Best of 2025

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BrentWelcome to Death Clock. I'm your host, Brent Franson. The mission of Death Clock is to help 100 million people live ten years longer. Today, we have a best of 2025 episode for you. 2025 has just been an awesome year. It was by far our best year as a business and for the podcast. The podcast has grown really nicely and we are excited to welcome all of the new listeners who have joined us throughout the course of the year.

BrentWe also had a ton of amazing guests this year. We're really honored to have such knowledgeable and thoughtful people come on and educate us on these topics that are so important to being healthy and figuring out how to live long and healthy lives. We've chosen five episodes from this year that we want to highlight, and we'll share clips from each of them.

BrentAnd then if you want to go listen to the full episode, of course you can do that. You can go to your podcast player and find these episodes. They're all available. This clip is from our episode on Blue Zones with Doctor David Rehkopf. Doctor Rehkopf is a social epidemiologist and associate professor at Stanford University in the Departments of Epidemiology and Population Health.

BrentBlue zones are these few places in the world where people live the longest. There's one in Japan. There's one in Costa Rica. There are about half a dozen of them, and Doctor Rehkopf has spent a significant portion of his career studying blue zones and trying to understand why people in these areas live so long, and then taking those insights back to us so that we can figure out how to apply them to our own lives.

BrentSo let's talk about blue zones. What comes to mind for me as somebody who's not deep on blue zones is that there seem to be these handful of places on Earth where people live a lot longer, and they live a lot better. They live decent lives to 100 at a higher rate than other places.

BrentAnd so before we dive into why that is, can you tell us what blue zones are, how we define them, and where they are?

David Rehkopf: It's a really interesting shift that Dan Buettner did. It's interesting what he's done. He built on work from scientists and then did his own investigations as well. It's a shift from thinking about what makes me healthy and what makes me live a long time to why there are places where people live longer.

David Rehkopf: He and others went around the world looking for these places. This idea has been around for a while, and a lot of things were debunked. There still is controversy because people think of these older high-longevity populations back in the 70s where it turned out people lied about their age.

David Rehkopf: The work now is very much like the work I do primarily in Costa Rica. We have really good death records and mortality data there, so we can really know. There are these places that are bigger than a town, but not as big as a whole region, where we've seen people living longer.

David Rehkopf: And so Dan and other folks started investigating why that is.

BrentThe one that probably comes to mind most for people is somewhere in Japan. You're referring to Nicoya in Costa Rica, right? How many of these places are there that stand out as outliers? Is it 5 or 10?

David Rehkopf: Right now, Dan in his book and work has talked about five, but there are others around and I think they're still being discovered. I have colleagues in Denmark who did a statistical scan of the country and found a few regions in Denmark where people live longer. In some ways, we're limited by that data.

David Rehkopf: They may be all over the place, but we can look at places where we have good mortality data and find them. There are likely many, many more. Right now, there are roughly 5 to 10. We found another small area of Costa Rica as well when we looked.

BrentFor a place like Nicoya in Costa Rica, what is the size of the population in this blue zone? How many people are we talking about?

David Rehkopf: I don't know exactly, but on the order of these blue zones, it's about 5,000 to 10,000 people. Somewhere in that ballpark.

BrentOkay, so what are the characteristics of a blue zone? If it's 5,000 to 10,000, that means at least one characteristic is rural.

David Rehkopf: Yeah, I'm not aware of any that are in cities. That's a really interesting observation. For these places to have that unique character, they tend to be a little more isolated. Many happen to be on islands, peninsulas, or up in the mountains.

David Rehkopf: In Sardinia, for example, it's not the folks living in the cities along the coast, but up in the mountains. Nicoya is a more mountainous, isolated region. I don't think there's anything special about elevation or mountains per se, but rather areas that are geographically isolated to have these unique characteristics.

David Rehkopf: In terms of the city point, one thing that is potentially destroying blue zones is the development that occurs. Development is great in a lot of ways, raising standards of living. But when it comes with things that limit physical activity and change the diet with fast food and prepared food in negative ways, those will wipe out anything positive you might see.

David Rehkopf: A lot of that unhealthy food and less natural physical activity happens in cities, so you just don't see blue zones there.

BrentIs that the core of why we think people are living longer in these blue zones? Basically, they're outside of the flow of the trappings of economic development. With economic development come efficiencies—needing a food system that produces at scale, or roads and cars.

BrentThe cities are more spread out, and people don't walk as much—they drive around. Are they isolated from modernity in a basic sense? Is it that isolation that keeps them living a more active life with locally grown food, and that's why these blue zones do so well?

David Rehkopf: That describes it really well. I think about it as a sweet spot. You don't want to be so isolated from modernity that food is scarce, or where there's a lot of infection, accidental death, and things that come without development.

David Rehkopf: It's a sweet spot that occurs in some of these places where they still have access to medication, physicians, primary care, and preventative health, but without many of the negative consequences.

David Rehkopf: There's also social connectedness, which comes up quite a bit as well.

BrentSo it's not simply that the more old-fashioned you live, the longer you live. Life expectancy was pretty flat for a long time, and technological innovation actually increased it. We reduced infant mortality, eliminated infectious diseases, and created vaccines.

David Rehkopf: Basic sanitation reduced infections significantly. You want all of those things coming along, but not some of the other stuff.

BrentThere's a causation versus correlation question here: how much can I replicate outside of Nicoya? Say I'm in New York City—the opposite of Nicoya. How much of it can you replicate in New York City, and how much is something going on in Nicoya that you need to be there to get?

David Rehkopf: That's a good question. Dan has done work to extract those things to think about creating your own blue zones. I've done other work on predictors of mortality that are consistent with what he is finding. There are things you can do in your daily routine.

David Rehkopf: As a scientist, I'm not promoting everyone moving to Nicoya. It's about what you can do in your own life and daily routine to be healthier and happier.

BrentLet's hit some of the basics one at a time. What do we know about diet in the blue zones?

David Rehkopf: The biggest thing is that there are very few highly processed foods, fast foods, or sugar-sweetened beverages. That's consistent with other studies showing those aren't good. They get a lot of protein from beans and other foods. People do eat meat, but they tend to be more plant-forward in their diet.

David Rehkopf: They're not all vegetarians, but they tend to have a plant-forward diet.

BrentSo plant-based with limited processed foods—not necessarily vegetarians or vegans, but a plant-forward diet. It's the Michael Pollan advice: "Eat food. Not too much. Mostly plants." That covers what we know about the diet. Nicoya is mountainous, but in the famous blue zone in Japan, there's talk of a fish-heavy diet. Do we see that across different blue zones?

BrentIs that not the case across all blue zones?

David Rehkopf: There's some of that. I haven't seen super strong evidence specifically for the fish aspect across all of them, but it may just be outside my awareness.

BrentWhat about physical activity?

David Rehkopf: People tend to just be naturally more active. I enjoy running marathons, but in Nicoya people aren't training for marathons. They are just moving around. When I visited, I saw a 100-year-old woman sweeping her porch in the morning and walking down into town.

David Rehkopf: It's amazing to see folks remain active throughout their whole lives. That's the kind of activity we miss out on with modern life and time pressures. Taking the time to walk places could really help people in the US.

David Rehkopf: Yeah. Could really, really help folks out here in the US a lot more.

BrentThis clip is from our episode on creatine with Doctor Scott Forbes, also known as Doctor Creatine. Doctor Forbes is a certified sports nutritionist and professor and chair of the Department of Physical Education Studies at Brandon University. There's so much talk about creatine. Should everybody be taking it? How much should you take? Is it hype or reality?

BrentDoctor Forbes does a great job helping us understand what creatine is, why it's beneficial, how much we should take, and how we should think about it.

BrentWhen we talk about creatine, are we talking about creatine monohydrate? What is the substance of creatine, and what specifically are we referring to?

Scott Forbes: There are different forms of creatine, such as creatine monohydrate and creatine HCl. But once creatine gets into the bloodstream, it breaks down into creatine and is taken up by the muscle. About two-thirds of it converts into phosphocreatine.

Scott Forbes: That is used to create energy very quickly, which makes that energy system useful. Creatine itself is made of three amino acids: arginine, glycine, and methionine. Your body can synthesize creatine from those amino acids, or you can get it as a supplement.

BrentWhen we use the word creatine, we're typically talking about a white powder mixed in water. Is that how it's usually consumed, or do people take it in other ways?

Scott Forbes: That's typically how you consume it. Creatine monohydrate is a water molecule attached to creatine. Dissolving it in water is a great way to take it, though mixing it in water isn't strictly necessary—it just makes it easier to ingest than dry scooping.

Scott Forbes: And, you know, dry scooping, creatine, for example.

BrentI take it with a glass of water after my morning meal and it doesn't bother my stomach. What are the negative side effects?

BrentI take it typically after my morning meal it doesn't bother me. What are the negative side effects.

Scott Forbes: Creatine is one of the safest supplements on the market. Across thousands of studies, side effects are rare. Less than 5% of the population experiences minor GI distress.

Scott Forbes: That usually happens during a loading phase where people take 20 grams per day for 5 to 7 days to saturate their muscles. Taking a lower daily dose minimizes those side effects while still providing similar benefits.

Scott Forbes: And then, you can still get, very similar benefits.

BrentWhen you say GI distress, you mean a stomach ache?

Scott Forbes: Exactly. Just a little gurgling in the stomach.

BrentSo there's no concern about long-term harm—it's just uncomfortable?

Scott Forbes: Absolutely not. There is no real negative side effect associated with creatine. Some think it stresses the kidneys, but at recommended doses, there is zero evidence of kidney stress. Kidney dysfunction was only reported in extreme case studies involving massive doses over 200 grams per day.

Scott Forbes: At recommended doses, it is very safe.

BrentWhat are the recommended doses?

Scott Forbes: For a loading phase, people take 20 grams per day split into four 5-gram doses (morning, lunch, dinner, bedtime) for about a week to saturate muscles. Then they move to a maintenance dose of 3 to 5 grams per day.

Scott Forbes: Taking a lower dose of 3 grams per day will also eventually saturate your muscles, though it takes closer to four weeks instead of one week.

Scott Forbes: So it might take like four weeks, for example, to saturate your muscles.

BrentI take around 5 grams in the morning using a slightly heaped scoop. How would you contextualize 5 grams for someone unfamiliar with measuring it?

BrentHow might you contextualize five grams for somebody who's not familiar.

Scott Forbes: A level teaspoon is equivalent to 5 grams. A heaping teaspoon would be around 6 or 7 grams.

BrentCreatine doesn't really have a strong taste. It might be slightly bitter, but it's easy to drink mixed in water without tasting awful.

BrentYou're not like, it's really bitter or it tastes awful.

Scott Forbes: It has virtually no taste. Supplements like beetroot juice can improve performance, but taste terrible, which keeps them from going mainstream. Creatine has no taste at all.

BrentIs the loading phase necessary for someone taking creatine for general health, or is it mainly relevant for weightlifters who want rapid results?

BrentYeah.

Scott Forbes: The main difference is how quickly your muscles saturate. If you want results immediately, consider loading. But for 99.9% of people, simply taking 3 to 5 grams daily will build up muscle creatine over time and yield the same long-term benefits.

Scott Forbes: Most people take 5 grams daily because a little residue might remain at the bottom of the glass, ensuring you still hit at least the 3-gram minimum target.

BrentSo the loading phase is optional: 20 grams daily for seven days (split into four 5-gram doses), followed by 3 to 5 grams daily for maintenance. I mix mine in water in the morning after eating.

BrentIs that how it's typically ingested?

Scott Forbes: Yes. We studied timing and found it doesn't matter whether you take it before or after exercise, or before bed. The goal is simply maintaining muscle saturation over time.

Scott Forbes: Timing isn't critical—just mixing about a teaspoon with water daily is sufficient.

BrentThere's a common belief that you need to drink significantly more water throughout the day when taking creatine to get the full benefits. Is that accurate?

BrentSo can you tell us whether that's right or wrong and if it is right? Why do am I drinking more water?

Scott Forbes: It's partially true. When you start taking creatine, it draws water into the muscle cell. However, muscles regulate water content well, so you won't have waterlogged muscles indefinitely.

Scott Forbes: Studies show that after eight weeks, fluid balance resets. Muscle tissue is naturally about 75% water, so initial supplementation draws in a bit of extra water temporarily.

Scott Forbes: It isn't necessary to drink massive amounts of extra water just because of creatine.

BrentThis clip is from our episode on skin cancer with Doctor Anna Pavlick. Doctor Pavlick is a medical oncologist with over 20 years of experience treating skin cancer patients, currently practicing at Cornell University. Skin cancer is highly preventable and manageable if caught early.

BrentIt is very treatable. Learning what to look for takes little time and helps you manage risks effectively.

BrentCan we talk about what skin is? It's the body's largest organ, but we rarely view it like other internal organs. What is skin, and how should we think about it?

Anna Pavlick: Skin has several layers and acts as a protective barrier for internal organs and muscles. It consists of the epidermis (outer layer), dermis, and subcutaneous tissue below.

Anna Pavlick: When evaluating skin cancer, depth matters much more than surface width for patient outcomes.

BrentDoes it function similarly to other organs like the heart, kidneys, or liver, where specific processes occur?

BrentIt's just not as obvious.

Anna Pavlick: Every organ has a role. The heart pumps blood, kidneys filter toxins, and skin protects everything inside. It has a critical job because when skin is severely damaged, such as in burn patients, the risk of infection and systemic dysfunction rises dramatically.

Anna Pavlick: Everything goes haywire when your skin barrier is disrupted.

BrentWhat are the most common types of skin cancer?

Anna Pavlick: There are three main types. Basal cell carcinoma is the most common in adults. It grows slowly when surface basal cells are damaged by UV radiation. It is extremely rare for basal cell carcinoma to spread elsewhere in the body.

Anna Pavlick: Dermatologists typically remove basal cell lesions routine-wise without needing ongoing oncology monitoring, unless they are neglected out of fear and allowed to grow unusually large.

Anna Pavlick: When left unchecked, they can require medical intervention prior to surgical removal. The second most common type is squamous cell carcinoma.

Anna Pavlick: Squamous cell carcinoma stems from chronic UV damage. It is frequently seen in farmers, people living at higher altitudes, and organ transplant recipients on immunosuppressive drugs. Dermatologists manage these with excision or Mohs surgery, and they rarely spread unless left unchecked for extended periods.

Anna Pavlick: The third most common is melanoma. Though third in frequency, it is the most deadly because it easily penetrates into blood vessels or lymphatic systems, spreading metastatically throughout the body.

BrentIs severity ranked in that same order: basal cell as least severe, squamous cell second, and melanoma as the most severe?

Anna Pavlick: Absolutely.

BrentBasal and squamous cell carcinomas are usually very treatable and rarely scary if addressed promptly.

BrentIn typical cases of basal or squamous cell spots, what does treatment and follow-up look like?

Anna Pavlick: Those patients rarely need an oncologist. Lesions are usually small, scaly spots or areas that bleed and refuse to heal, frequently appearing on the nose, ears, face, or balding scalps.

Anna Pavlick: A dermatologist will perform a shave biopsy to send to pathology. If confirmed as basal or squamous cell, the patient returns for local excision or Mohs surgery, which removes tissue layer-by-layer using microscopic evaluation.

Anna Pavlick: Pathology tells us is it squamous cell. Is it basal cell. Dermatologists will call the patient back and say you need to come back in. This is a basal cell or squamous cell. And we either do a local excision or we do a mole surgery, which is just a very technical way of removing a skin lesion. But they do it with microscopic assistance, so they shave a little layer off.

Anna Pavlick: Because Mohs surgery evaluates tissue margins under a microscope during the procedure, it preserves healthy skin better than standard excision.

BrentStandard removal of basal or squamous cell spots doesn't shorten life expectancy or cause systemic issues once removed, correct?

BrentOnce removed by a dermatologist, you just maintain routine monitoring.

Anna Pavlick: Yes. Having one skin cancer puts you at higher risk for others due to prior UV exposure, so patients typically visit their dermatologist 2 to 4 times a year for surveillance.

BrentDuring those surveillance visits, the dermatologist examines the skin surface to evaluate whether any spot requires further action.

Anna Pavlick: Dermatologists perform a full-body skin exam using a dermatoscope—a hand-held magnifier that provides detailed views of skin lesions to decide if a biopsy is needed.

Anna Pavlick: For patients with many moles, doctors look for the "ugly duckling"—a mole that stands out as darker or larger than the rest—to biopsy for safety.

BrentThis clip is from our episode on heart health with Doctor Arthur Agatston. Doctor Agatston created the Agatston score, which measures heart calcified plaque via calcium score CT scans. He also developed the South Beach Diet. As a cardiologist, he provided exceptional insights into heart risk and diagnostic scans.

BrentHe is a pioneer in preventive cardiology, and it was wonderful having him on the show.

Arthur Agatston: We have incredible new diagnostic tools available now. The Kraft test measures insulin response after a glucose drink, revealing far more about metabolic health than hemoglobin A1c alone. We also understand the distinct benefits of resistance training over purely aerobic exercise.

Arthur Agatston: We can now continuously monitor blood pressure without inflating a cuff. Genetic testing has also become far more affordable and informative in recent years.

Arthur Agatston: We are in a golden age of medical science, even if healthcare delivery lags behind.

BrentYou created one of the original innovations: the CT calcium score scan. This non-invasive scan measures coronary artery plaque buildup.

BrentThe Agatston score calculates 10-year heart attack risk based on calcified plaque in coronary arteries. But hard plaque isn't the only plaque that leads to heart attacks. How does plaque cause heart attacks whether calcified or soft?

BrentHard plaque in the arteries. But that's not the only type of plaque in the arteries that can cause a heart attack. So we you speak a little bit to you can correct any of that if that's wrong in terms of calcium score on the CT scan and what's happening with plaque in the arteries and how is plaque causing a heart attack calcified or not?

Arthur Agatston: Historically, cardiovascular risk relied on Framingham scoring (blood pressure, smoking status, and cholesterol levels). However, standard total and LDL cholesterol levels poorly predict individual heart attack risk, as most heart attack patients have average cholesterol numbers.

Arthur Agatston: Pathology studies in the 1970s revealed that total plaque volume (calcified plus non-calcified) best predicts heart attacks and strokes.

Arthur Agatston: Atherosclerosis begins early and progresses over decades. Early CT scanners took several seconds per image, causing heart movement blur.

Arthur Agatston: Sub-second acquisition technology allowed us to freeze the heart image cleanly to evaluate coronary calcium precisely.

Arthur Agatston: Calcified hard plaque itself doesn't trigger heart attacks directly, but reflects total underlying plaque burden.

Arthur Agatston: Soft fatty plaques swell, rupture, and form small blood clots. These initial ruptures heal over with scar tissue and calcium, leaving a record of past plaque ruptures.

Arthur Agatston: Irregular, calcified vessel walls alter smooth blood flow, creating turbulence that accelerates further plaque deposition, particularly near arterial branch points.

Arthur Agatston: Lumpy, bumpy vessel contours disrupt fluid dynamics, accelerating local silt-like plaque accumulation over time.

Arthur Agatston: Plaque consistently develops near blood vessel bifurcations due to localized flow turbulence, similar to sediment deposits along river bends.

Arthur Agatston: Fluid dynamics dictate that blood flow slows along inner curves, promoting plaque deposition in those precise areas.

BrentTraditional markers like LDL and total cholesterol work reasonably well across large populations, but fail to reliably predict heart attack risk for specific individuals.

BrentIndividual cholesterol numbers often don't correlate with actual disease, making direct imaging via CT scans far more actionable.

BrentDirect arterial imaging reveals early plaque formation long before a clinical heart attack occurs.

BrentInitial minor plaque irregularities disrupt smooth flow, creating turbulence that speeds up subsequent buildup.

BrentDo you think measuring standard cholesterol markers is obsolete compared to direct CT scanning, or do standard blood markers still offer value?

BrentStandard blood markers have value, but we have historically overestimated their diagnostic reliability for individual risk.

Arthur Agatston: Standard markers are poor individual predictors. I treat patients with cholesterol over 300 who maintain clean arteries into their late 90s, whereas others with cholesterol under 200 develop severe early heart disease. A calcium score of zero indicates near-zero short-term heart attack risk.

Arthur Agatston: Coronary plaque begins decades before clinical symptoms appear, making early CT imaging essential for targeted prevention.

Arthur Agatston: And the other point that you made, the arterial sclerosis starts really early. If you're heading for a heart attack in your 60s or 70s, you already have plaque in your 30s or 40s. And now we actually can can image that. And depending on the family history, genetics, metabolic health, we we can see who and who we become more aggressive at at young ages.

BrentThis clip features Doctor Thomas Seyfried on the metabolic theory of cancer. Doctor Seyfried is a professor of biology, genetics, and biochemistry at Boston College. He argues that cancer is primarily a metabolic disease requiring nutritional ketosis and carbohydrate restriction alongside treatment.

BrentHe advocates shifting how medicine addresses cancer prevention and therapy, presenting deeply researched, thought-provoking perspectives.

Thomas Seyfried: If healthy individuals received high-dose radiation and chemotherapy standard for cancer patients, they would become extremely ill rapidly.

BrentHope yeah, I think.

Thomas Seyfried: Cancer is a mitochondrial metabolic disease driven by glucose and glutamine fermentation. Cancer cells cannot efficiently switch to burning ketone bodies or fatty acids for fuel.

Thomas Seyfried: Would you recommend water-only fasting to achieve ketosis quickly for someone managing metabolic markers or elevated A1c?

BrentI am a researcher, not a clinical physician. Fasting should be approached carefully under proper medical supervision.

BrentIt's not enjoyable. There's some suffering involved.

Thomas Seyfried: Abruptly starting water fasting with existing metabolic dysregulation can be dangerous. We advise a gradual low-carbohydrate stair-step transition first.

Thomas Seyfried: Adapting gradually builds metabolic flexibility, making eventual fasting far smoother and safer.

Thomas Seyfried: Biomarkers like blood glucose, C-reactive protein, A1c, and triglycerides improve significantly during therapeutic fasting state adaptation.

Thomas Seyfried: What specific diet protocols do you utilize in your research studies?

Thomas Seyfried: We do not mandate one universal diet; any nutritional approach that successfully achieves low glucose-ketone index (GKI) levels works.

BrentDifferent dietary approaches—from ketogenic to carnivore—can effectively lower individual GKI ratios.

Thomas Seyfried: Patients monitor their GKI responses to specific foods directly, learning which items spike blood glucose and interrupt ketosis.

Thomas Seyfried: Tracking GKI provides immediate feedback to guide food choices effectively.

BrentHow frequently do you personally eat dessert?

Thomas Seyfried: Perhaps once a week. The focus is knowing how quickly your body can return GKI numbers to target range afterward.

Thomas Seyfried: Short intermittent fasts help reset blood glucose and ketone balances effectively after occasional indulgences.

Thomas Seyfried: GKI tracking serves as an objective tool empowering individuals to manage metabolic health parameters independently.

Thomas Seyfried: I'm not telling anybody what they should do and should and shouldn't do. Well, let me let.

BrentMe ask the question a little bit differently. How often do you eat dessert?

Thomas Seyfried: Continuous glucose monitoring is useful, but tracking both glucose and blood ketone levels provides the complete metabolic picture needed for super-fuel efficiency.

Thomas Seyfried: Do you see public perception shifting toward wider acceptance of metabolic therapies and ketogenic research?

Thomas Seyfried: Interest has grown significantly since our early research applying ketogenic diets to epilepsy management and cancer models.

Thomas Seyfried: Metabolic therapies target fermentable fuels like glucose and glutamine, weakening tumor microenvironments without generating systemic treatment toxicity.

Thomas Seyfried: That's good. But that only tells you what your blood sugar is. It doesn't tell you what your ketone levels are because it's the ketones. It is the ketones that are the super fuel. And when you lower glucose, you need to replace the something, something else. And that ketone body is the something else. And that's what generates the super energy efficiency within our cells.

Thomas Seyfried: So lowering glucose is great. But you got to balance it with an elevation of ketones. And we don't have a tool available now they're developing these tools continuous glucose ketone monitoring. They're just not available for the public at this point.

BrentDoesn't it feel like the the the tide is turning a little bit in that the awareness of the ketogenic diet, with, with all of its controversy, it's got to be at an all time high. People's awareness of their own biomarkers related to inflammation and related to blood sugar and related to cardiac health. That's got to be at an all time high.

BrentPeople seeking alternatives to, you know, the the widely accepted dogma seems to be at an all time high. So don't you see the trend turning and in your direction related to related all this?

Thomas Seyfried: Yeah, we started it all. People have to forget about that. We were the first ones to really put an emphasis on this was because we did it for cancer. The don't forget, I worked in the epilepsy field for decades before we started to switch deep into the cancer. We were working on ketogenic diet for managing epileptic seizures, but it was kind of a niche in that group of children that have epileptic seizures.

Thomas Seyfried: So we learned an awful lot about ketogenic diets for managing epileptic seizures, which are many, many children in the world are managing epileptic seizures using ketogenic diets. When we switched to cancer, oh my God, you can't do this. You can't do that. You know, it's it's hard. It's like dangerous. A cancer patient was told that if you switch to a it's dangerous.

Thomas Seyfried: And we're giving these little kids ketogenic diet to manage their seizures. It's dangerous. Compared to what doxorubicin and radiation. You think ketogenic thought is more dangerous than then? Poisonous chemicals and radiation. Are you crazy? You know we don't know anybody who's died from therapeutic ketosis.

BrentIf I'm the top cancer doc at Sloan-Kettering and I'm listening to this and I'm disagreeing with you, why am I disagreeing with you? What am I thinking? What's going through my head?

Thomas Seyfried: Okay, well, there's several reasons. Number one, you lack knowledge. You haven't read the science. That's number one. Number two, you don't believe in the science. That's that's another issue. And number three, you're not allowed to do it because the system will not allow you to do it.

BrentI find your first two to be respectfully, they're not that charitable. And so the let's the most charitable of the three is, hey, I'm not allowed to do it. I'm aware of the science, but I'm not allowed to do it. So you're telling me there's some set of rules at the hospital or the insurance company that say, hey, you cannot advise your patients to be on a ketogenic diet?

Thomas Seyfried: It's sometimes not advisable for them, what they want to do, invariably, is you must do, rigid standard of care, if you want to do a little keto on the side, that's great. But my, my, my argument is, is if you did metabolic therapy up front, you wouldn't need to do all that toxic stuff in the first place, and you would modify the toxic stuff so it wouldn't be so toxic.

BrentWell, so you're saying if you could wave a magic wand and just change how I'm just picking Sloan-Kettering. I don't know anything about Sloan-Kettering. And you could change the way that we're treating cancer at some at some top cancer hospital, the patient would come in and you would say, hey, the first thing we're going to do is we're going to think about your blood glucose and your ketones and your glucosamine, and we're going to get that into a place where it's really healthy.

BrentAnd then we are going to look at the more invasive treatment options instead of what's happening today, which is going straight to those in basement. Invasive treatment options.

Thomas Seyfried: You're absolutely right.

BrentBut isn't the concern there that they that the cancer is metastasize? It's growing at a rate where I don't have the luxury of time.

Thomas Seyfried: The cancer can't live without glucose. And glutamine. So you would you would then immediately start off once the patient gets into the nutritional ketosis, you go right after that. Glucose and glutamine. Don't forget nutritional ketosis reduces inflammation. Let me let me tell you something. They're arguing that, oh, the cancer is resistant to radiation and chemo and immunotherapies because it's so acidified and inflamed.

Thomas Seyfried: And the reason the acidification and inflammation is coming from the waste products of glucose and glutamine fermentation metabolism, when the cell takes in large amounts of glucose, it craps out lactic acid into the microenvironment as a waste product. And now we have discovered sucks in the acid as the waste product of the glutamine analysis pathway, the glutamine waste product, this succinate, those two are creating a resistance of that tumor cell against standards of care.

Thomas Seyfried: And yet you keep trying to break through the acidification when the acidification is caused by not targeting glucose and glutamine together. If you did that, the cancer cells become super vulnerable to low doses of chemo and small doses of radiation. So we understand very clearly how to manage cancer without toxicity. The problem is that the field is based on standards of care written in granite, and they will not allow metabolic therapy to come in, because if it works and it works really, really well, what the hell is going to happen to the whole cancer industry?

BrentThank you so much for listening. I hope you have a wonderful holiday and a great year ahead. We're excited for everything coming next year. We have fantastic guests scheduled and recorded, and we look forward to sharing those and continuing to learn together on Death Clock.

BrentDeath Clock is recorded in Boulder, Colorado and San Francisco, California. Produced by Patrick Gudino, music by Patrick Lee, and hosted by Brent Franson, founder and CEO of Death Clock.