Food as Medicine - Dr. William Li at Exponential Medicine

[Music] [Music] how many of you have heard of the phrase food is medicine that's almost all of you and how many of you actually understand it because I know in this room there are physicians who actually understand medicine but I don't see too many physicians who understand food what I'm going to try to do is to bring you up to speed on how the two worlds of of nutrition and medicine are starting to collide and give you a glimpse of the future of what food as medicine will really be like before I do that though I want to actually just bring us all back to the old man himself Epocrates who lived in a time when people didn't have a lot to eat they ate fresh foods there were no processed foods that we entreprises foods so to speak and he's the one that actually claimed that the term let food be thy medicine but back then it was really serious because they were they were actually mendick aiming to themselves going forward and not actually trying to treat disease that had already left the bar so where do we take you know 2,000 years of wisdom and move it into the future before we go to the future let's look at the present day right so everybody knows that this is the unfortunate scenario as was described expertly by my colleagues dari Motte Safari who's the Dean of the Tufts nutrition school and and Dan Glickman who's a former Secretary of Agriculture and the idea really is that our food is really compromising our healthcare system in the United States about a half a million deaths worldwide about 11 million deaths a year attributed to poor diet and this is actually the study that they cited from JAMA showing that the state of the u.s. of health in the US over the course of 25 years if you take a look at all those disease entities that are in small type on the right-hand side and look at the number one risk for mortality its dietary risks accounting for neoplasms cancer cardiovascular disease and diabetes right so these are the chronic diseases that actually al are system our health care system that we're trying to figure out a way as we've been talking about over the last few years how to do early detection how to do monitoring how to actually do the appropriate types of feedback so let's dive a little bit further into dietary risk to understand what that is because most of us think of dietary risk as foods that we should cut out of our lives right human nature abhors deprivation so we don't really want to cut things out of our life in fact if I were to tell you something to remove from your life you might actually at some point after I told you that think about adding it sneaking it in just so that you can actually try that now what are the things that we know about dietary risk we know that we're not eat enough nuts and seeds fruits and vegetables low in omega-3 fatty acids and we're eating too many processed foods like red meat and processed meats and of course sugar sweetened beverages but that doesn't mean that this is a solution to health the solutions really coming out of economic drivers so this is about two and a half trillion dollars of burden that is attributed to some of these dietary risks diet isn't the full cause to these there's lots of other things we've talked about epigenetics genetic factors there's other lifestyle issues stress social issues that actually are determinants of health and disease as well but I do think that we have to start here to take a look at what we can actually do about it now we are also not only interested in our persons and our commute our families in our communities we're also interested in the planet and in January of this year they eat Lancet Commission which is an international coalition made a release a statement a study that said basically in order to create the meat sustainability goals by 2050 we have to have the amount of red meat and sugar that we eat and we have to double the amount of fruits and nuts and vegetables in order to be good not only for the person but also for the planet and this kind of just raised a whole other set of issues that in some ways are controversial but also help to bring the focus of nutrition and food and health into clarity you've got economics you've got policy global policy you've got sustainability so it's not just no longer about the person going up on the podium talking about a vegan diet we're really talking about something that has true economic value in a driver of or opportunity as well now different states now actually have food as medicine programs now even though most of us here said well we're not really sure what that means I can tell you that's starting to be legislated even insurance companies actually are beginning to talk about you know cancer protection in a bag and so the vernacular of food as medicine is now actually starting to reach the public and corporations and it's also on Capitol Hill there was a bipartisan announcement of the formation of a food as medicine working group within a hunger caucus that is now actually a meeting to talk about this issue as well and then finally even the Vatican has gotten involved this is actually from a conference that I gave an address at talking about using die to mobilize our defenses against the disease and a degrading environment and so you can kind of see this is no longer really a bunch of extremists talking about vegan diets and at the salad bar we're really talking about a kind of a global awakening and that's really what I want to share with you is that this global Awakening is gonna drive things into the future so what does that mean does that mean that we all just go to the veggie counter at the Whole Foods to be able to get a plate full of healthy foods this is actually what most people think about is food is medicine let's let's get rid of all the bad stuff let's pile up a bowl and let's go ahead and munch down but if you think about it this is a solution but it's not the whole solution and it can't be because there's a lot of science that is still unknown that still needs to be unraveled about what it is about food I mean are there super foods is there a super supplement probably not there are no super drugs either we know is that the body actually is very complex and actually responds to foods on an individual as well as a systemic level in ways that we barely understand so where are the good ideas where is the scientific evidence the basis for actually innovation going into the future coming from I'm actually not going to talk about the the plant a plant-based food movement because there's plenty of other people out there that are very well qualified to talk about that I'm actually not going to talk about sustaining if it's a sustainable farming or regenerative agriculture there are other people that are talking about that important topic as well but I will actually tell you that out of what we're thinking about there's a in terms of science there are some really amazing innovations that really reflect the singularity of food as medicine food and health and the future of nutrition this is just a a partial list of some of the actual innovations that are underway some of which are already available like the impossible burger and beyond meat but there are some other amazing things that are actually in various stages of in some cases of advanced development that are going to be impacting how we view our dinner plate and the offerings related to nutrition I'm showing you this picture really to spark your imagination because while we're here on earth we can choose whatever we want to eat but one day when humans become extraterrestrial and we now all know the efforts that are underway to be able to get us there it's just gonna be us against the environment and the environment outside of Earth is hostile we will have to actually take countermeasures on a continuous basis in order to be able to protect our immune system protect our bone marrow protect our our DNA the radiation from outer space is going to be relentless and damaging so an interesting challenge I'm going to give to you mental framework to think if you really wanted to study food as medicine and nutrition model this future human in living in space and think about what it is when you're starting from nothing and when you're and you're pitted against damaging forces what do we need to do to maintain health so this is almost the ultimate model to think about is really how humans will actually live successfully in space so where does that take us well that takes us to real science you can't hand wave that answer I'm gonna suggest to you that some of the answers to the future for food as medicine is going to come out of the pharmaceutical world now I'm a physician and also a vascular biologist I've spent the last thirty years working to help develop medicate medicines that can actually influence angiogenesis which is how the body grows blood vessels it's a common denominator of diseases there's 60,000 miles with the blood vessels packed inside our bodies it is the common denominator to cancer heart disease stroke blindness obesity diabetes about 70 different disorders and I can tell you from my work which has actually led to a number of fda-approved drugs and devices that there are some amazing insights that I think we can apply to understanding how food can be used as medicine and the reason that we have to tap into this is because of the investment since over the last 25 years 802 new fda-approved drugs we cannot overlook this huge data set this experience the spiritual information coming out of the investment in life sciences and so what are we learning from there and this is just a list of 32 of the of the interventions I personally been involved with and so my street cred is that look science can be turned into practice but it really needs to go through a pretty rigorous process of validation testing and then ultimately figure out how to get you get it to market so some of the things that we're learning over the last 25 years in fact is the genome in ways that we've never even imagined we could know previously now of course we can do gene editing we've also figured out the human genome which is you know sort of the interrelationships of of cell signaling pathways and many of the cell signal pathways are now druggable targets and this is really the bread and butter of biotechnology and biopharmaceuticals today we've also really more recently broken through the glass ceiling of immunotherapy where it's now possible to activate and leverage the body's own immune system to fight disease so now we're not actually treating the disease using synthetic chemicals we're actually leveraging natural cells in fact our own body cells to allow them to actually overcome diseases in some cases very successfully so look at all this information that we've actually what how do we apply this to better understand food well that's really what I set out to do about 10 years ago and I thought what if you were to actually take everything we know about biotech development in the areas of angiogenesis which you know developed more than 30 different treatments for cancer diabetes and vision loss what do we took gene therapy a regenerative medicine looked at the emerging field of microbiome and looking at immunotherapy what if we actually took a look at everything that the industry the biopharmaceutical industry is working in those spaces and turned it inside-out and didn't ask about disease but asked about health didn't ask about drugs but asked about food so now I'm actually gonna show you what how we've actually proceeded preceded with that idea and the things that we've actually found I want to start with angiogenesis which is my home base blood vessels growing throughout the body we need blood vessels to bring oxygen and nutrients to every cell disease cells can actually hijack this process and cause all kinds of problems including cancer and the an angiogenesis is the microcirculation so the old science of the circulation when I went to medical school was you know the large vessels vasodilation and vasoconstriction and that's pretty much it and clotting now we know that the micro circulation is in fact a control system for all the organs in the body and it's critical for regenerating organs for modulating scar formation and healing and repair and so I want to show you what happens though when you actually have too few blood vessels you wind up having a whole series of ischemic diseases that can cause all kinds of serious chronic diseases and when you have too many blood vessels a loss of control where you have excessive florid growing angiogenesis blood vessels growing in the wrong place at the wrong time you also have other diseases that are heavily associated with and by the way these are where I've asterisks the disease's for which there have been fda-approved drugs developed gone through phase three FDA approval are now actually used in clinical practice so let's take a look at and what these medications are trying to do is to restore the body back to a healthy baseline of androgen the healthy microcirculation so I want to give you an example of what we're actually finding out in terms of this field as it applies to nutrition so we know that tumors actually are harmless until they hijack angiogenesis and grow blood vessels to feed themselves in fact the tumor will grow 16,000 times in volume once a a vascular tumor has a blood vessel touching it and bringing it nutrition and we know that you can cut off the blood supply to cancers through anti-angiogenic drugs and in fact there's a large number of those drugs they've actually been FDA approved these are so called you know cancer star verse and by starving a cancer you cut off the blood supply you interfere with the the immune repellent properties of a tumor themselves and again this is hard one biotech approvals and one of the assays that was developed very early on that I was a part of with the National Cancer Institute is to really be able to do drug testing so for drug discovery what you're seeing on the left is actually a aerial an eagle's eye view of a rat's aorta so that's just been a cross-section so it's just a couple of millimeters in diameter and you're seeing the eagle's eye view it's like a calamari ring and and inside the lining of the ring you'll remember there's endothelial cells the cells lining blood vessels that actually if you drop and grow these into a dish and you drop in those factors that are necessary that cancers do you'll get this explosive starburst of blood vessels that are moving out radially from to the outside and when you actually test a drug like the one on the right hand side you can shut those vessels down vessels go away tumors can't be fed this is actually part of the process of drug development and I'm only sharing this with you as a historical point to show you how you can use the same assay system used in biotech for developing drugs to test food all right this is the pharmaceutical response to one of the drugs in fact the one I just showed you and you can see this is a metastatic cervical cancer on the left you see the tumor after 18 weeks of treatment you can see starving the cancer gives you a beneficial clinical result the real question is you know I used to ask this question all the time you go to a cancer research lab and you can go under the computer you can actually overnight order some of your new chemicals that she tests to see their anti-cancer response but you could call a pizza delivery shop and they could deliver it within 20 minutes and you ask the researcher how you gonna test that and they wouldn't have any idea so what we've actually started to do is to figure out how do you deconstruct food into its outcome core components and test them in the same systems that drugs are evaluated food as medicine involves a validation to testing this discovery part so I just want to show you a little bit of what we've done by taking a broader view of the farmers market right so these are all healthy foods I mean you guys know that just by visual inspection but let's take a look at what happens when you test drugs in this case on the on the horizontal axis it's the magnitude of the fact of being able to of the blood vessels growing so on the very top the black line you can see blood vessels growing out full board okay like a tumor simulating and now you can add drugs both cancer drugs in blue and the and common drug some of the off-label common drugs by the way we heard this brilliant talk a few days ago about Castleman's disease and looking for off-label drugs so this is something we've been doing for a long time and you can kind of see the off-label drug with some have some of the great effects that specific indicated drugs actually have well that's an interesting thing all by itself but now here's what happens when you blind your samples and some of those samples are food you can see food and drugs can go head-to-head against each other if you extract the food and take take a look in the same system that's used for drug discovery and this has actually opened up the eyes of folks like myself and my colleagues to sort of say wow what else can we actually be testing in this system and can we move our testing of food through the same rigorous process for that they're used in the biopharmaceutical space so I want to give some examples and again this is lab I'm gonna try to show you how you put the whole picture together because you can't run a clinical trial of foods in the same way that you can actually run for a drug so this is the baseline system now look what happened to you actually extract soy soybeans you shut that down there's no estrogen receptors in here okay so this is a human estrogen and soy plant estrogens are very different but but soy contains phytoestrogens phytochemicals that actually are powerful inhibitors of angiogenesis so this actually overturns some of this this urban legend that women who are at risk for breast cancer who have breast cancer should actually avoid soy in fact we know this is true because if you go if you jump from the preclinical over into human studies take a look at this study this is actually published in JAMA where they actually studied 5000 women who already had breast cancer and what they found is that those women who ate more soy actually had a lower risk of desk this is women with breast cancer and and also and if they had a completely treated they had a fewer lesser chance of recurrence as well how much soy that they need to actually get consumed in order to get this effect about 10 grams of soy protein per day that's about the amount of soy protein in a cup of soy milk so practical levels can be achieved and this is actually a public health study that helps us to correlate what we're actually finding preclinically in drug development assay so this is actually an example of what we can actually do to be able to make a case and start to dig a little bit deeper using the tools that we already have to understand food is medicine now you might say well that was just one study you showed how do we know that this is true and a larger will it hold up over larger studies this is a meta-analysis seventeen studies and you can see the correlating breast cancer and soy intake in terms of death and survival in every single case the the the survival advantage is in favor of soy consumption not death so how do we actually overturn some of this urban legend that occurs there's a lot of rumors that are out there in the consumer world and and you know part of it is that really the FDA doesn't regulate I mean they regulate food safety there's some regulation of dietary supplements but really there's nobody there's no truth engine really that's evidence based when it comes to our diet so there's a lot of stuff that just goes floating around and what I'm trying to do is to contribute to solving that tomatos again does it actually have harmful compounds into it because it's related a nightshade that's like the latest urban legend well tomatoes actually have a lot of carotenoids one of which is lycopene well lycopene inhibits angiogenesis in that rent the aortic ring assay which I showed you earlier well that's pretty cool what could that actually possibly you'd be useful for let's let's jump back to the human studies this is actually the health professionals follow-up study of 46,000 men and it found that those men who ate two to three servings of cooked tomatoes per week had a 30% 30% reduction in their risk of developing prostate cancer which depends upon angiogenesis and in fact those men who did develop prostate cancer when they looked deeply in the tooth in a tumor this is molecular pathology they actually found that the men who ate more cooked tomato sauce actually had less fewer blood vessels and also they also found that the tumors were less aggressive as well so again it's possible to actually engage the real medical community to begin looking at these questions and any other question is dose what's the best dose right like what's the best source of lycopene well it turns out not all tomatoes were equal this is actually four types of tomatoes have you ever gone into the farmers market or the grocery store in a summer you saw all these different types of tomatoes wouldn't you want to know which one is the most potent well I do and this is why we started to take a look at which the light the relative lycopene levels of different Tomatoes these are just four of the cultivars or varietals that actually have the highest levels by the way why do you have to cook the tomatoes because the lycopene coming off of the vine tomato on a vine is actually in a chemical confirmation your body can't absorb when you heat it the ideal way of heating is with olive oil okay not too boiling temperature but simmering so now think about Mediterranean cuisine you've changed a chemical conformation into a form the body can absorb so that makes a lot of sense here are some foods with anti-angiogenic activity that can cut off the blood supply feeding cancers and also by the way other diseases associated with angiogenesis I wrote a book called eat to beat disease there's plenty of lists all throughout those books so if you don't have to try to copy this down let me just flip to the other side what about the conditions where you don't have enough blood vessels where you want to grow more blood vessels up to a healthy point well we know that the biotech community is trying to develop therapeutic angiogenesis for coronary artery disease ischemic heart disease for peripheral arterial disease critical limb ischemia is a cause of amputation in the country associated with diabetes and atherosclerosis so these are all the end stages of chronic diseases that we want to avoid and some people say well you know like if we could just eat more healthfully we'd actually be able to reverse heart disease true if we actually had the better type of a dietary fat we'd actually lower the risk of atherosclerosis possibly you know and we've got the statins of course but is that really the solution probably not so what could we actually do to actually add grow blood vessels naturally well this is an interesting study that showed beta-d-glucose hourly can be made into pasta you can feed the pasta to animals that actually have a deficit in their hearts now where they're not getting enough blood vessels of ischemic heart disease and you can measure and this is the only intervention dietary deliver a beta D clue can on the effect of angiogenesis and you can actually grow blood vessels in their ischemic tissue with just a dietary intervention again if I didn't tell you this was from pasta or or barley and I showed you this as a drug that's being discovered you might get interested in this if you were an investor and so again this is the kind of stuff that you know people are starting to take a look at is how do we use the tools here's another one this is a the peel of an apple that actually can that should be used to grow blood vessels with our Solek acid back in the ischemic hindlimb model and what's amazing is that these two sides actually don't antagonize each other they actually they actually work together foods with angiogenesis stimulating activity quite amazing regeneration starfish regenerate salamanders can regenerate and people do regenerate as well and we know that stem cells are called in action after injury we know that the bate worse the injury the more the stem cells respond we also know that aging slows down our stem cells we heard about aging the other day and we also know that if you actually have lower stem cells your chances of actually having an of outcome a cardiovascular disease are worse so what could you actually do to stimulate this besides going into clinical trials well what about cacao studies have been done looking at chocolate dark chocolate could count of the polyphenols and in fact they've actually studied this by looking at six year old men with cardiovascular disease and feeding them high polyphenol cacao and a month later you could double the amount of circulating stem cells in their circulation it's not the final answer but it's an amazing point that you can actually do it and if you study this with larger numbers of people looking at lowering the incidence of heart disease as well omega-3 fatty acids also can increase the activity of stem cells a lot of these medications can stimulate what about cancer stem cells this is one of the most amazing things to me because there is it's a Holy Grail to find something I can kill a cancer stem cell which actually helps tumors recur well it turns out that there are foods that inhibit cancer stem cells and one of them in fact is the walnut and this is the study from that was presented at ASCO the American Society of Clinical Oncology in which they looked at 800 patients with faith as stage 3 colon cancer getting regular treatment chemotherapy and then found that those who ate two or more servings of tree nuts a week including walnuts had a 50% 53 percent improvement in survival and a 66 percent reduction in cancer recurrence after surgery why does that happen look at this look at this kaplan-meier curve it's pretty amazing if you had a drug that could do this add it on top of the treatment you would actually call this something that you definitely should be explored further how does that work well it looks like when you've extract something the polyphenols from walnuts you can actually kill colon cancer stem cells amazing so again biotech informing us I want to just close quickly by showing you just a snippet of what the microbiome and immune system can that you do 37 trillion bacteria in our body is associated with all kinds of chronic diseases we don't really have good answers for clearly are connected how do we treat our microbiome well we can feed the bad bugs we can give the bugs and avoid things that can hurt the bugs here are things are some surprises kiwi fruit is prebiotic when you actually do small pilot studies you can give female volunteers kiwi fruit you we increase their beneficial bacteria by 30% in the first day and and another type over the course of about four days these are the foods that you can actually eat to actually consume bacteria I'm not going to go into that in detail and sourdough bread actually also contains a lactobacillus root Arai that is used to make the dough sour now what's really amazing is that this same bacteria used for sour dough can inhibit the growth of breast cancer and the activity of lactobacillus doesn't require live bacteria if you fragment and Sonic ate them the particles will actually have the same effect this is that she's showing a mouse study with a healthy diet and breast tumors a fast-food diet speeds up the growth of breast cancer but then you add the probiotic black tuba so screwed right in the drinking water and let them eat a fast food diet you decrease the risk that you've decreased the the growth the speed of breast cancer growth a lot of foods infect the microbiome the last thing I want to just close on is immunotherapy which i think is one of the biggest breakthroughs Jimmy Carter our president actually former president actually had melanoma spread to the brain he received immunotherapy the tumor Brazil responded and now he's the oldest living president today cancer-free not everybody responds though to these immunotherapies in fact there's a big gap between responders and non-responders and it was discovered is that a single gut bacteria seems to be responsible for them published in science by LaRon zip Vogel and in which he found is that the people who responded to checkpoint inhibitors one type of immune therapy versus the people who did not respond when they checked every compared everything that they possibly could they found the difference was one bacteria in their gut microbiome a cure Mansa Musa Nephila and by the way you can't actually eat that probiotic as a probiotic you only way you can grow a core Mansi is by eating with food so by having pomegranate you can cough the goblet cells to secrete more mucus which this bacteria likes to grow in and they will actually respond and there's a lot of literature coming out talking about how to grow this particular type of homeostatic cancer surveillance immune producing bacteria and think about the opportunities to combine this actually and in the study so Akram Anthea causes mucus secretion which then allows the immunotherapy to work better now why am I even telling you this with the confidence I have and it's because my mother who was in her 80s had metastatic endometrial cancer and was not given much chance to actually survive her disease we got her tumor we sequenced it we found the smoking guns that would make her eligible for immunotherapy and then we actually gave her foods that would actually support the Ackermann see growth and she actually wound up becoming a complete responder so again now people are beginning to look really at how do we actually optimize immunotherapy which is one of the expensive treatments so this isn't food as medicine or food versus medicines as food plus medicine a study of broccoli sprouts in in young people actually getting the nasal flu vaccine showed in 29 healthy volunteers if they had all had a nasal vaccine but if they split them up in one group actually got two cups of broccoli sprout in a shake made into a shake a day and the sprout years had 22 times more natural killer cells t-cells in their blood and the NK cells had more power in the lab and the sprout eaters had fewer viral particles in their nose as well it's really important to pay attention to this and to really look at this so it's not food as medicine as food and medicine all about activating our body's health defenses the future there's this this is going to take us into really distant locations that we can't even predict yet the flavor room is actually looking at what are the substances of mother nature's imbued into foods and how they relate biologically and so when we think about all these amazing things that I showed you earlier that people might be enthusiastic about because it really is today's innovations I hope I've shown you a little bit about what is possible in the future by really taking really the best of all we've got that we've done already in bio pharmaceuticals and applying that same kind of thinking and I'll just close with this quote by Andrei Gd who won a Nobel Prize he said man can discover new oceans unless he's got courage to lose sight of the shore and I think that's where we are with food and medicine this is about losing sight of the shore that we always talked about just go vegan you know eat sustainably like yeah we need to do all those things but look at how much further we have to go anybody who wants to learn more about the details of what I've shown you and get the lists of the foods that can activate angel Genesis stem cells microbiome DNA protection and immunity I wrote this book eat to beat disease feel free to connect with me and I hope this is something that will impact the decisions you make this evening thank you thank you that tour-de-force two quick questions I don't think I've had broccoli choice 20 as my mom is here thanks mom I never really it was good with my veggies all those sort of green powders that you combine some of these things concentrated broccoli can that help me question number one as opposed to the natural way we all want to cheat don't we well look I mean I think that is completely legitimate to try to take versions of Whole Foods and try to create simplified ways to actually get as much goodness as you can but really is what we've heard at this at exponential medicine is that we are just scratching the surface of being on a monitor how what we're doing if we can have an objective measure that can show that the green stuff will do just as well as a serving of steamed broccoli then we'll actually be able to compare those things in the meantime I would encourage you to eat the whole food eat your greens last question real quick when you and I went imedicalschool barely any nutrition how do we encourage clinicians beyond nutritionists to start prescribing food for both prevention and therapy right well medically indicated meals is actually already starting and I showed you the insurance companies are payers and are and self-insured employers are now beginning to actually reward people for making better choices doctors are really at the back of the bus on this and I think one of the things that we all need to do is to encourage the young people coming through the ranks and and also the administrators who are actually looking at curriculum and the board tests designers to be able to put more information about nutrition so we're not only thinking about medicines we're actually thinking about food okay thanks so much all right [Applause] [Music]

Channel: Exponential Medicine

Views: 397,510

Rating: 4.8076491 out of 5

Keywords: food, diet, nutrition, exponential medicine, food as medicine, william li, xMed, longevity, health

Id: qhJZcKFfu_c

Length: 33min 30sec (2010 seconds)

Published: Tue Apr 07 2020