Human Performance Outliers interviews Dr. Palmer – The connection between mental and metabolic disorders

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Show notes –

Human Performance Outliers Podcast

Episode 164 with Chris Palmer, MD


  • 6:08 My work right now is mostly focused on metabolism and how it relates to mental disorders
  • 7:08 Mechanics of metabolism
  • 8:52 Metabolic abnormalities in mental disorders have been well established since the 1960s 

A different view of mental illness

  • 11:10 A different perspective on mental disorders
  • 12:26 Metabolic disruption exists across the entire spectrum of mental illness severity, from anxiety disorders to schizophrenia
  • 13:42 The bidirectional relationship between mental and metabolic disorders
  • 15:44 Quantifying brain metabolic dysfunction in research vs clinically
  • 17:34 The insulin resistant brain has defective functioning
  • 20:28 Wide range of therapeutic interventions

Diet and disorders

  • 22:13 A bad diet does not cause mental disorders
  • 25:37 Surging incidence of mental and metabolic disorders over the last 20 years
  • 32:07 Over diagnosing vs. hard statistic: Suicide rate and surging deaths of despair
  • 33:54 Coexistence of two epidemics
  • 36:00 Dr. Palmer’s personal dietary practices

Ketogenic dietary intervention for mental disorders

  • 40:31 Ketogenic dietary intervention and treatment resistant depression
  • 41:31 Ketogenic dietary intervention and treatment resistant schizophrenia
  • 43:48 Full remission not a cure


  • 44:48 Research effort
  • 49:47 Flaws in nutrition research
  • 51:15 Tiers of research study evidence from anecdotal case reports (very low quality) to randomized controlled studies (gold standard for discovering causality)

US Dietary Guidelines Flawed

  • 52:46 US Dietary Guidelines repeatedly ignore existing randomized controlled study data that exist in the best medical journals
  • 54:54 The politics of dietary guidelines and nutrition “science”
  • 55:32 Ketogenic dietary intervention perceived as “quackish”
  • 57:07 The standard, but incorrect nutritional advice harms people
  • 1:01:59 Quantifying improvement with dietary Intervention

Harvard Research

  • 1:02:52 Dr. David Ludwig from Harvard received $12 million grant for a weight loss study
  • (See “useful links” below for more information)

Symptoms and monitoring

  • 1:04:27 Clinically quantifying response to the ketogenic dietary intervention
  • 1:05:24 Metabolic syndrome criteria: high blood pressure, high triglycerides, low HDL, but don’t include LDL at all
  • 1:06:26 Blood pressure and pulse are a window into metabolic health
  • 1:07:44 Symptom monitoring


  • 1:11:33 Diet is a complicated thing that includes social, financial, physiological, and personal ramifications
  • 1:15:42 Common sense illustrates the current dietary state of many Americans is not working

Gut microbiome

  • 1:17:51 Gut microbiome, permeability and mental disorders
  • 1:18:51 Gut microbes make hormones, neurotransmitters, neuropeptides
  • 1:20:35 Changes in your diet change your gut microbiome
  • 1:21:10 What works in animal studies may not work in humans
  • 1:22:12 We are decades away from understanding probiotics
  • 1:26:36 Supplemental probiotics may take patients out of therapeutic ketosis


  • 1:29:30 Caution: People with disorders need professional help and support to apply therapeutic dietary interventions. There are dangers. has a list of professionals who may be able to help.
  • This isn’t an “our lawyer’s made us say it” kind of warning. We mean it. Please discuss the information in this website with your own healthcare provider.

Useful Links

Human Performance Outliers Podcast Episode 164: Chris Palmer, MD

  • Contact information for hosts Shawn Baker, MD and Zach Bitter can be found on Human Performance Outlier’s episode’s webpage.
  • Listen notes uses voice-to-text technology to create a full transcript which can be found here. You can find it located below each podcast. While it is rough, readers may find it useful.

David Ludwig, MD’s clinical trial

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