#13: Dr. Spencer Nadolsky – Cholesterol, Genetics, & Carbs

Dr. Spencer Nadolsky

This is episode 13 of Evil Sugar Radio. In this episode, we interview Dr. Spencer Nadolsky. Dr. Nadolsky is a 3rd year medical resident with a background in athletics, having wrestled and played football for Michigan State University and University of North Carolina. And he’s not afraid to unleash with a fantastic rant about diet bloggers and the blogging world’s treatment of the medical profession.

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Episode 13 Overview

Here’s an overview of what we’ll be talking about in this episode:

  • Tell us about yourself.
  • Tell us about your recent experiment with high-carb, low-fat diet. Why are you doing this and what changes have you seen?
  • Why do people assign moral codes to diet?
  • Do low-carb diets push people towards binges and cravings?
  • Who is low-carb appropriate for?
  • You recently posted a study that as long as calories are kept consistent, protein vs. carb is largely irrelevant.
  • Another study you posted showed that diet and exercise is better than either alone. Is there a priority for one or the other?
  • Do you see any potential problems of high-fat, low-carb diets?
  • Talk about the paper you wrote for the Alan Aragon Research Review regarding Bulletproof Coffee and changes in lipid levels in your patients.
  • What about mycotoxins in coffee? Is that really an issue?
  • What are the actual changes in lipid levels that you see with Bulletproof Coffee or low-carb, high-fat diets more generally? Should people get their cholesterol tested?
  • What is the deal with carbs and triglycerides?
  • Are high-carb diets a problem over a long time period?
  • What is visceral fat and why is it a problem?
  • What’s up with carb backloading and other macro-cycling or manipulation plans? What’s the bottom line on fat-loss and macronutrients?
  • You said something recently like “Exercise isn’t good enough; you also have to lower your sedentary time.”
  • What tips can you offer for when science conflicts with your beliefs?
  • How did you make the low-carb to high-carb change?
  • How much is genetics involved vs lifestyle in terms of fat, health risks, etc?
  • What about genes and cholesterol?
  • You had a post about treating children that have familial hypercholesterolemia with statins. Are there dangers to that and alternatives?
  • What can people do to manage cholesterol issues?
  • What about fruit for diabetes management?
  • Is sugar evil?
  • If you could reform or upgrade the fitness industry, what two improvements would you make?

Show Notes

Get Lean RX
Leaner Living

Let us know what you think in the comments


  1. Just finished listening to the podcast and what can I say? GREAT show! I completely agree with Dr. Nadolsky on his comments about bloggers and so-called food/nutrition experts thinking they know more or better than doctors. So frustrating. I also enjoyed the discussion regarding carbohydrates. I, too, noticed a decrease in endurance during physical training when I am doing low carb. Loved the show. Thank you.

  2. I’m a bit confused. I notice that Spencer advertises on Jimmy Moore’s LivinLaVidaLowCarb site which pushes a very HFLC diet.
    Jimmy practices strict ketogenic and even wrote a book called Cholesterol Clarity. I was told I was prediabetic when I got an A1C of 5.9 3 yrs ago and with a low carb, high fat diet, I got it down to 5.2. That said, I noticed my thyroid numbers were sucking and my uric acid and fasting insulin were both over 7. So I began to follow Ray Peat. I’m losing some belly fat (perhaps different calorie intake?). Ray Peat has very different ideas on diabetes and is no fan of HFLC diet. I will know the verdict when I go for new tests. Any thoughts?

  3. Has anyone heard of John Kiefer who developed CarbNiteSolution and CarbBackloading? He is working with Dr. Rocky Patel, who is using this method on diabetics. In a nutshell, it’s basically ketogenic with small windows of high insulin spiking. Here is an interview where he explains the method….


    I just want to know if this is BS or unsafe or if it has extreme validity before I visit Dr. Patel and try this out.

  4. Elizabeth says:

    Whether someone is a blogger or not has nothing to do with whether or not they know better than doctors. If their information is well-researched, they most certainly can be. If we were to leave everything to “doctors”, there would be NO supplements despite hundreds, if not thousands, of studies supporting them. The comments regarding bloggers has to do with one thing and one thing only…the gatekeeper mentality. Physicians want to be sought for EVERYTHING, including things that they know nothing about, such as supplements. We have entered a new era of self care and patient-directed care. Embrace the change.

    • Hi Elizabeth I have no issues with supplements – in fact I am the director of the largest website that looks at supplement evidence http://www.Examine.com

      My biggest issue is when bloggers try to pretend like they know more than physicians in regards to many things. I have seen a lot of downright dangerous things. On the other hand I have actually learned a lot from some very smart non-physicians including the hosts of this show along with other prominent fitness guys (e.g. Alan Aragon etc). There is no way we can know everything, which is why researchers will always be near and dear to my heart.

      On the other hand I have seen way too many pubmed jockeys and self diagnosed internet cruisers do a lot of harm to themselves. Being an advocate for yourself is important but this should never take the place of seeing a doctor – e.g. folks that diagnose themselves with “adrenal fatigue” on the internet and bought a bunch of supplements when in fact they had SEVERE sleep apnea for many years that was undiagnosed. I have seen this too many times to count now.

      So having said that I love it when my patients come and know their stuff. It makes for a good discussion and best of all care likely 🙂


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