Season 1, Episode 3

Mayor of Ketotown

by | Jul 30, 2019 | Podcast

Dr Glen Davies (GP) has turned his medical practice and a whole town around. His low-carb keto approach to reversing diabetes is something you just have to hear about.

EP:03 New Zealand's Ketotown

Hosts & Guests

Prof Grant Schofield

George Henderson

Dr Glen Davies (GP) 

 Resources

 

About This Episode

Grant Schofield:               Today I’m with Dr. Glenn Daviess, who’s a general practitioner in Taupo in the middle of New Zealand, and I’m down in his place and we spend quite a bit of time exploring what he’s about.

Grant Schofield:               This is a real character of a guy. This is a guy that you will see has fundamentally changed the way he practices medicine and approaching the whole lifestyle is medicine angle. He’s reversing diabetes in his community, he’s got right hold of it. You’re going to love this. This guy is special and where our doctors need to be heading.

Grant Schofield:               Grant Schofield here with Dr. Glenn Daviess. Can you just say who you are and what you do?

Dr. Glenn Davies:             I’m Dr. Glenn Daviess. I’m 53 last time I looked. I’m a GP in Taupo.

Grant Schofield:               Where do you work?

Dr. Glenn Davies:             At the Taupo Medical Center. The other thing I do is I’m involved in the Australasian Society of Lifestyle Medicine and I attempt to be a lifestyle medicine practitioner.

Grant Schofield:               Okay, so I’ve got the big five questions for you, Glenn. Are you ready?

Dr. Glenn Davies:             Yeah, go ahead.

Grant Schofield:               First of all, you work in the health system every day.

Dr. Glenn Davies:             Mm-hmm (affirmative).

Grant Schofield:               What’s good about the health system?

Dr. Glenn Davies:             Okay. If I had a car accident and the paramedics would turn up, and they are incredible, they would take me to an ED or an emergency department and I would get the top quality care. If I needed to be in ICU I would be just looked after so, so well. If I needed surgery, acute surgery, then it would just be fantastic.

Dr. Glenn Davies:             That part of the healthcare system has done so, so well. The part that’s not done so well is chronic care management. We’ve just got that all wrong. Most of what I do in primary care, we’re just doing very, very badly.

Grant Schofield:               What is chronic care management?

Dr. Glenn Davies:             I was just going to be a little bit facetious in answering your question. Chronic care management is everything to do with insulin resistance, but I know that wasn’t quite what you’re asking me. Chronic care management is obesity, overweight, type two diabetes, ischemic heart disease, cancer, Alzheimer’s. It’s basically, I think 70% of consultations in primary care are for chronic health conditions.

Grant Schofield:               They’ve already got these?

Dr. Glenn Davies:             These are conditions that people have already got, so this is distinct from a child with an ear infection, a child with a sore throat, a sprained ankle, a fracture.

Grant Schofield:               Right and those latter ones you think we deal with quite well, you’ve got an ear infection, we can do something about it.

Dr. Glenn Davies:             Well yes and no. I think we’re actually getting better, because you’re bringing up the topic there of inappropriate antibiotic use, and I think we’re actually better than we were at that. Saving antibiotics for when they’re really required and not using them willy nilly as we have in the past. Apparently they don’t work for viral infections.

Grant Schofield:               Are you still … There are people coming in looking for antibiotic prescriptions?

Dr. Glenn Davies:             Yes, but I think people now expect only to get antibiotics when they need it.

Grant Schofield:               What do you say?

Dr. Glenn Davies:             If I recall the guidelines for ear infections, it’s if the pain has persisted for more than 48 to 72 hours, then it’s appropriate to use an antibiotic in an ear infection, otherwise it’s not. There’s guidelines for sore throats, so [inaudible 00:04:22] treat, otherwise probably not required.

Grant Schofield:               Okay, back to the chronic conditions then, so we’re talking about really the treatment and management of those. What about prevention? Is that part of your job?

Dr. Glenn Davies:             That’s a fantastic question. It really should be, but I think we’re appalling at prevention. It should be the responsibility of primary health care, but we are still functioning as the ambulance at the bottom of the cliff rather than preventing these conditions.

Grant Schofield:               What does a typical day in a general practice look like for a doctor in general practice?

Dr. Glenn Davies:             General practitioners would see somewhere between 24 to 40 patients a day. Consultations are generally 10 minutes to 15 minutes, and people will come in with their presenting complaint and we’ll do the best we can to manage it, and that presenting complaint could be anything. I think that’s one of the challenges of general practice.

Dr. Glenn Davies:             If you’re a neurologist, you’re going to see a small number of conditions most of the time. I think the challenge at general practice is you could see someone with Alzheimer’s disease who’s got behavioral problems, you could see a child with a sore ear, you could see someone with a sprained ankle, then you could see someone with uncontrolled heart failure. It’s that ability to …

Grant Schofield:               Or metastatic cancer or anything.

Dr. Glenn Davies:             Or a new diagnosis of cancer or somebody concerned about HIV. You know, that’s the challenge, is you really have no idea what’s coming through the door, and I guess having the …

Grant Schofield:               Is that part of the excitement of it all as well and the …

Dr. Glenn Davies:             I guess it is, but you know, if you think about a specialist, really they know a whole lot about a small amount of things and it’s absolutely fantastic that they know everything there is to know, for example back to our neurologist, everything there is to know about Parkinson’s disease. The challenge for the general practitioner is just to know enough to be able to make the diagnosis, but you can’t possibly be all over the topic of Parkinson’s disease like the specialist can be, but yeah, it makes it exciting. It really does.

Grant Schofield:               What’s changed over the years from when you started? You’ve been practicing for how long?

Dr. Glenn Davies:             I’ve been practicing in Taupo for 22 years.

Grant Schofield:               What’s different now than five years ago, 10 years ago, 22 years ago?

Dr. Glenn Davies:             About 18 months ago I developed a real interest in lifestyle medicine and that has dramatically changed the way I practice general practice. When I think about lifestyle medicine I’d say there’s two types of medicine, there’s pharmaceutical medicine and there’s lifestyle medicine.

Dr. Glenn Davies:             Pharmaceutical medicine is what I used to practice. I would make a diagnosis and then I would run through my head, which is the best pharmaceutical agent to use for this condition.

Grant Schofield:               And then write your prescription and that was it.

Dr. Glenn Davies:             Write your prescription, and if it wasn’t fixed by a drug you’d probably fix it with surgery. You know, that was basically the entirety of it. Now what’s completely …

Grant Schofield:               Just hang on, that’s interesting. In a day’s practice in that mode, the pharmaceutical mode, that’s 90% of what you’d be doing?

Dr. Glenn Davies:             I would say over 90% of what you do. Listen, examine, make a diagnosis and then which is the most appropriate medicine to use in the situation, that was general practice.

Grant Schofield:               Wow. What’s changed?

Dr. Glenn Davies:             Now my life has become much, much more difficult, because now instead of actually making a diagnosis and prescribing a pharmaceutical, now what I do is I start asking why, you know, why did this person develop the situation, and then you ask why again and why again, and you start thinking about the determinants of the end result. You start thinking about the stress, the sleep, the cultural environment, particularly their diet, but you know, that’s just opening … When you keep it to pharmaceutical medicine it’s just so simple and clear isn’t it, and it takes 30 seconds to write a prescription.

Grant Schofield:               Right. You don’t open that door.

Dr. Glenn Davies:             You start opening the door and wondering, you know, this person is a refugee and immigrant, what’s happening for them in their lives? What supports do they have? Is there a language barrier? Are there illnesses that they’ve brought with them? You know, it just starts … I don’t know, it just opens things up so much that you start … It could almost become overwhelming to start doing that.

Grant Schofield:               Then what happens? How does the consults go on from there, so you’ve asked the whys?

Dr. Glenn Davies:             What I’ve concluded is that there is probably one cause of most of the chronic health conditions that we see and that’s insulin resistance or hyperinsulinemia.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Generally that’s a consequence of a high carbohydrate diet, and I think that of all these things that we talk about in lifestyle medicine, we talk about stress, we talk about sleep, we talk about exercise, we talk about relationships, nutrition is the big factor. Nutrition’s probably 90% of it. You sort people’s nutrition out and I think most of these other things improve by themselves, and the key to understanding nutrition is to understand insulin resistance and the role of insulin, and going back a step, the role of carbohydrates causing hyperinsulinemia causing all these downstream effects of insulin resistance.

Grant Schofield:               You can’t control your blood glucose, you end up with high amounts of insulin in the blood and both of those combined are risks for eventual …

Dr. Glenn Davies:             For everything.

Grant Schofield:               For everything.

Dr. Glenn Davies:             Yeah. High carbohydrate diet, insulin goes up and insulin is a switch, okay. This is the clearest way to think about it. Insulin is a switch. You switch it one way, high levels of insulin, that’s anabolic, that’s about building.

Grant Schofield:               Which we need from time to time.

Dr. Glenn Davies:             Which you need and if you’re going to the gym and you’re wanting to build muscle, absolutely, yeah.

Dr. Glenn Davies:             You want to build, and then you switch the other way, insulin levels are low, that’s catabolism, and that’s when you rebuild and that’s when you renew.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             When you apply that to thinking about cancer, you know, when you’re destroying cancer cells that have popped up, that’s not going to happen in your building phase, that’s going to happen in your phase where the insulin levels are low.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             The big problem is that people do not get the insulin levels low for a majority of the day, which needs to happen for health.

Grant Schofield:               How do you deal with this? Say you’ve got someone coming in, they’re presumably expecting a prescription and then you’ve gone, why, why, why, and you’re thinking around diet and lifestyle. How do you now transition to doing something about it?

Dr. Glenn Davies:             Okay, so well one of the tools that’s really useful is to be able to measure fasting insulin and fasting glucose.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Then there’s an online calculator called QUICKI that has a very good correlation with the gold standard for measuring insulin resistance. Ideally I’d like to calculate what the QUICKI index is. If it’s above 0.45 then you’re normal, if it’s below 0.3 you have diabetes and if it’s below 0.399 you have insulin resistance.

Dr. Glenn Davies:             Looking at the United States statistics, 86% of adults in the USA now are insulin resistant.

Grant Schofield:               Wow.

Dr. Glenn Davies:             86% of adults in the US will fall into that range on the QUICKI index. To me that’s really powerful because I can say to people …

Grant Schofield:               Do you think we match the same in New Zealand?

Dr. Glenn Davies:             I’m sure we will be, because you look at HbA1c, look at obesity, it seems to be pretty much the same everywhere around the world, doesn’t it?

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Well then New Zealand seems to be, we’re in bronze middle position on the obesity stakes, are we?

Grant Schofield:               Yeah, possibly predominately because of the large mass of Maori and Pacific people that we have in the country.

Dr. Glenn Davies:             Yeah, if we can come back to that Maori and Pacific at some stage, because I think what we’re talking about here is really relevant in that situation.

Grant Schofield:               Yeah, and so you eventually say, hey look, I’m actually not going to give you a medication or do you do the medication as well or this is what I want to do? What happens now?

Dr. Glenn Davies:             What I’ll do is I’ll say, you’ve got obesity, you’ve got type two diabetes, and instead of diabetes being a condition that will slowly get worse and eventually you’re going to go blind, need a kidney transplant and your legs are going to get chopped off, now I say, well that’s not the case at all. This is something that you, by taking responsibility for your diet, can turn around and you can now be normal.

Dr. Glenn Davies:             I say to people, I explain that it’s all due to the high carbohydrate diet. They need to get the insulin levels down and I’ll talk to them about a low carbohydrate or a ketogenic diet. Then I’ll give them some resources.

Grant Schofield:               Is that what they’re expecting?

Dr. Glenn Davies:             No. Hell no, but I was just going to talk about the resources. I came across this very good book and we seem to have about 200 copies of it in our practice, and it’s by, I keep forgetting his name. He’s a professor of public health AUT.

Grant Schofield:               Oh, so you’re giving away What the Fat books?

Dr. Glenn Davies:             Yeah, yeah, yeah, yeah.

Grant Schofield:               Good on you. We appreciate it.

Dr. Glenn Davies:             Yeah, so that’s what we use as our …

Grant Schofield:               That’s been a reasonable resource for you?

Dr. Glenn Davies:             That’s been a fantastic resource. We give away copies of What the Fat, and we’ve also got another resource that we’ve prepared, and I give that to people and I just say to them, you go and study, you go and learn this stuff, go and look at every YouTube clip you can find and learn everything you can about low carb diets, and wow, amazing results. We’ve now had 36 people that have reversed their diabetes or prediabetes. 36 and that’s from probably zero and that’s an …

Grant Schofield:               What do you mean been by probably zero? What does that mean?

Dr. Glenn Davies:             I don’t think we reversed anyone’s type two diabetes before and now we’re getting people that are going from the diabetes range and into normal HbA1c ranges with using low carbohydrate, healthy fat and ketogenic diets.

Grant Schofield:               Right, and that’s the sort of results that we’re seeing from the actual trials as well, the [inaudible 00:15:21] study and these types of things [inaudible 00:15:22].

Dr. Glenn Davies:             Yeah and this is kind of real life. This isn’t big interventions, you know, this isn’t big trials with lots of resource and researchers. This is little old me sitting in my room and saying, this is a really good book, why don’t you go and read it, and here’s a printout which lists the foods you can eat, go and do it. Then they come back, I recheck their HbA1c and they’ve gone from diabetic to pre diabetic, and that’s it, that’s all we’ve done. It’s like low cost, simple general practice intervention.

Grant Schofield:               But you’re being a little bit shy here in many ways, aren’t you, because you’ve also got a social media and actual physical group that comes together, and that is interesting because that goes beyond normal practice. Tell us a bit about that.

Dr. Glenn Davies:             Yeah, so for about a year we’ve been running a group called Reverse T2 Diabetes Taupo. There’s a thousand people on the Facebook page and we meet once a week and we discuss either a topic or we do our beginners keto meeting where we just discus the basic science.

Dr. Glenn Davies:             Some of the topics we’ve done have been awesome, we’re about to do one on Alzheimer’s. We’ve looked at the role of ketogenic diet in cancer. We’ve had a man who’s done a carnivore diet for four years.

Dr. Glenn Davies:             We’ve tried to use Marae as much as we can to host the events. Yeah.

Grant Schofield:               As you said that is quite a big change in practice really, that’s part of your practice now is running social media groups and meeting people in the community, not at your practice. What’s that like?

Dr. Glenn Davies:             Yeah and I must admit I didn’t have a Facebook page before I started this so that’s a whole new world.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             I don’t know. I love it. I just enjoy that whole environment of being with a group of positive people and we’ve had up to 120 people in one of our meetings.

Grant Schofield:               Wow.

Dr. Glenn Davies:             I was expecting 10.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             It’s always a bit disconcerting.

Grant Schofield:               Well 10 is good than none though, right?

Dr. Glenn Davies:             Yeah, but it’s disconcerting when you intend to talk to 10 people and there’s 120, isn’t it.

Grant Schofield:               That’s good. [inaudible 00:17:42] go that I’ve talked to you since, I mean which I found profound, you said, “I’ve only just learned how to do my job.” What do you mean by that?

Dr. Glenn Davies:             Well, this comes back to that comment about pharmaceutical medicine versus lifestyle medicine. With pharmaceutical medicine I think generally you’re just fixing the symptoms. With lifestyle medicine, you’re actually able to cure the cause of the problem, and that’s the difference. I’m actually a healer now, whereas before … I don’t know, I was [inaudible 00:18:23] data, what was I doing before? I was just treating people’s symptoms, which has a role, of course it does, but now I’m actually a healer, which I think is what we all hope to be as doctors and health professionals.

Grant Schofield:               What do you say to other GPs who are still thinking about that move?

Dr. Glenn Davies:             Well, I’m involved in promoting lifestyle medicine. I think lifestyle medicine, for example, the Australasian Society of lifestyle medicine, that’s a fantastic group to get involved with and you learn the skills and develop some of the tools to practice lifestyle medicine.

Dr. Glenn Davies:             Hopefully people are going to see the results like 33% … No, 33 people have reversed their type two diabetes and they’ll go, wow, I want to get in on this, and a lot have. A lot of my colleagues really have jumped on board with this, but others haven’t.

Grant Schofield:               There’s also a whole community here, a Maori, that you’re peripherally involved with. Tell us about their story and what’s going on there, because that’s interesting, isn’t it?

Dr. Glenn Davies:             Yeah. Waitahanui is a small community about nine kilometers south of Taupo. Everyone in New Zealand has probably driven through it. It’s a 70 kilometer an hour area. There’s about 100 houses there. In the past it’s been, a low socioeconomic area with a lot of problems, but now there’s some amazing …

Grant Schofield:               All be it a nice spot. You’re lake front and then you’re off into the Waitahanui River and the forest there is just …

Dr. Glenn Davies:             Beautiful, yeah. There’s 100 houses there and they’ve built a new marae. There’s amazing leadership in that community, outstanding leadership, and they’ve adopted a ketogenic diet and they’re now measuring their weight loss in tons no longer in kilograms

Grant Schofield:               The whole community’s gone for this approach?

Dr. Glenn Davies:             The whole community.

Grant Schofield:               How’s that going?

Dr. Glenn Davies:             I might be exaggerating to say the whole community, but I would say a majority of the community, including the catering at the marae.

Grant Schofield:               The [inaudible 00:20:30] of public events and the sort of food that’s served up there, which is pretty common.

Dr. Glenn Davies:             Yeah, so previously I think marae have had a bad reputation in the past for the food that they’ve served at tangi, for example. Now Waitahanui marae in serving ketogenic food at tangi, which is quite a change. That really is quite a big difference.

Dr. Glenn Davies:             This whole community has got behind this and they’ve even got their own language around keto. They talk about the keto [Foreign Language 00:21:08], [Foreign Language 00:21:08] meaning vision or mission. They talk about cheato, which is when you fall off the ketogenic wagon, they talk about cheato. They all support each other, and yeah, really amazing.

Grant Schofield:               Why is it so interesting to you and why … I find that quite special and motivating, but what’s interesting to you about it?

Dr. Glenn Davies:             Well on a personal note, I lived at Waitahanui when I first came to Taupo. I was married at Waitahanui and so I have a strong association with that community to begin with, but what excites me is that, don’t you get despondent when you see Maori at the wrong end of all the health statistics? You know, they are wrong end of all the health statistics and now we’re seeing a community that’s at the right end. Their weight loss is out of this world.

Dr. Glenn Davies:             What I think this comes down to is that Maori have only had exposure to sugar and refined carbohydrates for 250 years. You know, Captain Cooke brought sugar and refined carbohydrates to New Zealand 250 years ago, and Maori …

Grant Schofield:               It didn’t help.

Dr. Glenn Davies:             It’s the cause of so many of these problems, and 250 years is just a blink of the eye in terms of genetics to adapt to a major environmental change.

Dr. Glenn Davies:             I’ve read that it takes 20,000 years to adapt to a major environmental change. Europeans have had exposure to agriculture for 10,000 to 12,000. Maori have had 250 years. What’s that? Five generations, it’s just not enough time to adapt, and that’s why Maori do so poorly with refined carbohydrate and sugar, but why they do so exceptionally well when you take it out. They do better than Europeans when you take it out, because of the fact it’s only been 250 years, and that’s why I get so excited. You know, that’s why we see these results.

Dr. Glenn Davies:             Yourself and I, we did a little venture down to the Pub and the Scrub, didn’t we.

Grant Schofield:               The Pub and the Scrub is a site to behold, I’ll tell you. It’s fantastic.

Dr. Glenn Davies:             The Pub and the Scrub is a converted house, which is down a gravel road beside the Waitahanui River, and we went there on a Friday night. We were so warmly welcomed, weren’t we? Really, really warmly welcomed, and I can recall you talking to a gentleman and you’d had a reasonably long conversation with you and you came back and Bill said, “Oh, he’s lost a heap of weight,” and you went back and talked to him and you said, “How much weight have you lost?” He went, “Oh a bit.” Then you come back …

Grant Schofield:               It was 48 kilos or something, from memory. Yeah.

Dr. Glenn Davies:             Yeah, yeah, and he was just so low key about it, wasn’t he? “Yeah, I’ve lost a bit.” You know, and you said to him, “How have you found the Keto?” He went, “Oh yeah, good.”

Grant Schofield:               Yeah he was quite under ….

Dr. Glenn Davies:             Understated.

Grant Schofield:               Understated about the whole …

Dr. Glenn Davies:             Absolutely understated.

Grant Schofield:               [inaudible 00:24:21] I think his name was, yeah. The thing about that though … Then an elderly woman from the right walked passed and I said, “What’s the story with [inaudible 00:24:33]?” She goes, “Oh yeah, he hasn’t got a big gut anymore,” and that was the end of the conversation.

Dr. Glenn Davies:             Yeah, that’s Sylvia. Sylvia, that was.

Dr. Glenn Davies:             The thing is that in Waitahanui it’s becoming so normal to lose 45, 30 kilograms, that it’s just not a big deal. There’s a little proverb, and I’m really sorry I can’t say this in [inaudible 00:24:54], but it’s something like, the kumara doesn’t need to tell everyone that it’s sweet. They’re just down there doing it. They’re not making a big fuss.

Grant Schofield:               Yeah, they’re quite humble about it.

Dr. Glenn Davies:             They’re not telling everyone and their message is that we’re quite happy for people to come to us and we’ll share this information, but we’re not going to be standing up there lecturing about it, you know, which is perhaps a little bit different from …

Grant Schofield:               The way we might do it.

Dr. Glenn Davies:             The way we might do it and got to respect it.

Grant Schofield:               The older guy there, Bill. Was it Bill?

Dr. Glenn Davies:             That was Bill, yeah.

Grant Schofield:               He was interesting, because when you got talking to him I was like … You asked him why he was doing it and his answer was, he’s like, “Well I’m now the second oldest here. I had four brothers, all of them died before they were 59,” and he said, “It’s not acceptable. We’re not doing that anymore, so we’ve changed …” I thought that was very powerful.

Dr. Glenn Davies:             Really, really cool.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Yeah. I don’t know. I really love the way they’re doing this in such an understated and humble way, but they are literally measuring their weight loss in tons, you know. That blows me away and you’re not hearing about this in the media.

Grant Schofield:               No one’s putting it up, and also it hasn’t really been a public health initiative. They’ve just gone on and done it.

Dr. Glenn Davies:             That’s what’s so cool about it. Yeah, there’s been no money spent on this.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             You know, not a cent. They’ve just got on and done it.

Dr. Glenn Davies:             There’s another … Maybe changing the topic a little bit. Isn’t it so cool how every single person now has access to the highest quality of information if they spend the time looking for it, and everybody can learn about nutrition, everybody can work out for themself a nutrition plan. That’s the beauty of the internet and that’s what they’ve done down there. They’ve [crosstalk 00:26:40]

Grant Schofield:               Yeah, and more often than not it’s the exact opposite argument, which is [inaudible 00:26:46] and give them more information because they just, they’ll get too confused, but this hasn’t been the case.

Dr. Glenn Davies:             No. Yeah, that statement alone I think is 100% wrong. You know, people can access information, people can digest it, understand it, interpret it and they can become experts in a field. No longer is health the domain of the doctor. You know, health is the domain of everybody. We’re not there now to hold the information and tell people what to do. We’re there to coach them and support them on their health journey. That’s what’s different.

Grant Schofield:               It’s quite a different role isn’t it?

Dr. Glenn Davies:             You’re a coach. Your role is to encourage and support and sometimes maybe interpret, because when you look on the internet with any symptom, you’ve always got cancer haven’t you. Whatever symptom you look up, you’ve got cancer.

Grant Schofield:               Yeah, or like I was self diagnosing myself with adult ADHD the other day.

Dr. Glenn Davies:             I’ve got that too.

Grant Schofield:               [inaudible 00:27:47]

Dr. Glenn Davies:             Yeah. Yeah. No, that’s … I’ve forgotten what we were talking about.

Grant Schofield:               All right. That’s a good chance to switch, so lets just talk about you a bit more, about the lifestyle behaviors you might do. What do you do to keep healthy?

Dr. Glenn Davies:             I was actually thinking about this earlier today. Since I became a lifestyle medicine practitioner I have become far less healthy than I was before, mainly because of all of this work that we’ve been doing, it does take quite a lot of time and energy. I think I’ve probably doing less exercise.

Grant Schofield:               Although you’re pretty fit, aren’t you, [inaudible 00:28:30]

Dr. Glenn Davies:             I haven’t been fitter, but yeah I do … If I can’t run or mountain bike I will always go for a walk.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Yeah, I always try, but yeah, it’s just that all this work sort of takes up quite a lot of time doesn’t it?

Grant Schofield:               Yeah, right.

Dr. Glenn Davies:             Diet totally different. I am absolutely sold on the concept that you have to keep your insulin levels under control and I will eat the amount of carbohydrate that I need to to control my insulin. How I do that is I’ll periodically measure my ketones and if there are some ketones there, like I don’t require myself to be at 0.5 and above, but if there’s some ketones, I know that my insulin level is under control.

Grant Schofield:               It’s low, it has to be.

Dr. Glenn Davies:             I’m managing my carbohydrate intake to maintain some level of ketosis and that’s because ketones and insulin are on a seesaw, you can’t have high insulin and ketones and if you’ve got ketones you can’t have high insulin. That’s just a really simple way that I can monitor the main determinant of metabolic health, which is insulin.

Grant Schofield:               Okay, so what … A good day’s eating in the last few days, what might it have looked like?

Dr. Glenn Davies:             My breakfasts, I will try and have an omelet for breakfast. Sometimes a little bit lazy and it might be eggs on paleo toast.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Otherwise I’ll use a grain free granola with Greek yogurt and berries. Always try and have some berries every day.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             That’ll usually be breakfast. Lunch, I would try and do a salad with some protein, chicken usually.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Then dinner is just protein and veggies.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             If I do feel like snacking, it’ll probably be dark chocolate.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             That’s … And I’ll drink water.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Coffee.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             That’s about it.

Grant Schofield:               Couple coffees in the morning, is that what you do?

Dr. Glenn Davies:             No, I don’t actually. Coffee makes me really buzzy.

Grant Schofield:               Yeah, and you’re already quite buzzy, so that’s …

Dr. Glenn Davies:             If I do have alcohol, the pure blonde, low carb beer.

Grant Schofield:               You like those?

Dr. Glenn Davies:             Yeah, yeah. Then I guess maybe on a Friday night it might be a spirit with some soda water.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             That’s the food.

Grant Schofield:               Under control.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               That’s changed over the years?

Dr. Glenn Davies:             Yeah. Well I used to … Being an ex athlete I used to be totally into the carbohydrate loading and the excess carbohydrate approach, and I’ve turned way away from that, especially after hearing yours and Dan Plews talk on …

Grant Schofield:               Athletic performance.

Dr. Glenn Davies:             Athletic performance on a low carb diet.

Grant Schofield:               Yeah, yeah, yeah, so we’re all …

Dr. Glenn Davies:             Totally convincing.

Grant Schofield:               We’re both aspiring athletes, but yeah, we’re probably getting passed our use by date in many ways.

Grant Schofield:               What do you find hardest? You touched on that with some of the time for exercise. What don’t you do well that you’d like to do better?

Dr. Glenn Davies:             I would just like to do … I think I’d do a moderate little bit of everything. I would just like to have more focus on doing all these lifestyle medicine things, and probably just time to sit and do nothing.

Grant Schofield:               Yeah, right.

Dr. Glenn Davies:             That’s not even necessarily meditation, I’m just really talking about those breaths you have during the day where there’s 10 minutes where you’re not reading, you’re not watching a YouTube clip, you’re not reading something. You’re actually just sitting or … That’s probably what I miss.

Dr. Glenn Davies:             You know, you sit down and you go, I can return that text or I can ring someone, actually just to have the time to just sit there for 10 minutes and just sit.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             You know, and then also you go … This active relaxation thing, you know, I’m going to deliberately watch this show on Netflix tonight so that I relax. You know, maybe just sitting there for a few minutes in the evening and do nothing.

Grant Schofield:               Just be bored. Being bored is underrated isn’t it?

Dr. Glenn Davies:             Being bored. I was actually, when I was in Wellington this weekend I was thinking, I used to go and visit my grandparents and they had this bay window that looked out over the airport in Hataitai, and it used to rain and the rain would come blasting in there. As a child I had never been so bored in my life, I don’t think they had a television, and I would sit there in that bay window for hours after hours doing nothing, just watching the occasional plane in the rain. Now I think back, that’s one of my fondest memories. Absolutely one of the fondest childhood memories I have, yet I hated it. It was destroying me.

Grant Schofield:               That’s a little bit like the A, B and C class family holidays. A, going to Venice and doing all these things and B, doing this and C, just going to the local camping ground and it turns out … And then, what do kids love? [inaudible 00:33:38] holidays. That’s what sits in their memory.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             You spent time with them, you were left to your own devices, you mucked around.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               Yeah. It’s astonishing, isn’t it? What else? If you are to sit down, it’s not a doctor conversation now, but it’s just you’re talking to some other people, which you are now. What do you say to them? What’s your best advice about a healthy lifestyle?

Dr. Glenn Davies:             I would always, there’s just really one key piece of advice and that is, it’s all to do with insulin and you’ve got to keep your insulin levels under control. You have to ingest the amount of carbohydrate or restrict the amount of carbohydrate to achieve normal insulin levels. There is nothing more important than that and it’s that simple. You know, that is the key piece of health advice for everyone and if everyone did that, I think we would have amazing health statistics. That thing alone will make all the difference.

Grant Schofield:               Awesome. Well thanks. Is there anything else you want to say while we’ve got you here?

Dr. Glenn Davies:             I think I mentioned that that book by Grant Schofield’s quite useful, but we had 200 copies of What the Fat, donated by a very generous donor, Wayne Richmond, and that’s kind of what got things started. That book is absolutely superb as an introduction to what a healthy lifestyle is, particularly the low carb diet.

Dr. Glenn Davies:             I think if every single person in New Zealand could have a copy of that one book, I think we probably would have solved most of the problems.

Grant Schofield:               It’s interesting though, because Wayne wrote back to the both of us with some … He was quite generous and donating and buying these books, but now he’s become disenfranchised with the whole approach and is actually quite critical of me in particular on two things that we had an interesting discussion about. The [inaudible 00:35:44], do you want to talk about that?

Dr. Glenn Davies:             Yeah. Wayne is one of the most intelligent people I’ve ever come across and he’s solved some very, very complicated chronic health conditions of his own through learning. He’s spent about four years researching these conditions, like the gut microbiome, irritable bowel syndrome.

Grant Schofield:               Which she was suffering of some.

Dr. Glenn Davies:             Yeah, and just metabolism and he’s worked a whole lot of stuff out. What he was critical of was the comments about protein and does protein cause a significant insulin rise and do you have to limit the amount of protein that you have on a low carb diet? I think …

Grant Schofield:               In What the Fat we were saying that’s probably a good idea to do that.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               And probably now, probably since we’ve moved a little bit on that.

Dr. Glenn Davies:             Yeah, and I was just talking about my latest hero, that’s after you of course Grant.

Grant Schofield:               Benjamin Beckman.

Dr. Glenn Davies:             Benjamin Beckman, who has some amazing YouTube clips and I think in his laboratory he’s really answered this question. If I am quoting him quickly, he’s saying in a low carbohydrate environment, protein has zero effect on insulin. In a high carbohydrate environment there’s a 40 times increase in your insulin levels in response to a protein load. I think that’s really the piece of detail that we’ve been struggling with in the Ketogenic environment, and I think he’s really nailed it.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             It depends.

Grant Schofield:               Yeah.

Dr. Glenn Davies:             Protein can raise your insulin and at other times it doesn’t, it depends on the context and the content. What we’re doing, a low carbohydrate diet, you wouldn’t expect to find protein causing a large increase in your insulin levels.

Grant Schofield:               Also protein itself is quite satiating and those sorts of things has that going for it, so it leverages hunger and …

Dr. Glenn Davies:             Yeah, and a lot of people also are not eating enough protein. Like we’re talking about two grams per KG and a lot of people, particularly elderly, are not getting even close to that.

Grant Schofield:               Yeah. Right.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               The second thing, so that was interesting that he raised it and we’re actually quite glad he did, it gives a chance to sort of keep changing your mind, which we should do as practitioners and scientists, right?

Grant Schofield:               The second thing he raised was about the value of vegetables at all.

Dr. Glenn Davies:             Yeah, so I’ve just … The book that’s open at the moment is The Plant Paradox by Steven Gundry.

Grant Schofield:               Yes.

Dr. Glenn Davies:             Have you read it?

Grant Schofield:               No, I haven’t read it, but I’ve heard of it.

Dr. Glenn Davies:             Because I’ve had patients of mine who have turned their irritable bowel symptoms around with this, and we knew when you’re in this environment, this ketogenic environment, you are challenged all the time. You know, if you think of my journey, I spent 20 years reinforcing the message that you had to avoid saturated fat and you had to eat large amounts of whole grains and you know, the usual message.

Grant Schofield:               The usual dietary guidelines.

Dr. Glenn Davies:             Then I would have been doing that, what, five to ten times every day, so that is so reinforced in my brain, then to get challenged with all of that and to actually have to turn your mind and now to be teaching what appears to be the opposite of that, you know, that’s really hard.

Dr. Glenn Davies:             Then you get challenged even further. You know, when you get a carnivore … You know, we had this talk in our group from a local man who has been a carnivore, exclusively a carnivore diet for four years, and when …

Grant Schofield:               And appears to be extensively healthy.

Dr. Glenn Davies:             You know, this challenged me, and when, I hadn’t met him before, when I came into the lecture I was wondering what this man would look like, you know, and here’s the 68 year old guy who does 68 press-ups every morning. He was lean and buff.

Grant Schofield:               He’s going to add one next year when he turns 69, is he right?

Dr. Glenn Davies:             Yeah. Yeah, yeah. Yeah. He’s lean and buff and clearly his brain was working really, really well, because he wasn’t satisfied with PowerPoint as a medium, so he integrated it with another program and he designed his own presentation format to give this lecture. You know, and he’d just won the club championships at golf, you know, so clearly his brain’s working well, his body was working well, his coordination was working well and he was just, he was eating a purely carnivore diet and that challenged me. I’m going, okay, you know, yeah.

Dr. Glenn Davies:             Then I’ve come across The Plant Paradox by Steven Gundry, and then again you’re challenged because, you know, you and I we know that above ground vegetables are just so health giving and such an important part of this diet, but then you get challenged by something like this.

Dr. Glenn Davies:             I think it’s about keeping an open mind, being aware of your cognitive dissidence, meaning your resistance to information because you hold a belief so clearly…

Grant Schofield:               Yeah, for that to be wrong then there must be something wrong with you.

Dr. Glenn Davies:             Yes, and that’s a challenge for everyone, including scientists. I don’t know, I think a lot of doctors … You asked me sort of a question like what’s wrong with medicine, I think doctors are at risk of becoming lazy. I think they’ve been told that you are the experts in the field of health and you were told that maybe 30 years ago, and I think a lot of doctors have just got lazy about their ongoing learning and some of them …

Grant Schofield:               Haven’t kept up.

Dr. Glenn Davies:             Haven’t kept up, and their cognitive dissidence prevents them from looking at new information.

Grant Schofield:               I see new information here that for some people, some reason for some vegetables they might mount into something like an auto immune response to eating them.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               Actually that’s causing ill health and for those people, for whatever reason [inaudible 00:42:06] those intolerances, stopping that might actually help. Is that the theory?

Dr. Glenn Davies:             That’s the theory. I’ve actually been so challenged by this that I hate to put it down, because it starts making you think, you know, well what am I going to eat? You know, and I haven’t quite got my head around the thought that I might personally become a carnivore. I put it down because I was challenged, but the idea basically is that a gazelle doesn’t want to be eaten by a lion and a plant doesn’t want to be eaten by an insect, and there’s a variety of chemicals in the plants that are insecticides. Some people if they’re very sensitive to those they may have an immune response to it, is basically the idea.

Grant Schofield:               That could cause problems?

Dr. Glenn Davies:             That could cause sort of irritable bowel type symptoms or autoimmune conditions. I suspect it’s a very small number of people, but you know, I think we have to be open to this idea.

Grant Schofield:               Because it also could be true for people who those insecticides, those poisons, their mild harm to other people might be the benefit, the big benefit of vegetables, right? That’s the idea of hormesis.

Dr. Glenn Davies:             Hormosis, yeah. Hormesis?

Grant Schofield:               Hormesis is the word.

Dr. Glenn Davies:             Yeah, yeah.

Grant Schofield:               It damages you slightly, but you build up stronger because of that.

Dr. Glenn Davies:             Yeah.

Grant Schofield:               Which is mind blowing, isn’t it?

Dr. Glenn Davies:             Yeah. Isn’t it? Just challenged all the time and I guess being open to the challenge and yeah, open to it.

Grant Schofield:               I think we’ll finish there. Be open to the challenge. Thanks, Glenn Daviess.

Dr. Glenn Davies:             Yeah, thank you very much, Grant.

Grant Schofield:               Next episode we’re talking with almost Dr. Cliff Harvey and how he’s approached his own health, his mental health and his research on low carb and ketogenic diets.

Narrator:                             This podcast is brought to you by PreKure, prevention is cure. If you enjoyed this podcast, please like and subscribe. If you know someone who could benefit, please share it with them. Together we can change medicine for the better. Change medicine for good.

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