cholesterol?” I checked their labs, and their cholesterol, and almost in 100% of the cases, they did better.

I started looking into the mechanism of weight gain and obesity. I went back to my actual medical school biochemistry book, and I drew the diagrams and lined everything out. It became pretty clear that insulin was a driving force behind it. I decided if you can lower insulin, you ought to lose weight. The only way you can lower it is with a low-carb diet because there aren’t any insulin-lowering pills. You just have to take away the stimulus. So that’s what I did.

I had success when I still had this niggling because of the cholesterol and the fat issues. All of a sudden, in the space of a short period, four patients came to see me which really changed the way I thought about everything. The first one Mary sent to me from her clinic was a lady in her mid-30s. She had a triglyceride of about 2500 mg/dL (28.2 mmol/L), which was the highest I’d ever seen at that time. So high that you really couldn’t determine some of the other lipid parameters. I took her on as a test case because I figured these premenopausal chances of heart attack are really negligible, so I’m going to go full-blown with her and put her on steak and salad. The first thing I did when she came to see me was to recheck her labs because as you know, there are a lot of screw-ups on labs. When I saw something that was out of whack, I wanted to recheck it and make sure it was a legitimate number, which I did. It was. And so I put her on a steak and green vegetable, salad, and cheese diet. I gave her my beeper number because I was concerned about her. I had her come back in three weeks and she had done great. I rechecked her labs in 3 weeks, and her triglycerides had virtually normalized. I couldn’t believe we were in the 100s. All of her lipid values were improved. She felt better; she had lost weight. And so that gave me some confidence.

Another lady who came in, and this was just the beginning of statins, had a total cholesterol of 700 mg/dL (18.1 mmol/L) – I don’t think to this day I’ve seen another one like that. She was an elderly lady and was the mother of a friend of mine. I talked to her about the diet, and she went on it. Same thing: I rechecked her in a few weeks. Everything had normalized.

Then I had a famous Little Rock person come in. It was a female. Same thing. They all came in because they wanted to lose weight, but their lipid values were crazy. Her lipid values had completely normalized.

A friend of mine who ran an ad agency was about 58 years old and just needed an insurance physical. So I did that for him and checked his blood work as part of it. He said, “By the way, while I’m here, how can I lose this little pot belly?” I told him of the diet, and he went away. I got his lab work back. I think he came out Thursday or Friday and got his lab back over the weekend. I saw it on Monday, and his lipid values were through the roof. And so, I called him. I called his office to say, “Hey, let’s talk about this diet,” because he was a middle-aged male in the age bracket who was prone to have a heart attack. They said, “Oh, he’s gone on a cruise, he’s going to be gone for 10 days.” I thought, “Okay, he’s on a cruise; he starts this diet on a cruise, so I’m safe.” I said, “Tell him to call me the minute he gets back.” When he gets back from the diet, he calls. “Hey, what’s up?” I said, “How are you doing?” He said, “Great, I went on this cruise, and I followed your diet. It was really easy. I ate a lot of seafood and a lot of meat. I avoided all the other stuff. It was great. I lost three, four, five pounds.” I told him about his lab value. Let’s come in and look at those again. And when he came in, this was 11 days later. This is the earliest I’ve ever checked anyone, and when he did, they were completely normal.

I started reading a little bit more about statins and the cholesterol pathway, which I memorized in biochemistry and immediately forgot. I realized with HMG-CoA enzyme reductase – the limiting enzyme in the cholesterol synthesis pathway and the same enzyme that statins block – is stimulated by insulin. So it made sense that if you were going to take some of the stimulation away that lipid value should normalize. Once I had those patients under my belt, then I was fearless. I put everybody on the program from that point on and have never had a problem.

Dr. Eric Westman: Mary Dan, were you a little harder to convince?

Dr. Mary Dan Eades: Oh no, I was fairly convinced. Mike had written a book just about that time based on the protein-sparing modified fasting program that we had done because we saw so many people in all of our clinics to be rechecked on this program that he was doing, and they all did so well. It occurred to him mainly that the need for weekly monitoring and all of the costs of those programs, which was thousands and thousands of dollars for monitoring them, was maybe not as necessary as it had seemed. If they followed the instructions, they did really well. He decided that people could do this on their own. And how many people would that open it up to who can’t possibly afford a hospital-based program or even a clinic-based program. He wrote a book, his first book without me, the only one he’s written without me, called Thin So Fast which came out in 1989. It told people how to undertake a protein-sparing modified fast with a slight modification. He wrote that book and, and we’ve seen a lot of success.

Then when he started doing just a full food-only program, those four patients too made me think, “Okay, this runs the gamut. It’s men, it’s women, it’s at ages that we should maybe worry about, and everybody’s doing really well.” And so it gives you a lot of confidence, since like you, we didn’t get any medical nutritional training. I think we had one three-hour class in med school. Beyond that, what you were taught to do is write orders. Put this patient on a low-fat diet and send it to the dietitian or diabetic service; put this patient on a low-cholesterol program or a low-salt program or whatever. We knew nothing about nutrition from our medical training. All of it came just feeling it out paper by paper. Mike spent half his life in the medical library because in the olden days, there was no such thing as this internet I hear talk of where you could just with the click of a few keystrokes pull up every paper known to mankind! That wasn’t the way it was back then.

Dr. Eric Westman: You’re most known in pop culture with the book, Protein Power. It sold millions of copies. What I love about that is when I think about nutrition, and how to teach it, the first place I start is to say, “Let’s consider what we’re made of.” Occasionally, I’ll ask medical students or residents or visiting doctors just to see how much they know or don’t know. I’ll point to the muscle and the bone. A student recently looked at me and said, “We’re made of sugar.” The basics of what we are made of is protein. We need protein. The brilliance of the name Protein Power has really stood the test of time. How did the name come about?

Dr. Michael Eades: We had about probably five or six pages of titles proposed for this book because nobody could come up with a title. Its original title was The Insulin Connection, but it was rejected because everybody will think it’s about diabetes, and they won’t buy it unless they have diabetes. We had five or six pages of just one title after another, and we sent them all off to the publisher, and the publisher went through all of them. One of the titles was Protein Power, and the publisher picked that. We were, strangely enough, unhappy about it because we thought a lot of the other titles were better, but Protein Power turned out to be a great title, so they were smarter than I was.

Dr. Mary Dan Eades: The thing about the Protein Power part was that everybody would refer to our diet as a high-protein diet, and it’s not a high-protein diet. It’s the amount of protein that you need in your diet, which is higher than a lot of people think. We were concerned that if it was called Protein Power, we were just going to draw all kinds of fire for recommending that people get on a high-protein diet because “everybody knows” those high-protein diets are going to damage your kidney, cause cancer, etc. Of course, none of that is true, but we didn’t really relish going all over the country having to defend it. As it turned out, they did ask questions about it, those who had never read the book and had read the front cover of the jacket of the book, and then that’s what they asked questions from. We would always answer: it’s not really a high-protein diet, it’s the amount of protein you need in your diet, which is more than most people get.

Dr. Eric Westman: Time has passed, and I think a lot of lawyers have been involved. The Virta company came up with “adequate protein” as the new term. You couldn’t say Fat Power at the time, right?

Dr. Mary Dan Eades: No, no, at the time we would have been ridden out of town on a rail, but we did get that one a lot. “It’s just a high-fat diet,” and “What’s the percentage of fat in this diet?”, and we both sat there thinking it’s 65-70%, and we’re not going to say that out loud because these people will kill us.

Dr. Michael Eades: One time I was giving a talk at Colorado State University to a whole auditorium full of people. I was giving this lecture and we avoided this whole percentage thing. I don’t like percentages because you don’t eat percentages, you eat grams. I gave this talk and somebody asked that question from the audience, and there was no way to escape it! I said probably about 65-70% fat and you can just see this gasp!

Dr. Eric Westman: Even then today, the language is “healthy fats.” I just go along with that, of course, natural fat is healthy fat. There’s this skirting around the idea that saturated fat is actually fine, but you can’t say it. Protein Power was brilliant because it didn’t. It went right through the age of walking between your two fires. Time has passed and there has been a lot of research. Has there been any fundamental change in your thinking over time or does protein still come first and don’t worry too much about the rest?

Dr. Mary Dan Eades: In that regard, I would even come down more strongly that protein comes first. On a plate of food, it’s got to be the center of the plate, got to be the cornerstone of a meal, and you put around it anything from nothing if you want to go that extreme to whatever amount of carbohydrate in fruits and vegetables that your metabolism can withstand at that point, and that may be different at different times. It’s going to be different for people, but the amount of protein that a given lean body mass needs is not going to change, they need that much. You can stop with just the protein if that’s as far as you want to take it. Just keep the carbs low, eat whole, natural foods. Most of what we said in Protein Power, I think we’ve changed less on the protein part of it than we have on maybe the fats part of it and what fats would be the healthiest. We both knew that saturated fat was okay, but we didn’t say it out loud a lot in the book.

Dr. Eric Westman: There’s a lot of confusion today about protein and its effects on the body. I think one of the most common questions I get is the effect of protein and carbs on insulin. How do you look at the relative effect of these macros on glucose and insulin, how do you see that today?

Dr. Michael Eades: I see it as the whole idea being that it’s not a push phenomenon, it’s a pull phenomenon. Protein can convert to glucose, the gluconeogenic amino acids, and protein can convert to glucose; that’s what happens during gluconeogenesis. Protein can convert to glucose, but it’s not a push phenomenon. You don’t cause it by eating more protein; it’s a pull phenomenon, you pull and get into action if you need more glucose. You’ve got to have a certain range of glucose, and if it drops low and you don’t have anywhere to get it because you don’t have any carbs or your glycogen levels have diminished and you need it from protein, then you pull it from protein by taking a lot of extra protein. You don’t push it.

There was a great study that I stumbled across 20-30 years ago that was done back in the 1930s at the University of Michigan where they took these medical students, actually, and that was a question that they had. They fed them a huge amount of meat and the glucose didn’t change at all. They determined even way back then that you do not get to high blood glucose levels by eating protein. There was another nice study about that a few years back that showed the same thing: you’re not going to push it, it’s a pull, so I never worry about that but for some reason, somebody went out and started that rumor. Now all the people worry about that but I don’t think it’s a worry at all. That is a worry with type one diabetics because they do have a problem where it can be a push phenomenon there so they have to cover it with insulin. People who don’t have type one diabetes in my view don’t have to worry about it at all.

Dr. Eric Westman: Internet keto has confused things. Do you have to calculate macros and has all this stuff been helpful or has it gotten us off track?

Dr. Mary Dan Eades: I think for people who need to overanalyze and over-measure things it’s probably wonderful because it’s measurable. If that helps somebody stick to something and if they need that, that’s okay but honestly, you can hand them “Page 4” and if they’ll do it it’s going to be fine.

Dr. Eric Westman: The method we use goes back to the Banting diet. It’s sad to see a lot of medical people conflate what we teach with the ketogenic diet for epilepsy; they’re very different. We don’t focus on macro counting and all that. There were no apps! Many people are concerned about that and wonder if they can do the carnivore diet. I’m curious – is there really anything in the vegetable matter that’s not in the animal matter that you might eat?

Dr. Mary Dan Eades: You could get by just fine and not become deficient in anything on a carnivore diet that has plenty of fat. You do need plenty of fat; you need about 70/30 or maybe 80/20 fat/protein if you’re just going to eat meat. You will use that protein to make blood sugar out of it. It’s more for variety I think than anything else. People have this notion that there are all these fabulous things in plants, and there are, but a lot of them aren’t even available to us because they’re bound. You can do just fine without them.

Dr. Michael Eades: Getting back to your original question that you ask a lot of people: “What are we made of?” When you’re on a carnivore diet, you’re eating 100% what we’re made of. I explain it to people. You really can get by with it nicely. I do it every now and then. The problem with it is it just gets a little bit boring and I haven’t tuned my taste enough to where I don’t want to eat anything but meat. But when I do it for a while I feel better, I sleep better – everything seems to get better.

Dr. Eric Westman: If you’ve reversed a serious medical problem by not eating vegetables, you’ll have more of a reason to try it. It’s fascinating to see.

Mike, your story was one of personal use of the diet to find it. That’s pretty common. There’s a young medical student at Harvard now, Nick Norwitz, who fixed his own ulcerative colitis. I don’t think he’s gonna say carnivore is boring because there’s nothing worse than a severe case of ulcerative colitis.

Let’s get into how much protein. Can you eat too much protein so that you can’t absorb it all in one meal?

Dr. Mary Dan Eades: You can only make use of a certain amount of protein synthesis, and beyond that, it’s just going into the amino acid pool and maybe not be used right away, but, you’ll absorb it, and you can use it. It’s so satiating, particularly if it’s fatty protein, that it’s hard to eat too much of it. If you just eat to satiety, you’re probably getting about the right amount that you need, and you shouldn’t worry about it.

Dr. Michael Eades: The cohort that I always think of in terms of protein consumption or excess protein are bodybuilders because they eat enormous amounts of protein, vastly more than any of us would ever think about eating. They do it regularly. I always say to people who wonder if protein causes kidney problems, whether there are lines of bodybuilders at the dialysis centers. It doesn’t bother their kidneys. They’re able to process it just fine. There may be a limit on the amount of protein you can eat but I don’t know what it is.

Dr. Mary Dan Eades: There may be a limit on lean protein. Someone was put on a very lean meat diet, and he was getting so much protein and so little fat that it made him upset his GI tract, and had some issues there. He said to them, “You’ve got to give me more fat.” It’s about the balance more than it is about protein count.

Dr. Eric Westman: A question from our audience: “Is it okay to have three scrambled eggs and one and a half scoops of unflavored protein isolate in water for breakfast?

Dr. Mary Dan Eades: Sure, if you don’t want more eggs.

Dr. Eric Westman: Another question: “Wanting to preserve as much lean body mass as possible as my wife and I age. Should we err on the upper side of recommended protein levels?”

Dr. Mary Dan Eades: Absolutely. Your lean body mass is like your retirement account. The bigger and more robust your lean body mass, the more gracefully you’re going to age, the healthier you’ll be, and the stronger you’ll be both physically and cognitively and the longer you’ll live.

Dr. Michael Eades: Yeah, it correlates with longevity and it’s really incredibly important. It’s difficult to do. 30 (grams of protein per meal) is a rough break point and every year and decade it gets progressively harder to do. You can lose muscle really easily if you’re inactive, you can lose it easily if you’re hospitalized, so it’s always good to have a little bit extra. The only way you can maintain protein or muscle with age is to eat good quality protein, mainly animal protein, and do resistance exercise. If you do that, you’re gonna have your muscle and bone mass be as good as it can be.

Dr. Mary Dan Eades: The lean body is not just muscles either. Lean body is organs, your ligaments, and your bones.

Dr. Michael Eades: Your bones are built on a protein template so you need to have protein even for your bones. There’s almost nothing more important as you age than maintaining your lean body and building your muscle mass. When that’s gone, it is incredibly difficult to get it back. When people lay in hospital in bed for six or seven days languishing because they’ve got pneumonia or whatever, it takes a lot out of them. Not just the disease but the muscle loss from inactivity. It’s so important to have that reservoir as you get older. The only way you can do it is to keep your protein intake up and do resistance exercises.

Dr. Eric Westman: The next question is, “Are there any types of cancers that shouldn’t be using a carnivore diet to treat it or as an adjunct or once you’ve been diagnosed?”

Dr. Mary Dan Eades: There probably are, but I can’t tell you off the top of my head. I don’t really know.

Dr. Eric Westman: I mean, the main thing you want to do is keep insulin low.

Dr. Mary Dan Eades: Cancers love sugar. They grow on sugar. They’ve lost their ability to respire. They ferment sugar. If you keep that away from it, keep your blood sugar low, feed yourself with fat, turn it into ketones, and let your brain, your heart, and everything run on ketones, then you starve the cancer. That’s the theory behind it. I can say for my part, if somebody told me I had cancer, the first thing I’d do is go on a very low-carb diet. I would immediately do that. I live on a pretty low-carb diet anyway, which I hope is to keep me from ever having it. I don’t know if that’s true.

Dr. Michael Eades: It’s a complex and tricky thing. If I did come down with cancer, I would put myself in the hands of somebody who’s really skilled in treating it with the ketogenic diet because there’s a lot more to it than just, “Oh, I got cancer so I’m going to go on a ketogenic diet and live forever.” There’s a lot more to it, a lot of nuances that have to be dealt with.

Dr. Eric Westman: It’s one instance where you might want to measure the blood ketones. There is so much to learn about that. Cancer is such an insurmountable fortress. In fact, when Jeff Volek moved to Ohio State they allowed him to choose the topic he wanted to study. He’s studying a lot of cancer. It’s such a tough problem to fix, but they’re looking at it. I’m humbled by just how difficult cancer is as a disease. I’m much more cavalier about reversing diabetes and obesity.

Dr. Michael Eades: I do think that cancer is a metabolic disorder and not just a genetic disorder. Treating it that way will probably have a lot more success. But there’s a whole lot of work that’s still left to be done to really pinpoint exactly what.

Dr. Eric Westman: Here’s a quick one: “Is keto or carnivore best for weight loss?”

Dr. Mary Dan Eades: Honestly, probably the carnivore diet will get you there a little faster if you stick with it. If it’s okay for you, I think it truly is probably faster because it’s lower in carbs.

Dr. Michael Eades: One of the things I came to a long time ago, I see the vast engine of weight loss is carb restriction. You can do all kinds of different things, but it’s the carb restriction that does the heavy lifting. You can fiddle around with the types of fat you eat, fiddle around with everything, but it’s the carb restriction that does the work. In our practice we had all our patients fill out diet diaries and they would come in every week, we got a review, especially if they were having a problem. Some people went on awful diets but what you consider in terms of what they eat is if they restrict the carbs, then they seem to do well. To me, that’s the big engine and all these other things are the trim tabs on the plane.

Dr. Mary Dan Eades: When we wrote the Protein Power Lifeplan which was the follow-up book to Protein Power, in 2002, we got at these three different, what we call, levels of commitment to doing the diet. The very first one was like Page 4. You get enough protein and fat, just cut the carbs; I don’t care what else you do. We had the real extreme end which we called the purists, the people who needed a very low-carb, pure diet. Then there’s the people in the middle which we called “diligent.” They did a pretty good job keeping their carbs down but they did like coffee and wine. That was the three levels of commitment to go and they all work.

Dr. Eric Westman: Carol asks, “In your book, Protein Power, you say that some people are sensitive to arachidonic acid in red meat and egg yolks. My blood pressure is being stubborn. Are there changes to your advice to determine whether this could be my problem?”

Dr. Michael Eades: We’re working on a redo of Protein Power called Protein Power 2.0. It’s an upgrade. We went back through it and decided to rewrite the thing, so we’re in the throes of doing that. The one chapter that I would definitely get rid of is the whole chapter on arachidonic acid. I think it didn’t stand the test of time. At that time, I was under the influence of Barry Sears. We were friends with him for many years and he was always very persuasive about that and we were always on the lecture circuit with him at the same time and so we would always go back and forth about it and listen to his lecture a million times. I thought it sounds reasonable, but the whole thing is that all these pathways are either inhibited or enhanced by insulin and glucagon. You can change all that just by lowering your insulin and increasing your glucagon. You don’t have to screw around with the fatty acids and all that stuff for the right mixture of this and that to get the proper end product. That’s a chapter I would ditch.

Dr. Eric Westman: This is the kind of advice from doctors who are in practice who realize that you’re not taught everything in books. For internet influencers, it doesn’t really have to work. It only has to work for some people. The idea of trying trial and error within reason is certainly something that any clinical practitioner would offer. I love it.

Jennifer asks, “I eat 120 grams of protein daily, yet my blood work shows low protein. How can I better absorb protein, and what should I think about?”

Dr. Michael Eades: I wouldn’t think it would be a matter of protein absorption myself.

Dr. Eric Westman: I’d check in with your doctor on that one. If someone comes in with something that I’ve never heard before, I think to myself, “No, it’s something else. It’s not the diet doing it.”

One thing that caught my eye in my React videos is the idea that the ferritin level can go up in people who eat carnivore, specifically. Although I’ve never systematically checked in my patients, the carnivore or the ferritin levels. What do you make of that? What I’m thinking is that it really doesn’t mean you have iron overload.

Dr. Michael Eades: I wouldn’t think so. What I would check first would be a gene panel and see if they’re H63D heterozygous, because people then tend to have elevated ferritin levels. That’d be the first thing I would check.

Dr. Mary Dan Eades: The other thing to remember about ferritin is that it’s very volatile. If you’ve had a cold or a little infection and you get your ferritin levels checked, they’re going to be through the roof because your body sequesters iron in the ferritin granules to keep it away from the bugs that are trying to make you sick. Even with just a virus, a stomach virus, or a head cold, your ferritin is not going to reflect your actual stores of iron. That’s why you probably need to get not just the ferritin but a total iron-binding capacity, the whole panel, so that you can make sense of it. Then you can see, “Oh, this iron’s been pulled into the ferritin granules to get it away from whatever invader was trying to enter.“

Dr. Eric Westman: That’s just a phenomenon where most doctors don’t know what to do.

Dr. Michael Eades: One of the things that I thought about a while back is that giving blood is good for you. People who give blood seem to be healthier. I don’t think giving blood hurts you. It’s going to help a lot of other people and if you do have a little bit of an iron problem, that’s going to solve it. When I got to thinking about that, I thought how in ancient days, in our past with the ancestors when we cut our genetic teeth and we’ve just been the way we are now for a blank of time, our genes have been laid down over millennia. We ate a lot of meat and didn’t get a lot of carbs. We had to have a way to store and cling on to the iron because we got cuts, we got disease, we got parasites – those were all going after our blood so we had to develop this system to really cling onto it. When I thought of that, I went back and started looking at some papers. If you go and you look at orangutans, you look at all these animals in the wild, they all have parasites. So there’s no reason early man wouldn’t have had parasites. Now, since we don’t have parasites, we’ve got clean water and live in sanitary conditions, it’s probably a good thing to give blood. That’s the way I reasoned it out. When you look at the data, it appears that that’s the case. In my view, that’s the reason. So, I would give blood if I had elevated ferritin, and I checked everything out, and there didn’t seem to be a problem.

Dr. Mary Dan Eades: Just give blood even if you don’t have elevated ferritin and if you’re not low because it’s the one thing you can do that’s always a life-saving thing for somebody else. I think it is a renewable resource.

When I do think about the carnivore, tell me if I’m wrong on this, Mike, I believe I remember that the iron is not absorbed in the intestine if their stores are replete.

Dr. Michael Eades: Yeah, you can regulate your absorption. You can’t regulate your absorption of inorganic iron. So if you get iron-fortified foods – and that’s a problem we have – but back in the day, people didn’t get enough meat, so they fortified all these things, and they continue to fortify them with iron. You can’t really shut that off, but you do have some control on whether or not you absorb organic iron.

Dr. Eric Westman: What do you think we have learned about the protein and fat ratios, now that we know low-carb is a good idea?

Dr. Michael Eades: I don’t think about it. If you have a good chunk of meat you’re gonna be fine.

Dr. Eric Westman: I love it! There’s a lot of obsession over fine-tuning.

Dr. Mary Dan Eades: If you get enough protein that is enough to nourish your lean body mass, and it’s going to be at the high end of the range if you’re older for sure. You need to get fat. The rest of what you eat is to satiate. Have enough calories, mainly fat calories, that you feel satisfied with that meal. This is infinitely adjustable to your own needs. For most people it’s just give me the steak, salad, and green vegetables.

Dr. Michael Eades: What we need to survive is vitamins, minerals, and nutrients. Protein is a nutrient. We need calories just to fuel our activities. You’ve got to have the protein because it does something for you. Fat and carbs are basically just calories, fuel for the engine. Protein is a nutrient and that’s why it’s so incredibly important that you get the right amount.

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