Derek P.'s routine, rated
Derek is the strongest person in this lineup and, in two specific ways, the most at-risk. His training and protein game are genuinely excellent. But he's adopted an ancestral-influencer package wholesale, including the parts that tell him to ignore the exact markers most likely to matter for his long-term health.
What's working
A lot. Derek's protein intake and training are dialed: heavy, consistent resistance work plus abundant high-quality protein is the single best combination for building and keeping muscle, the organ most associated with healthy aging. Creatine is the right (and well-evidenced) supplement to be taking, safe long-term at his dose.[1] Organ meats are a genuinely excellent, nutrient-dense choice. No alcohol, decent sleep. The discipline is real.
What he's been told to ignore, and shouldn't
The unchecked ApoB is the headline risk. "LDL doesn't matter on this diet" is the single most dangerous idea Derek has absorbed. LDL, and more precisely ApoB, is causally linked to atherosclerotic cardiovascular disease, in proportion to both how high it is and how long it stays high.[2] A high-saturated-fat carnivore diet drives LDL up sharply in many people, and feeling great in the gym says nothing about what's happening in his arteries over a decade. Dismissing a flagged LDL three years ago and never rechecking isn't ancestral wisdom; it's flying blind on the most modifiable cardiovascular risk factor there is.
Zero cardio is leaving the biggest longevity lever on the table. "Lifting is enough" is false for cardiovascular fitness. VO2max / cardiorespiratory fitness is one of the strongest predictors of all-cause mortality measured, each 1-MET improvement is associated with an 11–17% lower risk of death, and lifting alone doesn't build it.[3] Derek has optimized strength and ignored the metric more tightly tied to staying alive.
The daily raw milk is an unnecessary tail risk. Raw milk delivers little nutritional advantage over pasteurized while carrying a documented, sometimes severe pathogen risk, unpasteurized dairy causes roughly 840× more illnesses per unit consumed than pasteurized.[4] For a healthy adult the per-day odds are low, but it's a gamble with no real upside.
Zero fiber and minimal plant diversity is the most defensible of his choices but still untested long-term, and it removes a lever (fiber, polyphenols) some people benefit from.
Do this instead
- Get bloodwork now, full lipid panel including ApoB, plus fasting glucose/insulin. Make decisions from data, not dogma.[2]
- Add Zone 2 cardio 2–3×/week. It builds the fitness lifting can't, and it's the highest-ROI longevity addition available to him.[3]
- Drop the daily raw milk (or accept the documented risk knowingly), pasteurized gives nearly all the nutrition with virtually none of the pathogen tail risk.[4]
- Keep the lifting, protein, creatine, organ meats, and no-alcohol. Those are excellent.
- Consider adding some plants back, not because carnivore is proven harmful, but because the downside of a little fiber and variety is essentially zero.
The verdict
Derek built an impressive body on half the manual and threw away the chapters on lipids and cardio. The fix is humble: measure, add aerobic work, and stop ignoring the number most likely to shorten his life.
References
- 1.Kreider RB, et al. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation. Journal of the International Society of Sports Nutrition 14:18. PMC5469049. Link
- 2.Ference BA, et al. (EAS Consensus Panel) (2017). Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. European Heart Journal 38(32):2459–2472. DOI: 10.1093/eurheartj/ehx144. Link
- 3.Kodama S, et al. (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 301(19):2024–2035. PMID: 19454641. Link
- 4.Costard S, et al. (2017). Outbreak-related disease burden associated with consumption of unpasteurized cow's milk and cheese, United States, 2009–2014. Emerging Infectious Diseases 23(6):957–964. PMC5443421. Link
- 5.National Institutes of Health, Office of Dietary Supplements (2026). Creatine and electrolyte supplementation, fact sheets. NIH ODS. Link
This article is for educational purposes only and is not medical advice. It is not a substitute for professional diagnosis, treatment, or the guidance of a qualified clinician. Always consult your physician before changing your diet, starting a fast, taking supplements, or beginning a new training or heat/cold protocol, especially if you are pregnant, breastfeeding, managing a medical condition, or taking medication.