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Professor Grant Schofield

The Carb-Appropriate Podcast – Ep.7

I really loved chatting with Professor Schofield in this edition of the podcast.

Grant is a professor of public health and director of the Human Potential Centre at the Auckland University of Technology. He was also the supervisor for my PhD research, and we have collaborated on a bunch of research papers. Grant has emerged as a leader in the field of low-carbohydrate nutrition and the re-evaluation of the current (faulty) dietary guidelines. He’s also been a key mover in helping to get kids more active and in creating ‘livable’ cities with a focus on movement.

Grant and collaborators Dr Caryn Zinn and Craig Rodger have just released their latest book: What the Fat? Recipes which features over 130 delicious, low-carb recipes.


This episode is brought to you by The Carbohydrate Appropriate Diet book.
Professor Schofield wrote the foreword to Cliff Harvey’s 2017 book, The Carbohydrate Appropriate Diet.

The Carb-Appropriate book helps you to find your customised level of carbohydrate intake, so that you can go beyond the battle of ‘low-carb vs high-carb’ to find your unique, best-fit diet.

Carb-Appropriate Podcast listeners can get a massive 50% off The Carbohydrate Appropriate Diet by clicking:

https://www.nutritionstore.online/discount/CAGRANT?redirect=%2Fproducts%2Fcarbohydrate-appropriate-diet

or by using the code CAGRANT at http://www.nutritionstore.online

Intro includes sample of ‘Get Up Stand Up’ Public Enemy feat. Brother Ali. Outro sample; Jesse Spillane ‘Spastic Mumblings’ both from http://freemusicarchive.org

Patrons can read the full transcript below

[ppp_patron_only level=”5″]

Cliff Harvey: [00:00:05] Welcome back to the Carb Appropriate podcast. I am stoked today to have my good buddy Professor Grant Schofield with me. Welcome, Grant.

Grant Schofield: [00:00:13] Thanks for having me on.

Cliff Harvey: [00:00:14] My pleasure. Hey, so, we met quite a few years ago now, I had recently come back from Canada… I was getting back into practice here and one of our mutual friends, who was studying up at AUT at the time, John McQuillan, said that ‘this guy Grant Schofield is starting to look a little bit into low carb and so do want to come up and we’ll have a chat?’. And I think you called it the ‘Metabolic Efficiency Group’… we got together with a bunch of other people and started fleshing out ideas for research and obviously before that I had known you mainly for your work in movement and the sort of psychology of getting kids active. I think it’s a really interesting genesis story for you of how you came to be doing what you’re doing now. So how did that come about from your background in psychology and sports physiology and movement into being really one of the key pundits for the low carb movement?

Grant Schofield: [00:01:14] Oh, yeah, it’s an interesting story that goes well beyond there and you were involved peripherally as well and I’d known a bit about nutrition and then I’d done degrees in physiology and psychology and I was interested in both of those and about the only thing I never had any real interest in when I was a school kid was science. That’s any stuff that appealed to me, particularly biology. I was interested in that and I’ve known of the nutrition guidelines and I studied those in various aspects and just sort of gone, ‘ah, yeah’… hadn’t made much connection with reality and I just carried on and I ended up because my interest in sport and athletics through my life sort of coincided with that outbreak of the realization in the mid-90s that with the U.S. Surgeon General had finally published a report going ‘look, you know being physically fed and moving around is good for you’. That spurred a whole academic industry I guess if you’d like but sort of the more robust supported investigation of that side spent from the sort of mid 90s through to about 2010 at least set the main focus my career is about how to be active, particularly the public health aspects of that and particularly interested in children and young people and, you know, sort of often your academic career follows the life stages. You know they had started to get young children to understand the world that those kids were being born into was one where they didn’t move much and actually, compared to now… we just had video players in, but we don’t have devices and all that sort of stuff. So that was really the thing and I’d known about nutrition… I’d been interested in sports nutrition particularly because I’d been an endurance athlete my whole life and I just bought the whole Gatorade gel, low-fat high carb thing and at first, and it should have occurred to me more than that that something different was going on because I admit that at one Hawaii Ironman I actually ended up breaking my collarbone in a cycling accident just before it and so I turned up anyway and actually ended up doing the race and it sort of healed just in time but I was obviously unfit. So I sat in the pro briefing next to a man, Mark Allen, and a woman, Paula Newby Fraser, that’s both sort of seven- or eight-time champions and asked them about their diets because I was like “I might as well learn something while I’m here’  and they told me it was ‘sort of a low carbohydrate approach, we have a lot of fat, we encourage fat burning, we use nutritional ketosis’… the whole box and dice, and I’m just going ‘what a load of nonsense’. So, I ignored that, and then I had actually heard of you before you departed overseas and this guy Cliff Harvey was doing low carb and ketogenic diet and we’re like ‘oh ho, yeah… There’s definitely still a lunatic fringe in the world. Imagine that’. So, I had known about you actually and then through Joe, I’d known he’d known you. So, we generally laughed at what you’re doing. And that’s just shameful in hindsight because I got interested in this around 2012 and then started just to unpack all the evidence around that sort of Tim Noakes coming out era and in that year the world just exploded. And then I had naively sort of thought this would be the gentle world of physical activity and exercise research where everyone got along. And it’s just been a whole other world… a sort of battlefield of academics and medical professionals… the food industry, pharmaceuticals, and all those conflicts of interest and the dissonance that come along with it. So then eventually met you and we, as you said, got into that group and then you’ve come along and contributed even more to our group with your trials and other work and the general discussion that is necessary to keep moving food forward.

Cliff Harvey: [00:05:03] Yeah it was interesting for me because, as you know, I was moving much more down the mind-body path and I was actually starting my Masters in mind-body healthcare at AUT. But it was really nice to have a group of people who were coming on board and I had some collaborators then, to sort of ‘fight-back’ against some of these silly things that were happening in nutrition. So, as you can remember, I was pretty excited about the whole thing and probably a little bit too excitable at times… but what was really the ‘aha’ moment for you, because obviously, you started to see the writing on the wall… but what really changed your perspective on nutrition?

Grant Schofield: [00:05:43] Well, I think there are three things, but there was one big moment. First of all, I’d been doing a lot of work in the remote Pacific with non-communicable disease for the World Health Organization and you would walk around with these ridiculous guidelines that you were supposed to be preaching… you can only imagine. And of course, you’ll go to…. well, there are such profound differences in the metabolic health of people in the Pacific… the people living in the traditional manner where they’ve got very little contact with the outside world… You know southern Vanuatu probably best exemplifies that… there’s extraordinarily good health and not only that you’ll see people really living that Mark Sisson description of ‘living long and dropping dead’ so it’s really an empathic death over a couple of weeks that’s celebrated an otherwise healthy, full life. And you observe the differences between that when you get to a sort of urban urbanization of the Pacific… it’s like Vila or Nadi… these sorts of places… and then whole places like the island of Tarawa, where there’s really no local food supply and it’s all gone down to sugary drinks and two-minute noodles and the metabolic health has profound amputations and whatnot going on, so that’s one thing that was going on gently and you think it would be more or less gentle than that. But really it was just when we started doing work in metabolic flexibility with athletes and then people with type 2 diabetes just measuring- and we’ve done this for years without thinking about the respiratory exchange to the ratio of expired carbon dioxide to oxygen and then trying to understand fuel utilization and you saw that people were just pure ‘carb-burners’, or other people had this more developed flexibility where they could utilize fatty acids as a fuel when they’re sleeping and resting and at low levels of exercise and then they supplemented that with more and more carbohydrate burning as exercise became more intense. And that’s when it really occurred to me… and I think also at the same time if they had the Tim Noakes coming out stuff… and he certainly has been a hero of mine… I think someone who I have regarded as ‘smart’ for my whole life… and then to change his mind. I Caryn Zinn who had finished her doctoral studies with me in nutrition in a more ‘conventional way’ I should say… about this and we both went away and did a lot of work in insulinaemia with us and just… the world just came crashing in. I don’t mean in a negative way – it’s very exciting. But then the political and social ramifications of that came home to roost and it’s been a massive fight ever since.

Cliff Harvey: [00:08:19] Yeah, it’s funny even the terminology we use, you know ‘Tim Noakes coming out’… it’s pretty crazy to think that by positing something a little bit different to the accepted norm but pursuing it through the scientific method you’re basically outed as being a heretic. But… that’s the scientific method in a nutshell, right? As you develop a hypothesis, you explore it.

Grant Schofield: [00:08:41] Exactly. Dr Simon Thornley, who we both know well, is a colleague and he’s been involved in the doctoral work you’ve been doing as well. I mean, he’s very strong on that- the idea of science and what evidence says and where it takes you and that is a scientific method that you develop hypotheses and you’re sceptical about knowledge and then you could either move the body of knowledge in one direction or another. Either way, either outcome, the knowledge moves you, the more certain about this or you’re less certain about this but that’s not what happens in reality. I think the humanity of the scientists means that you’re driven into a space of that vision of the anointed and cognitive dissonance to say, ‘yeah, well mistakes might be made but not by us’. So, it’s very hard for a functioning human to go ‘yeah, this was all wrong’ and I think we’re seeing that more and more… and we’ve got to watch, both you and I, that we don’t end up those people… I mean, gosh, we so don’t want to be. But know what? We’re humans. And that’s probably the biggest fear I have in my research in public health career is that we become those that we most criticise- not open to change- because again, the knowledge will change in our lifetimes for sure.

Cliff Harvey: [00:10:06] Yeah. I think Simon Thornley is an unsung hero I think of low carb and the exploration of it here in New Zealand and he has been such a valuable resource for me to be able to go to the last couple of years because he’s really bought back home that you can be strong in your opinions, you can craft strong hypotheses, you can pursue them consummately, but you can also be excited about what you’re doing and you can write in that way… getting back to the old Feinmans and whatnot who used to write with a swashbuckling style. I think now it’s become too dry and too jargonistic. No one can understand it, and no one really cares because everyone’s whitewashing what they put out anyway.

Grant Schofield: [00:10:52] Exactly. Now, I’m going to tell you story about Simon that he told me the other day because he’s onto all sorts of alternative hypotheses as any good public health scientist should be. And the one he was talking about here has nothing to do with nutrition, it’s to do with the development of rheumatic heart fever in children. And he thinks that’s a plausible hypothesis that the rheumatic heart fever isn’t carried into the body through throat infections, through strep throat, but in fact the main carrier maybe through scabies. It’s a common skin infection in New Zealand, particularly in the lower socioeconomic areas. So, he’s interested in investigating this. He’s got a whole bunch of background research but the story I’m going to tell you now I think tells a big story that’s relevant to nutrition and expertise. So, he goes out to a South Auckland school, he takes a couple of public health nurses with him- both got some training in identifying scabies and skin infections- and roughly a quarter of the kids have permanent or long-term skin condition… which is a lot of kids in a school, really… I think it’s pretty high but typical of lower socioeconomic Auckland and between the three of them they do some different diagnoses and they reckon about half of that quarter have scabies and that responds well to topical treatment. You don’t want to give them a topical treatment of corticosteroids that you would give something like that like eczema because it actually makes it worse. So, I would be a better check on this. So, they get an expert- they get a dermatologist- English fellow comes in… polka bow tie… the whole box and dice… and you know you can imagine. He goes through all  the cases and looks at the kids and he proclaims that ‘there’s not a single case of scabies to be had here’, which flabbergasted Simon and the nurses and I think they end up treating these kids, and of course most all the cases that they had identified disappear… but I think it points to often that we think that the expert, the person who should know the most about these things, often is so clouded by other things. He was looking for the presence of burrows of scabies into the skin as being the diagnostic criteria that of course Simon’s point is, well, when you’re scratching your skin the burrows aren’t there because you scratch the burrows off… and I think you know something like low carb and keto just don’t cover appropriate diets in the way that you would contextualize it in something obvious like diabetes, a disorder of blood glucose. You either treat it with more insulin, which has a bunch of negative side effects, or you could just eat less glucose in the first place. The endocrinology community seems completely and utterly unable to see that as is a solution yet. For the average layperson it’s staring them right in the face and easily convinced by that as logic and they see effective treatments and the science is reasonably clear.

Cliff Harvey: [00:13:41] I think in the case of diabetes that the science is beyond clear. I mean, every systematic review shows a 150 per cent greater minimum reduction in HbA1c, right? From low carb versus best practices diets. The caution around that is always thrown out at the end of the paper that ‘we don’t know… Blah blah blah… Long term effects, and you know, whether the distortion in blood lipids is going to be negative, and all this kind of stuff. But I mean it seems as if there is a constant backpedalling because as you and I would see every marker that we would want to bring down is being improved by that. So, whether or not someone agrees with low carb as a general topic… I mean, for certain things there is no doubt that it is the best intervention.

Grant Schofield: [00:14:29] It is interesting in medicine because at one level people can introduce all sorts of medications with no known long-term effects, but they seem to be relatively safe on the basis of biomarkers, you know, something like an oral contraceptive will be the obvious candidate for the biggest thing in the history for no long-term effects. They introduced dietary guidelines with no long-term effects. You introduce a diet through a randomized trial that shows improvements in every metabolic risk factor that you know, and it shows overall improvement. And then they go, ‘oh well, no, we need long term studies on that’ which frankly are never going to happen. The cost of doing a long-term diet study is- we know from the Women’s Health Initiatives and the hundreds of millions of dollars… and it’s clouded anyway with long term adherence issues and all sorts of things.

Cliff Harvey: [00:15:18] What other dietary interventions are put through that same rigour anyway?

Grant Schofield: [00:15:23] I think vegetarianism and veganism are classic examples of this where often nutrient deficient diets are embraced as medically sounds without any sort of any evidence or even the metabolic improvements that you necessarily expect. There is certainly a religious layer and a belief layer over it for those types of approaches as well.

Cliff Harvey: [00:15:46] So where do you think that’s going to shift in the next couple of years? I’m really interested to know your thoughts around how dietary patterns are going to change in response to both what people are seeing in their health, what we’re seeing and the research, and what people are considering in the global context of climate change and ecological sensibility?

Grant Schofield: [00:16:05] Yeah, that’s a really interesting bit of thinking around there isn’t there with all sorts of fish hooks in it? And I guess the first thing I would say is I think in rich countries like the one we live in like New Zealand- what you have seen on one hand is a rapid increase in the demand for things like high-fat dairy and butter and those types of things but also a decrease in meat consumption There are confounding things. There’s certainly an increase in processed food consumption and a decrease in demand for things like cereals. That’s been plummeting year on year for the last decade now. Those are sort of trends and buying patterns which are interesting. You’ve got this whole climate change save the planet thing, and frankly, I do want to live on a planet that we can sustain, whether farming and farming practices have anything to do with that isn’t clear to me… it’s certainly clear that there are some fairly unethical farming practices. I had to shovel chicken crap out of a battery farming thing when I was a kid first to raise money for the rowing team I was in and from then I was deeply disturbed about the way those animals were treated and I refused to buy anything other than free range eggs and I think I’d be disturbed in the same way with pig farming in this country. I’m certainly disturbed by beef farming in the United States- especially the large multi-hectare feedlots with nothing about concrete the whole way in the sort of resources and what they’re fed on. There are ethical issues around the way we raise and farm animals that we eat that is a separate argument for the fact that meat on its own is a foodstuff. I’m not convinced there’s any relevance that fresh animal products are harmful to our health and in fact you’d have to do a randomised trial where you had diets that were roughly equivalent in nutrients, but one had the protein and fat sources from vegetable sources the other from meat and follow those people. I’m not aware of any such trial ever being done. That’s the obvious way to study this scientifically… so there’s that aspect. So, I don’t think there’s any evidence that animal products in their whole state are nothing but healthful. Seems obvious under most anthropological, Palaeolithic type analyses and just functional analyses of humans that we’re omnivorous. We are absolutely. So, that’s that. There seems to be very little discussion about the number of people on the planet. That’s just sort of an evitable fact that we’ve dealt with and at some point, there are too many people and how we manage that for the resources that we have available and those are the arguments I think we should be having rather than meat vs. non-meat. It’s also interesting to me…on the weekend I was doing some work in and I was under attack from– Because I was sort of supporting a low carb and a keto type approach- and I was under attack from the carnivore guys for being too mainstream.

Cliff Harvey: [00:19:26] Welcome to my world man, haha. I used to get criticism from the orthodox dietitians and docs and whatnot who were saying I was killing people because I was bringing their blood glucose and triglycerides down… I don’t know how that works. But now it’s that the real keto zealots, in particular, the carnivore people, saying ‘how can you entertain that some people might do well on carbohydrate?’. I mean, that speaks to the carb appropriate idea that I’m a big fan of obviously. What do you think about that? What do you think about the carb spectrum?

Grant Schofield: [00:20:06] I absolutely agree. And I think there’s a group of people that… I mean obviously, we vary in how insulin resistant we are… So, the exact same meal for different people provokes an entirely different metabolic response and it’s a metabolic response hormonally and neurally and then just even through the glucose in the blood and those sorts of things that are crucial to your health. It varies massively between people, but it also varies within yourself, both longitudinally as you age is different but just depending on the day you had in it’s highly labile. If you’ve been very stressed, then you’re going to have a very different response to the dietary carbohydrates. So, there’s an appropriate spectrum that people would fit on and for some people, it’s beyond that; there seem to be various types of vegetables, even ones low in carbohydrate however that have other responses to it. Remember that one of the benefits of vegetables may be the slight toxicity to the body and then the hormetic response to that and so perhaps it’s that these people have ever had a response that’s not adaptive to these and they respond very well by dropping all carbohydrates out altogether and cutting everything from vegetables and just going fully meat- and fat-based, and they benefit. That doesn’t mean that’s an appropriate public health recommendation, but it is on a spectrum of people that may be able to respond differently to different diets and that’s worth considering and equally, there are people who are quite insulin sensitive. My 16- and 17-year-old boys who seem to eat a range of macronutrients without consideration and be metabolically healthy and fine and quite vibrant.

Cliff Harvey: [00:21:51] I spoke about the sort of carnivore and the extreme keto side of things with Danny Lennon and Eric Helms the other day on a podcast and it was funny because obviously, Eric is more of your, you know, he would hate me saying this, but he’s probably more of the carb bias; I’m more of a low carb biased and he’s somewhere in between. But we all agree that it’s really interesting that people are doing carnivore now because probably like low carb did 20 years ago… 30 years ago… it’s starting to pose inconvenient questions for people that demand answers: ‘Do we actually need as much vitamin C as we’ve been told if we’re not eating carbohydrate? Do we absorb it more effectively? Can we get adequate amounts of vitamin C from meat and organs and things like that?’. I think those are interesting questions although I still think that carnivores probably are a risky diet if you don’t need to do it.

Grant Schofield: [00:22:49] Yeah, I agree. And people might thrive on it. And good for you. I actually don’t have any idea about the long-term implications of that. I mean obviously, whole societies seem to have persisted well on that. But those may be societies with different makeups than you and I and I’m just not certain about that.

Cliff Harvey: [00:23:11] I would say that there are no truly carnivore populations and probably actually no habitually long-term ketogenic populations either. Because the seasonal variability and you know locational variability… you know, there’s so much that goes into that.

Grant Schofield: [00:23:31] And there’s also… I don’t remember this, but you can tell me… is that the whole idea with Inuit is that their propensity to force nutrition ketosis is actually quite different than say you and I would be.

Cliff Harvey: [00:23:43] Yeah. That’s been what has been posited in the research for a long time since the 1930s- you know, they were starting to measure ketone levels that far back- and basically everything is shown that they weren’t necessarily in habitual ketosis and that the reasons for that were purportedly that they ate too much protein,  like massive amounts of protein upwards of 50 plus per cent of the diet in some cases,  but also… and because of that obviously they have really, really high levels of gluconeogenesis, they have a genetic propensity to not go into ketosis so that they can burn fatty acids at a higher rate because that’s more thermic and that’s through that malfunction in the carnitine palmitoyltransferase gene. Recently there’s been some discussion about that and whether the measurement was wrong or the measurements were wrong and whether enough samples had been taken across populations to really answer that question but unfortunately the paper that came out suggesting that was pretty- I thought it was pretty poorly written and there were a number of inconsistencies in the paper that I just couldn’t really take it seriously- but it was a pretty interesting thing again because you know we’ve got these ‘holy cows’, these ‘sacred cows’ like the fact that, hey, Inuit being the lowest carb consuming population in history still don’t get into ketosis… or do they?

Grant Schofield: [00:25:07] Yes. Yeah, that’s interesting stuff.

Cliff Harvey: [00:25:10] Yeah. So, what do you think will be the biggest shifts in nutrition in say, the next five years?

Grant Schofield: [00:25:15] Well it’s interesting the whole plant-based thing seems to be on a massive roll.

Cliff Harvey: [00:25:20] You don’t I think it’s creasing and falling now?

Grant Schofield: [00:25:23] I think you’re not going to see that. And I’ll tell you why… you don’t want to get too conspiratorial about it but when the inventors themselves published their own paper showing the influence they had head in investing in these sorts of things- they got quite large groups investing a lot of money and society in an effort to get the Sunday paper to see the full page ads on plant-based diets. I’m into a plant-based diet frankly except I have meat in it as well. Haha. So, I’m not anti-vegetables, but to claim that meat’s bad for you… I think people are concerned about the planet and it’s that whole sequestration carbon emission stuff they buy. Interestingly I think we’re understanding more fully now that they’ve buggered up the methane calculations because the half-life of methane is like 10 years… computer carbon not so much is more like a hundred years. So, the contribution that animal farming, particularly beef farming, is much less than you would have thought but I still think that’s got to roll on at the moment. I think you’ll see a big increase in that. I’m not thrilled about this, by the way, but I’m just saying the way things will probably roll out. This whole ‘meat-free meat’ stuff, which is just a bizarre situation… We’re talking about eating whole unprocessed food which is the one thing we probably should be agreeing on. We’ve got that whole artificial meat stuff coming and I just, oh, I hope I never eat any. And, you know, that’s going. Low carb and keto will continue to grow but I think it’s been a niche community. It’s been really interesting to me that in the US, in particular, one of the growth communities for low carb keto and I guess carnivore type stuff has been that sort of Silicon Valley entrepreneur early adopter type community. Big time. So maybe that’s got promise about that growing into the mainstream but who knows?

Cliff Harvey: [00:27:16] Well, keto, as far as I’ve seen in the last year it’s been because I’ve been tracking the Google Analytics and stuff… it’s definitely the biggest trending thing in nutrition. It’s not the biggest yet because plant-based kills everything else, right? But it’s well-overtaken Palaeo now which was obviously five years ago probably the biggest trending movement, and so it’s pretty interesting that you’ve got almost these two dichotomous movements that are growing quickly and obviously plant-based, is, you know, the predominant one. But I really wonder about that the ecological ramifications of diet because I think we’re at risk of falling into what happened in the 60s and 70s through the formulation of these dietary guidelines where we’re rushing based on what we see as being this big problem that’s looming… rushing into solutions that aren’t based on strong enough evidence.

Grant Schofield: [00:28:11] Yeah, that’s right. And it’s easy to do that. We need urgent solutions… the planet is warming up… there are all these ramifications… let’s just do this- we don’t it’s enough it’s worth. You know I’m the most scared about, Cliff? I actually think that at some point in the next century someone’s just going to go, ‘oh bugger, we’ll just let off a bunch of whatever things they work out- several balloons or something- into the atmosphere and we’ll make the planet a bit darker and it’ll cool down. You know, something ridiculous like that. I mean I think that’s actually not only possible but likely and then we’re interfering with stuff that we have no idea with.

Cliff Harvey: [00:28:48] And where has that ever worked out well in the past?

Grant Schofield: [00:28:52] It never had. I used to be really septic against the climate change deniers, but actually what you’re seeing in climate change is a widespread, ‘oh, the consensus is this… you know, the majority of scientists says that’ in which there is no argument that I’m aware of ever where science has taken that and there is a democracy of science and you have a vote and the people who have the most votes win. It’s not like that- it’s based on data and outcomes and that’s the only thing it should be based on. Now I do buy the idea that there’s more carbon dioxide and methane and those are likely to be human-made. I’m not denying that. But, I’m no climate change denier. But I think their argument is ‘the majority of people think this’ is being ridiculous. I was recently… well, a couple of years ago, taken aside by an eminent professor of nutrition in this country and told in those uncertain terms, ‘Well look, you think this and every other professor of nutrition and public health in the country thinks this. How could you possibly be right? And I was like, ‘well, science is not a democracy’. And he goes ‘you’re saying that it is?’ And I say, ‘no, no, no… not at all, just that they’re wrong’. And so how do you have an argument on that basis?

Cliff Harvey: [00:30:11] Exactly. I think we need to be debating, right? And we need to be debating based on the evidence. But we’re all going to… at the end of the day it comes down to opinion because we’re all going to form opinions based on the evidence that we are presented with. And so, we can’t even be this clear thing where the science says exactly this… And so, if you’re not in line with that, you’re wrong because that the science gives us data, and we interpret that data for how we can translate that into either clinical practice or into public health guidelines or whatever it happens to be. And I just think that with particularly the climate change thing… I’m like you, I’m not a climate change denier at all, in fact, I’m very convinced of the science that there is man-driven climate change and that it is a big problem. I just think that a lot of the models we have particularly with food production that is being used to justify solutions are very immature at this stage and we need to do a lot more research to see what is actually appropriate.

Grant Schofield: [00:31:15] Agreed, absolutely agreed.

Cliff Harvey: [00:31:16] I don’t know if you saw it but I did a little analysis and whether I got it 100 per cent correct or not I’m not sure but I pulled a whole bunch of data from cattle associations in the States and grain producing associations and all sorts of things and did some calculations on the sentient lives lost… and you basically kill more animals eating soy… probably also eventually yourself, but that’s probably a debate for another day.

Grant Schofield: [00:31:46] Yeah. So that’s a really interesting point and the trouble with these arguments is that there are very much beliefs precede evidence and then the evidence is brought in to back up the belief and that’s how most things in society roll, unfortunately.

Cliff Harvey: [00:32:07] Yeah. So, getting back to the real nitty-gritty of nutrition. We’ve got a bunch of research over the last couple of years. You’ve obviously been my supervisor and supported me through that process. We’ve looked at a range of different things and particularly the different outcomes from, say, non-keto more moderate low carb diets versus true low carb versus keto. Based on that what are your impressions now based on that research? For example, do you think keto is necessary or not?

Grant Schofield: [00:32:40] Well I think there are a few things about your research that’s been interesting to me. The first is this sort of whole keto flu keto induction thing. I think in general actually the effects don’t last that long and aren’t that severe and that’s good to document it, right? You’d agree with that, right?

Cliff Harvey: [00:33:02] Absolutely. I think most interestingly out of that last study which we’re about to publish the paper showing this- that the strongest association was with energy restriction not with carb restriction.

Grant Schofield: [00:33:14] Yes. And suddenly the next thing is… There is some variation- so some people do get some reasonably severe symptoms, you know there’s one or two in that first trial you did, and some have virtually no symptoms whatsoever. The thing that stands very clearly in my mind is we were doing some focus groups and this one woman said- who was a mother of young children- said, ‘Oh yeah I had quite bad symptoms’ and we were like, ‘how bad were they?’. And she was like ‘Oh well I couldn’t really get out of bed whole weekend and the kids, you know, who were 2, 3, and 4 were just running loose around the house and my husband was there and I didn’t know it was going on at all’. And you were sort of looking aghast going, ‘call me’. I think that was one example and then we had another woman that we were like, ‘so do you get anything?’ and it’s like ‘nothing. No, I didn’t notice any change and I got into ketosis’. And then the interesting thing was when we asked them about whether they were going to continue with it the woman that had the severe symptoms was like ‘oh, hell yeah, I feel so much better now… This is awesome’. And the woman who had no symptoms was like “uh yeah nah’. That just made me wonder about even if there are symptoms, we often assume that poor symptoms are really a negative thing, and in fact, in this way, there was sort of something associated with it like ‘oh well I’ve been through this I might as well carry on’. So that’s interesting. That’s first things though: symptoms and ketosis and severity.

Cliff Harvey: [00:34:39] It was almost a transcendence thing wasn’t it? Once you got through it, you know, it was like the challenge was overcome and now this is great.

Grant Schofield: [00:34:45] Yeah and I know, because I assume, she was so carb-addicted that all this ‘I actually feel good and am not getting hungry for the first time in my life and blah blah blah’. So that’s the first thing. The second thing is, yes, it’s minor improvements with MCT oil too and it could be good. Is this downsized MCT oil which I’ve observed on myself. I think the third thing is really that question about the amount of carbohydrate restriction and whether you need to get into nutritional ketosis to see most of the benefits. And I think I’m not 100 per cent clear on that. The first thing I would say on that study that you did… can you get benefits– when you ask people to restrict their carbohydrates in different ways as if any adherence to them that resembles what you’ve told them then the answer is ‘yes’. That is a big finding in and of itself and there’s this amazing thing that’s like, well people just go ‘well that might do it. I went ahead and it went to sustain it’. Well, they do it. At least the way you advise them which didn’t seem too complex. And I think that’s a translatable message. The second thing is that there are benefits from all those different levels of carbohydrate restriction. I still think on a more highly powered study with more metabolically unhealthy people I think part of the thing is that there’s a real decision that we made about studying healthy people rather than people that had serious metabolic syndrome in their responses. I actually personally think we don’t have the data for this but if we’d studied people with metabolic syndrome, we may have seen a more profound benefit of more serious restriction in carbohydrate and what that may have meant for keto induction symptoms and adherence is not clear to us so that’s a question we haven’t answered. I think it needs answering but for a healthy population right now I think some degree of carbohydrate restriction is beneficial and the differences in metabolic health are minor. Is that what you would say given more about what we’re going to have a defence of this soon.

Cliff Harvey: [00:36:58] Absolutely. I think that the differences between the interventions were relatively minor. I think the adherence between all of them was pretty much the same, even though there’s been a lot made about that in the mainstream that the very low carb group didn’t quite manage to hit their 5% level of carbs consistently it didn’t matter because they could consistently hit 8% so it was almost like  the aspirational aspect of trying to get to 5% they were still much lower than the other groups. And they were able to sustain that. But I still think one of the interesting things… and whether it translates to what people want to do or not is unimportant there still is in basically every study we look at a trend towards better results overall not per individual but overall from a greater carb restriction.

Grant Schofield: [00:37:50] That’s right and that’s why I suspect that if we had people with full metabolic syndrome, we’re going to see profound improvements at the highest end of carbohydrate restriction. I think that’s probably in support of what you would call a carb appropriate messages that if you’re a metabolically healthy person there’s a range of values you can improve over, and I think it’s probably likely that you’re going to improve more, and I think we’ve seen that in other studies as well. People with metabolic poor health have magnitudes of improvement with full keto carb restriction set in these types of studies of a much larger magnitude than what you observe in your one and it wasn’t an adherence issue it was simply a room to move issue. If your triglycerides are already 1.4, you can’t improve by 1.5.

Cliff Harvey: [00:38:42] No, exactly.

Grant Schofield: [00:38:42] You know you can’t. This system is a ceiling effect then.

Cliff Harvey: [00:38:46] Yeah, I think we certainly saw that graphically in the early analysis before I had done a full sort of analysis when we found that it wasn’t necessarily large effect sizes there and there wasn’t necessarily significance with all the measures. It was interesting just looking graphically at all the measures and seeing some consistency in that association between your baseline marker and your change depending on what that was. And that to me was pretty interesting because for all the major markers again that we look at it like HDL and triglycerides it seemed to be that progression where if you were more metabolically healthy at baseline given they were all metabolically healthy but the more metabolically healthy actually the better on less restriction whereas those who were less metabolically healthy did far better on the greater restriction. So, I still think that’s interesting in a sort of probability setting.

Grant Schofield: [00:39:39] Yeah absolutely. And I think you also make a very important point about data and data analysis and data presentation and it’s really hard to understand what happened in this study without seeing figures… graphs with individual data points scattered across them and going ‘Well, what does this look like… this is happening here and here’ and to be able to see that… and I guess I’d call it getting your hands dirty with the data… is just crucial but it’s also really important when you’re presenting that data to someone else to show the same thing it’s all very well putting up a table and going ‘this was significant’ but they have no idea of what the totality of your results look like and I’d much rather see something free of things like significance of going ‘well here’s what I saw… make what you want out of it.  Here’s the range of values and across the different people and this is what they got or what do you think?’. And so, someone as a practitioner is going to think something different who’s into this part of science and that’s a missing step in science and I was really pleased that you were able to do that level. I think we talked about it quite a lot early on. You know get your hands dirty with it and see what it says, and it allows a much broader interpretation of the science and we probably wouldn’t be in this mess especially of epidemiology if people looked at it that way. The classic for this is that there’s a Hoop Riddell Cochrane review meta-analysis of randomized trials for saturated fat reduction and different outcomes from coronary events to symptoms to mortality. You don’t really see anything for those things except for coronary events and it’s really interesting because you look at the intervention group vs. the control group and there are more events in the intervention group when you take up the totality of the studies and you put all the trials together, and you go, ‘well, this is ridiculous’. In reality, these randomized trials were done, and we had 950 heart attacks and symptoms related to heart attacks in this group and we had 980 in this group and this was a group that got the saturated fat reduction, so it actually had more. And they go, ‘Oh no no no no no no no no, nothing to do with that’. There is a confounding effect of this was a bigger study than that study and so we need some statistical adjustment to bugger around with this and all of a sudden, the result that happened, in reality, is reversed. Then you go, ‘How does it make any sense? We did these trials and the people who were in the trials got more heart attacks but because we think this and then we changed this we get the exact opposite result which didn’t even occur in reality’. So, looking at the data, understanding the raw data and seeing what it says is such a crucial thing and it’s really hard to…if you’re not trained in that or just spending the time to be bothered doing it. To take that on its face value. Another classic example that’s exploded in the last couple of weeks has been the University of Otago’s Professor Jim Mann’s claims about… in two studies, one a fibre study, another a meta-analysis which I think does show some small beneficial effects across populations with higher fibre intakes for whole grains and of grains from fibre there’s only weak evidence. So, you wouldn’t on that basis be any form of public health recommendation. The man goes on to say there is clear evidence that low carbohydrate diets… there’s sort of a death knell for them because you can’t get enough fibre from them. The study has nothing to do with low carbohydrate diets and not only that is that Caryn Zinn’s published quite good papers showing the fibre adequacy if you believe that’s even useful and Asseem Malholtra goes in front of the English Parliament and raises this and I think people underestimate this event… this is probably the biggest naming and shaming in the history of public health nutrition where in front of the UK parliament live streamed and he read it publicly… ridicules Mann and puts up Zinn’s research to refute that. So yeah that’s been going on. Then the following week same bloke comes out with another Chinese study where  they had moderate carb eaters and high carb eaters and in China, they substitute some of the carbs they’re eating with soybean oil and they notice that the gut bacteria deteriorate and again the claim is ‘well, low carbohydrate diets are death knell they destroy the gut microbes’. And this astonishing thing about that is we’ve known that soybean oil is toxic to gut microbiota in the quantities that Mann was talking about since 1945. One of the first things we knew was, soybean oil and other PUFAs are toxic and inflammatory and create a whole chain. And so, if any one of the public just look and have access to the data. In their interests they would just go, ‘huh, you’re joking’ and I guess we’re seeing more of that as the interested public.

Cliff Harvey: [00:45:04] And it’s difficult. I always bring up the DIETFITS study because I think it’s such a great example because it’s actually a good study. Very well performed study, it was controlled extremely well, the diet interventions were good because they were both on good diets unlike some of the old sorts of vegan diets and things like that. But at the end of the day you’re comparing two healthy diets– one with a fairly modest restriction in carbohydrate and yet the conclusion being that ‘well, there’s no difference between them after 12 months’– there was a difference between them because basically every category the low carb group got better results although it wasn’t significant except it was pretty close to significance for BMI and it was definitely significant improvements in HDL and triglycerides. So, I would be looking at for future health risk if you can adhere to both equally well, go lower carb.

Grant Schofield: [00:46:01] Yeah absolutely. And I think the low carb thing’s becoming obvious now if you understand your basic physiology around glycaemia and hyperinsulinaemia and the metabolic effects of high glucose and insulin then it just makes total logical sense and it’s borne out with the trial data that what we’re going to see is in fact improved metabolic health by reducing the number of times the blood glucose is up high or is just high. And the same for insulin. I mean why would you expect anything different than that?

Cliff Harvey: [00:46:35] Exactly. So, we’ve talked about carbs. I’ve been fairly big through the years on high protein diets as well and I think that got left out in the cold a little bit as keto rose to prominence. Where are you with higher protein diets?

Grant Schofield: [00:46:50] Yeah, it’s interesting. I’ve been thinking about revising some of the stuff I’ve written in ‘What the Fat” because I now think it’s wrong and I think I’ve been wrong for specific populations so I really never mentioned any of the sort of protein leverage work that I think I need to revisit and I think particularly that maybe particularly some of the indigenous populations who have persisted on much higher protein diets do very well by leveraging protein and using that as a satiating factor and we need to understand that more and I think wrongly wrote in ‘What the Fat’ and a sort of simplistic way about… because we observe that often when you start to eat extra protein on a ketogenic diet you knock yourself out of nutritional ketosis and I just assume well the only possible mechanism for that is a gluconeogenesis thing and you’re just pumping more glucose out, and I no longer believe that’s totally the case as well. I don’t even understand that full mechanism and I need to talk to you about it more, but I do need to revise both of those things. I think what I would now say about low carb healthy fat is it’s an adequate protein diet at the minimum. So, you want to be getting adequate protein like… it’s not a low protein diet… so ‘adequate’ and what does ‘adequate’ mean? Well, it’s a sort of circular argument that well you might need more if you got these needs or those needs. Do you do worse if you somehow leverage a bit more protein in and do that? Probably not and that may be different for other people. And so, we could probably start to consider some of the protein appropriateness and I’m not sure exactly how that would work. What’re your thoughts on it?

Cliff Harvey: [00:48:22] Well I agree. I think that for me, protein is probably the most important thing to set for a client first. So, I do that based on their desired outcomes- not on the desire to sort of mitigate gluconeogenesis and things because if it’s based on their desired outcomes it’s going to be appropriate based on the research as to what’s most effective. And because gluconeogenesis is demand driven not supply driven, it should actually fit in with their calorific quota and there should be enough fuel providing macro either from fat or carbs or some combination of both to basically provide for that. I also think that we freak out way too much because you mentioned it about getting kicked out of ketosis. Because I know from experience that if I’m in ketosis… let’s say I’m sitting consistently over 1.0 mmol even if I have a big low protein high-fat meal and test myself immediately afterwards, I’ll often be out of ketosis anyway… for whatever reason probably just the amount of insulin that I produce in response to just protein alone. You know, that initial insulin hit stops your ketosis, but you get back in pretty quickly. So, I think people forget that we, again, ketosis and ketones, like carbs, is a spectrum.

Grant Schofield: [00:49:38] Honestly, being well fat adapted and in this nutritional ketosis and I know we’ve talked about this, well I can go utterly off the reservation you know like beers, chips, the whole thing and be back in nutritional ketosis the next day with a little bit of fasting.

Cliff Harvey: [00:49:54] Exactly. It was my cornflake experiment that is running…

Grant Schofield: [00:49:57] You’re still eating cornflakes?

Cliff Harvey: [00:50:00] I’m actually on an anti-inflammatory diet at the moment which is working really well but there was a sort of experiment that I did for a while as you know it and a buddy of mine from the UCAN company because I do a bit with UCAN… he sent my results through to Steve Phinney and Jeff Volek and they said ‘no, that can’t happen’.

Grant Schofield: [00:50:18] Well, the only thing I didn’t like about the cornflakes was this whole Adventists connection with John Harvey Kellogg, haha.

Cliff Harvey: [00:50:21] Ha-ha, I’m not a big fan of that stuff. It certainly doesn’t fit with an anti-inflammatory diet. But I think it is interesting that now, you know, the work that’s being done with the Gonzo self-experiment is out in the field. You know, your Paul Cadman’s, yourself, me… yourself… you know, all these weird people doing weird things. We’re blowing the doors off what people thought ketosis was all about. You know, we got blowback obviously from that reviewer for one of our papers because he couldn’t put ketosis or ketogenic diets in any other context than a really low protein really high-fat diet for kids with epilepsy and go to 3 mmol and people just kind of the cheat that normally anyway.

Grant Schofield: [00:51:08] And why wouldn’t you want to?

Cliff Harvey: [00:51:10] Exactly. Particularly now when we’ve got… if you did want high ketones, we’ve got cool things like MCT’s and whatnot. Diet can be a lot less restrictive than people think. And I think we’re too often mired in the old paradigm of keto for epilepsy and I think we’re going to break out of that.

Grant Schofield: [00:51:30] Yeah that seems to be stuck there and I think… have you had Dan Plews on your show?

Cliff Harvey: [00:51:35] Yeah. Dan and Paul I had on last year and their podcasts were the biggest by far because people are fascinated by mixed fuelling.

Grant Schofield: [00:51:44] Yeah. So you know I’ve just been working with Dan quite closely and with the staff and then I’ve been training an athlete to do… did pretty well fat adaptable… mixed fuel… you’d be surprised how many carbs which he used faster on the day but in particular training sessions so essentially the keto people are just going ‘holy…’ but I mean I have this guy Matt… I’d have him do these sessions with a reasonable amount of intensity…. a lot of carbs… 200 grams of carbs in the session and he’s still in nutritional ketosis.

Cliff Harvey: [00:52:19] Exactly. That’s why I think we’ve discussed the lot and with Caryn Zinn as well about the difference between the mainstream perception of ‘you must have under X amount of grams per day of carbohydrate to be in ketosis’ versus is what I’ve thought for the last 20 odd years which is it doesn’t really matter as long as there is an appropriate percentage of carbohydrate of your calorie requirement.

Grant Schofield: [00:52:46] Yeah and there’s also a flux of different fuel utilization out as well which makes a massive difference. It’s like people going ‘you need 8 glasses of water’, well, it’ll totally be different if you’re sitting in a sauna all day or if you’re sitting in a freezer. There are different outs, so…

Cliff Harvey: [00:53:00] That area I think is fascinating and I would love… maybe we can do this in the next year or something… but I would love to look more at some of the old paradigms that have been used by athletes for probably 50 years, like cyclic ketogenic diet and targeted ketogenic diets. Really looking at that mixed fuel usage and looking at whether there are additional benefits from that because there are so many unanswered questions in the area of keto.

Grant Schofield: [00:53:29] Yeah. I really subscribe increasingly to the idea that this cycling of anabolic and catabolic is really what’s crucial for long term human health and well-being. And so moving in and out of nutritional ketosis is an absolutely natural thing and on one hand you’ll get into the shopping mall and you go well I’ll go find the person of nutritional ketosis just like no one and… so, they’re in a constantly anabolic state and that’s obviously a problem metabolically and that’s probably where a major public health issues are. The going on strict keto and trying to stay in nutritional ketosis– And this is a really strong therapeutic reason that you might need to be. I actually think it’s a mistake, both behaviourally and probably physiologically as well and that mix of signalling up and down sort of like intermittent fasting for some of that. I like weekends because sometimes on weekends you get a bit carried away with the friends and I’m not advocating junk food but it certainly allows that sort of anabolic-catabolic transition easily to move in and out and that’s something that I really think is going to be an interesting idea as we move forward for those people who are really interested in not so much public health but in maximizing their own health and well-being.

Cliff Harvey: [00:54:47] Yeah, I also think going back to that sort of question of what’s going to happen in the next five to 10 years… I think we are going to begin to drill down a lot more into the behavioural side of nutrition and even more than that the mind-body ramifications of health. But I think a big part of that is developing those strategies. You know I sort of call it having ‘freedom within structure’. Like what you suggest. For example, my partner and I are low-carb pretty strictly through the week, but we have our treats in the weekend because our area under the curve of carb intake is still pretty freaking low. So, who are your go-to people? I think you mentioned a few of them but right now who are you finding really interesting in the nutrition space to go to and get information from?

Grant Schofield: [00:55:33] What’s interesting I’ve actually been rather than nutrition at the moment I’ve been slightly into more mind-body stuff and…

Cliff Harvey: [00:55:39] You and I swap back and forward, eh? Ha-ha…

Grant Schofield: [00:55:45] And I’ve been really… it depends. My normal go-tos are Volek and Phinney and I started listening to Peter Attia a bit more, then it got a bit too much for me. I think he was just getting too bloody arrogant and it pissed me off in a Tim Ferriss sort of way. Quite interesting. And more recently now I’ve just started to be doing a lot of Sam Harris and the sort of waking up type meditation stuff… I’ve been really interested in mainly through a special forces soldier who loves working with nasal breathing and nitric oxide and those pathways… those obviously have implications for insulin resistance and vasodilation and those sorts of things. Interestingly I think the mind-body stuff is sleep and its role and how nutrition interacts with it and the use of carbs for a better night’s sleep. I think that actually does have a role. That’s the space I’m mostly just reading about in my lying around time at the moment and that sort of thing. Going through nutrition I mean we’ve still just got our standard trial stuff. As you know there’s a paper a week that needs reading and rebutting or is interesting and it could come from anywhere at the moment because there is a lot of research going on around the world. What about you? What were you in the mind-body space, speaking of it?

Cliff Harvey: [00:57:14] Especially now coming to the end of this sort of PhD process, I’m more and more interested in it as I was before starting this process because I think that it’s the next step in health… I think is the next step in medicine and I think we’re getting to a point now where it’s not enough to set the foundations of health RE: nutrition and physical exercise and things like that… and sleep and whatnot. Because if you do all of that you’re still not necessarily living in objectively desirable life there’s gonna be something more than that and that comes from, you know, discovering creativity, passion, and purpose and those things. And I think the whole spectrum from the foundations of health right up to creativity, passion, and purpose basically rests on how we can have a positive mind-body state. And so, I think there are exciting things to look at in the research there and I’ve got a bunch of ideas that I’ll throw by you at some point but you know I would love to go on and do a lot more of that research as well as keep filling in these gaps in the nutrition research as well.

Grant Schofield: [00:58:22] Yeah and they’re not sort of separate things like they quite deeply interact. And you know one of the amazing things to me is a simple, quick mindfulness meditation. Even you know five or six breathe deep relaxed empty mind belly breaths before you eat a meal and the profoundly different glucose and insulin response you have is astonishing. I mean you can halve it by that one behaviour. And so, when you start to think about metabolic health as just being what you put in your mouth it’s not the case.

Cliff Harvey: [00:58:55] There’s even a bunch of studies coming out I think that the guys at Mass that Eric’s involved with that just reposted one as well. There’s a bunch of studies that seem to be coming out showing that our perception of food has a massive impact on how we respond to it physiologically as well. Whether that was the arena of the study on the two drinks– one was a weight loss drink and one was a weight gain drink. Same drink but people’s leptin and ghrelin responses were completely different to the two drinks depending on what they thought they were.

Grant Schofield: [00:59:26] Well, that’s astonishing isn’t it? And to fully unpack that and understand how to deal with that and what they might mean behaviourally is just not clear to me but it’s cool. Some just treat food as it’s just what goes into your mouth and the physiological response to that by itself is clearly not the case.

Cliff Harvey: [00:59:46] It’s very exciting and I think it’s been bubbling away for a long time. You know, you remember that Dianabol study where they gave people placebo Dianabol- a steroid, and they put on massive amounts of muscle compared to the control group. It’s crazy, but yeah, interesting stuff.

Grant Schofield: [01:00:04] Yeah. So most of my reading recently has been I’ve read two books that Simon Thornley got me onto– one was called ‘Cracked: Why Psychiatry is Doing More Harm than Good’, and another one called ‘Placebo’ which is written by an Australian professor of orthopaedics, and those are both really interesting and good reads if you’re thinking about medicine and where it goes into creating cases, creating sickness, and then creating cures that don’t even work. And the ethics of that and those sorts of things are something that’s worth considering well especially the context of those that you just mentioned.

Cliff Harvey: [01:00:40] I mean it sounds when we start talking about things like that again it sounds conspiratorial but from what I’ve seen there have been some pretty good reviews of the efficacy of antidepressants for standard depression. I think there’s a bit of a difference when it’s really severe major depressive disorder, but for standard prescription of depression. And the results are terrible when you compare them to placebos– it’s the same thing.

Grant Schofield: [01:01:02] Yeah, yeah… so placebos work but only as well as…

Cliff Harvey: [01:01:05] As the drug.

Grant Schofield: [01:01:08] But I think it’s slightly different for more serious depressions where there’s probably some drugs and you look at other things like bipolar, psychotic disorders, and these sorts of things and you just go ‘oh my God, the balance of harm versus good’. This must be taken into consideration as well. And that’s also the same case with orthopaedics and you sort of look at the efficacy of surgery above sham surgery. It’s just non-existent for a whole bunch of things. But you know a couple of things like a hip replacement does work and you’re way better off but you know a knee arthroscopy it for a minor tear– no, you might as well do nothing. But you need to think that you’ve done something. So… how do you unpack that? It’s so interesting.

Cliff Harvey: [01:01:53] Well I wonder… to sort of tie that off… I wonder if maybe in the next decade we might move towards a gentler approach… first approach to health whereby we are looking– for example for chronic back pain and nutrition interventions and mind-body meditation things like that in the first instance rather than jumping straight into surgery. I mean that would make sense to me because the evidence is there anyway.

Grant Schofield: [01:02:21] Yeah, it’s interesting but what you going need is that there’s a guy Glen Davis who’s a general practitioner down in Taupo I’m working with– he’s got a reversing diabetes group… he’s got a thousand of them on it now. There’s a marae in Waitahanui which is 10k down the road towards Turangi– the whole marae has decided for some reason to go keto– it’s extraordinary– but one of the reasons for that is Glen’s just like ‘okay, in the first instance if you want to come to me I don’t do statins, hypertensives, anti-depressants. I just don’t do them. You know, have a go at these nutrition and lifestyle interventions first. Otherwise, I’m not your doctor, find someone else’. And that’s pretty brave but we’d need that sort of widespread change in general practice medicine, that sort of attitude to start to purvey it and I think that’s possible. I think many physicians that I talk to are disillusioned with the work they do and in many ways, their life exists outside of their practice. They now do that to get some money and they’ll go mountain biking or hiking or whatever they want to do. And you know they’ve lost interest in their career which is such a shame because it was pretty much the smartest guys who always went off to med school and they didn’t stay that way.

Cliff Harvey: [01:03:40] Yeah,  I think we’re seeing a bit of a groundswell of change. You know, just from the work that you’ve been doing with low carb GP’s and you know I’ve seen a lot of that… I now get a huge amount of referrals from GP’s and I was asked to speak it at ACNEM [Australasian College of Natural Medicine] a bunch of times actually… we’re both speaking there again but I find that really interesting because you’ve got doctors that take a more holistic yet evidence-based approach and they’re looking outside of the norm for additional advice and additional information.

Grant Schofield: [01:04:10] Yeah well, the interesting thing in Australia at the moment as part of that whole thing– integrative medicine is taking a bit of a beating at the hands of conventional practice because of going ‘well where’s the evidence’ and the mind-body stuff is there.

Cliff Harvey: [01:04:30] So with that in mind what does the next year hold for you, Grant? What are you working on that’s exciting right now and where do you see things going in the next year for you?

Grant Schofield: [01:04:39] Well I’ve got a few things going so… and they’re sort of low carb stuff and I put out a new low carb recipe book- the ‘What the Fat’ recipes that came out on Friday. So that’s cool.

Cliff Harvey: [01:04:50] Where can people find that, Grant?

Grant Schofield: [01:04:51] ‘whatthefatbook.com’ or just any local bookstore and all over the place here and in most countries. So that’s all good. The second thing, we’re in this ‘PreKure’ which is a social enterprise, ‘PreKure’ with a ‘K’– prevention is cure, food as medicine, fitness is medicine– that sort of stuff to try and offer easy to digest packages. And I think tertiary education has utterly lost its way. And I work for a university as well, but the value proposition of tertiary education I think you’re going to find is flimsy for the money involved… if you have to turn up with cash for the full cost of education every time you saw someone… you go ‘oh yeah, here’s three thousand dollars’ is astonishingly poor. I think you going to find that the private training industry is going to overwhelm that with niche work and our niche is to try and teach lifestyle medicine, prevention is cure, particularly to medical professions and health professions. I’ve got that on the go. Research-wise I’m still interested in the idea that cities could be designed around kids not cars and the free-range kid and that sort of social network… I’m still interested in that. I’ve got a new nutrition course this year… my third year called ‘Lifestyle and Nutrition’ and I decided that rather than having dumb ass exams and stupid stuff that no one learns in I think the whole course is about building a giant community garden on campus so I’ve sort of secured the area on the campus the size of a football field and we’re just going to start a multi-year project where year after year we build both the social media engagement, the brand, the community engagement, the actual planting and the infrastructure to support that. And so, you’re eventually going to see this giant garden on AUT’s north campus and I’m trying to get the outdoors guys to be interested in it and at the same time replanting over the other dipshit grass by certificates might into a kauri forest with natives and stuff. The grounds staff is so into it they’ve already got the whole bee thing going. Unfortunately, we didn’t realize we had to have beehives off the ground when it rained so, unfortunately, the queen actually drowned when it last rained. But we had to go get some more queens…long live the queen! So that’s a massive project and research-wise the low carb stuff will continue. I’m particularly interested in the mismatch between the perceptions between oral health and general health– you know, that fat is protective in the mouth… that starch of all sorts is the problem. And you know dental flossing does nothing in cleaning your teeth as a sort of a last-minute strategy particularly everything I think we could make progress there. The problem in New Zealand and most countries is that the major cost for hospitalisation and for our kids is being anaesthetised to get teeth filled. It’s just disgusting. Totally preventable. But it’s a teachable moment regarding diet because obesity certainly isn’t. So, you know maybe we can do some stuff there. So I’ve got onto there and we’ve got a whole little research technique about asking… we just asked a whole bunch of General Practitioners and nurses and parents and 10 to 12-year-old kids using the exact same technique of sorting cards to say what behaviours are the most important for your health and oral health and which things do you think are the best and worst for your body and it’s the… first of all the kids seem to know as much as the doctors. And there’s a real mismatch between some of the things that are known to be protective and those are not so much. So, I’m interested and that’s been a really interesting thing for me as well.

Cliff Harvey: [01:08:39] So I mean you’ve got a lot of things on as per usual. I’ll put in the Show Notes obviously how people can get in touch with you and your work… the ‘What the Fat’ book site and PreKure and all those things. I’m also linked to you on the Human Potential Centre. And I’m pretty stoked, Grant, to hopefully be involved with some of that stuff for the next couple of years as well.

Grant Schofield: [01:09:01] Yeah let’s bring it on. It’s gonna be awesome.

Cliff Harvey: [01:09:04] Thanks for being on the show today mate. I can talk to you like literally for hours and we have done that many times over a few coffees so I would love to get you back as well. There’s a couple of things I didn’t get around to. I’ll tease one of those out — I’m really fascinated in your opinion on the growing area of psychedelics for treatment of mental disorders, but we’ll leave that for another time. If you happen to come back, I’ll get you back on but thanks for being on today, mate.

Grant Schofield: [01:09:31] Cheers, mate.
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