In this episode of the podcast, Dr. Chris Horschig joins us to talk about his new book, Unconventional Medicine, and his new venture, Functional Medicine, which is a new approach to treating chronic disease through a holistic approach to nutrition, functional medicine, and a collaborative practice model that incorporates health coaches, nutritionists, and other allied providers to offer more support to patients with chronic disease. We also talk about the role of genetics and environmental factors in chronic disease, and how they play a role in our health and well-being, as well as the role that genetics plays in obesity, diabetes, and heart disease. We also discuss the importance of the food pyramid and how it can be applied to chronic disease and other chronic conditions, like diabetes, heart disease, high cholesterol, high blood pressure, and ulcer disease, which have been around for a very long time. This episode is a must listen! If you like the show, please consider becoming a patron patron and leaving us a five star review on Apple Podcasts! Thank you so much for your support, we really appreciate it. Cheers, Chris xoxo. -Jon Sorrentino and his book "Unconventional Medication" is available for purchase here: Unventional Medicine: A Guide to Functional Medicine and Chronic Disease: The New Science in the 21st Century" by Dr. Michael Hyatt, MD, PhD, CSE, D.D., M.D. (CSE, M.E. (PhD). Dr.S. and Dr. John R.CSE is the author of the book, "The Food Pyramid: The Food Pyramid." is available here. Chris talks about food pyramid, nutrition, nutrition and nutrition, exercise, and more! - Dr. Seuss, and the history of the Food Pyramid, and nutritionism, and why we need to be willing to challenge our most cherished views in order to make sense of the information we receive from the world. , and why food pyramid is not just for the average person? Thanks Jon talks about it all! . - Jon talks all things food pyramid. Jon s book "Food Pyramid" is out now! Jon's new book "The food pyramid: The food pyramid? Dr Seuss's food pyramid is out in the world! and why it's not so bad!
00:00:40.000And you're essentially doing nutrition-based Three components.
00:00:47.000Ancestral diet and lifestyle, which we've talked about, functional medicine, and a collaborative practice model that incorporates health coaches, nutritionists, and other allied providers to offer more support to patients.
00:01:00.000What does that mean when you say functional medicine?
00:01:03.000So the easiest way to understand it is it's an approach that is geared towards addressing the underlying cause of a problem instead of just suppressing the symptoms.
00:01:13.000So you go into the doctor, you've got high cholesterol, usually given a drug to lower it.
00:01:24.000Well, you know, for some people they can be.
00:01:27.000I wouldn't say they're devastating for everybody, and they do save lives in certain situations, but the idea that they're the first thing we would do in that situation, that's what's off.
00:01:38.000Right, that you wouldn't suggest, like, altering the diet.
00:01:46.000You go into the doctor, high blood pressure, you get a drug to lower it, there's rarely any investigation into why the blood pressure is high.
00:01:53.000And what are the main factors with high cholesterol?
00:01:54.000Because I know that a big part of it is hereditary.
00:02:30.000So, you know, 20, 30 years ago, the dominant idea was that ulcers were caused by stress and things like eating spicy foods.
00:02:39.000And a couple of Australian physicians presented at a conference this notion that, no, actually they're caused by this bacterium called Helicobacter pylori.
00:02:48.000And they were literally laughed off the stage.
00:02:53.000And they kept going, kept doing this research, kept trying to present this idea, and nobody would take them seriously.
00:03:00.000Finally, one of them swallowed a vial of solution that had the bacterium in it, developed an ulcer, As a result, and then treated himself with antibiotics and got rid of the ulcer.
00:03:13.000This is how committed this guy was to this idea and proving this.
00:03:18.000And finally, at that point, people started to pay attention, but it still was another 10 years before that theory was widely accepted.
00:03:26.000And then they eventually won the Nobel Prize in medicine as a result of that discovery.
00:03:31.000So to me, that's a great example of how groupthink is such a problem in medicine.
00:03:36.000We have a tendency to just get stuck on the status quo, even though a core principle of science is uncertainty.
00:04:35.000But the question is, does that actually have the desired effect?
00:04:39.000I think it was based on pain, wasn't it?
00:04:42.000And mammograms were supposed to prevent breast cancer, but then we saw the huge randomized controlled trial that showed that not only do they not prevent breast cancer, they may actually increase Death as a result of unnecessary treatments that come from the mammograms.
00:05:08.000So it could be a cyst or something on those lines?
00:05:10.000Yeah, and then somebody gets unnecessary treatment and it leads to an adverse event.
00:05:15.000So I'm just saying we've got to be humble.
00:05:18.000And realize that we don't always have the answers and that in 10 years, it's going to look really different than it does now.
00:05:24.000Just like 100 years ago, everybody thought they had the answers.
00:05:27.000And we look back on them and we say, how silly.
00:05:31.000But we forget that people 100 years ahead are going to look back on us with that same...
00:05:37.000That, you know, they're going to shake their heads.
00:05:39.000Yeah, it's very unfortunate, but that is a tendency that people have when they've been living their life based on, like, what they think is, like, certain rigid information.
00:05:46.000Like, this is absolute, this is true, and they've been teaching that.
00:05:50.000That's when it gets especially problematic, or writing books about that.
00:05:54.000And then they just never want to admit that their book is bullshit.
00:05:56.000And I think our education system needs to change medical education because, you know, you write a textbook and that takes a long time.
00:06:05.000And then, you know, the textbook is used in course, like the medical schools are still using the nutrition textbooks that were probably written in the 70s or the 80s or something.
00:06:14.000And then we get all these new studies showing that, like, cholesterol on the diet has no impact.
00:06:21.000You know, on your blood cholesterol for most people.
00:06:23.000Now, say that again, because for a lot of people, they're like, what did he just say?
00:06:27.000So, even the American, the standard U.S. diet guidelines last year, a lot of people might have missed this, they completely removed any restriction on dietary cholesterol from the U.S. diet guidelines.
00:06:42.000They basically said, there's no reason to limit cholesterol on your diet anymore.
00:06:47.000Now, for people who don't know why this is so crazy or how this came to be, you need to go to the New York Times article on how the sugar industry bribed scientists and convinced scientists to publish faulty or false information pointing towards saturated fats and cholesterol as being the cause of heart disease and heart attacks and all these different ailments.
00:07:11.000So that they could push the blame away from sugar.
00:07:14.000And I think they only got paid something like $50,000 to do it.
00:07:30.000They did some horrible things to people.
00:07:32.000It totally, you know, it's unfortunately pretty normal in medicine.
00:07:36.000There was a study that just came out a few days ago.
00:07:39.000It showed that the more gifts doctors receive from pharmaceutical companies, the more expensive the drugs they prescribe and the more prescriptions they write in general.
00:07:51.000My wife's mom was a nurse, and she would tell me stories about how they would take them out to nice dinners, fancy restaurants, and everything on the house.
00:08:20.000So, in 70% of people, eating, you know, egg yolks and cholesterol and meat and other things doesn't do anything to your serum cholesterol, the cholesterol levels in your blood.
00:08:31.000In 30% of people, you'll get a slight raise in your LDL cholesterol, the so-called bad cholesterol, but you'll also get a raise in your HDL cholesterol, which is the so-called good cholesterol, which means there's no net clinical Impact of that in terms of your risk of heart disease.
00:08:49.000And this is why the U.S. finally, the last industrialized country to actually do this, they finally said, okay, well, we just can't do this anymore.
00:09:00.000We can't tell you not to eat dietary cholesterol because there's just not any evidence to support that.
00:09:07.000Well, I think you just referred to one of the reasons, you know, conflicts of interest, people that were invested in maintaining the status quo.
00:09:14.000I think also there's probably some concern about losing credibility.
00:09:21.000You know, these government organizations, if they told us not to eat cholesterol for so long and then they tell us that we can and it's not a problem, and they do that with saturated fat, you know, people stop listening because they just throw up their hands.
00:09:33.000They're like, I don't know who to believe or what to listen to.
00:09:36.000You talk to the average person, they think you should restrict your intake of saturated fat.
00:09:41.000Yeah, average person, most doctors still.
00:09:45.000I think there is some nuance here, and maybe we talked about this on the last show, but where we're headed, in my opinion, with diet and nutrition recommendations is from general blanket recommendations that apply to everybody to more personalized recommendations that depend on your genetics,
00:10:11.000So let's take somebody who is ApoE44, which is a, you know, has a certain genetic haplotype, and they have, you know, they're They're really sensitive to the dietary effects of saturated fat if you have that genotype.
00:10:37.000I think it's 3-4% or something like that.
00:10:41.000And if those people eat a lot of saturated fat, their LDL particle number, which we can define if you want to, those are the particles that carry cholesterol.
00:10:53.000And what we know, at least from the research that we have, is that people who have a much higher LDL particle number can be at higher risk for heart disease and Alzheimer's.
00:11:04.000There's some murkiness there because that's just on average.
00:11:08.000We don't know if that risk applies to people who are eating paleo type of diet, doing CrossFit, taking care of themselves in every other way.
00:11:15.000We just know that the The general population, in the general population, a higher LDL-P leads to a higher risk of these conditions.
00:11:24.000I'm sorry to interrupt you, but I know some people know this, but some people don't.
00:11:29.000What is the difference between LDL and HDL, and why is one good and one bad?
00:11:33.000Well, here's an example of how things are changing again.
00:11:40.000So historically, the idea has been that LDL, which stands for low-density lipoprotein, and HDL stands for high-density lipoprotein.
00:11:50.000The LDL, the idea was it was bad, has a number of effects that contribute to the risk of heart disease, whereas HDL does a kind of like cleanup and repair process and actually reduces the risk of heart disease.
00:12:05.000But just a couple weeks ago, there was some pretty...
00:12:09.000Influential research published suggesting that HDL may not be actually so protective and it may be more of like a bystander effect where people that have lower risk of heart disease just also have higher HDL and it's not that the HDL is protecting them,
00:12:28.000it's whatever other underlying processes are protecting them happen to lead to higher HDL levels.
00:12:34.000And the reason that they think this now is that they've done a whole bunch of trials on drugs that raise HDL, and guess what?
00:13:05.000So it's just another example of something that we just assume for so long is true, and then we find out that it's not true.
00:13:13.000I had a conversation with a guy who was a brilliant guy, and we were talking about eggs, and I said I like to eat about four to six eggs a day.
00:13:21.000He's like, wow, what about all the cholesterol?
00:13:29.000Yeah, I mean it's and it's gonna take so so what I just told you about HDL think of everything that has to change to reflect that new understanding you've got textbooks that need to be rewritten you've got primary care guidelines you've got it's just massive it's almost impossible to get our head around and so the average primary care provider is not going to get this message for decades right I would say decades not more than years that's crazy yeah so they're going to be giving out bad advice to people So the average person who works all day and doesn't have
00:13:59.000the time to do the research that you do or maybe isn't informed about all the various blogs and books and just doesn't have time, goes to his primary care doctor and asks him questions, and he gets terrible information that could lead to poor health.
00:14:14.000The primary care doctor doesn't have the time either.
00:14:25.000They're doing their best, but they're seeing 2,500 patients.
00:14:29.000That's how many they have on their roster.
00:14:31.000Their average visit is between 8 and 12 minutes.
00:14:35.000Because they get reimbursed based on the number of visits.
00:14:39.000So in order to make a living, they see a certain number of patients a day, and the insurance companies often mandate that.
00:14:45.000So in a 10-minute visit, a patient shows up with multiple chronic conditions, taking multiple medications, and then presenting with new symptoms that they're concerned about.
00:14:56.000There's barely enough time to say hello and figure out what's going on with their meds and make an adjustment and make a new prescription, much less to talk to them in any kind of meaningful way about their diet and their lifestyle and their behavior.
00:15:10.000So the primary care doctors, I think, are as much victims Of our conventional system and the way it's set up as patients are.
00:15:18.000And if they're busting their butt, seeing patients eight hours a day every day, and then they have all the paperwork to do on top of that, last thing they're going to want to do is go home and fire up PubMed and start reading the latest studies that have come out.
00:15:36.000Yeah, and they got families, you know, they have other things to do, and there are studies that have shown that the majority of primary care physicians, understandably, given this situation, receive most of their education from pharmaceutical sales reps.
00:15:51.000You know, who bring in the brochures that talk about a particular condition.
00:15:56.000And of course, that's not going to be unbiased information.
00:16:01.000That's hilarious that they get their information from that.
00:16:35.000If you look at the numbers, by the year 2040, it's estimated that 100% of the federal budget will go towards Medicare and Medicaid expenses, leaving nothing for anything else.
00:17:01.000This is why the Department of Defense has named healthcare as an existential threat to this country.
00:17:07.000Just like nuclear war or any other military threat, they've named chronic disease as an existential threat that could actually threaten our survival as a nation.
00:18:50.000$14,000 a year to treat a single patient with type 2 diabetes.
00:18:55.000Imagine someone gets diagnosed at age 40, which is totally possible.
00:18:59.000I mean, now even 8-year-old kids are being diagnosed with type 2 diabetes.
00:19:03.000And imagine that person lives another 45 years, which is also feasible because we have these...
00:19:09.000One of the amazing things about conventional medicine is the technologies that keep us alive probably a lot longer than we should be.
00:19:17.000So let's say that person lives 45 years, we spend $13,000 a year, $14,000 a year treating that person, that's $630,000 to treat one patient with one disease over that patient's remaining lifetime.
00:19:35.000Now, if you start doing some math and you assume, you know, even 50 million people with diabetes times $630,000, you get a number with so many zeros after it, I don't even know what it is.
00:19:49.000It's like a Google or a Googleplex or something.
00:19:53.000So, this is why we're facing this threat, and this is why I wrote the book.
00:19:58.000It's like, people aren't aware that we're at this point where, you know, like, one in two Americans now has a chronic disease.
00:20:10.000One in four have multiple chronic diseases, and I know you're a parent, so, and I am too, 30% almost of kids now have a chronic disease, and that's up from just 13% in 1994. So there's been more than a doubling of kids with chronic disease in less than 25 years.
00:20:27.000What has changed in the American diet?
00:20:29.000Are you attributing it to the American diet?
00:20:32.000Or is it environmental effects as well?
00:20:40.000We've been sitting for very long periods, not moving around, not enough exposure to natural light, too much exposure to artificial light, not enough sleep.
00:20:54.000So all of these things come together, and now we've got a nation of people with chronic disease.
00:21:01.000Disease is bankrupting our country, and it's extremely difficult to treat.
00:21:09.000And our only hope, actually, of dealing with this problem and surviving as a country, as a nation, is to figure out a way to prevent and reverse disease instead of just suppressing symptoms and putting Band-Aids on it, which is what our current conventional medical system does.
00:21:28.000You really scared me with that diabetes number.
00:21:46.000In 2015, at least 1.5 million new cases were diagnosed in people over 18. It means that now a third of the U.S. population has diabetes or pre-diabetes.
00:23:24.000It's not a perfect metric, but they have done studies where they have accounted for that and you do see some variation, but you're not the norm.
00:24:08.000We can't It doesn't matter who, so the whole recent healthcare debate with, you know, Affordable Care Act and then the current administration suggesting something different, that whole discussion revolved around how we're going to pay for healthcare, you know, health insurance.
00:24:24.000But we have to understand that health insurance is not the same thing as healthcare.
00:24:29.000It's a method of paying for healthcare.
00:24:32.000And my key point in the book is it doesn't matter what method of health that we use to pay for health care, whether it's the government, whether it's corporations or whether it's individuals.
00:24:43.000There is no method that's sustainable in the face of the rising rates of chronic disease that we're seeing.
00:24:57.000I'm stunned at the number of people with chronic disease, and I'm stunned at the number of people that are either pre-diabetic or diabetic.
00:25:03.000I really don't know how to digest that.
00:25:16.000Type 2 diabetes is a fully preventable condition.
00:25:20.000And type 1 diabetes varies in what way?
00:25:22.000Yeah, it's an autoimmune condition, and it's strongly genetically mediated, which means that it doesn't necessarily mean that if you have the genes, you're going to get the disease, but there's 50% of the risk, I think, is the statistic that I've seen of type 1 diabetes is genetic,
00:25:41.000whereas we know now that 85% of the risk of disease in general comes down to environmental and behavioral factors.
00:25:51.000Or your sleep or your, you know, physical activity, stress management, etc.
00:25:56.000So that means only 15% of the risk of disease is genetic, you know, purely genetically driven, whereas the other 85%, which is a vast majority, is actually under our control.
00:26:09.000I was looking at a statistic that made a correlation between sleep and weight loss and saying that people who slept an average of 8 to 10 hours a day had a significant Significantly less body fat and weighed less and lost more weight than people who did the exact same activity but slept four to six hours.
00:26:35.000I would say that among people who research weight regulation, sleep is now recognized as being the second most influential lifestyle factor that determines our weight aside from diet.
00:26:54.000So I got a couple of good ones for you.
00:26:56.000A single night of sleep deprivation has been shown to cause mild insulin resistance even in healthy people with no pre-existing blood sugar disorders.
00:27:05.000So just one night of not sleeping well can cause a little bit of insulin resistance the next day.
00:27:26.000Yeah, I mean, partial but significant sleep deprivation for eight nights in a row.
00:27:32.000These people ate an additional 566 calories a day.
00:27:38.000During that period with no changes in resting energy expenditure.
00:27:42.000So that's equivalent to gaining a pound a week of body weight or 52 pounds in a year.
00:27:48.000So most people won't have that severe of sleep deprivation, but if you just even have mild sleep deprivation, you know, over a significant period, that could account for 10 pounds of weight gain a year.
00:28:00.000And over, you know, 10 years, you're talking about a lot of weight gain.
00:28:04.000Yeah, so is it because you're sleepy so you just force yourself to eat food?
00:28:09.000No, it totally screws with hormone production and all the hormones that regulate appetite and satiety and things like that.
00:28:59.000And now we know that a third of Americans get fewer than six hours of sleep.
00:29:07.000Outside of maybe 3% of the population that has a gene that allows them to be okay with that few hours of sleep, the vast majority of people need 7 to 8.5 hours of sleep to function properly, and that's been clearly documented.
00:29:23.000Yeah, I had read something about outliers in terms of performance outliers.
00:29:27.000There are a lot of people that are like entrepreneurs, guys are killing it out there.
00:29:34.000They're getting like four to five hours sleep at night.
00:31:04.000This is based on the statistic about diabetes and chronic disease.
00:31:10.000Yeah, the dramatic increase in chronic disease.
00:31:12.000So as long as we've been measuring it in the modern world, lifespan has just been going like this.
00:31:16.000There's been a few blips due to pandemics like the Spanish flu, but for as long as we've been measuring it, it's just going up, up, up, up.
00:31:23.000And now this is the first generation of kids that's actually expected to start going back in the other direction.
00:31:28.000I showed my kids that sugar documentary.
00:32:18.000But you won't eat more than you're hungry for.
00:32:20.000And even a steak, which most people like and tastes good, when's the last time you heard about somebody binging on a steak?
00:32:28.000It doesn't really happen because it's not highly rewarding in that way.
00:32:32.000But human beings evolved in an environment of food scarcity.
00:32:37.000So we have these hardwired genetic biological mechanisms that cause us to seek out foods that have a lot of calories and that are Very palatable and rewarding because that would signal to us that they have different nutrients,
00:32:56.000And in an environment of food scarcity, that works really well because stocking up on calories would allow us to survive a period of famine or food shortage or unable to locate food, etc.
00:33:11.000So we have all these mechanisms that were originally designed to help us survive starvation in a natural environment.
00:33:18.000That's all well and good when we're living in that kind of environment.
00:33:21.000But what happens when we live in an environment where there is a 7-Eleven on every corner and Amazon delivering food to your door and Costco around the block?
00:33:34.000And so all of these mechanisms that actually helped us to survive in our ancestral environment Set us up for failure in this modern food environment.
00:33:45.000And we capitalize on that with things like the banana split.
00:33:48.000Yeah, well, the thing is that big food, they hire scientists who understand these mechanisms and specifically design foods to hit all of those circuits.
00:34:02.000What do you think is probably, is there a statistically most addictive food?
00:34:07.000I don't know, actually, the answer to that question.
00:34:10.000I mean, there's a lot of controversy about whether sugar is addictive in the true sense of the way that scientists use the term addictive.
00:34:22.000And there are both sides of that debate.
00:34:24.000But I think most of us can, just in our own personal experience, can kind of Assess the effect that sugar has on us or our kids or whatever.
00:34:35.000It's highly rewarding in the sense that it makes us want more and more of it.
00:34:39.000Yeah, it's not addicted to me in the sense of like I get a detox if I'm not having it, but if it's around me and I want it, the craving is very creepy.
00:34:58.000I'll tell you what, man, there might be something to that.
00:35:00.000When we were in New York and you brought over those slices of pizza, goddamn those are good.
00:35:06.000If they could figure out a way to make that pizza here, we'd have real problems.
00:35:10.000Well, it's interesting that you showed that because the top six foods in the American diet according to the amount of calories that they comprise in our diet are pizza.
00:35:24.000Bread, grain-based desserts, alcohol, sugar-sweetened beverages, and chicken dishes, primarily fried chicken dishes like chicken nuggets from McDonald's.
00:35:35.000Those six foods comprise the majority of the calories that the average American eats.
00:35:41.000And then you look at our ancestral diet, it was mostly, you know, meat and fish, wild fruits and vegetables, not even the domesticated varieties that we eat today, nuts and seeds, and a lot of starchy, fibrous plants, many of which aren't even available to us at this point.
00:35:58.000But, you know, sweet potatoes would be our kind of modern analog of that.
00:36:02.000And so you have a situation where we evolved in the context of eating those foods, which are, they're nutrient-dense, they're anti-inflammatory, and they're naturally low in calories, and they're all foods that are very hard for us to overeat.
00:36:15.000Again, like, you don't hear about people binging on broccoli, you don't hear about them binging on steak, you don't hear about them...
00:36:35.000Like maple syrup or pecans or something like that, which then you might overeat them.
00:36:40.000But if those foods in their natural state, we're not going to overeat them.
00:36:43.000We're going to eat until we're satiated.
00:36:46.000But all the other foods that I just mentioned, those top six foods, pizza, grain-based desserts like cake, bread, etc., they're all foods that trigger all those reward circuits in a big way.
00:36:57.000And we've all had the experience, I'm sure, of overeating or overconsuming everything on that list.
00:37:02.000I used to always, coming home from jujitsu, I would order an extra large pizza and I would eat it myself.
00:37:11.000And I would get either pineapple, double pineapple and double anchovies, which I know some people think is disgusting, but it's very delicious.
00:37:20.000Or I would get a pepperoni and mushroom, and I would kill that thing.
00:37:24.000And then afterwards, I would literally feel like somebody opened up my mouth, like they were trying to force-feed a goose to make foie gras, and they just poured cement into my stomach.
00:37:33.000And then I'd just lay there and just feel terrible, and feel that insulin spike, and your whole body just reacts to this sludge that you're forcing it to process.
00:38:43.000Almonds, coconuts, egg whites, flaxseed, chia seed, zero trans fat, and 16 grams, 18 grams of protein, 4 grams net carbs, 12 grams of fiber.
00:39:26.000It is amazing how many foods there are that are like that.
00:39:29.000If you stop and think about just going down the street, in any normal street where there's a bunch of stores and restaurants, how much of that stuff is bad for you?
00:39:46.000Anyone who sets out to be lean and fit and healthy is swimming upstream.
00:39:52.000Yeah, you have to put in some serious extra effort.
00:39:54.000You have to constantly be putting in effort because there's a barrage of advertisements.
00:39:58.000You walk into a grocery store, all of those foods are triggering all of those circuits that make us seek and crave those foods because those are...
00:40:08.000Evolutionary mechanisms that cannot be consciously overridden very easily.
00:40:12.000And this is why weight loss continues to be a multi-billion dollar industry, because information is not enough.
00:40:19.000For most people, it's not enough just to know what foods are healthy and which foods are unhealthy, because we're operating from a much deeper System, the limbic, you know, the limbic system, our kind of lizard brain that is driving our preferences for food and what foods we seek and which foods we don't seek,
00:40:39.000and that's below the level of conscious thought that, you know, where we say, okay, I know that food's not good, and I know this food is good, but then that lizard brain is like, you know.
00:41:09.000And here's the key thing to understand, too.
00:41:11.000It's not because you're a weak person or you don't have willpower.
00:41:14.000It's because you're a human being and that's how your brain is programmed.
00:41:17.000Yeah, that is a very important thing, to realize that there's a reason why it's difficult for you.
00:41:22.000And even for people that think, well, it's not difficult for me, man.
00:41:27.000Well, maybe if you've conditioned yourself, and if you've conditioned your body, and conditioned especially your diet, there's something that does happen when your gut biome changes, where your cravings change.
00:42:19.000It ends up in mice and it changes the behavior of mice so that they are dumber in terms of their ability to evade getting eaten by a cat.
00:42:32.000So then they get eaten by the cat and then the toxoplasma transfers to the cat and goes to the cat's brain where it normally...
00:42:40.000So that's an example of how a tiny, tiny little microbe you can't even see with your eye can powerfully control behavior.
00:42:46.000And as you just said, we've got trillions of these microbes in our gut that control our behavior and things like our food preferences and cravings.
00:42:55.000We had Robert Sapolsky on the podcast talking about that, and he said that some of the mice, it actually rewires their sexual reward system, makes them attracted to the smell of cat urine.
00:43:49.000I'm going to paraphrase this because I won't get the quote exactly right, but he wrote a book about the gut microbiome, and he said something to the effect of, humans are just the elaborate vessels for the propagation of microorganisms.
00:44:22.000You know, the number of microbial cells in the body are more than the number of human cells.
00:44:27.000So, you know, there's lots of different ways to interpret that, but I think at the very minimum you start to see how important that microbial community is to our overall health and also our behavior.
00:44:39.000Yeah, and if you really want to get creepy, think about how, like, categorically, they don't vary individually.
00:44:45.000Like, they're essentially the exact same thing in mass numbers, acting in the interest of the mass numbers, and then influencing us, which vary widely, and our different actions propagate them in different ways.
00:45:23.000And our gut is a hollow tube that goes from our mouth to our anus, intersects our body, but everything inside the tube is technically outside of the body.
00:45:38.000So they're influencing us from inside the tunnel.
00:45:59.000It's a head spinner when I first thought about that.
00:46:02.000And the crazy thing is that they can affect mood, they can affect depression, they can affect your ambition, the way you behave, impulse control.
00:46:13.000I just saw a study on the way down here, and I get a feed of all the new research, and it showed that overgrowth of bacteria in our small intestine, which is part of our gut, is associated with heart problems.
00:46:40.000Sapolsky was saying that one of the people that he worked with found during his residency that there was a disproportionate number of motorcycle accidents that were attributed to people who were infected by toxoplasma because it made them more impulsive.
00:46:57.000Well, I think we talked about this last time, but the prevalent theory now on what causes depression is that it's a disrupted gut microbiome that causes inflammation.
00:47:07.000It leads to the production of what are called cytokines.
00:47:10.000They're chemical messengers, inflammatory cytokines.
00:47:13.000They travel across the gut barrier, they go into the blood, travel up into the brain and cross the blood-brain barrier, and then they suppress the activity of the frontal cortex, which causes all the telltale signs and symptoms of depression.
00:47:27.000So what if depression, which we have always thought about either as a, you know, disruption of brain chemistry or something that's purely situational, is actually, you know, has a physiological cause as a driver.
00:47:40.000Now, that's not to say that those situational factors don't matter.
00:47:43.000I don't want to be reductionist here and say depression is only caused by gut inflammation.
00:47:51.000The problem is the average person goes into the doctor with depression, they're going to come out of that office with a prescription for an antidepressant.
00:47:58.000There's not going to be any investigation into their gut and whether they have inflammation in the gut and intestinal permeability.
00:48:05.000There's not going to be a referral to a gastroenterologist.
00:48:10.000And this is, of course, one of the problems with the conventional system, the way it's set up, is we had a doctor for every different part of the body, and there's no quarterback that's really overseeing that whole thing.
00:48:22.000Ideally, that would be the primary care provider, but because their appointments are 10 minutes, they've got 2,500 patients on their roster, there's no time for that.
00:48:30.000Yeah, you'd have to find a doctor that's very meticulous, that's willing to go over your blood work for you and check out what your diet is.
00:49:13.000It was causing all those problems or one underlying cause that was leading to all that.
00:49:16.000So just, you know, in this example, what if that patient had gluten intolerance and they hadn't been properly diagnosed?
00:49:23.000We know now from the research that gluten intolerance doesn't just cause the GI distress that a lot of people get.
00:49:29.000It also can cause, you know, it's associated with dermatitis, which is eczema.
00:49:33.000It's associated with all kinds of cognitive and neurological problems.
00:49:38.000So A single food protein could be leading to all of these different symptoms, but in the conventional system, they might go to the primary care doctor, then they get a referral to the dermatologist, they get a referral to the gastroenterologist, they maybe get a referral to a neurologist or a psychiatrist.
00:49:55.000They're seeing all these separate people to deal with all these separate symptoms, like playing whack-a-mole with the symptoms.
00:50:00.000They take one drug, The antidepressant, but then maybe the antidepressant causes constipation.
00:50:07.000So then you go to the gastroenterologist and they get a drug for the, you know, a laxative for the constipation.
00:50:13.000And then before you know it, it's just this incredibly complex web of all these drug interactions and all the focus is on suppressing these symptoms with different doctors for different body parts when, in this example at least, it was something as simple as a food protein.
00:50:29.000It could be easily removed from the diet.
00:50:37.000And then all of those problems, which seem like they were separate and disconnected, go away.
00:50:42.000And that's really the promise of functional medicine because...
00:50:46.000Instead of looking at things, starting with the symptoms and then working backwards, we're starting from the inside and working out.
00:50:56.000So, you know, an analogy I like to use is if you have a rock in your shoe and it's making your foot hurt, you go into the conventional system, you'll end up with a diagnosis of foot pain.
00:51:38.000But my belief is that there's varying levels of this and that it's something that people have just dismissed as a weird feeling that you get after you eat gluten and that they're not really in tune with the effect of inflammation.
00:51:52.000And that there's a real difference between the weed of today and the weed of, say, the early 1900s.
00:51:59.000I think there are a few reasons there's misunderstanding about this.
00:52:02.000Number one is that there, up until recently, has not been an understanding of the difference between celiac disease and non-celiac gluten sensitivity.
00:52:15.000The idea was either you have celiac or you're not sensitive to gluten.
00:53:14.000If you use some different terminology, you can find more.
00:53:17.000So with celiac disease, the initial idea was it just causes severe diarrhea and cramping.
00:53:25.000And so the assumption was that if you don't have severe diarrhea and cramping when you eat gluten, you don't have celiac and you don't have any other kind of gluten intolerance.
00:53:35.000But we now know that with celiac, there are forms called atypical or silent celiac.
00:53:43.000These are forms that do not present with the typical gut presentation.
00:53:48.000And the number of atypical celiac cases is much higher than the number of typical ones.
00:53:56.000So a patient goes to the doctor, they're having, you know, headaches, they're having motor problems, they're having, you know, all kinds of other issues.
00:54:07.000The doctor, if they think that celiac is only about gut issues, they're not even going to think about testing that patient for gluten intolerance.
00:54:15.000What kind of motor issues would you get?
00:54:17.000Well, there's something called ataxia, which is a form of paralysis that can be caused by gluten sensitivity.
00:54:43.000So the doctor then rules out celiac or non-celiac gluten sensitivity because they don't yet know that it can manifest in all these different ways.
00:54:54.000Is that whatever intolerance that you have for gluten, when you consume that gluten, the gluten goes into the gut and interacts with your gut biome.
00:55:05.000In celiac, there's an autoimmune mechanism where the proteins in gluten, the body creates antibodies towards those proteins.
00:55:13.000And also, there's like a bystander effect where certain tissues in the body that have similar protein structures to gluten get attacked as well.
00:55:23.000Certain enzymes, transglutaminase 2, transglutaminase 3, and transglutaminase 6. And here's the thing, you know, related to what we were just talking about.
00:55:32.000Transglutaminase 2 is typically found in the gut.
00:55:35.000So that's why a lot of people who have celiac have these gut issues is because their body is actually attacking the gut tissue and breaking it down.
00:56:14.000It breaks down the enzyme, which plays a number of important roles in the brain.
00:56:19.000And so this is why celiac and also non-celiac gluten sensitivity is associated with a whole bunch of different cognitive issues and also actual motor problems like ataxia because it's attacking the brain.
00:56:33.000The immune system is attacking the brain and that leads to some potentially very serious problems.
00:56:43.000And I do think that is an issue because there's so many people that have gone to Europe, you know, they eat wheat here and they go to Europe and they can eat wheat and it's fine.
00:56:55.000But I think there are some other things that are actually more meaningful and significant.
00:56:59.000And this leads me to the third reason why I think we've underestimated, you know, gluten sensitivity and why people don't understand how significant it can be.
00:57:58.000They eat a crappy diet with a lot of processed and refined foods.
00:58:03.000They're sedentary, they're not exercising.
00:58:05.000So this person is in really bad shape and their immune system is seriously dysregulated.
00:58:10.000And then when they get exposed to gluten, which might otherwise be a harmless protein, it causes problems.
00:58:17.000So I think the reason that more people are intolerant of gluten and intolerant of other foods now is not just because the foods have changed, it's because we've changed.
00:58:28.000It's because we have become compromised.
00:58:31.000Human beings should be resilient and able to tolerate these kinds of food proteins.
00:58:38.000But when our immune system breaks down, we talked about the gut as a barrier system where everything that's inside the gut is outside the body.
00:58:46.000It's important to understand that the purpose of the gut is to serve as a selective barrier that determines what gets in and what stays out.
00:58:58.000Because everything we eat is either absorbed or eliminated as waste.
00:59:02.000And if that barrier becomes permeable in a non-selective way, meaning it loses the ability to Make appropriate decisions about what gets in and out, then food proteins that would otherwise be benign and be broken down into smaller particles and those small particles get absorbed and don't cause any problems,
00:59:27.000the larger food proteins get absorbed before they're broken down.
00:59:31.000And then that initiates an immune reaction that wreaks havoc.
00:59:36.000So if someone has a healthy gut, then the insult of some sort of a gluten protein being introduced into their gut is not going to be as big of a deal as if someone is just drinking Gatorade all day and eating cookies.
00:59:51.000So if you think of an ecosystem that's really healthy and you introduce a predator or something else that could Could potentially throw it out of balance.
01:00:02.000It won't go out of balance because the whole ecosystem is working together to keep that in check.
01:00:07.000But then, you know, you hear about like those small islands where they introduce a particular, you know, a predator or a prey species that then just because the ecosystem of that island is fragile, you get a huge proliferation, you know, where it's just all of a sudden there's nothing but deer on the island.
01:00:25.000Until they start dying because of that imbalance.
01:01:51.000Worked up about all the differences between, you know, because you could say eat real food and do vegan, you could say eat real food and do paleo, and, you know, that's all great.
01:01:59.000But I really actually believe that if people just ate real food of any kind, we'd be in a totally different place than we are now.
01:02:06.000And there were individual health issues who'd be worked out in the variations of those diets.
01:02:13.000But we didn't get to this point because everyone's eating real food and everyone's doing vegan or everyone's doing paleo.
01:02:20.000We got to this point because people are eating trash, essentially.
01:02:24.000So one of the most key things with the gut microbiome to understand is that Our healthy gut bacteria thrive on what are called fermentable carbohydrates.
01:02:33.000Or Justin Sonnenberg, who we talked about before, he calls them microbiota-accessible carbohydrates.
01:02:39.000These are fancy terms that just mean fiber.
01:02:42.000So what distinguished is fiber is that we don't break it down and turn it into glucose or other molecules that we can absorb and use for our own energy.
01:03:34.000That's present in a lot of fruits and vegetables.
01:03:38.000You've got non-starch polysaccharides like inulin and FOS and things like that that are in like onions and garlic, Jerusalem artichokes, leeks.
01:03:49.000And then you've got resistant starch, which is actually not...
01:03:52.000That's in a lot of starchy plants that we used to eat, you know, way back in Paleolithic era.
01:03:59.000And some traditional hunter-gatherers still do, but resistant starch these days can be found in certain types of starches that have been cooked and cooled, like potatoes or lentils.
01:04:12.000Some people now are supplementing with resistant starch, or they're eating, like, green, unripe bananas, unripe plantains, you know.
01:04:49.000Or you can bake a white potato, for example, and then let it cool.
01:04:53.000And that cooling process is what forms the resistant starch.
01:04:57.000And this is what's really interesting.
01:04:58.000You know, most people think of potatoes as something that would spike their blood sugar because they have a lot of carbohydrate.
01:05:04.000But when you cook and cool the potato, it won't have that effect because the resistant starch, you can't absorb and break that into glucose.
01:05:32.000This is probably the most effective diet that I've ever come across for weight loss.
01:05:37.000And this is what I use in my practice with patients when, like, nothing else has worked, or if someone's super motivated and just wants to make progress quickly.
01:05:46.000A guy named Tim Steele introduced me to this, and he has sent me some books that he found in the 1880s that reference this diet.
01:06:29.000So you just eat potatoes, and there are different variations or different ways of doing it.
01:06:36.000You can do it for maybe just three days a week, and then you can do your normal diet, you know, the other four days a week.
01:06:43.000Tim talks about a variation called potatoes by day, which means you just eat potatoes for breakfast and for lunch and then you eat a normal dinner.
01:06:50.000But in my clinic and from Tim's experience working with a lot of people, most people will lose an average of a half pound a day.
01:07:00.000And I think there are a few things happening here and why it works.
01:07:05.000Number one, it's totally playing towards these mechanisms that we talked about before.
01:07:11.000The reward value of food, which is called the hedonic system, that drives our food craving and preferences.
01:08:17.000You get a reduction in calorie intake.
01:08:19.000The second thing is that when you cook the potato, most people the way they do this diet is they'll just cook like, you know, all the potatoes that they need for the week on Sunday to make it easy so they don't have to cook the potato every time they sit down to eat.
01:08:34.000So they cook the potatoes and then they let them cool.
01:08:37.000And so then each time you can still heat them back up.
01:08:42.000But they now have a lot of resistant starch.
01:08:47.000And here's what's really cool about it.
01:08:48.000If you heat them up and cool them again, each cooling cycle forms more resistant starch.
01:08:54.000So that by the end of the week, if you're heating all of the potatoes back up and then cooling them again each time, you're going to have a potato that's mostly resistant starch, which means it will have zero impact on your blood sugar, and it will be like a feast for your beneficial gut microbiome.
01:09:11.000And that's another reason this diet probably works.
01:09:13.000You know all about the studies correlating disrupted gut microbiome with obesity and diabetes.
01:09:19.000And so you're basically, the way I tell patients is you're basically going on an all-fiber diet.
01:09:41.000So if you, let's say, you know, you decide, I want to lose one and a half pounds a week.
01:09:47.000You do it for three days a week and you do that for six months, then by the end of that six month period you've lost a pretty significant amount of weight.
01:09:58.000That's another fascinating aspect about diet is like how much of our life We're willing to forego health, happiness, all these different things just for some simple mouth pleasure for a few moments.
01:10:11.000I mean, if you think about a pizza that you would eat, I mean, how long are you going to eat it for?
01:10:35.000And I think, you know, the way I eat, for example, I love the foods that I eat, you know.
01:10:41.000But, and this is why I say I don't suggest that anyone should start here, but I think it's interesting because it gets at some of what we've already been talking about, how, why the modern food environment contributes to obesity, and how using that knowledge and understanding of what triggers You know,
01:10:58.000us to eat, we can turn that around and use it in our favor.
01:11:02.000So another strategy that's similar is to just eat, but not quite as extreme, is to just eat the same thing for breakfast, lunch, and dinner for like two or three days in a week.
01:11:16.000Someone would tell you, someone like Jocko would say, just suck it up.
01:11:20.000No, it's using our understanding of our biology and our behavioral mechanisms to combat the way that the modern food environment is working against us.
01:11:33.000What do you think about pre-planned meal programs?
01:11:37.000There's a lot of companies that sell pre-packaged meals, pre-portioned.
01:11:43.000Yeah, I think those can play a role, too, because it's kind of a set-and-forget kind of thing, and you know what the portion size should be.
01:11:50.000There's another strategy that's very simple that's been shown to contribute to weight loss, and again, it plays to these same mechanisms, which is to get smaller plates.
01:11:59.000So, you know, you go to Target and you buy plates that are like this big.
01:13:38.000I like kimchi, and most people think it's vile.
01:13:41.000Everyone in my house thinks it's vile.
01:13:43.000No, the beet kvass is good, and its beets are super nutrient-dense, and the fermentation brings out even more nutrients, so it's like a superfood beverage.
01:13:51.000The fermentation brings more nutrients.
01:13:58.000What nutrients does fermenting Well, fermenting creates vitamin K, for example.
01:14:06.000So fermented foods are one of the best sources of vitamin K2, and that's why natto, which is a fermented soybean product from Japan, is the highest, you know, pound for pound or ounce for ounce is the highest source of vitamin K2 there is that we know of.
01:14:19.000But cheese is another high source of K2, and that's because it's fermented.
01:14:24.000So most fermented foods have vitamin K. Is it in beer or wine or any of the other...
01:14:57.000And there's lots of different kinds of kombucha.
01:14:59.000There's also water kefir, which is like dairy kefir, but it's more like kombucha.
01:15:05.000But they use the kefir cultures to make it.
01:15:09.000Every traditional culture almost has a fermented food to it because our ancestors understood, even without knowing the science, that they were beneficial.
01:16:10.000But it's nice to be able to have a break from that, you know, not to worry about what I'm going to eat and cleaning up and all that stuff.
01:16:20.000These days, my average day is kind of like no breakfast, fasting, then I might have what Mark Sisson calls a fat bomb salad for lunch.
01:16:31.000If I have lunch, I might have a later lunch.
01:16:34.000So that would be like a salad with a little bit of protein, chicken, fish, etc.
01:16:39.000And then like avocado and olives and, you know, really good healthy fats.
01:16:45.000And then if I'm not doing a ketogenic phase, I'll have a normal dinner, which would look like a portion of protein, a lot of non-starchy vegetable, and like a sweet potato or a plantain or some taro root or one of these paleo-friendly type of starches.
01:17:03.000And if you were going keto, how would you switch it up?
01:17:06.000Man, I would typically have the protein, the non-starchy vegetables, and either like some zucchini noodles or turnip noodles.
01:17:13.000You can get like a spiralizer and make the noodles really easily.
01:17:16.000And I would put some additional fat on those vegetable noodles.
01:17:21.000Or I might just have another non-starchy vegetable along with that or a salad.
01:17:26.000So you're essentially just manipulating the fat levels.
01:17:29.000Other than that, you're eating primarily the same type of foods.
01:17:32.000You're manipulating the fat versus carbohydrate levels.
01:17:37.000Do you find it difficult to maintain the ketogenic diet?
01:17:41.000And how do you feel when you're on it versus when you're not?
01:17:44.000Yeah, so for me, because I'm lean, obviously, and I have a fast metabolism, I can do keto for a couple weeks and feel pretty good.
01:17:56.000I've done it for as long as three months, so I've done the full experiment.
01:18:01.000And what happens is, after about two or three weeks, my exercise tolerance and recovery starts to go down.
01:18:07.000So I start to have less capacity to do more glycolytic activities, explosive movements, weightlifting, or sprinting, high-intensity types of training.
01:18:22.000And my sleep starts to actually deteriorate a little bit.
01:18:33.000Number one, not everybody has that response.
01:18:35.000A lot of people just feel better and they're able to do it for a sustained period of time and they don't have that problem.
01:18:42.000Number two, the way I'm trying to do it is kind of replicating what I think was typical in the ancestral environment.
01:18:52.000Most hunter-gatherer cultures that we've studied would have naturally had periods of food scarcity.
01:18:58.000So they're not always starving, but because they don't have a 7-Eleven on the corner or Costco or whatever, they would have periods where they weren't successful on a hunt.
01:19:07.000So, you know, they would go without eating or they would eat less.
01:19:10.000That's just built into our template, I think.
01:19:15.000I do a thing where I'll do intermittent fasting for a period and I might do a week or two of ketosis.
01:19:21.000And then I might just eat my normal diet for six weeks or two months after that.
01:19:25.000And then I might do another week of ketosis.
01:19:43.000And from all the research that I've seen at this point, breath ketone testing is not accurate at higher levels of ketosis.
01:19:51.000It's accurate at lower levels, but when you get into the therapeutic range around 2.0, you know, 1.5 to 2.0, which is kind of the sweet spot for me, then blood ketones are more accurate.
01:20:02.000And the problem with the blood ketone strips is they're super expensive, especially if you buy them just like at the drugstore or something like that.
01:20:11.000But you can look around and try to find them in bulk and they're cheaper that way.
01:20:16.000And frankly, at this point, and I think this is true for most people, once you get used to it, you know, and you've done it enough, you don't need to keep using them over and over.
01:20:24.000You just kind of know when you're going to be in ketosis and when you're not.
01:20:28.000And I've tracked my values and I've tracked, you know, I've treated hundreds of patients where we've done these kinds of experiments.
01:20:34.000And this goes back to the discussion about LDL. So for me, on a ketogenic diet, you know, if I measure on my typical diet, my LDL particle number is about 1,200.
01:20:46.000So I'll just briefly describe what that is because I think some people might not be familiar with that.
01:20:51.000So if you imagine that your bloodstream is like a highway, The cars on the highway are the LDL particles, and the passengers in the cars are the cholesterol that are carried by the LDL particles.
01:21:06.000So for years we've measured the passengers, the cholesterol inside of the particle.
01:21:12.000And now most of the research suggests that it's actually the number of particles or cars on the road that is the biggest driver of heart disease risk, not the amount of cholesterol inside of them.
01:21:55.000So this is where I was talking before about getting to a point where we can be maybe a little more personalized in terms of the recommendations that we make.
01:22:03.000Cause not everyone who goes keto experiences that, you know, some people do and some people don't.
01:22:09.000It's just that for me, on a keto type of diet, it affects my lipids in that way.
01:22:19.000This is a much larger conversation around Does that actually increase my risk of heart disease?
01:22:25.000Again, I said before, we know that higher LDL on average in the general population does.
01:22:30.000But if, like, let's say I have a doppelganger, you know, genetically identical to me in every way or an identical twin, and that one is not eating healthy, not exercising, not sleeping, you know, not doing anything to take care of himself,
01:22:47.000and he has a LDL-P that's high, And I have an LDL-P that's high and they're exactly the same.
01:22:54.000Do we think that we're going to be at the same risk of heart disease just because that one number on the paper is exactly the same?
01:23:00.000That's the assumption that's made in the conventional research literature.
01:23:05.000But I think almost anybody, just common sense, would say, no, that's not true.
01:23:09.000There are many other factors that determine the risk of heart disease.
01:23:13.000So getting back to this thing, so for me with keto, one of the reasons I mean, the main reason I don't do it ongoing is I don't feel well when I keep doing it, like I said.
01:23:26.000Number two, I don't like doing it long term, and I think that's important.
01:23:30.000And number three, I don't necessarily want to have an LDLP of 2,000.
01:23:35.000But you do think there are some benefits to occasionally doing it?
01:23:38.000I think that it was very natural for human beings to be in ketosis at least part of the time.
01:23:43.000And whether you enter into that by just fasting or whether you do it with a ketogenic diet, I don't know that that really matters.
01:23:51.000I mean, fasting has some additional benefits above and beyond just ketosis, like autophagy, which is a cellular cleanup and repair process that happens in a fasted state.
01:24:02.000If you think about it If fasting or being in a fasted state was a normal part of human evolution, it makes sense that certain processes would only happen in that fasted state.
01:24:13.000It does make sense, but I would feel like talking to you based on your experience, I would avoid being in ketosis altogether because it sounds like it sucks for you.
01:24:58.000If I do one day of fasting or one day of keto, on the second day I'll generally be at 1, 1.2, which most people say is in a therapeutic range.
01:25:08.000And then by the third or fourth day I'll usually be at 2 without a lot of effort.
01:25:12.000And do you regulate your protein intake when you're doing a ketogenic diet as well to avoid protein converting to glucose?
01:25:18.000Again, that's highly individual from what I've seen.
01:25:21.000For me, protein doesn't seem to be that significant of a lever.
01:25:24.000I've tried, you know, I did an experiment where I was just fasting in the morning so I had no protein.
01:25:30.000And then I would have three ounces of protein only with the salad at lunch.
01:25:34.000And then I would have a kind of normal size portion of protein.
01:25:37.000So that's actually pretty low protein for someone of my size.
01:26:45.000I mean, it's so necessary for us to take that step because you see so much, like, you know, wasted energy, in my opinion, of people arguing back and forth.
01:26:59.000You know, Joe Blow goes on a low-carb diet, has a life-changing experience, and becomes like an almost religious zealot for the low-carb lifestyle.
01:27:09.000And assumes that because it had that effect on him, that it's going to have that effect on everybody else, and just starts, you know, proselytizing for low-carb.
01:30:40.000Yeah, I think there's definitely a role for the ketogenic diet and for ketosis in general.
01:30:45.000And, you know, fasting, as I mentioned before, has some really interesting benefits above and beyond ketosis that I've been exploring a lot in my work with patients.
01:30:56.000Have you heard of the fasting mimicking diet?
01:31:00.000So, Dr. Longo is at USC Center for Longevity, a superstar scientist, and he basically came up with this approach to get, you know, the idea was to get the benefits of fasting without doing a full water fast.
01:31:16.000And so it's a reduced calorie diet that's done for three to five days with specific macronutrient ratios.
01:31:23.000And he's done some really interesting research.
01:31:25.000Most of it is in animals, so you have to take that with a little bit of a grain of salt, but there has been some in humans as well.
01:31:32.000And it's shown things like in animals with MS, just doing this fasting mimicking diet has led to regeneration of the myelin sheath.
01:31:41.000Which is what breaks down in MS, which is just, you just don't see that.
01:31:46.000I didn't even know animals got MS. Well, they have animal models of MS where they create an MS-like condition in the animal in order to study it.
01:31:55.000And they've shown changes in the brain, you know, where actually things are regrowing.
01:32:00.000And the reason for its thought is that fasting can promote stem cell regeneration.
01:32:07.000So you can actually, through fasting, rebuild certain parts of your body, according to this research.
01:32:13.000So, and then there was the autophagy, which I mentioned before, which is like almost, you can think of it as like a cellular recycling or cleanup or repair process that happens in that fasted state.
01:32:23.000And so, if you look in the research literature, it's really fascinating because they're more older, you know, older studies, there hasn't been as much research until recently on fasting, but fasting has been shown to be a cure for all kinds of different conditions.
01:32:39.000You know, severe rheumatoid arthritis, a patient can fast and then be completely symptom-free.
01:32:44.000And of course, they can't keep that up.
01:32:58.000The consumption of carbohydrates, Dom D'Agostino put something up about it recently about sugar and carbs, that they're closer and closer to connecting sugar and carbs to cancer.
01:33:11.000This is a pretty controversial area, and I'll say right off the top that I don't consider myself to be an expert.
01:33:17.000So, you know, I'll probably just pass on this.
01:33:21.000But I think there's certainly enough research pointing in that direction to continue to look at that, and they're You know, even he probably talked about this, but drugs like metformin, which limit the availability of glucose, are being studied even by the NIH, you know,
01:33:36.000very traditional mainstream scientific organizations as therapeutics for cancer, as is ketogenic diet.
01:33:45.000I'm studying that and others are as well.
01:33:48.000But I think it's a little too early to say that all cancer is caused by high blood glucose levels.
01:33:56.000Yeah, I don't think anybody's saying all, but I think they're saying there's a strong correlation between the two.
01:34:01.000Now, when you look at the overall American diet and the number of chronic diseases and all the different various things that we have, and you correlate all these factors when you think about sedentary lifestyle, you think about the lack of sleep, and then, of course,
01:34:20.000When do you think people are going to recognize, or how do we get people to recognize, that what they're eating and what the average person is eating is not what the body is designed for?
01:34:34.000And this may very well be what has triggered this whole cascade of effects.
01:35:10.000Imagine, so you go into the doctor right now, let's say you're one of those hundred million people that has, you know, type 2 diabetes or prediabetes, and they test your blood sugar, they say your fasting glucose is 96, Joe, and your hemoglobin A1c is 5.5.
01:35:27.000It's in the normal range, but it's in the high end of the normal range.
01:35:31.000In the current system, they'll just tell you it's normal.
01:35:33.000They might maybe, maybe not make any kind of dietary recommendations and then send you on your way.
01:35:39.000And the idea is we're not going to pay attention to this until it's not normal.
01:35:43.000We're not going to pay attention to this until you actually do have prediabetes or diabetes.
01:35:48.000And so they'll wait until you have that.
01:35:52.000And then, of course, the longer that you wait to treat it, the harder it is to reverse.
01:35:56.000And then once they do find that you have it, they just give you a drug rather than...
01:36:03.000You know, give you any kind of real support to make diet changes.
01:36:06.000So even if the doctor does know what to do or what to tell you about diet, which they often don't because they just don't have a lot of training in that area.
01:36:15.000And it's also how few people really have the contents of their body analyzed.
01:36:20.000How many people actually get blood work done on a regular basis?
01:36:48.000And we know, most importantly, information alone is not enough to change behavior.
01:36:53.000I said that before, that's well-established scientifically, just telling someone, hey, you should eat a healthier diet.
01:37:00.000You know, 1% of people are going to be able to take that information and act on it successfully, especially over the long term.
01:37:06.000But let's imagine a different scenario.
01:37:08.000Let's imagine you go into the doctor, same thing, they test your blood sugar, it's, you know, high normal fats and glucose, high normal A1C, and they sit down and they say, look, Joe, and this is obviously happening in an appointment that's longer than eight minutes, right?
01:37:22.000They sit down, they say, well, you're not pre-diabetic yet, but your blood sugar is starting to creep up.
01:37:29.000And I'm worried that if we don't do something now, you're going to become pre-diabetic and eventually diabetic.
01:37:36.000You know, I could give you a drug, but that's just putting a Band-Aid on the problem.
01:37:40.000So what I'm going to do instead is I'm going to hook you up with our health coach and nutritionist.
01:37:44.000And he or she is going to create a recipe for you, a meal plan.
01:37:50.000They're going to clean out your pantry, get rid of all the bad foods.
01:37:53.000They're going to go shopping with you and show you actually exactly what you need to buy.
01:37:58.000They're going to help you set up these meal plans and give you recipes so that you know exactly what you should be doing or they're going to set you up with this meal planning service that we work with.
01:38:31.000This is all going to be covered by your insurance.
01:38:33.000You're not going to have to pay for any of this.
01:38:36.000That, you know, that is totally possible.
01:38:40.000And not only that, is there any doubt that even if we spent $10,000, let's say, which is more than that would cost, even including the health coach and the fees for the gym and the fees for the personal trainer, if we spent that amount of money right up front...
01:38:55.000We could get that person's blood sugar back to normal level, prevent them from ever getting type 2 diabetes in the first place, give them way more confidence in their own ability to take care of themselves and prevent disease, make them feel better in probably every other way,
01:39:12.000and save the healthcare system $640,000 over the next 45 years.
01:39:58.000Like you have a person who works a regular normal job and...
01:40:01.000They've got a big gut and they want to lose weight.
01:40:04.000It's shifting the focus from what's wrong, which is really disempowering, like I can't do that, I'm this way, I have no willpower or whatever, to helping them become aware of certain personality traits or characteristics that they can then use to make the change that they want to make.
01:40:23.000Motivational interviewing is like this.
01:40:25.000Imagine a woman who's 55, you know, finds out that she has type 2 diabetes and the doctor's like, you should eat a better diet.
01:40:32.000And she would like to, but she's overworked and tired and it feels overwhelming.
01:40:39.000And she's just not really finding the motivation to do that.
01:40:47.000She wants to be able to play with them without becoming blind and immobile from type 2 diabetes.
01:40:53.000And so the health coach who's trained in motivational interviewing can help that patient to be able to tie those deeper values and goals and motivations with the health goal.
01:41:08.000So that it's not just eating a healthy diet for the sake of eating a healthy diet.
01:41:13.000It's eating a healthy diet because I really want to see my grandkids grow up and be able to play with them.
01:41:19.000And then there are these principles of behavior change that are totally well established.
01:41:24.000So one is shrink the change is a colloquial way of putting it.
01:41:30.000Let's say you're going to start a meditation practice.
01:41:34.000The way to not do it is to say, okay, so do an hour meditation a day.
01:41:57.000Step three, you know, open the Headspace app and do your first two minute meditation.
01:42:02.000I mean, the Headspace app is actually built in this way where they start you very small and you build up gradually over time because they know about those principles of behavior change.
01:42:12.000We know that behavior change works better in community.
01:42:18.000Obesity, some people have argued, is a contagious disease because people who have friends that are obese are more likely to be obese themselves.
01:42:31.000And here's an example of something, one of the reasons why that makes a lot of sense.
01:42:35.000We just did this thing called Sober October, me and Ari Shafir, Tom Skor, Bert Kreischer and I, we took 15 hot yoga classes, no booze, no weed for a month.
01:42:46.000But because we were doing it all together and we kept checking in on each other, it was very motivating.
01:42:53.000No one strayed and we all were doing it to...
01:42:57.000We knew that we had We had a responsibility.
01:43:03.000We had a responsibility to the group and that we knew that we were motivating each other as well as pushing each other and talking shit to each other and making fun of each other, which is what we do professionally.
01:43:14.000But at the end of it, we were like, wow, that was great.
01:43:35.000And that's, again, been proven in the science.
01:43:38.000And even just having one person, like a health coach, who can play that role and be accountable, they can help you get in touch with the real motivation for doing it.
01:43:47.000They can actually design a program for you that's likely to succeed instead of fail.
01:43:54.000There's gotta be online groups you can get involved with.
01:44:22.000Like I said, imagine that you go into your doctor and they actually hook you up with someone like that who has all that training.
01:44:29.000If you think of the healthcare population as like a pyramid, yeah, at the top of the pyramid you've got people who are really sick and who are in the hospital or in some kind of acute care setting.
01:44:40.000They absolutely need intensive support from the conventional medical system.
01:44:45.000Then you go down, you've got another 25% of people who have some kind of pretty debilitating chronic disease where they need to be seeing a doctor regularly.
01:44:54.000But then in the bottom 70%, you've got a lot of people who are just overweight, they're a little bit tired, they're not sleeping very well, they've got some gut issues, they've got some skin problems.
01:45:04.000My argument is that those people could be really well served by well trained health coaches and nutritionists who can work intensively with them on diet, lifestyle and behavior change.
01:45:16.000And we know that those changes are the single most important step we can take to prevent and reverse disease.
01:45:21.000But we also know that just telling people about it doesn't work.
01:45:53.000If you took somebody from our culture and dropped them into, like, there's this group called the Simane in Bolivia.
01:46:01.000They're a hunter-gatherer group that still follows their traditional lifestyle.
01:46:03.000If you took someone from here, dropped them in there, and just made them live that way, they'd get healthy.
01:46:10.000Because they wouldn't have any choice.
01:46:11.000You know, they would eat what was there, and they'd be living outdoors, and they wouldn't have iPads that they're staying up and looking at until 2 in the morning.
01:46:27.000But if you took one of those people and you drop them into here, like Woodland Hills or New York City or San Francisco or anywhere else, is there any question that what's going to happen there?
01:46:38.000The same exact thing that happens to all of us in this modern culture.
01:47:57.000So I'm going to go around and study all of these traditional cultures all over the world.
01:48:02.000And first, I want to find out, do they have cavities in dental decay and like a narrowing of the dental arch and changes in facial structure that we have in the industrialized world?
01:48:12.000And the second question is, if not, what is the common element, you know, with all of these cultures that's different than our culture?
01:48:20.000And in his book, So first of all, the answer to the question was no.
01:48:25.000It's not normal for humans to develop cavities and rotten teeth.
01:48:29.000How could we survive in a natural world if our teeth are all falling out?
01:48:33.000So he went and he took pictures of these people all around the world, like in Africa, the Maasai, hunter-gatherer people, people living in the remote part of Switzerland, isolated up in the hills that had maintained their traditional diet and lifestyle.
01:48:49.000And all of them had these beautiful teeth, big wide round faces, you know, wide dental arches, you know, all of these signs of health.
01:48:58.000But he also in the book had pictures of people from those same areas that had switched to, moved to the city, you know, switched to modern lifestyle within one generation.
01:49:09.000You see people with these wide faces, big healthy teeth, smiling on one side of the page, and on the other side of the page you see people with these narrow faces like mine, rotten teeth, totally crooked teeth, and the kind of dental problems that we all have where most of us get braces and all this stuff.
01:49:28.000And that happened in just one generation of switching from a traditional diet to a modern diet.
01:49:35.000So vitamin K2 and a number of vitamins are responsible for facial development.
01:49:41.000So if you look in the book of Wes and Price's pictures, you'll see most people in those traditional worlds have these broad, healthy dental arches.
01:49:54.000In our culture, because of nutrient deficiencies, we're not eating the healthy nutrient-dense foods, our faces get more narrow, our chins recede, our mouths become more crowded, which is why many people can't fit the number of normal adult teeth in their mouth because their dental arch is so narrow.
01:52:22.000Yeah, it's very weird when you think about what we're doing to the human body.
01:52:28.000And when you're talking about the diabetes levels that you're talking about are pre-diabetes and chronic disease and all the different issues and 40% obesity rate and all these different factors.
01:52:39.000It's an epidemic that's sweeping through the entire nation and it's largely ignored other than health fads, weight loss videos.
01:53:12.000Even if you stay alive, the quality of life is being devastated.
01:53:15.000There was a recent article that came out saying just that.
01:53:18.000It was a paper that looked at what's happening in our older years and saying, yeah, we have a long lifespan, but our quality of life has significantly declined in those later years because we're burdened by all of these chronic diseases.
01:53:33.000You know, the average, something like...
01:53:36.000One in five or two in five elderly people over 65 are taking more than five medications.
01:54:05.000Again, the Samane, it's a subsistence farming hunter-gatherer population in Bolivia.
01:54:11.000And recently there's been some articles in the New York Times about them.
01:54:14.000There's some anthropologists, medical anthropologists, and doctors and researchers have gone down there to study them.
01:54:20.000They wanted to see, it's like, this is one of the last places on Earth where people are still living pretty traditional diet and lifestyle, so we better study this quickly, you know, to see what's normal, what's truly normal for humans.
01:55:06.000Yeah, they just, you know, they live in their normal, that's as close as we're going to get to a normal human population, right?
01:55:13.000So they studied, they did blood markers on them for heart disease, but not only that, they did scans, CT scans of their heart, you know, to see if they had calcification of the arteries.
01:55:24.000They found that the rate of heart disease in this population was 80% lower than it is in the U.S. 80% lower.
01:55:34.0009 in 10 Tsimane adults that they studied had absolutely no plaque buildup in their arteries, which means they have virtually no risk of a heart attack as far as we understand it.
01:55:47.000And, you know, before anyone who's listening to this says, oh, yeah, that's just because hunter-gatherers all die when they're 35 years old, you know, that familiar argument.
01:55:55.000Well, this study included people between the ages of 40 and 94 years old.
01:56:01.000What's more, the researchers estimated that the average Simane 80-year-old had the same vascular age as an American in his mid-50s.
01:56:12.000There's almost no cognitive disorders or Alzheimer's disease in the Simone.
01:56:18.000So that's a really clear example of what happens when you give human beings the right inputs and they're not exposed to all this crap that we're exposed to.
01:56:28.000They live long and healthy lives that are virtually free of chronic disease.
01:56:32.000And that's despite the fact that they have much higher rates of infection than we do.
01:57:12.000There's a strong, there's actually something referred to as the gut-brain axis, which is this very well-known connection between the gut and the brain, and it goes both ways.
01:57:21.000So, you know, the gut can influence the brain strongly, and the brain can influence the gut strongly.
01:57:27.000So, I mean, my point is just that What you said.
01:57:33.000When are we going to realize that just these changes, you know, making these changes is what we need to do to prevent and reverse chronic disease?
01:57:40.000And we have these examples of people like Tsimane that show us very clearly that it's the way we're living, not our genes, that are causing this chronic disease epidemic.
01:57:50.000So the easy way would be to Write books about it, have shows like this, keep educating people and doing that.
01:57:59.000And that's what I'm hoping for, and that's why I wrote my book.
01:58:03.000But the hard way is that our system fails, that it becomes so overburdened by the rising rates of chronic disease and the unsustainable expenses of that, that it basically falls apart.
01:58:20.000You know, we respond in a kind of to it as the crisis that it really is because it becomes apparent at that point that our way that we've been doing it has not been working and that we desperately need to find a new way.
01:59:50.000Pioneer in functional medicine, he recently, they tapped him to start a Center for Functional Medicine at the Cleveland Clinic, one of the most prestigious international medical institutions, always on the forefront of the newest changes in medicine.
02:00:05.000And when they first started, they were in this tiny little space.
02:00:08.000But within a few months, they had like 3,000 patients on their waitlist and they moved to 17,000 square foot space in Glickman Tower, which takes the whole second floor of this building in Cleveland Clinic.
02:00:20.000And they've got patients from nine countries on the waitlist coming from all over the world to do functional medicine because they have, you know, People know that the system, as it's set up, isn't really effective for chronic disease.
02:01:11.000Using a hammer, going around everywhere with a hammer, you know, expecting not to work.
02:01:16.000Hammer works really well when you're pounding a nail, and it doesn't work as well with a screw or, you know, with something else.
02:01:22.000So, I mean, Cleveland Clinic, it's just an amazing proof of concept for functional medicine.
02:01:28.000Then Rob Wolf, who, you know, we both know, He did some incredible work with the city of Reno and the first responders, where they projected that just by doing this dietary intervention, so what happened was that the firefighters and police cops were having heart attacks and strokes.
02:01:48.000And because of the way the pension plans are set up, if the city of Reno has to medically retire these people, They're going to spend millions of dollars over the course of their lifetime taking care of them.
02:02:01.000So Rob went in there with this other group, Specialty Health, and they got them on a good paleo-type diet, lower-carb diet, got them doing some more physical activity.
02:02:10.000Well, the estimate was that they saved the city of Reno something like $25 or $30 million just with this simple intervention.
02:02:18.000We're doing a pilot now with the Berkeley Fire Department, with our clinic, with a similar kind of goal.
02:02:24.000So I think you're going to see all these kind of examples of things happening on local community level because you can make changes more quickly that way.
02:02:32.000And then over time, some of those things are going to scale up.
02:02:35.000And, you know, we're going to start seeing them maybe on the state level or the, you know, local government level.
02:02:39.000And then eventually, at some point, that's going to get attention of people on the federal level who are looking around and going, oh, my God, it's 2025 or 2030. Healthcare expenditures are 35 or 40% of GDP. This is completely unsustainable.
02:02:55.000We're not even going to exist as a country in 25 years unless we do something about this.
02:02:59.000So I kind of think it's going to go like that.
02:03:05.000The model of the Cleveland Clinic where businesses sort of rise up and take advantage of this opportunity to get people healthy and to profit.
02:03:13.000I mean, it seems like that's the best way to make things happen.
02:03:16.000Make it a business or someone can profit off of it.
02:03:20.000As long as it's affordable for the vast majority of people, if it's not unreasonable.
02:03:26.000And Rob has talked about this a lot for years.
02:03:29.000If you look at economies of scale and you look at things like microprocessors and DNA testing, the first human genome sequence cost like $500 million.
02:03:42.000Now you can just go out and pay $200 to have your genome sequenced.
02:03:46.000And microprocessors, when they were first introduced, the computers were as big as the The room and, you know, millions of dollars, and now anyone can go buy a computer for a few hundred bucks.
02:03:56.000Well, your phone is many times stronger than what they used from NASA in the 1960s.
02:04:01.000But we don't see that kind of innovation in healthcare.
02:04:03.000Like, we see expenses going up instead of going down.
02:04:22.000I mean, Rob, we did what we call a rally to end chronic disease the other night, and Rob came and spoke, and so did Mark Hyman from Cleveland Clinic and a few others.
02:04:32.000And in Rob's talk, he mentioned that Healthcare should essentially be free.
02:04:37.000If we allowed the same forces that made microprocessors go from being extremely expensive to extremely cheap, DNA testing go from being extremely expensive to extremely cheap, if we allowed those same forces to work on healthcare,
02:04:53.000healthcare would be extremely affordable.
02:04:55.000The problem is, as you pointed out, we have a lot of misaligned incentives.
02:04:59.000So insurance companies, for example, they only benefit when the overall healthcare expenditures rise.
02:05:06.000So the more procedures are ordered, tests are ordered, treatments are prescribed, the more the insurance company benefits.
02:05:16.000That seems counterintuitive to people because you would think that you're paying for insurance and the insurance company is hoping that nothing goes wrong because then they'll have to pay out far more than you're paying in.
02:06:00.000And then you have Big Pharma that is basically, you know, their incentive is to sell more drugs and they're for-profit corporations and their duty is to make a profit for shareholders and that's how they do it.
02:06:14.000Selling more drugs is not always aligned with the interests of patients or even of doctors.
02:06:22.000Well, the real issue to me that stands out as an example of that is these stupid fucking commercials that they have for pharmaceutical drugs where people are having the best time ever.
02:06:30.000Well, you're looking at them and like, this is so deceptive.
02:06:34.000You're showing me like best case scenario, grandpa running, pushing the bike and the little kids laughing and everyone's having the time of their life like, oh, I want the time of my life.
02:07:39.000Then I'll tell you what significant means.
02:07:40.000...inclusive tuberculosis, serious sometimes fatal infections and cancers, including lymphoma, have happened, as have blood, liver, and nervous system problems, serious allergic reactions, and new or worsening heart failure.
02:07:51.000Before treatment, get tested for TB. Tell your doctor if you've been to areas where certain fungal infections are common.
02:07:56.000And if you've had TB, hepatitis B, are prone to infections, or have flu-like symptoms or sores, don't start Humira if you have an infection.
02:08:49.000In an explosive, imploding, rectal disaster.
02:08:53.000Or just, you know, get an infection that would be totally, you know, not a threat for you or anyone else, but because they had taken a drug that globally suppresses their immune system, can kill you.
02:09:03.000Yeah, that whole thing, like, if you, you know, if you have an infection, don't take it.
02:12:04.000Maybe there'll be a third drug that people who are already on antidepressants and Abilify can take for the suicidal thoughts that Abilify wasn't able to get rid of from the original antidepressant.
02:13:27.000The vast majority of Abilify prescriptions, therefore, are off-label, which means they've never been studied or shown to be safe or effective for the conditions that it's being prescribed for.
02:13:38.000So your doctor could legally prescribe you birth control pills?
02:13:43.000I mean, it would be frowned upon, and maybe if they did that enough and it was causing problems, they would have to justify why they were doing it.
02:13:51.000That's the missing key to bilify for men.
02:14:17.000You know, antidepressants have been shown a cause to ink suicidal ideation in adolescents and teenagers in particular, and yet they are still often used in that group, even though they were never studied or approved for that population.
02:15:05.000The alarms about the dangerous and sometimes deadly side effects of anti-psychotics affecting children and the elderly, among others, have been mounting for years.
02:15:18.000And many of these symptoms could be directly related to gut biome, gut bacteria, and you might be able to nip it in the bud with a change in diet, with addressing the sedentary lifestyle,
02:15:44.000It's actually the first chapter in my book.
02:15:46.000It's about a kid named Leo that I treated in my clinic a few years back.
02:15:49.000He was eight years old when he came to see me.
02:15:52.000His parents were like a wreck when they came to the office because they were just totally worn down.
02:16:00.000He would throw these epic tantrums where he'd be...
02:16:03.000You know, screaming and crying or writing on the floor for just the most random stuff, like trying to get his shoes tied as they were going out the door or, you know, not cutting the crust off his bread sandwich in just the right way or getting a stain on his favorite t-shirt.
02:16:20.000He ate only a handful of foods, all of them processed and refined, like toaster waffles, bread, crackers, cookies, et cetera.
02:16:28.000You know, they were concerned about nutrient deficiency, but every time they tried to reintroduce, like to introduce a different food, he would go ballistic.
02:16:34.000And they didn't have the energy to fight him at every meal.
02:16:37.000He was really rigid about his behavior and environment, so everything had to be just right.
02:16:42.000If the toys in his room weren't arranged in just the right way, he'd fly off the handle.
02:16:47.000Desks in his classroom weren't just the right way, he'd fly off the handle.
02:16:52.000He was really anxious in unfamiliar environments, so it was hard for them to leave the house for even a few hours, much less travel or go on vacations.
02:17:00.000I mean, this seems extreme, but there are a lot of kids with these kinds of behavioral disorders now.
02:17:08.000So, they took him to see doctors locally, and they started with a primary care doctor, then went to psychiatrists, and then several behavioral disorder specialists actually down here at USC or UCLA. You know,
02:17:24.000first diagnosed on the autism spectrum, then eventually OCD and something called sensory processing disorder, which is like on the autism spectrum where they're really sensitive to, you know, sense, input, touch, you know, sound, etc.
02:17:41.000The doctors, you know, they were relieved at first to have these diagnoses, but very quickly it became apparent that they were just labeled for the symptoms.
02:17:49.000It wasn't anything that actually gave them information about what to do.
02:17:52.000And then when they asked the doctor what the treatment was, the answer was medication.
02:17:57.000So they first started with Adderall, which you mentioned earlier, then Ritalin, both stimulants, and then eventually antidepressants, which again have not really been approved as safe or effective in kids.
02:18:09.000And they did help at least a little bit with some of the symptoms, but then he got a lot of brutal side effects.
02:18:16.000Gut pain, dry mouth, irritability, headaches, and the worst thing was severe sleep disruption.
02:18:23.000And he had two younger brothers and sisters, so his parents definitely didn't need more of that.
02:18:27.000And the crazy thing throughout this entire period, not one of his doctors even hinted at the possibility that something in its diet or like a disrupted gut microbiome or nutrient deficiency could even be contributing to his symptoms.
02:18:42.000And that's not the exception, that's the rule.
02:18:45.000So, you know, his parents weren't thrilled about, I mean, they weren't thrilled about medicating him, but they did it because they had no other option and nobody suggested that it could be anything other than just, you know, something wrong with their son.
02:19:03.000But fortunately, one of his mom's friends sent a couple articles for my blog.
02:19:08.000One was on the gut-brain axis, which we've been talking about.
02:19:10.000Another was on all of the underlying causes of behavioral disorders in kids.
02:19:17.000We did a whole bunch of testing, as I do, with all my new patients.
02:19:20.000And not surprisingly, we found he had a disrupted gut microbiome.
02:19:24.000He had SIBO, bacterial overgrowth in the small intestine.
02:19:28.000He had non-celiac gluten sensitivity, and gluten was in almost every food he was eating.
02:19:34.000But he also had intolerance of some other proteins like dairy and soy and corn and buckwheat, which were in the toaster waffles he was eating every night.
02:19:42.000He had deficiencies of vitamin D, B12, folate, and iron because he was eating just flour, basically, you know, flour and sugar.
02:19:50.000And he had high levels of arsenic, which is a heavy metal, because the only other beverage he would drink, aside from water, was rice milk.
02:19:57.000And rice milk's been shown to have, you know, higher levels of arsenic.
02:20:01.000So if a kid's just pounding rice milk, they could actually start to develop levels of arsenic that could be problematic.
02:20:07.000That's crazy because a lot of people think of rice milk as being a healthy alternative.
02:20:43.000He was less set off by the things that would have done that before.
02:20:46.000About four months into the treatment, his teacher called home from school and was like, where's Leo?
02:20:53.000You know, what have you done with Leo?
02:20:54.000And who's this guy you're sending to school in his place?
02:20:56.000Because it had been horrific for her as his teacher at school, to the point where its parents often had to come pick him up and bring him home from school because he was so disruptive.
02:21:07.000Then I talked to Leo's mom maybe six, seven months into the treatment.
02:21:11.000By then we had the follow-up test back.
02:21:13.000A lot of the issues that we set out to address had been resolved.
02:21:18.000He was eating foods that he would have thrown against the wall just a few months before.
02:21:22.000He was more tolerant, you know, more affectionate, less controlling and rigid and just better adjusted kid overall.
02:21:30.000And at the end of that time, his mom said, Something that really struck me, and it's why I wrote the book.
02:21:37.000She said, why don't more doctors know about this?
02:21:41.000There's so many kids out there like Leo who are suffering from these kind of behavioral disorders, but neither their parents nor their doctors are even looking at this other stuff, like the diet and the gut and all these things.
02:22:44.000It's even worse in kids because there's this idea that big food has been very successful at perpetuating that kids need special kids' foods.
02:23:30.000So yeah, I mean, someday we'll go to the doctor and you have something like this, the first questions are going to be around, what are you eating?
02:24:32.000Yeah, it's not just about health in that narrow sense of the absence of symptoms of the body.
02:24:37.000We're talking about your ability to perform at work, your ability to relate to your kids, to your partner.
02:24:43.000I wonder how much of the antidepressant, like the people that are prescribed or people that are experiencing depression has to do with their diet.
02:24:54.000Again, I think there are situational factors that cause depression.
02:24:58.000I mean, for someone who is poor and lives in an economically and socially depressed area and is fighting systemic oppression, there's good reason to be depressed in that situation.
02:25:13.000Nevertheless, given what we understand now about this inflammatory model of depression, it's also true that that is at the very least going to exacerbate it and make it worse, but in some cases may be the primary driver of depression.
02:25:26.000And I can't tell you how many patients I've had who've had depression that they thought it was something wrong with them, there's something broken about them, They're not cut out for this world.
02:25:38.000They don't fit in here, that sort of thing.
02:25:40.000And then we go in, we see, oh, you've got a severe B12 or folate deficiency.
02:25:44.000That affects your neurotransmitter levels.
02:25:46.000Oh, you've got a disrupted gut microbiome.
02:26:28.000It can cover a host of different neurological issues, physiological issues, or behavioral issues that are because of your environment and your life experiences.
02:27:00.000They hit the jackpot on that one, huh?
02:27:02.000Yeah, so they found like, okay, this isn't working very well for what we designed it for, but it's got some pretty interesting effects.
02:27:10.000But they knew it wasn't enough to just then go out there and start selling it to say, hey, here's a drug that will help make you perform better in the bedroom.
02:28:00.000I have erectile dysfunction and I know now there's a drug called Viagra that I need because I have erectile dysfunction and the doctor has seen that they have their own brochure.
02:28:10.000They pull out their brochure and it says erectile dysfunction.
02:28:15.000Yes, this patient's got erectile ED. So here's the drug prescription.
02:28:19.000How is it legal for an advertising agency to name a disorder?
02:28:25.000Well, I'll tell you that it's illegal in every single country in the world, except for New Zealand and the United States, to advertise drugs to consumers.
02:28:33.000Please, New Zealand, be the first to change.
02:28:36.000Please, turn it around, make us look terrible.
02:28:38.000They can do it first, because this is the result.
02:28:41.000This is the result of allowing drugs to be advertised, is that you get advertising agencies creating conditions that then require drugs to be treated.
02:29:19.000But the gist of it was, the real money in drugs is in selling them to healthy people.
02:29:25.000So he had realized that, you know, we basically saturated the market of medications that can be used to treat sick people.
02:29:33.000So the only way we can continue to grow and expand is to come up with ways to sell drugs to healthy people.
02:29:39.000When did they first start prescribing antidepressants?
02:29:43.000Well, the SSRIs, I think, go back to the 80s or late 80s or early 90s, but they had other kinds of antidepressants before that called tricyclic antidepressants and other types of medications.
02:30:17.000Yeah, from what I understand, Provigil, that was the initial creation of Provigil, they were trying to come up with a performance-enhancing drug for cognitive function.
02:30:27.000And they couldn't just sell it as such, so they had to come up with some sort of a reason why people need it, so they went with narcolepsy.
02:31:10.000Because his argument was, you know, these drugs are so effective for reducing the risk of heart disease that, you know, we should just be giving them to everybody despite whether they want to take them or not.
02:31:22.000Because doesn't that, don't they seriously disrupt performance?
02:31:25.000Well, you know, the bigger question is whether statins actually extend lifespan in people without pre-existing heart disease.
02:31:33.000And a lot of the research suggests that the answer to that question is no, or in an almost non-insignificant way.
02:31:42.000And then you have to balance that with the potential side effects, like the increased risk of diabetes, particularly in women, and now we have 100 million people with diabetes, and then the muscle fatigue and myopathy and that sort of thing.
02:31:55.000But, yeah, I mean, I think that's, this is, I mean, we got off on this when we were talking about misaligned incentives, and all of these things we've been talking about are just examples of how what's in the best interest of a drug company, duh, is not necessarily in the best interest of us as patients or for doctors.
02:32:12.000When it goes back to what you were saying about tooth decay and then fluoride in the water.
02:32:48.000There's an oral microbiome, just like there is a microbiome in the gut.
02:32:54.000It's what's likely, and archaeologists know that when they uncover remains from traditional, our ancestors, our Paleolithic ancestors, they have great healthy jaws and teeth.
02:33:21.000And so, what that suggests is that, you know, Look, I brush my teeth and I floss.
02:33:27.000I'm not suggesting that people shouldn't now and that there hasn't been some improvement.
02:33:31.000But the fact that Weston Price went around to all these traditional cultures and found that they had beautiful, healthy teeth and wide dental arches, they weren't brushing their teeth twice a day and flossing twice a day.
02:33:43.000But they had root, you know, underlying foundation of health and a healthy microbiome, not only in their gut, but an oral microbiome.
02:33:52.000That led to healthy teeth even without that kind of dental hygiene and dental care.
02:33:59.000And there are now oral probiotics, dental probiotics, which are chewable tablets that you can just pop one in your mouth after you brush your teeth, you chew.
02:34:12.000And I've had patients who had been having recurring cavities, dental issues, periodontal issues.
02:34:21.000That just by chewing one of these dental probiotics twice a day have had like a complete reversal in their dental health where, you know, they go from having like a cavity every time they go to the dentist to having no cavities at all.
02:34:32.000Because that's one of those woo-woo subjects where people go, oh, you fucking crystal hippie.
02:34:38.000When you start talking about fluoride in the water.
02:34:51.000That can be done with filtration systems.
02:34:53.000You know, people in the wild, not in the wild meaning like the Chumani, but people that live in camps for months at a time, like friends of mine that go on these backcountry trips, they use water filters.
02:35:04.000They'll take like a wallow that like an elk have been stomping around in muddy water and they'll put this water through this filtration system and make it so you can drink it.
02:35:18.000They have these pens that you could spin the pen around in the water for a predetermined period of time and it kills everything that's bacteria, all the bacteria in the water.
02:35:28.000There's a bunch of different filtration systems, pumps that they use on creeks to keep beaver fever.
02:36:03.000I think he mentioned something about how, and this comes up in other contexts too, where companies that have something that's toxic that they would otherwise have to pay for, to dispose of, have figured out ways to actually sell that stuff to the food industry.
02:36:37.000And then the brilliance of those companies at that time was figuring out a way to turn those things that would have otherwise been seen as waste into a food product that they could then sell and make money off of.
02:36:56.000Those are ubiquitous in the American diet.
02:36:59.000If you pick up any packaged food, you're going to see soybean oil, corn oil, cottonseed oil, etc.
02:37:05.000All these highly processed and refined omega-6 vegetable oils.
02:37:09.000And those vegetable oils are very difficult for your body to process.
02:37:12.000Well, first of all, they're almost completely devoid of nutrients.
02:37:17.000Some of them have vitamin E, but they have almost no other nutrients at all.
02:37:23.000Historically, humans consumed a balance of omega-6 and omega-3 oils that was somewhere between 1 to 1 ratio or maybe a 4 to 1 in favor of omega-6.
02:37:35.000The amount of omega-6 oils that we consume today is much higher.
02:37:39.000You know, sometimes like a 20 to 1 ratio of omega-6 to omega-3.
02:38:14.000And whether even the studies said what people say it said, which is often not the case when you look into it.
02:38:20.000That fluoride one is really freaking me out now that we're talking about it.
02:38:24.000Because I wonder, how would you ever stop that?
02:38:28.000Hasn't there been connections or correlations between fluoride and low IQ? That sounds familiar, but again, it's not a topic I've looked into in detail, so I don't want to say something that's not correct.
02:38:42.000That's the difference between you and me.
02:38:46.000I think I heard fluoride exposure in utero linked to lower IQ in kids, study says.
02:38:53.000Can you scroll up a little bit there, Jamie?
02:38:57.000Increased levels of prenatal fluoride exposure may be associated with lower cognitive function in children, a new study says.
02:39:04.000Published Tuesday in the Journal of Environmental Health Perspectives, evaluated nearly 300 sets of mothers and children in Mexico and tested children twice for cognitive development over the course of 12 years.
02:39:15.000Fluoride is not added to public water supplies in Mexico, but people are exposed to it through naturally occurring fluoride in water and fluoridated salt and supplements.
02:39:25.000Yeah, and I mean this highlights something else we haven't talked about much at all in terms of an aspect of the modern environment that's problematic, which is toxins.
02:39:33.000Fluoride being one of them, but also things like mercury, bisphenol A, BPA, which is in the plastic water bottles, receipts.
02:40:05.000You can't see a building 100 yards ahead of you.
02:40:07.000Yeah, so, I mean, air pollution's been linked to obesity and cardiovascular disease and stuff you wouldn't even think, not just respiratory things, like systemic inflammatory conditions.
02:42:30.000So this new study came out and they looked at kids and they looked at cortisol levels and inflammatory markers.
02:42:39.000And they found that kids that had mercury levels that were even as low as 1, so almost 10 times lower than the level of concern, had higher levels of cortisol and higher levels of inflammatory markers.
02:42:55.000So that totally turned things on their head.
02:42:58.000It was like, all of a sudden, lower levels of these toxins than we thought were problematic are actually problematic.
02:43:06.000And when they dove in and looked deeper, they found Some of the kids who were affected had certain genetic polymorphisms.
02:43:14.000There's something that made them more susceptible, or maybe they had nutrient deficiencies that made them less able to detoxify the mercury as they normally should be able to.
02:43:25.000You know, what further complicates it is that the symptoms that you see with high levels of a toxin can actually be different at low levels.
02:43:34.000So let's say researchers design a study to see the toxic effects of mercury when the exposure is severe, and they're looking for certain studies, and then they start lowering the dose of mercury to see when those effects go away.
02:43:57.000So this caused a problem for years where it was assumed that the low doses were harmless because they weren't observing the same effects they saw at the high doses.
02:44:06.000And now they know this and so they've redesigned studies to look, just cast a wider net and see what's happening and sure enough at those lower levels of toxins they're seeing all kinds of effects that are actually in some cases opposite of the effect that you see with the high dose of the toxin.
02:44:20.000Have you adjusted like where you live or anything because of all this?
02:44:26.000We just bought a house a couple years ago, and we had a choice of where to live.
02:44:36.000And so we ended up living up on top of the hill.
02:44:39.000And that was somewhat intentional for me.
02:44:42.000It's right near Tilden Park, which is an outdoor regional park space with a lot of green area and stuff.
02:44:48.000And there are parts of Berkeley that You know, where the air quality is really, really bad, like surprising if you don't know that area.
02:44:55.000If you go online to some of these air quality rating sites, you can see that parts of Berkeley are like C minus or D because there's so much industry there and the Chevron plan and stuff.
02:45:06.000But this is where it gets really, you know, the inequality is brutal because guess who ends up often living in the areas that are most toxic are the people who are, you know, economically disadvantaged and they're the least influential when it comes to any kind of political power to make changes in those areas.
02:45:34.000Well, there's a lot of factors we could talk about, but I think it's so important that there's people like you out there that are highlighting these things and writing books about these things and talking about these things on podcasts.