Metabolic Mind

Stress can disrupt sleep quickly, and when poor sleep becomes a pattern, the effects can reach far beyond next-day fatigue.

For International Stress Awareness Week, we’re calling attention to the broader health effects of chronic stress, including the way disrupted sleep can affect cortisol, metabolism, and brain function.

In this video, Dr. Scher discusses the glymphatic system’s proposed role in clearing brain waste during sleep, including proteins associated with Alzheimer’s disease. He also explores possible links between disrupted sleep, stress hormones, and brain energy metabolism.

He covers:

Type 2 diabetes is often treated as a chronic, progressive disease, but Dr. David Unwin has spent years showing that, for many patients, remission is possible through low-carb nutrition and a different approach to care.

In this episode, Dr. Bret Scher speaks with Dr. Unwin about how his work as an NHS primary care physician changed after he began focusing on insulin resistance, carbohydrate intake, and the underlying drivers of type 2 diabetes rather than blood sugar alone.

Dr. Unwin shares how his approach to care evolved and discusses published real-world findings on type 2 diabetes remission among...

Can stevia fit into a ketogenic diet? What does the evidence say about oxalates? And how might a ketogenic diet affect bone health?

In this episode of Metabolic Mailbag, Dr. Bret Scher and psychiatrist Dr. Georgia Ede answer listener questions about sweeteners, exercise, ketone levels, continuous ketone monitoring, and more.

They discuss:

Metabolic psychiatry is growing quickly, and clinicians and researchers around the world have been asking for a better way to connect and learn from one another to help move the field forward.

Dr. Bret Scher speaks with Dr. Kirk Nylen, Managing Director of Neuroscience at Baszucki Group, and psychiatrist Dr. Georgia Ede about MetPsy, a new global community for clinicians and researchers working in metabolic psychiatry.

The idea grew out of a needs assessment that drew responses from more than 500 people across 39 countries. The top request was clear: a dedicated space for community, collaboration, education...

Meal timing, morning light, sleep, and exercise can all influence circadian rhythm, with potentially important effects on metabolic health.

In this episode, Dr. Bret Scher speaks with circadian biology expert Dr. Satchin Panda about how our internal clocks work, what disrupts them, and how everyday timing choices can affect metabolism, brain function, and long-term health.

Dr. Panda describes how light helps synchronize the brain’s central clock, while food timing may influence clocks in other organs and tissues. He also breaks down why the timing of your first and last meals matters, what shift work ca...

Can ketogenic therapy help offset some of the metabolic side effects of clozapine while preserving its psychiatric benefits?

Dr. Deanna Kelly, a leading clozapine researcher, joins Dr. Bret Scher to discuss what she has seen clinically when ketogenic therapy is used alongside clozapine and other antipsychotic medications.

Dr. Kelly shares the case of a patient taking clozapine who also had diabetes and metabolic syndrome. After five weeks on a ketogenic diet, the patient’s glucose, insulin, and hemoglobin A1C returned to the normal range. She also explains why people taking antipsychotics such as clozapine or...

A recent study published in JAMA Psychiatry found that adults with ADHD had more than a fourfold higher association with cognitive impairment and dementia later in life. The finding doesn't mean ADHD causes dementia, but it raises important questions about what these conditions may share biologically.

In this video, Dr. Bret Scher breaks down the study and explores one possible connection: brain energy metabolism.

Researchers analyzed data from more than 187,000 adults and also found that people with a higher genetic risk for ADHD had a 35% greater likelihood of cognitive decline, even without an ADHD diagnosis...

ADHD is often described as a problem with attention or hyperactivity, but psychiatrist Dr. Georgia Ede argues that the condition is much more complex, involving executive function, dopamine regulation, and potentially brain energy metabolism.

In this episode of Metabolic Mind, Dr. Bret Scher and Dr. Georgia Ede take a deeper look at ADHD, from how it is diagnosed and treated to emerging research on nutrition and glucose metabolism, including questions about ketogenic therapy

Dr. Ede draws on years of experience treating ADHD, including her time at Harvard University, Smith College, and the Hallowell Center. She...

Does perimenopause make ketosis harder? Can a carnivore diet provide too much protein? And which nutrient deficiencies matter most for mental health?

In this episode of Metabolic Mailbag, Dr. Bret Scher and psychiatrist Dr. Georgia Ede answer listener questions about ketogenic therapy, menopause, carnivore diets, protein intake, and nutrition for mental health.

They discuss how hormonal changes during perimenopause and menopause can affect insulin sensitivity and ketone levels, and why some women may need to adjust their carbohydrate intake, exercise, or other aspects of their routine to maintain the same metabolic response.

They...

Some “healthy” foods may be working against your metabolic health.

In this episode of Metabolic Mind, Dr. Bret Scher examines how products such as agave nectar, commercial green juices, low-fat fruit yogurt, and açaí bowls can create a health halo while delivering large amounts of rapidly digestible sugar.

Dr. Scher explains how liquid carbohydrates, added sugars, and concentrated fructose may affect satiety, insulin response, hunger, and other markers of metabolic health. He also examines how front-of-package phrases such as “natural,” “low fat,” “made with real fruit,” and “superfood” can make certain products appear healthier than their nutrition l...

How did humans go from being deeply connected to our food to barely knowing where it comes from or how it was made?

In this episode of Metabolic Mind, Dr. Bret Scher speaks with experimental archaeologist and chef Dr. Bill Schindler about what human evolution can teach us about food, nutrition, and the way we eat today. Drawing on archaeology and his time with hunter-gatherer communities around the world, Dr. Schindler traces how human diets changed through hunting, food processing, agriculture, and eventually the modern food system.

A major turning point came with agriculture. Dr...

A new study claims ketogenic diets cause liver damage and early death. Here’s what you need to know.

A 2025 mouse study recently made headlines, warning that ketogenic diets may lead to fatty liver, high triglycerides, and a shortened lifespan.

But here’s the catch:

These findings were in genetically altered mice fed a 90% fat diet, filled with highly synthetic components, and they contradict what human trials have shown again and again.

In real people, ketogenic diets have consistently been linked to:

✅ Lower liver fat and improved liver enzymes

✅...

Can ketosis change symptoms of bulimia? Is low-carb eating safe in your 80s? And what really happens to digestion on a carnivore diet?

In this episode of Metabolic Mailbag, Dr. Bret Scher answers questions about ketogenic therapy for eating disorders, low-carb diets in older adults, carnivore diets and gut health, constipation on a ketogenic diet, and even a few easy keto movie-night snacks. He also looks at why being in ketosis may affect symptoms differently than simply eating low carb, what to consider when fasting later in life, and how to think about bowel habits and microbiome...

Alzheimer’s disease is usually discussed in terms of plaques, tangles, and genetics. Dr. Stephen Cunnane has spent years studying another piece of the puzzle: what happens when the aging brain can no longer use glucose efficiently, and whether ketones can help fill that energy gap.

In this interview, Dr. Bret Scher and Dr. Cunnane discuss the metabolic side of cognitive decline, including insulin resistance, brain glucose metabolism, and why metabolic health may play an important role in both prevention and treatment.

They cover:

College can be one of the most exciting times of your life, but it can also put enormous pressure on a brain that's still developing.

Psychiatrist Dr. Georgia Ede spent 12 years working as an on-campus psychiatrist at Harvard University and Smith College. In this video, she explains why college can be such a vulnerable time for mental health and how sleep, nutrition, alcohol, smoking, vaping, and other everyday habits may affect brain metabolism and resilience.

Dr. Ede explores the role of oxidative stress, why blood sugar and insulin matter for the brain, and how metabolic...

Does reducing carbohydrates improve metabolic health beyond what can be explained by weight loss alone?

Dr. Bret Scher breaks down a new randomized controlled trial published in Cell Metabolism that compared three diets in people with prediabetes and fatty liver disease: a ketogenic diet, a higher-carbohydrate Mediterranean diet, and a very low-fat, plant-forward diet.

One challenge with ketogenic diet research is that participants often lose more weight than those in comparison groups, making it difficult to separate the effects of carbohydrate reduction from those of weight loss itself.

In this trial, researchers provided...

For many women, the wellness strategies that carried them through their 20s and 30s can start to backfire in perimenopause. Changes in hormones, muscle mass, insulin sensitivity, sleep, and stress can make midlife feel like a completely different metabolic landscape.

In this episode of Metabolic Mind, Dr. Bret Scher speaks with nurse practitioner Cynthia Thurlow about why perimenopause can act like a metabolic stress test. They explore how midlife can change the way women respond to carbohydrates, fasting, exercise, meal timing, and other strategies they may have relied on for years.

As Women’s Health Mo...

Hannah Warren spent years living with severe bipolar I disorder before discovering metabolic therapies in 2021. Today, Hannah has been in remission for more than five years, is no longer taking psychiatric medication, and works as Metabolic Mind’s Community Engagement & Advocacy Manager, helping others understand the emerging field of metabolic psychiatry.

In this course module, created as part of Nutrition Network’s broader low-carb course for vegetarians, Hannah combines her lived experience with practical guidance for using vegetarian and vegan ketogenic approaches to support metabolic and mental health.

She explains how ketogenic therapy differs from gene...

How can clinicians become more comfortable using ketogenic therapy in mental health care? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Deanna Kelly about Live It, Launch It!, a training program designed to help clinicians learn ketogenic therapy by experiencing it themselves.

Dr. Kelly explains why evidence-based treatments can still take years to reach everyday clinical practice, especially when providers don't feel confident using them. To address that gap, her team recruited clinicians for a program that combined ketogenic therapy education with four weeks of personally following a ketogenic diet and published it...

How should we think about LDL and ApoB, and how much metabolic health changes the cardiovascular risk picture?

In this episode of Metabolic Mind, Dr. Bret Scher speaks with vascular surgeon Dr. Lily Johnston about cholesterol and plaque formation, along with the need to personalize cardiovascular prevention.

👉 Download our Make Sense of Your Cholesterol guide: https://metmind.co/cholesterol-listeners

Dr. Johnston brings a unique perspective as both a vascular surgeon who treats advanced blood vessel disease and a physician focused on cardiometabolic prevention. She discusses why ApoB and LDL can play a role in...

Is saturated fat really the villain it’s been made out to be? Or has decades of poor research and dietary policy misled us?

In this video, Dr. Bret Scher dives into the controversy surrounding RFK Jr.'s call to remove the cap on saturated fat, and the Wall Street Journal’s misleading take on it.

We explore:

✅ Why saturated fat doesn’t just mean pizza and ice cream

✅ The science behind whole foods vs. processed foods

✅ How carbs, fats, and metabolic health interact

✅ What the evidence really says ab...

Should LDL be treated? In this episode of Metabolic Mind, Dr. Bret Scher explains why the better question is who may benefit from LDL lowering, how aggressively it should be treated, and what outcomes matter most to the individual patient.

👉 Get our free 11-page Cholesterol Guide to better understand your lipid panel and prepare for a conversation with your clinician: https://metmind.co/cholesterol-listeners

Dr. Scher reviews two major trials that studied aggressive LDL lowering in very different populations. VESALIUS-CV looked at high-risk patients with serious vascular disease and found that adding a PCSK9 inhibitor red...

Is it possible to follow a diet that’s both vegan and keto? And can a diet like that be used as part of a care plan for bipolar disorder? In this episode of Metabolic Mind, Dr. Bret Scher speaks with author and advocate Dyane Harwood about how she uses a vegan ketogenic diet as part of her treatment for postpartum bipolar disorder.

Dyane shares how she first discovered vegan keto, why she started tracking ketones and net carbs, and what she eats in a typical day, from her vegan keto smoothie to tofu, avocado, nut butter, an...

Can therapeutic ketosis be considered for type 1 diabetes and bipolar disorder? In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard answer viewer questions about ketogenic therapy, type 1 diabetes, Parkinson’s medications, omega-3s, fasting, protein intake, metabolic rate, and why some protein foods are more filling than others.

They cover:

A red flag next to your LDL number can feel alarming, but LDL is only one part of a much larger cardiovascular risk picture. In this episode of Metabolic Mind, cardiologist and lipidologist Dr. Bret Scher explains how to read a cholesterol panel with more context and less fear.

Dr. Scher walks through LDL, triglycerides, HDL, non-HDL cholesterol, ApoB, Lp(a), and the triglyceride-to-HDL ratio. He also explains how the 2026 cholesterol guidelines use the PREVENT risk calculator, where LDL targets currently stand, and why individual risk factors, metabolic health, family history, and direct measures of vascular disease...

Can carnivore and vegan diets both be used as ketogenic therapies?

In this episode of Metabolic Mind, Dr. Bret Scher speaks with registered dietitian Denise Potter about two widely debated approaches to nutrition. They explore how each can be evaluated when someone is considering a ketogenic diet to support psychiatric, neurological, or metabolic health.

Denise brings more than 30 years of clinical experience, including approximately 20 years working with medical ketogenic therapies. She explains the importance of risk-benefit analysis, how clinicians can assess potential nutrient gaps, and how lab testing, supplementation when indicated, and individualized support may...

Animal-sourced foods are often framed as a problem for human health and environmental sustainability. In this episode of Metabolic Mind, Dr. Bret Scher speaks with forage agronomist and ruminant nutritionist Peter Ballerstedt, PhD (@GrassBased) about livestock, malnutrition, chronic disease, and why restoring metabolic health may require a broader conversation about nutrition and sustainability.

Peter shares his reaction to The Cholesterol Code documentary and explains why its message extends beyond cholesterol. He discusses how animal-sourced foods can fit into dietary patterns that may help restore metabolic health, why malnutrition can exist even when calories are abundant, and why...

The terms “low-carb” and “ketogenic” are often used interchangeably, but are they the same thing?

Not quite.

A low-carb diet can be a powerful tool for improving blood sugar, triglycerides, insulin levels, inflammation, and overall metabolic health. Ketogenic diets, on the other hand, involve a deeper level of carbohydrate reduction that shifts the body into nutritional ketosis, where ketones become a significant source of fuel for the brain and body.

That metabolic shift can be especially relevant when ketosis itself is part of the therapeutic goal.

In this video, Dr. Bret Scher wa...

Starting college can change almost everything about your routine, including how, when, and what you eat. For students using ketogenic therapy as part of their mental health treatment, that transition can take some planning.

In this interview, Dr. Bret Scher speaks with licensed mental health counselor Nicole Laurent about how students using ketogenic therapy with clinical support can navigate a college setting, where dining halls, dorm rooms, busy schedules, social events, and limited budgets can all affect food choices.

Nicole shares practical ideas for:

Every day, we make choices about what to eat. But how often do we realize how deeply these choices affect both our physical and mental health?

Today, an estimated 93% of adults in America are showing signs of poor metabolic health, which is a major contributor to many chronic conditions like heart disease, type 2 diabetes, obesity, and many psychiatric disorders.

The good news is that more people are recognizing the powerful role food plays in metabolic health. But with all the conversations about what to do next, like limiting ultra-processed foods or reconsidering saturated fat guidelines...

Do most people really need to eat less protein to live longer? In this episode of Metabolic Mind, Dr. Bret Scher responds to a new review getting attention for the claim that protein restriction may extend lifespan, and explains why that message can be misleading for older adults, active people, and anyone focused on metabolic health.

Dr. Scher walks through the biology behind the headlines, including mTOR, FGF21, animal research, and the limits of applying rodent data directly to humans. He also explains why adequate protein becomes more important with age, especially for preserving muscle, reducing frailty...

Can ketogenic therapy be safe for someone with heart disease, atherosclerosis, or a stent? Can you follow a ketogenic diet without losing weight? In this Metabolic Mailbag episode, Dr. Bret Scher answers viewer questions about ketogenic therapy, cardiovascular risk, anorexia recovery, pregnancy and nursing, schizophrenia remission, keto on a budget, and whether doctors learn about ketogenic therapy in medical school.

He covers:

How can clinicians use real-world patient data to personalize metabolic health care? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Jeff Pua, an internal medicine and obesity medicine physician, about obesity medicine, metabolic syndrome, nutritional ketosis, and what clinicians can learn from patient outcomes in everyday practice.

Dr. Pua shares how his approach has evolved from relying only on broad research categories to also paying close attention to individual patient experiments, blood tests, and lived experience. In his practice, he sees patients improve not only in weight and metabolic markers, but also in...

Can chronic stress undermine metabolic health, even when nutrition, sleep, and exercise are in place?

In this episode of Metabolic Mind, Dr. Bret Scher explains why stress recovery is an important part of metabolic health and how chronic cortisol and adrenaline activation may affect insulin resistance, blood pressure, inflammation, sleep, and long-term cardiometabolic health.

Dr. Scher breaks down the difference between short-term stress that helps us respond to challenges and chronic stress that keeps the body’s alarm system switched on. He also shares why stress recovery doesn’t have to mean an hour of medi...

Could GLP-1 medications play a role in treating bulimia or binge eating disorder? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Paige Gordon and psychiatrist Dr. Michael Lutter about Paige’s personal experience using a GLP-1 medication for treatment-resistant bulimia, and why researchers are beginning to explore the neurobiology of binge eating.

Paige shares how years of therapy and medication never quieted the overwhelming binge urges that drove her bulimia. After hearing someone describe their experience on a podcast, she began exploring GLP-1 medication and saw a profound change in her urges and eating pa...

Can ketogenic therapy improve symptoms, cognition, and metabolic health in people living with serious mental illness?

In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Judy Ford, Juliette Kyner (previously Juliette Ward), and Dr. Shebani Sethi about the first-ever randomized controlled trial of a ketogenic diet intervention in individuals living with schizophrenia spectrum disorder or bipolar I disorder with psychotic features.

The conversation explores what made this trial possible, from prepared meals and coaching to the structured support that helped participants stay engaged. It also highlights encouraging four-month findings across metabolic health...

Do GLP-1 medications improve metabolic health as much as they support weight loss? A new observational study in the Annals of Internal Medicine raises an important question about semaglutide, insulin discontinuation, type 2 diabetes, and what meaningful metabolic improvement may require.

In this episode of Metabolic Mind, Dr. Bret Scher breaks down a real-world study of more than 9,000 veterans with type 2 diabetes who were using insulin and then added either a GLP-1 receptor agonist, SGLT2 inhibitor, or DPP4 inhibitor. Despite semaglutide’s stronger association with weight loss, the study found similar insulin discontinuation rates across all three groups ov...

The questions around ketogenic therapy keep getting more layered, and your latest submissions reflect that. In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard tackle some of the most common questions about insulin resistance, ketosis, bone health, and a fun rapid-fire round on popular ketogenic products and practices.

In this discussion, you'll learn:

What does it look like to put bipolar II disorder into remission and become a voice of hope for others living with serious mental illness? Robyn Dobbins joins Hannah Warren from Metabolic Mind to reflect on how ketogenic therapy transformed her life, and what it was like to see her own story featured in The Cholesterol Code documentary.

In this conversation, you'll learn:

How do you know if you're actually in ketosis? Should you test ketones? And if so, what's the best method: blood, breath, or urine?

Dr. Bret Scher breaks down everything you need to know about ketone testing, including when testing matters, which tools are most accurate, and how to interpret your results based on your goals. Whether you're using a ketogenic diet for metabolic health, weight loss, or therapeutic ketosis for mental health and neurological conditions, understanding ketone testing can help you personalize your approach.

In this video, you'll learn: