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0:22

So what's the weirdest diet you've

0:24

ever been on? I

0:27

have only ever adhered directly

0:29

to the Mediterranean diet or

0:31

a diet exclusively of sour

0:33

lollies and individually wrapped Easter

0:35

eggs. You're so sensible. So

0:37

sensible. How about yourself? Probably

0:40

best not admitted to, but

0:42

these days I do adhere

0:44

to Got

0:46

me reaching for my Mediterranean diet bell over

0:48

here. Yeah, and I must admit that I've

0:50

done all sorts of weird diets over the

0:52

years. Not too weird, but weird enough. Have

0:54

you ever done the carnival diet? a

0:56

version of it. It's

0:58

what we're actually being discussing because we've

1:00

covered it on our recent live

1:03

show as part of the World Science

1:05

Festival in Brisbane. Which you get

1:07

to listen to right now here on What's

1:09

That Rash? The podcast where we

1:11

answer the health questions that everybody's

1:13

asking. So

1:17

you're familiar with my favourite

1:19

artefact? I

1:21

need some help today. I've got bells.

1:23

We've got bells and I need three volunteers.

1:25

Producer Shelby, who you will have heard

1:27

of as well if you've listened to it

1:29

before, is going to hand out some med

1:31

diet bells for your bringing pleasure. Only

1:33

when we say the words, you know

1:35

the rules. I was

1:37

actually doing a recorded interview with somebody for

1:39

the health report and he brought a

1:41

bell into the studio hoping I'd see it.

1:44

I love it, it's catching on. We also will,

1:46

I need a couple of volunteers to

1:48

help read out some of our questions as

1:50

the show progresses. If someone in the

1:52

room would read us our first question. Hi

1:54

Norman, hi Tegan. Over the

1:57

past couple of years I have seen a

1:59

number of people migrate to a complete

2:01

carnivore diet, only eating animal

2:03

products like cavemen. From

2:05

my understanding, the carnivore diet

2:07

suggests fruits, nuts, seeds and

2:09

vegetables are poisonous long -term

2:11

to humans. I don't

2:13

know how someone can survive long term

2:15

without these things. Would you not develop

2:17

scurvy? I personally would find

2:19

this diet incredibly boring. What

2:22

puzzles me the most is that the

2:24

people I know personally who follow this

2:26

diet look the most energetic, fit, lean

2:28

and healthy I have ever seen them.

2:30

What are the health benefits and consequences

2:33

of this type of diet? Anonymous.

2:36

Big clap for... I've

2:42

got to know, is anyone in this

2:44

room on a carnival diet? Has

2:47

anyone tried it before? That's

2:50

called selection bias. How

2:53

many here are on the

2:55

Mediterranean diet? Have

2:57

you ever tried the carnival diet? I tried it

2:59

occasionally without realising what it was before in the

3:01

days of the ketogenic diet. I was trying to

3:03

lose weight and I went on a meat

3:05

diet. I felt terrible. Meat diet, okay. So I

3:07

think it would be useful for us to sort

3:09

of take a look at the day in the

3:11

life of someone in the carnivore diet. And I

3:14

don't want to, I mean, it sounds like

3:16

this is a pretty safe. So far, not huge

3:18

carnival diet fans here, but there are lots of

3:20

people who say they feel better on it. Shall

3:22

we have a look at what a day

3:24

in the life of a carnival diet would look

3:26

like? So this is just

3:28

a sample size of one, I

3:30

guess. But breakfast, bacon

3:33

and eggs, that feels fine,

3:35

right? Unless you're vegan, maybe. No

3:37

toast. So just about we have

3:39

background, almost no carbohydrates, very

3:41

high fat, like 60, 70 % fat and

3:44

the rest protein. All right. So

3:46

breakfast, I'm giving that like a

3:48

Six out of ten on my own

3:50

personal like appetizing this scale. What

3:52

do you reckon? Yeah,

3:54

we've got some bacon fancy.

3:56

Okay, what about lunch lunch

3:59

is Just just a big

4:01

old fry fan of ground

4:03

beef Yum, what's our what's

4:05

our macro breakdown here Norman

4:07

the macro breakdown is? On

4:10

the beef, but if it's lean beef

4:12

not too much fat, but a lot of

4:14

protein in there you know what I

4:16

really like about that pan of ground beef

4:18

is a complete lack of the Maillard

4:21

reaction, like not even a crispiness piece inside,

4:23

just brown. No. As

4:25

far as the eye can see. All

4:27

right, so that's lunch. We're feeling

4:29

pretty satisfied. Let's have some dinner. Dinner

4:31

is just some steak with salt. With

4:34

the fat still on. What

4:36

do you reckon? What do I reckon?

4:38

I reckon, you know, that's pretty high

4:40

in fat. It's got marble fats, probably

4:42

wagyu, looking at the marbling there. So

4:45

we're talking high fat, with a

4:47

protein. High fat, high cost also.

4:49

I think that would be quite expensive. Yeah.

4:51

So I feel like if all I was

4:53

eating was bacon, weeks for breakfast, ground beef

4:55

for lunch and a steak for dinner, I

4:57

might feel peckish throughout the day. a snack.

4:59

Eat a snack. OK, let's have a look. Just

5:03

a stick of butter. Yeah.

5:05

So some people on the carnivore diet will

5:07

put the stick of butter in their coffee.

5:10

Yeah. I've heard it. Yeah, the

5:12

bulletproof coffee thing. Bulletproof coffee. There

5:14

is one more slide, just part

5:16

of my carnivore diet. So

5:20

the carnivore diet can be a bit of

5:22

a strain. And

5:25

for those listening to watch that

5:27

rash, we just put up a photograph

5:29

of a toilet. A toilet, very

5:31

clean toilet, not having much use at

5:33

the moment. OK, break

5:35

it down, why please? Why is

5:37

this toilet so sparkling clean? Well,

5:39

it's sparkling clean because you're constipated and you never use

5:41

it. Kind of constipation

5:43

is one of the problems of the current

5:45

war diet. Because it's just zero fiber in

5:48

it. To the extent that some people say,

5:50

well, the solution for your constipation, why don't

5:52

you just eat more fat? Oh,

5:54

so it just slides out of you? How

5:57

does that work? Well, it

5:59

works just because the fat doesn't get absorbed. So

6:02

it just yikes. So your

6:04

scientifically hypothesis is probably correct.

6:07

So when we heard the question that was

6:09

read out so beautifully before, the kind

6:12

of claims that were made by the

6:14

friends of the person asking the question were

6:16

that these people were eating like cavemen

6:18

and that perhaps fruit, vegetables, nuts or

6:20

whatever had poisons in them. There's

6:22

sort of two claims there. Let's

6:24

talk about the cavemen thing first. What

6:27

did cavemen actually eat

6:29

and cavewomen? Well, cavewomen

6:31

is a really important

6:33

caveat here. So

6:35

it depends where you were. as

6:37

an early human and which

6:39

environment you were in. So

6:41

if you were in the

6:43

far northern reaches of the

6:45

world and a cold climate, you

6:48

probably did eat very few

6:50

vegetables and were mostly eating blubber

6:52

and steel. But for most

6:55

of the world, you had carbohydrates

6:57

and the women would go

6:59

out foraging for really quite complex

7:01

carbohydrates. The mystery is

7:03

why it took so long for agriculture

7:05

to develop, but they were pretty

7:07

good at finding complex carbohydrates, and

7:10

they had tools to pound them

7:12

and make them more digestible. So

7:14

every parallelity diet pretty much had

7:16

complex carbohydrates in it, just of

7:18

different kinds, depending on availability. The

7:20

thing that I find really interesting

7:22

about the idea of going back

7:24

to hunter -gatherer societies, and I

7:26

can see the logic, basically humans

7:28

were evolving for a million, two

7:30

million years to get to like what we would

7:33

recognize today, Homo sapiens. And then we've

7:35

had sort of a lot of change in the

7:37

last 50, 60 ,000 years. So

7:39

we actually haven't had that change. So

7:41

the human genes have not changed that

7:43

much. Exactly. It's our environment that's changed. Exactly.

7:45

And so we really evolved to the

7:48

lifestyles that we live in today is kind

7:50

of the question that I think underpins

7:52

these sorts of things. The thing that I

7:54

find really interesting is we actually have

7:56

quite a lot of information about how humans

7:58

lived before the agricultural. agricultural revolution. And

8:00

there's also still lots of hunter -gatherer societies

8:02

that still exist in the world today that

8:04

we can look at. And none of them,

8:06

as far as I'm aware, eat nothing but

8:08

beef and salt, which is what the most

8:11

extreme version of some of the carnival diets

8:13

are, partly because cattle

8:15

weren't domesticated. Paleolithic

8:17

Lee and the parts of

8:19

the world where cattle are like

8:21

bovine ancestors are from Places

8:23

like modern -day Iran. We have

8:25

really good evidence about what people

8:27

ate there back then like

8:29

you say it was quite varied

8:31

I also found a really

8:33

interesting article about pre -agriculture remains

8:35

in North Africa They found teeth

8:37

and bones and also Preserved

8:39

pieces of food in this cave

8:41

entrance in Morocco found sweet

8:43

acorns pine nuts pistachios oats and

8:45

legumes much more starchy

8:47

plants and fewer aquatic species than

8:49

the researchers expected to find

8:52

in that particular environment. And

8:54

the teeth, they were ground

8:56

down from eating the rough carbohydrate. And

8:58

had decay, showing that there were starches in

9:00

it. So there's these hints there that

9:02

there were carbohydrates in that diet, in that

9:04

site. We obviously also have Australian

9:07

Aboriginal and Torres Strait Islander

9:09

societies that follow traditional parts of

9:12

their diet, very diverse humans are

9:14

omnivores. The thing that I

9:16

always take away from these sorts of discussions

9:18

is that humans are actually incredibly adaptable

9:20

and able to live under a lot of

9:22

different conditions and a lot of different

9:24

diets. We are omnivorous. We are omnivorous indeed.

9:26

Just part of our survival. The

9:28

other question that was part of

9:30

that question was the idea of

9:33

plants and plant foods having toxicness.

9:35

Is there anything in that? Yeah.

9:37

So you can have legumes which require

9:40

to be soaked, otherwise you get alkaloids.

9:42

So plant foods do have risks attached

9:44

to them in terms of spoilage, mold, that

9:47

sort of thing. But so do so

9:49

do meats. Meats can be contaminated as

9:51

well. What about? Particularly fecal

9:53

contamination if you haven't. I

9:55

mean, anything can have poo on it. Yep.

9:57

If you just believe. Plants

10:00

too, Norman. True. So

10:03

one of the key words that

10:05

piqued my interest in that question

10:07

was scurvy. Everyone

10:09

knows what scurvy is. Vitamin C deficiency,

10:11

it causes all sorts of skin and

10:13

other conditions. Like you

10:15

said before, there are some traditional societies

10:17

that did have very, very high meat

10:19

intake. Why didn't they get scurvy?

10:22

I'm thinking of the Inuits that ate

10:24

mostly seal and seal oil for most of

10:26

the year. Well the

10:28

evidence suggests that people on a

10:30

carnivorous diet are low in vitamin

10:32

C So you are lower than

10:34

probably we are because you're all

10:36

on the Even I missed that

10:38

one But there are they are

10:40

low lower than average so they're

10:42

teetering and there is evidence that

10:45

some meat and fat diets Preserve

10:47

vitamin C so they actually slow

10:49

down the metabolism of vitamin C

10:51

or provide alternative pathways and so

10:53

on So it's likely that you

10:55

get a little bit of vitamin

10:57

C from the meat that you're

10:59

eating, but also that there's something

11:01

in some of these diets which

11:03

preserves, in other words, it conserves

11:05

your vitamin C. You're not burning it

11:07

up. And it's the

11:10

overall nutrition. And remember that

11:12

the sailors who got vitamin, who got

11:14

scurvy, and there are reports, by the way,

11:16

of scurvy in not very many, but

11:18

there are reports of people with scurvy

11:20

who are on very strict. carnivorous

11:22

diet. I found a case

11:25

study called scurvy in an unrepentant

11:27

carnivore, which I just loved

11:29

as a title. He had

11:31

it twice, both times they went through a

11:33

barrage of tests to try to figure out

11:35

what it was and it was scurvy both

11:37

times. They treated the vitamin C, he went

11:39

home and then he came back with scurvy

11:41

again. Just eat a vegetable mate. So it's

11:43

not guaranteed that you will not become vitamin

11:45

C deficient, but your vitamin C will go

11:47

down. So the question then

11:49

is, what other health effects do we

11:52

have? We've talked about, yes, plants can

11:54

have poisonous alkaloids in them, but we

11:56

cook them and that basically deals with

11:58

it. Perhaps humans haven't eaten a lot

12:00

of red meat a lot of the

12:02

time for a lot of history, but

12:04

there are people who do report having

12:06

great results on a carnivorous diet. What

12:08

is happening? Like if people have felt

12:11

like they've had chronic health conditions, which is

12:13

often the story with these sorts of

12:15

diets, people have had thing after

12:17

thing that they've basically felt like

12:19

they've been brushed off by the medical

12:21

society and They found something that

12:23

they feel really good on What could

12:25

be happening there? Well, this

12:28

is a ketogenic diet So

12:30

you are producing ketone bodies

12:32

you're these alternate sources of

12:34

energy Which come from metabolizing

12:36

fat rather than glucose and

12:38

glycogen for your energy Well,

12:40

you use glucose, but the

12:43

root to glucose is different.

12:45

And you use these ketone

12:47

bodies, which also replaces normal

12:49

carbohydrate metabolism. So basically, you're

12:51

ketogenic. And you've got these

12:53

ketone bodies going around. And after a

12:55

little while on a ketogenic diet, most

12:57

people report feeling quite energized. First

13:00

couple of days are a bit rough, but you

13:02

feel quite energized, you feel quite good. And

13:04

that's what people are reporting

13:06

here. Your breath also smells. You

13:09

do tend to constipation, but

13:12

the ketogenic diet is associated

13:14

with feeling quite good. There

13:17

have not been very good studies, just

13:19

before we go on. Life

13:21

expectancy in the stone age

13:23

was 28. So just

13:25

be careful what you wish for. think it

13:27

had more to do with infections and lions

13:30

than heart disease though, right? Well, it

13:32

wasn't heart disease, that's right. So the studies

13:34

that have been done, some of

13:36

the bigger studies, at least one that we've

13:38

come across, not very well conducted

13:40

in terms of it's self -reported rather

13:42

than objective measures of how they're

13:44

going. Some objective measures

13:46

have looked at blood fats, for

13:48

example. And so if you

13:50

look at, again, in a self -reported

13:52

study, they're trucking along

13:54

at an LDL of

13:56

about... No, stop. I

13:59

want to... No, before you start saying numbers, in

14:01

many contexts, because we're not all... I mean,

14:03

maybe you guys are all doctors, I'm certainly not.

14:07

What's normal? What do I want to be

14:09

getting when I go to my doctor

14:11

and they take the blood out and they're

14:13

like, oh, you're so healthy. I can't

14:15

believe these numbers. They're so good. They're...

14:17

Right. It's

14:21

not a straightforward question. We

14:23

probably evolved to have a total cholesterol

14:26

of two or three. If

14:28

you look at some hunter -gatherer

14:30

societies, they are operated, not

14:32

carnivorous, but just regular hunter -gatherer

14:34

societies. They truck along at very

14:36

low total cholesterol

14:38

levels. But we

14:40

have come to an average cholesterol

14:42

that we think is reasonably

14:44

acceptable in a Western society, but

14:47

it's probably even that is

14:49

too high for what we've evolved

14:51

to, which is why heart

14:53

disease is so common, dementia and

14:55

so on. So total cholesterol,

14:57

five, 5 .5. Bad

14:59

form of cholesterol, LDL, two,

15:02

if you've had coronary heart disease, it should

15:04

be less than 1 .7. and

15:06

HDL over one and

15:09

triglycerides under one. These are

15:11

millimoles per litre. So,

15:14

for example, if we

15:16

had a patient whose dietary habits

15:18

included a high intake of fat

15:20

consisting of six to nine pounds

15:22

of cheese, sticks of butter

15:24

and additional fat incorporated into daily

15:26

hamburgers, I will say this person

15:28

reported weight loss, increased energy and

15:30

improved mental clarity, their

15:32

total cholesterol levels exceeded

15:34

25. significantly

15:37

higher than his baseline level

15:39

of five to seven millimoles per

15:41

liter. And it came

15:43

out in an unusual way,

15:45

literally. What's

15:47

this called? Well, it's

15:50

either called xanthoma or xanthalasma. The

15:52

xanthi be the Greek word meaning

15:54

yellow. Yeah. So it's basically

15:56

that coming out in your hands and

15:58

it comes out in your eyes, all

16:00

over your body. So this isn't like

16:02

this is an unusual case study, of

16:04

course. If that's what's coming out of

16:06

your hands, what is happening inside your

16:08

body? He's screwed. But

16:12

he said he felt he'd lost weight. He said

16:14

he felt really good. He said mental clarity. Yeah.

16:18

So there's a paper out today

16:20

or yesterday showing that the

16:22

lower your LDL, the less likely

16:24

you are to develop dementia. So

16:27

he his LDL was well

16:29

like 12 wasn't it? No, so

16:31

there's a different There's a

16:33

different person who posted in a

16:35

Facebook group called carnivore diet

16:37

for beginners This person their total

16:39

cholesterol was 15 millimoles per

16:41

liter HDL 2 .5 LDL 12

16:43

The doctor is ordering a calcium

16:45

test for the arteries doc

16:47

wanted to prescribe a statin right

16:49

away, but I declined So

16:51

the higher your LDL the higher

16:53

your risk cornea heart disease

16:55

stroke and dementia. And

16:57

some studies suggest that on a carnivorous

16:59

diet, so it's not all

17:02

bad. Your thymine levels and vitamin B

17:04

levels tend to be quite good.

17:06

And if you look at the fat

17:08

levels, again, they're not great studies.

17:10

But if you look at the fat

17:12

levels, the LDL looks as if

17:14

it's around about 4 .5, which is

17:16

very high, at least twice what you

17:18

would consider a normal level. But

17:20

the triglycerides were lower, which

17:23

surprises me because they're really visible fat. And

17:25

their HDL is a little bit

17:27

high, which is a good thing.

17:29

But essentially, the picture there

17:32

is not good. And that's the problem

17:34

with the carnivorous dives, is that they've

17:36

not gone on for long enough to

17:38

know what problem is. Because we know

17:40

in an epidemiological sense, when you look

17:42

at populations, red meat consumption

17:44

is directly proportional to the risk

17:46

of colon cancer, large bowel cancer.

17:49

And a significant part of

17:51

that is processed meat. but

17:54

your first slide there was bacon. So

17:56

it's not that they're necessarily eating

17:58

fresh red meat and they're not eating

18:01

lean meat either. So if you

18:03

talk to the beef industry they say

18:05

oh well lean red meat is

18:07

fine, may or may not be true,

18:09

but the reality is red meat

18:11

is strongly associated with colon cancer. The

18:13

other thing that red meat consumption

18:15

is strongly associated with these days feels

18:17

like far -right politics. It feels

18:19

like this space, and I don't, like,

18:21

it's kind of funny, but it's also, it

18:23

seems to be this, there seems

18:25

to be a real correlation between people who are

18:27

interested in these sorts of diets and a

18:29

certain bent of politics. What

18:32

could be behind that? Contrarian,

18:34

that's kind of a contrarian

18:36

view that we've been misled, we

18:38

don't believe people, you know,

18:40

public health officials anymore, we've been

18:42

fed lies. that

18:44

it's natural male thing to

18:46

do to eat red meat

18:49

grilled usually on the barbecue

18:51

and you know this is

18:53

the Andrew Tate, Joe Rogan

18:55

kind of story that real

18:57

men eat meat and they

19:00

don't eat vegetables. So

19:02

as a takeaway to Joe Rogan and

19:04

Andrew Tate who I'm sure are listening

19:06

as well as everyone else what can

19:08

we say about the carnival diet based

19:10

in science? Based in science? Short

19:12

term, like any ketogenic diet, you're going

19:14

to feel quite good. You may

19:16

well lose weight because it's... It's very restrictive. Your

19:19

appetite goes down because you're eating so

19:21

much protein. So you're probably not consuming as

19:23

many calories. So some people

19:25

with diabetes might find a short -term benefit

19:27

there. But in the long term, you've

19:29

got no idea what... We've got a reasonable idea of what

19:31

it's going to do to you. Is it's going to

19:33

clog up your arteries, increase your risk of dementia. And

19:36

it's not a healthy way to

19:39

do a ketogenic diet. You can do

19:41

a ketogenic diet. with high protein,

19:43

lower levels of fat and some complex

19:45

carbohydrate and still have reasonable levels

19:47

of ketones in your blood. It might

19:49

not be super high, but it's

19:51

enough to help you lose weight, feel

19:53

a bit better, but very hard

19:55

to sustain. No, and

19:57

I feel like I need a palate cleansing ding -ding of

19:59

the Mediterranean Diet Bell to round that one out, please.

20:02

Well, Norman, as you know, we

20:04

always do a mailbag as

20:06

part of What's At Rash and

20:08

we decided to keep this

20:10

tradition going with our live show

20:12

with some audience questions. Given

20:14

what we know now about the

20:17

link between microbiome and the

20:19

gut and general health and the

20:21

brain and so on, what

20:23

are the implications for somebody who

20:25

has had an ileostomy for

20:27

40 plus years with no gut,

20:29

no large colon, and

20:31

some shortening of the

20:33

small intestine. Nobody's

20:35

properly studied that. And

20:37

most people with an early

20:39

ostomy have had something like ulcerative

20:41

colitis and therefore the large

20:43

bowel has been really inflamed, very

20:46

high risk of colon cancer

20:48

and perforation. So you remove the

20:50

large bowel to save their

20:52

lives effectively. And then

20:54

there's a trade -off in terms of

20:56

quality of life, loss of fluids and

20:58

what have you. Nobody's

21:00

really until recently studied the effects on

21:02

the microbiome. And the fact that you don't

21:04

have a large bowel there to deal

21:06

with that. But you do have a respiratory

21:08

tract that's full of organisms. You have

21:10

a skin that's got microorganisms on it. It's

21:13

not as if you have no microbiome. But

21:16

I'm not aware of research

21:18

which looks at people who

21:20

might, you know, would they

21:22

feel better if they were

21:24

actually on So

21:27

the whole thing about this is, by the

21:29

way, if you're a microbiome's deficient, what do

21:31

you do? Do you go into the chemist

21:33

and buy probiotics? And

21:35

most people would say there isn't

21:37

really a probiotic on the market

21:39

that covers you fully. And

21:41

you're not going to eat somebody

21:44

else's poo. So prebiotics are the way

21:46

to go. And what's the best

21:48

prebiotic diet? Well,

21:51

that live show was a lot of fun.

21:53

Thank you so much to World Science Festival

21:55

Brisbane for having us. This won't be the

21:57

last installment of that live show that you'll

21:59

get to hear. We'll have another one for

22:01

you in another couple of weeks. But keep

22:03

your comments and questions coming and email addresses

22:06

that rash at abc .net .au. See you next

22:08

week. See you then.