The truth about why keto works and why you may be doing it wrong

Renowned heart surgeon Dr. Steven Gundry on the power of food, the truth about keto, and mitochondrial uncoupling.


Article highlights

  • The traditional keto diet overly restricts carbs and plant foods, but produces benefits by signaling mitochondrial uncoupling to handle excess energy and prevent damage.
  • Eating more polyphenol-rich plant foods directly provides compounds that stimulate uncoupling proteins and supports a healthy microbiome to produce uncoupling metabolites.
  • Lifestyle strategies like cold exposure, apple cider vinegar, and goat dairy also trigger mitochondrial uncoupling without carb restriction.
  • Uncoupling allows protons to leak out and wastes calories as heat instead of making ATP, enhancing fat burning without losing muscle mass.
  • Preventing mitochondrial overload through uncoupling may explain why diets rich in plants, fiber and polyphenols protect against modern diseases like heart disease.

Dr. Casey Means: Dr. Steven Gundry is an incredible independent thinker in the health space. He is a world-famous cardiothoracic surgeon, with several medical patents to his name. He has written hundreds of scientific papers and book chapters, in addition to eight incredible books. He was the chairman of cardiothoracic surgery at Loma Linda and has performed more pediatric heart transplants than almost anyone else in the world.

Dr. Gundry left his surgical career when he realized how food could prevent almost a hundred percent of heart disease, and totally shifted toward focusing on getting people to learn how to eat properly and avoid heart disease and surgery in the first place.

Changing Course

Dr. Casey Means: Welcome, Dr. Gundry. I’m thrilled to have you here. We share a similar thread in our paths, as we both left the surgical world in order to help patients through food. Can you talk a little bit about how, after doing thousands of heart surgeries and being deep in the cardiothoracic surgery world, you decided to leave and realized you could possibly make a bigger impact by helping people understand their diets and their holistic health?

Dr. Steven Gundry: My life changed 27 years ago. I met a patient from Miami whom I call Big Ed in all my books. He’s a real person. He was a 48-year-old gentleman diagnosed with inoperable coronary artery disease. That means you couldn’t put stents in. You couldn’t do bypasses because everything was clogged up.

He would go around the country, to centers like mine at Loma Linda, where idiots like myself would take on just about anybody—out of ego, I guess. Everywhere he went, he was turned down. Nothing could be done for him. He had spent about six months doing this before he arrived at my office. He brought in an angiogram, a movie of his heart, from six months earlier. I looked at it and I said, “You know, I got to agree with everybody. There’s nothing I’m going to be able to do for you. They’re right.” He said, “That’s what everybody says. But here’s the deal. I’ve been on a diet for the last six months, and I’ve lost 45 pounds.”

This guy, Big Ed, weighed 265 pounds when I met him. He had been over 300 pounds when all this happened. He said, “I’ve gone to a health food store, and I’ve been taking all these supplements.” He had actually brought in this giant shopping bag full of supplements. He continued, “You know, maybe I’ve got something in here.”

I scratched my professor beard, thinking, “Well, good for you for losing weight, but that’s not going to do anything in there. And I know what you did with those supplements. You made expensive urine”—which is what I firmly believe. I said, “You wasted your money.” He said, “Look, I’ve come all this way. Why don’t we just get another angiogram, and let’s see?”

I agreed, and in six months’ time, Big Ed cleans out 50% of the blockages in his coronary arteries. I’d never seen anything like that. I said, “What the hell? Wait a minute. Tell me about this diet of yours.”

Back in the dark ages, I did a special major at Yale University where we could design a major and write a thesis, very much like a master’s program. My thesis was that you could take a great ape, manipulate its food supply and its environment, and prove you would arrive at a human being. I defended my thesis, received honors, and then gave it to my parents and went off to become a famous heart surgeon.

As Big Ed was talking about what he was eating, I thought, “Wait a minute. This is my stupid thesis at Yale.” He was on “the ancestral diet”. I told him, “Well, let me see that bag of supplements.”

I’m very famous for protecting the heart during heart surgery. I invented a bunch of catheters, patented them, and created a secret sauce we’d put down the veins and arteries of hearts. I started looking through his supplements and several of the things he was taking. I was mixing in my secret sauce, and putting it down the veins and arteries. It never occurred to me to swallow the dumb things. I called my parents, who were in San Diego, and said, “Hey, do you still have my thesis?” They said, “Oh yeah, it’s in the shrine.” I said, “Send it up.”

I was a big fat heart surgeon. I was running 30 miles a week, going to the gym one hour a day, eating a healthy low-fat diet. But I had migraine headaches while doing baby heart transplants. I had arthritis. I needed knee braces to run. I had prediabetes and horrible cholesterol. So I put myself on my thesis, and started taking a bunch of supplements. I lost 50 pounds in the first year. I started putting my patients on this program, sending them to Costco or Trader Joe’s for supplements. There wasn’t an Amazon back then. And, lo and behold, these people’s diabetes went away. Their high blood pressure went away. Their arthritis went away.

About a year into this—my wife calls it Black Friday—I looked in the mirror before I went into work, and said, “You know, I’ve got this all wrong. I shouldn’t operate on people and then teach them how to eat to avoid me in the future. I should teach them how to eat. Then they’ll probably be able to avoid me in the first place.”

I mean, what a stupid career choice—at the height of my career to say, “I’ve got this backwards.” I actually resigned from my position at Loma Linda, and moved a few miles down the road to Palm Springs, where I opened up a clinic. I told people, “Look, I want to give you a list of foods to eat, and not to eat, and then I want to send you to Costco or Trader Joe’s. I want to draw your blood every three months, if insurance or Medicare will pay for it. You’re my research project. Okay?” And everybody said, “Yeah. Okay.”

As you may have found out, as a former surgeon, teaching people how to eat is not… Let’s just say the monetary benefits of teaching people how to eat are not as good as surgery. But my wife, bless her heart, said, “Hey, you’re in this for a purpose. You have a belief. Let’s give this a go.” That was 25 years ago. Doggone it, Big Ed. Look what you’ve done.

Dr. Casey Means: It is such an amazing and inspiring story. In medical school, we’re basically taught that reversal of atherosclerotic heart disease—true blockages in the heart—doesn’t happen. I can imagine that that was a big moment of thinking, “What is going on here? I’ve got to dig into this.”

Even to this day, there’s still a paradigm of, “You don’t reverse heart disease once it happens.”

It’s incredible that you have now spent the last 20 years really educating people about the power of food. A lot of your work focuses on a whole foods, unprocessed diet—really using food as medicine.

The Truth About Keto, and Why Mitochondria Matter

Dr. Casey Means: What I love about your new book, Unlocking the Keto Code, is that it shows a very different picture of the keto diet that is much more balanced, and more focused on colorful plant foods and a diverse, probiotic-rich diet. It breaks down how a lot of what people think is beneficial about the keto diet is actually beneficial for different reasons than they think. A lot of the benefits of the keto diet can actually be more impactful if you shift from the focus on macros to bringing in a lot more plant food. Why is our conventional dialogue about the keto diet flawed? What are people missing?

Dr. Steven Gundry: I’ve had a ketogenic version of my diet from The Plant Paradox. One of the things it’s based on is medium-chain triglycerides, MCT oils. Anyone who actually looks at the lists of my ketogenic diet foods, even in that book, says, “Whoa, there are a lot of plant carbohydrates in here, and how the heck is that a ketogenic diet?” Yet it worked very well, and still does.

When I was writing my last book, The Energy Paradox, I backed up my explanations with cold, hard research. I firmly believed that ketones were a great fuel source, and that the brain loved them. Your muscles loved them. They were the perfect fuel. Being in ketosis made you an efficient fat burner. That’s why you lost weight. It sounded really good to me.

I wanted to back this up. Work out of Harvard, led by Dr. Oliver Owen, showed that, in humans, it was the exact opposite. At full ketosis, only up to 70% of energy needs are met by burning ketones. The rest is primarily free fatty acidsEven at full ketosis, the brain, which supposedly thinks ketones are the greatest thing since sliced bread (but we don’t want sliced bread) still needs 30–40% glucose as a fuel. That’s the problem.

If you look at the ketogenic literature on athletic work, conducted by Drs. Volek and Phinney, even they would say, “You have to get keto-adapted, and it may take weeks.” But Dr. Owens’ work showed that, at three days in ketosis, the muscles’ preferred fuel was ketones. Then it falls off and becomes free fatty acids.

Phinney and Volek are saying, “Well, your exercise tolerance is going to really plummet for maybe two weeks, but your muscles do best with ketones for three days.” You can’t have it both ways: Ketones aren’t this amazing fuel. The work done in race walkers shows that you actually have to have a far higher oxygen consumption to match the ability that you would get from a more carbohydrate-based diet.

All of these human studies are saying, “Well, wait a minute. Ketones aren’t this amazing fuel.” In fact, ketones make you an efficient fat burner. Efficiency means you get more mileage out of a gallon of gasoline. As we all know, fat has nine calories per gram. Protein and sugars— carbohydrates—have four calories per gram.

Now, wait a minute. You’re eating more than twice the amount of calories when you’re eating fat, and you’re telling me you are an efficient fat burner—if that’s true, you all ought to be gaining weight. Some people do gain weight on the ketogenic diet. But a number of my patients like what I talk about in the book. Something’s not right with that idea. What in fact happens?

You go back to the seizure literature. The actual name “ketogenic diet” was coined in the 1920s at the Mayo Clinic as an anti-seizure diet for kids. The original ketogenic diet was 80% fat, 10% carbohydrate, and 10% protein. It was very effective. Over 50% of kids got major reductions in seizures. The problem was, as any of us who’ve had kids or now have grandkids know, it’s nearly impossible to deprive carbohydrates from children. And it’s pretty impossible to take carbohydrates away from adults.

What I found fascinating in the seizure literature was the ketogenic diet fell off when drugs came along. But in the 1990s, it had a resurgence as an MCT-oil-based diet. They found they could get the exact same effects using MCToil as the predominant fat, even while introducing far more carbohydrates and proteins, and still achieve the anti-seizure effect. That intrigued me because here’s a workable diet, without this overload of concentrated fats. I wanted to know, “Okay, if ketones aren’t this miracle fuel, what exactly are they doing?”

If you are starving to death, you are pouring out ketones right and left. Mitochondria are the final common thing that keeps us from death, and have to be protected at all costs. You protect mitochondria by basically not making them work so hard. As I describe in the book, there is an elaborate system that we have built into our mitochondria, where we can take a lot of the protons that would normally be coupled to oxygen to produce ATP, and uncouple them from oxidative phosphorylation—basically dispose of protons out of trap doors, emergency exits. In that way, the mitochondria don’t have to work as hard, and are protected from the significant damage that occurs during oxidative phosphorylation.

In a beautiful paper by a professor named Martin Brand, he showed that if you look at long-living human beings, they have the most uncoupled mitochondria of anybody. The other part of that is, “Okay, wait a minute. You’re starving a death and you’re going to tell mitochondria to waste fuel. That’s really stupid. You should tell mitochondria to be very fuel efficient because there’s not much left.” Part two of that is, “Okay, you’ve got to tell mitochondria to protect themselves, but simultaneously, you tell mitochondria to make more of themselves to carry the workload.”

I like to use the example of a dog sled. Let’s suppose we have one dog pulling the sled. The dog can pull the sled, but you’re not going to go very fast or get very far before the dog tires out. Why don’t we hitch five more dogs to the dog sled? Now we’re going to go a lot faster. We’re going to go a lot farther. But we now have to feed six dogs instead of one dog. The beauty of mitochondria is they have their own DNA; they can divide without the cell they’re living in dividing.

You have these two signals. One is, “Protect yourself at all costs by wasting fuel.” The other is, “Make a whole lot more of yourself so that each individual mitochondria has to do less work than the one we started with.” If you’re doing this right, you’re going to lose some weight. But the overall benefit is substantial. The only way you could possibly be in long-term ketosis, every day, is by signaling to the mitochondria you are starving to death. Everything else that eats fuel becomes your enemy.

Muscles are the biggest enemy of fuel eating. You need to become insulin resistant to keep those muscles from getting the fuel the mitochondria need. It’s no wonder, then, we see insulin resistance develop from long-term ketosis. In my first book I include a study where they took healthy men and women and put them to bed rest for seven days. They became insulin resistant. The only reason, evolutionarily, a healthy person would be at bed rest for seven days is that they were injured and couldn’t get food. This protective mechanism—protect the mitochondria at all costs—automatically kicks in. Who cares about everybody else? The body needs to get those energy-hungry muscles out of the system.

Dr. Casey Means: It’s fascinating. To summarize what I’m hearing, the benefit of ketones is not so much this conventional ideology that they are the best fuel source—it’s more that they are signaling molecules, which tell the mitochondria that a certain state is present, maybe starvation, and that they need to protect themselves by producing more of themselves so each one has less work. Then there’s also this process of mitochondrial uncoupling, where they’re leaking out wasting protons.

How does the wasting of protons lead to weight loss? Is it because you are also stimulating more mitochondria and are therefore more efficient at burning through free fatty acids that might otherwise go to fat storage?

Dr. Steven Gundry: You have to have more calories to produce the same amount of ATP. At rest, as much as 30% of our mitochondria are uncoupled. In other words, at rest, we can waste up to 30% of all the food we eat just by putting these protons through these emergency exits. What’s happening with that?

One theory is that uncoupling produces heat. We know that brown fat is brown because the mitochondria are so dense. It’s brown under the microscope. But these guys are profoundly uncoupled, and that’s how heat production is accomplished. Also, making ATP is hard work and incredibly damaging. A mechanism to prevent that damage from happening is probably built into our basic design. There are five uncoupling proteins. When they were discovered, in the 1970s, everyone thought, “What the heck are these guys doing here?” Now we know that these things are actually essential.

Some theorize that very small animals, in general, have short lifespans because they have high metabolic rates. Very large animals, in general, have much longer lifespans because they tend to have lower metabolic rates. That makes us all feel good until you look at birds. Birds, in general, are very small, and yet a parrot in captivity can live to be 80.

Years ago, I wanted to buy a cockatoo. I went to this crazy bird lady. She asked how old I was. I told her 40. She said, “Well, who’s going to take care of the bird after you die?” I said, “Huh?” She said, “You have to show me. Is it going to be your child? Is it going to be your sister? The bird is going to outlive you.”

She was right. At least one hummingbird in captivity has lived up to 12 years. Most live for three to five years, but that’s with a heart rate of up to 1200 beats a minute. It turns out that birds have incredibly uncoupled mitochondria. Actually, retinol is their uncoupling agent that they get in nectar. When we give them colored sugar, they aren’t getting any retinol, and maybe we’re doing them a disservice by doing this. Brand is right: uncoupling to survive. It carries a lot of weight with me now.

Dr. Casey Means: No pun intended. There were also some great puns in the book. People should definitely read it for that reason alone.

Fiber, MCTs, and Polyphenols: How To Support Our Mitochondria

Dr. Casey Means: We’ve talked about how you don’t actually want to go on a keto diet, you want to go on a mitochondrial uncoupling diet. That’s what you’re doing with the keto diet, but people aren’t realizing it. This is where the magic is. If the end goal is mitochondrial uncoupling, there are other things you can do that don’t involve just restricting your carb intake. It can actually bring in all these other nutrients that are beautiful for the body.

What are some of the other foods and lifestyle choices that also stimulate mitochondrial uncoupling and can give us the benefits of a keto diet without the intense restriction of a lot of helpful foods?

Dr. Steven Gundry: Back in World War I, it was noted that factory workers in Germany and France were very skinny despite eating a lot. And they were running at high temperatures. Nobody knew why that was until the 1920s, when they discovered that there was a compound in the making of gunpowder called 2,4-Dinitrophenol or 2,4-DNP.

When people were exposed to 2,4-DNP, they started losing weight and running at high temperatures. A couple of Stanford doctors in the early 1930s began giving patients DNP as a weight-loss drug. Over a hundred thousand prescriptions for DNP were written in the United States alone in the 1930s. It was miraculous: At low-dose DNP, you could lose a pound a week; at high-dose, you would lose five pounds a week. I mean, miraculous. Levels would be out of business.

It turns out DNP was the first oral mitochondrial uncoupler. The problem was that it wasn’t making any more mitochondria; it was not producing mitogenesis. People lost tremendous amounts of weight. They ran very high temperatures because they were generating heat. But they started having thyroid problems. People developed cataracts. Then people started dying because they ran out of ATP. They were so uncoupled they literally could not make enough ATP to live. In the late 1930s, the FDA banned DNP.

When I discovered that literature, I thought, “Wait a minute—phenol. Where have I heard the word phenol? Oh, polyphenol.” The mitochondria in plants are called chloroplasts, which are damaged by the very thing they need to produce energy, which are photons from sunlight. Plants have to be protected from mitochondrial damage from sunlight. To do this, they produce polyphenols to uncouple their chloroplasts. We see polyphenols all the time in the fall because the green leaves turn to pretty yellows and oranges and reds and purples.

The polyphenols have always been there in the leaves. But now we can see them. Those polyphenols were used by the plant to protect—to uncouple—its mitochondria. When we eat polyphenols, we don’t absorb them very well, but our gut bacteria absolutely love them. Polyphenols provide prebiotic fiber for gut bacteria, which in turn make those polyphenols bioavailable.

Now the plant’s polyphenols are given to us to protect our own mitochondria, through uncoupling. Every time I think about this, I start thinking about The Lion King and the Circle Of Life. These plant compounds were designed to uncouple their mitochondria to protect them, and then we get the benefit. When we say eat the rainbow, what we’re really saying is eat polyphenol-containing foods. When you look at the Mediterranean diet, as an example, it’s this cornucopia of polyphenol-containing foods. In the traditional Okinawan diet, 85% of their calories came from the purple sweet potato, a giant hunk of anthocyanin and polyphenols.

Dr. Casey Means: It’s amazing. A lot of people think the reason we want to have polyphenols is for antioxidant capacity. But as you pointed out, a lot of it is really what polyphenols do for the gut, which then produces metabolic byproducts that are incredibly helpful for uncoupling proteins.

Let’s say you have a lot of sun energy. You’re driving a lot of chemical reactions through the chloroplast, which is going to generate oxidative stress and reactive oxygen species, and you don’t want that type of damage in huge quantities. Does the plant also have release valves to help with that extra energy substrate?

Dr. Steven Gundry: Photon damage is the equivalent of oxidative damage in us. Photons—sunlight—is damaging. Any of us know that. But the plant requires photons to produce energy. In winemaking the closer the vines are grown to the sun—the higher the elevation—the more polyphenols the plant makes, because it’s far more exposed. Now we know that’s why they make more polyphenols: getting more hammered by sunlight. But you’ve got to repair the damage.

Plants are also a great source of melatonin. What is the plant making melatonin for? There are actually only two antioxidants that have ever been discovered in mitochondria: melatonin and glutathione.

For years, I used to present a paper at the World Congress of Polyphenols. One year, in Lisbon, the chairman, Dr. Marvin Edeas, got up in front of this big room of researchers and said, “If any of you here actually think that polyphenols are antioxidants, you could leave right now. I don’t have the time to show you why that’s not true.”

But he was absolutely right. They are not antioxidants. Our traditional antioxidants, like vitamin C or vitamin E, for instance, have no effect on mitochondrial antioxidation; it’s melatonin and it’s glutathione. Vitamin C has been shown to regenerate glutathione as well as vitamin E, but it’s not for mitochondria.

Dr. Casey Means: You mentioned that glucose inhibits mitochondrial uncoupling. I would have thought that, if the mitochondria were getting this excess signal of energy that was essentially going to drive increased oxidative stress, it would make sense that the cell would want to trigger uncoupling to have a release for that. But it’s actually the opposite.

Dr. Steven Gundry: It’s exactly the opposite. Back when it was feast or famine, great apes only gained weight during fruit season. We inherited those genes. During caloric excess, we would want mitochondria to shuttle any excess into fat storage. But that didn’t happen every day. We now have 365 days of endless summer, and we’re always in fruit season; we’re always in caloric excess season. We don’t have a genetic program that understands that this would happen 365 days a year.

Dr. Casey Means: That really brings it together. Two awesome books that also talk about this are Nature Wants Us to Be Fat by Rick Johnson and David Perlmutter’s Drop Acid. As you said, when we are exposed to high-fructose food during the harvest, our bodies stored all this fat because that was our survival mechanism. Now it is the harvest every single day.

What is your go-to list of mitochondrial uncouplers, diet- and lifestyle-wise?

Dr. Steven Gundry: MCTs, medium chain triglycerides, are absorbed differently than any other fat. They are absorbed directly, without a chylomicron carrier from our gut. They go directly to the liver, where they are instantly converted into ketones. You can get ketones by eating MCTs. You could have a bowl of fruit with a tablespoon of MCT oil, and you would produce ketones even though you ate that whole bowl of fruit. That’s a really great trick, and explains why I use MCTs in my program.

MCTs were named for the Latin word for goat, which is capra. About 2030% of the fats in goat’s and sheep’s milk are MCTs. You can actually get MCTs by eating things like goat’s or sheep’s yogurt, kefir, and cheese, and get the benefits. Some of the longest-living people in the world are goat and sheep herders. They’re uncoupling their mitochondria; they’re making ketones.

We’re also beginning to realize that things like cold therapy are working by uncoupling mitochondria. If mitochondria sense an incoming stressful event, whether that is starvation, extreme heat, or extreme cold, we need to protect ourselves at all costs: we uncouple.

In heart surgery, to prepare hearts for a prolonged period of ischemia, we cross-clamp the aorta. In these instances, we saw this miracle protein called heat shock protein protect the heart. It turns out that heat shock protein, produced by stressors like extreme cold and heat, uncouples mitochondria.

The same thing happens with acetic acid, found in vinegar. Vinegar is a short-chain fatty acid, which is a really good mitochondrial uncoupler. You want your gut microbiome to have a lot of things to eat to produce butyrate, acetate, and other post-biotics I’ve written about. You’re not going to get that from a ketogenic diet.

Dr. Casey Means: We love fiber. I’m a fiber evangelist. I’m mostly plant-based, and I honestly follow a very similar way of eating to what’s in your book. My ketones stay between 0.7 and 1.2 most days. The book really helped me figure out why this might be the case.

There’s not one path to get to this end state, which is what your book really clarifies for people. It doesn’t have to be this really restrictive thing. We can use physiology to understand all the different ways you can get the same positive outcome. Eating fiber and supporting the microbiome so they can support you are especially important.

Are short-chain fatty acids acting as genetic regulators in the sense that they’re upregulating uncoupling protein synthesis, or is it acting more in the cell at the level of the mitochondria? What is actually happening with these?

Dr. Steven Gundry: Butyrate, for instance, serves as a substrate for beta-hydroxybutyrate, BHB, which is the active ketone in us. But butyrate in its own right uncouples mitochondria, as does acetate. These short-chain fatty acids are really histone decarboxylase inhibitors. Histone decarboxylases help cancer cells grow and reproduce. If you have an inhibitor of histone decarboxylase, like butyrate and acetate, I would want a lot of that in my gut.

People know that fermented foods are good for you, but it’s actually the short-chain fatty acids that are produced during fermentation that are the power hitters in all of this. That’s why apple cider vinegar, believe it or not, is actually pretty darn good for you. Guess what? It’s uncoupling your mitochondria.

Dr. Casey Means: Drink that kraut juice; get every last sip, because you want those post-biotics they’re making.

You were talking about how plants closer to the sun have more polyphenols. We want our plants to have been stressed, in a sense. We want them to have had to work harder because we’re going to get all those benefits. In our unfortunate industrial agriculture, or mono-cropping, pesticide-laden world, our plants don’t have to work hard. They’re essentially babied with chemicals.

Can you talk about conventional produce, soil health, and how this is bad for us on multiple levels?

Dr. Steven Gundry: You are what you eat, but you are what the thing you’re eating ate. The plants are not eating what they used to eat. Our soil is so depleted. In one of my lectures, I show a picture from a Senate document in 1936 that says, “Our soil is now so depleted of nutrients that you could eat all day every day and never get the essential vitamins and minerals that would reduce health.”

It’s bad. The soil is a living organism as well. Plants have to have their nutrients delivered from the fungi and the bacteria that live in the soil, and they’re all gone. Everything’s gone. We can produce a head of lettuce—it looks like ahead of lettuce—but it has nowhere near what it was supposed to have. Luckily, Europeans are, for the most part, a lot smarter than us, and there are really big movements to ban Roundup and glyphosate. But it’s everywhere in us. It’s in our wine. It’s in our organic oats. It’s everywhere.

Dr. Casey Means: And then there’s also a secondary effect of this chemical on our mitochondria? Aside from just screwing up our food, what’s it actually doing to ourselves?

Dr. Steven Gundry: Itlooks like it’s a mitochondrial toxin in its own right. Monsanto didn’t bother to tell us that Roundup was actually patented as an antibiotic. They said bacteria and plants use the shikimate pathway, which is what plants use, and we don’t use it. They invented an antibiotic that targets the shikimate pathway, but it’s going to kill all of your microbiome because your microbiome uses the shikimate pathway.

The more the plant is stressed the better. Organic plants will have more polyphenols; the more polyphenols in you, the better.

Dr. Casey Means: The number one killer in the United States for both men and women is arteriosclerotic heart disease. How much of that burden of disease is preventable? How much could be totally avoided if we cleaned up our diets and lifestyles?

Dr. Steven Gundry: A hundred percent. That’s why I changed careers.

Dr. Casey Means: That is empowering. It is in our control. The answer is on the tip of our forks. I am so grateful for the message you are putting out in the world. It has inspired me. It has inspired my career. I know it is going to inspire many others. You’re doing incredible work, and I want to commend you. Thank you so much, Dr. Gundry.

Dr. Steven Gundry: Well, thanks. I’m going to keep doing it.

Dr. Casey Means: How can people find you?

Dr. Steven Gundry: I have the Dr. Gundry podcast, and you can find me on YouTubeInstagram, and at You can also go to for information on supplements and food.

Dr. Casey Means: Are you taking patients?

Dr. Steven Gundry: I still see patients—even on the weekends. This is Friday. I’ve got a full schedule tomorrow and Sunday. On the seventh day, I don’t rest.I better have good uncoupled mitochondria.