Stephen Phinney is the former Chief Innovation Officer and Co-Founder of Virta Health, the first clinically-proven treatment to safely and sustainably reverse type 2 diabetes without medications or surgery.

As a physician-scientist with 40 years of experience divided between academic internal medicine and industry, Dr. Phinney has studied nutritional biochemistry with a long-term focus on low carbohydrate research and its benefits for physical performance and insulin sensitivity. His career has emphasized the interaction between diet and exercise and their effects on obesity, body composition, physical performance, and cellular membrane structure.

A Professor of Medicine Emeritus at University of California, Davis, Dr. Phinney is an internationally recognized expert on obesity, carbohydrate-restricted and ketogenic diets, diet and performance, and essential fatty acid metabolism. He has held clinical faculty appointments at MIT and the Universities of Vermont, Minnesota, and California at Davis as well as leadership positions at Monsanto, Galileo Laboratories, and Efficas.

Dr. Phinney's clinical experience includes inpatient and outpatient clinical nutrition, directing multidisciplinary weight management programs in three locations, and he has designed, completed, and published data from more than 20 clinical protocols involving diets, exercise, oxidative stress, and inflammation. His extensive experience in the design of clinical nutrition trials in both academic and industrial settings has led to more than 87 peer-reviewed papers and book chapters on clinical nutrition and biochemistry. He is the author of four books, including The Art and Science of Low Carbohydrate Living and The Art and Science of Low Carbohydrate Performance, two foundational books on low carb nutrition science and nutritional ketosis that he co-authored with Jeff Volek, Ph.D, RD. Dr. Phinney also previously served on the editorial board of the American Journal of Clinical Nutrition.

Dr. Phinney received his medical degree from Stanford University, holds a Doctorate in nutritional biochemistry and metabolism from the Massachusetts Institute of Technology and completed post-doctoral research at Harvard University. 

In this interview at the Symposium for Metabolic Health in San Diego, California, Mike Giardina sits down with Dr. Stephen Phinney to discuss how the ketogenic diet can prevent chronic low-grade inflammation to improve health and performance. Dr. Phinney is the co-founder and former Chief Medical Officer of Virta Health.

Dr. Phinney explains how inflammation is very complex and can be damaging but is also essential for health and survival — as long as it is modulated and controlled. Inflammation is a necessary process when healing from acute injury or infection. This type of inflammation is acute and short-lasting. Chronic inflammation is at a much lower grade, meaning there is no fever associated with it, but it lasts for months and up to many years. People with chronic diseases typically have chronic inflammation and run the risk of severe tissue and organ damage.

Doctors tend to prescribe non-steroidal anti-inflammatory drugs (NSAIDs) or steroids to control inflammation, explains Dr. Phinney, but these medications come with a host of adverse side effects, such as lowered insulin sensitivity and catabolism. He has found that the ketogenic diet is a more viable and safer option. In January 2013, a study came out of the University of California San Francisco explaining how beta hydroxybutyrate (BHB) affects cell function. It turns out that BHB is not only a great fuel for the brain, but it also acts as a gene-expression altering signal. There are certain genes that are suppressed because they are wrapped in histones, explains Dr. Phinney, and when they are provided a level of ketones, proteins on these genes unwrap, which allows them to turn on. These genes provide an antioxidant defense we don’t have when we eat carbohydrates, which might explain why antioxidant supplementation is encouraged on a diet consisting of high carbohydrates, explains Dr. Phinney.

This inflammatory protection may apply to exercise as well. We know that vigorous exercise can lead to oxidative damage and muscle inflammation. This is a necessary stimulus to improve muscle strength and resilience. High-intensity training, while adapted to the ketogenic diet, may reduce the post-exercise inflammatory response, reducing recovery time between exercise bouts.

According to Dr. Phinney, CrossFit training while adapted to the ketogenic diet will likely have the same effect. A CrossFit athlete can expect the same training response, possibly with a higher perception of discomfort, but with the added ability to maintain a higher level of intensity with a greater frequency, leading to a greater training volume. As long as we provide an athlete enough time to fully adapt, the ketogenic diet can be used as a way to improve metabolic health as well as performance for both the general CrossFit athlete and the competitor. 

An impressive body of scientific evidence over the last 15 years documents long term benefits of carbohydrate-restricted, especially ketogenic, diets. We now understand molecular mechanisms and why they work. Popular books and articles now challenge the advice ‘carbohydrates are good and fats are bad.’ Circa mid-19th century urinary ketones were identified in diabetics sealing their toxic label for the next 150 years. Despite work four decades ago showing ketones were highly functional metabolites, they are still misidentified as toxic byproducts of fat metabolism. The vilification of fat by regulatory and popular dogma perpetuates this myth. But the nutrition-metabolic landscape is improving dramatically.

A growing number of researchers have contributed to what is now a critical mass of science that provides compelling clinical evidence that ketogenic diets uniquely benefit weight loss, pre-diabetes, and type-2 diabetes. In the last five years, basic scientists have discovered that b-hydroxybutyrate (BHB), the primary circulating ketone, is a potent signaling molecule that decreases inflammation and oxidative stress. BHB has been suggested to be a longevity metabolite, with strong support from recently published mouse studies showing decreased midlife mortality and extended longevity and healthspan. Although type-2 diabetes is often described as a chronic progressive disease, emerging evidence indicates that sustained nutritional ketosis can reverses the disease. There is growing interest in studying potential therapeutic effects of ketosis on cardiovascular diseases, cancer, and neurodegenerative diseases including Alzheimer’s and Parkinson’s. There are even reasons certain athletes may benefit from nutritional ketosis and ketone supplements ─ debunking the long-standing dogma that high carbohydrate intake is required to perform optimally.

With the support of the well-established Ohio State Food Innovation Center, this conference will bring together the top experts in these fields to share what has been achieved and what remains to be done to advance this exciting field of scientific discovery.