Joe Rogan Experience #1178 - Dr. Rhonda Patrick

1. 0:00 – 15:00

   Have you been here…

   1. JRJoe Rogan0:02

      Have you been here since he had a kid?

   2. RPDr. Rhonda Patrick0:03

      Yeah.

   3. JRJoe Rogan0:04

      Yeah. That's right.

   4. RPDr. Rhonda Patrick0:04

      I was here last, right, about four months after. I didn't sleep at all. It's amazing. I, like, was able to talk for ...

   5. JRJoe Rogan0:11

      And now your kid is how old?

   6. RPDr. Rhonda Patrick0:12

      13 months.

   7. JRJoe Rogan0:14

      Wow. Wait till they start talking.

   8. RPDr. Rhonda Patrick0:17

      He, oh, he says, I mean, he's, he's now, like, his new thing is he says, "All done. All done." So he'll say it, like, he'll say it before I change his diaper 'cause he doesn't want me to go through that, you know?

   9. JRJoe Rogan0:29

      (laughs)

   10. RPDr. Rhonda Patrick0:29

       He says, "All done. All done." (laughs) But he'll say it, like, he'll lay in his crib and say it, like, when he's ready to get out, you know, um, of bed early in the morning and I'm, like, waiting. I'm like, maybe he'll go back to sleep.

   11. JRJoe Rogan0:38

       Now, b- being a scientist and having a child, are you, are you, like, cognizant of, like, every single factor that's taking place, like nutrition, all the input, emotional input, environment? Like, must be kind of mind-blowing.

   12. RPDr. Rhonda Patrick0:59

       And ex- mind-exhausting too.

   13. JRJoe Rogan1:00

       Yeah.

   14. RPDr. Rhonda Patrick1:00

       Yes, it is. I'll give you an example right now, like, 'cause we're traveling.

   15. JRJoe Rogan1:03

       Right.

   16. RPDr. Rhonda Patrick1:04

       And, um, you know, I, I'm, I'm pretty ... This, the BPA, so plastic bottles, you know, I'm having to give him water and he's, like, obsessed. For whatever reason, he's obsessed with drinking ... I brought his, like, you know, n- nice cup, um, but he doesn't want to drink it out of his cup. He wants to drink it out of these plastic bottles 'cause it's novel and it's-

   17. JRJoe Rogan1:23

       Right.

   18. RPDr. Rhonda Patrick1:23

       ... crinkly sound and anyways. You know, so I'm like, all I can think about is the BPA and, you know, B- am I, am I exposing him to too much and what's it doing? And ...

   19. JRJoe Rogan1:33

       And does that BPA, is it leech only when it gets hot? Is that how it works?

   20. RPDr. Rhonda Patrick1:36

       So, and that's another thing I was thinking about in my hotel today because (laughs) I was making a coffee with one of those, um, one of those paper cups that has the plastic lining.

   21. JRJoe Rogan1:46

       Mm-hmm.

   22. RPDr. Rhonda Patrick1:46

       And like, I don't know what's in the plastic lining, BPA or some of the BPA alternatives which have also been shown to have-

   23. JRJoe Rogan1:52

       What does BPA stand for?

   24. RPDr. Rhonda Patrick1:53

       Uh, bisphenol A. So, um, y- to answer your question, there's been experiments done that have shown heat, so boiling, boiling water and putting it in plastic increases the BPA that leaches into the, the solution, into the w- the water by, like, 55 fold. So yes, definitely heating it up is, like, way worse. And so one of the things I'm always now thinking about is, you know, going to Starbucks, whatever, the plastic lining they're putting in those cups when you get your hot tea or your hot coffee, um, I don't know if there's BPA, but there's now studies that have come out, and these studies have been done in animals, that show like BPS and some of the other, um, BPA replacements also have negative consequences on endocrine system, on reproduction. In some, in some cases, they're passed on to multiple generations. Now, how much of that is actually translates to humans, it's unknown, um, but there have been studies at least with BPA that have shown that, you know, you give a person a s- a single dose of BPA and it disrupts, like, their insulin sensitivity. Um, it also plays a role in, like, um, um, causing problems with in vitro fertilization. So it's d- you know, disrupting hormones and things like that. So I was really cognizant about it during pregnancy because, you know, typically, um, we do detoxify, "detoxify" it, uh, quite well. Uh, the half-life is, like, uh, less than five hours and we excrete it through urine. It also comes out through sweat, by the way, which is really good. Um, but preg- but, you know, when you're pregnant, for whatever reason, the placenta, it, you know, you, you basically take the BPA, your body ... it's in your body and your, your liver will, you know, inactivate it to this, like, more benign compound. But when it crosses over to the placenta, it gets in, it gets activated again. And so it's like that's why the effects are much more, uh, robust always on, like, the developing fetus. And so I was really made sure I was, like, not drinking anything out of a plastic bottle or anything like that d- while I was pregnant just because, I mean, I don't know. (laughs)

   25. JRJoe Rogan3:51

       Right.

   26. RPDr. Rhonda Patrick3:51

       At the end of the day, there's, there's a lot of studies that have been done in animals and just how much of that, you know, translate, how significant is it, it's really hard to say. Um, but it's certainly concern.

   27. JRJoe Rogan4:02

       And it's probably a compounding effect, right? With all the other environmental factors, pollution, particulates in the air-

   28. RPDr. Rhonda Patrick4:08

       Oh, yeah.

   29. JRJoe Rogan4:08

       ... chemicals, all the other jazz that we take into our body all the time.

   30. RPDr. Rhonda Patrick4:12

       Right. Yeah. And then the fact that actually aging bottles, like, as you, for whatever reason, as a bottle sits, like, if you keep using, for example, the study was done with baby bottles. If you keep using a baby bottle and putting liquid in, as the, the bottle aged, more BPA was leached out into the liquid. So for whatever re- I know, it's just-
2. 15:00 – 30:00

   Mm-hmm. …

   1. RPDr. Rhonda Patrick15:00

      symptoms. And I see... That seems to be a real common theme-

   2. GUGuest15:04

      Mm-hmm.

   3. RPDr. Rhonda Patrick15:04

      ... um, in... at least if you, if you look in the blogospheres and stuff like that. Um, so that's, I think, kind of a good place to start, where it's like, "Well, you know, what are people doing this for?" And then, uh, so that's, that's kind of an important question. And, um, so, so further reading about this diet is sort of, sort of think about, "Well, okay, well, what's going o-"... (sighs) It's really important when you have, like, something that leads to a, an effect to understand the mechanism because the mechanism is, you know, what's leading to, to this effect. And so, if you can do something that's potentially not so dangerous, um, or risky, then understanding the mechanism will help you because then you can find other ways to do it, right? And so, um, if you look at, at, uh, published studies on people that eat low-carb, high-protein diets, um, what's pretty common is that there, i- there's changes that happen in a variety of different endocrine factors, um, like, you know, your less insulin that's changing your satiety and hunger hormones, leptin and ghrelin. And people become more satiated, and they actually eat less, and this has been shown, um, in, in multiple studies. So, people actually eat less when they're having a higher protein diet, which makes sense too because protein is more satiating, uh, as well. (clicks tongue) Um, and also, there's also been studies on what's called food habituation, uh, where basically... So, habituation is when you're constantly exposed to the same stimulus, you sort of have a decreased response to that stimulus. Where there's been intervention trials where people are given the same food every single day, both non-obese and obese people, versus people that are given the same food once a week. And the people that are given the same food every single day, they st- they start to eat less calories. So, they start to eat less, um, naturally start to caloric-restrict themselves. Um, so, I mean, and that's... It's kinda like a, a dietary monotony sort of thing. So, I think there... And, you know, if you read, and the people out there on the blogs talking about this diet, they say, uh, like, "I'm eating less. I only eat twice a day. I'm fasting." You know, so that's... People are talking about that as well.

   4. GUGuest17:07

      Mm-hmm.

   5. RPDr. Rhonda Patrick17:07

      So, I think there's published evidence to kind of explain that, and also, there's, you know, people saying, "Yeah, I eat less." So, that's p- an important point, um, because one thing that's really known to affect autoimmunity is caloric restriction and fasting. Like, it's probably one of the most well-known, um, technologies that you can intervene and have improvements in autoimmune disease. So, um, some of that has to do with the fact that you can sort of reset your immune system. There have been animal studies and human studies, a lot of this done by Dr. Valter Longo at USC. Uh, he's done some prolonged fasting, um, in animals. And also, there's been sort of, like, a fasting-mimicking diet done in humans, which kind of... A, a very low-calorie diet that sort of s- is meant to mimic fast. Um, and those have shown that, um, you basically kind of-... cross over because fasting is a type of stress, you cross over into this, like, stronger stress response, where you're not only, like, cleaning away all the gunk inside the cells. People talk about autophagy a lot when they're talking about fasting. You clean away things like damaged, you know, pieces of DNA, protein aggregates, things like that. Um, mitochondria that are damaged get cleared out. But you also sort of start to clear away entire cells through a process called apoptosis. And in animal studies, what's been shown is that if you do, for example, a 72-hour fast, you can clear away about 30% of the immune system and that... and, and, and re- replenish it with, like, brand new healthy immune cells. And literally, like, organs shrink when, during the fasting, and then they, like, re-expand because you're activating stem cells and you're, you're, you know, basically replenishing all your damaged old cells with new ones. Uh, well, Valter has shown in, in these animal studies also autoimmune, um, uh, cells tend to be selectively killed off and replaced with non-autoimmune cells. So he's also done a clinical study, a pilot clinical study, with people with multiple sclerosis doing this fasting-mimicking diet for one month ... sorry, for one week, and, um, their sy- their symptoms improved. Also, a ketogenic diet was done side-by-side, and the ketogenic diet also improved symptoms of autoimmunity. So those both were done in humans. So I think that, um, you know, understanding that, you know, some of these mechanisms that are at play and that fasting itself and caloric restriction both have been shown to improve autoimmunity, you may be tapping into something there by eating less. That's one possibility. Um, in addition, there's been stu- clinical studies in humans where ... that were done, um, they were m- basically fasted for 24 hours every other day for 15 days, so they had, like, a total of seven days of fasting. Um, and these were also people with multiple sclerosis, and there's m- profound changes in the microbiome that started happening, and this was in, in line with basically, um, having, you know, a lot of antiinflammatory cytokines, uh, basically producing immune cells that are really important for preventing autoimmunity called T regulatory cells or things like that. So that's another really important thing to consider is, you know, the microbiome, because the microbiome has been linked to autoimmunity in multiple, multiple studies. I mean, it's been linked to arthritis. It's been linked to multiple sclerosis. It's been linked to other diseases like Parkinson's, which is not really autoimmune, but ... Um, and the point of this is that, you know, again, understanding mechanism and realizing, you know, there's other p- potential factors that could be leading to an effect, right? It's, it's actually, um, the, the changes in the microbiome are really important, because there's actually been a few animal studies which have led to phase one, phase two, and phase three clinical trials that have been done in humans. So, um, humans with multiple sclerosis were treated with minocycline, an antibiotic, and there have been ... Basically, the antibiotic was shown to improve symptoms of multiple sclerosis, and because there, there's good bacteria and bad bacteria that have been linked to autoimmunity, and getting rid of, getting rid of bacteria, you know, the bad bacteria is gonna probably lead to improvements. And that's what was shown first in animal studies and then in human trials. So humans, um, taking ... with multiple sclerosis, taking minocycline for two years. So basically, they had improvements. It delayed the onset, um, uh, progression of, of the disease, but then after two years, the- those improvements went away, probably because you're wiping out the microbiome, and eventually, you're also getting rid of the ba- the good bacteria, and so th- things are gonna catch up, right? So you're not just ... You may be getting rid of some of the pathogenic bad bacteria with the antibiotics, but eventually, like, you're also getting rid of good stuff. So long term, you know, you're, you may not have those same improvements, and that, and that's very interesting, and I think it's a really important point to understand, um, with, with something like, you know, changes very ... profound changes in the microbiome. When it comes to someone just eating meat, um, y- so one thing to keep in mind with, with the microbiome is that basically, uh, ch- bacteria really are good at adapting to their environment. That's why antibiotic resistance is such a, a big deal. And when you ... There's been human intervention studies. When you take a human that goes from a high-fiber diet to a low-fiber, high-protein, uh, or, uh, vice versa, you get changes in their gut microbiome that happen within 24 hours. So within an hour, you actually start to have doubling of populations of bacteria, and within 24 to 48 hours, you actually start to lose other ... so basically, other bacteria start to die off. And this is at the species level. It's really hard to change the phyla. The phyla is more linked to long-term dietary patterns. Eventually, you can change phyla as well, but, um, it's been shown that people that go from a, um, a more high-fiber to a high-protein diet, they'd have changes in their microbiome, and these changes are a lot of the f- microbiome, you know, bacteria that are fermenting, um, a var- a variety of fermentable fibers start to leave, and you actually start to get bacteria cropping up that ferment amino acids. So, um, the amino acids, amino acids, simple sugars, fats, those are mostly absorbed in the small intestine, but some of them make their way into the large intestine, and there's a whole, you know, um, group of bacteria called the putri- putrefactive bacteria, and they ferment amino acids. Um, and some of these species of, of putrefactive bacteria have been linked to colon cancer. Uh, they're much higher in colon cancer patients. Animal studies have shown, you know, causal links where they can basically regressively cause a, a polyp to, to form a, a c- you know, tumor, um, and that's because these bacteria are making things called putrescine and cadaverine, which are damaging. They're genotoxic agents that damage the DNA inside your colon cells. And so, um, people that are typically eating, like, a omnivore type of diet where they're eating protein and they're also eating fermentable fiber, if they're eating the fermentable fiber that's facilitating the growth of lactic acid-producing bacteria, th-... it, that limits the growth of putrefactive. Be- so if you're, if you're, you know, bifidobacteria, lactobacillus, S. mutans, S. thermophilus, those strains of bacteria are lactic acid-producing bacteria, which you'd be getting if you're, I mean, you, you'd be facilitating the growth of if you're eating plants, fermentable, with fermentable fiber. You're gonna limit the growth of putrefactive because they can't grow with lactic acid. So it's not like, you know, you h- it's not a huge, huge concern, but the question is, what happens when you're only eating amino aci- when you're only getting amino acids?

   6. JRJoe Rogan24:29

      Right.

   7. RPDr. Rhonda Patrick24:30

      You know, so is there a long-term... So if you're, if you're, if you're killing off potentially some of this, um, pathogenic bacteria, and you're having this effect w- a positive effect, what i- what's gonna happen long-term? It's not known. I mean, this diet, I mean, hasn't really been studied at that level.

   8. JRJoe Rogan24:45

      There have been a few people that have, have anecdotal stories about l- doing it for 10, 20 years that are online, but it's very difficult to track, you know. I mean, it's, it's ... that you, you have to take them at their word for it. They've eaten nothing but meat for 20 years and they feel amazing.

   9. RPDr. Rhonda Patrick25:00

      Hmm.

   10. JRJoe Rogan25:00

       But there's not very many of 'em. There's a, you know-

   11. RPDr. Rhonda Patrick25:03

       Yeah.

   12. JRJoe Rogan25:03

       ... there's a- well, there may be more out there, but it's in terms of like what I've come across, articles, um, you know, uh, just, uh, social media profiles, people have talked about the positive benefits of it. It seems to me that most people that are talking about the positive benefits are talking about it within a one and two-year window. That's, that's what we're really dealing with a lot of. Um, Sean Baker, Dr. Sean Baker, who is probably the leading proponent of it, or one of the poster boys of it, along with Jordan Peterson and his daughter, Michaela ... uh, Jordan Peterson and his daughter, Michaela, uh, they're different in that they were dealing with severe autoimmune issues. Uh, his daughter's had two joints replaced b- before she was 18. She had her h- uh, well, she had her ankle replaced before she was 18, and I think she had her hip replaced shortly after that. And, um, Jordan has had some pretty severe autoimmune issues and depression. Within, w- with both of them, those things were cleared up. But as you've talked about multiple times before on this show, depression has been linked to disorders in the gut biome.

   13. RPDr. Rhonda Patrick26:06

       Right.

   14. JRJoe Rogan26:06

       And this is something that you feel like may be contributing to this. As long as, as well as both of them also got very lean.

   15. RPDr. Rhonda Patrick26:13

       Right.

   16. JRJoe Rogan26:13

       Jordan lost a ton of weight. He's back to the weight that he was when he was 25 years old. And I've eaten with him, and the guy eats. He eats a lot, but it's a lot of meat. Just like, he'll eat like a 30-ounce steak, you know, which is just crazy. It's a crazy n- amount of meat. But, um, I don't know how many times he's doing that a day. I don't know, you know.

   17. RPDr. Rhonda Patrick26:34

       Yeah. Yeah, I think, uh, you know, going back to the, the, the point, it's like there are other ... I mean, understanding the mechanism's important, and there's a lot of potential conte- confounding factors, right? And that, with any anecdotal data, is extremely important to consider. I mean-

   18. JRJoe Rogan26:50

       Right.

   19. RPDr. Rhonda Patrick26:51

       ... people can't even n- nutr- you know, scientists, nutritionists, just people can't even agree on the best diet, because a lot of these epidemiological and observational studies, which don't establish causation, have an enormous amount of confounding factors. And it is fricking, it's so hard to, like, control for that.

   20. JRJoe Rogan27:10

       Hmm.

   21. RPDr. Rhonda Patrick27:10

       I mean, just as a perfect example, we've talked about this before on the podcast, but you know, the vegetarian versus people that eat meat. One of the m- really large studies that was done, and, and, and Dr. Valter Longo was part of that study, looked, you know, at all-cause mortality and cancer mortality, and it was lower in vegetarians. But they decided to take the meat-eaters and say, "Okay, what about within this group, the people that are s- healthy meat-eaters or people that are, you know, not, you know, not unhealthy." So they're not obese, they're not sedentary, they're not smoking, they're not alco- uh, not excessively drinking alcohol. Those people, when they took out that con- those confounding factors, the meat-eaters had the same mortality as the vegetarians-

   22. JRJoe Rogan27:48

       Yeah.

   23. RPDr. Rhonda Patrick27:48

       ... and the same cancer. So confounding factors are so important, and that, with anything with anecdotal, you have people that are exercising like crazy. Exercise has also been shown to change microbiome, independent of diet, um, in a positive way, where you're actually producing more of the, the bacteria that are, um, producing things like lactic acid. So, and fasting does the same thing. And so you have people that are fasting, so you know, it's not like you can't do other things if you're on that type of diet to, to sort of help with the microbiome. But I think, again, if there is a way you can do, you know, if, if there's a way that you can get these benefits without having to do something so hyper-restrictive, and we'll talk about, I mean, I have concerns for that. We can definitely get into that. But, um, then, you know, why not try that? And you know, the thing with like, for example, doing like a prolonged fast, you know, once, once a quarter, once every couple of months, depending on how severe your, your issues are, I mean, there's, there's been benefits shown with that, like in aging. Like, you know, so people that have been put on this fasting-mimicking diet, they have improved biomarkers of aging. Um, they increased their lean muscle mass. I mean, so like I said, in animal studies, and you can't directly translate the animal studies to humans, because rodents have a really fast metabolism, and if you fast them for 48 hours, they lose 20% of their body weight, where humans only lose like one or 2%. I mean, that's, like clearly, you know, yeah. So-

   24. JRJoe Rogan29:10

       That's crazy.

   25. RPDr. Rhonda Patrick29:10

       Yeah. So you can't, I mean, it's obviously, you can't completely translate-

   26. JRJoe Rogan29:14

       Right.

   27. RPDr. Rhonda Patrick29:14

       ... everything that's done in a fasting rodent to humans. But there are definitely ... organs are shrinking and then literally regrowing after the fast is over. Like, it's like this rejuvenation process, you know? Where your, and it seems as though selectively damaged cells are killed. In fact, this whole, like there, there's a whole, um ... uh, Dr. Valter l- Longo's showing, um, that cancer cells are really, really susceptible to dying when they're, when you do like a, a prolonged fast, or even a fasting-mimicking diet. And he's, he's, he's shown this in animal studies, and he's done a couple of clinical studies, uh, where, where patients with cancer were treated with standard of care. But before their standard of care treatment, they were fasted for up to 72 hours, and what happens, um, what he's shown in animal studies happens is that, because the

3. 30:00 – 45:00

   Yeah. …

   1. RPDr. Rhonda Patrick30:00

      fasting is a type of stress, all your healthy cells increase all these stress response pathways. They make more heat shock proteins. They're increasing antioxidant production pathways, antiinflammatory. They're doing all this really good stuff in response. Cancer cells can't do that. They're like screwed up, and so they can't activate those stress response pathways, so it ends up killing them. So what you end up happening- happe- ha- hap- happening is that when you're given another-... genotoxic stress, like chemo or radiation, your healthy cells become more resistant to the damaging effects of the radiation and the cancer cells become more sensitized to the death. And so what he's shown in, in his pilot studies in humans is that basically, um, the humans that were tr- that were, uh, that were treated with the standard of care, I think it was chemo, and also fasted, they had less, uh, neutropenia, which is the loss of, like, neutrophils, which is the side effect because you're losing normal healthy cells. They had less of that happening, uh, less myelosuppression. Um, so, I mean, anyways, it... The point is that, I think, if you can find a way to get positive benefits, you know, without having to do something so risky and potentially dangerous and unstudied, um, you know, in a, I mean, unstudied in a really scientific way.

   2. JRJoe Rogan31:10

      Yeah.

   3. RPDr. Rhonda Patrick31:10

      You know, controlling for contr- confounding factors and all sorts of long-term. I mean, just all of that is really important. Then-

   4. JRJoe Rogan31:15

      Well, this just comprehensive breakdown that you just did is something that's really lacking from a lot of the discussion of this carnivore diet. And from the proponents of it, uh, uh, it's almost like a lot of them are going into it blindfolded. They're like, "Look, uh, it seems to be working, so I'm just going to stick with it." But th- uh, l- again, when you're talking about most people's cases, you're talking about one year, maybe two years, sometimes even less, where they're having these benefits. And as you're saying, it's entirely possible that they're setting themselves up for some potential long-term damage.

   5. RPDr. Rhonda Patrick31:51

      It is. Um, it is, it's definitely possible. And again, at the end of the day, there's no data. There's no data, so you can't say for sure. Right?

   6. JRJoe Rogan32:00

      Right.

   7. RPDr. Rhonda Patrick32:00

      There's no data. But I have concerns and we can talk about those concerns, for sure. I would like to. But, you know, e- the thing is understanding mechanism, like you said, going in blindly. I mean, you have a hypothesis and it's like, okay, your hypothesis is all plants are bad. Right?

   8. JRJoe Rogan32:16

      Yeah, that's what I keep hearing. Yeah.

   9. RPDr. Rhonda Patrick32:17

      And it's like, well, that's a hypothesis, but what about all the other things that are potentially happening while you're doing this diet?

   10. JRJoe Rogan32:22

       And more, and-

   11. RPDr. Rhonda Patrick32:23

       You're eating less, you're fasting more, your microbiome's changing, like dramatically changing, and those things all have been known. Multiple studies have shown humans and animals, mechanistic detail, to have benefits on autoimmunity, on aging in general, on brain function. I mean, all sorts of things. You know, so it's... Mechanism is so important. You have to realize, I mean, that- that's the whole basis of science. Understanding how the world works around you, understanding how your body works, mechanisms.

   12. JRJoe Rogan32:50

       Right.

   13. RPDr. Rhonda Patrick32:51

       Like, you have hypothesis and y- it's very... And I understand, it's like someone experiences something positive, it's like, "Well, this must be..."

   14. JRJoe Rogan32:58

       Right.

   15. RPDr. Rhonda Patrick32:58

       "This is it. This is the end-"

   16. JRJoe Rogan32:59

       Yes.

   17. RPDr. Rhonda Patrick32:59

       "... all, be all." And, but you also (laughs) have to realize the shit's complicated. (laughs)

   18. JRJoe Rogan33:05

       Yeah. (laughs)

   19. RPDr. Rhonda Patrick33:05

       You gotta understand the mechanism.

   20. JRJoe Rogan33:07

       Yeah. Yeah. Yeah.

   21. RPDr. Rhonda Patrick33:07

       And you may be doing something, uh, long term that potentially... I mean, it really hasn't been studied.

   22. JRJoe Rogan33:15

       Yes.

   23. RPDr. Rhonda Patrick33:15

       So...

   24. JRJoe Rogan33:16

       Well, that was one of the c- I mean, I had Jordan's daughter, Michaela, on, who's had some pretty dramatic results from this carnivore diet, but she's giving essentially nutrition consulting to people, but she doesn't really have a background in it, and she's in... She doesn't have the information that you just distributed. Like what you just said to all these people listening, and the way you're describing the, the mechanisms and the benefits of fasting and all these different various things that are happening inside your gut, and all these different things that are happening with healthy cells and, and damaged cells with fasting, and that this is mimicked by this restrictive diet, and that... This is all absent from the dialogue. This is all absent from the dis- and this is one of the things that's disturbing, the most disturbing for me. It's like, I get that they're seeing positive results. I get... I don't, I'm not gonna deny that they're, they're seeing... But when they start saying, uh, "You know, plants are bad," and there's a, you know... Like my friend Chris, he's always talking about the war on carbs. He's having this real... He's also got... Chris Bell, he's got autoimmune issues as well. He's had both of his hips replaced before he was 35. And, you know, severe arthritis. And he is leaner than he's ever been and benefiting greatly from this carnivore diet. But, you know, he's, he's like... He talks about it, like, he uses hashtag war on carbs, you know, and he doesn't eat salad. He won't eat greens. Like, he thinks greens are bad for you. And I'm like, "Man, I don't... Not sure that's correct." I think it's so important what you're saying. And, um, there's a, uh, researcher online that I've been in contact with, his name's Kevin Bass, and his, uh... Bass or Bass? B-A-S-S. Not sure which, how do you pronounce it. But he also brought up this possibility that it could be, uh, calorie restriction that these people are dealing with, and that this essentially some of the same, uh, mechanisms that are the, the positive reactions from fasting that you're, you're dealing with here. And I'm very happy that you're saying the same thing.

   25. RPDr. Rhonda Patrick35:18

       Yeah. I, I, I think that is one very strong possibility, and that is something, you know, there's lots of hypotheses here. And, you know, given all the data and there's lots of positive data about eating plants as well.

   26. JRJoe Rogan35:31

       Yes.

   27. RPDr. Rhonda Patrick35:31

       You know, so it's, it's really hard. Uh, that's one hypothesis and that seems to be the one everyone's sort of gravitating to.

   28. JRJoe Rogan35:37

       Mm-hmm.

   29. RPDr. Rhonda Patrick35:37

       Um, you know, if, if someone's also wanting to reduce their, their glycemic load and all that, I mean, there's, there are other... I mean, eating just a modified paleo diet. I mean, I eat something like a modified paleo diet where it's like I'm eating, I'm eating fish, I'm eat meat, poultry, and then a lot of leafy greens, um, and cruciferous vegetables. Now, you can do s- and nuts, you know, or you can do a ketogenic diet. Like, there, like I just talked about the study, um, that was done looking at the fasting-mimicking diet in humans with multiple scrotic- sclerosis. Um, there was, uh, the same in... Published in the same, um, paper, there was a study, they, they, they're s- um, study that, uh, put patients on ketogenic diet for, I believe it was three months, and it improved symptoms of autoimmunity as well.

   30. JRJoe Rogan36:23

       Was it comparable?... those-
4. 45:00 – 1:00:00

   Right. …

   1. RPDr. Rhonda Patrick45:00

      are essential. You have to get them from your diet because you don't make them in your body, and if you don't get them from your diet, it can lead to h- you know, health problems and death actually. So- so that's- that's kind of, you know, what micronutrients are. RDAs, so recommended dietary allowance. Um, those have been set, a variety of different studies are used, so there's randomized controlled trials, non-randomized controlled trials. There's depletion repletion studies. There's balance studies looking at how much, how long, how much of a micronutrient it takes before you start excreting it. Um, there's cross sectional studies and there's case studies, and this is a collaboration between the United States and Canada and some European, uh, countries as well. So, a lot of experiments are done to f- to figure out, um, the recommended dietary allowance. The first thing that's done is the- the estimated average, um, recom- the S-E-A-R, the estimated average rec-, um, intake. So, um, that is done by basically looking at any population and going, okay, how much of this micronutrient do we need so that 50% of the population has adequate levels? The other 50% will be deficient. So, like there's a bell curve and so it's like literally in the middle of the bell curve, and then the RDA is set from that two standard deviations above, and it's supposed to make, you know, about 97.5% of the population gets enough. So, that's how the- the RDA is set. For each micronutrient it's different. The- the experiments are done are different to look at them. So, there's a few concerns, of course, with an all meat diet with particular micronutrients because, you know, micronutrients, there's a lot of, you know, certain micronutrients that are concentrated in meat and there's a lot that are concentrated in plants, and you can find some of the ones that are more concentrated in meat in plants most, in most cases. Um, but it's much better to get it from the meat. And in plants there's, it's much more concentrated, you know, and you can find it in some amounts in meat, but it's much, you know, it's a lot easier to get it from plants. So, uh, one of the, of course, the micronutrients that's a concern is the vitamin C, of course, right?

   2. JRJoe Rogan47:01

      Right.

   3. RPDr. Rhonda Patrick47:01

      That's- that's the one that everyone talks about. So, vitamin C is a really important cofactor, um, for... What that means, a cofactor just means that it binds to an enzyme and helps it work. It's important for making collagen, it's important for converting dopamine into norepinephrine, which is important for that, you know, fight or flight response. Um, it plays a role in- in, uh, making carnitine, which is important for using fatty acids for me- you know, for energy. Um, and then it's of- of course an antioxidant. It also plays a really important role in- in neutrophils. So, neutrophils are, uh, a type of immune cell. When they're activated, when you have any sort of bacterial exposure, um, virus, uh, things that could even come from the gut, you know, like LPS we get from bacter- dead bacteria that are dying in the gut. Um, neutrophils get activated and they soak up vitamin C because they release a bunch of hydrogen peroxide, which damages the neutrophil itself. And so the vitamin C sort of prevents that from happening. Uh, it plays a- a really important role in, um, cell- cell integrity and things like that. So, the- the, um... There's a variety of ways vitamin C is transported into the cell, and I see, uh, reading on the internet a little bit of misunderstanding. Um, people following the carnivore diet seem to think that because they're not getting any... uh, their glucose levels are low, that they're getting more vitamin C in, so-

   4. JRJoe Rogan48:24

      Yeah.

   5. RPDr. Rhonda Patrick48:25

      So, vitamin C, um, also called ascorbic acid, uh...... goes between two different states. Ascorbic acid is the reduced form, which is the antioxidant form. It, it, it goes also into an oxidized form, so it's kinda going back and forth. It goes through about four cycles of that. The oxidized form, it's called dehydroascorbic acid, and there's two ways that you transport vitamin C. Uh, you absorb it through the gut. The epithelial cells is transported into a variety of tissues in the body. Ascorbic acid goes through sodium-dependent vitamin C transporters. Those are not dependent on glucose. There's no competition for glucose. They ... that's, that's how vitamin C gets into the, the cell. Uh, and most cells actually transport vitamin C in, in that form, with the exception of red blood cells, which don't have that transporter. They use another transporter called glucose transporters, or GLUT, and that one does ... Glucose does compete. Uh, interestingly, dehydroascorbic acid binds much better. Uh, it's m- actually tightly more bi- binds to the transporter than, um, glucose, but in conditions like, um, hyperglycemia, like type 1 or type 2 diabetics, they actually don't get vitamin C in the red blood cells and it leads to, like, vascular problems and stuff like that. So, so, um, it's an interesting hypothesis that maybe if you're having, you know, less of a, um, your, you know, blood glucose levels are really bottomed out, maybe there ... maybe that there's some salvage pathway you're able to help get vitamin C and the oxidized form is going in some other cells that it usually doesn't go in or whatever, something like that. It's an interesting hypothesis, which is there's no data on, right? Um, but the experiments that were done to choose the RDA for vitamin C were done, um, the, the more recent RDA, so that it changed back in, like, 2000, after 2000 or 2001 or something. It's about 90 milligrams a day for men and, uh, 75 for women. They were, they were depletion/repletion studies. So, uh, men were, were given about less than five milligrams a day of vitamin C diet- m- m- with their diet, and this was about a six-month st- study. They were in a metabolic ward. And, um, it was determined that, uh, it was kind of unsafe to keep, to keep going, so, so basically they started the repletion, where, um, they started giving, uh, the p- these men vitamin C at different doses. And, uh, vitamin C follows, like, a sigmoidal S-curve, so once you kinda deplete someone of their vitamin C, when you give them, for example, 30 milligrams, it isn't really enough to kinda go real h- it doesn't really raise plasma levels much. You have to get up to, like, 100. Once you get up to, like, 100, then you actually start to excrete vitamin C, but before that, you're just ... your body's holding on to everything. You're not excreting anything. 200 milligrams was, um, maximum bioavailability, and then after that, um, you start to, like, decrease bioavailability and you're excreting a lot of vitamin C. So the, the new ... So the scientist that published this paper, Mark Levine at the NIH, um, recommended that the RDA be set at 200 milligrams, but it was set at 90, which is literally right before you start to excrete, which was 100 milligrams. That data, along with the neutrophil data, there was some neutrophil data that was looked at, um, you know, how much vitamin C was i- important to ... because neutrophils sop it up to prevent that hydrogen peroxide-induced damage, and so that's kind of how the RDA was set. Um, now the question is, in any ... with any RDA, like, you know, the m- the important thing to consider is, well, the RDAs are set to prevent acute disease, but what about promoting optimal health? You know, like, that's really important. Like, how much of these micronutrients do you need throughout a lifespan to, to, you know, to maintain optimal health and age well? So this is something that's really important because a lot of enzymes that require micronutrient for preventing short-term disease, something that can kill you, like there's also enzymes that n- are required to prevent, you know, things that are associated with aging, like DNA damage. So if there's only so much of a micronutrient around, which where is it gonna go? Is it gonna go where the, you know ... Is it gonna prevent DNA damage, which doesn't make a difference until five or six decades later, or is it gonna make sure you live on to pass (laughs) on your genes and, you know, reproduce and ... So, um, my former postdoctoral mentor, Dr. Bruce Ames, sort of pr- proposed this whole, and he pur- um, has published a, a couple of foundational papers, um, supporting this idea, which is he calls triage theory, so he's saying that basically he thinks actually a lot of RDAs are too low and that, you know, optimal RDAs will account for p- you know, how much is needed for these long-term functions. So that's really important to consider. With the vitamin C, um, you know, it's, it's, it's, it's really, uh, a small amount that's needed to, to, to be used as a cofactor for, you know, an enzyme for, you know, collagen production. You actually don't need that much. And say it was done ... Like, studies were done years a- years ago that, um, established, like, 10 milligrams of vitamin C was enough to prevent scurvy, um, which can happen when you're ... basically you don't have enough vitamin C for, for collagen production. And, um, and even that's kind of questionable because back at the time when those studies were done, it was before really good analytical assays were available, so, you know, the assay that was done to measure, um, various things were ... it was lots of things could confound, so it's, it's ... It may even be less. May be more, may be less. It's kinda unknown. So, um, you know, that, that, that is something to consider as well as the fact that basically there's a lot of biological variation with, um, vitamin C requirements, and this has been shown, uh, in other animals that also require vitamin C, like guinea pigs. So, like, if you take 100 guinea pigs, and this is, you know, this was published back in the, like, '60s or '70s. Um, like, there was, like, tenfold variation in how much each of them required, vitamin C they required even though they were given, like-

   6. JRJoe Rogan54:12

      Wow.

   7. RPDr. Rhonda Patrick54:13

      Yeah. So-

   8. JRJoe Rogan54:14

      Tenfold?

   9. RPDr. Rhonda Patrick54:14

      Tenfold, even. Yeah, so there's, like, huge variation in the half-life of vitamin C and in their transporters and, like, s- you know. So this has been shown in rodents as well. Rodents make vitamin C in their liver, but the same thing's been shown. And s- actually back when the s- the European sailors were getting scurvy and dying of it, only about 50%, only about half of those sailors got-... scurvy. The other 50% didn't have any symptoms.

   10. JRJoe Rogan54:37

       Now, how are these-

   11. RPDr. Rhonda Patrick54:38

       Presumably-

   12. JRJoe Rogan54:38

       ... carnivore diet guys not getting scurvy?

   13. RPDr. Rhonda Patrick54:40

       Well, that's what, that's what I'm saying. I'm saying that, you know, for one, i- it doesn't take much.

   14. JRJoe Rogan54:45

       Right.

   15. RPDr. Rhonda Patrick54:46

       Right?

   16. JRJoe Rogan54:46

       And they're getting some of it from meat?

   17. RPDr. Rhonda Patrick54:48

       Yeah. Yeah.

   18. JRJoe Rogan54:48

       Yeah.

   19. RPDr. Rhonda Patrick54:48

       So, so the thing, um, you know, if it... it's, it doesn't take much to, to maintain the enzymatic fac- uh, function, um, of some of the, some of the enzymes involved in making collagen and that ... you know, so it doesn't take much for that. But the question is about what about, you know-

   20. JRJoe Rogan55:05

       All the host auto-

   21. RPDr. Rhonda Patrick55:06

       All the factors. Yeah, and the neutrophils-

   22. JRJoe Rogan55:08

       Mm-hmm.

   23. RPDr. Rhonda Patrick55:08

       ... and, um, you know, your body stores, like, orders of magnitude more vitamin C than, than, than it needs for that, for the, for its function as a cofactor. And it's like, you know, why does it do that? Is it just because maybe during scar- food scarcity you want- it wants to make sure it has enough? Or is there a- you know, the antioxidant functions and other functions really important or other unknown functions? So I think the vitamin C, you know, y- they're certainly, you know, getting enough to prevent scurvy, and there could be biological variation in that as well, right?

   24. JRJoe Rogan55:37

       Right.

   25. RPDr. Rhonda Patrick55:37

       You don't need much to prevent scurvy.

   26. JRJoe Rogan55:39

       And again, you're, you're dealing with a very small sample size, so you don't know how many people are actually on this diet or how many of them are reporting-

   27. RPDr. Rhonda Patrick55:44

       Are supplementing, right.

   28. JRJoe Rogan55:44

       Right. How many of them are supplementing, and why wouldn't they be?

   29. RPDr. Rhonda Patrick55:47

       Right. Yeah.

   30. JRJoe Rogan55:48

       Yeah.
5. 1:00:00 – 1:15:00

   Yeah. …

   1. RPDr. Rhonda Patrick1:00:00

      um, levels of folate also had a certain type of DNA damage called micronuclei. You know, so the question is, well, y- you know, if I, if I'm getting only so much folate, you know, is, is it something happening to my DNA? Am I getting strand breaks? The same goes for magnesium. I mean, you can get magnesium if you're eating... you know, this... it's just then what about the folate, and then what about the vitamin E and vi-... you know? So it's really hard. It's really hard, uh, to, to do that. And DNA damage, that's something you can't measure. You're not gonna go... your lipid panel isn't gonna tell you that. There's no consumer test available. There was a, a k- a few years ago, uh, a startup tried doing it, but it's really hard, um, because there's... if you're sending blood samples, um-... you know, to, to a lab to, to be tested for DNA damage. I have done many DNA damage experiments on, um, humans, so clinical studies. I was involved in Dr. Ames' lab. Um, and I've done studies, kinetic studies, where we took blood out of a patient, measured DNA damage immediately or froze it down, or we let it sit on a bench for 30 minutes, two hours, four hours, overnight. After two hours, all the d- tons of DNA damage started to come up because it's being exposed. The, the, you know, oxygen and all that is, um, creating basically DNA damage. So anyways, the point is, is that DNA damage isn't something you're gonna measure. You don't feel it, and you're not gonna feel it. I mean, it's happening in us right now. We don't know (laughs) to how many, but it is. We have enzymes that are repairing that damage, and those enzymes require magnesium. Um, we're getting enough folate to make sure that that damage isn't happening. And again, you can get a good amount of folate. Liver is one of the best, is a really great source. But you have to eat it every day, and you have to eat like, you know, I guess, 150 grams of liver is not that much. But you have to eat it every day, you know. Um, so it's, it's just really important to consider these, you know, the fact that these micronutrients are important. They have long-term effects. I mean, the two and a half years it took to show the, the hemolysis in red blood cells, two and a half years. So what happens if you're getting a modest amount, not quite three milligrams, but you're getting twice that or maybe you're getting nine? You know, what happens seven years from now? Like, you don't know. It's i- And it's important. It's your health. It's important. So I think that ... So those, you know... And there's a, a variety of other... Manganese, you can also get if you're eating a lot of, like, uh, stomach lining. Tripe, is that what it's called?

   2. JRJoe Rogan1:02:19

      Yeah.

   3. RPDr. Rhonda Patrick1:02:19

      Tripe? Yeah. I mean, so it's not like you can't get it, but-

   4. JRJoe Rogan1:02:22

      But fear not. Most of these people that are carnivore diet are just eating beef.

   5. RPDr. Rhonda Patrick1:02:25

      Right. And especially if the people are working a job where they go into a office nine-to-five or they're traveling, I mean, it's really hard to eat all this-

   6. JRJoe Rogan1:02:33

      Yeah.

   7. RPDr. Rhonda Patrick1:02:33

      ... cool s- Like, you know, the, the Inuits were eating things like raw... Like, they're eating raw liver, raw... like, raw whale blubber and spleen. Spleen's a good source. I mean, you can get vitamin C from spleen, um, I think heart. So there's some organs. Vitamin C, when you cook it, 25% of, you know, it, it's lost. So that's why a lot of the muscle meat and stuff, it does start out with vitamin C, but when you cook it, I mean, if you're not eating it raw, then, you know, you're, you're definitely ... it's negligible. You're not-

   8. JRJoe Rogan1:03:01

      There is one young guy who is a, um, carnivore diet proponent that seems to be approaching this in a much more comprehensive way. He's really big on organ meats, in particular liver and many other things. And he's talking about how these organ meats, uh, will, uh, be excellent sources of a lot of the vitamins that people are concerned that you're missing from vegetables. You're... Do you think that that is possible? And I mean, spleen, I guess, for vitamin C.

   9. RPDr. Rhonda Patrick1:03:29

      Yeah.

   10. JRJoe Rogan1:03:30

       But like, w- what a- What about just liver or kidneys or things along those lines? I mean, what, what are you gonna be deficient in if you go the organ meat route?

   11. RPDr. Rhonda Patrick1:03:39

       I mean, I think that, you know, if you're ... the, the, the magnesium and, um, uh, the magnesium would be important.

   12. JRJoe Rogan1:03:47

       Hey Jamie, while you're out there, could you get me another one of these? Thanks.

   13. RPDr. Rhonda Patrick1:03:50

       Um, magnesium. But you can get... I mean, it's... You can do it, right?

   14. JRJoe Rogan1:03:55

       Right.

   15. RPDr. Rhonda Patrick1:03:55

       I mean, you can do it, but, um, it seems very difficult, and I don't think most people will do it.

   16. JRJoe Rogan1:04:01

       And you recommend, of course, getting all this stuff from food.

   17. RPDr. Rhonda Patrick1:04:05

       From food.

   18. JRJoe Rogan1:04:05

       If you were gonna get magnesium, vitamin C, all those things.

   19. RPDr. Rhonda Patrick1:04:07

       Right.

   20. JRJoe Rogan1:04:07

       But i- i- Is it feasible that you could just supplement with multivitamins and, and cover all your bases? You think so?

   21. RPDr. Rhonda Patrick1:04:15

       I don't... I don't know. I mean, I think the same goes for vegetarians. I think they should... you know, they do supplement. They take B12.

   22. JRJoe Rogan1:04:21

       Mm-hmm.

   23. RPDr. Rhonda Patrick1:04:21

       Um, they take iron, which isn't necessarily... I think it's much better to take iron, get iron from food.

   24. JRJoe Rogan1:04:27

       It's not as bioavailable in a pill form?

   25. RPDr. Rhonda Patrick1:04:30

       Well, also, the bioavaila- the, the pill form has been shown to disrupt other things, like, whereas iron from food doesn't.

   26. JRJoe Rogan1:04:38

       How so?

   27. RPDr. Rhonda Patrick1:04:39

       Just depends on the ratios of other things, like, you know, disrupt- disrupting the transport of other, um, transition elements and things like that.

   28. JRJoe Rogan1:04:46

       Because it's isolated?

   29. RPDr. Rhonda Patrick1:04:47

       Also, yeah, something about that. Also, there's bacteria in the gut that, um, that can be pathogenic and that use iron, but it seems to be only in supplemental form that that's-

   30. JRJoe Rogan1:04:58

       Oh.
6. 1:15:00 – 1:15:33

   Section 6

   1. JRJoe Rogan1:15:00

      da, da, da, da, da, da, da, da. But they only want it to be because of the consumption of meat only. They think that it's because of the singular aspect of their diet and the fact that they've eliminated everything else, but they're not ... They don't do any studying of elimination diets. They don't do any study of the prolonged benefits of fasting and all these different things that you're talking about, which I think are v- they're ... These are all factors in this really complicated thing that's going on that most likely has something to do with their gut biome and their immune system.

Episode duration: 2:47:43