Joe Rogan - Dr. Rhonda Patrick on the Carnivore Diet

Now, before the podcast started, you were telling me that you wrote a 30-page paper on the carnivore diet. It's not a paper. I definitely spent a lot of time- With 30 pages. I thought about it for a long time, and yes, there's 30 pages of thoughts and references. Were you stunned that this became, I mean, this is a very recent thing, that people are just eating meat. At first, when I was, I think Dan told me about it a couple years ago, and I thought there's no way. I was like, I just ignored it. It was like, I don't have time for that. I definitely dismissed it when I first heard about it, but it's definitely been something that has gained a lot of traction. Does it disturb you that it's gained traction? Well, I definitely have concerns. I think that the most important question really is what is attracting someone to try such a very restrictive diet that potentially could be dangerous without published evidence or any sort of long-term studies and things like that. I think that the first question really is, well, why are people doing this? Looking on the internet and try to read about people's anecdotes, it seems as though a lot of people are drawn to it because they have some sort of autoimmune problem. They try this diet and it improves their autoimmune symptoms. That seems to be a real common theme, at least if you look in the blog of spears and stuff like that. That's a good place to start where it's like, what are people doing this for? That's an important question. Further reading about this diet is sort of think about what's going on. It's really important when you have something that leads to an effect to understand the mechanism, because the mechanism is what's leading to this effect. If you can do something that's potentially not so dangerous or risky, then understanding the mechanism will help you because then you can find other ways to do it. If you look at published studies on people that eat low-carb, high-protein diets, what's pretty common is that there's changes that happen in a variety of different endocrine factors like you're less insulin, that's changing your satiety and hunger hormones, leptin and ghrelin, and people become more satiated and they actually eat less. This has been shown in multiple studies. People actually eat less when they're having a higher protein diet, which makes sense too because protein is more satiating as well. There's also been studies on what's called food habituation, where basically habituation is when you're constantly exposed to the same stimulus, you sort of have a decreased response to that stimulus. There's been intervention trials where people are given the same food every single day, both non-obese and obese people, versus people that are given the same food once a week. The people that are given the same food every single day, they start to eat less calories. They start to eat less, naturally start to calorific restrict themselves. It's kind of like a dietary monotony sort of thing. If you read and the people out there on the blog talking about this diet, they say, I'm eating less, I only eat twice a day, I'm fasting. People are talking about that as well. I think there's published evidence to kind of explain that and also there's people saying, yeah, I eat less. That's an important point because one thing that's really known to affect autoimmunity is caloric restriction and fasting. It's probably one of the most well-known technologies that you can intervene and have improvements in autoimmune disease. Some of that has to do with the fact that you can sort of reset your immune system. There have been animal studies and human studies, a lot of this done by Dr. Walter Longo at USC. He's done some prolonged fasting in animals and also there's been sort of like a fasting mimicking diet done in humans, which kind of a very low calorie diet that sort of is meant to mimic fast. Those have shown that you basically kind of cross over because fasting is a type of stress. You cross over into this stronger stress response where you're not only like cleaning away all the gunk in the sides of the cells. People talk about autophagy a lot when they're talking about fasting. You clean away things like damaged pieces of DNA, protein aggregates, things like that. Mitochondria that are damaged get cleared out. You also sort of start to clear away entire cells through a process called apoptosis. In animal studies, what's been shown is that if you do, for example, a 72-hour fast, you can clear away about 30% of the immune system and replenish it with brand new healthy immune cells. Literally, organs shrink during the fasting and then they re-expand because you're activating stem cells and you're basically replenishing all your damaged old cells with new ones. Well, Volter has shown in these animal studies also autoimmune cells tend to be selectively killed off and replaced with non-automune cells. He's also done a clinical study, a pilot clinical study with people with multiple sclerosis doing this fasting mimicking diet for one week. Their symptoms improved. So a ketogenic diet was done side by side and ketogenic diet also improved symptoms of autoimmunity. So those both were done in humans. So I think that understanding that some of these mechanisms that are at play and that fasting itself and caloric restriction both have been shown to improve autoimmunity, you may be tapping into something there by eating less. That's one possibility. In addition, there's been clinical studies in humans that were done, they were basically fasted for 24 hours every other day for 15 days. So they had like a total of seven days of fasting. And these were also people with multiple sclerosis. And there's profound changes in the microbiome that started happening. And this was in line with basically having a lot of anti-inflammatory cytokines basically producing immune cells that are really important for preventing autoimmunity called T regulatory cells or things like that. So that's another really important thing to consider is the microbiome because the microbiome has been linked to autoimmunity in multiple studies. I mean, it's been linked to arthritis, it's been linked to multiple sclerosis, it's been linked to other diseases like Parkinson's, which is not really autoimmune. And the point of this is that, again, understanding mechanism and realizing there's other potential factors that could be leading to an effect. It's actually the changes in the microbiome are really important because there's actually been a few animal studies which have led to phase one, phase two and phase three clinical trials that have been done in humans. So humans with multiple sclerosis were treated with minocycling and antibiotic. And they've been basically the antibiotic was shown to improve symptoms of multiple sclerosis. And because there's good bacteria and bad bacteria that have been linked to autoimmunity. And getting rid of bacteria, the bad bacteria is going to probably lead to improvement. And that's what was shown first in animal studies and then in human trials. So humans taking with multiple sclerosis taking minocycling for two years. So basically they had improvements to delay the onset progression of the disease. But then after two years, those improvements went away. Probably because you're wiping out the microbiome and eventually you're also getting rid of the good bacteria and so things are going to catch up, right? So you're not just, you may be getting rid of some of the pathogenic bad bacteria with the antibiotics, but eventually you're also getting rid of good stuff. So long term, you may not have those same improvements. And that's very interesting. I think it's a really important point to understand with something like changes, very profound changes in the microbiome. When it comes to someone just eating meat. So one thing to keep in mind with the microbiome is that basically bacteria really are good at adapting to their environment. That's why antibiotic resistance is such a big deal. And when you, there's been human intervention studies, when you take a human that goes from a high fiber diet to a low fiber, high protein or vice versa, you get changes in their gut microbiome that happened within 24 hours. So within an hour, you actually start to have doubling of populations of bacteria. And within 24 to 48 hours, you actually start to lose other. So basically other bacteria start to die off. And this is at the species level. It's really hard to change the phyla. The phyla is more linked to long term dietary patterns. Eventually you can change phyla as well. But it's been shown that people that go from a more high fiber to a high protein diet, they have changes in their microbiome. And these changes are a lot of the microbiome bacteria that are fermenting a variety of fermentable fibers start to leave. And you actually start to get bacteria cropping up that ferment amino acids. So the amino acids, simple sugars, fats, those are mostly absorbed in this small intestine, but some of them make their way into the large intestine. And there's a whole group of bacteria called the putrefactive bacteria. And they ferment amino acids. And some of these species of putrefactive bacteria have been linked to colon cancer. They're much higher in colon cancer patients. Several studies have shown causal links where they can basically aggressively cause a polyp to form a tumor. And that's because these bacteria are making things called putrissine and cadaverine, which are damaging their genotoxic agents that damage the DNA inside your colon cells. And so people that are typically eating like an omnivore type of fiber, where they're eating protein and they're also eating fermentable fiber, if they're eating the fermentable fiber that's facilitating the growth of lactic acid producing bacteria, that limits the growth of putrefactive. So if you're at Bifidobacteria, Lactobacillus, S. mutins, S. thermophilus, those strains of bacteria are lactate acid producing bacteria, which you'd be getting if you're... You'd be facilitating the growth of if you're eating plants with fermentable fiber. You're going to limit the growth of putrefactive because they can't grow with lactic acid. So it's not a huge, huge concern, but the question is what happens when you're only eating amino acids, when you're only getting amino acids? So is there a long term? So if you're keeling off potentially some of this pathogenic bacteria and you're having this effect, a positive effect, what's going to happen long term? It's not known. I mean, this diet hasn't really been studied at that level. There have been a few people that have anecdotal stories about doing it for 10, 20 years that are online, but it's very difficult to track. I mean, you have to take them at their word for it. They've eaten nothing but meat for 20 years. They feel amazing, but there's not very many of them. There may be more out there, but in terms of what I've come across, articles, just social media profiles, people who talked about the positive benefits of it. It seems to me that most people that are talking about the positive benefits are talking about it within a one and two year window. That's what we're really dealing with a lot of. Dr. Sean Baker, who is probably the leading proponent of it or one of the poster boys of it, along with Jordan Peterson and his daughter, Michaela. Jordan Peterson and his daughter, Michaela, they're different in that they were dealing with severe autoimmune issues. His daughters had two joints replaced before she was 18. Well, she had her ankle replaced before she was 18. I think she had her hip replaced shortly after that. Jordan has had some pretty severe autoimmune issues and depression. With both of them, those things were cleared up. As you've talked about multiple times before on this show, depression has been linked to disorders in the gut biome. This is something that you feel like may be contributing to this, as well as both of them also got very lean. Jordan lost a ton of weight. He's back to the weight that he was when he was 25 years old. I've eaten with him and the guy eats. He eats a lot, but it's a lot of meat. He'll eat like a 30-ounce steak, which is just crazy. It's a crazy amount of meat. I don't know how many times he's doing that a day. I don't know. Yeah. I mean, I'm going back to the point. Understand that mechanism is important, and there's a lot of potential confounding factors. That, with any anecdotal data, is extremely important to consider. People can't even ... Scientists, nutritionists, just people can't even agree on the best diet because a lot of these epidemiological and observational studies, which don't establish causation, have an enormous amount of confounding factors. It's so hard to control for that. Just as a perfect example, we've talked about this before in the podcast, but the vegetarian versus people that eat meat. One of the really large studies that was done, and Dr. Balto Longa was part of that study, looked at all-cause mortality and cancer mortality, and it was lower in vegetarians, but they decided to take the meat eaters and say, okay, what about within this group? The people that are healthy meat eaters are people that are not unhealthy. They're not obese, they're not sedentary, they're not smoking, they're not excessively drinking alcohol. Those people, when they took out those confounding factors, the meat eaters had the same mortality as the vegetarian and same cancer. Confounding factors are so important, and with anything with anecdotal, you have people that are exercising like crazy. Exercise has also been shown to change microbiome, independent of diet, in a positive way, where you're actually producing more of the bacteria that are producing things like lactic acid. Fasting does the same thing, and so you have people that are fasting. It's not like you can't do other things if you're on that type of diet to help with the microbiome, but I think, again, if there's a way that you can get these benefits without having to do something so hyper restrictive, and we'll talk about-I have concerns for that, we can definitely get into that. Why not try that? The thing with, for example, doing a prolonged fast once a quarter, once every couple of months depending on how severe your issues are, there's been benefits shown with that, like in aging. People that have been put on this fasting mimicking diet, they have improved biomarkers of aging, they increase their lean muscle mass. Like I said, in animal studies, you can't directly translate the animal studies to humans because rodents have a really fast metabolism, and if you fast them for 48 hours, they lose 20% of their body weight, where humans only lose like one or two percent. That's clearly- That's crazy. Yeah, so you can't, obviously you can't completely translate everything that's done in fasting and rodent to humans, but they're definitely-organs are shrinking, and then literally regrowing after the fast is over. It's like this rejuvenation process. It seems as though selectively damaged cells are killed. In fact, there's a whole Dr. Balto Longo showing that cancer cells are really, really susceptible to dying when you do a prolonged fast or even a fasting mimicking diet. He's shown this in animal studies, and he's done a couple of clinical studies where patients with cancer were treated with standard of care, but before their standard of care treatment, they were fasted for up to 72 hours. What he's shown in animal studies happens is that because the fasting is a type of stress, all your healthy cells increase all these stress response pathways. They make more heat shock proteins. They're increasing antioxidant production pathways, anti-inflammatory. They're doing all this really good stuff in response. Cancer cells can't do that. They're screwed up, and so they can't activate those stress response pathways, so it ends up killing them. What you end up happening is that when you're giving another genotoxic stress like chemo or radiation, your healthy cells become more resistant to the damaging effects of the radiation and the cancer cells become more sensitized to the death. What he's shown in his pilot studies in humans is that basically the humans that were treated with the standard of care, I think it was chemo, and also fasted, they had less neutropenia, which is the loss of neutrophils, which is the side effect because you're losing normal healthy cells. They had less of that happening, less myelosuppression. The point is that I think if you can find a way to get positive benefits without having to do something so risky and potentially dangerous and unstudied, I mean unstudied in a really scientific way, controlling for compounding factors and all sorts of long-term, just all that is really important. This just comprehensive breakdown that you just did is something that's really lacking from a lot of discussion of this carnivore diet, and from the proponents of it, it's almost like a lot of them are going into it blindfolded. They're like, look, it seems to be working, so I'm just going to stick with it. Again, when you're talking about most people's cases, you're talking about one year, maybe two years, sometimes even less, where they're having these benefits. As you're saying, it's entirely possible that they're setting themselves up for some potential long-term damage. It is. It is definitely possible. Again, at the end of the day, there's no data. There's no data, so you can't say for sure. There's no data, but I have concerns, and we can talk about those concerns for sure. I would like to. The thing is understanding mechanism. Like you said, going in blindly, you have a hypothesis, and it's like, okay, your hypothesis is all plants are bad. That's what I keep hearing. It's like, well, that's a hypothesis, but what about all the other things that are potentially happening while you're doing this diet? Even less, you're fasting more, your microbiome's changing, dramatically changing. Those things all have been known. Multiple studies have shown humans and animals, mechanistic detail, to have benefits on autoimmunity, on aging in general, on brain function, all sorts of things. Mechanism is so important. You have to realize that's the whole basis of science, understanding how the world works around you, understanding how your body works, mechanisms. You have a hypothesis, and I understand it's like someone experiences something positive. It's like, well, this must be, this is it. This is the end all be all. You also have to realize, shit's complicated. You got to understand the mechanism, and you may be doing something long-term that potentially, it really hasn't been studied. Yes. Well, that was one of the ... I had Jordan's daughter, Michaela, on, who's had some pretty dramatic results from this carnivore diet, but she's giving, essentially, nutrition consulting to people, but she doesn't really have a background in it. She doesn't have the information that you just distributed. What you just said to all these people listening, and the way you're describing the mechanisms and the benefits of fasting, and all these different various things that are happening inside your gut, and all these different things that are happening with healthy cells, and damaged cells with fasting, and that this is mimicked by this restrictive diet, and that this is all absent from the dialogue. This is all absent from the ... This is one of the things that's disturbing, the most disturbing for me. It's like, I get that they're seeing positive results. I don't know why I'm going to deny that they're receiving, but when they start saying, plants are bad, and there's ... My friend Chris, he's always talking about the war on carbs. He's also got Chris Bell. He's got autoimmune issues as well. He's had both of his hips replaced before he was 35, and severe arthritis, and he is leaner than he's ever been, and benefiting greatly from this carnivore diet. He talks about it like he uses hashtag war on carbs, and he doesn't eat salad. He won't eat greens. He thinks greens are bad for you. I'm like, man, I'm not sure that's correct. I think it's so important what you're saying. There's a researcher online that I've been in contact with. His name is Kevin Bass. Bass or Bass, B-A-S-S. Not sure how to pronounce it, but he also brought up this possibility that it could be calorie restriction that these people are dealing with, and that this is essentially some of the same mechanisms that are the positive reactions from fasting that you're dealing with here. I'm very happy that you're saying the same thing. Yeah. I think that is one very strong possibility, and that is something ... There's lots of hypotheses here, and given all the data, and there's lots of positive data about eating plants as well. It's really hard. That's one hypothesis, and that seems to be the one everyone's gravitating to. If someone's also wanting to reduce their glycemic load and all that, eating just a modified paleo diet ... I eat something like a modified paleo diet, where it's like I'm eating fish, I'm eating meat, poultry, and then I eat a lot of leafy greens and cruciferous vegetables. Now, you can do nuts, or you can do a ketogenic diet. I just talked about the study that was done looking at the fasting mimicking diet in humans with multiple sclerosis. There was published in the same paper. There was a study that put patients on ketogenic diet for, I believe it was three months, and it improved symptoms of autoimmunity as well. Was it comparable? Yeah. The improvements? Yeah. Interesting. So, the modified ketogenic diet is also ... There's also concerns with that. Not everyone responds very well, and the micronutrient deficiencies have been a concern, but you can actually eat a lot of ... Vegetables. Vegetables. And good ones that are low in glycemic. So, my concerns ... Exactly. My concerns are much, much less. It's been studied a lot more. At least, there's been lifespan studies in animals on ketogenic diet, where it's improving the way they age. It's improving their cognitive function, brain aging, extending their lifespan. If people are looking for, in addition to wanting to help with their autoimmunity issues, if it's like, well, I also just don't want to have a lot of insulin response. I want to lower my glycemic levels and things like that. It seems like a much better option than doing something completely unstudied. I think that's a really good place to start, and obviously not disregarding everyone's anecdotes. And, of course, there's also the placebo and nocebo effect, which are very real. I mean, extremely real. It's why a lot of drugs don't ever make it to market, is because they can't beat placebo. People think they're going to get a positive response from something, they can. And the opposite is true. People think they're going to get a negative response from something, they can.