Dr. Sarah Hallberg made several career pivots—all fueled by her anger at unscientific and harmful practices perpetuated by the medical community—before becoming Medical Director at Virta Health. In this talk, delivered on Dec. 15, 2018, at a CrossFit Health event at CrossFit Headquarters, Hallberg speaks about some of those unscientific and harmful practices, specifically those pertaining to the management of obesity and Type 2 diabetes (T2D). She outlines the physiological problems inherent in treating T2D with insulin, the benefits of treating the disease with a carb-restrictive diet, and the data from a recent Virta Health study that demonstrates the positive effects of carb restriction. CrossFit® - Forging Elite Fitness® (https://www.crossfit.com/)

Dr. Jason Fung, MD, is a nephrologist and expert in the use of intermittent fasting and low-carbohydrate diets for the treatment of Type 2 diabetes. In this presentation, delivered on Aug. 2, 2018, at the 2018 CrossFit Health Conference in Madison, Wisconsin, Fung shares his first-hand experiences with “The Mess” and discusses how he shifted his research and medical practices as a result of those experiences. Fung’s objectives for his presentation include: 1. Understanding why long-term weight loss is so difficult. 2. Introducing the concept of therapeutic fasting. 3. Understanding some myths and misunderstandings associated with the fasting process. He recalls treating obese and diabetic patients with traditional methods, which included what he characterizes as poor dietary recommendations and a slurry of drugs. He explains, “It became obvious that I’m just sort of holding their hand until they get their heart attack, until they get dialysis, until they go blind, until we chop their feet off.” “It’s really sad to realize that the profession that you’ve chosen is not really helping people,” he says. This realization compelled him to diagnose the problems associated with traditional care and seek alternative treatment methods for his patients. Fung historicizes what he calls “the modern eating pattern,” which emerged in 1977 in the U.S. with the development of the Dietary Guidelines for Americans. He notes the 1977 guidelines led to the consumption of more grains and sugars, which in turn led to people “eating often, eating late, and eating all the time.” Incidences of obesity and Type 2 diabetes reached epidemic levels, and the most common treatments long have been drug interventions. Unfortunately, the prevailing non-pharmaceutical prescription — to eat less and move more — has a 99.9% failure rate. Fung observes that popular wisdom tells us to blame the patient and assume he or she did not adhere to the prescription. He claims a basic understanding of metabolism suggests otherwise, however. Fung explains why a significant reduction in caloric intake leads to a decrease in basal metabolism. This biological inevitability is ignored by the proponents of the “calories in, calories out” fallacy, he observes. He also explains why intermittent fasting is an effective alternative to traditional treatments for obesity and diabetes. The modern eating pattern keeps our insulin levels high all the time as we eat over long durations, and when insulin remains high all the time, Fung explains, our bodies store food energy as fat, and we remain hungry. Intermittent fasting, on the other hand, allows insulin levels to drop, which puts us in burning mode rather than storing mode. Fung claims his recommendations are so effective that patients no longer need to say, “Oh wow, I have to go see my doctor to see what pill I need,” or, “I need to go see my doctor to see if he needs to stick a stent in me.” Instead, Fung explains, “We’re giving you the power to take back your own health, because you’re not gonna get it from anywhere else.” — CrossFit is the world’s leading platform for improving health and performance. In the 20 years since its founding, CrossFit has grown from a garage gym in Santa Cruz, California, into the world’s most effective program for improving health and performance through nutrition and exercise. CrossFit is the world’s leading provider of accredited performance-based training courses and certifications and has more than 125,000 credentialed coaches across the world. The program can be modified to welcome people of all ages and abilities and millions of people have already experienced CrossFit’s transformational benefits in more than 13,000 affiliated gyms across 158 countries. CrossFit also directs the CrossFit Games season, beginning with the annual CrossFit Open, through which athletes at every level compete worldwide, and culminating in the CrossFit Games, where top athletes compete for the title of Fittest on Earth®. Learn more about CrossFit → https://www.crossfit.com/what-is-crossfit/?utm_source=social&utm_medium=youtube&utm_campaign=crossfit Find a CrossFit gym near you → https://www.crossfit.com/map?utm_source=social&utm_medium=youtube&utm_campaign=crossfit Find CrossFit Courses near you → https://www.crossfit.com/courses-near-you?utm_source=social&utm_medium=youtube&utm_campaign=crossfit View CrossFit workouts → https://www.crossfit.com/workout?utm_source=social&utm_medium=youtube&utm_campaign=crossfit Subscribe to CrossFit email newsletters → https://www.crossfit.com/newsletters/?utm_source=social&utm_medium=youtube&utm_campaign=crossfit Learn more about the CrossFit Games → https://cf.games/learn-more

Thomas Seyfried, Ph.D., is a biochemical geneticist, professor of biology at Boston College, and author of the groundbreaking book Cancer as a Metabolic Disease. As part of a lecture delivered on July 31, 2018, at the annual CrossFit Health Conference, Seyfried presented a report card on our current approaches to treating cancer in the United States. Looking at data from the American Cancer Society on cancer incidence and deaths per day between 2013 and 2017, he noted death rates are actually on the rise. “The more money we raise for cancer, the more cancer we get,” he observed. “So you have to ask, ‘What is going on here?’ ... This is a failure of monumental proportions.” The reason for the failure “has to do with a fundamental misunderstanding of what the nature of this disease is,” he explained. “We’ve been led to believe that this is a genetic disease, and I’ll present evidence to say that it’s not.” The belief that cancer is a genetic disease associated with somatic mutation has become dogma, Seyfried explained, and this dogma shaped much of the cancer research and treatment protocols of the twentieth century. So-called cutting-edge treatments, such as personalized therapy and precision medicine, are based on this viewpoint. Unfortunately, the viewpoint is wrong, as Seyfried explained in “Cancer as a Mitochondrial Metabolic Disease,” an article published in Frontiers in 2015. There, he aggregated existing research on cancer and reevaluated the information in light of the two competing theories on the origin of the disease (i.e., cancer as a genetic or metabolic disease). The research he surveyed supported Otto Warburg’s theory that cancer develops as a result of disturbed energy metabolism. Seyfried and his colleagues compared nuclear-cytoplasmic transfer and mitochondrial transfer experiments and found that the mitochondria are “calling the shots, not the nucleus,” which is “the opposite of what we would expect if this were a genetic disease,” he explained. Seyfried then described what he and his colleagues believe is the missing link in Warburg’s theory. Normal healthy cells derive energy from oxidative phosphorylation. Cancer cells, on the other hand, get energy through fermentation. What Seyfried and his colleagues discovered — and what Warburg did not know — is that cancer cells can ferment not only lactic acid but amino acids as well. That is to say, cancer cells can derive energy for proliferation from glucose and glutamine. Thus, to remove a cancer cell’s energy source, one has to remove its access to fermentable fuels, and an effective way to do this, Seyfried found, is through calorie restriction and ketosis. Calorie restriction and ketosis, he explained, are anti-angiogenic, anti-inflammatory, and pro-apoptotic. “No cancer drug is known that can do this without toxicity,” he said. He then added that those who claim they don’t understand the mechanism by which calorie restriction and ketosis work are full of “bullshit.” “They don’t read the literature. Nor do they contribute to it,” he said. Seyfried’s cancer research, particularly on aggressive forms of cancer such as glioblastoma multiforme (GBM) and other stage 4 cancers, led to his development of a glucose-ketone index calculator and the press-pulse therapeutic strategy. The calculator helps patients monitor their progress toward therapeutic ketosis. The press-pulse method pairs press therapies, such as following a keto diet while taking ketone supplements and practicing stress management, with pulse therapies, such as taking glucose and glutamine inhibitors while undergoing hyperbaric oxygen treatments. During his presentation, Seyfried explained how and why these methods are more effective for cancer patients than traditional standard of care. “GBM and other stage 4 cancers — I don’t consider them as terminal cancers,” he said. To read a full transcription of the presentation, click here. CrossFit® - Forging Elite Fitness® (https://www.crossfit.com/)

“There’s really only one goal for this talk, and that’s to arm you to answer any question about ketogenic and low-carb nutrition approaches,” Jim McCarter said during a presentation at a CrossFit Health event on Oct. 13, 2019. McCarter, MD and Ph.D., is an expert on the ketogenic diet, particularly its effectiveness for treating and reversing Type 2 diabetes (T2D). His personal journey with ketosis began in 2012 after he began researching the health-related effects of corn syrup and sugar. His research led him to Gary Taubes’ book, The Case Against Sugar, and the discovery of several misconceptions he had carried, “dating back to medical school.” During his talk, McCarter focuses on correcting some of these misconceptions about nutrition and metabolic health, particularly misconceptions about nutritional ketosis. He notes several benefits of ketosis, explaining ketones provide an alternative form of energy to glucose in individuals with insulin resistance (ketones provide about 60% of the brain’s energy during fasting). Ketosis also lowers insulin levels, which improves insulin sensitivity, and ketones provide a signal for the body to reduce oxidative stress and inflammation. McCarter then highlights the various ways clinical research has debunked 40 common myths about the ketogenic diet. As the former Head of Research for Virta, a nationwide telemedicine provider and full-stack technology company that focuses on the reversal of T2D, much of the data he uses come from the Virta-Indiana University Health (Virta-IUH) clinical trial. One of the prevailing myths about the diet is that it is unsustainable. McCarter claims this is false, observing that of the 465 participants in the Virta-IUH trial, 74% were able to maintain participation, even with extensive tracking demands. Most agreed to extend their participation to five years, he adds. For those interested in beginning the ketogenic diet, or those who are following the diet and would like to be equipped with data to defend the choice, McCarter explains where to go to find information debunking each of the following myths: Keto is unsustainable. Keto will cause diabetic ketoacidosis. Keto will cause hypoglycemia. Keto will deprive the brain of required glucose. Keto will impair the heart and cause vascular damage. Keto will worsen the blood lipid profile. Keto will cause inflammation. Keto will cause hypothyroidism. Keto will harm the liver and increase liver fat. Keto will harm the kidneys. Keto will cause muscle loss. Keto will cause loss of bone mineral density. Keto is just a fad. Keto is not the standard of care. Keto benefits are limited to weight loss. Keto weight loss is just water. Keto will cause “keto flu.” Keto will cause constipation. Keto will require too much sodium. Keto sodium will cause hypertension. Keto will cause adrenal fatigue. Keto will cause gallstones and requires a gallbladder. Keto increases mortality in nutritional epidemiology studies. Keto requires meat consumption. Keto will increase cancer risk. Keto increases circulating saturated fat. Keto provides inadequate dietary fiber. Keto interferes with the gut microbiome. Keto is environmentally unsustainable. Keto foods are too expensive. Keto will interfere with exercise. Keto will deplete muscle glycogen. Keto will raise long-term risk of gout. Keto will increase long-term risk of kidney stones. Keto will cause “keto crotch.” Keto will cause “keto bloat.” Keto will confuse the public. Keto will undermine science. Keto will cause diabetes. It’s better just to stay with usual care for diabetes management. After explaining how clinical studies have debunked each of these myths, McCarter concludes his talk by addressing the doctors in the audience: “Be informed. Talk with your patients. Debunk myths meant to cause fear … . Let patients know they have a choice to reverse diabetes.” CrossFit® - Forging Elite Fitness® (https://www.crossfit.com/)

“Blood-vessel disease was common (among the ancient Egyptians), contrary to assumptions that it arises from urban stress and a modern high-fat diet,” Dr. Michael Eades, MD, reads aloud to the audience at the CrossFit Health Conference on Aug. 1, 2018. Eades is a well-known physician and author of several books about the science behind low-carb diets, but this quote from Arno Karlen’s book Napoleon’s Glands brought to mind knowledge from a previous career path, when he was a college student interested in Egyptology. Eades had researched the dynastic Egyptians’ lifestyle and knew they had eaten a wheat-based diet. The statement he read in Karlen’s book, he says, “electrified” him. He recalls waiting in anticipation for the library to open the next morning so he could perform additional research on the ancient Egyptian diet and its potential relation to cardiovascular disease (CVD). In this presentation, Eades shares some of the outcomes of that research, taking his audience “on a journey through the anthropological literature and what that means in terms of ‘off the carbs.’” “So if you look at all the data out there,” Eades concludes, “you look at the metabolic constraints, the Kleiber line, the expensive tissue hypothesis, you look at the stable isotope data, you look at the hunter-versus-farmer data, you look at the ancient Egyptian data, you look at the modern RCTs, and it’s pretty clear that ‘off the carbs’ is the way to be.” More at https://www.crossfit.com/essentials/eades-health-conference-paleopahology

Zoë Harcombe, Ph.D., is an independent author, researcher, and speaker in the fields of diet, health, and nutrition. Over the years, research for her books and speaking engagements has made her an expert in the corruption and error plaguing the health sciences — a dire situation that she, like CrossFit Founder Greg Glassman, refers to as “The Mess.” Harcombe defines “The Mess” as “the escalating disease (and) the escalating medical costs, which many people are profiting from but none are combatting effectively.” During a presentation delivered on July 31 at the 2019 CrossFit Health Conference, Harcombe outlined many factors that contribute to this growing problem — specifically, the role of dietitians and the food and beverage industry in influencing how and what we eat, accreditation that regulates who can offer dietary advice, and the disparity between what we are told to eat and what the evidence suggests we should eat. Early in her talk, Harcombe shares her research on the dubious back-door maneuvers multibillion-dollar food companies use to promote their products, including paying for studies that tout their products’ health benefits and adding public health advisors to the payroll. She observes that the only thing that would make their marketing efforts easier would be if these paid advisors had a monopoly on doling out dietary advice — which is precisely what they have sought to do in many states in the U.S. by joining forces with the Commission on Dietetic Registration (CDR) and the Academy for Nutrition and Dietetics (AND). Harcombe shares the story of Steve Cooksey to offer one telling example of how these organizations and others like them try to maintain a monopoly over nutrition advice. Cooksey was diagnosed with Type 2 diabetes, but rather than following the medical advice he received to eat a low-fat, high-carb diet, he ate the opposite way and lost 70 lb. He started a blog, sharing his story and offering free advice to others, and was promptly rebuked by the North Carolina Board of Dietetics and Nutrition, which claimed he was “practicing without a license.” CrossFit and the Institute of Justice helped Cooksey with his case, developing a defense based upon the First Amendment’s protection of freedom of speech. Cooksey won. Nevertheless, industry-backed organizations continue to pursue sole rights to offering nutrition advice — advice that proves convenient for the companies that support the organizations financially. To demonstrate how problematic this system is, Harcombe compares the AND’s food recommendations to scientific research on nutrition. Apart from the AND’s tendency to confuse macronutrients with food groups, Harcombe also points to its support of the overconsumption of carbohydrates. Citing a 2005 government panel on macronutrients, Harcombe notes, “The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed.” “There is no essential carbohydrate,” she explains. “There are essential proteins, and there are essential fats.” Harcombe discusses how to evaluate the credibility of a scientific paper then brings this to bear on the nutrition recommendations promoted by the Evidence for Dietary Guidelines for Americans (DGA) and the AND. She finds their evidence entirely inadequate. Nutrition advice provided by the AND, DGA, and CDR “is not evidence-informed, let alone evidence-based,” she argues. These credentialing organizations “need to be countered with an equal and opposite force.” CrossFit® - Forging Elite Fitness® (https://www.crossfit.com/)

“What scientists do and what journalists do are similar in that we’re both supposed to be establishing reliable knowledge about the universe,” Gary Taubes told the audience at the annual CrossFit Health Conference on July 31, 2019. Taubes, an award-winning investigative journalist, has spent the last several decades turning a critical eye toward places where received wisdom in the fields of science and medicine has diverged from reliable knowledge. In this presentation, he evaluates what the experts say about why we get fat and explains why he has become a critic of the consensus. In assessing the scientific evidence related to the question of why we get fat, Taubes uncovers two hypotheses about the relationship between obesity and various metabolic diseases that lead to premature death. Each hypothesis is associated with unique assumptions about the driving cause of obesity. The first hypothesis suggests obesity causes metabolic diseases. The second suggests whatever causes obesity causes these diseases. The World Health Organization provides an example of the conventional wisdom associated with the first hypothesis: “The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended.” In his research, Taubes sought out the origin of this idea about energy balance. He found it dates to the 1860s and the birth of modern nutrition science in Germany, specifically with the invention of the calorimeter, which measures energy expenditure. “Our ideas are dependent on the technologies we have to observe the universe,” Taubes explains. “So if all you could observe related to obesity is the intake and expenditure of energy, you end up with a theory related to the intake and expenditure of energy.” Taubes asks several questions that reveal the problems inherent in the energy balance model: Why don’t obese people compensate by eating less or exercising more? Why is it that some people can be thin without starving? We know men and women develop fat tissue differently, so what is determining the specific areas where fat accumulates? If we know puberty is adipogenic (fat-accumulating) for girls but not boys, why don’t we talk about hormonal forces determining fat accumulation when we talk about these caloric imbalance issues? After pointing to several holes in the energy balance hypothesis, Taubes explains his reasons for supporting the alternative — the hormonal/regulatory hypothesis — which suggests “obesity is a disorder of excess fat accumulation.” Scientists and physicians have construed obesity as a psychological disorder since the 1930s, when L. H. Newburgh claimed it is caused by “various human weaknesses such as overindulgence or ignorance.” The hormonal/regulatory hypothesis, on the other hand, suggests overeating and sedentary behavior are compensatory effects, not causes of obesity. In his survey of the history of obesity research, Taubes locates two leading proponents of the hormonal/regulatory hypothesis whose work dates back to pre-war Germany and Austria: Gustav von Bergmann and Julius Bauer. Taubes argues the hypothesis Bergmann and Bauer developed fell out of favor after the Second World War, when Bauer fled Austria, the lingua franca of the medical literature shifted, and people no longer read studies in German. The hormonal/regulatory hypothesis all but disappeared until 1965, when a group of researchers including Rosalyn Yalow and Solomon Berson discovered a method for measuring fatty acids in the blood, thus uncovering a way to study fat metabolism. They discover insulin is the primary regulator. Since then, several scientists have gone against the consensus of their peers and called for new research on the dysregulation of insulin signaling and fat metabolism. Taubes lists a few notable examples and describes the backlash such research often encounters. Dr. Robert Atkins provides a telling example. Atkins’ research included support for the hormonal/regulatory hypothesis by demonstrating the positive metabolic effects of a low-carbohydrate diet, but physicians and other members of the scientific community who feared fat more than carbohydrates worked to make Atkins' name synonymous with quackery. “And in order to get rid of Atkins, you had to get rid of the science behind Atkins,” Taubes explains. “So Atkins was the bath water, the endocrinology was the baby, and by the 1980s, there was no discussion anymore of the hormonal, endocrinological regulation of fat metabolism in obesity textbooks or obesity papers, because if you discuss that, you are led de facto to a low-carbohydrate diet.” CrossFit® - Forging Elite Fitness® (https://www.crossfit.com/)

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