April 20, 2013

Mental models

TEDMED 2013…now I get it

Read Time 7 minutes

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

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

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

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

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

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

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

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

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

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

Medical school connection

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

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

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

The most moving talk

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

Greatest human spectacle

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

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

Best line of the week

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

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

Most surreal moment

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


Closing thoughts

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

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

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

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

Photo by Mike Wilson on Unsplash

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

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

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

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

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

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

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

    Kind regards,


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

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

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

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

  4. Dear Dr Attia,

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



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

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

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

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

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

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

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

  8. Peter,

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

    Phoebe M. Olivera

  9. …………….

    Heart rate Monitor

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

  10. Hello Dr. Attia,

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

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

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

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

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

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

    Thank you so much for all that you do.

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

  11. Hi Peter,

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

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

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

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



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

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

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

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

    • > … diagnosed a non functioning thyroid.

      What tests were run to establish this?

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

      What med?

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

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

  13. Peter,

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

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

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

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

    Gratefully, & w/ a warm smile,

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

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


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

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

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

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


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

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

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

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

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

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

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

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

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

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

  19. Peter,

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

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

  20. Peter,

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

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

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


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

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