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The Carnivore Debate Part 2

In part 2 of The Carnivore Debate, we cover the philosophy of the carnivore diet and the potential pitfalls of carnivore and keto.

The research that Dr. Saladino and I discussed with each other before this debate is listed in the show notes -- there are five pages of references!

Here’s what we debated: What exactly is a carnivore diet?
Is a 90% meat diet a carnivore diet, a carnivore diet you cheat on, a carnivore-ish diet, or just a meat-heavy omnivorous diet?
And why definitions absolutely matter. Is the carnivore diet ancestral?
What can we learn from present-day hunter-gatherers, the archeological record, and our evolutionary history as revealed by our genes?
Who is the carnivore diet for?
To what extent do carnivore and keto overlap?
What are the benefits of keto and how broadly applicable are they?
What are the potential harms of keto?
In particular: acid-base balance thyroid, stress, and sex hormones oxidative stress and glycation sports performance
We agree we need to cycle between the fed state and the fasting state.
Can the keto diet, designed to mimic fasting-state physiology, provide adequate fed-state signals to keep our body feeling well nourished?
Inuit CPT-1a deficiency redux: did a genetic impairment in the ability to make ketones sweep through the Arctic to protect the Inuit from acidosis, or to help them stay warm?

Dr. Saladino completed residency in psychiatry at the University of Washington and is a certified functional medicine practitioner through the Institute for Functional Medicine. He attended medical school at the University of Arizona where he worked with Dr. Andrew Weil focusing on integrative medicine and nutritional biochemistry. Prior to this, Dr. Saladino worked as a physician assistant in Cardiology. It was during this time that he saw first hand the shortcomings of mainstream western medicine with its symptom focused, pharmaceutical based paradigm. He decided to return to medical school with the hope of better understanding the true roots of chronic disease and illness, and how to correct these. He now maintains a private practice in San Diego, California, sees clients from all over the world virtually, and has used the carnivore with hundreds of patients to reverse autoimmunity, chronic inflammation, and mental health issues. When he is not researching connections between nutritional biochemistry and chronic disease, he can be found in the ocean searching for the perfect wave, cultivating mindfulness, or spending time with friends and family.

Find more of Dr. Paul Saladino on the Fundamental Health podcast and at

Listen to the Audio

I highly recommend watching the video above so you benefit from seeing the data on the slides, but you can also listen to the audio here:

Show Notes

00:00:42 Cliff Notes

00:03:49 Introductions

00:03:59 What is a carnivore diet?

00:16:46 Is the ancestral human diet carnivore or omnivore?

00:49:11 Who is a carnivore diet for?

01:06:34 To what extent do carnivore and keto overlap?

01:09:05 Who is a keto diet for?

01:17:21 Ketogenic diets are only a partial mimic of fasting physiology

01:22:17 Ketones effect on the NAD/NADH ratio 

01:26:02 Ketogenesis has opposite effects in the liver as in the ketone-utilizing tissue.

01:28:02 Ketogenic diets and oxidative stress

01:38:49 Longevity: why you want to cycle between the fasting state and the fed state

01:43:35 Can the ketogenic diet provide a sufficiently robust fed-state signal?

01:51:42 The keto diet and thyroid, stress, and sex hormones

02:08:36 Keto and sports performance

02:16:36 Why do the Inuit have a genetic impairment in making ketones, to protect against acidosis, or to stay warm?

02:34:19 Wrapping up

Research Paul and I Discussed With Each Other Prior to the Debate

Latitude, local ecology, and hunter-gatherer dietary acid load: implications from evolutionary ecology

High endogenous salivary amylase activity is associated with improved glycemic homeostasis following starch ingestion in adults

Diet and the evolution of human amylase gene copy number variation

Insights into hominin phenotypic and dietary evolution from ancient DNA sequence data

stable isotopes reveal patterns of diet and mobility in the last Neandertals and first modern humans in europe

Exceptionally high δ15N values in collagen single amino acids confirm Neandertals as high-trophic level carnivores

Isotopic evidence for the diets of European Neanderthals and early modern humans


Ketoacidosis in a non-diabetic woman who was fasting during lactation

Ketoacidosis is not always due to diabetes

A life-threatening complication of Atkins diet

Ketoacidosis during a low-carbohydrate diet

Ketoacidosis: The Dark Side of Ketones

The effects of a glycogen loading regimen on acid-base status and blood lactate concentration before and after a fixed period of high intensity exercise in man

The effects of diet on muscle pH and metabolism during high intensity exercise

Dietary composition and acid-base status: limiting factors in the performance of maximal exercise in man?

Chronic ketogenic low carbohydrate high fat diet has minimal effects on acid–base status in elite athletes

Keto-Adaptation: Some Clues to Its Complexity

Acid–base safety during the course of a very low-calorie-ketogenic diet

Measurement of blood acetoacetate and β-hydroxybutyrate in an automatic analyser

Metabolic characteristics of keto-adapted ultra-endurance runners

Reduction in serum leptin and IGF-1 but preserved T-lymphocyte numbers and activation after a ketogenic diet in rheumatoid arthritis patients

Elevated polyunsaturated fatty acids in blood serum obtained from children on the ketogenic diet

The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists

The Ketogenic Diet's Effect on Cortisol Metabolism

Cardiovascular and hormonal aspects of very‐low‐carbohydrate ketogenic diets

Body composition and hormonal responses to a carbohydrate-restricted diet

Glucose but not protein or fat load amplifies the cortisol response to psychosocial stress

Postprandial glucose, insulin and glucagon responses to meals with different nutrient compositions in non-insulin-dependent diabetes mellitus

Acetyl coenzyme A: a central metabolite and second messenger

Glutathione synthesis

Hormone-mediated down-regulation of hepatic glutathione synthesis in the rat.

Sugar Is the Ultimate Antioxidant and Insulin Will Make You Younger

The ketogenic diet increases mitochondrial glutathione levels

Acute oxidative stress and systemic Nrf2 activation by the ketogenic diet

Modulation of oxidative stress and mitochondrial function by the ketogenic diet

Ketogenic diet increases glutathione peroxidase activity in rat hippocampus

Ketones inhibit mitochondrial production of reactive oxygen species production following glutamate excitotoxicity by increasing NADH oxidation

Antioxidant capacity contributes to protection of ketone bodies against oxidative damage induced during hypoglycemic conditions

The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism

The redox state of free nicotinamide–adenine dinucleotide phosphate in the cytoplasm of rat liver

Comparative studies on lipogenic enzyme activities in the liver of human and some animal species.

Ketone salts inhibit production of superoxide anions during normobaric and hyperbaric hyperoxia in rat solitary complex neurons

Ketogenic diet attenuates neuronal injury via autophagy and mitochondrial pathways in pentylenetetrazol-kindled seizures

The Tim Ferriss Show Transcripts: Dom D’Agostino on Disease Prevention, Cancer, and Living Longer (#188)

Ketosis leads to increased methylglyoxal production on the Atkins diet

Effects of a ketogenic diet as compared to a hypocaloric diet on metabolic parameters, oxidative stress (OS), advanced glycation end-products (AGES) and the soluble receptor for ages (SRAGE) in obese children and adolescents

Glycation, ageing and carnosine: are carnivorous diets beneficial?

Inhibition of fluorescent advanced glycation end products (AGEs) of human serum albumin upon incubation with 3-β-hydroxybutyrate

Quantitative screening of advanced glycation endproducts in cellular and extracellular proteins by tandem mass spectrometry

Regulation of Methylglyoxal Accumulation by Glutathione and Dietary Antioxidants

Is the “Receptor for AGEs (RAGE)” Really a Receptor for AGEs?

Leptin: a molecule integrating somatic energy stores, energy expenditure and fertility

Transcriptional control of the forkhead thyroid transcription factor TTF-2 by thyrotropin, insulin, and insulin-like growth factor I

Coupling between nutrient availability and thyroid hormone activation

DuOx2 promoter regulation by hormones, transcriptional factors and the coactivator TAZ

The Effect of Ketogenic Diets on Thyroid Hormones

Carbs and Sports Performance: The Principles

Carbs and Sports Performance: The Evidence

The effect of low carbohydrate diets on fertility hormones and outcomes in overweight and obese women: A systematic review

Effects of a 4-Week Very Low-Carbohydrate Diet on High-Intensity Interval Training Responses

Keto-adaptation enhances exercise performance and body composition responses to training in endurance athletes

Inuit Genetics Show Us Why Evolution Does Not Want Us In Constant Ketosis

Quantitative Variation of Erythrocyte Carbonic Anhydrase Levels

The Scientific Approach of Weston Price, Part 2: Problems With Comparing Different “Racial Stocks,” With Inuit Adaptations in Vitamin D Metabolism As an Example

Acid-base and electrolyte disturbances in hypothermia

Outcome from severe accidental hypothermia in Southern Finland—a 10-year review

The P479L gene for CPT-1a and fatty acid oxidation

Coconuts and Cornstarch in the Arctic?

Glutamate/gaba-glutamine Cycle

Metabolic control of vesicular glutamate transport and release

β-hydroxybutyrate alters GABA-transaminase activity in cultured astrocytes

Anesthetic properties of the ketone bodies β-hydroxybutyric acid and acetone

Clinical calorimetry XLV. Prolonged meat diets with a study of kidney function and ketosis

Use of animal fat as a symbol of health in traditional societies suggests humans may be well adapted to its consumption

AHS18 Michael Rose - Evolutionary Biology of Diet, Aging, and Mismatch.

β-Hydroxybutyrate: a signaling metabolite

Ketone bodies mimic the life span extending properties of caloric restriction

Ketone bodies in the blood of full term newborns, premature and dysmature infants and infants of diabetic mothers.

More Resources on Carnivore Diets

Dr. Saladino’s work can be found at

Dr. Masterjohn’s guide, Doing a Carnivore Diet Right: Vitamins and Minerals, can be obtained here.

Read the Transcript

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I am not a medical doctor and this is not medical advice. Nor is this financial or legal advice, nor is anything contained herein to be construed as an explicit accusation against any individual or organization mentioned. My goal is to seek the truth and to empower you with information. Please make all health decisions yourself, consulting sources you trust, including a caring health care professional.

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