[MUSIC PLAYING] PAT DOYLE: Hello, everyone. Welcome to Talks at Google. Today is World Health Day,
and we have the perfect guest for that occasion-- Dr. Neal Barnard. He is here to teach us about the
power of nutrition for health. To start off, introduce myself-- I'm Pat. I'm a software
engineer at Google. And I have the honor of
hosting Dr. Neal Barnard today. First off, I want to let you
know that you can ask questions live in the YouTube
chat, and we will bring some of your
questions directly to Neal to answer at the end of
the presentation today. So time to introduce
Dr. Neal Barnard. He has a long list
of credentials I want to share with you. He's a nutrition
researcher who has authored more than 100
scientific publications and 20 books. His most recent book is
"Your Body in Balance." I encourage you
to check that out if you want to learn
more after today's talk. He's hosted four PBS
television programs on nutrition and health. He has an M.D. degree from the
George Washington University School of Medicine, a fellow
of the American College of Cardiology, adjunct
professor of Medicine at the George Washington
University School of Medicine. He's the editor-in-chief
of "The Nutrition Guide for Clinicians." He's received the
Medical Society of the District of Columbia's
Distinguished Service Award, and he is the president and
founder of the Physicians Committee for Responsible
Medicine, where he puts this research to work
in shaping public policy. He's also founded
the Barnard Medical Center, where he
puts this research to work in treating patients. So with that great
list of achievements, I want to welcome to Google,
to Talks at Google, Dr. Neal Barnard. Thanks for coming. NEAL BARNARD: Well,
thank you, Pat. It's great to be with you today. Really appreciate
the opportunity because we're going to
talk about a new topic, and that's how foods
affect our hormones. PAT DOYLE: Excellent. NEAL BARNARD: Should I
go ahead and jump in? All right. The old approach to
thinking about food was you eat a bad
food, and what happens? You might gain weight, or
your cholesterol will go up, or you get diabetes, or the
bad food causes some disease. But we can be much more
sophisticated about it. The foods that you eat
control your hormones. And your hormones control
everything in your body. And so if you can control what
they do, you can lose weight. You can have any number
of changes in your body that you hadn't
otherwise anticipated. So let's start at the beginning. What the heck are
hormones anyway? Well, hormones are made
in one part of the body, and they go in the bloodstream
to another part of your body, like a letter in the mail. And what could ever go
wrong with the hormones? You might have too many
letters in the mail. You might not have enough
letters in the mail. So let's say your thyroid gland
at the base of your neck-- if it's not sending out
enough thyroid hormone, you're hypothyroid. But if it's sending out too
much, you're hyperthyroid. OK? So hormones are just
information that goes from one part of
the body to another part to control its action. Example-- insulin,
made in the pancreas, goes in through the
blood to the muscle cells to let sugar get into the
cell, goes to the liver cells to let sugar enter
the liver cells. And we did a research study
back almost 20 years ago to try to see if we could help
insulin to work differently. Here's what we did. We brought in people
who had type 2 diabetes. And you know what that means. That means their blood
sugar has gone up. Why? Their body is making
insulin, but the insulin is not able to get sugar
to go from the blood into their cells. They're insulin-resistant. And we tested a
portion-controlled diet that's a conventional
kind of diabetes diet versus an entirely
plant-based diet. And in a minute, I'm
going to show you why we decided to do that. Let me walk you through
what the diets were. The portion-controlled
diet is a traditional kind of diabetes diet that you
might get at any clinic. Cut calories to
try to lose weight. Keep carbohydrates
fairly steady. Don't eat bad fats
like saturated fat. Pretty standard advice. But the plant-based diet
used a different theory. It didn't limit calories. It didn't limit
carbohydrates at all. It just said, don't
eat animal products. Keep oils really low. You can see that we're
getting away from animal fats and vegetable fats. But note to self-- we're going to see why
fat might be important. Third step-- favor
low-glycemic index foods. All that means is-- say, white bread is
high-glycemic index. That means it causes
your blood sugar to rise. But if I have the same
amount of rye bread, it's more gentle
on my blood sugar, pumpernickel even more so. Fair enough. So no animal products,
minimize oils, favor low-glycemic index foods. What did we find? To cut to the chase,
we tracked A1C. Hemoglobin A1C is an indicator
of your blood sugar control. And we want it to be below
7 if you have diabetes. The red line here is the
portion control diet, the conventional diet. And they did really well. Their A1C dropped by about 0.4
absolute percentage points. That's good. So that red line dropped. That's important. But that blue line drop,
that's the people in the vegan group, the plant-based group. And their blood sugar
improved three times more. They had a drop of about 1.2
absolute percentage points-- not only bigger than
the control group, but bigger than you get
with oral medications. OK. And when we did this study,
one of our first participants was named Vance. Vance had been a policeman,
and he worked in a bank. And he came into our
study, and he said, my grandma had diabetes. My grandpa had diabetes. I got diabetes. And if I don't get
this under control, I'm probably going
to lose a leg, go blind, something like that. Well, he was randomly
assigned to the vegan group. And the first thing he said
was, this is a really easy diet. And I thought, wait
a minute, Vance. People don't think
of vegan as easy. They think it means
you've got to acquire a taste for folk music
or wear tie-dyed clothes or something like that. He said, no, no, no. You don't make me count carbs. You don't make me cut
calories or anything. You just say, instead of
meat chili, have bean chili. Instead of ground beef on my
spaghetti, have tomato sauce. Very easy. And he lost 60 pounds
over about a year. He stopped his
diabetes medications. And his A1C dropped
from 9.5, which is high, to 5.3, which is
absolutely normal. When I got that result, I
had to close my office door, because this was not
something that doctors see-- a person with
well-established diabetes that is poorly
controlled that actually goes away in a person
on no medication. That's what I seem to have in
front of me on this lab slip. And of course, now we
see this all the time. But let me walk you through
what happened in Vance's body. If you're doing something else--
if you're texting or talking to somebody else, let me have
your attention for the next 2 minutes. I'm going to show you my
most important images. This purple circle is going to
tell us what causes diabetes and how we reverse it. This oval is a muscle cell. And it's a muscle
cell in your body, and muscles run on glucose. That's their
gasoline, as it were. And the glucose is
all in the blood, and it cannot get
into that cell. The muscle cell's
membrane keeps it out. It won't go through until
you have a certain key, and that key is insulin-- hormone made in the pancreas,
it goes through the blood to the cell, and it attaches to
the surface of the muscle cell. And once it does, that
key opens little channels to let the glucose come in. So the insulin key
opens up the cell, and the glucose can come
in, and everything's fine. What could go wrong? What goes wrong is that
that was my dinner. That was my lunch. That's my breakfast. I'm eating a lot of fatty foods. Are these fatty foods? They sure are. There's fat on all
these things, including chicken without the skin. 23% of its calories
are from fat. So what happens? The fat that I eat builds
up inside the cell-- tiny, microscopic fat particles. Now, doctors hate
words like "fat" because it's got
only one syllable. So we like to call it
intramyocellular lipid, but it's just fat
inside the muscle cell. And what that means is
that insulin can still attach to the
surface of the cell, but the insulin stops working. The cell is now
insulin-resistant. The fatty accumulation
in the cell stopped insulin from working. It created insulin
resistance, and now the sugar can't get into the cell. It raises the blood sugar. And your doctor says, I
don't know what's wrong, but if I were you, I'd
stop eating carbohydrate. Don't eat any
sugar, and let's try to control your blood sugar. Wrong. That was never the problem. The problem is inside that cell. What can I do? Let's say I do what Vance did. How much animal
fat is in his diet? None, none, zero. How about if I keep
oils really low? Well, then there's not
much of any fat in my diet. And the fat inside the
cell starts to dissipate. And as it does, the
insulin sensitivity returns to that cell. The insulin can now signal
the cell to open up again, and the glucose can
come back into the cell. And if you're Vance, your
diabetes improves and improves, and you get off your medicine. And eventually, it's
no longer detectable. That's good. OK. Let me shift gears. Insulin is a hormone. And we've seen that we can
change insulin's action based simply on what we eat. And that difference is
profound, but it's not the only hormone in your body. Estrogens. I was sitting at
my desk one day, and I got a call from
a young woman who had terrible menstrual cramps. Many women get cramps. But for about 1
in 10, it's like, I cannot get to work today. And I suggested
to her something. She had a business
trip the next day. She needed to get on a plane. And she wanted painkillers. And I said, I'll give you
some painkillers for two days. But I said, let's see
if we can stop this from happening next month too. Let's head it off in advance. She said, I love it. What can we do? I said, no animal products
for the next month, and minimize oils. Now, wait a minute. How could that affect cramps? Hold that thought. She decided to try it. She got to her meeting,
and she came back. And four weeks later, she called
me again and said, Dr. Barnard, this is astounding. I got my period today
with zero symptoms. And the same thing the next
month and the next month. And as long as she followed
these two steps, she was fine. So I thought, that's impressive. We need to put this to the test. So with our colleagues at
Georgetown University's Department of OB-GYN, we
did a randomized trial. Women with menstrual
pain were randomly assigned to either the
diet that I just described or to a supplement that
was actually a placebo. Then after two
months, two cycles, they switched, the diet groups
to the supplement and vice versa. And in a nutshell, it worked. We published the
findings in the "Journal of Obstetrics and Gynecology,"
and pain intensity fell. Pain duration fell. PMS, like bloating and water
retention and moodiness, improved as well. OK. Wait a minute. How does this work,
and what can your diet have to do with cramps? Let me show you. This is a woman's
uterus, off to the side of the ovaries connected
by the fallopian tubes. Look inside. In the very center
of the screen, do you see that pink line? That's the endometrial lining. That's the inner
lining of the uterus. And every month, that thickens
in anticipation of pregnancy. And when the woman called me
up on the phone, she said, I'm hurting. And I was thinking,
why are you hurting? My educated guess
was that she had too much estrogenic stimulation
of the endometrial layer so that it was
thickening up too much. And as it was,
when it degenerates at the end of the
month, it breaks apart to release prostaglandins
that cause really bad pain. But if we could turn
down the estrogens, we can turn down this process. That's the hypothesis. Now, by the way, for
some women, it's worse. It's not just a thickened layer. For some, they
have endometriosis. That's the cells from
the endometrial lining are now implanting outside the
uterus, all around the abdomen. And researchers have
found that they're on the uterus, the ovaries,
the fallopian tubes, even on the intestinal tract. So it's your period,
but now your intestines are all messed up because
of the endometrial growth. Wait a minute. Can we stop this? Tufts University, 1994. Researchers did a
really cool study. They brought in 48 women. They put them on
a metabolic ward, and they gave them
special diets. Each diet was 8 to 10 weeks. Some of them cut the fat. Other diets increased fiber. Some did both. And they tracked what
happened to their hormone. Now, what were they thinking? They weren't thinking cramps. They were thinking
breast cancer. Because if I can
reduce estrogens, I can reduce breast cancer risk. And it worked. Reducing fat-- if you do nothing
else but just cut the fat content of your diet, estradiol
and free estradiol, estrone, estrogen sulfate-- these are all fractions of
estrogen in a woman's body-- they all drop. If I do nothing other than
increase fiber-- that's beans and vegetables and fruits
by roughage-- estrogen levels drop again. So I remember this study. And when the woman called me
up with menstrual pain, what was going through my
mind was something is causing too much
stimulation of your uterus. Thinking they're not
lining up too much. You feel horrible at
the end of the month. Maybe if we could cut down
on the estrogen circulating in your blood, maybe
you'll feel better. And my educated guess was cut
the fat, increase the fiber. So why a vegan diet? Because there's no animal fat
in it at all, and everything you eat is from a plant,
so it has maximum fiber. I wanted to cure her if I could. And we kept the oils low too. And that turned out
to be the answer. OK. Let me walk you back through
the fiber part of this. How could fiber affect hormones? See the liver? The liver on the upper
part of your screen. The liver filters estrogens out
of the blood, excess estrogens, sends them down that green bile
duct into the intestinal tract. And the estrogens go
through the small intestine, through the large intestine, and
actually down into the toilet. But if there happens not to be
adequate fiber in your diet, that doesn't happen. If there's not enough
fiber in your diet, the estrogens that are in
the intestinal tract now don't stay there. They're reabsorbed
back into the blood, and they end up
back in the liver. Doctors call it
enterohepatic circulation. What it is is estrogens
cycling and cycling and cycling in a woman's body,
and it never gets gone until she brings
the fiber in her diet that stops that cycling
and sends the estrogen out. I want to make sure you're
all paying attention. Spam. Does it have any
fiber or no fiber? What do you think? OK, you're right. It's not a plant, so it
doesn't have any fiber. Here's a trash can. There it goes. KFC-- fiber or no fiber? Well, there is some fiber
if you eat the carton. Otherwise, no, that can go too. How about-- well, yes,
you know what I mean. There are a lot of things that
started out life as a plant, but in a factory, they lost out. And we're going to get
rid of that junk too. OK. Oh, one other thing-- cheese. Cheese comes from milk. Milk comes from the cow. Cows are impregnated annually
to keep their milk production happening. Pregnant cows make estrogens. It gets in the plasma, and
then it gets in the milk. And they are milked
during pregnancy. Yes, that's right. The cow's gestation
is about nine months. And for much of that
pregnancy, they are milked. The estrogens that are
produced in the cow's body get into the milk. And every scoop of ice
cream, every slice of cheese that you ever ate or ever fed to
your child, had estradiol in it from a cow. It's not on the label. Yep, that's right. There's no such thing
as hormone-free milk. It's all there. All right. Shifting gears,
one last example. We've talked about diabetes
and the insulin hormone. We've talked about
estrogens in a woman's body. And you're thinking,
hopefully, wait a minute. This can control
cramps, but maybe this can reduce breast cancer risk? You can see where we're going. We're getting control
over our hormones. We're controlling all kinds of
things that we used to think were just things that
went bump in the night and we couldn't control. We can now do this. Hot flashes are at the end of
a woman's reproductive window. She's 55 now, and she's
sitting in a boardroom. And she's going to have
the symptoms of her ovarian activity coming to a stop. What's she feeling? Vasodilation. She's minding her own
business, and the blood vessels in the skin widen out. And it's just like a
radiator turning up. It's 150 degrees. She breaks into a sweat. That's a hot flash. They happen at night. And suddenly, your
room is 150 degrees, and you're in a pool of sweat. And if this happens three
or four times a night, your quality of life
goes through the tank. OK. Well, what can I do? The doctor says I
could take estrogens. Yes, but if you look at the
prescribing information, there are quite a few
risks that are disturbing, to say the least. Now, doctors argue about
what's the real risk of endometrial cancer,
breast cancer, stroke, blood clots, dementia. How often is that
going to happen? Well, wait a minute. What if we decide that we're
not going to take these risks? Could diet help us? A tentative yes came from Japan. Back in the 1980s, researchers
interviewed women in Japan. And they found that
hot flashes affected maybe 15% of
postmenopausal women as compared to maybe
80% in North America. And when they had them,
they were really mild. What was the diet? Rice, more rice, some
vegetables, a little fish, more rice. No dairy at all to speak of. A little bit of meat here
and there, but mostly plants were the bulk of the diet. Well, what's going on? The first hypothesis was
tofu, soybeans, edamame. Soybeans have isoflavones,
which are part of the reason that soybeans reduce the
risk of breast cancer. But also, researchers
thought maybe that's why they're there
fighting hot flashes too. Well, more data came in as
the Japanese diet westernized. Burgers came in, the golden
arches arrived in Tokyo, and hot flashes went up to
about 40% or a little bit more than that by the early 2000s. OK. So it's not just the soybeans. There's something
about this diet-- a meaty diet, a Western diet--
that's part of the problem. And further confirmation
of that came not from Japan but from Mexico. Fly to Cancun. Get a rental car. Drive two hours west. You'll be in a town
called Valladolid. And researchers went
there 20 years ago and interviewed 118
postmenopausal Mayan women. And what they found is they
didn't have hot flashes. In fact, they didn't have any
menopausal symptoms, really, at all. Periods stopped and
whatever, but no big deal. OK. They're not eating rice. No. Corn is their grain. And they're not eating soybeans. They're eating black beans. And they eat
vegetables like-- this is one called la chaya,
which is not from Japan, but it's a big thing
in Mayan tradition. And there's something
about the plant-based diet that seems to be effective. OK. So my research team decided
to put this to a good test. Because if we can control the
hormone shifts of menopause, maybe women don't
even have to have a discussion about
medicine, because they are turning the dials themselves. Here's what we did. We brought in
postmenopausal women. Half of them started a diet, and
the other half made no change. The diet was three things. It was no animal products,
minimize oils, and 1/2 a cup of soybeans every day. And we encouraged
women to follow this over a 12-week period. And, first of all, the control
group didn't make any change, gained a little bit of weight. The diet group lost
almost eight pounds. That's good. But the big thing was the
change in hot flashes. The diet group dropped
their hot flashes about 84%. Yep, huge. And the number of
women who didn't have any hot flashes at
all-- well, everybody had hot flashes at the
beginning, but by week 12, about 60% of women were free of
moderate to severe hot flashes. In the control group,
there was no big change. And we saw other changes. Not only were these vasomotor
symptoms changing more in the diet group, but so
were psychosocial symptoms like mood, physical symptoms,
and sexual symptoms. They all improved. Now, with regard
to breast cancer, if you talk to people about
soy and breast cancer, they have the idea
that soy causes it. It's just the opposite. Soybeans affect primarily the
beta estrogen receptor, not the alpha receptor. And so researchers
have clearly shown that the more soy women consume,
the lower their breast cancer risk. This is also true for
women previously diagnosed with breast cancer. The high soy consumers
have the lowest mortality. Let me be clear about that. Soy products reduce the
likelihood of getting cancer and are associated
with better survival. OK. Now, by the way,
if you're thinking, maybe I'd like to
make some soybeans, but how do I do it-- quick tip. Edamame-- delicious,
but that's not what we're talking about here. Edamame is the juvenile soybean. Leave it on the vine
a little longer, and you get mature soybeans with
a lot more isoflavones in them. And you can buy them online. You'll see all kinds of brands. They're non-GMO, organic,
whatever you want. It's there. Pop it in your Instant Pot
or your pressure cooker, cook them 40 minutes, or soak
them and boil them overnight. And really easy to do. You can do this. They come out, and then
portion of them out. Have a 1/2 a cup per day. This is a menopause treatment. You don't need it
for anything else. That's all it is. You add them to a
salad or a soup, or you can roast
them too if you want. You can go online and buy
toasted roasted soybeans in bulk. Or if you want, you can
roast them yourself. It's very fun to do. You cook them as I described. Lay them out on a
parchment-coated baking sheet. Bake it for an hour, 350. And wait, they've
got to be really dry. They shouldn't be mushy. Make sure they're totally dry,
and then put them in a bag or in a container, season
them with whatever you want. And it's a really cool snack. It's like dry-roasted peanuts. And that's what we found
could knock out hot flashes. OK. Healthy diet-- fruits,
grains, legumes, vegetables. You do need vitamin
B12 for healthy blood. Don't miss it. To start a healthy diet-- if
you're thinking this is cool, but it sounds hard,
easiest thing in the world if we break it into two steps. Step one-- take one
week and just check out the possibilities. Do this yourself. Take a piece of paper. Write breakfast,
lunch, dinner, snack. Take a week to fill
this out with ideas of things that happen
to be plant-based, like oatmeal for breakfast or
almond milk on your cereal. Fair enough. Or a vegan pizza, no cheese. Fair enough. Or go to your favorite
Italian restaurant, have the tomato sauce
instead of the meat sauce. Or at a Mexican restaurant,
beans and rice, veggie fajitas. Easy. Chinese-- rice dishes, tofu
dishes, vegetable dishes. Or Japanese food-- why not have
the sushi, not the fish sushi? Have the cucumber roll. Have the sweet potato
roll, the asparagus roll. Delicious choices. Now, Taco Bell is not the
pinnacle of culinary art. But if you're trying to
make a list of vegan things you might eat, well, they've
got the bean burrito, hold the cheese, or
Subway's got you covered. OK. Fair enough. A week later, you have done it. You've got your list. Great. Now step two is now we're going
to do three weeks on a totally plant-based diet. For the next three weeks,
no animal products at all. But that's now easy because
you've got your list. OK. Good. At the end of those three
weeks, physically, you will have lost weight. If you have diabetes,
your blood sugar is already getting better. Your digestion is better. But in addition to
the physical changes, your attitude about
food is different. You haven't had chicken wings in
three weeks, and you discover, I don't really miss them. So it becomes really easy. This is my book, "Your
Body in Balance," which talks about all these things. But if you don't mind, I want
to just share something more about food. Yes, "Your Body in
Balance" has good recipes, but there's one
other food program that I want to share with you. This is free, and it's a
service that we are encouraging companies to institute. Here's what I mean. Everyone has a
seat at this table. If you look at any workplace,
any university, any meeting room, any street in America,
we are more diverse than ever before. And with that diversity
means there are different dietary cultures,
different dietary needs, different expectations
that people may have. And so you're on the
airline, and they might say, well, we've got this kind
of meal, that kind of meal, a million special meals, but oh,
I'm sorry, we don't have yours. Stop. What if some people
are gluten-free? What if some people
are allergic to things and are avoiding those,
and somebody else has a religious mandate? I was raised in a
Hindu tradition. I'm not going to eat beef. I don't want to
have meat at all. Or what if I'm vegan? Are there foods that could
work for all of these things? The answer is yes. If we skip problem
ingredients, we can do it. OK. What are those
problem ingredients? I'm in this boardroom here. Here's a person who is
from an Indian tradition and does not want to have beef. So beef, that's out. Here's somebody else from a
Muslim tradition who says, pork, if you don't
mind, leave that out. Here's someone from an
observant Jewish tradition who says, thank you for
getting rid of the pork, but get rid of the shellfish
too if you don't mind. Here's someone who's
got a peanut allergy. Peanuts-- you're gone. Well, let's see. How about gluten grains? Some people have gluten issues. They're gone. And then here's somebody
who doesn't want the animal products. Get rid of dairy, eggs,
fish, maybe even honey. What does that leave? Vegetables, fruits, legumes,
non-gluten grains like rice and corn and many others. We then worked with the Culinary
Institute of America and said, can you take these foods that
ought to work for everybody, and can you turn them into
meals that will be irresistible, that are going to work in
my workplace, or on a plane, or on a train, or
wherever I might need? And we also worked with Spork
Foods, which is in Hollywood, and we said, give me
some of these foods that are on the high end. And we also worked with a
group to make some foods on the cheap end. And what they came up
with was really fun-- golden waffles,
sweet potato hash, and beautiful lentil
soups, and an Aztec soup, and clear noodle soup. These are arancini. It's an Italian tradition. And this is the arancini
in my fancy restaurant. This is the arancini on a plane. Yup, universal
meals work anywhere. This is my veggie
burger on the plane. Here it is in my restaurant. And the universal meal says all
of these choices that we have made, including-- yes,
including dessert items-- what if we did this at Google? What it means is everybody
has a seat at the table. I don't have to
just say, well, I've got a gluten-free meal over here
or I've got this meal there. As long as there's
a universal meal, you're going to be covered. OK? Would you like this idea? Wouldn't it be fun? We have all the menus,
all the recipes, all the nutrient
information for you. And we would love
to see it happen. You'll see it at PCRM.org, where
you can get in touch with me. Let me stop at that point. And I hope you
found this useful. But before I finish, I just
want to say a huge thank you. I know that you're watching
this because you're interested in nutrition,
you're interested in health. And these concepts are
novel and powerful. And to the extent that we
share them with other people, we intrigue other
people in things that might take a little time
to understand their full import. But over time, we'll inspire
people to make changes that can even save their lives. And that's you that's done that. So thank you for allowing me
to share this time with you. PAT DOYLE: Neal, thank you. It's great of you to come and
share that knowledge with us today. I actually learned about a lot
of this about nine years ago when I went vegan myself. And you were one of the people
I found that helped convince me. And so it's really
great to have the chance to talk to you about this today. A bit of a dream for
me, I guess to say. So-- NEAL BARNARD: Well,
thank you, Pat. I'm delighted to
be able to do this. PAT DOYLE: Awesome. So yeah, on that note,
one of the first things I wanted to ask you about is-- I've noticed myself when I
tell people about these things, it almost seems too
good to be true. How have I not heard that
we can reverse diabetes and all these chronic diseases? I'm curious what
your thought is on-- clearly, you've
done this research. You have proven
all these benefits. So why don't more
people know about this? And what do you think? NEAL BARNARD: Well,
more and more people do. I'm right now speaking to you
at Florida Atlantic University. And the reason I'm here is
I was invited to a lecture just before this. And the medical students
are so eager to learn about this approach
for various reasons. Partly, it addresses the
cause of the problems. I mean, let's face it. If a person has a
high cholesterol, they don't have a
Lipitor deficiency. The drug is really just
treating their diet excesses in maybe 90% of cases. So the students are
really eager too. But I guess a couple of
things should be said. I think we do need more
research in certain areas. Also, diet is not going
to necessarily have the same effect for everybody. One person's diabetes
may improve dramatically. Somebody else may not. That's possible. However, what we
are discovering is that if we do the diet
changes in the right way-- if we don't just take
the skin off my chicken or have modest
changes like that, we're really getting the
junk out of the diet-- when we do it, the diet
is so much stronger. And it's really quite unlikely
that a person would not benefit from it. So we're doing these
research studies. We always try to make sure
that we've got the data. But we're also open to
individual experiences. And so I described
a couple today, where people have had an
individual experience, which always prompts us to test it
out in larger numbers of people and end up doing
controlled trials to see if the individual experience
actually does pan out. I got to tell you, Pat,
it's exciting to see things that befuddled
us for a long time are now becoming clearer. PAT DOYLE: Yeah,
I was going to say it must be so rewarding
to see these changes and hear these personal
stories of people making real improvements in
their health and their lives. Your book is full
of those stories. It's really inspirational,
I have to say, as well. NEAL BARNARD: Yeah,
Pat, I have to say, for me, it's slightly
more than that too. I grew up in North
Dakota, and my father was the diabetes
expert for Fargo and all of Eastern North Dakota. And he himself had grown
up in the cattle business. And that's kind of the way
we all ate, unfortunately. And so he was at
the Fargo clinic. And every day, he'd
get home about 6:30 PM. And he'd sit down
his medical bag. And I never, ever heard him
say that anybody with diabetes ever got better. His whole job was to try to
slow down the complications-- to slow down the loss
of sight, to make sure that you didn't
have the amputation or tried to avoid it. But still, people would die
10 or 15 years prematurely. And he didn't expect that you
could reverse this disease, because we never really gave
the diet changes the chance. So it wasn't his
fault. We didn't know what intramyocellular
cellular lipid was. We didn't have MR
scanners at the time. We couldn't look in muscle
cells as I'm able to do now. If they had been
able to do that, I think we would have had
these answers much earlier. But I want to tell
you, Pat, I very often think I'd love to
be able to tell my father about the technology
that we have, what we've seen, and how we can exploit
it and then how it comes full circle to just
relating to simple dietary choices. PAT DOYLE: Yeah, for sure. We've talked about this too, but
I'm from North Dakota as well. And my mom had borderline
high cholesterol. And I told her about
the stuff I actually mentioned to you as an
example, someone else in North Dakota who's doing this. And she changed her diet,
and now her cholesterol is totally normal. And many success story there. NEAL BARNARD: That's great. What are the odds, two
North Dakotans on one call? PAT DOYLE: Yeah. NEAL BARNARD: It's
got to be about half the state right there. PAT DOYLE: But on
that note, actually, that leads into-- one
question I had for you is, what if you're doing
all these things right, but you have friends and
you have family members, and you're worried
about their health, but maybe they're a little
harder to persuade-- do you have any
tips for how you can nudge other people in your life
along toward these healthier choices? NEAL BARNARD: Well,
it's that way every day in clinical practice. People don't want
to be unhealthy. They want to be healthy. And in clinical practice,
we recognize that we're not the employers of the patient. The patient has to be able to
make his or her own choice. But it starts with information. And for many people,
the information is totally new, like the idea
that intramyocellular lipid, fat inside muscle cells,
might impair insulin action. That's well known if you're in
the Department of Endocrinology at Yale University. But if you work in a drugstore,
you never heard of it. So we have to get
the word out first. And that's, frankly,
why I'm grateful to you and to many others who are
able to reach a lot of people. But that's where it starts. And then the other
piece is once you decide I want to
make a change, people do need some support
because our culture may not be quite there with us. And that was the same with
the person quitting smoking, or a person who
has decided I want to make some other
healthy choices, I want to start exercising. And if my culture is not
supporting me, what do I do? And that's why we have
this two-step method for making the diet change. And I got to tell
you, when we do it, the patient says I
need to lose 65 pounds, and I want to get off these
medicines, and da, da, da. We plan-- let's
say it's his diet, but we bring in his
reluctant spouse too, so that they're getting
on the same page together. And then the other thing
is you don't just say, here's your diet, go away. We get back together
every week, at least by phone, because there are
little bumps in the road. They're not bad. They're not tough, but there's
little bumps in the road. I got a wedding
in North Carolina. There won't be
anything for me to eat. I'm on a road trip for business. What am I going to do? I had a craving for
something, whatever it is. They're easy problems,
but they're there. And people need a
little coaching. So my feeling is that
if it's a friend, you can give them information. You can give them guidance. And if the information is
there, they'll often get it. I do have one more tip
for you, though, Pat, and that is if you give people
a book, that book is not going to get opened. I learned this with
my dear mother. My mom had a high
cholesterol level. I'm like, here, mom. And I gave her a book
that I wrote years ago. And I went and visited
her six months later. And you know how
you can tell when a book has not been opened? So finally, her own
doctor threatened her with putting on Lipitor. And she finally
decided to go vegan. When she did, her
cholesterol level plummeted, just like your mom. OK. But I learned a lesson. Now when I give people a
book, I do the Post-It trick. You take a Post-It,
you put it on page 41. You take another
Post-It, you put it on page 95, and another Post-It
that you put on page 120. And a final Post-It goes
on the cover of the book and says, my friend,
my mother, whoever it is, I thought of you at
certain places in this book. I flagged them. You'll see. They will call you up a week
later and say, what are you-- I read that book
six times, and I was trying to think
what it was that made you think of me at those pages. And you say, really nothing. I just wanted you
to read the book. So do the Post-It. This also works with videos. Give somebody a copy
of "Forks Over Knives" or whatever and tell them,
between about 8 minute, 45, and an hour and
15, that was you. And they will watch
it to find themselves. And it works every time. PAT DOYLE: That's a good trick. I want to quickly
remind everyone to ask questions
in the live chat. We will get to
some of those soon. I just had a couple more
things I wanted to ask. I feel like I have to ask
you the obligatory question, where do you get your
protein, as kind of a joke, just to clear that one up. NEAL BARNARD: OK. That was the 1950s view, is
that protein was in meat but not in other things. But there's actually plenty
of protein in beans, grains, and vegetables. And any varied diet that
includes these things provides the essential
amino acids that build the protein you need. So not a big issue. But calcium is a little
bit more of an issue. You're not having dairy. So have plenty of
green leafy vegetables. They have calcium in them. There are other sources too, but
greens are just the healthiest. And don't forget B12. If you're doing those
things, your diet is not only an
adequate diet, it is miles ahead of the diet
you were doing before. It's now higher in vitamin
C, higher in fiber. You've gotten rid
of the bad fats. You are you're
putting in your body the fuel that it's designed for. PAT DOYLE: For sure. I've definitely
experienced that too. There's many other things that a
lot of people are deficient in, and protein is rare to
ever be one of them. The other thing you mentioned
in "Your Body in Balance," which I think is interesting
just for people to be aware of and to demonstrate the
power of these changes, is that if you are on
medications-- for example, for diabetes-- you'll actually need and
want to work with your doctor while doing these changes
because you may actually be effectively taking too
much of these medications as you address these root
causes like the intramyocellular lipids you were talking about. So just wanted to
bring that up here. NEAL BARNARD: The changes
happen really fast. So if you've got diabetes
and you're on medicines, let your doctor know
that you are going to do a low-fat vegan diet. Your doctor, first of
all, will jump for joy because they know it's
a great way to go. But your insulin
dose or whatever is very likely going
to go way down. And so your doctor needs to work
with you to ratchet you down in a sensible way, and
then eventually, hopefully get off of it if all goes well. PAT DOYLE: Yeah. I think for me, that's one
of the most striking things. You may need to work
with your doctor because this diet is going
to replace many medications. Another theme of
the book for me is there are these many
conditions that people-- most people seem to run
into in our culture and age. And I think it's
tempting to assume that we're just living
longer, and this is kind of just what happens. But you mentioned specifically
in the book this idea that people actually
have been living to old age for a long time,
and this is not actually a new concept. And it doesn't just
have to be this way. I was wondering if you could
elaborate a bit on that topic. NEAL BARNARD: Yes. Where that really
hit home for me was with regard to
menopausal symptoms. There were writers who, not
so long ago, said, well, if you're a woman over 50,
you're past your sell-by date. The whole reason that
you've lost your periods and everything is-- if this was 1900,
you'd be dead by now. And let me say clearly,
that is ridiculous, and there is nothing to it. As you said, Pat, people
have lived long lives for a very long time. Menopause is not
the end of life. Menopause is nature's way of
saying, you're now in your 50s. This is not a time for you to
have a toddler on your kitchen floor. The reproductive
window is closed so you can get on with
life and do other things. And that's a perfectly
sensible and normal thing. The symptoms that come with it
appear to be, in many cases, greatly exaggerated
by the dietary choices that are causing our
hormonal transitions to be much more violent than
they would otherwise be. And so now that we know that
and we can put it to work, we can make that
transition into-- instead of it being a diagnosis,
it's just a part of life. PAT DOYLE: Yeah, that's great. I think with that, we'll go
to some audience questions. Let's see what the
live viewers have. Question from Naga-- "With regards to
plant-based food, does going organic
and avoiding GMO help? Should we be checking on this? Thanks." NEAL BARNARD: I think it's
good to choose organic. If you have a choice
between something that's got chemicals
in it and something that doesn't have
chemicals in it, to me, it's an obvious choice. And if it costs extra
for organic, that's fine. If that's what it costs to eat
healthy food, I would do it. With regard to GMO, it's pretty
easy to avoid GMO soy or GMO-- many of the GMO products. Let's say you buy tofu. If it says organic on the label,
which most of the brands will, by law, it cannot be GMO. The GMO soybeans are what
you feed cattle, or chickens, or pigs. Same with GMO corn. So yeah, it's not
really clear that GMO matters that much for health. But personally, I'm
trying to opt out of the experimental group. And so I just buy organic to
the extent that it's possible. If you have no idea if
the vegetables brought to you at a restaurant
are organic or not, you're always better off
having vegetables than not. But if you've got a
chance to choose organic, it's good to get it. PAT DOYLE: So you'd pick
a conventional vegetable over an organic
animal, basically. NEAL BARNARD: Absolutely. Keep in mind, an animal's body
is a factory in and of itself. The animal's body is
manufacturing cholesterol that gets into what you're eating. And you do not need to
have the animal products. And whenever I say
that, my grandfather is rolling over in
his grave because he spent his life raising cattle. And one of my grandfathers on
my mother's side died at age 62. And I thought, well, that's
because they were old. And now we realize,
wait a minute. Our diet was not conducive
to longevity at that time. PAT DOYLE: All right. Next question from Ivan. "There are fake-meat products
in the market which are mostly highly processed soy. The tradeoff here
is soy equals good, but many scientists say
highly processed equals bad. How do you approach this?" NEAL BARNARD: I
think soy is fine. You will see all kinds
of scare messages all over the internet
about soy causing cancer and all these things. It's really a misunderstanding
based on old research. When we look not in rats,
but look in human beings, soy products are
clearly associated with not just reduced
risk of breast cancer but also reduced risk
of prostate cancer, and also reduced cholesterol. That said, the closer the
thing looks like a soybean, the better off it is. So if it's whole soybeans
or something like tempeh, you can actually see
the soybean there. Once it's pulverized and
processed, it's less soybeans. And who knows what
they've added? I will also say that
fake meat products-- one of the easiest ways
to separate them out is look at the
saturated fat content. If it's pretty low, I
think it's an OK choice. If your veggie burger doesn't
have a lot of bad fat in it, great. And when I say not a lot, I
mean as close to 0 as possible. In recent years, the Impossible
Burger or Beyond Meat, these have come up. They're not intended for vegans. They are intended to
seduce meat eaters. So they take
plant-based ingredients, and they pack enough
coconut oil in there so that it has the mouthfeel
of a greasy burger. It's sort of nutritional
methadone to try to get you off of your addiction. That's not what we're
really talking about. But most veggie burgers and
veggie hot dogs and things are really quite low in
fat and are OK choices, especially for kids. If it's birthday time,
this is not the time to bring out the lentil loaf. You can give them
all veggie hot dogs, and the neighbor kids
won't beat your kid up. PAT DOYLE: Sounds good. I'll take the next question. Annie JK says, "For
those who struggle with food restrictions,
how do you keep a balance between
a plant-based diet and other foods?" NEAL BARNARD: OK,
great question. The easiest thing
to do is to think of these four food groups--
vegetables, fruits, whole grains, beans. And that's your palate. If those things are part of
your daily routine, that's good, complete nutrition. Don't forget the vitamin B12
that you need to add to it. So if you might have
a food restriction of some type due to allergy
or whatever, that's it. You don't eat that food. If you're gluten-intolerant, if
you actually-- if you're just avoiding gluten because
you think you feel better, that's something you
can choose or not. But if you've got
celiac disease, you cannot have gluten. So that just means
you don't have wheat, and you don't have rye,
and you don't have barley. But you can have rice,
corn, and cleanly produced oats and
lots of other things. So those four food groups
should keep you covered. PAT DOYLE: Sounds good. Yeah, I can actually
relate to this too. In the past, in my
own journey, I've-- some people who worked
with me in the past know I've gone very extreme,
like no oil, no processed food ever. And you can do
that, but it also-- you can get to a point where
that's pretty inconvenient. So luckily I try to
be more open to-- if I go to the office, and
there's some oil in the food, I'm not thinking that's
the end of the world. So I can relate to the balance. And I mainly think-- I think it clarifies
that if you just want to exclude animal
products and you want to keep the
oil low-- but there can be special occasions too. You don't have to have to
have the lentil loaf for you birthday like that. I'll take the next
question from Evan. "Has the difference
in effectiveness between intermittent
fasting versus veganism in fighting insulin
resistance been studied? I've heard intermittent
fasting can be effective, too." NEAL BARNARD: To my
knowledge, nobody has done a controlled
trial where some people went on
intermittent fasting, and others went on a vegan diet. But with regard
to the pathology, the pathology relates to the
buildup of fats in the muscle cells and liver cells. Those fats come
primarily from diet. That's the source. So getting them out of
the diet should really be the first step. And there are some people who
will add intermittent fasting to it if they want to. And there's nothing
wrong with that. That's OK. The only danger with
intermittent fasting is-- let's say
Saturday and Sunday are going to be your fasting days. If you find over
time that you're anticipating that on Friday,
and overeating a little bit, and then making up for it on
Monday with a little bit too much, what you'll discover
is that the benefits are being lost. But apart from that,
intermittent fasting is an OK way to go if
you want to do that. But I wouldn't do it
instead of a healthy diet. I would do it in addition. PAT DOYLE: Yeah, it sounds good. Yeah, I would say you
can definitely do both. And yeah, I agree on-- if you are doing
it more extreme, that might increase
cravings, and you might fall off the wagon
in terms of what you eat. Might be something
to think about too. We have one more
question lined up. I've got one from Ashley. "There have been so many fads-- non-fat, healthy fats,
organic, paleo, fasting. As time goes on, I'm
skeptical about this just being another one. What would you say about this
diet being here to stay?" NEAL BARNARD: Well,
thank you for that. First of all, this diet
has been-- the kind of diet that I'm describing, getting
away from animal products and so forth, has been
subject to an enormous amount of clinical testing. And that's been very
reassuring about recognizing that its power is real. With regard to some other
diets, other fad diets, that's really not the case. And, for example,
on a ketogenic diet, people will lose weight
on it, pretty clearly. Not everyone does,
but many people do. But when you look at what
happens with their lipids, it's often really
not what you want. And so the more we
test these things, the more their
benefits become clear and the risks become
clear as well. And with a plant-based diet,
you just don't see those risks. Culturally, a
vegetarian or vegan diet wasn't invented in the
past six or seven years. I mean, this is something
that goes back millennia. And the motivations for
it now are multiple. I'm a doctor. We're talking about diabetes. But on the other
hand, many people-- when I see a patient
comes in, and we talk about plant-based
diets, they will say, well, my brother
went vegan for the environment. Because I can't,
in good conscience, be eating meat,
eating dairy products when I understand what it's
doing to the environment. Or somebody else says,
well, my biggest motivation is for the animals. When you start to realize that
the animals are not volunteers, that what happens to them is-- including the animals
raised by my family-- really, very challenging to
think about and to contemplate. And when people realize that
Americans eat a million animals every hour-- and
maybe you don't-- that's right-- a
million per hour-- maybe you think, I
don't really want to be part of that anymore. All of these
motivations are there. They're not going away. So I think there's a reason
why plant-based diets have been growing and growing and growing,
and now the commercial products are coming in to
satisfy that demand. Although I've got to tell you,
the getting back to simple stuff-- vegetables and fruits
and beans and grains-- really has got you covered
pretty much most of the time. PAT DOYLE: Yeah, for sure. We personally eat a lot
of simple wheat pasta and vegetable kind of stuff. And I've gotten more in touch
with food actually as a result, what you might expect. Yeah, that's great. I think too, I feel
it's a win-win-win. Not only does this address
a lot of health issues, there's environmental
issues, ethical issues. And so totally agree with that. NEAL BARNARD: And
you know, Pat, that was why I brought up
the universal meals question-- because there
are so many people who are looking for something. Because maybe their
tradition is they were raised in a
Muslim household. But now where they are, it's
hard to avoid the pork being all over the cafeteria line. And I really don't want that. And the idea of
universal meals-- this is something where it's
not as if diversity is a fad, or diverse needs are a fad. They're here to stay. So I'm frankly hoping that
maybe people at different Google facilities might say,
OK, let's try it. And if so, that
would be really a fun project to see people
feeling that they had a place at the table. PAT DOYLE: Yeah,
sounds good to me. With the last few
minutes we have, I wanted to give you a chance
to let people know more about your work and where they
can find out and support it in addition to all
this research you run at the Physicians Committee
for Responsible Medicine and the Barnard Medical Center. Just wanted to give
you a few minutes to let people know
more about those things and where they
can find out more. NEAL BARNARD: Oh, well,
thank you for that. That's very kind of you. The Barnard Medical Center
is a medical center. It's in Washington, DC. It's a clinic where people go
because they've got diabetes or some weight to lose or some
cholesterol to get rid of. And so they come in and see us. And we will use medicines
if we need them, but we mostly try to get
people off their medicines to the extent we can and help
people to really feel better. But we also do a lot of
work by telemedicine. And the pandemic has really
brought that process along. So our website is
barnardmedical.org. And you'll see a
lot of information about that, including
telemedicine, if people are interested
in that side of things. With regard to the
Physicians Committee, we do research studies. We do a lot of them where
we bring in individuals. We change their diets. We see how they're doing. And this is our menopause
work and our pain work and our diabetes work. And we've got lots more of
these studies right now. And I hope people will
stay involved with us. And I might mention
one other thing-- that we're trying to make sure
the research is worthwhile and that it's ethical. And back when we got started-- I'll never forget there was
the Diabetes Foundation that contacted me and said
they were tired of funding rat experiments. And they said, everybody wants
to create a diabetic model in a rat. And they said, we're not
getting anywhere with this. Can we work with
people and understand the disease in people? And I said, yes, you
can do it, but we've got to do it the right way. I have become so impressed
with the benefits of focusing on the human species-- not just
the ethical benefits of not having to deal with experiments
on monkeys, cats, dogs, rats, mice, whoever it is, but also on
the scientific benefit of being able to actually--
now I can do something my dad could never do. I can look into your body
with MI spectroscopy, and I can see your
liver and your muscles while you are living
and breathing. And with my DEXA scanner,
I can tell you about things that we couldn't have
told decades ago. We can do that now. So I am very excited about what
technology allows us to do. And when we can do
it in human patients ethically and
carefully, it gives us not only the best possible
science but results that apply almost immediately. So that's the work
that we're doing here at the Physicians Committee. And if people would like
to see more about it, our website is PCRM.org. PAT DOYLE: Awesome. Well, thank you so much for
joining us today and sharing this information. I hope this helps people
listening and family members. And just happy to help
spread this information. And thank you for
taking the time today. NEAL BARNARD: Well, thank you. And when we go back
to North Dakota, we'll have to see
our relatives all having [INAUDIBLE] and the
occasional bit of lutefisk. And we'll talk to them
about healthier choices if we need to. PAT DOYLE: Sounds good. Thank you so much, Neal. NEAL BARNARD: Thank you, Pat. PAT DOYLE: Bye. [MUSIC PLAYING]
