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TEDMED 2013…now I get it

TEDMED 2013…now I get it
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I just got back from the 2013 TEDMED conference at the Kennedy Center in Washington, DC.  I’ve always enjoyed watching TED talks online, but I’d never been to the actual conference.  I was told the experience is very different.  That was an understatement.  I don’t even know where to begin.  I don’t think anything I can write about this week will come close to actually sharing my experience, but I’ll try.

I was one of 50 speakers/performers, but the conference is about much more than the 50 of us.  There are nearly 2,000 participants and unlike most conferences where people are spread out over different sessions and ‘breakout rooms’ (a term that, to this day, makes me laugh out loud – I keep picturing a room with broken down cardboard boxes on the floor and nylon pants and 80’s hip hop), at this conference we all experience it together.  No parallel processing.  That it also takes place in such an epic building, overlooking the Potomac River, is another story.

To answer the first question you may have, I do not know when my talk will be on line, let alone where.  It could show up on the TED and/or TEDMED websites.  I’m told it will be no sooner than 6-8 weeks, and probably closer to 3 months.

This was not a typical Peter Attia talk. Information density was somewhere between zero and small. When I was preparing for the talk I had the complete privilege of working with the TEDMED editorial team.  Talk about an All-Star team.  These people are too talented for words.  It was simply amazing to be in their presence.  Jay Walker, the curator of TEDMED (and one of the most intuitive people I have ever met) gave me the most valuable advice when I was preparing my talk.  He said,

  1. Leave your “M.D.” and “McKinsey” personas off the stage.  While those are your comfort zones, get out of those zones.
  2. Don’t try to “teach” people a bunch of facts (even though you love facts); don’t try to “prove” how smart you are; don’t even try to “convince” people of anything.
  3. Engage both sides of your listener – their intellect and their emotion.
  4. Be authentic. The audience cares less about what you know, and more that you care at all.

This was really hard for me!  I love to teach, and I love data, and I’m much better at engaging intellect than emotion.  But with that advice, and the amazing help of Marcus Webb (TEDMED’s Chief Storyteller), I gave it a shot.  In a few months, I suppose, you can be the judge.

There were so many moments this week that just shot me back onto my heels – moments when it didn’t seem like “this” could be happening.  I’d love to share a few with you.

Meeting the man who gave my favorite TED talk of all time

Before you read another word, watch the 2011 TED talk given by Ric Elias.  Seriously. STOP READING THIS NOW AND WATCH IT.  I have watched this talk, perhaps, as many times as I’ve watched all other talks combined. Probably every 3 or 4 weeks, actually.  Why? Because, unfortunately, that appears to be the frequency with which I need a little reminder of what matters more than NuSI. A few months ago I mentioned this to Jay.  He said, “Do you want to meet Ric? I’m happy to introduce you.”  That was like asking a 15-year-old girl if she wanted to meet Justin Bieber.  Except I didn’t scream as loud. And Ric is way cooler than Justin.

The day after my talk, I was introduced to Ric and we spent about an hour together. It was a unique experience to understate it.  Too often when we meet people we “feel” like we know (due to their celebrity), we’re often let down because we build them up to be more than they could ever be.  Amazingly, and I don’t say this lightly, the person Ric is far exceeded the image of Ric I had, based on a 5 minute video.  He’s one of the rare few I’ve met (one day I’d like to write a book about this short list of folks) that I could imagine dropping everything I was doing to go and work with and for them.  Every man should aspire to be half the father Ric has become since that flight.

Medical school connection

The day before my talk, I was backstage trying to figure out where everything was, and I looked up and saw Zubin Damania!  You may not know who Zubin is, or even his YouTube alter-ego, ZDoggMD (though you’ll definitely want to check out his video on screening for testicular cancer, among many others).  But here’s the thing…the last time I saw Zubin was 13 years ago when he was my intern on my internal medicine rotation at Stanford.  For 8 straight weeks Zubin had me rolling on the floor laughing (and enjoying every single moment of being in the hospital with him).  Zubin is sui generis.  I remember staying up nights on call with him, asking him, “Are you sure this [medicine] is the best use of your talent?  I mean, you’re too damn funny and talented to do this!”

Well, let’s just say, nothing I saw this week surprised me.  Zubin is a rock star and the world is a better place because of his humor and brilliance, and the way he actually combines them. Zubin’s talk was, without question, the peak of TEDMED 2013 entertainment.

If that wasn’t enough, two days later (the day after my talk), a woman stopped me in the lobby and said, “Peter, I really loved your talk.  Thank you for sharing that story.  I hope other doctors hear this message.” I thanked her and we chatted for a minute, the whole time I’m thinking, “Gee she looks really familiar…,” when it finally hit me.  This woman, Dr. Ramona Doyle, an amazing pulmonologist, taught me respiratory physiology 16 years earlier at Stanford!  What made this so special, though, was hearing what she does today.  In addition to her “day job,” she runs a free clinic for uninsured patients in South San Francisco.  Her stories were amazing.  She seemed happier than ever.

The most moving talk

The last talk of Session 7 (there were 10 sessions, each with 5 speakers, for a total of 50 speakers/performers), was given by author Andrew Solomon.  Since you’ll all be able to watch this for yourselves in 2 months or so, I won’t say much. But, if you think back to Jay’s advice to me, Andrew gave a seminar on how to do this.  Andrew is a very special man, and though I was only able to speak with him for 10 minutes backstage, it was clear that he was cut from a different cloth.  A very special cloth.  When his talk began, I thought I knew where he was going.  And I was looking forward to it.  But where he went instead, well, I can’t describe the emotional rollercoaster.  If you can only watch one talk, and I hope you can watch many more, Andrew’s is the one to watch.

Greatest human spectacle

Charity Tillemann-Dick, a remarkable singer, who has undergone a double lung transplant due to primary pulmonary hypertension, simply lit up the room with her soprano voice.  I just could not imagine for the life of me how this woman could sing with such a beautiful voice not powered by her ‘native’ lungs.  In Charity’s case, there was also a deeply personal reason I was so touched by her story.  It highlights the importance of organ transplantation. As she shared with us, life is neither a marathon, nor a sprint.  It’s a relay.

After her talk (and song), I caught up with her back stage and shared the story of my friends, Jeff and Teena Webster, who lost their son Aaron in September 2009, one day before I swam from Los Angeles to Catalina Island – a swim I dedicated to Aaron.  Aaron’s story is both tragic and glorious, as 13 people now live with a part of Aaron in them, including a man who was probably a week away from death due to liver failure.  Today, that man has a tattoo on his arm that reads: Aaron Webster, my hero. 

Best line of the week

Spoken by a juggernaut of a woman, the amazing America Bracho, who is empowering impoverished communities in Southern California by creating participants out of patients, left an impression on me.  Sounds crazy until you hear her tell you and then watch her show you. Make sure you watch her talk when it’s out.  Like Andrew’s talk, this moved me to tears.

She was asked, essentially, can this model she has deployed work with anyone?  She said, “no, you must choose the right people.”  The clincher: “Recruit the heart. Train the brain.”  As someone obsessed with building a great team, truer words have not been spoken.

Most surreal moment

A team of artists created portraits of each speaker, which hung as banners.  A man named Robert Brinkerhoff, who I had never met until my talk, created the following image of me.  I realize this may sound strange, but this struck me as very touching.  Someone who didn’t know me put that much time into trying to represent me?  Very humbling.  Thank you, Robert.

Attia_Brinkerhoff_LR

Closing thoughts

I don’t know if they will ever read this, but if they do, I really want to thank the following people at TEDMED for guiding and encouraging me to share my story, which I was very reluctant to do.  There are so many people behind the scenes whose names I don’t know, but who I owe my gratitude.  I really want to thank Jay Walker, John Benditt (and Gary Taubes, who suggested me as a speaker to John), Lisa Shufro, Lindsay (none-of-my-boys-are-named-Harry) Potter, Pritpal S. Tamber, Jon (the-apple-doesn’t-fall-far-from-the-tree) Ellenthal, Alyssa Picchini Schaeffer, and Marcus Webb, without whom I could not have told my story.  And, Steve Maler.  You gave me the confidence I needed to be so vulnerable, my friend.

I have no idea how I got to be one of the people there this year.  I felt such a responsibility to give back to TEDMED, as I’ve received so much from TED and TEDMED over the past 7 or 8 years.  Though Ric Elias’ talk is my favorite, there is a huge tie for second place (including Virginia Breen, who I just happened to sit beside by random luck during Andrew’s epic talk – once you’ve seen Virginia’s talk and Andrew’s talk, you’ll understand why this juxtaposition was so powerful).  The talks I fall in love with are simply the ones that move me the most.  I spend my whole day learning things.  What I crave is inspiration.

A day after my talk, a woman came up to me in the common area.  She was crying. Just sobbing.  She said she cried through my entire talk.  She couldn’t figure out why.  What was I saying to bring out such emotion, I thought? I apologized. But then she said the most insightful thing that, I think, explains why some of these talks just really move us.  She said, “Peter, it wasn’t what you said, or even how you said it.  You just made me look at myself differently.  These emotions pouring out of me are about me, not you.  You just gave me a different way to think about myself.”

I think that sums up why these talks are so special to me.  It’s about the mirror inside me and everyone else.  I did learn many things this week and met people I want to know better. But for 3 glorious days on the Potomac, I didn’t think about my world or my vision.  I simply got inspired and moved by everyone else’s.

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About the Author:

Peter Attia, M.D., is the co-founder and President of the Nutrition Science Initiative (NuSI), a non-profit based in San Diego, CA. He received his B.Sc. from Queen's University in Canada and his M.D. from Stanford Medical School in California. After his surgical residency in general surgery at Johns Hopkins he worked as a consultant at McKinsey & Company. He founded NuSI with scientific journalist Gary Taubes in 2012.

Discussion

  1. Caroline  April 20, 2013

    Thank you so much for sharing this,…I love your writing and am always inspired by you!

    (reply)
    • Peter Attia  April 20, 2013

      Thank you, Caroline. I hope you’ve already watched Ric’s talk!

    • Kathleen McGill  May 2, 2013

      Too cool. Very keen to see your talk. Fascinating to know that there is a team of specialists who help speakers prepare. May I ask…is this eating regime an all or nothing proposition? I have a 12-year old son who eats 2 meals a day at home a la few carbs high fat style. At school the best we can request is wheat free. He still carries more weight than I think is healthy. Also wonder about lipid profile. He’s on 300 mg 3x day tegretol which possibly complicates things.

    • Peter Attia  May 2, 2013

      Remains to be seen. I (personally) would not suggest a mixed diet of very high fat and very high carbs for reasons too complex to explain here.

    • Krissy  July 10, 2013

      I just wanted to thank you again for your TED talk. I was so relieved to find it. My mother died of Diabetes complications in November last year, I know I am becoming / or am Insuline resistant. I also have problems with lactose and gluten. I am tired all of the time, not helped by the fact that my parter has restless leg syndrome which has been getting continually worse of the last 30 years resulting in him being off work and regularly missing sleep for up to 3 days since about the same time my mum died. I am so exhausted. This imformation is providing me with a lifeline that will help me slowly get myself back together. :-)

    • Peter Attia  July 10, 2013

      Krissy, I’m sorry to hear about your mother. I hope you can find helpful in here and elsewhere.

  2. Squatchy (Christopher Williams)  April 20, 2013

    Looking forward to watching your talk, and the others that you mentioned. I feel inspired already!

    (reply)
    • Peter Attia  April 20, 2013

      Imagine how I feel? Can’t wait till you can experience it, too.

  3. Danny J Albers  April 20, 2013

    Wonderful experience in your life and something to always remember.

    I cannot wait to see it!

    I hope you post a reminder of all these as they become public.

    (reply)
  4. Phil Niles  April 20, 2013

    The way you feel about Andrew Solomon’s talk is the way I feel about yours. Thank you for sharing, sincerely

    (reply)
    • Peter Attia  April 20, 2013

      Well, that’s an amazing honor.

  5. Brad L  April 20, 2013

    Peter,

    Congratulations on you recent talk at TEDMED 2013. I was very excited when I saw that you had been invited to speak. I am writing from Alberta and have been following your blog since only January of this year. It is nice of you to share how others have inspired you, just as you have inspired so many. I look forward to seeing your talk once it is finally released (I was able to find a 2 min teaser posted yesterday). Thank-you for all that you have been doing and for all that you will be doing for the next few years to come. A second congratulations is in order for the 40 Million dollar funding that NUSI has received. I have no doubt that you will continue to inspire and with any luck, this inspiration will bring change.

    Brad

    (reply)
    • Peter Attia  April 20, 2013

      Thank you so much, Brad.

  6. Bob West  April 20, 2013

    Peter, thank you so much for this. I did go immediately to Ric’s talk and it was all you said it was. I did not have a dry eye.

    I’m looking forward to yours. I’m sure that the thread of emotion will be as real, and I’m glad that you have done this.

    Bob.

    (reply)
    • Peter Attia  April 20, 2013

      Bob, I’m so glad I could share Ric’s story with you, and others.

  7. Bryan Barksdale  April 20, 2013

    I was lucky enough to watch your talk live online through my medical school. It was extremely inspiring and emotional for me. I can’t wait to see the kind of impact it has on the medical community.

    (reply)
    • Peter Attia  April 20, 2013

      Thanks, Bryan. I guess as you could see, it was very emotional for me, also. Best of luck with your journey.

  8. kats612  April 20, 2013

    Wow! I had never heard of TED before and now I can’t wait to view this year’s talks. Thanks for sharing your experience and YES, I went straight to watch Ric just like you said to and when you said to…it was enough to create the desire to see what everyone had to share! So cool!

    (reply)
    • Peter Attia  April 20, 2013

      Bonus! So happy I could introduce you to this.

  9. roxanne nelson  April 20, 2013

    Hi Peter,

    Thank you so much for posting this. I have to say, in the list of most memorable and greatest talks from TEDMED, your own talk ranks right up there in the top five. Maybe top 3. You and America Bracho moved me to tears. In particular, as a healthcare practitioner who had frequently felt judgmental towards patients and families, your own story resonated with me. Particularly when I found myself dealing with a health issue that was almost instantly resolved when I reached outside the box and sought my own answers.

    You rock Peter, and I hope you continue speaking and sharing your story as well as your research. We need more people who are willing to consider alternative viewpoints, and who realize that we are all individuals, and therefore, a “one size fits all,” or in many cases, the “one size fits no one” solution is not the answer.

    I am currently in the air, en route home from TEDMED. But I just had to write now, and let you know how much you inspired me.

    Roxanne

    (reply)
    • Peter Attia  April 20, 2013

      Thanks so much, Roxanne. The discomfort of my talk seems worth it to have shared the revelation.

  10. Sandi B  April 20, 2013

    Wonderful post! Ric’s talk is amazing and I so look forward to seeing yours and the others you’ve mentioned in a couple months! Do let us know when it’s available.

    (reply)
    • Peter Attia  April 20, 2013

      Will do, or I’m sure someone else will figure it out. Glad you watched Ric’s talk.

  11. Dan Ordoins  April 20, 2013

    Thank you so much for sharing this,…I enjoy your writing and love your insights and personal journeys!

    (reply)
  12. Shell  April 20, 2013

    I just watched Rick’s talk, it was a very timely reminder to me to live in the moment and be a good parent (though i did shout at the kids to keep quiet so I could hear it). Just what I needed actually. I heard you also received a standing ovation. Congratulations, I’m really looking forward to watching. Thanks Peter.

    (reply)
  13. NM  April 20, 2013

    That was a great post, Peter! Do you know if Gary Taubes ever got invited to speak at TED? Perhaps he’s kind of “retired” from speaking for a while? Also, a suggestion is to try to find a talk given by “Scully” (sorry forgot his real name). He was the pilot of the aircraft that landed in the Hudson River. His talk is also great because he discusses fear and how it really only exists in the mind, not in reality. Kind of hard for me to explain, but it’s great.

    Love TED! Seek ou Steve Jobs’ speech from Stanford. I think it’s the #1 rated clip on TED–it’s great! Kind of similar to Ric’s. So much good stuff on that website.

    (reply)
  14. Longbow  April 21, 2013

    Fantastic post and email. saw through Ric’s TED task and shared with a friend over an outdoor fire , rum 21 and wind chimes. Can’t wait for your TEDMED talk to go online. Enjoyed your writing and your insights about life and health, Peter. Keep them coming, please.

    (reply)
  15. Jessie  April 21, 2013

    I work in the research side of a med school so had access to the TEDMED talks. I planned my week around getting to watch you. You did an amazing job, although I admit the scientist in me wanted those details that you had to leave out (but you succeeded in bringing me to tears too). I am finding myself obsessed with this topic and am fully convinced that correcting the “backwards hypothesis” of obesity is critical. I read more publications now than when I was a Master’s student. Any advice of what I can do to contribute in some larger way? Does NuSi take volunteers?

    (reply)
    • Peter Attia  April 21, 2013

      I guess best advice I can give, Jessie, would be to try to avoid the mistake everyone is subject to…selection and confirmation bias. Rather than correcting the backwards hypothesis, I think we should strive to test it. That would be an essential first step – to test it with open minds and at least a willingness to be wrong. Of course, there are many questions embedded within the conventional wisdom, but I have to constantly remind myself if I fail to consider all options, I may miss something. Remember Feynman’s famous quote?

  16. James  April 21, 2013

    Thanks Peter and having to come to know you a little bit of course you could not but share this. Whenever we have experiences like this we want to shout it from the roof tops. It’s 4 o’clock on Sunday morning and I’m up. Probably worried a bit, it’s freezing again and there are plants in the greenhouse. (this is between Toronto and Kingston). Fed the wood stove and scanned the e-mails. Yours. And forwarded Ric’s TED talk already to the kids. May I make one suggestion to the old guys among us (I am 71) : don’t waste too much time regretting. There is an awful lot in everybody’s life to be regretful about. Don’t ! All that you have ever done, all that you have ever experienced has added to who and what you are today. It is neither good nor bad. That is only a perspective. Ric’s talk is one among many that will add to who you are today and tomorrow. I think it is safe to say that the people who will read this are already a special bunch. They have realized that life is too precious to fritter it away with stuff and more stuff. That’s probably also one of the reasons they ended up on this site and subscribed to the updates.

    (reply)
    • Peter Attia  April 21, 2013

      James, great advice. Thank you.

  17. Scott Sterling  April 21, 2013

    Peter, the spirit in which you wrote this post was as moving as a TED Talk. I would love to learn what you learned from Jay Walker.

    (reply)
    • Peter Attia  April 21, 2013

      Well, I hope I have privilege of learning a lot more from Jay before I have to answer that…

  18. Leigh  April 21, 2013

    Hi Peter – I am the sobbing woman. I’ve already emailed my endocrinologist at Yale with your site/blog and am interested to see what her response will be. [For readers, I have both a metabolic disorder and thyroid disease, both diagnosed only recently - years after being treated like a gluttonous slug by doctors.] A friend asked me yesterday how TEDMED was. I responded that it was transformational, and that’s largely due to you, Peter. So while the talk may have been outside your comfort zone, it was revelatory for me, and I’m grateful. Sharing your experiences and knowledge with such fluency and compassion is a great gift to so many. Leigh

    (reply)
    • Peter Attia  April 22, 2013

      Leigh, I don’t know where to begin. I’m glad we were able to meet last week. I hope your current doctor treats you the way you deserve to be treated.

  19. JJ  April 22, 2013

    Had not even heard of TEDMED. Thank you again for opening my eyes to a bewildering source of inspiration and energy. I am tremendously happy you had an opportunity to share your story.

    Please do not sell yourself short or the work you are supporting, you deserved to be up there. You and Gary have the potential to shift Western culture. The magnitude is unfathomable.

    (reply)
  20. matthew  April 22, 2013

    Can’t wait to watch. Thank you for your invaluable blog; I recommend it to anyone willing to listen! How do you interpret the recent Nature Medicine article claiming that red meat is unhealthy due to its L-carnitine content?
    http://www.nature.com/news/red-meat-wrong-bacteria-bad-news-for-hearts-1.12746

    (reply)
    • Peter Attia  April 22, 2013

      Addressed two weeks ago. See Twitter and FB.

  21. Dan  April 22, 2013

    Thanks for sharing Peter — I watched the Elias video (a few times…) and can’t wait to see your TEDMED talk!

    (reply)
    • Peter Attia  April 22, 2013

      Not as good as Ric’s…

  22. Mike Kramer  April 22, 2013

    OK. I’ll be the first commenter to admit that I would rather read one of your articles 5 or 6 times until I get it than click on a video link. But, hey, I think I understand your mission, and I support it. We need to reach as many people as we can.

    So, even though a 17-minute Ted talk doesn’t get me that I excited, I plow through the comments thinking I might pluck some new gem about ketosis or quantum mechanics. Instead, I find that you are getting a cool $40 million to fund some really high-quality investigation of low-carb living. I had to do some Googling to figure out what that was all about.

    This is incredible! You are the Vihjalmur Stefansson of the 21st century! It might even be bigger than a Ted talk.

    Yeah, a Ted talk is pretty cool. But I don’t think people will be writing about your Ted talk a hundred years from now. Seriously good research, on the other hand, could be of world-historical significance. I’m celebrating. I hope you are too.

    (reply)
  23. steven  April 22, 2013

    Peter here is a link to a small preview of the 6 best TEDMED talks of 2013, yours being one of them. I can’t wait to see the full speech. Thank you for educating me and for empowering me. This blog has been a true lifesaver. Thank you!

    http://medcitynews.com/2013/04/get-a-peek-at-6-of-the-best-tedmed-2013-talks-video/

    (reply)
  24. Laura Babbitt  April 22, 2013

    Peter, thank you for sharing your favorite TED talks by Ric Elias and Virginia Breen and Elizabeth Bonker. This may sound funny to you, because your blog and a TED talk are such very different things, but I am just as inspired and moved by your writing as these talks. We have such a need for the information you seek to make available, and the passion you have for its pursuit burns as bright as Elizabeth’s desire to speak, and Ric’s and Virginia’s desire to be there for their children. Honestly. The work you are doing inspires the h— out of me. And I see from other comments, I’m not the only one.

    I am glad to know how moved and inspired you were by TEDMED 2013. Keep feeding that fire!

    (reply)
    • Peter Attia  April 22, 2013

      Thanks very much, Laura. Appreciate it.

    • oallen  April 23, 2013

      I have wanted to praise you for the influence, teaching, guidance, inspiration, etc but some many have already commented. I second Laura’s comments which were right on. Thanks Laura.
      I look forward to Cholesterol Part X. Sorry for my over-anticipation but my first NMR shows more particles than any example I have seen.

    • Peter Attia  April 23, 2013

      I look forward to part X, also!

  25. Joshua  April 22, 2013

    Peter – I can’t watch video at work, but I’ve made a mental note to catch Ric’s talk later.

    I just want to thank you for your enthusiasm. I’ve watched more TED talks than I can count and I’ve started to get burned out on them a little bit with the TEDx brand. I have an unfortunate tendency to get cynical and jaded and your post reminded me that there’s still a lot of great stuff out there and that it really does have the best of the best when it comes to speaking.

    (reply)
    • Peter Attia  April 22, 2013

      I think Ric’s talk, along with several others, will rejuvenate your appreciation for this forum.

  26. Pam Kryskow  April 23, 2013

    Hi Peter,
    I was at TEDMED 2013 too and I put your talk in my top ones as well. It was great. I’m an MD dealing with obesity in the First Nations populations in British Columbia (fortunately with good success). I have been following Gary Taubes since he wrote Good Fats, Bad Fats and have been incorporating that into my teaching ever since. I know there are lots of ways to help people with their obesity and I am open to all tools. I look forward to seeing how your research gives us all further tools to help our patients and ourselves.

    (reply)
    • Peter Attia  April 23, 2013

      Thanks so much, Pam.

    • Amanda  May 16, 2013

      Pam I am so happy to hear that someone in Canada is trying to help First Nations people. I’m a Canadian nurse working in a dialysis unit in Alberta and I see everyday how this people are dying thanks to the advice to eat healthy grains.
      I would like to see more doctors like you.

  27. samwise  April 23, 2013

    Alright, I will be the second one to say that there are much better things than TED. TED is cool for introducing people to new concepts, but not very useful for those that want more than just an introduction. Don’t get me wrong I have watched many hours of TED, but have been mostly disappointed by the lack of substance.

    What I love about your site is your detailed analysis of biochemical systems and how they relate to human health. This country has a major public health problem and your foundation is a well needed tool.

    I have noticed that you are not posting as frequently:-( I really enjoy reading your technical posts. Whenever I see a new one I get very excited:-)

    As for the talk by Ric Elias, I found it interesting, but you would seem to have a greater purpose than just being a great father. Your foundation could make a real difference in a great many people lives. If successful, that is something you will be remembered for 100 years in the future.

    (reply)
    • Peter Attia  April 23, 2013

      In the TED format it would be impossible to introduce deep, new content. There are no shortage of conferences out there that do that — I’ll be speaking at one this weekend where I’ll provide detailed molecular explanations of cholesterol synthesis. TED is not trying to replicate that. So I think your disappointment with the lack of substance may be because of your expectations, not a failure of TED. It would be like me saying I’m disappointed with my dog’s ability to do long division. Is it my fault or his? His purpose isn’t to do long division. Lots of other tools for that, right? I realize you’re being very complimentary to the work I’m doing, and I really appreciate it. And you’re definitely right that my posting frequency is down. But I disagree completely with your last statement. You see, being a great father matters more to me than anything, *especially* a blog (and especially on the days when I get nasty emails from people telling me to go F*ck myself…can you imagine what it feels like to get 10 of those per week?). So my rank order in life is: My family > NuSI > My life (and sanity) > Blog. I hope you can respect this, or at least understand it.

  28. Lauren  April 23, 2013

    Hi Peter,

    Thank you for the incredible talk at TEDMed and sharing your experience at the conference. Your humility and vulnerability on stage turned a room of 1800 strangers into an intimate and inspiring moment between friends.

    I was so struck by that extraordinary sentiment, I had to write about it: http://www.practicefusion.com/ehrbloggers/2013/04/tedmed-2013-dispatch.html

    Best,
    Lauren

    (reply)
    • Peter Attia  April 23, 2013

      Lauren…such kind words. Thank you. From you blog post, it’s clear you understand how difficult that talk was for me and how vulnerable it felt. I really appreciate your comments.

  29. Charles  April 23, 2013

    Dr. Attia,

    TEDMED was fantastic, and your perspective on the confab is the richest I’ve found, yet. You invoked Feynman, above, and I just love that guy. I’d like to join the conversation, here, add a few observations of my own from TEDMED and then pose you a question. Forgive me for the gambit and amble of this post, my intention is to add to the atmosphere of sharing you’ve created on this site and maybe spark some more.

    First, a few thank you’s ad hominem. As a physician, I’m very pleased with your career focus. We are too commonly prescribing advice that is not built on the bedrock of evidence. Ironically, because nutrition is extremely important and accessible, it has been one of the most abused victims in healthcare. The first step everyone on this post can do is “stay in the question.” We need to train ourselves to be comfortable with ambiguity. Many reading this post may be surprised that suggesting perhaps the quality of the food, and not just caloric quantity alone, is driving a global health crisis quickly upsets a lot of people. It is an ambiguous question and the human mind naturally resolves ambiguity. We are a nation of deciders, GW Bush was the decider, etc. Well, turns out a lot of our decisions stink because we made them without (1) considering the evidence judiciously, and (2) we didn’t have evidence to consider in the first place. Thank you for helping us out of this mess, Dr. Attia!

    A second thank you for sharing Jay Walker’s advice, above, so lucidly. I think it’s profound advice on story-telling 101 and how to behave with other people in general conversation. Too often we try to convince and cajole others to agree with us, or worse. But we don’t need everyone to always agree, do we? How stultifying to the advancement of nutrition science if we all already agreed that the RDA figured things out long ago and there was no more work to do?

    On reflection of TEDMED, I feel like I passed through the back of the wardrobe into Narnia. As I write this, I still have a child like certitude that that I could return to the Kennedy Center at any moment, enter stage left, and find everyone still there, waiting to strike up conversation. The amazing TEDMED team did their level best to create a world where we could check our titles at the door – free of their restrictive weight for a moment, we were able to exchange ideas and make connections more freely, more solidly. There was only one currency – curiosity – and only one entry requirement – flexibility of thought.

    A Feynman quote was referenced for Jessie – I’m guessing it was something along the lines, “the first principle is that you must not fool yourself, and you are the easiest person to fool.” Feynman was a prolific mind, and he was not averse to giving advice. I love the advice he gave a doting mother for her son who could not explain his physics lessons to her satisfaction. He said, “[T]ell your son to stop trying to fill your head with science — for to fill your heart with love is enough.” Passion like yours is very valuable, Jessie. I would suggest, that by consciously focusing it in two ways, onto others when you meet them and onto your work, you have the rudiments for success. Taking Peter’s advice to conduct honest scientific inquiry – i.e. not being afraid to routinely questioning yourself and others – in addition to those traits… well, you will rule out all other possibilities except success in science, and in life.

    I’ll close my thoughts, before I pose a question, by borrowing more quotes from Feynman: (1) What I cannot create, I do not understand (2) I think I can safely say that nobody understands quantum mechanics. While we probably should not speak in absolutes, I’ll take a risk and say true genius is about recognizing what you don’t know, and relentlessly pursuing discovery. Feynman admitted that, freely, and I am trying to get better at it.

    Here is my question for you, Dr. Attia. I would like to know more about how you have dealt with loneliness during your career. I’m not talking about the loneliness of surrounding yourself with loving family and friends, I am sure you have many. I’m talking about the intellectual loneliness of pursuing a line of thought that is together so iconoclastic and omni-disciplinary, that few people on the planet are capable of wrestling the multi-headed beast to the ground. While we all accomplish more together, and battles in life are never won alone… it’s the scouting, the reconnaissance, the experimentation and then the application that advances human knowledge and well-being. I’d love to hear the human elements that sustain you on your intellectual roaming as you morph from surgeon to consultant to evidence based nutrition scientist to roles undefined.

    Thank you,
    Charles

    (reply)
    • Peter Attia  April 25, 2013

      Well, Charles, I must say…in 10,000 comments this blog has received since its inception, I’ve never been so put back on my heels. Congratulations! Your question is so amazing and I can’t figure out how to respond, without writing 10,000 words — something I can’t do. I guess I would just like to thank you for having such piercing insight into my demons and insecurities. I don’t really know the answer to your question, other than to say I constantly remind myself, when I do feel alone, that I am not. When my actions are driven by ego, I feel alone. When driven by service — when really authentic — it doesn’t seem to matter. I hope this sort of explains it.

    • jw  April 26, 2013

      Taking a couple of examples in fiction, Holmes (Doyle, not Downey) and modern interpretations like Monk and House all occasionally touch upon how difficult it is to walk into a room and see so much that others do not see, and dealing with the fact that most people will never see things in the same way. Their intellectual/intuitive loneliness is I think what we are discussing here.

      The internet certainly helps connect with similar people, but getting some critical mass together for interpersonal communications is a challenge. This may help explain your reaction to TEDMED.

      A gentle reminder – the anniversary of Part IX is July 12th…

    • Peter Attia  April 26, 2013

      Ahhhh…the pressure…

    • Dave Nelsen  April 28, 2013

      No need to worry Peter, as you have a child – you’ll never be alone. :) While your areas of interest may be outside the current dogma, I would say you’re far from alone in your area of pursuit. It’s not like you’re John the Baptist crying out in the wilderness. I’ve come across a good number of people in the last year who are losing weight and they have a variety of names for the plans, but at the heart they are all using carb restriction to get the job done. The fact that a lot of people have a War on Insulin underway I think is a sign in the right direction. And if you want a good laugh, click on the link below:
      http://www.despair.com/loneliness.html

      Cheers, Dave

    • Peter Attia  April 28, 2013

      One of my favorite sites lets you upload pictures and make your own “de-motivational” posters in this exact format. Priceless. I’ve made countless variants.

    • Charles  May 4, 2013

      Thank you for your considered and honest response(s), every one is an opportunity to learn something. I certainly do not intend to point out hidden insecurities nor mean they are unique to you. I am convinced they are shared by everyone, by every single person since we all have transitioned from one place in life to another – new professions, new cities, and, in general, new roles on life’s stage as we hurtle through time. I guess when I think about the ‘price’ of being alone, I am reminded of the reward illustrated by a quotation attributed to Einstein: “The man who follows the crowd will usually get no further than the crowd. The man who walks alone is likely to find himself in places no man has ever been before.” It’s being able to relate those stories and images in your mind sans camera and with emotional connection, that is often the tricky part. I like your distincition between ego and service, it is poignant, and something I will continue to ponder. I guess we all need to remind ourselves we are not alone – not at 1 AM in a lab, nor on the podium delivering iconoclastic research findings, and never a stranger in a strange land. I do think many posting and reading on this page would agree that life is so much more exciting when lived as an explorer! Good luck to you ,and everyone on this post, in your intellectual roamings and purposeful experimentation to advance human welfare.

    • Peter Attia  May 4, 2013

      Charles, I can’t take any credit for coming to that realization (ego vs. service). It all goes to my coach who has spent a great deal of time helping me realize the contrast.

    • Daniel Comp  May 18, 2013

      Charles, and Peter,

      I applaud your appreciation for (self) understanding as a great and daily expedition. Physics gave me mental tools to consider the unknown, and life (between my plans) has provided many spotlit stages from which I’ve explored. Thus I appreciate Ric Elias’ talk first-hand, as with many other over-comers we have met online.

      Thank you both for posting reminders that we are NOT alone, even though we are not frequently connected. Your thread trumps all the tech-TED-Singularity minyans that I frequent.

      Thank you for sharing transparently. I hope to reciprocate value with you both in the future.

  30. Sue Minger  April 23, 2013

    Hi Peter,
    Thanks to Denise, I was able to view your talk early and have to say it was one of the most touching talks I’ve ever seen. I am so happy that she is working with a man of such high integrity and intellect. Thank you for introducing this new way of looking at the link between obesity and insulin resistance–who would have thought?

    (reply)
    • Peter Attia  April 23, 2013

      Sue, thank you for such kind words. As you probably know, I think the world of Denise and consider myself so lucky to know her and have her be a part of our team.

    • David Nelsen  April 30, 2013

      Speaking of Denise MInger, does anyone happen to know when “Death by Food Pyramid” will hit the shelves? The last prognosis was early 2013, but it’s getting late for early 2013. Enquiring minds want to know.

    • Alexandra  May 1, 2013

      David:

      Death by Food Pyramid
      Author: Denise Minger
      Publisher: Primal Nutrition, Incorporated
      Publication Date: 07-16-2013
      ISBN: 9780984755127
      Pages: 288
      Subjects: Health Nutrition

    • lorraine  June 4, 2013

      Two things to feel wonderful about here: one, to read here that Denise Minger is part of the NuSI team! Two, I just saw the live feed video of all the TEDmed presentations that included yours, and the bits and questions in between them, and, while I really appreciate Charles’ question to you, I believe it is moot as I think it impossible to feel any substantial loneliness when you are that beautifully connected to your patients. That was remarkable. And the whole world is your patient now.

  31. Sam Y  April 23, 2013

    Peter-
    Thank you very much for your effort on this blog. I have learned very much from you, and I am very grateful to be able to use what you have taught me on a daily basis. I have a question that I am dying to ask.

    When it comes to going in and out of ketosis and also achieving long term health goals what is the most important part of managing blood glucose levels? If I imagine my blood glucose as a function of time f(t), should I be worried most about df/dt or the integral ?fdt of that function ie glycemic load over a period of time?

    Maybe the answer is, it depends. I suspect LPL and ketone synthesis are affected by df/dt while metabolic syndrome may be ?fdt. I would love to hear your thoughts.

    Thanks,
    Sam

    (reply)
    • Peter Attia  April 24, 2013

      Great question, Sam. Hb A1C is a pretty good “poor man’s” estimate of the integral of g(t) over time, where g(t) is glucose concentration over time. Not sure what pathological information is captured in dg/dt, since I’ve never seen it reported. Presumably very large (and +) dg/dt is not good, but I’m not sure how to benchmark. No doubt B-OHB production is impacted by dg/dt, as you suggest.

    • Sam Y  April 25, 2013

      In addition to variations in dg/dt between individuals, I was thinking of it as far as food choice. Because as far as I can tell, the main difference between 30g of carbs in soda and 30g of carbs in superstarch is the rate of change of g(t). It seems to me that a high dg/dt causes (through insulin) a decrease in B-OHB, intake of free fatty acids by adipose tissue, and de novo lipogenesis. All of those things I want to avoid, but I wonder to myself how much damage is a sweet potato doing relative to soda?

      Thanks,
      Sam

    • Peter Attia  April 25, 2013

      Absolutely. That’s really what the GI is trying to estimate (for a fixed glucose load).

  32. samwise  April 24, 2013

    Your points about TED are valid; I just hold you to a higher standard, my bad. TED is a great place for getting a message out, and I am sure you did a great job.

    Peter, your desire to be a great father is admirable, but that only helps your children. I could go on about how helping the many outweighs the needs of the few, but that is a philosophical issue.

    I am very sorry to hear that you receive hate mail in the quantity described. I am sure this is an unpleasant experience, but please do not be discouraged. Your posts to date have been very helpful and informative to me. You have made a difference in my life and for that I am grateful. I am anxiously awaiting the next installment on ketosis since I have had some strange results experimenting with it on myself.

    Your priorities seem very reasonable, but I wish you had more time for the blog. I can dream can’t I?

    (reply)
    • Peter Attia  April 24, 2013

      Well, I appreciate your understanding. And believe me, I love writing this blog, despite the hate mail, because I know that for every person who would prefer to see me dead (according to them), there are probably 99 (or hopefully 999) who do not! But when it’s all said and done, if my desire to help others comes at the expense of my family, I will have failed. So I’ll keep trying to balance things. Keep in mind, though, the work that occupies the most hours (about 80 per week out of a possible 168) is NuSI. NuSI has much more of a chance to help people than my blog. So while progress there will be slow(er), it will be worth it, regardless of the outcome.

  33. Jeremy tyler  April 24, 2013

    Can’t wait till the video’s are released. Really looking forward to it. Sorry to hear about the hate mail. Your 9 posts on cholesterol have been very helpful in my keto presentation that I present to people and I’m really thankful for all your posts.

    (reply)
    • Peter Attia  April 24, 2013

      Thanks, Jeremy. Most days it’s ok. Once in a while it gets to me.

  34. LesliM  April 24, 2013

    I have watched dozens of TED and TEDMed talks. I got to see your talk via TEDMedLive. Of all the talks I’ve ever watched, Ed Gavagan’s (http://bit.ly/17TYVeb) ranks #1 and yours is #2 as far as emotion. If this is you outside your comfort zone, you must rock it while in your comfort zone. :) Congrats!

    (reply)
    • Peter Attia  April 24, 2013

      Thanks for sharing Ed’s talk. I had not seen it before. Very moving.

  35. Bob West  April 25, 2013

    Hi Peter,

    I just saw this article in the NY Times (which I will not ask you to comment on specifically), citing an article in NEJM on the lecithin in eggs being used by unidentified intestinal bacteria to produce a substance (TMAO) that is “linked to increased risk of heart attack and stroke:” http://www.nytimes.com/2013/04/25/health/eggs-too-may-provoke-bacteria-to-raise-heart-risk.html?hp&_r=0

    (I will note that choline, the component of lecithin that is involved in this study, is an essential human nutrient: http://en.wikipedia.org/wiki/Choline)

    There appears to be a similarity with another recent study regarding carnitine in red meat, in which choline is released on the ingestion of carnitine, and is then subject to bacterial action.

    Again, I’m not asking you to comment on these articles specifically. It’s like a game of whack-a-mole — not very productive overall, and they just keep popping up. It probably has to do with the direction of most current research.

    It appears that current conventional research is satisfied with investigating linkages (correlations) instead of causation. It also appears that it is thought to be better to find linkages that agree with current dietary ideas. Perhaps there is more funding in that direction, or probably it is just a matter of going with the current flow, as human beings tend to do.

    I trust that NuSI will help in reversing this tendency, with funding for let-it-fall-where-it-may research projects that really start out neutral on the outcome, and just look for the facts.

    I guess that is all I would like you to comment on. I began this comment with a feeling of exasperation, even though I knew I couldn’t ask you to address every instance of the same phenomenon. And if you can forgive my ranting too long, can you comment on the general phenomenon?

    If it’s just too big a thing to address all at once, that’s great, you’re doing the right job one step at a time. Please carry on. This is how we’ll get there.

    Bob.

    (reply)
  36. Jed Batchelder  April 25, 2013

    The presentations are still available on the livestream site. http://new.livestream.com/accounts/3320021/events/2005920
    Your presentation is in session 4 and starts at the 1:15:14 mark.
    I had the privilege of attending TEDMED this year and as a long time reader of your website, I was delighted to hear that you were going to be a presenter.

    Your presentation, and others at TEDMED illuminated the empathy that is already present in healthcare today, but is often trapped in the confines of our current, impersonal healthcare delivery model.
    Thank you!
    Jed Batchelder

    (reply)
    • Adam  April 26, 2013

      Thanks Jed, just listened to Peter’s excellent talk. Something was nagging at me all through it though – who does he sound like? If I was just listening to the audio, I’d swear it was Jeff Goldblum.

    • Daniel Comp  May 18, 2013

      Jed, thank you very much for the link.

      I’d appreciate an exchange on your thoughts to transform the “impersonal healthcare delivery model” as that is what we’re working on: internet models to assist the ‘champions’ with.

  37. Paul Jacob  April 25, 2013

    Hi Peter –

    I was distressed to read that you receive hate mail for your incredibly valuable work. I’m sure ( I hope) you realize it’s not a reflection on you, but rather an indication of how psychologically and emotionally attached people get to their eating, and how threatened they feel when someone convincingly challenges that. For whatever reason, I think people are as defensive about their eating habits as anything in their lives. I can attest to that as a long time LC proponent in a family that loves their “balanced” diets after a big round of chips and dip. I’ve found that proseletyzing doesn’t work! Add to that the bewildering array of contradictory “sound” medical advice about eating and the equally bewildering array of self serving commercial enterprises that have their livelihoods at stake, and you’ve got quite the metaphorical headwind to sail into.

    I guess my point would be that there are lots of people out there who you may not hear from who appreciate your work and, importantly, your willingness to put yourself out there personally as an n=1 study. I would add my voice to those who wish you had the time to add to this blog more often because it has been by far the most valuable resource for me personally (I love your ice cream recipe and your breakfast shake!). You’ve shown me that I can be an athlete on a ketogenic diet (and feel great in the process!). As an engineer, Stanford alum, masters athlete (6 paddling Catalina crossings) and husband to a Canadian, I feel like I have a lot in common with your background. I’m really looking forward to seeing your TEDMED talk when it’s available. Keep up the good work!

    Paul in San Diego

    (reply)
    • Peter Attia  April 25, 2013

      Paul, appreciate the insights.

  38. Bart Windrum  April 27, 2013

    Hi Peter. I’m currently prepping my first TEDx talk (Dying IN Peace to Die AT Peace). Your ruminations have helped me in this, the last 10 days’ runup. My talk’s first section includes a rundown of major obstacles to dying in peace (it’s last half explores a new one and a solution I’ve developed for it). The aha that occurred to me is to frame the obstacle run down in terms of how we failed to recognize, and hence overcome, each one during my parents’ terminal hospitalizations. Simply by including that three word reference (“we failed to…” makes a profound difference because it anchors the talk in my family’s story.

    (reply)
    • Peter Attia  April 28, 2013

      Sounds like it will be an important talk.

  39. Bart Windrum  April 28, 2013

    Peter, I also want to commend you for your remarkably brave TEDMED talk. You thought you were going out on a limb but you actually contributed to growing a new branch of medicine’s tree.

    (reply)
  40. Ali B  April 28, 2013

    Hi Peter, thanks for such a useful website as a resource for low-carb eating – plenty of insightful and detailed discussion on many questions I was having. As a person with no expertise in advanced nutrition or medical science I was hoping you could pass comment on a supplement I’m considering taking. I’m hesitant on it’s safety, it potentially sounds ‘too good to be true’ and I was hoping you could offer some advice. It’s a multivitamin called IntraMAX? (http://www.intramax.co.uk).

    (reply)
    • Peter Attia  April 28, 2013

      No insight into this, except that this industry is not regulated and as such most of what is produced is somewhere between harmful and of no value.

  41. Ali B  April 29, 2013

    They claim to use organic ingredients, and the product derives all vitamins from whole foods rather than synthetically producing them, also some C-C bonding which increases absorption. Amazon.com is full of hundreds of rave 5* star reviews, giving the impression of a miracle product with some genuine claims behind it. Some comments even claim a professional in some medical field had suggested it to them.

    However, if you were to suggest backing away from such a product, what advice would you offer on supplement taking in respects to trusting the quality of a product and what supps to consider taking?

    Thanks,
    Ali

    (reply)
  42. Ali B  April 29, 2013

    OK, apologies if this is boring, but I’m very hesitant about putting any supplements in my body before trusting the brand/quality.

    I read your ‘What I Eat’ posts, and see you’ve made reference to your daily supplementation plan alongside the brands you use. I’m going to follow your advice here and follow this same plan, though being from the UK it’s difficult to obtain some of the listed brands. The ‘NOW’ brand seems to have made it across the pond, so I’m presuming if you promote some of their products I’d imagine their Magnessium Oxide tablets will be of equal quality.

    However, what else I’d like to enquire about is that as a ‘dry-land’ resistance trainer approx. 5 times a week and a recreational runner/swimmer on the weekends, is their other more specific products you would advise to assist me? Obviously whey protein is a cornerstone supplement to any athlete, and I saw in one of your posts a mention to L-glutamine – well which I’ve never used.

    A general supplement plan to assist my exercise routine would be very much appreciated.

    (reply)
    • Peter Attia  April 29, 2013

      Hopefully you’re able to find a good trainer to help you with your needs. I agree this is important.

  43. Jodi  April 30, 2013

    Well, it just so happens I am a medical student and was in attendance at TedMed. Your talk was beyond inspiring to me. Just as you experienced the “effect” of TedMed, you were also the “cause.” Considering your talk, I think that’s pretty interesting to think about :)

    As a medical student, I’m finding that such prejudices with patients start early. I often feel like we are trained to be narrow-minded in focus, but it’s our job to keep questioning what we have learned as “given.” You can be confident in knowing, that sharing your story has saved at least one medical student from making a similar mistake, so I thank you for giving me the foresight to be a better doctor and human.

    I’ve shared your talk with as many people as possible; from colleagues, to faculty, to my family (of which Diabetes is prevalent.) In fact, my mom just replied saying, “AMAZING HUMAN FOR BEING SO COMPASSIONATE AND HONEST NOT TO MENTION HIS QUESTIONING CONVENTIONAL WISDOM.” (She’s very fond of capital letters.)

    And she’s right! Your talk was even more powerful because you delivered it humbly, with grace, and courage. Thank you again!!

    (reply)
    • Peter Attia  April 30, 2013

      Jodi, thanks so much for letting me know this. I’m still reeling in the aftermath of that talk and wondering if being so open was the right thing to do. A note like this makes it seem much more likely that, despite the discomfort, it will be (and has been) worth it. Best of luck in your journey.

  44. Neil Feldman  May 1, 2013

    Peter: I am brand new here – found my way after watching your moving and thought-provoking presentation at TEDMED last week (I was not there – I found it on the internet). By way of background I have stage IV (metastatic) renal cell carcinoma (mRCC).

    I have not yet had the time to explore your website so please forgive me if this has been covered before or if this is the wrong place to post the following. Yesterday the following press release went out: “Mayo Clinic Finds Experimental Drug Inhibits Growth in All Stages of Common Kidney Cancer” (http://www.mayoclinic.org/news2013-jax/7446.html?rss-feedid=5 ). Actual study is here: “Stearoyl-CoA Desaturase 1 is a Novel Molecular Therapeutic Target for Clear Cell Renal Cell Carcinoma” (http://clincancerres.aacrjournals.org/content/early/2013/04/22/1078-0432.CCR-12-3249.abstract). Why I bring this up is due to this NIH presentation here: “Role of Stearoyl-CoA Desaturase-1 in Metabolism: Implication in Human Diseases” (http://www.youtube.com/watch?v=CmWJ9ZmZv3E). I know you are very busy but I wonder if at some point you would comment on the practical dietary implications of what this all might mean. Thank you so much for what the NuSI is attempting to accomplish on behalf of all of us.

    (reply)
    • Peter Attia  May 1, 2013

      Neil, though I trained in oncology, I have been out of the field for several years and am not up to speed on latest advances in RCC, so I really would offer little insight into the efficacy of this treatment. Have you look for experimental protocols at NCI? When last I was there, Dr. James Yang was actively working on RCC from and immune-based approach.

  45. Milen  May 1, 2013

    Very interesting Tedtalk….i just found this blog, i like the articles i have read so far, looking forward to reading more….

    (reply)
  46. David S  May 1, 2013

    Peter,
    Congratulations on your journey, your results, your blog and now your growing recognition and reputation. I take my hat off to your many responses after every post! People are starting to starting to listen.

    I’ve been a convert to low carb ever since I read NHI by Rob Fagan in my teens (probably the only one in Scotland at that time). If only I practice what I preach because I’ve been on a carb/no-carb rollercoaster ever since, hovering between two equilibriums. As you’ve said previously, it’s easy to go from 1 treat to 2 then 3 ad infinitum! I have a couple of questions if you don’t mind? One is meal frequency as there is often the debate that small and often is good to continually increase metabolism regardless of metabolic state, do you have a view? Also, with respect to nuts, particularly mixed salted nuts that have net fibre and sodium – would you still recommend consumption in moderation? Being a Brit, I do like some nuts and a cup of tea often during work when Im low-carbing (I can often be at my desk for 8-12 hrs so that a lot of tea and a lot of nuts). Finally, being a bit of a data geek too, what would you recommend that I monitor and the frequency. I’m just of the view that if many practitioners took the same approach from the bottom up and were consistent (perhaps a shareable Google docs file?) it would help change the perception in the scientific community.

    Anyway, keep up the good work
    D

    (reply)
    • Peter Attia  May 2, 2013

      The meal frequency issue is, to my mind, not really settled yet, and I’ve experimented a lot, including one meal per day. It may come down to (for me it does) balancing performance metrics. Monitoring questing is too complex and depends on too many variables.

  47. Neil Feldman  May 1, 2013

    Peter. Many thanks for your response and your suggestion. However, dealing with my situation was not why I brought this up. My point is that the approach that the Mayo Clinic researchers are espousing is to use a new drug to interfere with basic cell metabolism. This drug is used to inhibit SCD1 – a key metabolic protein. “We found it to be incredibly specific to cancer cells … but it is also being investigated for its role in promoting obesity and diabetes.”

    In particular, if you then view the NIH presentation, it goes into detail about certain dietary influences on the expression of SCD1 in humans. In particular, and of direct pertinence to your present interests, a low carbohydrate diet will also inhibit SCD1 – in much the same manor as this experimental drug that the Mayo folks are touting in their PR.

    (reply)
    • Peter Attia  May 2, 2013

      Sorry, I misunderstood, Neil. Thank you for clarifying.

  48. Serge  May 3, 2013

    Hi Peter,
    I have been trying to adapt to LCHF lifestyle for at least 3 months now but am still dealing with sleepiness and fatigue during the day. I understand about the importance of salt and add it to my meals and mineral water, but looks like it is not enough to overcome the tiredness. I couldn’t find your comments on this issue apart from salt during the keto adaptation. Can you please suggest what else can be done, as you have mentioned in your interviews similar issues with adaptation? Thanks!

    (reply)
    • Peter Attia  May 3, 2013

      I have no idea, Serge.

    • dakal  May 3, 2013

      I’ve struggled with lchf also but did improve with eating a large amount of spinach each day, possibly potassium an issue? I also took a half teaspoon of epsom salts (magnesium) in a glass of water each day and this seemed to make a difference.

  49. alan2102  May 3, 2013

    Did I miss something, or is there no link anywhere to the whole of Peter’s talk at Tedmed?

    (reply)
    • Peter Attia  May 3, 2013

      It’s not up yet. Probably June or July.

    • alan2102  May 3, 2013

      OK. Thanks, Peter. They sure take their time!

    • Peter Attia  May 4, 2013

      It is available in a few places now, but it’s “raw” and unedited. Others have posted links in the comments section.

    • gemma  May 4, 2013

      Already mentioned above but here is the link again (Session 4, time 1:14 or so…):
      http://new.livestream.com/accounts/3320021/events/2005920

  50. Biz  May 4, 2013

    Hello Peter … I have been a lurker on your blog for some time. I have enjoyed immensely your writing style and was super excited to see that you were invited to TED (it’s an addiction!) – can’t wait to see your broadcast. TED is a dream of mine, not to speak (although it was be totally awesome) but just to sit in the audience would be a privilege beyond compare. Thanks so much for sharing your experience, and also, thanks for turning me on to ZDoggMD. I am amazed how the artist captured you in the painting. It’s scary close, wow. Thanks for all you do!

    (reply)
    • Peter Attia  May 4, 2013

      Yes, I was completely humbled by that picture, and by being there at all.

  51. Neil Feldman  May 4, 2013

    Peter, I found it here:

    http://hibc.tv/2013/04/19/tedmed-4-shifting-the-patterns-of-power/

    It starts about 1 hour, 14 minutes in.

    (reply)
  52. Maryann  May 4, 2013

    I found Peter’s beautiful talk via this previous comment copied below for you. God bless you Peter, maryann

    Jed Batchelder April 25, 2013

    The presentations are still available on the livestream site. http://new.livestream.com/accounts/3320021/events/2005920
    Your presentation is in session 4 and starts at the 1:15:14 mark.
    I had the privilege of attending TEDMED this year and as a long time reader of your website, I was delighted to hear that you were going to be a presenter.

    Your presentation, and others at TEDMED illuminated the empathy that is already present in healthcare today, but is often trapped in the confines of our current, impersonal healthcare delivery model.
    Thank you!
    Jed Batchelder

    (reply)
  53. Flurina  May 6, 2013

    Dear Peter,
    this is the first time I have ever commented on a blog, ever. But I just feel the need to say “Thank you for sharing this!”
    Really touched me to realize that there are people out there who feel this way about TED and therefore maybe even about the human spirit in general. I have troubles phrasing this without making it sound cheesy, but I feel truely inspired – thank you so much for sharing your thoughts so honestly!
    I just subscribed :)

    Kind regards from Germany,
    Flurina

    (reply)
    • Peter Attia  May 6, 2013

      Well, Flurina, I’m kind of cheesy, as you can probably tell… Thank you for the kind words.

  54. Jeff U  May 6, 2013

    Peter-

    I have been an avid reader and viewer of your work and have also enjoyed TED for some time. Your post tied the both together in an amazing way. I watched the Ric Elias talk first and was awed by it. After reading your post I watched your talk and was equally moved. I put down my ipad and went to say goodnight to my 15 year-old daughter. I mentioned Ric Elias’ talk only to find that she had watched it it school! I then explained how I found it and described in basic terms (the only way I can express this science!) what you were positing and trying to accomplish. In telling her about your talk I was visibly moved by it, as I explained not just your honesty and sincerity, but the passion you have and the courage to -as you say- bet your career on your beliefs.

    It occurred to me that I was doing what Ric implored us to do: to be the best parent I could be, which to me means guiding, teaching, and supporting my kids in their journey to hopefully being happy and fulfilled. Your post became a great vehicle for reinforcing the the vital messages I have tried to convey to my kids: Follow your passion and don’t be afraid to express it; believe in yourself and your ideals, even when the doubters come, and work hard for what you believe in; but don’t forget to be a good person- trustworthy, humble and willing to admit when you are wrong.

    You are setting a great example as you lead the way and I hope the multi-disciplinary cross-pollination of inspiring thinkers and leaders has an effect that is greater than the sum of its parts. Keep it up!

    Thanks,

    Jeff

    (reply)
    • Peter Attia  May 7, 2013

      Jeff, your story is very moving and inspiring. Thank you so much for sharing this. Your daughter is very lucky. I will share this comment with Ric, who will be equally moved.

  55. Robyne Jane  May 7, 2013

    Dear Peter,

    I watched the excerpt video a bit over a week ago, and it made me cry too. You have a very genuine and caring spirit. But I think what made me cry was the apology, from a doctor. In my mind you were my doctor. The one I went to see a bit over 8 years ago, I had lost 25 kg doing the low fat high cardio thing, when my weight lost stopped for months. I went to see my doctor for advice, for help… and he said the old calories in calories out, I must be eating to much. I was at this point still 120 kg, so still obese, and I saw him struggle to believe me when I tried to explain how little I was eating and how much I was exercising…actually I think his eyes glazed over and he stopped listening. I left the surgery in tears… and started eating again. Your apology meant the world to me…its not my fault!

    I found primal / paleo five years ago, but only really dabbled in it, as I needed a long time to get my head around the fact this is how I would now eat for the rest of my life. But I woke up a month ago and started the whole30, I’ve lost 10kg, but more than that I feel great, energetic and positive again. And most important I know I can live like this for keeps.

    Thank you for your great work and kind words.

    (reply)
    • Peter Attia  May 7, 2013

      Robyne, I can’t…really can’t…tell you how humbling this is. You deserve a doctor who will care for you the way your friends do. I hope you will find that soon.

  56. Tom Hughes  May 7, 2013

    Peter,
    I watched your TEDMED lecture, I really enjoyed it.
    As you know I am from the other side of the pond and to be honest from my view we are lagging far behind you in the US.
    Its painful to see.
    I have felt this way for a long time now, I have worked as a junior doctor in the leading cardiology hospital in the country and to be honest I felt I had to leave. I could no longer stand by the advice I was forced to deliver, I could not stand to see younger and younger patients walk through the doors. In the course of 3 months we had 4 20-30 year old men with an MI, no genetic or underlying condition detected, just atherosclerosis.
    This to me is heart-breaking. The level of obesity and insulin resistance/type to diabetes is rocketing, the british diabetic associations guidelines are for lots of slow release (this is an oxymoron surely) carbs such as pasta, bread and rice throughout the day.

    I have given multiple talks now to local authorities, I planned on giving one to the Cardiologists at the Glenfield where I worked, but at the time I feared it would impact on my career. I no longer have those worries!

    I see the work you and Gary Taubes in particular are doing and I want to be part of it, in that I can only do so much on my own over here. I am changing 1 person at a time, my friends and family are now eating far healthier than they were before and enjoying life more.
    My cousin who is a type 2 diabetic, diagnosed at 28 (and very lean to go with it) is now reducing her insulin and is on the right path.
    Let me know what I can do to help, my email should be attached to this.

    Tom

    (reply)
    • Peter Attia  May 7, 2013

      Let me noodle a bit, Tom. Maybe getting you plugged into progressive doctors and cardiologists (specifically) in the U.S. would be a good start? I know several.

  57. James  May 7, 2013

    It might be only wishful thinking, a fool’s hope or whatever, but I want to believe in what I start to feel stronger everyday: that humankind is on the edge of a “healing” era, an era that is the “prophesied” change of spiritual tides of ancient knowledge and wisdom that took on many forms and shapes, oftentimes disbelieved, ridiculed, finger-pointed for not being rational, logical, scientific, etc. A reconciliation of humility and genuine science, body and spirit, etc. Time will tell …

    (reply)
  58. Tom Hughes  May 7, 2013

    Peter,
    That sounds fantastic. Anyone I can talk to/help or gain help from is always a good step.
    I feel a little alone over here, frustrated at being able to see all that is going wrong and not only unable to do anything but being beaten down at the smallest suggestion that ‘conventional wisdom’ may be questionable.

    James,
    I hope you are right and I think you are. As we move out of this economic crisis (I don’t know how hard you have had it in the states, but we have had it pretty hard over here, especially for the poorer members of society) there is a sense that we cannot control these economic issues, but can we control our own lives in terms of happiness and health?
    People seem to be caring more about the elements of life they CAN control, which is fantastic to see.

    (reply)
    • Peter Attia  May 7, 2013

      One idea you may consider is forming a group for doctors and patients. The “forum” could serve at least 2 purposes — let like-minded doctors “chat” about these issues (e.g., share learnings, discuss patient cases) in a private forum for the docs; give patients a resource to identify participating doctors.

  59. Ali  May 9, 2013

    You are obviously EXTREMELY busy but did you ever write a follow up to the fantastic comment in July on the Harvard (Ludwig et al) diet study (about cortisol & thyroid hormones?) I’ve scanned other posts but can’t see.

    Also, did you speak with him?????

    (reply)
    • Peter Attia  May 10, 2013

      I speak with David every week, but we’re talking more about other things these days.

  60. Max Favilli  May 10, 2013

    Thanks Peter I already learnt I was making few mistakes reading your blog and watching interviews to you (and Stephen Phinney).

    But I still have a question I wish you could answer, I love pasta and rice and pizza (I am italian), I always cooked it with raw ingredients; now for the past three weeks I shout them down completely and I am ok with it but I know I can’t go on forever like this because I just love the taste of it.

    Also, you often mention you still eat some rice and pasta, but how much and how often? 100g of pasta contains 40g of carbs, so if I eat 100g I should eat no more carbs in any form for the whole day. Right?

    Is there anything I can do to re-introduce some pasta, some rice, some pizza, at least once a week, at least in small quantities, at least with some limitations?

    Thanks in advance for your time!
    Max

    (reply)
    • Peter Attia  May 10, 2013

      This is only relevant if one is in ketosis. If not in ketosis, but doing a low carb diet, I think there is room for occasional rice and pasta. It’s more the sugars and highly refined grains one ought to remove. Personally, I don’t consume pasta and the only rice I eat is when it’s wrapping sushi. I always timing a sushi meal right after a glycogen-depleting workout with RQ above 0.85 for sustained periods of time. Amazingly, in such situations, blood glucose actually goes down after consuming rice.

  61. Greg  May 10, 2013

    Peter,

    Long time follower, albeit somewhat inconsistently over the past year or two. I can’t wait to see the TED talk when it becomes posted online. The last interesting TED piece which has weighed on my mind over the past several months is that of Dr. James O’Keefe and his discussion with regard to exercise, or more specifically is more “extreme” exercise “killing us?” It has caused me to rethink running long distances and racing.

    In fact it would seem that exercise is undergoing a parallel “revolution” in science and wrestling with its dogma that is now taking place in the nutrition world. In fact, I suspect the two are part of the same narrative. The calories in, calories out paradigm infects both at all levels of science and public knowledge.

    I would say I am curious as to pick your brain: have you rethought your own exercise/fitness approach based on your own research and the new research out there that may in fact be pointing us away from endurance racing activities and to a more moderate and holistic approach to fitness and exercise.

    (reply)
    • Peter Attia  May 10, 2013

      I have given it thought, and I know James O’Keefe well. We correspond often. I’ll probably do a post on this at some point in the next year where I will address the state of science, and how I personally navigate it.

  62. Greg  May 10, 2013

    Thanks Peter.

    I respect your judgment, and therefore your thoughts on this matter would be something that I would clearly take seriously as part of my personal calculus on this issue. All that said, I still either 1) don’t entirely buy into his thesis or 2) remain a hypocrite, or perhaps 3) am trying not to think about it too much as I just went for a rather intense run this morning that was admittedly as much for my mind as it was for my body. That said, the critique with intense endurance exercise seems to focus on dangers to the heart. Important, yes, but not the whole picture of health and only part of the impact of exercise of course (even if it is something that can be generalized to a large population).

    (reply)
  63. Milind  May 15, 2013

    Peter, you speak and write from the heart. That is what comes across to me the most. Your single-minded pursuit of health and nutrition has inspired me to look at myself through a microscope, and I now realise the mess I’ve been creating within myself. Thank you for the wisdom.
    cheers
    Milind

    (reply)
    • Peter Attia  May 15, 2013

      Very kind of you, Milind. Hope you are untangling.

  64. brad  May 18, 2013

    I don’t think you quite realize how many lives you have touched. Your ‘fat but fit’ hit me like a load of bricks. 9 months later and I am less fat and WAY more fit – setting PR’s every day this season on my bike. I thank you for sparking that, and for being there when I have questions and need inspiration. Please keep it up, and all the best fortune in your ventures. People like you change the world and make history. You are one of them.

    (reply)
    • Peter Attia  May 19, 2013

      Thanks so much for sharing this, Brad. I can’t tell you how much it means to me.

  65. Tara Scherner de la Fuente  May 19, 2013

    I came here because I heard you are an obesity researcher, and I wanted to see what you had to say. Now, I want to thank you for the link to the Ric Elias video. I’ve watched a lot of TED Talks, but that was a darn good one. Thank you so much.

    I did eventually get to the stuff I came here for, and I appreciated reading your story and journey. I’ve lost over 100 pounds–twice–eating a low carb diet. Sadly, I have to lose almost 200 now. I don’t seem to be able to do moderation. I am great with the discipline of low carb weight loss. And I am great at being off the low carb plan. I don’t seem to be very good at the low carb as lifestyle diet. I hope, in your research, that you’ll be able to figure out some way to help those of us who CAN and HAVE lost weight effectively (so we know it’s possible!) but seem to have other issues (psychological? biological?) that keep getting us off track.

    I so want to conquer my obesity. It seems like a lifelong journey, and I suppose it is, even once I drop the weight. Anyway, I hope your research helps make it more likely that people like me will be able to keep it off. It is encouraging, though, to have an expert in obesity advocate for the low carb way of life. I’ll keep at it.

    And yes, I know I shouldn’t drink Diet Coke. :-)

    Thanks again for the Ric video. I’ll look forward to yours.

    (reply)
    • Peter Attia  May 19, 2013

      Glad you found Ric. Amazing human being.

  66. Sandi  May 19, 2013

    Peter;
    I found your name while reading an article about John and Laura Arnold. When the article described your “out-of-the-box” way of addressing obesity and weight loss, I had to find out more. I became lost in your blog for the next several hours. I was pleasantly exposed to information that nourished not only my body but my soul as well. I will be utilizing your changes in eating information and look forward to the upcoming results. I as well as 95% of my rather large family suffer from obesity. I have tried several diets to no avail. I along with my husband are dumbounded. When we looked at my food intake I was eating fruit and vegetables with a small portion of meats. I do not have a sedentary lifestyle (I am a nurse and am on my feet 12 hours a shift). I have been telling myself that there’s gotta be an answer to my dilemma and I believe I have found it. Thanks for your belief that there is a solution to obesity and I believe that I will be a true testament of that belief as I apply the methods I’ve found in this blog. Will keep you posted.
    Full of anticipation – Sandi

    (reply)
    • Peter Attia  May 19, 2013

      I can only imagine how frustrating it is, Sandi. Hopefully we’ll have answers soon.

  67. Patti  May 19, 2013

    I eagerly await this new talk. In the meantime, I viewed another youtube video of yours (JumpstartMD presents Dr. Peter Attia on the Role of Fat in Weight Loss). You made a statement about constipation, and I was wondering if you would clarify it. I believe you stated that you don’t need fiber to stimulate peristalsis in the GI system, but you do need salt and fat. I understand that too much protein from animal sources does cause constipation, but I also thought fat would as well. Besides your personal experience on the Ketogenic diet, is there any literature pertaining to your findings? It just seems counterintuitive to what I’ve been taught about the role of fiber in the diet (but then again so was the low-fat movement). Thank you.

    (reply)
    • Peter Attia  May 19, 2013

      Much of the literature is aggregated in the book by Jeff Volek and Steve Phinney, The Art & Science…

    • Patti  May 19, 2013

      Excellent. Thank you for the research direction.

  68. Karl Hungus  May 20, 2013

    You seem like a brilliant man and your open mindedness in a close minded world is a breath of fresh air.

    The best TED talk I have ever seen is Dan Pinks on what motivates people. I think it would be right up your alley. http://www.ted.com/talks/dan_pink_on_motivation.html

    (reply)
    • Peter Attia  May 20, 2013

      Yes, I liked this one, too Karl. I saw it after reading Pink’s book, so I sort of “knew” a lot of it. But he delivered very well.

  69. Mitch Gallant  May 21, 2013

    Great read, thanks for the suggestion on Ric’s video. It’s amazing to see what that kind of clarity did for his life. Any thoughts on how he keeps himself focused on being the best dad in the world? I can only imagine but it must not be a matter of will but simply his way of being, but any thoughts would be outstanding. His video excellent! With a soon to be 1 year old it’s become a gigantic priority as has my health…thanks for all the content and fuel!

    (reply)
    • Peter Attia  May 21, 2013

      Ric (like all great parents) works at it. It’s a priority, just like his most important work meetings or calendared events. He refuses to let the day without doing the things with his kids that he believes are best for him and them. Ric sent me a book that I’m partway through and really enjoying about the special relationship between fathers and daughters.

    • Mitch Gallant  May 21, 2013

      Thanks for the note back Peter. I’d love to know what book that is. If he’s recommending it I’d best check it out! : ) My “soon to be 1yr old” happens to be a baby girl.

    • Peter Attia  May 21, 2013

      “Strong fathers, strong daughters: 10 secrets every father should know.” Very interesting read.

  70. Jamie  May 21, 2013

    Peter,

    Thanks for sharing this amazing information. If I understand it correctly, the primary cardio health marker is LDL-P, correct? I ask because I just had some testing done, including NMR profile, and my CRP was high—4.8; yet, my LDL-P was 987. My LDL size is pattern A, HDL-P was 26, HDL-C was 42, Lp(a) was 1. LP-IR score was 47. Insulin tests high–15-18—even with a low carb diet.

    I don’t have a baseline for CRP, having never had it tested prior to this. I eat what I believe to be a low inflammation diet—LCHF—consisting of healthy sat and mono sat fats, low carb, and moderate protein from whole foods—mostly vegs, nuts, meats. I’ve been doing this for a little over two years. During that time, my weight has dropped 90 pounds.

    Should I be concerned with inflammation? If so, can you point me to a source of information that would help me understand what causes it and what can be done to improve? Doctors in my area are not helpful as they still follow the dated “science” on what makes us fat and causes cardio issues.

    I look forward to your future posts. Please keep sharing. You and others sharing their knowledge and experiences have already made a positive impact on my life.

    Jamie

    (reply)
  71. Joel Doyle  June 11, 2013

    I saw an excerpt of the talk on YouTube: http://youtu.be/_V37zFVVkVI
    Can’t wait to see the whole thing! You totally belong on TED talks.

    (reply)
    • Peter Attia  June 11, 2013

      Thanks, Joel. My talk will be up on TED and TEDMED sites in the last week of June, I’m told.

  72. penny  June 25, 2013

    i’m a daily TED viewer and just watched your amazingly eloquent and moving talk. your passion, compassion and humility are inspiring. like the woman who came up to you after the talk, i was in tears.

    thanks for sharing the fantastic tips from the tedmed editorial team – wow those people sound like they know how to bring the best out of speakers!

    i don’t have an insulin or weight issue, but will check out this site for your dietary philosophy.
    wishing you continued good health!
    Penny

    (reply)
    • Peter Attia  June 25, 2013

      Penny, thank you so much for the kind words. Very unpleasant (for me) talk to give. Hard to believe it’s “out there” now… I appreciate your support.

  73. Meesha  June 25, 2013

    Peter,

    I visited ted.com today and was excited to see your talk highlighted! I just finished listening and I wanted to let you know I thought it was great. Rather than strictly educating, ted talks plant a seed and I think your talk did that perfectly. Thank you for working to make a difference in the world!

    (reply)
    • Peter Attia  June 25, 2013

      Thanks so much, Meesha. Glad it didn’t come across at too “educational” … plenty of time and other resources for that.

  74. Rita  June 25, 2013

    Thank you for sharing your experience, I could sadly relate to your ER experience. Thank you also for introducing all the other speakers who moved you. I was one of the zombie doctors who retired early, no regrets, except I wish I had the physical and mental fortitude to do what others have done. I’ll satisfy myself by cheering you all on.

    (reply)
    • Peter Attia  June 26, 2013

      Rita, thanks for sharing. Did you have a chance to see the talk by Zubin Demania? It also went up today on TEDMED.

  75. Bethany  June 25, 2013

    Dr. Attia,
    A friend of mine (who knows my story) sent me the link to watch your presentation on TED.com. I cried through the entire video! I, like you, share the same story of insulin resistance. I have a master’s degree in Exercise Physiology, and yet at 34 years old, I could not maintain my weight despite practicing what I preached (even training and completing 2 half marathons). I worked in cardiac rehabilitation for 7 years and frustratingly counseled patients on eating a low fat diet with little positive outcome. My father became diagnosed with Type 2 diabetes regardless of his efforts to eat well and exercise 5-6 days per week (religiously). I then became interested in learning about diabetes nutrition and became the diabetic educator at my facility. So, when I received blood work showing insulin resistance at 34 years old, it was the low point of my life. But, I picked myself back up and started following the same diabetic diet that I had preached for so many years. 35 pounds later, I have never felt better. Thank you so much for dedicating your life to this important topic. I feel so blessed to have had so much success that I have began counseling and helping others! I have even started a blog telling my story and ideas! It is so refreshing to see your passion and my prayers are that your research and diligence will rock the medical community and change the lives of many! Blessings!

    (reply)
    • Peter Attia  June 26, 2013

      Thanks for understanding this, Bethany. I can tell… you “get it.”

  76. Nikki Leonard  June 25, 2013

    Hi. I am struggling with being obese and having metabolic syndrome. I’ve been looking for some answers that make more sense to me than the advice I have received in the past (eat the Mediterranean diet and exercise more). I have found several resources which include books by Dr. Robert Lustig and Gary Taubes, and your blog. I am still working my way through the different nooks and crannies of your blog and, in the process, just watched your TedMed talk. It is wonderful. Inspiring, hopeful, and heart-felt. Well done!

    (reply)
    • Peter Attia  June 26, 2013

      Lots of folks here to help, Nikki. Very thoughtful readers of this blog who are always happy to share their insights.

  77. Darren  June 25, 2013

    I just watched the talk. It was very moving – I shed some tears towards the end.

    (reply)
  78. Bill Daguanno  June 25, 2013

    Peter,
    I also subscribe to Ted.com and found your speech extremely interesting today.
    After watching I visited your site and am in the process of reading more. I am 55 years old. When I was in my twenties I followed the Atkins diet and it worked well.
    I’m Type 2 diabetic and have had 2 small strokes. After the first stroke I put on 30 pds and had another recently.

    The question is is your diet good if just having had a stroke.

    I could ask my doctor but I think with your experience with ketosis would be more reliable.

    (reply)
    • Peter Attia  June 26, 2013

      Bill, your question hasn’t been tested per se by a rigorous study — i.e., which diet is best for a diabetic patient post stoke — however, there is a lot of evidence that they way I eat may be better than the conventional wisdom. In fact, tomorrow a large study will be published in the New England Journal of Medicine showing that patients with diabetes who went on a low fat diet (and lost weight) did not do better than those on a regular diet. You may want to look at the books by Volek & Phinney, and also Richard Bernstein.

  79. Paula Tereault  June 25, 2013

    Dr. Attia,
    Thank you. Your TED talk was amazing. It has given me, and I’m sure others that watch, hope for our conditions. I look forward to reading and hearing about everything you discover.

    Again, thank you,
    Paula

    (reply)
    • Peter Attia  June 26, 2013

      Thank you, Paula. It will be a long haul to answer these questions, but it’s worth the effort.

  80. Bruce Abbott  June 26, 2013

    Dr. Attia .. I just watched your Ted Talk and am so thankful for people like you who have the clout and courage to try to change the world. I am a HUGE fan of Gary Taubes and Jimmie Moore (where I first learned of you). I am so worried because my son is obese and I have been struggling to find the right way to introduce him to the concept of insulin resistance. I think your talk may be the right introduction. Thank you so much and God bless you and the others like you on the forefront of nutrition research.

    (reply)
    • Peter Attia  June 26, 2013

      Thank you, Bruce. I wish you and your son the best of luck in your journey.

  81. Mark-John Clifford  June 26, 2013

    Peter,

    This talk at TED was amazing. I watched it today for the first time and as a diabetic, heart attack survivor and polio survivor it really made me think.

    I have been up and down all of my life and nothing seems to work. All of what I have read on the blog makes sense and I am ready to jump in and make it happen. Hope during the process I can share my thoughts and updates as I go along. I plan to start right after my 59th Birthday tomorrow.

    I know this is a long haul and a risky one for me with my situation but I also know it will work.

    Thanks for your research, your honesty and your conviction to help people like me.

    Mark

    (reply)
    • Peter Attia  June 26, 2013

      Mark, thank you for your kind words. Wishing you a happy 59th with many more to come. Hopefully info here can help.

  82. Devra Mattes  June 26, 2013

    Peter,

    Thank you for standing up, for being authentic. It’s extraordinarily difficult to say “I was wrong” – it is even harder to admit “I was unkind”. Few of us have the courage to publicly acknowledge our shadows.

    Great talk, well done.

    Been reading your blog for quite a while, I appreciate having a reason like this to de-lurk & comment.

    Take care! And keep on doing your work.

    (reply)
    • Peter Attia  June 26, 2013

      Devra, you made me smile…love the concept of de-lurking… I think you really hit on the hard part of this experience. Saying I was wrong was awkward (in front of so many strangers), but I was raised to ‘fess up the second I made mistakes, so this wasn’t the *really* hard part of that talk. It was admitting that I was an unkind and arrogant jerk. There’s no way around it.

    • Devra Mattes  June 26, 2013

      Much love to you, Peter – keep doing what you’re doing.

  83. mack  June 26, 2013

    Hey Peter,

    Watched your talk today, it is already up on TED. You were great and very different than usual at the same time.

    I would like to believe that the lady you were talking about will forgive you. Admitting we were wrong is such a rare quality in people, but anyone who is willing to do it, accept it and embark on a journey to try and help people, deserves respect.

    Regards,
    Mack

    (reply)
    • Peter Attia  June 26, 2013

      Yup, Mack, definitely NOT my usual talk…about as far from it as I’ve ever gone. I really appreciate your support and encouragement.

  84. christy kennedy  June 26, 2013

    Luckily for me the Ancestral Health folks just posted your TED talk on Facebook. My kids and I have overcome a variety of problems, including abnormal glucose tolerance and reactive hypoglycemia, after first going gluten free and then (duh!) grain free a couple of years ago. Your talk was not only brilliant but very moving. My only wish was that we could make exact copies of you, and people like you, so that people everywhere could have doctors like you. Much love and best wishes to you and your team.

    (reply)
    • Peter Attia  June 26, 2013

      Very kind of you to say, Christy. The list of folks who would rue the day is pretty long…

  85. Wendi  June 26, 2013

    Dr. Attia,

    I’m here specifically as a result of watching your TED talk, and after reading this post and the comment thread, I wanted to add my thanks. As I understand it, you are primarily addressing other physicians, but from a patient standpoint, your talk was very healing for some of us, as well. Being shamed or dismissed by physicians is the primary experience I have with the medical industry, which has made me reluctant to see a physician for *anything*, and… I’m sure you know how THAT usually turns out.

    Now, in my 40’s, I have found a physician who actually listens to me and acknowledges the value of my own research into my conditions – and to find your talk now as well restores a bit of my faith in doctors in general.

    Thank you for being willing to be vulnerable. Please don’t beat yourself up too much over having the arrogance of youth; I think every single one of us can point to an action or an outlook we’ve done or had that we’re now ashamed of. The important part, the part that keeps us human, and growing, and an inspiration to others, is that we’re willing to admit an ugly moment and recognize it as a chance to do – and be – better than that.

    I look forward to reading through the rest of your blog; I expect it will be very interesting.

    (reply)
    • Peter Attia  June 26, 2013

      Thanks so much, Wendi. Glad to hear you’ve found a doctor who is listening. I know there are so many great doctors out there (I have one, too), but sometimes it takes some looking.

  86. Joe Lovely  June 26, 2013

    Dr. Attia,

    Brilliant TEDMED presentation.

    Keep up the great work. I am a Critical Care Pharmacist at a large teaching hospital. I frequently recommend your online presentations as examples to medical professional colleagues and residents in training to emulate your style and presentation techniques.

    On a personal level, I thank you for all you do. I have lost over 100 pounds; 14 inches off my waist; I feel incredible — as if I have erased 20 years of ageing and disease. I credit my success to you, Gary Taubes and Mark Sisson. I am also thankful to the many other low carbers that have shared their n=1 success stories and ideas online.

    I am 43 years old. I began ketogenic lifestyle November 2011. I fluctuated from 260 – 320 pounds the 10 years prior; pre-diabetes; liver inflammation; hyperlipidemia; et.al. Now all metabolic syndrome and liver function lab parameters ‘pristine’ (quoted from my physician).

    So many other amazing pearls to note: my lifelong-size-6 wife took up low carb in fall 2012 and now is wearing size zero.

    I have been lurking online but have recommended your website to about 100 people; many are enjoying significant success with low carb eating.

    Many, many thanks,
    Joe Lovely
    Rochester MN

    (reply)
    • Peter Attia  June 27, 2013

      Joe, what an awesome story. Thank you so much for sharing. Will pass on to Gary and Mark.

  87. Jude Baland  June 26, 2013

    Hi Peter, Just heard the TED talk and wept through most of it. I’m very interested in your diet and following it. I am a 66 yr old woman with HDL of 56 but the doctor I’ve been going to says my LDL is too high. Total cholesterol is 240. He has attempted to put me on statins twice ,the first time muscle aches and fear of getting cancer stopped me the second time I turned them down for the same reasons and never got them at the pharmacy. I do have a family history of heart disease, stroke, and cancer. I have drastically changed my diet already and lost ten pounds but hope to lose more. I would like to know more about your food choices and why you chose the foods you did. Thank You and God Bless.

    (reply)
    • Peter Attia  June 27, 2013

      Jude, hard to know if you would be better off with or without a statin (or other drug). The cholesterol series explains some of this, but ultimately, it’s best to have a doctor who really understands the pathogenesis of atherosclerosis. Thank you for your kind wishes.

  88. Mrs C  June 26, 2013

    I just watched your TED talk through my phone app… amazing! You are the 1st speaker that I watched that I had to google right away to learn more about. I am very interested in your research.

    My personal story is that I was relatively healthy (BMI of 21-ish), had 6 children in 10 yrs, and then got thyroid cancer at age 33. Now 4 years later and 40 lbs heavier (BMI of 29), I was just diagnosed with insulin resistancy (and some neuropathies) & put on MetFormin.

    The frustrating thing to me during all the weight gain was that I was actually eating very very little. No fastfood, few sweets, no soda, low carbs, low total caloric intake. It was so frustrating to watch the scale steadily increase while I was being so careful.

    One thing I have felt was that going through this has really given me more compassion for obese people I meet. It used to be that I thought they must be lazy, gluttonous, and eat terribly, but now I wonder if they may have medical issues that are causing the weight gain.

    Anyway, I wanted to thank you for your desire to help others and for speaking at TED!

    (reply)
    • Peter Attia  June 27, 2013

      Hopefully you have a great doctor who is really able to make sure your thyroid regimen is “dialed in” … sounds like that may have a played a role in the reduction in your insulin sensitivity.

  89. Jai  June 27, 2013

    Hi Peter,
    Heard your talk. Glad that you have embarked on this journey. I don’t have metabolic syndrome or insulin resistance but have pretty much changed from and high carb low fat diet to a low carb high fat diet because that helps me be more functionally fit. Through the years my wife and I have gone through the journey of different diets and constantly trying to understand our bodies and what works best. We are healthier and stronger as a result. One thing that has largely been missing in our discussion is emphasis on micro nutrients. We only talk about macro nutrients and calorie counting – which misses the point. All calories are not equal.
    Lot of the science that you are probably researching has been looked into and published. Not sure whether you are aware of Dr. Loren Cordain, Dr. Arthur DeVany, Dr. Doug McGuff, Dr. Mary Enig, Dr. Stephen Phinney and many others who have published about metabolic syndrome based on our “FDA” food pyramid diets. Barring a very few people, insulin resistance is eminently avoidable and reversible for most who have it, if they are willing to make tweaks to the way they eat. Minimize the carbs, eat lot of fat, get all the micronutrients, and get sufficient protein.

    Best Wishes.

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  90. Patricia T  June 27, 2013

    Hi Peter… caught your TED talk today and suddenly wanted to reach out and say…. here is a doctor who gets my problem… alleluia!

    I am 37, and was diagnosed with insulin resistance five years ago. I was on medication (Glucophage) for 2 years then my GP decided to get me off the medication, since then I have not been on any medication except high blood pressure… is that normal or should I raise an alarm and speak to my GP?

    I have battled obesity as a child and suffered ridicule from family and friends, a plight i wish on no one.

    For an obese person, I spend at least 1.5 hours every day in the gym. I bushwalk, 16 kms on weekends, spin cycle every alternate days – at least 15 km, swim for 30 minutes twice a week, and fit in zumba, body balance and yoga classes during the week… I cook most of my meals so focus on proteins and vegetables… and yet I battle with weight…

    I would like to learn more / read more about your research and discuss ideas on how to make that switch in diet that will enable me to lose weight…..

    please help….

    (reply)
    • Peter Attia  June 27, 2013

      Patricia, hopefully there is plenty here on the blog to get you started.

  91. Ruth  June 27, 2013

    Peter,
    WOW! Are you really an MD? ;-) I have never heard one speak with such passion about a topic that every MD I have ever spoken with find to be “the patient’s non-compliance”! I heard your TedMed talk and was amazed that someone is actually researching this issue and how we can potentially ‘fix’ the problem. I had never heard of you before yesterday…today I am scouring your blog site! I have struggled with weight issues for years, living an active lifestyle and eating a healthy diet (but retaining a high BMI). Fast foods have never been part of the diet, but sugars creep in regularly as they are hard to always spot. I feel for the person that responded above about Thyroid disease. I had my thyroid removed in 1999 because of cancer and that has had a negative cascade effect on most aspects of my life! Thank you for your time and energy you are devoting to finding a ‘cure’. This reader appreciates it more than words can express!

    (reply)
    • Peter Attia  June 27, 2013

      Ruth, thank you for your kind words. Hope there’s something here to build on your passion.

  92. Gunnar  June 27, 2013

    I am a Swedish citizen and have seen your speech at TEDMED. I myself resently got insulin resistance and early type-2 Diabetes. However I turned to a ketogenic diet that is known here in Sweden as LCHF. Low Carb High Fat and now I am 8 kg thinner and my glycose level is normal. How wonderful.

    In your speech, you are talking about the lack of knowledge to why we get insulin resistance. I have been thinking about that and have a hypothesis that is not proven or might even be wrong. During our teenage the number of fat cells is established and is constant during the rest of our life. They get renewed when needed but the total number is fixed. That is what I have learned and is supposed to be true. Now as we get older and more obese, the fat cells gets filled up and eventually the fat cells can’t store any more fat with normal levels of Insulin. This is what I believe is the reason for Insulin resistance.

    I myself was very skinny in my teens, almost underweight and I didn’t get bigger until I was 25 years old and my studies was finished. My number of fat cells must have been very low during the age when my fat cell count was established.

    I believe that very skinny teens are more likely to become Insulin resistant or get Diabetes as they grow older since the fat cells are few and they can’t simply store all the exess energy they are eating. It would be interesting to receive your opinion about that. I am not involved in the medical profession in any way so I might simply have got it all wrong.

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  93. Nathan Cosgrove  June 27, 2013

    I am simply in awe of your speech on TEDMED. I am a 36 year old Type I diabetic with a high insulin resistance. I was diagnosed with diabetes at 28. At the time, no matter how I dieted or how much physical activity I did, I could not lose weight. When I was diagnosed with Type II Diabetes, I was 300 lbs. I blamed myself for the diabetes. I thought “I’m a Paramedic and I should know better!” After 2 years of the normal routine of Type II Diabetes and starving myself (to which I lost 120 lbs due to a strict starvation diet), my glucose levels had not gotten any better. My physicians conceded and re-diagnosed me with Type I Diabetes with a high insulin resistance. When I started eating a normal diet again, my weight skyrocketed back to 245 pounds in a matter of a few months. I have been humiliated by so many endocrinologists and physicians because they have all said, in one way or another, “Well, if you start eating right and doing what we tell you, your diabetes would be under control.” I am so relieved to see some one taking a serious look at this situation and how it affects us diabetics. The changes that could come from this fresh point of view would be earth shattering. Please do not give up the fight and be persistent. God bless you.

    (reply)
    • Peter Attia  June 27, 2013

      Nathan, hopefully new research can shed light on the embedded mysteries within your situation and that of others.

  94. Amir  June 27, 2013

    Hi Peter,
    Before WW2 German scientists concluded that becoming fat is due to hormone imbalance, and not due to eating too much fats, etc. (Why do we get fat / Gary Taubes).
    Hormone imbalance is widely caused by the eating too much sugar or starch, which in turn drives our insulin crazy, and since hormones effect one another, like a domino effect, the whole hormonal system gets out of balance.
    Film “Reversing diabetes in 30 days” shows the effect of cutting starch, sugar and proves exactly that.
    The facts are on the table. PEople choose to ignore them.
    I hope what you’re doing would help point to the truth.

    Good luck.

    (reply)
  95. Klim  June 28, 2013

    Peter,
    I found your TEDtalk extremely personal and moving. On the practical side of things, you are spreading a message that people need to hear. On the human side of things, you shared a story that really resonates with me. During my time in medical school, I went into DKA, with what would later be diagnosed as ketosis prone type 2 diabetes (KPD), while eating a whole foods, minimal fat vegan diet. Since that time, I did extensive research, resulting in my following a very low carbohydrate, moderate protein, high fat diet.This has gotten me completely off insulin, and normalized my a1c, and with a great deal of energy I previously lacked. This experience certainly shed light onto the biases and judgments I was making at people, and perhaps even still catch myself doing now. I hope you continue doing what you are doing, and I want to wish you the best of luck with your endeavors.

    Take care.

    (reply)
    • Peter Attia  June 28, 2013

      Wow, Klim, that’s an amazing story. Thank you for your support in this effort.

  96. Gretchen Smith  June 29, 2013

    Dr. Attia,

    I enjoyed your TED talk very much. I stuggle with obesity and belive you are onto something with your hypothesis. My question is this. Considering the fact that many obese people are poor how do you think we can manage to eat healthy on a small budget. Personally my budget for the whole month is $150. Obviously I eat a lot of rice and beans (high carb) and I take no supplements beause they are not affordable to me. I excercise daily by doing yoga, walking on the beach, riding my bike, surfing, etc. I take Lithium and Prozac for Bipolar disorder and Thyroxizine for thyroid problems. I am 6’1″ tall female and weigh 280 pounds. My whole family is obese but our diet is not horrible. I have juiced, detoxed, done low-carb, attempted ketosis and many other diets but on my budget I find it really difficult. I am starting to grow my own vegetables but it’s not working very well yet. I am hungry nearly all the time. Anyway, I just wanted to point out that the solution needs to be budget friendly for those of us on small incomes. BTW, I live in your area but on the Mexico side of the border so if you are doing any studies I would very much like to participate. I think I would feel a whole lot better if i could get this weight off. Supposedly I am supposed to weigh 100 pound less than this. Seems impossible no matter how hard I try. https://www.facebook.com/photo.php?fbid=10151631109834415&set=t.762509414&type=3&theater

    (reply)
    • Peter Attia  June 29, 2013

      It is certainly more difficult to eat a healthy diet (whatever, exactly, that means) for less money. This is one of the structural issues that need to be fixed, but only once the science gets fixed first. It’s a real problem when the bottle of Coke costs more than the bottle of water and when the veggies cost more than chips.

    • Michael Hirasuna  July 1, 2013

      Eggs remains the best bargin for protein. Just get the the most economical brand, they should be about $1.80 a dozen. Whole chicken goes for $1 a pound when on sale. Eat the skin, liver and heart that comes with it. Make soup from the bones and neck. Cooked vegetables are cheaper than salads. Onions, carrots and kale can go into your chicken soup. For variety, try liver and onions, which is healthy and inexpensive. Use generous amounts of butter on your bread or potatoes. It will slow down the carb digestion and will give you the calories to satisfy you hunger. Four sticks of butter goes for $2.75, which is cheaper than snack food. I assume that you already use dry beans and not canned beans. Fruits are overrated and overpriced; you can get you vitamin C from vegetables. Don’t waist your money on fruit juice, just drink tap water, that’s what I do.

  97. Dom  June 29, 2013

    I just watched your TED talk and I was really moved by your depth of feeling, honesty and commitment to your cause. It’s rare to see a man nowadays drop the facade of machismo and be real, and that is to be applauded and admired. Good luck with your mission – there is no failure in the path that you have taken, only honour.

    Dom, UK

    (reply)
    • Peter Attia  June 29, 2013

      Dom, REALLY appreciate the way you put it. Thank you for your kind comments and understanding.

  98. Ramesh Gandhi  June 30, 2013

    Dr. Attia: Just watched your TEDTALK and also, Ric Elias’s talk. Thanks for a very new perspective on obesity and diabetes. This “out of the box” thinking/approach will certainly help us find the solutions in future. I admire your courage and decision to admit that may be you were wrong. That is very bold.
    Ric Elias’ talk is equally inspiring. I have read Captain Sully Sullenberger’s book “Highest Duty”, where he devotes couple of chapters on that fateful flight. It was interesting to listen to a different perspective from a passenger’s viewpoint. So, again many thanks for sharing the TED link.

    We need more people like you who challenge the conventional thinking and willing to risk their reputation, and give up the ego, and help solve problems. Can the same be done regarding climate change? Immigration? Affordable education – especially college education that doesn’t require $50-100K? I don’t know but I certainly hope so.

    Again, thanks for an inspiring talk and thoughts. I wish you the very best.

    (reply)
  99. Co Besan  June 30, 2013

    Dr. Peter, wowed wow. Thank you! I just watched your Ted Talk and while your science is lovely and amazing (thank you. We Need you now more than ever) the redemptive moment you experienced and shared was the meat of our collective experience. It makes you formidable and welcome to any future discussion/discovery about humanity’s future. Welcome to the party. Do your best and it will be good enough. Thank you, thank you, thank you.

    (reply)
    • Peter Attia  June 30, 2013

      Thanks very much, Co. Appreciate your kind words and support.

  100. Mark-John Clifford  June 30, 2013

    Doc,

    As I make plans for this journey I have two questions for now anyway.

    #1. How will this lifestyle affect my heart and clogging the arteries? I just wonder due to the high amount of fat?

    #2. I copied your meal plan for 5 days that you have posted. What about the other 2 days?

    #3. Sorry one more. Exercise. What if you are limited to what you can do and for how long at the beginning, will this help you to still lose weight so as you lose you can do even more exercise?

    Sorry for all the questions Doc but I really want to get going. What I need to do is speak with you and the team about working with you.

    Thanks
    Mark

    (reply)
  101. Mihirini De Zoysa  July 1, 2013

    Dear Peter

    I was so moved by your TED talk.

    From the point of view as a researcher I loved how you and research team has categorised the meta themes and most importantly you are not only asking the scientific/technical question of the relationship between food and metabolism, but what can be done safely and practically and HOW behaviour can be changed. It is so heartening to know that scientific research is being approached in this humane and empathetic way.

    What I was mostly moved about your talk Peter was by your conscious vulnerability. Your willingness to allow what happened to you to openly reflect on how you are as a doctor and a human being towards others, your openness and personal bravery to reveal it to others and your courage and determinism to do something about the insights you have had as a doctor, scientist and human being.

    I have shared your TED talk with many people.

    I would love to know how it has been for you, and other’s reactions, especially from your colleagues in the medical community been as you embarked on this journey of being so open about your insights in to yourself? I ask this because I too am on a journey to be more open and brave in my own life, in my own practice as a leadership coach and management consultant and I am researching ‘conscious vulnerability’ as part of my doctoral studies.

    Thank you for your vulnerability and your compassion to others. I hope you are as compassionate and loving towards yourself too as your progress on this journey.

    Sending you many blessings.

    (reply)
    • Peter Attia  July 1, 2013

      Very provocative questions you ask, Mihirini, and they show how insightful you are! It’s been a bit overwhelming, actually, but most of the feedback from my “peers” has been very positive. I may do a post about it at some time down the line, as I’ve been asked by a few folks close to me to do this. Thank you for all you’ve said and shared.

  102. George  July 1, 2013

    Peter,
    Thanks for all you do.
    Your TED talk was outstanding as was Ric’s and Andrew Solomon’s.

    (reply)
    • Peter Attia  July 1, 2013

      Thank you, George. At some point I’ll post a list of my 10 favorate TED talks ever, a list I do maintain and share with friends.

  103. Marcia  July 1, 2013

    Peter – After hearing (and crying through) your TED Talk ,then revisiting your blog, I’ve started a folder of talks that I want to get “out there.” Yours is definitely at the top. There are no words left to thank you for allowing the world to experience your vulnerability – but thanks anyway (seems entirely inadequate). And thanks for the links to Ric and Zubin (when he says he has no talent, what I want to know is — what’s he smoking these days? sheeeesh!!). Brilliant, all of them.

    I feel a change coming in the world . . . .

    (reply)
    • Peter Attia  July 1, 2013

      Thanks, Marcia. I’ll probably post my favorite 10 TED talks of all time soon. Hopefully you’ll like some of them, also.

  104. Michael Hirasuna  July 1, 2013

    Hi Peter, Loved your TED talk but unlike the others, I am interested in the details. I am a follower of Gary Taubes, so I know how much you left out of your talk. By the response you are getting, it was probably the correct decision. One quick question, do you hope to be able to influence the 2015 Dietary Guidelines process which just got started?

    Oh, there was an odd comment left on the TED comments for your talk by a person who claims to be Diane Kress. She is claiming that you talk took material verbatim from her book. In case you did not get the word, here is a link to her TED profile page which links to the two comment she made.

    http://www.ted.com/profiles/1938460

    (reply)
    • Peter Attia  July 1, 2013

      I have not heard of Ms. Kress, nor have I have I read her book. I have not read any comments on the TED website, so first I’m hearing of this comment.

  105. Anna  July 1, 2013

    Thank you so much for doing the work that you do. Very inspiring and your talk was moving.

    I also want to thank you for exposing me to other great minds through this post.

    Lastly, proud that you are a former Torontonian! (I’m currently living and studying here.)

    (reply)
    • Peter Attia  July 1, 2013

      Thank you, Anna (fellow/former resider of the “big smoke”).

  106. Biniam Gebre  July 2, 2013

    Great talk Peter! Very inspiring.

    (reply)
    • Peter Attia  July 3, 2013

      Biniam, is this you!? My long lost friend? If so, I’m delighted you found me and honored to have inspired you. (p.s., if it’s you Biniam, I had lunch with Hamid yesterday…and all we talked about was credit risk modeling!).

  107. Ash Ali  July 2, 2013

    Moved and inspired by your Ted Talk, Finally a Dr, who doesn’t just deal with the end result but goes to the root of the issue. Thank you.

    I wanted to know what you thought of Spirulina dietary supplement and green juicing as i’m a diabetic and trying this now? They have classified me as having type 1.5 diabetes, LADA and I’m on insulin and had enough of the side effects of this horrible disease.

    (reply)
    • Peter Attia  July 3, 2013

      Thank you, Ash. I know a bit about spirulina, though I have not seen any compelling evidence to suggest it’s a “magic” food or uniquely special protein. I’ve also seen no compelling evidence for juicing, especially for someone with either T1D or T2D.

  108. danie  July 3, 2013

    Thank you Peter for your talk on TED.

    Excuse me for my english, isn’t my first language.

    In fact, I was interested in your site because of that talk on TED. You seem sensitive and logical at the same time, so I will just relate you with some of my interrogations.

    First: About this lady with diabete that you had to amputate, I wonder if her diabete could have been worsen by some anti-cholesterol medication. As I learn form some research I have made through litterature, statins increase the diabete. So, if somebody having diabete or beeing near of it, takes statins, it may become harder to control it. How come a toxin can be a good thing? How come the pharmaceutics came to make us think that a natural thing thar our body produces for his needs (cholesterol), is a bad thing? How come doctors always say that cholesterol is a bad thing when naturaly low cholesterol levels are related with higher risk of death in general and more often from cancer?

    Second: Is there a link between hypothiroidism and obesity and other long term disability. Thyroid hormones give the cells (mitochondia) the power to transform sugar and fat into energy. If that system don’t work well i think that all the others in the body cann’t do ther work well either. Isn’t it?

    Like you, I think I do everything ok for my health. I eat well, according to the Michael Pollan rules, I watch for IG of my food, I try to take good fat and avoid trans fat, I eat legumes, fishes, etc. Only the good stuf. I train 5 to 10 hours a week. I realy enjoy doing sport, bicycle, trekking and X-ski (my favorite).

    A few yaers ago, I met a new doctor, when she saw me, she asked a few questions and told me I might have hypothiroidism. In fact my TSH level was near 5.5. I started to take syntrhoid, and I feel better, though my TSH is still not keeping in the normal range. My former doctor, told me it was OK. For him there’s no need to treat if TSH is not higher than 5. His target is to bring it between 3 and 4. My new doctor wants it around 2. Normal people have TSH between 1 and 2. So how come when doctors treats us, they don’t want to bring us in the normal range of everybody. I’m sure that before the birth of my babies, 30 years ago. my rate was as normal as anybody. At that time, I could eat whatever I wanted, whenever I wanted. Since then, I gain 3 to 4 pound yearly. I’m very frustrate with that. I train like hell and perform like (*&*&). Never again a doctor will tell me my results are OK. I want to read them myself. I’m intelligent enough to understand them or to do some research and learn. For now, all my numbers are in the normal range, except for my TSH and the number on my scale. I”ve lost some pounds with exercice and diet, they all found me back. I think I gather the pounds that people lose on their way. Where and how can I give them back where they belong?

    A friend of mine is struggling with the same patern. Her thyroid had been burned because of a cancer. She now takes synthroid and gain 3-4 poiunds a year despite she cycles for almost 8 000 km/yr and go to the gym on winter. She eats well also. She just takes more “sport drinks” than I do. I just hate this kind of stuff and simply not beleive in it. She’s not fat, but she added 15 pounds in the past years.

    Thank you for your attention. I’ve been longer thant I though.

    (reply)
    • Peter Attia  July 3, 2013

      Danie, to your first question, it is possible, though the data suggesting this linkage or generally observational, not RCT. To your second question, no doubt hypothyroidism can contribute not only to obesity, but more importantly, lipoprotein abnormalities.

  109. Kathy  July 3, 2013

    Peter,
    Just want to say, great Ted talk and that I have sent the link to your talk through-out the public health department I work for. I’ve gotten a few very positive comments back already (just sent it around this morning) and one director is talking about gathering all staff to watch it. This is a big deal in a culture that is essentially directed in all it does through the CDC (funding issues, of course), and that is focused to such a large degree on the obesity crisis.

    I think it was very effective to focus so exclusively on the precise point of cause vs. effect. Very well done.

    Thank you.
    Kathy

    (reply)
    • Peter Attia  July 3, 2013

      Thank you very much, Kathy. Appreciated greatly.

  110. Ely  July 4, 2013

    Peter – I just watched your talk on TED. Thank you for making me realize that the world is a better place than I thought it was 15:58 minutes ago.

    (reply)
    • Peter Attia  July 4, 2013

      Ely, thanks so much for this. Really makes my 4th.

  111. Barb Murphy  July 6, 2013

    Dr. Attia,

    I just watched your TEDMED talk on YouTube. More sincere, heartfelt, supportive words…well, I’ve never heard them until today. Morbid obesity has been my curse for the last 15 years. I used to be lean and fit until everything changed. I was 23, had just been through my own perfect storm of personal tragic events and with the onset of depression and my own self-esteem dying, my weight more than doubled over a 5 year period.

    I was told it was PCOS although no tests were done. The gynecologist looked at my 311 lb body and assumed. Years later my family doctor tested my hormone levels (specifically testosterone, androgens, etc) to find they were within normal limits for a woman my age. He told me that I was obese by my own doing, that poor dietary choices and lack of exercise were my issue. The diagnosis changed to one of blame and ‘it’s your issue to fix. Just lose weight and you’ll be fine.”

    Today, I’m 38 years old and weigh 340lbs. Regardless of how many doctors explain that although my health indicators (BP, cholesterol, blood sugar, etc) are all within normal ranges, their next statement is always that I’m on the verge of a health crisis. I will develop Type II diabetes, heart disease and likely cancer…one doctor even went so far as to say “You have such a pretty face! It’s so sad that you can’t get your weight under control. Men would chase you!” It’s also been 15 years since I’ve been in a romantic relationship…understandably that last last statement made me cry. The doctor was right…no man could love me this way.

    The pressure does nothing to help motivate lasting success. I’ve always known that the excessive weight I carry is a mere symptom for the true underlying cause. While many people judge me and assume that those underlying issues are recklessness, stupidity and laziness, I know better. I know it’s something more connected to the myriad hormones coursing through my body. I’m not a doctor, but could the biochemical changes tied to depression and anxiety trigger insulin resistance?

    I’ve rambled on long enough! LOL Thank you for sharing your insight, encouragement, compassion and empathy. Your former patient may never see the video, but I did, and it comforted my heart. It takes courage to ask for forgiveness and I’m sure many physicians will learn by your example.

    (reply)
    • Peter Attia  July 7, 2013

      Barb, it breaks my heart to hear this, but more to know that I don’t know “the answer.” If I can give you even one ounce of hope, I’d say the following, there is at least one other person today who knows this is not your fault and that your worth as a person has nothing to do with what the scale says.

    • Hemming  July 7, 2013

      Hi Barb,

      Please go to Jack Kruse’s blog and read his own story and his different protocols for getting to optimal, I truly believe that you can lose the weight and feel better with the right ‘tools’.

      Good luck!

    • Donna S  July 7, 2013

      Barb,
      I hear you loud and clear. I wish I could give you answers but I can’t. I’ve been on the same treadmill of trying to cure my obesity for a very long time. I did not come to my obesity through a disastrous accident like you did. Rather mine started when I was very young about 6 years old and went downhill (uphill?) from there. I’ve gone the same route of trying to discover why as well as trying to ‘fix’ it to very little success.

      It is difficult when health care practitioners spout the same old theories about losing weight. Even more difficult when you ask them about current studies. I have two doctors that discount anything about insulin and LDL etc. when I ask. They assume incorrectly that I am referring to spurious studies instead of information gleaned from reliable sources. Furthermore, I cannot look for a new doctor. Under the current health plan I am stuck with what I have. It makes it all the more frustrating.

      Unlike you I have moderate high blood pressure and diabetes that is well controlled. What irks me is the blame I receive for my weight for any problem I may have. My weight is responsible for my having an ear infection….really. I had one neurologist discount me immediately the moment I set foot in his office because I was an obese female. He refused to listen to what I had to say instead making comments that my imbalance and nerve loss was due to my weight.

      If you have no other factors for metabolic syndrome then chances are you are not a candidate for trouble down the road. Obesity is a symptom yes but you have to have at least three or maybe it is five of the factors to be said to have metabolic syndrome. And the retort that has been on my lips when people tell me they don’t have a problem because they are of normal weight is that even people of normal size can have metabolic syndrome. Weight is not the only indicator. Dr. Lustig’s book Fat Chance is a must read. I wish I could give it to my health team to read.

      I’ll sum up here for as usual I am long winded. I believe my obesity is due to a hailstorm of hormonal problems exacerbated by addiction problems (I believe I am addicted to sugar. I have withdrawal symptoms that are very unpleasant when I stop sugar. I’ve cut down but …..) and depression (which does not respond to chemical intervention) I have made changes for the better and have lost some weight but not enough for society or the medical establishment which does not seem to want to celebrate even small victories.

      I don’t know if it helps to know you are not alone in your frustration. It is not your fault just as it is not my fault that we are obese but that is hard to remember when individuals feel free to take jabs and deny us the basic right of even being alive. ( I won’t go there. It’s too painful for me to recount ) I’m glad Peter does his blog. There is a host of information here that is very helpful and I’m glad you found it.

  112. cheryl  July 6, 2013

    Dr. Attia,

    I saw your favorite talk some time before I saw yours. I liked yours better. You were talking about me and many of the people I love. To hear a doctor say it might not be my fault, is life changing for me.
    What you said was not that strange to me as I did Atkins for 2 years. I didn’t have good success with Atkins. I had trouble staying in ketosis. I had no idea protein could cause an insulin response.
    I’ve been back to low carb for a week and have already lost 6 pounds. Thank you so much.

    Cheryl

    (reply)
    • Peter Attia  July 7, 2013

      Cheryl, thanks so much for your very kind comments. (I like Ric’s talk much more than mine, but I really appreciate your sentiments.)

  113. Debbie  July 7, 2013

    Dear Dr. Attia,

    I watched your TEDMED talk on Upworthy through a Facebook advert. Wow! (I sent it to my sister who is a family practitioner.) I work with frail elders and very disabled adults and more than 50% have Diabetes. I work in Adult Day Health Care and we feed everyone a “nutritionally” balanced meal each day – I put nutritionally in quotes because we get federal funding to supplement the cost to provide the meal and thus use FDA requirements that define balanced. Potatoes are a vegetable accordingly. We carb load diabetics excessively as they must have two servings of bread and then at least 4 oz of potatoes if that is the vegetable of the day. And then we measure their blood glucose levels. It’s insane. But I digress – for them, I thank you. Our agency’s mission is to provide dignity and independence to people with disabilities and other special needs and this is what you spoke to at the end of your presentation. Dignity. Not blame. So we look at each person – whether they have Diabetes or Alzheimer’s disease, as a human being who deserves care.

    I have been on your site now for the better part of two hours and feel inspired and depressed all at the same time. As an executive in the mom and pop nonprofit world, and mother of one biological and two full-time step children, your life will never be mine. I so relate to Barb and her post. I have almost doubled my weight in 5 years. I exercise daily and have tried every diet under the sun from South Beach to Atkins to Suzanne Sommers to organic low fat and I could go on. I have had every test run that I know of and nothing is “wrong” with me. I think it is hormonal – I have never been fat and unhappy in my life until these last few years – I have always had a crappy body image, but never been overweight – and have always been a positive and outgoing person. Now I go to work and do not want to be seen in public. I dread going to meetings where I haven’t seen colleagues for a while and they see me and get that, “Oh my God what happened to her?” expression they try to hide. And while I believe what you write and am inspired, I also look at your lifestyle – between your style of exercise and consumption – as impossible given my reality.

    I write this to agree with you, with your thoughts, and to support you in your devotion to healing over judging. But I also write to tell you I believe that women have hormonal challenges that your study does not address (unless I haven’t read that part – I can’t say I’ve exhausted all you’ve written – so forgive me if I’ve missed this). And until such a time as we fundamentally change what we feed America – we can make marijuana illegal but sell Big Macs by the millions – things won’t change. The wealthy will continue to have access to education and healthy food and the poor will lack the education to know better and the money to eat better.

    So thank you – for your raw presentation – and your work – and I wish you continued growth in a way that looks even more broadly at what is necessary to flip the switch.

    Debbie

    (reply)
    • Peter Attia  July 7, 2013

      Debbie, thank you so much for all you’ve shared and for your kind words. There is no doubt in my mind that many (some? I don’t really know, actually) women have additional layers of endocrine complexities that can really complicate insulin resistance, and by extension, diabetes. Fortunately, one of the three studies NuSI will be funding to launch this year will be able to address this issue, and hopefully many more to follow. We have to address this issue and many more.

    • Debbie  July 8, 2013

      Thank you so much for writing back :) – definitely made me smile! I get 100 plus emails a day and I know I can’t always respond to all – and I imagine you get significantly more and do that crazy exercise routine – so am doubly grateful. I am reading more on diving back into ketosis in a healthier way. Thank you for your inspiration and I promise to check in as I go.

      Additionally, we have a late-stage Alzheimer’s/related dementia program and I am seriously considering foregoing our federal subsidies and seeking a grant to do the ketosis program at work and encourage it with caregivers. Often times, folks in the late stages are hard to even get interested in food – so ice cream is something somehow universal. But I’ve made my own with Stevia and know it can be done.

      At any rate – your response means so much and I look forward to your research results. In the meantime, I will switch to ketosis, give it at least a month, and continue my daily exercise and meditation practice.

    • gemma  July 9, 2013

      Debbie, related to Alzheimer: this is a must read for you and perhaps your patients/clients: http://www.coconutketones.com/. And perhaps even better this, also by Mary Newport: http://youtu.be/feyydeMFWy4

  114. Steven James Beto  July 8, 2013

    Dr. Attia,
    You assembled a cognitively diverse group with each colleague having different backgrounds and ideas whose individual opinions may not be the answer, but whose collective insights may well provide breakthroughs if not cures, and certainly greater understanding. I’d be interested to know if and how intestinal flora may be involved.

    I look forward to following your progress and celebrating your successes. Courage, doubt, and compassion are the key components of your mission.

    (reply)
    • Peter Attia  July 8, 2013

      Yes, there will be extensive analysis of gut biome.

  115. Katherine Barich  July 8, 2013

    A friend just linked your TED talk, and I have to say I shed tears watching it. If you ever want to consider a clinical trial or DNA analysis, please keep me in mind. I have lost (and gained) hundreds of pounds in my lifetime. I have lost 130 – 150 pounds three times when I stick to a low carbohydrate regimen. I can even maintain my weight for years at a time through very strict protocols, but I do have an addictive response to sugars that kicks in after about 30 mg of sugars in a 2 hour period and go into an eating spiral. My weight loss is rapid – 130 pounds gone in a matter of months, but the opposite is also true – gaining 3 pounds from one muffin, for example. My friends call it freakish – it just now either makes me angry or I get apathetic. If only the problem were as simple as quitting smoking or drinking alcohol – one can simply walk away, but with food I’m always in a bit of danger every few hours.

    I went to my doctor at 290 pounds with knee pain and begged to see a nutritionist. Finally after long badgering and tears he relented. In the interview with the nutritionist, she told me that my low carbohydrate plan was sound, and after switching my diet, the weight just fell off. Frustratingly, it seems that I am constantly hungry no matter what my weight or current state of intake, although it is less a problem with a low carb diet.

    Thank you so much for making this your life’s work. You have a new follower and I am looking forward to learning more to improve my health. If I have an insight, I’ll be happy to share.

    (reply)
    • Peter Attia  July 9, 2013

      I think you’re right, Katherine. Not to minimize the difficulty of overcoming addiction to cigarettes, alcohol, or other drugs, but none of these are essential for life the way food is. It sounds like you’re on a path that is moving you in the right direction for a sustainable dietary strategy.

  116. Jeanne Stagner  July 10, 2013

    I just got through watching your TED video. Thank you.

    I would like to tell you my story. I am a PhD student currently in Healthcare Innovation. Also I have been a practicing midwife for 30 years.

    I was diagnosed with PCOS in my teens. I have struggled with weight gain my whole life, but I managed to stay normal weight until my 40’s when I became obese. I was diagnosed with Type II diabetes almost two years ago after 3 years of graduate school. I had been eating a lot of fast food and junk food. I was put on meds but did not tolerate them. I was sent for diabetes dietary education. I knew I couldn’t follow what they were telling me. I dislike diet foods. I had recently read “The Fertility Diet”. I decided to experiment on myself and change my diet. Historically before graduate school I had always tended toward whole foods, organic, etc.. So when I say I changed my diet, I really didn’t change it but returned to what I had eaten in 20’s before I was obese and when I had time to garden and preserve my own food. At about the same time I took a job in a rural community with no access to fast food and only one grocer. Needless to say, I planted a garden and ate what I raised. My diet consists of whole foods in their most natural state, mostly organic. I eat some meat, but mostly farm (small rural family farm) of beef and chicken. But mostly I eat fresh vegetables and fruits. Very little rice or pasta. I eat whole grains. My fats are olive oil, butter, and whole fat diary. My diabetes is gone. I didn’t loose any weight, but I will continue to learn what I can to loose it. In the mean time I will garden and love myself for who I am and what I do.

    Thanks again.

    (reply)
  117. Elise Wormuth  July 10, 2013

    Dr. Attia — I watched your talk this morning (and also Ric Elias’ — wow!). Two things: I’m among the group who are so damned moved by the things you said because of my experiences as an overweight person, struggling with insulin resistance and trying not to tip over into diabetes. You’ve given a gift to so many people in that someone in the medical field “gets it,” and offering compassion and, potentially, help, rather than disgust and scorn. But secondly, I want to comment on your speech itself, your construction of it and your delivery — I’ve already shared the link with a number of colleagues who teach oral or written communication (I’m an English prof), and your TED talk will be appearing in classrooms as soon as they can get it into them (including mine). Your talk was a model of what such a speech should be, a wonderful combination of logos, ethos, and pathos that are perfectly balanced for maximum rhetorical impact. It’s a powerful piece of communication, and I thank you for it. I’m looking forward to exploring your blog and work further.

    (reply)
    • Peter Attia  July 11, 2013

      Elise, wow, what a compliment. I have to share the credit, as I’m not sure how much (if any) I deserve. The TEDMED team, a remarkable group of people, all played in hand in helping me shape my story. (If you saw the first version — 3 times longer, way more technical, etc. — you would be delighted you didn’t have to sit through it). In particular, Marcus Webb at TEDMED was simply ‘gifted’ at forcing me to balance the “facts” with the “story.” At some point in the coming months, I will write more about this experience, which may be of interest to you. I’ll also share my 10 favorite TED talks of all time (Ric’s plus the 9-way tie for second).

  118. Jeanette Smith  July 11, 2013

    I just watched your TEDMED talk…..even though you did not directly apologize to me, Dr. Attia, I want you to know that, as an obese woman with Type II diabetes, I forgive you. I hope one day soon that all physicians will have the same compassion for people like me that you have shown in your talk.

    (reply)
    • Peter Attia  July 11, 2013

      Thank you, Jeanette. I was, in reality, apologizing to many people.

  119. Katie McDaniel  July 12, 2013

    Wow,

    I just watched your TED talk twice to let everything soak in and I wish I could give you a warm hug. I am so moved by your humility and honesty.

    I am food geek to the core and have been studying nutrition for the past three years. I currently doing nutrition counseling at two treatment centers and while I don’t work with many patients who are insulin resistant or diabetic, many of my client’s feel powerless over sugar and carbohydrate cravings. People often dismiss poor diet choices or obesity as a lack of personal restraint or laziness. In a feminist theory class I took in college, we explored that notion that prejudice towards people who are fat or overweight is the last “acceptable” form of prejudice. Your speech tore apart this notion and after studying the bodies complex endocrine system, I have great respect for the intricate balance of hormones and how imbalances in the system can overwhelm any human being, no matter their relationship with nutrition and exercise. Thank you for igniting another spark in my passion for health and food. I want to stay connected with your work and look forward to reading new research and your blog.

    (reply)
    • Peter Attia  July 12, 2013

      Katie, thank you so much for your kind words. I think I have to agree with the conclusions from your class. I think it speaks to the underlying belief that obesity is a disorder of gluttony and sloth. Unlike, say, race, gender, or sexual orientation, most people still believe that an overweight person is 100% responsible for his or her state, and therefore worthy of no empathy. This fuels the prejudice, of course.

  120. Aubrey  July 15, 2013

    I was diagnosed as having PCOS about two years ago. I was told by a specialist at UCLA that I was also insulin resistant. I have done a good bit of research and most women with PCOS are obese, but at that time I was 23 years old and 140lbs and 5 feet 11 inches tall. I decided to see what would happen to my body if I discontinued the use of oral contraceptives and sprinolatone while maintaining a ridged workout schedule and I even followed the exact same diet you have mentioned in your videos (basically a diabetic diet). Instead of feeling better, I became very anxious, my hair began to thin and I gained 20 pounds. Now that I have been on an oral contraceptive, spirnolactone, and metformin for two years, I feel like a completely new person. I am now 130 pounds and I cannot seem to gain weight. Why is it that you were able to control your insulin resistance through diet and I am not able to stop taking metformin without feeling exhausted all the time? Do hormones play an integrated role when it comes to being insulin resistant? I cannot seem to find information that addresses this issue. Thank you for your time.

    (reply)
    • Peter Attia  July 15, 2013

      Aubrey (and anyone else reading this who is interested in PCOS), I really need to do a post on this topic, as it is such a clear example of IR resulting from something other than “eating too much.” I don’t think I yet have the expertise to really do the topic justice, but if you can be patient with me, I’ll get to it in the next year, I hope.

    • Maryann  July 15, 2013

      Jimmy Moore’s Livin’ La Vida Low Carb Show episode 700 links to an interview he did with an expert on low carb and PCOS. Perhaps there might be information there that can help you.

    • Aubrey  July 17, 2013

      Thank you for your response. I am having trouble finding information on very thin people with PCOS; seems to be a rare occurrence. I look forward to your post!

      Maryann, I will check it out! Thank you for your help!

    • Kelsey  July 17, 2013

      I actually came on here (just watched his TED talk today) to mention PCOS. How my endocrinologist explained it to me, is that having PCOS throws off your hormones. The imbalance between these male and female hormones caused by our thicker uterine wall (and the cysts) effects our metabolic abilities. This can CAUSE insulin resistance. I think this would be an interesting area of research because part of me believes that this epidemic is caused by our hormones being out of balance, something that might not be noticed. I was actually misdiagnosed 3 years before my actual diagnosis of PCOS. They actually believe there may be a male counterpart to PCOS. And a lot of doctors (like my family doctor) don’t know what needs to be seen to diagnose PCOS (they usually do one test, that if positive then yes you have PCOS, if negative, then you may still have it) and then what to do to treat it. There are also many doctors that I have to explain it to. I actually wanted to ask Dr. Attia if he had thought of it and now I’ve see his comment, so he has, and that is good. I think a lot of women have this problem and don’t even realize it.

      As for me, I have found that a low-carb option works for me. I’ve always been incredibly active and eaten pretty darn healthy, but I never lost any weight (this is how I knew there was a problem). I now essentially eat lean proteins and vegetables. I’ve found that the sugar in fruit can set off my BGL, not just high, but mine actually kinda freaks out and gets high, then low, then high, etc. So I’ve chosen to not eat fruit (which I miss dearly). I’ve found this lets me lose the most weight, and as long as I keep my water intake up, it’s pretty great. I exercise often. I HOPE, but I know this isn’t always the case, that someday I’ll be at a point where I don’t need my medicine. But I know there’s a chance that my hormones still will be crap, but hopefully with my diet like this and weighing less will allow my hormones to balance out.

      But because of my experience, I hate when people give larger people a harder time. I’ve always had great cardio; my resting heart rate sits around 55 – 60. Yet people think I’m unhealthy for how I look. They don’t understand how hard it is to lose weight when your hormones and body DO NOT want to cooperate, at all. They just say, eat less, exercise more, but don’t understand that there is so much more to how much somebody weighs, and they do not know what could be wrong with that person. Yes, for some people, they can lose weight easily, but people with hormone imbalances, it can be nearly impossible. Metformin is probably the only reason I lose the little bits I’ve been able to lose so far.

      Sorry for the long post, but thank you Dr. Attia for your talk, outlining how we really shouldn’t judge people by their weight. I also look forward to your post about PCOS. It’s really an interesting syndrome, and I’m glad you’ve thought about it, because I think it directly correlates to your topic.

    • Peter Attia  July 18, 2013

      Kelsey, It may be at least several months before I can write meaningfully about this topic.

  121. Jeff Ostermiller  July 16, 2013

    Wow! I became teary-eyed twice. Once while listening to your talk and again on reflection. I forwarded you talk to my spouse—among others—who sent me to this blog. The site is even better, albeit less emotionally moving.
    My mother almost tied due to morbid obesity and diabetes complications. While she was in the hospital, she experienced and I observed first-hand the disrespect and disgust that you describe in your talk. As if she needed the attitude on what many thought, at least at first, was her death bed!

    This experience made me realize that I needed to lose some weight too. While not morbidly obese, the #s crept on since leaving graduate school. Problem was…too many conflicting pieces of information, fad diets, etc. This led me to a pretty extensive lit review on pub med (I’m not a physician, but am a scientist), which ultimately placed my in your anti-sugar and processed carb camp (as well as an advocate for high intensity interval training but that is OT). I’ve lost 55# now, which makes me “normal” on the charts. I’ve also become fascinated these topics in the process. As they say, everyone needs a hobby.

    I can’t believe that I never encountered you blog before, but consider me a new regular.
    Thank you so much for your work! Your passion is obvious, as is your humility and humanity. This happens maybe once every few years, but I can honestly say I’ve found a new hero! I can’t wait to see the other talks that you mention in this blog. If they are even half as inspiring as yours I’m in for a treat.

    (reply)
    • Peter Attia  July 16, 2013

      Jeff, thank you very much for sharing this. I really appreciate it. Hope you find helpful things on the blog.

  122. G. Gremmen  July 17, 2013

    Yesterday I saw your ted talk and I must say, I was sort of surprised. I agree with everything said, but I have to say all these things weren’t new to me.

    I have an insuline resistent horse. The reason that I am writing, is because this might be interesting for your studies as well. I did some internet research on what to do with my IR horse and it came up with the following:
    – keep feeding horse lots of hay and straw but cut out all starches and sugars, like grains and rich grass
    – feed extra magnesium (mine gets magnesiumoxide 54%, 20 grams per day)
    – keep up regular exercise

    She used to be so fat that we were afraid she would burst (and at very high risk of laminitis, a horse-disease closely connected with obesity and magnesium deficiancy). Only the ‘diet’ and exercise didn’t help at all, but the magnesium made het loose about 18% of het bodyweight.
    Now only starches and sugars make her rapidly gain body weight again, hay and straw she can eat as much as she likes.

    This information is readily avaiblable to horse owners in the Netherlands. Maybe it may be of use in your research as well.

    Kind regards,

    Gineke

    (reply)
  123. Nicole  July 21, 2013

    My husband and I started the Zone diet a while ago. He, already a relatively thin guy, lost 20 lbs. I, perpetually “not thin” despite consistent exercise, lost a few pounds. After seeing your talk, it finally dawned on me that weight loss, like everything in humans, is going to depend a lot on individual differences. I decided to give up sugars and starches, cut back more on carbs in general, and replace the lost calories with fat. Finally, I’m seeing the weight loss and energy gains my husband saw months ago.

    What is most remarkable to me is that my food cravings are gone, and were gone almost instantly (within a day). I exert no willpower to avoid sweets and refined grains. I eat enough and don’t want to eat more. I finally feel I am eating to live rather than living to eat, and my BMI is inching toward normal. I feel energized and 15 years younger. I’m recovering from my workouts faster and performing better. Oh, and did I mention this all happened in the course of the past week?! I can’t wait to see where I am in a few more weeks.

    Thank you for the work you are doing and your willingness to push back against the status quo by demanding evidence, and thank you even more for making time to share your findings and knowledge with the world.

    As a neuroscientist, I look forward to learning more about how insulin resistance affects brain performance and health. I have a suspicion that the effects of using fat rather than glucose for fuel have even more far-reaching benefits than improvements in cardiovascular health (not just with Alzheimer’s, as you mention, but with more “psychological” factors such as cognitive performance, emotional resilience, and even the treatment of disorders such as anxiety and depression).

    (reply)
    • Peter Attia  July 21, 2013

      Nicole, it’s really an open field right now and as such, the data are sparse. Much of the data that do exist are sub-optimal.

  124. joseph  July 27, 2013

    Dear Dr Attia,

    I want to become a health educator and study nutrition and its effects on me through various hormonal and nutritional pathways in the body. Would it be possible for me to be involved as a volunteer in one of your studies. I come from a family of diabetics and watch what I eat very carefully but my blood sugar is the only response I can measure on my own?

    thanks

    Joseph

    (reply)
    • Peter Attia  July 27, 2013

      Joseph, NuSI does not do experiments, but rather funds scientists.

  125. Tim  July 31, 2013

    Just saw your TED Talk. And Ric Elias’s as well. Thank you for shining the light of compassion rather than contempt on those with diabetes and obesity. I work in the field and I pray for the day when mainstream medicine figures it out. Your bruise analogy was brilliant. As someone said, do we tell someone who wants to be rich it’s as easy as earn more spend less? Why do we simply tell the obese move more eat less?

    I can’t wait for your work at NuSi to move past incubation. Thanks again.

    (reply)
    • Peter Attia  July 31, 2013

      Tim, if I was giving out awards for “comment of the week” you’d win this week’s award. I love your comparison to “earn more, spend less.” Simply brilliant. Thank you for sharing.

  126. Jack  August 5, 2013

    I just found your website a few days ago, and frankly I can’t remember what I was looking for when I found it, but wow am I glad I did. I am an endurance athlete like yourself and I did some experimenting with changing my diet without really knowing what I was doing nor was I able to pay for or even think about getting actual tests done to see that I was doing the right thing in reducing my intake of carbohydrates. It was 2002 and I tried this. I lost weight, dropped from 165 to 142 over the course of 5 months and ran my best marathon ever, just by reducing the carbs from what was considered “normal.”

    Okay, enough about me. I just found the video of your speech at the TEDMED a few minutes ago after trying to catch up with everything on this website. And I just wanted to say, you sir, are a godsend to our society. What a speech! Thank you, and keep up your excellent work. You have a new, huge fan, and I will spread the word to anyone who will listen.

    (reply)
    • Peter Attia  August 6, 2013

      Jack, very kind of you. Hope you find/found what you came looking for.

  127. Baseer  August 26, 2013

    I find your Analyzer communication style to be extremely annoying and boring. Please use the TED guidelines for your website/blog. Or take a class in communication styles. I have a supporter communication style and from your entire blog i read i found below the most enjoyable. Will most definitely like the TED talk.

    1. Leave your “M.D.” and “McKinsey” personas off the stage. While those are your comfort zones, get out of those zones.
    2. Don’t try to “teach” people a bunch of facts (even though you love facts); don’t try to “prove” how smart you are; don’t even try to “convince” people of anything.
    3. Engage both sides of your listener – their intellect and their emotion.
    4. Be authentic. The audience cares less about what you know, and more that you care at all.

    (reply)
  128. Phoebe Olivera  September 3, 2013

    Peter,

    Thank you for your elegant words and heartfelt confession. I am a morbidly obese health educator at a community health center. We work with patients who are underserved of which many suffer from diabetes and a cascade of other chronic conditions. Many of my patients are morbidly obese and struggle with feelings of dispair, frustration, and often time failures as they furtively battle their weight.
    It was like new breath being blown in my lungs- after long hours of trying to help people and constantly battling providers who often time have the same thought processees – the fault is all on the “fat” patient. I have seen some very common denominators and while I’m not a scientist or a doctor- I would like to tell you one of my theories. I’m sure you’re a very busy doctor but I’d be honored for only 10 minutes of your time. Thank you,

    Phoebe M. Olivera

    (reply)
    • Peter Attia  September 3, 2013

      Please share, Phoebe.

  129. Jeff Johnson  September 4, 2013

    …………….
    ………………..
    ……………………….

    Heart rate Monitor

    I assume you use one of these – as well as most of your buddies – so – which one ? – please recommend something – would a Walmart no exceptions 2 year guarantee be worth it ?

    (reply)
    • Peter Attia  September 4, 2013

      Polar for HIIT; Garmin on bike.

  130. B  September 8, 2013

    Hello Dr. Attia,

    I was introduced to you watching your TED talk, three times (at current count). You may be my Ric Elias. I have sent it on to everyone else I know to watch.

    I am working on my post doc in clinical psychology- quite by chance (initially anyway) I have done further study, research, and clinical work on obesity. You communicated and modeled the willingness to be vulnerable, question, and grow professionally and personally- for which I was am grateful- as both a clinician and a patient. And to have done so in such a venue is even more remarkable. You have given so many a true gift- I hope you know that. I can see that others have tried to communicate this to you in their comments.

    I looked you up yesterday and came across your blog. I have been reading through your various articles- thank you so much for the information and your personal reflections- and not just regarding your journey with obesity and insulin resistance. Two years ago I was injured in a car accident, damaging my L5-SI, had surgery that did not solve the problem but made it worse, and I am continuing to seek medical answers/treatment. My lifestyle is significantly limited and while I want to (hoping to be able to) eventually be off pain medication I fear the withdrawal process. I have experienced difficulty connecting with medical services because of prejudice regarding pain management- which has been truly shocking to me! I have tried to use my experience to inform me in regards to how my own clients suffer and experience systematic oppression. Reading about your experience (which was worse than mine) was truly inspirational and provided hope for me.

    Apart from wanting to share briefly with you my gratitude and how you have impacted me I have two questions.

    I have suspected for some time now that my family history and personal history suggests that I may too be suffering from underlying insulin resistance problem that isn’t being addressed properly- the information in your blogs supports my hypothesis further. I have just moved to a new city and need to connect with new providers. Are you able to provide (and do you know of) recommendations for doctors in Atlanta?

    Oh- and have you had any reunion with the patient you spoke about in your talk? (that is the question that prompted me to search for you and find your page)

    Thank you so much for all that you do.

    (reply)
    • Peter Attia  September 9, 2013

      Thanks very much for your kind words, B. I don’t know of any doctors in Atlanta off the top of my head, but Jimmy Moore’s website may have a doc in that area. To your question, I have not had a reunion with the woman I spoke about, but I’m worried she may no longer be alive, as that took place over 7 years ago. The mortality for a diabetic patient once he or she has had an amputation is quite high, unfortunately.

  131. Kim Carlson  September 10, 2013

    Hi Peter,

    I just ran across your website–which I’ll digest in small chunks when I have time–but I wanted to tell you that as Hodgkin’s lymphoma survivor (and lover of TED) I appreciate your blog tremendously! Only those who’ve gone through a life-threatening illness will understand the extent to which our medical system is severely lacking and admireand cheer on those doctors who go beyond the boundaries of their training to fill those terrible gaps. (An MSKCC surgeon I met related how one of their oncologists confessed he had no clue what his patients endured until he was diagnosed with cancer and underwent chemo. Needless to say, his attitude has changed radically. ;-)

    I had many questions and theories about my cancer and it’s treatment, about food and cancer, about psychology and cancer, and was pretty much blown off by the experts I saw. I went to scores of doctors post-tx to help me resolve the terrible late effects of chemo to no avail. I was told by one GP–formerly a screenwriter in Los Angeles!–that he was unable to treat for anything that did not fall under the purview of his medical school curiculum. IOW, he couldn’t help me. I either found my own solutions or the problems eventually resolved themselves. It made me an even greater believer that people should never blindly accept the word of any physician, especially since many physicians are specialists who treat patients as a collection of parts instead of an organic whole. Most doctors are trained to treat the symptoms instead of the root cause which does not effectively cure the patient. I fortunately found a book at the time of my diagnosis written by a psychotherapist who treated terminally ill cancer patients for 40 years. He developed a groundbreaking model of treatment since the old therapeutic model–what’s wrong with this patient and how can we fix it?–did not work. He found a common denominator among those he treated: they all had unlived parts of themselves, unexpressed desires, unhatched dreams that they had not allowed themselves to have. The new model he developed asked instead: what’s right with this person and how can we bring more of that into her life? When a person who’d always wanted to play piano, for example, was given lessons and encouraged to play, she got better. When I read in this book that the poet W.H. Auden in one of his poems defined cancer as a “foiled creative fire” I knew instinctively that that was the reason for my diagnosis. I had sat on my creative energies; since they were not directed outward, they burned up inside like acid in a drum. No one can scientifically prove this, but in my gut I knew it was true. I was able to express the psychological and spiritual trauma of being a cancer patient in a way that other cancer patients could relate to (thanks to other battles I had waged and won) and I realized: no one talks about this. No one in the medical profession sees this as a problem. When we see a hole in the dike, it’s up to us to plug it!

    There ought to be more doctors like you, people who connect the dots and understand that everything is related to everything else. Nothing, but nothing, is separate. I love your humility, your understanding that this isn’t about ego (‘Your ego is not your amigo’, as we say in a certain anonymous program) but to use your knowledge and experience to heal a greater community. It takes great courage to be the dissenting voice in a chorus of party line repeaters. You inspire people, give them a light to follow in a very dark world.

    You made my day today and I wasn’t even looking for you.

    Cheers,

    Kim

    P.S. As a former tri-athlete who became a couch potato after treatment (8 yrs. this month), I’m finally getting back into shape. (Easier in NYC where you walk miles each day, harder in LA where you mostly walk from house to car.) As a recovering sugar addict I was always conscious of what I ate because I was so fanatical about my body and weight. After cancer I got lax and let myself go, as they say. I recently went on a modified low GI diet to improve my fat to muscle ratio, and the detox from whatever carbs I was eating feels awful. However, I know it won’t last forever. I’m also doing a pretty challenging 4 mile hike every day and hope to start riding and swimming regularly. I find that my mind is productive to the extent that my body’s in shape. ;-)

    (reply)
    • Peter Attia  September 11, 2013

      Thanks very much for sharing, Kim, and best of luck as you begin your journey back into fitness and maybe even another triathlon.

  132. LeeAnn M.  September 11, 2013

    I saw your Ted talk last night. Thank you.. thank you for getting it.. I am a fat woman,. I struggle everyday with my diet, with feeling like crap and being tired. It’s a viscous circle. I have been on thyroid meds for over 8 years now. I was so excited to get on them because I thought it would help my weight. I knew something was wrong. So i was relieved when they diagnosed a non functioning thyroid. Three months after going on the medication I had gained 60 lbs. Not one doctor believe it had anything to with the medication. I know in my heart it was.

    But as you talked about.. they looked at me with contempt and disgust. Your talk gave me a glimmer of hope that maybe doctors will look at the symptoms as whole.. not the fact that a person is overweight. thank you for your heartfelt talk. I hope more follow your footsteps.

    (reply)
    • Peter Attia  September 12, 2013

      I’m sorry you’ve gone through this, LeeAnn. I hope my talk, which many doctors have communicated to me changes how they feel, will bring you closer to solving your own mystery of why, despite how hard you’re working, you are not where you want to be.

    • Boundless  September 14, 2013

      > … diagnosed a non functioning thyroid.

      What tests were run to establish this?

      > Three months after going on the medication I had gained 60 lbs.

      What med?

      Consensus testing, diagnosis and treatment of thyroid problems is almost as screwed up as for lipids, and has resulted in books being published with titles like “Stop the Thyroid Madness” (Bowthorpe). There’s a nice summary of a sane approach on one of Dr. William Davis’ blogs:
      http://www.wheatbellyblog.com/2011/10/thyroid-tune-up-checklist/

      A screening question you can use with practitioners is:
      “Although it might or might not be indicated in my case, do you ever prescribe T3 or dessicated thyroid such as Armour?”.
      If the answer is “no”, find someone more interested in your health than in adhering to dogma.

  133. Lisa Gundry  September 12, 2013

    Peter,

    The vulnerability and compassion you shared during your TED talk brought me to tears. I connected to your talk in so many ways. Like many, I am very frustrated with my doctor’s mantra “eat less, exercise more” despite my attempts to explain my healthy diet. As a nurse, I too, have treated patients unsympathetically in my ignorance and wish I could take it back. Your openness to seeking more information instead of providing pat answers gave me encouragement (and lead me to your blog). I was also reminded of the shame I have for being overweight. Your blog has provided me with many resources and has empowered me to trust my body’s wisdom by listening to its response to what I eat. While yearly blood tests are currently coming back within normal ranges, I know it is only a matter of time before I develop IDDM (significant family history)- a multitude of symptoms have been telling me this for years. I make regular changes to my diet (meat-free, RAW, gluten-free, etc.) and learn something new about my body each time. It wasn’t until I read your blog that I realized that my diet modifications are not about lack of discipline, but are in fact a process of exploring what my body responds well (or poorly) to. Thank you for telling your story and for using both your heart and your mind to bring light to the dark places in ourselves and in medicine. I am so thankful for you!

    (reply)
    • Peter Attia  September 12, 2013

      Lisa, thanks very much for sharing your experience. I’m glad you found this and hope it helps you navigate the steps ahead.

  134. Jennifer Sheridan  September 13, 2013

    Hi Peter! Thank you so much for you sincerity on TED! After being 35 and considered healthy got the news that I needed my gall bladder out. I was shocked! I soon found out that most of my friends, neighbors and family also have theirs out. With all of the strange diseases popping up not just amongst the elderly but also among our youth. I set out on a path to slowly educate the public on what I believe to be a breakdown of the food industry that we know it to be today. My educational video is on our page called “Whirled Up Fundraiser”. I believe all of the problems with our health come from the soil. The animals, and the foods we are consuming. We are actually becoming the food we eat for example the DNA of plants are changed to produce larger fruits and vegetables and the animals are pumped full of hormones to grow bigger and faster – in essence everywhere you look people look that way. The woman I created the video with is an obese woman who eats healthy has done two triathlons, exercises for hours a day and cannot lose any weight – she is so frustrated because her body does not respond to any.type.of treatment. I have told her my theory and now we are on a mission to test that on a large scale. Many hugs. Would love to know your thoughts

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  135. Jack Emeyer  September 29, 2013

    Dear Peter,
    I and a few professionals in bio-engineering, etc. research are together digesting your writings as we continue to integrate & balance our (re-)thinking strategies for preventing (long-term) emerging, disease-associated properties, like “obesity” for one, as well as atheroslerosis, etc. In addition to “us” academic professionals, an entrepreneurial team of two highly focused & systematic thinkers have monitored their /own/ myriad blood/breath/urine/imaging biomarkers since mid-90’s: Google “morelife Paul’s Lab tests intro”.

    With that, I am curious for your further elucidation behind your opinion written above:
    “Monitoring questing is too complex and depends on too many variables.” — 2013 May 2 response.

    Gratefully, & w/ a warm smile,
    Jack

    (reply)
    • Peter Attia  September 30, 2013

      Sorry, Jack, I don’t recall context or original question.

    • Jack Emeyer  October 1, 2013

      Understood.
      (Context pasted below, from original question posted by David S on May 1, your answer on May 2):

      “Finally, being a bit of a data geek too, what would you recommend that I monitor and the frequency. I’m just of the view that if many practitioners took the same approach from the bottom up and were consistent (perhaps a shareable Google docs file?) it would help change the perception in the scientific community.”


      J

    • Peter Attia  October 1, 2013

      I don’t know how to answer the question, Jack. How often should one monitor biomarkers? Presumably, as frequently as one expects to see a change, which varies by biomarker and intervention. Most metabolic processes can change in as little as 3 months.

    • Jack Emeyer  October 2, 2013

      Agreed, the “ought” begs one to create goals that are measurable (and understandable) during the lifetime. My assumption is to collect mucho & varied affordable info, to inform decision-making at future times. Prevention from unknown issues is Uber-tough, but I seek to grasp my “norms” & mitigate? changes as I age (synonym for “live&love life to fullest”).

      Chatting with a team leader, (EF), w/ whom I volunteer @ ASU, Tempe; she took my advice to invite you to learn about and possibly speak at a Dec metabolism workshop wherein comparisons between instruments & methods evolve to introducing training for the new mobile metabolic-rate analysis tool Breezing. Low cost, plus mobile app, API management, etc. all part of this QS movement…

      Many thanks for your representation of ketosis-related topics! I’m a 1x day feaster myself…and have strange ketone fluctuations (initial data sets, need longer self-study!) when I work out. Cheers & warmth!

      J

  136. Michelle  September 30, 2013

    I know you’re going to get hundreds of comments just like mine, but I really felt compelled to send a note to say that this morning, while getting ready for work while my 3 year old played nearby, I watched your TedMed talk. I was just browsing through featured talks and yours jumped out at me. Struggling with insulin resistance myself (somehow in and out of the diagnosis), and having a father with “lifestyle” Type 2 diabetes (no one else in his family ever had it, and I try hard not to judge…), I was really taken with your talk. You listened well to Jay Walker and delivered a stirring (not TOO information driven) and VERY emotional presentation. I appreciated your vulnerability (I hope too that that woman from 7 years ago will hear this talk! Though for those who have judged my “spare tire” or “muffin top” I will forgive you on behalf of us all!), and even more so your vision of medicine with no “new idea resistance,” always challenging current “beliefs” and striving for better patient (whole person) care. I really look forward to delving into more of your work and learning more about being my own source of healing. Because at the end of THIS day, until things change, it has to be me. Thank you!

    (reply)
    • Michelle  September 30, 2013

      P.S. – You were right about Ric Elias! Thanks AGAIN!

    • Peter Attia  September 30, 2013

      Michelle, thank you very much for taking the time to share this. I hope the woman I spoke about could hear this, but I worry she won’t.

  137. Curzon Dax  November 10, 2013

    I know some stuff about old Cretan diet from personal experience. It’s mostly hearsay but it’s consistent among most people in touch with the historical roots of the island:

    The bread they had was only ‘black'(a local term meaning whole grain) and I suspect it was not that abundant or eaten every day, the form they had it was dry, this is how it was prepared https://en.wikipedia.org/wiki/Dakos , with plenty of olive oil on it and considered a whole meal, hence not part of every day of the week.

    Also they had sweets but they were considered part of special occasions, e.g. visits of guests to a house, rare holidays, etc.

    (reply)
  138. Chris  February 2, 2014

    Hi Peter, I recently found your site and am working through all the fantastic material you have here. Thankyou for the work you put into it. It is so incredibly helpful and refreshing to have a source of accurate, detailed material to get into rather than just “carbs are bad”, ie the very received, potted wisdom you steer away from.

    I watched your talk and it was very moving and clearly for you too. Your judgement back then was based on what you knew then. I think we’d all like to go back, grab our younger selves, and talk some sense into them. I’m sure that lady would forgive you.

    (reply)
    • Peter Attia  February 2, 2014

      Thank you, Chris. I guess this is only one example of the stupid things I did in life. It’s a long list, though. I really appreciate your words.

    • Chris  February 2, 2014

      I had a friend online who died from terminal cancer years ago. I had no idea he had cancer. During a chat I mentioned I wished I’d become a paramedic instead of getting into IT. He replied that if you could go back and do things differently you’d replace one set of regrets with another. A couple of weeks later I learned he’d died. Clearly he’d been thinking about his decisions in life and reached that quite profound and somehow reassuring conclusion.

      Since then I no longer feel regret over decisions that turn out less than ideal or things that were said, at least not how I used to. Previously I would dwell on them for a long time. Now I treat them as a catalyst for improvement. I ask myself what if I could take something, anything from that poor judgement and find an advantage in it. I discovered there is always something to be had on reflection. It’s too late for me to become a paramedic, but on reflection I can be a volunteer first responder which in many ways is more rewarding still. I will be starting that in a few months.

      You’re a good person, driven to help people with your previous work and the likes of this site. You’ve already helped me and you don’t even know me. I was having seizures and after much personal experimentation believe these to be related to extended high-intensity interval training at the gym, ie some kind of metabolic response to the HIIT lowering the seizure threshold. However I was unable to find any detailed material on the specific metabolic processes which could be involved. Your site is a mine of information at the detailed cellular level which is really helpful as I try to nail down what is going on.

      I hope you have forgiven yourself for that night you regret so much. If not, my friend would probably want to whisper in your ear that now it is time to.

    • Peter Attia  February 3, 2014

      Chris, very profound advice from your friend. Thank you for sharing it.

  139. b  February 3, 2014

    Peter,

    I stubbled upon a presentation of yours three weeks ago. It immediately resonated with me since i have experienced Ketosis many times during fasts. I love the mental clarity and often wish to keep fasting due to the sharpened focus. So this was exciting to me and I decided to give it a try. I have been suffering from gallbladder issues for the past three years. I will cleanse the gallbladder 3-4 times a year to pass the stones. Almost immediately after I switched to the Keto diet the pain and symptoms I felt from my gallbladder disappeared. I am curious to know why? Thx a million, i respect the work you are doing!

    (reply)
    • Peter Attia  February 3, 2014

      Hard to know for sure, though it may be the frequent contraction of your GB due to more CCK stimulation (CCK is the hormone that stimulates GB contraction in response to dietary fat; it is secreted as an exocrine hormone of the duodenum).

  140. Lou Berkowitz  March 15, 2014

    Peter,

    I appreciated your talk, and perhaps more importantly your decision to devote your career to helping others while being devoid of judgement, and at the same time bringing as much empathy and compassion as possible. Your path to enlightenment will benefit immensely by incorporating such strategies.

    I came to a similar decision a couple of years ago, and in a much different manner. I was eating my lunch in a small restaurant in a lower socio-economic neighborhood, sitting near a handicapped entrance, facing away from the door. There were a number of people sitting at other tables near the door. As we were each eating our meals, the door opened and a person in a wheel chair was attempting to gain access – I noticed every person sitting at different tables got up to help this individual through the door. As I sat back down a thought occured to me, “We, as people, are so willing to help and tolerate those with handicaps, why are we unwilling to do the same for everyone else?”. It was at this point that I realized that we all are “handicapped”, it’s just that we don’t know what each other’s handicap is. I now approach life understanding that we should all strive to treat others, as much as possible, in a non-judgemental and compassionate manner, similar to how we approach someone less fortunate than ourselves.

    Again, congratulations on your life’s choice and the awakening of your non-judgemental, compassionate self.

    Lou

    “Even a poor man can give the gift of a smile”

    (reply)

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