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Carole Freeman:              Hi everybody, it’s Carole Freeman, I’m the creator of the Eight Week Keto Bootcamp program. I am here today with Doctor Ted Naiman, Naiman?

Dr. Ted Naiman:               Naiman.

Carole Freeman:              Naiman, Doctor Ted Naiman.

Dr. Ted Naiman:               Hi.

Carole Freeman:              I’m really excited to have you here. You have quite a following on the … What is it called? The TwittoSphere?

Dr. Ted Naiman:               Tweetosphere.

Carole Freeman:              Twittosphere, yeah, yeah. Will you share with everyone your credentials, who you are?

Dr. Ted Naiman:               Right, okay, so I’m a family practice doctor here in the Seattle area. You and I are local in the Pacific Northwest.

Carole Freeman:              Yeah, yeah.

Dr. Ted Naiman:               I’m a board certified family practice physician. I work for Virginia Mason Medical Center, which is just a big, local, cool hospital.

Carole Freeman:              Yeah, that’s fantastic. We have a real doctor in the house, people. Not just one that plays one on the internet.

Dr. Ted Naiman:               That’s right.

Carole Freeman:              Yeah. So I want to know then about your background, you are following a low carb ketogenic diet somewhat. What do you call your dietary approach?

Dr. Ted Naiman:               You know, it’s really just basic low carb. I haven’t really used the word paleo, I haven’t really used the word keto, necessarily. I’m basically just restricting carbohydrates as my main angle.

Carole Freeman:              Okay, well we’re going to dive into that a lot more too. Before we get to that I want to know what let you to be a doctor. What’s your story coming up to that?

Dr. Ted Naiman:               Oh wow, okay, so I got a engineering degree, actually …

Carole Freeman:              Okay.

Dr. Ted Naiman:               … mechanical engineering, here in the Seattle area, and I really wanted to work for Boeing Aerospace. The year I got out of school they laid off 1,000 engineers at Boeing. Nobody could get a job and I was so depressed that I just went back to school, and just randomly, last minute, decided to go to medical school.

Carole Freeman:              Wow.

Dr. Ted Naiman:               I never even took general biology, I just took the MCAT cold and applied the last day I could and somehow got into medical school. Then here I am. It’s kind of a weird story.

Carole Freeman:              Yeah, well it sounds like it’s maybe a little serendipitous then that something lead you there perhaps?

Dr. Ted Naiman:               Yeah, hopefully.

Carole Freeman:              Not a family medicine background?

Dr. Ted Naiman:               No, no, no, no. It’s not my lifelong dream to be a doctor. I just randomly ended up here.

Carole Freeman:              Wow, well that’s pretty remarkable, speaks to, probably, your wit and intelligence that you can just take the MCAT cold.

Dr. Ted Naiman:               I don’t know about that, but thank you.

Carole Freeman:              No? Okay. All right. So that was how long ago then?

Dr. Ted Naiman:               Oh gosh, wow. I got out of college in ’93. I went to medical school and graduated in ’97, 1997. I’m old as dirt. Yeah, I’m super old.

Carole Freeman:              Well it’s all that good fat keeps you nice and young.

Dr. Ted Naiman:               I like to think so.

Carole Freeman:              Yeah. What’s it been like being a family practice doctor for, what, about 20, not quite 20 years then?

Dr. Ted Naiman:               Right, I mean it’s a great career. I have job security for miles.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               I’m really glad I ended up where I did. I’m very happy with that.

Carole Freeman:              Great, excellent. Do you have anything you see a lot of patients for? Do you see kind of a trend of what comes in, or is it all sorts of things?

Dr. Ted Naiman:               Oh gosh, well okay, so my special interest is hyperinsulinemia and metabolic syndrome. Kind of like when you have a hammer everything looks like a nail.

Carole Freeman:              Yes, yeah.

Dr. Ted Naiman:               I started realizing, wow, all of these chronic diseases that I’m seeing are all just different flavors of hyperinsulinemia.

Carole Freeman:              Okay.

Dr. Ted Naiman:               That’s kind of my angle.

Carole Freeman:              Yeah, yeah. Well, so for people watching that don’t know that fancy word of hyperinsulinemia, how would you describe that to maybe one of your patients that’s coming in?

Dr. Ted Naiman:               Right, this is someone who has insulin resistance. This is someone whose insulin levels is way higher than other people.

Carole Freeman:              Okay.

Dr. Ted Naiman:               I have patients who are very insulin sensitive, and tend to be really thin, and all their labs look great, and their fasting insulin level might be two, three, four, five. The average fasting insulin level is eight in this country. Then I have other patients who are insulin resistant and they tend to be obese, and pre-diabetic or diabetic, and their insulin level can be 10, or 20, or 30, or 40, or 50. So you could have order of magnitude higher insulin than a insulin sensitive person. Then you have all these chronic diseases as a result.

Carole Freeman:              Okay. The interview I just did yesterday was with a girl that, her insulin was at 70 before she started doing keto.

Dr. Ted Naiman:               Wow, fasting insulin?

Carole Freeman:              Yeah.

Dr. Ted Naiman:               Yeah, that’s …

Carole Freeman:              Yeah.

Dr. Ted Naiman:               I’ve seen a little bit higher, but not by much.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               Pretty dramatic.

Carole Freeman:              She was in her 20s with that too, so that was starting early, yeah.

Dr. Ted Naiman:               Yeah.

Carole Freeman:              Do you ever see lean people that have hyperinsulinemia?

Dr. Ted Naiman:               I do, although for the most part body fat mass mirrors your fasting insulin level.

Carole Freeman:              Okay, okay.

Dr. Ted Naiman:               Pretty linearly.

Carole Freeman:              Okay, interesting. So then what percentage of the population are you seeing that are having this hyperinsulinemia?

Dr. Ted Naiman:               Well we actually have studies that show that it’s about 80% of the general population.

Carole Freeman:              Wow.

Dr. Ted Naiman:               Yeah. It’s not … It’s pretty much freaking everybody.

Carole Freeman:              Right, right, and the scary thing is, is that if nothing is done with that, it’s leading to diabetes and all these other …

Dr. Ted Naiman:               Absolutely.

Carole Freeman:              … complications that you’re seeing, yeah.

Dr. Ted Naiman:               Yeah.

Carole Freeman:              We’ve got a huge crisis on our hands.

Dr. Ted Naiman:               We’ve got a crisis. It’s an epidemic. It’s huge. It’s basically everywhere.

Carole Freeman:              Yeah. Well so with your … You look at research a lot, and you look at studies of all this. How did you get to the place where … Have you always been a carb restrictor? How did you get to that place?

Dr. Ted Naiman:               Oh no, wow. Okay, so I was actually raised sort of vegetarian.

Carole Freeman:              Okay.

Dr. Ted Naiman:               I was a vegetarian for a long time.

Carole Freeman:              You’re from the Northwest then, right?

Dr. Ted Naiman:               I’m from Denver originally.

Carole Freeman:              Okay, okay.

Dr. Ted Naiman:               I went to medical school at Loma Linda University in southern California, which is this famous blue zone with nothing but vegetarians. It’s a vegetarian mecca.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               It’s a vegetarian school, I had a vegetarian training. I was a vegetarian for a long time. Wow, so what happened to me is I was a vegetarian and I was very healthy with my diet, right? I never ate saturated fat, I rarely ate animal products, and I ate tons of just soy, and grains, and my diet was really clean, really healthy, and as a result my health just sucked. Okay, my body composition was crap. My health was crap. I was not any better than anyone else, possibly quite a bit worse. This taught me something. It taught me that diet doesn’t matter. Diet is a joke. Diet is worthless.

Carole Freeman:              Oh that’s your perspective then.

Dr. Ted Naiman:               Yes, okay. Here I am with this textbook healthy diet …

Carole Freeman:              Right, right.

Dr. Ted Naiman:               … you know, lots of whole grains, and very little saturated fat and cholesterol. I’m eating this perfect healthy diet. I’m going way out of my way to do this and my health sucks. My athletic ability sucked. My body composition sucks. I’ve got eczema. I’ve got skin rash. I feel like crap. I realize, “Oh wow, diet’s not a big deal, and everything’s really just genetic.”

Carole Freeman:              Okay, okay.

Dr. Ted Naiman:               Then I go to medical school and they beat the same thing into me, right? They don’t talk about diet at all, kind of doesn’t matter.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               What happens is if you have a bunch of family members who are fat, and diabetic, you’re going to be fat and diabetic.

Carole Freeman:              Yeah, okay.

Dr. Ted Naiman:               If all your family members are skinny and healthy, you’re going to be skinny and healthy, and they really push the genetic angle.

Carole Freeman:              Okay.

Dr. Ted Naiman:               The idea was if you have the wrong genetics this is just your lot in life. All this chronic disease is going to happen to you. We were taught as doctors to just kind of feel sorry for people who had poor genetics and were destined to have all these diseases, you know what I mean?

Carole Freeman:              Yeah. They’re chronic progressive.

Dr. Ted Naiman:               Right.

Carole Freeman:              There’s nothing you can …

Dr. Ted Naiman:               There’s nothing you can do so if your patient just gets fatter and sicker, it’s not your fault as a doctor. You just have this detached pity for them. You don’t feel like a failure. It’s just bad genetics. My instructors had this phrase for people with bad outcomes, they called somebody a triple P, which stood for piss poor protoplasm.

Carole Freeman:              Wow, wow.

Dr. Ted Naiman:               They would literally say, “Oh this person just have bad genetics, and they’re just a bad … They’re piss poor protoplasm.”

Carole Freeman:              Wow.

Dr. Ted Naiman:               Which is terrible, and really callous and horrible. This was what they taught us so that we wouldn’t completely feel like failures when our patients just got sicker and sicker, and had amputations, and blindness, and dialysis, and then just died.

Carole Freeman:              Did they also then also frame it as the people were non compliant?

Dr. Ted Naiman:               Oh right, right, right.

Carole Freeman:              They weren’t following through with what you told them to do?

Dr. Ted Naiman:               Yeah, if only the patient would eat the right way, you know. They probably … It’s an exercise shortage, or something. The big one was genetics and then noncompliance was part of it.

Carole Freeman:              Right, right.

Dr. Ted Naiman:               And then there’s me thinking, “Wow, I’ve learned my whole life that diet is basically a joke, basically worthless, because …

Carole Freeman:              Right, ’cause look at your own experience, yeah.

Dr. Ted Naiman:               … look at me. Yeah.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               So here I am. Diet’s a joke. It’s all genetic. Everyone just gets worse. So I did my residency in South Carolina, which at the time was the number one state in the country for everything bad you could name. Obesity, number one. Diabetes, number one. Heart attacks, strokes … From a metabolic point of view it was ground freaking zero, right?

Carole Freeman:              Yeah, just bad genes everywhere.

Dr. Ted Naiman:               Just bad genes everywhere, just people down there had bad genetics, yeah. What can you say? And then one day … Well, I had all these patients just getting worse and worse right? Everyone progresses, everyone’s blood sugar is way too high. You just give them more and more insulin, so people are on every pill we’ve got for diabetes. Now they’re on insulin. Now they’re on U500 insulin. We’re just pumping people full of insulin.

They get fatter, and sicker, and eye damage, kidney damage, dialysis, just complicated. And then one day some guy came in and he said, “Hey, I’m doing great. I lost 30 pounds. My blood sugar’s better,” and I was like, “Wow. What the heck did you do? How did you do this? You have to tell me what your secret was.” And he’s like, “Oh, I just read this book right here,” and he holds up the Atkins book, right, the Atkins Diet.

And I’m like, wow, that’s amazing. So I go to my instructors. I’m in residency, right, and I’m an intern, and I said, “Look at this guy. He just lost 30 pounds. His triglycerides are lower. His blood sugar is lower. His A1C is perfect. He feels good. He looks good. His blood pressure … ” You know, I was really excited and I thought, “Man, this is a big deal. I’ve never heard of anything like this.”

And my instructors just sort of looked at me and said, “Well, what happened to his total cholesterol?” And I was like, “Oh shit. I didn’t think of that.” So I was like, “Well, it did go up like 10 points.” And they were like, “Oh, great. Well he’s probably dead by now with a heart attack. Way to go.” And I was told, I was strictly forbidden for recommending Atkins Diet for any patients because of cholesterol concerns. They’re like, “You’re just gonna kill people.”

Carole Freeman:              Yeah, even though all the other health markers …

Dr. Ted Naiman:               Everything else you could measure got better, but bad cholesterol went up, so it’s basically just a death trap.

Carole Freeman:              So how did you overcome that?

Dr. Ted Naiman:               Right, okay. So it didn’t feel right to me. I’m like, hold on. This guy looks great. He feels great. Everything you can measure is better except for this total cholesterol. Just didn’t feel right to me. So I did a three year residency, and I finished in the late 90s. Basically we were supposed to do a research project. We had to do a three year research dissertation thing where we pick any topic in health that we wanted and research a whole bunch and write a big paper. So I decided I would research macronutrients and human health.

And I read every article I could find throughout medical literature, through the world, looking at macros in health, and I realized, wow, we’re just all eating way more carbohydrates than we should.

Carole Freeman:              Yeah. That is so exciting that you actually did that because … You know that as a doctor you got very little information about nutrition at all.

Dr. Ted Naiman:               Yeah, like zero.

Carole Freeman:              It doesn’t matter. It doesn’t have any effect on that. And then for you to be attracted to that research, that makes you a really valuable resource.

Dr. Ted Naiman:               Well I hope so. It was fascinating to me, and then I realized, wow, everything we’re telling people is kind of wrong, and maybe even the opposite, and I’ve just been researching it ever since. At first it was kind of lonely ’cause there weren’t a lot of people doing that. It was like Atkins, and then Protein Power came out around the time I was doing this, which is great.

Carole Freeman:              Which is like late 1990s?

Dr. Ted Naiman:               Late 90s yeah, Dr. Eades, and I just love that book. I was like, “Oh thank god. I’m not the only crazy person out there.” It’s just kind of grown from then.

Carole Freeman:              Okay. So when you were forbidden to use this approach with your patients, how did you start sneaking that in then? Was it later when you were out of residency that you could have a little more freedom?

Dr. Ted Naiman:               I was super under the radar in residency, but I was already recommending this because I was like, “Guess what? This guy just cured his diabetes by reading this book,” and so you didn’t hear it from me, but you might want to check it out.

Carole Freeman:              There you go, okay.

Dr. Ted Naiman:               So I was very under the radar then, and sadly I’m still a little bit under the radar because I have a lot of colleagues who just think this is not the way to go.

Carole Freeman:              Right, yeah. Now what do you attribute that to?

Dr. Ted Naiman:               Really it’s fear of cholesterol and coronary artery disease. Yeah. I think the main problem that everybody has …

Carole Freeman:              Let me pause for a minute.

Dr. Ted Naiman:               Oh, sure.

Carole Freeman:              This is on the keyboard and he’s on the keyboard so … There we go. All right. Carry on.

Dr. Ted Naiman:               Yeah, I think the main problem people have is theoretical concerns about cholesterol and saturated fat, and coronary artery disease.

Carole Freeman:              Yeah. This last weekend I was at Low Carb USA.

Dr. Ted Naiman:               Oh, how was that?

Carole Freeman:              Oh my gosh, it was amazing.

Dr. Ted Naiman:               I’m jealous.

Carole Freeman:              You gotta go next year.

Dr. Ted Naiman:               Yeah. I’m really jealous.

Carole Freeman:              You gotta be on the speakers list next year, yeah. So Dr. Eades was there speaking, and all the big names and the clinicians and all that, and I totally lost what I was gonna say about it. I got so excited about thinking about the conference again. Oh gosh, okay. I’ll have to come back to that then, sorry.

Dr. Ted Naiman:               Who were your favorites at the conference?

Carole Freeman:              Oh my gosh. Everyone was really great. I have to say that I really loved listening to Dom D’Agostino because … So my own journey to a ketogenic diet was really related to crush injuries to my legs after a car accident, but then about eight months later I ended up developing post-traumatic hypopituitarism, but all the doctors that I was seeing, even the neurologist that I saw was like, “Oh no, we don’t think you had a brain injury so therefore you can’t have this.” And that would have come up right after the accident.

And it turns out that I found research articles where there’s neurologists out there saying, “Hey look people, this is common that doesn’t come up until 8, 12, or even 60 months after these injuries and you need to watch for this because this is a really big deal. And so I ended up finding that research myself, and even though I was showing that to the doctors I was seeing they were like, “Meh.” They wanted to just dismiss it.

So anyways, I have a heightened interest in how a ketogenic diet and ketones help the brain heal, and give it energy. So he’s done research in a bunch of different areas of how ketones are beneficial in the body, and one of those is, he started presenting research about how after some kind of a traumatic brain injury, whether it’s from a car accident or combat veterans, or sports injuries, that the glut receptors in the brain shut down. And I was like, “That explained all the symptoms that I had after that set in.”

And then as soon as I switched over to a ketogenic diet, within days it was like all of that subsided. It was like, “Oh.” So seeing his research and seeing the why behind what was going on for me and why it worked was like … It literally brought tears to my eyes ’cause I was like, “Oh, there’s an explanation for it. It wasn’t just this placebo effect that I had, and there is somebody that’s doing that research.” So I couldn’t get enough of all the biochemistry and stuff that he was presenting.

So that was kind of my top, but also, Gary Taubes was there, and he’s just phenomenal. His work that he’s done has been so important for getting the information out to just the average everyday person, and helping switch that. Dr. Jeff Volek was there as well and that was really fantastic. Just being in there with all those people. Dr. Eric Westman as well, and yeah, really, really phenomenal people that are all there.

The conference culminated with a couple of speakers that talked about, “How can we change the face of health care? How can we change the paradigm of what we’re in, where you’re not allowed because everybody’s afraid of cholesterol, and heart attacks, and things like that?” So they talked about how it has to be a grassroots approach that people that are following this diet and having health transformations and then sharing that with their friends, and then the healthcare providers that are actively using this approach then going out and speaking, and just sharing the transformations that they’re seeing.

Dr. Westman showed case, after case, after case of reversing diabetes, and he shared two that his approach was that the very first day that somebody follows a low-carb diet, that they cut their insulin in half.

Dr. Ted Naiman:               Oh yeah.

Carole Freeman:              That’s his instructions to them, and that just shows you how powerful that is …

Dr. Ted Naiman:               That’s right.

Carole Freeman:              … that day one you’re gonna cut your insulin in half.

Dr. Ted Naiman:               In half, that’s exactly right.

Carole Freeman:              Yeah, that’s a whole side note about the Low Carb USA conference that was really phenomenal.

Dr. Ted Naiman:               Yeah, awesome. I gotta go next year. I’m really jealous.

Carole Freeman:              Well, you can get tickets through Sunday for 199 on their website, yeah.

Dr. Ted Naiman:               Cool.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               I gotta get in on that.

Carole Freeman:              This’ll be expired by the time this video comes out though.

Dr. Ted Naiman:               Sorry.

Carole Freeman:              You’ll get … I’ve got my ticket already for next year, yeah. So wait, what were we talking about before that, about your approach for working with people? Oh, so you’re still under the radar as far as recommending this with people?

Dr. Ted Naiman:               Right, unfortunately. There are about 400 docs where I work and a few of them are okay with it or slightly friendly to it, but a lot of people aren’t and it’s kind of weird. All the nurses are on board, and all the diabetes care managers are on board, but the …

Carole Freeman:              Oh, that’s great.

Dr. Ted Naiman:               … docs are more resistant. And the nutritionists, of course, are extremely hostile.

Carole Freeman:              Wow.

Dr. Ted Naiman:               Yeah, I’m very unpopular with the nutritionists, the dietitians.

Carole Freeman:              Oh wow, yeah. Unfortunately there’s this psychological phenomenon of people want to keep believing what they believed for a long time …

Dr. Ted Naiman:               Right.

Carole Freeman:              … and even if you present them with evidence to the contrary, research, no matter how valid it is they still want to reject that because, “I can’t have been wrong for the last 30 years.”

Dr. Ted Naiman:               Right, you just can’t wrap your brain around it.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               You gotta just take it to your grave. You’re just gonna die being wrong ’cause it’s way too painful.

Carole Freeman:              We gotta wait a long time then, yeah.

Dr. Ted Naiman:               Yeah. I just don’t get that. I had no problem turning my beliefs around. I was like, “Oh, this is dumb.”

Carole Freeman:              Yeah. I apologize every day to my clients and just people in general, like, “I’m sorry. I was one of those people. I was making fun of my mom for using bacon grease to cook hamburgers when I was a kid,” and you know, “Mom, we gotta get the skim milk, and the fat free Kraft cheese.” Oh, I’m sorry.

Dr. Ted Naiman:               Yeah, I’m real apologetic about it. I just apologize on behalf of all of western medicine too for just basically a bunch of crap diet advice.

Carole Freeman:              Yeah, yeah. Well we start this united front of getting the same message out there, and it’s basically what you’re seeing, that people are getting better this way, right …

Dr. Ted Naiman:               OH yeah.

Carole Freeman:              … as opposed to what you were doing before, they were getting worse.

Dr. Ted Naiman:               Absolutely.

Carole Freeman:              Yeah. So let’s talk a little bit about your Twitter presence, because you’re pretty prominent on there. You’re pretty well known in the doctor spheres and the Tweetosphere. I have to see that you’ve got this knack for creating these infographics and other things that people just really love, that resonate with people, so how did, now I know that you have an engineering background, I can see where that came from, but how did all that all come about and evolve?

Dr. Ted Naiman:               Oh wow. I don’t really know.

Carole Freeman:              Okay.

Dr. Ted Naiman:               Honestly, I like to extremely dumb things down, like the simpler I can make it the better. So for that reason I just like just a really simple graphic. If you can’t explain your concept in 140 characters and a picture, either you don’t understand it or you’re never gonna be able to explain it. So I like to try to simplify everything as much as possible.

Carole Freeman:              Yeah. Well, and it really resonates with people too. And you’re able to do it on demand, and people are like, “Hey, what about this concept?” You’re like, “Let me just whip that out for you.”

Dr. Ted Naiman:               Oh, I don’t know about that.

Carole Freeman:              It seems like you can do it pretty quick, but maybe you have a stash of them that you’re reusing?

Dr. Ted Naiman:               Not really, no.

Carole Freeman:              No, okay.

Dr. Ted Naiman:               I just pull this stuff out of thin air.

Carole Freeman:              Well, we appreciate that. The other thing I wanted to ask too is that, your photos you have of yourself on Twitter, on social media that I’ve seen, you look really serious. So I’m wondering if this keto diet is making you really unhappy or something?

Dr. Ted Naiman:               No, I’m angry. I’m angry at conventional nutrition. I’m angry at conventional dietary advice, and conventional nutrition, and I’m just mad about it. I think that comes across in those pictures.

Carole Freeman:              But we can see that you actually do smile.

Dr. Ted Naiman:               Yeah, I smile like once a month like clockwork.

Carole Freeman:              Okay. It’s the beginning of August so it’s time for your next smile right?

Dr. Ted Naiman:               I’m almost done, yeah.

Carole Freeman:              Well let’s talk about your health transformation then.

Dr. Ted Naiman:               Right.

Carole Freeman:              So you come from a very sick person to what we see now…

Dr. Ted Naiman:               Absolutely. I was never really obese, but I’m sure I was extremely over-fat from a body composition point of view, and if you look at my website and see my before and afters I was just skinny-fat and really in bad shape, and changing my diet was huge for me, I mean a really big deal. I had this horrible eczema all the time. I was tired all the time. Just bad skin, bad energy levels, really awful, and now, complete change.

I used to have hypoglycemia on the daily. I would eat my whole wheat toast, and my fat free milk, and my cereal, and man two hours later …

Carole Freeman:              A banana or two.

Dr. Ted Naiman:               … I thought I was gonna die. I would just be shaking like a leaf. I would bonk just in doing activities of daily living on my high-carb diet. It was awful.

Carole Freeman:              So did you radically change your diet, or was it a gradual progression?

Dr. Ted Naiman:               Actually it was pretty radical.

Carole Freeman:              Okay.

Dr. Ted Naiman:               Yeah, pretty radical and very dramatic results immediately.

Carole Freeman:              So what was that like going from being mostly vegetarian to then consuming a moderate amount of animal proteins, saturated fats …

Dr. Ted Naiman:               That was fine. That was like a Tuesday or something.

Carole Freeman:              Okay.

Dr. Ted Naiman:               It really wasn’t that big a deal, and I realize now there’s a reason why vegetarians and vegans try to make things that look and taste like meat, ’cause that’s what the hell we’re actually supposed to be eating, right?

Carole Freeman:              Right, right.

Dr. Ted Naiman:               Yeah, so it wasn’t hard at all.

Carole Freeman:              Okay. Your mindset came first and then your body’s like, “Yeah, thank you.”

Dr. Ted Naiman:               Mm-hmm (affirmative), exactly.

Carole Freeman:              Yeah. So how quick of a transformation in your health, your skin issues, your energy …

Dr. Ted Naiman:               Oh wow. It was very rapid. I think it took a little bit longer before I could exercise in a fasted state and have just the same level of energy fasting long periods of time, and exercising with no calories. That took probably months.

Carole Freeman:              Okay, yeah.

Dr. Ted Naiman:               But just looking better, feeling better, that was a couple weeks.

Carole Freeman:              Wow, yeah. Those things happen fairly quickly.

Dr. Ted Naiman:               It’s pretty quick, yeah.

Carole Freeman:              Yeah. So what was that like to, then, the other people that were close to you in your life, maybe friends and family? Did they notice the change?

Dr. Ted Naiman:               I kind of moved out here to Seattle all by myself and didn’t know anyone, so I wouldn’t say that anyone around me really noticed. I mean, my family members eventually did. They were like, “Wow, you look a lot better.”

Carole Freeman:              Are they still mostly vegetarian?

Dr. Ted Naiman:               My mom is a vegetarian, but the rest of my family … My sister is a doctor and she’s completely jumped on board with this, and she’s doing awesome.

Carole Freeman:              Oh that’s great. We get one more on the train.

Dr. Ted Naiman:               Exactly. Yeah.

Carole Freeman:              All right. You also are known for promoting efficiency of physical activity.

Dr. Ted Naiman:               Right.

Carole Freeman:              Tell us about what you’re all about with exercise, and training, and …

Dr. Ted Naiman:               Yeah. I feel like exercise, we’ve really made it this thing that is basically non-sustainable for most people, right? You have to have a gym membership, and you have to have a personal trainer, and you have to block out three hours of time, and you have to pack your gym bag, and drive to the gym, and put your stuff in a locker, and change your clothes …

Carole Freeman:              Take your snacks and your drinks.

Dr. Ted Naiman:               … bring your towel. You got your pre-workout. You got your intra-workout. You got your post-workout. This is just a giant load of crap, and I really want to democratize resistance training because it is incredibly shocking how very little you actually need to get results, and nobody sees or understands this because the changes from exercise are so gradual you don’t really see it. If everyone saw the benefits right afterwards, everybody on the planet would be doing pushups, pull ups, and squats to failure in their living room for five minutes every night, and everyone would look awesome.

They’d all be on a low-carb diet, and they’d all be doing just 5 minutes of resistance training, and everybody would be in great shape. These improvements are so gradual, if you don’t know what to do, you never do it.

Carole Freeman:              Yeah, okay.

Dr. Ted Naiman:               It just never happens.

Carole Freeman:              Right, because there’s so many different approaches out there …

Dr. Ted Naiman:               Right.

Carole Freeman:              … recommendations, and people see the before and after pictures of the protein powders that have gained 40 pounds of muscle in 2 weeks.

Dr. Ted Naiman:               Right.

Carole Freeman:              That’s their expectation, right.

Dr. Ted Naiman:               Oh yeah, yeah, and then there’s so much misinformation, and so much financial stuff out there, it’s just ugly.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               So I’m trying to cut through some of the BS on exercise.

Carole Freeman:              So what’s your approach? What do you recommend then for people to do? How long everyday? What kind of exercises? How frequently every week?

Dr. Ted Naiman:               Well I think everybody should be doing resistance training of some kind.

Carole Freeman:              Okay.

Dr. Ted Naiman:               You want to do brief resistance but super high intensity to failure.

Carole Freeman:              Okay.

Dr. Ted Naiman:               So I like high intensity training. Your average person should be doing that two to three times a week. If you’re more advanced you could probably maintain with even once a week, but ideally twice a week. If you’re a newbie you definitely want to do it three times a week. So we’re talking about two or three times a week, resistance training to failure, pretty much all the muscles on your body. You can do that with weights. You can do that with body weight, but the goal is to hit complete failure with every major muscle group in your body a couple times a week.

And if you just do that consistently you get some amazing results, even with a super tiny time investment.

Carole Freeman:              All right. So for the person at home that doesn’t even know what resistance training is, or failure even, what would that look like for Tammy Joe that’s watching and she’s like, “This sounds good. Two days a week? Tell me more.”

Dr. Ted Naiman:               Right. That would be doing basic body movements, like a pushing exercise. There’s really five basic exercise movement types. There’s horizontal pushing, which could either be a chest press machine in the gym or a pushup movement, and you can scale how difficult that is. If you can’t do a pushup you start with a wall pushup, then you go with a pushup on the table or a couch, then you go to a pushup on your knees. Then you go to a pushup on your toes. Then pretty soon you’ve got your feet elevated.

You can make it harder and harder with body weight, or you can go to the gym and use the stack, and make the weights harder over time. So you got a horizontal push exercise. You got a horizontal pull exercise like a row. You’ve got vertical push and pull, so an overhead press with a machine, or with dumb bells, or something like that.

Carole Freeman:              I think I saw that video of you doing a handstand pushup.

Dr. Ted Naiman:               Handstand pushups. That’s basically one of the harder varieties, but you can start out with just a pike position pushup where you’re standing and you put your hands down in front of you. Then you want to do some sort of overhead pulling movement like a pull up ideally, or an assisted one in the gym, or a pull down with the weight machine, you know what I mean? Then you want to do some sort of compound leg exercise like a squat.

So you’ve really got just basically five basic exercises; horizontal push, pull, vertical push and pull, a squat. This is the big five as described by Dr. Doug McGuff in his super awesome book Body by Science; great book. If you don’t know anything about resistance training, “Why would I want to do it? What the heck is that even,” ready Body by Science by Dr. Doug McGuff.

Carole Freeman:              Oh good.

Dr. Ted Naiman:               It’s a very, very useful book.

Carole Freeman:              Okay.

Dr. Ted Naiman:               So yeah, you just spend 15 minutes doing all these to failure, these big 5, 2 or 3 times a week. And it’s consistency. You won’t see anything at first. Everyone gives up, or no one bothers, or they’re like, “Why would I do that,” but you keep doing it and you get big results.

Carole Freeman:              Yeah. Well, and so what are some of those health benefits that people see?

Dr. Ted Naiman:               Oh wow. You get tons more mitochondria in your muscles, which is just huge from a metabolic point of view.

Carole Freeman:              Okay. Why do we want more mitochondria?

Dr. Ted Naiman:               Right, okay. So mitochondria are the little energy factories inside all your cells, right? All your cells have anywhere from a few hundred to thousands of mitochondria, and your mitochondria actually oxidize all your food, all your calories, either glucose or fat, and produce ATP which runs your whole body, it’s just this energy molecule.

Carole Freeman:              Okay.

Dr. Ted Naiman:               So these are the little energy factories in your muscles, and the problem I see with a lot of patients is that they’re on a super low-carb diet. They’ve got that nailed. Maybe they’re even fasting. They’ve got that down. They’re a fat burner. They’re a fat burning machine, but they have maybe one mitochondria in their entire body, right? You’ve got one mitochondria. It’s fat burning. It’s fat adapted. It’s burning fat like crazy, but it’s just one. It can’t burn a lot fat. It’ll never burn enough fat to get that person the results they want.

But you do pushups to failure, the next day you’ve got two mitochondria; mitochondrial biogenesis. Your muscle only make more mitochondria if you convince it that it has to. You have to give it a reason. It will never grow more unless you give it a reason. But you exercise to failure then your muscle is like, “Oh dang, we almost just died.” So your mitochondria, bling, now you’re got two. So you do that again, now you’ve got 4, and then 8, and then 16, and you can literally get way more mitochondria in your muscles versus someone that’s not exercising.

Carole Freeman:              All right.

Dr. Ted Naiman:               If you look at people who do tons of exercise, they have orders of magnitude more mitochondria in their muscle, and their metabolism just goes through the roof. They’re just burning calories twenty four seven. You get so much more metabolic efficiency, and mitochondrial health is basically everything. All these people with chronic diseases, they have very few mitochondria, and their mitochondria don’t work that well. They’re not that efficient, or they don’t oxidize fat well.

So exercise just blasts through all of that. Way more mitochondria, way better mitochondria. It’s a huge, big deal.

Carole Freeman:              So what happens to somebody that’s eating a standard athletic diet. they’re very high-carb and they’re active, what kind of comparison do they have for mitochondria. Are they still making massive amounts, are the mitochondria just not very good at burning fuel?

Dr. Ted Naiman:               If you’re exercising enough, like huge volume, huge intensity, huge duration, you can get away with eating tons of carbs. You look at Michael Phelps who’s the Olympic swimmer guy who eats 12,000 calories a day, but he’s in the pool all day, and it’s this heat sync where, you know how you just lose tons of heat when you’re in water all day, so you do a lot of mitochondrial uncoupling and you’re just burning thousands of calories for heat. And he’s probably even entering ketosis because the intensity’s so high you have to. You burn through all your glycogen and glucose, and you still have to switch over to fat.

So you can do enough exercise to basically be able to eat crap and still be in pretty good shape. I don’t recommend that.

Carole Freeman:              Well, and we’re seeing more and more stories of people that have followed that model and then they’re still getting really sick in later life.

Dr. Ted Naiman:               Well the day he stops swimming he’s totally screwed. Like the next day. It’s like instant diabetes. Yeah. So you can get away with it, and it’s good to know that. I don’t recommend it.

Carole Freeman:              Well, and I see it commonly, the weekend warrior marathon runners that they say, “I run so I can eat whatever I want,” but you can tell lookin’ at ’em that it’s not workin’ so good for ’em.

Dr. Ted Naiman:               Right. Definitely.

Carole Freeman:              Yeah, yeah. ‘Cause I think they end up eating even more.

Dr. Ted Naiman:               Mm-hmm (affirmative).

Carole Freeman:              Yeah. Let’s see, so health transformation you experienced. What are some stories of things you’ve seen in your patient’s?

Dr. Ted Naiman:               Oh wow. I’ve just seen it all with 50 pound weight loss, 100 pound weight loss, 150 pound weight loss, coming off hundreds of units of insulin a day and just throwing all your meds directly in the trash. I’ve seen tons of awesomeness. Really nothing but success, and it’s very exciting. It really makes my job easier.

Carole Freeman:              Yeah. I’m sure you have a certain portion of people that, either they’re just psychologically resistant to trying this, or they’re not ready to make a dietary change, how do you approach that?

Dr. Ted Naiman:               I do see … Honestly, a lot of what I see in my practice ends up being addictions medicine. So I have a lot of patients who can’t quit smoking, have a lot of bad health outcomes, can’t quit drinking, bad health outcomes. I have a lot of patients with opioid addiction, and different forms of addiction, and this gives them bad health outcomes, and I have a lot of people who just quite frankly have a carbohydrate addiction. It raises dopamine in your brain.

If you know something bad is happening to you because you’re eating carbs and it is happening, you’re having a bad outcome, but you can’t make yourself not do it, that’s basically pure addiction. And I do have a lot of people who are addicted to carbohydrates. That’s tough.

Carole Freeman:              Mm-hmm (affirmative), yeah.

Dr. Ted Naiman:               I don’t have a really great magic solution for that one. That is tough. I even have patients who, they know this is happening. They admit it. They don’t want to be that way but it still happens, and we just try to come up with coping strategies, or a way to minimize the damage. Try to be a little more strategic with carbs, you know what I mean? Try to save them for the very, very end of the day so you don’t have as far to fall.

Maybe try to make them post-workout or post-fasting so you’re not gonna damage yourself ’cause your glycogen’s already tanked up and everything you eat just goes straight to de novo lipogen [inaudible 00:39:35] stored as fat.

Carole Freeman:              Well, and one of the attendees at the low carb USA conference that stood out the most to me, we were just at the same vendor booth and I overheard him sharing with the person running the vendor booth that, he say, “I’ve done been hooked on every street drug that there is.”

Dr. Ted Naiman:               Right.

Carole Freeman:              And he says that low-car ketogenic diet takes away 80% of my desire to use those drugs, but he says, “I’ll tell you the drug that’s been absolutely the hardest to get off of,” I’m sure you can guess.

Dr. Ted Naiman:               Sugar.

Carole Freeman:              Sugar, yeah.

Dr. Ted Naiman:               Yeah.

Carole Freeman:              He says, “I’ve done heroin, and coke, and everything.” He says sugar is by far most addictive substance …

Dr. Ted Naiman:               Yeah, sugar is bad.

Carole Freeman:              And I run into that with people that I work with that, they’re going through physical withdrawal from cutting out the sugar and carbs, and it doesn’t make any sense to them. They think, “Oh, this diet must be doing something bad to my body because sugar’s legal, so how can it be that bad? How can I go through that? Doesn’t make any sense why it makes my muscles hurt.” And we live in a world where there’s this addictive substance on every corner, and in every home, and people’s cars …

I sometimes make the analogy of like, if people gave heroin as birthday gifts, and you could drive through heroin stores, and at the grocery store there’s heroin displays, it would make more sense to people why it was so hard to get off of those and why we’re having this health epidemic, but instead it’s like this legal substance, and it’s what love is, and it’s how you show affection for people, and celebrate things.

Dr. Ted Naiman:               Right. Yeah, it’s bad. If you want to wonder if sugar is addictive or not, just look at some five year olds and some candy.

Carole Freeman:              Mm-hmm (affirmative). Yeah.

Dr. Ted Naiman:               Pretty much tells you.

Carole Freeman:              Even the fact that in hospitals with newborn babies, they use sugar water as the opiate to numb whatever procedures they’re gonna do.

Dr. Ted Naiman:               Right, yeah.

Carole Freeman:              Yeah. They know.

Dr. Ted Naiman:               Absolutely. Yeah, unfortunately I have a lot of patients who are heroin addicts, because they have a suboxone license, and these people have near universal massive sugar cravings, and their diet is just Mountain Dew and candy. It’s just horrible. There’s almost a little bit of crossover there unfortunately.

Carole Freeman:              Yeah. Well maybe we could figure out a way to help transform that.

Dr. Ted Naiman:               It’s tough.

Carole Freeman:              It’s a big job, yeah. Well, I wonder then, what are your top tips for people that are hearing this maybe for the first time and they’re kinda like, “Yeah, maybe I’m ready to give it a try, make some kind of a dietary change.” What are your tips for …

Dr. Ted Naiman:               Okay, my number one tip for everyone is just target protein first, and plan your whole day around, “How am I gonna get my protein target?”

Carole Freeman:              Okay.

Dr. Ted Naiman:               That should be your goal every day. So every day I eat maybe a pound of fatty meat or eggs, and my whole eating day is centered around that, and that’s really what you want to do. You want to highlight your protein source, make sure it has fat in it, and I’m basically talking meat or eggs. So many people are, I think, trying to restrict carbs, but they don’t first go out of the way to eat what you’re supposed to eat.

So if you make, you know, a six egg omelet cooked in butter with cheese, with bacon, with an avocado, with heavy whipping cream in your coffee, and you’ve built this meal around this giant pile of eggs, you can walk right past the donuts. You can walk right past the cupcakes and the carbage at work. But what you can’t do is just say, “Okay, today I’m gonna restrict carbs. I’m just not gonna eat the donuts, and I’m not gonna eat the muffins.” That’s not gonna work.

You’re gonna be starving. You’re gonna eat all this stuff. So the goal is, what is the giant one or two pounds of fatty meats or eggs I’m gonna eat today? Am I gonna eat a steak the size of my head cooked in butter? Am I gonna make a dozen egg scramble? So you just get a bunch of high quality animal product fatty meat or eggs and just center your whole eating day around that. Many days all I’ll eat is just a big pile of eggs and a giant piece of meat, and that’s cooked in butter, and maybe some green vegetables.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               Maybe.

Carole Freeman:              Okay.

Dr. Ted Naiman:               And that’s my advice.

Carole Freeman:              I love that starting place. Before I even knew anything about a ketogenic diet, or low carb high fat, that was the thing I found with my own clinical patients, the best results, was just, especially breakfast, getting a big pile or a decent dose of protein at breakfast, because that’s probably universally the most deficient thing that people have. They either have a really high carb breakfast, or they skip breakfast and then eat high carbs later the rest of the day.

Dr. Ted Naiman:               Right.

Carole Freeman:              That’s what I’ve found as well, is if they can just get a decent source of protein in the morning that helps level out the blood sugar the rest of the day and take away a lot of those cravings.

Dr. Ted Naiman:               Absolutely.

Carole Freeman:              Yeah. Get your biology in line and then willpower is much easier.

Dr. Ted Naiman:               Right. Go way out of your way to eat a whole bunch of what you actually need, and then you can just walk past the crap.

Carole Freeman:              Yeah. And I always love the thing that happened too when I tell people to have like three or four eggs at breakfast and they’d be like, “Oh my gosh, that’s way too much food. I could never eat that.” And then I would point out the fact that like each egg is about a quarter of a cup, so four eggs is only a cup of eggs, and most people will eat a cup or two of oatmeal no problem. So it’s a mindset thing of like, “Well, eggs are bad, and they’re high in fat, so therefore I should have two cups of oatmeal for breakfast, ’cause I can digest that easily.”

Dr. Ted Naiman:               Right, it’s terrible, although some of this just comes straight down from the American Heart Association, American Diabetes Association advice. They’re like, “Go ahead and have an egg a week.”

Carole Freeman:              Yeah, one egg.

Dr. Ted Naiman:               An egg, one egg.

Carole Freeman:              And then a couple egg whites on the side.

Dr. Ted Naiman:               Right. Which is just disturbing.

Carole Freeman:              Well, we’ve come far, and we have a very, very long ways to go. I appreciate your work, and more of us coming together and trying to get the word out about how to actually get healthy. It isn’t about some fad diet that’s like a temporary thing that people need to go on and then they can go back to their old thing, or that we’re gonna find out that like, “Oh, it turns out that high carb really is healthy for us.” Well, I don’t see that happening.

Dr. Ted Naiman:               Right.

Carole Freeman:              So was there anything else that you were hoping that I would ask you?

Dr. Ted Naiman:               Wow, no. I think the number one issue I see with my patients is that they’re nailing a low carb diet, they’re nailing fasting, but they’re not exercising, and their whole body has one mitochondria in it, and you’re not gonna get it until you just do pushups to failure in your living room, and it’s only gonna take you five minutes.

Carole Freeman:              Yeah.

Dr. Ted Naiman:               So that’s the direction I want to see more people go.

Carole Freeman:              Okay.

Dr. Ted Naiman:               And I feel like a lot of the low carb community, we know that exercise doesn’t fix the problem. You can’t outrun a bad diet. I totally agree, diet has to come first. But, you throw some exercise in there and get more mitochondria, and your whole health improves. So I don’t want to be the, “Just eat less move more,” guy, but …

Carole Freeman:              Yeah. Eat different, move more.

Dr. Ted Naiman:               Right. I’m not recommending hours on the treadmill. I can be very brief and very focused, but I do want to see people do more resistance training.

Carole Freeman:              Okay. So abs are made in the kitchen, especially if you do your pushups in the kitchen as well, right?

Dr. Ted Naiman:               Right, there you go. I like it.

Carole Freeman:              Well, I have one closing question for you. If you knew today was your last day on earth, what would your last meal be?

Dr. Ted Naiman:               Oh wow. I’m such a egg fan, it would probably be a giant omelet. This is like my favorite food on earth.

Carole Freeman:              What kind of eggs?

Dr. Ted Naiman:               I buy just chicken pastured chicken eggs, but I would probably make a giant omelet with some Parmesan cheese, avocado, bacon on the side. You would think I’d be sick of that, but definitely not.

Carole Freeman:              Makes you happy and makes you feel good.

Dr. Ted Naiman:               Mm-hmm (affirmative).

Carole Freeman:              All right, very cool. Well, Dr. Naiman I really, really appreciate you being here. It’s been a pleasure, and if you all like this video give us a thumbs up and subscribe if you want to see some more. That’s all for now.

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