Translator: Ellen Maloney
Reviewer: Rhonda Jacobs I'm wearing a sport coat
so that you will trust me. (Laughter) If I had wanted you to think
I was creative, I would have worn jeans. (Laughter) But I have a story
to tell you about chronic disease, and you're the first generation
that can ever hear this story because we didn't know it before. I want you to join with me
in a "hard think." I'm going to tell you some nice stuff
to make you feel good at the beginning, but we have a lot
of serious issues to face and I'm going to tell you about those. I hope you'll enjoy it so you will feel
like we're all part of the same team that's going to make our world better. When I talk to you, I want you to answer
this question all the way through: I want you to ask, when will we decide
to eliminate chronic disease? The reason we can ask that question now
is because we know what causes it, and we know how to fix it. So I hope that by the time
I've finished my talk, you will be convinced that you can make
a big difference to do something about it. So first the good feelings. Here's the good feelings:
if you look at the last century, you'll notice that in 1900,
we had a life expectancy of 50. And now, at the end of the century, actually in 2010,
when we calculated it again, our life expectancy was now 80. Can you believe it? Our life expectancy increased
by 30 years over one century of time. There's another interesting fact, and that's chronic diseases
like heart disease, stroke, and cancer, those diseases have been killing
fewer people every year. So we should start feeling good
that we're going to be healthier. And if you look at these two facts,
what you're going to think is, "I can sit back and relax
because isn't it nice we as a human race, and we as Americans,
are getting healthier?" Now if you think that,
you would be dead wrong. And the reason is that our health
has been declining over the last 25 years. Now, why is that true? We have some evidence for that
and some of it you've read in the paper. For example, more people
are becoming obese, more people are acquiring diabetes, more people have
uncontrolled blood pressure, and all of these three things
are the foundation for heart disease. Now the interesting part of it is,
we don't see it in our statistics yet because it is predominantly
affecting younger people and they haven't died yet to show us
that there has been a change. So what you have to realize
is that we are in a new predicament of being able to predict
what's going to happen in our future. And here's one other thing I need to say
that you might not have thought of before: That is that our children
are the first generation that represents three generations
of eating processed food. And because of that, we now have
a really big job on our hands to understand what that has done
to the human race over the last three generations. In this slide, you can see the first line
is the one I already showed you, that's 100 years of increase that's perfectly linear
over that period of time. And if we did everything right, we should be able to gain another 30 years
in the next century, right? That's what we'd like to do. But, in fact, medical scientists now tell us that
because of diabetes and because of obesity that are happening in our young people, that they are going to be
the first generation ever in the United States to live
shorter lives than their parents. So what that means is that we are now
on the trajectory that's going down. And we don't even know it. We know it because we who study disease
can predict what's going to happen to the people who have these diseases. Are you feeling better? (Laughter) Just checking your pulse. Okay, so what we need to do is find a way to take that downward arrow,
and put it on the up. And if we can do that, we should be able
to face a century of increased health, and increased longevity. Now I have to talk
about my friend, David Barker. David Barker is a brilliant Englishman, who came to Portland
to work with us over a decade ago. He died a year ago, last August. And 25 years ago, he started
the whole movement for us to understand
how chronic disease works. So what he showed was this curve, and if you forget
everything else I say today, take this curve home in your mind
because it tells the whole story. What he showed was that if you're born
at the low end of the birth-weight scale - this has been done
in seven countries now - if you're at the five-pound end
of the birth-weight scale on the average, you have a three to five times higher risk
of dying of heart disease than if you were born
at the eight to nine-pound range. And furthermore,
if you are on the upscale, at the very high end of that scale, say, above nine or ten pounds, your risk goes up like the babies
that were born small. So, all of the sudden, we have
a really new profound thing to say about chronic disease
that we never knew before. And what that is, is that how you grow
before you're born matters. And it's not just how [you grow]
before you're born, it's also in the first
two years of your life. So the nutrition,
and the conditions you lived in, in your very earliest moments of life determine whether or not you're going to have
a high risk for disease later on. And how does this work? I need to tell you a little about it so that you can believe something
about how this works What it means is that the babies born
at the low end of the scale are small for two reasons. One: they didn't get enough nutrition
from their mothers. That can be for lots of reasons. Her diet, for example, or her placenta that she tried to make
to give nutrients to the baby didn't work. Those babies are very different, and they are vulnerable
for the rest of their life. Why are they vulnerable? Because they have fewer heart cells, they have fewer
filtering units in their kidney, and they also have one other problem
and that is that their pancreas, that makes insulin,
has fewer insulin-making cells. And because of that, they're vulnerable
for disease as they get older. Now what about the babies at the high end? The babies at the high end are vulnerable
because they got too much nutrition and that's almost always because
their mothers had poor glucose control, their blood sugars were high,
that sugar went across the placenta, and the baby saw it as energy,
and deposited it as fat. So those babies have a lot of fat, and I just want to tell you the most
interesting thing we've discovered: The babies at the small end
and the babies at the large end have almost the same risks. And the interesting part about those risks is they cause an inflammatory reaction
that's very low-grade, and they make those people vulnerable
for the rest of their lives. Now if you're feeling bad about that, I'm just going to try
to make you feel worse. (Laughter) And the reason I am going to
make you feel worse is because it turns out that those cases, the small babies and the large babies, can pass that effect on to their babies
in the next generation. First of all, I have to tell you
a story about me. I'm trying to get you convinced
of this, so here it is. I'm in my late 60s,
not many months left, actually. It turns out that the egg that made me was made in my mother -
she is 90-some years old, still alive - it was made in her ovary
when she was in my grandmother's womb. Do you get that? The egg that made me
was made in my mother's ovary, when she was a fetus in my grandmother. That means that the egg that made me
was nourished by my grandmother. That nourishment changed the way
my risks for life will be. I was also nourished by my mother, so there's a two-generation effect
on the nourishment. I want to tell you about this picture: This picture was taken in 1931,
and if you look at the woman on the right, she's a handsome woman,
she's 86 years old, and when she was a baby,
she was being held by her mother in 1931. It turns out that the egg that made her
was made in her mother's womb when her mother was in
her grandmother's womb, who was born in 1897. There's one other
interesting fact about this: If you look at the lady on the left, she was born to the woman
sitting down in front. Now that lady doesn't look too happy. (Laughter) I don't actually know what her issue is, (Laughter) but I think part of it is she was born
before the civil war, right? Times were tough. So it turns out that I, who am now in my late 60s, the egg made me was made
in my mother almost 100 years ago. So that means in egg years, I'm 100. (Laughter) And this lady, that I am showing you here
on the right, in egg years, she's 110. We call this "The 100-Year Effect." The 100-year effect means
that nutrition flows across generations from one person to the next,
through mothers, each successive generation. And this nutritional flow means
that you have to have good nutrition every single generation in order to keep
from having a risk for chronic disease. So it turns out that it's a more
complicated story than you might think. That's because the nutrition that a woman
gives her baby when she's pregnant, not only comes from the food
she eats, her diet, but it also comes from the body
which she was made as a child, and as she was growing up. And there's a man's story here too. And that's because men also influence
the health of their babies, and both men and women do this
through an effect we call "epigenetics." Now if you don't know
this word, learn it right now: Epigenetics. Learn it, say it,
and use it on your friends. (Laughter) It'll wear out in a few generations,
but right now it's hot. (Laughter) So here's the word. Epigenetics means this: The genetic code you got
from your mother and your father determines many things about you. Those genes you got
are expressed all the time, and they're made of a DNA code,
that you learned in biology. The truth is, you can't change that code. That code is found in every chromosome
in your body, in every cell. And that doesn't change. However, what you might not know,
is epigenetics, and what that means is that before you're born, those genes,
some of them, not all of them, some of them are very sensitive to stress
from the mother and diet from the mother, and you can alter those genes
that will change the way you're going to grow
for the rest of your life. So you can't blame women for the bad health of everybody. And you shouldn't try. Why? Because both men and women,
in this country now, eat the worst diets
of any Western country in the world. We eat fast foods and we've been trained
by industry to love the food they feed us. And many of us
have trouble getting off of it. So don't blame women for this;
blame our food culture, because our food culture is doing us in. So what will happen if we don't change? Well, in 1960, one person
out of every 100 was diabetic. In 1995, one person
out of 50 was diabetic. Today, in 2015, one person
out of eight is diabetic. And it's predicted that by 2050,
one person out of three will be diabetic. Why do we care about this epidemic? There's one reason: We not only care for those people
who are going to suffer the illness, but we are also going to
have to pay for it because 70 percent of people
who get diabetes will also acquire heart disease. And heart disease is terrible
and expensive, and by 2026, we estimate the financial burden
to be $650 billion a year, and by the way,
it's $1 billion a day right now, and then it'll be $2 billion a day. We can't afford this. And because we're becoming diabetic, and it's the younger people
who are doing it, we're going to pay this bill
in our future. So, what is a good diet? A good diet, you don't have to read
a fad-ish book to get it. All you have to know is to eat
fruits and vegetables, beans, nuts, and whole grains. And if you eat those most meals,
every day, you'll be eating a good diet. If you're a pregnant woman, I recommend you throw fish in
two or three times a week, because the development of a baby's brain
needs the oils that you get from fish. Otherwise, it's a simple prospect. So how are we going to get better?
And what are we going to do about this? Because we are in an epidemic. And of course, the answer is you,
and the answer is me. We have to work together,
and how can we do that? We can do that because we can influence
our family, our schools, and the policies that we make. So let me just suggest one thing for you: If you care about yourself
and your family, go home and find out how many
processed foods you are eating. You know, those ones
with the labels all on them. And gradually find foods
that are actually healthy, and replace all those, and stop buying
those foods with all those labels. (Applause) (Cheers) The next thing is make sure
that the kids that we love go to school and have healthy meals. (Applause) Influence the workplace where you work, and make sure that healthy foods
are always available, and lastly, don't forget
to talk to your legislators: We need policies to stop what's happening,
and poisoning our bodies. (Applause) (Cheers) When will we decide
to eliminate chronic disease? Today. When we realize that our society
today is providing the nourishment for children,
and our grandchildren of tomorrow, and if all of us work together,
we can better the future. Thank you. (Applause)
