The Dietician’s Dilemma: : What if Everything You Learned is Wrong?
I was raised on margarine, diet soda, low-fat milk, and I avoided sugary cereals. We followed the guidelines of the USDA and the Food Pyramid.
How did we get it so wrong? Find out as we meet an experienced dietician and high performance athlete who is rethinking the conventional wisdom on nutrition.

Michelle Hurn is a registered and licensed dietitian with eleven years of experience as a clinical, acute care dietitian, lead dietitian in psychiatric care, and outpatient dietitian. She is the author of The Dietician’s Dilemma-What would you do if your health was restored by doing the opposite of everything that you were taught?
Michelle is an avid endurance athlete, she has qualified for the Boston Marathon 12 times, and on November 7th 2020, she recently won her first ultra marathon covering 44.63 miles in a 6 hour timed race.

Some of the things we cover:
What is a dietician and what do they do?
What is the state of modern dietetics?
What does the ADA still get wrong today?
What are your current recommendations?
Optimal diet? Fasting?

https://thedietitiansdilemma.net/

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TRANSCRIPT:

Robert Lufkin 0:02
Welcome back to the health longevity secrets show with Dr. Robert Lufkin. What if everything you learned was wrong? Michelle Hearn is a registered and licensed dietitian with 11 years of experience as a clinical acute care dietitian, lead dietitian and psychiatric care and outpatient dietitian. She is author of the dietitians dilemma. What would you do if your health was restored by doing the opposite of everything that you were taught? Michelle is also an avid endurance athlete. She is qualified for the Boston Marathon 12 times and on November 7 2020, she recently won her first ultra marathon covering 44.63 miles in a grueling six hour time, Grace. Before we begin, I would also like to mention that this show is separate from my teaching and research roles at the medical school which with which I’m currently associated, it is part of my continuing effort to bring quality evidence based information about health and longevity to the general public. Now, please enjoy this interview with Michelle Hearn. Michelle, welcome to the show.

Michelle Hurn 1:13
Hey, thank you so much for having me on.

Robert Lufkin 1:16
I can certainly relate to the work you’re doing. Because my my mother was a dietician. And my experience in being raised in her household was that that she loves her her children very much. And she very much wanted to do the best and most healthy things for us, which at the time meant we were raised on margarine, low fat foods, including low fat milk, and occasional diet soda only. And we avoided sugary cereals and and we religiously followed the guidelines of the USDA and at the time, the food pyramid, but that is all changing now and evolve this we’re about to hear. I’m also a big fan of your of your book, The dieticians dilemma. And I understand it’s just come out on a audio version also that is that available now?

Michelle Hurn 2:17
Yeah, the audio versions now up on Audible as well as iTunes.

Robert Lufkin 2:22
Great, great. Well, before we dive into, into this, maybe you could start us off by telling us a little bit about how you came to be interested in such a fascinating area.

Michelle Hurn 2:36
Yeah, so like you like you mentioned, you know, dieticians are traditionally very healthy, whole grain sugar in moderation, you know, low fat, all as many fruits and vegetables as possible for all disease states. And I kind of traditionally followed that path as well. I’m a long, long distance athlete, I’m a marathon runner. And it actually wasn’t until I lost my own health in 2019. I’d qualify for the Boston Marathon 12 times I wanted to qualify for the Olympic trials in the marathon. So to do that, as a woman, you have to run under two hours and 45 minutes. So that’s a 617 mile pace for 26 excuse me, 26 miles, and I was eating so many carbs, I was eating, you know, all these quote unquote, healthy carbs. And I was training really hard. And I was working, and I just my body wasn’t recovering. Well, I was extremely sore. I had suffered with anxiety my entire life. And I really want to back up, I actually had a very serious eating disorder when I was much younger. And so you know, as I was training, I just I wasn’t like I said, I wasn’t recovering. My body hurt. And so I reached out to my family doctor, I actually reached out to two different sports dieticians just to get some feedback. And they both said, you need more carbs. I’m like, are you sure I’m eating 350 grams of carbs. I’m eating six times a day. Oh, no, you need more more carbohydrates. So I ate up to 450 grams of carbohydrates a day and my health went from bad to worse. I was breaking out in cold sweats. I couldn’t sleep. And as I share in the book, kind of the kind of the come to Jesus moment was I came home from work. I fell asleep early. I woke up at two in the morning when searing muscle pain. And I just I couldn’t get it to stop actually drove to 711 and got 30 pounds of ice and put it in the bathtub. And I was just like, I can’t do this anymore. And my wife came in and sat with me and was like, you know, maybe we should do something differently. And at that time, I was 36 you know, I said I’m too old roots. I’m too old to keep training. I’m too old to keep running. Clearly My body is just as burnt out. And so at that point, I intuitively knew that carbohydrates didn’t make me feel great. But I also just the indoctrination of you need them you need the cereal, you need these whole grains, you need all this stuff. But I was like Well, I’m not running as much. Maybe I can just running at all. Perhaps I can get my body just a break. I can eat more fat and more protein. I decided I would just go ketogenic for you know 30 days to see if that would help my body And you know, it’s so crazy now that I’ve been in this world for a while is I was afraid. There’s so much fear mongering in the world of dietetics. And even when I, I mentioned that idea to my co workers, oh, what if you’re, that’s so much fat, you can heart disease, you’re not gonna have any energy. How’s your brain going to function without glucose? Like all these myths we have? And so yeah, I actually decided, you know, I came across the the world of the carnivore diet, and I was, I was blown away. I was like, there’s people that just eat me. In fact, they don’t eat any plants at all. And, but it was interesting, you know, and I would encourage, you know, your listeners and viewers and anybody we have, we see something online, and we get so like, that’s either right or that’s wrong. But I was curious, because I said, you know, my health is bad. My anxiety is at an all time high. My, I’m 36. And I’m having trouble walking, my body hurts so bad. So I just I started asking, I got online, and I saw these people that were on a ketogenic or carnivore diets, and they just thought health was amazing. And then I saw an athlete named Zack better, who was the current 100 mile world record holder, and he was following a low carb diet, and my mind was literally blown. And so yeah, that was kind of how I got started. I just said, Okay, you know what, let’s do this for 30 days and see how it goes. That was my only intention was 30 days, maybe this will help my muscle pain. And then we’ll go back to something else.

Robert Lufkin 6:21
Well, yeah, well, I want to come back to that and talk about your your ultra marathons and all and the diet, the diets for that, and, but beforehand, perhaps we could start off for our audience by telling them just what is a dietitian and what is the dietitian do?

Michelle Hurn 6:40
Yeah, absolutely. So to become a registered dietician, you, you know, you go and you get your four year degree. And then you have to go through the dietetic internship and then you sit for the rd exam. And you know, every every dietitian, every health professional event from dieticians, and nurse to doctor, we all genuinely want to help you go into this profession, because you’re like, I want to help people, I want to help heal people. But you know, working in acute care, it’s, it’s not good. You know, unfortunately, my jobs in acute care, you usually are getting to see a patient for maybe five minutes or so. And you’re really your only goal is just to make sure they’re getting protein and calories. You know, when I was a young guy cish. And I used to think like, Oh, I’m going to go in, and we’re going to talk about nutrition, and I’m going to teach them, but you just don’t have time. You know, for every patient. You see, you’ve got 30 plus minutes to chart for, you know, insurance reimbursement. And you know, you’re not even really trying at least an acute care to food quality, it doesn’t really matter, are they getting protein and calories. So it doesn’t matter if it’s sugar, it doesn’t matter if it’s, you know, just these ineffective soy proteins. And that was really disheartening. Because I saw over time just patients coming back and coming back in, you know, with diabetes or kidney problems, people weren’t getting better. And you know, the dietitian, the Academy of Nutrition, which is the governing board of all dietetics is very heavily sponsored when I became a dietitian in 2000 2009. They’re number one sponsors for Coca Cola, Hershey’s, Kellogg’s, Sara Lee, and I couldn’t do it. I said, What is going on? You know, and I kind of made a fuss, you know, you’re in your 20s. And I was told, oh, it’s not a conflict of interest. It doesn’t matter. You know, and I, as I went through my dietetic internship, I would I would see these things, I would ask questions, I would say like, Hey, we have this patient who has been diabetic for 20 years, why are we giving them 75 grams of carbohydrates, every meal, and dosing them with insulin? Why don’t we remove their carbohydrates, and I was immediately told as a student, like, That’s dangerous. That’s not what we do. And you know, your student, you’re young, then I would go into the ICU. And I would flip over the bags of tube feeding. And I would say, Hey, you know, if you have to be fed, you know, you can’t you can’t even in a traumatic accident. Are we sure that these ingredients maltodextrin corn syrup, soy protein kernel oil? Is this what we should be feeding our critically ill patients? I know, once again, it was just like, I was kind of pegged is this, like this intern? Michelle is really difficult. She doesn’t, you know, she asked all these questions. And I was told more than, more often than not, like, like, you just need to go with the flow. Like, you need to be quiet. Like, they’re starting to stir things up here. Um, and yeah, you know, things, things haven’t changed the nutrition guidelines have it. I mean, we could do a whole podcast on the history. It has to do with politics, it has to do with religion has very little to do with actual health. And, you know, we now obviously, we have, you know, more studies on a low carb diet, you know, showing that it’s efficacious. It works. It’s safe, it’s sustainable. But because there’s so much money and the Academy of Nutrition, you know, our corporate sponsors, and we’ve got new ones as a 2021. Gorilla, the pasta company is a new one, the NCAA the national confectionery confections. Basically, the sugar is a new one. And you just you If you can’t win, you’re fighting against a very big institution. And I found at least on a large hospital level, you know, you’re you’re not allowed, you’re not allowed. I’m not allowed to go in the hospital and teach low carb, you know, you have to teach these guidelines that we know are keeping people sick. So I’ve had many dietitians students reach out to me and say, like, I don’t know what to do, you know, I ethically I don’t feel good about this and hence my book but dieticians dilemma, what do you do?

Robert Lufkin 10:29
Yeah, this is this is really, this is very tragic, because in the health care system, the we all look to the dieticians as the specialists in nutrition for sort of the wisdom that and the advice that we can all all take for our patients. And, and the fact that the advice is incorrect is is a real problem. And, and like you say, it’s not that everyone wants to do the best for their for their patients and for themselves, but without access to the proper information, they can’t make the right decisions. What, how do you how do you think this can ever change? What needs to be done? What would you like to see happen to? To make a difference here?

Michelle Hurn 11:18
Yeah, I mean, I guess if if I could, like wave a magic wand, you know, I would have you I mean, you nailed it, you don’t know what you don’t know, you know, like, once I learned like, Oh, my God, look at all these studies. Look at all this like, nobody ever taught me as a dietitian, the impact of foods on neurotransmitters in your brain, nobody taught me the importance of saturated fat and specific amino acids. And, you know, you learn very briefly about insulin, but it’s not really like, you know, dug into your, into your brain and certainly isn’t carried into practice. So yeah, if I can wave a magic wand, I would change our education, because of every dietitian is educated about low carbohydrate diets. I have patients and I’m sure you’ve seen patients that died of complications of diabetes, screaming ravaged and pain, and a guy came into the hospital after stepping on a piece of glass. He stepped on the piece of glass seven days ago, but he had no feeling in his feet. And he ended up dying because he had a he was septic, he had an infection in the blood. We can reverse diabetes in eight days, not eight weeks, not eight months, eight days, on a low carbohydrate diet. And we’re keeping people diabetic for 20 years because of money and profits and propaganda. So what we need to do is we need to educate, we need to teach people, patients deserve a right to know their options, you know, and I’m not dogmatic, like if somebody were, if you have the capacity to make a choice. And you you know, you’re not when I say that I also worked into different psychiatric hospitals. So not everybody has capacity. But if you have the capacity, and you want to continue to use insulin and eat sugar and carbohydrates, and you know the consequences, then that’s your choice. But I you know, I’ve had people come to me and be like, nobody told me, nobody taught me I suffered for years, and I was able to heal so quickly. So I want dieticians to be empowered. Because you know, what’s exhausting, is exhausting is seeing your patients get worse and get worse and die. And I saw that I saw this disciples sickness in the hospital and it starts to wear on you and not just physically mentally, you know, patients in the psychiatric care rarely get better. And you know, now with Chris Palmer, we’re seeing so many ends and oral studies, and we’re going to have clinical trials soon with the ketogenic diet and psychiatric care. And I can’t tell you how many people myself included. Anxiety is like, Oh my gosh, it’s so much better when I’m not constantly chasing my blood sugar and when my neurotransmitters are stable, so I want people to be taught correctly. I want people to be taught, you know, both sides, once again, not dogmatic. I don’t, I don’t think I think you need to have a right to choose and I think you need to understand the power of your options.

Robert Lufkin 14:00
Yeah, that’s that’s really key. Certainly, I would agree with that. That like, like you say, nobody wants to make a decision that harms themselves intentionally, but most people just don’t know of the possibilities of how their lifestyle can affect affect their health. So so much and and like you say, the vested interests, the large manufacturers of processed foods and and insulin and the the all the interests that benefit by continuing this model, have very little motivation to come up with a solution that’s going to decrease it by

Michelle Hurn 14:42
even argue that they have motivation to not no it’s not that they they have the motivation. I can’t if you just like once again, like take the emotion out of it. How do I how do I make money as a processed food or an insulin company, I cannot heal you. If you no longer need my product, I lose money, I can’t kill you. If you’re dead, you delete it. I know you no longer get money, I have to keep you’re perpetually sick. Like, it’s just capitalism. And that’s the country we live in, you know. And so, I think people have to take a step back. And you really have to be you have to advocate for your own house. But you know, interestingly, in the hospital, like the hospital I used to work at, if somebody wanted to smoke a cigarette, we don’t allow you to smoke cigarettes, like yeah, we all recognize that’s not good for you, you know, we’ll offer you a smoking cessation while you’re here in this hospital, you will not smoke a cigarette. But while you’re here in this hospital, even if you’re diabetic, we’re going to give you a lot, you can order cake and cookies and whatever you want, we’ll just give you insulin. So it’s very interesting. It’s almost like we don’t really, we don’t really teach people in the hospital, you know, and I’m often told, you know, like, oh, Michelle, they can get counseling at an outpatient diabetics plays, you know, they’ll see an outpatient dietitian, awesome, they’re gonna get the same, you know, high sugar, carbohydrates in moderation. And you know, we all know that moderation doesn’t work your body can’t do that on us is a physiological or psychological level, you just the body is not designed to, to utilize these processed foods. Well, it doesn’t it doesn’t work. So

Robert Lufkin 16:16
yeah, I mean, I think education is the key and may not be the complete solution. But the work you’re doing with your book, and and appearing on on shows like this will hopefully help get the message out to people. So I’ve heard one suggestion even for diabetes, instead of calling type two diabetes, type two diabetes, call it carbohydrate intolerance. And if people visualize it as just they can’t process carbohydrates, and then they avoid it, they would cure their diabetes, in most cases, for type two diabetes, you know,

Michelle Hurn 16:56
yeah, unfortunately, most dieticians don’t even know like, if you ask a lot of dietitians, like how many carbohydrates Do you need a day? You’d probably get a range of answers. I mean, very few people will tell you zero, you know, you do not need any carbohydrates to survive. And if you cannot tolerate them, you know, context is very important. Context is important when it comes to you know, talking about LDL and heart disease context is important when we talk about diabetes, you know, and if you are a type two diabetic, you can no longer tolerate carbohydrates, it makes zero sense to continue eating them utilizing them. But unfortunately, you know, when you have dieticians telling you, oh, we just need to eat these and give you medication. I’ve never seen somebody heal that way. Just, you know, putting that out there for your audience. If you If you or anyone you know is type two diabetic, I’ve never seen somebody become non diabetic, continuing to eat carbohydrates and take insulin and Metformin. So, but you can reverse it very quickly. Right? To go low carb, so yeah, it’s unfortunate.

Robert Lufkin 17:56
I do see time restricted feeding or fasting do play a role in your, in your dietary, your practice or for any of these health conditions.

Michelle Hurn 18:11
I mean, I I believe in it hardcore and you know, as far as most dietitians are going to tell you to eat, you know, diabetics, you know, six times a day, and you know, unfortunately every time you eat every time you get that insulin response, you’re starting you’re basically telling your body to store fat, I guess and that’s another thing is most people don’t even understand insulin. Insulin is a powerful hormone and we use it just like it’s nothing right insulin like it immediately switches off your body like it basically says like stop burning fat burn sugar, you know, put push that sugar into the blood. So you know, once we see very quickly when people start intermittent fasting, you know either skipping breakfast, maybe having two meals, especially when they start shifting what they eat and more protein and fat. I mean, we see levels of glucose, fasting insulin, which is not the lab that’s done very often it’s something you have to request but I’ve seen that a one C is one I’ve seen improved dramatically triglycerides and those are really what we want to look at when we come to disease, heart disease specifically, you know, people lose their mind about LDL, it’s like you know, if your LDL is high, but you’re here a Wednesday and you’re fasting insulin, your triglycerides are low, you’re a very healthy human. You know, we we were never sick as a population when we you know, think about evolution, we meat and fat, seasonal fruits and vegetables that look very different than they did today. You know, they had almost zero carbohydrates they were very bitter very small. And we have zero chronic disease, you know, and then you add these processed foods and we have half the population it’s like meat is bad for you fat is bad for you. Notice these with meat and fat and we can look at the you know cultures that still eat a lot of meat and fat like the you know the Indian Eskimos or the Messiah out in Kenya and they’re perfectly healthy. We have processed food carbohydrate, specifically and disease goes off the charts. So it’s just like, it’s amazing the propaganda that’s out there that we will be true. A lot of people truly believe that meat and saturated fat are truly what’s driving disease, even people, some people believe me Causes Diabetes, even dietitians. It’s just like, are you getting your information?

Robert Lufkin 20:22
Yeah, it’s amazing. And like, like you said, with insulin, it was it’s, it’s fascinating the way that we used to think of insulin as as foundational for for diabetes, which it is. But we’re also seeing as we’re seeing now, insulin resistance, and metabolic abnormalities are foundational and thing in chronic diseases as diverse as Alzheimers disease and some cancers and, and stroke and, and, and heart disease as well. So it’s, it seems to be really at the at the heart of things, and from what you’re saying, this can be controlled largely with diet.

Michelle Hurn 21:05
Yes, yeah, diet, you know, people. I feel like a lot of times too, when I’ve talked to more traditional dieticians, they’ll start to get very defensive. And it’ll be like, Oh, well, what about sleep and stress? And, yes, there are many different things that affect your blood sugar. But the number one thing, in my opinion, and all these other things get better is when you shift how you eat. And it’s not, you know, especially if you’ve been eating the traditional diet that you and I both grew up on, you know, I, you know, total and skim milk growing up and Diet Coke and slim fat, my parents were always on diets. Um, you know, the goal of health is, in my opinion, is you need to keep your insulin levels very low. You know, we want to be utilizing your own body, your body is very good at burning fat, even people who are very lean, I’m relatively lean, I’m an athlete, you have enough, I have enough fat to go out and run over 100 miles just on fat, you know, your mother’s muscle fatigue and other things. But you’ve got to keep those insulin levels low. And every time we carbohydrates specifically, there’s more processed carbohydrates, insulin increases, and most people aren’t eating carbohydrates. You know, we talked about sugar and moderation. You know, most people aren’t eating carbohydrates or sugar, once a week, once a month, once a year, they’re eating a daily 678 there was a study that people are actually taking in sugary, is spiking their insulin up to 16 times a day, because they’re drinking coffee, and they’re having a soda and they’re having a snack. And so your poor body is constantly in this fat storage mode. It’s very stressful. And over time that contributes to diabetes. And over time, that contributes to heart disease, if you have diabetes, you have up to a fourfold risk of having heart disease. Also, if you have a mental illness, you know, people think people with schizophrenia and bipolar disorder, oh, they’re crazy, they die of something crazy. You know, the number one cause of death for people with mental health disorders is heart disease. Once again, they’re at an increased risk for metabolic syndrome. Not only and we can talk more about that, but everything in our health, we can shift the health of our nation, but we have to shift how we eat, you know, we’re not going to medicate our way out of it. We’re not going to exercise our way out of it. And we’re certainly not going to moderate our way out of it. We have to be we have to actively choose to reduce carbohydrates.

Robert Lufkin 23:24
How many? How many of your colleagues in in dietetics have a similar view of us as yours? It’s obviously a minority position. But But how much of a minority is it?

Michelle Hurn 23:37
And the hospitals I worked at or maybe in the few renegades I found online, I mean, in the hospitals, I’ve worked at zero, um, I was literally pegged as a weirdo. I mean, a couple dieticians seem to rally around the fact that like maybe I would do this for like a run or race but, you know, I’d walk into the the office and they’re eating, you know, bagels and doughnuts and oatmeal, and I’m in there with my beef and butter, like, well, that’s different, you know, um, but ya know, most dietitians I had one dietician tell me he would never prescribe a ketogenic diet to anybody because it would kill them. And when I questioned him further, oh, it causes heart disease. And what can I show you all these studies that it doesn’t know, I don’t want to see those, you know, like, very defensive. Um, so yeah, I would say zero. It’s not a popular idea among dieticians, and I don’t honestly, I don’t blame them, because their education. And also if you if you start to take in the truth, and you start to see, like, oh, wow, I can actually feel people with a low carb diet. There’s gonna be a lot of cognitive dissonance because you can’t teach that in the hospital. I was told, like, Look, you can’t teach this. And I couldn’t do it. I had to leave the hospital because I was like, I can’t I know that I’m hurting people with this high carb, sugar in moderation information. I can’t keep teaching what doesn’t work and what ultimately hurt people. And I’m not judging anybody who learns that and stays in the system. Um, I mean, you know, like I said, what are you supposed to do? You know, you worked. I got student loans out the wazoo, right, like, you got to figure it out. Um, but yeah, you know, there’s definitely more I’ve been very encouraged. There’s some some Renegade dieticians online. You know, I have a few in my book, some amazing people that get certified as nutrition therapy practitioners, because they’re not sponsored by all this processed food nonsense. So they get to learn the actual facts. So yeah, you know, I’ve been encouraged by those people, but I’m regularly sent emails from well, meaning dieticians with some criticizing me so but that’s alright, you know, anytime you you step outside the box, and you’re doing something different, I’m very confident in what I’m doing. And I have lots of science to back it up.

Robert Lufkin 25:46
Yeah, I mean, it’s great to see some, at least some other organizations springing up to to support this view. And I was I was gonna say you could have you could have a society of dieticians for, you know, ketogenic diets or something like that. To do that. Maybe we’ll see that in the future. Hopefully all dietitians will embrace it. So, there’s so much misinformation even among my physician. Colleagues, when when I talk about a ketogenic diet, Vail, they’re going Oh, no, you don’t want ketoacidosis? You know, in there, you’re conflating you know, two very different things, you know, are you in ketosis? Are you in ketoacidosis? And there’s just so much so much confusion, we’ve, we’ve, at least so far failed to educate. And these are, you know, with the dietitians and the physicians, these are the the experts that people go to for, for advice about their their health and their lifestyle choices. And if they can’t even deliver the, the appropriate thing. So obviously, there’s a lot of work work cut out for us to be done. Well, tell me a little bit about your your ultramarathon that you just won, congratulations. Well, Boston Marathon, so you qualify for and that’s so exciting. And maybe you could speak a little bit about your true choices with your diet and and how that informs your your running.

Michelle Hurn 27:20
Yeah, absolutely. Absolutely. And thank you. So, like I shared earlier, you know, when I lost my health, I really had no ambitions of running again, you know, I was in so much pain. And so it was just as I followed, you know, carnivora, and then transitioned into low carb diet. I was just around the house more. And so my wife who likes her solitude was like, You should go for a run. It’s kind of like, casually threw it out there, then run in over a month. So I was like, Oh, good job. Why not? Maybe I’ll be like a hobby jogger. And I ran a few miles, and I felt really good. And so the kind of the wheels started turning like, Oh, goodness, like, what could I do this low carb, like, I’ve never, I’ve never thought about this. And I also I’m just, I’m very competitive. So I was like, I don’t want to run really slow. But, you know, I reached out to Zack better. And he agreed to coach me, and we just, you know, let’s take it one day at a time. Let’s see how it goes. Let’s try this crazy, low carb journey. And I was amazed by how much better My recovery was, you know, I was eating so much more protein and a lot less carbs than I ever have. And just felt amazing. And just kind of took it took it one day at a time. And yeah, a little bit more specific. Because Yeah, it’s funny, and I certainly I profess low carb, you know, so if you’re curious on what I do. Um, so when I’m in a really low training volume, I would say like 30 miles or less, I’m very ketogenic, you know, definitely under between 25 and 50 grams of carbohydrates, we get a cow share from a farm just kind of down Well, not really down the road about an hour and a half away. So we get like a lot of meat at one time, we have a chest freezer from Costco in our basement. So eat a lot of beef. my diet is pretty beef heavy, a lot of beef, a lot of butter, a little bit of fruit. And then for like supplemental carbs for my running. My wife makes long fermented sourdough and I have some rice sometimes. But yeah, it’s mostly a liver wheat, some Oregon stuff, but really meat heavy. And I found that’s what works really well for me. You know, I know some people do like either a zero carb or no grains. And I’ve done that, you know, I’ll do that when I’m my volume is really low. But I find once I’m running, you know, 6070 miles like I do a little better when I add some carbohydrates back in. I use a product called s fuels. It’s an electrolyte coconut oil, some collagen protein when I’m running and I found that settles in my stomach really well. And yeah, I just, you know, I’m grateful. Like, you know, if you told me that day that I got the ice and I decided I wasn’t going to run if you said like, Hey, you know what, you’re gonna switch to a low carb diet and you’re actually gonna go run like an ultra marathon, I would have told you like, you’re smoking. Like, there’s no way I can’t even walk around the place. Like it was my hope was so bad. Um, but yeah, it’s just and I guess that would be my message to anybody is just the hope, the hope and how quickly my health changed, you know, my mental health like the anxiety was gone within weeks. And I just after about a month you know, I just felt physically stronger and I just felt like with all the protein and all the the iron and all the you know, there’s so much in meat people are like, oh me this protein, soy protein versus protein. That’s not true. You know, they’re very different proteins. Beef has full aids, and you know, all the different B vitamins and carnitine and creatine and taurine and all these amino acids, you know, ruminant animals are, in my opinion are essential for health. So yeah, so I mean, that’s kind of what I do. And, you know, when I decided to write the book, actually wasn’t even gonna include a chapter on running. But a lot of people told me like, oh, we’re kind of curious what you do to run. So I do have like, like, what I eat in the day and kind of my training. Um, but yeah, you know, the goal of the book was just to, I wanted to talk about topics I felt I could speak really well on, you know, there’s so many things low carb can do. But, you know, we do diabetes, mental health, including major depression, anxiety, bipolar, schizophrenia, eating disorders, which is a very controversial topic, I’m actually going to give a talk on binge eating disorder and the ketogenic diets, we now have our first case study that was published on that sarcopenia, because I saw way too many people in the hospital setting that were overly fat under muscled, couldn’t even walk up the steps to the bathroom, and heart disease, because you know, everyone thinks all that mean fat, it’s gonna make your heart explode. Oh, and I also have a chapter on where the guidelines came from. Like we said, it’s a bizarre, it’s very bizarre. So yeah, so I mean, that’s what I do. I run anywhere between eight and 20 miles a day. And I work, I work part time now kind of, you know, just hustling hopefully, at some point, I’ll figure out what I want to do when I grow up and be able to settle but it’s, it’s good. I’m very blessed. And I’m a very happy person.

Robert Lufkin 31:59
People say the choices when we optimize something will be different depending on what we’re optimizing for. So when you’re when you’re optimizing your nutrition for an ultra marathon, let’s say, how does that differ from optimizing your nutrition for health and longevity?

Michelle Hurn 32:18
Yeah, I always say health and longevity. Like, if you might only go with health, I would be I would be purely ketogenic, maybe even slightly higher on the protein, you know, a ketogenic diet tends to be 60 to 70%, fat 20% protein, and like 10% carbs or less. So, when I’m optimizing for my ultra marathon, I mean, I’ll get up to 25% carbs, and you know, I’ll eat up to 150 grams of carbs a day when I’m leading up to that, that major race, and of course, race day, you know, you’re running for six, seven hours. I mean, all I’m eating basically, is carbs. Like after that day, I’m ready to be done with carbs. So I wouldn’t recommend that for health. I wouldn’t, I’m sure. I also don’t know how great running, you know, 2030 miles a day is for your health. I’m sure that people come at me with the cardio fatigue or whatever. Um, so yeah, that may not be the best for your health. So, so yeah, and that’s why as soon as I’m done running, you know, take some time off and just flex back into ketosis. I think for health, specifically, being ketosis, most of the time, being metabolically flexible, you know, so I don’t think I think it’s fine to eat seasonally to have a little bit of fruit, you know, between 25 and 50 grams of carbs, I think is very tolerable for most people who are metabolically healthy. Unfortunately, you have a population that 88% is not metabolically healthy. But I think to get there, you know, ruminant animals, you know, so that’s beef, lamb, venison, eggs, butter, tallow, all those things, they tell you not to eat. And then you know, what, if you tolerate plant foods, you know, I eat berries, carrots, you know, a little bit of rice and sourdough for my running, kind of figuring that out from there. But as you know, you didn’t hear me. There was no Oreos, granola bars or doughnuts, you know, it’s just it’s amazing. I’m so out of that world that sometimes I forget, you know, I’ll go to a grocery store. And you know, look in people’s cards and you’re like, there’s no food in there. There’s like a box to pizza Cheetos. bagel bites the jelly man, you know, there’s like, we have to eat food. And ideally, we’re eating food that’s keeping our blood sugar stable and insulin low, and that’s meat and fat.

Robert Lufkin 34:24
Yeah, yeah. For your ketosis. Do you use any tools to check that like blood sticks or acetone breath meters or anything to monitor whether you’re actively in ketosis or you just sort of know it as you go along?

Michelle Hurn 34:39
I can feel it for the most part we we have some of the sticks I’ve measured before like in you know, when I’m really low carb, you know, like after the season, you know, I’m definitely like it shows on the the keto meter, but yeah, during during training, I’m not too worried about it just because like, you know, I reading so much I may or may have you flexing anatomy with my carb intake. Yeah, I like to make sure I’m in the offseason I am just because I think that’s like a good recovery time.

Robert Lufkin 35:08
Uh huh. And how about CGM or continuous glucose monitors you,

Michelle Hurn 35:12
I would love to use one. And if anyone’s watching this, and that has one sponsored by one hit me up, because I think it’d be crazy to see how my blood sugar is especially like throughout an ultra marathon, but and I’ve never personally used one, my nephew is a type one diabetic. So I love watching his you know, it’s fascinating, just how different foods affect his blood sugar, but I’ve never personally used one.

Robert Lufkin 35:33
Yeah, it’s interesting that more and more companies are coming out, sort of, they’re like, coaching companies for lifestyle and also for treating type two diabetes. And part of their plan is continuous glucose monitors for the patients that then feed back. And so hopefully, we’ll be seeing a lot more of that. And I mean, there’s rumor that the Apple Watch at some point may have it as well. And wouldn’t that be amazing and Android watches also using Raman spectroscopy with it so that’ll

Michelle Hurn 36:06
be back in real time is helpful. I you know, like people because it’s one thing to say like to say like, hey, banana will really raise your blood sugar. And then you know, my 10 year old nephew is a type one diabetic needs a banana you like, woof, you see it like, Whoa, look at that, you know, so it’s very different when you actually like for me to say something to somebody when they actually see it? You know, I think I think that can help make changes. You know, I imagine the insurance companies might push back against that now heaven forbid, we actually help people get off insulin. But

Robert Lufkin 36:34
yeah, that’s true that the other thing I’ve experimented with him and and I’ve, it was interesting to learn how my body responds to certain foods. I mean, some foods I know will spike my glucose, other foods I know well, but then other foods was it was a surprise to go, Whoa, this one really went up. And this one I thought would be bad, but it wasn’t. So a little bit of individuality that the CGM can help out with as well. And how about the last last few minutes? Anything on your personal lifestyle choices? We’ve talked about a bunch of how about supplements? Any any particular things you use there?

Michelle Hurn 37:12
Yeah, you know, I, I am a big fan of like organ meats. I eat liver, almost daily, we it’s definitely not my favorite thing. I think, you know, if you if you don’t deliver, I think an iron or just even like, you know, capsules, just because that’s so dense, and you know, the iron and B 12. And I was shocked that 25% of the world is deficient in iron. It’s the number one mineral deficiency worldwide. And for kiddos under four, it’s 50%. You know, magnesium, I would say I guess electrolytes as a runner, you know, I do potassium, magnesium, sodium, salt my food pretty heavily, and then use magnesium at night. But yeah, that’s about it. I don’t do a whole lot. Certainly when it’s warmer. I mean, I live in the Pacific Northwest. We’ve had some heat waves going here lately. But in general, the weather’s pretty mild. So I don’t have to do a ton of that. But yeah, I feel pretty. And that’s one nice thing about eating, you know, lower carb diet is that it’s pretty it’s nutrient dense nutrition is bioavailable, so I’m not really worried about having to supplement But yeah, I would say liver and then the electrolytes.

Robert Lufkin 38:19
This has been fascinating. Michelle, how can our audience follow you on social media or find out what you’re doing in the future? Yeah,

Michelle Hurn 38:28
thank you. Um, so my website the dieticians dilemma dotnet you can contact me directly through there there’s links to buy about my book up on Amazon paperback ebook or now the audio book and then on Instagram I’m most active on Instagram at run eat meats repeat. And it’s all one word run eat meat repeat and then on twitter at Michelle her an RD

Robert Lufkin 38:52
right and then we’ll be seeing you at an upcoming conferences as well many conferences for lay people that I understand you’ll be speaking at in the future. It’ll be great.

Michelle Hurn 39:04
I’m excited. You know I have applied for the Quito con that’s supposed to take place in July. I’ll be going with Dr. Berry on a low carb cruise as coming May May 2020 to

Robert Lufkin 39:17
two we’re on the cruise Virgin Islands.

Michelle Hurn 39:19
Yeah. Yes, that’s not i’m not i’m very happy to go on

Robert Lufkin 39:27
a cruise gonna be all low carb.

Michelle Hurn 39:28
I mean, we’ve got several are from what I understand there several speakers and I’m sure the food will be low carb. Um, so the whole idea of imagine

Robert Lufkin 39:40
the whole ship will be all low carb then. Right.

Michelle Hurn 39:44
Yeah, we’ll see. It should be fine. But yeah, I mean, I’m always, you know, looking for opportunities to continue to advocate spread the word, you know, hopefully, we’ll still have lots of conferences. You know, I know things may we’ll see if hopefully things are going to stay open, as you know, as we move forward into the next year. So we’ll see.

Robert Lufkin 40:05
Well, it’s great. You’re getting the word out however you do it. And it’s it’s so good to follow your your work and your book and all and thanks. Thanks again, Michelle, so much for taking the time to spend an hour with us and be on the program today.

Michelle Hurn 40:19
Thank you. Thanks for having me.

Robert Lufkin 40:23
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