Our guest today has setout to do accomplish something that decades of research and billions of dollars from the top pharmaceutical companies in the world have failed to do- that is to demonstrably reverse alzheimers disease. And he proposes to validate it  with what is the gold standard of evidence based medicine- the randomized controlled clinical trial. 

 Matthew Phillips MD is a full-time clinical and research neurologist at Waikato Hospital, Hamilton, New Zealand. His foremost passion is to explore the potential feasibility, safety, and efficacy of metabolic therapies, particularly fasting and ketogenic diets, in creating alternate metabolic states that may improve not only the symptoms, but also function and quality of life, for people with a variety of difficult disorders.

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Robert Lufkin 0:00
 Welcome back to the health longevity secrets show and I’m your host, Dr. Robert Lufkin. Our guest today has set out to accomplish something that decades of research and billions of dollars from the top pharmaceutical companies in the world have failed to do and that is reverse Alzheimer’s disease. And he proposes to validate it with what is the gold standard of evidence based medicine, the randomized controlled clinical trial. 

Matthew Phillips, MD, is a full time clinical and research neurologist at y Kato Hospital in Hamilton, New Zealand is foremost passion is to explore the potential feasibility, safety and efficacy of metabolic therapies, particularly fasting and ketogenic diets in creating alternate metabolic metabolic states that may improve not only the symptoms, but also the function and quality of life for people with a variety of difficult disorders. And now, Matthew Phillips, MD, Hey, Matt, welcome to the show. 

Matthew Phillips 1:14 Era. Thanks for having me. 

Robert Lufkin 1:17
 I have to say I, I share, I share your vision about what you’ve stated in the past about exploring potential therapeutic benefits of metabolic strategies, particularly fasting and ketogenic diets in addressing our most challenging chronic diseases. I have to say, I also admire your courage in that you have set out to accomplish something that decades of research and billions of dollars from literally, the top pharmaceutical companies in the world have failed to do, and that is to demonstrably reverse Alzheimer’s disease and show those changes. And, and you propose to validate it, as we’ll see, as we talk about this, with what is the literally the gold standard of evidence based medicine. And that’s a beautiful randomized control trial. And in the pilot studies, and this is very early, but I can’t wait to hear about all this. But before we before we dive into that, maybe you could just take a moment and tell us a little bit about how you came to be interested in this fascinating area. 

Matthew Phillips 2:34
 Sure. Okay. Well, I’ve said this story a few times, but I guess I can always put a twist on it. So I’m a clinical neurologist by training. I’m Canadian, I trained in Australia for 12 years. And when I finished my neurology training, which is a long road, as you would know, I wanted to specialize in a therapy. So I wanted to specialize in something but I wanted to be a therapy rather than a CS. And the only real options were diseases, so stroke, or multiple sclerosis, or Parkinson’s, and so on. And I didn’t want to just confine my thinking to one disease, and also I didn’t want to just specialize in how to mask the symptoms of a disease. So I, I was a bit frustrated, and I bought a one way ticket to Buenos Aires, Argentina, and I just decided to sell absolutely everything, I sold everything, even my computer and my phone, I had no computer, no phone, landed in Buenos Aires, I had three or four days at a hostel somewhere. And I just thought, you know, I’m just gonna let life do with me as it will. So I started that, and it turned into an adventure as things often do, and you don’t have a plan. And during the next year, 

I was able to really think hard away from the hassle of, you know, being on call and answering phones and, and just being stuck in the same in, in a hospital where many doctors think the same way because we’re all trained in similar models of thinking, I was able to think about different things, ways to maybe approach to disease, and, you know, from a therapeutic perspective that could actually do more than just mask the symptoms. And it was a long search. I didn’t latch on to fasting or ketogenic diets right away, but eventually I got there. And it actually took three years. So I did a bit of work and volunteering for the next two years after that year, and that’s what I landed on is, to me, it seemed the most and I was objective about this. I resisted it initially I didn’t want it to be fasting or keto it I didn’t know anything about them. It sounded kind of silly in a way, but objectively and mechanistically. And evolutionarily, that is what I landed on those two therapies in particular as the most potentially beneficial for a broad range of disorders. is related to lifestyle. And so that is it in a nutshell. But yeah, it was a three year sort of self induced fellowship, if you will. 

Robert Lufkin 5:10
 Hmm. And then from there, you wound up in New Zealand where you are now correct? 

Matthew Phillips 5:15
 Yes, I always wanted to come here to work. I visited here a couple times. I love the place. I love the people. I love the mountain senior, I missed the mountains in Australia, being from Western Canada. And I decided to stay for a year check it out. And then I, we started the Parkinson’s study, I got the ethics approval for that I couldn’t believe I got it. And we started to sort of get patients interested. I thought that was pretty neat. And, you know, one year turned into two turned into three and now we’re looking at almost six. So here I am. And here we are. 

Robert Lufkin 5:49
 So, so fasting and ketogenic diet, how, what was the what was your underlying thinking about that? Or how does that all? How does that all fit together? 

Matthew Phillips 6:03
 You know, these things, I think, in my own thinking, it wasn’t like, I had a single aha moment. I mean, you do have a few of those. But it’s been a journey where your brain just constantly puts more connections together, and you see how this can possibly help a disorder such as Alzheimer’s, or, you know, other ones like cancer and atherosclerosis, I think. So. Which is most common cause of heart attacks is you know, so I guess, initially, it just sounded weird, and I saw a few people speak about it. Jason Fung, Dominic D’Agostino, Valter, Longo, a few other people like that. And I just thought that’s really intriguing. These guys seem to really know what they’re talking about. And they, and they sort of are advocating for this, I’m going to look into it further. And I looked into it further. And I just noted that, you know, when you do a particular longer fast, or you really remain dedicated to a ketogenic diet, it’s doing a whole lot more than just changing one or two pathways, metabolic pathways within the body. And we learned in med school about, you know, this medication does this and this medication does that we’re, you know, it’s all about being targeted and specific, and we want to be targeting things very precision wise, but fasting keto, or the opposite. It’s like it’s an orchestra, you’re changing a 

whole ton of things in sort of a non precise way, from a simplistic perspective, but from a more mature perspective, the body is able to when one thing changes in the body and other thing compensates. And so by orchestrating a massive change through fasting or ketogenic diet, you’re allowing the body to you’re unleashing this power that it has locked up to make all these changes and regulate them all with each other simultaneously, simply through the cessation of eating or changing how much fat and carbohydrate you eat. And I thought that was fascinating. And when I looked into it more I saw that may be you know, I learned in med school, in my earlier degrees that what I learned was that genetics was sort of the big focus the big area of interest, and that’s where we should be looking at to to gene therapy for Alzheimer’s and gene therapy for cancers and so on. But then fasting keto, they were really producing so many benefits for the mitochondria. And now I mitochondria as the mitochondrial dysfunction. So where mitochondria are not working effectively, and as you know, they make most of almost all the energy for most of our cells, when they’re not working, think bad things happen, these disorders have a chance to progress when they are working. Well. I don’t think the vast majority of these disorders, these lifestyle related disorders, which are the big ones have much of a chance to progress, or you at least slow them down a lot. So to me, it’s all about orchestrating huge changes within the body’s metabolic machinery to help protect and and enhance mitochondrial function. And that is, that is a huge sort of amount of mechanistic thinking, if you will, that I’m trying to summarize in five minutes. But that’s it in a nutshell, 

Robert Lufkin 9:15
 in how does how does fasting and and or ketosis, how does that help the mitochondria help this mitochondrial dysfunction? 

Matthew Phillips 9:27
 Okay, so I mean, I view fasting and keto, the mechanistic effects as an iceberg, you sort of see a few of them at the top, but then the deeper you go, the more there is, so the ketones, which are energy molecules produced by both methods are the most obvious aspect of them in a way and the ketones when you fast your body will create ketones from your body fat. When you have a ketogenic diet. It’s quite similar, I think, but the ketones are coming from a lot of the ketones are coming from the fat you eat in the diet. So you Either way, they’re the body’s turning fats, whether it’s from your diet or from your body into ketones, and these ketones are energy molecules like glucose. And glucose is what most people on a modern diet run on pretty much all the time. But ketones have benefits. So benefits include greater energy efficiency, so they will produce more energy per ketone than than a glucose molecule, they will also produce fewer free radicals. And I think the or reactive oxygen species for Radicals call them what you will they, that’s important, because the body is okay with a certain amount of that, but after certain point, it becomes damaging. The ketones also have a number of signaling functions that we’re finding out, they can actually affect how DNA creates proteins and what proteins are created. So they can help turn down certain proteins that may not be beneficial or desired from an aging stance, and they can help turn on proteins that may be desired. So these ketones have many functions. And the deeper you go, so and the ketones well, I’ll leave it at that. The other thing that I guess deeper you go is that fasting and keto they induce the mitochondria to actually repair themselves and undergo this phenomenon called mitochondrial biogenesis. 

Whereby they divide and can actually can actually grow within the cell and thereby produce more energy. And another thing they do, when you do these fasts a ketogenic diet is the mitochondria have a chance to undergo mitophagy, which is a form of autophagy, which I’m sure most of your viewers know about. autophagy is cell eating, and it’s colloquially called Cell eating. And it’s basically where the the cell recycles chunky proteins and DNA, and in mitophagy, old damaged mitochondria. And when you’re eating all the time, and having a lot of glucose on top of that sugar, carbohydrates, you really hinder that process. And so fasting is probably the best at this, it basically stops the onslaught of nutrients into the body and allows ketones to be produced, which are more energy efficient. And it allows the mitochondria breathing space to actually try to repair, rejuvenate, and undergo biogenesis and remove the old ones that need to be removed and let the younger ones come into play. So those are some of the benefits, just looking at things from a certain number of levels. So 

Robert Lufkin 12:39
 oh, excuse me, it’s not a quick thing. Let me just see if I summarize. So there are benefits from from eating a ketogenic diet, being in ketosis all the time. But there’s an additional benefit from fasting in addition to the ketogenic diet, and that’s the autophagy that’s activated. In other words, you could be in ketosis all the time, then why do I need to fast? Well, you need to fast to turn on the autophagy. Is that Is that what you’re saying? 

Matthew Phillips 13:06
 Well, nobody knows. Exactly. And autophagy may not be, you know, switch on switch off thing like that. But yes, I think that particularly the multi day fasts, more than likely induce autophagy to a far greater degree, the ketogenic diet does, in some animal studies seem to promote a tougher cheat. But, you know, it’s like I’ve always said this, the fasting is like Batman, the Keto diets like Robin, if you really want to induce autophagy maximally, you’ve got to do some fast and really, the longer fasts are probably better and more powerful at doing this. 

Robert Lufkin 13:40
 I see. I see. And it seems like there’s so many benefits to switching to ketosis as a metabolic. A metabolic system is should we be in ketosis all the time. All right, 

Matthew Phillips 13:57
 Eric. Yeah. Yeah. Very good question. So look, there’s a lot of people get very supportive, almost religious about the diet, about diet, you know, there’s diet wars, things like that. To me, the ketogenic diet is not really a diet. It’s a way of putting your body in a fasted state. So it’s a method it’s not a diet. Of course it’s a diet and that you have to eat certain things. But a keto diet can be vegetarian, it can be vegan, it can be carnivore, it can be whatever you want it to be Mediterranean, Indian, can be Japanese, it doesn’t matter. I’ve I’ve designed and had people on all these different ketogenic diets, no problem. So it’s a it’s a method. The keto diet is a
 method. It’s a protocol, if you will, if you want to be really scientific about it for putting the body into a semi fasted state. So So everyone’s body is adapted to fasting, evolutionarily, at some point in time, our ancestors no matter where you evolved, went without food for for a period of time, maybe more if you were in the more northerly latitudes, but you did. Your 

ancestors did and so therefore everyone is adapted to fast And thereby set since the keto diet really the only special thing is that it kind of makes the body go into a semi fasted state, everyone’s body is adapted to keto diet, in my opinion, because it’s not a diet, it’s a method. And so should people be in ketosis all the time. So if you have a normal body mass index, and you’re fairly healthy and fit, no, that’s not necessary. In fact, I think you should cycling carbohydrates periodically, particularly if you’re going for certain performance states, such as power lifters, power lifters, you know, strictly on fasting ketogenic diet protocol that might not be optimal. And also, you know, I think, depending on where people evolved, so people have, you know, Northern European ancestry, their ancestors would have evolved with far fewer vegetables, they might have been in ketosis a lot longer, maybe most or all the time. And so that might be more reasonable. Certainly people with metabolic syndrome, and that is, gosh, metabolic syndrome, which is a combination, I’m sure viewers know of, you know, type two diabetes, obesity, slash being overweight, hypertension, and abnormal cholesterol profile. You know, you’ve got 50% of the US population, pre diabetic or diabetic, and I think 75%, at least is overweight or obese. And basically, the vast majority of people in the West are metabolically unhealthy. I think those people should be, I think it would be, I don’t think they should be people have a right to choose always, but I think it would be ideal for them to be in ketosis. Certainly most and maybe all of the time until they achieve metabolic health. And once they achieve a certain degree of metabolic health, it’s like a, it’s something you can never perfect, but you always can get better, then once they’re happy with their metabolic health, and maybe they’ve reduced the risk of, you know, getting a heart attack or stroke or, or whatever, to a certain degree, then then they can cycling some carbs. So I’m not anti carb by any means I’m, I’m anti processed carbs, but I think some people would be ideal to be ketosis all the time, until they reach a target, and then no longer required. 

Robert Lufkin 17:08
 You and I both come from traditional medicine, medical system backgrounds, and, you know, I still work in a medical school and all that, how did how did medicine get so far off the rails and miss this, this key point about? I mean, I, you know, I’m still in my colleagues, they still treat, you know, hypertension with a drug and then they think they’re done. You know, when they you’re not treating the underlying condition. They you know, you treat heart attack with a stent and or bypass and you’re done. You know, you might might give him advice about lifestyle, but lifestyles really not. Not considered the powerful game changer that it is, what where did we go so wrong here? 

Matthew Phillips 17:59
 Well, yeah, like you, I do. The vast majority of the neurology teaching and training at Waikato Hospital, and I see the medical students all the time, and I, whenever I, I don’t, I try to stick to their traditional curriculum, I, they have to learn the basic neurology, of course, but, but also I do mention these things, and I practice them myself, with my patients and with myself too. So they everyone knows, I find that they, you know, when you’re at a young age, as a medical student you are 

you just want to learn stuff, and you don’t want to be controversial. And it’s, it’s difficult until you finish your training, which most people are going to be into their 30s. At that point, it’s difficult to be too controversial when you’re in a system and you don’t and you’re a junior specialist amongst your senior colleagues, and you don’t want to be too controversial. And this continues for the rest of one’s life. So that once you get on the medical school, the current dogmatic way of thinking, which is you know, medications, disease, hypertension, give, you know, anti you know, an angiotensin inhibitor or something, it’s very hard to get off it unless you do some stupid like, I didn’t charge yourself in the system for three years, you know, buy a one way ticket to Argentina. So where did we go wrong? That’s where we’re at. It’s we’re on this train of medicine, where it’s hard to think differently. It’s very hard and you know, every time I come to work every single day, I do. You know, I encounter that amongst my colleagues as to you. Where do we go wrong? Maybe 200 years ago, it went a little south when there was this great debate in France between pasture and Bishop Bishop. So Louis test you’re who I was a hero of mine since I was like five years old. I had a little book, book picture book of pastures success. Pasteur was this advocate for a germ theory. And he was a pure scientist. And he had he just thought he championed this theory. He didn’t invent it. He championed it, though that germs cause disease. So you get the bacteria, the virus, and it causes this disease, which is a set of clinical symptoms. And Beauchamp was a contemporary of his a little bit older, I think. And he certainly lived a lot longer. Beauchamp was actually a physician and scientist. So he had both hats. And Muschamp was quite a gentleman. So he didn’t have quite the oratory skills of Pastor but also perhaps he was a little more polite. And bishop had anyways had a different theory, it was terrain or host theory. And he said, Well, now it’s, it’s more like this, these bacteria and viruses, most of them are scavengers. And if you have a unhealthy terrain, so a weak diseased body a sick body metabolically, he didn’t say that word. But this is I’m trying to parallel into what he may have been alluding to. If your terrain is weak, the ground the soil, whereby the scavengers sort of, you know, mess around and do what they do. If that’s weak, then disease is going to happen, because the scavengers will kind of take over. But if the terrain is strong, ie healthy, then the scavengers will remain scavengers, and we’ll have these bacteria and viruses in our body. And they’ll do a little a little of that, but they won’t cause disease as in, make you feel give you a high fever, make you feel fatigue, making her vomit and have nausea and all the things that disease does, or outsiders cancer and those things right. So to take to another level. Not saying those are from infectious diseases, but it’s an analogous thing. So his theory was the complete opposite. And they had this debate for decades. And eventually, by towards the end of the 18 hundred’s, the dawn of the 20th century, pastures germ theory had really taken off in the shops, for a number of reasons had really faltered, and it almost faded away into nothingness. Not quite though. It’s been held alive by a few people. So I think maybe where bishops’ theory had a problem was, I think the health, he was referring to the terrain, he didn’t have a target shot up pester had these targets, he could target the bacteria, you could there’s a this bacteria that causes this disease targeted with with this vaccine, and so on. Bishopp didn’t have that he said, you know, things like get sunlight, get exercise, but it was all very vague. And he didn’t have protocols, because he couldn’t because he didn’t have a target. He just sort of said this terrain, and what’s the terrain and he he came up with some ideas, these micros IMAS and other under other funny things that he thought of which in an attempt to try and make an explanation. And really, we hadn’t discovered mitochondria big way. By that point in time, that 

was the problem we didn’t know about mitochondria. And so it may be if he’d known about them, they could have sent off the target is mitochondrial dysfunction, the mitochondria are damaged, I need to fix those two, to actually improve a lot of these disorders. So rather than attacking or suppressing or eliminating a bacteria virus, which is the way we think today in medicine, it was more about restoring a disease target something that’s damaged and needs to be restored, not targeted, or suppressed or eliminated. And so since Pasteur lost that debate, sorry, Bishop lost that debate and pest, you’re basically his theory, one, germ theory is taken off, and now it’s spilled over and beyond all the infectious diseases. Now we think about non infectious disorders, which are the ones that are killing people in the West today. So atherosclerosis, the hardening of the arteries, gives you heart attacks, and a decent proportion of strokes, cancer, Alzheimer’s, Parkinson’s, all these type two diabetes, metabolic syndrome, all these guys. Now, these are non infectious disorders, probably, and, but yet, we’re still trying to target, eliminate and suppress things. So we’re trying to target and eliminate cholesterol, we’re trying to target and eliminate these proteins and Alzheimer’s neurons that can be doing any damage. We’re trying to target the mutations in cancer cells, which it probably are, to some extent, just bystanders. And the whole models, in my opinion, gone off kilter, because we’re not thinking hard anymore. We’re just accepting what we’re told when we’re in medical school in our 20s. And we just keep going on that train and life gets in the way, and we keep going and keep going. And then you know, we’re 75 years old, and that’s it. So it’s it really stems from I think the lot that the problem is that we didn’t have Beauchamp didn’t have the target mitochondrial dysfunction and not just him, but other people at a time that that whole host of terrain theory didn’t have that. 

Things ironed out compared to the germ theory. And so the germ theory took off And here we are with germ theory, absolutely out of control. In my opinion, it pervades our thinking. And we really need to get some common sense back into medicine and, and re relook at host or terrain theory, not the actual theory, but a better superior theory that takes mitochondrial dysfunction into account of metabolic theory, if you will. And I think that would be a beautiful thing, because then we could actually really start doing some serious, seriously good work in mitigating, and reducing Alzheimers, and heart attacks and strokes and cancer, these things should not be as prevalent as they are and killing as many people as they are. 

Robert Lufkin 25:38
 And how we conceptualize a disease is very important. If we think of the, the, the, the heart attack is the disease and the narrow acute narrowing of the blood vessel is the disease, then we miss the underlying cause, and it never gets treated. It’s sort of like, if my roof leaks, because it has a hole, I treat the hole, but I don’t realize they’re termites or, you know, something that’s causing the hall. And that’s almost what’s going on with metabolic disease and these underlying disorders that that, for the most part, don’t get treated. I wonder if also that we failed in our messaging for lifestyle, that life’s the idea of lifestyle, it’s become so vague and so, so confounding, you know, when I was diagnosed with hypertension, a couple of years ago, before I, before I got my metabolic health in order, and D prescribed my drugs, and I’m fine now. But at that point, I was, I was put on a hypertension, any hypertensive drug? And we said, Is there anything else I could do, and, you know, the physician sort of, you know, he did the best he 

could. And he, you know, he said something about, well, you know, fix your lifestyle or something, you know, lose weight, or exercise or your diet. But, you know, for someone to try and take that into actionable items, you look at diet, and there’s there, there’s all sorts of different diet viewpoints on conflicting viewpoints on the on the internet and elsewhere, even among physicians and exercise. It’s not a clear message. And it’s sort of, you know, it’s it’s very, very confusing. And for the most part, people don’t trust lifestyle. And I think a lot of my colleagues don’t trust lifestyle as an effective regimen, when actually, as as we’re going to hear from you and the other people are showing, perhaps the most powerful medicine we have is literally the diet and when we eat fasting, you know, if you fast you you you make things happen whether you want to or not, that are metabolically very, very powerful. You know? Absolutely. Yeah. Not bad, either. Or, 

Matthew Phillips 27:48
 yeah, so to some extent, Duchamp’s original problem is still with us, right? We still haven’t defined when we say lifestyle, prove your lifestyle, most people think I exercise more, eat less. And that’s just nonsense. that’s those are two strategies for failing. And that’s what most people doctors included, think, because they didn’t get trained any better. So we still lacked target. The target is the mitochondria dysfunction. In my humble opinion, if we think of it that way, always from that perspective, then you can actually start tailoring metabolic programs, metabolic therapies, even for these disorders. And, you know, it’s like I said, it’s so complicated, what, on one level, fasting is simple to understand, oh, you stop eating, and, you know, drink water and salt and all that. But on a deeper level, a mechanistic metabolic level, it’s incredibly complex. And it just, it, it’s very hard to design trials that test these things, and also with metabolic things like lifestyle, you know, fasting, keto, it’s not like a drug where the change that you expect to see happens right away, right? It takes a while, weeks, months, even really years to optimize things for for your metabolic health to improve. And so it’s hard to test you have to do these trials that are, you know, at least in the level of weeks or months, and they they have to be designed a little differently, for scientific reasons. And, yes, that there are so many challenges, but the challenges are surmountable. Absolutely and imply it’s absolutely worth doing it. You know, if you hadn’t done what you did, Rob, you would still be you might be on two or three antihypertensives now, and your metabolic health will probably be even poorer. And you be maybe your blood pressure number would be okay, but you would know deep down and most of my patients know deep down when they’re being sold something by their physicians, that things aren’t quite right. It’s not normal to be on so many medications now at this stage. And, you know, most of the patients I see do suspect deep down that something’s not right. And that’s the thing that I find fascinating is, you know, people do trust their doctors, but that trust is being eroded. The more we cling to this dogma of, of medicine and drugs and disease, and that’s it, that’s all there is to it. And, you know, the more we claim, the more trust made mainstream medicine is going to lose and more trust will be eroded into the Internet into a lot of alternative therapies, and some of which are okay, but some of which are not. And that’s a shame to me, I really want to help, you know, mainstream medicine change so that it can adapt and become much more powerful, and able to, to deal with these disorders, because right now, we’re losing trust. And from our patients, I don’t like that it’s not the way it should be. So we need to change how we fundamentally view ourselves. I don’t want to see myself as a 

doctor of medicine, in brackets, drugs, I want to see myself as a Doctor of Health and Health can be drugs can be a part of that I’m not anti drug. So I’m not, you know, I think, using many drugs and correct circumstances, absolutely appropriate. But the main game is not the drugs. The main game for most people today, with our disorders is fasting ketogenic diets and similar metabolic strategies. 

Robert Lufkin 31:09
 Yeah, it’s fascinating the way they help the medical system that were a part of treats all these all these symptoms of metabolic disease with, you know, very powerful tools that are effective when they’re needed, you know, for cancer, heart disease, radiation, surgery, drugs, but the fundamental problem, the metabolic disorder, there’s not really a drug for it, or radiation therapy or chemotherapy, it’s a lifestyle, it’s a way of being that people have to change and, and we, as physicians, and other healthcare professionals need to get our heads around that, that that’s equally important to the drugs and the surgery and everything else, that the lifestyle is even even more important. It’s fundamental and all and now you you’ve taken the step to actually do that with with your, with your answer there to two clinical trials that I think are both the first at least a first and Alzheimer’s and, and, and then one also for a related neurodegenerative disease with Parkinson’s disease that many people are familiar with. Maybe we can start with the Parkinson’s one. And you just summarize that and then we could take a little deeper dive into the Alzheimer’s one and and see what it looks like. 

Matthew Phillips 32:25
 Yeah, so they, they were the first randomized trials in either disorder involving a ketogenic diet. So you’re correct. And, you know, so I gotta say, also, you know, part of the reason I do these trials is I want to make sure that, you know, I’m not full of a dogma that is nonsense to write. So it’s difficult road trying to be enthusiast, you have to be enthusiastic to get these kinds of things done, otherwise, you’ll fail. But you have to try and stay objective to and that’s difficult. Anyway, so the Parkinson study, we did that three years ago, and that involve 47 people with Parkinson’s and we it was randomized controlled trials. So we, they would only been one trial and Parkinson’s before that, like 13 years before 2005 by a Dr. Ted van Italy, who is sadly no longer with us. And he looked at, I think, seven patients with Parkinson’s, it was just, you know, no, no randomize aspect, just seven people put them on a diet for four weeks, see what happens. And he had some encouraging results. So I, I wanted to make one that was much bigger, and it had randomized component. Randomized means you have a control group, so they do some intervention that’s would be normally standard of care or recommended. So in our case, it was a low fat, healthy, low fat, New Zealand eating guidelines, guidelines recommended diet. And you compare those people with a experimental intervention, in this case, the ketogenic diet. So we we put 24 on keto and 23 were randomized to the low fat diet. And you know, it’s good low fat diet had a lot of vegetables and fruits and so on what people would say is good. So and then we ran that for eight weeks. So I doubled the time that Ted used because he had impressive results in only four weeks. So I thought eight would be fine. And you know, money was an issue, because at this time, it was this was, you know, getting funding for this kind of thing was not easy. And we ran it through and that’s a really great trial design. You know, it’s, it’s really important to do randomized, controlled randomized crossover trials, in this 

kind of work, because otherwise it’s both are not as powerful as they could be. And even with the best randomized controlled trial design, you still have some things that may not be optimal, but it’s as good as you can get. 

Robert Lufkin 34:54
 It’s obviously not blinded. So, no, that’s an issue too. 

Matthew Phillips 34:58
 That’s one big limitation of a diet. trial that people don’t get is you can never so you can’t do a double blind trial where the assessors and the patients don’t know what they’re taking with the drug, right? You give them a pill and they don’t know what it is. But with a diet, you can blind the assessors. So you can make it single blinded, which is what we did, they had no idea that patients are being kept blind a patient to what they’re eating that a patient knows if they’ve drastically changed their diet and it’s high fat, or, or full of carb or whatever, right. So you have to realize that you just it simply cannot be done. And you accept that as a limitation. So anyways, we did that and change nothing else. Everything else stayed the same. Their medications say the same. We’ve made sure they time their medications the same before and after meals, very important Parkinson’s, we measured them at the same time of day, on the same day, the week with a blinded assessor, they made sure they exercise the same, but that didn’t change. Everything was the same except for the diet change. And by the end of only eight weeks, Parkinson’s improved in the ketogenic diet. And the thing about parks is just a complicated sorter even more complicated and Alzheimer’s in many respects. So you get the obvious symptoms, like the tremor, and the stiffness, and maybe some walking changes and things like that. But most of Parkinson’s, the the real things that affect quality of life and disabled people are these things called non motor symptoms. So it’s things like pain syndromes, mood disorders, particularly depression and anxiety, its major problems with sleep, it’s fatigue throughout the day, it’s falling asleep throughout the day. It’s problems with the bladder problems with the bowel. It’s so it’s it’s really tough. And the non motor symptoms improved by 40% 41 or 42%. In the Keto group, they did improve in the low fat group. Remember, this was still a better diet, the low fat diet was a much better diet. And most of these people were taking they were eating beer and ice cream and stuff, as most people do on a modern diet. They improved by 10%. So they still improved, but it wasn’t 42%. So massive difference there with the ketogenic diet. And I found that very encouraging. 

Robert Lufkin 37:07
 Huh, wow. So that was that was two years ago. And then the, the Alzheimer’s diet then started, excuse me, the Alzheimer’s study started right after that. Is that right? 

Matthew Phillips 37:22
 Yeah, so we launched into the Alzheimer studies shortly after, it always takes like, a couple years to get ethics and funding and get people interested. So advertising and newspapers and things. And yeah, so we started the Alzheimer’s, this is a slightly different design, it’s actually I thought it would be easier to recruit people for Alzheimer’s because it’s much more common than Parkinson’s but actually was harder. The reason it was harder is people with severe 

Alzheimer’s are stuck in high level care facilities. And they’re not suitable for this because you know, they’re extremely restricted in what they can eat. And then people with very mild Alzheimers often are undiagnosed, people don’t want to know, or they’re labeled with mild cognitive impairment, which is a sort of a risk factor stage for Alzheimer’s and things like that, and subjective cognitive impairment. And I didn’t want those I wanted outsiders, I wanted to study Alzheimer, so I was stuck with maybe the bad miles and the not so bad moderates. And so that restricted greatly the amount of people that I could recruit. So it was harder than I thought. And partly for that reason, I decided to go to a randomized crossover design, which is, which is the most powerful kind of design. And you could run a trial with even fewer people than a randomized control design. So that was ideal, because I knew I was I was restricted in how many people I could get. So anyways, randomized crossover design that one, we extended the time to 12 weeks. And with a crossover, what you do is you split people up into again, it was a similar healthy eating guidelines, low fat diet. This time though, the Alzheimer study we, we emphasize just recommendations, they stuck to their normal diet. And we as a true, our dietitian sort of made these. We made these dietitian recommended changes, but they didn’t have to change as they wanted. So they were recommended to lower the fat and remove certain foods from their diet stick to what they were on more or less. And then the keto diet was one we designed for Alzheimer’s, we ran both groups for 12 weeks. And then we had a 10 week period where everyone just stopped eating either of these, the control or experimental diet, and they went back to their normal diet completely normal diet for 10 weeks. And that’s called a washout. And you have to do that in a crossover to remove all the effects of the previous two diets whether they be good or bad. And for many reasons we did 10 Weeks was sufficient and I think it was just and then we flipped people so the people who were On the control diet did the keto diet and vice versa, and we did it another 12 weeks. So it’s a much longer study. And then you compare all the people, because everyone in that trial all 26 of them tried both diets. And that’s very powerful, because now everyone’s tried both. And you can compare everyone on keto versus anyone, everyone on the other one, and yeah, I mean, the results were were good. So the cognition improved, but it wasn’t statistically significant. Quite there. It’s, there were some reasons. Again, you always have to think about reasons we got unlucky with a severe COVID-19 lockdown, which hit us for the last six weeks, five weeks of the study. But things the other two things we looked at were daily function and quality of life. And if you ask people with dementia, what are the most important things to them, it’s actually not cognition, its function and quality of life, they want to be able to do stuff, and they want to be able to have good relationships and quality of life and that kind of thing. So those things improved, and they were statistically significant. But I, in my opinion, more importantly, clinically significant as in, when something’s clinically significant, it’s kind of obvious to the patient and or people around them that things have improved. So you can get a statistically significant improvement. But if you have a humongous trial 1000s of people, then you can even the tiniest improvement that nobody will notice becomes statistically significant. But with these guys, it was clinically significant. And I was not involved in assessments, but I saw them at the assessments because I was coordinating stuff. And you know, some of these guys, it was quite remarkable, the improvement. So yeah, that’s what we did in nutshell, 

Robert Lufkin 41:45 

in the fact that, you know, many people now believe Alzheimer’s disease to be a very heterogeneous disease, you know, like people like Dale Bredesen is, you know, is saying, well, there’s, you know, there’s a mold toxicity component, some people may have a toxin, you know, Neil Nathan, or Lyme disease, those kinds of things, or there may be people with other deficiencies, that present with cognitive impairment and actually may actually develop Alzheimer’s disease. But so, potentially there could be only a subset of these that would respond necessarily to aggressive ketogenic diet and fasting if they’re if the problem is a toxin, or, or vascular dementia or some other some other thing, they might not respond as much to a ketogenic diet, necessarily. 

Matthew Phillips 42:34
 Yeah. That’s one possibility. I do. I mean, I’ve huge respect for Dale and what he’s trying to do. I do see things differently, though. So again, somewhat differently, there’s overlap, there’s definitely overlap. I think, to me, it’s, again, it comes back to the mitochondrial dysfunction being the underlying problem in 90% of Alzheimers, the rest being a bit genetic and stuff like that. And so I look at it as mitochondrial dysfunction primarily. And if you if you are doing these therapies correctly for someone then then mitochondria dysfunction should improve. Now, that being said, many different things can cause or trigger mitochondria dysfunction, right? So it’s not just excess carbohydrates all the time. They can damage mitochondria through free radical mediated mechanisms or whatever thing you know, heavy metals can damage mitochondria. Aluminum, for example, Alzheimer’s, can damage mitochondria. Infections can damaged mitochondria, viruses, chemo, chemo, radiation, both of those carcinogens and radiation can damage mitochondria. So all those things that he talks about can also damage mitochondria. And so, you know, I think that there is a lot of overlap, we may just be interpreting things a little bit differently. But there’s a lot of synergy. And the other thing I would say also is, yes, perhaps for certain people, the mitochondria dysfunction arose primarily from an infection or exposure to something that a diet of fastest search you won’t immediately fixed, and maybe that kind of person won’t respond as well. I agree. But they should, in theory, if if, if this theory is correct, what I’m thinking of most people certainly should have some improvement. And that’s why it’s important to look at larger numbers and randomized trials to to actually tease out whether that’s the case and that was the case in this trial. I looked at all the people how much they improved, and there were less than, you know, the number of fingers on my hand that didn’t have an appreciable improvement. And I’ve been thinking about why those few people didn’t I’ve got some some theories but again, you there’s always a few things you can’t explain. So Yeah, I think there’s overlap with with his way of thinking, but there’s also some important differences. 

Robert Lufkin 45:07
 And what, what’s been the impact of your work? How have you seen that influencing colleagues? Or? 

Matthew Phillips 45:18
 What? Yeah, well, what’s the impact? Yeah, no, that’s a great question, too. So, I, the impact has been, and I’m not surprised at all, you know. I mean, when the paper came out, it was the 

second most popular paper ever published by Alzheimers readers research and therapy, which is the second highest impact factor Alzheimer’s journal. So very good journal. Wow. Yeah. And
 it remains the number two most sort of, is measured by Altmetric score, which looks at things like Facebook Mentions, tweets, newspaper articles, videos, like, like something like, so that’s really good. So a lot of people are interested. That being said, amongst the mainstream, mainstream colleagues, it’s, it’s more like, it’s kind of like, interesting, you know, that’s sort of the comment I get. And it’s just two different it’s two out far removed from the paradigm, the dogma, it’s hard to conceptualize why this might have an impact. And I’m totally okay with that. In fact, I don’t want to receive a lot of fame or whatever, because I think there’s just too much work to do to do more. So it has been, I guess, in one sense, achieved a lot of attention from the groups of people that you’d expect it to achieve, achieve attention from, but for mainstream doctors, it’s, it’s, it’s still lukewarm. And I’m totally fine with that. Now, I’ve done some talks for the Jeep, for example, the New Zealand GP College of GPS, I’ve done podcasts for them, and I’m going to be I’ve done some talks for them. So GP is actually of all the mainstream physicians are the most interested in. So that’s seems to be gaining traction amongst those guys. among specialists, though, it’s a, it’s going to be a little bit more work to do. But again, I’m okay with that. I don’t want to be, I’d rather just do the work, do the science and try to do things the best they can. And if the truth is in there somewhere, it’ll come out. And I’m cool with that. It doesn’t matter if I’m 80 years old, that happens. Fine. 

Robert Lufkin 47:28
 Oh, boy, it won’t be that long. Well, are there people reproducing that are you aware of studies that are larger studies? Are you Are you do you have one another one underway? 

Matthew Phillips 47:38
 So what I’m trying to do, so I’m trying to specialize in the therapies so what it’s great being a general neurologist, because that means I have many diseases, or disorders to choose from. So I, you know, I’ve done this in Parks has done this in Alzheimer’s. Now I’m trying to work on cancer. We’re working with patients with glioblastoma multiforme, which is the worst brain cancer you can get. It’s, it’s pretty tough. And it’s very different from Alzheimer’s and Parkinson’s, no less challenging, but it’s different. So that’s where I’m working with now. I’ve got a few people with other disorders. So Huntington’s and muscle dystrophies that I’m working with that are trying these strategies. And I’ve spent because the Zealand’s been in a lot of lockdowns, the last year and a half, I’m been working very hard on a review paper that talks about the whole past year versus Beacham way of thinking that what you and I’ve been discussing for the last half hour. So that’s where I’m focusing on in terms of a big randomized control trial don’t have anything in the works at this moment. I would like to but the threat of lockdown here is too great lockdown can really make a randomized control trial difficult. So I’m waiting until things get better from a CNI team point of view. 

Robert Lufkin 49:03
 I mean, you think from just in the face of it, if you know if I had a loved one or you know a family member or you know, even you know, non physicians, non health care people hearing about the work you did, you know, what have you got to lose by switching to a ketogenic diet. 

There’s really no downside. And ketogenic diets are not that not that tough. Or not exactly, but a ketogenic lifestyle. 

Matthew Phillips 49:31
 That’s fine. Yeah, it’s, I think you can call the diet I don’t want to call Yeah, absolutely. If you do it, right. I think a lot of people try it maybe without the right guidance, or they try some diet this on the internet. And it’s really the basics that are so important. So water and salt are two things that are especially salt. It’s so important to maintain those things, you have to increase them. If you don’t do that you’re going to get a lot of the symptoms that people get Like fatigue and dizziness and headaches and so on, guaranteed. So but if you do these things, it’s not difficult and it’s not difficult because you’re just doing something the body knows how to do which is go into a fasted or semi fasted state. We’ve just forgotten with our modern lifestyle. 

Robert Lufkin 50:18
 Yeah, I mean, and having said, going back to our conversation about how, you know, lifestyle or how metabolic disease, metabolic health is basically driven by lifestyle, and there’s not going to be a drug that drops down to, you know, fix it for us or a surgery even having said that, looking at some of the the new understanding of the drivers for fasted versus non fasted state and the the nutrient sensing proteins and genes like mTOR, and a MP kinase, what do you think about rapamycin for Alzheimer’s patients as a way, I mean, in addition to a ketogenic diet, maybe but really driving things. Okay. 

Matthew Phillips 51:03
 Yeah, so again, that’s again, where I might differ a little bit from the Bredesen approach, which relies on supplementation to a degree and I’m not against supplements, but I’m not for them. The reason is, so the reason is this, like, I would rather suppress mTOR, for example, through a fasting or keto strategy, as part of the orchestrated change as the body does it on its own, in conjunction with other things rather than trying to target and PK or mTOR or insulin or whatever, with any, any drug. And I mean, supplement to either one, because whenever you change one thing, other things, compensating the body, the body just fiddles, you know, when you fiddle with it, it changes things. So I’d rather just induce a state that the body knows how to do and how to coordinate itself and get the body doing that. That way. That being said, I’m not against people using supplements at all, if they want to use them, fine. I don’t advocate them, though, for that reason. The other reason is a lot of supplements are costly. And I find that patients are really looking for anything when they have things like glioblastoma or Alzheimer’s, or anything that will help and they’re susceptible to paying large sums of money on the internet to get these things. And I don’t like that. So I always say to people, Look, if someone’s going to make money out of it, like I make no money out of this at all. So I you know, I just say, Look, if someone’s making money out of it, you just gotta think maybe they’ve got a another motive that isn’t entirely pure and directed towards improving your health. And that, by the way, is a problem with a lot of scientific studies today is financial conflicts amongst the people doing the studies and drug companies in particular that promote the studies. That’s a different topic. So I don’t think we have to talk. 

Robert Lufkin 53:04
 Absolutely, no, that’s that’s that’s a very important point. And I guess, in both the the good news, and the bad news is a ketogenic diet, a ketogenic process program can be cost neutral. In other words, it doesn’t have to cost more than then your other foods that you eat, and fasting will actually save you money. 

Matthew Phillips 53:28
 Big time. Yeah, there’s so handy that way. It’s yeah, keto diet that we’ve designed, we made sure that every single ingredient was available at our local packing save food store. And I’m of course, I’ve tested it almost all the recipes myself. And yeah, it was a, it depends on someone needs, if someone tries to eat, you know, quote, unquote, well, then our keto diet was really no more expensive than any normal diet. But if you know that, a highly processed carbohydrate diet tends to be cheaper, because processed carbs are kind of on the cheap side. And it worked out to about 25 30% More expensive than then that kind of which I would say is terrible diet. And if you’re not going to spend money on on this kind of health oriented program, to me, that’s the best thing you could spend it on period. So we’ve had we had some people on, you know, on receiving payment benefits in these trials, who really have no significant income at all, and they could still afford it. So I think that’s great. You have to if you’re doing these things, you know, and this is again, a problem with I won’t mention any names, some therapies, therapeutic approaches to Alzheimer’s as they cost a lot. And you know, you can’t have a therapy that only 5% of the population can actually afford. To me that’s not so cool. So that’s what I love about fasting and keto. If you do it right, they’re really not expensive and as you say, fasting saves you money and time in the long run. 

Robert Lufkin 55:03
 Yeah, yeah. Well, maybe in the last couple minutes as an expert in in fasting and and ketogenic programs, I I’d love to hear and our audience would love to hear if you you kind of be kind enough to share with us what what personal choices you make in your life that you feel, create to a healthy lifestyle and create a healthy lifestyle for you. 

Matthew Phillips 55:30
 Alright, so, for me, it’s, it’s all about the mitochondria, remember? So I first of all, I’m on first principles. So a lot of my knowledge comes from actually my choices. So I, I try to I try something myself before I even think about subjecting a patient to it, I try it to the 10th degree so. So that includes, you know, very long fasts and all the rest of it. So what I do right now, constantly thinking about mitochondria health, and again, I make a distinction between health and fitness. So health is the ability to remain, have your mitochondria be functioning optimally ward off disorders, things like that fitness is the ability to run fast or be really strong. And that’s important. And I do focus on that. But it’s mostly health, I think is the most important thing. So I do omad for the last, and it’s always changing for the for the last year. So I’ve been doing Oh, mad one meal a day. It’s usually dinner, I’d rather it was lunch, but just because of the way my lifestyle is work, I can never get a lunch at work that I want. And I don’t want to take the time in the morning to make to make it so it’s a as early dinner as as I can make it which never is before six o’clock, unfortunately. And it’s a ketogenic diet. So I’ll have a one meal a day ketogenic diet. 

That is, I range it from pure carnivore, sometimes to mix of veg and carnivore and sometimes I go vegetarian, I have some lovely vegetarian recipes, it doesn’t matter, so long as you’re keto. And once every one to two months, I will do a four to five day fast. I’m doing one right now, actually. So that I think is good to just do a nice reset. And when I do that, I feel so great. And you know, I just did periodic resets important. I was doing longer fasts, I was doing seven to 14 day fasts every couple months. And I found those, when I got into the second week, I didn’t feel quite as good, I still felt pretty good. But I prefer in the four to five day ones, that’s just for me, that might not be the best for someone with, you know, metabolic syndrome, I think the longer fasts might be very good. And in terms of the fitness, so water and salt, I make sure I drink lots of water and have lots of salt. And my blood pressure is very low, despite huge amounts of salt, it’s somewhat of a myth. If you look at the data, that high salt is in any significant way contributor to hypertension, from the fitness side of things, all I do, you know, I used to play lots of sports and running, I don’t run any more, I decided to do high, so hits high impact training. And it’s just bodyweight biometric isometrics. So at home and I do that for five to 10 minutes every morning, five days a week, that’s it, and I find I get a really good workout from that I produce some lactate. And a lot of people don’t know this is the brain can utilize three fuels very well. So glucose is one ketones is another that’s my favorite. But lactate, when the brain can run up to sort of 20% of its metabolism on lactate. So when you do a high intensity exercise program, and you get that burn and you’re glycolysis and your muscles is going overtime, it goes the lactic well guess what your brains loved it. And that may be one reason people feel somewhat euphoric and think very well in the hours after a good exercise session. So I do strongly encourage you to, to do your exercise if you want to augment these these fasting keto strategies. That’s, that’s in a nutshell. I don’t do anything too crazy out of those things. 

Robert Lufkin 59:13
 Any, do you use breath ref monitors for ketosis or keto Mojo or any of the stress any of those things or 

Matthew Phillips 59:22
 CGI? I’ve tried them. But I’m a fan of the blood glucose ketone monitors. So I’ve got a whole I’ve got a whole bunch of those. And yeah, I used to measure my ketone sort of twice a day, religiously, maybe five, six years ago, when I was really experimenting hard on myself. And now I rarely mentioned them because at the time, I didn’t know what my ketones were, it was hard as heck to predict. But now I have a good idea. And I check them once in a while just to make sure Yeah, okay. They’re, they’re at a certain level, but I don’t measure my ketones too much anymore. Very important, though, when you’re starting very important when Starting otherwise you don’t know if you’re doing things right. And that’s one thing we did in the outsiders and Parkinson’s trials is we had every patient measure their ketones themselves every day. And that’s the best way for people to know because people get competitive in a good way. If the ketones are high enough, then they can talk to me and I’ll go, Okay, well, it’s it’s this or that that’s causing you trouble. 

Robert Lufkin 1:00:21 

That’s, that’s great. That’s great. Great. useful. Yeah. That’s, that’s very useful there. So how, how can people follow you, Matthew, could you tell us your website, maybe just tell it, tell us so the listeners can hear it now? 

Matthew Phillips 1:00:37
 Yeah, sure. So it’s a website that a patient started for me a few months ago. I’m eternally grateful to her. It’s metabolic neurologist.com. If you go there, more, you know, all pretty much all the studies are there. I’ve got some other videos, podcasts, anything I’ve done. So like this with yourself, I’ll put there when it’s done. I’ve got some meal. Some plans, there are some fasting keto plans if you want to try them. I’ve got including the ones we use in the Alzheimer’s and Parkinson’s study. There’s a few interesting things there if you if you want to do this, and yeah, go have at it. 

Robert Lufkin 1:01:19
 Great. Well, Matt, thanks so much for taking the spending time with us today. I’ll let you go. I’ll let you go back out into that gorgeous New Zealand sunshine today. But thanks for spending the time with us and telling us about the fascinating work work you’re doing. And I look forward to connecting again soon. 

Matthew Phillips 1:01:41
 Thanks, Rob. I really appreciated speaking to you that was, you know, you let me speak a lot. So that was nice of you. But thanks for everything you do and spreading the good word and getting different opinions out there on how we might be able to make things better for humanity in the future. 

Unknown Speaker 1:01:58
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