The $10M Gap: Why Metabolic Health Research is Failing Us | Nick Norwitz DSH #908

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It happened to work for me, but I was surprised to find I had this response, and my cholesterol shot through the roof. And so using myself as a case in point, you get caught between a rock and a hard place, right? It's like my levels are so high that some people think I might get a heart attack in a few years and die in my 20s.

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of heart disease, at the same time, this dietary intervention is working wonders for something that basically had me in palliative care, in the ICU. So there's a lot of patients, different conditions, that are caught between this rock and a hard place.

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And so the reason this is an area of interest is I kind of want to address this cholesterol boogeyman, particularly in that context, and start to unravel some of the really interesting metabolic mysteries

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The obvious comparison is the most common medication used for Oreo cookies, statins. So I used high dose statins. And, you know, I actually had a lipidologist consulting, a professor named William Cromwell, who's highly respected in academia.

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I went through the Harvard IRB, got the appropriate exemptions, you know, dotted my I's, crossed my T's, and then ran this protocol that we ended up publishing the data. So you can go look Oreo versus statin on PubMed. You will find it. And basically the intervention was I just did a run-in of my normal ketogenic diet, and then I added on Oreo cookies, one sleeve per day.

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So that's 12 cookies, about 100 grams of carbs, and did that for about two weeks. Then did a washout period of three months to kind of return to my baseline status, and then did high-dose statin therapy for six weeks. The results were that in my particular metabolic context, which I engineered to kind of do this metabolic demonstration, the Oreos lowered my LDL cholesterol.

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Some people call that the bad cholesterol. They lowered it by 71%. in two weeks. Wow. And this is not something I'm faking. This is going straight into my health record online in Epic to my PCP. I'm getting the labs done standard through. There's no faking that result. In fact, actually, the funny thing is if you look at the paper, it's a 16-day

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So there was always a gamble this could do more harm than good, and I was going to try to be honest and audit the effects. I would say I'm pretty confident it's had a positive effect. Really? Yeah, we can break that down. But I'll pause right now and just kind of get questions high level and explain why this happened or – anyway, go ahead.

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This proves statins are poison. I definitely didn't say that. This proves Oreos are healthy, question mark. I definitely didn't say that. I said none of those things. And so my whole shtick, you hear me say it again and again, is stay curious. I think curiosity is really what like lets us fully manifest our humanity.

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And so I invite people, I do a lot of now weird demonstration, put out provocative content, but not one that is actually like in any way dogmatic. It's just like, here's a curiosity and I want to invite you to investigate this with me rather than reflexively jumping to a value statement. And then when people do jump to that value statement, Kind of investigating, well, why did we do that?

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And how can we attenuate that response to actually have more productive dialogue? And I will tell you, you know, I was saying that I think the Oreo versus statin study had positive effect. It's been really funny. I mean, I've talked about this in academic circles, at Harvard, at conferences, universally in academia. People are like, wow, this is fascinating.

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And I get emails from clinicians, cardiologists, like, I read this study. and I was provoked to go down the rabbit hole of your literature, because we have a lot more studies on it. This was just kind of like a provocation to get people to look at those studies. And they're now saying, I understand the physiology of your model. It's called the lipid energy model.

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And now I have patients in the metabolic state you're in, but rather than jumping to medications, we're trying like carbohydrate, quote, titration protocol. So we're using bananas, sweet potatoes, and we're lowering LDL more than medications ever would. And so then the patient's happy, the doctor's happy,

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Metabolic health interventions don't immediately make people money, which actually sets up a really unfair comparator because when you go into medicine, people want, quote, evidence-based medicine. And that sounds sexy. It's great virtue signaling, right? We want the high-grade RCTs to prove this intervention works. However, if you have millions of dollars –

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But often philanthropists who are funding these trials because they've – or their family has suffered. And so, you know, I'm only in this space because I suffered terribly with inflammatory bowel disease. I mean, examples like the Bazooka Group, I don't know if you've heard of them. They're funding a lot of trials in metabolic psychiatry at Stanford, at Harvard.

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They gave a friend and colleague of mine, Chris Palmer, I think some several million dollars to start up like a metabolic psychiatry clinic at McLean. I don't know if they've branded it that exactly, but the only reason they're pouring money into this is because one of the members of the family suffered terribly with bipolar disorder.

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and ended up going into remission only with metabolic therapy in this case a ketogenic diet and so then they became passionate about this as something that is worth doing to help people but you see kind of like the disconnect there you have a business model for pharmaceuticals and on the other end you have a research environment that is being built on the backs of passionate people who have suffered right and people with different resources which is really unfortunate

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At the one level, it doesn't seem fair that it's happening that way. However, the silver lining I put there is that motivation and that purpose-driven energy, I think... is going to win the day in the end. Because the data will win the day in the end.

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And, you know, once you get enough people, and there's more and more of us who are suffering, and you have the right people suffering come together, then... Trauma bonding. Yeah, then you're going to get the studies done. And that's not to discount, like, you know, the New England Journal trials that prove a pharmaceutical is beneficial or say that pharmaceuticals aren't beneficial.

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So why do we do that? So then it just never gets studied.

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Yeah, I think we need to reshape the way, you know, medicine is very dysfunctional. That is not even a controversial statement to say. People think of medicine and hospitals as this giant entity that is all aligned. You go into a hospital, you're training in medicine. The doctors, the nurses, the healthcare workers, they will say, they will shout, this is a dysfunctional system.

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And we're just trying to do the best by our patients within it. which I fully believe, like the vast majority of physicians I've met are tirelessly hardworking and always trying to put their patients first and often martyring themselves in a system that is broken. Which is why I feel kind of like bad you hear a lot of doctor bashing because people get frustrated and they don't realize

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that the doctors are just as frustrated, if not more frustrated. And so you have these two parties that appear on social media to be warring when they could not be more aligned. It's just the broader incentive structures, which only a little bit, we've talked about the economics, say with respect to the research and pharmaceuticals, they're the things that are messed up.

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And so how do we restructure the incentive structure? How do we reshape medicine to be metabolic and foundational health-focused, preventative medicine, all of that, all the nice terms you hear? If I had a solve for you, if I had an answer for you, everybody listening should say I'm crazy. Because everybody's trying to – not everybody, but a lot of people are trying to solve this problem.