How You've Been Lied To About Calories, Dieting, Exercise & Losing Weight | Dr. Robert Lustig

most everybody has this insulin resistance problem that you know is called metabolic syndrome but insulin's the bad guy no matter how you look at it there is no weight gain without insulin you got to get the insulin down bottom line is anything that gets the insulin down ultimately leads to weight loss welcome back to the Doctor's Pharmacy Robert it's so good to have you back oh listen you know you and I are like thelman Louise yeah are we going to drive off the cliff in a convertible we're going to do our best you know sometimes you have to sacrifice yourself to get to the truth but you know I I think we met first as part of this film called the fed up right essentially fed up with the uh food industry making all of our children sick and fat and killing them and needing liver transplants as teenagers and and bariatric surgery as teenagers and this movie did quite well and it oh theatrical release you know I mean you know you and I were the two Talking Heads you know that sort of you know but we didn't get to meet until the uh the LA Premiere that's right we met at the premiere and and it was you know it was a really impactful movie for me because I realized you know in in that scene that I was working in in in the movie where I was working with this family of five that lived in a trail around food stamps and disability that had you know the father was 42 and had dialysis from diabetes and the mother was 100 plus pounds overweight the 16-year-old kid was almost diabetic with a body composition we did dexas scans of 50% fat 50% at 6 years old and you know they lost 200 lbs in the first year the father lost you know 45 so able to get a kidney the son lost ultimately 132 L PBS and went to medical school amazing what good food will do well it just taught me that you know people don't know the impact of all the ultra processed food they're eating they were trying to do the right things and you know it really s of set me to understand that it's really not that hard if people understand the biology of how their body works well the fact of the matter is they've been fed a uh a uh a myth and the myth is that Ultra processed food is food yeah well they you know it was interesting because they had they had all this stuff in their kitchen that they thought was lowfat Diet this healthy that and it was all processed junk that had high sugar even the Cool Whip which they thought was a healthy dessert topping said zero trans fat on the label and in the the container if you read the ingredient list forget the the front of the package labeling which is so misleading I always say if it has a health claim on the label you it's dangerous for you like gluten-free potato chips you know and it said zero trans fat but was only because it's mostly air and the FDA through a loophole that the food industry forced them to do because they basically have captured these agencies said if it's less than half a gram per serving of trans fat you don't have to say trans fat but when you read the ingredients it was high fructose corn syrup and partially hydrogenated soy oil that was it I was like wow so you know it was so powerful and and it kind of kind of made me realize that you know we really we really have a problem of awareness and education and how our bodies work and so your work has been so important because it it unpacks the biology of how food interacts with our hormones our gut microbiome our immune system our metabolism in ways that it's really information so food is instructions and and there's a huge debate out there which drives me crazy which is this debate that I want to get into today around the idea of is a calorie a calorie because this is what we've been taught and I'm just going to set this up and I don't let you roll so I'm going to set this up and let you roll because I know you can roll for hours uh the whole debate is is a calorie a calorie and is weight loss just about eating less and exercising more which has an implicit bias toward blaming the person for not excising more and eating enough so it blames the victim in my view absolutely it doesn't understand the real root causes it's great for the food industry because it's like oh it doesn't matter what calories you eat it could be a Coca-Cola calorie or a Twinkie calorie and it's the same as a broccoli calorie as long as you don't go over your calorie count and then there's the Other Extreme of the model which is the carbohydrate insulin hypothesis which essentially states that it's not what you eat it's it's not how much you eat it's what you eat and that the quality of the calories matter and that different macronutrients has different effects on your body on your hormones and your metabolism and your gut microbiome and your immune system all which impact your weight and then there's other schools of thought around obesogens which are environmental toxins that screw up your biochemistry and make you gain weight and there's oxidative stress theories there's a lot of theories out there and and that you know we we you know it's un nutrition is one of those really uh you know poor black sheep of the family in medicine where it doesn't get funding for real research and we need to be studying these things but we do know enough I think and you and my friend David lwig have really uh helped us understand a lot about the role of sugar and fructose and and carbohydrates refined carbohydrates affect our metabolism so can you help us kind of navigate this whole story and tell us uh you know what you know lay out you know the the the insulin hypothesis versus the energy balance hypothesis versus the obesogen hypothesis and how they all interconnect and and are they all sort of right they are all sort of right they're all sort of right and they're all sort of wrong and they're all sort of wrong so help us understand you know whether we should be just do Cal counting or we should just be focusing on quality or we should be detoxing our bodies or we should be like I don't know what so tell us cuz we're all lost the short answer is they're all right and they're all wrong alog together last month uh a group of four authors of which I was one the first author is hindell Jerry hindell who was the head of the um environmental uh uh endocrine disruptors uh uh group at the uh National Institute of Environmental Health Sciences and myself and Sarah Howard who runs heeds which is healthy environment endocrine disruptors and also Barbara corki who is the um uh named professor at uh Boston U won the Banting award for the American Diabetes Association so not exactly lightweights yeah we came out with a paper in international Journal of obesity which were very proud of yeah and it's called obesogens a unifying hypothesis for the pathogenesis of obesity now how does this work there are four prevailing models right now on weight gain and how it works you've mentioned all four but let's put some meat on those bones energy balance calories you eat too much you exercise too little and there is absolutely no question that people who are obese have been shown to eat more and exercise less yeah and I don't argue that the question is is that cause or effect right right okay is it a causative phenomenon is it a resultative phenomenon or is it an epif phenomenon okay and they can't tell us which so keep that in mind there's nobody in the energy balance model Camp who can actually say that that's the reason for weight gain all right could it be the cause could it be the result so keep that in mind now there is no question we are eating more as a society okay 175 calories per day more for adult men 335 calories per day more for adult women yeah 275 calories per day more for teen boys okay everyone's eating more and I I want to make a point on this before you dive into that yes we're eating more calories per person but if you look at the data from 2000 and this is from the N Hayes data the National Health Nutrition examination survey which is a national survey of you know tens and tens hundred thousand people right and what they found was from 2000 until now calorie counts have gone down as obesity rates have gone up which is kind of a paradox that's hard to explain with the energy balance hypothesis well in fact the food industry actually argues that Sugar consumptions gone down as obesity rates have gone up that 20 period so they say Well it can't be the calories and it can't be the sugar well wait a second it depends how you define sugar there a lot there are a lot of um you know it's cane sugar yeah maybe but that's because of other reason there are a lot of wise and wherefores to that we we'll get there now all of that is true in addition okay people say well we're exercising less and we are exercising less except not in the last 20 years in fact exercise rates have actually stabilized out yeah it's crazy I see like gyms on every corner Orange Theory solid core all these businesses up that doesn't really work it's because you don't know what they're doing in those gyms they're paying their money in for initiation and then you don't know if they're actually being used so gym memberships does not fair I know when I go plac kick energy expenditure okay and remember there are three kinds of energy expenditure there's a resting energy expenditure you know just living which is 65% of energy burning there is um uh the thermic effect of food which is 10% of energy burning that is just the metabolism of food itself that you know generates heat yeah takes work to digest digest food energy yeah and that gives you body heat and then finally there's voluntary energy expenditure which you know runs between 25 and 35% of total energy expenditure so if energy expenditure is going down which it's not but if it was going down okay which of those three buckets actually explain it well in fact none of them do so there are a whole bunch of issues with regards the energy balance model to start with okay in addition it doesn't explain why when people lose weight they Plateau because if they eat less and they lose weight you'd expect them to continue to lose but they don't they plateau and of course thats everybody crazy and then they say oh I'm a failure and then they go eat the Ben and Cherry's you know and it's and it's all over and they've you know yo-yoed back up to where they belong in the first place right so if if energy balance were the only issue okay it that would that phenomenon would not occur so there are a whole bunch of things wrong with energy balance in addition energy balance does not explain why we have newborn obesity yeah why little kids come out why babies come out obese now four separate studies one in Israel one in South Africa one in Russia one in the United States over the last 25 years newborns weigh 200 gram more than they did 25 years ago and when you stick them in dexus Scanners to figure out what the 200 grams is it's all fat almost half a pound is what you're saying half a pound of extra fat wow before they eat even had a chance to eat right mother's milk never mind Ben and Jerry's right okay so whatever uh phenomenon whatever uh model you want to profer to me about what the cause of obesity is you have to explain that yeah and you can't not with the energy balance model it's right and it's you know I think just to kind of double down on this you know calories do matter like obviously but and it's it's really about uh you know the the the quality of those calories and people and what they do to your body you you always have this saying that a calorie burn is a calorie burn but calorie eating is not a calorie eating you say that 100 times and what that means is when you eat food it interacts with your microbiome it interacts with your immune system it interacts with your hormones so it's not the same and when people say it's all about calories then I say well how do you explain the fact that a type 1 diabetic can eat 10,000 calories a day and lose weight at the same time because they have no insulin because they have no insulin and so that's where the second model comes in the carbohydrate insulin model now I will tell you until about two years ago three years ago I was a proponent of the carbohydrate insulin model because I had done research in it myself so this is a uh model that has been particularly proferred by David lewick and you know appropriately so and I I was Professor basically he does what I do except at at B and he he's one of the few people who do randomized clinical trials and he does most rigorous kind of research not just population data but he does it on humans and it's a lot of money but he does it perspective clinical trials done with appropriate controls um David's a top-notch scientist I I I have zero zero uh concerns about his accuracy the quality or the veracity of his data or of his thinking yeah he's he's he's he's solid yeah absolutely okay across the board and he's a friend you know full disclosure me too yeah he's a good friend yeah all right now I was a proponent of that model too and the reason I was a proponent of that model was because I did a similar experiment when I worked at St Jude research Children's Research Hospital in Memphis Tennessee so you're probably familiar with this phenomenon called hypothalamic obesity so these are kids for the most part adults too but mostly kids who get tumors of the posterior FASA the hypothalamus mostly and they require uh uh surgery they require radiation uh they end up with hypothalamic damage and now they can't see their leptin so leptin is a hormone that your fat cells make that feeds back on the brain and tells your brain hey I've eaten enough I don't need to eat anymore and I can burn energy at a normal rate because I have enough energy stored in the body okay so it's a Servo mechanism just like the thermostat on your house okay so leptin's basically telling you the Heat's high enough okay we don't need any more heat so you don't have to eat anymore okay well these kids lost their ability to see their leptin yeah because those neurons were dead and so number one they ate like crazy and number two their energy expenditure was in the sewer and the catac Coline levels in their urine were zero because their sympathetic nervous system was basically shut down because they're trying to conserve because the sympathetic nervous system is what inates the muscles to work yeah the sympathetic nervous system is what inates the fat cells to give up their fat yeah okay so they can't give up their fat and they can't burn so they're eating like crazy and they're burning like zero right okay and so they're gaining weight out of sight 30 lbs 40 lbs a year at infinitum and there's nothing that anyone could do about it yeah like the the governor is off like the thing that tells you I'm full is just off yeah the thermostat's broken right so I inherited a Cadre of about 40 of these kids at St Jude yeah okay who had survived their brain tumors but became massively obese because of the therapy yeah and the parents would scream at me this is double jeopardy I you know my kids survive the tumor only to succumb to the therapy yeah and that was you know unfair to say to say the least and it was up to me to do something about it now as a neuroendocrinologist I did know that there was this literature okay about something called the vmh lesioned rat the ventromedial hypothalamus lesioned rat so you put an electrode in the hypothalamus you go and those animals become massively obese also but what was interesting was you could cut the vegus nerve the nerve that connected the brain to the pancreas and then they wouldn't so that's we assumed we assumed at that point in time this was 1995 now so almost 30 years ago Dark Ages right the days of the Giants remember them um I was there I graduated medical school in ' 87 so yeah I was there so we assumed that these kids couldn't see their leptin so their brains thought they were starving so their sympathetic nervous system was in the sewer and Vegas nerve was telling their pancreas to release more insulin in order to drive whatever they did eat into fat to raise the leptin but they still couldn't see it because because the body thought it was starving because the body thought it was and even though there was plenty of food without leptin saying stop the body is like I'm hungry so let's store fat let's get everything stored because I don't know when I'm going to get my next meal and insulin is that fast storage hormone and right exactly so insulin was the business end of the equation so I'm not a neurosurgeon I can't cut a Vegas nerve but could I do something similar yeah so we gave them a drug that suppressed beta cell insulin release so that drug is called octreotide it happens to be used usually for acromegaly for growth hormone secreting tumors but we repurposed it because it also suppresses pancreatic insulin release because there are somatostatin receptors on the pancreas yeah on the beta and we gave these patients octreotide and lo and behold they lost weight they lost weight but something even more remarkable occurred they started exercising spontaneously yeah one kid became a competitive swimmer two kids started lifting weights at home one kid became the manager of his high school basketball team these were kids who sat on the couch ate Doritos and slept okay they had lost all uh touch with you know the world around them because they felt like crap awful they felt like crap all the time and all of a sudden they woke up and the parents would REM you know like within a week they would say before there's any weight loss they say I've got my kid back and the kids were active and they were saying my head this is the first time my head hasn't been in the clouds since the tumor so what did what did that teach you so well so we did a double blind placeo control trial proved it again then what we did was we did a study in taking this trial taking the drug and blocking the effect blocking the effect of insulin insulin right so then we ask the question are there adults without brain tumors who might manifest the same problem that is leptin resistance not being able to see their leptin High insulin release driving their weight gain and driving their sloth and by the by the way with leptin resistance just like in resistance you see high levels of leptin in the blood so you can measure it oh yeah super high because because their fat was so large that you know their leptins were you know in the stratosphere yeah and the company I co-founded function Health where people can ask for their Labs their basic lab panel includes leptin insulin and adiponectin three things you need to know that are really important for understanding insulin and carbohydrate metabolism without question yeah you know um explain that to the American Diabetes Association I know so we said are there adults who might have the same pathophysiology that is leptin resistance insulin release driving their weight gain and if we gave them octreotide would they lose weight and sure enough they did not every patient only 20% of the total eight out of 44 but what was interesting about the eight was that their insulin response to glucose was markedly different from the patients who did not respond number one meaning meaning they had higher levels of insulin they had higher spiking levels after eating sugar yeah and what we did in that study was we measured resting energy expenditure with a metabolic cart yeah before and six months your basic metabolic rate your basal metabolic rate and what we saw was that the patients who lost the weight the responders who had the high insulin response their energy expenditure did not go down even though they lost weight you expect it to go down because once you lose weight you know you conserve yeah their energy expenditure went up really because we got the insulin down down yeah so there is a subset yeah of patients with obesity that are just like these kids yeah and so insulin is a Lynch pin in driving weight gain in everyone but not everybody has this insulin release problem that the kids did most everybody has this insulin resistance problem that you know is called metabolic syndrome to some degree or another some degree or and and what is but insulin's the bad guy no matter how you look at it there is no weight gain without insulin you got to get the insulin down and so once I learned this I changed my clinic practice completely and instead of being a weight loss program it was an insulin Reduction Program get the insulin down any way you can and I have been trying to promulgate this as a modality as a as a you know model for other obesity programs and only my uh former fellows do it that way it's been we've been doing this in ultral Wellness Center for 25 years yeah so absolutely you know I I just want to sort of highlight this point because just to go back to this Diabetes Type 1 diabetes if you have no insulin like a type 1 diabetic you can eat 10,000 calories and you'll lose weight absolutely but if you eat very little and you have high insulin you're going to store all that fat exactly and and and I had a patient once that just was one of those teaching patients you know how you think you learn medical school and you learn no it's actually the patients to teach you of course and this patient she looked like an apple she had big round belly I was convinced she was going to have high blood sugar high1 C she was going to be having diabetes checked her blood sugar was perfect so I said let's do a glucose tolerance test but measure insulin also right fasting and after 1 hour and two hours her blood sugar never changed like it was at 90 and then it went to like 110 and then 105 in 2 hours it was like perfect blood sugar you never would have thought she had issues and that's what doctors do but they don't measure insulin insulin her insulin fasting was like I think 50 and it went up to two or 300 two or 300 two or 300 my kids went up to 1,200 oh yeah I never saw that well you're a pediatr you're a pediatric indology you see the worst of the worst but I was like oh wow okay insulin is the problem here for her she's spiking so much insulin she can't lose weight and she's storing all around her belly bottom line is anything that gets the insulin down ultimately leads to weight loss and there are different ways to be able to do that obviously caloric restriction will get insulin down carbohydrate restriction will get insulin down the ketogenic diet which is the extreme of carbohydrate restriction will get insulin down metformin will get insulin down and all of those are clear you know uh having lots of fiber yeah high fiber diet will get insulin down ex thank you exactly right all of these are modalities that basically impact insulin response the insulin kinetics and so there is absolutely no doubt that insulin is the Lynch pin in weight gain so the carbohydrate insulin model that David you know helped promate and which I subscribed to because of the work I had done you know I I was uh in that camp yeah until about two to three years ago ah okay interesting when I learned a little more yeah okay you know that's why you do see me the the thing about everything is that we polarize everything and there's truth in everything like it's not one thing and in functional medicine we understand the network effect in biology it's basically an ecosystem a set of biological networks that all interplay with each other and there are many variables that can create the same outcome right agreed so the bottom line is if you think it's a nutritional issue you'll stick with nutrition if you think it's an endocrinological issue you'll stick with the Endocrinology if you think it's a GI issue you'll stick with the GI we have siloed medicine so severely the fact is this is a systems biology issue yeah exactly I mean you can do a fecal transplant and make someone less insulin resistant by changing their microbiome exactly right so if you just do a poop transplant you can lose weight and and improve your diabetes Well how does that make sense even not changing your diet it's because there's so many variables right well and because there are so many different uh nodes because um uh uh energy is so integral to survival of the species that there's redundancy built into the system you don't make energy dead in a couple minutes that's what does four right exactly exactly all right and why because it affects the mitochondri so we're going to go back to the mondri again little energy Factory right because that's our systems biology you know 101 for today is the mitochondria you're going to hear this a lot people all right so about three years ago um Jerry hindell put together a meeting uh on environmental obesogens now I've done some of this work as well because I worked uh along with my colleagues at UC Berkeley on a study called the chamacos study which is children and mothers of the Valley Farmers I know about this I wrote about it my book and these uh kids you know these were The Offspring of mothers who were exposed to high doses of pesticides through their pregnancy and so they measured the you know pesticides in the pregnant Mother's urine and then watched the outcome of the babies after they as they grew up so you know and we looked at several different phenomena we looked at growth we looked at reproductive capacity we looked at um neurologic IQ I there 41 million IQ points lost in that cohort that was striking to me and of course we looked at puberty we looked at obesity MH okay and so we know that Mother's uh pregnant mothers uh DDE levels which is a metabolite of DDT which hasn't been around since 1972 but it's still everywhere it's still everywhere it's a forever chemical predicted obesity in their 5-year-olds MH mhm so this clearly means that there's something going on even before birth like for instance those newborn obese kids we just talked about so trying to understand how obesogens that is environmental factors that can lead to wake gain what might be the reason for that well we wrote SE three papers back in 2022 uh about this 44 authors uh I was lead author on one of the three papers and there are a lot of different ways that you can make a fat cell yeah okay estrogen will make a fat cell Androgen will make a fat cell PPR gam will make a fat cell uh the uh um aeral hydrocarbon receptor will make a fat cell make a fat cell bigger or make a make a new fat cell both you know different ones at different times and there are windows of uh critical periods yeah so the question is does does the energy balance model explain this no does the carbohydrate insulin model explain this no okay so clearly ex we needed some more and so the question is what ties all of this together in walks Barbara Corky who has done you know a lot of this work and she had done work on reactive oxygen species both in the dish and in the animal and it turns out reactive oxygen species which are you know things you can't get away from if you're alive you've got Ross's okay because mitochondria make Ross it's part of normal biology it's part out of control like anything like your blood pressure your blood sugar whatever it's like normal but you don't want it too much Ross's change the phosphorilation status of the enzymes in the cell in English please every cell in its lifetime yeah has to grow or burn make energy utilize energy yeah okay but not both they do one or the other and there are there's an energy metabolism pathway in every cell to teach that cell whether it's going to burn or grow and there three enzymes one is pi3 kinas phosphat andosol 3 kinas this is the um uh enzyme that luk kley uh at uh first at Harvard then Cornell you know found is uh basically predictive of cancer right because what it does is it opens the spigot for glucose to enter the cell in high in high concentration the second one is am kinas that is the fuel gauge on the liver cell on on pretty much every cell that's regulated by metformin which is a drug for diabetes yeah exactly and so what it does is it tells the cell to make more mitochondria because the energy is low it's when energy is low That's goes up I call that one of the longevity switches it's part of our Hall marks of Aging yeah correct and then finally the third enzyme is mtor Mamon Target of rapamycin that's a kinase also all three of these are kinases again I call that one of the longevity switches which makes protein and it's good but it could also over be overdone well it tells the cell to divide yeah okay it's the division signal so if you're dividing you're growing okay but if you're burning you're not growing yeah okay you're one doing one or the other no cell does both at the same time okay so there is uh there are two pathways and the switches are these three enzymes well these three enzymes are kinases which means their phosphorilation status dictates whether they're on or off that's just a chemical reaction that kind of regulates whether they working or not working right that's right and guess what makes that phosphorilation occur reactive oxygen species so we started looking with Barbara at the question of whether or not all of the things that we know cause weight gain whether it be inflam atory things like for instance um air pollution has been associated with weight gain uh or um uh uh environmental obesogens like you know phalates or uh BPA and um uh parabens uh whether they all petrochemical things that are everywhere from pesticides to Plastics and everything in between and whether they cause reactive oxygen species to drive the weight gain and Bruce blumberg at UC Irvine has shown that tributal tin is a great model for this because not only does it cause reactive oxygen species but it changes the genome The epig genome I should say okay so that it carries forward for four at least four generations because of reactive oxygen species so um and then we looked at the diet yeah and sure enough everything in our Western diet generates more reactive oxygen species just the inflammatory process food in general not necessarily containing toxins but just pulverized science like science food projects as soon as you generate more Ross's than you can quench you know and antioxidants are the quencher yeah so R is a reactive oxygen it's basically like rusting so we talk about is like when you get wrinkles in your face your car rust cataracts that's going on in your body inside not just outside and that's normal but if you have too much of it it causes damage to your cells faster you die faster yeah basically it is the Aging uh reaction sped up yeah okay and it turns out ultr processed food does all of that and so the question is can we use this uh um uh Paradigm of reactive oxygen species generation and lack of quenching as the model for being able to actually do something about obesity and we are now in the process of Designing the study you know to do that yeah so it's interesting you know uh Robert in 2007 I wrote an article it was titled systems biology toxins obesity and functional medicine and I literally wrote and that was like almost 20 years ago writing about my observations that there were certain patients that were struggling with weight they weren't because of what they were eating or not exercising it was something else I had one woman she was a fitness trainer she ate perfectly and she couldn't lose the 40 pounds that were hanging on her body I'm like geez you know I don't know but I think there's some data that shows that environmental toxins May why don't we check what we can check we checked heavy metal and she had high Mercury and we got the Mercury out of her system we detoxified her she lost 40 PBS like that and her blood pressure probably came normal and I you know started looking at the data and there was data on how environmental toxins are interfering with every cellular process including metabolism and drive insulin resistance and also affect thyroid and one of the interesting things as people lose weight you mentioned the plateau well when you lose weight where are the toxins stored they're stored in your fat tissue so they get released and then they start to interrupt your metabolism so they interrupt the conversion of T4 to T3 which is the active thyroid hormone which is your metabolic rate so it it's it's sort of the science then was in in in its infancy but but I saw it and I actually had a chapter in my book in 2005 called love your liver uh in Ultram metabolism to kind of help people understand that detoxification and getting rid of these chemicals from their environment and lifestyle and also from their bodies by a scientific detoxification approach really works right so there are a whole bunch of different things that we are exposed to that affect different aspects of our um uh energy burning pathway uh the one that we are now most interested in and most concerned about is the mitochondria because after all that's where ATP generation occurs that's where your metabolism is essentially is in your metaconda right right so we can talk about um environmental obesogens we can talk about food or we can talk about stress yeah it turns out stress does it too yeah for sure so pretty much everything that you know drives weight gain yeah and drives these chronic metabolic diseases you know can be basically bundled into one of these four um you know one of these three bins sorry U the food the environmental exposures or the stress and say none of this has anything to do with genetics right and I would say that you know the calorie quality and the amount matter so it's it's not like it's an either or you you need to pay attention to well yeah of course because calorie amount means more Ross's yeah so it's not that and actually noticed this one sec I just interrupt because I just thinking all these things but I had I had this meal in Martha's Vineyard once on a summer with a friend and we ordered from this like organic regenerative thing we order like so much food and it was so delicious and both of us are you know like basically fit healthy guys who have no metabolic issues and we eat enormous amount of food of healthy food and we had our continuous glucose monitors on and we call each other at 10:00 and I'm like hey Michael what is going on your blood sugar high yeah my blood sugar is high so it was like my blood sugar went to like 150 because it was the amount of food also had this effect well of course I mean there's no question you can overwhelm your body's ability to handle or to clear glucose and so that you know brings us to the question of should we be monitoring glucose you know this phenomenon glucose and Insulin yeah so I believe that insulin is the bad guy I wish that we had a method for monitoring continuous insin monitor monitoring when are we getting that I've been asking that for 20 years 5 years 5 years 5 years serious like a patch or that's going to be a game because glucose is sort of fine but it's the last thing to go up it's coming yeah okay everybody's interested and everybody knows that's where the action is going to be but we don't have insulin right now but we do have glucose but you can measure your blood test for insulin yeah fasting and you can also do postprandial insulins if you know how and if your doctor actually understands what they're doing and if you can find a lab that will actually stick you at you know for glucose and Insulin you know and send all of them you know for the most part the insurance company won't pay they pay for but it's not that expensive and I do it I've done I've been doing it for 25 years so you can get it done easily I did oral glucose tolerance tests with simultaneous insulin levels on all of my obes patients that's how I you know came to the realization insulin was the bad guy yeah me too me too exactly right so you know when is the rest of medicine going to wake up you know when we have the continuous insulin monitor that's when yes but it's coming it it's just not here yet point is we can use glucose as a proxy for insulin yeah now glucose is bad by itself because high glucose leads to endothelial dysfunction it changes the cells inside your arteries it's one of the reasons for high blood pressure it's one of the reason you know and also generates uric acid which also increases blood pressure and you know it it there's neuropathy nephropathy retinopathy all you know small vessel disease related to you know severe fluctuations in glucose so glucose is a bad guy in the story but there are two worse guys in the story yeah one of them is insulin yeah and the other one is fructose which is not measured in the serum glucose no you don't measure it's it's a it's a different Phenom you can measure like human GL A1C we used to measure fructosamine well you can yeah but fructosamine is a measure of glucose it's not a measure of frose I wish it were true I would be measuring it on everybody but it's not true okay I wish it were so yeah anyway bottom line is there are other things to know yeah other than glucose yeah glucose is in my estimation about 10% of the equation on metabolic Health okay but that's a 10% we have now and we can glean the information on both insulin release which is its own uh problem phenomenon and insulin resistance which is its own problem phenomenon and be able to figure out which is which and then be able to address our therapies to the appropriate pathology by understanding what's going on with glucose so I am for continuous glucose monitoring even in non-diabetics and of course that's one reason why both you and I full disclosure are advisers to company called level's health and that's exactly what they do and I have to say that we have data that shows that exercise affects that glucose response that we have uh data that shows sleep affects that glucose response in non-diabetics in you know normal weight people and we also have data that shows that if you know your glucose you lose weight yeah yeah it's a feedback mechanism it is it's like electric shock like oh my BL sugar is high when I ate that whatever cookie I'm not going to eat that again so so there are there's data to be had that we can access today is it perfect no of course not do we need more information absolutely but you know to to you know ignore this possibility I think is you know not serving our patients properly I will tell you I uh recently just uh within the last week had dinner with two of my former trainees and they didn't know a thing about this I mean they're Pediatric and the chronologists yeah and they didn't know a thing about this tell me about my daughter's a thirdy year medical student Rachel learn about insulin resistance not really so so there there is this big hole about nutrition nope no no n Medical School yeah there's a big hole in medical education okay and the reason I think is because you know what we learn in medical school and we've talked about this you know is there's a pill for that yeah well there is no pill for this that's what we've learned there is no pill for chronic metabolic disease well OIC no okay let me let me just unpack what you said because it's so important I want to make sure people got all the things we talked about so there's basically three to four hypotheses that are needed to explain all the facts so you you know science is designed to try to explain the facts that are observed however a l lot of times in science we misinterpret the facts and we create meaning in ways that actually aren't true for example I'm reading this book called rethinking Diabetes by our friend Gary TOS it's this fascinating history of diabetes and he talks about how in the early days with type 1 diabetics you had to give them a high fat keto diet or they would die so Elliot Joslin knew glucose is of no use to the body that's a direct quote from Elliot Joslin before he knew what insulin was 1893 he said and Fred Allen who took over for jlin in 1919 published a you know Trea basically saying way to treat type 1 diabetics was a 70% fat 8% carbohydrate diet so so they said that but then what happened was years later when they started getting insulin they saw that all these people were dying of premature heart disease and ecosis right so they made the observation that the fat in the arteries was happening in these patients and they hypothesize based on that set of facts that it was the high fat diet that they ate when they were younger that caused clog arteries they just misinterpreted those facts so what what why I brought that up is is we have to agree that we have a whole set of facts that don't meet all the theories so we need multiple theories to actually understand it so is the energy hypothesis wrong not completely is the carbohydrate insulin model wrong no it's actually mostly right but this doesn't explain everything is the obesogen model the entire story no not exactly because like stress plays a role for example stress I found out when I was researching one of my books that that your vagus nerve and your sympathetic nervous system inates every one of your fat cells that's right so when you're stressed it literally sends a nervous signal a nerve single to your fat cells to say stop burning calories so these are the four things we talked about that all play a role and have to be encountered and and you have to personalize the approach to each person it's not like oh this is going to work for this person that going to work for that person person there is no one size fits all so to to that point and I'm glad you brought that up you know people think that the sympathetic nervous system results in lipolysis because you exercise bur fat burn fat right and that is true in the acute situation in the acute situation you release norepinephrine from your sympathetic nervous system norepinephrine via the intermedial lateral cell column and the uh peripheral sympathetic nerves go to each fat cell bind to the beta 3 energic receptor activate hormone sensitive lipase ultimately leads to dissolution of the trial glycerol into free fatty acids and glycerol which then circulate back in the bloodstream to the liver which then turns them into ketones for the rest of the body to use that's lipolysis and that's what acute sympathetic nervous system activation should the exercise does acute and by the way everybody should know that insulin blocks lipolysis so basically insulin prevents the fat breakdown so as long as your insulin's high it's hard to lose weight that's exactly right insulin blocks your ability to be able to lose weight that's why in getting insulin down is job one yeah for just that reason exactly right now here's the problem with that yeah chronic activation of the sympathetic nervous system does the opposite now how come so every sympathetic neuron in your body whether it's in your per in your spinal cord or in your brain doesn't matter releases norepinephrine but also releases a neuropeptide called neuropeptide y oh yeah npy they are co-released the turns that npy binds to its receptor in the case of the fat cell it's the Y2 receptor and what it does is it shuts off that hormone sensitive lipase so the uh you know the lack of insulin and the sympathetic nervous system now instead of generating lipolysis you are actually generating lipogenesis you mean you bail fat instead of burn fat yes yeah exactly and so chronic stress because I'm I'm the I'm the like Obama had his anger translator I'm the Robert ltic translator absolutely the point the point is chronic stress does the opposite and we all know that chronic stress is the bad guy in the story acute stress is for the most part adaptive but chronic stress is clearly maladaptive all sorts of and it's not just because when you're stressed you eat that Pine Ben and& Jerry's it's another mechanism right it's another mechanism it just if you eat that Pine and B and Jerry's on top of it it makes it even worse but it's yeah well the pine and B and Jerry's is because of what's happening at the amydala at at the at the fear center of the brain okay because dopamine is one of the ways to basically put you know plate that amydala you know at least short term you know and so that's you know what stress eating is about um and you know I'm I'm you know card carrying uh member of the stress eating Club you know um until until until I did the research and understood it better and now I'm a whole lot you know uh uh more appropriate I know last night I I was really tired I had a very stressful weekend uh and I flew from New York to LA and I was really you look pretty good I was really tired and I went shopping and I was really hungry I went shopping at aan and literally this voice in my head was buy the ice cream Buy the ice cream buy the ice cream and I literally had to like override that cuz I knew if I brought it home I would eat the whole thing of course right but I just I was able to manage my higher self kind of kicked in and told that guy to shut the f up and I was able to sort of manage the store and you know was very tough but I got out of the store safe and didn't bring it home but I would have eaten it even though I know everything I know I've written 19 books about this I I it's not something you can willfully control right so the bottom line is we have to number one get the insulin down and number two we have to get the amydala working properly those are our two most important things now how do you get the insulin down well number one don't let it go up well but can I just interrupt for a sec because you're you're you're basically laying out these different hypothesis but I hear you going back to insulin is are you leaning more towards the carbohydrate insulin hypothesis well I'm leaning more to the Ros hypothesis so the question is what is Ros is due to your beta cell turns out it makes more insulin release Ross's in the beta cell actually generate an bigger insulin response so basically oxidative stress from anything environmental toxins sugar Ultra processed food are microbiome being messed up chronic chronic stress all these variables have to be looked at so it's exact it's not just a I mean obesity is not an OIC deficiency is it no and we'll talk about that in a minute that's right the point point is the point is everybody who's got metabolic disease which is 93% of America has a problem with one or more of the five things you just mentioned that's staggering Robert 93% of Americans have some degree of this problem even though 75% overweight so you don't have to be overweight to have this problem you can be what we call skinny fat or metabolically obese normal weight or you know tofy thin on the outside fat on the inside and what we know is that those patients have liver fat yeah so just just because you don't have uh subcutaneous fat doesn't mean you don't have liver fat so there just because you're healthy doesn't mean you're well and just because you're fat doesn't mean you're sick yes okay the the overlap is huge yeah all right so this is a problem for everybody and so the question is what do you do about it how do you figure it out are you at risk does your doctor know it will they help you and if not how are you going to figure it out for yourself well you know that's what you and I are doing this freaking podcast for is to try to help people understand that exactly right okay point is insulin is one of the drivers promote metabolism get insulin down the other one is suppress inflammation because inflammation drives insulin resistance to from anything an infection viruses have been linked to obesity right ad vir virus 36 for for one and and others too but mostly ad36 um point is inflammation drives Ross's because inflammation drives nadph oxidase at the level of the liver driving those Ross that's that's what nadph oxidase makes as Ross's okay now the part of your mitochondrial processing of the food you eat and oxygen you breathe and it sort of has these little Pathways and when it goes kind of arai it's like going on the wrong pinball thing and it doesn't go where you want it to go exactly and ends up causing more damage exactly right Ross's have to be quenched now the quenching occurs in the peroxisome and that's where the antioxidants live so in the liver it's glutathione or maybe vitamin E in other cells it might be uh you know other sod Catal proxy these are all these are all antioxidants that your body makes and they're so powerful and often they're overwhelmed and they often we don't support their their function with the right nutrients right exactly so for instance glutathione needs methionine well methionine is the second rarest amino acid after tryptophane that's rarest and you need tryptophane in order to be able to turn that amydala off all right but methionine is necessary to be able to make edenal methionine which then contributes the methyl group for glutathione well if you're methionine deficient you got a problem yeah and glutathione is like the King Kong of antioxidants essentially exactly my colleague your body makes it my colleague Jackie Mah at San Francisco General Studies the methine choline deficient rat the McD rat poor rat not R but it might as well be okay this is the fastest way to fatty liver disease there is and the reason is because um uh without methionine you can't generate glutathione so you're going to get uh uh naff non and also choline choline makes phosphole choline which is part of apob which helps export the fat out of the liver so it can go to the atpy instead yeah so without choline you can't get the fat out of the liver so you you know you make too much and you can't clear it and so these animals have fatty liver like crazy like about almost 100 million Americans point is point is methine and Coline are things that you don't find much in processed food no no where are they found well they're found in real food I mean methionine is found in you know basically good protein when I say good protein fish poultry eggs okay um oh sure red meat absolutely absolutely um you know and also you need iron for this too you know Coline is where and Coline is in red meat as well eggs egg and eggs sardines sardines which I have I have a can of sardines here with me now for lunch um the the problem with Coline is that choline can be acted on by the intestinal microbiome to form trimethylamine TM and then that gets oxidized in know Stanley Hayes in a Cleveland Clinic where you by the way are um you know working as well you know with Michael royen uh you in their Wellness uh program so you know the so you know even though sometimes things are good sometimes too much of a good thing is not so good and so we have this problem in nutrition also is that we have inverted u-shaped curves for certain things like choline yeah you know Chine used to be called vitamin B4 you know so it's it's essential it's essential right it's essential so it it's these are the things that are wrong that we have to fix you're saying inflam you going about inflamation right you're going inflammation is driving this so where inflammation is coming from if it's coming from stress if it's coming from toxin it's coming from sugar from your microbiome it's coming from our diet diet that's where it's coming from so if you have an autoimmune disease it's coming from your immune system but if you don't have an autoimmune disease which is 90% of us 10% do but 90% of us don't okay it's coming from your gut now your gut is a sewer what's the definition of a sewer a pipe with you know what in it yes okay that's what the gut is it's a sewer well all that junk in there is bad for you you don't want it in your bloodstream it stays in your gut so there are three barriers in your intestine to keep the junk out of your blood the first is the physical barrier the mucin layer mucus right it's and it lines the intestinal epithelium all the way through the second is the biochemical barrier which is the zulin the tight junctions that hold the intestinal epithelial cells together like Lego Lego blocks suuck together yes kind of sort of like Lego blocks and when they become dysfunctional then they get permeable and that leads to what we call leaky gut yeah and the third is the immunologic barrier and those are called th17 cells and they make a cyto kind called il17 so those are white blood cells and they're making inflammatory compounds right exactly to get rid of foreign yeah okay so three it's like the front line of the military on the front lines right yeah well you've got the yeah you've got the guys at the front the pawns then you got the knights and then you got the Bishops all right before you get to the King right I mean you have all of these um things you know in defense of your bloodstream the point is all three of those are failing today because of ultra processed food yeah the mucin layer because of the lack of fiber m the microbiome will actually chew up the mucin layer layer for its own purposes because it otherwise is starving fiber is the food for your microbiome fiber is the food for your bacteria fiber is the nutrient you don't absorb because it's not for you it's for your bacteria but our food is fiber you know fiberless on purpose because you can't freeze fiber exactly so the food industry took it out yeah well we got to put it back in and that's what this yeah what is that so you know full disclosure I am the chief medical officer and co-founder of a fiber company and it's called biolumin and the product is called Munch Munch and we just released it end of November it's doing very well and what what's in it what is in it it these are microcellulose sponges seven microns in diameter so the size of a red blood cell so it flows like a powder it's colorless odorless tasteless textureless CU your tongue can't tell six microns yeah it's got to be 12 microns or greater for your tongue to be able to discern the that it's there so it can go into U uh uh bean dip it can go into chocolate it can go into ice cream smoothies yogurt anything that's non aquous well well you can put it in water and then drink it drink it right away right if you leave it it'll swell to a gel and you can put a spoon in it stands straight up right right we don't want to do that cuz then no one will drink it yeah yeah you you swallow it in the food or otherwise in the in the stomach it'll start expanding it expands 70 fold over its original size incredible so that'll give you a feeling of fullness which helps and when it expands it uh uh exhibits the nooks and the crannies in the sponge right like the kitchen sponge you know has the holes in it yeah impregnated in all of those are a set of proprietary hydrogels soluble fiber which sequester absorb soak up glucose fructose sucrose simple starches even fat too no not fat not fat not fat if it doesn't limit GL like cholesterol because a lot of the fibers will like meduse will reduce cholesterol absorption yeah but this one won't interesting so that's one of the Geniuses of this is it only works on carbohydrate interesting because you don't want to absorb fat because if you absorb fat number one you get bad GI side effects that's what happens xal or you know you don't want to prevent the absorption fat right exactly orat and that fat blocker everybody was having disaster pants with right so this is basically what's in regular food and everything that's in this packet is food yeah all the components are food they're food grade we get them on Amazon we just assemble them in a specific proprietary you take it before you eat essentially you take it with you with the FI I just came back from Tanzania and I met with the honey Hunters the I mean the uh the hza which are this incred the last Hunter gathered tribe and and they hunt and they gather and 20% of their diet is honey right honey and and the other part of their diet is an enormous amount of fiber they eat 150 grams of fiber a day we literally dug a root out of a bottom of a tree it was kind of a wild yam and they eat that and so you know we all ate about 100 to 150 grams of fiber per person a day now we eat about eight or less right and and it's it's destroying our microbiome it's making us metabolically healthy and it's hard to get that much unless you're eating unless you're azda yeah unless you're a HDA eating tons of fiber all the time and it and it's hard and I think the data is really clear on other studies too like from Metamucil and we even things like uh polyglycol Plex from glucomin helps in there some of that in there right so the concept is right I mean so this is both insoluble fiber cellulose and soluble fiber these hydrogels okay and so it's unusual because it's a combination of both so it's going to do a couple things tell us the things that it does multiple actions in terms of its effects six separate effects so the first thing is it gives you a feeling of fullness second it absorbs carbohydrate and you know especially simple sugars in the dadum preventing their ability to cross into the bloodstream thus you reduce the glucose response you reduce the insulin response we just said that's the most important slow absorption of sugar into your blood and it's prevents this glucose Spike and the insulin Spike that makes you gain weight correct in addition it moves the food through the intestine faster because fiber you know is El Transit time we call Transit time Transit time decreases that means that you get your satiety signal sooner because it's at the end of the intestine the peptide YY signal at the end in the ilium at the end of the intestine in addition so so what you just said there was you you feel full the the satiety signal right which is py y and others that get released in the lower part of the intestine get activated from the fiber so that makes you actually shut your brain down from wanting food correct which is by the way is what glp1 does yeah okay we'll get to that number four it feeds the microbiome so it increases microbial diversity which is you know a way to prevent inflammation yeah there's like bugs that are good bugs in your gut and bad bugs and the when you eat processed food you grow bad bugs when you eat fiber you grow good bugs exactly okay and the good bugs are anti-inflammatory and the bad bugs are inflammatory so it doesn't matter what you eat if you have inflammatory bugs you get something called metabolic endotoxemia which means your inflammation from your bugs causes insulin resistance independent of your diet and do you know what does that Sugar because sugar nitrates those tight junctions and makes them nonfunctional and so transiently increases leaky gut yeah and gluten and gluten gluten and all the food additives the emulsive fires which destroy the lining of the gut yeah that's destroying that mucus layer that's right number five the uh the um soluble fiber acts as food for the colonic bacteria generating short chain fatty acids which have been shown to be anti-inflammatory anti-alzheimer's anti-cancer anti-cancer yeah and finally the insoluble fiber helps clear um uh cancer cells from you know sloughing from the colon so basically I think there's one more what's the one more well you secrete extra toxins from your liver into your bile and goes in your gut and so you have environmental toxins yeah they get pushed out as well faster so you have seven there yeah seven seven is a lucky number we have studied that one yet but that's that's actually very true the point is what this does is it recapitulates the effect of the fiber that was in the food to start with before the uh food industry got to it but it doesn't mean you can take that and eat Ultra processed food you want to still eat healthy food right well ultimately the question is can you have your cake and eat it too and that by the way that was just an article in the guardian three days ago that with that title um I'm not proposing we abandon trying to fix Ultra process I just have one of those before my Pine a Ben and Jerry's or what we need we need all the tools I bet that's what people are thinking well we need all the tools we can get okay there are sugar addicts out there who you know no matter what information we give them you know they're going to continue you know hitting the U hitting the sodas hitting the um the the Ben and& Jerry's and we have to provide them with uh methods for dealing with their problem as well think of it this way okay you got a heroin addict okay why is heroin bad because it's addictive because it's addictive well caffeine is addictive but there's a Starbucks on every street corner true so why is heroin such a problem because during the withdrawal phase you go steal a car that's why all right so what did Society do we came up with this thing called methadone and methodone based basically is an oral opioid which basically takes the edge off the peaks in The Valleys think of this as methodone for your sugar that's incredible addiction how how do you like that I like that I mean fix the it doesn't fix the problem but it helps mitigate the it's also not addictive methodone methodone is addictive so not quite methodone but I I I think you know I just want to bring this up because I there are a lot of criticisms about this whole food addiction Theory yeah and and there are a lot of people who are pushing back and saying it's not a problem that it's really just people's gluttony and that it's not really a biological phenomenon it doesn't meet the criteria does meet but if you look at I mean listen Kelly brell has created a whole Yale food addiction score it's a valid Ashley Gearhart has done enormous work Nicole Aina has demonstrated sugar addiction in animals and now in humans and I just met with her we just did the Commonwealth club last week we're going to meet in New York uh um next week as well there's a food addiction Symposium in London in May it and there's different degrees of it you know like there's different but there was a really interesting metaanalysis of systematic RW of 281 studies from 36 countries and they found that overall the prevalence of of food addiction according to the AL food addiction score which is a validated metric was 14% out outs yeah and 12% in kids and 14% of the population is alcohol addicted so it's like the same as ISM and tobacco is about 18% so let's use alcohol as the as the uh as the uh uh the template for this okay let's take the American population 40% of Americans are tea totals never touch this stuff 40% are social drinkers pick up a beer put it down I'm in that category yeah 10% are binge drinkers MH and 10% are chronic alcoholics yeah okay so even though alcohol is available everywhere 80% of the population does not seem to have a problem yeah and you know but 20% do do right and the question is what are you going to do for that 20% and why do they have it and why do they have it well it turns out they're probably the same people yeah so the idea that there's no sugar addiction doesn't make sense just because not everyone's addict doesn't mean it doesn't exist in fact sugar and alcohol are metabolized virtually identically the fructose molecule and the ethanol molecule basically do the exact same thing at the level of the mitochondria so it shouldn't be surprising that children who don't drink alcohol have the same diseases as alcoholics type two diabetes and fatty liver disease even without alcohol because they have a substitute yeah they have sugar yeah it's it's really interesting I mean I think the the food addiction thing is fascinating because even you know there's people say where the randomized control trials well David lwig did one where he basically took it was fasinating stud I call it the milkshake study you know about this study basically took two a group of overweight guys and he gave them on different times different milkshakes but they were identical in terms of calories carb fiber protein fat and the the speed of the absorption of the sugar was the only difference so one had a rapidly spiking sugar and the one didn't right and and they measured their brain MRIs and they measured their blood chem and even though they were identical in calories the group that had and they didn't and they tasted the same the group didn't know which one they were eating right the ones that had the high spiking sugar carbohydrate had higher levels of insulin higher levels of glucose higher triglycerides more inflammation and higher cortisol higher adrenaline and their brains in the area of addiction the nucleus that come is lit up like a Christmas tree exactly and that's a same area that lights up with heroin and cocaine and I think the anything anything that makes that nucleus cumbent uh activate in the extreme is addictive and now we know there's genetics to play a role right so so I don't know if you do this but I we haven't found the genetic Locus yet for alcohol or for nicotine or for sugar we may not know exactly but we do know that there's difference in dopamine receptors so we can measure genes for dopamine receptors and dopamine is the receptor that feels pleasure so in these people with dopamine receptor problems they end up needing more stimulation to feel the same goodness because the dopamine receptor has been downregulated it's the law diminishing returns basically uh well it's both right down regulate well there's habituation but there's genetics also right well yeah so the TAC A1 alil of the dopamine receptor so it's it's in about 20% of people okay turns out they make 30% fewer dopamine receptors on their neurons they gain more weight and those are the people more likely to be addicted or gain weight or have sugar addiction so it's you're right it's not some people oh sugar addiction not everybody's alcohol addicted not everybody's sugar addicted but it's a thing and it's as big a thing as alcoholism and it's causing societal Devolution okay in the same way alcohol did and so the then the question is all right if you know that something is both toxic and addictive Like Cocaine heroin nicotine alcohol you have um uh you know societal interventions that deal with it we call it public health yeah what do we have for sugar NADA not here I mean I I just came back from Chile and Argentina they have incredible laws that have really radically changed their food consumption patterns and to reduce the amount of refined uh sugars and carbohydrates and junk food because they put blackbox warnings on the front of the package they have eliminated advertising the got rid of Tony the Tiger they have no junk food in school so there's a lot of ways that we actually can fix this in policy you're working on policy I'm working on policy stuff so we have to get this done right so to that point uh we got uh standards for sugar in California down uh to 5% of calories in schools uh it's called SB 348 and my nonprofit eat re which you're very familiar with I help support and my CEO nor Lori is you know good friend force of nature she's amazing okay um you know worked with Nancy Skinner of the California legislature to push this through and we're trying to make this National and just today the White House announced that eat re is now one of its model uh programs for dealing with childhood obesity going into 2025 we are going to be taking 1 billion meals in out of uh in schools and making them low sugar uh and zero process that's God's work I mean because our kids are our future and we poison our kids I mean we have 40% plus overweight 25% are obese we have uh decreased performance in school decreased job performance decreased earning capacity shorter life expectancy 13 years of your obese as a kid I mean it's it's really a big deal it is well so so let let let the audience understand you know how this occurred because ultimately when you drive into a ditch you have to know how you drove in in order to be able to back out okay you can't just hit the the the the accelerator and expect to be able to come out the other side of the ditch okay you have to back yourself out so you have to know how you drove in why did this happen so when you and I were kids and we're about the same age okay we had school and we had cafeterias and we had lunch ladies I my mom always made my lunch okay all right well you know I my mom made me tuna fish sandwich every day and I could kill her to this day you didn't have school food when I was in I don't remember that well they had they had the blue hairs with the hairnets and lunch okay in 1971 the Department of Education passed a u uh an ordinance you know administrative law called resolution 242 which basically said that all cafeterias in the United States and public schools had to make book that is they could not lose money for the school they had to basically fend for themselves with their own budget yeah now that sent every food services director in every school in America running for cover what are we going to do how are we going to solve this because the biggest is issue was the personnel and the infrastructure you know keeping it running to be able to make school food yeah so in walks Aramark and Cisco and uh Guggenheim and McDonald's and Pizza Hut and says hey we'll do it for you will'll provide every kid with an air quote nutritious an air quote meal every single day and you won't have to do anything we'll take care of it and most importantly because we'll take care of it you can take your infrastructure you can take your preparation facili and get rid of the kitchen and turn it into classrooms and that was the goal is a deep fry in a microwave and you're fine right and and the point is that once you take the the the equipment out now you're Hostage to the food industry for the rest of your life and 1971 you can track when grades in elementary school started and the RSE is true I don't know if you know about my friend uh Jill um Shaw who created a program uh called MyWay Cafe in Boston where she basically paid for so philanthropist paid for the re institution of a kitchen in a school showed how powerful it was got the entire Boston City Schools do it and now the entire interner Cent Boston Schools all have kitchens the menus would all been designed by top chefs the food's delicious the kid eat it they don't throw it out it meets the school budget guidelines the the federal guidelines for school lunches and everybody's winning and they're not getting food shipped in across state lines and in packages with plastic with who knows what kind kind of toxins that infiltrating the food in addition to the junk that's in the food that's heated up in microwaves and deep friers the point is there are a lot of business models that work so e re is dedicated to finding the business model that would work with within any District so for instance we started out in Contra Casta County you know right across from San Francisco enterprising Food Services director wonderful guy Dominic Mackey he purchased a dilapidated Factory repurposed it into a food preparation facility for the entire District 20 7 schools 27,000 kids they made 27,000 lunches per day and because they were buying at scale they could buy cheaper and they could control what was in the food and so they could get rid of get this 10 lbs of sugar per kid per year they got rid of 100,000 pounds of sugar in the first year we have now gotten rid of 5 million pounds of sugar from kids diet that was some great visual that Jamie Oliver did in a t we took a bathtub full of sugar and that's School Bus what an average kid eats in a year right right the point the point is uh Dominic was able to actually save money because they could buy its scale yeah and so they made it in the one Central facility and then shipped it out to the 27 schools each day and so every kid got a real nutritious meal a hot food meal where we could control what was actually in it and you saw performance get better everything got better attendance got better behavior issues got better weight got better another example and this was not our example this was in Israel um 15 years ago um the uh rala School District yeah okay in the West Bank yeah had a 27% graduation rate 27% and you know if you don't graduate what happens to you you know is a likely you're marginalize terrorist whatever you know not good and the Israeli government did not know what to do with this a entrepreneur who's done very well in the tech industry Yosi vardy okay went to Netanyahu said give me the rala school district I will take care of it and they were only too happy to devest themselves of it yeah and vardy did one thing change the food he fed them yeah he didn't even change the food he fed them that's so right and they went from a 27% graduation rate to a 95% graduation rate in two years yeah no I've seen this I just came back from Kenya and I went to this school called little Alliance where it's in the worst slum kber slum in Kenya it's the worst slum in Africa I went visited there walked around it was incredible people live on $3 a day it's there's garbage everywhere I mean it's awful and this friend of mine started this whole school and his main thing was feed these kids three meals a day real food and these kids are thriving they're performing academically they're going to be doctors now and getting out of their poty why are we surprised your brain need needs nutrients well let's let's let's back up a little bit not just glucose it needs fatty acids it needs protein it needs you know anthocyanins it it needs selenium it needs zinc it needs you know Omega-3s where are you going to get them except your food so I want to I want to back up because this clearly we need to fix our school system we need to fix schools eat re is an amazing nonprofit I encourage people to check it out I I I'm a huge fan of I'm a friend and a supporter of of the the whole program and Jordan schlain and Nora and you so it's great thank you but I want to back up because we spent a lot of the conversation talking about these four different not opposing but different models of thinking about the causation of obesity and if we're going to address this obesity epidemic I mean yeah we can all take OIC and spend 5 trillion doll a year and bankrupt the country and cause all these side effects and B struction and so forth or we can really address the cost exactly and so you talked about the energy rebalance hypothesis which is essentially the calories and calories out the carbohydrate insulin hypothesis which is eat too much sugar and carbs causes too much insulin which makes you gain weight and prevent fat loss and disregulated your brain you talked about environmental toxins or obes obesogens that disrupt things in many ways by destroying our mitochondria by screwing up our microbiome by causing inflammation by causing oxidative stress by triing our thyroid function by so many different mechanisms which I actually outlined in that paper I should send it to you you'll love it it's like 20 years old but I I saw it coming and and then lastly this whole Redux hypothesis which is all these things also cause too much oxa stress so so for the average person listening they're like well that's cool interesting science but like what the heck do I do so let's take the rest of the time to break down what are the action steps to address these things and how do we create an integrated model and what is the average person going to do who is struggling with weight gain who struggling trying to lose weight who's trying to understand all this conflicting biology who's hearing one in Instagram influencer saying you know this is garbage another one's saying this is garbage no this is true no that's true eat this be a carnivore be a vegan you know don't eat fat eat fat eat carbs don't eat carbs it's like you're going to go crazy so AAL so help us from a scientific perspective how do we break down the action steps for the average person listening who wants to understand how do we take the scientific advances which are really remarkable in our understanding about BCD and metabolism and turn those into action steps that people can do to help their lives get better and lose weight right so I I'm I'm on record you can't fix health care until you fix Health you can't fix Health until you fix diet and you can't fix diet until you know what the hell is wrong MH and for the last 50 years we've been barking up the completely wrong tree we've been working on you know the idea that fat was the bad guy yeah fat ain't the bad guy yeah okay now what is the bad guy well it's a bunch of things basically anything that makes Ross's all right well what makes the the most Ross's mhm okay turns out trans fats make the most Ross's shortening but we now know that and it's basically been banned from the American diet finally you know why they call it shortening right no it shortens your life oh fair enough but no this is like Crisco right back in the day but but it's it's it's been regulated as non- grass which means generally not recognized as safe however it's still in go to the grocery store it should not be there it was almost 10 years ago and you can still find that crap everywhere you are exactly right and for the exact reason you said because they round down yeah so read the label in other words Scott Grundy uh years ago showed that two Gams of trans fat per day is enough to lead to uh diabetes and cardiovascular disease two grams per day okay if a serving of ultra processed food in America has .49 G less less than5 okay they can say it's zero because of rounding down yeah so if you consume four servings of whatever that is which is not hard which is not hard okay you have achieved your two G that is all still a problem so you are absolutely right we have actually not completely solved the problem okay so trans fats are bad next is okay so the question is what to do about all of these issues so anything that cause a reactive auction species is a so there's a lot of things well what's the next thing fructose fructose causes the myard reaction the glycation reaction the Browning reaction seven times Chen glucose Creme Brule um uh bananas yeah you know anything that Browns yeah okay um uh you know barbue sauce on the grill okay and that's an oxidative stress reaction that's an and generates 100 times the reactive oxygen species ages right we call Advanced lication and products otherwise right AG you it can it can happen in your cell or you can eat it so dietary ages okay so basically if you take a a a can of sweeten condensed milk and you put it in a pressure cooker for an hour you get pudding okay it went from white to Brown okay that's the myard reaction okay it occurs in the food yeah the point is the sugar is what drives those Advanced glyc it's not just fructose right any kind of sugar will glucose will do it but fructose does it seven times faster and generates 100 times the Ross's because of the stereochemistry of the molecule so fructose is particularly egregious yes glucose does it too but fructose does it way more lactose galactose much less so lactose is not a big problem people think Dairy is a problem it's not a problem okay so don't quit your breast milk don't quit your breast milk don't quit the breast mil no and we can talk about neonatal nutrition maybe on on another podcast but the bottom line is um the amount of sugar in our diet is a mess yeah the third thing is the inflammation because that's generating the Ross's and that there it's the emulsifiers because the emulsifiers are leading to that leaky G so name some um carboxymethyl cellulose polysorbate 80 car by the way which food has the most caragan almond milk ice cream ice cream ice cream and who introduced caragan to ice cream is it quiz I don't know the esimo it's seaweed Mar Thatcher Margaret Thatcher Margaret thater she like your ice cream thicker she was an ice cream chemist before she was an MP what that's a good little trivia okay so there's there's other ones xantham gum gu gum all these thickeners that you see in even health food well the thickeners don't necessarily mean they're emulsifiers they you know emulsifiers very specifically hold fat and water together so the thickeners are yet another issue um there's uh and they' been linked to autoimmune disease absolutely they cause leaking gut no question okay another thing that's a big problem is monog glycal uh uh acids okay um you the 3 ncpd um it's a a um compound called e471 but you don't see on the label of a food that's well no you do see it it just doesn't call they don't call it1 monog glycal Esters call okay so those are a problem as well so bottom line is here's what we need to and the food itself is inflammatory right so if you're eating trans sugar if you Ultra processed food just by Nature it's inflammatory exactly through a whole series of mechanisms so we have to promote metabolism best way get rid of the sugar and we have you you also mean flour you also mean refine carbohydrate sugar carbohy and we have to suppress inflammation and how do we do that increase the fiber get rid of the emulsifiers increase the Omega-3s okay so get rid of the sugar increase the fiber increase the Omega-3s and decrease the emulsifiers all right what food looks like that sardines eat the bones I don't know well real food real food right real food oh I mean fish in particular yes I mean I'm am a big proponent of fish because they got Omega-3s but remember it's not the fish that make the Omega-3s the fish eat the Omega-3s the algae make the Omega-3s the fish eat the algae we eat the fish that's why small fish have more Omega-3s than large fish large fish eat small fish right exactly so how do we do that so um in 2020 I was contacted by a company but I no didn't you didn't say reduce calories no nothing about calories you didn't say it's not about calories yeah yeah okay not about calories in 2020 I was contacted by a company in the Middle East called Kuwaiti Danish Dairy and they recognized that they wanted to be part of the solution not part of the problem Kuwait has an 18% diabetes rate and an 80% obesity rate it's about 10% here so it's almost double it's 11.4 right now okay jeez I can't keep track I know I know every day you know keeps going up they wanted to become a metabolically health company and they wanted to lead the way and they're a a privately held company so they could take the Long View they didn't have Wall Street quarterly reports to have to deal with so their business model was make better food and make it at a price point that they could still make a profit that was what they wanted to do so they contacted me to convene a scientific advisory team to help them re-engineer their entire food portfolio 180 items that's amazing and so um do you know Tim Harland who is the head of culinary medicine at George Washington University Rachel GA who uh ran the um omega-3 for add trial at the NIH um Andreas corot who is a computer scientist out of Stanford and wolf from Alderson who's been in the food business longer than all of us um started the first farmers market in Los Angeles back in 1979 okay um we convened the scientific advisory team to basic deconstruct the entire portfolio of this company to determine what were they doing what ingredients were they using did they actually meet criteria for healthfulness or not were the vendors actually telling them the truth about what was in F the the uh things that they were selling them okay and what could we do about the uh production and the packaging in order to actually improve the health of the food and we came up with three precepts yeah and these are the precepts of metabolic health and we call it the metabolic Matrix I love this yeah here we go protect the liver yeah feed the gut support the brain any food that does all three of those is healthy irrespective of its processed or Ultra processed any food that does none of the three is poison so feed the gut support your liver help the uh protect the liver the brain yeah okay those are the three precepts and you can actually determine how do you do that how do you do that yeah well it it's it's easy when you know what each of the foods what each of the ingredients do within the body so you have to understand metabolic Health to be able to do that so nutrition does not answer those questions so there's this thing called food science there's this thing called nutrition there's this thing called metabolic Health they are not the same food science is what happens to food between the ground and the mouth in the laboratory in the laboratory not not when you buy an Apple in the grocery store there's no food science there nutrition is what happens to food between the mouth and the cell yeah metabolic health is what happens inside the cell but all of these metabolic diseases are all happening inside the cell so nutrition is only valuable as it informs metabolic health food science is only valuable as it informs metabolic Health but they are one or two steps divorced from metabolic health so if you use metabolic health as the North Star as the watch word as the goal and the world economic Forum has endorsed this they came out with a white paper called the true purpose of nutrition and the uh World Business Council for sustainable development is coming on board with that as well okay if you use metabolic Health as the North Star and gear your food re-engineering efforts to V concept of protect the liver feed the guts support the brain you can actually make he healthy food yeah even if it's ultr processed and that's what we have done in Kuwait and they have turned 10% of their portfolio over in the last two years based on the so if you're not eating Kuwaiti Danish food what do you eat well we we need to impress upon the food industry here in America to do the same it is a uphill battle to say the least I love this cuz everybody's looking for Solutions so this is really a well solution yeah um I am a an adviser to the uh scientific adviser to The Innovation Institute for Food and Health at UC Davis who is you know uh has lines to all of the uh food industry at different levels startups and cpg companies and the goal is to get companies to understand what it is that they are doing basically ditching the idea of nutrition and focusing on metabolic Health instead yeah example Unilever and Denon in the last two years reduced their carbon sorry their sugar footprint both of companies by 14% MH now you think that's good or bad I don't know 14% I think I think it it it sounds good but there's a catch well I mean it's better than not yeah but 14% when you are you know when you use triple your limit right in the food going down by 14% doesn't quite get you there yeah it's like when they said they're going to take 6 trillion calories out of the food supply by making Oreo cookies 90 calories instead of 100 calories exactly it's BS exactly BS that that's exactly right and they did that in 2014 and it was a piece of crap then and it's a piece of crap now exactly that's how you really feel Robert yeah I will how about so the point is 14% sounds good actually got emanu Faber fired at denn yeah because of it at kdd at this qu Danish Dairy we have reduced the sugar footprint of that company by by 78% that's amazing that's amazing 78% so again what do people changing what are people ate for lunch those thing like this all sounds great mark this all sounds great Dr lck but what the f do I eat for lunch all right so the so obviously the the the the easy answer is real food so what's real food food that came out of the ground or animals that ate what came out of the ground that's real food all right like I I make it simple I say eat the food that God made leave the food that man made right if you if you think Cheetos is food I mean you know you're sunk It's it's just that simple so we have to redefine forood population what is food okay so what is food what is the definition of food Mark it's something that provides nutrition to the cells no that's not the dictionary definition to the of of something you eat I don't know substrate should know I read a book about that yes you should substrate that contributes to either growth or burning of an organism yeah growth or burning yeah yeah okay remember we said it the every cell has to grow at one point in its life every cell has to burn at one point in its life but it can't do both at the same time burning or growing okay so does ultra processed food contribute to burning well sugar inhibits three mitochondrial enzymes we named them before sugar actually inhibits burning okay and 73% of the items in the grocery store are you know overdosed with sugar does sugar contribute to growth does Ultra proca Food contribute to grow yeah kind of makes you grow my colleague Dr FR monso Oran who's the head of nutrition at Hebrew University of Jerusalem has looked at this question it actually inhibits tricular bone growth cortical bone growth skeletal bone growth cancellous bone growth but it makes belly growth bigger yeah it hijacks growth actually drives cancer formation okay point is it does not contribute to growth yeah so if a food stuff if if if a compound that passes your lips does not contribute to growth and does not contribute to burning is it a food yeah no yeah well if it's not a food what is it it's a food like substance po poison poison right there yeah and so we have to start redefining what we need so you are big in food as medicine yeah okay da mosa farian big in food as medicine I am here to say food can be medicine or can be poison can also be poison and when we food is Slayer it's like the both right as soon as we start teaching the public the difference that's when things will start changing but not until so education has to come first now can we provide the public with tools to help them my colleagues working with uh kdd we have developed a tool that everyone right now online can use this minute you can look it up it's called perfect p e r f a c not perfect perfect fact yeah and you can find it at HTTP perfect. Co and what it is is it's a recommendation engine with a set of filters that will filter your grocery store your grocery store not any grocery store your grocery store to basically only show you the things that are metabolically healthy for you mhm so if you're if if you have a gluten problem it will only show you the gluten-free stuff if you have a metabolic syndrome problem it will show you all the things that don't have refined carbohydrate or sugar or um trans fats Etc if you have a problem with oxalate it will show you the low oxalate items if you have a problem with um so it helps you navigate this confusing landscape of nutrition figure out what's going to be good or bad for you because as soon as you walk in the store you're sunk yeah because all of those nutrition facts labels are staring you in the face there are 40,000 items what are you going to do L read 40,000 uh uh nutrition fact La even if you go to Whole Foods it's still impossible it's still impossible point is this does it for you yeah okay and it does it based on what you want it to to to look for not what they want you to look for so everyone can use this and there are four filters right now there is a metabolic matrix filter that does protect the liver feed the gut to support the brain there's a robber lustic filter that is no added sugar no artificial sweeteners okay there is a NOA filter you know our colleague Carlos Mona so basically takes all the Nova class 4 items off that's 80% of the store food right right okay um you know so so it's a guide for people to shop and it's really helpful and where can they find that perfect. Co it's free Okay spell it again p e r f a c okay we're going to put that in the show notes and we're also going to put the link to levels because people want to know their blood sugar it's levels. linkman if you want to get access to the special offer to sign up to get your own blood sugar looked out because that's really important to track things that are going on so you know actually what's happening with your own biology exactly and and you have this whole framework of the metabolic Matrix feed the gut protect the liver support the brain which you've written a lot about and we're going to link to all your articles all your TED Talks all your videos uh and your books which are incredible and I think people need to take a look at them I I've read most of them fat chance was the one I read through all the way through hacking the American mind and metabolic meta metabolical metabolical metabolic I want to say metabolical but like diabolical but well it is yeah and and so you know your work is so important I feel like we literally just scratched the Sur I mean this has been a phenomenal conversation and a frustrating conversation because everything I want to spend an hour or two just talking about that I got to have you back because we just touched on things like artificial sweeteners we touched on some of these high level conent about toxins but I I think just to summarize for people as we close you know obesity is complex weight is comp complex it's not one Theory it's it's understanding the full Matrix of the science and all the data and trying to help understand where the data actually supports one idea or another and it's understanding how those all fit together so the energy balance hypothesis calories do matter but maybe not in the way we think you know carbohydrate insulin is a real thing but there's it's more complicated you know there are the gut microbiome plays a role environmental toxins play a role Redux plays a role and and I think all these are really really important in understanding how we deal with our weight and our metabolism and so the Science Now is better than ever before and what we're trying to do what you do what I do is trying to get this out there to people to help them understand this to talk about it you slept all the way down here from San Francisco because you want to talk to me and I I grateful for that not a bit and I and I think I think we're gonna have to do this again Robert because because I I I just I'm just up the road you know it's only 4 miles so thank you for your work thank you for being the advocate of across policy science business and you know you could be playing golf right now but you're not you're actually doing the right thing and helping us all understand this complexity and I think anybody who kind of tries to reduce any of us me you any of who are talking about this to some simple soundbite it's just it's just unfortunate because we really have such a deep understanding of the biology from our clinical work from our scientific work from from our understanding of of all the literature and we put it together in a way that I think is the right way way and I think all the things you came to are the things that I've been thinking about for decades and and it all makes sense right right absolutely and the point is you know thank you for you know acknowledging my work but you know it vice versa you know I mean look we we are you know I I hate to say it but you know we're two very lonely Warriors you know I mean there are people coming on board there are a few but I got to tell you I have been very very disappointed in the uh standard medical um uh uh architecture you know only 28% of medical schools even have a nutrition curriculum I wonder if it's CU AMA gets $192 million from an industry and exactly and 80% of the medical curriculum is underwritten by big Pharma they don't want to know this they don't want to know there's this thing called prevention they don't want to know there's this thing called Public Health they want the pill they want the procedure because that's where the money is and I would say prevention is is so important but I would also say what we're talking about is treatment actually can reverse these conditions it's not like you're oneway Street and so people should check out um the the perac they should check out uh biolumin which you're part of which helps uh you know create this fiber that you're talking about where can they find that um they can find it at Munch munch. shop spell that so m o NCH m n ch. shopshop they can put all that in the show notes we'll put all your work thank you for coming uh let's do this again soon because I I'm like I told you we got to hang out I feel I feel like I'm been a marathon and I'm at 100 yard line and I still have another 26 plus miles to go with you to unpack all this stuff so thanks for again for being here and coming all the way down and being on the podcast all right if you love that last video you're going to love the next one check it out here

Channel: Mark Hyman, MD

Views: 165,629

Keywords: Mark Hyman, Mark Hyman interview, Mark Hyman live longer, Mark Hyman diet, how to live longer, how to age in reverse, nutrition tips, healthy foods, health tips, health theory, fasting tips, how to never get sick again, prevent disease, self help, self improvement, self development, personal development, inspiration, motivation

Id: 9cHh7k3CtAw

Length: 101min 0sec (6060 seconds)

Published: Wed Mar 20 2024