This Doctor Knows How to Find the Root Cause of Your Medical Problems | Paul Saladino

And I think that I'd had a little taste. You know, growing up in the suburbs I'd had this little taste of something bigger than me in the natural world. And I think that humans find some clarity in our meaning and our place in the universe when we stand in front of things that are bigger than us. And that can be technology, that can be city, that can be art, that can be creative processes, and that can be a mountain or an ocean or an avalanche, right? And so, that was where I went cuz I'd had that little piece of nature being bigger and kind of wild. Hey everyone, welcome to Health Theory. Today's guest is Dr. Paul Saladino, MD. He's a certified functional medicine practitioner who completed his medical residency in psychiatry at the University of Washington. He's taken a pretty unconventional path to where he is today, participating in ultra-marathons and spending 2 years hiking and skiing the Teton Mountains of Wyoming, as well as extended periods exploring the back country of the southwestern United States and the wilds of New Zealand. Through all of his physical endeavors, he's gained a powerful appreciation for the impact that nutrition plays on our strength, endurance, and overall well-being. And that is precisely what led him to getting his MD. And I want to start in the back country. That was like such a unexpected turn of events for me in that you took a lot of time off before you went and got your MD. And I can see in your eyes like there's something very exploratory about the path you've taken. What is all that back country stuff about? I think for me it was just about exploration and curiosity and wanting to understand where I could find meaning. I grew up in a pretty normal household in suburban Virginia. You know, I was raised in the East Coast. My dad's a physician, my mom's a nurse, so I saw medicine a lot growing up, and I had a pretty normal path until I finished college. I had a couple of professors in college who incidentally had like really big curly hair, you know, like every nutty professor does, and they just opened my eyes to some interesting things. I got interested in philosophy and Buddhism and meditation. Wow. And I got interested in the natural world, which I had only seen a piece of being a suburban kid growing up, right? And I thought, "Wow, this is what I really want to go explore. I'm not ready to go into medicine because what I had seen up to that point, from what I'd seen from my dad and his colleagues, was a lot of people in medicine weren't that happy. These are practicing physicians, and a lot of patients weren't really getting that well." That was the first point that I was like losing my religion, thinking, "I want to be a doctor, but doctors aren't happy. Patients don't seem to really always be getting as well as I would hope." And I was like, "I got to go exploring. I just got to put everything on the back burner." And at that point, I didn't even know what was on the back burner. I just figured I was done, and I was like, "I'm going to go and just be an explorer my whole life." Interesting. Okay, so, uh, talk to me about the Buddhism thing. So, I went through a hardcore Eastern philosophy, um, phase in my, sort of, end of high school, beginning of college. Really explored that, found a ton of benefit in that. Um, what was that about for you? How's it impacted you? Do you carry any of that still with you? Absolutely. So, my spirituality was perhaps a similar sort of path. I was raised Catholic, and personally never really resonated with it. I respect Christianity and Catholicism extremely, and I think there's beautiful traditions, and I think a lot of the Christian teachings are so valuable, but I never really found a whole lot of resonance there when I was growing up. When I found Buddhism and just these concepts of non-impermance and suffering and how to release suffering and really mindfulness as the first piece of that, and mindfulness leading to compassion and empathy, that grabbed me, and it was probably just the point in my life where I was, but starting to meditate a little bit as like a 19- or 20-year-old. I mean, imagine a 19-year-old mind and starting to meditate. It's like trying to corral a wild horse, right? But it's it's a good process. It's an important process, and that was the beginning of a lot of learning for me and just thinking about things philosophically. You know, you think about scientific disciplines, right? You get biology is very macro, you can see things, I can see this amoeba. Then I can get to microbiology, I'm talking about bacteria. Then I'm getting to like molecular biology, I'm talking about DNA and transcription factors. And then, you know, chemistry, you can think about general chemistry, the movement of atoms, and then you can get into atomic quantum chemistry, and then you're really into physics. What's after that? It's sort of like philosophy and Buddhism, right? I mean, if you keep going and you keep sort of like expanding the lens and pulling the microscope back, after quantum, you sort of get into that philosophical realm, like what are we made out of? And you're asking questions about who we are as humans and what life is about and what this experience is about and where meaning comes from. And I think that lends itself to exploration through meditation, through mindfulness, all of these things. And I think that's the natural continuum beyond quantum questions. Wait, what are we made of anyway? And then you start thinking, what what have people thought of? And then the philosophical things start to become relevant and you start to meditate and think like where am I? And you look up at the sky and you think, what am I doing here? And it's with that then that we go off and we're skiing in the Teton Mountains and we're exploring Southwestern US. Like, so this is something I think a lot about. Like, you can capture these really interesting mental states, they are hyper ephemeral. But the desire to hold on to that sense of awe and wonder is so profound. Um and I actually, this is interesting, I'm so curious to know if this is what was driving you. So at the end of high school, um I was telling my mom, once I graduate from college, I'm actually going to go backpack around China. Uh I was obsessed with Taoism, I was obsessed with Laozi and the Daodejing. And so it was like, there was just something I wanted to go experience that, sort of the imagery that you see in a lot of Chinese art from around that period of like the the really exotic mountains. They do mountains very different than the we do. Oh, I know, it's beautiful. And so I had like this real obsession with going and experiencing that because I wanted to hold on to that that sense of awe. Was that part of what was pushing you? I think it was. And I think that I'd had a little taste. You know, growing up in the suburbs I'd had this little taste of something bigger than me in the natural world. And I think that humans find some clarity in our meaning and our place in the universe when we stand in front of things that are bigger than us. And that can be technology, that can be city, that can be art, that can be creative processes, and that can be a mountain or an ocean or an avalanche, right? And so, that was where I went cuz I'd had that little piece of nature being bigger and kind of wild. And I just wanted to see what it felt like to be in these places that were bigger than me. I wanted to feel small. I don't think I knew this at the time, but in retrospect I have a sense of it. What was the plan though? Like how were you going to make money exploring? plan. How old were you? I was 20, 21. I was fortunate to have gone to a state school. You know, William and Mary was a state school. It wasn't extremely expensive. And I didn't have a lot of debt. I didn't have any debt at the time. I had a kind of a junker car that would break down frequently, but that was all I That was all I needed. All I needed was the clothes on my back and the ability to go explore something. When does that begin to change? I think Because you end up coming full circle back to the MD thing, which is really surprising cuz you took a look at it. Your family was in it. You rejected it. So, how do you end up coming back to it? I think that eventually uh the intellectual curiosity rose. You know, I sort of had my time in the wilderness. After 6 years I was 26, 27. I was like, "What am I going to do with my life, you know?" I had that sort of blissful Peter Pan time to just go exploring and do my adventuring and connect with all these pieces of the natural world. And the other curiosity kind of rose again from the depths, you know, Atlantis rose up and was like, "Oh yeah, I have questions about what makes people healthy and not healthy." And I think that would be a good thing and a meaningful thing for me to pursue for my career. And it wasn't until I got into medicine as a physician assistant in cardiology that then I saw firsthand what the practice of medicine meant, what it looked like when the rubber met the road, and I then I started to think, "Oh man, the medicine that I'm seeing here is not really what I'd hoped, and people are really not getting better." Because it's all drug based? Because it's all drug based and because it's all symptom focused. With the success of penicillin and infectious disease, we used that paradigm for the whole rest of medicine, and it works in the acute phase, but it doesn't work for chronic disease. Right. And it was kind of at that point in my PA career, my physician assistant career in cardiology, that I thought, "Okay, nutrition is what's going to move the needle. Food is the biggest lever." a PA? Mhm. One thing you've said that I think is really interesting and and I'd love to know how a guy who's already sort of awoken to the power of nutrition deals with going into studying traditional medicine where they don't talk about nutrition. But um you said uh very powerfully that people think, you know, about the drugs they take and they're measured in micrograms or whatever, you said I don't think that's the exact word, but that we take in like kilograms where the food. Explain why that's a powerful concept. So, what I mean by that is if people are familiar with medications, metoprolol, benicar, lisinopril, whatever medication they take for blood pressure, amlodipine, and they look at the the bottle you get from the pharmacist, it'll say amlodipine 5 mg. That's a 1/1000 of a gram. And then you look in your kitchen and you open your refrigerator and you have hot dogs or bread or steak or eggs, you're looking at kilogram, you're you know, kilogram is thousand 1,000 g versus 1/1000 of a gram. These are multiple orders of magnitude different. We're talking 10,000 times different scale in these things. But what ultimately what what we're talking about now is just molecules. That's we're all made up of molecules, we're all run by biochemistry, which is molecules, and and we're pretty good at predicting the way that molecules work. And so, whether you're taking a milligram quantity of a molecule called amlodipine, or you're taking a kilogram quantity of hot dogs, which are, you know, thousands and thousands of molecules, you're doing the same thing in your body. That hot dog gets made into the same thing that amlodipine does. It's just lots of biochemical signals in your body. You're giving your body information. You're giving your body signals. And so, I've never really understood why mainstream Western Western medicine doesn't get this, right? Why don't we understand that food is signal, and that food is information going into our bodies? Food is a program that we are loading into the computer of our bodies every day. And that's coming in from molecules and the environment, right? It could be sun, it could be cold, but the biggest download, the biggest amount of information coming to us is food. And I would argue it is the biggest lever for health and disease. So, this is one of the things I I actually don't understand at a very fundamental level why people push back on that. Can you steel man the argument of why people say it's just calories in, calories out? Because the second somebody said this isn't just everything is the same, it's signaling molecules, there's hormonal responses to food, there's all these different responses. And it was sort of instantly like, oh, that makes sense. The base assumption may be incorrect, I guess, but there's so much internal logic that once I accept that they're signaling molecules, the cascade of things that make sense after that are pretty profound. But people push back on that [ __ ] and I've never quite understood. So, is there are they saying that there is a what I'll call a presentation layer to macronutrients that can manifest as a hot dog or manifest as cauliflower or whatever. It's just a reorganization of the same sort of fundamental molecules. And so, no matter what the presentation layer is, what matters is the macronutrient, the carbohydrate, the fat, the protein. You know, I've heard some people in the space suggest that calories in calories out is as simple as you could eat Pop-Tarts all day and take a multivitamin and it would be the same thing. And I obviously don't believe this. I think it's like a reductionist perspective and it misses the entire immunologic and hormonal response to foods, which is so nuanced. And I think that at some level they're saying there's no research to prove that that's valuable and there's no research that can dissect it all out because it's so complicated. So, the only thing we can look at are macronutrients and then for micronutrients, we just give you a multivitamin. It's interesting. So, you quoted uh Jeff Bezos. And you said Bezos says, "When your studies disagree with the anecdotal evidence, your your studies have a problem, not the anecdotal evidence." Well, you need to re-examine the data you're getting, yeah. That makes a lot of sense to me. So, in researching, I was talking to my wife Lisa. She's had massive microbiome issues. And so, all of a sudden, I got thrust from the notion that um like what your food ate doesn't really matter. Like once it's a steak, it's a steak and, you know, sort of the again, the presentation layer doesn't really matter. It's the the macronutrient content. And so, even though I didn't think a calorie was a calorie, I thought by the time you boil it down to something as simple as it it's just [ __ ] animal tissue. Like you're ready to rock and roll. And then watch her you could you could blindfold her, she'd have no idea and she can tell you from the way that she feels if something was grass-fed or corn-fed. It's freaky. I never would have [ __ ] believed it. But she'll have real problems from stuff. So, I was like, "Okay, clearly there's something more that's going on." And so, when I think about somebody saying, "Oh, Pop-Tarts and a multivitamin are going to play out the same." It's like you could all the money in the world would never convince Lisa that that's true because experientially she just doesn't like get down like that. So, one of the things that's interesting about the um the carnivore diet is the hypothesis that you've explained very well, which is forget even macronutrients for a second. Plants contain antinutrients, and the antinutrients themselves cause a problem. What What are antinutrients? Is that not a problem in the Pop-Tart hypothesis? Well, it's absolutely a problem in the Pop-Tart hypothesis. I think I understand your question because Pop-Tarts have lots of plant foods and have lots of antinutrients in them as well. just like straight sugar is an an antinutrient or a potentially dangerous nutrient in some ways if we're thinking about things in terms of fructose being a dangerous molecule for humans. And really what we're getting to here is the nuanced idea that the devil's in the details, and that a grass-fed steak and a grain-fed steak can look pretty similarly in terms of macronutrient ratios, fat, protein, carbohydrates, but in terms of micronutrients and other molecules, they're completely different. There's pretty good evidence that grass-fed meat will have higher concentration of nutrients. Vitamin C, vitamin E, and beta-carotene were the three nutrients that they looked at in grass-fed meat relative to grain-fed meat in this paper. And then also what they looked at were the amounts of glutathione, reduced and oxidized. And the glutathione is this major molecular uh antioxidant policeman in the human body. It's our endogenous antioxidant currency that runs around getting rid of free radical uh molecules or free electrons on molecules, which are free radicals. So, there's more glutathione in grass-fed meat, which is a good thing for us, and there's more of these nutrients. So, at a basic micronutrient level, which is vitamins and minerals, a grass-fed steak is richer in those. But I think that the biggest difference between grass-fed and grain-fed steak is the things that the grass-fed steak doesn't contain, which I would argue are toxins in the grain-fed steak. And this is coming from what is sprayed on the grains that are fed to the grass the grain-fed animals. Glyphosate specifically. Glyphosate and atrazine and potentially a molecule called zearalenone, which is a mycotoxin that is formed in moldy grains. But, we don't really know what glyphosate does in the human body right now. It appears to disrupt a pathway, without getting too granular, a folate pathway in bacteria called the shikimate pathway. Glyphosate could be a real disrupter of our gut microbiome, which may be, you know, relevant to your wife. And also, there've been a number of court decisions recently people may be aware of where the court has ruled in favor of people saying that glyphosate exposure gave them cancer. These are people who are using large amounts of glyphosate to spray college campuses, groundskeepers, things like this. People may know that glyphosate is Roundup, and you can walk into Home Depot and see a wall of glyphosate there, which is pretty pretty scary, right? So, glyphosate is a big thing, and that's water soluble. That's going to be a higher concentration in grain-fed meat because they're fed grains for the last part of their life. The other thing is the corn they're feeding them is sprayed with atrazine, which is this lipid-soluble toxin. And atrazine is part of a family of compounds called xenoestrogens. And these are compounds that can affect our hormones, specifically estrogen, by mimicking estrogen in the human body. So, when you're eating a grass-fed steak, you're getting less of those, and a grain-fed steak is going to have all sorts of extra compounds in it. Again, it's just the molecules. If we could see the molecules in a grass-fed and grain-fed steak, they look different. They're pretty similar, but that 1% is important. You know, that 1% can be very bioactive. We know that these estrogen-mimicking molecules, molecules like glyphosate, can be very bioactive at very small concentrations in the human body. When we're talking about plants and plant toxins, that's a whole 'nother issue, but it's perhaps very parallel. Plants do make molecules. They make these small molecules to defend themselves against insects and predation by herbivores. And those small molecules can have similar effects in the human body. In fact, there are a whole There's a whole class of compounds called flavonoids. People have heard of flavonoids. They're often touted as a good thing, but we know that flavonoid molecules mimic estrogen in the human body as well. There are papers that would show that flavonoid molecules can activate the 17 beta estradiol receptor, which is just our body's estrogen receptors. So Why is that bad though? Because it's it's changing our hormonal signaling. So we're taking in a molecule from a plant that the plant has made as a pigment and then it is programming our biology in a way that we're not expecting. It's bad for men because excess estrogen causes gynecomastia, which is the formation of man boobs, or lower testosterone, competes with testosterone for metabolism, or effects in the human body. It's bad for women because higher levels of estrogen can affect the balance of other hormones, can affect cycling, the menstrual cycle, can affect perhaps breast cancer rates, and all these things. That's just one example of a plant toxin, but these molecules, the details are so interesting. Yeah. So, that brings us to the carnivore diet. So, what is the carnivore diet exactly cuz I think people think it's eating hamburgers all day. Um and so breaking that down would be really helpful. Yeah, so I was going through medical school thinking about food and thinking about food as a big lever. And I went back to medical school with the intention of becoming a functional medicine physician. But throughout the process I was always trying to iterate for myself, my n of 1, my test tube, how do I function on different diets? What does my body feel like, look like, perform like when I'm doing different things and what's the ideal way to eat? For most of medical school and residency, I was pretty almost entirely organic paleo, which I think is a great base, but one thing kept nagging me and it was that I had eczema. And it reminded me or it signaled to me personally that even though I was eating what I considered to be the best diet after, you know, all of my iterations and thinking, well, this is probably how we ate as humans, I still had this autoimmune condition. I still had activation of my immune system. So, I kept iterating and I kept thinking about it and I would sequentially cut out more and more things from my diet. And then I just ate less and less plants in an effort to see if that would affect my immunologic activation and eczema. And then it all clicked when I heard Jordan Peterson on Joe Rogan and talking about the fact that he had an autoimmune issue, his daughter Michaela had an autoimmune issue, and they tried this thing which to me at the time sounded crazy called the carnivore diet. It just sounded ludicrous because throughout my functional medicine education I'd been so steeped in this idea that plants had these magical compounds in them and they were really valuable for humans. And so, when I heard Jordan and Michaela's stories, I thought, "Isn't that interesting because the other piece of the equation throughout this whole journey for me was autoimmunity kept coming up and over and over." Most of what we're dealing with outside of hospitals, outside of heart attacks, and people who are sick enough to go in hospitals can really be seen or formulated as autoimmune disease. Most inflammation is autoimmune. It's all connected. So, that's when the immune system reacts against itself. That's what eczema is. That's what psoriasis is. think that that a base cause of that is the gut has become permeable and so pieces of like errant proteins or whatever actually getting into the bloodstream and so the immune system is freaking the [ __ ] out? that's probably what's going on in the treaty of this. one of the things I didn't quite like get. Why isn't the immune system freaking out so much? Like supposedly when you're eating something you're essentially like dropping it through a tube and it's never actually in your body and all of a sudden I was like, "How the [ __ ] then is the the body reacting so dramatically to it?" The gut. When you eat food, it's never really in your body until it passes across your intestinal wall. But it eventually gets in your body because we get nutrients. So, at some point between here and here in the magical nether regions, I'm going to take nutrients and molecules from my food and I'm going to pass some molecules out. I'm now I'm going to take some molecules and I'm going to discard some molecules. And at some point in there there's this delicate barrier between our self and not self. And we know that outside of us is the microbiome, which is a broad term which means trillions and trillions of microorganisms, bacteria, fungi, eukaryotic organisms which are yeast, probably some protozoal organisms which are larger, and that is separated by oftentimes one cell layer, and then our immune system. The majority of our defense system is right there in a layer called the lamina propria. And so, this is our diplomacy, you know? This is our demilitarized zone. This is where the talks happen. This is where the peace accord happens, and where sometimes things get a little rowdy. And I think you're absolutely on to something there, and it's it's probably a very complex dance between our immune system, the epithelial layer, and what's in our guts. But, I think that in a very in a simplified distilled way, I would suggest that most autoimmune disease is due to antigens in the gut or bacteria in our guts causing that barrier barrier to break down. And then the immune system gets triggered and goes on alert. And this is the interesting piece. We all have different susceptibilities to that activated immune system. So, everyone has genetic differences. And I think that the nuance is that when your immune system gets activated, your immune system might go after your thyroid or your uh your bowel if you have inflammatory bowel disease like ulcerative colitis. But, when my immune system gets activated, it's looking for my skin. And this is why it manifests differently in other people. And I think this is what Western medicine misses. It can all be the same trigger with multiple different manifestations. Maybe there's a lot of people for whom plants could be triggering autoimmunity. Wouldn't that be a wild concept? And wouldn't that challenge the majority of our nutritional norms today? And that is the beginning of thinking about could humans just eat animals? And as you suggested, the response to that is, "Okay, don't eat plants." But it's much more nuanced than just eating hamburgers or steaks, in my opinion. And for that, I think about it from an ancestral perspective. And this you you need to explain because you're the first person I've ever heard say, cuz I'd never dove into the carnivore diet before, but you're the first person I've ever heard say, "No, no, from an evolutionary standpoint, this is probably how we ate." And so, I'd like to know sort of the the main things that that people throw out, that our digestive tract is clearly set up to do both, that our teeth are the teeth of an omnivore, like how do you show that that isn't true? lot of nuance there, and I think the evolutionary discussions are always a little bit conjecture. And the whole discussion here is premised on the fact that what we did in the past is what we should be doing now. And that is debatable as well. I mean, some people in evolutionary biology would debate how quickly humans can adapt to things. What we do know is that humans have really only been doing agrarian, that is farming, type societies for about 10 to 12,000 years. This is called the Neolithic Revolution. But if we back up way further, we can go back 80,000 years and look at stable nitrogen isotope studies of collagen. So, basically, they look at different types of nitrogen in the bones of Neanderthal and Homo sapiens. And what they see is so much nitrogen, so the ratio of the nitrogen gives us a sense of what these people were eating. Because we know that when we eat higher up the food chain, we accumulate more nitrogen. And what we see is that there is so much nitrogen in those bones that those people were essentially carnivores, meaning they were eating almost entirely animal-based diets. And then if you look back further, 2 million years ago, again, we're getting into the realm of extreme paleoanthropology, but there's pretty good evidence if we look at the size of the cranial vault of a human, our brain size had this logarithmic uptick 2 million years ago. That was when we were Homo erectus, Homo habilis, and we also see the uh the onset of stone tools and evidence for hunting then. So, there's a really compelling story you can put together there that hunting animals, access to animal foods, made us human. It made our brains go what? And we got from 700 cc's in the cranial vault to about 1,500 cc's in the cranial vault in about a million years. The previous 30 million years of primate evolution, we'd stayed about level at about 300 to 400 cc's in terms of the size of our brain. There's pretty good evidence that the bigger your brain, the more developed the neocortex, you have more complex processing. So, I like the the I get it's a narrative you're putting it together, maybe this, maybe that, and it comes together and this is a nice uh narrative that has internal logic. Um but one thing that seems certainly plausible in that same internal logic is if we pass through a primate evolution and that we had, you know, um similar ancestry for a very long period of time, and as far as I know, most primates are designed to munch on a bunch of leaves and [ __ ] um and deal with that. If we started there, then why would we think that we swung all the way to entirely carnivoristic? And I think that this The interesting thing here is in that brain size that we had eaten vegetables, and there actually are examples of primates eating other primates. The primates do eat animals. But we had had primarily a vegetable-based diet or a plant-based diet for 35 million years of primate evolution, and then something happened, right? And we became human. And I think that it was this sudden access to nutrient density and macronutrients that we hadn't seen before in higher quantities. So, we had much higher quantity fats, so DHA, EPA, these omega-3 fats. There's lots of theories about what caused this expansion of the human brain, and I would argue much greater access to micronutrients in the animal foods because we were eating these much more bioavailable foods that it was the eating of the foods that made us human. But I think that what happened was if we look at the stable nitrogen isotope studies is they said our ancestors said, "Wait a minute. This food, animal food, is much better for us. We can get more calories." That's really what they're thinking about. They don't care about micronutrients, but they're getting micronutrients by accident because they're eating essentially animals that look like humans. So by seeking out better sources of calories, namely bigger animals with more fat, they automatically got micronutrients that changed the fate of humanity forever, right? Give us a bigger brain and smarter. And so then it became this risk-benefit or just an like a an availability equation. If I can go hunt a woolly mammoth and I can get a million cal I mean, how many calories in a woolly mammoth? Like millions and millions of calories. It can feed the tribe for a week, or I can go look for tubers. What am I going to do, right? There's no question what you're going to do in terms of calories and fat. I think that the point is well taken, and it gives us this really interesting survival advantage. Because we're not always going to be able to hunt perfectly. If you and I go out and hunt, I guess today is different in terms of the scarcity of animals, but say we're on the plains 30,000 years ago and we're hunting. If we don't come across a buffalo, we may not have any food today or tomorrow. And in that situation, I think the idea is that humans probably still ate some plants, but the plants were probably just the survival food. That when you really look at where humans get nutrients, and this is bioavailable micronutrients, and where humans would have gotten calories from evolutionarily, animals dwarf plants in every way. There aren't many people today who are calorie deficient, but there are many humans that are micronutrient deficient. And so if we're talking about micronutrient adequacy, micronutrient bioavailability, this to me is the great leveler. It's so interesting. Animal foods are far and away the winners. If you look at the bioavailability and the presence of vitamin A, vitamin C, vitamin E, or the micronutrients calcium, zinc, selenium, manganese, or the DHA and EPA, they're just animal foods are the richest source. They're the best multivitamin we've ever encountered. So, we're going to go hunt that. But, evolutionarily, I think that if we couldn't get that, we would eat some plants, and they're going to tide us over in terms of calories, and they're going to give us sub-optimal micronutrients. We know that the micronutrients in plants are less bioavailable. And so, we can use them as survival food, kind of hearkening back to our ancestry, but I think that what happened is we became people who realized that animals were the best source of nutrients, and that is kind of the roots of the carnivore diet. The stomach and the digestive system is an interesting story, too. Again, this is conjectural, but we'll entertain it. If you look at the pH of the human stomach, it's actually so acidic, meaning low pH, it looks like carnivores. It doesn't look like an omnivore. The pH of an ape is about four or five, I believe. And our pH is between one and two. We have a freaking boiling cauldron of acid in our stomach. Our stomachs do not look like omnivore stomachs. And then you look at the gut, and there's this whole set of ideas around the expensive tissue hypothesis, which is the idea that if you look primate to human, the large intestine got much smaller, and the small intestine got much bigger. And the hypothesis suggests, the expensive tissue hypothesis suggests that that was to allow for a big brain, because we have to shrink one thing, the large intestine, to grow a bigger thing somewhere else. And then what we did in the process was we evolved a larger small intestine, where we can absorb all the micronutrients. We were getting different foods. So, it kind of is consistent, right? We're getting micronutrient-rich food out of animals. Plants are not that micronutrient-rich, contrary to what you've been told. We can dig into it, but they're really the nutrients in plants are very hard for our body to pull out. They're stuck. They're kind of glued to the plant molecules, which don't look like human molecules. But, a small intestine like we've got is huge and voluminous and redundant. That's where we pull in the nutrients. The colon is pretty much where we pull water out. By the time stool gets to the colon, we'll probably get some nutrients out, but the majority we get out in the small intestine. So, what happens in the colon of an ape is they ferment all this vegetable matter into short-chain fatty acids, and then they run on fat, too. But, they make fat out of carbohydrate. We get our fat from the animal and absorb it directly through the small intestine. So, that allows for a smaller colon, a bigger brain in terms of our energy. And there's a very interesting anecdote of a fish, it's called an elephant nose fish, that has a similar thing. It has the largest brain of any fish, and it has the smallest large intestine of any fish. So, same idea that sometimes there are trade-offs in terms of brain and intestine size. That's really interesting. It's we're trying to absorb more nutrients. Yeah. So, all of this stuff, I think I'm I'm going to make a a really ignorant, but bold statement, because I am not at all qualified to talk about this stuff like you are, by any stretch of the imagination. But, going through what I'm going through with my wife gives me a certain like, I've [ __ ] done it, and so like there's little you can tell me. Um my thing is, you just experiment. Like, stop waiting for the data to come in. Just because it's going to be so individual anyway, no matter what study I publish, it may work for you, it may not work for you. Just [ __ ] try. So, now let's get into the nitty-gritty of a carnivore diet. Nose to tail, what does that mean? How do I do it? Where do I get this stuff? So, how does one in today's world eat um a carnivore diet? Yeah. So, it's I think Tim Ferriss has this saying, it's not simple, but it's not complex, right? You imagine that you and I are out hunting, and we kill an antelope, or we kill a moose. A nose-to-tail approach to a carnivore diet thinks, "I'm not just going to eat the tenderloin and throw the rest of the animal out. We're going to eat every piece of that animal because every piece of that animal has calories, and when you think about it, every piece of that animal has micronutrients that are unique." And so So, you can eat the cartilage? You are going to eat the cartilage. I do think that eating cartilage is a valuable thing, but in talking to my clients over the last year that I've been doing this, I've realized that there's like there's like junior varsity and varsity versions of carnivore, right? And when people come on the team, you got to put them on the JV team first unless they're super gung-ho. So, I'm writing a book now, and in the book there'll be like tier one, tier two, tier three, etc. I think that if people get intimidated by the ideal version of a carnivore diet, they can just think of like what is the doable version of a carnivore diet. But, I want them to understand the basic paradigm because the most basic version of a carnivore diet often goes wrong because it's just too basic. And that is just eating that the muscle meat, which is what we see in the grocery store. So, if people want to try a carnivore diet for 30 days, you really could almost get away eating steak and eggs. I don't think that's ideal long-term, nor do I think that's the best way for a human to do it in terms of micronutrients or macronutrients. But, the simplest version is steak and eggs. Is that better than hamburger and eggs? Probably. The thing I like about steak is that you can cook it medium rare, rare, and hamburger's like cooked all the way through all the time. don't want to cook out you cook out nutrients, I'm assuming is that right? cook out some of the nutrients. And so, the nice thing about a steak is you can get a steak that's rare, people like that, and the inside of steak is better. I think it's better in terms of the nutrients in there. So, you're trying to Interesting. Would you eat something if you didn't have to worry about microbial content, would you eat raw? Absolutely. I've done it. I personally, and I don't recommend people do this, eat the majority of my diet raw right now. [ __ ] out. No, you should have seen my raw eggs? I do eat raw eggs. That's scary. You're freaking me out. So, the here's the thing with eggs. What we worry about with eggs is contamination of Campylobacter and Salmonella on the shell of the egg. Correct. The inside of the egg is generally sterile. Uh-huh. It's better be, right? Wouldn't it have to be? It has to be. And if it's not sterile, you will know because you'll open it and it'll look like something died in there, which it did, essentially, almost. So, when you eat the white of the yolk the white of the egg, I don't want to eat raw because it has a compound called avidin, which binds biotin. Most of the avidin in the egg white is denatured when you cook it, but there's some evidence that not all of it is. Interesting. And so, what I'm interested is the most amount of nutrients, and I really try to be a fat hunter in my carnivore diet. We can get into the nitty-gritty fat to protein ratios, but I eat the yolk because the yolk is where most of the nutrients are, and I eat it raw because I'm lazy and I just want to eat it fast, and it tastes good. Before we get to that, going back to your initial hypothesis, if you [ __ ] found an egg, you were not going to not eat the egg yolk or the egg white. You were going to eat that whole [ __ ] You know, I wonder what our ancestors would have done because they'd throw it out? know if they They might not You're right, they might If I were in the wilderness and I came across an egg, I would probably cook it and eat the whole thing. Yes. But I don't need extra protein, and so I'm just going to discard the white, eat the yolk, and I eat it raw. I'll eat six to eight raw egg yolks a day. I'm not saying this is the way everybody should do it. Do you just chug them? Do you put them in a glass? in my hand and slam it down. God. So, how are you just letting the white sieve through your fingers? right through. And then you can eat the yolk raw. This is You don't have to eat the yolk raw. You don't have a lot of friends over when you're doing this, do you? This is not table friendly. Dating is hard for me, man. It's interesting. Wow, okay. So, we're pounding six to eight egg yolks. Then we've got a steak chilling in the fridge that we're going to eat. thing I eat is liver. Culturally as Westerners, we do not eat liver. Mhm. I ate a little liverwurst growing up. That probably saved me. When I first started eating liver, I would gag, and I thought, "Oh, that's such a strong flavor. I'm not used to it." And then gradually, I got to the point where I was like, "Oh, now I'm adjusted to it." It's an acquired taste, for sure. I watched like a documentary or something about polar bears. Is it their liver that has too much vitamin A or something like that? This is a urban legend or urban myth. Yeah, so there's never been a case report of vitamin A toxicity from eating food. There have been case reports of vitamin A toxicity people taking vitamin A palmitate supplement, but you can eat a pretty decent amount of liver per day and not have vitamin A toxicity. So, I eat raw liver. People can eat it cooked and I'll do 3 oz or 4 oz of raw liver per day. So, I ate the egg yolks, then I ate raw liver. Again, this is the super varsity version. Yep. Yep. And I put a little sea salt on it and then you're going to love this. I've I've gotten really interested in eating organs and so now I'm eating I'll then eat kidney raw. Raw? Raw kidney. Yep. And then I'll eat raw brain. Whoa. What kind of brain? Cow? brain, yeah. Why lamb? Just taste better? Uh cow brain is impossible to get because of concerns about bovine spongiform encephalopathy. Super wild. But you think about it evolutionarily, this is all my experiment, right? I'm the N of 1. I want to know what this is like so I can share with people. The brain and the bone marrow would have been I think things that we prized the most. Brain is a delicacy in many countries because it's rich in nutrients. I mean, think about where the DHA goes. Here. That's what we used to make it and think about all the potentially unique factors in the brain. I'm not saying anyone needs to eat brain. hard as hell for a a normal animal though to crack that [ __ ] open. Like we'd be like the only ones eating brain. People have thought that humans are some of the only animals to do it. There are accounts of lions doing it a little bit, but that may have been part of our evolution that we had the tools and the smarts to get into the bone marrow. Lions can crack a bone, maybe it's going to get bone marrow, but that might have been at the at the kill, you know, you have an elephant. Somebody brings down an elephant. Elephant's got a huge brain. Humans come along as scavengers, break open the skull, then you've got all that stuff. And it sounds gross to us. Really gross. completely gross. I want I want forever and if I have to eat elephant brain, then I'm going do it. They die of natural causes only though. I want to be very clear about that. No poaching. Don't poach animals. Don't poach elephants. But, it's been interesting for me personally at this point in my carnivore journey to try and eat more of the animal and go past like that's gross, okay? And so at that point, I will eat a steak, you know? And but a lot of times there's this anthropologic evidence and this interesting historical evidence of a lot of cultures eating the organs first and then saving the muscle meat for later or giving the muscle meat to the dogs or other animals. Wow. One of my good friends in Seattle, Mike Mutsell, has chickens. So the raccoons got into his chickens. And what did the raccoons eat? They ate the viscera of the chickens and didn't eat anything else. Weird. They don't eat chicken breasts like we do. They eat the viscera because that's where the fat and the organs are. So I thought, well, that's absolutely freaking gross. intestines? They do. Wow. They do. They eat it all because the intestines are covered in fat. Uh. And there's like all this perinephric fat around the kidneys and the omental fat. That's where the fat is on animal too is in abdomen. Yeah. So it sounds gross, but I thought, well, what is in these organs and how do we do it? If people are primarily grossed out or probably grossed out about organs, there are ways to get organs that you don't have to eat them. There are these desiccated organ tablets which I think are really interesting new sort of subset of a supplement industry where you can take brain, heart, liver, spleen, kidney, thymus, gallbladder of an animal dehydrated at low temperature and then put it in a pill, right? Do you actually get the nutrients though if you if you [ __ ] it up by cooking it? Right. I've got to imagine by doing all that crazy processing that nothing gets in it. to study it and see how much is in there, but you know, desiccation is like low temperature dehydration so they're like know. They're like freezing it and then pulling the water out that way. Mhm. So if if there's any way to do it, that would be the best way, but that's a very valid point. It can't be as good as raw liver which is clearly the best thing ever. Okay, so let's get to um well, any I'm guessing that that's got to cover most of what you're eating. most of what I eat. So give me tier one. So the basic carnivore diet is probably meat and eggs, right? You can do that all day long for 30 days, you'll be fine, okay? Okay. What What am I missing? Micronutrients? Because I I Here's what I don't want. I don't want [ __ ] where you have to supplement. Like if somebody's giving me a diet and they're like, "Well, but make sure that you take the zinc, the magnesium, No, no, no. It's like, I want something where What you're missing is liver. Liver, because it has copper, biotin, folate, riboflavin. Okay, so it's stuff I'm not going to find in the regular There's a little bit of ribo- There's a moderate amount of riboflavin in egg yolk. There's a moderate amount of riboflavin in muscle meat, but the majority of the riboflavin is in the liver. If you wanted to make the simplest most nutrient-rich carnivore diet, it would be meat, eggs, and liver. Meat, eggs, and liver. Steak, egg, and liver would be just the most basic days. 30 days. And then you could add things to that, you know? If people want to eat other things, you can eat seafood, right? You can eat chicken, you can eat pork. I can have chicken? Yeah, yeah. Chicken breast? Sure. Or I have to have chicken liver No, you can have chicken breast, yeah. The carnivore diet is kind of this There are another name for it, which I perhaps like a little more, is a whole foods animal-based diet. Whole foods animal-based diet, yep. If it comes from an animal, you can eat it. carnivore has a PR problem? Uh I just want people to understand that our ancestors ate fish, our ancestors ate scallops, our ancestors ate shrimp. Those are kind of all be on a carnivore type diet. In terms of the most doable, easy way, this is it. If you end up liking it or your wife ends up doing it long-term, there are other manifestations I would make or other modifications I would make when Let's hear some of them. when you go to varsity. So, I would include more organ meats. Just different organs? Different organs. Heart. Kidney, heart, yep. The brain sounds horrifying. It's actually not that bad. It looks nasty. It does, but isn't that kind of fun? No. Not There are some things that I get down because it's like, this is hard and I want to do it. Brain doesn't make the list. But I just ask people to remember, if you're an ancestral person 80,000 years ago and you kill an animal, this is what you're going to eat, right? And that doesn't mean that's exactly what we have to eat now, but it hearkens back to these ideas of maybe we should mirror this in some ways or maybe there are Here's my thing. I I am um Joe Rogan has a quote that I love. What's the point of having [ __ ] you money if you never say [ __ ] you? So, I am not at all shy about like trying crazy [ __ ] and taking a real [ __ ] stance. Like if if it is true that what's causing the immunological response and the inflammation is permeability of the gut and the primary drivers of that are the pesticides and the plant toxins that the plant creates specifically so you don't [ __ ] eat it cuz it's stuck in the ground, then we have as a society I think we have an awesome um maybe even moral obligation to do the animal industry in a way that is um sustainable and cruelty-free. I think that's really [ __ ] important. Yeah. So, I actually wanted a vegan diet to be the answer just so that I I didn't have to eat animals. Like that would be super rad. But if if the real [ __ ] answer is that this is the way that it has to be, then that's the way that it has to be. I think a lot of people wanted that. I was a vegan for a while. I wanted a vegan diet to be the answer, too. I don't think any carnivores are going around saying, "I want to kill animals." Have you ever hunted? No. It's a really life-changing experience. So, I hunted with a bow a few years ago when I lived in Flagstaff. Mhm. There's a spirituality when you're in the natural world and I think that our ancestors would actually give you that. Much to my dismay, I will acknowledge that. Right. I think that there's an animism around this and we talk to the universe and we talk to animals and we say, "Look, I need to live. Thank you for the sacrifice." And when you kill an animal, it's like that animal gave itself to you. I respect. That's what I'm saying. and when I killed a deer, I saw that deer and the first thing I thought was, "Oh shit." I did like and the the next thing I thought was, "I better be a good person." Mhm. And in retrospect, I think that's really cool. I would probably be a better person if I did that more. That's really interesting. eating I'm eating the same amount of animals, you know, and divorcing humans from the collection of those animals makes us not have the responsibility. It pardons off us of the responsibility of killing the animal and understanding what that means to kill an animal. Can can we go somewhere super weird for a second and pretend like we're not filming this? Yeah. Um I don't want an apocalypse to happen. I think that'd be really really [ __ ] bad. But should the apocalypse happen, what's interesting to me is that I don't want to hunt now and I'm open to changing my mind, but I don't want to hunt now because I don't need to to survive. Right. And so it would be very distressing for me to take a life um without like real imperative. But that spiritual sense of we're all part of some grand cycle is really interesting. It's also interesting because like when you getting in touch with your animal nature, that's something I had to learn to do. So I like growing up as a kid was very soft, emotionally weak, and so like I really had to toughen up. I really had to get um you know, lean into like what does it mean to be a man? I had to define that for myself. I'm not I'm not trying to project on anybody else. But for me, like that was the thing that I had to do. And I never took up I did super super briefly, but I was too emotionally weak to deal with it. I never took up like a martial sport or anything like that. And so in this apocalypse that I hope never comes where I actually need to hunt and kill and can do it in a part of a group and feeling like, "Dude, there's some real [ __ ] on the line here." Do it in a respectful way, but also in a way like I'm [ __ ] fighting to survive. Because let me tell you that deer did not give itself. That deer was [ __ ] trying everything in the could in his power not to die. And so that like the like this [ __ ] matters. This is actually a matter of life and death. And to know that we're on the hook like that and to and to take the mantle of I'm going to go and do this. And I think about this this is one of the most interesting things about being a CEO that nobody talks about is you're saying I'm responsible for the life and death of this company. I'm responsible for you being able to pay your [ __ ] rent and to go home and feed your family. Like I take that [ __ ] on. Yes. And like to to go when I'm going to a meeting I have the chills. When I go into a meeting like you know trying to level up the company and all that I I'm like carrying that with me of like my face has the chills of like I'm going into this as a representative of this group and it really [ __ ] matters and failure matters success matters. And like being able to walk into that scenario connect to the fight for survival like that to connect to the animal in that you didn't want to necessarily give your life but I'm going to show you so much respect and that notion of like I actually want to be a better person. I just [ __ ] took a life and like it needs to matter it needs to mean something I need to do something with that. It's [ __ ] interesting man. And I think that that's the way I felt and I forget it because I don't hunt as much as I want to anymore and I'm going to hunt this fall I've decided and it's going to be a different experience for me because I know that I'm going to eat every piece of that animal and I'm going to butcher that animal myself and I'm going to take that animal respectfully and I think I know what's going to happen is every time I eat that animal I'm going to remember all the time I spent who I was with and the moment I took that animal and all the time I spent looking for that animal and I'll tell you what I think I'm going to be much less likely to like be an [ __ ] to somebody in traffic or get miffed at the grocery store. It's just this reminder like hey you're alive and you should be grateful for that because the fundamental idea is that in order for something to live something else must die. That is the way of the natural world and that does not mean that it's a bad thing. This goes back to kind of Daoist and Buddhist concepts like death is only bad when we're thinking about it from like a Western perspective. Perhaps death is just the completion of a life and it it's a cycle and it's moving. But when we when we take a life, when I took a life, it really enforced on me the fact that the rest of my life should be an honor to that animal that I just sort of consumed and took on their energy from. Like and I should live well. Dude, I could have you back. We had so much fun doing this. Thank you so much. Where can people find you? So I have a podcast called Fundamental Health with Paul Saladino and I talk about all kinds of cool health stuff. It's not just the carnivore diet. I Though I really believe a carnivore diet is an optimal diet for many people, I try to really talk about all kinds of cool stuff on that podcast. How do people live a well-intentioned and healthy life? And then my website is carnivoremd.com. All my stuff is on the website. You can find links to my Instagram, my Twitter, and everything. But carnivoremd is my website. Fundamental Health is my podcast. All right. I like it. That's amazing. If you were going to have people make one change you think would have the biggest impact on their health, what change would you have them make? There are two answers to this. The The big answer is Buddhism in the sense that mindfulness, right? Mindfulness. And not Buddhism per se, but mindfulness. I would congratulate any person that makes an intentional choice with regard to exercise, lifestyle, sleep, diet, anything. Even if that choice isn't a vegan diet or plant-based Like making an intentional choice in your life, I think is the first step to health. The second thing from a carnivore perspective would be eat more well-raised animal products, which are very nutrient rich. And that I think will create more nutrient density and that will improve people's health. And then there can be this gradual decrease in plants or you don't even have to really decrease plants if you don't want to. You can just increase the amount of nose-to-tail animal products and you're getting more of the nutrients, you're getting the best multivitamin, and that's I think the beginning of the molecular health. But, the mental health, the spiritual health, I think comes first. I love it. Yeah. Dude, thank you so much for being on here. This was amazing. Total pleasure, brother. Guys, I had so much fun researching him, check him out, and this was definitely one of my favorite episodes. I hope that you like it. If you haven't already, be sure to subscribe, and then till next time, my friends, be legendary. Take care. Thank you guys so much for watching and being a part of this community. If you haven't already, be sure to subscribe. You're going to get weekly videos on building a growth mindset, cultivating grit, and unlocking your full potential.