Nick Norwitz
speaker
450 appearances
2 recordings
2 series
first heard Apr 2025
last heard Apr 2025
Nick Norwitz’s voice in public audio — every appearance, attributed to the second.
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Appearances
And I just could not conceive of a world where a high fat, very low carbohydrate diet was a healthy diet.
Yeah, yeah. So I had a very negative perception of it. Now, how I ultimately found my way to it is after a couple of years of trying standard therapy for ulcerative colitis, I just, I wasn't getting better.
All the regular stuff, you know, first line therapies and then steroids for flares. And, you know, like I'd exit a flare and go into remission and then I just relapsed. which is obviously incredibly frustrating. It was just tearing at me from the inside. I just, I couldn't be a reliable person.
I couldn't say yes to offers that I wanted to say yes to because I just didn't know what would happen to me. I got very desperate and I started experimenting with things. I didn't think diet would help, but I had nothing to lose. So I started experimenting with diet because, you know, on a superficial level.
I tried paleo, I tried Mediterranean, I tried vegan, I tried, you know, pescatarian. Anything you can imagine, I've probably tried, along with the standard things like low FODMAP, specific carbohydrate. And I'd try them pretty rigorously for like a month or so. And then eventually I came to a ketogenic diet. And I just thought I'd try it because what the heck.
And what happened for me was my inflammatory markers dropped to the lowest they'd been. My disease started. I started feeling so much better, getting my energy back, getting my mind back. And then the next time I got a colonoscopy, I was in biopsy for permission. which was stunning. And I was forced to reconcile with the fact that this was my lived experience.
This has been my lived experience, despite the fact that it's not a quote, evidence-based approach. So a lot of what I've been thinking about with respect to metabolic health- The absence of evidence is not the evidence of absence.
But I'd heard that saying before starting medical school, but it really didn't sink in until I started to think about our current biomedical infrastructure business models around health. and why certain interventions would or would not be explored.
Right, so it hasn't been properly explored and which makes it, to me, the low-hanging fruit for treating all these chronic metabolic diseases, which we have been poorly equipped to address. Cardiovascular disease, inflammatory bowel disease, obesity, diabetes.
Mental health issues as well.
Is it Shabani Sethi? Yeah. Yeah.
I've done a little bit of work with her, Chris Palmer, Suzuki Group, Metabolic Mind. The universe of things that we could treat with rigorous metabolic therapies is truly impressive. But in order to make that standard of care, we need to grapple with the fact that they're not by conventional metrics currently, quote, evidence-based.
because there isn't the research and funding infrastructure to do these trials with the same degree of, quote, rigor as pharmaceuticals. Because again, the business model isn't as clear. It's very clear if you produce a pill and it treats a disease, you can sell that drug and make a massive profit, even if The drug doesn't help most people.
You can get a statistically significant result in a trial that you publish in the New England Journal, and it can still help only a minority of people.
I think the top 10 drugs only help like 1 to 4 to 1 in 10 people who take them.
I think the first thing to acknowledge is there's not a good definition of metabolic health. When we're talking about scientific communication, there are some terms that have very strict definitions and criteria and other terms that are more like Porn, where you know it when you see it. Another example would be ultra-processed foods.
Really defining that scientifically is difficult, but it's a useful term and heuristic in the public sphere. So I'll just say up front, I feel like metabolic health is similar where it encompasses a lot of things and there's a lot of definitions, but I just want to be up front. There is no consensus on what the definition is. With that said, there are different ways to slice it.
The way I like to think about it is it's when your body's systems are running in a way to optimize performance and minimize risk of chronic disease. You can start to intuit that through certain biomarkers. So there's like canaries in the coal mine for poor metabolic health. Like if you have high fasting insulin or insulin resistance score,
Things like triglyceride to HDL ratio or, you know, features of metabolic syndrome. You look at your waist circumference, your visceral fat. There's a lot of things you can look at.
I think a way to think about it is, I don't know if I came up with this analogy, I can't imagine I did, but that of the tree of metabolic illness, where, you know, if you look at a tree and you look at all the different branches, you can see each different branch of the disease, obesity, diabetes, cardiovascular disease.
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