Gallbladder issues
My wife was diagnosed with acute cholecystitis after a hospital visit likely from the previous particularly fatty low carb meal. She has had abdominal discomfort for over a year and we think it could be related to me pushing a strict paleo style diet. How should someone eat when their body is struggling with gallbladder issues and a very high fat diet? Reduce/eliminate long chain triglycerides and eat more MCT's? Less red meat more chicken and fish? We currently eat a diet based on your advice even though I do not understand how you eat bananas based on their sugar content.
Accessible to Everyone?
I'm referring to your podcast intro, just as a friendly reminder of your stated goal. I listened to a recent podcast episode with ZDogg, VP, and Marty Makary. It was entertaining and informative, but, I often feel like I'm "on the outside looking in" with these guys. They tend to talk really fast and use acronyms with no explanation. I know it's hard to slow things down and kill the flow. And, I'd say you do a decent job of stopping to explain what something means for the benefit of the listeners. I'd like to see some charts comparing your favorite efficacy benchmarks for the most popular, if alleged, Covid treatments. (ivermectin hydroxychloroquine fluvoxamine) And, also the risks. Personally, I've been on an SSRI and an SSNRI, so I imagine I could take some comfort in taking fluvoxamine at a somewhat lower risk. Maybe you can show how you extracted the numbers mentioned in the Facebook video (regarding pharmacies not filling fluvoxamine) from the study. I'm willing to what video for this! :^) Thanks!
What are the percent macronutrients in various diets?
People bandy about terms like low-carb, high-protein etc., but what are the % of energy for these diets? I think the classic 4:1 ketogenic is pretty well defined: 80% fat, and around 15% protein, 5% carbs. Call that 80/15/5. (Also seen 75/20/5.) But what is a low-carb diet in percentages? Same for high-protein? It seems rather vague. And aren't high-protein folks worried the cancer potential (via IGF-1) of high-protein diets? Example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988204/ ("Among those aged 50–65, higher protein levels were linked to significantly increased risks of all-cause and cancer mortality (Table 1). In this age range, subjects in the high protein group [>20%] had a 74% increase in their relative risk of all-cause mortality (HR: 1.74; 95% CI: 1.02–2.97), and were more than 4-times as likely to die of cancer (HR: 4.33; 95% CI: 1.96–9.56) when compared to those in the low protein [<10%] group."
Protein g/kg/d
Protein consumption for adults tends to be one of the more controversial topics. The National Academies says the average need is 0.66 grams/kg body weight/day (abbreviated g/kg/d), and so sets the RDA for 97% of the population at 0.8 g/kg/d. Valter Longo's Longevity Diet for <65-70 suggests 0.7 g/kg/d. Some recent papers suggest >65yo should get 1.0-1.2 g/kg/d (e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882708/). The International Society of Sports Nutrition says "For building muscle mass and for maintaining muscle mass through a positive muscle protein balance, an overall daily protein intake in the range of 1.4–2.0 g protein/kg body weight/day (g/kg/d) is sufficient for most exercising individuals, a value that falls in line within the Acceptable Macronutrient Distribution Range published by the Institute of Medicine for protein." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477153/) What is your take on all these very different numbers?
Metabolic syndrome
What I've taken so far from the podcast is that for metabolic syndrome (e.g. elevated ApoB and Triglycerides, BMI ~30, ALT ~25, uric acid > 5), the first steps should be diet (particularly TRE and fasting, no fructose, limited purines), exercise, and statins. For someone doing all of these already and seeing big improvements, but numbers still above healthy levels, is there a next step, perhaps temporarily, to accelerate rate of progress (e.g. reset what Richard Johnson calls the Fat Switch)? Allopurinol? Metformin? Something else?