Mark Bell's Power Project - EP. 526 - Sugar Makes You Fat NOT Calorie Intake - Dr. Robert Lustig

Episode Date: May 19, 2021

Dr. Robert H. Lustig is Professor of Pediatrics, Division of Endocrinology at the University of California, San Francisco (UCSF). He specializes in the field of neuroendocrinology, with an emphasis on... the regulation of energy balance by the central nervous system. Dr. Lustig has fostered a global discussion of metabolic health and nutrition, exposing some of the leading myths that underlie the current pandemic of diet-related disease. Grab Dr. Lustig's Book, "Metabolical" now on Amazon: https://amzn.to/3frCKaP Subscribe to the NEW Power Project Newsletter! ➢ https://bit.ly/2JvmXMb Subscribe to the Podcast on on Platforms! ➢ https://lnk.to/PowerProjectPodcast Special perks for our listeners below! ➢LMNT Electrolytes: http://drinklmnt.com/powerproject ➢Piedmontese Beef: https://www.piedmontese.com/ Use Code "POWERPROJECT" at checkout for 25% off your order plus FREE 2-Day Shipping on orders of $99 ➢Sling Shot: https://markbellslingshot.com/ Enter Discount code, "POWERPROJECT" at checkout and receive 15% off all Sling Shots Follow Mark Bell's Power Project Podcast ➢ Insta: https://www.instagram.com/markbellspowerproject ➢ https://www.facebook.com/markbellspowerproject ➢ Twitter: https://twitter.com/mbpowerproject ➢ LinkedIn:https://www.linkedin.com/in/powerproject/ ➢ YouTube: https://www.youtube.com/markbellspowerproject ➢TikTok: http://bit.ly/pptiktok FOLLOW Mark Bell ➢ Instagram: https://www.instagram.com/marksmellybell ➢ Facebook: https://www.facebook.com/MarkBellSuperTraining ➢ Twitter: https://twitter.com/marksmellybell ➢ Snapchat: marksmellybell ➢Mark Bell's Daily Workouts, Nutrition and More: https://www.markbell.com/ Follow Nsima Inyang ➢ Instagram: https://www.instagram.com/nsimainyang/ Podcast Produced by Andrew Zaragoza ➢ Instagram: https://www.instagram.com/iamandrewz #PowerProject #Podcast #MarkBell

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Starting point is 00:00:00 This episode is brought to you by Piedmontese Beef. Now, Andrew. What's up? People are wondering. They want to know that we have this Deluxe Bundle. Can you tell them about it, please? I'll tell them about the Deluxe Bundle. So, again, I always recommend people check out our Power Project Deluxe Bundle on piedmontese.com
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Starting point is 00:01:38 What up, PowerProject crew? This is Josh Settleage, a.k.a. SettleGate, here to introduce you to our next guest, Dr. Robert Lustig. Dr. Robert Lustig is a professor of pediatrics, division of endocrinology at the University of California, San Francisco. He specializes in the field of neuroendocrinology with an emphasis on the regulation of energy balance by the central nervous system. His research and clinical practice has focused on childhood obesity and diabetes. Dr. Lustig holds a bachelor's degree in science from MIT, a doctorate in medicine from Cornell University, medical college, and a master's of studies in law from UC Hastings College
Starting point is 00:02:21 of the Law. Dr. Lustig has fostered a global discussion of metabolic health and nutrition, exposing some of the more leading myths that underlie the current pandemic of diet-related disease. He believes the food business, by pushing processed food loaded with sugar, has hacked our bodies and minds
Starting point is 00:02:39 to pursue pleasure instead of happiness, fostering today's epidemics of addiction and depression. Yet by focusing on real food, we can beat the odds against sugar, processed food, obesity, and disease. On top of that, through his research, Dr. Lustig has found the three primary causes of chronic disease in children and adults. But you guys probably don't want to hear about that because that's a different story. Please enjoy this conversation with our guest, Dr. Robert Lustig.
Starting point is 00:03:08 How are you feeling after your cocoa shot? Yeah, well, yesterday was odd. If you guys listened to yesterday's podcast, you know, I felt real like weirdly space headed and high. Sleeping was a little bit rough. I woke up a few times last night, but today I feel fairly normal. I woke up like six times last night. I usually do not wake up at night, so it was a little odd, but we are back
Starting point is 00:03:29 at it today. Nice. Yeah, you'll probably feel pretty good later today. Oh yeah, yeah, yeah. I feel good right now. Yeah. Be careful with that cocoa shot, people. People always talk about that second the second shot,
Starting point is 00:03:45 the second freezer. Yeah. So I thought I was built different. I apparently I'm not, I would still say you're built a little bit different. Uh, well, one thing you don't have to be careful about is so technically today,
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Starting point is 00:04:34 dot com. You guys can get everything 25% off. That's amazing. And yeah, dude, we had some more of the Hop Dottie Patties. Yeah, good. There's some. Yeah. Okay, I'm happy that you're finally eating fat i know you should be well i still my favorite is still the flat iron and when you look at the overall calories like i can have that and all kinds of other fun foods true but
Starting point is 00:04:58 yeah something about the extra fatty patties that's the fat. Need that fat. We got a great guest on today, Robert Lustig. Super popular in terms of somebody that talks a lot about nutrition. He's been in the field for a long time. He's attacked it from many different angles. He's worked with kids childhood obesity, and I think that's kind of where he started to really question a lot of the things that he knew. Bless you, Andrew. A lot of things he knew, a lot of things he learned, because it's a complicated
Starting point is 00:05:38 thing to try to figure out. As weird as it sounds, it's kind of controversial. And Robert, he'll share with us today how he doesn't think it's controversial. But I've seen people argue and fight over what makes us obese in the first place. And so trying to identify that problem. Some people say it's insulin. Some people say it's other things. I think it's a mismanagement of energy, over consuming energy each and every day and after a while that leads to some negative impacts and I think it does matter quite a bit on what you eat, the quality of foods, I think if you were to eat whole
Starting point is 00:06:16 foods, natural foods and even if you were to overeat a little bit, I think maybe you would gain some weight but I don't think you would end up with a lot of disease and I don't think you would end up with nearly as many problems and I don't think you would end up with a lot of disease. And I don't think you would end up with nearly as many problems. And I don't think you would end up nearly as overweight. But Robert, Dr. Lustig, I guess I should call him. He has over 12 million views on one of the YouTube videos that he did years ago. ago. And, you know, he goes back and forth between giving you real world, like evidence in real world, I would just put in quotes proof, I don't think anyone has like real proof of anything. Because your real world information, along with giving you some of the science and
Starting point is 00:07:00 giving you some of the reasons how we landed on all these different things. And also like, this is a weird thing, but people talk a lot about free, free will and whether, whether we actually get an opportunity to choose things and that kind of whole thing gets to be very confusing. But our, our food is kind of in a weird way. Our food is kind of fed to us and we don't really have control over, we have control over what we purchase and how we purchase it and things like that. We don't have that much control over what is done to our food. Unless we take it upon ourselves to go out of our way to get the highest quality foods, which are usually more expensive. And we go out of our way to cook the foods in a way that we think is the best for us.
Starting point is 00:07:44 And that is usually where some of the problems start to happen for a lot of people, because if it's not convenient and it's not simple, it's going to be hard for people to do it every day. And so people are feeding themselves and their children these convenient, highly produced foods, highly processed foods, I should say. produced foods, highly processed foods, I should say. And it's leading to a lot of problems because there's sugars and weird fats and all kinds of just chemically type stuff that are in these foods that don't belong in our body. They kind of override our ability to stop overeating.
Starting point is 00:08:21 Insulin levels stay high throughout the day. Your hunger hormone stays jacked up throughout the day. And you continue to overeat each and every day. And you end up with some diseases after a long period of time of doing that. It's something interesting, especially since we're going to be talking about sugar so much today. Because you have a lot of individuals like trainers who do talk about how it's not sugar that's at fault. And if somebody tells you sugar, that's at fault, you know,
Starting point is 00:08:49 buyer, your trainer, buyer, your trainer, blah, blah, blah. And it, that's an understandable sentiment because, you know, some people, you know, you think about the calories in calories out aspect of it, and you can understand that you can fit some of that in. But sugar is very, very easy to overeat. It's very, very easy to overconsume on a consistent basis. I think when people are talking about sugar being the culprit, that's one of the big aspects that they're talking about,
Starting point is 00:09:14 the ability to overconsume sugar. It's very hard to overconsume protein. It's very hard to overconsume vegetables, right? But when it comes to sugary treats, it's very easy to over consume vegetables right but when it comes to sugary treats it's very easy to over consume so like that kind of needs to be understood when people are talking about how big of a problem is it's like it's it's readily available and you can eat and eat and eat it without getting filled up that is a problem and it's super cheap and it's super cheap yeah And it's super cheap. Yeah. So then if somebody were to, you know, because researching like a Snickers bar only has like shit, it's like under 200 calories or something. Or maybe not.
Starting point is 00:09:56 Maybe now I'm misremembering. But like a protein bar would have close to 300. close to 300 if somebody were to just literally be able to stop eating sugar they'd be able to have the snickers bar and be okay or something else going on inside so let's just say okay a protein bar with we'll say sucralose 300 calories versus a actual candy bar that has half the amount of calories if this person were to somehow be able to shut off completely like hunger signals, uh, you know,
Starting point is 00:10:30 have all of a sudden crazy willpower to say no to other sugars, would there be something else going on? Like as far as like, Oh, now this person is just going to gain more weight because of the sugar. Or is it because that sugar is going to lead to more sugar? If an individual's like if they're counting their calories and they're made a snickers bar fit right um like i have seen that be okay it's not that that isn't going to like magically turn into fat or something people are
Starting point is 00:11:00 able to do that successfully people are able to make things fit, but it's just most people have a problem with that. For most people that opens up a door to have more, it leads to more easily. So if, since that's the issue, like it's very hard to just keep that in control. Some, for some people it's best to avoid it.
Starting point is 00:11:22 It's kind of a, maybe a little similar to alcohol where it's like, is it okay to have a drink or two and to drive? Right? Like, sounds like a bad idea in general. Like, you should have no drinks if you're going to drive anywhere at any time. But a drink or two doesn't sound that harmful. It sounds like you're probably going to be okay, especially if it's over like a period of time, especially if it's with food, you're probably going to be just fine. But a lot of times once somebody has that first drink and they get excited and they have four drinks and
Starting point is 00:11:54 now we're running into, you know, running into some issues. And so it's the dosage that is a huge factor. But when it comes to our children, this is where, this is where it's easier just to say, Hey, look, let's get rid of sugar because your kids are kind of everything they eat is kind of sugary. Um, or most of the things that we try to,
Starting point is 00:12:15 uh, say is for kids is sugary. Yeah. It doesn't always even have sugar in it though. But like I would consider cheese. It's as being sugary because it's a highly processed food and it has a lot of carbohydrates in it it's sure sure it has fat in it and stuff like that too but it doesn't have much protein that's going to be something that's going to
Starting point is 00:12:33 spike your insulin levels probably just as good as some like apple juice or something like that so i would put it in that category and And children eat just enormous amounts of carbohydrates. It's really skewed. And they snack most of the day. And then when it comes time for them to eat, they're not hungry. I have my own children, and I've seen this happen before, where we give them a lunch that is fairly healthy. It's just a sandwich with some protein
Starting point is 00:13:05 and stuff like that. It's not, not any sort of weird special, uh, you know, protein meal or anything. It's just a normal type of the type type of thing, but they're not hungry for it. Sometimes I've seen that happen before just because they maybe had cereal in the morning. Then they have a snack in the afternoon. They eat like five granola bars with chocolate chips in them or whatever. So after a while, we just got rid of a lot of that stuff because we're just like, we see empty wrappers. We're like, you know, we're trying to send them off to school with a snack that goes with other food
Starting point is 00:13:35 that they have. But then they're just randomly snacking on it throughout the day. So we got rid of a lot of that stuff. Here we go. Thank you so much for coming on our show today. Just a little bit of a lot of that stuff. Here we go. Thank you so much for coming on our show today. Just a little bit of a background on us. I don't expect you to know everything about us over here. We've been talking a lot about nutrition. We've talked to some of the best people in the world about this very topic. And we kind of land on some of the same similar information quite often. So I think you'll be like-minded with some of the people we've had on previously.
Starting point is 00:14:08 I'm Mark Bell. This is in SEMA. And we got our buddy Andrew over there. All three of us are involved in fitness. We love to train. I have two children. Andrew has two children as well. And so I think a great place to start for today would be to kind of dive
Starting point is 00:14:24 in and talk about children, because I think I think the kids of today are maybe our only way out of the obesity epidemic that we really suffer from here in the United States. So I guess, can you explain to us how people get to be obese? Like how is obesity such a part of American society and what triggers it in your understanding of it? So I'm going to tell you that this is way more complicated than anybody out there has suggested. There are a lot of pieces to this. There are a lot of pieces to this. The standard mantra is, well, you eat too much, exercise too little.
Starting point is 00:15:15 And, you know, so you're blaming the victim, you know, gluttony and sloth, a calorie is a calorie. You eat more than you burn. You know, it's diet and exercise. If you're fat, it's your fault. And don't blame our calories. Go pick on somebody else's calories. All of that comes from a simple precept. And that precept is that a calorie is a calorie, that calories are fungible. So it doesn't matter if we get your calories from carrots or cheesecake or Coca-Cola or kumquats, they're all the same. And that's what we're told. And that's what a lot of people still believe. Well, that's not what the science says. Science says
Starting point is 00:15:53 something very different. So let's back up now that my job in this world is to kill the calorie as a unit of measure, that we should never talk about calories again because they are useless. I want them removed from the nutrition facts label because they are more than misleading. They are detrimental. How's that? Okay. So let me explain how children actually demonstrate this. Four studies, Russia, South Africa, Israel, the United States. In the last 25 years, every single one of those four countries has witnessed an increase in birth size. those four countries has witnessed an increase in birth size. Okay. And this is not because of late term births. This is,
Starting point is 00:16:51 you know, increase in birth weight by 200 grams, a half a pound. And if you look and do DEXA scanning, which, you know, gives you body compositional analysis, that 200 grams is all fat.
Starting point is 00:17:18 So we have fat newborns. And those fat newborns become fat children, and those fat children become fat adults. And in fact, those fat newborns, you can actually see cardiovascular risk factors as early as age five. Now, you can say what you want about personal responsibility, about it's your fault, but newborns don't choose what they eat. And any hypothesis that you want to proffer for what's going on with the obesity epidemic in this country has to explain that. And you can't. So you know something more is going on. And the reason something more is going on is because it's not about calories. So that's the first piece of information. Second piece of information is that as a pediatrician, I have watched this tsunami of chronic metabolic disease overwhelm the United States over the past 50 years.
Starting point is 00:18:26 I entered medical school in 1976. And back then, type 2 diabetes was 2.5% of the population over age 65. Now it is 9.4% of the entire population. And in fact, 5% of the population under age 50. And now we have five-year-olds getting type 2 diabetes. So these children are the canaries in the coal mine. In fact, there are two diseases, two, that now occur in children as young as age five that were never seen before in adults, type 2 diabetes and fatty liver disease. Since when do children get fatty liver disease? Prior to 1980, if you saw a patient with fatty liver disease, that was due to alcohol. Okay, you knew they were an alcoholic. But you know what? Kids don't drink alcohol, at least most. All right? Certainly five-year-olds don't drink alcohol. Yet,
Starting point is 00:19:38 20% of children today have non-alcoholic fatty liver disease. 20% of all children today? All children in America today have fatty liver disease. 20%. Not just the obese children. The obese children, it's 40%. 20% of all children, maybe your kids, and you don't know it. But when you do the liver ultrasound,
Starting point is 00:20:12 you can find out. Okay. And there's some other ways which we can talk about as to how you diagnose this. This is a silent disease until it's not. All right. I mean, basically you can reverse fatty liver until you can't. When you start getting inflammation and you start getting necrosis and cell death in the liver and you start getting fibrosis and scarring, you know, then you've got cirrhosis. And it is now true that non-alcoholic fatty liver disease is the leading cause of liver transplant in the United States. Now, having overtaken hepatitis C. liver disease is the leading cause of liver transplant in the United States, now having overtaken hepatitis C. This is a disease that didn't exist before 1980, and it is now epidemic. And it's not just in the United States, it's everywhere. Not to our extent, but it's everywhere. Hong Kong, Korea, Australia, you name the country, it's there. So where did this come from? And what's causing non-alcoholic fatty liver disease? Oh, and by
Starting point is 00:21:14 the way, these diseases have nothing to do with obesity. Yes, they're made worse by obesity, but normal weight people get these things too. So if children, five-year-old children have fatty liver disease, do you really want to tell me that this is about gluttony and sloth, that this is about calories in, calories out, that this is about energy balance? Okay, doesn't make sense. Let me give you another one. Okay, this is not children. We're going to adults now. There is a founder effect cohort in Ecuador, and they are known as the Little Women of Loja. And they're very interesting. They have a mutation in the growth hormone receptor. All right. So their growth hormone does not work in any of their tissues.
Starting point is 00:22:11 So that's why they're little. All right. And these women are obese. These women are very large compared to their, you know, neighbors or to their, even their sisters or brothers who don't have the mutation. They are obese, yet they have almost a 0% prevalence of diabetes or heart disease compared to their sibs who have a high prevalence. And cancer, right?
Starting point is 00:22:41 And they're thin and they have no cancer. That's exactly right. All right. So here's obesity without its complications. So there are a zillion reasons why this is not about obesity. Yes, obesity is a problem. I'm not saying it's not. But if you want to pin all of these health care problems on obesity, and if you want to pin all of these healthcare problems on obesity, and if you want to pin obesity on this concept of energy balance, then you really need to read my book. Because once you're finished, okay, you're not going to believe that anymore. So that's, you know, the first thing, okay? And it's all revolving around this myth, this notion that calories are the problem.
Starting point is 00:23:25 They are not. Which calories are the problem? That's what we have to get into. It's the food quality rather than the food quantity that is the problem. And I'm sure we will go there. Yeah, the name of your book, I think it's a great name, Metabolical. That is a really, really cool name. I think it hits the nail right on the head. When you're mentioning it's not about calories, let's dive into that deeply because in our community, in the fitness community, in bodybuilding and in powerlifting, when people are trying to maybe bulk and gain weight. They up their calories when people are trying to get leaner slash thinking that they're maybe getting healthier. They're going to try to reduce their calories.
Starting point is 00:24:10 And also a lot of people will track their macronutrients, will track their protein, will track their carbohydrate intake and so forth. What are some of your thoughts on that? What do you feel is maybe missing when people are implementing that and they're losing weight and thinking that they're getting healthier, but there could be other problems that they're not paying attention to. Absolutely. So, I mean, that's the $64 zillion question. So let me give you a few examples of how this works and why counting your calories is basically a fool's errand. It's just never going to work.
Starting point is 00:24:47 Hasn't worked yet, not for the general population. And to be honest with you, probably doesn't work for the weightlifting population either. And here's why. Let's take almonds. You like almonds? Indeed. I like almonds. Almonds are pretty good, actually. All right. You eat 160 calories in almonds. How many of those calories do you absorb? Yes? Yeah, there's fiber.
Starting point is 00:25:16 There's protein. So maybe half of them. I don't know, 80? You absorb about 130. Okay. So you ate 160, you absorb 130. Where'd those other 30 go? Great question. Did they go out your poop?
Starting point is 00:25:36 Did they go out your kidneys? I mean, they went somewhere. Where'd they go? You know, this isn't sleight of hand. They went somewhere, but where'd they go uh into uh digestion maybe i don't know not quite they went to the intestinal microbiome so each of us is 10 trillion cells but our bacteria are 100 trillion cells okay our bacteria in our intestine outnumber us 10 to 1.
Starting point is 00:26:06 And you need those bacteria. They actually help keep you alive. People who don't have bacteria in their intestine are actually kind of sick. Now, those bacteria have to eat something. Now, the question is, what do they eat? Well, they eat what you eat. The question is, how much did you get versus how much did they get? Now, if you ate those almonds, the fiber in the almonds, the soluble and insoluble fiber, form a gel on the inside of your duodenum,
Starting point is 00:26:34 the first part of your intestine. You can actually see it on electron microscopy, this whitish gel that covers the inside of the duodenum and it makes a secondary barrier so that simple carbohydrates, monosaccharides, disaccharides, simple starches don't get absorbed as early on in the intestine. And what that does is that means your liver is not going to have to experience the tsunami of all this carbohydrate coming out at all at once. And it will reduce your glucose excursion. You know, and everyone's right now interested in keeping your glucose excursion down because that keeps your insulin excursion down. And that's true. All right.
Starting point is 00:27:21 That's all. That's all good. And what it also means is that those calories that would have gotten absorbed, but for the fiber, are going to get transported further down the intestine to the next part called the jejunum. And what's in the jejunum that's not in the duodenum? The bacteria. That's where the bacteria live. The bacteria don't live in the duodenum. The pH is too low. It hasn't changed yet from the stomach acid. Okay. So after the pancreas injects its pancreatic juice through the sphincter of Odie in the duodenum and starts mixing with all of the intestinal contents, then the pH comes up to 7.4. and that's where the bacteria are. The point is, now the bacteria are getting the calories that were in those almonds delivered further down the intestine. And so they chew it up for their own purposes. So even though it passed your lips, even though it registered as a calorie consumed,
Starting point is 00:28:21 it wasn't a calorie absorbed. And if it wasn't absorbed, who cares about the math? So this whole concept of counting calories is irrelevant because it's not what you eat, it's what you absorb. And you can't measure that. So that's one reason a calorie is not a calorie. that. So that's one reason a calorie is not a calorie. Because if you ate it with fiber, it wasn't for you. It was for your bacteria. And you need to feed them. So that's one reason. Let's take a second reason. Protein. Now, you guys love protein powder. Now, you guys love protein powder. Okay, I am here to tell you that if you are a bodybuilder, if you are a weightlifter, and you want to build muscle, then you need protein powder. And the reason you need protein powder, I'm not giving a specific brand or anything.
Starting point is 00:29:21 I'm not here to endorse anything. The reason is because protein powder is basically branched chain amino acids. Leucine, isoleucine, valine, all essential amino acids. You have to consume them. Your body can't make them. And those three amino acids are 20% of muscle. They're very high in muscle. So if you are trying to build muscle, you need them. You can't get them anywhere else except your diet. And so if you're building, then you need a source of those branched chain amino acids. By the way, do you know what has the highest concentration of branched chain amino acids?
Starting point is 00:30:02 Dr. Justin Marchegiani Whey protein. Dr. Tim Jackson Corn. Dr. Tim Jackson Oh, there we go. Corn. Corn. Carbohydrate. And there was just a paper that came out from South Korea that basically said it's carbohydrate that drives branched chain amino acid consumption of all the different things you could be eating.
Starting point is 00:30:25 And that also generates an insulin response. And leucine, by the way, is a very specific insulin stimulator. So if you're trying to put weight on, all right, branch chain amino acids are perfect because number one, they give you the components of muscle and they generate an insulin response. Okay. But what if you're not a bodybuilder? What if you're a mere mortal like me? And what if you consume excess branched chain amino acids, not because you're consuming protein powder, but because you're consuming a corn fed steak? And let's say you don't need those branched-chain amino acids
Starting point is 00:31:08 for muscle building because, like I said, you're a mere mortal. Where do the excess go? Is there a place in the body to store them? So what happens to them? They go to the liver. The liver has to take the amino group off. So now instead of a branch chain amino acid, now they're a branch chain organic acid. And that branch chain organic acid will enter into what's known as the Krebs cycle, what happens in the mitochondria to burn energy all the way to ATP and carbon dioxide.
Starting point is 00:31:44 And that's the chemical energy of life, is to make ATP. All right? Now, that's all well and good, but two things. Number one, it costs more energy to take that amino group off, the amino acid, than it does to phosphorylate, say, a carbohydrate. So there's a net loss of energy when you're burning an amino acid compared to a monosaccharide. So they're not equivalent. If you put them in a bomb calorimeter and you explode them, they're equivalent. But in the body, because there's a net loss of taking that amino acid
Starting point is 00:32:26 and turning it into energy, they're not equivalent. But you can't determine that from quote, calories, unquote. Another reason a calorie is not a calorie. In addition, you ate those branched chain amino acids, you didn't need them. They enter the Krebs cycle, but the Krebs cycle can only run so fast. Everyone's got a fixed rate of maximum velocity on that Krebs cycle. You can only go so quick. If you overwhelm it, what happens to the excess? It gets thrown off out of the mitochondria, a citrate through a process called the citrate shuttle. That citrate can then be broken back down into acetyl-CoA in the cytoplasm, not in the mitochondria. And then that acetyl-CoA will then
Starting point is 00:33:11 generate two carbon fragments and you will have basically built from scratch a fatty acid with an enzyme called fatty acid synthase. This process of taking citrate all the way to fatty acid is a process that we study at UCSF and Touro University called de novo lipogenesis, DNL, new fat making. This is how your liver turns carbohydrate and particularly sugar into fat. And it is that liver fat that causes chronic disease, unrelated to its calories, having nothing to do with its calories. So the more de novo lipogenesis, the more liver fat, the more insulin resistance, the more chronic disease. So you want protein powder? You better be a bodybuilder. You know, this, okay, so this has me curious because individuals that are like, I guess, in the fitness industry,
Starting point is 00:34:25 individuals that are like, I guess, in the fitness industry, um, individuals that are trainers, cause you, you hear a lot of trainers talk about this or people that compete and they've been able to successfully change their body composition to the left and to the right, uh, gaining and losing. They've done it for people using calories, right? They're listening and they are kind of probably trying to really rack their head on why it doesn't matter and i mean we can understand that it's not exact when you put all these calories that you're tracking into one of your trackers you have an idea of what it may be even though that is probably wrong to an extent but they would say well it's a consistent measurement that's wrong and i'm tracking my change wrong consistent measurement. That's wrong. And I'm tracking my change. It's wrong.
Starting point is 00:35:07 It's wrong. But then they're tracking their change off of that wrong measurement. And then they make more changes to that measurement. Right. So it ends up still leading them in the direction. So, well, sure. Sure. I mean, I'm not going to argue that.
Starting point is 00:35:19 I mean, the fact is, if you eat less, you will lose weight. I'm not arguing that. The question is why? Is it because of calories? No, it's because of insulin. It's because of insulin. Because of insulin. Now, calories in general correlate with insulin response.
Starting point is 00:35:38 But there are specific foods where it doesn't. That's not true. In general, it's true. Carbohydrate definitely generates an insulin response, no argument there, but carbohydrate with fiber generates a very weak insulin response. In fact, I have a slide that I show, which shows the glucose excursion in your blood in response to a low-carb diet versus a high-fiber diet. And they're almost identical.
Starting point is 00:36:09 Almost identical. High-fiber diet, you know, high-carb, high-fiber, low-carb. Same glucose excursion, therefore, same insulin response. So here are all these people yelling, you know, low-carb, low-carb, low, low carb, low carb, keto, keto, keto. The fact of the matter is I understand why, and I'm not against keto. I'm actually for it. But I can be for vegan too, because vegan, if you do it right, that is, has lots of fiber. So the Ornish diet is pretty much vegan. All right. And it's pretty much, you know, a bunch of twigs and sticks. All right. And if
Starting point is 00:36:51 you like twigs and sticks, you know, that works very well. The point is that Coke, Doritos, and Oreos are also vegan. So just eating vegan doesn't mean you're doing it right because Coke, Doritos, and Oreos don't have any fiber. And so your glucose excursion will be enormous, will be massive, and that will drive weight gain. So really calories and carbohydrate and glycemic index, which I also think is a canard. These are all proxies for the insulin response. It's the insulin response that actually determines weight gain, weight loss, body compositional changes, et cetera. The problem is right now, we don't have an online, in real time measure of our insulin excursions, but we're working on it. I'm
Starting point is 00:37:47 actually working with a couple of companies that are trying to develop a wearable to be able to do just that. And that will be a big, big boom. Yeah. At the moment you can mainly track your glucose levels, right? Which is maybe just not as accurate of a measure of what's happening with your insulin due to the fact that you might be eating other things with the carbohydrates and it might be slowing down the absorption, digestion, and so forth. That's right. So I'm not saying that monitoring your glucose excursion is bad. It's good. It's just not enough.
Starting point is 00:38:22 In the grand scheme of things, I would say that monitoring your glucose excursion will give you about 10% of the equation. Now, 10% is more than 0%, so that's good. But if you think that's all you need, then I got a bridge to sell you. What you will also need in order to do this properly is the insulin response, the postprandial insulin response. And with that, you will need the postprandial C-peptide response because you'll need to know whether that insulin is really insulin or pro-insulin. And that's a big issue. And also you will need the postprandial triglyceride response. And that's something that, you know, is really just
Starting point is 00:39:06 very new. And, you know, we're just publishing the paper on it now. And then lastly, maybe we don't know this, if we need this yet or not, we're going to find out if we need it, is a postprandial lactate response. Now, you know all about lactate because you're bodybuilders. Okay. Your audience probably knows about lactate because you're bodybuilders. Your audience probably knows about lactate because they're bodybuilders. But lactate tells you about more than just muscle mass. It tells you about mitochondrial dysfunction. When your mitochondria are not working right, your lactate goes up. your mitochondria are not working right.
Starting point is 00:39:43 Your lactate goes up. And we know this because we actually studied this in children when we took the sugar out of their diets. Obese children, we took the sugar out, we put the starch in, and their lactate went away. And that's telling us that their mitochondria are now working right. So understanding what your postprandial lactate response is may also be important for figuring out a rational meal plan that works in terms of not just bodybuilding, but in terms of metabolic health. And these are things that are not there yet. You know, they're coming down the line, you know, maybe seven to 10 years from now, we'll have them.
Starting point is 00:40:24 Right now, all we have is glucose. What if an individual is to follow a diet that is mainly protein and mainly fat? Could they still run into fatty liver? Could they still run into some signs of even diabetes without fiber and without maybe paying attention to some other things? So basically, you're asking me, is the carnivore diet okay? Something like that. In 10 words or less.
Starting point is 00:40:50 Yeah, right. And the answer is the carnivore diet's fine. Okay. Provided you get enough vitamins and minerals. Now, that's not an automatic. You will certainly get enough B12. You'll certainly get enough B12. You'll certainly get enough B6. But you may not get everything you need from a carnivore diet.
Starting point is 00:41:10 You may not get vitamin D. If you're drinking milk, vitamin D fortified milk, you may. But not everybody on a carnivore diet likes milk. but not everybody on a carnivore diet likes milk. In addition, there are other things that you only get out of green vegetables, you know, such as biotin and flavonoids. So, you know, what I would say is if you want to be on a carnivore diet, add some green vegetables. I understand why you don't want others, you know, other vegetables, starchy vegetables. That makes perfect sense. And you don't want to generate an insulin response, but green vegetables will do it nicely. There was actually a paper in the British Medical Journal about 2018 that showed that you can add green vegetables to a ketogenic diet and not come out of nutritional ketosis and actually supplement all the things that the ketogenic diet's missing.
Starting point is 00:42:04 ketosis and actually supplement all the things that the ketogenic diet's missing. Do you think you'd be in line with fatty liver disease if you overate on those particular diets, keto diet, carnivore diet? You would not. You would not. And the reason is because the saturated fat and the other fats that you'd be taking in. They would be processed in the liver as LDL, LDL, low-density lipoproteins. That's what happens to dietary fat is it gets converted into LDL. LDL is not the cause of fatty liver. LDL sometimes occasionally can be the cause of heart disease, but it's not the cause of fatty liver. The cause of fatty liver is the VLDL, the very low-density lipoproteins, also known as triglyceride. And that triglyceride in your liver is not from dietary saturated fat. That triglyceride in your liver is from de novo lipogenesis.
Starting point is 00:43:04 That's from sugar. So no, being on a carnivore diet is actually, or being on a ketogenic diet is actually a way of alleviating the fat burden in the liver rather than the opposite. And that's another myth that has to be debunked you know by the uh by the science you know because the uh the uh the people you know the populace just doesn't understand that they think fat makes you fat and that is just not the case so i have a question um now in in practice let's like let's think more general population then because like you know a lot of people are thinking than the subsect of people that are working out and doing all this but within the general population um how is it that you have people make change because did you look at it more
Starting point is 00:43:57 through like um a hierarchy of like food habits like let's look at what you're eating. Let's remove processed foods. Let's remove sugar. Let's remove this, that, and the other. Um, right now, some people from the sect of counting would be like,
Starting point is 00:44:13 okay, yeah, you remove all that. It's very hard to overeat whole foods or eat a massive caloric surplus of whole foods. That's right. Still possible. So I'm guessing that you,
Starting point is 00:44:27 with, with that being done, which is a much better way to eat anyway you also like pay attention to the amount of food that these individuals are eating and they will naturally end up eating in a way that will allow them to not just reverse their fatty liver etc but lose excess body fat that's what i'm assuming is happening here correct yes so let me let me tell you what the missing link is. Because you're absolutely right, but the question is through what mechanism? And that's the missing link. And to be honest with you, that was how I got into the obesity business in the first place, was investigating that missing link. So there is a hormone that comes from your fat cells that goes to your brain and tells your brain, you know what? I got enough energy on board here.
Starting point is 00:45:12 I don't need to overeat. I'm good. And I can burn energy at a normal rate because my stores are topped off. And this hormone is called leptin. Okay, and you've probably heard of leptin. It was discovered in 1994, right? And I was at St. Jude Children's Research Hospital, the pediatric cancer hospital, in 1995. And when I got there, I was presented with a cadre of about 20 to 25 children who were normal weight at birth, normal weight until their brain tumor was diagnosed. was in the hypothalamus, the energy regulation center of the brain, the hormonal regulation center of the brain, kind of like right at the base of the brain, just above the pituitary. And they had either surgery or they had radiation. Some of them had chemotherapy
Starting point is 00:46:17 and they had survived their brain tumor, which is great, except that now they were massively obese. They were perfectly normal weight before the tumor, and now they weigh 350 to 400 pounds. And not only that, but these kids would just sit. They would do nothing. Nothing interested them. No activity. They were lumps on a log. They sat on the couch, ate Doritos, and slept. And the parents of these 20 to 25 kids would come to me and say, you know, Dr. Lustig, this is double jeopardy. kids would come to me and say, you know, Dr. Lustig, this is double jeopardy. You know, my child survived the tumor only to succumb to the therapy. And it was up to me to try to figure out
Starting point is 00:47:13 what to do for them. Well, leptin had just been discovered. And so I postulated way back 26 years ago now that these kids, clearly their leptin used to work, but now it doesn't. And it must be because of the brain damage. And because their leptin doesn't work, their brain thinks they're starving. Because if you can't see your leptin, that tells your brain you have no energy stores down below to be able to conduct normal energy expenditure. All right. And so that would shut your sympathetic nervous system down. That's why you lay on the log. And it also would activate your vagus nerve. And that's why you would eat everything, you know, that's not nailed down. All right. Now, how could I fix that? Well, I can't fix the leptin problem because I can't fix a brain. Not even a neurosurgeon can do that. So the question is, what can I do instead? endocrinologist. So, you know, I had a little bit of training in this. And what I realized was that the hypothalamus sent a message via the vagus nerve to the pancreas to release insulin.
Starting point is 00:48:34 So the leptin tells the hypothalamus, calm down on the vagus nerve so that you don't eat everything in sight. And so these kids had enormously high insulin levels, and we knew that. So I said, what if we give them a medicine that blocks insulin release so that their pancreas is not putting out all this excess insulin? And so we designed a research study to answer this question and signed up eight kids, pilot study, everyone got drugged. And I told all parents, you know, call me after two weeks to tell me how things are going and I'll see you in a month. going and I'll see you in a month. Patient number one, mother calls me after one week, frantic. Dr. Lustig, something's happening. And I'm going, oh God. Adverse event,
Starting point is 00:49:42 study shut down, go to jail. I'm just waiting for the shoe to drop. And I go, what happened? What happened? And the mother said, well, normally we would go to Taco Bell and she would eat five tacos and an Enchirito and she'd still be hungry. Well, we just went to Taco Bell and she ate two tacos and she was full and she just vacuumed the house. She just vacuumed the house. Okay. All of a sudden, and the kid hadn't had a chance to lose weight yet.
Starting point is 00:50:18 It had only been a week. Okay. She feels better. You know, she's not eating as much. She has energy to be able to do something else, something with physical activity. Turned out this was not a fluke. One kid became a competitive swimmer. Two kids started lifting weights at home.
Starting point is 00:50:38 Could have gotten some training from you guys. One kid became the manager of his high school basketball team, running around collecting all the basketballs. These were kids who sat on the couch, ate Doritos and slept, and now they're active. Because we dropped their insulin. Their leptin still wasn't working, but we dropped their insulin. And so what happened was,
Starting point is 00:51:02 because the insulin's job is to take energy and put it into fat cells for storage, by blocking that with the drug, now they had the energy to burn and they were burning and they felt better. One kid said, this is the first time my head hasn't been in the clouds since the tumor. This was really a big boom. This was amazing. So in the next study, we did a double-blind placebo control trial, and we built in a quality of life questionnaire to assess this. And sure enough, if we got the insulin down, these patients both lost weight and felt better and started being more physically active. And what this proved to me, and this is proof, this is not conjecture anymore. This is a proof study.
Starting point is 00:51:52 What this study said to me was that the biochemistry drives the behavior. So you see gluttony and sloth. I see insulin. You see you eat too much, you exercise too little. I see leptin resistance. And I see that you can fix that by getting the insulin down. by getting the insulin down. And so that's what we did at UCSF in my weight assessment for teen and child health clinic, our pediatric obesity clinic for 17 years is get the insulin down any way you can.
Starting point is 00:52:37 And when you do the patient, number one, loses weight. Number two, patient feels better, and number three, once they understand what feeling good feels like, they never go back. How do we get people to understand that part of it? Because I think that the information that you just gave us is amazing, but just somebody without disease, but somebody that's sitting on the couch that is eating Doritos, that is struggling, how do you propose they start taking that first step? Because we know once they get momentum, they will feel a lot better. But man, that momentum is a tough thing to find. I hear you.
Starting point is 00:53:18 I lived this for how many years? This is what we did. for how many years? This is what we did. So our weight assessment for teen and child health clinic at UCSF, which I've clinically retired from now, so I don't see patients anymore, but the clinic still goes on. So patients can still come. We did a couple of things. First of all, we never blame the patient, ever. You never blame the patient. If you blame the patient, it's over. And I will tell you, there is one word that if you said it in my clinic, you got thrown out. Bodily, headfirst. And that word was calorie.
Starting point is 00:54:10 If you said the word calorie you were gone and what because if you said the word calorie basically you were blaming the patient because if it's about calories it's about calories in calories out therefore it's about gluttony and sloth therefore it's about behavior rather than biochemistry therefore you, you're blaming the patient. Let me ask you this, back up just a second. If you're not blaming the patient, it's totally understandable to eight-year-old kid. What about the person that's responsible for this child? What about the parent? So one conjecture I would have towards blaming the parent would be I would also blame the owner of a pet that has an obese pet because they're the one that control, you know, they control what they feed their pet. So what is your take on that side of it? Yeah.
Starting point is 00:54:57 So, Mark, I very much appreciate this. And I had to deal with this every day because I didn't have one patient. I had to deal with this every day because I didn't have one patient. I had two. I had the patient and the parent, and I had to treat both of them in order for things to get better. So what we did in our clinic, which was, and we studied this, we actually validated this instrument to show that it works. All right. And we wrote a paper about it. What we did that was the most important thing to fix the problem was what we called the teaching breakfast. So all of these kids came fasting. All right. Because we were drawing their blood to determine their comorbidities,
Starting point is 00:55:36 to determine their liver fat, to determine their fasting insulin, all this stuff. Okay. So they all came fasting. So four things would happen at the clinic. Number one, they'd see the doctor. Number two, they get a physical exam. Number three, they'd fill out a whole bunch of labs, forms, sorry. Number four, sorry, they would, five thing, they would go to the teaching breakfast. And it was held in both English or Spanish at different hours. Six kids, six parents sitting around a communal table. And every month, we would get a $100 gift certificate from Trader Joe's to buy the food and we would basically feed them. And the food that was on that table was narrated by the dietician. And she would explain to each of the kids and each of the parents why those foods were the ones on the table for breakfast and not the foods that they were eating at home that were on the table for breakfast.
Starting point is 00:56:52 All right. And what the difference was. All right. And basically we said, this is to keep your insulin down. And this is why. Okay. And in addition, we had shown them that their kid already had eye insulin because we looked at the back of their neck. You ever go to church? You ever look at the back of people's necks? You ever see the ridging, the hyperpigmentation? Kind of looks like elephant skin on the back of the neck. And it's under the arms too, and sometimes in the groin. That's got a name that's called acanthosis nigricans. Okay. That's not dirt. Parents think it's dirt. So we have to explain to them that's not dirt, right? We explained that that's insulin working on the skin. So even though we haven't drawn your kid's blood yet, we already know your kid's insulin is high.
Starting point is 00:57:39 And as long as your kid's insulin is high, you're not going to be able to solve this. long as your kid's insulin's high, you're not going to be able to solve this. And here's why. Because insulin high, kid eats straight to fat. Next day, kid eats insulin high, straight to fat. Every day, bigger, bigger, bigger, bigger, bigger, because the insulin's high. Not because of specifically what was eaten that day, but because the insulin's high all the time. Until finally the kid becomes so rotund, so enormous, that finally the pancreas, which makes the insulin, can't even make enough for as big as the kid will have gotten. The kid will have basically outgrown their insulin supply. And when that happens, now the sugar stays in the blood, starts to rise, and now you got type 2 diabetes. Okay. So we had to explain that this is an insulin problem. And I know your kid has a high insulin because I can see it. And
Starting point is 00:58:35 so can you, because they'd never seen this before. We actually pull it up on the computer and show them, you know, look, this isn't ring around the collar. This isn't dirt. You know, here are people who have this and this is why. All right. So we basically had to personalize this for them so that they understood that. And we then, you know, use the teaching breakfast to say, we got to get your kids' insulins down and here's how you're going to do it. And you're going to do it by doing things differently than you did before, because it's what you did before that got you into this problem. You know, Einstein's theory of insanity, you know, doing the same thing over and over again, expecting a different result. You got to do something different. All right. So four things
Starting point is 00:59:19 had to come out of that teaching breakfast. Number one, the parent had to see the kid would eat the food. Two, the parent had to see the parent would eat the food. Because they're not going to buy it if they won't eat it. Number three, the parent had to see other kids would eat the food. Because they got other kids at home. And number four, we showed them the bill. They had to see they could afford the food. And we actually ticked those four boxes.
Starting point is 00:59:47 If we ticked those four boxes, patient did well. Patient lost weight. And then we would just say, you know, more and more. All right. If they didn't get those four, then the patient did not do well. So we know what has to happen and we know how to do it. Now, the question is, how do you do this at scale? How do you do this not for a kid sitting in obesity clinic? How do you do it for an entire population? Now, that's a bigger question. That's why I write books, is to be able to explain this but ultimately
Starting point is 01:00:27 we have to get this into the medical curriculum we have to explain to doctors and dieticians and dentists and you know ancillary medical staff and insurance companies okay what's going on and ultimately we have to get the food industry to re-engineer and reformulate the foods that they produce and procure and market. Okay. The point is they have no impetus. They have no interest because, you know, sugar's their gravy train. It's their juggernaut. And, you know, they're not going to give it up without a fight. And they're going to drive this bus till the wheels fall off. So we're not going to get a lot of traction at the food industry level. So right now, what we have is education of the public.
Starting point is 01:01:14 And we're trying. That's why I'm here with you right now. Yeah, education alone, I don't think will cut it. I do think that maybe one way to do it is to just make it not cool anymore like if it's not you know if it's not if it's not in vogue anymore i know we don't want people fat shaming people and stuff like that but just imagine if uh taco bell was viewed as a cigarette and you saw someone eating taco bell and you're like, I can't believe people are still doing that. Well, so in fact, that's exactly right. And the thing is that the addiction paradigm is absolutely active here. People don't understand that sugar is addictive.
Starting point is 01:01:59 And you asked me before, but the parent is in charge. The parent's responsible for the kid being fat, right? Even if the kid's not responsible, then the parent's responsible because they can control what they're eating. The problem is that likely the parent is sugar addicted themselves. And, you know, if they were cocaine addicted, it would be the same thing. If they were heroin addicted, it'd be the same thing. The difference is that sugar is socially acceptable. How many people do you know who come up to you and go,
Starting point is 01:02:29 oh God, I have a horrible sweet tooth? That's sugar addiction. Now, do they ever come up to you and say, oh, I have a horrible cocaine addiction? That's not socially acceptable. But it is socially acceptable to say I have a horrible sweet tooth because they're looking for enablers. They're looking for somebody to sit down to share that apple pie with. Okay. And that's still acceptable. So 30 years ago, you would walk down the street and you would see a guy smoking and you'd think that was cool, was fashionable. Today, smoking and you'd think that was cool, was fashionable. Today, it's a filthy habit. You feel sorry for the guy. All right? So, my goal is for you to be walking down the street 10 years from now, see somebody drinking a Coca-Cola and feel sorry for them. Can that happen? Well,
Starting point is 01:03:18 it happens for tobacco, happens for alcohol. These cultural tectonic shifts, and there have been four, count them, four in the last 30 years in the United States. And here they are, ready? Bicycle helmets and seatbelts, smoking in public places, drunk driving, condoms in bathrooms. Okay? 30 years ago, if a legislator had stood up in a state house and promoted any sort of legislation about any one of those four they'd have gotten left right out of town nanny state liberty interest get out of my kitchen get out of my bathroom get out of my car today they're all facts of life nobody's arguing about any of those everyone has accepted them right and if you who has kids okay if you pull out of your driveway and you haven't buckled
Starting point is 01:04:17 your seat belt your kids will scream at you right yeah and the car too okay and the right and the car will too right so how'd that so how'd that happen and why did it take 30 years answer we taught the children the children grew up and they voted and the naysayers are dead you don't change people's minds you change generations minds so maybe people aren't allowed to eat a certain amount of carbs within 20 feet of your building maybe sure sure why not why not citizens arrest if someone has too many carbohydrates well you know in fact you know bloomberg tried the big gulp ban and he tried to get you know
Starting point is 01:05:11 of sodas off snap these were appropriate public health measures you know they were they were a little too early for the uh you know for the level of education. Ultimately, the reason education is important is to allow for society to be able to allow for these policy measures to take hold, to basically smooth the playing field. That's why education is necessary. Say Dr. Lustig is in charge. What do maybe food labels of the future look like? Lustig is in charge, what do maybe food labels of the future look like? Or what kind of regulations are you looking to maybe impose on some of the big food companies? Right. So I wouldn't even impose regulations on the food companies. I mean, I would, but
Starting point is 01:05:57 there are two things that I would do that are more important. With respect to the food label, I would completely gut the current food label. All food is inherently good. It's what we do to the food that's not. And that's what I explain in my book, which is metabolical. There it is right there. Okay. Is that it's the processing, it's the food processing. And that's not on the label. So what I would do is I would basically take the current label, throw it in the garbage. And what I would do is I construct a new food label that told people what's been done to the food, what's been added and what's been subtracted. Because that's more important than what's in it is what's been done to it.
Starting point is 01:06:45 And I actually explained with the empiric science why that's true within the pages of the book. So from the label standpoint, that's what I would do. And then from the policy standpoint, yes, we could talk about food industry regulation and all, and that we can do that, but I actually think there's something way more important that's way higher up the echelon in terms of making change. And actually, you will agree with it. Let's get rid of all food subsidies, every food subsidy. Currently, the only things we subsidize are corn, wheat, soy, sugar, all the things that are killing us. Those are the bad guys in this story,
Starting point is 01:07:34 corn, wheat, soy, sugar. What if we just got rid of all food subsidies? There's no economist on the planet that actually believes in food subsidies because they distort the market. So let's let the market work. Even libertarians can get on board with that, right? You don't want government basically telling you what to buy, but when they subsidize something, they're telling you what to buy. That's their job, as it were. But we don't need that. We needed it when we had the Dust Bowl. We needed it when we had the Depression, but we don't need it now. So the question is, what would happen to the price of food if we got rid of all food subsidies? The Giannini Foundation at UC Berkeley actually did this exercise several years ago, the mathematical modeling of this. And what they showed was that the cost of food would not change
Starting point is 01:08:33 except for two items, corn and sugar. Those would both go up. Well, that's what we want because that's what's killing us. So I would say you can't do anything in terms of food industry regulation until you remove the subsidies. Right now, the processed food industry has an impetus to create all the wrong products because they're paid to. wrong products because they're paid to get rid of the subsidies. And then we can start talking about what we need to do to get the food industry to do the right thing. They can't do the right thing. As long as the subsidies are in place, that's where I would start.
Starting point is 01:09:21 This is so interesting because it's like, I totally understand like what you're talking about and the benefits of getting rid of sugar getting rid of processed foods yeah um it's just the rough part is that that is such a big battle in and of itself because a large part of dieting culture is oh can help you lose weight and you can have your snacks, right? Well, right. So I hear you.
Starting point is 01:09:50 It's like trying to get people out of that mindset of even wanting to keep those things involved because they're so good and so palatable. That's right. Well, that's sugar addiction, isn't it? Yeah. So, you know, it all comes around again and I hear you and that's basically what we have to work on and what we have to change. You know, there are a lot of people who still think that eating small frequent meals is a good idea to maintain your blood glucose. Okay. What a crock
Starting point is 01:10:22 of you know what, right? If that were the case, then why would intermittent fasting work? Now, intermittent fasting does work for alleviation of chronic disease. The question is why? And it's not about the calories. You're not actually reducing calories when you're intermittently fasting. What you are doing is you are giving the liver a chance to burn off the fat that's accumulated because you're providing with a greater window of no eating. So that means that whatever fat has built up has a chance to be burned off first,
Starting point is 01:11:01 and the liver will burn that off first when provided with a period of no calories coming in. So that's why intermittent fasting works, and that's a good thing. And I'm a proponent of that for the right patient. The question is, why do you need to intermittently fast? Well, it's because of the liver fat. Well, you know what? If you ate real food, you wouldn't have had the liver fat in the first place. So, you know, this concept that you need your snacks to maintain a glucose level, you need your sports drinks to provide hydration and, you know, that sugar in order to replete glycogen, I'll be honest with you, it's all canard, big canard, okay? And the data actually show it, but, you know, the food industry, they ain't going back. And all canard, big canard. Okay. And the data actually show it, but you know,
Starting point is 01:11:45 the food industry, they ain't going back. And, you know, we can certainly talk about sports drinks if you want, but you know, I think they are one of the biggest problems and especially for kids. There's an unbelievable assortment of choices when you go to a store, go to a grocery store, even just the beverage area, you're just like, whoa, like when and where did this happen? There's aisles and aisles of beverages. Like, holy crap. But the truth is, is there not that. Because sugar got cheap.
Starting point is 01:12:14 Yeah, right. That's why high fructose corn syrup made sugar cheap. But a big, big piece of the puzzle here that people may not realize is there's not that many big food companies. that people may not realize is there's not that many big food companies. I think you have pointed out, and this was years ago in your speech that had like 12 million views on YouTube, that one that blew a lot of years have blown up like that. But that one in particular, I think you mentioned there was like seven kind of big players. Is it still the case now? Or is there a lot more people in the field because the economics of it all?
Starting point is 01:12:42 Right. Well, so there are 10 major food conglomerates and i actually show them on that slide um you know and they control 90 of the food in this country and actually around the world so yeah that leads us to not having as many choices as you think as you think because they're promoting particular things because they are already getting stuff cheap that's right well so what they're promoting is their own stuff i, so there's a lot of choice within a company, but the fact is because they're also few companies, in fact, and they're all using sugar as their hook, as their juggernaut, as their gravy train, because basically they know that we're all addicted because they know when they add it,
Starting point is 01:13:19 you buy more and I can prove it. The fact is that they have no reason to change. Now, there are some startups, there are some early entries into the processed food field that might have some, shall we say, traction in terms of improved health because they're scientifically designed to do so. But you know what's happening to those? They're getting bought up by the big CPG companies and for the most part getting killed. So they bought them. It's basically catch and kill for them.
Starting point is 01:14:00 Or sometimes that same company that harms you is the same company that offers something in a different aisle that's healthy. Nestle's offering Butterfingers and diabetes pills at the same time now. You know, so this is a huge problem. Oh, man. Have you found that, you know, using something like artificial sweeteners has caused the same insulin response, or has that messed anything up with some of the patients that you've worked with? Right, so that's a really good question.
Starting point is 01:14:34 Everyone wants to know about artificial sweeteners. And actually, the data are starting to come in. I used to say, I don't know, but actually, we do have the data now. Hold on, there we go. We do have the data now. There was a paper that came out in the European Journal of Clinical Nutrition in 2019 that stated essentially, I mean, it's a paraphrase, but this is what it came down to. The toxicity of one Coca-Cola equals the toxicity of two diet Coca-Colas. So better, but not good. Better, but not good. All right. So the question is, if it's no fructose, there's no sugar and there's no calories,
Starting point is 01:15:17 why is it not good at all? So let me give you an experiment that was done in 2012 in the American Journal of Clinical Nutrition. The first author is Mayersk. Really good, really good article. Here's what happened. They took 100 normal adults in Copenhagen, divided them up into four groups of 25 adults each. First group, normal diet plus a liter of sugared soda per day for six months. Next group, normal diet plus a liter of diet soda per day for six months. Third group, normal diet plus a liter of whole milk per day for six months. Fourth group, normal diet plus a liter of water per day. For six months. Got it? So what happened?
Starting point is 01:16:09 The liter of soda per day group. Gained 10 kilos. No surprise. The water group. Lost two kilos. No surprise. All good so far. It's the two groups in the middle.
Starting point is 01:16:23 That are the interesting ones. The liter of diet soda per day, what happened to them? They gained 1.5 kilos. Now, they didn't gain 10 kilos. They only gained 1.5. The question is, why'd they gain any? The question is, why'd they gain any? How come they gained any? If the diet soda was zero calories, zero fructose, zero sugar, why'd they gain any? Answer, because when you put something sweet on the tongue, message goes tongue to brain, sugar's coming, brain to pancreas through that vagus nerve that we talked about with the hypothalamic obesity kids.
Starting point is 01:17:06 So sugar's coming, get ready to release the insulin. And guess what? It releases the insulin anyway. Not as much, but it still releases the insulin and that insulin is still straight to fat. So not as bad as the sugar, but still a problem. The liter of milk per day group. Now, the liter of milk has as many calories as the liter of soda, but there was zero change, no change in weight at all. How come? Because the liter of milk, the fats in the milk and the proteins in the milk were satiating. They bound to receptors on the inside of the intestine, sent messages to the brain, don't need anymore. And so they cut down on their normal food intake. So they ended up in energy balance because their leptin worked.
Starting point is 01:18:03 So the bottom line is, it's not about the calories because they were about the calories. The diet soda group would have done what the water group did and they didn't. Another reason a calorie is not a calorie. And another reason why it's the insulin stupid. And you can't figure the insulin out from a calorie sheet so period just real quick so in that study so the the group that drank the milk they ate less food because they were satiated so was there something similar with the the group that drank the diet
Starting point is 01:18:41 soda that just consumed more food and is it okay to blame the diet soda instead of saying it just tastes really good and therefore they ate more food well we don't know the answer to that but the assumption is that the insulin that the diet soda drove which it did the you know because of the sweet taste was the thing that caused energy deposition. And therefore, the patient had to eat more in order to make that back. Got it. So bottom line, it's the insulin that matters. And the problem is that calories and insulin are so loosely correlated as to not be useful.
Starting point is 01:19:23 And because it's not the calorie you consume, it's the calorie you absorb. And it's the insulin response, not the calories that make the difference in terms of the weight. So bottom line, throw out the calorie sheets. And to be honest with you, dieticians are still promoting this because that's what they learn in dietary school. And I know because I got a cousin who's one. All right. Bottom line, dietitians can be part of the problem or they can be part of the solution. And they can choose.
Starting point is 01:19:54 If they're doing math, they're part of the problem. If they're doing science, they can be part of the solution. They can choose. Okay. But my job is to kill the calorie. And so I may be killing a few dietitians in the process and good riddance. One thing that, so like I personally, I do track my calories. And in the space where people do track, the kind of end all be all argument is the law of thermodynamics.
Starting point is 01:20:23 I know you've spoken about that in the past, but can we talk about that today? Sure. So the first law of thermodynamics says that energy can neither be created nor destroyed, just shifted around. The total energy within a closed system remains constant. Agreed. The first law is a law, and I don't argue that. But the first law has two interpretations. The law is the law. It's the interpretation of the law that matters here. So here's the first law as you would interpret it, Andrew. If you eat it, you better burn it or you're going to store it. In which case, the energy storage is a function of the food intake and the expenditure, those are the behaviors. The behaviors come first, and the biochemistry, which is the energy storage, comes second. So far, so good?
Starting point is 01:21:34 That's what you would say. There's another way to state the first law, and here it is. law. And here it is. If you're going to store it, that is an obligate weight gain set up by a high insulin that is out of your control, and you expect to burn it, that is normal energy expenditure for normal quality of life, because energy expenditure and quality of life are the same thing, like the kids with the hypothalamic obesity I showed you. Then you're going to have to eat it. And now the two behaviors that you associate with obesity, gluttony and sloth, are actually secondary to a biochemical mechanism called insulin. So the first law of thermodynamics is a law. The interpretation is the issue issue and i'm going to tell
Starting point is 01:22:28 you andrew you got it wrong okay switch it turn it around and then you'll have it right thank you i was curious about something and this may sound really really dumb but i'm curious if there's anything to it so do you have is there any idea to understand if like for example artificial sweeteners there is a slight insulin response maybe not as much as like normal it's not as much not as much but with that being said it's like a sweet taste so if the person over time ingested less actual sugar and more artificial sweeteners, right? Like from diet soda or whatever, does that response become less and less over time as far as the insulin response?
Starting point is 01:23:13 Like, or does it stay? Not that we see. Okay. Not that we see. No, just the same, just lower response. What does change are the taste receptors on your tongue. What does change are the taste receptors on your tongue. This is work that Monica Deuce, who's actually a fly neuroscientist at the University of Michigan, has shown is what happens to the taste receptors and then how that ultimately predicts the insulin response.
Starting point is 01:23:40 So it doesn't change the insulin response. It changes the sensitivity of the sugar to generate it. So you need more in order to get the response. So basically that's the phenomenon of tolerance. And so the phenomenon of tolerance occurs at two places. It occurs on your tongue and it also occurs in the reward center of your brain. So you need more to get the same effect. More and more for less and less. The phenomenon of tolerance.
Starting point is 01:24:02 And then when you add on top of that stress, now you have addiction. Tolerance plus stress equals addiction. I think it's also fair to say it's important for people to pay attention to their behaviors. You know, pay attention to your behavior after you eat a cookie. Pay attention to your behavior after you have a diet soda. Because I think for some people it may trigger a response to them wanting to eat a lot more or for them to want to have this daily. And as you mentioned, you know, maybe having five or six diet sodas a day, I think most
Starting point is 01:24:36 of us can kind of recognize like, hey, you want to have one here and there. You don't have any current health risks. Looks like you're pretty healthy. Go for it. Because I think it's just as important to do some of the things that are enjoyable in life. You don't want everything to be so monotone and so, you know, all the time. So, enjoyment here and there. Look, number one, I'm for dessert.
Starting point is 01:25:00 For dessert. I am not for dessert for breakfast, lunch, snacks, and dinner. Okay? for dessert. I am not for dessert for breakfast, lunch, snacks, and dinner. Okay. If you want to have a really good, fantastic dessert, hey, invite me over. Okay. That's great. Okay. The question is, why is breakfast dessert? Why is lunch dessert? Okay. Kids, okay. National school breakfast program. Okay. 29% of all children in America are on the national school breakfast program. 45% are on the national school lunch program. All right. What's in the national school breakfast program? What's a standard breakfast? A bowl of Froot Loops and a glass of orange juice. That is 41 grams of sugar. Okay. That is 10 teaspoons of added sugar. The American Heart Association says that for children over age five, it should be three to
Starting point is 01:25:59 four teaspoons for the day. There's 10 and it's just breakfast. So would you call that breakfast or would you call that dessert? Dessert. All right. So how do you explain to a parent that it says healthy on the Froot Loops and really it's poison? How do you explain that? Well, that's my job, and that's what I do in this book. What I was going to ask is how do we, like, you know, being a parent and seeing what other parents do with their children and stuff like that, it's easy for me to observe and it's easy for me as a parent to have noticed that if I was to take my child to an orthodontist and they said, hey, you know what? It looks like your son needs braces. I'd talk it
Starting point is 01:26:53 over with my wife, talk it over with my son, and he would probably wear braces. If I went to the doctor and I said, my son's very fatigued. He's not feeling well. And they came back and they said, hey, look, he's like 40 pounds overweight and he's pre-diabetic or he's diabetic. Why in this country is that such a harder thing to deal with? Is it because to throw braces on somebody like doesn't it just cost something? It's like it's a fee. You put the braces on, the doctor tightens it up here and there. And I don't have to do anything as a parent. is it because we've gotten to be like super lazy we don't want to attack it or is it too sensitive or like what's your vantage point on that so first of all everyone wants the pill
Starting point is 01:27:35 you know no one wants to do anything and prevention is irrelevant you know it's basically fix it after it's broken that's the the American way. That's the insurance company way. And you know what? The insurance companies were very happy to do that because that's the casino model. Pay to play, set the rates. And that's how they made money. They were happy when you got sick because that gave them an excuse to raise your rates. And they could also still say no, which they did frequently. Well, the fact is Obamacare, and I don't care if you like Obamacare or not, it's irrelevant to me. Obamacare did one thing, one thing. It capped insurance company profits at 15%.
Starting point is 01:28:19 And now, because of that, the insurance company can't make money raising the rates. They actually have to give money back if they didn't spend it. So all of a sudden, that's not so profitable anymore. So for the first time in their existence, since 1929, when the first Blue Cross appeared in Fort Worth, Texas, they want you to be healthy. And they don't know how. They have no idea how. Because all these years, all they did was provide sick care. Nobody provided health care.
Starting point is 01:28:59 Nobody provided prevention. Nobody provided well care. Well, the fact of the matter is, it's the processed food that's killing us. well-care prevention. Nobody provided well-care. Well, the fact of the matter is it's the processed food that's killing us. And it's interesting that you brought up the braces issue as the paradigm to get into this. So I actually have a chapter in the book about this. So my question to you is, why do so many kids need braces today? Is it because there are so many orthodontists? Right. Is that the reason? No, there are, but that's not why. The reason is because so many kids have malocclusion.
Starting point is 01:29:38 So many kids have overjet or overbite way more than before. And it's not just an American thing. China has gone berserk with malocclusion. Since 1994, their rate of malocclusion has risen like 150 fold. They never had malocclusion before in the kids, and now they do. And guess what? If you have malocclusion, you also have obesity. You also have sleep disordered breathing. So why is this? And the answer is bottle feeding and pureed, processed baby food. So think of it this way. When you're born, you have an airway, okay?
Starting point is 01:30:25 Your mouth right here, okay? And your palate back here, okay? And that has to grow. How does that grow? Chewing. Well, first, it grows because of sucking. of sucking and sucking on mother's uh nipple provides an enormous negative pressure pushing up on the hard palate and there's a suture you know where the bones the maxilla bones come together it's called the incisive suture and the um tongue is pushing up against it expanding it
Starting point is 01:31:02 right but if if you're sucking on a plastic nipple, you don't have the same negative pressure. And so it doesn't expand as much. And that ends up leading to the high arch palate, which ends up leading to the malocclusion. Then after age six months, when you start introducing solid foods, the thing that grows that airway are the muscles on either side, the temporalis, the masseter muscle, and the medial and lateral pterygoids that are involved in chewing. So before there was processed baby food, which basically started in 1901. How did parents feed their babies before 1901? We had many thousands of years of raising children. How did parents feed their babies before there was processed baby food? The same way the birds did. They would put some regular
Starting point is 01:32:04 food in their mouths, macerate it up themselves, and then drop it into the baby's mouth. And that's how the baby also got the mom's microbiome. And it also caused them to have to gum it and chew it to death, which generated increased muscle tone in those muscles of the face that grew the airway and provided for more oxygen, which basically kept us healthy. Now, everyone's got malocclusion and sleep disordered breathing and obstructive sleep apnea, which then only fosters more because now the fat in the neck actually causes the airway to, you know, get even smaller while you're sleeping because, you know, you don't have the ability to hold it open. And so now you've got obstructive sleep apnea and that puts you in right heart failure and now you're dead. So our food practices, not just for kids and for adults, but actually for babies, is a total, complete disaster. We have basically undone our own biology.
Starting point is 01:33:21 And we have no choice but to get it back because there's no pill for this. Would you say that, um, cause you had mentioned that at six months is when they would chew up the, uh, the food and then give it to their baby. Is that like a good recommendation? My son is about to be four months old and, and I've been wanting like, let's show, let's see what happens is chew up a steak and throw it down there.
Starting point is 01:33:39 But, um, that's just me being a meathead. Um, but I was curious, like what recommendations would be for a solid food for him? so my question is, do you want the American Academy of Pediatrics recommendation or do you want
Starting point is 01:33:53 mine? I would, I would very much appreciate yours, but also curious what the American Academy of Pediatrics does say about this. Well, I'm trying to fix that. Yeah. It's,
Starting point is 01:34:04 it's a, it's a long, lonely road. But the pediatric orthodontists are starting to come on board. I just wrote a chapter in a textbook with my colleague, Dr. Kevin Boyd of Lurie Children's Hospital at Northwestern University in Chicago about this whole issue. And there's also a book out that is already out. It's called Breath by James Nestor, which talks about this issue as well. It's about growing the airway and why this is important. So for me, the answer is we need to let kids chew. And the only way to do that is to give them real food. And that's what we used to do. But, you know, then everybody got scared about kids choking. And, you know, the question is, how many kids actually choked and ended up, you know, needing
Starting point is 01:34:57 to go either to the emergency room or died? And the answer is virtually none. But, you know, we put the fear in people, you know, that that would happen. And, you know, it was the processed food industry, you know, making pureed baby food in pouches, you know, and so it sounded like a good idea. We've actually undone something that was good. And so we need to rethink this. And the American Academy of Pediatrics needs to rethink this. And I actually give talks on this called the nutrition transition from fetus to toddler.
Starting point is 01:35:30 So, you know, I'm doing my part, but it's a long, lonely road. And then your own recommendations? Well, I think that it's good to get that kid chewing. And I think meat is good. It's a good thing to chew because it will get macerated and it will go down and hey, it tastes good and it doesn't have any sugar. How about that? How do we determine what's like, or how do you determine what's a good food and a bad food? I know you said all food is kind of inherently good. It's just kind of what we do to it, but how do you determine what's good for us?
Starting point is 01:36:05 Right. So what's healthy? In the book, I actually define healthy. The FDA has a stupid definition for healthy, low unsaturated fat, high in vitamin D, high in potassium and magnesium. That's the FDA's definition. The USDA doesn't even have a definition of healthy because if it did have a definition, then all of the packaged foods couldn't say healthy on them. So they don't even try to define it because then all the industry would go bonkers trying to meet that. So this is like a joke. It's the biggest canard in Washington is the FDA and the USDA. These are captured agencies. All right. So what's my definition of healthy?
Starting point is 01:36:51 And it actually fits the empiric data. Six words. Two clauses, six words. Easy to remember. One, protect the liver. Two, feed the gut. Protect the liver, feed the gut. Protect the liver, feed the gut. Any food that does both is healthy.
Starting point is 01:37:14 Any food that does neither is poison. Any food that does one or the other, but not both, is somewhere in the middle. And that's what the empiric data show, which is why I offer it in the book. Chapter 11 is how that works and why it works and the data that actually support that contention. Where does some steak sit on that? Steak doesn't flood the liver. And the steak ultimately feeds the gut. Steak fits fine. What are some foods that some people would maybe have expected to be good or healthy that, you know, probably isn't?
Starting point is 01:37:54 Strawberry yogurt. Strawberry yogurt specifically? Strawberry yogurt. Okay. So, yogurt is good. Nothing about yogurt, plain yogurt, that's bad. Everybody is eating this low-fat yogurt. That's a mistake.
Starting point is 01:38:10 Eat the whole fat yogurt. Get the satiety out of that. Don't look at me. Okay. So people think saturated fat is bad, and that's wrong. Saturated fat is not bad. It turns out that dairy-surated fat is not bad. It turns out that dairy saturated fat is good. Dairy saturated fat and red meat saturated fat are not the same.
Starting point is 01:38:32 Red meat saturated fat are even-chain fatty acids, C16 and C18. Dairy saturated fat are odd-chain fatty acids, C15 and C17, which are metabolized in the liver differently. are odd-chain fatty acids, C15 and C17, which are metabolized in the liver differently. And they also have a specific phospholipid signature, which has been shown to be protective against diabetes and heart disease. So dairy-saturated fat is good, but we've taken the fat out of the milk and out of the yogurt because we thought it was bad. It's not, it's good. Is there anything to be made of grass fed? Does that matter much? Well, grass fed will mean less branch chain amino acids. And like I said, if you're a bodybuilder, you need branch chain amino acids, but if you're not a bodybuilder, you don't.
Starting point is 01:39:15 So I think it depends. For your audience, it might not matter as much. For other audiences, it might matter a lot. And the thing is that when you take the fat out, the yogurt tastes terrible. So what do they do? They add the strawberry. So if you look at the side of a plain yogurt, it says seven grams of sugar, and that's all lactose, which is fine. Nothing wrong with lactose. That's glucose and galactose. It's fine. But if you take a look at the side of a strawberry yogurt, it's 23 grams of sugar because that's what's been added. And it's not the fruit. It's all this fruit puree. So there's no fiber in that. So that's basically all added sugar. So basically, when you eat a strawberry yogurt
Starting point is 01:40:06 you are eating a bowl and a half of fruit loops so i mean so you think that's good no well there you go that that gets you curious because we don't think there's anything wrong with fruit but you do hear a lot of people that umize fruit, right? So where does that fall in line with what we're talking about here? So there's a difference between fruit and fruit juice. Fruit is fine. And the reason is because fruit has fiber. And the fiber, and remember, there are two kinds of fiber, soluble and insoluble.
Starting point is 01:40:40 You need both. The soluble fiber are like pectins or inulin, like what holds jelly together. The insoluble fiber is cellulose, like the stringy stuff in celery. Fruit has both. What happens is that, remember that duodenum? Remember the gel? So imagine that the cellulose, the insoluble fiber, is like the lattice work of a fishnet.
Starting point is 01:41:04 The soluble fiber are like the kelp that plugs the holes in the fishnet. And together they form that barrier to prevent the sugars from getting to the liver early. So you are protecting your liver. In addition, the fiber moves the food through the intestine to the jejunum where the microbiome will chew it up. So you are feeding your gut. And also soluble fiber is specifically food for your colonic bacteria. And they turn that into short chain fatty acids, butyrate and propionate, which are anti-inflammatory and anti-insulin.
Starting point is 01:41:42 They keep your insulin down. Remember keeping your insulin down is the goal of this exercise, right? So fiber does that. So fiber is the nutrient you don't absorb because fiber is the nutrient for your bacteria and you have to feed your bacteria. So protect the liver, feed the gut. Fruit does both. Fruit juice is fiberless. The insoluble fiber has been removed. And you need that insoluble fiber to make the gel and also to move the food through the intestine faster. So bottom line, you will flood the liver. The soluble fiber will still feed the gut to some extent.
Starting point is 01:42:24 So it's not as bad as a soda. And that's what the data show. Juice is not as bad as a soda, but it's still bad. And juice consumption still correlates with diabetes and heart disease. Real cool question. And I, I want us to continue going on here,
Starting point is 01:42:42 but I figure since we're close to what we were just talking about, I want to ask, we were talking about kids I figure since we're close to what we were just talking about, I want to ask. We were talking about kids bottle feeding versus breastfeeding. Has there been a bottle that's been made that simulates the pressure of a nipple? Not yet. Really? Is that possible? Because I feel like that should be possible, right?
Starting point is 01:43:03 No, I'm not a material science engineer i don't know okay we actually bought one that like at least the shape kind of looks like a breast yeah but i we have doesn't mean that doesn't mean it works this no yeah and and thankfully my wife is on board and she's been you know savage and my son has been 100 breastfed but yeah hopefully i'll include a steak in there pretty soon yeah okay well okay i will say you know if i can toot my own horn here a little bit um while i'm not a material science engineer i work with some and what we are doing in an attempt to try to mitigate this disaster of chronic metabolic disease you Basically, fast food, processed food is fiberless food. They take the fiber out for depreciation and shelf life. And it makes it
Starting point is 01:43:54 go down real easy. The point is, we have to be able to turn apple juice back into apples. The question is, how do you do that? Well, some colleagues of mine and I are developing a proprietary fiber that is a micro-sized cellulose, like a mini-cellulose sponge, micro-cellulose sponge, impregnated with some hydrogels that are actually food for the bacteria, but hold on to mono and disaccharides in the duodenum and prevent their early absorption. Is it a little bit like Jell-O? Well, no, it's a pill, but it will end up being like Jell-O by the time it gets into your intestine. Got it. And so it expands to 20 folds larger and will actually sequester the mono and disaccharides in the gut in order to prevent them from being absorbed early.
Starting point is 01:44:55 And then so it can feed the gut later. So it protects the liver, feeds the gut, even with processed food. So the company is called Biolumine Technologies, and you can look it up online. And we're trying to, you know, get this to market. One thing I was actually really surprised when, you know, with my son finally going down like the baby section, was seeing that all the baby formula was locked up,
Starting point is 01:45:21 and it was really, really expensive. And it surprised me because as soon as he was born, these companies had been sending formula to our house. Like, seriously, we have like way too many, like I just threw them away. What's, I mean, is baby formula okay? Like if babies are kind of getting, they're gaining too much weight, is formula a reason for that? Yeah. Well, the baby formula companies will tell you that baby formula is good for you. The question is, is it true? And the answer is, well, if your wife can't pump, then you have no choice.
Starting point is 01:45:56 But if your wife can pump, then breast milk is way better. And the reason breast milk is way better is, number one, it has omega-3s. And now the formulas now have omega-3s. They've been adding it because they understand how important it is. In addition, the breast milk has what are known as oligosaccharides. Now, these are strings of sugars that are anywhere from two to five sugars long that the breast specifically makes. This is work from Bruce German at UC Davis and Lars Bode from UC San Diego. And it has been shown that these oligosaccharides, and each one of them is different, and there
Starting point is 01:46:43 are like 200 different versions of them that the breast makes. And different people, different women make different ones of them. And so they have different functions within the baby's intestinal tract, but they can act as antibiotics so that bad bacteria don't grow in the baby's intestine. And so they have anti-inflammatory and anti-microbial activities that are good for babies that formula could never be able to fix. that breast milk, because of its calcium to phosphorus ratio, because of these oligosaccharides, because of the omega-3s story, is better than formula. And the American Academy of Pediatrics is very clear on the fact that breast milk is better than a formula. However, having said that, there are a lot of women who cannot breastfeed either because of their jobs or because of, you know, just inability to lactate or because of medications that they might be on, et cetera, et cetera. There are a whole bunch of reasons why parents can't breast in a certain woman can't breastfeed and they need an
Starting point is 01:48:05 option and so you know the formula uh um you know industry is there for a reason and i'm not against formula i'm just against it as a first choice so uh just a last question about breast milk i guess it's a two-part question um if a if a mother can produce breast milk is that a it's a two-part question. If a mother can produce breast milk, is that a sign of a healthy diet or at least a good diet for her? And then second question, because this is what my wife is, it's heavy on her mind. Anytime she wants to eat something, she believes that that's going to go directly into our son and it causes a lot of anxiety when it comes to her diet now. Is there truth to that? So, yeah, is there truth to that?
Starting point is 01:48:50 And then also, because she is able to produce so much, is that an indicator that, like, no, you're actually doing fine with your diet right now? So, I don't think that the mother's diet has anything to do with the volume of breast milk. Okay. Okay. So I don't think those two things are related specifically. I mean, the volume of breast milk may have to do with her state of hydration, but it won't have anything to do with whether or not her diet is replete or not. Having said that, your wife is correct about certain things that she eats getting into the breast milk. The big one, the one that the dietician still can't believe is sugar, is fructose.
Starting point is 01:49:36 So the molecule fructose acts like alcohol in terms of what it does to mitochondria. Fructose is a mitochondrial poison. It inhibits mitochondrial function, and it does it two ways. It does it by inhibiting an enzyme called AMP kinase, and it also does it by inhibiting an enzyme in the mitochondria called ACADL, acyl-CoA dehydrogenase lung chain. And it may even do it a third way by increasing the amount of uric acid in the liver. And uric acid impairs carnitine palmitoyltransferase 1, which is the enzyme that shuttles fatty acids into the mitochondria for burning. And so when you inhibit that enzyme, then you can't get the fatty acids into the mitochondria to burn in the first place. can't get the fatty acids into the mitochondria to burn in the first place.
Starting point is 01:50:26 So, they may even do it three ways. So, sugar, fructose is bad for your mitochondria. Now, it was always assumed that fructose did not cross the placenta. It does. They said fructose doesn't get across the placenta because the placenta does not have the GLUT5 transporter, which is specific for fructose. That's true. It has the GLUT7, 9, 11 transporters, which transport fructose just fine, but those are not specific transporters. Point is, fructose gets across the placenta and can damage the baby's liver and the baby's brain. Second, it was said that fructose doesn't enter the breast milk. Oh, yes, it does.
Starting point is 01:51:06 If you drink a 20-ounce Coke, you will overwhelm the mother's, if the mother drinks a 20-ounce Coke, it will overwhelm the mother's liver's ability to extract it on the first pass. You will end up with a serum fructose level, and that fructose will enter the breast milk and will feed the baby. And that has been shown very nicely by my colleague, Dr. Michael Gorin, down at Children's Hospital of Los Angeles. And so if the baby's consuming excess fructose because the mother drank a Coke, that's a problem. What if it's a diet Coke? Well, then it won't be fructose, but then you've got the question of
Starting point is 01:51:41 what does that diet Coke do? but then you've got the question of what does that diet coke do? There's recent data that says that sucralose causes leaky gut. And in addition, some of the diet sweeteners, if they get into the bloodstream, have receptors on fat cells that can actually cause those fat cells to take up extra energy, just like if they were exposed to insulin, and it's just in response to the diet sweetener. So if that's happening in the baby, that could drive baby's weight really fast. So you can see that what the mother does has everything to do with how the baby fares.
Starting point is 01:52:27 And so this is not to be taken lightly. What did you, or when you were talking about how it can have an effect on the baby's brain, and you also mentioned earlier that kids are being born in general heavier. So do these children, I mean, let's say that parents are paying attention to what their children are eating. They're purposefully not letting their children have a lot of processed sugars, processed foods. Do these children, because of potentially maybe what the mother ate when she was pregnant, do they have a higher propensity to crave sugar even if you don't give it to them ever or often. So that study has just been completed out of the Menel Chemical Census Center in Philadelphia, and the answer is yes. We've been waiting for that study and it just got done. Yes, the answer is yes. You can actually train your fetus's tongue to like sweet before the baby's even born.
Starting point is 01:53:29 Dr. Lustig, thank you so much for your time today. Where can people get your book? Well, the book's everywhere. I mean, Amazon, Barnes & Noble, but to be honest with you, I would very much prefer if you bought the book at your local bookstore. They need your support. very much prefer if you bought the book at your local bookstore, they need your support. Bookstores are happiness. We do not want them to go out of business. Bookstores are good things. They are good things for everybody. And so if you have a choice, get it at the bookstore, but in any case,
Starting point is 01:54:03 get it because I'll bet you didn't know all this stuff and you need to. And you have to understand what the food and you need to. I just, you have to understand what the food industry is doing to try to keep you, shall we say in place and, you know, and that, and that means profit for them and, you know, illness for you.
Starting point is 01:54:17 So, you know, this is, this is a war. All right. Because what's good for them is bad for you. And what's good for you is bad for them. And until the food business paradigm changes, you're not going to change.
Starting point is 01:54:32 The question is, how do you fix it? And the answer is you vote, and you vote with your fork 21 times a week, and you have to know how. You have to know how to vote for as it were okay so uh i think that this book is an essential read i hope you know you guys do too and you know uh pick it up and you know it will debunk modern medicine it will debunk nutrition and it will debunk processed food. It will debunk big pharma and it will debunk big government. It's half science, half expose. If it were a Hollywood book, it'd be a kiss and tell. But because it's about diabetes, it's a piss and tell.
Starting point is 01:55:19 Very inspiring to have you on the show today, doctor, lawyer, writer, and many other things. I'm not a lawyer. I did one year of law school on purpose to learn public health law. I am not a lawyer. I can't sue. I just can talk to people who can. Awesome. Thanks again for your time.
Starting point is 01:55:39 Have a great rest of your day. Thank you so much. Thank you, sir. Thanks for having me. Man, he hit us with a lot of good stuff. That's some food for thought. Mm-hmm. I really hope that individuals kind of understand
Starting point is 01:55:55 the message in terms of the calories don't matter idea and what he's looking for, what he's kind of opting for instead as far as good food habits, et cetera, because he's right for instead as far as like good food habits etc because he's right like you know if you do have those good food habits you will naturally drop weight drop body fat etc because like eating a lot of those foods it's not easy to just eat in excess i think sometimes it's very hard to say like what works and then you have to define what we're talking about when you talk about does something work um calorie counting uh has it been effective to help the united states uh fight obesity no no
Starting point is 01:56:34 has it been effective to help us fight disease no but in the people that comply to it and people that follow it yeah i think it's worked pretty good. Does it work? Does it work for someone to go from not counting their calories to being 20% body fat to making a decision where they want to be 12% body fat and they start to track their calories? Turns out they eat 4,500 calories a day. Then they figure out a way to reduce their calories. They learn about protein. They learn about, you know, kind of how their calories. They learn about protein. They learn about, you know, kind of how to eat.
Starting point is 01:57:06 They make better food choices because they're tracking their calories. That's an important piece of the puzzle that people leave out often is that it's, you're more, you're more than likely to make better food choices because you're now accountable because you're counting up what you're eating. You're tallying up what you're eating every day. And so you're like, I'm not supposed to eat that because that's going to register too high. And if I have 850 calories now, then it's going to mess up. I can only do that
Starting point is 01:57:35 one more time and I'm done for the day, you know? So it makes people accountable and it allows people to have a measure, how accurate it is very very debatable, because I don't think that protein is much of an energy source. I don't think that fiber is much of an energy source. We know that food labels are incorrect, but very much like getting your body fat checked or very much like weighing yourself every day. Who really cares if the scale is inaccurate? It's a unit of measure. The scale says you weigh 180 versus you actually weigh 190, it really doesn't matter.
Starting point is 01:58:09 If you're trying to trend downward and the scale shows that you keep going downward, it might not really matter that much. You still are trending in the right direction. And so to try to even define that something's working or not working is a really hard thing to give credence to. But when he's talking about fatty liver disease and diabetes, it does make you wonder, and I don't think the information is out there yet because I don't think people have been meticulously counting calories the way that we have been
Starting point is 01:58:43 with maybe just the last 20 years, 30 years. It hasn't been that long yet. So we don't know the health implications of somebody spiking their insulin multiple times a day through maybe not making the best food choices, but still keeping their calories in check. I don't know if we have enough information to determine whether that is something that's going to not promote fatty liver and things like that. Hard to say. Yeah, you hit it right on the head with, you know, if you are tracking and accounting for every calorie, you know, as an example, like I used to grab like a Quest bar almost every day on my drive home just so that way i get bored and sometimes i start to doze off not not the best best thing but if i eat something it keeps me awake
Starting point is 01:59:32 um now that i'm tracking like i'm not grabbing you know that protein bar i don't need it there's no need because when i look at i'm like wait if i eat that then that means i have less calories for dinner tonight like i know i'll just chew some gum or whatever and take the five calories instead. But in regards to the, I mean, there's a lot of people that, you know, I wish we could like tag one of our friends in, like when it comes to like him saying calories don't matter. Like, cause I know Lane Norton, he's pretty heavy on heavy on you know the energy in and out type of thing it'd be cool to just have like the the conversation um so the only thing that I will take from this is I'm just going to keep stacking the odds in my favor um I will research and try to figure out like the insulin response and that sort of thing but But in the meantime, I know if I eat 2200 calories,
Starting point is 02:00:26 I can pretty much like maintain and grow a little bit. If I eat 1700 or less, I'm going to start losing weight. And yeah, it definitely does matter what foods I eat. But if I, again, stack the odds in my favor, then there's a good chance that my weight will trend in the direction that I'm hoping to go. I mean, just another just practical takeaway, you know, as far as when it comes to like fatty liver and actually type two, one thing that people can do, like if you are an individual that does track, if you do pay attention to that and it's working for you in terms of the specific goals you have set maybe do your best to just keep the processed sugar and processed foods out of the diet like we talk about that
Starting point is 02:01:11 all the time just maybe just keep that out yeah right um because it's like again that's why like i get what he's saying i totally understand what he's saying as far as the calories don't matter thing. It's just try to tell that to somebody who's making so much progress in their mind. Um, try telling them that that doesn't matter and it doesn't make a difference and they'll just put their weight in front of you or they'll just put their progress in front of you and show you what type of progress has been made. But you know, the, the big thing we're talking about here is the general population outside of let's say people that are really zoned in on that exercising having good fat like having good habits it's like what he's like that it would be ideal if the general population could stray away from processed foods and sugar everyone would be healthier for it everyone would be um
Starting point is 02:02:07 you can't necessarily say that that's that's wrong i think uh you know when it comes to like uh gaining body fat like there's it's hard to point to one thing that that quote unquote makes you fat um i would even say that insulin doesn't make you fat. I mean, bodybuilders use insulin. They're not fat, you know, and, you know, they, they inject it. There's people that are type one diabetic that have to utilize insulin every day. If insulin made you fat and these people were injecting it all the time, I think it would be likely to conclude that they would automatically be really, really heavy. And a lot of times they're not. Sometimes they're not even overweight at all.
Starting point is 02:02:48 In a lot of cases, not overweight at all. So the only thing that you can equate to people being way overweight and having excess amounts of body fat seems to be people overeating day in and day out. Overconsuming energy, you want to call them calories. That seems to be people overeating day in and day out, over consuming energy. You want to call them calories, however you want to, however you want to mark that. And then people saying like a calorie is not a calorie. I can actually agree and disagree with both of those statements, because I think the way that we light calories on fire inside of a box, like just to me, that's ludicrous. Like, I don't think that makes a lot of sense, but it is our unit of measure.
Starting point is 02:03:27 We currently don't have anything else that matches that. That's the way that we decided to measure it like 50, 60 years ago. And with a bomb kilometer or whatever the fucking thing is. Calorimeter. Bomb calorimeter. There we go. Yeah. It sounds like something out of a superhero movie or something.
Starting point is 02:03:45 That's the way that we measure them. And it can be something that we've seen work for people before. And when I talk about work, I'm talking about the management of their body weight. weight, we've seen many times over, both research wise and just our own observation that when people can manage their body weight and they start to lose body weight and body fat, they normally get healthier. Does everything get healthier? Do they fix all their problems with that? Maybe they would have to investigate more on the actual foods that they're eating at that point to get better and get rid of everything or to try. But it is a unit of measure.
Starting point is 02:04:30 And, you know, it does seem I hate I hate the conversation sometimes because I think that both Dr. Lane Norton and Dr. Ludwig are both helping people. And so I don't like the I don't like um i don't like the fighting you know um if if we if we were if we were to get mom dad stop yeah yeah well if we like if we were if we were to get attacked you know like it's my fault well if the three of us in this room were to get attacked it wouldn't be the best time for me to test out my boxing skills against and seem as jiu-jitsu skills we'd be better off saying hey let's and and andrew let's see if we can fight these fucking people off yeah since we're all part of the same mission you know what
Starting point is 02:05:15 i mean and instead it's like the butting of heads and no one cares no one no one cares about uh you know dr rustig and and and uh and um lane norton like fighting like no one really cared like we care because we're nerds so we would listen to it and we'd have fun listening to the different conversation back and forth but the person that's 350 pounds that's really struggling they don't care they just want the advice that's going to help them get to the next level or the motivational thing that's going to help them get off the couch and get moving probably. You mentioned something that was super important for people to pay attention to during the conversation. After you have some of these foods, pay attention to your behaviors after. Pay attention to the way you feel after you have a Ben and Jerry's or a Reese's and then pay attention to what your appetite does. I think it's necessary to have a reference of having time away from it first,
Starting point is 02:06:11 like having time where you've gotten stopped eating sugar for a bit, like processed sugars, and see how you feel as far as your palate and your appetite is concerned. And then play the dark game of bringing it back. Cause then you'll realize how much you then start getting driven to have more and more and more. I think I realized that when I did get rid of that. And then when I started having a little bit here and there. I realized like, oh shit, I'm starting to really want more. Like the next day, I'm craving it way more. Like I really want to and I have to actually fight that feeling.
Starting point is 02:06:43 Whereas when it's just gone for a while, I can stay away. I remember I took some painkillers. I had something happened in the gym. I can't remember what it was. One of the guys got me some painkillers. I didn't want to take them, but I was literally in a lot of pain. I took them. They felt great.
Starting point is 02:06:59 I was able to move around for a few days. And I told my oldest brother, I told Mike, I said, I'm like, Hey, like, you know, the next day I'm like, I feel like shit. And he goes, the only way to get rid of that is to take more. He's like, you need to take those and you need to fucking give them to somebody else or throw them away. Like you need to do it like immediately. And I didn't, you know, I didn't, I didn't really know exactly what he meant, but, and I was only like after being, doing that for like three days. So I think the same thing happens to food.
Starting point is 02:07:27 It's maybe not the same, you know, pull like people when they're dealing with drugs or alcohol, people can die if they go cold Turkey off of certain drugs or certain, certain, even alcohol sometimes. So people have to be really, really cautious with that. But when it comes to food, I've noticed that I have pizza one day, the next day, my mind is racing. I have ice cream or something like that. The next day, my mind is racing. And the only cure for it seems to be like to fill in that gap again, is to get that sugar. And it's great to, you know, really push away and stay away from them. And I think I mentioned to you before, Andrew, even the best times of my life in terms of my nutrition, I don't think I've ever even gone that far.
Starting point is 02:08:08 Like where there hasn't been. I probably have only gone about two weeks or so without having something that's not great for me or something that's even during my bodybuilding show, I would get a little break here or there. I'd get like a small cheat or I never, I definitely have never gone like 30 days or, you know, a couple of months without anything sweet at all. I'm trying to think like even like carnivore diet stuff, like I still have a protein shake, like I've never. And so I think it's a good practice just to see how many days, I'm not saying that you need to go a month or two months or three months, but maybe just see if you can go like two, three days, learn what that feels like, learn about it. And sometimes you'll find yourself when you dive deep into stuff like that, that it actually kind of makes you a little bit miserable. But I think experiencing some of that and knowing some of that and then recalibrating and saying, I didn't really like that. That was kind of like bullshit.
Starting point is 02:09:06 I didn't like that that much. That was too severe. Let me kind of find some middle ground that makes me happy and allows me to get progress. You know, the fact, though, that not having processed sugar can make one feel so miserable should be something to really think about. Right. Like, we shouldn't feel so miserable without that substance. Like we shouldn't feel so miserable without that substance, but we do because it's like straight up, like people don't want to take away their sugar or they'll get angsty and angry that kind of a problem even though we can be shredded and eat sugar it's still not necessarily healthy for us all it's all a thing right like even opening opening up a thing of cereal like the smell of the uh cocoa pebbles or whatever right like yeah all that
Starting point is 02:10:06 the the uh those are amazing the sound of like pouring them into the bowl the sound of like putting the milk on top the combination of the milk and then the kind of soggy and then still kind of crunchy yeah at the same time you get to the bottom of the cereal bowl and it's like it's like the sugar has seeped into the milk and it's like a juice. I'll always leave like a mountain of dry and then mix that with the wet. So that way it's just like a good combination of crunchy and soft. I think maybe you mentioned before, Andrew, like not understanding how to enjoy yourself at a party without a beer in your hand. Correct.
Starting point is 02:10:40 Right? And I've heard people say that before. I've heard people say that about food. Like, I don't know how to sit down in front of my TV without crunching on something. And I never think that you have to completely get rid of that. I actually just think that you might need to just make better choices. You know, protein shake, maybe trade out your, you know, food with something that has is less dense in calories or there's, there's usually better option. Make sure you had a good dinner beforehand where you had a lot of protein. You did everything you needed to do in the day. You walked, you lifted. Now it doesn't matter as much if you have something, you know, but anyway, I thought, I thought today was great. And Robert Lustig, uh, people should look up a little bit more information on him. Check out some of the, uh, posts that he's made or some of the YouTube things he's made. He's got one in particular that's got like 12 million views. And it's just, it's amazing.
Starting point is 02:11:32 He goes through the whole entire thing of kind of how we got here in the first place. It's amazing. Yeah, and I'll link his book down in the YouTube and podcast descriptions. I like what he said about a sweet tooth. That was pretty funny. What are you talking about? Cocaine? Yeah.
Starting point is 02:11:49 Oh, yeah. We got a steak tooth is what we got. Steak tooth. I like that. Yeah. Speaking of steak, so today that you're listening to this, check the clock. So 1 p.m. Pacific time, Piedmontese is having a 25% off sale for Memorial Day.
Starting point is 02:12:12 And so if you order by, what's the order, April, May 19th through May 26th, it'll ship and arrive before Memorial Day. So if you want to have that big Memorial Day barbecue, make sure you order before then. And if you're listening to this after that sale has happened, make sure you use promo code POWERPROJECT for 25% off your order. And if your order is $99 or more, you get free two-day shipping. Are we out of here, Mark? Do you want me to close this thing down? Absolutely.
Starting point is 02:12:40 Cool. Thank you, everybody, for checking out today's episode. We just released another newsletter. So if you guys have not subscribed to that, check the links down below. Make sure you're following the podcast at Mark Bell's Power Project on Instagram at MB Power Project on TikTok and Twitter. My Instagram is at I am Andrew Z as well as Twitter and SEMA. Where are you at? Head to iTunes, people. I'll tell you every time. Head to iTunes. Give us a... I'm sorry. And yeah, we were rating. You guys have been leaving some dope stuff there.
Starting point is 02:13:07 So thank you. Add Seema Inyang on Instagram and YouTube. Add Seema Yin Yang on TikTok and Twitter, Mark. Strength is never weakness. Weakness never strength. Catch you guys later. Bye.

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