Episode 32 - Dr.Feinman gives the 2017 Low-Carb State of the Union

by Break Nutrition | Podcast

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Show notes:

  • Professor Feinman’s blog https://feinmantheother.com/, Twitter @DrFeinman and book The World Turned Upside Down
  • Raphael asks Dr.Feinman what the Nutrition and Metabolism Society is all about
  • Prof Feinman and Raphael agree that getting original, forward thinking scientists to form a united front on an important matter is like herding cats
  • Prof Feinman likens Gary Taubes’ book Good Calories Bad Calories to Thomas Payne’s pamphlet Common Sense that helped push the American Revolution forward
  • Raphael summarizes the results from his MSc thesis that suggest MCF-7 breast cancer cells do in fact have a (fermentative) Warburg phenotype. These results contradicts those of established researchers like Moreno-Sanchez or Michael Guppy
  • in vitro, acetoacetate (a ketone) seems to inhibit the metabolism of muscle cancer cells according to Prof Feinman and Eujene Fine’s results, possibly due to increased mitochondrial uncoupling
  • Raphael and Prof Feinman use the same analogy to explain what it means for a cell to be uncoupled; it’s like putting a car in neutral and pressing down on the accelerator. The car uses energy, heats up, but doesn’t move
  • Prof Feinman says the difference between science and medicine is that it’s easier to say “I don’t know” in the former whilst medicine often requires us to make pronouncements or take action with much less certainty
  • Raphael asks Prof Feinman about what he thinks of exogenous ketones and where their use is appropriate or not
  • Raphael mentions Dr.D’Agostino’s quite positive view on exogenous ketones
  • Raphael brings us how we should define nutritional ketosis (in terms of mmol/L of beta-hydroxybutyrate) so that Prof Feineman can share his thoughts on the matter
  • Raphael harps on the importance of using an evolutionary framework to think of question about nutrition
  • Raphael asks Prof Feinman what he thinks of Amber O’Hearns statement in episode 28 saying “We are one species and we’re much more likely to have variation in the way that we break down rather than in the way we are healthy
  • Prof Feinman says the benefits of fiber have been greatly exaggerated. Raphael strongly agrees
  • Prof Feinman is not actually a low-carbohydrate diet advocate (but don’t think this means he doesn’t think they’re a good dietary option)
  • Prof Feinman we may not be able to really ‘count calories’ at all (or to any decent degree of accuracy). He suggests that dropping carbohydrates from one’s diet is a good way therapy to lose weight (or fat, more precisely).
  • Raphael asks Prof Feinman what will it take to get low-carb diets the respect they deserve given the excellent data supporting its use for many health and ill people
  • Prof Feinman mentions that meta-analysis and reviews treat scientific data like a financial balance sheet and that this makes them de facto non-scientific. A strong statement that Raphael agrees with
  • Prof Feinman points out that non-experts (gasp!) that we might call individual end-users, contribute mightily to the state of the science by communicating their self-experiments and ‘armchair research’
  • Raphael mentions his scientific hero the physicist Richard Feinman and Prof
  • Raphael asks Prof Feinman a question Richard Morris of @2ketodudes had
    • Could statins increase (or decrease) ketogenesis?
    • Can HMG-CoA diffuse across the mitochondrial wall or be transported into mitochondria?
    • Given that statins inhibit HMG-CoA reductase, could it then accumulate in the cytosol? Would that then increase HMG-CoA in the mitochondrial matrix and thus increase ketogenesis?
    • The question stems from observing how circulating ketones dropped about 6 months into keto (which is not strange in and of itself) but it was around the same time the statin was stopped. Also, acetoacetate is made from HMG-CoA
  • Prof Feinman sees statins as an emergent property of sorts of the low-fat movement
  • Prof Feinman is inclined to believe physicians who report seeing statins help patients having suffered a secondary cardiovascular (CVD) event. Yet he cautions us that physicians cannot tell you if statins are effective in preventing primary CVD event and that these drugs have serious side effects
  • Prof Feinman says that saturated fat, across the board, are not a health risk in the absence of additional variables. Could it increase risk with additional factors mixed in? He doesn’t know and doesn’t think others should say they do at present
  • Prof Feinman points out that the US dietary guidelines say that ‘cholesterol is no longer a nutrient of concern’
  • Prof Feinman likes to mention Max Planck’s famous quote “Science advances one funeral at a time”
  • Raphael asks Prof Feinman what his favorite paper is. The prof cheekily mentions a paper asking the question “Does the inertia of a body depend on its energy content?” which is in fact Einstein’s famous E = mc2 paper – and Raphael embarrassingly responds with “I don’t think I’ve heard of it”!?Prof Feinman does mention Volek’s papers and the ones he collaborated with Volek on.


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