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Ep. 60 Three Cardios Talk Keto

Ethan Weiss, MD

For decades, the academic cardiology community has focused its attention on pharmacological interventions to prevent heart disease.  Our guest is an accomplished clinician-scientist who tells us his personal story that led him from the lab bench to becoming interested in dietary interventions and in the ketogenic diet in particular.

Dr. Weiss is Associate Professor of Medicine at the University of California San Francisco.  He has a stellar academic pedigree, having received his MD degree from Johns Hopkins Medical School, where he also trained as part of his internship and residency.  He completed his fellowship in cardiology at UCSF and has had an illustrious career as a basic science investigator at UCSF, studying the relationship between heart disease and metabolism.  He is also the co-founder of a start up company, Keyto, to help people measure their blood ketone levels in real time as part of a diet management program.

GUEST:

Ethan Weiss, MD. Twitter and UCSF professional page.

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5 Comments

  1. Miriam on 02/03/2019 at 6:29 AM

    This is the first time I’ve listened to your podcast. I was driven to listen as I was curious to hear three cardiologists discuss the perceived benefits and risks of a LCHF dietary approach. My feedback is this: the interviewer (Dr Accad?) spends so much time interrupting Dr Weiss that the interview ends up detoured on long tangents, and so areas of interest that could have been covered (for example: does BOHB help in HFpEF?) were not addressed. Having participated in podcasts myself, perhaps a plan in advance, and an outline provided to the interviewee, will make for more productive use of your, and our, time.

    • Michel Accad on 02/04/2019 at 5:48 AM

      Hi Miriam,

      Thank you for listening and for your comment. The episode was meant to be conversational (hence the title) and the focus was on the personal story of our guest leading up to his interest in the keto diet. All 3 of us believe that nutritional science is highly uncertain and the episode was not meant to endorse strongly or speculate too much on any clinical claim for or against that diet, as was made clear in the course of the discussion. I can see why listeners expecting a deep dive into clinical matters would be disappointed.

      That said, your points are very well taken and your feedback about podcast prep is truly appreciated. Thanks again.

  2. Marius on 02/10/2019 at 12:00 AM

    Michel the term willful blindness occurred to me as I could only listen to the first 16 minutes of this podcast. My apologies to you if the remaining time discussed the studies of Drs Esselstyn, Peto and the China Study, although you did briefly mention Ornish’s work. How could it be that this podcast did not focus on the by now well documented reversal of ischemic heart disease by a vegan diet?

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466936/

    You have set the bar very high with your podcasts despite this one failing to make the grade. Perhaps you could remedy the deficit by inviting Dr Caldwell Esselstyn on your show.

    • Michel Accad on 02/10/2019 at 4:42 PM

      Hi Marius,

      Thanks for listening, although I wonder if “willful blindness” doesn’t more aptly apply to someone who turns off the channel before the show gets going? 🙂

      This episode is the one that has been most criticized and, if you listened to my intro, that was not unanticipated. We opened ourselves to criticism particularly because we are so agnostic on the question of diet.

      We’d consider inviting Dr. Esselstyn (he’s the person whose name I blanked on in my comment to Ethan, but perhaps you didn’t get to that part) but I don’t know that that will satisfy the listeners who are looking for a deep dive on the question of health and diet.

      Not that this question is without merit, of course, but to do it justice would easily occupy a podcast season entirely dedicated to it.

      Although our podcast touches on a variety of topics, an underlying theme is the lived experience of physicians. That was the focus of this interview with Ethan, with the keto question serving as a platform for the conversation. See my response to Miriam in the comments here.

      Again, Marius, thank you very much for listening.

  3. Anthony Perry on 02/12/2019 at 3:15 AM

    In keeping with your disclaimer I did not expect a learned scientific discussion. Diet and obesity management is a morass. I do think however that, on the general subject of weight control, Dr Weiss should not have been allowed to get away unchallenged with the contention that the direct approach of regular measurement of body weight is fruitless whereas indirect measurement of breath acetone is possibly more meaningful.

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