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Eric C. Westman, MD MPH

Dr. Eric Westman is Co-founder and Chief Medical Officer at HEALcare, Co-founder of Adapt Your Life, and Associate Professor of Medicine at Duke University. He is board-certified in Internal and Obesity Medicine. His clinical research in obesity and diabetes includes 45+ peer-reviewed articles. He is past Chairman of the Board of the Obesity Medicine Association. He is also a Fellow of the Obesity Society, and a co-editor of a medical textbook on obesity. He is author of NYT bestseller The New Atkins for a New You.

Transcript:

Hey, welcome everyone to another episode of Keto Chat. I am your host, Carole Freeman. Today, I’m excited to be here with Dr. Westman.

For those of you that don’t know who he is, you must be living under a rock, but let me tell you. Dr. Eric Westman is co-founder and chief medical officer at HEALcare, co-founder of Adapt Your Life, associate professor of medicine at Duke University. He’s also board-certified in internal and obesity medicine, and clinical research in obesity and diabetes includes over 45 peer-reviewed articles.

He’s past chairman of the board of Obesity Medicine Association. He’s also a fellow of the Obesity Society, and co-editor of a medical textbook on obesity. He’s also the author of the New York Times bestseller The New Atkins for a New You.

Welcome, Dr. Westman.

Thank you very much.

We’ve had the opportunity to hang out a couple of times at some conferences around this great country. You’re joining us now from North Carolina?

Right, from Durham, North Carolina. That’s where Duke University it.

Excellent. Okay. I’m out here in Seattle, and it’s been freezing lately. How’s the weather in the fall/winter down there in North Carolina?

Well, it can be nice. This weekend we were up in the 70s, but now we’re back down to the 30s, 40s. So it does get cold every now and then here.

I got to get out there one of these times. Can you believe I’ve never been to the East Coast of this country?

Well, we’re thinking about maybe doing a conference either fall, when you’re just starting to get really cold; or spring, when it’s spring here and everyone else is still under snow. That’s when North Carolina really shines.

Oh, nice. Oh, that would be great. All right, well, I’m curious. How did you get started in medicine? What was your life before you were doing what you’re doing now?

Yeah, well, I always wanted to be a doctor. That’s an easy thing to talk about. My father was a doctor, I wanted to be a doctor, I always wanted to go to medical school. But the reason was curiosity, I didn’t have any purpose I’d become a surgeon, it was just kind of general helping people, be a doctor. So it led me to internal medicine, which for those who don’t know, it’s kind of like you’re the doctor of all of the different organs when they go bad, and so you fix different organs.

I was attracted to multisystem kind of problems like if a joint problem, but it would also affect the liver or the brain, and so infectious disease, rheumatology, and now it turns out that same curiosity has led me to obesity medicine. Or more specifically, keto medicine, or more specifically, just changing the food because it fixes so many things.

I was always attracted toward challenging cases, that’s why I stayed as what’s called a chief resident after residency, it was a job that not many were chosen to do. Then went through a clinical research fellowship at Duke University where I learned how to do statistics and to formalize ideas into research and publish papers.

Out of curiosity and taking care of patients, two of my patients did this wacko diet. I mean, a wacko diet, now we know that it’s not wacko. But back then, in 1998, two of my patients, can you believe it? Lost 50 lbs by just eating steak and eggs. It was unique because no one had lost weight.

I’m in the ambulatory care VA, Veteran’s Affairs hospital, I’m taking of patients, and I send all my patients to the dieticians, and no one would be really losing weight because of the standard approach, well, for most dieticians, even today, is the low-fat, low-calorie, which really doesn’t work for most people.

It works for some, but it’s funny, two people lost this weight, and I asked them how they did it. And, “Steak and eggs.” “Oh, c’mon.” And “No,” they said, there was this book. “You have to look at this book.” I said, “Oh, gosh, a diet book. Are you kidding me?”

Now I’m a researcher, I’m a physician at a university, and so I read the book after being shamed and guilted into it. I knew it would be harmful because you’d be eating all this fat. One of my patients comes back and says, “Why are you worried about it?” I said, “You’re eating all this fat, your cholesterol will go up.” He said, “Oh, well, why don’t you check it? I want you to check my cholesterol.” he said. I said, “Well, okay.”

Today, I’ve heard stories of doctors who won’t even check it because they know it will be bad. So I’m not sure what it was. Again, I think it was that curiosity thing, and I said, “Well, okay. I’ll check it.” Well, two in a row, they lost weight doing the Atkins diet, which everyone said was bad, and their cholesterol gets better by any way you look at it. So either lightening strikes twice in the same place, or maybe what we were taught was wrong.

I guess it was a strange thing for most people to consider about what I did, that I looked at the bookstore and found the only doctor still in practice was Dr. Atkins. So why don’t I write him a letter, see what he says? He calls back, kind of to my surprise, I kind of forgot I’d written the letter, but we talked on the phone. I say, “It’s all anecdotal. It’s all in your book.” I say, “You need research.” He says, “Well, why do any research? I know what you’ll find. I’ve been doing this 30 years.”

My colleagues at Duke in research said, “What are you doing? The guy’s writing books to make money. The diet doesn’t work. Clearly, there’s no studies behind it.” But, again, there was that curiosity thing. So Dr. Atkins broke the ice, I think, and said … Well, he cleared the log jam and said, “Why don’t you come to my clinic?” On my nickel, I went out to New York City.

He had a big clinic, four-story flat in Midtown Manhattan. I sat in the office with Dr. Atkins and Jackie Eberstein. Now, Jackie was a nurse who was skeptical about the Atkins diet. Her story’s very compelling too about all of her medical issues, and hypoglycemia and palpitations were gone by her doctor. Anyway, it was Jackie, actually, that kind of let me sit in the office where we were actually looking at charts, we were seeing people come in.

I pitch a study, I designed a study and say, “You should fund it.” And he does, Dr. Atkins funds the first study on the Atkins diet. This is 1999 now, and I go back to Duke, and basically they say, “You’re crazy.” The guy’s got everything to lose. They hired Broadway performers to come into the clinic to be actors. That was the level of skepticism they had. I see that today in other areas of just kind of disbelief and often arrogance of the people in power.

Anyway, we do the study, it look great. “Six months, so 50 people over six months, publish it on a peer-reviewed journal, and then I’ll carefully consider what you’re talking about, but anything else that we doubt, 90% of what you see on the Internet … show me a paper.” For us, that paper was published in 2002, so now that is some time ago, so a lot of people have forgotten about that.

We went, said, “You need to do another study, randomize trial.” Dr. [Yancy 00:08:31], I brought him on my team, and he and I now have studied this for almost 20 years, and now some people have studied it all around the world. Counter to what we were all taught, it’s actually not only therapeutic for diabetes, obesity, prediabetes, all these things, it may actually be healthier to live without eating many carbs than it is to live eating a lot of carbs.

So it’s come 180 degrees to not only does it not kill you, it actually helps a lot of medical issues, and that’s been my focus as an internal medicine doctor. How can I use this in an internal medicine clinic? I know it’s still hard for a lot of people, doctors, dieticians, nurses, any health practitioner. We were all taught that this was not something you wanted to do, or if you did, you didn’t want to do it very long.

Now the latest scientists, they’re saying that it might even be better to live without eating many carbs at all. Again, in listening to my patients, I wasn’t so overtrained to say, “Oh, it can’t be true.” But I took it stepwise, not just starting to use it in my practice.

After eight years of research, we opened a clinic at Duke that uses the keto diet as the first-line treatment. We opened that clinic called the Duke Lifestyle Medicine Clinic in 2006, so I’ve been treating people in a clinical setting in a university, insurance-pay system for the last 12 years now.

Well, I love that you’re talking about all this, especially the history because every day I’m talking to people that their doctor said, or they heard that this isn’t sustainable, it hasn’t been proven safe for very long. And we’ve got people like you that’ve been doing this for decades and-

Yeah, I hate it when you say it like that. It doesn’t seem that long. Either I had a lot of fun, time went fast, or maybe just two decades goes by pretty fast.

Yeah, yeah, yeah. I haven’t memorized and read all of your studies, so I’m curious. I’m going to mention one, and then I’m curious if you had an influence on it or not. I did an undergrad and graduate program in nutrition back to back, and so I was in school from 2007 through 2012. I’m pretty sure it was in my undergrad, so somewhere between 2007 and 2009, is when I stumbled across the A to Z Diet Study, published in 2004. Where you involved in that?

No, no. That was Christopher Gardner at Stanford.

Okay. I went to Bastyr University, which the whole time we’re there, don’t fear fat. We wouldn’t fear fat, but also healthy carbs like whole grains and ‘don’t cut out any foods’ was the approach that I was trained in was if you restricted diets-

Most people … Yeah.

… yeah, eat whole foods, don’t fear fat, but also don’t restrict diets because that’s what causes eating disorders, and people just can’t ever keep the weight off, so don’t try to make them feel bad about themselves.

I found this A to Z Study, it wasn’t presented as anything, we weren’t learning about low-carb diets at all as any kind of therapeutic approach, and I found this study doing research for something. I talked to my professor about it, my nutrition professor. I said, “Have you seen this study?”

For those people who are watching this, A to Z Study, it compared was Atkins, The Zone Diet, and then was it Ornish or Pritikin?

Yeah, Ornish.

Ornish, okay, which is a very low-fat diet, and so basically ran the gamut.

We’ve got the high-fat, low-carb; we’ve got the middle-zone diet, and we’ve got the super low-fat diet. They found all across the board, everything they measured, the Atkins diet won in all races. Plus, the other thing that always stood out to me was that it showed that after people went off the diet, or long-term, the people that followed Atkins were able to maintain more of their weight loss longer than any of the other diets as well.

When I presented this to my professor like, “What is this? How is this? We know Atkins’ bad for you.” Like, “How is this?” She was like, “Yeah, it’s …” That study came out, and it was such a surprise, we just didn’t know what to make of it, so we just kind of swept it under the rug and ignored it because it didn’t fit with what we knew was true.

It’s funny, the information’s been out there a long time. We’ve been choosing to ignore it because it doesn’t fit with our paradigm.

Right. Well, among the studies that were done, most were low-carb versus low-fat, not the four groups of A to Z trials. So that was a really important study to go across the whole range and not just be … It’s a false choice to say low-fat or high-fat because there’s this whole range in-between.

But the people who did those studies originally wanted to show that the low-carb diet was bad; low-carb, high-fat was bad. When they found that it wasn’t bad, they didn’t do another study.

It’s fascinating because it was the first time they ever did a low-carb study, all of these people, and none of them went to talk to Dr. Atkins. It turns out, Dr. Yancy and I were the only ones to go and approach someone who knew something about the diet, how to implement it. The adherence that we had in our study and the effects were better than the others.

But all of the people who did a one-and-done kind of, “Oh, well, it wasn’t bad, didn’t kill anyone. We’re not going to continue this research because we didn’t show it was bad.” Christopher Gardner at Stanford persisted, and carried on, and did some further research, and I have to give him credit for that because he could’ve done the one-and-done.

I mean, in our studies, we always say that, well, the control group works. Whether it was low-glycemic, or low-fat; for the low-carb, keto works better. But, then again, that doesn’t fit in this all-or-nothing, we-win-they-lose kind of world. That’s why I don’t think our studies get a whole lot of media attention, because we don’t claim that something wins.

We say that, “Well, they both work, but this one’s better.” I think we were successful in getting it at the table of something to consider. That’s a huge change from 10 years ago where nobody even thought this was worthy of research.

Of course, remember my stories, I went to visit Dr. Atkins who’d done this for 30 years, so I feel like I’m just carrying a baton forward. I didn’t create this. Remember, I learned how to formalize things in a research program at Duke with a really good clinical research. As my brother says, “Ah, it’s brother Eric. He validated the Atkins diet.” Just kind of, “What did he do?” Can you summarize my whole research life in one sentence?

But there are a lot of other people now who have recreated, or you never want to value one study, there’s always replication, and this has now been replicated in research centers all over the world. But, again, it goes against the paradigm that eating fat would always be bad, and this book bursts this paradigm because, at least in the context of low carb, eating fat is not bad.

The question remains of if you eat high carb, high fat, is fat bad? I think fat can be fattening. Yes, if you have the insulin signal from carbohydrate, so when you’re eating carbs, fat can go to fat. But when you’re not eating carbs, it’s really hard to gain weight. I mean, you can, but because that insulin signals come down so much.

It’s been fun. I think when it becomes mainstream, and I don’t see disbelief, or, “Oh, I can’t believe …” This won’t be as fun anymore.

I know, I like that.

I had to flip it that way.

It’s true that instead of selling all the sick care that we have now, I’ll have to have a lot more yoga and weight training studios or something to help people [crosstalk 00:17:19]-

I’m all for that.

… I want to clear up a myth that’s out there real quick though too because often, when you bring up Atkins, there’s still this pervasive myth out there. They’re like, “Oh, didn’t he die of a coronary heart attack or blocked arteries?”

Right. No, he didn’t. In fact, I was doing research at that time, so I had made a couple of visits to New York City to visit Dr. Atkins. He slipped on the ice in New York City during a freak snowstorm. In fact, I know the doctor who found him on the way to work. He had a brain injury and passed away, I think, within a week or 10 days.

But, yeah, the media attention by the people who don’t want you to do the diet was that, “Diet doctor dies heavy.” “Dies obese.” “Died of heart disease.” To this day, I hear that frequently, “Well, didn’t he die of his diet?” I say, “Well, no.” “Didn’t he have heart disease?”

Well, so it’s more complicated. I think he had what was called a cardiomyopathy, which was from a visit to Eastern Europe. He traveled a lot, especially in Europe. Sorry, it’s more complicated than he was healthy and great, I mean, everyone dies, eventually, and he did not die of a heart attack, best we can tell.

Although I gave a talk to other doctors about that time, and one of the doctors said, “Well, he must’ve had a heart attack, then he slipped on the ice.” How can you go there? Anyway, doctors sometimes are not so friendly.

Well, yeah. I mean, there’s this psychological phenomenon that when you’ve believed something to be true for a long time, despite mountains of evidence in your face, you don’t want to believe it. I mean, I’m here in Microsoft territory, so every year they have a health event where they do some biometric screening, cholesterol, and blood sugar and all that. Then the dietician, nutritionists can counsel people on how to change their numbers, basically.

There were other dietitians that were at these events, and I’m secretly saying, “Hey, have you seen this low-carb stuff?” And that was how I was counseling people even before I did keto myself. I was like, “Reducing your carbs and sugar were going to be a way to fix all of this stuff.”

This was maybe three or four years ago when we started having research and articles coming out about how saturated fat wasn’t going to kill you. And there were dieticians that were there that, even though the research was really solid, they were like, “Yeah, I just … I don’t believe it though.”

I know.

“I don’t believe it though.” She literally said that to me, and I was like, “Wow!”

Yeah, but it would be like you were raised religious, and someone said there is no God. It’s a hard thing because it is a belief system. Well, no, the low-fat thing was entirely a belief system. It was shoddy science, and so we all were kind of convinced not on science but on belief. Now when science comes out, I guess it’s easy to dismiss it than …

Sadly, the different diet approaches sometimes get put into salesmanship too fast, so it’s kind of like, “Well, my car is better than your car.” But you wouldn’t hear one car manufacturer saying the other car didn’t work. One might be safer than another, but you wouldn’t say that car doesn’t drive.

Now I’ll, in the right audience, so the cardiologists in Canada had a workshop that I attended. [Blair O’Neill 00:21:25], who’s the former president of that organization, got a workshop, and we talked about the keto diet in a cardiology conference, actually.

There was a great interest, it was standing room only at this meeting, but there was still all these furrowed brows and disbelief about the fat and all that. Of course, even though we showed data of fat being eaten, all these things getting better, the first question at the microphone was, “Well, doesn’t saturated fat harm you?”

Again, we show all the evidence, and then there’s the ‘we’re going against something we all believe’, which that’s not science, that’s belief.

Right, right. Yeah, thankfully we’ve got a lot of great books out now can refer people to. Planning it all if people are willing to take the time.

Let’s go down a little bit this fat and cholesterol thing. I know it’s a really complicated topic, but what do you say when you tell people about this diet, and they say, “Well, isn’t that going to make my cholesterol go up?”

Well, two thirds of the time it doesn’t. So if you were rolling the dice … In fact, I looked back at those two patients I had, it was a 60% chance each time that it would get better, and it did.

A third of the time, it won’t look better based on the way that you look at it traditionally. It’s easy, I’ll say, “Well, let’s try it and see.” And I’m going to win two thirds of the time even if we look at it the old way. The third of the time, when the total and the LDL cholesterol might go up, the HDL and the triglyceride get better. The HDL goes up, the good cholesterol; and the triglycerides go down.

If I have the time to teach someone and follow their levels, I just say, “The old way, was to look at this way.” I’ll cover the screen where the cholesterol levels are, so the old way will look bad, but the new way looks good. It takes a little time to explain that.

Someone comes in, “My Cholesterol is really high on this.” If you’re losing weight at that time, all bets are off. Even low-fat, not high-fat, even low-fat diets with weight loss will be able to raise the cholesterol, so you don’t look at the cholesterol level while you’re losing weight, wait until you’re at the goal or close to your goal.

That’s, I guess, rule number one. The next thing is that you want to look at the triglyceride and HDL, not the total and LDL. If you want to look at the type of LDL, you can get a test to look at the small, and the large, and the particles, and all that. But I’ve come to the point where I’ll just reassure people and say, “It’s going to be fine.” That’s all the person wants to know.

It’s like me going to the car mechanic, “Just tell me you fixed it. I don’t really want to know if it’s the this, the that, the gasket, and the this.” I mean, I used to know all that, now I don’t. “So just tell me that it’s fine, and you fixed it.”

A lot of people fly to me in North Carolina from lots of places just to be told that, “It’s okay, and you don’t have to go on a statin drug.” And, “Oh, okay.” Isn’t that crazy? But, again, that’s the culture, that we were all taught that eating fat would be bad, and raising cholesterol would be bad.

Now there’s an elite group of people with very high LDLs in a Facebook group, Dave Feldman runs it. If your LDL’s over 200, you can join this group. Of course, the 200 LDL is really high. It’s kind of like the ‘in your face’ of ‘LDL is not going to kill you, let’s all band together’. If someone does have really high LDL like that, I’ll encourage them to join that group.

I didn’t know that he have the group. Do you have the name of the group? I’ll have to look it up.

Yeah, Lean Mass Hyper-responder.

Okay.

Of course, Dave Feldman is the young man, not a researcher or medical guy, but he was just curious about cholesterol. I remember seeing him on the Low-Carb Cruise to get cholesterol levels five times a day. I’m like, “What are you doing?” He said, “Well, look. It changes.” I’m like, “We really don’t know how to look at these things, us doctors.” He said, “But look at the biologic changes.”

Now he’s got a protocol where you eat high fat, thousands of calories of fat a day, and your cholesterol plummets. So he says this is something you should do before your insurance test because they value the low cholesterol to give you better insurance. Or, I guess, conversely, if it’s high, you might have to pay more.

You have to hand it to Dave. He sells funds with Patreon so you can actually help fund his research. He even, one time at Ketofest, which is one of the fairs, festivals going around and around the country about keto diets, he recruited people to change their diet, and he brought all the equipment to check the blood on all of these people. You’ve got the approvals and all that, and did a little study of people who came to this town around the diet. I mean, that’s really fantastic.

Of course, we’re trying to get the medical … We, I mean, I’m helping a little the best I can, the medical mainstream to at least engage in, how can this happen? What’s the biology? And there’s big resistance because, again, it shatters the paradigm that eating lots of fat is always bad.

Yeah, his research he’s doing is really fascinating, I’m really excited to see where it goes. Is there any talk of actually a bigger study that will get published from this?

I’m not sure. Dave works pretty fast. I don’t know. I know he’s building a team. He’s not trained as a researcher, so that actually is a process of learning how to put data into a certain format and all that. But he’s presenting at meetings quite avidly showing all the data. It’s available on his blog and on YouTube, so I hope that there will be some publications.

But the world exists, and there’s information that never gets into publications that’s still valid. There’s no study that says the sun will come up tomorrow, but I’m banking on it. I mean, that’s the extreme case.

That’s funny tough, that’s so true.

There’s kind of an intellectual laziness to ignore until it comes into a paper. Of course, I said, at the beginning of the show, that if you don’t have a paper in a peer-reviewed journal, six months of 50 people on your diet, don’t bother me, I don’t want to look at it.

But that’s just because I want to weed out the weed from the chaff. There’s so much to be able to consider, and I can’t possibly know everything. I’m pretty focused on the keto science, and that’s just a way for me not to have to be bothered by all the … which might be really good stuff.

Like intermittent fasting and total fasting is in that sort of holding room, if you will, of it’s not in the medical mainstream very well. The old data says you might risk using your own protein if you fast for too long. The new theory is that you’ll have autophagy, and you’re going to be able to preserve your protein. But until that science is put into papers and vetted that way, I don’t have the confidence in that that I do in the keto low-carb approach.

That’s kind of my process of how I look at what is happening, what people say. Individual results are great, and everyone is different, but if you’re going to do a policy-level decision that, yes, a million people can do this, you want to have better confidence that it’s a safe thing to do.

Yeah. Let’s talk about one of your companies, Adapt Your Life. What are you guys doing with that?

Adapt Your Life, yeah, it’s product company, basically. After a long time of kind of staying out of the fray of business, I decided to get into that world to create things that I thought were really needed.

There were really no truly low-carb keto products that didn’t have a whole lot of junk put in it. So I was approached by my business partner, “Hey, why don’t we really create excellent products that are clean eating, you don’t have all these artificial preservatives and all that, and they’re truly low in carbs?”

That’s Adapt Your life. In fact, there’s a keto bar, there’s coffee shots and fat shots for a quick fat source or protein source. It’s basically nut butters and then the coffee shots are a lot less calories than bulletproof coffee, but the same kind of idea. You switch from cream to using oils that will raise the ketones a little bit. Then there’s a cereal product as well. There are other bars that are coming out in the future.

Adapt Your Life really is filling the niche of truly low-carb convenience food. It’s not meant to be a meal replacement, our philosophy is still to have real food as much as possible. But the website has a free side of teaching. I did a video teaching for Adapt Your Life, and a lot of questions and answers. If they were not medical questions, I answered at the Adapt Your Life website.

It’s been fun. I’ve got [Glenn 00:32:01] and [Yale Finkle 00:32:02] are my business partners, and they decided, “Let’s put on some fairs around the country on Saturday so people don’t have to travel to the big conferences.” We did that, and we’re going to do that again this next year where we’ve seen 100, 120 people come out on a Saturday in Vancouver, and Houston. In North Carolina, there were 390 people, so almost 400 people that came out on a Saturday to talk Low-carb and keto, and then you don’t have to travel anywhere.

The philosophy there is to bring local experts together with local people and Adapt Your Life, these are called Adapt Events. The idea is to support people in their low-carb keto journey.

It’s actually a lot of information as well, it’s not just products. The current model, that I understand, of selling things is not to sell, what you want to do is give information and make sure people value that information first.

As far as I know, as knowledgeable as I am about the keto products out there, I’m pretty sure you guys are the only ones that have the little keto bar that actually doesn’t have a bunch of fillers and things in it. They’re small because most times we’re used to the really big ones with bulky fillers and stuff like that in them, but a lot of those aren’t as keto friendly as the label says they are.

So you guys are doing a good job with actually having …

Thank you. Yeah, well, the keto bar, they’re surprisingly filling because there’s so much fat in it. That’s the other barrier that these product companies wouldn’t burst through. They’re actually high-fat products, and you get protein with it as well, and then the natural ingredients so that you’re not having all that artificial stuff, so it’s a Paleo friendly kind of thing. Yeah.

Now, let’s talk a little bit about your approach to low carb in keto. I’ve seen your talks on YouTube where you’re explaining what the diet is to a group of people, or you’re training other physicians, actually, in how to implement it. You’ve just a no-nonsense, keep-it-really-simple approach.

Do you want to speak about that? About how it is training other people to do something that seems so simple?

Sure. Well, I borrowed the system that Dr. Atkins and Jackie Eberstein developed, actually. We use that in our research studies. Any research study that you read about what we’ve done has used the system I use. It’s actually a sheet of paper of food with limitation on the high-calorie items like cheese, oils, and cream, and mayonnaise.

The problems that I see today in the keto, I just learned it off the Internet from my friends, is people are consuming zero-carb items that are very high in calories. So put it in another way, if you don’t have the sheet, you want a standard 20 total carbs, not net. You want to eat fatty sources of protein, don’t add fat, just eat protein, but don’t fear the fats. Then eat when you’re hungry, stop when you’re full.

Actually, this was the three-phrase item that Casey Durango of Go Keto with Casey created based on the system that she learned from me. It’s under 20 grams total, not net, that erases all of the other products and all that. It’s eating fatty sources of protein, don’t add fat. Don’t have oils, and butters, and excessive cream and cheese. Then if you’re not hungry, you don’t have to eat.

What I see, a lot of people don’t use the 20-total-gram rule, and they say, “Oh, I’ll have 40 here, or I’ll do 20 nets or something.” Just going to 20 total fixes a lot of the people who are stuck.

The next item is the idea that you have to limit high-calorie things. “Well, but the coconut oil had no carbs, so I had all of this bulletproof coffee.” So one person is having thousands of calories, I’m sure you see this, thousands of calories of bulletproof coffee and wondered why they weren’t losing weight.

And they’re saying, “But it keeps me full and satisfied.”

Especially if you’re trying to lose weight, we want the fat to come from your body fat, not the fat you eat or drink. That’s a common mistake I see in the current kind of keto, you got to eat fat to burn fat. No, the best way to burn fat is to not eat anything.

Right?

But that’s not healthy, you don’t want to do that too long.

That’s so funny. I had one of my clients this morning asked that very question. She goes, “What’s the optimal macros to lose weight as fast as possible?” I said, “Zero grams of everything is going to make you lose weight the fastest. It’s just not sustainable though.”

What we’re seeing is that these apps, these people who are new to the field think that that’s all you need to know. Again, there are no studies, 50 people over six months, with any of these new apps, or products, or all that. Be careful about all of those things, have real food as much as possible.

Proteins, to me, mean any kind of meat, poultry, fish and shellfish, and eggs. That’s really the main source of nutrition. If someone’s getting meat-based protein, you don’t have to worry about the vitamins and minerals much because the meat, the eggs, the poultry, delivers the vitamins and minerals with the food you’re eating. It makes me worry less about the micronutrients.

Now, vegetables are limited. We recommend about a cupful so you get about five to six carbs in your veggies. We have a list put out, and I’ll just say, “Hey, if it’s not on this list of vegetables, you can’t have it.” So you don’t have to look up in an app, or on Google, or anything.

That system works really well. Again, it’s using one sheet of paper like the old ‘if you can’t fit it on one sheet of paper, it’s too complicated’ idea, which I like a lot. Of course, it’s in a little book, it might be on two of three sheets of paper.

Had someone who thought that Page 4, which is the original page number, was only half of it because it was in a smaller book, and it was Page 4 and 5. Anyway, now on Pinterest I think there’s Page 4, but one of them has fruit on it, which is not on the original Page 4.

You can know you get the trusted source of information from the program that we’ve developed.

Excellent. Yeah, the infamous Page 4. That’s a …

It’s hard for me to gauge and being on YouTube is not like being on network TV. Sometimes people think, “Oh, I know all your videos.” all that. But I’m starting to worry or wonder because I was traveling in Europe last fall, and I was at the metal detector going through, and the TSA or the security guy came up to me. I didn’t have my ID or anything, he came up to me and went, “I know you. You’re the kero guy.” I’m like, “Oh, my …” I thought my travel partner put me up to this. “You told them to …” “No.”

So I thought for a moment, “Well, if he truly knows …” He said, “Adapt Your Life, I watch your videos.” This is Portugal, okay? I’m like, “Well, if this was really true,” I said, “well, what page is it?” He thought for a moment and said, “Page 4!”

Anyway, that’s kind of the free [inaudible 00:40:12] that if you’re able to do it on your own, there’s going to be, gosh, so many people need this that I finally decided that if someone can wrap their head around it, do it on their own with a video, go for it. But a lot of people need the extra help coaching, what you do, and what we do; then, of course, with medical problems.

In my experience, if you have medications and all, you got to be seen by someone who understands the medicines. Or at least have the knowledge like if it’s a nurse, a dietician, a doctor, and they’re on insulin, and they understand insulin and glucose, you could wiggle around, it’s not a hard and fixed rule.

In North Carolina, and it’s probably true everywhere, there are some people that don’t really understand what insulin does, and so I prefer to see people for the safety side if they have medical problems or are on medications.

Is that your feeling as well?

Absolutely, yeah. Yeah, if anybody is on any kind of medication, before I’ll even work with them, I’m like, “You need to go talk to your doctor about this.” I screen them ahead of time, “Tell me all the medications you’re on.” Then okay, it’s like, “Okay, this one is one you’re going to need to have a conversation with your doctor on that you guys need to watch this on.” Where they check blood sugar ones, blood pressure ones are the ones that I’m [crosstalk 00:41:41]-

Yeah, the mains ones. Yeah.

… mainly concerned with. I even coach them how to talk to your doctor because I said, “Your doctor’s probably going to say, ‘Nobody ever gets off that. You’re crazy.’” I tell them, “Say, ‘Well, this crazy nutritionist I’m working with says that people are. How do I wean off it?’” I tell them, “It’s not in my scope to tell you how to take your medication, you need to work with your doctor on it. This is a powerful diet, it’s going to help those be no longer necessary. But if you combine them together, it’s very dangerous.”

Definitely, yeah, any medical conditions, I want them … And it’s still really hard to find doctors that are knowledgeable about what keto does, or low carb, or anything like that. But I at least want them supervised by their doctor, and I can coach them about how to coach their doctor.

Let’s talk about your HEALcare Clinics. This is really exciting, what you’ve got going on. You’re just changing the lives of so many people, but tell us, what is HEALcare?

Well, to your last point, there just aren’t doctors who understand this. After years of, again kind of, “Who’s going to do this? How do we scale it up?” I’m very frustrated with the current system. The system has other forces at play. Understanding the food really matters, is a big barrier for many doctors, they just weren’t taught that. Understanding that you don’t need medications to do things, you can just change the food, is a big barrier because a lot of people are taught, “Oh, you have diabetes, now you’re on medicines forever.” So frustrated with all that.

Finally, met up with a business team and said, “Let’s start our own company. Let’s start a company that trains our own staff to know how to do this.” After a couple of years of trying to figure out the right business model and all that, we were set. The business model is kind of like putting a Starbucks in a Walmart or Target, Starbucks makes the coffee and sells it themselves. We go into the doctor’s office, the health care system, do our own business, but the people there at the health care system or the clinic get the benefit for their patients.

What we found is that if a doctor knows about keto or low carb, they want it for their patients, but they realize that they can’t do it themselves, that’s perfect for us to go in, do our own practice there. We’ve signed on now four different clinics. We have a lot of others in the queue. We do our own practice, our own medical record, all of that stuff.

The other thing is we trained nurse practitioners and physicians assistants in how to help people get off the medication. There’s a new term called ‘deprescribing’ that’s been taking people off medication.

That’s exciting.

Rather than wait for the system to change, which is many of the investors, people who’ve invested in the company say they just can’t wait. I mean, “You can’t wait for the American Heart Association to change. Why don’t we change it ourselves?”

In trying to get to the next level for the company, we decided to do the only kind of way you can invest in a keto company, that I’m aware of at the moment, so that any individual can buy stock, buy partial ownership in the HEAL Clinics through what’s called an equity fundraising, crowdsourcing fundraiser, or campaign.

I didn’t know much about this kind of mechanism. Of course, my children know all about it. But it’s different. It’s not like a kick-starter where you want to buy the product first, so you give money to the company, and then when the company makes a product, you get it. It’s actually, you buy stock and get stock in the company so that when the company grows, you make money from that investment.

It’s a way to change the future in the direction that you want it go to. Current investors are saying things like, “I don’t want other people to have to wait and figure it out all by themselves.” Or, “Mom in California, I live in North Carolina, I want her to get access to this kind of clinic.”

One way to do that is through investing in a company. What’s really cool is for as little as $480 you can invest and buy ownership in this company. I didn’t know that it was that little as I don’t do a lot of investing, but I always thought you had to put in $50,000 or something like that, and then angel investors put in millions, and I don’t have that kind of money.

For the change in the world for individuals, so if you’ve been affected by the diet in a good way, so another investor said, “I have lost 80 lbs. This is fantastic. I’ve tried to lose weight all my life. I’ll need to get this. I feel like it’s the right thing to do to put in just a little money into this company to make this available.”

Of course, as a researcher myself and someone who wrote grants, the big scheme is that we want to influence, change medical care to nutrition care, not medication care. That’s the big picture, but to get the company going, we’ve decided to do the host-clinic, clinic within a clinic like Starbucks in Walmart kind of model to get it going.

It took us a long time to get the right kind of business model to work it in because the current system doesn’t want to for various reasons. I’m really excited about it, and you can actually go to the HEALClinics.com website and learn how to do it. You can actually put it under your credit card. I mean, they’ve really made it easy, and it’s not ‘they’, this is the SEC. It’s the Securities and Exchange Commission.

We’ve worked several months to get this all approved. The other thing, there’s no pressure. You go, you take a look at the website, there’s a lot of information about the business model, about who we are, who Jackie Eberstein is. She and I created the HEAL Clinics teaching model, and we do all of the training ourselves. There’s no pressure, you can go take a look.

I’ve swiped my credit card, put in the numbers, and I’m investing in this model as well. I hope, for those who want to make this available to other people and maybe even make some money on it, that it becomes profitable. You’ll make money, it’s not giving it away, remember. I hope you’ll consider investment in HEAL Clinics.

So HEALClinics.com/offering is direct to the start engine page. That’s the crowdsourcing platform. Or if you go to the HEALClinics.com, that’s H-E-A-L-C-L-I-N-I-C-S, Clinics.com, but the top, it says ‘For Investors’. That takes you to the same /offering page.

Of course, it’s almost too easy to take the money, but actually the money isn’t debited immediately, some time passes, and then you get an email saying, “Are you sure you want to do this?” It’s actually, there’s another step. I think the government SEC is really careful that businesses don’t do this to scam.

We already have clinics that they’re in business and this is offering to take the HEAL Clinics to the next level.

Oh, that’s really exciting. I know you’ve been working hard on this for a while. Yeah, and it’s really cool too, people can have an influence. They can invest in something that is changing the health of the world, so it’s really great.

The 20 and 30-year-old folks do this mainly when they want a product like the Oculus 3-D, that was a crowdsourcing fundraiser that got it started.

I guess you have to envision that if you want to have a clinic somewhere, that’s the product. It may not be for you, but it might be for your loved one or do it for the sheer investment of it as well.

Of course, you sign off to say, “I know that this is a risk.” and all that. But what’s really neat is the level that you can come in at. I think most people can afford $480. When you look, it tells you the number of investors and also the total amounts. The average investment is by the thousand dollars per individual, which is great.

Very, very exciting. Any other things we that we didn’t talk about that you were hoping I’d ask about?

No. I think the idea of taking this research and clinical knowledge and scaling it up in the product company and then the clinical company is my mission. I mean, I have the background in the research and have the business teams now and, this is what I want to do. I’m poised to scale this up to treat as many people as we can.

It’s like there’s an epidemic or there’s a flood, and we’re creating the relief workers to go fix the flood. You don’t have to train someone to diagnose 100,000 illnesses. All we need to do is train people to get people off medication, teach them to not eat carbs, and then we can make a big dent in the diabetes and obesity and treat diabetes epidemic.

Wonderful. All right, well, I have one closing question for ya.

Of course.

It’s the last day on Earth, the meteor’s coming at us, we’re all going to be wiped out today. What are you going to have as your last meal?

Oh, that’s funny. I was just introduced to a dish in a local restaurant, it was pork belly, and the side is pork rinds, and then a beer.

Pork on pork on pork.

Yeah, pork on pork, and then one of the craft beers they have, I think, and then a couple truffles to end the meal.

Nice. You’re [crosstalk 00:52:39]-

I want to go out on bacon.

… chocolate.

Yeah, a little bit of chocolate at the end.

Okay, nice.

What is your meal? What would you have?

Oh, yeah, I know. I love a good medium rare filet mignon.

Yeah, hard to beat that.

Yeah, I’m thinking right now it’s sounding really good, for some reason, is just some sauteed mushrooms, probably some red wine. I’m trying to think if I’ve even … Sugar doesn’t go with me right, but I’m wondering if I could eat it right before the meteor hit.

Like maybe a really dense flourless chocolate cake or something like that. But I don’t know, I’d even go for the keto version of it just to make sure. What if the meteor didn’t wipe us out? I want to make sure I don’t feel like garbage the rest of the hour or how long we have.

Yeah, I think that’s what’s sounding good right now.

Great.

Yeah. Well, thank you so much for being here, Dr. Westman.

Thank you.

I’ve really appreciated you sharing. I’m really excited about all the work that you’ve done over the decades that you’ve been doing this work and all the impact. I can’t imagine how many people you’ve changed their lives.

All the links are down below, everyone. We’ve lots of links and good stuff to share here. If you’ve enjoyed this video, give us a thumbs up. If you want to see more, hit the subscribe, but also hit that little bell that’s right next to that because that’s what’s going to get you the notification that we’ve gotten new episodes coming up.

Thank you again, Dr. Westman, for being here with us.

Thank you.

All right, everyone. We’ll see you soon. Bye.

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