Dr. Paul Saladino, MD, is the leading authority on the carnivore diet. His best-selling book, The Carnivore Code, earned significant praise and introduced many to the science behind the diet’s benefits for health. He has appeared on programs like The Joe Rogan Experience and The Doctors, among others, to evangelize the powerful role the carnivore diet can play in making healthy lifestyle changes.
Dr. Saladino also serves as a medical advisor to (and proud user of) NutriSense’s Continuous Glucose Monitoring (CGM) program. On his podcast, Fundamental Health, Dr. Saladino speaks with experts across multiple medical disciplines to follow research that reveals the true roots of chronic disease.
In this episode, Dr. Saladino sits down with NutriSense Director of Nutrition, Kara Collier RDN, LDN, CNSC for an eye-opening discussion on the science behind CGMs and how our blood glucose can indicate potential chronic diseases.
In this episode
Dr. Saladino and Kara answer all your questions about how a CGM can snapshot your metabolic flexibility and give you insight into your overall health.
They cover a ton of ground over the two-hour, data-packed conversation:
- What is a CGM? [14:06]
- Why you can’t out-exercise a bad diet [24:41]
- Signs you may be metabolically unhealthy [30:56]
- How to interpret CGM readings [32:20]
- Learning how your body uniquely responds to certain foods [42:59]
- Do carbohydrates cause diabetes? [53:01]
- An analysis of Dr. Saladino’s CGM data [1:10:56]
- Glucose levels and sleep quality [1:20:03]
- The downsides of ketogenic diets long term [1:35:36]
- Trusting CGM data over diet dogma [2:04:03]
- Differences in glucose responses by ethnicity [2:08:02]
Using your CGM to find a signal in the noise
Below are just a few of the most notable data discoveries Kara and Dr. Saladino discussed during the episode:
Do carbohydrates cause diabetes?
Dr. Saladino explores the nuance of carbohydrates’ role in our diets, stating that the answer is no, “carbohydrates do not cause diabetes. It’s more about the processing of carbohydrates and mixing them with processed vegetable oils. The things I have been beating the drum to raise awareness about are how they affect our metabolic health negatively.
Processed sugar, processed carbohydrates, and processed vegetable oils. These are the culprits. I do not believe that strawberries are causing diabetes. I do not believe that real, raw honey is causing diabetes, and I will share my evidence for that. I do not believe that other carbohydrates like squash are causing diabetes. These are not the cause of diabetes.”
What is the problem with mainstream healthcare carbohydrate recommendations?
“A carbohydrate recommendation of 55% is absolutely ludicrous,” Dr. Saladino says. He goes on to explain that “there is no way that anyone can get to that without eating processed carbohydrates or processed sugars. There is no way that you can get enough iron, zinc, choline, carnitine, and these nutrients from eating 55% carbohydrates.”
Is there a downside to long-term ketogenic diets?
Dr. Saladino acknowledges that there are many benefits to a ketogenic diet. However, in the long run, there is a point of diminishing returns. When discussing CGM data from a person who has had a zero carbohydrate diet for over five years, Dr. Saladino and Kara show the potential negatives of keto to watch for.
Following a discernible pattern in the user’s data, Kara notes “what we see is that it doesn’t occur in the first year of the zero carbohydrate diet, but after you hit year one, two, three. The fasting glucose slowly starts to creep up. You can see that in this person, their fasting glucose is 120 mg/dL, which is after five years of being in strict ketosis. There is very little variability, but the whole baseline is much higher.
We like to see fasting glucose levels below 90 mg/dL. To me, this is concerning. This is called physiological insulin resistance or adaptive glucose sparing. This is different from pathological insulin resistance that occurs in diabetes. What’s happening is that the muscles start to go into glucose refusal mode. They only want fat or ketones because that’s what they have now learned to use as fuel. However, we do have glucose-sensitive organs like the brain, so the body starts to compensate with this by creating more endogenous glucose.”
How does using CGM data differ from trying popular diets?
Both Dr. Saladino and Kara agree on the importance of following your own CGM data to make dietary decisions. Kara explains that when it comes to finding the right diet for you, “the number one thing I tell everyone is ‘data over dogma’. Test for yourself, see how you feel. If you try something strictly for a certain amount of time and you don’t feel good or your labs aren’t what you want them to be, then it might not be the best option for you. Experiment. Test for yourself. Be an advocate for your own health.”
