Dhru Purohit Show - #253: The Power of Plants with Simon Hill

Episode Date: December 23, 2021

This episode is brought to you by BiOptimizers and InsideTracker. We now know that food is medicine, perhaps even the most powerful drug on the planet with the power to cause or cure most disease. If food is more than just calories, if food is information that controls every aspect of our biology and health, then the fundamental question is what should we eat to feel good, lose weight, and stay healthy? This week on The Dhru Purohit Podcast, Dhru sat down with Simon Hill to talk about why we are confused about what to eat, how our food choices affect our health, and the key things we can do today to improve our overall health.  Simon Hill is a physiotherapist and nutritionist who is passionate about making nutritional information simple and accessible, so that people can make informed decisions about the food they feed themselves and their families. He is the founder of the hugely popular Plant Proof podcast and blog, and the Nutritionist in Chris Hemsworth’s fitness app, Centr. Simon is also the author of the newly released book, The Proof Is in The Plants. In this episode, we dive into:   -The benefits of polyphenols (7:19) -How fermented foods impact our microbiome (14:00)   -Personalization when it comes to dietary recommendations (22:10)  -Why the South Asian population is having the highest risk of cardiovascular disease (25:46) -Understanding saturated fat, cholesterol, and heart disease (44:53) -Insulin resistance in the liver (54:10) -Seed oils and inflammation (1:20:25) -Lean mass hyper-responders (1:37:11) -What Simon’s diet consists of (1:51:01) -Understanding how the human diet has evolved (2:00:35) For more on Simon Hill, follow him on Instagram @plant_proof, on Facebook @plantproofnutrition, on Twitter @plant_proof, and through his website https://plantproof.com/. Get his book, The Proof Is In The Plants at https://plantproof.com/book. Check out his podcast The Plant Proof Podcast at https://plantproof.com/all-podcasts. This episode is brought to you by BiOptimizers and InsideTracker. BiOptimizers Magnesium Breakthrough contains 7 different forms of magnesium, which all have different functions in the body. I haven’t found anything else like it on the market. Right now, BiOptimizers is offering my audience 10% off. Just head over to magbreathrough.com/dhru, with code DHRU10.   InsideTracker looks at everything from metabolic and inflammatory markers to nutrients and hormones. Traditional lab tests can be hard to read on your own, but InsideTracker makes their results easy to understand and provides tips on how to use food first for optimal nutrition. Right now, they’re offering my podcast community 25% off. Just go to insidetracker.com/DHRU. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Our overall health is dictated by more than just our diet. But if you look at the global burden of disease study in 2017, poor diet is definitely the number one risk factor. It's the biggest contributor to chronic disease and premature death in the world. Hi everyone, Drew Proet. Today we have Simon Hill on the podcast talking to us about the power of plants. It's a fascinating conversation. Stay tuned.

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Welcome to the Drew Perrault podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Simon Hill. Simon is a physiotherapist and nutritionist who's passionate about making nutritional information simple and accessible so that people can make informed decisions about the food they feed themselves and their family. Simon's the founder of the hugely popular plant-proof podcast and blog and the nutritionist in the Chris Hemsworth Fitness App Center. In 2019, he opened a plant-based restaurant, Eden, in his Sydney neighborhood of Bondi.

Simon is also the author of the newly released book. The Proof is in The Plants, how science shows us a plant-based diet could save your life and the planet. I love having guests on that have a different perspective or viewpoint than I do. And Simon and I don't agree on a lot of stuff, but there's a lot that we also do agree on.

And that's why I wanted to make sure this whole conversation unedited was available for you. Really respect Simon in the world that he's out there teaching folks and highlighting the power of plant foods. And I think you're going to enjoy today's conversation. Stay tuned. Simon, welcome to the podcast. It's a pleasure and honor to have you here.

True. Thank you. It's an honor to be here. I'm looking forward to this. Before we jump into your story and a little bit about what got you into this work, I actually want to geek out on a topic. that you've written about in your book, you've talked about another podcast,

and that I'm a huge fan of. And it's this topic of polyphenols. And what they do in the extent, you know, at one point in time, people were thinking, polyphenols were just lumped in this category of antioxidants and that they would help with free radical damage and other things like that. And as our research into the world of the gut microbiome

went deeper and deeper, We started to truly understand the benefits of some of these phrases, my friend Deanna Minnick, she has his phrase, you know, we got to like strive to eat the rainbow that's out there. So talk to us about polyphenols. Why are they important? And how can we incorporate them more into our life to get the benefits? Yeah, I'm fascinated by polyphenols. And, you know, I think over the last 10 years, as you alluded to, the understanding of the microbiome has,

evolved greatly and a lot of that is is the development of new technology that has allowed us to better look and understand what the microbiome is and so prior to this our understanding of polyphenols was that you know like other phytochemicals they're they're found in these plant foods that are very colorful like anthocyanins for example in blueberries and that you would consume them and they'd be absorbed in the small intestine and enter your bloodstream and circulate for what was thought to be around 30 minutes. However, as we've been able to better understand what's happening in the microbiome, we and also be able to understand what metabolites are

produced by the microbiome. So that is, as the bacteria are feeding on components of our food, they are producing certain compounds. And really, we had no visibility of those until this last sort of 10-year period. Now we understand that only about 5% of polyphenols are actually absorbed in the small intestine. 95% pass through to the large intestine where the 38 trillion-odd microbes reside. And most of these are prebiotic. So we often hear about prebiotics and we think of prebiotic fiber and resistant starch, but polyphenols, many of them also have the capacity to be prebiotic in that they feed the bacteria. And then bacteria is producing up to a thousand different metabolites, which then enter the bloodstream. And unlike the absorption that occurs in the small intestine, those metabolites are, are in the bloodstream for up to 48 hours.

So if you eat a cup of blueberries, those anthocyanins 95% of those pass through to the large intestine and are essentially fed on by the microbes, those metabolites produce will be in your blood for up to two days. And we're just starting to get science that is now studying this at a deeper level, and looking at, okay, well, if we do a randomized controlled trial and we split people into two groups and one group we exposed to a cup of blueberries, for example, very rich in anthocyanins,

and then the other group we expose them to a placebo. We'll match it for sugar, but it won't have the polyphenols, but the energy content will be matched. You know, what, what can we see in terms of health outcomes or certain acute outcomes? So there are a range of studies, for example, that are looking at cognitive domains and have done exactly that. So from children to adults to elderly, looked at what are the acute effects in terms of cognition following the consumption of anthocyanins, this class of polyphenols.

And you can see that there are significant improvements in cognition in that three to six hour window after consuming blueberries. And there are a variety of mechanisms that are thought to explain what these metabolites of the polyphenols are doing. And I think now what we understand, and I think in the next five to ten years, this is going to change a lot. But as it stands now,

it's almost like these metabolites sort of are on the offensive and then they're also on the defensive. So on the offensive, they seem to be increasing cerebral profusion, so blood flow to the brain. And that's thought to be to explain these acute improvements in cognition in that sort of three to six hour window after consuming blueberries. But then on the defensive, they seem to be increasing brain-derived neurotrophic factor and decreasing inflammation in the brain, which line. up with a lot of epidemiological research showing that people who are more regularly consuming berries have a slower rate of cognitive decline. So, you know, that's one example of polyphenols in one food group, right?

But there are many different types of polyphenols broadly classified as flavonoids and non-flavinoids. and so people will be familiar with catechins in green tea or curcumin in turmeric and our citrus foods are really rich in polyphenols and cocoaa and cocoa are in chocolate for example is another one or resveratrol in red wine so I think the main point being here is that we're kind of just on the cusp of understanding what these molecules do for a long time we were kind of, we didn't have the visibility into better understanding their action in the body. And although they're not an essential nutrient like a vitamin and mineral that we need for survival. And if we don't have, we can develop a deficiency and an acute illness. They are

essential for optimal health and longevity. Yeah. So many times we think of food as we're eating this food for us, the human, our human cells, our human DNA. And what's been great to see about all this research around polyphenols that's been coming out. And every day more and more, like you said, we're just at the beginning, is it's just another reminder that there's a lot of things that we eat that are not just for us, that our gut bacteria are driving the show in a lot of instances. And I mean, there's so many areas that I want to take that with you from personalization, to, you know, food sensitivities to so many aspects and we'll get to all that.

But I wanna start off with, I wanna piggyback off of that. And I wanna talk about another thing that's related to the gut, which is fermented foods. I think of fermented foods, especially some of the recent studies that have come out of it, as probably like one of the most underrated category of foods. I'm Indian by background from South Asia. And growing up,

every other meal that we had, especially for dinner, because during the day, you know, we were eating a processed vegetarian food diet. I grew up vegetarian. I'm eating crappy school lunches in America and things like that. And at night, we'd have a really amazing, you know, home-cooked Indian meal. And every other night, depending on my mom's schedule and what she can make, there was always some sort of fermented dish that was there. And then we'd go visit family in India to the state of Gujarat, which I was where my family comes from. and fermented foods are so baked into the culture. And you were often sort of scolded or told,

you know, if you don't eat that, then you can't get some sort of other reward that was there. They didn't know fully why. They just knew it was part of, it was just the intuition that was baked into the society. Yeah. What do you want to say about fermented foods? Yeah, and I mean, there are many cultures around the world.

In South Korea, there's kimchi, for example. And, you know, you know, know, intuition is incredible, right? And I often talk about this. It's science is our method to test intuition. And, you know, I think you're alluding to a recent study that came out of Stanford University led by a group of researchers, the Sonnenbergs and Professor Christopher Gardner. These are kind of like the dream team researchers. If you were to get any researchers around the world to ask this question, how to fermented foods affect our microbiome and particularly our immune system. These are the researchers you would want to do that study. And they were really interested

in looking at the differences between fiber and fermented foods on the diversity of microbes and also on markers of inflammation. Really looking at how do foods modulate the immune system. And we know from a range of studies that healthy people tend to have a more diverse microbiome. And people with chronic diseases, metabolic disorder, and other illnesses tend to have a less diverse microbiome. So the kind of hypothesis was that if you feed people more fiber, you'll increase the diversity of the microbes. And they weren't 100% sure with fermented foods, but we kind of do see fermented foods as this probiotic rich gut health food, so they were interested in seeing what would happen. And they enrolled 38 subjects, so not a huge study,

but this is a very highly controlled study. And they split those people into two groups. one group took their fiber intake from around 20 grams a day up to 40 and the other group added fermented foods to their diet and they actually added six serves of fermented foods which is a lot right it's it's i don't think i've ever had a single day where i've had six serves of fermented foods a serve being about a quarter of a cup of kimchi or kraut or one glass of kefia for example And these two different groups that were put into the study, they adopted that the given diet that they were randomized to for a 10-week period. And the researchers were taking stool samples at the start and along the way and measuring these markers of inflammation as well. And they really found some very interesting things.

and I think this is quite instructive actually. I find it instructive in terms of feedback I get from clients that I deal with on a one-to-one basis. In the fiber group, they actually didn't see an increase in the diversity of the microbes, which was very surprising. That was on the aggregate, on the average. and in the fermented group they did see across the board an increase in diversity exactly what we want to see what we believe is associated with improved gut health and from an inflammation point of view in the fiber group there seemed to be a very personalized response some for some subjects adding more fiber actually increased inflammation

Whereas for others, it decreased inflammation. In the fermented group, across the board, the addition of those fermented foods reduced inflammation. Specifically, 19 inflammatory proteins were reduced. So the outcome of this study, and I guess the key takeaway points here for now, that fermented foods seem to be very beneficial for promoting diversity of the microbiome and for reducing inflammation. But six serves a day, I'm not sure how achievable that is for everyone. And they didn't study two and they didn't study four.

And this is a trick in science, actually, if you're looking for funding. At the start, when you first go for funding, start with something that you are more likely to see a significant effect with. Of course, six serves. Moderate effects don't really earn a lot of attention. And when you do that, you'll get some attention, you'll get some media, and also you'll have a good reason then to go back and get more funding later on to test four serves and two serves. And, you know, researchers love funding. So that's a bit of a strategy that they have up their sleeve. And then on the other side, on the fiber group, the researchers went back and they thought, you know, why is this person who increases fiber?

why are they actually seeing a reduction in inflammation, but this person here is seeing an increase in inflammation? What may explain this? And they were able to go back and look at the baseline diversity of the microbiome, and they saw that those who actually, who did well, had good diversity at baseline, so a sign of a strong gut. Those who did poorly had low diversity. So perhaps they'd been eating an ultra-processed diet for many years. Perhaps they had a history of significant antibiotic use. You know, the list goes on, the things that they could have been doing to contribute to that.

But it is instructive because it often we do here, and I know I certainly hear when someone goes to increase their fiber in their diet, it doesn't always work for everyone. And that's not to say that fiber is bad for them. It might just be that where they are right now, they need a few extra tools and tips. to help them increase the diversity in order to be able to tolerate an increased amount of fiber in their diet. Yeah. And that really sets up this idea that I'd love to talk to you about, which is, you know,

in the book, which is well outlined and well referenced and everything. And that's kind of like your thing, right? Like you are making sure that all the recommendations and suggestions and the controversial topics you dive into, saturated fat, you know, dairy. fish and omega-3s and everything like that, that you back it up and you talk about the weight of different evidence that you link to, I'd love to talk to you about how you see personalization in the context of giving people dietary recommendations overall, right?

So we know broad spectrum strokes that are out there. And then where does personalization come into it when it comes to how much fiber, saturated fat, fish, not to have this to have. I love this question. I think this is a great question. You know, I think that often I'm asked whether science has really understands what a healthy diet is because you see one headline one day and then the next you see a completely different headline. And you can kind of understand how the everyday person out there is left thinking, well, science actually doesn't know anything.

and then they just end up, you know, sticking with what they know. And I don't think that's right. I don't think that the science is confused. I just don't think it's completely black or white, and there is some nuance in there. But overall, there are some very consistent findings that do define what a healthy diet is. And rather than that being some sort of label that we kind of come up with, the dietary label, it's more of a theme, a set of characteristics. And this is consistent in all of the major guidelines,

whether you look at the American Heart Association guidelines, for example, that came out two weeks ago or guidelines in Europe. These are diets that are low and saturated fat, they're rich in unsaturated fats, they're high in fiber, and they're low and ultra-processed foods. And that can sound quite vague, and you can achieve that in a number of ways. There are a number of different variations.

It could be a well-done paleo diet. It could be a well-done Mediterranean diet. It could be a vegetarian diet. It could be a well-done vegan diet, whole-food plant-based. So I don't actually like to sort of point to one diet being the single best diet for health because I don't believe science has shown that. It shows this theme. And your question around personalization, I think,

is really is really interesting because my view is that we are going to be seeing more and more tools coming out that really do help us with personalization so we can look at blood glucose we can look at lipids in the post-pranidial period we can look at our microbiome you know there are a lot of companies out there that are emerging not sure if the science is completely there yet but they're getting there and they're building data and so it will only become more refined and more specific as we go on. I don't think that those tools and companies are going to change what we understand about a healthy theme or overall characteristics of a diet. But what they might do is they might give you specific feedback within that theme, hey, you know, you're better suited to these types of legumes

or you're better suited to a little bit more fat in your diet. So I see them as a way of being a little bit more granular within that overall theme that has been clearly established and is a theme that we know is associated with lower risk of cardiovascular disease, neurodegenerative disease, type 2 diabetes, obesity, etc. You know, I mentioned earlier, and I know you have connections to this too and I want you to share a story in a second. I come from the South Asian population in America,

the South Asian community, you know, Bangladesh, Pakistan, India, that sort of thing, but specifically the subclassifications of individuals from India, which is a high percentage of people that are vegetarian, have the highest cardiovascular risk of any ethnic minority in the United States, so much so that, you know, Stanford has a whole school that's there to, you know, to look into it. And again, not everybody in that category is, you know, everybody eats differently. And there's a lot of other markers besides just diet, right?

It's generally a sedentary population set that's there. High stress environment. You have a lot of individuals that themselves might be, you know, doctors or professionals or other things that are there. There could be some genetic components that are at play and even some insulin resistance. that, you know, a population that has a high level of insulin resistance. So I used to look at that, you know, growing up, I was raised vegetarian, and I would see that, you know, a lot of people that were there, you know, in India, when you go to, like, the

rule side and other stuff, people are lean, they're working out, they're on the fields, other things, like, they look great. And even my grandmother and my dad remember his grandmother and great-grandmother, like they would be squatting at the age of, you know, 80, 90 years old, you know, sweeping on the floor, doing things. There's a lot more movement. And as our mutual friend Dan Butner has talked about in his book, the Blue Zones, there's so many things besides you just died alone that plays into those things. But I did pay attention to that society growing up.

And I thought, you know, this is a group that is low saturated fat, right, comparatively speaking. They do have saturated fat that comes in from ghee that was there. largely had moved over to vegetable oil because there was so much fear inside of that population that was there. A good amount of vegetable quantity that was there. Unfortunately though, very sedentary lifestyle, probably a lot of high stress.

Do you think that could be some other things that are at play why that population set was still having these increased risk, the highest risk of cardiovascular disease? I don't know how familiar you are with that population. said or not, but just getting you to, you know, tossing your thoughts into the mix. It's a great question. I mean, we definitely need to understand that our overall health is dictated by more than just our diet. But if you look at the global burden of disease study in

2017, poor diet is definitely the number one risk factor. It's the biggest contributor to chronic disease and premature death in the world. Specifically to that diet, look, you know, I think a lot of Dan Butner's work has clearly shown that the change of environment overall has a significant effect on our chronic disease risk and longevity. You know, I would need to dig in and see what when someone's reducing saturated fat in their diet, what really dictates their risk of cardiovascular disease and incidents or mortality is what it's replaced with. And so I would really need to look at that specifically.

I know you mentioned there, vegetable oils, but it would be interesting to see specifically the amount of ultra-process or more refined grains that are in that diet. We know clearly from a large amount of science, both observational and randomized controlled trials, that when you do swap saturated fat for polyunsaturated fats, you do see a reduction in coronary heart disease. So I would be surprised if their saturated fat intake was down well below 10%, which seems to be that kind of threshold.

When you get down below 10% compared to above, that's when you see a reduction in risk. But I would be very surprised to see that they have super low saturated fat intake, high polyunsaturated fat intake, high fiber intake, and are still that significant. higher risk of heart disease. Now, that said, one thing that's important here is often just comparing population to another population can be deceiving. What we'd need to do is go into that population and look at, okay, within that group of people who have the same exposures to all these different aspects of their lifestyle, let's compare those that did get their saturated fat down really low to those that are in that same population with higher saturated fat. And can we see a difference between them within that population. So there's probably a few things in there

that I'd need to look at specifically. But across the board, even though saturated fat seems to be still debated a little bit, you know, I think it's, it's reasonably clear that, you know, it's not the be all and end all at all. But I think the guidelines are good that do suggest lowering it down below that 10% of total calories. And consider, what you're replacing it with. If you replace saturated fat with refined carbohydrates or trans fats, then there's no change in risk or you may be increasing risk of heart disease. And we see that in certain populations around the world. But if you replace it with polyunsaturated fats, mono-unsaturated fats, or even whole grains, you see a reduction in risk.

I definitely think that population said there's a lot of refined grains that are there. And it leads to a lot of pre-diabetes population, even if people are not at pre-pre-diabetes, right? I mean, most people don't even really know that they're in that pre-diabetic range. That can increase the overall levels of inflammation inside of the body. Definitely. I think that the most instructive thing for us here, we could look at this at some point and touch base on it, is that within that population, look at those with lower saturated fat compared to those with higher and see if there's a difference in the outcome.

I'll connect you with the Stanford has a South Asian heart department because it's been such a big issue in that population. And it'd be very curious to see, you know, for them to go down that pathway. Anyways, enough about my story. Let's talk about your story. Talk to us about your life growing up and your father and how his health crisis was a big part of what took you down your path. Yeah. I grew up in Melbourne, actually, the first few years of my life, and then we moved actually here to the States.

I lived in Texas. I learned to speak in Texas. I had a Southern American accent. You probably can't imagine that now. My dad was doing his PhD in Texas in physiology, and he was very interested in micro-circulation and looking actually at what happens to our blood vessels. when we develop type 2 diabetes and cardiovascular disease.

And we moved back to Australia when I was about 10 years old. And on weekends, we would spend a lot of time, dad and myself and my brother would spend a lot of time outside of Melbourne in a wine district called the Yarrow Valley. And this was just more of a kind of way to bond and drive around to these different small winery. speak to the winemakers and have some fun together. And on this one particular day, just my dad and I,

we had a great day together exploring a few different wineries. We were driving home. And my dad started to get some chest pain. And I could see that he was uncomfortable. And I inquired to check that he was okay. And he reassured me, you know, everything's okay. I have a bit of chest pain, but I think it will be okay. And we proceeded to go home and cook dinner, and I checked in again, and he said he was fine,

and I actually went off to bed. And not too long after, I was woken to some noise, and I thought I better go and check if he was okay. And I came out, and he was like clamoring on his way to, to, make him. make a phone call to the paramedics. Triple zero in Australia is the L number for 911. And he actually had called them and he handed the phone to me to help describe the situation. And I spoke to the paramedic and explained what was happening. By then he was pale.

He was out of breath. And it was really the first time that I'd ever seen my dad scared. I could see the fear. You know, it was, it was beyond the point where he could now deny it. And they said, look, you're very remote where you're located. We were about, you know, an hour out of Melbourne, and there was no hospital that close then. So they asked me if there was enough room to land a helicopter,

and there was luckily a grass sort of patch out the back. And before I knew it, a helicopter came. They swept him up off the ground, put him on a stretcher, checking his vital signs, connected him to oxygen. And off he went. I couldn't fit in the helicopter. So I was told that I would just trail by road in an ambulance. And so I did that and it was a very long drive to the hospital. I had called my mother and brother by that stage. They were staying in the city and had told them to come and meet me.

and that this was what was happening. All of this was happening extremely fast. And I think for context, it's important. My dad was 41. And he had no prior diagnosis. He wasn't on any medications. He wasn't relying on the healthcare system. He just looked like a sort of young father who was reasonably fit and healthy.

He would go to the gym three, four times. a week, perhaps a little overstressed from work and eating, you know, what I would say is the typical Australian diet, not an overly, overly processed diet by any means. So it was very unexpected and out of the blue. And we went to the hospital, we waited and waited, and the doctor came out and explained to us that my dad had had a severe heart attack, which was, you know, a big shock for us given his age and however they had saved his life which you know was a huge relief for us and the the doctor said look tomorrow you'll have a meeting with the cardiologist as a family a kind of debrief and we can explain the prognosis so we went back and had that meeting and you know I can

remember this this meeting you know vividly going in there and sitting down with this cardiologist and it was only a 10 or 15 minutes sort of time that we had explained what had happened to my dad's heart and had taken my dad's history and my dad's dad's dad, my grandfather had also had a heart attack. His was when he was 61. So had to explain that this is in our family and sort of gave my brother and I a bit of advice that where, you know, I was 15 and my brother was 18, you know, you're nearly young men where you practically are. This is a something that you will need to keep an eye on and be screened for because cardiovascular disease clearly runs in your family. And that was that. And so we kind of just all went back to living

our lives as we were. No real examination of lifestyle. And I and my brother both really thought that, you know, our sort of genetic card that we've been dealt is, you know, weak genes when it comes to cardiovascular disease and and this is going to be something that we will likely have to deal with like our father did at such an early age. And that's, you know, very disempowering. And so it was a number of years sort of living like that without questioning how much control we actually had until, you know, I had done a lot of research and did my master's in nutrition and saw that we actually do have a lot more control, a lot more to say in terms of our health fate and that even if we do have certain genetic predispositions that predispose us to cardiovascular disease or to type 2 diabetes,

that doesn't mean that is our fate. There are things that we can do that change the trajectory, the course of our life and ultimately how healthy we are and things we can do to say healthier for longer and there are a bunch of different studies looking at identical twins, for example, that exact same genes have lived in different environments and have been able to tease out, well, how significant are one's genes, typically speaking, compared to their environment? And it seems that genes probably dictate around 20% of your health fate

and your environment and the decisions you make day to day about how you're navigating through life, what you're eating, are you exercising, how you're sleeping these things, control about 80% of your health fate. So you have four more times control than your genes. Of course, there are, you know, very rare genetic variants where, unfortunately, no matter how someone lives, their fate is determined by their genes. But what I'm talking about is these chronic diseases of type 2 diabetes, of cardiovascular disease, fatty liver disease that we've essentially accepted in our societies and normalized, it doesn't have to be that way.

In the case of your dad, because that sends you down a whole rabbit hole, as you mentioned, you got your master's, you went down this path, you know, I think it was your brother first who started to change his diet a little bit, and then you started to change your diet. And we'll come back to that in a second. But looking back now with what you know to kind of put a button in that story, did your Does your family have any of the classic sort of genetic markers that might be associated with increased heart risk? And of course, from the lifestyle lens, diet, sleep, working out, what were some of the things that you think looking back now were the key contributors to what led to your father having a heart attack at 41 years? Well, his cholesterol was high.

His blood pressure was high. So there's two big risk factors straight away. And did he know, just asking, did he know that those things were elevated? No. He didn't go in for an annual physical, like he didn't go in for, or he didn't pay attention to it. You got to remember what's considered normal, for example, for LDL cholesterol or APOB, if we wanted to even get more specific, is at a level where people are developing arthroschlorosis. So, for example, in this country, LDL cholesterol, the average sits at about 130.

And 100 is considered optimal. But there are a plethora of studies that have shown that even at 100, around 40 to 50% of people are developing atherosclerosis. And it's not until you get your LDL cholesterol down to 70 milligrams per decilator, which is about 80 milligrams per deciliter for APOB. ApoB, I'm not sure if you've spoken about that on this show that March. We've talked about it. You've talked about it.

We talk about it. That's, you know, that's, we talk about LDL cholesterol, but really measuring LDL cholesterol is kind of just a surrogate marker for how much APOB there is, because around 90% of the APOB lipoprotein, which is the atherogenic component. It's what causes the particle to get stuck in the intemar. About 90% of that is usually found in LDL particles. So you can measure LDL cholesterol and get a good idea for how much APOB there. is. But it's not until you get down to 70 milligrams per decilator of LDL cholesterol

where you see people are not developing atherosclerosis. And interestingly, this is something that Lauren Cordane has written about, who was the author of the Paleo Diet book, and he's very aware of and published, he's published a paper in 2005 that is titled, The Optimal LDL cholesterol level is 50 to 70 milligrams per deciliter. And he goes in there and talks about how the current accepted LDL cholesterol level, the optimal level, is too high. People are developing plaque build up in their arteries at that level at 100 milligrams per deciliter. And at 130 milligrams per deciliter, which is the kind of average in Australia and in America, that's double the level where you do not see atherosclerosis.

So my dad was operating with a higher than normal LDL cholesterol. I think that if he had his time again, he probably would have made some lifestyle changes to bring that down. His blood pressure was also a little high. And that does seem to run in our family. My grandfather has high blood pressure or had high blood pressure. or had high blood pressure. So, you know, I think that like a lot of people, and particularly males, even if you're

getting your annual physical, you're not paying a lot of attention to it or you're not even doing annual bloods. And so there can be these different risk factors bubbling away under the surface that are predisposing you to a disease. And then if you throw on top of that some genetic predisposition, then, you know, these things can happen. You know, some of that you were referencing some of these studies. And I think one part of evidence-based medicine is also clinical experience, right?

Like the clinical experience from doctors and things like that. I'm not a medical doctor myself. I know we've had some people on a podcast that come in and say, okay, you know, cholesterol, LDL, great. And one other additional layer that we have to look at is we want to look at lipid particle size, right? NMR testing. And we're also looking at overall CRP to see how,

is the inflammation going and maybe a little less worried for patients who cholesterol bumps up if they feel like they can handle a little bit more fat, as long as their inflammation is staying low and their particle size of the cholesterols that are there are on the higher end versus the lower end. Anything that you've come across while you were writing this book together about those components? Yeah, I'd point everyone to a paper written by the cardiologist, Brian Ference. It's part of the European Cardiovascular Society guidelines in 2016. because he goes into this in detail, and I think this is really important for people to understand, is that often when you speak about high cholesterol being a risk factor, I do hear, well,

my HDL is high, or, you know, but I don't have oxidized LDL, for example. Or, you know, what about particle size, large, fluffy versus small dense, for example? and we have enough science to show that even when you adjust for those, and what I mean by adjusting is that let's say we're looking at someone with higher LDL to someone with lower. When we adjust for particle size, which means we're removing that as a variable, we're not going to compare people high LDL versus low LDL who have different particle size. We're going to remove that. So we're only going to look at people with the exact same particle size.

we still see that LDL cholesterol being higher increases risk of coronary heart disease. And that's what this gentleman wrote about. So he's done his own studies. This is, this is completely summarized in that guideline paper. And that is why, you know, despite some of this stuff that you'll hear online and on Twitter about oxidized or about large fluffy, and don't get me wrong, large fluffy can modulate the risk. But it's, it's not like if you have high LDL and it's large, fluffy that you're not at increased risk compared to having low LDL. You would be at much lower risk at low LDL, regardless of the particle size. That is so clear in the literature.

And so, you know, that's a good paper for people to go and look at. And I think to add onto this, you know, because sometimes people will say, well, you know, I've adopted this diet and I've lost weight. and my APOB has shot right up. And when you say this diet, you mean like a higher fat diet. Yeah, it could be a high, well, yeah. Like a higher fat diet that's saturated fat. Yeah, you can do, we could talk about,

I think you can do a keto or a low carb style diet in a way where you're not jacking up your APOB. For sure. And so I think there's a way to do it in a really healthy manner. Well, I think one thing that's there is that, I mean, some people, my brother-in-law, he's a cardiologist, he's a functional medicine doctor based in San Diego. and, you know, there's because, because heart health is such a big thing in our South Asian population,

he's also Indian too. There's very much just understanding that like high LDL is something that we want to stay away from, right? There does seem to be, him and I both did go on an experiment a few years ago where we went, let's say, higher saturated fat. His lipids headed in the right direction. My lipid's headed in the wrong direction. My LDL went way up and I also noticed, actual changes in my body. I felt more inflammation, other things like that. And when I was talking to a few of the folks that have been on this podcast,

you know, they were like, look, you have to understand that saturated fat for some people that especially have like higher amounts of saturated fat that are coming from grass-fed B for MCT oil or other things like that, for people especially that have had a history of antibiotic usage or other things

besides your own unique, call it genotype, phenotype, whatever you want to add in the mix, there's people that are not going to do well on that. And I significantly dialed back the saturated fat of my diet. And I've actually felt better. Forget about my lipids.

They improved too. My LDL came down, everything like that. But I actually noticed less inflammation in my skin, less redness in my skin. And my brother-in-law is over there trucking along and his LDL and his particle size and everything is staying in the, in the right direction.

Now, I would have to dig a little bit deeper to get to you what is his total percentage of overall calories that come from saturated fat. Besides just doing mathematical math on it, is there any other way to recommend? Well, I mean, saturated fat, let's also remember it's an umbrella term. There are lots of different types.

So we could be talking about pulmitic or, for example, which will increase cholesterol. Whereas steric acid, which is a saturated fat predominantly found in foods like chocolate, for example, doesn't increase cholesterol. And MCTs do not appear to increase cholesterol. Coconut oil does, but that has a lot more loric acid, which some people will say is not really an MCT, but pure MCTs do not seem to increase cholesterol. So there is some nuance here.

If two people do a diet, high and saturated fat, what foods are they eating? Is it the same type of saturated fats that they're being exposed? to. We know, you know, typically in most people, the saturated fats in red meat, for example, will have more of an effect on cholesterol than those in dairy. But, you know, there are a number of instructive studies that have looked at exactly this, like Bergeron in 2019. This study looked very clearly at three different groups, red meat, lean red meat, actually. actually, lean white meat and vegetable protein, plant protein, legumes, for example. And they were able to show very clearly in this study that even though they were lean,

lean types of meat, red and white, those people that were consuming the plant proteins saw much greater, significant reductions in LDL cholesterol and APOB. Now, back to our personalized point that we made. earlier, there may be some genetic differences where certain people can eat a little more saturated fat and doesn't have the same effect on their LDL cholesterol or APOB. These studies are aggregates, averages. So, you know, we have these rules of thumb, eating more unsaturated fats and plant protein and more fiber for reducing cholesterol. But certainly people need to be doing their labs and looking at, well, what's actually happening to them. Yeah, it's one of those things that I'm just so glad that

as, you know, I think your book is trying to cut through the confusion, but as confusion, as much as can, listen, I'm confused at times, right? Like, there's even times where I'm trying different personal experiments. And again, I don't have a master's like you. This is not my full-time thing. I'm just trying to interview the people and ask good questions that are out there. But I am a partner at a medical clinic and I see how those functional medicine doctors approach it and I've seen it go both ways. There's people that do really well on a, you know, there's these classes. underlining things, getting away from ultra-processed foods, having a ton of good quality plant fibers inside of the diet, having a wide array of the colors of the rainbow, minus some exceptions that might be there for unique challenges that people are dealing with with gut sensitivities in particular. And then once that's healed, then being able to eat a lot more variety, a lot more variety. And I've been vegan before. I've been a raw foodist before. I've done vegetarian and I just try to run these personal experiments where I'm just looking through, but at least I know those base things to be true. And then the other layer that I add on that

is that keeping my, because insulin, because being insulin resistant is something that I think that my population said deals with more so than other people, keeping a watch on things that jack up my average blood sugar to a level where I don't feel is optimal. But I still, outside of that, I definitely still get confused sometimes, right? I know you don't. I mean, I certainly still do. And I think anyone who says they don't get confused at all is lying or they're not looking deeply enough at these topics. Because, yeah, for sure. I mean, I'm constantly trying to stay on top of the literature and make sense of things. And not every Everything is completely black or white.

You know, insulin resistance is a big, interesting topic in and of itself, but it kind of ties into what we're talking about. Yeah, yeah. Do you want to chat about it? You know, there, I think a lot of the time, we shoot the messenger with insulin resistance because someone who's insulin resistance, they have a banana or some type of carbohydrates, have poor blood glucose reading, fasting glucose or post-pranedly. And we tend to blame carbohydrates for that.

But the literature is pretty clear. And some of this ties into fatty liver disease and insulin resistance in the liver. And there was a huge review just published in 2020 that looked exactly at this and looked at human clinical intervention studies and looking at insulin resistance in the liver. And this is important because as you become more insulin resistant in the liver, you can't turn off the glucose that's being produced in liver and going into the blood and you end up with higher fasting blood glucose. This review really showed that it was essentially looking at different nutrients, saturated fat and carbohydrates, refined carbohydrates, fructose, high fructose corn syrup,

for example, and was looking at how do these differentially affect insulin resistance? and they were able to clearly show, and again, these are all human clinical intervention trials, that when you feed people in a calorie surplus, both refined carbohydrates and saturated fats will increase insulin resistance. But if you are feeding people at maintenance calories, so the amount of calories that their body requires on a daily basis, not putting them into a surplus. The refined carbohydrates did not increase insulin resistance in the liver, but saturated fat did. So I think sometimes when I see this discussion around insulin resistance, my view is that this fatty build-up, so hepatic fat in the liver, or if we're talking about fat in muscle

cells, ectopic fat is what it's called as, is primarily coming from an excessive consumption of calories, but can also be driven by saturated fat. And even though we see the metabolic marker where we're looking at is fasting glucose or post-pranidial blood glucose, we are shooting the messenger. Those carbohydrates can't get into the cell because of ectopic fat. And I've spoken with Dr. Nicola Guess about this, who's doing a lot of research in this space. And I think her work is consistent with what I've just explained, that primary driver being excessive calories. But if we were to start looking at individual nutrients, we would probably be zooming in more on saturated fat than anything else.

Yeah, this is the confusing part is that when people come into our clinic or let's say any doctors working with the patient of, you know, like one of the earliest indication in men that maybe that there's some insulin resistance going on is like, is erectile dysfunction, right? And one in women is often PCOS. And so it's great to see the approach of how do people traditionally, like an integrative functional medicine doctor, regardless of what their views on dietary stuff are, some of vegetarian, some of this, some of that, it's always interesting to see what the approach is to address, like how do you address that? Like, how do you address that, you know, erectile dysfunction? How do you address? You know, erectile dysfunction? How do you address that PCOS that somebody's dealing with. And it's often getting them off of ultra-processed foods, which helps on both sides,

getting them off of refined carbs and saturated fats. Yeah, we should. That's a great point because that's often overlooked, right? We've often ultra-processed foods are sort of used synonymously as refined carbohydrates. Oh, there's a saturated fat too. Totally, totally. So there's that component. There's generally of an approach of getting.

the better quality fats in the diet, which naturally, even if the tension isn't to reduce, and again, there's different types of saturated fats, as you mentioned, getting better quality fats in the diet, olive oils, fish, which we'll come back to in a little bit. I know you have some comments on that. And then there's also just reducing the total sugar intake overall, which, let's say if they're using a continuous glucose monitor or anything like that, they're going to, they're going to be indifferent, whether it's your Starbucks for after you know, or whether it's you having, you know, tortillas in the day that are bumping you up and you're just cataloging it all. And that approach within a very short period of time, you know,

30 to 90 days typically is the approach where, you know, people start to see a reversal in symptoms that are related to that. And, you know, all of that is consistent with the literature. I don't think that's really in conflict with any of where I'm coming out. No, no, it's not at all. I think the thing that it was added as a layer is that I wonder, you know, and I'd love to hear from you is like, what would be the best beautifully designed study that would parse out the difference between those two, right?

Because like, I would love to hear you that because I see it as like a little bit of both. I see what seems to consistently work is that people are reducing their overall sugar intake, which includes some of the refined carbs, and they're reprioritizing the fats and getting people off of trans fats and ultra-processed foods. So it sounds like it's a little bit of both.

Is it fair to say that it's more saturated fat or it's more carbs? It kind of seems like it's both of those things. Well, it's tough in that scenario because I imagine a lot of those people reducing ultra-processed foods. There's a lot of weight loss. And really a lot of the improvements

that you're going to see in insulin resistance are driven through the reduction in weight. So to tease out what you're talking about, you would want to remove, eliminate weight loss from this as a variable and look specifically at modulating nutrients. So looking at one group who is significantly reducing their refined carbohydrate intake, the other group significantly reducing their saturated fat intake, but keeping total calories equivalent. Would be the way to kind of tease that out. But I believe that there is some research that has looked at that.

And, you know, even to date, if you look at type 2 diabetes, for example, I believe to date, the only trial that has shown improvement in insulin resistance without weight loss is a high carbohydrate diet. And that was done back actually in the 1970s and hasn't been reproduced, which is something that should raise a few alarm bells. But if you look at the big, big trials like the Verte Health Studies, for example, low-carp diets, you know, weight loss is probably the primary factor that is seeing the improvement in, you know, various biomarkers and reduction in medications.

Have you ever experimented with like a continuous glucose monitor yourself, or do you recommend them, or do you feel like that is taking us in the wrong direction of what people are paying attention to? No, I'm open-minded about those. I know that that seems to be a charged topic sometimes online. I see different people with different opinions about them. Actually was sent a kit from a company called Zoe. They haven't paid me anything, but I have received this, so I thought I should mention it.

I haven't used it yet. I have this kit. They send it to me while I'm here in the States because you can't do it in Australia. So that has a CGM in there and has like a microbiome stool test and whatnot. So I'm looking forward to seeing what information. it provides. Is it adding more confusion? I don't think so as long as the information to the person using it understands how to use it and how to use the data that it produces. So, you know, I don't believe there's any evidence to suggest, for example, an increase in blood glucose or insulin

in the post-pranidial period that is within the physiological norm range is problematic. Sometimes I'll see online people suggesting that the goal should be to completely flatline it. So I think we just need to understand what is the data producing. And then when we look at all of the overall science and literature that we have on that biomarker, what does that mean to us? Now, is that hard for the everyday person? Perhaps if, but I think these companies can support them and help them make use of that data. Yeah, I'd love you to meet Dr. Casey Means.

She's been on the podcast before. She's also outside a little bit of fish inclusion in her diet. You know, it's very vocal about being plant-focused with her approach. Yeah, I've heard her before. I think I heard her on this show. I think the stuff she's doing is great. Yeah. And the thing that I feel like that we've gotten a chance to dive into,

and again, you guys would have a much better understanding of the research than I would, is that it seems to be a lot of strong evidence that high variations in glucose are directly upstream tied to the downstream effects of ultimately leading to lowering that insulin sensitivity that we all want inside of the body and building more insulin resistance that's there because your body's constantly having to recalibrate comparatively to eating again, however you want to do it. You know, she's more plant-focused, which I appreciate that approach. And she's talked about how she does it, including beans and good quality carbohydrates

and everything like that. But it seems to be that the goal is not to flatline, but not to have these Krailey-Z roller coasters, which are very typical of also the sort of processed American or Australian diet that's out there. Yeah, I mean, I would agree with that. And that can affect your appetite and how you feel in the post-pranidial period as well. I guess where I was going with the flatlining is more in the ketogenic community, I think. I think it can be a little deceiving as well if you go on a very extremely high fat diet without any carbohydrates.

are you actually improving insulin sensitivity? Or are you just removing carbohydrates, and so you don't have to worry about that as a problem. But I think if you challenged most of those people, they would be insulin resistant. Depending on where they are from a weight point of view, sure, if the ketogenic diet allowed them to lose a lot of weight, then their insulin sensitivity would improve.

But if they're just at a sort of maintenance level, I would suspect that many of them are insulin resistant, and I actually know quite a few people with type 1 diabetes who are really the perfect model for this because they know how much insulin they're actually injecting, who, after a fairly long period, three, four, five months on a ketogenic diet, do notice they have to inject significantly more insulin.

So I guess my main point around these CGMs is, I think there is potentially a place for them, but we really need to be guided by very good quality science. And the education piece needs to be there. Or my fear is they'll be misused online, you know, where you can show, for example, have a bacon and four eggs compared to, you know, oatmeal with some berries on it and on a, sort of comparison chart, you could show that the bacon and eggs is more of a flat line and on the right is an increase in glucose. And I'd see this online all the time. And you can kind of make it out, well, look, on the oatmeal, you see the glucose go up and that's a problem. But really, that's not a problem. We need to, we need to help people make sense of these tools

to then really either for themselves or if they're a health professional, make good recognition. recommendations and choices. Same thing with alcohol, right? I mean, like, not every alcohol, but like if you drink, you know, wine, you're not going to see a big bump. And of course, everybody knows that alcohol is not ideal and is a neurotoxin. And so just because something doesn't spike your blood sugar doesn't mean that it's something that we want to be eating all the time on a regular basis.

But I do think that it's part of a trend and where I was going before of some of the good side of this confusion and this attention that's there is, number one, people are suffering more than ever before in the history of humanity and there's more awareness that they're suffering when it comes to this aspect of health, right? We're not living in our natural environments where a lot of these things were sort of baked in and before like the industrial age that was there. So that's led to a deep curiosity. A lot of people have questions. I think that's a great It's amazing. It's a great thing. It's a great thing. It's a great thing. It will push it forward and help us tease all of that out. I don't think it should distract us from, you know, I don't think we're at a position right now in terms of big picture, this, the chronic disease pandemic. It's not like we don't know what to do. We just can't do what we know. And it's our environment that in many ways needs. to change. And so while all of this new technology and stuff, I think is super cool and for personalization,

it's fantastic. None of this will really matter if the overall environment like Dan Butner talks about does not shift. And we have to shift it in a way where the convenient, delicious, healthy, affordable choice is the healthy choice. And these are the foods that people are eating more regularly and we're shifting people to that theme that I described earlier, when we're doing that on scale, which really requires a lot of thought and a lot of regulation and just changes to the way we've set up our society, that's when we'll squeeze chronic disease out of society. I don't think that the fancy tools are going to be enough because you can give people as many tools as you want, but if their environment is set up in a way where it's designed for them to

fail, it's going to be very hard for them to succeed. I a little bit disagree with you, and I'd love to chime in. I think that for the, I mean, we're talking about like the whole population of the world. I think food, and I'm not talking about the current tools that we have access to, I actually think that the only solution out of this is technology. And I'll tell you why. I think food is so addictive, I think it's harder to change your diet than it is to change your religion. And I think that sugar is so addictive. And I think that sugar and fat in combination is so addictive. And I think that we live a life of luxury where you and I get to like study this stuff and the people that are listening get to hear and make these changes. And I think that willpower, which of course

can get you started, but is not the ultimate thing to keep you going, is so tough that if people don't have some recognition, of are they head in the right direction, supported by the science, right? Just like you're talking about earlier, it's, I think it's going to be too difficult. I agree, it's not about willpower. I would agree, it's not about willpower. And I think also, I'll add him one more thought

before you chime in. I think also this idea of making the connection between what you eat and how you feel on a daily basis, just even like going back to like your dad's story, right? it's not enough feedback for most people to know. Like your dad, from what I've heard from other interviews, he was kind of not feeling like the best for a little while before. It's not like he felt perfect health.

Would you say so? Or you correct me if I'm wrong. No, no, he was good. He was, yeah, he may have been a little stressed and overworked, but yeah, he was healthy. He was healthy going into that. Okay. So I guess my definition of what I mean by,

that health aspect is that it's very rarely that you, in the truest sense of mental cognition, right? Like it's not you go from zero to heart attack. Most people are gonna experience stuff a lot of things along the way. They're gonna notice a little bit of decrease in, you know, could be immunity, could be for men, it could be erectile dysfunction,

could be a lot of different things that are kind of like markers along the way that are there. But most people don't know that, and they're not gonna know even to look for. So I think that if we just tell people what to do and it's primarily based on education alone without the intervention of technology, I just feel a little skeptical that that and it's set that that people making decisions on their own without the help of tools is it's almost a luxury. I'd love to hear your thoughts against that. I think feel free to disagree with everything

that I say. No, I agree with what you say. I think maybe I didn't really explain what I, what I meant clearly enough. So I don't believe this is about education on an individual level or collective willpower at all. And that can seem funny for someone who writes a book. I say in the book that, let's look at smoking, for example, we knew from the 1940s that smoking was increasing risk of lung cancer. It took until really the 70s and 80s for legislation to come in. There was taxes. It was changing in advertising, and by that state, doctors were now recommending people not to smoke. It took three, four decades from the science to those changes to actually come into place. And so there was a long period of time where if people were able to get good information,

they could make change, and they didn't end up with lung cancer, and they lived for longer. So education in the book for me is about giving people information now, who are privileged enough to be listening to this podcast or by the book to say, hey, the food environment is not going to shift overnight. So you are going to need to navigate in this tricky environment and make better decisions if your health is important to you. Where I was going with what needs to happen to really squeeze chronic disease out of the society is not that. It is actually legislation changing, physically changing our cities. and our food environment, stopping marketing of junk food to children.

We're getting them addicted from the beginning, stopping these ultra-processed food companies from sponsoring all of the sports stars and the advertisements at half-time that all these young children are watching and they're seeing their idols associated with these junk food brands. It's about changing the way that the foods show up on the shelves at the grocery stores, both by increasing the availability of healthy foods, but by making those less healthy foods less accessible through pricing and through various strategies

in terms of where they're sitting on the shelf. For example, the UK just brought out a piece of legislation that stops ultra-processed foods, Mars bars and all these different foods that sit at checkout because they know that's where people make impulse purchases, it's where kids are grabbing stuff and throwing it into the trolley, and they're replacing those ultra-processed foods with healthy foods. So, you know, I'm talking about a recreation of the food environment.

We need to have better regulation, these transnational ultra-processed food companies. You've got to remember, 60% of the average person's calories in this country are coming from ultra-processed foods. We have to really reduce that. And so what I'm talking about, is recreating that environment. And I don't believe that, you know, the fancy tools and technology, as good as they will be, I don't believe will succeed if we do not change that food environment.

So, you know, I think that all of this is necessary. But I do feel like, you know, we need our governments to develop the political will to start making, introducing regulations, new policy that speaks to improving the food environment. If you were a betting man, what's your bet on that happening, whether it's Australia, America, you know, there might be some European countries, Denmark. I could see, you know, can get behind that, some other countries there. But let's say Australia and America individually. If you're a betting man, what are your thoughts of a major policy, policy shift happening in that direction where it's like a dedicated component, right, knowing that

also a lot of things happen incrementally. It's not like there's a sweeping legislation that ends up happening. But to that degree in the next, let's say, 50 years in our lifetime. I think it will happen, but it will happen slowly. Look at smoking. I see that as a perfect example. You know, it took a long time for changes to come into place and to see big reductions in the incidents of of smoking in our communities so you know in many ways i look at our politicians and i don't see

them as leaders their followers they follow the the community and the the way the society changes its views on certain things and it it will incrementally get to a point where it's just not acceptable to be marketing these foods to children that we know are have addictive properties and are setting them set them up for obesity and type 2 diabetes. It's just going to get to a point where they're going to have to step in and regulate. And, you know, like things like sugar taxes. These are not policies that governments traditionally have wanted to touch. It's a great way to lose votes because people don't really want to be told what to eat. You know, it's a very unfavorable area of policy for a politician to step into. So we've really,

really for a long period, seeing them just steering clear of it. And as a result, these transnational food companies have had a very free run in an under-regulated market. But it is changing. There are now sugar taxes in 20 plus countries around the world. So there are countries that are putting their foot down saying, this is enough. We need a healthier population that's happier. They're going to be more productive. There'll be less healthcare costs. You know, there are, there is, introduction of policy in certain countries that are stopping what's called the revolving door. This is happening right now. So you have politicians in high up positions who are creating policy, who will leave their position and then go and work in a senior position in the food industry.

And they have these very tight relationships that exist between government and food industry. and of course that that results in you know certain policies that would be unfavorable getting blocked and favorable policies getting approved and what's happening in certain countries is they're putting what's called a cooling off period in place which i think just has to happen from a conflict of interest point of view if you're in government in a higher position and you leave that position instead of being promised a job in the food industry you actually have to for three four five years, you can't jump and work in the food industry and vice versa. So, you know, call me an optimist, but we have a big problem, right? But there are things happening around the world and, you know,

the chronic disease numbers are just mind-boggling. We can't just keep ignoring them and, you know, throw on top of that planetary health. And, you know, these, I think there will be enough pressure on politicians to to start implementing these things, particularly, you know, the younger generations that are coming through more and more increasingly, they care about these issues. So, you know, it'll hit a point where it becomes the favorable thing to actually start changing the food environment so that it is a more equitable one. It's a healthier one, and people are eating healthier food that's actually nourishing them more often.

What do you think are a couple of foods or food topics that you've covered inside of the book that you personally feel have the most confusion around them right now? I mean, we touched on saturated fat. That's a big one in that category. Are there any other couple ones that you feel are like there's a lot of... You throw me, throwing me under the bus here. I didn't make a big deal of seed oils in the book, but I think there is some confusion. fusion about seed oils. Yeah, let's go into it.

I read a little bit about your thoughts on seed oils and their connection to inflammation. I know that we've talked a lot about seed oils. We've had people talk a lot about seed oils, but would love to hear your perspective and what you've gathered together from the science that's out there. So firstly, I'm not a sort of seed oil advocate. I don't think they need to be part of a healthy diet. I was just really interested in there seems to be some significant demonization of seed oils out there. And the general sort of rhetoric is that they're very inflammatory and that they promote obesity.

And I thought that was really interesting and wanted to look at the studies. And again, go back, evidence hierarchy, look at what's the quality of the science that people are using when they're suggesting that the, these oils are inflammatory and what do we see when we look at human intervention studies? And most of the claims around these seed oils being inflammatory are from mechanistic studies. So petri dish level science, which is an important area of science. That's what my dad still does today. He's done for 40 years. But that's really hypothesis generating science.

you can rarely use that to make public health recommendations because many, many things that we see under a microscope do not play out in a human. And so... And can add in one note there? And part of that is also, too, talking about a subject enough to support the people that are doing research around it to actually go and do research.

Like prior to a lot of the work on fasting that's come out by Walter Longo, such in Panda, that like all these people that are there, the research on fasting 15 years ago was more limited, right? So sometimes there's not the research that's there. And sometimes in some cases, there is the research that's there. So just want to make the distinction between the two

is that if they've done the research to look at the, you know, seed oils versus not. And then and then the variations of what that research would look like. So I was just making the note that sometimes things have not been done at a high enough level because nobody's funded that study. And in that case, if all you have to work with, I mean, this is how the evidence hierarchy works, if you have a certain topic and there's no data on humans and there's some interesting findings at a mechanistic level, so it's hypothesis generating, but it might be enough to make

a public health recommendation at that point, say, you know, proceed with caution, this is what we've seen at this level of science. We don't have higher level of evidence to date. But in this instance, we do. There are lots of human clinical intervention trials showing, and I guess I should rewind. The idea that seed oils are inflammatory really comes from the fact that if you look at the omega-6 pathway and you look at linoleic acid, which is omega-6, It's a short chain omega-6. If you look at that pathway, and this is, linoleic acid is rich in seed oils, if you look at that pathway, linoleic acid gets desaturated and elongated and gets reduced into a long-chain omega-6.

And I know you've spoken about this on your show, but one of the intermediary omega-6s is is arachidonic acid. and this is a precursor to a number of inflammatory derivatives molecules. So the idea is that these seed oils are inflammatory because they're rich in linoleic acid that will increase arachidonic acid. It's a mouthful that one. We'll call it AA from here on. And you'll get an increase in interleugans and various inflammatory markers, molecules. and, you know, it makes sense on paper when you look at it, but when you look at the human

clinical intervention trials, if you feed people linoleic acid, you do not increase A in their tissues, and if you feed them linoleic acid, you don't increase inflammatory markers. And this has been reproduced time and time again. And so I found that really interesting, and there's a paper people can refer to by Philip Calder. He's probably one of the main researchers looking at omega-6 linoleic acid and inflammation. And he wrote this paper last year, reviewing all of the literature. And he describes exactly that, that despite the claims of increasing inflammation, the studies show that's not the case. And in that study, do you know what was the primary marker? Because this has come up with a lot of

studies on inflammation. What is the primary ways that they're measuring? Is it CRP? Like, what is the primary methods are looking at information. So that's a review and they're looking at all of the various human clinical intervention studies. So each of them looks at different markers. They tend to all look at CRP, but there are other interleukins and other markers. I think it's 20 or 30 different markers across the board that have been looked at. So, you know, is something being missed? Maybe. But it doesn't seem based on the most common markers that, you know, when you feed linoleic acid, it doesn't seem to increase inflammation, which then does line up with large-scale observational research, which shows people that are consuming more linoleic acid

have lower risk of all-cause mortality. And this is even in large population studies that have looked at tissue levels as a marker of linoleic acid. So much more specific than, say, a food frequency questionnaire. So, I mean, you have to wonder when there's converging lines of evidence all pointing in that direction, you know, is the mechanistic data that suggests these oils are inflammatory? You know, is this another case of something we see at a mechanistic level that doesn't play out in humans? And, you know, reverting back to what my initial point was that I'm not some sort of seed oil

advocate, my problem with the anti-seed oil rhetoric is not that I think seed oils need to be in someone's diet. I don't. But usually what happens is it's anti-seed oil rhetoric followed by you should eat saturated fat instead. And really if you zoom out and look at all of the literature, there's no need to be consuming seed oils in your diet. You could. I don't think we need to completely fear them. I don't personally think that's unwarranted and I think are warranted. And I do refer people to that article by Philip Calder. But saturated fat, I do think we need to be mindful of. Yeah, I would love to dig into those a little bit more.

I saw the references to them in the book and do a part two where I can ask more appropriate questions that come in from them. And to dive into it, you know, I think the component that you've talked about with a lot of aspects with salt and the same thing goes with seed oils, we'll put salt aside for a second because that's a little bit different.

I think I look back and I just think most seed oils that people are going to be consuming is probably corn and soy, right? And then there may be a handful of other ones. And then rare amounts of cold pressed, you know, seed oils that are actual seed oils. They're coming from a very deep chemical process, 18 to 32 steps, depending on the seed oil that's there. And the vast majority of them are going to be coming from processed foods that is how people are going to get them. Whether they're regardless of what type of diet that they're eating, they're going to be getting them from processed foods, ultra-processed foods.

that the seed oils are built into. I look at it from the standpoint of these foods were not really a big part of our diet to partly hardly existed that were there. And then it does seem that keeping an optimal ratio of omega-3 to omega-6 is connected to not demonizing any particular thing because, you know, I do agree with you that the tendency is to demonize one thing and then to, to prop up your argument of, in this case, let's say somebody saying saturated fat

are better than seed oils. We need to get away from seed oils, we need to move towards saturated fat. But it does seem to be that, as you mentioned, you're not a proponent of seed oils, staying away from them, from them not existing inside of our diet. Yeah, I think there's a difference between,

I would agree that we shouldn't be increasing ultra-processed foods in our diet, and a lot of those foods will contain seed oils. But I think there's a difference between that and seed oil has been inherently bad for us, inherently inflammatory, or inherently, you know, going to increase our risk of obesity, for example. So I think we need to be careful of kind of delineating that. And, you know, the fact about the processing of the food, it's an interesting one. You know, there are certain foods that are processed, like vinegar, for example, which we know will, you know, reduce blood glucose excursions in people with insulin resistance.

It's a processed food, but it has a healthy effect on physiology. Right. It's a question of how many steps of processing and everything that goes into it. But I do. And even on that. Can people make vinegar at home? Yeah. They can make vinegar at home.

I would push back. I would push back a tiny bit. Please, please. That's why I invited you on. I wanted to hear your thoughts. And it's not because I think what you're saying is not logical. I think it's completely logical. And I used to hold that view that, well, if something is not natural, then it must not be good for us.

And I don't believe that. Or as good as something else. Yeah. So I might be putting words into your mouth. But the fact that seed oils aren't natural, I don't think that that can be a reason for writing them off. I think we do have to look at what the science shows in terms of inflammation. You know, again, we have our intuition, but we test it with science. And, you know, there are many things in our life that are not natural that have improved health outcomes,

modern housing and heating and cooling and stuff. Access to insulin, access to peptide, access to everything. Yeah, so I know you're not going there, but sometimes you can go down that sort of naturalistic fallacy kind of pathway. I guess to summarize this is my view is that often if people are taking absolutes and looking to direct people to their diet being the single only optimal diet, they have to find a scapegoat. And for me, for proponents out there saying you don't have to worry about saturated fat, their scapegoat is seed oils. And my challenge to them is to look at the science that I've just shared, look at the review from Philip Calder, who is probably one of the world experts on omega-6s and studying inflammation,

and to step outside of the mechanistic data, right, and look at what's happening in humans, and to look at that evidence and then to decide whether that updates their thinking of this food group or to provide other evidence that suggests that that is incorrect and being misinterpreted. Yeah, I'm excited about with all these different camps that are out there that have their own opinion, I think one thing that's going to come out of this, and we're already starting to see it a little bit, is right now a lot of the studies, many that are included in your book, and many that all the people reference that are out there. You know, you can find a study that supports

this and of course there's a hierarchy that's there that you've talked about. It's generally institutions are the ones that have access to it, the ones that have access to the funding, call them universities, research institutions. Peter R. T. at one point in time, try to set up Nusie, you know, the nutritional science institute and running their own studies. And, you know, he was talking about how it's, it's difficult to get the funding. And yet one trend that I see that's coming up is crowdsourcing funding. And I'm really, excited about that. There's a company that I know called Proof Pilot. Some people are working with them. We just started working with them. But I'm very interested because it always feels that every

side feels that when there's a counter argument, especially if there's a viewpoint of, let's say, this group comes more from the vegetarian or the vegan lens. This group comes more from like the keto or the saturated fat lens. It always feels that the default is, well, there's not the right study that's out there. And I want to see more people funding. studies and getting independent groups to do studies, this is not to discount your earlier point that there is a lot of plenty of good data that's out there. But when you as a listener and myself as a listener are hearing some of these conversations and you hear these rebuttals of people coming back and forth, they look at the holes that are there inside of each study. And I'm not

giving weight to them. I'm just saying I'm excited about people crowdfunding and agreeing to, hey, we all agree that this would be a good example of helping us to settle or these multiple studies would help us settle the science a little bit more, where there might be some debates. Yeah, and that's needed, you know. Because you made this, can I make one more point that's there that I'd love your chiming on? Because one of the thing that comes up is you have talked about in your book is that even when you do see some improvements on a higher fat diet or this, you're always asking compared to what?

Right? Compared to what? Then the other side of it, I know my business partner, Dr. Mark Hyman, has talked a lot about this, is the healthy user effect, which is, can you explain that to the audience that's listening in? And I know you have some thoughts on it. Yeah. So compared to what, I guess we'll start there, that's really important because you, you know, you can show a food is healthy or not healthy but what's really important is what was it compared to and that is a source of huge confusion you know you'll see for example you might see a headline talking about coconut oil being the new healthiest cooking oil and they looked at its effect on cholesterol and they compared it to butter but it wasn't compared to anything else so you know the the kind of interpretation it becomes

comes misinterpreted because people are just saying, you know, the conclusion from the abstract and are not aware of the methodology. Now, your question about... And within that, there's also absolute changes, relative changes. The relative changes tend to make it on the headlines that are there on both sides of the, you know, the camp of different dietary wars that are there. Oh, so I was saying just crowdsourcing funding and people. agreeing on, you know, hey, this would be a good quality study because there's the, it always

seems to be that there's some reason why this wasn't, and there's no perfect study. And that's not the goal of science either. It's the ongoing, you know, continuing to look at things that are there. But I'm excited about more crowdfunding of studies that come from this. And there's an example. Let's come back to a healthy user. Yes, please. You asked me that, but there is an example of crowdfunding.

I believe it was crowdfunded that Dave Feldman. I'm not sure if you've come across. No, I'm not familiar with him. He's looking at a study of people adopting a ketogenic diet who have significantly high LDL cholesterol, but also have low triglythrides and high HDL. He's come up with a term lean mass hyper responders. Oh, yes, yes, yes. His theory is that these people are different to someone with traditional lipid sort of metabolism dysfunction.

Right, because they have a unique phenotype. Yeah, but and so I support his idea to go and do a study and he's crowdfunded and I think that's amazing. But what I will say is that just because someone has a theory and is going to run a study, we shouldn't be overlooking what the current consensus position is because in that instance, it can lead to public health recommendations that could be harmful. So while there's room for more science, the public health recommendations of today need to be from the very best data that we actually have. And going back to that evidence hierarchy, I think that's a really important point to note.

And that's essentially what these guideline papers around the world, I mentioned some of them before, whether it's the European Atherosclerosis Society or the American Heart Association or the American Endocrinology Association, they are tasked with exactly that. They have a number of committee members anywhere from 10 to 20, all individuals who adopt different dietary patterns. So you can remove that personal bias of, you know, they're not all people adopting a paleo diet or all vegetarians. It's a committee. and they are tasked with looking at the totality of the evidence and using the evidence hierarchy to come to recommendations. And really those recommendations should be where we're all going to for our own recommendations until further research is done and suggests otherwise. I think it's risky to be veering off those path and going rogue because you have a hypothesis that you believe is correct.

most hypotheses are falsified and proved wrong. So I think that's a really important thing for people to remember. In the American Heart Association, I would say that, okay, maybe there's a feeling around saturated fats and their recommendation that's there. For the longest time, I mean, their recommendations on sugar seemed to be influenced by the industry that was funding them. They're making pretty hard regulations on sugar. saying to really limit. That's like more recent, but we've known the data on sugar for quite some time. And the funding on the American Heart Association, look at the top funders.

You know, it's primarily a good chunk of industry that's there. So is consensus really always the goal? I think there can be big gaps of knowledge that are inside, especially when you have an organization not dialing back on alcohol recommendations or, you know, in the case of sugar, which I think was the most recent example of. only maybe recently being dialed back from where the recommendations were. Yeah, I think all of the organizations have at some point probably been influenced by industry, right? But I do believe they're getting better.

Look at Health Canada's guidelines. They actually came out and said, this is the first time we will not be affected by industry. If you look at their 2020 dietary guidelines and they actually removed dairy as an essential food group as a result. They still say you can consume it, but it's not there as you have to consume dairy every single. day. Yeah, that's rich. And even the AHA, the new guidelines, and anyone can look these up, you know, they are now taking a much harder stance on sugar, absolutely.

They are actually mentioning how important the environment is. Now, you know, of course, ethically, if you're promoting dietary guidelines from a human health perspective, you have to acknowledge that human health is very dependent on a healthy planet. So they're including that in. From a protein point of view, their latest guidelines specifically say to choose more plant protein more often. So I think they've done an enormous job with those guidelines. But the other thing that I would add there is that all of these guidelines around the world are consistent. It's not like they're all disagreeing with each other.

They are all very, very consistent. in and they just they go back and speak essentially to that theme that we we spoke about before. So, you know, I push back a little bit there because I do feel like I see people online who are not necessarily qualified to look at the evidence suggesting that they know better than the guidelines. And I think that is somewhat problematic, can be problematic. Healthy user effect, do you want to go there? Yeah, yeah, it's worth touching on.

And then I want to talk about what you eat. So healthy user effect can be a real problem. Yeah, just describe what it is for everybody. And it's really, it's mostly a problem in observational research epidemiology. If you're looking at large populations of people, you know, a type of study design that can be really informative and helpful because it helps fill in a gap where clinical intervention trials can't really help us answer questions from a feasibility point of view. So the problem that you can come into in these populations is that, say, for example, you're looking at a large population of people that eat differently. Well, those that are eating more fruits and vegetables are probably drinking less alcohol.

They're probably doing more physical activity. They're probably smoking less. So when you go and you look at- Better relationships, right? So when you go and they probably weigh less. When you go and you look at, okay, those people, compared to those people, what was the differences in terms of cardiovascular disease or type 2 diabetes or Alzheimer's dementia? The question then becomes, well, was it the fruits and veg or was it something else?

And so you hear people online talk about healthy user effect. And I think it's important to acknowledge that the research is doing this, this type of research, if they're good, they understand the limitations of these studies. more than people on the internet. So they are fully aware of the healthy user effect. And they use what's called a multivariable analysis, multivariate analysis, which essentially if you properly define your cohort,

characterize it. So when you are taking information about what they eat, you're also getting information about alcohol, exercise, and smoking. And you're properly defining that. So it's not just like, do you smoke yes or no? Or do you drink alcohol, yes or no? It's one drink a day, two drinks a day, three, four, five, seven, same with smoking.

And when you run the multivariate analysis, the whole point of doing that is to reduce the effect of these confounding variables. So let's say, for example, I barely eat fruits and vegetables. And let's say you eat a lot of fruits and vegetables, right? But you also exercise, you know, much more than me. It would be unfair to compare you to me and attribute the benefit to the fruits and vegetables. Maybe the exercise, right? So with this multivariate analysis, what they do is they remove the effect of exercise. So they only are looking at, essentially, people that consume a lot of fruits and vegetables,

with people that consume few, but exercise levels are the same. smoking levels are the same. Alcohol consumption is the same. And I think that is overlooked. There is this sort of general idea that all observational study is completely affected by healthy user effect. But that multivariate analysis now is just standard protocol. Now, could there be some other type of confounding variable that's not picked up in the study like relationships or things outside of these very obvious ones, perhaps? But they're going a long way to kind of reduce the chances of that. Or just even just dietary logs, right?

Like not even like do people tend to underestimate, overestimate when it comes to filling out surveys? And that goes on all sides of the spectrum. And I think that the better that we have tools and technology they can look at isolating certain types of biomarkers, which can be one part of it, it's not it's not to say that you have to write off every observational study it's just to say that that might be some influence that could be there like they're not nothing's perfect you need to get

into the methodology right and and this is again comes back to you know understanding how to look at these studies for example if if a study is using a food frequency questionnaire they should have validated it in that that population again this is standard protocol in good epidemiology So the idea here is that there are a number of tools to do epidemiology really well, and we need people to lean in and continually to do it better and better and better because it will give us more confidence in our results. And what I mean by validating a food frequency questionnaire is we do actually weighed food records in that population over a three, five or seven-day period and match it

to the food frequency questionnaire, and we see if people are, if there's good high correlation between the survey and the weighed food records. And if there is, then you can determine that that food frequency questionnaire is a valid tool to use in that population to give us a very good general idea of how people are eating. It doesn't really feel, and I'm much more limited than you, but I just started taking a foot into this world because we signed this partnership with a company called Proof Pilot, which helps companies run their own clinical trials and things like that. And we're, you know, we had introduced in the Cleveland Clinic where there's Dr. Hyman Center, the Center for Functional Medicine over there, and they published their

first study in JAMA. I'm going through these validated questionnaires that are often used in dietary inventions. And again, anybody can do a clinical trial. Doesn't mean that it's even high quality. Doesn't mean, you know, anything about it. But looking at some of these validated questionnaires on gut health, we have a study that's coming up on gut health that we're preparing for with this company proof pilot, I'm looking at them. And even though it's a validated, accepted questionnaire in sort of that space on GI health, it's like there's so many interpretations of the way that somebody could answer a particular question set. I think that it just feels like it could be a little bit of confusion that's there. I wonder. And it really goes towards your bigger point

that I feel like you're talking about the book, which is what is the broad spectrum of all these studies saying and the meta-analysis, as long as you're getting good quality studies in, what is that showcasing? Because you'll always have some studies that are done well, some studies that are not. But if the overall direction is pointing in this place, then it's probably a good thing to pay attention to. Yeah. The point I was making with the food records is that if I was to kind of break this down,

the weighed food records is taking a person and and you know how much white meat are they having a day how much uh when you say wait just want to make sure understand actually weighed on scales so so you get people a subset of the of of a sample group of people from within that population and you go you go through everything they eat you actually weigh is that happening on a regular basis this happens in any good quality epidemiology, right? And so you get a small, when that tool's validated. So the tool, for example, may have already been validated in that population and another study uses it as a valid food frequency questionnaire, but at some point it really has to be validated. And the idea is that you're literally, you know what this subset, you know exactly what they're eating, because

you're able to weigh it, you know, a serve of blueberries, a cup of greens, however, many walnuts, et cetera, and then they're completing their food frequency questionnaire, and you can see, does it actually match? And, you know, if you end up weighing all the food and you know exactly what they eat, and then their food frequency questionnaire says the exact opposite, you know that you've got a pretty lousy tool. But if it's coming back and it's showing very high correlation, those people are saying quite accurately how much white meat they're eating in seafood and walnuts, blueberries, and dark leafy greens

and whatever, then you know, okay, this is a... good, robust tool that we can then go, you can't weigh food for 500,000 people or how many are in the total population, but you can use that food frequency questionnaire. I want to pivot, because I'm sure that was a little bit inside baseball for some of the audience that's there. Let's talk about you and your diet and just like how you navigate life. You know, I'm sure you get the question all the time. You know, what do you eat?

How do you eat? And I'm also curious, too, about, since you're not. since you having gone on this journey and your dad with his whole experience, you know, what's his life and his diet and his world look like now? Let's start with you and then we'll come back to your dad. Okay, cool. So my diet, I'd say, is a, you know, it's a whole food plant-based diet, but it's not a quote-unquote perfect diet. I don't really believe that that exists. I still, you know, deviate and enjoy some of the more indulgent foods that are out there from time to time. And I would say at a high level, you know, my diet is full of fruits and vegetables, whole grains,

legumes, nuts and seeds. It's not a low-fat diet. I know that there is, you know, certain low-fat plant-based diets that have been sort of promoted in the past. I don't believe there's any evidence to suggest that's better than a diet that is rich in unsaturated fats. and in actual fact, I think adding in lots of unsaturated fats is a good idea for most people than going to a super low fat diet. So I'm certainly not restricting fats.

It's more about the type of fats. And I am fairly active. And so my protein intake, I'd say, is on the higher side compared to someone perhaps who's living a less active lifestyle. So I have a bit more of a bias in my diet. away from whole grains more to the legume category, be it beans or chickpeas or tofu or tempe, those sorts of foods, which helps me, you know, achieve that sort of total protein intake that I'm looking to get to. We can explore that if you want.

I'm not sure how much detail you want here. But, you know, my meals are really very depending on the day, but I do things like tofu scramble. I do a lot of very big salads, particularly more towards the end of the day. I tend to have my lightest meal is usually my evening kind of dinner meal, big salads with lots of dark leafy greens, spinach, arugula, lettuce, etc., like a good mix of different types of dark leafy greens.

There will be some, nuts and seeds in there. Walnuts are a big go-to for me. They're really rich in ALA, Omega-3s. Put some pumpkin seeds in my salads a lot, very rich in iron. I will usually, in this kind of big salad that I'll make, put some type of legume, like chickpeas, for example. And dressing-wise, the salad's going to have,

olive oil with some perhaps with some mustard and that's for a few reasons one you you have the healthy fats in there but also you know fat so it's it's important to have fat in our meals to absorb a lot of of the vitamins particularly the the fat soluble vitamins so and and also carotenoids like lutein for example which is found in abundance in dark leafy greens. So there'll be some olive oil toss throughout there, probably some tomato, avocado, and that's kind of like one dish. Sometimes I put strawberries into that. It might sound a little weird, but I'm a big one on getting sort of at least a couple servings of berries a day. There's some good research on that from Martha Morris's group

at Rush University looking at prevention of dementia. So, I mean, that's a description, I guess, of one meal. But there's smoothies, there's stir fries, there's, I will do oatmeal for breakfast here and there. And you eat any animal protein at all? I don't eat any. No animal protein. I haven't had animal protein for seven plus years. And during that time, so I was probably, I weighed 95 kilograms now, and so in pounds, a little over 200. So, and I was at the start, I was probably around 83, 84. So I've managed to build strength and put on quite a bit of size over that period,

which I believe lines up pretty nice. with quite a bit of science that's come out speaking to if your goal is to build lean muscle, if it is to improve strength, then what seems to be most important is total protein intake at around 1.6 grams per kilogram. And if you're hitting that mark, the actual source of the protein doesn't seem to make a difference in terms of those actual hard health outcomes, which I've had a number of those researchers on my show that have conducted those studies. And that has been very surprising for a lot of these protein researchers to learn over the last handful of years because, you know, the prevailing

theory was that animal protein is much better, much more anabolic, much better at building lean muscle and strength. And so for you, just because you brought up protein, how much does that translate that into grams? 150. 150 grams of protein is what you're having a day. And usually from just having been vegetarian and vegan, looking at 150 grams, again, that's you. You're a bigger guy.

You're more active. Again, you have different goals that are there. Some people would say that, you know, to get it from an animal source that might be more concentrated. Just, again, not talking about animal sources is better or not better. you definitely do have to eat quite a volume of plant food to get to that 150 grams for you, like in terms of like total amounts. Yeah, I think, well, let me explain how I get there, I guess. So probably 100, 110 of that would come through whole foods.

I'll have a plant-based protein shake, which I think most guys that are working out will have some sort of shake if it's way or plant protein purely because it's a convenient way to get 30, 40 grams in. Any favorite brand, by the way? Any favorite brands that you like? That's hard for me to say. I get sent so much. It's hard for me to choose one brand.

Okay, sorry, I interrupt. Did you please continue? Yeah. I'm not like sponsored by a particular brand, so I don't feel obliged to kind of mention one. But if I am choosing a plant protein, usually I look for a blend of at least two different types of plant protein, like a brown rice in it. pea protein for for example uh but you know the the there's protein in all plants but most of the

the protein in a plant-based diet is going to come from that legume food group so that 100 110 grams is coming through uh chickpeas and kidney beans and lentils and tofu and tempe but also legume pasta so there's a lot of those chickpea pastas and whatnot now out um i consume satan i have no problems with gluten. So that's a very concentrated source of protein. It's not going to be for someone if they're avoiding gluten. And then mycoprotein, I'm not sure if you've heard of that. Like mushroom, which I think is, yeah, I think this is a really fascinating and is one of many solutions that will help feed a growing population, the amount of protein that's required in a sustainable manner. I mean, if you think about a cow, for example, you, you feed

the cow plant nutrients plant foods or it's grazing on grass and um it produces muscle and and you eat that uh similar to that with uh with fungi these microbes you can feed the microbes plant um foods potato or rice or whatever and it will produce this very very high fiber protein rich food and it's it's a uh the texture is much more like meat than say tofu so this is a very emerging food it's it's on the market in in certain places the UK there's some here um but it's very it's very early uh but that in particular is super protein dense so uh you talk about volume when you add in some of these foods like the satan and mycoprotein for example you you're reducing that total volume of food.

It's not as if you have to get to 150 grams of protein from chickpeas alone. What's your thoughts zooming out a little bit in terms of, you know, you eat the way, you just described the way you eat, and you had also mentioned, you know, people are always curious. You don't eat any animal protein. What's your thoughts in terms of how human diet evolved? And do you think that the absolutely, Absent, your ability to not include animal proteins, which do you eat eggs?

No. No. So you don't need any animal. So you're vegan, right? Would that be safe to say? Yeah, well, I mean, I don't really wear that bad. Yeah, yeah, but I guess my diet would be described as a vegan diet. Right, right.

Your diet would be described a vegan diet. Do you think that it's a byproduct of our modern day and age that we have the life that we do and we can make protein patterns and we can make all these different types of things and other components that allows us to be plant-based and it's a better option for the planet. It's a better option for, you know, us. Or do you think that we sort of veered off course and, you know, yeah, just curious about that. No, I think if you go back to look at Paleolithic era, and I've had Herman Ponce on my show, I'm not sure if you're familiar with him.

He wrote a book called Byrne. Great book for anyone. He's an evolutionary anthropologist, one of the leading in the world and has spent time living with the hardser and um fascinating book and he goes back and and looks at the diets of hunter gatherers around the world and you know uh different depending on where tribes lived the the makeup of their diet look different and also through different seasons so some tribes had a whole lot of animal uh calories coming from animal foods and less from plant foods and then other tribes had a whole lot coming from plant foods and less from animal foods and they also within those

tribes through the season, the diets would change quite a bit. He specifically makes a point that Lauren Cordane, who wrote the paleo diet, when he sort of formulated that paleo diet and the citations that he's used in his book, it comes from the Murdoch Atlas. And he essentially looked at all of the hunter-gatherer tribes around the world and produced an average of calories from fat, from protein, from carbohydrates, and what the typical paleo diet looks like. Now, you might be imagining that there's some problems with that because what's interesting is not actually,

the most interesting finding about looking at these hunter-gatherer tribes around the world is the variation that existed. There wasn't one single paleo diet. And still for those groups today, by the way, there's so much variation for those modern-day hunter-gatherer tribes. And this seems to be lost, I think, online. When people are talking about ancestral eating, there wasn't one ancestral diet. And I think what's most instructive for me has been most instructive for me,

and particularly talking to Herman Ponzer, is that Homo erectus was not eating for longevity. They were very much eating for survival, to stay alive, to avoid periods without food, to reach an age, to procreate. And that was the important goal for Homo erectus. But today, I really believe most of us have different goals. It's not about just getting to an age to procreate. We want to live healthy to 70, 80, 90, most of us anyway. And so with different goals may come different decisions, particularly in an environment

where you have more food availability. And that's where I believe science comes in to say, hey, we now have all of this abundant food choices. What are the best choices to make to increase your chance of longevity? And my view is that it is diets that are plant predominant, they're plant forward, they're plant rich, and I think that's a consistent finding across the world. Your point about, do you think it would be possible to eat a completely vegan diet without the kind of modern access we have to things like B12 or, you know, certain, certain

modern plant-based foods, let's call them that. Perhaps not, but what I think is most important is the actual health outcomes and what are the hard health outcomes that can be achieved. And I think if someone does a vegan diet, it can be done in a very poor, manner and lead to very poor health. But if they do it in a way where it is appropriately planned, you know, and they take a B-12 supplement for example, they can have very, very good health outcomes. And I don't think that we should discount the diet based on the fact that it's not, quote, unquote, natural because I think the most important thing is what does the data say? And if they do it

well, what are the typical outcomes? Yeah, and I by no means I was trying to discount. I was just trying to get your own perspective on stuff. I come from one of the longest lineages of vegetarian societies in the world. And it's the Jain tradition, J-A-I-N. And there is a super long history, almost like six, seven thousand years of this group becoming, Jainism is a particular religion from India, more of a way of life that's there. And being vegetarian is a central part of that background. I don't abide by that label, and I'm not vegetarian in my life right now, but that's the lineage

that I kind of came up with. And I was, you know, we would be talking about this. And you'd kind of learn in sort of like a Bible study class growing up about the history of vegetarianism and different thoughts and theories. And I was just curious about, you know, getting yours. I think about the hunter-gatherer tribes, I think one thing that's important to note is that I think there's a misconception sometimes in the general population that these groups only live to an age of procreation.

when you discount infant mortality, you know, they weren't, they weren't dying at 40. You know, they had, and even if they died earlier from infection or other things like that, these groups regularly had individuals that were living to 70, 80, 90 years old. I went to go and spend time with the group in Kenya and they're cousins of the Maasai. They're called Samburu. Still a modern-day hunter-gatherer tribe, very interesting. Not the diet that I eat at all whatsoever, but they primarily live off of milk. They just only drink milk.

And then occasionally when there's no rainy season or whatever, they drink some cows blood and things like that. And maybe on a ceremony or whatever, a wedding, they'll slaughter a goat or anything like that. But they really don't eat. They just drink milk all day. Anyways, we were talking to them about just chronic disease. And, you know, these modern-day hunter-gatherer societies, you know, they don't have instances of chronic disease. And again, from what I've seen, that goes, and I'll have to check out the guy that you mentioned, that goes for people both that are more carb-you-know, they might have more have a higher carb diet

and less animal protein and more of a higher fat. So I'm not sure of what you were saying about, I do think that people were not thinking about eating for longevity. I do think it was about survival and procreation. But I don't think that these groups didn't have longevity inside of them. They definitely didn't have chronic disease. Yeah, I'm just, I was more getting at the basis of their disease. It would be it wouldn't be logical for us to assume that the food that they were eating is necessarily good for longevity

Because their food choices that they were making were primarily for to survive and to get to procreate I mean that's what evolution is but I do agree with you there are examples of people and and populations where they do have good health and Herman Ponzer he does speak about this in his book the one thing to get to to to consider there is survivorship bias. So in those communities, because there is high infant mortality, a lot of the weaker people genetically might not be making their way through. So when you see a high proportion of people living into their 60s, 70s, 80s, there could be a real bias in that population. So that's something to consider. On top of that, I'm just not sure how validated a lot of those populations are. I know people talk about examples of longevity, but I'm not sure that those

cohorts have been as validated as, say, for example, like the Okinawans. And what I mean by that is actually not just conversations, but getting in there and scientists looking at exactly how people are dying. What are the records? Because so many of these places have no records. You know, there's no public health records. So we really, many of them don't even know how old they are. So it's, it becomes very murky, right? If you're dealing with this population, there's no health records. You know, do you just kind of, you know, just assume that they're living long because there are a few people that are surviving to a certain age? Or, you know, I think it would be nice to have better data to be able to look at.

But I guess the main thing here is that we would definitely agree on is that, you know, is that, The, you know, the biggest difference between these diets and the diets in Western populations is ultra-processed foods. Yeah, for sure. All of those hunter-gatherer tribes, as you mentioned, they're eating whole foods. Some are eating more animal foods and some are eating more plant foods. But the one thing they're not doing is they're not eating ultra-processed foods. 100% agree.

And like you said, we were chatting a little bit before the interview started recording. There's so much more that people agree on. Like if you probably looked, I'm in the process of I did a deep gut repair. I grew up on antibiotics and other things like that, you know, got sick often a lot. And probably didn't have the best, definitely didn't have the best vegetarian diet during the day. And then the evening had like a really great, you know, access to all sorts of really great foods and things. And my gut was destroyed. And when I first started shifting my diet, actually, I first started.

thinking that I might want to consider eating some other stuff because I was experiencing depression-like symptoms. Again, I'm just talking about my story. And I had a doctor that I just got introduced to that was in the world of functional medicine. He said, hey, look, I want to just share some of the literature that's out there on, you know, omega-3 fatty acids, right? Just something for you to consider, to look at. And I said, okay, you know what? I'm open and trying something. So at the time I had done this test, no affiliation with the company, I talked about it recently in an episode.

I did this test called a mega quant. If you're familiar with it, it's like a mega three to a mega six index ratio. Looking at blood levels, and I know there's a big controversy around, you know, a lot of the studies on fish are looking at sort of the observational requirements that people are putting in and saying how much fish they eat. This is actually looking at like blood levels or mega three floating inside of the blood. and my ratio was in the, what was considered not, like, the lowest ratio, right? My omega-6 was really high and my omega-3 was really low. So I just did a personal little experiment over a period of time. Again, N-1, not applied to anybody who's listening over here, wasn't a clinical trial,

anything that was there, just somebody who's trying to figure things out for himself. And I started eating a little bit of salmon and cod. I would say probably about two to three servings. a week that I'd make myself and well caught and everything like that. And there could have been other factors that are going on. Again, this wasn't a trial. This wasn't anything that was there. But over the course of about 60 days, probably about 45 days, 30 to 45 days,

I just started to see a difference in my mood. There is clinical data on that. Yeah. There's clinical data on omega-3s helping to reduce symptoms of depression. Yeah. So, I mean, that's consistent with that, for sure. Right. And so where I was going with this is that, you know, there's there's going to be people are, and generally, besides that inclusion of like my fish and my diet, I was talking about my gut health as well. Then I went high saturated fat with mostly like coconut oil. Actually, I was cooking only with coconut oil, other things like that. I was still mostly eating fish. And I met a microbiologist. named Kieran Krishnan, and he was like, I was telling him I was having a resurgence of some

acne, which I used to have way back in the day before I gave up dairy, right? Dairy was deeply connected to my acne before. And he said, you got to be careful because it seems to be that coconut oil and just saturated fat in general could induce an endotoxemia by piercing a little bit of that leaky gut situation that people are dealing with. So I didn't experiment. I took out all the, you know, coconut oil and saturated fat that I've loaded up on my diet on. And I saw that go away. I felt a little bit better. And I think that a lot of people are doing these, you know, they're just trying to figure out what's right for them. But in general, for most people that are listening to this podcast and probably your podcast, they have a lot more in common that they're eating with the plant foods. And sometimes

there are times where I'm like, should I do another episode on nutrition? Because am I just talking to people who are just arguing about whether or not they should include a little bit of saturated fat or not but generally we you know we agree on everything else and and I would also agree that fish are a healthy food I think they can they can feature have you chosen not to eat fish primarily from an environmental standpoint yeah so my my decision not to eat fish is not really a health decision you know there is some observational research that suggests if you swap calories from from fish for plant protein there might be a small benefit but it's very inconsistent and it's limited and overall the evidence on fish suggests it's very health promoting.

You get married in the future. You guys decide to have a baby, right? Would it be important for you or would you recommend to your wife at the time, right, that to include having looked at some of the data and omega-3s in their association with brain IQ and most recently the Framingham data that came out of longevity of potentially adding an extra five years, looking at blood levels of omega-3 inside the diet, or would you say, no, we can handle this through supplementation? Well, that would be a decision for me to make in conjunction with my partner.

Of course, of course. I would be coming at it from a completely judgment-free point of view, which is how I always approach this. I mean, really, the option there is you eat fatty fish a couple times a week, or you have an algae oil supplement that is, um, can be. contains, you know, around 500 milligrams of DHA at least during pregnancy along with some EPA. So there are ways to do it. You could, you could certainly supplement if you didn't want to eat seafood. I don't see any problem with that and there, you know, the literature doesn't

suggest otherwise, not that I've seen anyway. So, and that's what I do personally now. I supplement with, with an algae oil. Now, for a sort of non-preignant adult. salt that's not eating fish. Do they have to supplement with an algae oil? That's often a question that I get. This is heavily debated, by the way. I know. It's another one of these charged topics.

My take on the data, and usually when looking at DHA and EPA, it's pertaining to cardiovascular disease and to cognition to brain health. they're usually the kind of outcomes of interest. And overall, the omega-3 supplementation trials looking at cardiovascular disease, probably in the media have been reported as quite disappointing. But there are some nuances, and I explore them in the book, when you sort of break through the abstract and the primary outcome being like a composite of cardiovascular disease outcomes,

So stroke and heart attacks, death from strokes and heart attacks all lumped together. When you look at those more broken down, there does seem to be a benefit in terms of myocardial infarction for omega-3 supplementation, particularly in people who are consuming low or no amounts of fish. So there is some data there that, and people will point to that and pick a few holes in it and say it's not perfect data. and it's not. But it is there. There's a signal that people who have low baseline fish intake seem to derive benefit from the omega-3 supplementation

from a cardiovascular point of view. And then when you look at the cognitive studies, the cognition studies for healthy adults have been a little disappointing. There's some on mild cognitive impairment that has shown a little bit of a signal with benefit for supplementing omega-3. However, that's heavily debated, and people talk to the methodology

and talk about how those studies aren't perfect as well. So going back to your point, more studies needed. And then by the time someone has Alzheimer's dementia, it seems to be too late just to take an omega-3 supplement and expect to sort of reverse the condition. Overall, my position is that,

The data is not perfect, but I think if you're not consuming fish, then supplementing with an algae oil, if you can justify the cost, is a good insurance policy. And if you're taking around 800 to a milligrams to a gram a day, at least around that mark, every day, that is equivalent to sort of two to three pieces of fatty fish a week, two to three pieces of salmon, for example. You know, I've noticed something really interesting is that regardless of people's dietary viewpoint, when women get pregnant, I've seen like there's this deep intuition of kind of reaching for certain foods that maybe they didn't used to reach for. So personally, again, I was very involved in the plant-based community. I used to have like a deep website on that.

And still, I eat so much of my diet is based around those core components that are there. So this is not at all that I'm on the other end of the spectrum. And I'm a carnivore or, you know, keto junkie or anything like that. I believe in metabolic flexibility. I believe in, you know, I think you and I probably eat very similarly. Minus I probably have less legumes just because I noticed the irritation. I'm still in the process of healing my gut. And I know you've talked about that on how to ramp up and build yourself back up to you.

you can handle more of some of those foods that might be causing people irritation. But going back, I just saw something very interesting, which is that my female friends who were very much firmly in the plant-based world, this is completely anecdotal, but it'll go into this crazy theory that I have, which might have nothing to do with this podcast at all. When there is a pregnancy and they've never considered before including something like fish, I even had Ocean Robbins. Do you know Ocean Robbins? I've had him on my shirt.

Yeah, yeah. I don't know we've talked about this at all, but he told me a story about his dad, John Robbins, for those that are not familiar, Baskin Robbins, found, you know, family, and then left that whole empire because he didn't believe in dairy and everything that it was contributing to the environment

and it's not healthy for people. I asked him, you know, hey, with all the research that's out there and this is what I do now, I fish a little bit, what are your thoughts? He said, actually, I had a very similar experience. He started including fish inside of his diet for, And I said, what was the impetus?

He said, well, actually my wife got pregnant. And for the first time, you know, she had also been, I think, vegan and vegetarian for a long time. Is this ocean or John? Ocean, ocean. Yeah, yeah. Ocean. Yeah. And there was just this intuition of, hey, this is what I need.

I, and I'm bringing this story up because you said something earlier. You said, I would approach any situation from a dogma free standpoint. And you were talking about having a kid and like making that decision. with your partner. Yeah. Like you two together. And I think that one thing that I'm just really big on, in addition to following the broad stroke science recommendations that are out there,

you highlight a lot of them in your book. The proof is in the plants. You know, definitely get it. It's in the show notes. There's this component of, and I find women are a little bit better than men, of if you find out that what you're doing is maybe in some way not working or you don't feel that it's working, give yourself some freedom to, maybe explore. As long as there's some markers that are there that you can say like,

okay, what does success, you know, look like in addition to annual physicals and other things like that? Yeah. You have to be real with yourself. And if you're getting signs or signals that something's not quite right or, you know, you're just not feeling as healthy as you want to, as vibrant as you want to, I think it's worth examining. and you know i know that that you and definitely me i it's not about telling someone how to eat and they can sustain it for a short period of time this is about the long the long uh the long game you know what can you adhere to over a very long period of time and not thinking about doing it perfectly quote unquote perfectly and and so i i do i encourage people to play around within

that theme, to tweak things, to not get stuck in this ideological view of their diet. I think that that can hold people back. And so, you know, there are going to be circumstances where people need to grapple with, you know, the ethics side and the health side. And with all of that information, make the decision that feels right for you, not feel pressured from dietary tribes and the outside world. It's sitting down with yourself or your significant other. And you're just making the best decision that you can each and every day.

And I think there is this sort of growing tribalism. And when you identify within those tribes, you know, you just need to be mindful of the fact that if you fall into a completely ideological view of how you're eating, then your health may suffer at some point because you're not staying open-minded and you're not listening to your body and thinking about making changes. Now, that's, that's, becomes a tricky thing, I think, when in the planetary health and then animal welfare comes into the situation, for example,

but I think it's just something for people to keep in mind and you know if ethics are important for you if sustainability is important for you you do need to find a way of eating that you can sustain for the longest period possible absolutely and I think that increasingly more and more like even on the animal side like what's been nice to see out of the world of even though there's some maybe some different viewpoints in terms of, you know, regenerative agriculture and its ability to sequester, you know, carbon. And could that be one way of, for those people that do eat animals, is that one other way to raise a healthier animal, give a better quality life? And I know there's a lot of debates that are on that side. But I think the one positive side is, I think

increasingly everybody understands that, you know, we've had many people on this podcast say that if the choice is don't eat animal protein, like eating animal protein from factory farm meats or don't eat, like fast, you know, for that meal or that you're at the airport, everybody's understanding like not like completely staying away from factory farm meats is best for you, best for the planet and best for everybody. So I think there are unifying themes that are coming out that are there. even though there might be some smaller touch points that people have different viewpoints on. And that's at least one side that makes me hopeful.

Yeah, I had to laugh. I saw recently Paul Saladino, you've probably come across him. I do know of him. I don't know him personally. He eats a sort of all meat diet or had. But recently, you know, you're talking about people changing their diets. I saw he, it's ironic because his name is the carnivore, M.D. he's now added back into his diet, honeyberries and bananas.

So there you go. There's an example of someone listening to their body. Nice. I don't know too much about his world besides he's a carnivore and other things like that. But, hey, at the end of the day, I also think, going back to our other point, I think all these, you know, it's good. I'm glad diet is getting a lot of attention because in the past, the consensus and the limited information that we had prevented us from having, you know, just think about it back in

the day, X amount of servings of sugar was good, having this amount of dairy was good, having this amount of refined carbs in your diet was like, you know, the standard recommendations. And now, at least through mechanisms of people getting access to your podcast and other people like you, people can make different choices and decisions that are there. Anyways, we've been recording now for almost about two and a half hours. So one more final question. Then I'd love to wrap up, the world that you've put together. Your dad, how's he doing? And yeah, actually, that's just it.

How's your dad doing? He's doing great. He's gone on to have a very successful career. He's published hundreds and hundreds of papers in leading journals like metabolism and cell and physiology. And his health is great. His diet is a very plant-forward Mediterranean diet. is how I would describe it.

So there's still some animal products in there, but that is the dietary pattern that he can sustain. And that has resulted in incredible improvements in his health. And, you know, it's sometimes the hardest people to influence in your life are family members. So I sort of take what I can get and are very proud of the changes that he's made to his diet. and, you know, he's always sending me photos of these new dinners that he's cooking up and is very much now excited by food and understands the importance of not being perfect in any single moment or any single meal, but being very consistent over time.

And that's a sort of key takeaway, I think. So, yeah, all in all, he's doing well. Well, there's a term. It was coined by this guy, Dave Ramsey, who was a financial author. He calls it powdered butter. syndrome. Once somebody's wiped your ass and taking care of you as a kid, there's this look on you, no matter how smart or master's degrees or information you have or following or whatever, it's like, what could I possibly learn for you? I used to wipe your butt. So I think everybody has that,

but it sounds like overall, I mean, I've known some parents that have gone in the opposite direction from what their kids are doing. So it sounds like your dad is doing a lot. So hats off to him, and I'm glad he's in great health as well. Talk a little about your world. You have a podcast in addition to the book that's out there and just anything else you want to highlight. Thanks. Yeah, so if folks want to hear more of what I have to say, they can tune into the Plant Proof podcast.

Similar to this, I sit down with different people from different walks of lives and chat to them mainly about nutrition and human health, but also planetary health as well. A lot of the researchers that are performing new studies, I'll get them on and sit down with them and dig into a bit of the methodology and what the study does and doesn't say.

So if you like that kind of stuff, we'd love to have you over there. The book is called The Proof is in the Plants. That is out in America now in Canada and UK, Ireland and Australia. So if you want to grab a copy, you can do that. There's an audio book that I read as well for that. That was fun. There's also Kindle and E-Book as well, if that's what floats your boat. and you can find me on the socials at Plant underscore Proof.

Awesome. Well, Simon, it just worked out perfectly that you happen to be in Santa Monica at this time period. I'm glad that we got a chance to talk. And thanks for being open to my long-winded questions and my own theories on things. I think always healthy dialogue, even if we have different views than people or even if we think we have different views. A lot of times we think we have different views and then we're like, well, you know, actually I look at the world very similarly to this individual or we have the same values even if we have different views. I think that's the most important thing. We both want to get the world.

In addition, actually probably eating very similarly, we want to get the world healthy. We want to make this information more available to people. And I think that we have to have people on that have a different approach than we might be doing momentarily because we always see something. something new and we always get excited about some aspect of food that we didn't previously see. So thanks for coming on and getting me excited and sharing your view. Thank you for having me. I've thoroughly enjoyed it. I love your curiosity.

And it's been nice to sit down and have. I think we did a good job. I think, you know, you had a lot of thought-provoking questions. And I agree we need more communication like this where, you know, people broadly may come to similar recommendations. perhaps don't see completely eye to eye on certain things, and it's good to be able to have thoughtful, constructive conversation, and then be able to shake hands, walk away, look at research, and together refine recommendations,

and become more knowledgeable as a community. And I love science. I think it is our only way to solve so many of the world's issues. and, you know, if I was to kind of reiterate one sort of point that seems to be a bit of a theme in this episode, it would be that whether you're looking at human health or you're looking at planetary health, we don't need a few people doing this perfectly. You know, we need billions and billions people doing it imperfectly. So take a bit of pressure off.

Find that way of eating that works for you. adapt to that theme that I spoke about. I wish you all the best of luck and hopefully we can connect in the future. Thank you, brother. Appreciate you.