Tetragrammaton with Rick Rubin

Guest: Dr. Paul Saladino
Date: March 14, 2025
Episode Summary & Detailed Breakdown

Overview

In this profound and thought-provoking episode, Rick Rubin sits down with Dr. Paul Saladino, a physician known for his exploration of functional medicine, elimination diets, carnivore/animal-based nutrition, and the critique of many mainstream medical practices. The conversation traverses Dr. Saladino's personal journey through various health paradigms (from raw vegan to carnivore and beyond), his critical view of Western medicine's symptom-focused approach, the root causes of chronic disease, individual food sensitivities, the role of plant toxins, and the science and controversy surrounding diet culture. Throughout, both Rubin and Saladino explore food not only as fuel, but as powerful information for the body, with huge implications for health, disease, and modern dietary misconceptions.

Key Discussion Points & Insights

1. Medicine, Burnout, and Work-Life Balance

[00:24 – 03:39]

• Saladino's career began as a physician assistant (PA), inspired by medicine but wary of the unhealthy work-life balance he witnessed in his physician father:

  • “I saw him get really out of balance in his life... I never wanted to be that.” (Saladino, 01:06)
  • Personal sabbatical: Mountain biking, hiking PCT from Mexico to Canada, before returning to medicine with a clearer purpose.

• Early experience in cardiology as a PA highlighted the limitations of the "box-thinking" in Western medical specialties.

• Profound realization: Treating symptoms rather than digging for root causes is insufficient for true health.

• Quote:

  “It really felt like we were just treating a symptom and we weren't getting to the root cause.”
  (Saladino, 02:31)

2. Western Medicine vs. Functional/Root-Cause Medicine

[03:39 – 05:57]

• Western medicine compartmentalizes (silos) organ systems, leading to missed connections between different parts of the body.
• Example: Takotsubo (‘broken heart’) cardiomyopathy as a clear mind-body connection.
• Saladino discovers pioneers like Jeff Bland and the functional medicine movement:
  • “Not simply making the symptom go away, but why did the symptom come.” (Rubin, 05:49)
  • Rebelling against the mainstream notion that patients are "broken at their core" and only pharmaceutical intervention is possible.

3. Diet as Information, Not Just Calories

[07:02 – 07:47]

• Saladino emphasizes that food is information, not simply calories:
  • “We give people... microgram or milligram quantities of drugs to affect the system profoundly. We are eating kilogram quantities of food, and that is a lot of information coming into our body every day.” (Saladino, 07:19)

4. Personal Diet Evolution: From Raw Vegan to Paleo to Carnivore

[07:53 – 12:25]

• First experiment: Raw vegan diet. Lost significant muscle mass, suffered severe GI issues (embarrassing gas in clinical settings).
  • “I lost about 20 pounds of lean muscle mass... bordering on gaunt.” (Saladino, 09:12)
• Transition to Paleo: Inspired by functional medicine and personal feedback (including being rejected on a date for being too skinny).
  • “I started adding meat back to my diet at that point... meat along with vegetables and fruits and nuts and seeds.” (10:59)
• Persistent issue: Eczema and asthma never fully resolved.

5. Food Sensitivities and Autoimmunity

[12:25 – 15:32]

• Allergic responses range from classic IgE (anaphylactic) to chronic, subclinical immune activation.
• Many autoimmune conditions (eczema, psoriasis, MS, depression, type 1 diabetes) may be triggered from immune reactions in the gut, possibly from food.

6. Individuality in Food Reactions; The Role of Elimination Diets

[17:01 – 22:16]

• Immune system programming is "infinitely complex."

  • "That's just a personal process of discovery.” (Saladino, 17:15)

• Most common triggers: Plant foods, but some react to animal foods (egg, dairy, even beef or lamb).

• Signal vs. noise: The power of radical elimination (e.g., carnivore) to clarify what foods work.

• Quote:

  “When you can lower the noise, you can see the signal.”
  (Saladino, 22:13)

7. Carnivore & Animal-Based Diets: History, Practice, and Evolution

[19:46 – 28:19, 61:28 – 65:00]

• Saladino references earlier experimenters and pop culture references (Jordan Peterson, Owsley from the Grateful Dead).

• Original strict version: Meat, salt, organs. Eczema disappeared, felt energetic and well at first.

• Long-term challenges: Muscle cramps, heart palpitations, "hypnagogic jerks" (sleep disruption), declining thyroid/testosterone—likely due to electrolyte deficiency from chronic ketosis.

• Led to reintroduction of carbohydrates (honey, fruit) and later raw dairy, forming his animal-based diet:

  • “Meat and organs, plus fruit and honey and raw dairy.” (Saladino, 102:04)

• Notable quote:

  “I do not subscribe to the idea that sugar in fruit is harmful for humans.”
  (Saladino, 64:19)

8. Local, Seasonal, and Ancestral Food Context

[25:18 – 27:58]

• The importance of eating locally and seasonally—effects on the microbiome, tolerance, and potential health benefits.
• The nuance of local honey and food sovereignty in Costa Rica.

9. Raw vs. Pasteurized Dairy

[38:16 – 47:34]

• Pasteurization: One-century-old adaptation to poor sanitation, but eliminates beneficial commensal bacteria in milk.

• Raw milk linked in studies to lower incidence of asthma, eczema, and allergies; tolerability may be increased due to microbiota and unique proteins.

• Fermentation further reduces lactose and plant defense chemicals, making foods (milk, vegetables) safer and more digestible.

• Quote:

  “I definitely wish I'd had raw milk growing up.”
  (Saladino, 45:44)

10. Plant Defense Chemicals: Oxalates, Phytic Acid, Lectins, and More

[49:23 – 55:06, 103:33 – 106:23]

• Seeds (grains, beans, nuts): Highly defended, may cause digestive or immune issues; grains contain gluten and phytic acid, beans and nuts have enzyme inhibitors.
• Fermentation (e.g., sourdough bread) makes some grains more tolerable but doesn't eliminate all antinutrients.
• Certain vegetables, especially leaves (spinach, kale), roots, seeds, and spices (turmeric), contain high oxalate levels and may cause health issues in some.
• Turmeric/curcumin: Potential anti-androgenic effects; benefit or harm is context-dependent.

11. Modern Food Quality vs. Ultra-Processed Foods

[55:06 – 61:17, 125:15 – 130:49]

• Industrial meat: Grain-finishing introduces pesticides, plastics, less healthy fats.
  • Emphasis on grass-fed, grass-finished; seek trustworthy local producers when possible, but perfection shouldn’t preclude improvement.
• Processed meat (deli, sausage, hot dogs): Higher risk (additives, microplastics).
• Dairy: Best when raw, from healthy animals; next best is grass-fed, less processed.
• Ultra-processed foods (crackers, cookies, chips): Considered "poisonous," cannot be redeemed by calorie restriction.

12. Controversies in Mainstream Nutrition: Seed Oils, Carbs, and Saturated Fat

[75:10 – 88:31]

• Seed oils (PUFAs): Viewed as a significant driver of mitochondrial and metabolic dysfunction, based on mechanistic biochemistry and evolutionary mismatch.
• Mainstream dietary advice often conflates observational studies (correlation, not causation) with experimental evidence.
• Red meat, eggs, and animal fats remain wrongly vilified.
• Counterpoint: Saturated animal fats, butter, and dairy appear neutral or beneficial, offering protective odd-chain fatty acids (e.g., C15, C17).

13. Eggs, Coffee, and Fiber

[88:33 – 99:48]

• Eggs: Highly nutritious, issues mostly for a minority with egg protein allergies.
• Coffee: Caveats regarding pesticides, mold, acrylamide, and especially caffeine’s potential impact on sleep quality.
• Fiber: Not a panacea; for some (especially with gut/immune issues), high-fiber grains may be problematic. Fruit/vegetable fiber typically better tolerated.

14. Supplements, Protein, and Protein Powders

[106:23 – 116:09]

• Supplements: Best used for genetic/personal context (e.g., methylated B vitamins for MTHFR).
• Protein: Favor animal protein for bioavailability; plant protein roughly half as usable.
• Collagen/bone broth: Complements muscle meat for glycine, balances methionine.
• Whey: Benefits immune system uniquely due to immunoglobulins.

15. Perspectives on Fasting, Weight Loss, and Ozempic

[133:23 – 140:28]

• Intermittent Fasting: Mixed data, risk of increased stress hormones, lower sex/thyroid hormones if overdone.
• Weight Loss: Emphasis on food quality rather than calorie restriction or pharma solutions (e.g., Ozempic).
  • “Ozempic is essentially a pharmaceutical antidote for a highly processed diet..." (Saladino, 120:54)
• Satiety and nutritional sufficiency, not calorie deficit, cited as keys to sustainable fat loss and high health span.

16. Ancestral, Weston A. Price, and Animal-Based Diets Compared

[130:49 – 133:23]

• Weston A. Price: Traditional diets prioritized meat, organs, some fermented grains/vegetables—reflected in superior oral/facial health.
• All healthy pre-modern diets included nutrient-dense animal foods, not plant-based exclusivity.
• Carnivore & Animal-Based: Modern distillation focusing on most bioavailable, least problematic foods for modern health context.

Notable Quotes & Timestamps

• “It really felt like we were just treating a symptom and we weren't getting to the root cause.” — Dr. Paul Saladino, [02:31]

• “It's all connected. It all works together... Western medicine still thinks this way.” — Dr. Paul Saladino, [03:45]

• “You are broken at your core. You were dealt a bad genetic poker hand... take this medication, which is actually a gift.” — Dr. Paul Saladino, [05:57]

• “We are eating kilogram quantities of food, and that is a lot of information coming into our body every day.” — Dr. Paul Saladino, [07:19]

• “I lost about 20 pounds of lean muscle mass. Horrible gas... they had complained to the business about how bad my gas was.” — Dr. Paul Saladino, [09:12]

• “There's pretty good evidence now... There's lower sort of chronic subclinical allergy... We see immune reaction, right? ...almost everything, even like Alzheimer's or Parkinson's, certainly depression.” — Dr. Paul Saladino, [13:16]

• “That's just a personal process of discovery. But I think there are some, like, metrics that we can use to kind of look at the most common things that people react to.” — Dr. Paul Saladino, [17:15]

• "When you can lower the noise, you can see the signal." — Dr. Paul Saladino, [22:13]

• “What’s interesting about the carnivore diet… is when you're eating only animal foods, you can do that longer without running into problems like nutritional deficiencies.” — Dr. Paul Saladino, [22:41]

• “I do not subscribe to the idea that sugar in fruit is harmful for humans.” — Dr. Paul Saladino, [64:19]

• “Ozempic is essentially a pharmaceutical antidote for a highly processed diet.” — Dr. Paul Saladino, [120:54]

• “A lot of what we hear in mainstream dietary recognitions has some science. It's just that it may not be a comprehensive scientific analysis.” — Dr. Paul Saladino, [85:52]

Timestamps for Important Segments

• Western medicine’s pitfalls & work-life balance: [00:24 – 03:39]
• Functional medicine, root cause thinking: [03:39 – 05:57]
• Diet as information, not calories: [07:02 – 07:47]
• Raw vegan / paleo journey: [07:53 – 12:25]
• Food sensitivities, autoimmunity, gut-immune axis: [12:25 – 15:32]
• Bioindividuality in food reactions: [17:01 – 22:16]
• Carnivore diet: history, benefits, and limitations: [19:46 – 28:19]
• Animal-based diet evolution & justification: [61:28 – 65:00]
• Raw/local foods, honey as ancestral food: [25:18 – 27:58], [70:51 – 75:10]
• Seed oils & metabolic health controversy: [75:10 – 88:31]
• Eggs, fiber, protein, supplements: [88:33 – 116:20]
• Perfect vs. good in food quality hierarchy: [55:06 – 61:17], [125:15 – 130:49]
• Difference between carnivore and Weston Price diets: [130:49 – 133:23]
• Fasting & longevity myths: [133:23 – 140:28]

Memorable and Practical Takeaways

• Holism over reductionism: Health is more than treating symptoms; interconnectedness of organs, diets, and disease is real.
• Animal foods at the center: For Saladino, nutrient density, bioavailability, and evolutionary precedent put meat, organs, raw dairy, fruit, and honey at the core of optimal eating.
• Ultra-processed foods as toxins: The combination of seed oils, additives, refined sugars, and grains is central to the modern health crisis—not carbs or fat per se.
• Individualization above dogma: Elimination diets may uncover surprises; what's “healthy” is often context-dependent, not absolute.
• Plant foods and defense chemicals: Not all vegetables are benign; antinutrients and defense chemicals in seeds/leaves/roots can be problematic.
• Raw and well-produced foods matter: Pasteurization, industrial farming, and processing disrupt the biological harmony of ancestral diets.
• Caution with fasting and pharmaceutical shortcuts: Focus on satiety, food quality, and metabolic health over restriction and symptom suppression.

This summary encapsulates the depth of Dr. Saladino's arguments and the natural, inquisitive tone of Rick Rubin's interview style. Their wide-ranging discussion provides a powerful resource for critical thinkers, nutrition enthusiasts, and anyone interested in the connections between food, health, and self-experimentation.