The Peter Attia Drive - Qualy #102 - Is the food industry still saying that all calories contribute equally to adiposity and insulin resistance？

00:00:00.000 Welcome to a special bonus episode of the Peter Atiyah Qualies, a member exclusive podcast.

00:00:16.100 The Qualies is just a shorthand slang for qualification round, which is something you

00:00:20.120 do prior to the race, just much quicker. The Qualies highlight the best of the questions,

00:00:25.320 topics, and tactics that are discussed in previous episodes of The Drive.

00:00:30.000 So if you enjoy the Qualies, you can access dozens more of them through our membership

00:00:33.520 program. Without further delay, I hope you enjoy today's Qualies.

00:00:40.560 And currently the food industry says, I mean, I haven't really paid much attention to this,

00:00:45.560 to be honest with you, in the last few years, but is the food industry basically still saying that

00:00:49.200 while a can of Coke is not ever deemed even by Coca-Cola to be as nutritious as a carrot,

00:00:55.320 in the end, are they basically saying that all calories contribute equally to adiposity

00:01:01.380 and insulin resistance?

00:01:02.960 Yes. They are all saying it's about obesity and therefore it's about energy balance,

00:01:07.140 therefore it's about calories, therefore all calories are the same. That's what they say.

00:01:12.140 It is absolutely not true. And we have all the reasons in the world to show why it's not true.

00:01:18.820 We have empiric data. We have mechanistic data. We have plausibility data. We have hard data that

00:01:25.460 show that is just not the case. And if you want, I'll give you examples of it. All right, let's start.

00:01:31.940 Yeah.

00:01:32.220 Let's talk about fiber. You eat 160 calories in almonds. How many do you absorb?

00:01:37.880 Two-thirds.

00:01:38.680 130. Yeah. I mean, 75%. Okay. Well, what happened to the other 30?

00:01:43.760 Presumably, it's going to drag some stuff out in your colon.

00:01:47.920 Well, no. What happens is the soluble and insoluble fiber in the almonds forms a gel on

00:01:52.260 the inside of the intestine. You can actually see it on electromicroscopy, a whitish gel.

00:01:57.060 That's going to act as a secondary barrier preventing absorption of some of those almond

00:02:02.560 calories early on. Well, if they don't get absorbed in the duodenum, where do they go next?

00:02:07.880 Jejunum.

00:02:08.120 Ilium, jejunum.

00:02:08.780 Jejunum. Well, what's in the jejunum that's not in the duodenum? The microbiome.

00:02:12.580 Yeah. The duodenum is essentially sterile. It's got a pH of one. Only H. pylori can live

00:02:19.180 there. You have to get the bicarbonate infusion.

00:02:21.740 Wait, you're saying that that lining is formed in the duodenum?

00:02:25.060 Duodenum, yeah. Exactly. To prevent your liver from getting the whole dose because anything

00:02:32.680 that's absorbed in the duodenum goes straight to the liver.

00:02:34.540 So how much fiber is in an apple?

00:02:36.560 A lot. I mean, I can't give you a number of grams.

00:02:38.440 But I'm just directionally, I'm making this number up. But let's say there's, how many grams

00:02:42.260 of fructose in an apple? 20?

00:02:43.700 There's 30 calories in a standard apple, half of which would be fructose of 15.

00:02:49.980 That seems low. An apple, like a big-ass Fuji apple?

00:02:52.540 Well, I mean, not a big mother apple, but like an apple apple.

00:02:56.700 But so based on that, you're saying only half the fructose that you would eat in a piece

00:03:01.340 of fruit might actually get to the liver?

00:03:03.080 Yeah, or less. Most of it's going to end up in the jejunum. And once it goes to the jejunum,

00:03:07.920 it's a free-for-all. Do you absorb it or do the bacteria digest it and metabolize it for

00:03:12.140 their own use? Remember, you have 10 trillion cells in your body, but you have 100 trillion

00:03:17.160 bacteria in your intestine. Every one of us is just a big bag of bacteria with legs. Those

00:03:21.960 bacteria have to survive.

00:03:24.360 If the fructose gets absorbed at the level of the junum, in other words, if the gut outcompetes

00:03:28.380 the bacteria, can it still get back to the liver?

00:03:30.320 Oh, yeah. But the area under the curve will be wider, which means the insulin response will be

00:03:36.740 lower, which is what you want because it took longer. But a lot of it won't get absorbed. It'll

00:03:42.540 be digested. It doesn't come out in the stool. It gets digested by the gut bacteria who use it for

00:03:48.260 their own purposes. Now, here's the thing that I only learned about a month and a half ago, which

00:03:54.100 is absolutely essential. If you don't consume fiber, that means that your gut bacteria are not

00:04:01.820 getting the food they need because you're absorbing it all early. Well, they still have to survive.

00:04:08.200 So what do they do? They protealize and lipolyze the mucin layer. 0.96

00:04:14.100 So auto-digest.

00:04:14.940 They auto-digest the mucin layer that sits on the surface of your intestinal epithelial cells,

00:04:20.300 protecting them. And you can actually see on electromicroscopy an increased apposition of

00:04:27.280 the bacteria with the intestinal epithelial cell, which likely causes damage, possibly a leaky gut,

00:04:36.300 and possibly GI disease like colitis and even maybe Crohn's. So the idea is to feed your bacteria

00:04:45.640 or your bacteria will digest you. And what sources of fiber do you think? I mean,

00:04:51.700 people talk about using psyllium husk and all these other things to sort of augment fiber.

00:04:55.320 Do you think that's necessary or do you think you can get enough of it just from...

00:04:58.940 Well, so psyllium is soluble fiber. It's not insoluble fiber. You need both. Fiber has soluble,

00:05:07.620 insoluble like pectins, like what holds jelly together. Insoluble fiber like cellulose,

00:05:12.920 you know, stringy stuff in celery. You need both to make that gel. So the insoluble fiber forms the

00:05:19.040 lattice work like the net. Let's say you put a layer of petroleum jelly on a strainer. You would

00:05:24.960 have an impenetrable water barrier, right? Yeah. So the insoluble is like the strainer

00:05:29.200 and the soluble becomes the thing that fills in the lattice. That's right. Exactly. So when you have

00:05:34.640 both, it works. And there's data that shows that if you have either one or the other, doesn't work.

00:05:40.460 You need both. Well, you get both in real food. And this is why the food industry keeps adding

00:05:47.140 soluble fiber like psyllium husk to food like fiber one bars. It doesn't make a damn bit of

00:05:52.460 difference. They have insoluble fiber in things like certain breakfast cereals. But if you don't

00:05:59.320 have the soluble fiber, also doesn't work. You need both. Real food has both. The point is...

00:06:05.360 So the fiber fortified stuff is... The easy way to do it is to add soluble fiber.

00:06:08.840 That doesn't work. Okay. And that's what the food industry keeps doing and keeps telling us that

00:06:12.760 it's good because it's got extra fiber. Wrong. Doesn't have functional fiber. Doesn't have the

00:06:18.300 fiber that does what you want it to do. That's the reason a calorie is not a calorie all by itself.

00:06:23.280 Hope you enjoyed today's special bonus episode of The Qualy. New episodes of The Qualys are released

00:06:28.960 Tuesday through Friday each week and are published exclusively on our private member-only podcast feed.

00:06:35.180 If you're interested in hearing more, as well as receiving all of the other member-exclusive

00:06:38.740 benefits, you can visit peteratiamd.com forward slash subscribe. This podcast is for general

00:06:45.800 informational purposes only and does not constitute the practice of medicine, nursing, or other

00:06:50.300 professional healthcare services, including the giving of medical advice. No doctor-patient

00:06:56.020 relationship is formed. The use of this information and the materials linked to this podcast is at the

00:07:01.840 user's own risk. The content on this podcast is not intended to be a substitute for professional

00:07:07.300 medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical

00:07:14.260 advice from any medical condition they have, and they should seek the assistance of their healthcare

00:07:19.280 professionals for any such conditions. Finally, I take conflicts of interest very seriously. For all of

00:07:26.800 my disclosures and the companies I invest in or advise, please visit peteratiamd.com forward slash about

00:07:34.580 where I keep an up-to-date and active list of such companies.

00:07:56.800 Thank you.

The Peter Attia Drive - January 29, 2020

Qualy #102 - Is the food industry still saying that all calories contribute equally to adiposity and insulin resistance？

Episode Stats

Summary

Transcript