The BITTER TRUTH About Sugar & How It CAUSES DISEASE! | Dr. Robert Lustig

sugar restriction actually causes a bigger decline in blood pressure than Salt restriction does Sugar's a bad guy in the story full stop so what Robert is wrong with our diet number one what everyone thinks is wrong with our diet is not even remotely what's wrong with our diet um you know every country that has adopted the Western diet is now sick and that goes around the world and there are countries that are actually more diabetic than we are and they're not even fat like for instance yeah Pakistan and China now they think well they're not fat so there's nothing wrong with their diet because after all it's the Western diet just causes obesity no obesity is just a marker for the problem it's not the problem itself in fact 20 of obese people are metabolically healthy that will live a normal life die at a normal age not cost a taxpayer a dime we have a name for these patients MHO metabolically healthy obese they will outlive you and me okay they're just fat they have increased subcutaneous fat well that subcutaneous fat is protective not detrimental okay that's a good thing to have not a bad thing to have yes some people have more than others on the other hand there are plenty of thin people who are sick and the reason they're sick is because they have fat where they didn't know they had fat like for instance the viscera in you know in terms of waist circumference and mostly most importantly liver fat and we've identified the liver as being the you know sort of Sentinel problem of this entire thing liver fat I was just at the Obesity medicine association meeting just this past weekend explaining why fatty liver is basically where the problem is so the question is why is it that we had never heard of fatty liver disease before 1980 and now 45 of adults and 25 percent of children not obese adults not obese children all adults all children now have a disease that didn't even exist 50 years ago yeah I mean except for alcoholics they'd get fatty liver right and that's the point only alcoholics had this and now everyone has this and children don't drink alcohol but children consume something that is just like alcohol and that is sugar sugar and alcohol are virtually identical as far as the liver is concerned the big difference between sugar and alcohol is that for alcohol the yeast does the first step of metabolism which we call glycolysis anaerobic glycolysis for sugar for fructose the sweet molecule sugar we do our own first step of metabolism but after that they're exactly the same and so it makes sense that children would get the diseases of alcohol without alcohol so until we fix this problem and by the way this is just one of several problems with the Western diet until we fix this problem nothing else is going to work and I actually proved this in our own Clinic here at UCSF because what we did was we took 43 children from our Clinic who had metabolic syndrome so I mean this was in the this was in the the movie Fed Up right this is no we have we had not gotten the results on this study back when Fed Up was recorded this is actually newer um so no it's not in there so there was something like that in the in the study where you put the kids in a metabolic Ward and you fed in different diets and you saw what happened very quickly right right right well this so 10 days 10 days what we did was we figured out what they were consuming on their home diet okay we studied them on their home diet then for the next nine days we catered their meals no added sugar so we took the percent of calories from sugar from 28 which is a lot 10 okay now if you do ten percent is still a lot that was that was when we gave them fruit so we gave him fruit that was the pretty much the only sweet thing we gave them yeah yeah now if you do that you're going to take 350 to 400 calories a day out of kids diets and if you do that number one they're going to be hungry and number two um they're um gonna lose weight we didn't want them to lose weight because hey if they lost weight and they got better people say well of course they got better they lost weight we didn't want them to lose weight we actually wanted them to gain weight so ah we had to substitute the sugar first with something else that was equi caloric we gave them refined starch so in the vernacular we took the pastries out we put the bagels in we took the sweetened yogurt out we put the baked potato chips in we took the chicken teriyaki out there turkey hot dogs in okay so we didn't give them good food we gave him crappy food we gave him processed food we gave him Safeway food kids would eat okay but it was no added sugar food and we also gave them a scale and every day we'd call them up on the phone watch your way and if they were losing weight eat more in order to keep their weight constant through the 10 days and then we studied them 10 days later and lo and behold no change in weight but the fat in their liver went down 22 percent wow their conversion of sugar to Fat went down 46 percent their triglycerides went down 49 just 10 days they're visceral fat the belly fat went down seven percent and most importantly their insulin in their pancreas started being released and working properly in other words we reversed their metabolic syndrome with no change in calories and no change in weight and what they told us was that it's not the weight it's not the fat it's the liver fat yeah that's interesting you can't see that's the fat you can't measure when you stand on a scale and that's why we have metabolically healthy obese people who don't have liver fat and we have very thin sick people who do in my understanding you know and this is David Letterman says this you know below the neck your body can't tell the difference between you know uh Corn Flakes and a soda right or between a bowl of sugar and a bagel and I think you know refined starches are also a problem so I don't want people to take away from this is that you can eat for fine starches and that's okay and I think it's still a problem let me let me let me uh you know delve into that a little bit let me unpack that okay sugar dietary sugar the sweet stuff you put in your coffee you know the crystals is two molecules in one okay it's called sucrose but it is two molecules one is called glucose one is called fructose now glucose is the energy of life every cell on the planet Burns glucose for energy glucose is so important that if you don't consume it your body makes it okay makes it out of proteins it makes it out of fats it so you will always have a serum glucose level the Inuit who basically didn't have any carbohydrate because they didn't have any fields to grow any carbohydrate they ate whale blubber they still had a serum glucose level because yeah glucose is that important but it's not important to eat because you can make it now fructose that sweet molecule and sugar is a different animal entirely okay there is no biochemical reaction in any vertebrate that requires dietary fructose it is completely visible to all animal life now it just so happens it's sweet it just so happens we like it a lot it just so happens it's addictive but it is actually metabolized like fat but it is completely unnecessary now glucose will stimulate insulin release and that's not good because insulin release will drive energy into fat cells and increase weight gain and that's what Dave Ludwig is talking about and he's right and he's right I'm not saying he's wrong he's right but fructose because it gets stuck in the liver and causes liver fat you get insulin resistance it's a two different phenomena two different things one's called insulin secretion insulin release the other one's called insulin resistance they are not the same insulin release will cause weight gain insulin resistance will cause heart disease diabetes Alzheimer's cancer and virtually all of the other chronic metabolic diseases that are chewing through our entire Health Care System insulin resistance is the bad guy insulin secretion is basically what we're talking about when we're talking about the scale insulin resistance is what we're talking about in the doctor's office but eventually though if you have enough of the restoring starches even if you don't have refined sugars you will see an increase in insulin resistance because you're producing more and more insulin and the cells become resistant so it's sort of related but I I get your point fructose really has a unique effect on the body we had Richard Johnson on the podcast we talked a lot about the dangers of fructose and uh and David promoter talked about this uh what he called drop acid meaning uric acid in this role as a as a real accelerator oven some resistance and and chronic illness so I I agree with you Robert and I think you know it's so amazing to me that the single biggest driver of our exorbitant health care costs of our declining Health globally of all of our chronic diseases heart disease cancer diabetes dementia even depression uh and more are driven by insulin resistance and yet it's something we learn almost nothing about in medical school my daughter now is the second year medical school I think she had like a an hour on it and and it wasn't really in the context of what's really driving it and and it's like if you treat that you treat so many of these chronic illnesses and it's one of the drivers of all aging I just finished my book on longevity called young forever and it basically if you look at the science of this the science of instant resistance is really the science of chronic disease and the science of aging and the science of death couldn't agree more in fact insulin resistance is the Sentinel problem in all of these chronic metabolic diseases because insulin resistance is a manifestation of mitochondrial dysfunction mitochondria are the low energy burning factories inside each of our cells and when our mitochondria work efficiently we are healthy and our blood glucoses do not vary very much and our weight stays stable and we feel good and we can sleep well and all is right with the world and as soon as our mitochondria don't work well all hell breaks loose and we get all of these chronic diseases and we feel like crap etc etc and we end up starting to having to take medicines in order to try to make our mitochondria work better except because what we don't have a medicine to make our mitochondria work better because no medicine can actually get to where the problem is okay but it's suitable not druggable right right so that's so that's the whole point is how what's wrong with the mitochondria and how do you fix it that's basically what this whole story is about and to be honest with you mark that's what functional medicine is about okay for sure friggin mitochondria all right so absolutely so what's poisoning them that's the the big question in all of medicine and before before we get into the the I want to get deep into mitochondria and all this but before I just want to kind of back it up a little bit because we all we said a lot of stuff and I want to make sure people get it so so I want to talk about how we diagnose insulin resistance and and you have in your book a way to self-diagnose because it's really important because your doctors are missing 90 of it you know if it taught how to diagnose it they don't because there's no simple drug for it so there's no drug for it why test for it right and and you're talking you just talked about a few major things that are a little bit confusing one is you can be metabolically normal obese meaning you're overweight but metabolically normal and I think that's a small number of people you can be metabolically obese and normal weight like the people from India and China that can be on their BMI their body mass index normal but they're still diabetic right right and that's dangerous in fact I've seen some studies that that name may be more dangerous than being overweight and metabolically unhealthy and then there's the obviously the overweight the metabolically obese and obese obese patients so there's these different categories some of it's genetic some of it's you know had a lot of variations but you you kind of can't know until you test so explain to us how we can understand what's going on in our bodies how do we test for this phenomena that's driving all these diseases for which we're taking so many medications that aren't really working they're just managing the disease and they're not actually treating the the problem they're treating the symptoms totally the problem of course is that your doctor has access to all this and you don't and you need to and they need to but they don't understand it which you know maybe you can teach your doctor what to do how would that be or you or your audience out there okay I love that all right sometimes doctors are a little you know shall we say provincial and they don't necessarily you know listen to their patients but they really should if they listen to their patients they'd be much better doctors all right number one you look at your waist now your waist is a conglomeration of many things but primarily visceral fat and liver fat that's what determines your waist circumference if you are a male and your waist is 40 inches or greater the chances are you have visceral and or liver fat and that probably means you have insulin resistance and you have mitochondrial dysfunction if you are a female and your waist is 35 inches or greater same thing now that's the cheap way unfortunately it's sensitive but not specific so there are other things that can you know cause you problems as well like ascites and other things but you know pregnancy yeah pregnancy thank you yes okay so which of course is insulin resistance also you know but that's for another day um then you start getting into the lab tests okay what lab tests do you need to get the most important lab tests for determining insulin resistance is a fasting insulin now doctors don't draw fasting insulins I think it's the single most important lab test to draw but they don't draw it why don't they draw it because the American Diabetes Association told them not to draw it now why is it that I'm saying that this is the most important test that you have to run and The Diabetes Association is saying don't bother how come we are so completely diametrically opposite the answer is because I'm right and they're wrong by the way I've been measuring this test for 30 years me too astounding to me how important it is and how nobody tests for it who's in the conventional medicine that's right so here's why the Ada says don't draw it two reasons and they're both wrong and spacious number one they say well lab tests around the country for fasting insulin are not standardized yeah now that is true that is true I don't argue that and the reason is because cheap tests cheap insulin tests do not distinguish between the insulin molecule and its precursor to the pro-insulin molecule now pro-insulin is a pro-hormone meaning it's before you get the active hormone it's bigger and the pancreas betas the beta cells in the pancreas make this thing called pro-insulin and then there's an enzyme that cleaves the c-peptide piece off and then you release the insulin now when you're sick when you're insulin resistant your pancreas doesn't have time okay and that may actually even be a problem that you have a problem with that enzyme and that enzyme is called pc1 or pro hormone convertase one yeah now you may if you're sick release both you may release both pro-insulin and insulin and So Pro insulin gets picked up in the insulin assay so indeed insulin assays around the country are not standardized so yeah the American Diabetes Association is right about that but so what if it's high you got a problem okay exactly and they basically don't understand that and that's so that's that's specious issue number one yeah suspicious issue number two they say insulin levels don't correlate with obesity that is also true they correlate with metabolic health and heart disease and cancer and dementia exactly okay and we just told you that there are thin sick people okay so they're not registering on the scale but then they don't know that they're sick yeah so this is exactly why we need to be drawing fasting insulins is to figure that out yeah so fasting and by the way you know the other the other thing I do I would just say it's going to add my two cents because I've been doing this for a long time too and I started measuring not just uh fasting insulin but I measured a glucose tolerance test with insulin almost on every patient who I thought even smelled that they could have had metabolic syndrome and it was fascinating to see the date on this you'd see people with like blood sugars that were perfect like I had this one woman like like a big apple her fasting blood sugar was like 90 after the two 75 gram glucose which is like you know two Coca-Cola worth of sugar her blood sugar went to like 110 never even went into glucose intolerance but her fasting insulin was like 50 and it went like 200 at one in two hours so I found that very helpful and fasting insulin uh is is a is probably the second stage the first stage is a post perennial insulin that goes up right yes exactly right so in fact we did oral glucose tolerance test with simultaneous insulin levels on kids published this back in the early 2000s where we this is where we realized where we had these two problems one's called insulin hypersecretion and those kids are fat but healthy and this thing called insulin resistance and those kids were fat and sick and so even though they are both insulin problems they are for different reasons and different things in our diet cause each of them is that hypersecretion can be genetic insulin resistance usually is not but it's very very fat liver fat specific and very much dietary fixable so we learned quite a bit by doing that I don't need to do that anymore and actually retired anyway so I'm not seeing patients but um but the point is I can figure out from the other lab tests what's going on so I don't have exactly exactly me too it's a it's actually when I was in residency training I had a I had a pulmonologist who was one of my preceptors and he you know he taught us to read x-rays he goes well you know this is this this is that then he goes and this is the aunt Millie sign I'm like well what do you mean what's the aunt Millie sign well it walks like Aunt Millie and talks like it it looks like Emily so it must be a million it's it's not basically if you look at the pattern it's a pattern recognition and if you look at right the types of cholesterol if you look at uric acid if you look at you know all these other phenomena hormones you can tell so much about what's going on so besides the insulin fasting level what else should people be measuring besides their waste and their fasting insulin right so the next thing down the list is their Alt alanine Amino transferase okay now the problem with alt is not it's a liver test it's a liver test it's a test that tests for fatty liver okay it's again sensitive not specific but the problem with alt is not the test the problem with alt is the interpretation yeah now when I in 1976 when I entered Medical School the upper limit for alt was 25. today you'll look at the lab slip it's 50. we're 50. sometimes 50. yeah so same test but you know now double the uh the upper limit of normal how'd that happen the answer is because everyone has fatty liver disease that's right okay the entire curve shifted to the right and the way the lab determines normality is they do a whole bunch of tests on you know ten thousand or a hundred thousand people okay and they get the mean and they get two standard deviations and they draw a line at those and say okay that's the upper limit of normal well if the entire curve shifted guess what the upper limit shifts but that doesn't mean it's normal and it just means that the patient didn't know they had a problem yeah Landing an American today it would be normal to be overweight and obese because that's what Americans are it doesn't mean it's optimal that's right and so in fact uh an ALT upper limit is 25. if you're African-American and ALT upper limit is 20. so if you see an ALT above that you got a problem and you don't necessarily know why and your doctor's looking at it and saying well you know your alt is 30. you know it's below 40 or 50 you know then no problem and so your doctor's missing it yeah so that's that's the second test and those are cheap these are cheap tests these are cheap tests these are tests that are normally done on standard chem panels uh the next test is uric acid as David Pro Mudder and Rick Johnson you know our espousing now uric acid is the breakdown product of purines so if you eat a lot of meat you will get a higher uric acid it's true all right and of course everybody with gout knows this Benjamin Franklin knew this okay he wrote an Ode to his gout many years ago but it turns out sugar also increases uric acid now how can red meat cause increased uric acid and sugar increase uric acid red meat and sugar don't look alike well in fact in the liver they do and the reason is because they both cause an increase in uh ATP being converted to ADP ATP adenosine triphosphate being converted to ADP adenosine diphosphate which then goes down the breakdown Pathway to uric acid so uric acid is a proxy for both red meat and for sugar in our society it's actually a proxy for sugar now uric acid is bad for two reasons one it inhibits an enzyme in your blood vessels called endothelial nitric oxide synthase or Enos this is your endogenous blood pressure lower keeps your blood pressure down and so when your uric acid Rises your blood pressure Rises and it is the reason why sugar is more important for hypertension than Salt is and we actually yeah thank God you're saying that the salt restriction sugar restriction actually causes a bigger decline in blood pressure than Salt restriction does yes thank God I mean I I've seen this over and over that the cause of high blood pressure is not to say salt it's sugar and when I need some resistance is driving the high blood pressure in the first place indeed indeed and and Insulin also prevents you from being able to excrete sodium so the higher your insulin the more sodium you hold on to with the kidney which raises your blood pressure too so by fixing the sugar you're fixing the insulin resistance you're fixing the uric acid and you're lowering your blood pressure virtually overnight yeah sugar and starch like they just pee a lot because they lose the sodium because their insulin goes down and they start peeing a lot lose a little fluid which is water weight but that actually is a good thing that's a good thing we showed in our 43 children's study that these kids blood pressures went down by five points in just 10 days when with no change in Saudi yeah that's true yeah it's true so that so um that so that's one reason why uric acid is important is because of the blood pressure thing but the second reason uric acid is important is because uric acid blocks an enzyme that you're are in your mitochondria carnitine Palmetto transferase one cpt1 this is an enzyme that regenerates the transporter carnitine carnitine is a transporter for fatty acids from the outside of the mitochondria to the inside of mitochondria so that they can be burned for energy if you poison that enzyme you don't regenerate the carnitine you can't transport the fat into the mitochondria mitochondria become dysfunctional and guess what you have buildup of fat in your cells because you can't burn it so Uric acid's a bad guy in the story and sugar makes uric acid so yeah the problem with uric acid just like the problem with alt is the interpretation if you look at the lab slip it says seven is normal wrong 5.5 yeah yeah anything about 5.5 you got a problem so by the way what should fasting insulin be because I you know I think we didn't talk about the number there uh but it's important because it's what your doctor is going to say is normal and you is normal and not do the same thing agreed agreed fasting insulin should be less than 10. optimally if you're an exerciser and all you know you might even get it less than five okay if your price is less than two well you are well you you are a paragon of virtue mark because you practice but well no I just don't need a lot of sugaring and starch and exercise that's right well mine's not as good my my the last time I checked was 8.6 okay but it's below 10. um if you're fasting insulin's above 15 that's a problem okay to be sure all right so fasting insulin alt uric acid okay the next thing you want to check is your lipid panel now yeah the problem with your lipid panel is that everybody just looks at the LDL the LDL is the least important thing on that lipid panel I'm not going to say it's not important but it's the least important what's more important is the triglycerides because the triglycerides are much much more atherogenic than the LDL is which is amazing right because our entire medical system a trillion dollar pharmaceutical drug is focused on lowering LDL and not addressing triglycerides because you know why there's no drug that really works the lower triglycerides that well except fish oil and maybe niacin which is vitamin B3 right exactly the reason everybody focused on ldls because we had a drug for it called statins okay not because it was the really atherogenic particle but rather because we had a medicine for it okay same thing we did with growth hormone okay we made short stature disease in order to be able to prescribe growth hormone so that the drug companies could make lots of money and then by the way this is all in the book you know in terms of how how you how you um you know how big Pharma kind of games this is yeah okay so um triglycerides more important than LDL and also HDL more important as well and the reason is because HDL you know aside from being the good cholesterol is actually the evolutionary byproduct of when LDL gets uh offloads its lipid but the IDL or the intermediate density lipoproteins which you measure in the LDL fraction are actually from the triglyceride so yeah in other words these are evolutionary byproducts of each other and so you have to look at the pattern in order to figure out what actually happened to the molecules coming out of the liver ratio is way more predictive than your LDL or even the total cholesterol uh to HDL ratio and that's exactly why is because they are evolutionary products of each other so yeah I agree with you the TG to HDL ratio tells you the most so you need to look at that lipid panel but you don't just need to look at the number you need to look at the ratio you need to look at the at the at the pattern okay and then finally we get to the things that matter the least hemoglobin A1c and fasting glucose because those are the last things to change okay by the time those change horses out of the barn yeah so you know yes we do measure them we do look at them but you know that at that point you know you're already uh you know mitochondrally unfit yeah and and also you talk in the book about not just looking at like LDL which is basically the weight of the cholesterol but the quality of the cholesterol and the number of particles and the particle size as a big predictor more important predictor and yet you know we're practicing 20th century medicine in the 21st century because most doctors don't even measure that and it's available through Quest or Lab Core it's not it's not hard to get well you know in order to do it right you have to do what's called a VAP analysis you have to really sort of ultra centrifuge all of them to figure out what these different things are it costs money it's about 500 bucks there are companies that do it like arthrotech um yes I Quest does it but the bottom line is insurance doesn't usually pay for it yeah and so people tend not to order it for that reason one is like 50 bucks I think the NMR from the lab core yeah it's not it's not it's not expensive I I've been doing this on everybody since it was made by lipo signs and then liposcience was bought by LabCorp this was back 30 years ago and it's it's been around Ron Kraus pioneered this over 40 years ago and it's like it's not like a new thing but it's that it takes forever for stuff to get incorporated into medicine so amazing what you're saying is if people can look at their own lab tests using the guidelines you you provide in your book the things that we just talked about through some really pretty easily accessible standard tests you can determine whether you have metabolic syndrome and insulin resistance which is the big cause of all these Health Clinic concerns we're talking about exactly right so you know your doctor has the capability if they have the knowledge the problem is invariably they don't have the knowledge so you may have to arm yourself and that's what I try to do in the book is try to help people understand their own bodies okay amazing so I want to move on to another a key part of the book which was so exciting to me because as a functional medicine doctor to see someone from an academic Medical Center who's been a professor and a researcher for 40 years come to the exact same conclusions that I've come out from clinical practice was just was like you know music to my ears and and you basically say something I often say it's just because you know the name of the disease you don't know what's wrong with you and you say in a different way but you say you know because he's like cancer hypertension diabetes heart disease they're just Downstream symptoms of the real problem right so talk about that and then let's get into these eight subcellular pathologies that underlie all these metabolic diseases sure so let's take a typical example okay let's take LDL okay doctor says you have high LDL all right they say that's the disease here's the Met here's the treatment for it it's Statin yeah okay total garbage all right the fact of the matter is if you look at the Statin literature which we did and which we do and which you know is out there for everybody okay 44 studies in the meta-analyzes the Cochrane group and dubrov Etc you know there are several of them bottom line for primary prevention for primary prevention if you take a Statin you will increase your lifespan by four days yeah but four days could be a lot you know you can do a lot in four days is it worth the trillions of dollars I guess the question is since 20 of people but since 20 of people who go on statins develop diabetes and uh yet another 10 percent have Rhabdomyolysis and other problems related to the statins you know is that a good trade the bottom line is the doctor will tell you oh you have high LDL here's the treatment garbage okay the high LDL is a symptom of the problem not the problem itself same for high blood glucose so you have high blood glucose the doctor gives you you know a sulfamiliaria or glutenide or whatever you know to lower your blood glucose and it will lower your blood glucose the point is the high the high blood glucose was actually a manifestation of the mitochondrial dysfunction you haven't done anything for that yeah and the bottom line is all of these medicines are treating the symptoms they're basically salutary they're not actually dealing with the problem it's like giving an Aspirin to a patient with a brain tumor because they have a headache might help the headache ain't going to do a damn thing for the brain tumor yeah and that's the way modern medicine has been dealing with all of these problems until you get to root cause and Mark I know that that is like the the two words that make that put your hair on fire as a functional medicine doctor I got it I got those are those are those are the num those are the words root cause okay you got to fix the problem you don't fix the symptom of the problem as I as I say in the book look you go up into your attic and you find a wasp buzzing around your attic what are you gonna do you want to kill the WASP are you gonna find the wasp's nest all right exactly where there's one wasp there's many wasps all right yeah you gotta fix the problem not the result you gotta fix the problem not the symptom all right diseases are not druggable that's an interesting concept they're not druggable you may modify the symptoms but you're they continue to progress they can get worse and you need to die from them it might be a little slower you might slow the rate of it you might improve it a little bit but they're really not fixing the problem right well in the case of the high blood glucose it's not the glucose that's causing the problem it's the insulin the insulin is actually driving all the chronic metabolic disease not the glucose and I can prove that too okay there's a mouse my favorite Mouse can we talk about mice for a minute sure okay talking something about mics okay my favorite Mouse in the entire world okay it's called the poderco mouse the glomerular podocyte insulin receptor knockout Mouse Okay so this mouse is whatever that means but yeah okay doesn't have the insulin receptor in his kidney okay it's going to lift it out genetically all right this animal has normal blood glucoses this animal has normal glucose tolerances this animal has the worst diabetic kidney disease of any animal model on the planet well why blood glucoses are normal everyone says oh it's the glucose that's causing the kidney disease garbage it's the insulin that's causing the kidney disease and then we know that because the type 1 diabetics they have high blood glucoses but their kidneys don't get shot for 30 years type two diabetics their kidneys are shot before they even walk in the door yeah yeah because they have high insulins because it's the insulin that's the problem and we're not touching that this is really important and I I you know one of the things that really woke me up to this was this big study of 10 000 diabetics called the Accord study if you remember the study from a long time ago and the guy the idea is let's aggressively lower blood sugar in order to improve so it comes reduce deaths and kidney failure and all the complications around diabetes and we'll increase the deaths yeah so it actually was fascinating because the more insulin you gave the more drugs like the the oral hypoglycemic you mentioned the sulfonurias they work by increasing insulin which is like flogging a tired horse and they produce more insulin the more insulin you give the worse the outcomes so this was just a fascinating study better glucose control more deaths and more complications there are actually five studies that have shown the same thing that's accord's one of them but the advanced study showed it the addt trials showed at the mirror Glitters are study showed the UK PDS studies showed it the bottom line is more insulin more death yeah and yet we continue to do the same thing in medicine over and over despite all the research we see we practice evidence-based medicine but we really don't we ignore the evidence that isn't actually fostering an increase in the sale of drugs and medical procedures it's just all the incentives are so backwards bottom line is Einstein's theory of insanity his life within medicine you know and he you know he famously said you know doing the same thing over and over again and expecting a different result well we've been doing the same thing over and over again for the last 50 years and you know what no different result so so you frame all these diseases as really the tip of the iceberg and underneath it you say are these eight processes these eight metabolic phenomena uh these sub-cellular pathologies you call them that are really driving everything and and I'll just list them and then we can kind of go into them all we talked a little about dinosaur resistance but glycation oxidative stress mitochondrial dysfunction we've touched on this membrane Integrity inflammation epigenetics autophagy you talk a lot about this in the book it's a lot of big words but it's actually a lot of the same topics I wrote about in my book young forever because it all drives chronic disease all drives aging and they're underneath uh well they're often these are also known as the Hallmarks of Aging which are the phenomena that happen that are driving the disease so Hallmarks actually are upstream and and uh and they're not they're not symptoms they're basically these phenomena that happen from different insults mostly from food by the way we'll talk about how to fix them with food and and and you kind of break it down I was just like jumping up and down when I saw it I was like wow this is this is it you got it you know so tell us about these eight processes and how they lead to all these diseases exactly so these eight processes are you know for the most part not processes that you can sort of test for they're happening in the cell okay there are ways to do it I mean researchers can do it but they're not shall we say clinically available but they're going yeah yeah they're going on in all of us it is part of life all of these are part of life you can't stop them but you can slow them down but you can only slow them down with food all right so so they're foodable they're all suitable right exactly not druggable all foodable all right example glycation so glycation a glucose binds to a protein now when it does that it makes that protein less flexible it makes that protein end up being recycled okay it might uh change the function of that protein it might cause that cell to become uh more fragile and friable and might end up causing cell death okay so glycation is not a good thing now this is what diabetics measure when they measure hemoglobin A1c this is glycated hemoglobin the glucose binding to the hemoglobin molecule well that's happening all over your body it's happening all the time yeah the question is how much it is the cause of wrinkles cataracts all right yeah the cause of cardiovascular disease the blood vessels well it's one of the causes of dementia not the only one but it's okay the bottom line is you don't want to be glycating all right now you're going to be glycating because it is a a process you can't stop okay it is part of life but you can slow it down how do you slow it down stop providing the substrate okay and the substrate for glycation or two glucose yes but fructose is seven times worse so both wow but fructose does it seven times faster and releases a hundred times the number of um uh oxygen radicals which were in number two so that's why high fructose corn syrup this and everything is super bad right extra fructose yeah but the the fructose and sucrose too I mean so it almost doesn't matter the point is Sugar's a bad guy in the story okay you know full stop that's that's what we don't you know tell our patients and that's the thing that they need to watch and it's the thing that they can control themselves if they choose to so that's number one number two oxidative stress those little hydrogen peroxides now hydrogen peroxide is good if you have a wound but it's not good if it's inside cell because those hydrogen products you want to kill an infection or cancer or something then it can be good but but you know your body makes a little bit but it shouldn't make too much right but it shouldn't you shouldn't be making it in your liver right now every time a hydrogen peroxide gets made okay it's doing damage it's doing damage to a lipid it's doing damage to a protein ultimately it will kill cells the bottom line is oxidative stress occurs every time that glycation reaction occurs now it also occurs from Iron it also occurs from various other processes that go on in the body but the sum total of that oxidative stress is the Aging reaction that is and so we need to basically try to mitigate it as much as possible now you can't mitigate the iron but you can mitigate the sugar you can mitigate from some of other reactive oxygen species drivers like for instance environmental toxins okay like insecticides and things like that that will cause it as well all right number three mitochondrial dysfunction yeah we talked about mitochondria being sort of at the heart of this whole problem well it turns out fructose that sweet mole Kiln sugar inhibits three count them three separate enzymes we've talked about one cpt-1 and mitochondria basically make energy from the food you're eating and the ox when you breathe that runs everything in your body so when that process gets up you're having a energy crisis exactly right exactly right it inhibits an enzyme called ambikinase which is the fuel gauge on the liver cell it inhibits an enzyme called acad L acyl COA dehydrogenase long chain which is necessary to get the fatty acids oxidized so the bottom line is if you are mitochondria are dysfunctional you're going to be sick and fructose is a three in one mitochondrial toxin there are others I mean there's a good deal three for one right you know but yeah I mean but bottom line that's that's like number one yeah number four okay insulin resistance now we've spent enough time on that so I think we'll go to number five yeah number five membrane instability now imagine you have a balloon okay you blow up the balloon and you try to pop a hole in that balloon with your finger well yeah but if you put if you take a pin it will pop okay now take a balloon blow it up and put it in your the corner of your bedroom for three weeks it will slowly deflate okay now undo the knot and now blow up the balloon again now try to puncture the balloon with your finger now it'll puncture what happened how come the balloon would not puncture with your finger the first time but it would three weeks later how come answer because the membrane the balloon okay changed properties so yeah the membranes of your cells and especially of your neurons okay you have to turn over and they have to basically maintain integrity and the problem is that there are a lot of things that can inhibit that Integrity again one of them being sugar insulin being another one but there's a way to fix that there's a way to treat that omega-3 fatty acids those are the things that improve membrane Integrity in your liver in your arteries and most importantly in your neurons so where did the Omega-3s come from well unfortunately not farmed fish there omega-6s Omega-3s are made by the algae the wild fish eat the algae we eat the wild fish well unfortunately wild fish is expensive and not immediately available in many parts of the country and parts of the world right another reason for a problem number six inflammation now you have talked about inflammation till the cows come home yeah okay if I mean your PBS special is all about inflammation I know and I agree I totally agree okay questions where's the inflammation coming from a bunch of places could be you know I mean like for instance if you have an autoimmune disease like rheumatoid arthritis you know it's coming from your immune cells and stuff but where's the inflammation coming from in people who don't have autoimmune disease yeah it's coming from your gut okay yeah your gut microbiome so your intestine is functionally outside your body and your intestine provides a barrier to keep the stuff in your intestine the literal in your intestine you might have to bleep that out but hopefully no I'm fine okay all right the the bacteria the cytokines the lipopolysaccharides the stuff you do not want to get into your bloodstream okay it's a sewer in there it's a sewer that's exactly right it is a sewer in there and the goal is to maintain the barrier so that those bad guys don't end up in your bloodstream now you have two mechanisms for doing that one is the mucin layer okay so there's a mucous layer like mucus yeah like mucus on the top of your intensive cells that's one and the second is that there are proteins that guard the Junctions between the cells you know that where stuff could slide through okay those are called tight junctions and tight junctions like for instance zonulence that's what goes wrong in Celiac disease yeah so you need the mucin layer you need the tight junctions you need to all be effective all right in order to maintain that intestinal barrier well guess what if you don't feed the bacteria in your intestine your bacteria will choose the mucin layer to be its food it will chew through the mucin layer exposing all those intestinal epithelial cells to all these bad guys intestinal pathologies paper that just came out that showed that Crohn's disease severity and instance in severity is related to ultra processed food consumption for exactly this reason interesting also if colitis was not but crumbs was um so that's so you've got to feed your bacteria microbiome those little you know they're 10 you've got 100 trillion bacteria in your intestine okay they got to eat well what do they eat they eat the fiber in your food so you have to feed your gut well unfortunately the Western diet is fiberless food and so they're going to eat the mucin okay exposing your intestine and generating inflammation second you have those tight junctions well those tight junctions can become dysfunctional you can nitrate those tight junctions and guess what nitrates those tight junctions best sugar yeah again so again it's a bad guy yeah you know I don't know this is true Robert but um I talked to Bruce Ames uh and he said that they did research in his lab where they found their fructose because it requires extra energy to be absorbed uh meaning it requires more ATP to be absorbed it actually uh draws energy out of the gut and you need energy to keep those tight junctions together and so just the fructose actually has another effect which is to create a leaky gut and then you get this whole phenomenon we call metabolic endotoxemia meaning the bacteria and toxins leak out it activates your immune system your immune system is activated and that causes insulin resistance in the cellular level so it's like all connected it's all connected exactly right so you need that intestinal barrier to be working and you need to be working 24 7. and you're right fructose because it has to be phosphorylated in order to get across is depleting ATP from those intestinal epithelial cells so again you know oh and the paper came out just about two weeks ago in the journal cell from evinov's group at Columbia which showed that Sugar depletes the th17 cells which are the barriers yeah il-17 which is the barrier which then allows all the fat to rush in and generate its own inflammation so bottom line you got to keep your gut happy and the way to do it is to feed it and what you have to feed it is fiber and the problem is processed food is fiberless food so there you go number seven yeah we're not done no I know there's two more two more two more number seven methylation so methylation is a process that goes on normally but you don't want to methylate things out of hand and um if you are methylating uh uh proteins okay they are losing function okay isolate DNA and it will also cause problems in terms of function we know this from various genetic differences like for instance the agouti mouse and also from patients with methyl tetrahydrofolate reductase deficiency they end up having high levels of uh protein called of an amino acid called homocysteine and homocysteine is a sticky amino acid that can drive cardiovascular disease and so by increasing B1 B2 B6 B12 folate we can keep methylation at Bay but again processed food not high in those things and then finally number eight which is my favorite autophagy you know autism garbage night for the cell okay yeah your cell makes junk okay during the course of the day it makes junk and those junk that junk can be protein aggregates or lipid epoxides um various uh dysfunctional mitochondria because they burn out and so you have to recycle the stuff to get it out so imagine you you wherever you live you live in Massachusetts imagine your garbage men go out on strike okay for the first week ah you're okay for the second week you know maybe starting the smell third week you know now the rats are kind of you know tempted by the fourth week you know you may have some problems with your plumbing and by the fifth week you're going to move out of your freaking house all right yeah yeah that's autophagy that's garbage night okay you have to recycle all the junk in order to make room for the new stuff okay that's a key part of longevity is to activate autophagy right absolutely or autophagy and um uh longevity are you know part and parcel of the same thing and we're actually very interested in that we're studying um of specific supplement that might um improve autophagy and therefore improve longitude that's near and dear to home so no Robert you've talked about all these a processes and and the key to fixing them is what the key to the fixing virtually all of them is food okay now glycation fructose and glucose oxidative stress fructose glucose various fatty acids like trans fats mitochondrial dysfunction again fructose cadmium other insecticides insulin resistance fructose glucose branched chain amino acids uh intestinal and sorry a membrane Integrity Omega-3s inflammation fiber methylation vitamins B1 B2 B6 B12 folate and finally autophagy intermittent fasting and also uh keeping your insulin down so bottom line all eight fixable by food so then the question is what about exercise turns out exercise is very good for you I'm for exercise I mean you're for exercise two this there's okay exercise is excellent okay exercise is the second best thing you can do for yourself after diet but when you actually look at those eight exercise only helps you with four of them yeah so you cannot outrun a bad diet no I say that a lot yeah exactly uh that's amazing so so basically in your book you go into great detail about how to I understand whether you have these practices going on how to fix them because these are all the things that are underlying all the diseases that we get and we're just treating the symptoms and not the disease so this is really powerful and it's really in line with functional medicine uh I want to talk about something you also talked about the book which is four specific things in our food supply the damage mitochondria and and what they have in common and what do we do about it and we've touched on them a little bit but can you just kind of break it down for us because you basically keep saying that mitochondria are key to longevity to health to to preventing uh insulin resistance and that people who have insulin resistance by definition had dysfunctional mitochondria so what are those things that damage them and what do we uh what do they have in common and what do we do about it okay so number one um fructose number two trans fats number three alcohol number four branched chain amino acids now branched amino acids are a little harder um yeah I was surprised by that I want to hear about that leucine isoleucine valine okay now these are three essential amino acids you have to consume them your body does not make them they are very important for muscle 20 percent of muscle is branched chain amino acids this is why bodybuilders you know consume protein powder they put you know a big scoop of protein powder in their smoothies okay to provide them with extra branched chain amino acids and if you are building and if you're building muscle that's an okay thing to do however what if you're not building muscle what if you're like a mere mortal like me okay and you're consuming extra branched chain amino acids and we'll talk about where they come from in a minute okay what's happening is you're not able to lay down more muscle because you need the exercise to do that so those extra branched chain amino acids are going to your liver the liver is going to turn them into energy the liver deamidates them it takes the amino group off and now they've become instead of uh branched amino acids now they're branched chain organic acids and then they go into the Krebs cycle the tricarboxylic acid cycle they overwhelm the Krebs cycle just like fructose did just like an alcohol did and they end up making liver fat and that liver fat ends up causing insulin resistance also don't don't break any immunos help with muscle synthesis and building muscle and if you're a building muscle if you're building muscle but if you're not then no so that's the point is that you the exercise is the cofactor there that requires required so take them after you exercise basically yeah and that and that's fine but only if you after you exercise now the question is where is the mere mortal like me getting his Branch chain amino acids from and the answer is corn fed beef chicken or fish because corn is very very high in branched chain amino acids so if you're having regenerative meat or having wild meat you're not seeing that that's right that is shall we say healthier amino acid and healthier amino acid profile yeah trans fats are pretty bad and they're still on the marketplace which is shocking to me because in 2015 seven years ago the government said they weren't safe to eat and they're still out there it's amazing I don't know how the drug companies I mean the drug I should call them drug but the Food and Drug is insane these bad uh bad uh foods are really like poison medicines for the body but they they are still in the food supply to be very diligent about it listen once upon a time the Food and Drug Administration in 1958 codified 100 170 items in food as being safe okay that was the beginning of what we call the grass list generally recognized as safe 170 items okay 1958. okay it is now what 60 years 63 years later how many items are on that list now you really think there are ten thousand things you can put in your body that won't make you sick really I mean this is insane okay and in fact the Food and Drug Administration privatized that list they basically farmed it out to the food companies to decide what should be on that list so basically any food company can put any damn thing they want and say it's okay and that is just not true no well this is this is amazing so Robert this book metabolical is so fantastic everybody needs to read it you can get anywhere you get books I I just want to uh you know I mean there's so much in there we didn't get to talk about such as you know how we think about these nutrient sensing systems and kinases and it gets a little technical but but the book Explains It All beautifully really accessible but I want to close by talking about how to fix the food system because what you're saying is essentially is they were living in a swamp of toxic foods that make us sick that cause disease and kill us prematurely and that it's a hundred percent preventable and that the costs associated with the suffering with it is preventable but that it's not something that we alone can solve that we have to look to the government and and people are skeptical of the government uh you know but but drain the swamp but I mean honestly we we have to and I started as a non-profit to help work on food policy I know you're working on it so in your book you also talked about what the USDA the Department of Agriculture the FDA and Congress can do uh and and and uh what they can do to help us and maybe why they're not doing it and how do we really create real change in the food system so maybe we got another 10 minutes left why don't you wrap up with that because I think that's a really important piece of the conversation absolutely so bottom line is the FDA is not doing anything that's what it comes down to um the FDA really has become more of the FMA the federal medicines Association than they are the the Food and Drug Food and Drug Administration um they've really abdicated you know food to the food companies and I think that has been a you know terrible disservice to us and to the country and in general now why did they do that well the reason is because 56 billion dollars a year in tariffs on processed food when they uh when we sell our food abroad to the federal government in other words this is part of you know their money stream you know this is part of you know this this is you know basically sucking on the teat of uh you know of of uh of the food industry and so the government makes its own money that's one reason now the second reason which I think is a bigger problem is food subsidies now not everybody believes this but I think that food subsidies are sort of the reason why we have this problem in the first place and why it's been driven all right we subsidize corn wheat soy sugar in fact we've been subsidizing sugar since the Inception of the in of the Union in 1790 it is the second oldest piece of legislation on the books in wow you know post-constitution okay 1790 we have been subsidizing sugar okay we've also been taxing it we've done we do both which it makes even less sense all right point is the food industry can sell its processed food for cheaper because of subsidized food because they're basically getting a kickback they're getting a rebate for using those corn wheat soy sugar all right well all of those are the bad guys okay the corn is the branched chain amino acids the soy is the Omega-3s okay the wheat Mega sixes omega-6s give me omega-6 my mistake you're right omega-6 is um the wheat is the gluten which is you know pro-inflammatory and of course the uh you know insulin secretion that we talked about and then finally sugar which you know I've now beaten this dead horse you know but it's it it's a horse that needs to be beaten because it keeps you know rising from the ashes um yeah so bottom line we are subsidizing all the things that are killing us and we have all along and we have since 1933 the original Farm Bill now the very first farm bill came out in 1933 and the impetus for that 1933 farm bill was the depression and the dust bowl of 1932. yeah right and we had a destitute population in this American southwest that were dying okay because there's no food and the problem was that if you took the food which was being grown in the Midwest and the Northeast and you put it on railroad cars and you shipped it to the Southwest by the time it got there would be Rancid so the way to stop it from being rancid was to defyburtize it to basically strip the fiber off to process it to basically pack it into Big 10 pound bags of flour okay and then ship it on the railroad cars and bake it up you know locally and you know what that worked that worked and we saved an entire destitute population and then came World War II and we needed it even more because we needed to feed the soldiers in the field and so that was okay and then and then came 1946 all right and the war was over and the Depression was over and the Dust Bowl was over and we should have gone back to square one we should have gone back to previous but hey people figured out hey I can make money at this yeah okay and so instead of taking away a policy that didn't work anymore had no need to be anymore we doubled now okay and we double down again and we double down again and then in 1971 okay Richard Nixon said you know food prices are still fluctuating we need to make food cheap okay and so he told his agriculture secretary Earl butts you know to basically make food cheap so he went to the Heartland to Nebraska to Kansas to Iowa and he said three things three things he said row to row Furrow to furrow get bigger get out yeah and that's bigger go home that started monoculture and that's why all of the corners in Iowa and all the cattle are in Kansas okay is because of Earl months all right well that did lower the price of food but unfortunately what it also did was it now made the food less nutritious because now instead of the soil being rotated and being able to regenerate the soil microbiome which is actually the bacterium the fungi that are actually in the soil that actually feed the plant and make the plant healthy and nutritious okay now it's dirt it's dead and so what they had to do is they had to spray it with nitrogen fertilizer to grow anything and all of that all the you know the the green peppers and the radishes and everything else they basically don't have any nutrients in them the tomatoes have nothing in them all right so we're eating all of this nutritionally depleted food because we're growing our uh our our produce in dirt instead of in soil like it was supposed to be and all of that was to basically continue to make food cheaper so now we have the cheapest food in the world okay and we are paying not really yeah exactly you don't pay now you pay later and exact medical bills and drugs you can pay me now or you can pay me later but hey if I'm paying you later you know what then that's some other administration's problem past the mark yeah amazing so how do we fix this how do we change those policies I I'm curious because I'm deep in this policy world and I'm here to your perspective you got four minutes until we until we get rid of subsidies nothing good can happen period is what you're talking about yeah well that's one thing to do is crop insurance but the bottom line is there's no reason for subsidizing food there's no Economist on the planet who believes in food subsidies because they distort the market let the market work and the giannini foundation at UC Berkeley actually did this exercise several years ago they said they modeled what would the price of food look like if we got rid of all food substance and guess what it wouldn't change except for two items corn and sugar which is what we need to change so exactly to me that's where you start is the food subsidies now after you do that then all hell breaks loose and you know other things are possible but ultimately we need this thing called regenerative farming and we need it for climate change because if you keep spraying nitrogen fertilizer all you're doing is making nitrous oxide which is the worst greenhouse gas of the bunch everybody's methane okay and the reason is because 300 times you know but the bottom line is the nitrous oxide is way worse than the methane it's more trapping capacity it has longer residence time and it is higher in terms of the uh the amount in the atmosphere so as long as we keep thinking that we can just gross in dirt you know we're going to keep having this problem now can we fix that yes we can fix that but what we need to do then is we need to be able to access bigger uh plots of land and have them grow green vegetables and that can be done very easily you take a big poll a 500 foot pole you stick it in the center of a field you put a white sheet over the edge and you tent it on the edges and you can grow green vegetables underneath it even in you know Maine even in Michigan even in you know Minnesota you can actually uh we can increase the crop yield in this country like that okay for almost no money okay but the point is we have to want to do that we have to uh direct the federal government to you know uh support those kinds of programs but they're not well I'm optimistic uh yesterday I just came back from giving a talk it was a talk at rodale Institute which is kind of the original organic farming regenerative farming Research Institute where they're literally studying the difference in between soil and dirt and organic or or conventional farming and it was a conference of doctors and it was really inspiring to sort of hear that that they're actually things are changing uh they just uh part of the work we did with food fix was we got we got David Scott to come who's the chairman of the AG Committee in the house through Rhode Island student he got awakened to these ideas they just testified a few weeks ago they got 25 million dollars as a start to help uh incentivize bipart farmers and on in areas where the soil is bad to actually regenerate soil it's very was very very exciting so I think in the ira bill you can argue whether it's good or bad but there was you know 20 billion dollars that that was allocated for some of these changes in farming practices so I think we're moving along the right direction it's not fast enough for either of us obviously but I think I think I'm a bit hopeful than I was a few years ago so Robert your your work has just been so inspiring it's been great to call you a friend and uh co-conspirator and good Troublemaker along the path and keep doing your work uh I I think everybody who is listening should get the book metabolical the lore and lies of processed food nutrition and modern medicine it really will help you not only understand what's going on in your own body but how how you can really make real change in the world so I just honor you and thank you for being on the podcast uh and uh thoughts yeah basically we need all of us you know this is a problem that's not going away and it's also problems going to outlive both you and me and and ultimately no one's going to remember you or me and the only way we're going to fix this is by banding together and speaking with one voice thank you thank you this is as they say this is a big nut and we all have to be on top of this well thanks for being such a leader in it really and uh everybody can learn more going to his website Robert's website robertlustin.com or the metabolical website metabolical.com where there's over a thousand references that he couldn't fit his book because it would have made it 70 Pages more you can watch his video on sugar that's had 11 million views uh but for sure check it out and if you love this podcast share with your friends and family on social media maybe you can share comments about how you have addressed your metabolic disease and what's worked for you and how you've discovered how to get healthy or the challenges maybe you've had and struggled with and uh subscriber ever get your podcast and we'll see you next week on the doctors Pharmacy if you love that last video You're Gonna Love the next one check it out here you know if you you go to your doctor and complain of this they'll just Pat you on the back and say welcome to old age you know or that's just part of the normal aging process I don't think it is I I mean maybe to some extent but what happens when we age is we're less likely to absorb a lot of the nutrient

Channel: Mark Hyman, MD

Views: 1,052,002

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: Lpsmq6S7BMQ

Length: 75min 37sec (4537 seconds)

Published: Wed Nov 02 2022