Transcript Of Today's Episode
Dr. Martin, Jr.: Hello. I'm Dr. Martin, Jr.
Dr. Martin, Sr.: And I'm Dr. Martin, Sr.
Dr. Martin, Jr.: And this is The Doctor Is In podcast, and this is Episode 140. Now, today we want to talk about [00:00:30] some recent news that came out about the Mediterranean Diet, specifically, and how one of the big papers that was published on it that had some of the more exciting benefits for the heart, was retracted. That doesn't happen that often. I was reading that it happens about one every thousand or so papers do they get retracted. So it's not a common thing that that happens, but this major study on the Mediterranean Diet was retracted. I guess there was too many errors, in a sense, to fix it [00:01:00] so they pulled it back, and they're going to republish it with some of the, you know ... Basically, the conclusions, from what I've read, will be softer than they were in the original paper in terms of like 30% decrease in cardiovascular stuff.
We'll talk about the Mediterranean Diet today. We'll talk about really what the purpose of diet is. We'll go through a whole bunch of things along that line, but first, there's a lot of times ... See, the funny thing is about the Mediterranean Diet, is it's [00:01:30] defined as this, which is basically it's a diet that's full of fruits, vegetables, olive oils, nuts and fish. It's really a whole food diet in a lot of ways. Some would-
Dr. Martin, Sr.: Olive oil.
Dr. Martin, Jr.: Yeah, a lot of olive oil, and this is the problem that I have with the Mediterranean Diet is that it's really tough to define. How much of that stuff do you eat? How often do you eat it? It's really one of those diets that people get frustrated with, especially researchers, because the goalpost seems to move [00:02:00] on that diet all the time. It's very hard to nail down exactly what the Mediterranean Diet is. Just that it's rich in those things, is that all they should be eating? That's what makes it difficult. Plus, sometimes you read about the Mediterranean Diet and they'll recommend whole grains. They'll recommend those kind of things. Again, it's a very difficult diet to define, but if you mention the Mediterranean Diet, everybody thinks of healthy right away. Right?
Dr. Martin, Sr.: Yeah.
Dr. Martin, Jr.: They think of healthy. If you go off the basic [00:02:30] definition which is fruits and vegetables. Okay, healthy, healthy. Olive oil, very good for you. Nuts, very good for you. Fish, very good for you. If somebody were eating that way, they would be very healthy, generally speaking. They'd be very healthy. The problem with just saying that, is that all they're supposed to eat? Right? Because that's the difficulty. If you're, really at the end of the day there are a lot of ways - You and I are kind of always known as the low-carb and that's a tool that we use because it's a very effective tool, but I mean there are [00:03:00] really a lot of ways that people can lose weight. The problem is this. Low-carb, it satisfies one of the hardest things for people, which is hunger. Once they cut their carbs out enough and they start burning fat for energy, generally speaking, hunger goes away.
Now, when you first start eating any kind of diet, you're going to be hungry at first. Right? You're generally, as you cut back on the amount of foods you're eating, you're not going to feel as good. Your energy may dip a little bit, and that happens with low-carb as well. They call it the keto flu if they go that low. Right?
Dr. Martin, Sr.: Yeah.
Dr. Martin, Jr.: [00:03:30] If they go as low as ketogenic, that is definitely something that happens. At the end of the day, all these things really, at the end of the day, help lower insulin one way or the other. Now, what's your take on this?
Dr. Martin, Sr.: Well listen, I ... Whenever anybody ever talked to me about the benefits of the Mediterranean Diet, I said, "Well, any benefits they get is because they're not being like North Americans who are carbaholics." Right?
Dr. Martin, Jr.: Yeah, not a lot [00:04:00] of processed foods on the list.
Dr. Martin, Sr.: Yeah, they're not eating the processed foods. Any time you do that, you're lowering your sugar content in food. I mean, not that in Mediterranean areas that they wouldn't have any kind of dessert or anything. It's not that they would never have sweet, but they don't live on it. They're not consuming 180 pounds to 200 pounds of sugar a year, which the average North American consumes. That's just the way it is, so any deviation from that carboholic [00:04:30] diet that we live on would be good for you. What I always had an issue with the Mediterranean Diet is that they left things out. I always felt that fish is great, and I love fish. I mean, for people it's good for you. Right? There's no doubt, but I always felt that they were not, never enough on, they weren't getting enough protein in their diet. I always felt that it was good, be it could be better. We were the ones ... I always said that [00:05:00] we sort of focused in on eating more eggs, more meat, and fish. Fish is great. Right?
Dr. Martin, Jr.: Yeah.
Dr. Martin, Sr.: I was always one, as you lower your carbohydrates down, that you're going to be upping ... It wasn't just for weight loss. I'm talking about the way we talk about food is weight loss is a benefit, but the other benefits come when you lower your insulin.
Dr. Martin, Jr.: Yeah, and you're right, I mean the Mediterranean Diet, unless you're eating fish all the time, it's very [00:05:30] hard to get enough protein in a day with simply nuts and some fish. Again, I mean you had to be eating fish all day to get enough protein. One of the biggest problems with people as they age is a condition called sarcopenia, which goes hand-in-hand with osteoporosis. One of the motivating or driving factors of that is really a lack of protein intake over their lifetime and then a lack of muscle-building. It's very hard to build muscle if you're not eating enough protein. [00:06:00] That's just the reality of it. Right? If you're not getting enough protein, you're breaking down amino acids and, of course, your amino acids - muscles are a great source of amino acids - so your body's breaking down its own muscles-
Dr. Martin, Sr.: It becomes catabolic. Right?
Dr. Martin, Jr.: It does. It definitely does. You start to break down, so that's the issue that I have with the Mediterranean Diet in the sense that nobody can really define exactly how to follow it. Because if a person can only eat those things, would they lose weight? Yeah, absolutely they would lose weight, but again, losing weight is not always the objective [00:06:30] in a sense that if you're going to lose weight, and most of you have heard this before ... But I mean, you can lose fat, you can lose water, or you can lose muscle. Now, muscle and water are kind of the same thing in a lot of ways, but you definitely want to lose fat. You don't want to lose muscle. When somebody loses weight, and they don't get enough protein, and they're not exercising or doing weights, they tend to lose a lot of muscle mass as they lose weight. Just strictly eating less [00:07:00] food, you're going to waste your muscle away, so you have to have a plan, especially as you get older. Right?
Now, losing weight's always a good thing in a lot of ways because it lowers your blood pressure, it decreases a lot of cardiovascular risks and on, and on. But if you're going to lose weight, you definitely want to do it the right way, and that's making sure that you get enough protein. Protein really has to be that kind of, that has to be the target. Right? You have to build a diet around protein [00:07:30] intake. You have to make sure that you're getting enough protein in your day. If you look at the way to eat --right -- if protein remains constant or you want to increase protein, a great strategy for people to lose weight is you increase protein because it really does fill you up. You increase protein and then you have two other macros, in a sense. Right? You have carbohydrates and you have fats. That's where all the different diet variations come in. Now, you can just eat less food of everything, but if you decrease your protein intake, you're going to lose muscle. I don't care who you [00:08:00] are. You're going to lose muscle.
You can see, when people lose a lot of weight, and they lost it by eating less food but they didn't really pay attention to protein, they look fragile. Right? They don't look as healthy. In a sense, they look weak and frail. You've seen it. They just look like a shrunken-down version of them self. Their body composition has changed, in a sense, that they look skinny or thinner, but they really don't have that composition that would indicate that they got enough protein when they did it. [00:08:30] So you can just simply eat less. Right? Forever, doctors gave that terrible advice, just eat-less-move-more, like that's a magic formula. Right? So you can eat less-
Dr. Martin, Sr.: That's a recipe for failure.
Dr. Martin, Jr.: Oh yeah. No question. If protein is the anchor, if that's the kind of anchor of every way of losing weight - getting enough protein - then you definitely want to do something with your carbs. In fact, and this is where there's a lot of debate. But let's get one thing [00:09:00] straight, if you eat a high-protein, low-carb, moderate-fat, you're going to lose weight. If you eat a high-protein, moderate carb, and low fat, you're going to lose weight. I mean, no question. And that's what we always tell people. The thing is, what we deal with all the time are people that are insulin resistant, that are a mess metabolically, and research is pretty clear on that. If you're on that end of the scale [00:09:30] where you are no longer insulin sensitive, then you are better to go on the side of low-carb and higher fat, than you are on low-fat, higher carb. That's just the reality of it.
If you are not metabolically messed up, if your hormones are okay, if you don't have a metabolic disorder, if you're not insulin resistant, then you could kind of choose both ways. You could say, "All right. I'm going to increase protein. I'm going to cut my fat down, and I'm going to eat [00:10:00] a little bit of carbs." But, for most people, especially as they age, they don't do well like that. They don't.
Dr. Martin, Sr.: And if they got any hormonal - like you say -
Dr. Martin, Jr.: Yeah any issue.
Dr. Martin, Sr.: If they got any kind of that hormonal storm, where they're out of balance and they are living in a metabolic disaster for them, then guess what? They need very, very specific-
Dr. Martin, Jr.: And that's why we tend to talk a lot about eating this way because [00:10:30] what we see every day, if somebody's fatigued ... we got a webinar, we're doing a live presentation of a webinar coming up on Thursday night on fatigue. If somebody's fatigued, they do much better on the, generally speaking, eating more fat, less carbs, because it usually means that their insulin's messed up. That's why we talk a lot about diet composition. We're not naïve, in the sense where we say the only way to do something is by going low-carb. We understand [00:11:00] that. But, for what we deal with every day, and the people that we deal with every day, there's no question that's the best route for them.
Dr. Martin, Sr.: We're not looking at the vast majority of our patients are not coming in, they're not weight-lifters, they're not professional athletes that are at the top of their game, and they just want to tweak a little bit, and whatever. [crosstalk 00:11:23] The reality is that the vast majority of our patients, they're in for a reason.
Dr. Martin, Jr.: They've either got high blood pressure, [00:11:30] I mean they got either-
Dr. Martin, Sr.: Thyroid's not working
Dr. Martin, Jr.: Yeah, they're symptoms of insulin...
Dr. Martin, Sr.: They're adrenally exhausted. They have insulin resistance. Their estrogen is dominant. All those things, they create a cascade of symptoms and that's what I have to deal with. That's what we're dealing with with the biomarker testing, that's what we're dealing with. When we created our way of eating, there's a reason for it. [00:12:00] I get people that... the problem is when you're online and you're dealing with people that they're not into seeing patients. They're into... they might know a fair amount about nutrition, but they're not dealing with people, so they're not... Look, you've got to understand at the Martin clinic, we've got real people. Every day, people are unwell from cardiovascular, to hormonal, to [00:12:30] adrenal exhaustion, to thyroid not working to their ovaries secreting an enormous amount of estrogen, they've got insulin resistance.
We've got to deal with that. If we're going to get in any results, it's, just, stop eating, cut your carbs down-
Dr. Martin, Jr.: And what those say a lot of times, too, in research, is that, and this is what is kind of what is a pet peeve of mine, when they talk about all the different ways of eating, they say, "Well, there's no difference if protein and calories are equal." But that's the thing, that's not real [00:13:00] life. THat's in a lab. That's in a metabolic ward in a lab where they control every aspect. That's not real life. In real life, it's very difficult to count your calories. And also, the calorie counts on foods are way off, sometimes, as much as 20% sometimes. And perfect serving size and measuring, and all, that's a pain in the butt.
Now, you can go about that method if you want, and you hit your protein target, you hit your carb target, you hit your fat target every day, and you do that over a long period [00:13:30] of time. But man, the advantage that a lot of people have when they cut out their carbs is 1, they get hungry, they eat less food. There's no question, generally speaking, after awhile on low-carb, especially when they get over onto that fat-burning side of the equation, when they stop burning carbs for energy and they tend to burn more their own fat for energy, what ends up happening is they generally are less hungry. They end up eating less food. People always say calories are equal. But, the amount of calories that a low-carb person would have to eat, in [00:14:00] a lot of these studies they're actually eating more calories than they normally would on their own. They're eating more food than they normally would on their own.
When they do these side-by-side studies and they get the calories equal, it's like, well, see, they both had similar weight-loss. The problem is that's not real life. In real life, people tend to eat less food when they're going low-carb because their hunger hormones are not out of whack. Their blood sugar level is stable. They feel better all the time.
Dr. Martin, Sr.: Their inflammation markers are down.
Dr. Martin, Jr.: Yeah. So, it's not that you can't get healthy the other way, it's just it's a lot more work. And [00:14:30] the difference is if you are pre-diabetic, type 2 diabetic, if you are metabolically messed up, if you've got bad hormones, then there's no question that going down the route of lower carb... and here's the thing with low-carb. And this is something that you and I deal with a lot of questions on this issue, is what does low-carb mean? Well, listen, low-carb is very, very subjective because somebody who is used to eating 300g of carbs a day, and they cut it down to [00:15:00] 150?
Dr. Martin, Sr.: That's low-carb.
Dr. Martin, Jr.: That's low-carb. THat's eating 45g or so every meal. That's not a lot of carbs, in a sense. That's 150g of carb. That's low-carb. And, generally, when they do that, they'll lose the weight over a period of time. Then you can eat under 100g of carbs a day, then you can get ketogenic which is when you get down to a certain amount, men is around 50, women around 30, if they're really messed up metabolically, it could be even less than that. But they end up going into a process called ketosis, which is, basically burning fat for [00:15:30] energy. They're making ketones.
There's a lot of things with low-carb. The difficulty is, everybody has a different carb tolerance. You and I talk about this in some of the programs we've done before, but everybody can handle carbs different. There's a lot of factors that determine how many carbs a person can eat. For example, like you've mentioned, a person that has more muscle mass can tolerate more carbs because they have more storage for glycogen. They don't use it right away for energy, it gets turned into glycogen and put into storage. [00:16:00] More muscle means more metabolism, means more storage, means more, higher carb tolerance. Somebody, who has less muscle, a whole bunch of factors, they generally can't tolerate as many carbs as somebody else. Also, how insulin resistant the person is - the more insulin resistant, the less carbs they can tolerate. Which is why a type 2 diabetic, which is really another way of saying an allergy to-
Dr. Martin, Sr.: Carbs.
Dr. Martin, Jr.: Carbs. Unfortunately, they can't tolerate many carbs at all. So, a Mediterranean [00:16:30] Diet with all the fruits they can eat would be a nightmare. It would be a disaster. That's the issue we have with the Mediterranean Diet, is it's a good idea, I think, if you're metabolically healthy and it's all you eat, you would definitely have to supplement with protein. I think the Mediterranean Diet, without eating enough fish, you have to eat enough fish. Plus, you have to, then, some kind of B12 supplement, because it'd be very difficult to get enough B12 in your diet that [00:17:00] way.
They'd get enough omega-3s for sure, they'd get enough DHA. If they're eating fish all the time, they would cover that trail pretty good right at one of the chronic deficiencies in people is not enough omega-3, they'd get enough omega-3s in their diet eating that way, for sure. B12 they'd struggle. If they're not eating any red meat, they'd struggle getting B12. They'd have to supplement with that. And then, again, like anything else, you can overdo it on fruit.
Dr. Martin, Sr.: Oh yeah. Yeah.
Dr. Martin, Jr.: You can eat too much fruit.
Dr. Martin, Sr.: Well, we see it a lot today, and, just again, I always tell people fruit is like God's [00:17:30] candies, right? You've got to understand that the world's changed. We don't live in the same world and it's wonderful if you live in Europe and you probably weren't consuming 180 pounds of sugar a year. You might, the Mediterranean Diet for you, and you can have some grapes and bananas, and you're eating that stuff and you've got no issues at all, it's good for you, they're God's candies.
But if you live in North America, and, again, like I said, the average Canadian is insulin resistant. [00:18:00] North American absolutely insulin resistance, we are sugarholics, carboholics. And now your metabolism has changed to the point that you're creating uric acid, and uric acid, that is a big no-no for fruit. I always tell people, whether it's God's candies or just bad candies, it's still sugar. And now, again, because of insulin resistance and what happens at the kidney level, you're not getting rid [00:18:30] of all your uric acid. You're not converting all of it to urea, it's coming back into the bloodstream, and now you're creating inflammation, you're creating- So, again, fruits are good, "But doc, can I have as much fruit as I want?" Well, not in this day and age you can't. Most people can't anymore-
Dr. Martin, Jr.: No, you definitely can't.
Dr. Martin, Sr.: It's too much sugar, right? So...
Dr. Martin, Jr.: There's a lot of evidence showing that fruit today are bigger. Apples [00:19:00] are more sugary today. You see those pictures of bananas, older bananas, definitely don't look like the big, yellow ones we have today. Again, a lot of things have been modified to a certain extent. But, again, if you're metabolically healthy, then you can have some fruit every day, and a little bit of fruit, again. One way to become metabolically unhealthy is to eat a lot of fruit, especially, and let's just end the podcast by just kind of talking with this.
In research, [00:19:30] if you want to fatten up a mouse for the purpose of a study. If you wanted to run a study on mice, and you wanted some of those to be fat, then what you do is you would feed them a combination of fat and carbs, and, specifically, the fat is like, vegetable oil type fats, inflammatory type fats. And carbs are like a higher, sugar-based, high fructose kind of stuff. That's the worst combination. You combine [00:20:00] that kind of fat, and that kind of carb, that's not good news. And you know that because there's none of that in nature. There's no high fat, high carb-
Dr. Martin, Sr.: But look at an avocado.
Dr. Martin, Jr.: Yeah. It's a fruit, but it's a high-fat, it's a very low sugar fruit. It's just a bad combination, right? A lot of the times people run into problems when they eat fruit at the end of a fatty meal, or [00:20:30] they eat fruit and they're eating fats, or they're eating - there's a lot of things. Sometimes the fruit itself is not even the problem. It comes in combination with what you're eating. You have a piece of fruit after a big, fatty meal, that's just not smart because, again, you have to think about how the body stores fat, right? You burn off what you can for energy. Let's just say you eat a carb-y meal, and you have some fat with it. [00:21:00] Carbs burn quickly, so whatever energy you need right then and there you're going to burn those carbs off. However, what happens is all that energy you ate, and that fat, you don't need it. So, you break it down into glucose, convert it into storage, you store it as fat.
Fat will be stored as fat when you eat too many carbs. If you're not eating too many carbs, fat is a great source of energy, a great, slow-burn of energy. But, the problem that comes in our society is that we mix all these things together, and that's [00:21:30] a lot of the issue. Again, if somebody is eating a piece of fruit a day, no big deal. If they're metabolically messed up, it's a huge deal. But, you could see why there's a lot of confusion on diets. People have so many questions on it.
Now, as you mentioned we like a low-carb... In fact a book we wrote awhile ago, way before the keto fad came out, was Serial Killers where we talk about a ketogenic diet, but that's a cyclical ketogenic diet. So, there's a day where you can carb-up a little bit, [00:22:00] so that it's easier to maintain, easier to follow, and people get tremendous results on that.
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