Franziska Haydanek: There's a lot of this that's extremely moralized where it's like, well, you just need to pull yourself up by your bootstraps and eat better. That has been a failing approach to public health for a really long time. And it all lets you do at the end of the day is just blame people for their poor chronic health conditions, which when your approach is pull yourself up by your bootstraps, pay for some supplements. I don't really know who that's supposed to help. That's not public health. That's all I know. Welcome back to I Did My Own Research. I'm Dr. Fran, and today I'm joined by Dr. Kevin Klatt. Dr. Klatt is a research scientist and registered dietitian who focuses on translation metabolism research. He attended Temple for his undergrad, Drexel for dietetics, and received his B.H.G. in molecular nutrition at Cornell University. He currently works as an assistant professor as well as an associate editor for the American College of Clinical Nutrition and posts online about the science that is happening in the world at KC Klatt online. Dr. Klatt, welcome to I Did My Own Research. Thanks for having me. I'm so excited to chat with you today because you have such a unique background with your education where you have both the dietetics portion and then you have your PhD and online you merge a lot of that and you really are such an expert in this space online. I'm really excited to just like hear, first of all, your educational journey, because it seems a little bit unusual. Yeah, yeah. It's a bit unusual on several fronts. I mean, I think your audience is a lot of... medical folks and medically oriented folks. And I don't know that everyone really knows like what a dietician is and how that differs from the nutritionist. yeah, so I, when I was in undergrad, I didn't really like go to any advising things. I might have had a very different career path if that had happened, but I, you know, was getting an interest in nutrition. My undergrad didn't have a nutrition degree. And I had a scholarship there that I didn't want to lose. And so I was like, oh, like, do I, what major do I pick here to get as many classes as I can to kind of like do nutrition without actually a degree title in nutrition, at least initially. And so I was like looking into it and I was like, okay, I want to think I want to be a registered dietitian for the clinical nutrition side of things. Cause there's not a clinical nutrition specialty really within medicine. And maybe we can. dive into the whys of that at some point, but at least when you look it up, like if you want to do clinical nutrition and be an expert nutrition, they always say become a dietitian. And then the more I looked into that though, it was like at the time bachelor's entry level, even the clinical side, but the science or sciencey side maybe was a little bit lighter. And then that's why I started to look into like, well, what's the route for PhD? And then kind of sub it onto there. There's very small number of PhD RDs. And so I was like a 19 year old. I, for some reason, like hyper fixated on like. we're going to do PhD, RD. And it's kind of exactly what ended up happening. But I actually majored in anthropology, biological anthropology in undergrad, because it was close to a build your own sciences major. It was fun. did like population genetics and medical stuff that I think is helpful. But I could take all the biochemistry and biostats and things that were all like prerequisites for dietetics. And then I did a short year at Drexel University for one year after and kind of rounded out the dietetics. didactic portion. So to become a dietitian in the US, you have to do a core set of courses, which is nearly a complete undergrad, but it's called the didactic program and dietetics or DVD. And once you have your DVD, you can qualify to do a dietetic internship, which is a one year immersive, heavy clinical, but you also do food service rotations and you do public health and community nutrition rotations. But of meeting specific competencies that are laid out. Usually about a 1200 hour internship that lasts about a year. And then you can sit for an exam. at the time point of going to Drexel, had rounded out most of the DPD. And then I'd sort of did the other weird route of I didn't do my dietetic internship right away. I was really like kind of eager for research. I found myself asking more of the Like, well, why do we say these things more than like, what do I do? So I was leaning more towards the research rather than the clinical side. And so I went and did my PhD at Cornell and then ultimately did my dietetic internship the year after before I went on to do a postdoc. Oh, that is interesting. Yeah. Some people do it that way, a small handful of folks, but not too many. It's a bit of an odd route, but it was sort of started with a... I don't want crazy college debt, because there were nearby universities with dietetics degrees, but it was just like, ugh, I don't want to give up the scholarship. So I kind of did a lot of mental gymnastics to make it work. then what did you do your PhD in? Like, what were you studying? Yeah, I went to Cornell, and so they have the Division of Nutritional Sciences there, which is a pretty classic old school nutrition department that's a mix of human, molecular, nutritional biochemistry stuff, as well as international and global. nutrition. if you train there, you kind of train in one of those four fields. I was sort of at the crossover of human and molecular. I worked in Marie Caudill's lab, which is a really like legacy. OG PhD RD did a lot of work in pregnancy. So a lot of her dissertation was some of the data that we still rely on to set the folate recommendation during pregnancy and folate, you know, it's a crowded field, particularly after the kind of NTD world happened in kind of 1998 when you have folic acid fortification recommendations. so she continued to do work in Foley, but jumped a little bit to work in a related nutrient, choline, that metabolically overlaps. And so I did some work in choline in pregnancy with her. And then at the time, I also had a co-chair over at the biomedical sciences department in the vet school that was doing more basic science work. So Marie's lab was like control feeding studies and human intervention trials, stable isotope tracing to understand metabolism, big focus on pregnancy. And then... More on the basic science side, I was working in a lab that their big focus was the hypothalamic-pituitary-ganatal axis and knocking out different proteins along that and rodent models and seeing what happens. But also they were doing some work in placental biology. so that's sort of where the two worlds met that Marie had done some work on what nutritional interventions were doing when you took the placenta at the end and did microarrays and RNA-seq type stuff and what was the impact of... nutrients on the molecular profile of the placenta and then kind of working with that basic science side of things and more cell culture and animal models. And so that sort of teed me up nicely to kind of have a bit of the in vitro and animal model experience and more molecular side of things. And then also the human trial biochemistry side of things as well. Yeah. It's always ⁓ interesting for me as a clinician who does not actually do any actual research, hear about the actual research that's being done by actual scientists. When I named my podcast, I was being a little spicy about it, because when we as clinicians have patients tell us, well, I did my own research, I'm like, I wish you would talk to an actual researcher. What it takes to do actual research is truly incredible. And us as clinicians are so thankful for those of you who choose to do this work that makes us understand our world better, because like, I could not do any part of my job if it wasn't for the people who did their actual research. Yeah, I always love when people say they did their own research and I was like, can we bond over changing mouse cages and pipetting for hours a day and writing grants? No, I can't. I can't bond with you over that because I didn't do that. Their version of research sounds much more like less stressful and more fun. Yeah. really like, you know, perusing some Facebook groups. It's a lot more, you know, a little easier for us. How did you translate that world into now being online and trying to kind of relay what you guys are learning in like actual science to like the lay public? Like, how did you get to being online to doing this? Yeah, I was actually online, but mostly Twitter focused since like 2013 or so and... I mean, Twitter now is obviously X or whatever we're calling it, is a totally different world. And I still pop in occasionally just to see how the world's on fire over there. But at the time, you know, it's a shame for current trainees. It was great. And like 2013 to 2017, you had this kind of peak of sci-com. You had really famous clinicians, researchers, all talking about the science. And I learned so much from it. I feel like I got as much out of it as I, way, way more out of it than I put into it. But there was a lack, and I think this is still true across a lot of spaces, that lots of people talk about nutrition. again, how many people have actually read the dietary reference intakes, know the history, know how nutrient requirements are estimated, understand the metabolism, and have that sort of training. was quite few people talking about it. So I started kind of early in my training, but I knew enough to least kind of call out why some of the messaging and interpretations of the research was... oversimplified and kind of being click baited. And this is also peak era of like the media funding model was changing and very click based. And so you would get all these headlines that also kind of dovetailed with a lot of defunding of clinical research and nutrition. So there used to be this network called the general clinical research centers that were used to do a lot of feeding studies. And as the funding for those was pulled by Francis Collins. the commodity boards took over. you'll notice in this time period, like 2012 to 2020-ish, you see walnuts, avocados, blueberries, eggs, et cetera, kind of like dominating the media headlines. And you know, this is a thing in nutrition, we don't have a placebo. So whenever you see a single food in a headline, it's like, well, the first question you should immediately ask yourself is what did the comparator control group eat instead? And so, you know, I was just... pointing out these basic things of kind of first principles of nutrition science. So like, well, we care about dose response relationships and we care about like, we don't have a placebo. So what's the comparator and kind of what are these nuances of study designs and nutrition that sort of start to overcomplicate the story. It's a lot different if it's almonds are amazing for blood lipid profile that sounds. cool and you can clickbait that. It's like, well, if almonds are better than a muffin made with coconut oil, sugar, and refined grains, like that's a much less impactful headline. But that's the reality of the science that we're dealing with and those sorts of complexities that I think made people think that error. think people still look back on it and be like, oh, nutrition doesn't know anything because one day it's this in the headlines and the next day this is good in the headlines. And it's, think that was mostly driven by kind of a media funding model change, plus a lot of people talking who'd didn't have training in nutrition and understand these kind of first principle differences of how nutrition is different than medicine and pharmacology and things. So I was kind of just talking about those sorts of things. I would blog a little bit. And then I was advancing through my own training and my own understanding. Like, you in 2013, I hadn't done a lot of mass spectrometry. By 2017, I could run a mass spectrometer. And so my ability to critique methods and statistical approaches just kind of grew. so, anyhow, I solve rigor and reproducibility things and the incentives in academia that I think really needed change. And so I would talk about these kind of various topics. another, like, I guess, big thing that I thought about and talked about was like, there's all these nutrition kind of issues in societies in nutrition, like the American Society for Nutrition and Academy of Nutrition Dietetics didn't necessarily always provide guidance and American Medical Association wasn't providing guidance, like GMOs is like a big hot topic. 2014 or so, and I had a blog post I wrote for ASN about American Society for Nutrition, about why is no one having a position statement on these things and providing the public with some basic guidance and taking a stance on things? And it's kind of wild to be 10 years later and feeling the same, where it's nutrition's all over the kind of maha landscape, and a lot of professional societies still say nothing about it. And there's this lack of an authoritative voice in nutrition. That's so interesting that I, because I've never, you I haven't looked for those authoritative statements from anyone, but I could see why without someone kind of saying like, like for me, it's easy, right? I can say like, ACOG says this, right? Like my body of like medicine is based off of this. And for nutrition, I get, you know, once, if you're not in it, you don't know, but that does make sense why it's kind of seems that there's such an opening for misinformation and changes to like whole... structures of how we're supposed to eat in this country because there's no one saying, these are the most basic parts of this. I think there's like a ton of interesting reasons for this too. Like there's no other nutrition specialty within medicine and the public immediately thinks of doctor. I mean, doctors get so much credit, you turn on any movie and doctors are scientists and clinicians and they know how to like run PCR and all this kind of stuff. And so people's idea of a doctor or physician is so... on a pedestal that they know everything. then you don't have, and nobody knows what a dietician is, how that's different than an nutritionist, which nutritionist is not a regulated term. So at least in the U S anybody can be a nutritionist. The public has no familiarity with dieticians, which are kind of like closest experts. But so yeah, you just don't have like a big society that is dominated by physicians that also the money that comes with those things. If you look at American Heart Association, American Diabetes, ACOG have a pretty large societies. you don't have that, there's no really equivalent of that. The Academy of Nutrition Dietetics is like the professional organization for dieticians, but they don't have like a yearly conference where there's massive controlled trials being publicized and all the nutrition science people are kind of like going to them and seeing what the big trial is, what the new practice changing research is. And then American Society for Nutrition is only a few thousand members. And it's sort of, think... There's bigger issues of nutrition started as like an agricultural in like agricultural chemistry. It was like the beginning of nutrition in the United States. And you know, you're just measuring the carbs, fat, protein, calories in foods and food composition type data. And so you, nest nutrition within the agricultural extension that we're kind of away from major medical centers for the most part. So, and then dietetics grew out of home economics and sort of, so like all of the historical sexism that comes there is still kind of present a little bit, or at least you see echoes of it today. And so you have this weird like nutrition science is done by PhDs historically and male PhDs, and then dietetics is done by women who kind of, it was seen as more of a woman's career. And then you don't have any medical specialty in nutrition. And so it's an, You take, lead that up to this point in time and there's a big discussion of like, well, who should be the authority? And a lot of people, think clamoring to be seen as the expert nutrition. Yeah. I mean, I would say as a clinician, and I have made this argument many, many times, is that like physicians cannot be also the experts in nutrition. And I talk a lot about like registered dietitians. think I am because I work in an office where we have a registered dietitian. So like all my pregnant patients get a referral to the registered dietitian. Anyone who has... gestational diabetes goes and sees her. All my patients who I diagnosed with PCOS, I offer for them to see her. So like, I am very familiar with having a registered dietitian, but one, that's like a privilege to me in my office and the way that my... healthcare system has set that up for us. But the majority, I would assume of other doctors don't have this luxury. And some of that falls to doctors who don't have the appropriate training. Like you said, for your internship, it's like thousands of hours of work that's done to be a registered dietitian. And you know, the government's currently telling us that now doctors, physicians, need to learn more about nutrition in medical school, as if that's gonna be the problem is solved now. doctors or physicians have learned 20 more hours of nutrition and therefore the chronic disease will go away. And you recently wrote a sub stack about this and really what the cornerstones are about what the HHS is proposing here. So I'd love for you to like go a little bit into that and like what is happening, like what they're saying we should be learning and really why that may not be the best choice for our patients. Yeah, I think I'm broadly supportive of doctors learning more about nutrition. And I think they, a lot of the groundwork is already laid there. Like you guys take metabolic biochemistry and things, you're like learning about what the vitamin does and, but tying that directly to clinical practice. And there might be a disconnect between like MS1, MS2, step one kind of stuff, and then what actually happens in year three and four. But I'm always amazed in talking with like my, I see patients for Danielle Blardo who's a cardiologist. And we've chatted about this a bunch of times, like, how many, how many times did you consult a dietician or interact with them in your medical training? And they're like, never, she's a preventative cardiologist. Yeah, you would think there'd be much more of a continuum of care on that. So I'm like a big fan of just like, even if it's one lecture hour that gets added to every medical school being like nutrition is a thing, it's real, it exists. There's many, you know, disease states that impact nutritional status and change dietary requirements. And you don't need to know them all, but you should like be coordinated care with everything from not only registered dietitians, but pharmacists who are involved in nutrition support and parental nutrition, nurses who are involved often in enteral nutrition, speech language pathologists who come into play when people have kind of swallowing difficulties and things. And so there's this whole nutrition care process that we all talk about in a language that Doctors don't know. I think it's very hard for dieticians even in the hospital. When you're trying to be like, okay, well, Aspen says, just American Society for Perineural and Endometrician, and their recommendation is to do this, then doctors look at you like, what acronym soup are you spilling at me? So if we could all talk the same language and all appreciate like, what are the indications for when nutrition interventions are warranted? That'd be great. I think that's what we need to do. And everybody kind of comes up with these arbitrary numbers of hours. I think they're saying 40 hours now, but everybody's counting what counts as an hour and what are they actually covering in their current medical curriculum? What counts as nutrition or not? But I'm, I want to make it clear, like this isn't a trade war between RDs versus MDs or anything. I just think we have. we don't have a good continuum at the moment and we should do things to improve that. And so there's already been work happening for a while. There was a large Delphi consensus statement on what the competencies for nutrition training for physicians should look like in 2024 in JAMA. And so the movement around like getting more nutrition into medical education has been happening for a while. Obviously that's a big conversation of like, well, what's the minimum that we can add because In the same way, the nutrition people want more nutrition for doctors, the genetics people want more genetics, and the psych people want more psych. And so everybody's fighting for those very few hours that happen in the didactic years and then in sort postgraduate training, where do you fit nutrition into specialties? so... I think there's a lot of agreement like, yeah, some should happen, but what that actually looks like boots in the ground is still hotly debated. But those consensus, I think statements were pretty big and many medical schools are already moving to incorporate it. I know I did my postdoctoral training at Baylor College of Medicine and in their foundations curriculum, they already had like nutrition and metabolism as a core foundation. so, you know, everybody was moving, I think in a good direction, but HHS now put out these their own competencies and they say it's based on this 2024 JAMA consensus. They don't really justify why they need their own and they're not just like endorsing. Like there's a very rigorous consensus building process behind the JAMA 2024 competencies and all the major players in, you know, nutrition physicians and dietitians and nutrition scientists were involved in that process. HHS did their own and there's, they don't really justify why again, they're doing it instead of the JAMA and then. If you read them, they don't really read like medical competencies a lot of the time, like the way that they're wording them. They're like hyper-specific of like using, knowing how to use a continuous glucose monitor and diet plan and that. And you're like, well, okay, like it's much more normal to say like. have an understand of emerging technologies involved in nutrition assessment and planning, and sort of have a competency where like, knows, assesses, demonstrates, like these are all the typical language about broader umbrella things. Because you want these things to be able to stand the test of time, not just like call out the one hot topic cross sectionally in this year. But the HHS companies, if you read them, they contain a lot of these like hyper-specific topics, specific lab tests that people should know. endorsement of like using nutraceutical interventions and supplementation. And then there's like a lot of talk of regenerative farming and there's like the normal stuff and that's worded a little bit strangely, but most of the normal things are there like understand food composition and understand like nutrition assessment and these things that sort of just copies off that JAMA 2024 piece. then there's dozens of hours where they start to basically invoke functional medicine, which if you, if you, I mean, they literally don't say refer to dieticians, but they do say refer to functional nutritionists. That's insulting actually. Yeah. Uh, dieticians are pretty, pretty riled up about this and sort of like, you know, we already have this framework and there's clear missing pieces and, a lot of people are trying to identify like, okay, you know, we got to fill out these new church physician training and then touch on reimbursement and how we actually implement this across our medical system. And so everyone's like geared up for that. And then these competencies are a little bit somewhat out of left field of like, what's the point of them other than if you're familiar with the folks in the orbit of HHS and Maha who are like Casey and Cali Means who own continuous glucose monitoring companies and TruMed that gets reimbursement for supplements and Mark Hyman who's got a whole functional medicine empire. And you know functional medicine where they talk about like for generative farming kind of randomly and say that our soil is so depleted of nutrients and kind of these hyperbolized clickbait fear mongery claims and big enthusiasm for arguably over testing and supplementation without indication. You see all of that appear in this. So I'm like, I don't know why they didn't just endorse the JAMA competencies. When you actually read it, I'm like, well, you can make a solid inference of why the people who were probably involved in this were. likely to benefit financially from it, which is just yet another conflict of interest that is coming out of the Maha movement that really doesn't reach the goals of making a healthier America. and I think, you, Dr. Jessica Norrick, make that a point so well online, like consistently and over and trying to point out those inconsistencies to the people who aren't paying as close attention. You know, I've kind of had my eyes on Casey Means for a little while, because I find her brother also, like, very sleazy in a way, because of all the things that you said. But if you're not paying close attention, know those ties, when these things come out, of course it sounds great. Make physicians learn more nutrition. Like, how would you argue with that? And I think that's like a lot of maha, right? When anyone comes out who has expertise and goes, here's why this isn't working, then people go, what, you don't want me healthy? You just want me in chronic disease? I'm like, I think... None of us want anyone to be in chronic disease, but this is not how we go about it, right? Like, same with like the environmental protections that we're losing. Like, so you want me to be healthy, so you're gonna focus on red dye, but we're not focusing on the poison you're putting in our water. Like, you're the... We're not taking the right thing seriously. And then on top of that, you add, you know, the grifting part into it. Now you're building that into the government. Like, it feels really gross. Yeah, it's very like right vibes. right problems, all the wrong solutions sort of thing. I don't know, I always joke, like, taking the red dye out of the Skittles doesn't make the Skittles healthy. It's like, why are we, that's where all the noise has been. And then you get like, it's pretty, nutrition has been really gimmick-ified of in the past year or so where it's like, okay, we're gonna eat beef tallow french fries instead of seed oil french fries. And it just, feels very unserious and it's a shame because it's burning through a lot of political capital that We last saw this with Michelle Obama where she tried to do a lot on nutrition and it just got so watered down. I the same conservative media that's like uplifting R.F.K. Jr. and everything that he's doing were the ones calling on Michelle Obama, the food police and the nanny state. And there they were considering real things about like, okay, well, how do we use all the levers of government, taxation, considering policy changes? considering campaigns to get people moving and all these sorts of things. there's, very few, I think, policy levers that government actually has and you need a Congress that's willing to legislate to actually impact why what ends up in our food environment and on our plate is kind of at odds with all the basics of nutrition. And I think Maha hasn't really had any serious look at like, they won a silver bullet of like, well, if we just get the dyes out, we'll be good. Or if we just get the seed oils out, we'll be good. And that is kind of just... making a mockery of the entire science of nutrition and how big of a problem this is. We have to look across the entire food system and pick a lot of economic winners and losers and saying from everything, what we grow, what we subsidize, how we produce it, how we manufacture it, how we process it, how things are taxed, how things are advertised, where they're placed on the supermarket shelves. You just go through the whole list of all the little things you could do to change that would start to impact kind of what... it's in our body. But when you believe that it's just the food dye that's added, you have a very unserious, you've got the wrong problem and so you're going to have the wrong solution. find the oversimplification of very complex problems very frustrating, especially like as a content creator, because then people like from in my field of OBGYN, for example, anytime I talk about inductions, people go, well, that's why we have the highest like more maternal morbidity and mortality in the world. I'm like, you think it's because of side-attack inductions that we have people dying and you don't think it's because of systemic racism, our lack of universal healthcare, our maternity deserts? Like, you think it's the pitocin? Or do you think it's no one can get their chronic condition managed prior to pregnancy and then they have a heart attack while they're pregnant? Like, which one do you think it is? But it's much easier to blame induction methods. It's much easier to blame seed oils. than to have to look at, where is your food coming from? How is our government protecting us? Like, how do we support people getting, not living in food deserts, first of all, and second of all, getting them food that's, made, like, nutritiously? Like, it's so much easier to be like, well, if we just take the red dye out. It's like the over... For the people who have done, like, the work like you have to really be experts in so much of this, to really understand for the most molecular basis to, the bigger... ways that our government impacts it, it's like insulting to say like, it's the red four, it's the red 40, and that's gonna make us healthy. Yeah. I mean, it's... The other part that I think really frustrates me is everybody is like demanding that we have an immediate solution. And I'm like, I don't think people realize how much we haven't studied nutrition seriously. Like, I mean, we know a little bit. One of the reasons I did my PhD in choline in pregnancy is because... the dietary recommendations for colon and pregnancy are derived from a study done in men. Like, you know, it's not about patriarchy in medicine. Like, and then when you actually start to like pull back the curtains on what the recommendations are and why they are what they are, there's so much we don't know in vulnerable life stages, like pregnancy, like lactation, like early life, we have very little data. Everyone's mad about infant formula, but you go and actually look to see, okay, if you look at trials where we've actually modified infant formula and measured health outcomes, how many do you have? Just a handful, there's not like a clear conclusion. And nutrition research is 10, if not 100 or a thousand times harder to do than pharmacology, because you're not just putting something in a capsule and comparing it to a placebo. You're, you can change the, like, you have many different levels of the nutrient within a food. You can change the background composition of the diet, because all these things interact. I mean, there's... a lot of different ways that you can look at this and you don't have a placebo, you have many different comparators. Like you want to say that red meat is bad, well, you've got to do a trial that compares it to chicken and pulses. And like, you you can have a 12 arm trial and still be like, ⁓ well, we need that a 13th arm. And that's not to be a doomer, but just to say that like, you've got to put way more resources into nutrition than you would. just a sort of pharmaceutical trial, but you look at the funding priorities and things and they've just never been there. And so what we do know, I think is kind of amazing and we've made a lot of progress in nutrition, but if you don't study it adequately and rigorously, then you're not gonna have high confidence results. Everybody claims to wanna be science-based, but then everybody wants an immediate conclusion with no real science behind it. And so that's like, I wrote something really early on on Substack, just basically been like, if Maha wants to change anything, like their legacy could be taking, you know, either adding a ton of money into the research funding budget, which obviously has not happened, and putting that towards not only nutrition, but environmental health research. And I called out some, there was a big, the National Children's Study that was mandated by Congress to be funded in 2000, that never really got off the grounds and was kind of... There's a whole bunch of reasons that flopped, part of it being that it was underfunded from the beginning. So basically back in 2001, you got the Human Genome Project coming out and we've been focused so much on genetics. There was a big recognition that environmental health, especially during childhood and pregnancy and developmental life stages where kids are really sensitive to developmental exposures, that we needed to study this better. And that cohort never got off the ground. It was basically canceled, I think in 2015-ish. Here we are in 2025. that study never got off the ground, we haven't repeated it. And so I had encouraged Maha to like, okay, well, your legacy could be really like doing that thing that we all acknowledged 25 years ago that we needed. Like you should do that. And so that in 25 years from now, we don't have to look back and say, we still don't have it. so, and that's like, it doesn't need to be this zero sum thing. Like we can make regulations now and try and change things now. You know, that's again, gonna involve picking an economic. winners and losers, which no one seems to have any appetite for in Congress. But you can do these small things like change the generally recognize a safe for food additives and reform that and all that kind of stuff that they've been talking about, which are really, really, really tiny incremental wins. Like we'll have probably in health statistics data, you won't be able to see an effect of it, but sure, let's do it. But then let's actually like prioritize funding research that's going to potentially have real impacts and able to create an evidence base that can stand up to bigger industries and things that are kind of questioning the quality of the science that we currently have. So yeah, I don't know. Watching the EPA get all of its regulatory capacity removed for everything from environmental pollutants and greenhouse gases. then the FDA hasn't even revoked the approvals for some of the artificial food colors. They've claimed to just be taking a deregulatory approach, or not using anything with the regulatory powers that they already have currently. And they're just working with industry to kind of get companies to remove them, which they already were kind of, I was already happening because of state level regulations that were occurring even before this administration. on the food front, there's really been pretty minimal that is really changing the quality of food. I mean, let's not get down on yourself here, Kevin. We now have Doritos that are like not- So I think we're really making big strides. Yes. And we have a protein Doritos now after the guidelines. they're good. Well, I feel so much healthier already. That's wonderful. It's just so frustrating, right? And I think for the people who pay close attention, especially who really have an understanding of like what could be helping us here and in the future. And it's just the wrong focus. And then you put in that layer of people who are going to have personal gains from this because they sell continuous glucose monitors in their business, even though everyone says that there's no research that backs it up. But now we're teaching the frontline physicians that we should be doing that when the rest of us are screaming about the things that can actually maybe make an impact if you just gave us the money to understand it better. Yep. We'll have more rich people with CGMs. And then, you like you look at the Supplemental Nutrition Assistance Program, which people might colloquially know as Food Stamps, and they cut the funding for all of the educators that were mostly dietitians that were working to help know, educate folks who are qualified for SNAP to make healthier purchases. So, don't have money for that, but we have, we can definitely tell everyone to do CGMs. wonderful. I mean, I think, you know, I work in the low resource areas for my patients. Like we literally started a food pantry in our office because our patients didn't have food, right? So the privilege that comes with some of this, these, like sometimes, you know, there are supplements that have some evidence behind them. And when you have a... medical condition that has an evidence-based supplement, I like to talk to my patients about that. But what kind of an asshole do I sound like when my patients can't put food on the table? I'm like, well, if you bought this $60 supplement, maybe your HPV will go away. But my patients would look at me like a crazy person. So I think the complete lack of understanding of the privilege that comes with, especially a lot of Maha, is so different from the reality that so many people in our... are dealing with. Like, just yesterday, they published a survey of patients or people in this country, and a third of people in the United States right now are skipping meals because, so they can pay for healthcare expenses. They're not eating so they can go to the doctor. Like, they don't... They're not gonna buy a $300 glucose monitor, like, for this, like, fake health. Or maybe they are because the marketing is so good, but the privilege and the lack of understanding of what actual people in this country are going through is really astonishing. and even when you have, like... blockbuster drugs like the GOP1 receptor agonist, just probably like the people who could benefit most from them, they're priced out of it. And there doesn't seem to be a pretty, pretty minimal, I don't follow this space as much, but pretty minimal efforts to make those things accessible. And if anything, they're still being painted by lot of mahas, like this getting out easy and people just need to eat better and not use these conditions. It's just totally ignorant of the entire biology of obesity and the disease pathophysiology. But it's still stuck in this. There's a lot of this that's extremely moralized where it's like, well, you just need to pull yourself up by your bootstraps and eat better. And that has been a failing approach to public health for a really long time. And it all lets you do at the end of the day is just blame people for their poor chronic health conditions, which you know, is terrible for people, it's terrible for the economy that's like overloaded with healthcare costs and things. And so it's just a lose, lose, lose. But when your approach is pull yourself up by your bootstraps, pay for some supplements. I don't really know who that's supposed to help. That's not public health. That's all I know. it's not public health. But that's the problem when you have people in charge of public health who don't actually have any training or experience in public health. I wanna veer off just a little bit. You had a post recently where you were really calling to other scientists to be online more. I feel in this space of like medicine, doctors and other healthcare providers really have, feel in the last, I feel through COVID really kind of step up on especially like the video platforms more, making content to try to reach our audience. But do you feel like science, now that science Twitter is no longer that... there's still a little bit of lagging there online with communicating with the lay public. Yeah, yeah. Not just healthcare professionals, think. What I've been struck by, you know, 2014, I was heavily criticized by senior academics, basically being like, you're smart and a promising academic, why are you wasting time on social media? You're gonna say something that's gonna like... ruin your career. Don't take a public stance on something that means you won't be on a National Academies committee in 20 years. And I'm like, what? And at the time I was raising the alarm bells about, all this functional medicine stuff is taking off. Hey, like nutrition is kind of this gateway drug to like anti-vaccine sentiments. mean, everything that's happening now, if you were on Twitter and in the diet kind of online spaces 12 years ago, literally none of this is shocking to me. Like, this is just like mainstreaming. kind of like Revenge of the Nerds, but like Revenge of the Diet Nerds, who were all like on these niche things. And then now it's like 12 years later and I've got all these societies and things reaching out to me like, can you explain to us, like, how did we get here? And I'm like, well, like we're just, you're really far behind and you're bringing like, like in the current day talking with people like, ⁓ well like scientists need to go to like, go to rural areas and like... talk more like 4-H fairs. It's like literally things I've heard floated. And I'm like, talking about bringing like a sewing needle to a gunfight, like, what are we doing here? This is... It's very unserious. And you you've got academics who now suddenly care about science communication because their federal funding for a lot of their science has been entirely pulled and they're getting extorted by the federal government. And they're like showing up 15 years late being like... Hey, I think we need to do something about the fact that we've lost the public. And I'm like, yeah, that probably something should have 10 years ago. But still, even through it all, if you ask, OK, in all of your grants, you have to talk about whether there's a broader impacts of your science and how are you communicating and translating it. And everybody. writes the hand waves basically. And it's like, is anything really changing in tenure and promotion within academia to not incentivize just getting grants and getting publications, but actually like communicating the results of research to the public in garnering public trust? No. Like we are, it is amazing to me that the folks higher up who have just had billions of dollars of funding canceled are still so unserious about engaging with the public. And so some of the posts you're probably mentioning are just call outs of that of like, Yeah, like you, we have lost public trust. Even some of the academics I do talk to that are kind of maybe older and interested in science communication and talking to the public, they still think like a quote in the New York Times is relevant. And I'm like, no, you need to be thinking about like, how do you get on the Manosphere YouTube channels and like have a real conversation? Like it's really like turning points USA I know is giving. like $10,000 of podcasting equipment to like every kind of promising young, mostly white male who had a YouTube account like 10 years ago. Like guys, we're 10 years late to the party. Your public health has infinitely fewer resources than sort of the right-wing funding infrastructure. that's out there. And so I'm like, the way that the conversations are happening, even when they're happening is so unserious. But everyone wants to opine about how we've lost public trust. And was it overstating the COVID vaccines benefits? And I'm like, no, literally, like this is the approach to communication from a government level, from an academic level, from all of our institutions. Like, there's a reason that they've lost faith and they've done nothing to garner faith. And we're still having really unserious conversations about it. And I I worry about just like whole hog saying like, get on social media and talk about it. Because I see a lot, I mean, I'm in the field of nutrition. I've been watching people butcher the science of nutrition, arguably with good intentions. Some of them probably not, but let me give a really good faith interpretation where people get on and you know, the doctors dancing to Five Foods, shouldn't eat TikTok videos and COVID. I don't think I'll ever get over, but I want people who really understand the science. about their micro niche and really like truly like expertise is so narrow. And so when you're getting on and talking about something like you really need to stick to your lane. We don't need another influencer with a supplement company ad or whatever. Like, and I understand the plight of influencers inside comm and how hard it is to get funding for it. And it feels like a lot of free labor. even if you just come online and you can build a following talking about like your specialty, things you're super confident in, things that are not gimmicky and talking about it, that would be great. And I think physicians do a lot better job of this. I've, you know, clinical dieticians I know that like are swamped with seeing 10 patients, 16 patients a day, whatever. And then they just go home to their families. It's like, well, how do I have time to talk about this? And I don't think everyone needs to do it. I don't think it's like a, it's not a moral or shaming thing, but I'm like, if there is just... 0.001 % of the dieticians out there that are listening to this, they get online and make a little poster or something just to like flood the zone a little bit and talk about this, at least present the alternative viewpoint to a lot of what folks are seeing out there. And where I've kind of gotten to the point where I don't even try to network with the general public. like, I'd rather know all the top hitting physicians and scientists and nurses and pharmacies and whatnot that are doing the communicating, make sure that when they talk about nutrition, they get it right. that they know what the facts are, how to communicate the nuance of things so that others who are maybe better or have more time communicating, that they have the resources to answer some of these things. So it's like, I encourage people to do it, but like with this caveat of like, please don't go down the dark path of like the influencers who are kind of, I think, ruining trust because... they had trust for like five years, then suddenly they're like making a protein shot or whatever. And you're like, whoa, what happened? Yeah. I mean, I think it's important that you think about like what your expertise is and you know, like if you are an RD, if you're a PhD, if you're a physician, you know how long it took you to get to that point of like knowing... what you know, right? So you're never, I'm not gonna, first of all, I don't dance on TikTok, but also I'm not gonna talk about like food things because like, I know that I wasn't trained in that, right? Like I'll talk to you about birth control all day long. And I know you're not gonna talk about birth control all day long because like, you know what you don't know. And I think sometimes people don't know what they don't know and that's a problem. But I think for people who want to communicate more and like get in front of... people, like not everyone has to do it like my way or your way. You can write a sub stack, you can write a blog, you can get back onto science X if we call it that. Like there are so many ways that you can still get out there. I think it's hard and I imagine it's hard for scientists to take the very nuanced complex things that you guys are writing and coming, you know. your studies and all that and creating it in a way that is easier for the lay public to understand. I think us as clinicians are have a little easier because we are very used to like funneling the science to the patient because we do that all day long with patients in real life. So it's a little easier for us to like educate in simpler terms because we're supposed to do that with patients. can imagine for people who do work up in the ivory towers of science who only talk to other very smart scientists, they're not used to always having to translate down. to the public and that must, it would, I feel it would be very hard for people to try to do that and still feel like they're making a difference. Yeah, for sure. And I give talks about this to like, you know, perspective science communicator groups and things and just like, we are at a time when there is like this shadowy they or them that everyone talks about these evil scientists that are all sitting in room and they're withholding the cure for cancer. And so like... No one knows what a scientist is or what their day-to-day life does. So anything you can do to just humanize the scientific process and that, you know, you're not some evil, abstract, kind of ethereal they that is out there, like, colluding with industry and whatnot. Really, just, I'm like, take a video of yourself pipetting and talk about what you did that day and why. That little thing, and maybe you won't have 100,000 followers, but maybe that's... isn't the goal also? Like, and if you have humor and use all these other things, but just humanizing that like scientists exist, we're not just the evil guys in movies. What is the process of like designing a study to say whether a supplement works or not? Like, how would you design a study to say that sugar feeds cancer? like, you know, which it doesn't, but... Well, I mean, think everyone should go look at your recent post that you made about the David Barr controversy, but you made it in relation to Mean Girls, right? That was, Right? So like... Every millennial woman was like, well, yeah, of course I have to look at this now, because I get every single reference here. And I got a little lost in the weeds in the middle there, because it got very science-y. But I was still following along for the most part, because the Mean Girl gifts were in there, and I was paying attention. I know. I actually wrote that post. I do this myself. I'm my own biggest enemy, where I'm like, oh, well, this is like... this is so obvious why this is wrong. And then I'm like, ⁓ no, it's not obvious at all. No, it's not obvious at And even though I think that posts, I'm like, ⁓ I broke it down so much, but I could have broke it down even more. ⁓ God. And it's always a tenuous little line of, my audience is always journalists and other medical professionals is who I'm thinking about. I get critiqued all the time of like, you're not making this like consumer friendly enough. And I'm like, I'm not really trying to, I'm not trying to be- Yeah, that's not my new goal. Yeah, it's not. But, you know, maintaining, like, I think there's some strategy I guess I have of, like, making sure that, like, the science doesn't get lost. And if you're a little bit like, I'm not sure I totally got that, I think that's fine with me, because I'm like, ⁓ it reminds people that they don't really actually know, like, the nuances of these things, and maybe don't talk super confidently on things you don't know. And so, and then, know, I've had a bunch of DM exchanges with people who are like, so break this down a little bit more for me so I can talk about it with my patients or whatever. And so that's sort of my goal is take the really high level controversy thing, talk about where the science is on that topic, and then people can translate that to their own audiences in the ways that make sense to that audience. Well, I really appreciate the effort you put in, because I can only imagine how long it took to even like... boil down the science, but then also make it related to Lindsay Lohan. So I appreciate the work that you do and all the work that you continue to do educating us who know that we are not the experts in all of this. But I've been so grateful for you to spend this time with me really like talking about your history and your philosophy and like the problems that we're seeing today. And I think we could do like 12 more episodes. I'd love to get more a little bit to like the upside down pyramid, big wellness supplements. So like we'll have to have a episode two together, but for those people who are not following you online, where can everyone find you? Yeah, everywhere I'm just K-C-K-L-A-T-T, so K-C-Klat, and Klat is my last name, and Kevin's my first, and C is the middle initial, but Subzak, X, BlueSky, and Instagram, it's all that. think I'm the only one that you'll be able to kill it. Well, Dr. Klat, thank you so much for being here. I really appreciate it. Of course. Thanks for having me on.