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The Dental Diet with Dr Steven Lin

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The Dental Diet with Dr Steven Lin

According to Dr Steven Lin we're facing a health crisis with issues such as Type 2 diabetes, sleep apnoea, obesity and behavioural disorders now at epidemic levels. Worse still, these issues are affecting the population younger and younger as time progresses.

As a dentist, Dr Steven Lin is seeing these issues in practice and witnessing the relationships between dental health and systemic health and/or disease. It has prompted him to re-examine the underlying causative factors and resulted in him writing a book; The Dental Diet to raise awareness of the issues of the lost nutrients in modern day diets.

Today we talk to Steven about his observations and how focussing on fat soluble vitamins is crucial to turning many health issues around. 


Covered in this episode:

[00:38] Welcoming back Dr Steven Lin
[01:41] Fat soluble vitamins
[04:48] Vitamin D testing
[07:02] Vitamin K2 - "The dental vitamin"
[17:01] The tooth immune system
[19:24] Don't be scared of Vitamin A
[21:36] Vitamin A, D, E, K depend on each other
[27:02] Focussing on dietary behaviour changes
[37:33] Kids, nutrients and dental disease
[40:32] The Dental Diet book

Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. Joining us on the line today is Dr Steven Lin. Trained at University of Sidney in a background of biomedical science, Steven works with a focus on the systemic effects of oral disease in his dental practice. 

A TedEx speaker and passionate health communicator, he is working to merge the dental and nutritional fields with the publication of The Dental Diet: An Exploration of Evolutionary Diet, Genetics and Nutritional Medicine, due for release in 2018. 
Based on the pioneering work of Dr Weston A. Price, Dr Lin explores the link between modern industrialised food, dental disease and every other degenerative health problem known to mankind. 

You can follow him for dental, nutritional and lifestyle tips at drstevenlin.com or via @drstevenlin on Facebook, Twitter, or Instagram

Welcome back to FX Medicine. Steven, how are you? 
Steven: Oh, thanks Andrew, I'm really well. How are you going? 
Andrew: Really good. Now, last time we podcasted, we explored some of the functional aspects of dentistry, and indeed, evolution. But today I want to explore something that we eat every day, we take for granted. Modern medicine will tell us that we get ample of, but indeed we're seeing issues with, and that's the fat-soluble vitamins.  
Steven: Yeah, absolutely. We kind of covered a big topic last time in terms of where jaw growth and our teeth and how orthodontic braces and crooked teeth aren't just… you know, we're not just fixing misaligned dentitions. We're actually dealing with jaws that also house, you know, jaw airways. 

But what I've really kind of looked into is what are the bodily processes that cause that cause our jaws to grow? And what have we removed that has stopped our jaws from growing? Because we're really in an orthodontic epidemic now. And we can nealry track it directly, to what we eat. 
Andrew: Well, when you say what we eat, you know, most people would think about jaw growth and they'd be thinking minerals, not fat soluble vitamins. When we're thinking fat-soluble vitamins, A, D, E, and K, what's so important about them and indeed where are the issues? 
Steven: Yeah, exactly. We do have a bit of a focus on minerals, and that is the problem. But if you look at what we eat and the nutrients that the human body needs, it's how we manage these minerals. And our body has these amazing systems to actually absorb, transport, and place minerals, but we have to eat the right nutrients. And the fat-soluble vitamins, are the… they're the key factors in getting your body doing these things. I think we've misunderstood this in a way. And for growing strong jaws and teeth, they're the key nutrients. 
Andrew: You're indeed right. We concentrate on calcium, but then we know, it's medically accepted that Vitamin D helps with calcium placement. But indeed there's other things that help in that. And not just calcium but of course, other minerals. 
Steven: Absolutely, absolutely. And the calcium issue, you know, it really is at the core of when we're managing bones and tooth mineralisation. How your body manages calcium really shows you whether you're getting enough of these nutrients. And when you're talking about Vitamin D, this is exactly getting to the root of the problem.  
And we really haven't had a great understanding of Vitamin D up until quite recently. And the research on Vitamin D has really streamed out over the last two decades. But before that, you know, our knowledge of Vitamin D was really simply just based on its role in calcium. In terms of when we are VItamin D deficient, we'll only absorb 10% to 15% of calcium from our intestines. But it goes far beyond that as well and it actually doesn't act alone. So even testing Vitamin D alone, which is important, doesn't give us the full picture on how our body is distributing calcium. 
Andrew: Without throwing hundreds of dollars at testing, I do remember there was somebody who used to...I think it was $400 odd worth of testing. It was a lot of money, placing doctors in a very awkward position in Australia with regards to Medicare. How do you do appropriate testing and what testing do you recommend? 
Steven: I do recommend Vitamin D testing, and there are still options where we can get Vitamin D testing under Medicare. And that's usually when it's associated with another condition, which is always almost is. So that's the current state we're at. 

And we do unfortunately have a little bit of a...well, physicians have been placed under a bit of pressure because of this cost. So I think in Australia, we really need to move towards a cost-effective measure where we can test everyone. And there are some good companies coming out now where we can do some blood prick tests and test Vitamin D. Which should be coming out and, unfortunately, we don't have, you know, some of the options that they do in U.S. and UK. 

But Vitamin D testing, in my opinion, is one of the most important measures we should be keeping an eye on. Because everyone is different and if you're not getting a lot of direct sunlight, and even in the winter months, you simply don't have enough. And when I started testing my patients, I found that nearly all were deficient and or it related to their dental disease. 
Andrew: There are some cheap Vitamin D tests around now. 
Steven: Yeah, no, there certainly are. And I think we're going to find that they are more available coming out. And I do think that you know, there should be a role of both self-testing, but also alongside a physician and, as you say, user pays. 

But also I think, you know, I don't know if we use our Vitamin D levels right, you know? So, just testing and getting a level may not be useful. We're really not understanding these fat-soluble vitamin system. And I that's really, you know, potentially at the root of this problem is that we've got these levels and we've got tests that are costing us money but are we really doing the right thing to address that? 
Andrew: So when you're saying address that, you mean you use the right tests? 
Steven: Well, I mean, not so much tests. So, for instance, there was a study in 2011 that showed that...I mean, one of the most well-known applications of Vitamin D supplementation, for instance, is for osteoporosis. And so they tested the osteoporotic women who were taking the Vitamin D supplements with calcium, and they actually had an increased risk of heart disease. 

Andrew: Oh, right. 

Steven: Yeah, so those studies are no longer ethical because of the increased risk of cardiovascular events.  
And so there is really a, you know, kind of a moment there where we realised that maybe VItamin D isn't the only picture with calcium. And if people are having increased heart attacks, and they weren't having increases in bone density, by the way. So we were giving them Vitamin D and calcium supplements. They were having been no increase in bone density, but they were having cardiovascular effects. 

So it shows that there was some more to the picture here, and I think that really kind of gets to the root. Problem here is that we're not understanding the system. 
Andrew: This is very typical of medicine. They want one magic thing to do a magic job. And I remember the study they used, what was it, 1,600 milligrams of calcium citrate? So they're using one form of calcium, it is well absorbed, certainly better than calcium carbonate. But it's one form of calcium, it's not the breadth of minerals that's found in bone. 

The other thing was that it was a very large amount of Vitamin D that they gave. Calcium is sort of like...to me, it's a canary. This issue with Vitamin D with calcium and cardiovascular disease, to me that raises a red flag with inflammation. 
Steven: Absolutely. You know, using that term as a canary is, I think is excellent. Because it really shows that we've been giving people calcium supplements. If you think about the body, it doesn't make a lot of sense. Why not get their system so they're using calcium in the appropriate way? And like you say, inflammation, underlying gut inflammation, underlying liver or kidney issues will mean they won't absorb Vitamin D in the first place. 

So why aren't their Vitamin D levels high enough or getting to the blood levels that we need and being used by the body? Also, the other levels, the other parts of this system that distribute calcium alongside Vitamin D, we haven't even considered them whatsoever. 
Andrew: I think one of the other issues, of course, is the sloth mentality. You know, you take a tablet, and you want it to do all the good. It's kind of like, you know, giving an astronaut a calcium supplement and saying, "There you go. Your bones are going to be okay." 
Steven: Yeah, this is it. Probably the calcium… the way we approach calcium came from the rickets approach back in the late 1800s and early 1900s where young kids weren't growing their femur bones because of a lack of Vitamin D. And we simply...you know, it was the cod liver approach that cured that epidemic. And we kind of just struck that off as, you know, Vitamin D and calcium. And then the forward moving movement of osteoporosis was...you know, vitamin D was thought to be the only factor, but there's more to it. 
Andrew: So, with regards to more to it, we've got another fat-soluble vitamin which, of course, is really, you know, one of the late-breaking heroes, and that's Vitamin K. But then there's different forms. 
Steven: Yeah. Exactly, exactly. And this kind of goes back to what Weston A. Price wrote about. He was kind of saying in the '30s, you know, after we'd had this rickets epidemic that all these traditional societies, they ate these diets rich in these three factors. And it was Vitamins A and D, which he identified. He went back to his lab for years after traveling around the world. But then Activator X, which he wrote about, he couldn't identify it and he died. His work was left as Activator X, as these three factors that were, you know, sometimes 10, 20 times richer in traditional diets than what his patients were eating back in Cleveland, Ohio. 

And for 70 years, we didn't know what Activator X was. And that really was a huge misnomer, I think, as to why Price's work wasn't understood because it wasn't until 2007 that Chris Masterjohn put it together and said, "Well, hang on." And they looked through some evidence going back through some Japanese studies. But also some quite obscure physiology around VItamin K and found that there's actually two of them. And that Vitamin K1, the one that we know that is involved in blood clotting, is one molecule called the phylloquinones, but the menaquinones was actually the molecule that Price was talking about, and that was rich in these diets.  
And menaquinones have a completely different role to phylloquinones. And this is… now we're getting into what we're talking about in terms of calcium distribution because they activate proteins in the body that carry calcium. It's one of the most obvious yet misunderstood physiological processes is that, you know, once Vitamin D absorbs and yields us all the calcium that we need, Vitamin K2 has to activate the proteins. Osteocalcin and matrix GLA protein to, one, take the calcium into bones, which is osteocalcin primarily. But matrix GLA protein needs to go around and pick up the calcium out of our soft tissues. 

So, we're throwing Vitamin D and calcium into our patients that were absorbing some calcium, but it's going into our vessels and soft tissue, where it shouldn't be, and we're having cardiovascular risk. 
Andrew: Did Vitamin K2 become evident to us because of the work of Weston A. Price, and they were looking at this activating factor X? 
Steven: Well, it's one of the most misunderstood vitamins, I think, of the, seeing it was the 20th century, but I think ever. So we identified it in the 1920s and '30s, so it was identified as a chemical molecule, but it was so similar to the Vitamin K1 that we put it into one category as Vitamin K. 

Andrew: Yeah, that’s right. 

Steven: Yeah, but they're two different things. And then, as Harvard in '75, they picked up that osteocalcin was this protein that was Vitamin K activated. And then in the '90s, we found the MGP protein. So, it was a very pieced puzzle along the way.  
And then they found that the MGP protein prevented arterial calcification. But we still didn't connect to that fact that there were two Vitamin K molecules, and that they did different things in the body. And so that wasn't until 2007. It was kind of this huge culmination of looking at Price's work but then all this Vitamin K, very kind of in-depth chemical...it's a very specialised area of chemistry, so I think only a very small group of chemists really understood the molecule. And then putting that together with what Price saw and trying to understand that K1 and K2 are very different. 
Andrew: You know, when I did nursing, there was Vitamin K. That's it. There was no K2. It was just Vitamin K, that was its name and that's all it's for, you know, clotting. And that's what you use it for and you give Konakion to a baby when they're born. End of story. And even now, you'll get medical professionals that are not aware of Vitamin K2, and they will automatically assume that Vitamin K is one entity, and it's for blood. 
Steven: Exactly, exactly. And the name K itself is really flawed because they really are two separate molecules. You know, they behave very differently, they're related but, you know, we haven't been taught the physiology of K2. And it's all there in the literature. We know what it does in the body. But we simply have not been taught how it connects to, one, bone mineralization and tooth mineralisation, but also prevention of soft tissue calcification. 
Andrew: Right. So do you find that it has a role in gingivitis as well or is it mainly to do with just that remineralisation of teeth? 
Steven: Yes. We can pretty much rename, if we're going and rename it, the dental vitamin. Because it’s just magic in the mouth. 

K2, when my patients start to eat K2 when we start to introduce it back… And there's actually something very interesting. There's an observation you see in dental patients that is, I think, one of the most cardinal signs that we're not getting enough K2 potentially, and that's actually calcification of dental plaque. So, dental calculus. 
So, people who get that big buildup on the back of their lower teeth, if you run your tongue along there, and that's the stuff you get cleaned off at your dental prophylaxis. 

Andrew: Yep, yep. 

Steven: People have a very...certain people have a very illogical buildup of this dental calculus, and it's caked on. And sometimes completely covering the tooth for two, three, four, five centimeters. And there's no explanation in dentistry why some people would have a bigger buildup of this calcified plaque, you know, besides the fact that they don't brush and floss. And it doesn't make a lot of sense. 

I've seen patients who have very good oral hygiene but have this amazingly persistent and large buildup of dental calculus. And it is a lack of Vitamin K2. Their body can't place calcium into the bones. 
Andrew: You really did blow my mind with our last podcast. You were talking about things that I just thought weren't possible. And one of the things that you really woke up in me was the immune system of the teeth. So, are you saying therefore that calcium is being the canary, because it a) it can't be placed to where it should be and so it's settling out in places where it can't. Well, it's settling down as plaque because of an aberrant immune response or a problem with the microbiota of the oral cavity? 
Steven: Well, there's a two-pronged front there. And this is really kind of the central dogma of oral health. Is that bacteria in the mouth are the environmental dictators of the oral environment. And we have probiotic bugs in there that are protecting its species. So, a diverse oral microbiome, just like a diverse gut microbiome is what promotes oral health. That's part one. 

But part two is that the body and every tooth has its own immune system. And this immune system...so every tooth has a junction between the enamel, which is the hard outer coating and the dentine, which is the inner coating. And the enamel is mineralised, it doesn't have cells. It's not alive, as such. But what the dentine has is a blood supply and a nerve supply from the dental pulp. And they're actually cells called the odontoblast that sit down at that dental enamel junction. And they're like kind of the SWAT police of the tooth. 

But the odontoblasts are run by Vitamin A and D. So, if you don't have enough Vitamin A and D, you're not activating this osteo immune system that is defending your teeth. And so odontoblasts will actually release the proteins, MGP protein, and osteocalcin. And so if you don't have K2, they can't release the immune factors that protect your tooth against any invading bacteria. 

So you have an inbuilt defense system in there that is run by Vitamin A, D, and K2. So that's why people today have, you know, we have rampant tooth decay because we don't have that inner defense system. We've got an imbalanced oral microbiome, and then whole thing's out of whack. 
Andrew: Do you have to have preformed retinol, as in topical exposure, or can it just be absorption from diet? You know, a good dose of carrots, and if you're that way inclined, you can have some lambs fry. 
Steven: Well, yeah, exactly. You've hit the nail on the head there. Price did find that preformed Vitamin A, and we know there are absorption issues with preformed Vitamin A. Certain people don't convert it well. And so it seems that we do need a dietary source of preformed Vitamin A, so it's being delivered to the teeth. 

And Vitamin A plays a crucial role in things like jaw growth and clefts and facial growth as well. So, it's all interconnected. So we know that Vitamin A plays a role in cleft lips and palate. And there seems to be a role in these midline deficiency with Vitamin A. 

Because our knowledge of the physiology of Vitamin A isn't very detailed. There are many, many different Vitamin A receptors. So how it works in the body and how it signals facial growth, we understand that it works in these processes. And we understand that, for instance, in clefts and cleft lips, Vitamin A is a factor. But we don't go into much depth into, for instance, going further into understanding how it relates to, for instance, malocclusion, but also jaw growth as a whole. 
Andrew: Look, again, glad you mentioned it because, like I constantly am dumbfounded by the paranoia about Vitamin A. Yes, high doses of Vitamin A are teratogenic, and cause all sorts of issues. But there's an International Vitamin A Working Group, an IVAG paper on Vitamin A and it states that 10 thousand IU can be given at any stage of pregnancy regardless of existing status of Vitamin A. And indeed I remember reading a paper of 15 thousand IU was preventing facial cleft deformities. 

But there seems to be this area above where we don't know what happens. Then it becomes a problem. So what's your experience? 
Steven: Well, I mean, so the thing is with Vitamin A and A, D, and K2, they all work together. We create a need in the body for Vitamin A when we ingest Vitamin D. And this was Price's entire theory and observation with what he looked at in terms of the dietary aspect of dental growth. Was that these three vitamins worked together. And if you look in terms of, you know, going back to our calcium distribution problem, you can probably see Vitamin D as being kind of the material truck pulling up to a house construction site. And then vitamin A activates all the osteoclasts and the cells to turn over all the workers to bring the materials into the job. But then K2 activates...it's kind of the water into the cement mixer. So without K2 we don't activate the materials to actually put into the house. But you need all three together, and they're work in this beautiful synergy all over the body. Vitamin A and Vitamin D activate genes, both with VDR receptor, but both interacting with each other as well. So, Vitamin D will activate a certain gene, but it will also depend on vitamin A as well. 
Andrew: And I've got to say, I wanted to do a call out before because the brilliant work with regards to Vitamin D from Professor Michael Holick, elucidating its other actions in the body outside the bone. 
Steven: Absolutely. And this is really what last 10 years of...you know, the last two decades, really, of research that has shown us is we can link Vitamin D deficiency to digestive issues, to immune issues, to metabolic issues, right through to the brain and Alzheimer's disease. 

And we're talking about, you know, these VDR receptors being on two to three thousand genes. So there are genes sitting there and waiting for Vitamin D, and yet, close to 75% of us are what we would classify insufficient. And it's just insane that we have not had this conversation in more depth. 
Andrew: Well, indeed, in Australia there's still this pervasive attitude that anything above 50 is fine. Indeed, if you're at 50, you're fine. That's optimal. Which is not. That's the lower limit of acceptability. And there's people that...like, I think it's the Osteoporosis Society finally sort of saying, "Now, look, we really should be looking at 75." But then there's other work. Indeed, Michael Holick did work showing African tribesmen. They had levels of 220 nanomoles per liter. 
Steven: The recommendations of Vitamin D levels, when you really look at them, they don't have a lot of...there's not a lot of logic there. You know, like you say, we're generally hovering around the 50 stage across the board now. 

But there's one Canadian study, 1,000 schoolkids, and they showed that the risk of tooth decay increased below 50, but there was also relative risk between 50 and 75.  
Andrew: Oh, really? 
Steven: Yeah. And that comes up also in studies like Alzheimer's as well. That there is a relative risk as we decrease our levels, as the levels drop… 
Andrew: Yeah, MS. There's a world map of multiple sclerosis and the higher latitudes and the higher the risk of MS. 
Steven: It's really that simple. I don't understand why this hasn’t been better communicated. And for one, in the dental industry, I think dentists should be probably at the forefront of managing Vitamin D because of what we know and what it does in the mouth. Yet, it just has not propagated in how we practice or even our understanding of what it does in the mouth.  
Andrew: I've got to say, though, you really opened my eyes once again about stop using these things in isolation, because, you know, if we're just going to go, "Oh, there we go. An intervention of let's say 4,000 IU of Vitamin D." Well, it might raise the Vitamin D, but does it change the outcome of disease? Maybe the issue is that you're being too simplistic and you're not giving, you know, K or vitamin A with it. K2, I should say. Or Vitamin A with it as well. 
Steven: Absolutely. And the fat-soluble system, you know, really is a system. And we've really misunderstood...this goes right down to our message of blood cholesterols. Blood cholesterol are our lipoproteins are what carries these vitamins around the body. And so without, for instance, taking a Vitamin D supplement with a fatty meal, and that's probably likely, even with the saturated fat, a decent percentage of saturated fat in that meal, we're unlikely to absorb this nutrient from the get-go.  
So, you know, how we're recommending that these supplements are taken and what they're taken with. For instance, a Vitamin D supplement should never be taken without a K2 supplement full stop. But we don't get this message. And there are some brands out there now, they put it all together, they put D3, they'll put K2, magnesium, and calcium. 

So, it is getting there, but it has been a very, very slow message, and a lot of physicians aren't aware of this, and, unfortunately, a lot of dentists as well. 
Andrew: But of course, we should always be, you know, favouring diet over supplements. So how do you access this with your patients, about correcting the real problem, which is their dietary intake? 
Steven: Absolutely. And that's always the baseline moving forward. You know, we have a system here that is waiting for this stuff. These are the most crucial nutrients, in my opinion. When you shape a diet around the fat-soluble vitamins, everything falls into place. 

Andrew: Right. 

Steven: And you kind of the physiology, you know, it makes a lot of sense. Because they're actually the hardest nutrients to get in the diet. And so traditional society always treasured these foods that were rich in fat-soluble vitamins. Because you have to treat them well or you don't get them. And we're talking things like, you know, amazing grass raised butter, things like organ meat, which, as you said, the lamb fry up, a slice of organ meat or dishes that contain organ meats have been treasured in every society around the world.  
The things like eggs, things like fermented foods such as Japanese natto, high in K2, cheeses and full-fat dairy. These are foods that have been treasured, you know, for many, many thousands of years. And the reason is because if you don't treat them right...our modern dairy freesia’s would have very little vitamin K2, and likely Vitamin D unless it's fortified because our animals aren't...they're not receiving for instance, the precursors of sunlight, preformed Vitamin A and K1 through eating grass. 
Andrew: Okay. Couple of questions here. Firstly, it's been shown that the major impact of changing of Vitamin D is really behavioural. We need to be eating lunch or at least five minutes of lunch outside and exposing the upper parts of our body, even if it's just the arms and, you know, the top part of our chest, the neck area. People eat lunch indoors. I think that's been shown pretty well. Notwithstanding that we do get Vitamin D from food. Vitamin K, however, is very interesting. Now, I don't like liver. Steak and kidney pie, I remember vomiting up into the bowl. So, for those of us that don't like organ meats, where do we get Vitamin K2? 
Steven: So, grass-fed butter. So dairy, if you do tolerate dairy, if it's grass raised, it will have K2 because the cows eat the grass which has K1 in it. 

Things like fermented foods will give the MK-7 version of vitamin K2. So sauerkrauts, and they have to be fermentable and quality. But Japanese natto is one of the richest sources of the MK-7 vitamin K2. There are certain foods...kefir is a great one as well. Eggs, so a few eggs a day, as long as they're...the chickens are pastured and have kind of, been running around and eating seeds and bugs. They have K2 as well. 
Andrew: You mentioned cheeses before. Are there any certain cheeses that are higher in K2? 
Steven: Yeah. The brie and gouda are both rich in K2, and that's the MK-7 form because it's the fermentation process. So there is a bacterial mode of K2 synthesis. You've got the MK-4s, which are found in the animal products because they're converted from the K1. But the MK-7s are actually bacterially-derived. So you find these in cheeses which are fermented. Your sauerkrauts, natto for instance.  
And so it is, it's a very small set of foods, actually, that have K2 in them. So it's really, really important that we focus on them. And that's what societies have always done. Organ meats are actually...I get what you're saying there, it’s an ajustment. . But there is a way to work it in. For instance, creating mince with, you know, just having a few slices of organ meat. You can hide it in the bolognese for instance. I get my patients to do that, especially with kids as well. 

But a slice of liver just has this full spectrum of these nutrients. And you know, it is difficult to get. And we've just had these foods in our history for a very, very long time. So I think a slight readjustment in that sense is important, but there are other dietary sources as well. 
Andrew: I like the thought of hiding it. So what about things like Vitamin A, of course? We talk about preformed Vitamin A, and you get that in high amounts in liver. Fantastic. What about carrots? What about vegetable sources? 
Steven: Well, vegetable sources have that proformed vitamins and beta-carotene. Our body will convert a certain amount. Also, there are certain people, depending on their...there are certain genes that will depend on how well we convert our beta-carotenes. Whether we eat it with fats so that the rest of your diet... So a higher fat diet is crucial for this as well because these vitamins are fat-soluble. 
So we need to be eating a lot of fats, and this includes saturated fats. You know, to what we would normally, in our diet in a modern Western diet, in order to absorb these properly. So, there's studies that show that if you eat a salad with fats, you're going to absorb more of the beta-carotene. That's simply because of the fat-soluble nature of the molecule. 
Andrew: I was going to make another point and that is for those listeners that might not be able to handle something like lamb's fry, you know, the lamb liver, or steak and kidney pie, that sort of thing. Then, even things like chicken liver, like the pates, they're much dietarily accepted for a lot more people. So even things like chicken liver can help with Vitamin K and Vitamin A. 
Steven: Absolutely, yes. Duck and goose liver pates are really high in K2, and you can kind of salt them and give them a bit of a taste. And kids tend to like them too. So that’s one, pates are good for kids as well. But, yeah, they also have desiccated liver tablets. But I don't know, I just think that you know, we should try and least have, you know, one meal a week. 

Andrew: Yeah.

Steven: But the thing is too, that when you understand what it does in the body, and I'm not sure if you've tried a slice of grass-raised liver? It's like a strong, strong coffee. But your body is really happy when you're eating this stuff. And you feel a million bucks. You know, liver cooked in turmeric, and you know, a nice butter and coconut oil. 
Andrew: I really think I would have to cook it with some flavoring.  
Steven: Yeah. Well, you know, like a bolognese in a mince, you would completely not notice it there. 
Andrew: Well, look, these are the things that we need to do for our patients, and I think anything that we can do to increase them, great. 
Steven: Yeah, we've really not had this conversation that these foods are important. So that's the first step is that we need to understand which of the foods and why we need them. So there's not a lot of this information out there, unfortunately, for our patients. And so I think that really is a big first step. 
Andrew: And these are covered in your book, The Dental Diet, yeah? 
Steven: Exactly. So there's a 40-day meal plan in The Dental Diet to reintroduce these traditionally, ancestral based foods in a modern world, you know, both for taste and also convenience. 
Andrew: When you re-institute the intake of these vitamins in your diet, I would hope that you don't have to supplement, but maybe there's this short-term period where you might do an emergency, sort of, supplementation phase. Do you do that? 
Steven: Yeah. Generally, with patients, I find that the dietary changes are certainly long-term, but for healing of certain conditions, supplementation is needed. And things like cod liver oil tablets and also Emu oil is a great source of A, D, and K2, one of the richest, actually. We're very lucky here in Australia. It's one of the richest sources of the MK-4. They're dietary supplements. They are needed in certain situations. 

And because of all the physiological processes that happen to convert Vitamin D, many people with digestive issues or metabolic issues or kidney or liver issues will take a long time for their levels to lift up, and we need to monitor. And they sometimes do need to supplement with higher doses. People with sleep apnea, for instance, have been shown to have low Vitamin D, and it does take time to reestablish a good gut microbiome that can absorb it all and get things moving back. 
Andrew: And once people correct their intake and have adequate amounts of these vitamins, how quickly do you find a resolution or at least a mitigation of their conditions? I mean, you know, sleep apnea is something very serious. I wouldn't be relying on just a little bit of supplementation to cure this, so what do you do? 
Steven: No. Absolutely. The dietary change is significant, and it is usually a significant lifestyle shift that we need to get people off harmful foods for one. You know, the sugars, the flours, the vegetable oils. These are all things that are stopping us from absorbing these nutrients in the first place. 

But once we replace, and if we can get people eating a fat-soluble nutrient-dense diet, in kids especially, we see a rebound, you know, nearly immediately. It's quite amazing that you know, their bodies just appreciate so much when they begin to eat foods that are actually giving them what they need to grow and develop.  
In people with sleep apnea, I've seen very, very good results, for instance. People with sleep apnea often have chronic gum issues, because there is a breathing/inflammation thing going on in the body, you know. And these periodontal issues will not be resolved, you know, just by scraping the teeth through periodontal treatments and regimes. 

Yeah. So when we get the vitamin D levels up, when we change their diet, all of a sudden their inflammation levels in their mouth have resolved, and their sleep is starting to get better. And so they're on a track to getting better. And they're eating better, and they feel a lot better as well. 
Andrew: Now, you mentioned kids there, I have to ask, with regards to A, D, E and K, I'm thinking maybe particularly A, D and K, but what about growing pains? 
Steven: Yeah, well, exactly. And you know, there's a lot of things like, you know, tooth eruption, you know, thyroid issues. You mentioned hormonal issues. Vitamin D is completely fundamental in managing the hormonal systems in the body. 

So, these are vitamins that kids drastically need. If you test kids, especially the kids that I have seen with dental disease, they are always at dangerous levels of vitamin D. This goes across a full spectrum of conditions. And when we're talking about growth and development, they're absolutely fundamental. 
Andrew: We've got a scourge of obesity in the community, and particularly in our kids. 20% of our kids are overweight. I would imagine a rather big backlash from the Orthodox sector of the medical community saying, "How could you recommend a high-fat diet in kids that are overweight?" How would you answer that? 
Steven: Yeah. I mean, I think the problem with this is that the evidence heavily suggests that simple refined carbohydrates, in terms of sugar and especially fructose that kids are consuming now, is driving the increase in obesity and also, even type 2 diabetes in younger and younger people. 

So, removing sugars is almost agreed across the board as being the, you know, the approach to this. But one big problem, and I think we're kind of in a grey zone with dietary recommendations now is that we don't know what to replace with. And we've now established, you know, the whole saturated fat conversation, we've had that. We need to really...you know, because these foods that we're talking about do contain high levels of saturated fat. But the evidence has shown that the reason why we were hiding from these foods in the first place, you know, weren't grounded in good science in the first place.  
So, saturated fats don't cause obesity, they don't cause heart disease. We need to straight up say that. We need to have that conversation and turn this kind of dietary confusion that we've had around. And, you know, the really kind of scary thing too is that when you kind of track what we did in terms of what Weston A. Price was writing about in the '30s and '40s. Then what we did in the '60s and '70s in terms of removing these saturated fats... These are the foods that are rich in fat-soluble vitamins. We directly advised against them and this is the reason why. So we've taken the exact opposite route of what we knew developed dental arches. And the result has been the type 2 diabetes epidemic, the obesity epidemic. We're now walking into behavioural epidemics and sleep apnea epidemics. So that, we've got our answer. We've had an experiment on ourselves. It's time to turn that around.  
Andrew: Steven, and I think the way to turn around is certainly to start reading your book, and I'm going to. The Dental Diet: An Exploration of Evolutionary Diet, Genetics and Nutritional Medicine.

Brilliant. I want one. Steven, I can't thank you enough for taking us through the dietary sources, the issues that can be corrected by concentrating on a fat-soluble diet and getting enough fat-soluble vitamins back into our diet. 

Can't thank you enough. Thank you so much for joining us on FX Medicine. 
Steven: Thanks so much, Andrew. It was an absolute pleasure. 
Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. 

Additional Resources

Dr Steven Lin
Book: The Dental Diet
TEDx Talk: Dr Steven Lin: The Power of a Smile
Dr Weston A. Price
Chris Masterjohn
IVACG: International Vitamin A Consultive Group

Research Explored in this episode

Schroth RJ, Rabbani R, Loewen G, et al. Vitamin D and Dental Caries in Children. J Dent Res. 2016 Feb;95(2):173-9

Other podcasts with Steven include:


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