Episode 246: Dr. Bart Kay - Quit the Carbs or Quit the Fat? Sorting Strategy from Science

Dr. Vera Tarman sits down with Dr. Bart Kay—former professor of health sciences turned “nutrition science watchdog”—to unpack a big, practical question for people in recovery from ultra-processed food use: If sugar needs to go, what about other carbs? And where does dietary fat fit in? We explore Dr. Kay’s perspective on the Randle (Randall) cycle, insulin resistance, mixed macro diets, seed oils, ketogenic/carnivore patterns, and real-world considerations for folks with sugar/UPF addiction who struggle to “moderate.” We also discuss staged change (don’t flip your diet overnight), what “abstainer vs. moderator” can mean in food recovery, and how to keep any nutrition experiment aligned with your health team and your recovery plan.

What we cover

• The “Randle cycle,” plain-English: why mixing higher carbs and higher fats may worsen metabolic friction, and why choosing one dominant fuel is central to Dr. Kay’s model.
• Insulin resistance re-framed: why Dr. Kay views it as a protective cellular response (his position) and how that informs low-carb/carnivore advocacy.
• Carbs in recovery: “quit sugar” vs. “how low is low?”—Dr. Kay’s thresholds (e.g., ≤50 g/day unlikely to cause problems in his view) and why many with UPF addiction do better with abstinence than moderation.
• Fats & satiety: why dietary fat often increases fullness cues; practical guardrails; “can you eat too much fat or protein?”
• Seed oils: Dr. Kay’s strong critique of industrial seed oils and his inflammation concerns.
• Cholesterol worries on low-carb/carnivore: why lipid numbers may rise and how Dr. Kay interprets A1C and lipid changes (controversial; see note below).
• GLP-1s, metformin & meds: Dr. Kay’s take on drug mechanisms vs. root-cause nutrition changes.
• Change management: why he recommends a 4–6 week ramp instead of an overnight switch to very low-carb/carnivore; supporting thyroid, energy, and the microbiome while you transition.
• Recovery lens: abstainer vs. moderator, harm-reduction steps when “only food will regulate,” and building a plan that supports mental health and addiction recovery.

Key takeaways

• Abstinence can be a kindness. If you’re a “can’t moderate sugar” person, treating sugar/UPFs as an abstinence-worthy trigger can protect your recovery.
• Don’t crash-diet your microbiome. If you’re experimenting with lower-carb or carnivore, step down over 4–6 weeks with plenty of electrolytes, hydration, and support.
• Pick a lane with macros. In Dr. Kay’s model, mixing higher carbs with higher fats is the most metabolically problematic; choosing one dominant fuel source may reduce friction.
• Numbers are data, not destiny. Lipids and A1C can shift on low-carb—interpret changes with a clinician who understands your whole picture (medical history, meds, symptoms, goals).
• Harm-reduction still counts. If full abstinence isn’t feasible today: remove red-light foods first, shrink access, use “pause + plan” tools, and reach out before the binge.

About our guest

Dr. Bart Kay is a former professor of human physiology, nutrition, and vascular pathophysiology with teaching/research stints in New Zealand, Australia, the UK, and the US. He’s consulted for elite sport and defense organizations and now educates the public on YouTube as a self-described nutrition myth-buster. One of his core topics is the Randle cycle and its implications for diet composition.

Dr. Kay's YouTube: https://www.youtube.com/@Professor-Bart-Kay-Nutrition

 

The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.