Metabolic Mind

How did humans go from being deeply connected to our food to barely knowing where it comes from or how it was made? In this episode of Metabolic Mind, Dr. Bret Scher speaks with experimental archaeologist and chef Dr. Bill Schindler about what human evolution can teach us about food, nutrition, and the way we eat today. Drawing on archaeology and his time with hunter-gatherer communities around the world, Dr. Schindler traces how human diets changed through hunting, food processing, agriculture, and eventually the modern food system. A major turning point came with agriculture. Dr. Schindler describes how dietary diversity declined as societies became more dependent on a smaller number of staple crops, while people also became increasingly removed from the source and preparation of their food. They cover: How hunting and food processing shaped human evolution What changed when humans transitioned to agriculture What Dr. Schindler has learned from spending time with modern hunter-gatherer communities Why…

A new study claims ketogenic diets cause liver damage and early death. Here’s what you need to know. A 2025 mouse study recently made headlines, warning that ketogenic diets may lead to fatty liver, high triglycerides, and a shortened lifespan. But here’s the catch: These findings were in genetically altered mice fed a 90% fat diet, filled with highly synthetic components, and they contradict what human trials have shown again and again. In real people, ketogenic diets have consistently been linked to: ✅ Lower liver fat and improved liver enzymes ✅ Reduced triglycerides ✅ Improved insulin sensitivity and A1c ✅ Medication reduction or even remission in type 2 diabetes So why the disconnect? In this video, Dr. Bret Scher breaks it down: What the mouse study really showed (and what it didn’t) Key biological differences between mice and humans Why human evidence still supports a well-formulated ketogenic diet’s safety and benefits What to look for when evaluating nutrition headlines Animal data can provide hints…

Can ketosis change symptoms of bulimia? Is low-carb eating safe in your 80s? And what really happens to digestion on a carnivore diet? In this episode of Metabolic Mailbag, Dr. Bret Scher answers questions about ketogenic therapy for eating disorders, low-carb diets in older adults, carnivore diets and gut health, constipation on a ketogenic diet, and even a few easy keto movie-night snacks. He also looks at why being in ketosis may affect symptoms differently than simply eating low carb, what to consider when fasting later in life, and how to think about bowel habits and microbiome changes when fiber intake is very low. He covers: Whether intermittent fasting and low-carb eating are appropriate at age 81 Why adequate protein remains important with fasting What current research suggests about ketogenic therapy and eating disorders Fiber, bowel habits, and constipation on carnivore and ketogenic diets What emerging research suggests about microbiome diversity on carnivore Magnesium options for constipation…

Alzheimer’s disease is usually discussed in terms of plaques, tangles, and genetics. Dr. Stephen Cunnane has spent years studying another piece of the puzzle: what happens when the aging brain can no longer use glucose efficiently, and whether ketones can help fill that energy gap. In this interview, Dr. Bret Scher and Dr. Cunnane discuss the metabolic side of cognitive decline, including insulin resistance, brain glucose metabolism, and why metabolic health may play an important role in both prevention and treatment. They cover: Why brain glucose utilization declines with age and Alzheimer’s disease How ketones may provide an alternative fuel for the brain What clinical trials of ketogenic diets, MCTs, and exogenous ketones have found so far Why some studies show improvements in quality of life or daily function even when cognitive measures change less What APOE4 may mean for treatment and prevention Why type 2 diabetes is such an important modifiable risk factor for dementia The roles of exercise,…

College can be one of the most exciting times of your life, but it can also put enormous pressure on a brain that's still developing. Psychiatrist Dr. Georgia Ede spent 12 years working as an on-campus psychiatrist at Harvard University and Smith College. In this video, she explains why college can be such a vulnerable time for mental health and how sleep, nutrition, alcohol, smoking, vaping, and other everyday habits may affect brain metabolism and resilience. Dr. Ede explores the role of oxidative stress, why blood sugar and insulin matter for the brain, and how metabolic health can influence mood, concentration, memory, and the ability to cope with stress. She shares practical strategies students can use on campus, including: Choosing whole foods and reducing refined carbohydrates Making better dining hall and snack choices Prioritizing sleep and regular exercise Limiting alcohol, smoking, and vaping Using a continuous glucose monitor to better understand individual responses to carbohydrates When a very…

Does reducing carbohydrates improve metabolic health beyond what can be explained by weight loss alone? Dr. Bret Scher breaks down a new randomized controlled trial published in Cell Metabolism that compared three diets in people with prediabetes and fatty liver disease: a ketogenic diet, a higher-carbohydrate Mediterranean diet, and a very low-fat, plant-forward diet. One challenge with ketogenic diet research is that participants often lose more weight than those in comparison groups, making it difficult to separate the effects of carbohydrate reduction from those of weight loss itself. In this trial, researchers provided all of the meals, and participants achieved greater than 95% dietary compliance. Importantly, all three groups ultimately lost the same 10% of their body weight. That gave researchers an unusual opportunity to compare metabolic outcomes across the three diets without differences in weight loss muddying the picture. And even with weight loss held constant, the outcomes differed. The…

For many women, the wellness strategies that carried them through their 20s and 30s can start to backfire in perimenopause. Changes in hormones, muscle mass, insulin sensitivity, sleep, and stress can make midlife feel like a completely different metabolic landscape. In this episode of Metabolic Mind, Dr. Bret Scher speaks with nurse practitioner Cynthia Thurlow about why perimenopause can act like a metabolic stress test. They explore how midlife can change the way women respond to carbohydrates, fasting, exercise, meal timing, and other strategies they may have relied on for years. As Women’s Health Month brings more attention to the health challenges women face across different stages of life, this conversation focuses on one that is still too often misunderstood: the metabolic transition through perimenopause and menopause. They cover: How perimenopause can affect insulin sensitivity and body composition Why preserving muscle becomes increasingly important in midlife The roles of sleep, stress, protein,…

Hannah Warren spent years living with severe bipolar I disorder before discovering metabolic therapies in 2021. Today, Hannah has been in remission for more than five years, is no longer taking psychiatric medication, and works as Metabolic Mind’s Community Engagement & Advocacy Manager, helping others understand the emerging field of metabolic psychiatry. In this course module, created as part of Nutrition Network’s broader low-carb course for vegetarians, Hannah combines her lived experience with practical guidance for using vegetarian and vegan ketogenic approaches to support metabolic and mental health. She explains how ketogenic therapy differs from general healthy eating, how nutritional ketosis changes the fuels available to the brain, and why that shift is being studied in metabolic psychiatry She also takes a detailed look at the practical side of vegetarian and vegan ketogenic therapy, including: How to structure a meat-free ketogenic diet while maintaining ketosis Why ketone testing is especially…

How can clinicians become more comfortable using ketogenic therapy in mental health care? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Deanna Kelly about Live It, Launch It!, a training program designed to help clinicians learn ketogenic therapy by experiencing it themselves. Dr. Kelly explains why evidence-based treatments can still take years to reach everyday clinical practice, especially when providers don't feel confident using them. To address that gap, her team recruited clinicians for a program that combined ketogenic therapy education with four weeks of personally following a ketogenic diet and published it as a study: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2026.1913325/full Clinicians started with very low confidence in their ability to use ketogenic therapy. With education alone, those scores improved substantially, and actually living the diet pushed confidence even higher. Participants also reported improvements in mental and physical health,…

How should we think about LDL and ApoB, and how much metabolic health changes the cardiovascular risk picture? In this episode of Metabolic Mind, Dr. Bret Scher speaks with vascular surgeon Dr. Lily Johnston about cholesterol and plaque formation, along with the need to personalize cardiovascular prevention. 👉 Download our Make Sense of Your Cholesterol guide: https://metmind.co/cholesterol-listeners Dr. Johnston brings a unique perspective as both a vascular surgeon who treats advanced blood vessel disease and a physician focused on cardiometabolic prevention. She discusses why ApoB and LDL can play a role in atherosclerosis, while also emphasizing that vascular disease is shaped by many factors, including insulin resistance, diabetes, blood pressure, inflammation, smoking history, fitness, sleep, stress, social connection, and personal goals. They cover: What vascular surgeons treat and why atherosclerosis affects blood vessels throughout the body Why prevention starts long before surgery becomes necessary…

Is saturated fat really the villain it’s been made out to be? Or has decades of poor research and dietary policy misled us? In this video, Dr. Bret Scher dives into the controversy surrounding RFK Jr.'s call to remove the cap on saturated fat, and the Wall Street Journal’s misleading take on it. We explore: ✅ Why saturated fat doesn’t just mean pizza and ice cream ✅ The science behind whole foods vs. processed foods ✅ How carbs, fats, and metabolic health interact ✅ What the evidence really says about saturated fat and heart disease ✅ Why individualized, whole-food diets matter Removing the cap on saturated fat isn’t about giving fat a health halo, it's about making room for nutrient-dense, metabolically supportive diets. 👉Subscribe to Metabolic Mind for more real conversations about metabolic health, metabolic psychiatry, and mental health: https://www.youtube.com/@metabolicmind. #MetabolicMind #KetogenicTherapy #FoodAsMedicine #SaturatedFat Expert Featured: Dr. Bret Scher Baszucki Group Medical Director…

Should LDL be treated? In this episode of Metabolic Mind, Dr. Bret Scher explains why the better question is who may benefit from LDL lowering, how aggressively it should be treated, and what outcomes matter most to the individual patient. 👉 Get our free 11-page Cholesterol Guide to better understand your lipid panel and prepare for a conversation with your clinician: https://metmind.co/cholesterol-listeners Dr. Scher reviews two major trials that studied aggressive LDL lowering in very different populations. VESALIUS-CV looked at high-risk patients with serious vascular disease and found that adding a PCSK9 inhibitor reduced both cardiovascular events and all-cause mortality. STAREE studied older adults without known cardiovascular disease and found fewer cardiac events with statin therapy, while overall survival and hospitalizations did not change. Disability-free survival also showed no difference He covers: Why LDL treatment depends on the person, not just the number What VESALIUS-CV found in high-risk…

Is it possible to follow a diet that’s both vegan and keto? And can a diet like that be used as part of a care plan for bipolar disorder? In this episode of Metabolic Mind, Dr. Bret Scher speaks with author and advocate Dyane Harwood about how she uses a vegan ketogenic diet as part of her treatment for postpartum bipolar disorder. Dyane shares how she first discovered vegan keto, why she started tracking ketones and net carbs, and what she eats in a typical day, from her vegan keto smoothie to tofu, avocado, nut butter, and carefully chosen supplements. She also discusses the practical challenges of vegan keto, including protein intake, B12, omega-3s, magnesium, vitamin D3, eating out, social pressure, and finding a clinical team that understands metabolic psychiatry. They cover: How Dyane discovered vegan keto for bipolar disorder Why ketosis became more important to her than dietary labels What a typical vegan keto day looks like How changing her protein intake affected her ketone levels Why tracking net…

Can therapeutic ketosis be considered for type 1 diabetes and bipolar disorder? In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard answer viewer questions about ketogenic therapy, type 1 diabetes, Parkinson’s medications, omega-3s, fasting, protein intake, metabolic rate, and why some protein foods are more filling than others. They cover: The association between type 1 diabetes and serious mental illness Why ketogenic therapy may be possible for some people living with type 1 diabetes, but only with careful medical supervision How Parkinson’s medications can interact with protein timing Whether cooking salmon changes the benefits of omega-3 fats How intermittent fasting can affect protein intake and ketone levels Why MCT oil in coffee may change the meaning of a “fast” What basal metabolic rate means and how ketogenic diets may affect it Why a protein shake may feel less satisfying than meat, even with the same grams of protein From medication timing to protein needs, this episode…

A red flag next to your LDL number can feel alarming, but LDL is only one part of a much larger cardiovascular risk picture. In this episode of Metabolic Mind, cardiologist and lipidologist Dr. Bret Scher explains how to read a cholesterol panel with more context and less fear. Dr. Scher walks through LDL, triglycerides, HDL, non-HDL cholesterol, ApoB, Lp(a), and the triglyceride-to-HDL ratio. He also explains how the 2026 cholesterol guidelines use the PREVENT risk calculator, where LDL targets currently stand, and why individual risk factors, metabolic health, family history, and direct measures of vascular disease can change the conversation. He covers: Why LDL should not be read in isolation What triglycerides and HDL can reveal about metabolic health Why Dr. Scher pays attention to the triglyceride-to-HDL ratio When LDL above 190 may raise concern for familial hypercholesterolemia Why Lp(a) should be measured at least once in adulthood How ApoB differs from LDL cholesterol What the PREVENT risk…

Can carnivore and vegan diets both be used as ketogenic therapies? In this episode of Metabolic Mind, Dr. Bret Scher speaks with registered dietitian Denise Potter about two widely debated approaches to nutrition. They explore how each can be evaluated when someone is considering a ketogenic diet to support psychiatric, neurological, or metabolic health. Denise brings more than 30 years of clinical experience, including approximately 20 years working with medical ketogenic therapies. She explains the importance of risk-benefit analysis, how clinicians can assess potential nutrient gaps, and how lab testing, supplementation when indicated, and individualized support may help identify and manage potential risks. They cover: The difference between a carnivore diet and a carnivore ketogenic diet Why some people report mental and physical health improvements with carnivore ketogenic approaches Common questions about vitamin C, iodine, electrolytes, fiber, calcium, omega-3s, and LDL Why bowel habits and the…

Animal-sourced foods are often framed as a problem for human health and environmental sustainability. In this episode of Metabolic Mind, Dr. Bret Scher speaks with forage agronomist and ruminant nutritionist Peter Ballerstedt, PhD (@GrassBased) about livestock, malnutrition, chronic disease, and why restoring metabolic health may require a broader conversation about nutrition and sustainability. Peter shares his reaction to The Cholesterol Code documentary and explains why its message extends beyond cholesterol. He discusses how animal-sourced foods can fit into dietary patterns that may help restore metabolic health, why malnutrition can exist even when calories are abundant, and why the health impact of food deserves a place in the sustainability conversation. They cover: Why diet and metabolic health matter for rural communities How animal-sourced foods may support health restoration Why LDL can be one part of a broader health conversation How obesity, type 2 diabetes, and metabolic dysfunction can…

The terms “low-carb” and “ketogenic” are often used interchangeably, but are they the same thing? Not quite. A low-carb diet can be a powerful tool for improving blood sugar, triglycerides, insulin levels, inflammation, and overall metabolic health. Ketogenic diets, on the other hand, involve a deeper level of carbohydrate reduction that shifts the body into nutritional ketosis, where ketones become a significant source of fuel for the brain and body. That metabolic shift can be especially relevant when ketosis itself is part of the therapeutic goal. In this video, Dr. Bret Scher walks through: How low-carb and ketogenic diets are typically defined The amount of carbohydrate that may support nutritional ketosis What changes in the body once ketone production increases How each approach may be used for different metabolic goals Why ketosis is being studied for serious mental illness and other brain-based conditions How clearer terminology can help people set more realistic expectations The right level of…

Starting college can change almost everything about your routine, including how, when, and what you eat. For students using ketogenic therapy as part of their mental health treatment, that transition can take some planning. In this interview, Dr. Bret Scher speaks with licensed mental health counselor Nicole Laurent about how students using ketogenic therapy with clinical support can navigate a college setting, where dining halls, dorm rooms, busy schedules, social events, and limited budgets can all affect food choices. Nicole shares practical ideas for: Keeping simple foods that support nutritional ketosis in a dorm room Making dining hall options work Planning ahead for busy weeks Using meal prep or delivery services strategically Talking with roommates and friends about dietary choices Asking for support when staying consistent gets difficult They also talk about the importance of paying attention to food quality. For students who are not using ketogenic therapy, reducing ultra-processed foods and eating…

Every day, we make choices about what to eat. But how often do we realize how deeply these choices affect both our physical and mental health? Today, an estimated 93% of adults in America are showing signs of poor metabolic health, which is a major contributor to many chronic conditions like heart disease, type 2 diabetes, obesity, and many psychiatric disorders. The good news is that more people are recognizing the powerful role food plays in metabolic health. But with all the conversations about what to do next, like limiting ultra-processed foods or reconsidering saturated fat guidelines, are we overlooking one of the most impactful steps we can take? In this video, cardiologist Dr. Bret Scher explores why focusing on reducing or eliminating ultra‑processed carbohydrates may be one of the most powerful ways to address the chronic disease epidemic. Dr. Scher breaks down: What refined carbohydrates are and how they can wreck metabolic health How constant glucose spikes and crashes can fuel hunger, fatigue,…

Do most people really need to eat less protein to live longer? In this episode of Metabolic Mind, Dr. Bret Scher responds to a new review getting attention for the claim that protein restriction may extend lifespan, and explains why that message can be misleading for older adults, active people, and anyone focused on metabolic health. Dr. Scher walks through the biology behind the headlines, including mTOR, FGF21, animal research, and the limits of applying rodent data directly to humans. He also explains why adequate protein becomes more important with age, especially for preserving muscle, reducing frailty risk, supporting insulin sensitivity, and maintaining independence. He covers: Why “eat less protein” headlines can miss important context What mTOR and FGF21 have to do with protein restriction and longevity Why rodent studies do not always translate cleanly to human health How sarcopenia and anabolic resistance change protein needs with age Why the protein RDA is a minimum, not a personalized target…

Can ketogenic therapy be safe for someone with heart disease, atherosclerosis, or a stent? Can you follow a ketogenic diet without losing weight? In this Metabolic Mailbag episode, Dr. Bret Scher answers viewer questions about ketogenic therapy, cardiovascular risk, anorexia recovery, pregnancy and nursing, schizophrenia remission, keto on a budget, and whether doctors learn about ketogenic therapy in medical school. He covers: Ketogenic therapy and cardiovascular disease after a stent or atherosclerosis How to follow a ketogenic diet without unwanted weight loss What early research suggests about ketogenic therapy for weight-restored anorexia Ketogenic therapy during pregnancy or nursing, and why clinical supervision is essential Lab markers that may change during sustained nutritional ketosis Why schizophrenia symptom remission is different from a cure How genetics and metabolism may both contribute to serious mental illness Budget-friendly ways to approach a well-formulated ketogenic diet Why keto is…

How can clinicians use real-world patient data to personalize metabolic health care? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Jeff Pua, an internal medicine and obesity medicine physician, about obesity medicine, metabolic syndrome, nutritional ketosis, and what clinicians can learn from patient outcomes in everyday practice. Dr. Pua shares how his approach has evolved from relying only on broad research categories to also paying close attention to individual patient experiments, blood tests, and lived experience. In his practice, he sees patients improve not only in weight and metabolic markers, but also in mood, mindset, mental sharpness, and confidence as they begin to see measurable changes in their own health. They cover: How obesity medicine is evolving beyond the number on the scale Why metabolic syndrome is a major focus in Dr. Pua’s practice How N-of-1 patient data can help clinicians personalize care What blood tests can reveal about real-world metabolic improvement Why…

Can chronic stress undermine metabolic health, even when nutrition, sleep, and exercise are in place? In this episode of Metabolic Mind, Dr. Bret Scher explains why stress recovery is an important part of metabolic health and how chronic cortisol and adrenaline activation may affect insulin resistance, blood pressure, inflammation, sleep, and long-term cardiometabolic health. Dr. Scher breaks down the difference between short-term stress that helps us respond to challenges and chronic stress that keeps the body’s alarm system switched on. He also shares why stress recovery doesn’t have to mean an hour of meditation or a weekend nature retreat. Even brief, consistent practices like 10 minutes outside, a short walk, sunlight exposure, calming music, or nature sounds may help the nervous system reset. In the episode, Dr. Scher covers: How chronic stress can affect blood sugar, insulin resistance, and blood pressure Why cortisol and adrenaline are helpful short term but harmful when constantly elevated How…

Could GLP-1 medications play a role in treating bulimia or binge eating disorder? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Paige Gordon and psychiatrist Dr. Michael Lutter about Paige’s personal experience using a GLP-1 medication for treatment-resistant bulimia, and why researchers are beginning to explore the neurobiology of binge eating. Paige shares how years of therapy and medication never quieted the overwhelming binge urges that drove her bulimia. After hearing someone describe their experience on a podcast, she began exploring GLP-1 medication and saw a profound change in her urges and eating patterns. Dr. Lutter adds the scientific context, including genetic findings that may help explain why some people with binge eating or bulimia respond strongly to GLP-1 medications. They cover: How Paige’s bulimia began and why standard treatments didn’t fully help What “food noise” felt like in her lived experience Why GLP-1 medications may affect appetite, reward pathways, and binge urges…

Can ketogenic therapy improve symptoms, cognition, and metabolic health in people living with serious mental illness? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Judy Ford, Juliette Kyner (previously Juliette Ward), and Dr. Shebani Sethi about the first-ever randomized controlled trial of a ketogenic diet intervention in individuals living with schizophrenia spectrum disorder or bipolar I disorder with psychotic features. The conversation explores what made this trial possible, from prepared meals and coaching to the structured support that helped participants stay engaged. It also highlights encouraging four-month findings across metabolic health, cognition, depressive symptoms, and both positive and negative psychiatric symptoms. They discuss: Why this trial is an important step for metabolic psychiatry How participants adhered to a ketogenic diet with structured support What changed in metabolic health markers like BMI, A1C, and HOMA-IR Why cognitive improvements were especially…

Do GLP-1 medications improve metabolic health as much as they support weight loss? A new observational study in the Annals of Internal Medicine raises an important question about semaglutide, insulin discontinuation, type 2 diabetes, and what meaningful metabolic improvement may require. In this episode of Metabolic Mind, Dr. Bret Scher breaks down a real-world study of more than 9,000 veterans with type 2 diabetes who were using insulin and then added either a GLP-1 receptor agonist, SGLT2 inhibitor, or DPP4 inhibitor. Despite semaglutide’s stronger association with weight loss, the study found similar insulin discontinuation rates across all three groups over three years. Dr. Scher covers: Why weight loss and metabolic health improvements may not always move together What insulin discontinuation can reveal about insulin resistance and beta cell function Why semaglutide did not outperform older diabetes medications in this study The limitations of observational research and real-world medication data How…

The questions around ketogenic therapy keep getting more layered, and your latest submissions reflect that. In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard tackle some of the most common questions about insulin resistance, ketosis, bone health, and a fun rapid-fire round on popular ketogenic products and practices. In this discussion, you'll learn: The difference between pathologic and physiologic insulin resistance and why insulin levels matter most Why someone in deep ketosis may fail a glucose tolerance test and how to interpret it How metabolic health affects how strict your ketogenic approach needs to be Why some people can stay in ketosis at 75 grams of carbs while others need under 25 Why claims about ketogenic diets causing bone loss don't hold up under scrutiny The role of protein intake, resistance training, and walking in supporting bone density A rapid-fire round covering MCT oil, electrolytes, caffeine, diet sodas, keto bread, creatine, exogenous ketones, intermittent…

What does it look like to put bipolar II disorder into remission and become a voice of hope for others living with serious mental illness? Robyn Dobbins joins Hannah Warren from Metabolic Mind to reflect on how ketogenic therapy transformed her life, and what it was like to see her own story featured in The Cholesterol Code documentary. In this conversation, you'll learn: What it was like for Robyn to see her personal story on the big screen Why she has always been open about her mental health journey, even at the time of her bipolar II diagnosis How her psychiatric symptoms showed up before ketogenic therapy, including persistent anger, exhaustion, and the urge to escape her own life What changed once she began ketogenic therapy and how her day-to-day experience shifted Why she continues to advocate for awareness around metabolic therapies for mental illness How The Cholesterol Code documentary could expand awareness of ketogenic therapy beyond current circles What inspires Robyn to keep sharing her story…

How do you know if you're actually in ketosis? Should you test ketones? And if so, what's the best method: blood, breath, or urine? Dr. Bret Scher breaks down everything you need to know about ketone testing, including when testing matters, which tools are most accurate, and how to interpret your results based on your goals. Whether you're using a ketogenic diet for metabolic health, weight loss, or therapeutic ketosis for mental health and neurological conditions, understanding ketone testing can help you personalize your approach. In this video, you'll learn: Why ketone testing can be a valuable tool When ketone levels matter, and when they may not The differences between urine strips, breath meters, and blood ketone monitors Pros and cons of each testing method How often to test and the best times of day to measure ketones Why ketone levels naturally fluctuate throughout the day The emerging role of continuous ketone monitors (CKMs) How to use ketone data without becoming overwhelmed or obsessive…

Could metabolic therapies become part of the future of cancer care? That question sits at the center of Dr. Bret Scher’s conversation with neurologist and researcher Dr. Matthew Phillips, whose recent study explored a metabolic approach in people with glioblastoma, one of the most aggressive forms of brain cancer. Rather than relying on a single intervention, the study combined a ketogenic diet, intermittent fasting, and repeated five-day fasts alongside standard chemotherapy and radiation. Together, these strategies were designed to lower the Glucose Ketone Index, or GKI, by reducing glucose and increasing ketones. In this conversation, they explore: Why cancer cell metabolism is becoming an important area of research How glucose, ketones, and mitochondrial function may influence cancer growth Why the GKI was a central target in the study How fasting and ketogenic therapy were integrated with standard cancer treatment The difference between intentional weight loss and cancer cachexia Why quality of life…

Can a ketogenic diet help improve mood and reduce depressive symptoms? A new meta-analysis published in JAMA Psychiatry examined 50 different keto studies, totaling over 40,000 participants, that included depression and anxiety outcomes. The results of the review demonstrated a modest improvement in depression symptoms across different populations and diagnoses in both controlled and real-world scenarios, and greater symptom improvement was observed in trials that included ketone monitoring. Improvements in anxiety were also observed in most studies, but with less consistency than depressive symptoms. While many of these studies weren't originally designed to treat depression or anxiety, the consistent improvements associated with verified ketosis as well as the larger effect seen in “very low carbohydrate” diets compared to just “low carbohydrate” diets, tell us that ketogenic therapy for depression warrants further investigation. And when we combine the findings with the results of another recent…

Do GLP-1 medications like Ozempic reduce physical activity? Preliminary research suggests they might, raising important questions about how exercise should be supported alongside treatment. GLP-1 medications are helping many people achieve meaningful weight loss and metabolic improvements. At the same time, findings presented at the Endocrine Society’s annual meeting showed declines in daily steps and moderate-to-vigorous activity after treatment began. In this video, Dr. Bret Scher examines those results, explores why activity levels may fall, and explains how similar concerns can arise with medications such as statins and antipsychotics. He covers: What the study found about physical activity Why side effects and rapid weight loss may reduce movement How muscle loss can affect long-term metabolic health Why resistance training and protein intake matter How clinicians can provide more structured exercise support These findings highlight the importance of pairing GLP-1 medications with proactive support for…

Could a ketogenic diet and low-dose GLP-1 medications work better together? A new case series suggests they might, while highlighting a more personalized approach to metabolic health. GLP-1 medications have transformed obesity treatment, but they aren't the only tool available. In this interview, Dr. Bret Scher speaks with physician assistant Bill Jensen about a newly published case series exploring the combination of a ketogenic diet and low-dose semaglutide. Together, they discuss how this approach may help preserve lean mass, improve insulin resistance, reduce side effects, and empower patients to take an active role in their health. In this video: Why low-dose GLP-1s may complement a ketogenic diet The importance of preserving muscle during weight loss Which patients may benefit most from this approach Why this case series is hypothesis-generating, not definitive How lifestyle and medication can work together to improve metabolic health This conversation examines how a more personalized approach to care…

What does it take to truly understand and assess cardiovascular risk in modern medicine? Dr. Bret Scher joins Dr. Ford Brewer at the Collaborative Science (CoSci) conference to discuss the recent screening of The Cholesterol Code documentary and the bigger picture of metabolic health, cardiac imaging, and the future of risk assessment. In this conversation, you'll learn: Dr. Ford Brewer's reaction to The Cholesterol Code documentary and what stood out most Why metabolism, not just plumbing, drives cardiovascular disease How CT angiogram with AI analysis is becoming the gold standard in cardiac imaging What CIMT (Carotid Intima-Media Thickness) measures and where it fits in evaluating risk Why calcium scores can miss important soft plaque What to look for when seeking a high-quality CIMT scan Dr. Brewer's personal story of being diagnosed with manic depression in medical school and how lifestyle and metabolic changes shaped his journey Why GLP-1 medications, when used responsibly, can be a useful tool rather…

Type 2 diabetes is a chronic disease that can often be put into remission. So why do so many people still struggle to get better? In this discussion, Dr. Bret Scher explores how the environments we create, from our food system to our healthcare system, shape metabolic health in ways that are often overlooked. Using a thought experiment as a starting point, he examines why remission is possible for many people with type 2 diabetes, why that shouldn't be confused with 100% personal responsibility, and what needs to change if we want to improve outcomes at scale. He covers: Why type 2 diabetes remission is possible for many people How ketogenic nutrition and other metabolic therapies can improve insulin resistance Why type 1 and type 2 diabetes require fundamentally different approaches How modern food environments contribute to metabolic dysfunction The limitations of decades of conventional nutrition advice Why clinician education and public policy matter for metabolic health How shifting the conversation…

Dr. Bret Scher began his career practicing conventional cardiology, following the same guidelines taught in medical training. Today, he is Medical Director at Metabolic Mind, as well as The Coalition for Metabolic Health, and one of the leading voices advancing metabolic health, ketogenic therapy, and metabolic psychiatry. What changed? In this special episode, Metabolic Mind producer Erica Gerard turns the tables and interviews Dr. Scher about the experiences, patients, and pivotal moments that challenged his thinking and reshaped his approach to medicine. In this conversation, you'll learn: How a conventionally trained cardiologist became known as the "low-carb cardiologist" The patients who changed the way he thought about nutrition and metabolic health Why he believes medicine should treat individuals, not just follow guidelines What drew him from cardiovascular medicine into the emerging field of metabolic psychiatry How interviewing researchers, clinicians, and patients has influenced his perspective…

What questions matter most to people living with serious mental illness when it comes to metabolic interventions? Dr. Dina Farran and Dr. Toby Pillinger from King's College London set out to answer exactly that through a Priority Setting Partnership, an extensive collaborative process bringing together people with lived experience, family members, caregivers, clinicians, and researchers to identify the top research priorities in metabolic psychiatry. Their findings reveal a powerful shift in how patients and clinicians think about mental illness, and what the future of treatment may look like. In this conversation, you'll learn: What a Priority Setting Partnership is and why it matters for psychiatric research How over 450 participants and 1,400 submissions were narrowed down to a top 10 list Why 8 of the top 10 priorities focused on mental health outcomes, not just physical health Why ketogenic diets ranked as the number one research priority How GLP-1 medications, exercise, gut health, and nutrient…

A recent study made headlines for claiming a ketogenic diet may worsen fatty liver disease and raise triglycerides. But when you take a closer look at the research, it’s clear that the conclusions are far less supported than the coverage suggests. To clear things up, Dr. Bret Scher breaks down what the study actually found, where the methodology falls short, and what the broader body of research has to say about ketogenic therapy and liver health. In this discussion, you'll learn: What the study examined and how the data was collected Why the lack of ketone measurement makes it impossible to confirm anyone was actually in ketosis How reverse causality may explain the findings entirely What baseline differences in BMI and adiposity reveal about the study population Why cross-sectional observational studies sit lower on the evidence hierarchy than RCTs What a meta-analysis of 62 randomized controlled trials shows about ketogenic diets and triglycerides What a 12-week supervised intervention revealed about…

Is a plant-based diet the best for supporting metabolic health? Cardiologist Dr. Jaimela Dulaney spent years practicing plant-based nutrition before her own experience with insulin resistance, blood sugar swings, and endurance running led her to rethink what personalized nutrition can look like. In this episode, Dr. Bret Scher speaks with Dr. Dulaney about what changed her perspective, both personally and professionally. They cover: How CGMs helped reveal unexpected blood sugar patterns Why insulin resistance can show up even in active, normal-weight individuals How Dr. Dulaney thinks about LDL cholesterol in the context of metabolic health Why low-carb and ketogenic diets may help some people improve energy, recovery, and blood sugar stability Why there may not be one “best diet” for every patient This conversation highlights the importance of listening to patients, tracking meaningful lab trends, and staying open to new evidence when personal experience and clinical outcomes begin to tell a different…

Metabolic health may be the foundation of a healthy brain, and a growing community of researchers, clinicians, and educators is working to bring that message into mainstream medicine. In this interview, Dr. Bret Scher talks with Dr. Dom D'Agostino at the Citizen Science Initiative (CoSci) conference to discuss everything from the recent screening of The Cholesterol Code documentary to the rise of N-of-1 research, the future of metabolic psychiatry, and the urgent need for nutrition education in medical schools. In this conversation, you'll learn: Dr. D'Agostino’s reaction to The Cholesterol Code documentary and what stood out most How N-of-1 citizen science is reshaping the way we think about metabolic health Why metabolic health may be a stronger predictor of cardiovascular outcomes than LDL alone How nutrition education made its way into the USF College of Medicine curriculum What the latest research is revealing about ketogenic metabolic therapy and cancer, brain health, and immune function Why metabolic…

New results from first-of-its-kind randomized controlled trial on a ketogenic diet for schizophrenia and bipolar disorder with psychosis offer important insights into metabolic psychiatry and mental health treatment. In this interview, Dr. Bret Scher sits down with Dr. Julie Milder to walk through the study results, recently published in Schizophrenia Bulletin. As the first RCT in psychosis-spectrum conditions to publish in the peer-reviewed literature, it’s an important step toward understanding how metabolic interventions may play a role in serious mental illness. Key insights from the study: In the 1-month randomized portion of the trial, the ketogenic group showed significant improvements in metabolic health markers compared to diet-as-usual Psychiatric symptoms trended toward improvement, but were not statistically significant at 1 month Participants who opted into the ketogenic extension part of the study (4 total months of keto), saw improvements in depression, cognition, and positive and negative…

New evidence from the first-ever RCT shows ketogenic therapy can rapidly improve metabolic health in schizophrenia-spectrum and bipolar I disorders, and shows early signals of psychiatric improvement. In this video, Dr. Bret Scher breaks down this newly published study led by Dr. Judith Ford at UCSF: the first randomized controlled trial with peer-reviewed results investigating ketogenic therapy in people with schizophrenia-spectrum disorders and bipolar-1 disorder with psychotic features. You’ll learn: How the study was designed (a 1-month randomized phase plus an optional 3-4 month single-arm extension) What happened in the first 30 days (clear improvements in metabolic markers; psychiatric outcomes showed trends that did not reach statistical significance in the randomized portion) What improved over longer follow-up in the extension phase (encouraging changes in metabolic health, cognition, and psychiatric measures) Why this matters for patients and families today, and what future, longer controlled…

Why are seed oils suddenly everywhere in nutrition debates? What is anhedonia? Is the dawn phenomenon something to worry about? And how can you tell the difference between nutritional ketosis and ketoacidosis? In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard answer some of the most common questions from our community about ketogenic therapy, mental health, metabolism, and nutrition science. Topics discussed include: Why seed oils have become such a controversial topic and what the evidence actually shows Whether seed oils deserve their negative reputation What anhedonia is and why it can be one of the most challenging symptoms in mental health conditions like depression, bipolar disorder, and schizophrenia Emerging research on ketogenic therapy and improvements in anhedonia Why debates between plant-based and ketogenic diets often miss the bigger picture The limitations of observational nutrition research Why there may not be one “best” diet for everyone What the dawn phenomenon is…

A newly published study called NATURE-CT is generating significant attention in the cardiovascular and ketogenic communities, but some of the conclusions being drawn online don't hold up to scientific scrutiny. Dr. Bret Scher walks through what the study actually shows, what it doesn't, and why comparisons being made to ketogenic therapy are scientifically misleading. In this discussion, you'll learn: What the NATURE-CT study examined and what its findings mean for coronary plaque progression Why the average LDL of 111 mg/dL still showed substantial plaque progression What this data may suggest about looking beyond LDL as the sole driver of coronary disease Why comparisons being made between NATURE-CT and KETO-CTA are scientifically flawed Why the original KETO-CTA manuscript was retracted and what that means for current claims How baseline coronary artery calcium scores influence valid scientific comparisons Why findings in lean mass hyper-responders cannot be extrapolated to all forms of ketogenic therapy…

What should you eat on keto? A ketogenic diet shifts your body from burning carbs to burning fat and ketones, and it can be a powerful tool for supporting metabolic health as well as mental health. But knowing what to eat, what to avoid, and how to get started makes all the difference. Here, Dr. Bret Scher walks you through the essentials: The best proteins, fats, and low-carb vegetables for keto Foods that can kick you out of ketosis A full sample day of meals with net carb counts Smart snack options and lifestyle factors that affect ketosis Whether you're new to a ketogenic diet or exploring it as part of a broader ketogenic therapy plan, the right foundation can make a significant difference in outcomes. Want to dive deeper into the specifics of a high-quality ketogenic diet? Check out our blog to learn more: Understanding the Well-Formulated Ketogenic Diet 🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic…

David Baszucki - founder and CEO of Roblox - sits down with his son Matthew for the first time on a podcast together. They walk through Matthew's five-year journey with severe, treatment-resistant bipolar I disorder: the first manic episode in 2016, multiple hospitalisations, the dozens of medications, the 2017 incident in Los Angeles when David flew down on a rescue mission to find Matt homeless on the streets, and the discovery by Matthew’s mother Jan of ketogenic therapy that sent Matt's symptoms into remission. David and Matthew talk about how their family journey led to the establishment of the rapidly growing field of metabolic psychiatry their family now funds, and the daily metabolic practices both father and son use today. 👉 Learn more about Matthew Baszucki and his incredible journey with metabolic psychiatry on his THINK+SMART page: metabolicmind.org/thinksmart/explore-strategies/matt-baszucki/ 🔎 Have questions about how to apply metabolic therapies effectively? Submit them at…

The Cholesterol Code documentary is challenging long-held assumptions about LDL cholesterol, ketogenic diets, and what really matters for cardiovascular risk. In this interview, Dr. Bret Scher sits down with Dr. Eric Westman, internist and low-carb researcher, to discuss the film's impact and what it could mean for the future of clinical practice. From Dave Feldman's citizen science journey to the growing body of evidence on type 2 diabetes reversal, this discussion explores why the conversation around cholesterol is finally starting to shift. You'll learn: What stood out most about The Cholesterol Code documentary Why elevated LDL on a ketogenic diet may not carry the risk many assume How citizen science is reshaping nutrition and metabolic health research Why type 2 diabetes reversal deserves far more clinical attention than it gets How GLP-1 medications and lifestyle interventions can work together responsibly Why the future of medicine depends on diet-focused research, not just drug trials For…

Can ketogenic therapy help atrial fibrillation? What should you make of the KETO-CTA study? And do higher ketones always mean better results? In this Metabolic Mailbag episode, Dr. Bret Scher answers audience questions about cardiovascular health, ketosis, ketone levels, and how to personalize a ketogenic approach based on your goals and metabolic health. From AFib concerns to cholesterol controversies and troubleshooting low ketone readings, this episode tackles some of the most common questions in the keto community. In this episode, we cover: Ketogenic therapy and atrial fibrillation (AFib) The latest update on the KETO-CTA study LDL cholesterol, plaque, and cardiovascular risk Why ketone levels don't tell the whole story Raising ketones without sacrificing energy or muscle Carbohydrate intake and metabolic flexibility Fasting, protein, and thyroid considerations MCT oil, exogenous ketones, and other strategies to increase ketosis One of the biggest takeaways: context matters. Whether you're evaluating…

Are eggs bad for you because they may raise cholesterol? It's one of the most common nutrition questions in cardiology, and one of the most misunderstood. The reality is that raising cholesterol and harming your health aren't always the same thing, and when it comes to eggs, the data tells a much more nuanced and reassuring story than most people have been led to believe. In this conversation, Dr. Bret Scher walks through the science of eggs, cholesterol, and cardiovascular risk, cutting through decades of nutritional confusion to help you understand what it actually means for your individual dietary choices. You'll learn: Why the original "eggs cause heart disease" logic doesn't hold up under scientific scrutiny What happens to LDL and HDL when most people eat whole eggs Who the "egg hyper responders" are and what genetics has to do with it Why hazard ratios in observational egg studies are often clinically unhelpful What the American Heart Association now says about eggs and cardiovascular risk Why eggs…