Episode 106 Summary 

  • Dr Bret Scher is a cardiologist in the USA - He has a special interest in working one on one with patients to help them focus on lifestyle changes within the realm of cardiology instead of being primarily reliant on prescription medications. 
  • Dr Bret Scher is also Medical Director of the internationally successful dietdoctor.com website - The website contains multiple invaluable resources, a directory of low carb health professionals, recipes, articles, cast studies and science. https://www.dietdoctor.com/
  • There may not be one perfect diet for everyone - But there is enough evidence, with studies and literature in science demonstrating the efficacy of low carb real food and ketogenic diets that it needs to be something that all clinicians are aware of and understand as a therapeutic option as it can be incredibly successful in practice. Patients sharing their success stories and sharing information with clinicians is an additional way in which clinicians’ awareness can be raised. 
  • The real whole foods aspect of a ketogenic or low carb diet - Real foods are essential to obtain the maximum health benefits. Eating whole foods excludes the packaged and processed junk foods. A whole foods diet consisting of real food is always going to be better than a processed foods diet.
  • Prioritise protein, reduce your carbs, enjoy fibrous vegetables and add enough fat for the enjoyment of your meals - Protein can be incredibly satiating and along with resistance exercise helps to maintain lean muscle mass. Fat is a great nutrient but it is also an energy source so there is no need to add large amounts of fat to our foods, as any excess energy will still be stored in the body as fat.
  • Different individuals thrive on different methodology - Often data minded individuals like engineers thrive on tracking their food, however other individuals who have been traumatised by diet culture, and calorie restriction may prefer not to track their macros. Be true to yourself and follow the path that works best for you as an individual. 
  • Don’t fall into the “All or nothing” trap - Both lifestyle interventions and medications can have a place together in best practice medical care. Both the patients who insist on no medications ever and those who won’t consider lifestyle interventions at all are potentially depriving themselves of the very best care available. Dr Bret Scher mentions statins as an example of this. He believes they can be helpful in secondary prevention and should not be disregarded.
  • BMI is a great tool for analysing data in a population - Unfortunately relying on BMI and scale weight as a determination of health for a specific individual is unhelpful. Waist circumference, waist to height ratio and body fat % are all more helpful in practice. 


Dr Bret Scher’s Top 5 Tips For Living Well and Looking After your Heart Health: 

  1. Eat REAL foods
  2. Move your body regularly
  3. Prioritise Sleep
  4. Manage your stress effectively
  5. Maintain strong connections with friends and loved ones

Dr. Bret Scher, MD:

Dr. Bret Scher is a board certified cardiologist and lipidologist practicing in San Diego and licensed to practice in seven states. He’s full-time Medical Director for dietdoctor.com, writes medical blogs, reviews guides and news stories for medical accuracy and hosts The Diet Doctor Podcast. 

Dr. Scher’s main focus is on preventing and reversing heart disease naturally - rather than putting patients on medication and performing surgery. When he started his own preventative wellness center he was introduced to the whole low-carb world. Being a bit skeptical at first, he was soon convinced by the benefits of a low-carb diet.

In Dr. Scher’s many patients suffering from heart disease, he found that there was a big overlap with cardiovascular disease, diabetes, metabolic syndrome and insulin resistance. It was all very interrelated. When he started treating his patients who suffered from heart disease with a low-carb diet, he could quickly see signs of improvements or even full reversal in all of these diseases.

Dr. Scher has also obtained specialized certifications in functional medicine, nutrition, personal training, and behavior modification.

He is also the author of the book Your best health ever!


Dr Bret Scher has a blog and website at lowcarbcardiologist.com.

Dr. Bret Scher is on Twitter, Instagram and LinkedIn.

If you want to contact Dr. Scher you can also send an email to [email protected]. Please note that Dr. Scher can’t give personal medical advice about diet or health via email.


Show notes:

The Low Carb Cardiologist 


Dr Mary Barson  (0:11) Hello, my lovely listeners. I'm Dr. Mary Barson.


Dr Lucy Burns: (0:15) And I'm Dr. Lucy Burns. Welcome to this episode of Real Health and Weight Loss. Gorgeous ones, Dr. Lucy here this morning on another fabulous episode of Real Health and Weight Loss. And I have an absolute treat for you today. I am super, super excited to be welcoming Dr. Bret Scher, who is a cardiologist based in the US, but is also the Medical Director of the very well known dietdoctor.com website. He writes phenomenal articles and is just a joy. So I'm sure that you are going to enjoy this episode with Dr. Bret Scher. Bret, welcome to the podcast. Thank you so much for coming on.


Dr Bret Scher: (1:04) Oh, it's my pleasure. Thanks so much for having me on today.


Dr Lucy Burns: (1:07) I would love to know how you discovered low carb.


Dr Bret Scher: (1:13) Yeah, you know, it certainly wasn't because I was taught in medical school residency or fellowship, that's for sure. In fact, I was taught the opposite, right, as most doctors were. But I was fortunate enough to, I guess, be frustrated with my practice, to be frustrated with the lack of impact I was having by trying to help people focus on lifestyles within the realm of cardiology rather than just prescription medications. And because of that frustration, I was sort of driven to do something different. So I started Boundless Health, which was sort of like a boutique practice to really try and work with one on one, spending more time with them. And I was lucky enough that the health coach I was working with at the time was very knowledgeable about ketogenic diets. So working with him introduced me to the world of low carb and keto, which once I started looking into it, I actually got really frustrated and upset because the evidence was there. There were studies and literature and science, showing efficacy of low carb and keto diets, but yet it was really never discussed or taught, and that, that really charged me especially then once I tried it on myself, and then started trying it on patients and, and said, “Look, I get it, that there's not one diet for everybody”. And this may not be a diet for everybody. But this absolutely needs to be something clinicians know about and understand, so that they can use it with the right patients to really help them because it helps in ways that I've not seen anything else help for certain subsets of patients. And, and that's pretty dramatic. And to have that type of a therapy swept under the rug just really tore at me, so I sort of made it my mission to really get this word out there - not just to the everyday public and individuals - but to clinicians as well. 


(2:58) But it's important for both spectrums to really understand it, because one, not every clinician is going to know about it. But for the patients to bring the information to the clinicians and their success stories to the clinicians, is so powerful, and then at the same time to try and target the clinicians with education and, you know, continuing medical education programmes or whatnot, so that they understand it, really bringing those two worlds together. So that's sort of my little circuitous route to where it got me today. And then, you know, I was lucky enough to meet up with a crew at diet doctor and come on board with them as the medical director, where I've been for, like, almost three and a half years now. So it's been a great journey.


Dr Lucy Burns: (3:34) Absolutely. And what a massive platform diet doctor is, really isn't it for spreading the word and I read your articles and they're fantastic. So you know


Dr Bret Scher: (3:44) Thank you.


Dr Lucy Burns: (3:46) Lovely listeners, I would definitely be recommending that you head over to dietdoctor.com for some actual evidence based articles and advice on how to manage a low carb lifestyle.


Dr Bret Scher: (3:57) Yeah, as with anything when things are - as with anything - when they get popular, when things get popular, they can sort of take on a life of their own and then it can become very confusing as to what to believe and you know where to turn. So we hope at diet doctor that we are that place to turn to for reasonable and evidence based advice that's going to help people and you know, is well vetted. Yeah, so hopefully we fill that role.


Dr Lucy Burns: (4:22) Ah, you know, I totally agree and you're right about the concept of the popular thing, you know, we see it now in processed food companies who are making, you know, low carb pizza bases and they've got keto splashed across it or supplements. The supplement industry is one of my biggest bugbears because people think it's natural and it's going to be good for them. And it really it's just an unregulated trillion dollar industry for which, you know, 95% of it is quackery, but yeah, that's just my little soapbox in there.


Dr Bret Scher: (4:58) No, I agree with you completely. I mean, And I think if you can say one thing that's currently the worst thing about the Keto movement, so to speak, or the potential downfall of the Keto movement would be the infiltration of processed foods and the infiltration of keto junk foods. You can say the same thing about vegan right now, you know, whole foods, plant based vegan diet is very different from the vegan diet based on all the vegan junk food that's out there. And the same for keto we're seeing the exact same things starting to happen in keto, which is unfortunate. And, you know, it always comes down to whole foods, however you want to say, you know, but whole foods, low carb, whole foods, keto diet is definitely a different approach than using all the packaged and processed junk foods that are out there.


Dr Lucy Burns: (5:41) Ah! Absolutely. In fact, at Real Life Medicine, we use the phrase low carb real food. 


Dr Bret Scher: (5:46) Mm hm. I like that.


Dr Lucy Burns: (5:48) Yeah, that and we do a little hashtag of LCRF, because I think also, part of the reason that people get confused perhaps or the messaging gets mixed up is that people focus on the high fat component of LCHF or keto. And I think I've certainly seen it and I can see that in diet doctor, there's been an evolution focusing a lot more on protein as a macronutrient, rather than necessarily high fat. Is that how you're approaching things?


Dr Bret Scher: (6:19) Yeah, I think that's a very fair statement. You know, for keto that you just have to reduce your carbs. That's what makes a diet ketogenic, and then the rest is trying to figure out, how do you optimise your nutrition within that setting? And with regards to nutrition I really think most people do need to focus on protein. Now the question is, what does “focus on protein” mean? Some people think that means 40% of your calories are from protein. Other people think it means, you know, maybe 20-25%. And the key is it's not 10% or 15%, you know, which is sort of what the average American is eating right now, it's higher than that. Because protein can be very satiating, certainly up to you know, 25% or that 1.6 grams per kilo range, you know, depending on how you want to look at it protein can be very satiating, and it's what you need. For healthy weight loss we don't just want to lose weight period, we want to lose fat mass, while maintaining lean mass. And for that, gosh, protein is so important as is some form of exercise. But interestingly, when we've done that one of the push backs we've gotten is like, how can you now promote low fat, but it’s different, right? Saying a ketogenic diet with 80% fat versus a ketogenic diet with 60% fat, neither one of those is a low fat diet by any means. Fat is still a great nutrient to help you enjoy your meals.  To add your food, and if you're burning fat to use it as energy, but just like anything, too much energy can lead to weight gain or stalls of weight losses. So it is important to sort of regulate the fat intake, but it's very different than saying 20% fat, you know, low fat type of diet. It's just saying, prioritise protein, reduce your carbs. And then if you add the fat for enjoyment of your meals, and if you need more calories, I mean it doesn't have to be much more complicated than that.


Dr Lucy Burns: (8:06) No, I love that. And I think that, you know, sometimes people get overwhelmed by the complexity of how to, I guess, formulate a low carb or ketogenic diet. And, you know, for some people, they love that, like, some people are mad about data and tracking and calculating and spreadsheeting and, and there's lots of, I guess, programs and websites and apps that help people do that. But for other people, and I find this particularly for women who have done “dieting”, and listen, as you can’t see my air quotes, but they've done that they've done calorie counting, they've tracked they've, they've journaled. They're almost traumatised by that concept. And so to ask somebody to do that, again, can be sometimes really difficult for them.


Dr Bret Scher: (8:52) Yeah, you know what I found, because I still work with a number of patients, one on one, the engineers love to track if they're engineers, they're just going to go to town on the data. But I think you're right, people who have had that diet experience, don't want anything that feels like a diet experience again, and tracking and counting and logging and monitoring and weighing, that is the diet experience. And the anxiety and the stress sort of builds up with that and that is exactly what you don't want. And that's part of the beauty of low carb is that the rules are very simple, right? Just cut out the carbs. Make sure you're getting enough protein, you know, a couple fistfuls per meal or a couple of hand palms, both per meal and add the fat to enjoy your meal and you're done. You know, very simple.  Or if you're not keto or low carb, and you're just want to eat, you know, higher satiety, trying to eat foods that are going to fill you up more then again, you prioritise protein, you fill up with fibrous veggies, and add the fat to enjoy your meals. Like if you can live by those priorities, without having to count and measure it and just sort of have that concept. It's a much more simple approach than counting and measuring for most people? Now, a lot of my engineer patients would hate it, though. They're like, Oh, no, no, I need to know, I need to know, which is so funny right there. I mean, there's just two different polar opposites. But each one works for them.


Dr Lucy Burns: (10:12) Absolutely. And I think you've just hit the nail on the head there with actually tailoring or speaking to the patient or the client, as to where they're at, like meeting them at their point. And trying to convince an engineer to just sort of freeball that if you like, that's a bad word. But anyway - we're using it - is problematic and trying to convince somebody who's traumatised by diet culture, neither of those are going to work. So right, yes, meeting them where they're at is wonderful. I love that. I love that. So I guess with your epiphany back in, you know, last decade of recognising that, and I suppose for you, Americans' health overall, it's going down the gurgler. And we're seeing, you know, Australia mimics America. We're seeing more and more obesity, diabetes, heart disease, and all the other things that go with that. What is your first step when someone comes to see you? Particularly if they're feeling like they're, I have lots of people, and you probably do, too, where they go, “I think it's too late for me Doc. I think I'm done.” What's your step there? How do you give them some hope?


Dr Bret Scher: (11:20) Yeah, that's a good question. And I mean, the first is, of course, convincing them that they do have hope and showing them that they have hope. So whether it's other people's testimonials, or just, you know, telling them about some of the patients I've seen who have turned it around, and, you know, just giving them some element of hope, but also giving them an initial victory.  Some sort of immediate victory, because they may have a long term goal. But if it's going to take years to get to their long term goal, a lot of people are gonna get frustrated and give up at the first negative turn. But if you can show them stepping stones on how they're going to get to that long term goal, and each stepping stone has its own short term goal, then that can really inspire them to continue on their course and to get more motivated. And I think that's something that people can fall into the wrong trap. Like we hear so much about reversing type two diabetes, we hear so much about people losing 100 pounds, and they're like, “Wow, that's what I want to do”. But if that, you know, three months, you're doing great. And then at five months things stall, you're like, “See, I knew it, I knew it wouldn't work, and I am never gonna get there”. Yeah, we got to avoid that trap. So that's where I like the stepping stones, whether it's, you know, initial, not even weight loss, but just like, okay, not having the snack, you know, during the day. Boom, victory! Right? Or being able to now walk a little bit further than you did before. Boom, victory, whatever those little victories are, build those in, so that they see their progress. Because as humans, we're sort of hardwired to see the negative a lot more than the positive and hang on the negative more than the positive. So it also helps to chart, to say, “Look, you look back when you're like, “Oh, I'm so frustrated, it is not working!” Well, let's look back where you started six months ago. See you started here, now you're here! So you may feel stuck. But look at that progress. I think that's so important, because that's just human nature, right. And we don't learn that in medical school, right, we don't learn that in residency and fellowship. And that human behaviour, part of it is just like, it’s thought to not be important or not to be taught or not our job, or whatever it is, but it's absolutely our job, and we have to be good at it to help our patients succeed. 


Dr Lucy Burns: (13:27) Ah, I love that. I totally love that. Because as you know, I love behavioural medicine, and helping, I guess, translate, you know, complex theory into real life behaviour, so that it becomes relatable. And I think in medicine, we’re still very good at the complex theory, and, you know, talking to somebody about talking to somebody about the theory of things, and you know, you start talking about complex things like, you know, “gateways” and some of those words that we love to use, “code chains” and all that sort of stuff. It just frightens people, and I think frightening people is really unhelpful.


Dr Bret Scher: (14:06) Yeah, I think that's right. And it's easy to do, unfortunately, in medicine, and you know, I guess I'm as guilty as anybody of speaking badly about, you know, medicine and the way it's gone. But look, if, if I'm having a heart attack, or if I need a valve replaced in my heart, like the technology and the advancements in medicine are phenomenal. And absolutely, I want the most experienced and knowledgeable person, you know, backed by the tools and the interventions and the medications needed in that situation. But boy, do we drop the ball when it comes to managing chronic disease? And that's where I think we do scare people more than we help people in general as a medical community. And so it's sort of a tale of two medical systems. I think the polar opposite.


Dr Lucy Burns: (14:49) Yeah, absolutely. And in fact, I love that because of what you've kinda said is that, and I think people can fall into this trap of ‘all or nothing’, in lots of things that we do, but you know,  I see lots of people who, who don't want to take any medications ever. And the thing is that sometimes you do need things and you know, optimising your lifestyle is the best way to have minimal medications, but it doesn't always guarantee no medications. Do you find some of your, and again, I'm sure that people seek you out for the same reason they seek me out for looking for lifestyle, but then you've got to actually sometimes say, “You know what? Sometimes medications are okay”.


Dr Bret Scher: (15:30) Yeah, it's funny, when I go to cardiology conferences, I'm sort of the black sheep who promotes lifestyle over drugs. And when I go to sort of low carb and nutrition conferences, I'm a little bit of a black sheep, who still uses drugs rather than just lifestyle, right? Like, I don't quite perfectly fit in either one. But yes, that does happen a lot. Patients come to me and they say, like, my doc wants me on a statin, my doc wants me, I need my blood pressure. I don't want to take them. And then we do our intake, I'm like, “Look, you definitely can improve things with lifestyle. And in certain situations, medications have a role”. So frequently, you know, statins are the most common one I get all the time. And we really do have to differentiate secondary prevention versus primary prevention, higher risk versus lower risk, and there are things we can do to better define that risk more than just checking what your LDL is. Right. So that's really important. But we still have to factor in that medications do have a role in certain situations. So absolutely. I mean, I don't think we can be absolutely dogmatic on either side of the equation. But as I can say statins are over prescribed, and it's easy for me to say statins are over vilified, and probably the same for most medications, and the answer lies somewhere in the middle. But the key to finding that answer is better determination of what your risk is. And your risk benefit ratio is for you as an individual. Because when we look at the studies of, you know, 10,000 people, 100,000 people, this is the general public, most of whom are eating a high fat, high carb, high caloric diet, most of whom have some metabolic dysfunction. That's who the majority of these patients are in the drug trials. So it's trying to take that data and apply it to you as an individual, and frequently is not a one to one correlation. So it's like, okay, what else can we add to bring this data closer to what we know about you as an individual?


Dr Lucy Burns: (17:19) Yes, yes, yes, 10,000 times over, because it is trying to take big trials and public health measures are sometimes not helpful for the individual. And I think that we can, I mean, we can look at something as simple as BMI for that. 


Dr Bret Scher: (17:39) Yeah. 


Dr Lucy Burns: (17:40) And I'd love it if you could, perhaps explain to our listeners about BMI and what it actually is, because so many people go, you know, “I'm still above my BMI.” So yeah. What are your thoughts on BMI?


Dr Bret Scher: (17:53) Yeah, and I think you alluded to it for a population basis on the study of hundreds of 1000s of people BMI tends to track well with, you could say overfatness. And that's the difference that you want to make. Is your elevated BMI because of fat tissue and adipose tissue? Or is it from lean tissue like muscles and bones? And for the general population, it tracks pretty well. Not ideal, but pretty well with overfatness. But when you're sitting across from one specific individual, BMI is worthless. I would never even check BMI in a patient, I want to know what's your waist circumference, your waist to height ratio, some determination of body fat percentage, whether you can get a DEXA scan or hydrostatic weight, or even just one of those, those bioimpedance scales, some better measurement than just what is your number of pounds when you step on a scale? That's so much better for an individual than BMI. But like you said, for, you know, big population studies, BMI tracks fairly well. But that's not what I want to know, when I'm working on a patient and for individuals listening, I don't think they should care what their BMI is. They should want much better data and information about themselves than just BMI.


Dr Lucy Burns: (19:07) Yes, absolutely. And I think we are often saying that the scales, like just standard scales, are such a rudimentary tool as well. Like they really yeah, they're like the equivalent of the temperature. They're just one data point, but they don't actually tell you anything about your health. They're just a number.


Dr Bret Scher: (19:26) Yeah. So I finally found a good use for my scale. My scale has been sitting in my in my closet for a year or more and I haven't used it and my son was going off to sleepaway camp, and we packed this huge bag for sleepaway camp and it had to be less than 50 pounds to get on the airport, to get on the aeroplane. So I'm like, ‘Oh, I finally found a use for my scale, but that's what a scale is good for!’ Not for telling me about my health at all, but whether my son's bag is too heavy to get on the aeroplane. That's what a scale is good for.


Dr Lucy Burns: (19:54) I love that. That's hilarious. Absolutely. And good. And I guess that just keeps adding to our thing where we say to people just pop the scales away. They're not your friend. They're not always helpful. I know people sometimes hop on them thinking it's going to be motivating for them and a bit like your stepping stones. They go, “Oh, good, oh, good, oh, good.” But then if they go up, they go “Oh bad.” And then they stop doing what they're doing. So,


Dr Bret Scher: (20:19) You know, if you have a hard workout, and you get some swelling that can increase your weight, right? You hang on to a little fluid that increases your weight. That’s got nothing to do with your progress in your health, it could actually be a good thing. Right? So yeah, it can be a trap that people fall into and put too much faith in for sure.


Dr Lucy Burns: (20:37) Yeah, absolutely. Absolutely. So do people come and see you in your clinic? Or tell me how you work these days?


Dr Bret Scher: (20:45)  Yeah, so my practice is, it's all online. It's a telemedicine practice. And I'm licenced in seven states here in the United States. So anybody in those states can see me as a patient. You know, it's not a full time practice. My day job, so to speak, is as the medical director of diet doctor, but I never want to give up clinical practice. I just love working with people one on one too much, so I still have that practice. So I can see people and, you know, really focus on this intersection of lifestyle and mainstream medicine and really help people better define their health and their cardiac risk and what might be the best lifestyle for them. And you know, what's interesting, you know, I'm sort of known as the low carb cardiologist and the keto cardiologist, but for as many people as I put on a keto diet, I also take people off keto diets too. I don't think I wouldn't say it's the one diet for everybody. And I think that's an important message that we all have to stick to, that we, we can't be in a bucket. And this is our tribe. And this is what, what we apply to everybody just like, you know, I think that's what got us into this mess in the 1980s. With the low fat diet is the one diet for everybody. Why don't want to fall into the same trap that a low carb or keto diet is the one diet for everybody, either.


Dr Lucy Burns: (21:53) No, oh, my God, you're speaking my language. Because I think what happens is that it's very easy to be dogmatic about your way. You know, your way is the right way. Everyone should do things your way. It's the only thing that's suitable for everybody and it becomes easy, because you just bang the same drum, morning, noon and night. Being in the middle is not nearly as sexy or, or controversial. And so, you know, controversy is what sells, you know, everything in the world. That's why suddenly reality TV is so controversial. And being a moderate, if you like, seems a bit boring, but I actually think it's, it's the key to being really able to help the majority of people.


Dr Bret Scher: (22:36) Yeah, and it seems like I don't know, like a prime example is the big debate and battle about the energy balance model or calories in calories out or the carbohydrate insulin model, which one is right? And they're both right. And they're both wrong, right? Like, there's not one explanation of why people gain or lose weight. You want to eat fewer calories than you expend to lose weight. But you want to do it in a way that is going to improve your body's hormone responses, it's going to do it in a way where you're not hungry, and do it in a way that's going to give you the nutrition and the protein that you need. Right. So it's not just a simple math equation, but it's also not just simple, reduce your carbs and do whatever you want, and you're going to be fine. It's not that simple. But people like simple answers and people, they like to be on the edge of things, I guess you could say. And like, Yeah, I agree with you, trying to try to be more nuanced, and kind of in the middle of things is not nearly as exciting for a lot of people, but it's where a lot of the accuracy and success, I think lies.


Dr Lucy Burns: (23:36) Yes. I often feel like I need a badge that says I'm a loud and proud omnivore because, yeah, I'm not, I'm not carnivore, and I'm not vegan. And, suddenly, I'm a bit boring. But, you know, I also think that's for me, again, you can use the other diets in certain people, and they suit certain people. So it's not that I'm not supportive of those. But it's not who I am and what I like to promote, and sounds the same for you.


Dr Bret Scher: (24:04) Yeah, it is. And look, I mean, I can think of two patients I've seen this week. And one, I helped start on a carnivore diet, with the idea being he was going to be on it for a few months. And then we would start introducing foods back at his checkup. He's like, I feel the best I've ever felt in my life. I have so much energy, this is great. All my numbers are better. I don't want to change. So you know, why would I tell him to change at that point, right, just because I have some preconceived notions of what the right diet is. No, I mean, I think he's found his diet. And then the other one is almost exactly the opposite. He came to me already eating a plant based diet. And so we were making a couple changes with the thought of maybe adding simple changes without any meat products, the same thing he's feeling so great and doing so well. Maybe he doesn't need to add meat products, right? Like if that's what works for him and fits his belief system and his ethics. Why would I want to change that if it's working? And then you have to define what working means for each person of course. So they all can work now, I would say the majority of the people are going to do very well with an omnivore diet that's relatively low carb and at least moderate protein, right? Like, those are the concepts that I think are going to fit most people. But again, it's not going to fit everybody.


Dr Lucy Burns: (25:14) Yeah, absolutely. I mean, you alluded to the formula before, and we use it all the time, which is pick some protein, pick some non starchy vegetables, add a bit of fat if the proteins lean, and then add some flavour, which is herbs and salt. And it's really simple.


Dr Bret Scher: (25:32) Yeah, yeah. It doesn't have to be complicated. 


Dr Lucy Burns: (25:35) No. So as a cardiologist, what are your kind of five top tips for living well, and looking after your heart health?


Dr Bret Scher: (25:44) Oh, good question. Good question. Well, I mean, I think eating whole foods is a great starting point. Moving your body regularly, including resistance training is fantastic. Prioritising sleep is also very important, something that we don't do nearly enough in our busy run, run culture.  Stress, you know, acute stress can be good, chronic stress that you just like keep building up is a danger for sure. And having strong connections with friends and loved ones. Now if I was going to pick five sort of main topics that people need to address, those are the five. Now, you can't always address all of them at once. That's intimidating, that can be overwhelming. And make you want to throw your hands up and say I can never do this. But you know, having those as goals for where you eventually want to get. And again, building stepping stones along the way. Addressing each one individually is a great way to go.


Dr Lucy Burns: (26:40) Yeah, absolutely. And I love it. And you're right. I mean, it does. Sometimes you feel like you've got to go through this list. Right! Gotta get up, I've got to get up and see the sun, get outside, do 10 minutes, I've got to go brush my teeth and make sure I floss, I’ve gonna meditate for 10 minutes, I've got to connect with some people, you know, and it feels like this giant list of too many things to do. And so people do nothing.


Dr Bret Scher: (26:59) Yeah, yeah, you sort of give up. And, look, I mean, you can say a lot of things about the mental health of our society right now. And I think it is trending in the wrong direction. And there's quite a lot of despair, and depression in American society, for sure. And I think globally as well. So people are a little more prone to maybe giving up and just seeing the negative in things and not wanting to try if they're not going to see immediate results. So I think that's, that's important too, especially with social media, again, you see, you'll see posts about, you know, people doing all these different things, and you're like, I gotta do it all. And it's difficult to do it all. So I see that as part of our job too. Again, getting back to the behavioural aspects of things, and having to be able to understand those as clinicians, and how to communicate that to our clients, that taking little pieces at a time rather than trying to, you know, one big bite of the whole thing is, is probably the better path to success. 


Dr Lucy Burns: (27:57) Absolutely. And, you know, on top of that, removing blame and guilt, because people feel bad, you know. They want to do, air quotes again, “the right thing”. And if they don't do it, they then feel guilty or feel ashamed of themselves. And I'm sure you've heard this phrase I and I hear it all the time, which is,  “I can't believe I let myself get to this point”. That’s their self-talk and it sort of permeates the whole mind. Like it's part of the health thing, isn't it just having a beautiful, healthy mind?


Dr Bret Scher: (28:27) Community is at fault for a large part of that as well, because there has been a lot of blaming, sort of implicit maybe, you know, maybe not the doctor saying it's your fault, but this sort of just implicit in the message was that, well, you're overweight, and you have diabetes, because you didn't do what you were supposed to do. You know, that message, which is just so wrong, has really sort of been the default message for decades.


Dr Lucy Burns: (28:52) Yeah, absolutely. And I think, you know, there's two things to that. One is that many people have had the wrong information or information that wasn't helpful to their particular circumstance.


Dr Bret Scher: (29:01) Yes, yes. 


Dr Lucy Burns: (29:02) And the second thing is just this idea that, you know, food is used in our society for so many things other than nutrition. And it's used to celebrate, it's used for reward. It's used to mitigate sad feelings, etc. And that's well and truly populated on commercial television, and advertising. You know, at the moment, there's an ad going around in Australia for a chocolate bar, and there's a girl, there's a mum and a little boy sitting on a bus, and there's a girl sitting on the bus just in the seat next to them and she's crying. So the boy reaches into the mum's bag and gets out a block of chocolate and gives it to her. And you know - that in itself - everyone goes “Oh what a lovely ad!” But that really just exemplifies exactly what is going on that people use food to soothe because we've been told to do it and taught to do it. But then when they develop problems from this, then they're blamed. And that's.. I dunno. That's just wrong.


Dr Bret Scher: (30:01) Yeah, yeah. Sugar equals love. No, not really. It does not. But marketing wants you to believe that.


Dr Lucy Burns: (30:09) Absolutely, absolutely. Right. So if people want to read more about you or find you or look for your information, how do they contact you? What's the best way?


Dr Bret Scher: (30:20) The best way is probably through dietdoctor.com or our Diet Doctor YouTube channel, that's where most of my content is. I usually do about two videos a week on our YouTube channel plus a podcast every other week. And then we have, you know, Diet Doctor dot com just has hundreds of different educational guides, depending on the topic you're interested in, that I've either written or medically reviewed. So that's a great place to start. And then for those in the US who want to work with me as a patient, lowcarbcardiologist.com is probably the best place to start there.


Dr Lucy Burns: (30:52) Yeah, absolutely. And you've got a book. Are you still selling that book? Because that was awesome


Dr Bret Scher: (30:57) Yeah that book’s on Amazon. Your Best Health Ever. I wrote that, gosh, maybe five years ago now. It's probably in desperate need of an update, I think but that's not happening anytime soon. But the information is still very useful. And just a way to put everything down and in one place.


Dr Lucy Burns: (31:14)  Yeah. You know, when I was first starting out in the low carb world, I bought that book because it was really good. So yeah, yeah, I know it still is… I actually bought the hard copy of it, too. So it's like, oh, so often, I’ll lend it to people but I definitely make sure I keep it back. So there we go. 


Dr Bret Scher: (31:32)  Great. 


Dr Lucy Burns: (31:33) Wonderful. Well, thank you so much for your time today. I'm sure our listeners have had, you know, just consolidated their knowledge and just really now have an extra resource to go to. So I really, really appreciate it. Thank you.


Dr Bret Scher: (31:45) Yeah, my pleasure. Thanks for having me on today.


Dr Lucy Burns: (31:52) So, my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr. Lucy Burns.


Dr Mary Barson  (31:59) And I'm Dr. Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com 

Dr Lucy Burns: (32:11) And until next time, thanks for listening. The information shared on the Real Health and Weight Loss podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.


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