The Power of Diet and Lifestyle: A Conversation with Dr. Matt Caulkins

In a recent conversation, Dr. Matt Caulkins, a family medicine resident, shared his insights on the role of diet and lifestyle in managing metabolic health. His approach, which emphasizes patient empowerment and education, offers a fresh perspective on tackling chronic diseases such as obesity and type 2 diabetes.

Pioneering a New Approach

Dr. Caulkins’ journey into the world of low-carb and ketogenic diets began when he followed in the footsteps of his colleague, Laura, who had paved the way for this approach in their medical practice. Laura had started ordering fasting insulin tests and calcium scans for patients, a practice that was not common among their peers. When Dr. Caulkins joined the practice, he continued this approach, using these tests to better understand and manage his patients’ metabolic health.

The Power of Group Medical Visits

One innovative approach that Dr. Caulkins and his wife, Laura, implemented was the concept of group medical visits. They used continuous glucose monitors and held sessions every two weeks to review everyone’s readings. They taught patients how to eat low carb and how to react to what their continuous glucose monitor was showing. This approach not only improved patients’ A1C levels but also empowered them to take control of their health.

The Role of Diet in Managing Metabolic Health

Dr. Caulkins emphasizes the importance of diet in managing metabolic health. He points out that the current medical system often incentivizes the prescription of new medications over lifestyle changes. However, he believes that diet and lifestyle changes can be more effective in managing metabolic diseases. He often spends more time discussing these changes with his patients, even if it means extending the appointment time.

The Carnivore Diet: An Ongoing Conversation

When asked about the carnivore diet, Dr. Caulkins stated that while he hasn’t had any patients on this diet yet, he is open to working with patients who choose this path. He believes that it’s always about discussing the risks and benefits and that aggressive risk stratification with calcium scores can be done to monitor the patient’s health.

The Future of Medicine

Dr. Caulkins’ approach to medicine, which emphasizes patient empowerment and education, offers a fresh perspective on tackling chronic diseases such as obesity and type 2 diabetes. His work stands as a testament to the power of diet and lifestyle changes in improving health outcomes. His innovative methods, such as group medical visits and the use of continuous glucose monitors, provide a blueprint for how medicine can evolve to better serve patients in the future.

Time Stamps

TIMESTAMPS:

04:21 – Discussing Importance of Fasting Insulin Levels and Patient Care

04:43 – Insulin-Sensitive vs. Insulin-Resistant Patients

05:07 – Laura’s Experience and Pushback on Lab Tests

05:20 – Introduction to Calcium Scan (CAC Scan)

05:27 – Connection Between Insulin Resistance and Calcium Score

06:10 – When to Consider Getting a Calcium Scan

06:53 – Ordering CAC Scans for Patients with Family History of Heart Disease

07:16 – CAC Scan’s Ability to Detect Soft Plaque

07:36 – Peter’s Example of Early Detection through CAC Scan

08:25 – Alternative Methods to Detect Soft Plaque

09:08 – Dr. Matt Caulkins’ Anaphylactic Reaction to IV Contrast

09:25 – Dr. Matt Caulkins’ Unpleasant Experience with IV Contrast

09:43 – Improving Medical Education for Metabolic Health and Nutrition

10:21 – How Nutrition Affects Non-Communicable Diseases

11:07 – Motivating Medical Students to Learn About Nutrition

12:01 – Top-Down Change and Factors Influencing Healthcare

12:26 – Breaking Unhealthy Cycles in Healthcare and Food Industry

12:42 – The Three-Body Problem: Food, Healthcare, and Pharmaceutical Companies

14:12 – Overcoming Inertia in 15-Minute Visits with Patients

14:16 – Group Medical Visits for Diabetic Education

14:36 – Quality Improvement Project on Group Medical Visits

15:22 – Using Continuous Glucose Monitors in Group Medical Visits

15:42 – Power of the patient and physician

15:51 – Introduction to Dr. Westman

16:00 – Dr. Westman’s background

16:35 – Dr. Westman’s encounter with the Atkins diet

17:00 – Dr. Westman’s research and work with low carb diets

17:15 – Low carb conferences and collaborations

17:35 – Observing the impact of low carb diets on patients

18:00 – Weight loss and health improvements

18:26 – Changing the narrative around chronic progressive diseases

18:44 – Obstacles in prescribing diet and nutrition

19:23 – Misaligned incentives in medicine

20:00 – The impact of billing and complexity on patient care

20:57 – Incentive to put patients on new medications

21:28 – The ambiguity in medication management

21:51 – Balancing time in residency clinic

22:35 – James Miller’s experience with the carnivore diet

22:57 – Dr. Matt Caulkins’ thoughts on the carnivore diet

23:23 – Dr. Rob CWIs and the carnivore diet

23:59 – Patient experiences with different diets

23:45 – Working with patients on different diets and discussing risks and benefits

24:13 – Most concerning metric for carnivore diets: Apo B or LDL

24:36 – Monitoring lab work and evaluating improvements

25:02 – Satiety per calorie (SPC) argument and its role in patient diets

25:38 – SPC as an innovative and disruptive idea

26:43 – Concerns about introducing SPC without trials or case studies

27:51 – Potential issues with SPC scores and food industry influence

28:49 – SPC blind spots and limitations

29:26 – The role of food industry in popular diet programs

30:06 – The potential for open-sourcing SPC for physician customization

30:15 – Final thoughts on metabolic health and lifestyle changes