The Checkup with Doctor Mike
The Truth About Seed Oils, Food As Medicine, and RFK Jr. | Kevin Klatt PhD RD
Wed, 23 Apr 2025
I'll teach you how to become the media's go-to expert in your field. Enroll in The Professional's Media Academy now: https://www.professionalsmediaacademy.com/Huge thanks to Kevin Klatt for appearing on this episode. Follow him here:Instagram: https://www.instagram.com/kcklatt/?hl=enTwitter/X: https://x.com/KCKlattLinkedIn: https://www.linkedin.com/in/kcklatt/00:00 Intro1:23 The Field Of Nutrition Right Now09:34 What We Actually Know14:32 High-Fat Foods/Cholesterol25:50 Food As Medicine36:14 Customization Of Care47:52 Patients Getting Misinformation54:09 Purveyors Of Misinformation1:05:36 Nutritionists vs Dietetics1:16:29 Who Should You Go See?1:34:19 Pharmaceutical Advertising/Influencers1:39:31 Good/Bad Supplements1:47:42 MAHA / RFK Jr.2:11:28 Magic Wand Nutrition Changes2:28:23 Seed Oils2:41:13 TakeawaysHelp us continue the fight against medical misinformation and change the world through charity by becoming a Doctor Mike Resident on Patreon where every month I donate 100% of the proceeds to the charity, organization, or cause of your choice! Residents get access to bonus content, an exclusive discord community, and many other perks for just $10 a month. Become a Resident today: https://www.patreon.com/doctormikeLet’s connect:IG: https://go.doctormikemedia.com/instagram/DMinstagramTwitter: https://go.doctormikemedia.com/twitter/DMTwitterFB: https://go.doctormikemedia.com/facebook/DMFacebookTikTok: https://go.doctormikemedia.com/tiktok/DMTikTokReddit: https://go.doctormikemedia.com/reddit/DMRedditContact Email: [email protected] Producer: Doctor MikeProduction Director and Editor: Dan OwensManaging Editor and Producer: Sam BowersEditor and Designer: Caroline WeigumEditor: Juan Carlos Zuniga* Select photos/videos provided by Getty Images *** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional **
Chapter 1: What is the current state of nutrition?
In this episode, I sit down with Kevin Klatt, PhD and RD, who is a research scientist and instructor at UC Berkeley's Department of Nutrition Sciences and Toxicology. He's earned his PhD in molecular nutrition from Cornell University and completed his dietetic internship at the National Institutes of Health Clinical Center.
Basically, he's the guy who actually reads, teaches, and performs the nutrition studies everyone loves to quote. We dive into great detail throughout our conversation, unpacking why nutrition seems messier than ever, focusing specifically on the viral claims around eggs, seed oils, and the food as medicine mantra.
Kevin does a great job in laying out the guardrails you can trust amidst all the noise. What I'd like for you to pay special attention to is how he answers my complex questions. He rarely gives a simple soundbite answer like your typical podcast bro guest. Instead, he focuses on the nuance to make sure you're getting the most accurate and unbiased information.
That's what experts are supposed to be doing. Anyway, I hope you learn as much as I did throughout this conversation. Please welcome Dr. Kevin Klatt to the Checkup Podcast. Nutrition. It's become a bit of a buzzword. Least controversial topic. Right? Most people agree nutrition is important, but they agree for vastly different reasons. Participate in vastly different food camps.
It used to be left, now it's right, then it's left, then it's right. I think the field of nutrition is the most confusing it's ever been. You're an expert in the field. Ostensibly, yeah. Although people don't like the word expert. I was going to say, don't call me that.
But unlike most podcasters these days or health gurus or health podcast guests, you truly are an expert because you've actually put in the time to do the research, to understand what is being said, to understand when someone quotes a research article, what was studied, what was missed, where the limitations are.
What's your gut take on the field of nutrition right now if you were to give a banner for it?
Oh my goodness. I mean, the field of nutrition, I feel like is often very separate from like the popular understanding of nutrition.
Like we have an NIH nutrition roadmap that was released a couple of years ago that heavily embraces like precision nutrition, understanding inter-individual variability, understanding more about food composition, how it affects health, both in the longterm and chronic disease. And then in the short term, like how in the hospital do we feed patients better to improve outcomes? Um,
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Chapter 2: What are the misconceptions about food as medicine?
Chapter 3: How do high-fat foods and cholesterol affect health?
And so sometimes the questions aren't, um, I think adequate, uh, things like are eggs good or bad, you know, that's always in the media. And there's so many first principles in nutrition science that I think are violated by that question on its own. I always take these questions and turn them into a study design.
And you have to ask, if you're going to do a trial of are eggs good or bad, you immediately have to ask, well, what are people eating instead of the eggs? And so are eggs good or bad are going to immediately be a relativistic answer of like, Are eggs good or bad relative to lentils or to red meat?
And there's an infinite number of these trials that you can do that I think gets at a major issue in nutrition. We don't have a placebo in our trials. And so you have essentially infinite pairwise comparisons across foods. And nutrition is inherently interested in the dose-response relationship.
In pharma studies, you're trying to do all of your pharmacokinetics early on to optimize for the dose that's going to lower your target and then not have side effects. In nutrition, we care about high, medium, and low and everything in between there. And so you can imagine this egg question.
We've got now infinite comparators across many different doses, and you can quickly come to a 65-arm trial that's never going to happen. Yeah. And even then, that would only be certain for the population that you studied it within. Are they high risk at baseline? Are they going to be somebody who's a hyper-responder to dietary cholesterol and their blood cholesterol levels?
There's all these effect modifiers. But that, I think, illustrates the questions that we're asking sometimes are not the right ones, both in the literature and then also in the public sphere.
So will we never know are eggs good or bad?
I think the question is like, it's like, are eggs good or bad for like, for who? Um, and their eggs are like nutrient dense foods that I think, uh, I mean, I'm not here to endorse any food in particular, but like, um, the impact of them on a dietary cholesterol, like on LDL cholesterol, it's like quite small.
And I think, you know, if you're somebody who's at elevated risk, you might be counseled to consume less, um, And if you're somebody who's not, the general population data largely doesn't implicate them as at least anywhere near the top of nutritional priorities anybody should be coming up with.
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Chapter 4: What should you know about misinformation in nutrition?
intervene and significantly sort of alleviate that choline stress so like obviously a vitamin supplementation is going to do a whole bunch more if somebody is like deficient at baseline and you need a lot fewer participants because you just expect a bigger effect right but in like a well-nourished population like the u.s like i don't think a vitamin a supplementation is going to be like a magical necessarily so you need a huge number of participants
Yeah.
You need a lot more participants to see that much smaller effect and to handle all the variation that exists. And so same with chronic diseases. Like it depends on, are you recruiting people with high blood pressure at baseline? How high the more modest and closer to like a relatively, um, you know, or homeostasis is maintained a relatively healthy state.
Like to see diet effects, you tend, they tend to be much smaller and you need a bigger sample size to see them confidently. And so that's a problem for our nutrition research infrastructure. The ability to recruit hundreds of patients like you would do for a pharmaceutical trial is extremely difficult.
It's very, very hard to do that in any meaningful timeframe with the current way that we fund nutrition science now and the research infrastructure that we have.
With the Galaxy Watch 7 or the Galaxy Ring and the Samsung Health app.
Why do you think there's so much disagreement when it comes to the consumption of, let's say, animal products or saturated, high saturated fat content foods and its impact on cholesterol and thereby impact on cardiovascular disease?
Yeah, I mean, I think there's few people debate that like saturated fat raises LDL cholesterol. There's a bit of an effect modification by the food matrix there. So we talk about these nutrients, but like you can get saturated fat from meats or dairy and different types of dairy. And the relative effect of saturates on LDL varies a bit with those foods. But.
I think you find very few people arguing that replacing saturated sources with mono and polyunsaturated sources isn't going to reduce LDL. I think a lot of people question... The second part of that equation. Yeah, does that change in LDL meaningfully reduce cardiovascular events, which can be influenced by its effect size? It can be small in some individuals.
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Chapter 5: Who should you consult for dietary advice?
Can we take the data that we've gotten from statins, their effect on impacting LDL cholesterol and, in general, the cholesterol profile, seeing the reduction in the ASCVD risk score and events, and then say, well, if we're seeing these... substitutions in certain fats lower the LDL cholesterol and the cholesterol profile, shouldn't we expect to see the same or is it not as simple as that?
I think that's one supporting line of evidence, but it's not a direct one-to-one. So all drugs lower LDL. There's many drugs out there. They lower it through different mechanisms. We don't even 100% know the mechanisms by which dietary fat composition changes lower LDL.
um they do a similar thing of like obviously there's enhanced clearance of ldl from the plasma compartment by the liver there's also some debates about whether there's reduced cholesterol synthesis for the mechanism of how they actually lower blood cholesterol but um we would expect that ldl lowering to produce beneficial effects i think the big question becomes like what are potential off-target effects of the diet so if you go like
super high in polyunsaturated fatty acids, you might at some point... Create a new problem. Yeah, there might be a toxic effect at some point. And finding the dose response data there is pretty limited. You're often relying on epidemiology. I know the cardiology world is kind of like right now at the point where it's like the lower the better on LDL. Yeah.
and diet is like recommended as a major way to as a lifestyle way to help control ldl but um that effect size is going to vary quite a bit and i don't think you can do anything with diet to get down to like less than 30 or 40 there's these old um sort of like simian diet like sort of mirroring this like super high plant-based diets lots of soy protein uh lots of high pufa oils and
And people can get pretty substantial, like 15 plus percent lowering in LDL cholesterol from these diets. But that's not getting you down to below 40 necessarily.
Well, it's also the same when I screen people for cholesterol and I find their LDL to be above 200. I'm almost telling to them, this is probably not because of your diet. This is a genetic issue. Because to get it that high is...
Yeah, it's tough. I mean, we've seen it in the era of carnivore keto diets where people are getting like, if you're getting 80% of your calories from fat and you're escaping PUFAs, then the natural fat composition of the foods you're eating is getting you like 40 plus percent of calories from saturates.
And so we've seen people get like super really high and like it comes down with dietary switches. But apart from those like obscure scenarios, I try and orient people like, Let's see if we can get down like 10 to 20 points with a lot of dietary changes. And people vary like the nature of the genetic issue that they have. It's leading to their cholesterol being high.
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Chapter 6: What are the differences between nutritionists and dietitians?
But food is medicine also like tends, I see a lot of hyperbole around it that makes me quite cautious. Like, Oh, olive oil, polyphenols are going to like cure you of breast cancer. And I'm like, It comes with this weight of having this massive treatment effect. And there is, again, Evans, the DASH diet having close to first-line pharmacological therapy for blood pressure lowering.
And I don't want to undersell that at all. And I want people to appreciate that what they're eating on their plate every day does impact their health. Um, but it's definitely like overstating it and I think makes it very prescriptive when there is a lot of flexibility. Like we, nutrition has not always done a good job of tailoring the diet to an individual's culture preferences.
Um, and there's a lot of ways that you can take dietary interventions and adapt them to, um, Whatever your socioeconomic status is, whatever your religious beliefs are. Food is medicine sort of takes the very small subset of foods that we have studied, which are mostly like there's a lot of like love for the Mediterranean diet.
And there's nothing like that we know of that's like so uniquely amazing about the Mediterranean diet. It's just that like nutrition is like science.
Happens to study it.
Yeah. Science is founded in like Western traditions. And so they got interested in the Mediterranean, but like you could probably have a Japanese traditional Japanese diet, traditional African diet, all that. If we put the money and resources into understanding those foods, the food composition and design trials around it, um, that you would find similar benefits to the Mediterranean diet.
When you look compositionally at the foods, there's no reason to believe that like It's all that magical. So it puts a bit too much mysticism around food for me. It's not about the food. It's about the totality of a number of interventions across their nutrients.
It's like a food lifestyle.
Yeah, yeah. I want something that conveys a similar message but more timid. Food almost is medicine. Cause I, you clinically, you see the dark side of this.
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Chapter 7: How can diet impact chronic disease management?
Yeah. You get the, the diabetes prevention program and then like trial in the nineties and, you know, a few publications that come out from it that start to show that like, you know, the degree of adherence to the low fat diet and the weight loss is like highly predictive of not progressing onto type two diabetes, like to late nineties, early two thousands, you see these publications pop out.
And so by like,
2002 2004 ada is putting out their position statements and you can track it across the 90s they always kind of said beyond the evidence at least the way that we look at it now like lifestyle is important weight is probably a risk factor like council on weight loss but it gets more i think the impetus for and focus and the guidance like really starts to get hammered in and around 2002 where they're like we've got the dpp trial now which is still a super landmark trial you look back on like
we know that it randomized either to lifestyle or to metformin or just to control. And the lifestyle and metformin do quite similarly and quite well in preventing a number of individuals, a large majority of individuals from progressing from prediabetes to diabetes. And like, that's, prevention 101. If you want to call that food is medicine, but all those people are eating different foods.
They were all had sort of their lifestyle counseling individualized to what their current state was. Um, and just, again, it focused a lot on weight loss. Um, and there were like other dietary goals, but it would, this was like even pre the era where like there was a big focus on like reducing sugar, sweetened beverages. Like that was not like a major component of the DPP per se.
Um, so yeah, like the people, I think we're,
want it's like fine-tuned hyper prescriptive super granular and that's fine if you've done all the big think things leading up to it I think people have to realize there's like diminishing returns for the most part yeah and you know maybe like you individually will like benefit a ton from this supplement that's great and I'm not here trying to like gaslight you if you think something does something amazing but for the population at large the tools of nutrition research can at best for the
broader guardrails that you should be following. And then it's, you know, it takes more and more trialing and one type stuff if you want to like fine tune the details later on. And then you should be seeing a medical professional if you have like very specific issues or concerns. Yeah.
Yeah. This is where doctors take a lot of, smack talk where they say doctors don't know anything about nutrition or my doctor has never talked to me about nutrition.
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Chapter 8: What are the key takeaways about seed oils?
Yeah, and I know that's like what grandma used to say. And a patient will come in and say, is it terrible that I have ice cream once a month or I have a hot dog? Because I saw this study from some classification that said processed meats increase rates of colon cancer by X percent.
And I'm like, look, it kind of is in moderation, but what moderation means to you might not be what moderation means to someone else. So we have to be careful about how we say it. But in reality- when I'm talking to patients who are living in real life, and when I say real life, I mean not the concierge medical population that are millionaires and billionaires that have a chef traveling with them.
Yeah, exactly. So that is kind of a unique population because it's not real life. Like I'm talking to people who have jobs, who have children, who have multiple jobs, multiple children and are stressed out and what is right for them. Yeah.
And for me, it's more about trying to remove some of the bad habits or limit some of the bad habits rather than think about boosting immune system or boosting health or health hacking. And people view that negatively on social media because they say, oh, it's because you're not as advanced as the experts on the Huberman podcast.
You don't understand the research that they're looking at and you're just being simplistic. What is the counter to that? So I can use it in the future.
Yeah. Oh, well, I mean, there's not like a quick counter, which I think it's gets back to this problem. Um, but I mean, to like unpack that, I think, you know, people are, I guess the other experts that are providing hyper prescriptive advice, I would just always encourage people like a real and real like clinical nutrition where, I mean, you're getting five,
five minutes to talk about diet, maybe max, like even where in nutrition, you have an hour, like to a real diet, like a dietitian has an hour with a consult for a patient.
Like you're doing like a whole diet history, a whole assessment of all of their, whatever they've had to clinically done to them, their biochemical labs, their body, what we call anthropometrics of body waves or come waist circumference, anything that they,
might inform upon their nutritional status before we then talk about like, what are your values and preferences and, and kind of what foods do you even have available to you? And like then thinking about like, what changes can we make?
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