The Dr. Hyman Show - 5 Nutrition Tips To Fix Your Health And Live Longer

Episode Date: November 26, 2021

This episode is brought to you by Rupa Health and Paleovalley. If I had one “medicine” to take with me anywhere in the world to heal people it would be food. Real food contains thousands of molecu...les, each designed to regulate and optimize the functions of your body—your gene expression, hormones, brain chemistry, immune system, gut microbiome, and more. In this episode, I talk to Tom Bilyeu, Lewis Howes, Dr. Elizabeth Boham, Dr. Shebani Sethi Dalai, and Fred Provenza about the power of using food as medicine.  Tom Bilyeu is a filmmaker and serial entrepreneur who chased money hard for nearly a decade and came up emotionally bankrupt. To that end, he and his partners sold their technology company and founded Quest Nutrition—a company predicated not on money, but rather on creating value for people with the mission to end metabolic disease, something impacting Tom’s own family. Bilyeu then turned his attention to the other pandemic facing society, the poverty of poor mindset and co-founded the media studio, Impact Theory with his business partner and wife, Lisa Bilyeu.  Lewis Howes is a New York Times Bestselling author of the hit book, The School of Greatness. He is a lifestyle entrepreneur, high-performance business coach, and keynote speaker. A former professional football player and two-sport All-American, he is a current USA Men’s National Handball Team athlete. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Dr. Shebani Sethi Dalai is a double board-certified physician in Obesity Medicine and Psychiatry. She is the Founding Director of Stanford University's Metabolic Psychiatry program and Silicon Valley Metabolic Psychiatry, a new center in the San Francisco Bay Area focused on optimizing brain health by integrating low-carb nutrition, comprehensive psychiatric care, and treatment of obesity with associated metabolic disease.  Fred Provenza is professor emeritus of Behavioral Ecology in the Department of Wildland Resources at Utah State University where he worked for 35 years, directing an award-winning research group that pioneered an understanding of how learning influences foraging behavior and how behavior links soil, plants, herbivores, and humans. He is the author of three books, including Nourishment: What Animals Can Teach Us about Rediscovering Our Nutritional Wisdom; Foraging Behavior: Managing to Survive in a World of Change; and The Art & Science of Shepherding: Tapping the Wisdom of French Herders (co-written with Michel Meuret).  This episode is brought to you by Rupa Health and Paleovalley. Rupa Health is a place for Functional Medicine practitioners to access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, Great Plains, and more. Check out a free live demo with a Q&A or create an account here.    Paleovalley is offering 15% off your entire first order at paleovalley.com/hyman.

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Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. If you're eating processed food, sugar, starch, bad fats, it's going to be a problem. You're not going to get better. Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me helping patients heal using real food and functional medicine as your framework for getting to the root cause. What's critical to understanding what each individual person and
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Starting point is 00:01:10 Rupa Health helps provide a significantly better patient experience and it's 90% faster, letting you simplify the entire process of getting the functional medicine lab tests you need and giving you more time to focus on patients. This is really a much needed option in functional medicine space and I'm so excited about it. It means better service for you and your patients. You can check it out and look at a free live demo with a Q&A or create an account at rupahealth.com. That's R-U-P-A health.com. Now, so many of my patients ask me how I manage to work multiple jobs, travel frequently, well, not so much anymore, and spend time with my family and still focus on my health. I know it can seem hard to eat well when you got a lot going on, but the trick is to never let yourself get into a food emergency and to stay stocked up with the right things to support your goals. So recently I discovered Paleo Valley Beef Sticks. I keep these beef sticks at home and at the office so I know
Starting point is 00:02:00 that whenever I'm in a food emergency, I have a healthy and delicious option to keep me on track. It's no secret that I have high standards when it comes to what I put in my body. And Paleo Valley Beef Sticks checks all the boxes. They're gluten-free, grain-free, dairy-free, soy-free, and non-GMO. Plus, they use 100% grass-fed and grass-finished beef, which not only adds to the flavorful taste, but it also means they're free of any harmful antibiotics or hormones that you'll find in most meat. With grass-fed beef, you'll get more nutrients than you would with beef fed with grains, things like higher levels of omega-3 fats that help reduce inflammation, and more B vitamins and other
Starting point is 00:02:41 antioxidants to support your body's converting food into energy, and also more of the fat-soluble vitamins that are beneficial for a healthy heart. Plus, instead of being processed with chemicals and other questionable ingredients, these beef sticks are naturally fermented, so you get gut-friendly probiotics with every bite. How cool is that? Right now, Paleo Valley is offering my listeners 15% off your entire first order. Just go to paleovalley.com forward slash hymen to check out all their clean paleo products and take advantage of this deal.
Starting point is 00:03:16 That's paleovalley.com forward slash hymen. I definitely recommend stocking up on the grass-fed beef sticks to keep in your house, in your car, and in your office. It's one of my favorite tricks to staying healthy while on the go. All right, now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Feehan, one of the producers of The Doctor's Pharmacy podcast. Every day we can make a choice to use the food we eat as medicine. Real food contains thousands of molecules, each designed to regulate and optimize the functions of your body, your gene expression, hormones, brain chemistry,
Starting point is 00:03:51 immune system, gut microbiome, and more. On today's compilation episode, Dr. Hyman talks to Tom Bilyeu, Lewis Howes, Dr. Elizabeth Bohem, Dr. Shivani Sethi Dalai, and Fred Provenza. You'll learn how to use nutrition to improve your health and live longer. You'll also hear the importance of phytochemicals from plant foods and proteins and much more. Let's jump in. You can listen to all the nutritional advice you want, but pay attention to how you feel. Your body's going to tell you. You're eating pounds of food every day and that is what's landing in your gut and feeding your bugs and if you're eating processed food sugar starch bad fats it's going to be a problem you're not going to get
Starting point is 00:04:31 better so you need a whole foods diet i call it the pecan diet which is kind of a joke but it's like you know less extreme more inclusive but whole foods focusing on quality not so much worrying about quantity and uh and sometimes eliminating things like gluten and dairy and other things that can trigger food sensitivities. And combined with the diet and this protocol, within a few weeks, people started to feel significantly better. And then it takes about three months to really kind of reset the whole thing. When somebody has a stubborn problem, like Lisa is insanely disciplined. If you tell her to do something, she's going to do it for sure. Um, her diet is clean. In fact, I would probably consider that one of the things that, um, became her problem was too restrictive, too restrictive. So,
Starting point is 00:05:15 and then once the SIBO kicked in, once she encountered the parasite and had the threshold event, it's like the, the seed, and feed thing, I don't know that we've ever gotten perfect. Is there any particular thing that creates a stubborn problem when the person is being disciplined, but it continues to not go away? Absolutely. Almost 30 years ago, I had another problem, which was mercury poisoning, and that messed up my gut big time and i i got a triggering event which
Starting point is 00:05:46 was some bug i picked up somewhere in a lake in maine and then my entire gut broke down and i literally had diarrhea bloating pain for years whoa and a whole and i developed chronic fatigue syndrome my whole system broke down and it wasn't until i got rid of the mercury that my gut sorted out so if she has mercury poisoning, if she's mold toxic, if she has a tick infection, some underlying thing, it can impede people getting fully better. Yeah. So now let's say that we've identified the problem, we've done the weeding. What should somebody be eating? So obviously in your new book, What the Heck, you go into, it's all whole food based, but there's obviously a lot of whole foods in the world. So what should people be aiming at?
Starting point is 00:06:32 Well, here's the thing. You know, there's so many diet wars. You know, nutrition is often based on ideology, not on good science. And there's so much conflicting information and people are buffeted about by the media. One day that meat's bad, then it's good. One day eggs are bad, then they're good, then they're bad. I mean, it's just, it kind of makes people crazy and give up and what a scientist doing and it's just a mess. Right. But you know, I've, I've been studying nutrition for 40 years and I've been not only studying it in a book, I've been using food as medicine for 30 years as a doctor. And I'm humbled
Starting point is 00:07:07 by it because I realize everybody is different. Everybody needs different approaches based on their genetics, their preferences, and so forth. But there are some common principles. I call them the Pagan principles that are universal that no one will argue with. And I was sort of joking because I was on a panel with a friend of mine who was vegan It was a cardiologist and I think I was a paleo doc and they were fighting and I was in the middle and I'm like well If you're P paleo and you're vegan then I must be pegan and it was like just kind of a goofy joke and and I realized Wait a minute. They they agree on about everything except where you get your protein from
Starting point is 00:07:40 So they all agree that we should be eating whole foods. They all agree. We should be eating any industrial processed foods. They all agree we should be eating a ton of vegetables, lots of good fruit, lots of nuts and seeds, lots of good fats. Everybody agrees that. The things that are different are, should we have our protein from animals or from beans and grains? That's the only difference. And I thought, you know, well, not everybody has a problem with beans and grains and not everybody has a problem with animal protein. In fact, it can be a very important source of food for most people. The question is what, right?
Starting point is 00:08:15 What grains, what beans, what meat, what fish? And so that's really what those principles are about. It's focusing on quality. So for example, do you want to eat a feedlot burger? Heck no, right? Because they're raised on grain? For many reasons. One, they're raised in a way that is inhumane for them. They're raised on foods that create bad metabolic profiles in the animal. So you're eating a lot of inflammatory stuff. They feed them chicken shit. They feed them candy. They feed them corn.
Starting point is 00:08:46 And then there's how they grow the food for the animals, which creates massive environmental destruction, loss of biodiversity in the soils and animals, loss of water resources because of all the irrigation to grow the crops for the animals, the deforestation that results, the destruction of our soil, the use of fertilizers, pesticides. The fertilizers run off and destroy all the rivers and lakes and oceans and create dead zones the size of New Journey in the Gulf of Mexico that killed 212,000 metric tons of fish a year.
Starting point is 00:09:18 And there's 400 dead zones like that, the size of Europe around the world that are in coastal areas that are killing the food supply for half a billion people. That's because of the consequences of how we the world that are in coastal areas that are killing the food supply for half a billion people. That's because of the consequences of how we're growing our food. And not only that, it's a giant source of climate change
Starting point is 00:09:33 for all those reasons. So no, but you should be eating factory farmed animals. On the other hand, you look at regenerative animals, which means regenerative means you farm or grow animals in a way that is bringing the ecosystem back to health, which is restoring soils, reducing
Starting point is 00:09:50 water use, reducing or limiting fertilizer, pesticides, herbicides. And there was an interesting analysis. Everybody's into these plant-based burgers now. And I think, yeah, it's better that we eat plants, and that's great. But what plants? Should it be a highly industrial product, like Impossible Burger, for example, is GMO soy. So it's grown in a way that you're getting lots of glyphosate, which is not good for you. It destroys your gut.
Starting point is 00:10:16 The food is grown in big monocrops, intensively with fertilizers, pesticides, herbicides, destroying the soil, using up water, and so forth. It's way better than a feedlot beef. But when you compare it, this was done by an independent life cycle analysis company, Qantas, that looked at both Impossible Burger and a regeneratively raised beef burger from White Oaks Farms in, I think, Missouri. And they found that you literally had to eat one regeneratively raised burger to offset the carbon emissions of a Plant based impossible burger to offset it in other words the the soy burger Added three and a half kilos of carbon the environment the grass-fed burger took out three and a half kilos of carbon from the environment
Starting point is 00:11:00 Because soil is the biggest carbon sink on the planet it can hold three times the amount of carbon in the entire atmosphere if we took care of it and built organic matter in the soil which only happens through the use of animals right that dig and pee and poo and move around and chew down the grass and that builds soil in this and that doesn't use fertilizer it doesn't use pesticides doesn't use herbicides uses It uses rainwater, so you're not using 1,800 gallons for every pound. It's called green water. It's producing higher quality meat with high levels of antioxidants, high levels of omega-3 fats, better for the animals, and you're not destroying ecosystems. When you grow soy, you're destroying ecosystems. You're destroying the habitat of animals and rabbits and mice and birds when you're making these giant mega farms.
Starting point is 00:11:44 So, I mean, probably eating a regener regenerative grass fed burger is probably the most vegan thing you can do. So you know it's like and I think it's just we get this false dichotomy like all meat is bad or only vegan or you know oh you should only you know you'd be paleo. It just doesn't make sense right. That's really interesting. The green argument is fascinating, seeing sort of the balancing out that's going to happen between whether there is some amount of farm raise
Starting point is 00:12:11 that's actually necessary. I've heard you talk about the topsoil before and that that's actually something that without animals, you're going to erode the soil and that in and of itself causes some dramatic issues. We lose 200,000 tons of soil every hour. Every hour? Every hour. We lose a country the size of Nicaragua or North Korea of soil every year. We have 60 harvests left, according to the UN, before we run out of soil and can't grow food.
Starting point is 00:12:39 No soil, no food, no humans. Forget climate change. I was going to say is that sounds relatively problematic and by actually using the strategy of regenerative Agriculture we can draw down carbon not add to the carbon in the environment. Even if we stopped all fossil fuels Tomorrow we still would be screwed We need strategies that draw down carbon out of the environment and the food system is the number one set of solutions Let me ask you so even just forgetting anything ecological why
Starting point is 00:13:09 Plants so that when you were saying everybody agrees we should eat more vegetables Obviously, I would say Stephen Gundry probably doesn't agree that we should eat more vegetables Maybe if there's certain yeah the right vegetables. Do you have a take on that? Like what's your vibe about lectin? Yeah. Yeah Okay vegetables. Do you have a take on that? What's your vibe about lectins? Yeah, yeah. Okay. So I think it's really personalized. And so for some people who have serious illnesses, getting off of inflammatory foods, including lectins, can be helpful. But look, 60% of our diet is ultra processed food. That's the first priority I have is get people off that stuff. Don't restrict vegetables. Because unless you're really sick and you want to try it as a therapy, fine.
Starting point is 00:13:48 But I'm really not a big fan of telling people to not eat vegetables because I think there's so much value in them. And I think if we actually have the problem of restricting unnecessarily for people, it's not great. Well, let's talk about, so what do you think about the carnivore diet? Is there any logic there? Well, you know, it's interesting. I mean, like Jordan Peterson's doing that, and his daughter did it to cure autoimmune
Starting point is 00:14:12 disease. And yes, if you are really sick, sometimes it can be profoundly helpful. I mean, if you have autoimmune disease, if you have severe obesity, I mean, there can be real benefits. But again, you know, we used to eat 800 species of plants as hunter-gatherers. We ate animal products when we could find them or hunt them. And it was a part of our diet. It wasn't a staple. Some cultures like the Plains Indians, like the Lakota, they lived mostly on buffalo. And were the longest live, uh, people in history.
Starting point is 00:14:46 They were, had more centenarians per capita than any other population at the turn of the century. Yeah. So you've talked about, you know, one thing that medicine really has got to start doing is looking at the laws of biology. So, you know, physicists are looking at the laws of the universe. What are the laws of biology? I'd love to hear what are some of the laws of biology? How does that play out in terms of plants? Because I can walk you through, it's admittedly like a lay person's understanding, but when I walk through the notion of the plant paradox and you start thinking of a plant as having a basically a chemical evolutionary advantage or the way that they stop predators is by creating these chemicals that either upset their stomach or they're bad for them or they are bitter tasting
Starting point is 00:15:30 or whatever. It's like, oh, that makes sense. When you have something, it has to have a mechanism against predation and humans are one of the predators. And so, okay, it didn't develop claws or whatever. It developed like these chemical signals. You've talked about food being signals more than just calories. It's like, okay, well, there's actually some logic. Whether it's true or not is a totally different question, but there's a followable chain of logic to why plants potentially have issues. It's like, is there anything that they all share that for somebody with a sensitivity, they're an issue? Or no, no, no.
Starting point is 00:16:07 There's so many other nutrients in vegetables. If you're not eating them, you're committing a cardinal sin of the laws of biology. Well, if you're eating nose to tail, like you're eating the liver, which has more vitamin C, more vitamin A than any vegetable on the planet, right? You can get by, but- You can get by or it's ideal? I don't think it's ideal. I think your gut microbiome feeds on carbohydrates. It feeds on phytochemicals. It feeds on fiber, right? What does happen to your microbiome if you're
Starting point is 00:16:38 only eating carnivore diet? Nose to tail. It changes. It changes. But in a bad way? Potentially. Potentially. I think there's some interesting experiments. I think we're still in the exploration of what happens when you eat different diets. But I have a little different view about vegetables. And I call it symbiotic phytoadaptation, which is a fascinating concept. But essentially, yes, there are defense mechanisms in plants that help the plants, but also can help us, right? So for example, we don't make vitamin C. We get it from plants.
Starting point is 00:17:12 We need things to help us detoxify. So when you eat broccoli, you upregulate the glutathione, the pathways of detox in your liver through phytochemicals called glucosinolates. Your microbiome loves the polyphenols in pomegranate and cranberry, right? So I think we have evolved, co-evolved with plants. So we use these compounds, these phytochemicals to regulate all sorts of biological functions from inflammation to our microbiome to detoxification, to our transmitters, and so on. So I think there are plants you don't want to eat.
Starting point is 00:17:48 You don't want to eat poison mushrooms, right? You don't want to eat foxglove, which will kill you. But there are a lot of plants that we've evolved with that we use in our bodies to regulate our biological functions, and I think they're really necessary. Talk to me about soy. I heard you say something, which I had heard before, but I don't know. There's something about the way you said it that really hit me that you see women drinking or young girls drinking like soy milk, like it's going out of style.
Starting point is 00:18:12 And then it, it will put them into premature. Happened to my stepdaughter. You know, soy milk was the big rage and she liked to drink. I mean, she was allergic to dairy. So she was like drink, you know, quarter of soy milk a day. And she ended up like at nine years old getting little boobs. Whoa. And we're like, Oh, because it's upping her estrogen. Yeah. So, so soy, soy is a very controversial topic for many reasons. There's all the environmental issues, obviously of big monocrop fields of
Starting point is 00:18:39 tearing down rainforests in Brazil of all the consequences of climate change and all that. But from a dietary perspective, it's been a staple in diets for millennia in Asia. And it's always been processed in a way that makes it more digestible. Tofu, tempeh, miso, soy sauce. Those are traditional foods. When you start making soy hot dogs and soy burgers and eating all these processed things, even soy milk is not something we used to consume. You get one, trouble with digestion, two, increased risk of allergy, and three, you get extra hormonal effects when you
Starting point is 00:19:19 have these massive quantities of these things. Yeah. Thinking of food as a signaling molecule and then all the talk around soy, what is the mechanism that's happening that makes soy trigger an estrogen response? I've never understood that. Well, all food is information, not just calories. It's all information. It's instructions. It's literally like code that programs your biology with every bite. At like an epigenetic level? At every level. So every bite of food you take can change your gene expression across a whole range of genes. So you drink green tea or eat broccoli, you upregulate the gene called glutathione as transferase that helps you detoxify heavy metals, environmental chemicals, metabolic toxins. So it regulates your genes. It regulates your hormones.
Starting point is 00:20:07 So if you lost starch and sugar, it increases insulin, lowers testosterone, increases estrogen, for example. It affects your brain chemistry and what your hunger hormones are, your craving levels are, and what foods you're attracted to. It affects your immune system. It regulates inflammation or it's anti-inflammatory. It regulates your microbiome with every bite. So every single system of your body is regulated by the quality of the food you
Starting point is 00:20:31 eat. And when you realize you shouldn't just focus on calories, you should focus on quality and the information you're eating changed everything. So that's really what I have people focus on. And I think when people do that, then you have a different relationship to your food. You go, well, I'm eating, am I going to eat toxic information or am I going to eat healing information? So if you were to put together a few groups of the sort of healing signals, what would they be like? What would be, if you were so um in investing there's this thing called the all-weather strategy and they say okay look uh i'm sort of blindly talking to my um grandchildren i'm you know gonna pass away and all i can leave behind is a strategy that will work in in any
Starting point is 00:21:17 environment but if you had to just put together an all-weather eating strategy what would the ideal in air quotes, diet be? I wrote about it. I wrote a whole book about it. It's called Food, What the Heck Should I Eat? And it's about these principles. I call them the Pagan principles. And it's really focused on quality first, right?
Starting point is 00:21:35 Nobody thinks we should be adding additives and hormones and antibiotics and pesticides and glyphosate to our food. It's in it, but nobody's like, yeah. How do we avoid it at the grocery store? If you look at the label of something, if it has something you can't recognize, pronounce, then you shouldn't have it. Or if you don't have it in your cupboard at home, like butylated hydroxy toluene, which is in almost every processed food is BHT. It's illegal in Europe. You wouldn't sprinkle that on your salad, would you? No. So that's a good rule. The second principle is we should be eating a plant-rich diet and across the spectrum from fruits and vegetables to- Do you treat fruits and vegetables
Starting point is 00:22:19 as sort of one and the same or- No, it should be vegetables and fruit, right? So it's like you don't want to be consuming only fruit because that's full of sugar and and if you're diabetic or you're overweight or have issues you might want to cut back on the sugary fruits or eat berries which are less glycemic um lots of nuts and seeds everybody agrees with being lots of nuts and seeds you want to soak them reduce the lectins that's fine if you're going to eat beans and grains pick low starch onesarch ones, right? And also... Give us a few examples.
Starting point is 00:22:47 So, like, black rice, which is like the blueberries of rice, quinoa. What does that mean? Well, the black rice is called the emperor's rice, or forbidden rice, and it's full of these dark... It's black, so anytime you see color in nature, there are polyphenols and phytochemicals in there, so it's got more antioxidants
Starting point is 00:23:05 per serving than blueberries and then and then you want to make sure if you're eating you know grains the gluten grains are are interesting so most of the gluten we eat is is wheat uh it's 133 pounds per person per year that's a pharmacologic dose it is worse for your blood sugar than table sugar. Really? Yes. What? Yes. When you look at the glycemic index,
Starting point is 00:23:32 which is how much the fixed amount of the food will raise your blood sugar, table sugar is 80, bread is 100. Whoa, I had no idea why. Because it's so processed and so quickly absorbed. And if you want to eat, like, if you're not gluten sensitive, you want to have farro or einkorn wheat or spell, you might tolerate those because those aren't highly altered genetically. But the wheat we eat is super starchy, has a lot more gliadin proteins, create more gluten sensitivity, is sprayed with glyphosate at harvest to defoliate the plants.
Starting point is 00:24:02 And it also has a preservative called calcium propionate, which causes autism in animal models and is shown to cause behavioral problems in kids. So ADD, all that stuff, could be all the flour. So I'm not a big flour person. Plus, it's just like sugar. So if you want to have other grains, if you're not going to have rye or barley, that's fine. And then beans, again, lime beans, kidney beans.
Starting point is 00:24:23 Look, 75% of Americans are overweight. So most people should be eating a lot of starch. And, you know, you have to eat three cups of beans to get the equivalent of like four, six ounces of protein. So have lentils and things like that, which are lower starch beans, the zuki beans, other kinds of beans I talk about in my book. And then if you're eating animal products, you want to eat animal products that are not going to hurt the animals, not going to hurt you, and not going to hurt the environment. So for beef, it should be regeneratively raised, ideally, which is hard to find. But you can actually get more and more of that around. And there's ways to do it by looking online to get it.
Starting point is 00:24:59 Thrive Market is a great resource for regeneratively raised beef. And again, chicken should be pasture-raised. Pork and all that should be raised in ways that are more organic or sustainable. Fish, you want to eat fish that's sustainably harvested or sustainably organically aquacultured because we over-harvest the fish. And then we don't want to eat big fish that's full of mercury and tuna and swordfish. Just because they've lived longer? Well, what happens is the coal and all the fossil fuels go in the ocean, go in the algae, get stored in the algae.
Starting point is 00:25:30 The little fish eat the algae, then the bigger fish eat the little fish, and it goes on up the food chain. When you've got a swordfish or a tuna, these are monster fish, and they bioaccumulated all this. And so you want to eat the right animal products. You want to eat the right grains, the right beans, the right vegetables, the right fruits, the right nuts. And so give me the right vegetables.
Starting point is 00:25:48 Are we just looking for color spectrum? So non-starchy vegetables. If you want to cut out nightshades and give it to the lectins, that's fine. But I love tomatoes. And they don't make me feel bad. So there's no point in restricting your diet necessarily if you're not sick. Talking really fast, just because you mentioned that you eat nightshades, which are problematic for a lot of people. I've heard you say that your body is the best doctor. What do you mean by that? Yeah, exactly. So, I mean,
Starting point is 00:26:11 you listen and watch my stuff. I'm impressed. So the whole idea is that you can listen to all the nutritional advice you want, but pay attention to how you feel. Your body's going to tell you. If you go vegan and you stop having your period, you lose muscle, you feel tired, you're B12 deficient, you feel like crap, you develop autoimmune diseases, you gain weight, whatever, maybe it's not for you, right? I mean, I literally just did a whole analysis on a very well-known celebrity, and he's a vegan, and he's massively nutritional deficient. No omega-3s, extremely low vitamin D, extremely low B vitamins, extremely low zinc, selenium.
Starting point is 00:26:52 I mean, it was frightening to see in a young guy how depleted he was. But other people it works really well for. And then see how you feel. If you get rid of gluten and dairy, do you feel better? So I have people do a detox, essentially a dietary cleanse, which is get off all the junk,
Starting point is 00:27:09 get off all the sugar, get off all the processed food, eat whole foods, get rid of gluten and dairy, even get rid of grains and beans for a while and see how you feel. And if you don't feel good, try to add things back.
Starting point is 00:27:19 If you feel amazing and your autoimmune disease goes away, your digestive problems clear up, your brain fog's clear, your migraines are gone, well, then that's probably a sign that your body likes that way of eating. So you think living a vegetarian or vegan, fully vegan or vegetarian lifestyle, that it's hard to gain muscle mass?
Starting point is 00:27:36 I think it's hard. It's hard. It's not impossible. I mean, if you really work at it and really work out, and there are great vegan athletes out there, but there's never been a historically voluntary vegan society ever and when you look at the yes and we look at the zones or no they were never exclusively vegan really right they always had some animal food right the fish or something yeah and you know as hunter-gatherers we eat 800 species of plants so we had a very plant-rich diet, but we also included wild animals when we
Starting point is 00:28:06 could catch them. And so it's part of our evolutionary history and our bodies are well adapted and the protein in vegetables is different. So for example, there's something called leucine, which is an amino acid that is the rate-limiting amino acid for muscle synthesis. In other words, in order to build muscle, you need this amino acid. And it's very low in plant proteins, very high in animal proteins. Right. So why not just live a plant-based diet and then have the supplements? You could.
Starting point is 00:28:35 You could. And I have patients who are vegans, monks. I mean, I'm not going to force people not to eat it, but it's much harder to do, and you have to know what you're doing. And I see people over time, initially, when they switch from a processed American diet to a whole foods vegan diet, they are going to get so much better. Of course, yeah. But the real issue is compared to what?
Starting point is 00:28:51 Right. Right? What we really need to do is... And they've looked at, over time, these big studies looking at animal and plant proteins and stuff over time, looking at what people do. There's a vegan vegetarian omnivore study, which was 245,000 people. It was an observational study, but they didn't find any difference in outcomes. Another study, a 42-country study looking at food pattern consumption over long periods
Starting point is 00:29:14 of time showed actually the people that had animal fat and protein did far better than people who focused on cereal grains in their diet, less heart disease. Another study, the PURE study, just came out recently, 135,000 people. It was five continents, I think 18 countries, 10 years. And there was actually an improvement when people had more saturated fat and more good fats and less cereal grains and more animal protein. More animal protein or more animal protein? Dr. More animal protein, yeah.
Starting point is 00:29:40 Yeah. It was not a risk factor. Now, these are difficult studies to interpret sometimes because they're observational, but you look at interventional studies where you intervene by giving people high-fat protein diets with lots of plant foods. People do better metabolically. Really? Yeah, and it's very hard to eat a low-glycemic diet if you're a vegan.
Starting point is 00:29:58 You can, but it's very hard. I have a friend who's a keto vegan, and she's a type 1 diabetic, and she's rocking it. But you have to know what you're doing. You so disciplined yeah super disciplined super smart about it that's challenging yeah so i think i think you know and the data on meat honestly which i go into the book in great detail is confusing for people because there's this all depends on the factors of the meat yeah i mean you get it the environment it's in how it's fed how it's raised exactly stress of it right exactly how it's processed everything how it's fed, how it's raised, the stress of it. How it's processed, everything, right?
Starting point is 00:30:28 Totally, right. So people go, we shouldn't be eating meat because it's bad for the animals, better for the environment. Yes, we should not be eating factory farmed meat. This is really bad. It's bad for the animals. It's bad for the planet. It's bad for us because the quality of the meat is very poor. But let's say a wild elk or a grass-finished bison or even cow, very different. And it turns out that these animals actually have higher levels of omega-3
Starting point is 00:30:53 fats and higher levels of antioxidants and minerals and nutrients and beneficial fats and actually are a great source of protein and don't have the harm that we think they do. When you look at the studies that showed there was harm, the reason they show that is because when you do a study, observational study, you give people a questionnaire every year. So you take 10,000 people, 100,000 people, and every year you give them a questionnaire.
Starting point is 00:31:15 What'd you eat? What'd you eat last week? What'd you, if you can remember. And people answer according to what they think they should answer a lot of times, right? So if meat is bad, they're gonna underestimate the amount of meat they're eating. So during the time of these studies, meat was considered bad. So people who ate meat didn't really care about their health.
Starting point is 00:31:31 And the data show it. When you look at the factors of these people, their characteristics, which you can read in the studies, which I read, they were overweight. They smoked. They drank. They didn't eat fruits and vegetables. They didn't exercise. They didn't take vitamins.
Starting point is 00:31:43 They ate more processed food, more sugar. Of Of course they were sicker. Wow. Yeah. Now, what are the three basic food rules that you live by? Me? Yeah. Well, you know, I always, I was joking. I used to teach a lot of churches and I go, if, ask yourself one question when you're shopping, did God make this or did man make this, right? Did God make a Twinkie? No. Did God make an avocado? Yeah. Pretty simple rule.
Starting point is 00:32:09 Yeah. And you can even take that to its logical extreme. Did God make a feedlot cow? No. Did God make a grass-fed cow? Yes, right? Sure. So you can kind of go down the line on all that.
Starting point is 00:32:21 That's the first principle. The second principle is we should be eating mostly a plant-based diet. Yeah. We call it plant-rich. I like to call it plant-rich. You've got 80-20, right? Yeah. 80%, 70% of your foods on your plate should be lots of vegetables, nuts and seeds, fruit, whole foods. And the third principle is we need a lot of good fats, avocados, olive oil. I think there's controversies about certain things., nuts and seeds are good, but then there's the whole saturated fat debate, which we can get into where refined oils. But essentially we need a lot of good fats, low starch and sugar, plant-rich diet, and stay away from processed food. Yeah. Now, should that be true for everyone,
Starting point is 00:32:59 or does it depend on your body type, your blood type, your genetics? So I jokingly call this the vegan diet, right? Because I was sitting on a panel with friends of mine. One was paleo, one was vegan. They were fighting, and I'm like, listen, guys, you're paleo, you're vegan. I must be a vegan. And I was joking. And then it occurred to me that there was more in common than there was different.
Starting point is 00:33:18 And we could come up with these general nutritional principles that nobody's going to disagree with, right? Nobody thinks we should be eating a lot of starch and sugar. Everybody thinks we should be eating more plants. Everybody thinks if we eat animal protein, that we should eat only sustainably raised or harvested or grass-finished protein. That we should eat fish, but it should only be fish that's low in mercury and toxins, that doesn't overfish the oceans. If it's farm-raised, it should be sustainable. We should eat lots of good fats. I mean, there are a few outliers who still are holding on a low-fat dogma, but the train has left the station on that one. And so there's these simple, that nobody thinks we should be consuming pesticides and herbicides and GMO,
Starting point is 00:33:53 that we should be having three pounds of food additives per person every year. I mean, nobody thinks we should be eating those things. Like nobody's going to say, okay, I think you should have more butylated hydroxy toluene with your salad. Red dye number 40. These are things that are inserted into our diet. So those are principles that I've outlined, and it's adaptable. What about grains and beans? Well, some people do well on them, some people don't, and it really is individual.
Starting point is 00:34:20 But I talk about if you are going to, here's the things to know about. Here's the grains to eat. Here's what you should or shouldn't do. Gluten, why is it a problem? Who is it a problem for? Is our current wheat the wheat we used to eat? No, it's not. So that has an impact. What should we focus on? Could you have rye, which has gluten in it, but it's probably, if you're not gluten sensitive, a much better food. So it goes through every single chapter. I go through meat, poultry, fish, eggs, vegetables, fruit, nuts, seeds, beans, grains. I talk about the controversies. What are the people fighting about?
Starting point is 00:34:45 What does the science say? What do we know? What do we not know? There's still stuff we are learning, right? We're still discovering every day. So it's really kind of a foundational principle book. It's not extreme. It's sort of the middle of the road.
Starting point is 00:34:56 This is kind of the Bible for you then. Kind of. All the things you've learned. Pretty much. 40 plus years now. 14 books. Yes, it is. It's actually different than other books I've written because the other books are more topic specific.
Starting point is 00:35:08 They're on the brain or they're on metabolism or diabetes or sugar. This is really, if you're an eater, and there's about 9 billion of us, it's probably something that'll help. And I also talk about how do you eat, not just for your own health, right? But what is the overall footprint of the food you eat? What's the health footprint, the economic footprint, the carbon footprint, the environmental footprint, the educational footprint, the national security footprint, and even poverty and social justice footprint of what you eat? Because there are things we can't change as individuals.
Starting point is 00:35:38 We can't end nuclear war. We can't single-handedly end climate change. But we can change what we eat because we do it all the time. And the choices we make matter. I mean, I was just with the vice chairman of Pepsi, who's my new best friend. You can imagine. We had a great time together. And we don't agree on a lot of things.
Starting point is 00:36:02 But it was fascinating listening to him talk about what's happening in the company as they're trying to shift to meet the consumer demand. Really? So they're like, how do we create special? And he introduced me to this engineer who was working for him. How do we create special types of packaging that's compostable but that keeps the food fresh? We don't need to use preservatives or artificial ingredients. And we can have whole foods that we distribute globally. And I'm like, wow, that's a great thing to be looking at, right?
Starting point is 00:36:27 So they're thinking, and he said, I was also asked to talk to the USDA annual meeting, the agriculture department. And I'm like, they asked Pepsi? But he's talking about regenerative agriculture. He's talking about how we're losing water by our farming practices. We're losing soil. We need to change that. And they have enormous power because they're, you know, if you count their bottling facilities,
Starting point is 00:36:50 they're probably the number one food company in the world up there with Nestle. Right. And they are interested in doing this. And I'm like thinking, wow, here's the vice chairman of Pepsi talking about regenerative agriculture. I'm like, holy cow. That's pretty cool. They want to make an impact.
Starting point is 00:37:07 Yeah, they can have an impact. But they're responding to the demands of the culture. They're responding to people who are voting with their forks. So it's a hopeful message. You not only get to change yourself, but you get to impact everything. I mean, imagine if everybody in the world for one day had an eat-in where they only ate real fresh whole food and they didn't shop or buy
Starting point is 00:37:25 anything in a package that's processed in any way and didn't go any fast food restaurants and just ate at home and cooked a meal together. Totally. Just for one day. Imagine if we did that for a week or a month, the whole system would change. Wow. Yeah. Now as a functional medicine doctor, I believe that you're more of like a therapist for a lot of people too. They come to you with all their challenges. They feel pain in one thing, but there's something else that's affecting them, right? Yeah. What do you think is the main thing that they're feeding themselves, maybe that's not food,
Starting point is 00:37:53 that affects them on the pain or their body or... Yeah. I think people are feeding their feelings a lot of time. Food has such an effect on mood. It's so connected to how we think and feel. And so when we're feeling sad or depressed, we can stimulate our biology through food, whether it's caffeine or alcohol or sugar or other chemicals in food that actually stimulate our brain to sort of feel better for a minute, right? And so we do that.
Starting point is 00:38:19 And we're human. And we don't understand the difference. And we don't know what's going on. We don't see we're in this vicious cycle. And it's tough. And people have hard lives and hard situations, but I believe in the power of community. I believe in the power of each other to help support the change. It's got to happen that way. And that's what we do. We work with communities. We work in churches. We help people become empowered in schools to actually start to do this together. And it's so much more fun. It holds people accountable. It inspires people to change and it works. And if we look at behavior change,
Starting point is 00:38:49 which is the biggest thing we're talking about here, the hardest thing to do is on your own. So I would say friend power is far more powerful than willpower. It's way easier to stay consistent with something with someone else supporting you, an accountability partner, a coach, whatever it may be, than trying to do it on your own. Absolutely. It's almost impossible to do it on your own. Right. And that's why people listen to your podcast and seek out these things because they're
Starting point is 00:39:10 looking for some connection to something that they can hold on to that inspires them, that uplifts them, that gives them an idea of how they can be better. What's the biggest challenge you face in your life right now that you could improve on or get better at? Health-wise? Anything. life right now that you could improve on or get better at health-wise anything um you know you're this this top expert super credible doctor cleveland clinic seems like you got it all figured out but what's the thing either personal or fitness i'm emotional or yeah i mean i think
Starting point is 00:39:38 you can improve on well i'm i recently got married and i have the most amazing wife and i'm just growing and growing and learning. And how do I be like the best version of myself? How do I be fully expressed and honest and in integrity and like value what's actually happening? And I think that's like my most important work. A lot of my career, I just focused on my work, work, work. And I'm like, I'm like, wait a minute, you know, this, this, something else here going here going on right so what's the biggest challenge you face with this new chapter I think my phone so I actually I'm giving I'm giving her for our anniversary present a box which is a little like like sealed box that I'm
Starting point is 00:40:23 gonna put my phone in when we're together. For what, an hour? No, for a weekend or longer. Okay. You know, and I'm going to tell my assistant if she needs anything to call her phone. If it's an emergency. But I'm like, it's symbolic, but it's like, and it's sort of invasive. And I'm like, you know, nothing is that important that should interfere with our human connections.
Starting point is 00:40:45 Right, right. There's one other thing that I'm working on. It's struggling. It's a struggle for me because, you know, I feel like I've been lucky enough to see the emerging patterns that are changing in medicine and how we've come to think about disease quite differently based on the science called functional medicine. But it's taking a long time to get it up to running in scale. And that's a challenge to figure out how to do that well. And the second thing is the food system, because I feel like if we can all get how powerful
Starting point is 00:41:14 we are as individuals, as communities, when we band together to do something around the food system, it's bigger than anything we could ever do. Because for example, civil rights, that affects one group of people. Women's rights, a large group of people. Gay rights, a large group of people, but small. Food affects everybody. And people don't understand how our food system is keeping them down and is limiting our ability to thrive and succeed as individuals or as a society. And that's my real, I think, my next phase of my work is figuring out how do we empower people around the food system to understand these connections, to understand how to become
Starting point is 00:41:53 empowered, how to activate movements and communities to sort of change the way we do things and just to then inspire policy change. Because it all has to come to that. Right now, our food policies, I mean, just the farm bill alone, which is every 10 years, it's about a trillion dollar bill. There's 600 lobbyists that spend half a billion dollars funding and lobbying congressmen on this farm bill. Wow. And I remember when I went to Washington during the Obamacare era and I was advocating for funding for lifestyle interventions so we could incentivize doctors to do the right thing, not just do medicine or surgery.
Starting point is 00:42:27 And everybody was like, this is the greatest idea, greatest idea. And, you know, they would say, what lobby group are you from? Like, who are you from? I'm like, nobody. It's just I'm here for the patients and the science. Like, I'm lobbying for the science. And it was flabbergasted. All these staffers and the congressmen,
Starting point is 00:42:47 the senators we met with, they were like, they didn't understand it because they don't experience individuals advocating and not as part of some big, massive lobby group. Right, right, right. That's interesting. I'm curious now, when did you become a doctor? When did you-
Starting point is 00:43:02 When did I go to medical school? Was it 40 years ago when you- I graduated medical school 31 years ago. 41 ago 31 years 31 years i graduated medical school yeah graduate but you got into it 40 years ago yeah well i got into nutrition when i went to college okay so 31 years you've been is it called licensed doctor or what do you call certified yeah i'm i got my MD degree in 1987. Okay, 31 years ago. I'm curious, what were the beliefs that you had going in 31 years ago that was industry standard? That was like, this is the belief of medicine or food or the body. That you believed in so wholeheartedly, but now you've realized 31 years later is completely false.
Starting point is 00:43:48 Well, actually I have ODD. You know what that is? What's that? I'm odd. And I was weird from the beginning. So I was a vegetarian in college. I was a yoga teacher before I was a doctor. I studied systems thinking in college. I studied alternative systems of healing and medicine from around the world. My thinking was already there. And I was studying herbal medicine. I was going to go to China. I spoke Chinese. I was going to go to China and study Chinese medicine, but I didn't want to grow up in a communist dictatorship. So I basically said, I'll try medical school and see if I like it. And I was fascinated with the body. And I really never went away from it, although I did really take it all in.
Starting point is 00:44:27 I had to suspend all my criticism, disbelief, and just learn it as a system. Then I could unpack it. And so then I began to sort of unpack it and discovered functional medicine early on. And since then I've just been focused on that as the new model for thinking about the body as a whole dynamic system. Was there any belief that you had after you learned everything from medical school where you realized you believed in something that became debunked over the last 31 years? Yeah.
Starting point is 00:44:54 I mean, I really believed that there were these diseases that we label and name and that they were real things. Just like when you get TB bacteria, that's a real thing that you get tuberculosis when you have TB bacteria exposure. But chronic disease isn't like that. So we've created these categories of disease like dementia or diabetes or cancer or rheumatoid arthritis or irritable bowel or whatever it is. And we group people according to symptoms, not according to causes. I was just with Thomas Insel, who is the former head of the National Institutes of Mental Health. And I'd asked him before, I said, what do you think of the DSM-5, which is the diagnostic category for psychiatric illness?
Starting point is 00:45:37 He says, I think it has 100% accuracy, meaning it groups people according to depression or anxiety. It's very good, but it has 0% validity. Meaning it's not valid because it doesn't describe the why, only the what. And that was a big aha for me to understand that all these diseases I learned about in medical school as these finite things, they were like, they weren't something you get. You don't get heart disease. You don't get diabetes. You don't get dementia.
Starting point is 00:46:05 You can get a cold, but you don't get heart disease. You don't get diabetes. You don't get dementia. You can get a cold, but you don't get these things. And it's a very different way of thinking about disease. It's a systems problem. It's how the body is out of balance. It's a way of working with the body that looks at the body as a whole dynamic interacting ecosystem that you can change by taking out the bad stuff and putting in the good stuff. Grelin is really an interesting hormone. And it is secreted from the stomach, mostly stomach and part of the small intestine. And it goes to the brain and then it says to the brain, okay,
Starting point is 00:46:39 you better eat, you're hungry. So it is that hormone that makes us feel hungry. And so when we eat, typically, our ghrelin levels go down. And we'll talk about this a little later. Sometimes our food composition, what we eat in a typical meal impacts our ghrelin levels differently. So when we eat, typically, our ghrelin levels go down. And it says, okay, now you're full and you can stop eating. And so one of the reasons people always say, don't eat too fast, or if you're hungry, take a few minutes to, you know, make sure you still want to get seconds is just to give the body time for that, um, for the hormones to shift. So, and for that, you know, ghrelin level to go down. So the other reason we know a lot about ghrelin is because when people lose weight, they often feel more hungry. And I always explain this to my patients, you know, I'm like, you know, they need to and want to lose weight. And when they do,
Starting point is 00:47:43 sometimes they feel more hungry for a period of time. And I think that's a really natural, normal thing. And we sometimes have to work through that to continue to get to our goal if we're working to lose weight. So we've got a lot of hormones that, that have an influence on what we choose to eat when we choose to eat. Yeah, it's so critical because if we don't, if we don't understand how those are regulated, it's really a big deal. I think, you know, when you're not eating and when you're losing weight and when you haven't eaten for a while, your body will naturally produce this hormone in your stomach that makes you hungry, which is a good thing. So we don't starve to death, right? Right.
Starting point is 00:48:24 And so, you know, it goes down if you eat and, you know, and so forth. But if you have a diet that's causing a dysregulation of that hormones, it can really create a problem. And I think, you know, we mentioned the microbiome, which also is key, but so, so tell us about how, how from a lifestyle perspective, you know, we mentioned the microbiome, which also is key. But so tell us about how, from a lifestyle perspective, we're affecting ghrelin and what we can do with our diet, with our timing of eating, with sleep and other factors that are really driving a lot of issues. Yeah. One of the things we know is when we have a meal that has sufficient amount of protein
Starting point is 00:48:59 in it, that our ghrelin levels decrease and we feel less hungry with that type of a meal. So it's really important. But our ghrelin levels decrease and we feel less hungry with that type of a meal. So it's really important. You know, we've talked a lot about how insulin can trigger hunger too, right? But ghrelin also. So when we eat a meal that's balanced, that has sufficient protein and fat, along with all the good healthy carbohydrates, that helps with making us feel more full and not as hungry. So it's really important to think about
Starting point is 00:49:25 each of your meals in your day and say, okay, did I have sufficient protein there? And remember, protein is like your eggs and fish and chicken and beef and beans and legumes and nuts and seeds. And that protein will help when you consume it, help that ghrelin go down and make you feel more satiated after a meal. And ghrelin is one of those reasons that that occurs. You mentioned also with lifestyle, sleep. Sleep is critical. When people are sleep deprived, ghrelin levels go up and they're more hungry. And so we're seeing an epidemic of sleep deprivation in this country and worldwide even, right? So we're seeing this epidemic of sleep deprivation, which is one thing that's driving higher levels of ghrelin. And we want to make sure that we're getting adequate sleep. If somebody has this process
Starting point is 00:50:17 called sleep apnea, if somebody has interrupted sleep where they're having episodes where they're not getting oxygen into the body. That's what sleep apnea is. They're having episodes where either they're somewhere in their nasal area, the back of their throat that's preventing oxygen from getting into the body. Then the body has to wake itself up to take a deep breath. So people will often be snoring and then will stop breathing for a period of time and then take this really big deep breath. They might not even realize they're having these episodes of apnea or not getting oxygen into the body. But what we're learning is that when you have sleep apnea, ghrelin levels are higher. So people who have sleep apnea have ghrelin levels are higher. So people who have
Starting point is 00:51:06 sleep apnea have higher levels of ghrelin. And again, one reason why that drives this vicious cycle of weight gain, obesity, weight gain, obesity, fatigue, hunger, hunger, hunger, right? So it drives this vicious cycle. They know that when people have sleep apnea, their levels of ghrelin are higher than the same group of people that even have the same body weight. So even if both groups are overweight or obese, if you have sleep apnea, your level of ghrelin will be higher. And so it's really important that we pay attention to the sleep, work with our patients and find out, you know, are they getting adequate
Starting point is 00:51:46 sleep, first of all, and, you know, adequate hours of sleep that is, and of the hours of sleep that they're getting, are they restful? Are they sufficient? Is there any concern about apnea or something that would be disrupting their sleep? But, you know, Liz, it's really true that, you know, sleep apnea is a big factor. And I remember a patient I had who was a lawyer and was telling me about his struggle to lose weight, and he needed to lose about 50 pounds. He says, nothing you can do about it. I said, well, tell me about your life. What do you do?
Starting point is 00:52:13 He said, well, I'm a lawyer. I'm like, what do you do? I'm going to do this and that. But I have to stand up on my desk every day to work. Otherwise, I fall asleep at my desk. I'm like, oh, well, maybe you have sleep apnea. So we tested him. He had severe sleep apnea. We put him on a CPAP machine and he lost 50 pounds like that. And I think, you know,
Starting point is 00:52:31 most people don't understand the connection between sleep, but it's not just sleep apnea. If you're not getting enough sleep and you and I both as doctors know that when we were on call and we're working all night or we don't sleep, that we tend to crave more food. We crave carbs, we crave sugar and our appetite's so screwed up. And I remember this one study, it was healthy young 20-year-olds who weren't overweight, who were sleep-deprived on purpose compared to a control group. And they found that the sleep-deprived group were much hungrier and they were craving more carbs and sugar. So that's an interesting phenomenon. That's why we see such an incredible consumption in this
Starting point is 00:53:03 country of these products who are sleep-depri deprived as a nation and we have poor quality sleep. And there's 70 million people that suffer from some type of sleep issue, which is a lot of people. I think maybe even more, actually. Yeah. It's a lot of people. And so it's not just sleep apnea, but it's all the sleep deprivation. What about other foods like protein and fiber and fat?
Starting point is 00:53:22 How do those affect ghrelin? Right. Well, they'll trigger ghrelin levels to go down after you consume them. So it's really important. We work with all of our patients to say at every meal, each meal you have, make sure you've got a good source of protein, a good source of fiber, which is all your vegetables and beans, legumes, nuts and seeds, ground flaxseed and healthy healthy fat at every meal because that's going to help you feel more satiated. It's going to help those ghrelin levels go down.
Starting point is 00:53:49 I mean, we also know things like cannabis can cause ghrelin to increase. And that may be why people get the munchies. And so it's important to understand what things you're doing and how they're impacting your hunger in your body. Yeah, I think that's right. I mean, you know, obviously people smoke pot and they get the munchies for sure. And that drives appetite. So how do we work with people who have these problems? How do we sort of help?
Starting point is 00:54:19 And by the way, you know, one of the things that I wanted to sort of mention was sort of the theory about gastric bypass. One of the theories about gastric bypass is that since ghrelin is produced in the stomach, that when you have a gastric bypass, it shuts down the ghrelin levels. But I'm not sure if that's the only thing that's going on. And I think the reason I say that is it was a recent randomized controlled trial comparing people who had a gastric bypass
Starting point is 00:54:40 with those who were matched to them but who didn't have a bypass but just went on the bypass diet. And they both lost the same amount of weight. Now, I don't know what their appetites were like, or if there was a difference, but they basically lost the same amount of weight. So I'm being very curious, actually, to look at the fine print of the study to see if the people who didn't have the bypass were hungry, or they just starved them and lost weight, or if it was that they actually cut down their diet, and they actually were able to accommodate to a lower
Starting point is 00:55:04 caloric intake. Yeah, I think it's really important what you just said is that and prior actually prior to working with you at both Canyon Ranch and the Ultra Wellness Center, I worked in a practice where we worked with surgeons who were doing gastric bypass surgery. So I saw a lot of patients who were going through the surgery and I saw a lot of the side effects and the negative side effects of the surgery as well. And what I think is what you mentioned is really so critical to understand is that when we can help people get off of this vicious cycle of hunger and eating and hunger and eating and hunger and eating, when we can help them break that cycle,
Starting point is 00:55:51 they can be successful at getting to where they want to be in terms of their intake of food. So you're right, maybe at the beginning, for that group of patients who didn't have the surgery, that first couple of weeks may have been really hard of saying, okay, I'm going to really cut back on the amount of calories, the types of calories that I'm eating, the balance of my nutrients. And they might have felt really hungry for those first couple of weeks. But we see this all the time. Once people get through that time, they start to feel better. They don't have that hunger anymore, that drive to constantly eat and snack and choose unhealthy foods. And then they can kind of start to be successful. You know, the surgery prevents, you know, makes it so you can't eat for those first few weeks. And then that just spirals into, yeah. But then, of course, you're dealing with all the
Starting point is 00:56:41 side effects of the surgery, unfortunately. So, you know, that is an interesting thing that we see, right? Fascinating. And, you know, you've seen patients with this and you've had, you know, I remember many patients who have struggled with this. And you get their numbers dialed in and you kind of sort through everything with them and they do so much better. So can you tell us about this patient who's a 45-year-old guy who was hungry all the time, was overweight and struggling with his sort of appetite and hunger? Yeah, you know me. So he came to see me and he was really trying to be healthier.
Starting point is 00:57:15 I mean, he was working hard to be healthier and really frustrated that he couldn't get his weight to where he wanted it to be. And he had gained 25 pounds over the last couple of years. He was feeling hungry all the time. He didn't have the same level of vibrancy anymore. He was just feeling kind of sluggish and low energy. He, you know, we noted when we did his vitals and his physical exam that he had really gained a lot of weight around his abdomen and around his belly, right? That visceral adiposity, that belly fat that's really
Starting point is 00:57:49 causes a lot of inflammation in the body, causes high levels of insulin, and is associated with all of those negative things like heart disease and stroke and cancer. So he had gained a lot of weight around his belly. His waist to hip ratio was one, which is higher than it should be. And, you know, you know, when you his diet, he was trying to be healthier, but he was grabbing coffee drink for breakfast. You know, at lunch, he was having orange juice, he had switched that out instead of soda, sandwich and chips. You know, he did have a few beers at dinner, you know, and maybe snacked on crackers and popcorn after dinner. And, you know, so he was trying, he felt like he was trying to make the healthier food choices. But we saw a lot of issues when we really delved deeper in terms of his diet, where we needed to do some work.
Starting point is 00:58:43 And we also, when we got his full history, realized, you know, that he was a snorer. So he was, uh, you know, he was, he was snoring frequently. Um, and you know, we talked about how snoring can be a sign that you may have sleep apnea. I mean, there's lots of other signs to, high blood pressure, weight gain, fatigue, you know, falling asleep during the day or when you don't want to fall asleep. So, but because of all this, I really encouraged him to get a sleep study. And we found out that, you know, he did end up having sleep apnea. So, but what we saw with his blood work, we saw high levels of fasting insulin. They were 10. We saw a C-reactive protein. That marker for inflammation was really high. We saw that he had low levels of vitamin D. do it something called an omega quant which looks at the amount of omega-3s in the red blood cell membrane and we saw that his omega-3 levels were low and
Starting point is 00:59:51 we know that omega-3s are really important for resulting in you know helping lower inflammation in the body we can also do some special testing of something called an organic acid testing and we did that for him and we saw that that his mitochondria, which are the powerhouse of your cells, needed a lot more support. And one of the reasons that people develop problems with hunger and weight gain and insulin resistance is with issues with their mitochondria. And we saw that we needed to really support that. He had high levels of free radicals or oxidative stress. And so there were a lot of things we needed to work on with him. One of the first things we did is we got him his sleep apnea treated, he got a CPAP machine, and he started to feel better right away. You know, patients resist this a lot. But you know, we see, when they really do jump on board and start
Starting point is 01:00:45 using that CPAP machine and it's fitted right, many times they just feel so much better. Their energy is better. And one of the reasons, and their hunger decreases because that ghrelin decreases. Cause remember we said that if you have sleep deprivation or sleep apnea, your ghrelin is going to be higher and you're going to just be wanting to eat and eat and eat. So that was one of the first things we really, really helped him do. And it really was very helpful for that decreasing his hunger and that drive to just eat and eat. We also really supported him nutritionally with cutting way back on his carbohydrates, getting more vegetables in his diet, more nutrient-dense foods.
Starting point is 01:01:29 We gave him some supplements that supported his mitochondria, like CoQ10 and B vitamins and alpha lipoic acid. And he did really well. With some of these simple shifts, he started to lose weight. After six months, he got to lose weight after like six months. He got, you know, down to his ideal weight. After about four months, his waist to hip ratio got to 0.9, which is really where we wanted to see it. And he just started feeling better and he was having more energy and not hungry all the time.
Starting point is 01:01:58 And he really understood what foods to choose. And then most importantly, from my perspective, was that, you know, we just really decreased his risk of all sorts of diseases, right? Because we know that, that that insulin resistance pattern drives heart disease and stroke and cancer and dementia and diabetes. And, you know, so we really, you know, that that was really great that we were able to intervene at this age, and, and I think help prevent a lot of diseases for him in the future. With people who are struggling with hunger and cravings, I think one of the books that I really loved about this is called Always Hungry by David Ludwig, who's a friend of ours. Brilliant book. He's a Harvard professor, and he's really studied the biology of hunger.
Starting point is 01:02:38 And he showed that you can literally retrain the brain to not be hungry by regulating what you're eating, by increasing fat, protein, decreasing sugar, timing eating when you're eating, you know, not eating late at night, making sure you have a little period of fast. Snacking is probably the worst thing in the world. When you go to the grocery store, I mean, most of the food is snack food, which is crazy, you know, and it's just like, I don't even go into those aisles, but it's mostly just snack food. And it's just striking to me how we've kind of gotten this culture of eating all the time and snacking and hunger and ups and downs. And it's something that we can really manage by addressing these
Starting point is 01:03:13 underlying biological systems and paying attention to the simple daily rhythms that we need to follow in order to regulate our appetite. And then, you know, I just noticed in my own biology, when I am dysregulated, I get hungry, I get cravings, I want this, I want that. When I'm eating well, and I'm eating whole foods, and I'm giving myself the nutrients I need, I don't feel hungry. I don't want, you know, before dinner, I'll get all hungry. That's fine. Or if I'm working out a lot, I'll get all hungry. But it's not this crazy, oh, I want to eat, you know, a muffin, or I have to have something bad. So I think there's a real science of hunger and people are more in this topic i'd encourage them to read his book called always
Starting point is 01:03:47 hungry he's got a great cookbook that goes along with it but you know this is something we see all the time liz we see so many people struggling with weight and with metabolism and hunger and cravings and and feel discouraged but you know i found people within days can change quickly their biology and and get rid of the, get rid of the hunger. I just remember this one woman who came to one of my workshops years ago on ultra-metabolism, and we basically put people on a really simple whole foods diet. We eat broths and protein shakes and lots of vegetables and good quality protein, good fats. And she was like, look, I'm never going to be able to do this. I've been craving sugar my whole life. I have to eat it. I don't know what to do. I'm really worried about it. I'm so stressed. I'm like, look, I'm never going to be able to do this. I've been craving sugar my whole life. I have to eat it. I don't know what to do. I'm really worried about it. I'm so stressed. I'm
Starting point is 01:04:27 like, look, just try it for a couple of days, see what happens. And the design of the program was really designed to regulate these hormones, to regulate the ghrelin and to regulate the insulin and to regulate the blood sugar and the brain chemistry. And within two days, she's like, I can't believe it. I don't have any cravings anymore. I don't want this. I don't want that. So happy. And I think people don't realize just how close they are to feeling good and you're bringing them all those. So I would say to, you know, any American listening, whether they have a preexisting chronic medical condition or not, the single most effective intervention that they can take today, you know, besides not smoking, obviously, especially now
Starting point is 01:05:03 is to not overload their body with that excess sugar and the highly refined carbohydrates. It causes a lot of damage to the body. And we really should be encouraging improvements in health and immunity in every way possible. And we should look to other ways to increase our dopamine, for example, and improve our immunity. And sleep is really important. Physical movement. We may not necessarily have the same access to the gyms that we do before, but even if you can just move, that's going to be helpful. And getting connected to close friends or family and not feeling that loneliness or the isolation,
Starting point is 01:05:49 it's physical distancing is different than social distancing. Yeah, I know it's true. I mean, I think we are, I think, needing to think about different ways to raise our dopamine. I think that was a really brilliant thing you just said. And dopamine is the pleasure, you know, stimulating amino acid in the brain. It's a neurotransmitter. And we look to stimulate it a lot of different ways.
Starting point is 01:06:12 And most of our society uses sugar and starch and processed food to stimulate it. But things like love and connection and exercise and sleep, meditation, yoga, all those things, food and the right kind of food, right? That also is so interesting to me when you look at the brain biology of what happens to the pleasure center in the brain. When you eat starch and sugar and processed foods, your ability to receive pleasure goes down the more you eat it. So you need more and more of it to get the pleasure, which is really the sort of definition of addiction, right? Right. I drink a glass of wine, I can barely walk up to my room at night. And some people who are
Starting point is 01:06:56 alcoholics can drink a bottle or two and they're fine. And I think that's what's really going on in our society. Now, if I have a sugar load, I'm like, oh, you know, I feel pretty wired. But it really is a matter of redesigning your biology. And what do you see in your patients? How long does it take them to sort of break out of the sort of pattern that they're in and see the changes? Does it take months? Is it days, weeks? Yeah, so it really depends on the individual and what they are coming to me with.
Starting point is 01:07:25 There's a, you know, wide variety of different complications and symptoms. So usually within a couple of weeks to a month, there's significant improvement in their health. But there are patients that have a little bit more trouble because they've had past trauma or no significant adverse childhood event still affecting them today. And I do think that that takes like talk therapy, as you said, psychotherapy to kind of even get them ready to make any changes in what they're eating, for example. And so for some people, weight can be protective. Weight can be protective for them to feel more secure because of past trauma. That's real. I mean, those are issues that really have to get sorted through. But the food part is an interesting therapy that goes along with the talk therapy and other
Starting point is 01:08:21 modalities to help people deal with these psychological issues. And it's often not used. And my experience, it just accelerates people's progress. Like if, you know, I always sort of joke is if you're, you know, if you're eating junk food, or if you're, you know, if you're thyroid not working, or you're gluten sensitive, and you're eating gluten, it's a lot harder to talk through your issues until you get your brain working properly. Yeah, that's exactly right. So what do you think about things like ADD and nutrition? I think you have a number of papers on your site looking at, for example, artificial colors and additives and omega-3s and stuff. But just in terms of general nutritional quality and ADD, are you seeing this sort of epidemic of ADD and autism connected to our diet? I do think it's connected to our diet. And,
Starting point is 01:09:12 you know, like I mentioned before, that these conditions are heterogeneous. And I think that the number of cases of autism over the last 20 years has doubled, even maybe tripled. Both autism and ADHD is just rising. And I don't think that we're giving our brain, we're not feeding our brains the right fuel. And that does affect attention, that does affect memory, that makes our brain cells more lazy or tired, not working properly. And so those are conditions that require, you know, behavioral changes with autism and improvements in memory and, you know, concentration is really important. So I think what you're eating is so important for that. Yeah. I don't know if you said you mentioned you read my book, The Ultramind Solution. I don't
Starting point is 01:10:08 know if you saw the case of this little boy who had ADD and his handwriting before and after he got treated. Changed. Yeah. And that was really what got me to write the book was when his mother brought in his handwriting before and after two months later after he started changing his diet and fixing his nutritional deficiencies. And his handwriting went and after two months later after he started changing his diet and fixing his nutritional deficiencies. And his handwriting went from completely illegible to really perfect penmanship. And I thought was, well, how did his brain go from being totally chaotic and asynchronous and uncoordinated to being coherent and functional? And I thought, wow, this is incredible. If that is really true, like, you know, you can, people can talk about their behavior
Starting point is 01:10:46 and their mood. It's more subjective. But when you see like this objective reality of handwriting before and after, and it wasn't like he took penmanship lessons, we know what's actually happening in the brain. And when I went back to look at this kid's history, it was fascinating because he had a lot of inflammation, right? So if you look at all these comorbidities that he had, he had asthma and allergies and eczema and hives,
Starting point is 01:11:09 and plus he had irritable bowel, and he had all these sort of physical issues that were inflammatory, but they were coming from his inflammatory diet, and the kid never had a real food in his life. He never even probably saw a vegetable in his life, and he had high levels of trans fats in his blood. He had no omega-3s. He had very low levels of B6. He had low levels of zinc and magnesium. And, you know, it was really pretty striking when we just cleaned up
Starting point is 01:11:37 his diet and we got him on some basic supplements, just a multi and fish oil, vitamin D, his literally, his brain completely changed within just two months. And he became functional and his ADD went away and all his asthma went away and his gut issues went away. And, you know, and it's years later now and he, you know, he graduated in astrophysics from University of Colorado or something. You know, it's like, you go, you know, this kid got kicked out of kindergarten, was on Ritalin for years. And yet this is not something that most psychiatrists even think about doing with their patients, which is so frustrating to me because, you know, as a family doctor and someone who does functional medicine, like this just seems so self-evident.
Starting point is 01:12:17 And your work is just such an example of how things are really changing. Do you find that your colleagues are like, what are you doing, Shivani? Or are they like, this is interesting? Or are they giving you a hard time? No, so I completely believe that, you know, that story you told me. I can believe that a patient with ADHD has significant improvement after, you know, what you treated him with. And my colleagues have been pretty supportive, actually, and very interested to learn more and very open to making that change. In fact, even just last week, we have different clinics based on subspecialties,
Starting point is 01:12:58 like neuropsychiatric clinic or mood disorder clinic or depression clinic. And the depression clinic and the depression clinic and the bipolar clinic and this woman's wellness clinics they all reached out to me and want to collaborate and I think one of the attendings uh told me last week that 40 percent of his patients um have metabolic issues and talking about weight gain and um most likely I think a lot of people have nutritional deficiencies. And we already know the general population has a lot of nutritional deficiencies. So if we look at the population and mental health, we're going to see, you know, even more. So I do think that this is something that's going to change. I'm optimistic. I think you can tell.
Starting point is 01:13:42 Yeah, well, you're changing it. You're clearly at the forefront. Are you a lone wolf out there? Are there other people out there in the psychiatric world who are on your same path? I think there are other people out there on the same path. I think that metabolic dysfunction, per se, is not necessarily looked at as much compared to nutrient deficiencies or specific vitamins and supplements, for example. But I do think that, you know, the combination, these are all important, all important topics and all important things to work on. So let's last question, looking forward five, 10 years, how does it feel to psychiatry change? How would you like to see it change in
Starting point is 01:14:23 how we treat mental illness based on what you're learning in your research? So I would like to see the change actually across the board and even in medicine is to focus on nutrition and metabolism. And I think over time, we need to really include that as part of the assessment in the initial, you know, history that we take. And we have to have a careful intake history about nutrition and what people are eating for breakfast, lunch, dinner, snacks, their drinks. I mean, how they're sleeping, you know, how they're looking at food. So I think that should change. And I also think that the treatment of insulin
Starting point is 01:15:09 resistance and detecting insulin resistance, because I often find that it's not being detected and I'm not necessarily the doctor that sees them as frequently. And so that's something that I feel needs to change within our whole system. We need to think about, you know, aside from just looking at blood sugar every now and then and thyroid, we also need to look at some, you know, like their fasting insulin level. You know, what is their consumption? What is that early process? The things that make us sick later start early. Yeah. And it's a gradual process towards decline. And what if we intervened earlier, detected things earlier,
Starting point is 01:15:58 asked about things earlier so that we can prevent what happens later? We know what happens later, right? So this is just a radical idea, right? The doctors should ask their patients what they eat. That's the future of medicine. Actually, no one can come and see me in my practice unless they fill out a three-day diet record. And then on top of that, you can't get an appointment
Starting point is 01:16:24 unless you agree also to see the nutritionist, because if food is medicine, I can't practice without a nutritionist. And the other thing you said was really important, is that the most common disease in America, insulin resistance, the most common problem that affects hundreds of millions of Americans, is not diagnosed 90% of the time by the doctor. That's a shocking stat. I think we're missing a lot of it. Unfortunately, I think we're missing a lot of it. And I think, I think we don't necessarily know how prevalent it is as a medical society, perhaps as a whole, we don't necessarily know how common it is.
Starting point is 01:17:08 And it's really common. And every time I mentioned that statistic, people are shocked. No. Yeah. And with kids now too. So, I mean, it used to be that the majority of liver transplants in this country were done because of alcohol cirrhosis. And now the majority are being done because of fatty liver caused by fructose and high consumption of sugar. Even in young adults, which is terrifying. I mean, I was at an obesity conference and there was this guy there who was a pediatric gastroenterologist. I'm like, what are you doing here? He goes, well, you know, we see a lot of fatty liver in kids, five--olds i'm like really that's what we used to see in old people with diabetes right yeah that's it's very sad so make sure you do your five three-day diet record and the uh the other thing is ask your doctor for a fasting
Starting point is 01:17:56 insulin this is something i've been measuring for 30 years and i almost never see it done by most physicians and it's probably the most important test because your fasting insulin goes up way before your blood sugar. And that's something you can easily detect by checking your, your blood tests. And it's an easy blood test. And if your insulin is over five, you're heading towards trouble. If it's over 10, it's not great. And if it's way more than 10, you're in trouble. So that's, that's a, an easy thing to measure.
Starting point is 01:18:24 And it's something that'll tell you where you're going and it affects your mental health. So I would say to people who are listening, if you have mental health issues or you know someone with mental health issues, you should really think carefully about the role of food nutrition and how that plays a role in what's going on and experiment because there's really very little harm to cutting out processed food and sugar. In fact, there's only benefits. And there's even very little harm to cutting out processed food and sugar. In fact, there's only benefits. And there's even trying something more aggressive, like a ketogenic diet, often with, you know, the help of a physician or someone who knows what they're doing can be helpful. But these are simple things that have low risk, high benefit, and they're actually being
Starting point is 01:18:59 validated in the research. And your work is just so exciting to me. Shivani, I think, you know, this is really the future of psychiatry and mental health in this country. And I hope that you can become, you know, a bigger voice than you already are, because I think the world needs to hear this. I think our government needs to pay attention to this in terms of our policy of funding research in this area. So if I can, if I can help you get millions of dollars from the NIH,
Starting point is 01:19:23 I'm going to do what I can. That would help. I do need some research funding. If anybody's listening, you can find it. Go ahead. I did want to just say, I had a comment to what you were saying, is that because people are listening, I want to make clear that it's not just people with obesity that have insulin resistance, but people who are
Starting point is 01:19:46 even just normal weight can have this insulin resistance. And so it's really important to, to think about that, as you decide whether you want that assessment, because you may not even know that you may be insulin resistant. And you may not know that you have a high blood sugar, and you think you're eating healthy, but there are a lot of foods out there that you think are healthy that are not, and a lot of added sugar in these things. Well, that's a really important point because there's a lot of people walking around saying, well, you know, I eat a lot of sugar, but I'm skinny, so it doesn't matter. It doesn't affect me. Well, it does. In fact, about 20 to 40% of skinny people are metabolically unhealthy, meaning they're, we call skinny fat or
Starting point is 01:20:26 metabolically obese, normal weight. So you look thin on the outside, but you're fat on the inside and you're maybe not overweight, but you're over fat. And especially around your belly fat, which is what the danger of fat is. It drives all the insulin resistance. So it's important to really have a real look at this for yourself. And I think I'm so encouraged by this conversation. I can't even tell you, I've been waiting for you for 30 years to talk to you. And now you're doing this incredible work at Stanford. It makes me so happy. That's very sweet.
Starting point is 01:20:54 Another just comment is that with excess weight and that visceral fat that you were getting at leaks inflammatory molecules and causes damage in the body as well. And so how much of that is contributing towards mental health and mental health symptoms is also an important question. So I just wanted to mention that because sometimes that fat is not fat you can actually see. It's fat that's built around the organs and around the arteries and things like that. We've gotten in a world where we are over-consuming ultra-processed foods in ways that make us the most obese nation in the world and are staggeringly undernourished, even though we're
Starting point is 01:21:40 overfed. Overfed and undernourished. We have significant nutritional deficiencies in this culture. Forget about phytochemicals. I think probably 99.9% of Americans are deficient in phytochemicals because I think less than 9% of the recommended amount are fruits and vegetables. That's right. That is a minimum.
Starting point is 01:21:57 Like five cups is minimum. Five servings, which is basically two and a half cups. I would say people should eat more like eight or nine cups of fruits and vegetables a day. Right. So we've lost that. And these compounds we're not getting and we don't know we need, but we're so deficient in our diet and the cravings we have and the overeating we do often is an attempt to try to replace those nutrients that we're not
Starting point is 01:22:26 getting from our food. And one of the studies by Kevin Hall along with some others was fascinating to me. You talked about it, which is that when given an unlimited amount of ultra processed food to eat or a whole food to eat, that the people who ate the whole foods felt satisfied on far less food. They ate 500 calories less a day now that is a massive amount of calories if you're 100 calories off for 20 years you're going to gain 20 or 30 pounds so 500 calories let's say 3500 calories right right right right which is basically a week of of of the calorie excess would be equivalent to a pound of weight gain a week. Yeah.
Starting point is 01:23:07 Excess food. So that's why we're so overweight because we're looking for love in all the wrong places. We're looking for nutrients in nutrient-depleted food. Forget about phytochemicals. Like the whole idea of phytochemicals regulating our appetite and our desire for food was something I just, you know, didn't fully understand until I read your book. And the thing that struck me was some of the experiments you did
Starting point is 01:23:31 where you help explain how flavor and nutrient needs and the animal's feeding behavior are all related. So they will find the foods that they need and will eat enough of those to meet their needs and then they'll go eat something else. They won't eat too much or too little. They have this natural intelligence and that flavor
Starting point is 01:23:56 is associated with these phytochemicals. So most people understand. When you eat like a wild strawberry, it's an explosion of flavor in your mouth, even though it's the size of a pea yes you eat a big fat strawberry you buy in the grocery store it tastes like cardboard you know and there's no real flavor there and dan barber has done a lot of work around this as a chef and created a company called rose saline foods where he's hybridizing plants not you know but just breeding plants for flavor he's hybridizing plants, not GMO, but just breeding plants for flavor.
Starting point is 01:24:27 He's not thinking about phytochemicals. I'm thinking as a doctor about the phytochemicals because the phytochemicals are what give the plant the flavor. So the whole relationship between plants, even in humans and their dietary preferences, and plants and animals is something most people understand. So can you explain the way in which these flavor feedback loops help regulate animals' feeding behavior and how it might inform, as humans, what we should be eating and how we need to reclaim and listen to our own nutritional wisdom? That's so important.
Starting point is 01:25:01 That was something that really blew my mind. I wish there's a way that we could make this come alive for people there to realize that liking for flavor is being mediated by these metabolic feedbacks, hormones, neurotransmitters, peptides, all those things are those signals are coming from cells and organ systems as a function of their need. And so that's changing liking as a function of need. And when you're eating wholesome foods, then that's going to be in sync with what your body needs. That system can be hijacked. We looked at a little video last night. I showed you a sheep and uh one group of sheep had been uh when they when they ate a really a straw which is not not a nutritious food at all we we would put either water in one group
Starting point is 01:25:56 of sheep directly into their stomach or an energy a blast of energy and the sheep that got the blast of energy they love that straw right that's the food industry is doing with the refined carbohydrates you get a flavor and you follow that with a blast of energy and you immediately form a really strong preference so so we stop there so basically we're saying is you take straw which is like eating processed food right cardboard no nutrients you add sugar on it and they go oh sugar that's good i want energy and they eat the straw even though it has no nutrition right which is what we do as humans we eat ultra processed food we eat fast food which has no uh real nutritional value but it has tons of energy so they add sugar and all these flavorings
Starting point is 01:26:42 to it in order for us to start craving it. So we associate the boost in energy with the flavor. The flavor of the fruit. But it's actually kind of mismatched. It is. And what we were showing is that it's that feedback. And the way you do that is to give the flavor of straw. So we would make maple-flavored or apple-flavored or whatever it is. And you've got this straw that's
Starting point is 01:27:06 worthless you have to emphasize that it's it's not nutritionally anything but when you follow the ingestion of that straw with with nutrients in the gut put the nutrients directly in the gut that's the cells and work you know those nutrients are getting absorbed and cells oh this is great and it's feeding back to make you say, oh, I love maple-flavored straw. Or I love apple-flavored straw. It's not even the taste because you're not giving them maple flavor. That's right. That's exactly.
Starting point is 01:27:34 That's to try to get that through. And then to realize, you know, and none of this is conscious. As we were talking, nobody thinks about which enzymes to release to digest the food they're eating and it's the same thing with these feedbacks it's happening automatically yeah and that's where um if you're eating wholesome foods it works the system is solid as it can be but if you get on the ultra process you it gets hijacked and the food people in the food industry have really learned how to do that well and then to put not you know not wholesome herbs and spices let's say as a flavoring agent it's all
Starting point is 01:28:12 these 600 million pounds a year whatever artificial flavoring 600 million pounds of artificial flavorings are added to our food every year. That's frightening. Yeah. And it's caused this disconnect between our natural inclinations to eat foods that nourish us with our ability to pick those foods. And we tend to eat foods that are associated with these artificial flavors because they've scientifically figured out how to hijack our brain chemistry and our hormones and our metabolism. And so we tend to crave all the wrong stuff. Rather than the phytochemicals we've been talking about, we use artificial, yeah, artificial flavoring agents.
Starting point is 01:28:57 And so we're not getting, just as you were saying earlier, all those things that our bodies evolved with over the years and that regulate all these systems inside our body, we're not getting that. Yeah, and these animals seem to have profound ability to sense what's going on, not necessarily through even taste, although the flavor plays a role, is even the levels of these metabolites of plants in their bloodstream can regulate their eating behavior. So you talked in the book, for example, about eating sagebrush. For example, elk in the winter eat sagebrush, which is not the greatest food, but it has nutritional values in the winter when they can eat other stuff.
Starting point is 01:29:37 And there's high levels of this thing called terpenes, which are potentially toxic to these anions. They will stop eating when their levels of the blood of these terpenes gets to a certain level and they'll go eat something else. Yes. But you kind of hijack that through studying this process where you infused the terpenes into their blood. So they never even kind of, it wasn't like they were tasting it and eating it.
Starting point is 01:30:00 It was like their body knew immediately that it was time to stop eating that. Yeah, and if the guests in the audience can just picture, so there's an animal that's there eating. We were working with sheep on those studies, and it's eating its meal, and we're slowly, slowly infusing terpenes into the bloodstream to look at detoxification and elimination processes. And when we reach a level that's enough for for the particular animal they'll just lie down and stop eating so we would stop infusing at that point but
Starting point is 01:30:31 it's the animal is associating the food that it's eating with the feedback signals they're so in tune with that it it's amazing actually when you start to watch it if you can picture it and it just changes absolutely changes your views of nutritional wisdom of the body, how that's working. So basically, we've gotten this predicament of a food system
Starting point is 01:30:54 that's producing food in a way that depletes the plants of the phytochemicals and the nutrients that's needed to feed animals and humans in a way that destroys the soil and humans in a way to destroy the
Starting point is 01:31:05 cell microbiome in a way that has hijacked our own ability to know what's good for us or not good for us because our innate nutritional wisdom has been hijacked by these industrial chemicals and starch and sugar and food that has completely disconnected us from our ability to have any nutritional wisdom. And for anybody listening, if you've ever done a detox or an elimination diet where you get rid of all the junk, all the processed foods, even on my 10-day detox diet, you'll very quickly start to reclaim your natural wisdom. You'll start to crave the things that are good for you.
Starting point is 01:31:39 Like I don't crave starch or sugar or processed food. In fact, I can walk by the Candy Island. I mean, it just looks like a rock to me. I'm like, why would I eat that? It doesn't even look like food or a muffin or something. I was at a coffee shop today in Montana, and I was getting some coffee. Although coffee is the richest source of phytochemicals in the American diet, which is not a good thing, by the way, because you just drink coffee and don't eat any plants.
Starting point is 01:32:08 But they had this sugar cookie and this banana bread and lemon bread. And I was like, oh, I want to eat that. But I was like, no, I actually don't. I looked at it. It sounded good. But then I looked at it. I was like, no, that doesn't look edible to me anymore. And I think I used to want to eat that stuff.
Starting point is 01:32:24 I think if we can kind of reclaim our own bodies, it doesn't take long to me anymore. And I think I used to want to eat that stuff. I think if we can kind of reclaim our own bodies, it doesn't take long to do that. No, that's right. And I have a story for you. When Sue and I really, many years ago, got moving more and more in this direction of getting all of that out of our diet, we decided, look, that stuff's really hard to resist when you're on it, right? I mean, you talk to a lot of their hosts.
Starting point is 01:32:49 Once you start, it's hard to stop. Yeah, you're hooked. And sugar can be addicting and all those things. So the place to stop is at the grocery store. It doesn't go into the basket. It does not go into the basket because you don't get it home. But I love to tea soup, and I was in the store a while back back and so we'll go down the aisle where all that stuff is i grabbed this huge old cake and stuff and this older lady was watching me and she knew what i said and i put that and i put a couple
Starting point is 01:33:18 of these and sue came back to the basket and it was just so fun to watch the old lady she's get that out of here you know and the older lady but it's a so fun to watch the old lady. She says, get that out of here! The older lady. But it's a key point, though. You can't surround yourself with that stuff and think that you've got the, quote, willpower to avoid it. It's in your house. So at Christmas time,
Starting point is 01:33:37 when we get really gifts from other people. Yeah, it's bad. Yeah, and we hate to... We accept them nicely, but Sue throws them away. She just... Because, you Yeah, it's bad. Yeah, and we hate to, we accept them nicely, but Sue throws them away. She just, because, you know, it's...
Starting point is 01:33:49 Why do I want to give them to a food bank because, you know, it's like, you don't want other people eating that. No, you don't. It's not.
Starting point is 01:33:56 So, you know, that's one of the things that we did anyway was to say, you've got to get on wholesome foods and let your body start to tell you what you need from day to day.
Starting point is 01:34:07 I'm like Claire Davis' kids, you know, and sometimes they'll say, eat this or eat that or eat something else. I don't want it today. My body doesn't want it. Okay, I don't need that particular thing today. My body's not telling me that. Well, one of the things that struck me from your book was the discussion of the intelligence of your cells and organs that's beyond your brain.
Starting point is 01:34:32 And how those cells and organs are constantly sampling their environment and deciding what they need or don't need and regulating your behavior. It's almost like a decentralized brain. I just blew my mind. or don't need and regulating your behavior. It's almost like a decentralized brain. I don't, I just, it blew my mind. And one of the stories you tell us to illustrate that is a woman who had a, I think a liver transplant or heart transplant,
Starting point is 01:34:55 heart and lung transplant, heart and lung transplant. And she's pretty healthy year before. And all of a sudden she's like wanting KFC and wanting junk food and was so confused so tell us about that story implications around how our cells and organs are also intelligent and how that works it's it blows your mind because it'll make you stop to think who is this person I call me actually right it'll really make you stop to think that when you realize how all these cells and
Starting point is 01:35:25 organ systems are interacting to influence all that you do but so the book a change of heart by claire sylvia it's an old book now but it's so worth reading because um so here's this 40 year old woman one of the first people ever to get heart and lung transplant and so doctors know no one understood much that what would happen and I remember one part in there related to what you were saying where she was saying man I'm just I'm a different person now that I've got these heart and lungs it wasn't only food it was a whole bunch of so yeah so it's set her on this quest to try to find out where these organs come from. Yeah exactly where did these organs come from and the book is
Starting point is 01:36:14 telling of this story and she finds out it's it's a young man named Tim that was a you know late teens was killed in a motorcycle accident and that's the heart and lungs she got and so she's telling these doctors about all this stuff and i remember one the doctor said you know the heart's just a damn pump and she said no it's not just a damn pump you don't know it's not in your body you know it's you're not experiencing what i'm experiencing yeah and the and the lungs aren't just the way to get air into your body and And then the part, you know, so she's, since she was one of the first people to do that, there was great interest. And the press was there about the time she's getting ready to be released from the hospital.
Starting point is 01:36:55 And one of the reporters asked her, if you could have anything you want right now to eat, what would you like? And she said, actually, I'd like a beer. And she said the minute she said that she wanted to take the words back for two reasons one it was a flippant response but two i don't even like beer she said and so that goater started thinking about this whole deal and then like you say it just went on and on things that she she never liked before green peppers and almond and KFC. She came to like. And so her dietary habits broadened out.
Starting point is 01:37:31 She didn't quit liking the things that she once liked. She still liked those, but they broadened out. And then she's asking the family, Tim's family, what did Tim like to eat? You know, and they're saying, oh, he just loved KFC. And she said, Chicken McNuggets. She said, first time she could drive, her car nearly steered off the road, which went by a minute. How do you kind of reconcile that with the promise of reclaiming our nutritional wisdom?
Starting point is 01:37:59 Because if the programming of our cells and organs is so intense by the processed food industry that it survives death you literally give someone else your heart and lungs if you die and you also give them your all your bad habits right how do you undo that yeah i think like you say i think you you have to really you have to radically change what you're doing. She has to retrain the new heart and lungs. You have to retrain them. I know people that I visit with quite a lot that were really born, raised on ultra-processed foods and those sort of things. And it's a lifelong battle for them.
Starting point is 01:38:39 They tell me. I still struggle with that. We just talk about it. I guess it's like alcohol. Once you're an alcoholic, you just leave that stuff alone, right? And you put wholesome things into your diet. You're right, but it lets you know the deep level, right? The deep, deep level at which all of this is happening.
Starting point is 01:38:59 And then the amazing level. Well, there's far more afferents feeding up to the central nervous system than, like, it's all the same nerves growing from the central nervous system down to the body. They're so huge. Many, many times. Yeah. Many, many more times ascending than descending, right?
Starting point is 01:39:17 In terms of neurons. So basically your cells and your organs are all talking to your brain and giving information to them about what to do or not to do, what to crave and what to want. Absolutely right. So if you look at the taste system, nerves for taste converge with nerves from throughout like the vagus and so forth. Those nerves right here in the brainstem, then they synapse and relay throughout the central nervous system. They converge with nerves for smell and so forth and so on so yeah we we know we we understand a good deal about the basic anatomy and physiology of those systems and now
Starting point is 01:39:56 we're learning that the microbiome is also sending signals right i mean that's that you're not eating only what you crave you're eating what your microbiome craves. Well, it's like the whole thing has got to be fed, right? It's got to feed itself. And so, and the part that makes me a little bit sad is the, the, the microbiome and it's important. Absolutely. It's, it's getting so much press and people are saying, well, the microbiome is sending these signals to the central nervous system, but there never gets a word said about all
Starting point is 01:40:23 these other organ systems, cells and organ systems. They're doing the same thing. Yeah, everything has to be fed, and the brain has certain needs, and the lungs, and the liver, and they're all, it's a democracy, I guess you would say, how they're all feeding into it. Yeah, and that's where it's humbling, too, for me. And then you think, so an animal eats a meal tens of thousands of compounds and these feedbacks are mediating all of that to meet needs and i think you realize at that point
Starting point is 01:40:54 that we can study up to a degree and then it just points you in a direction right that that you either come to appreciate that all that's going on and that, you know, this diversity that we're talking about of wholesome foods is what matters. And then you figure that complexity, the body knows. And the more we understand it, and it helps us to appreciate that, right? But then there's a humility for me at this point where you say it's incredible. It's incredibly complex. And sometimes in our reductionist approach, and I did this for years, you know, we went down that path. What compound is causing what?
Starting point is 01:41:30 What's what? Yeah, it's not in the knowledge. Yeah. No, it's not how it works. So, I mean, we learned from that, but I'm back so far away from that. It's about the richness of all that and the combinations. And I've heard you talk about it, Mark, and really appreciate it, you know appreciate it you know so you could say well meat's bad meat's bad for you and the epidemiological kind of work but it ignores something we learned really early on is that you've got to think about
Starting point is 01:41:55 all the other things that are in the diet right yeah how they're how they're synergizing with one another or in good ways or in bad ways to influence. It's not is meat good or bad. It's the whole diet. Right. It's like what you eat in combination with it. It's a combination. You eat fries and a burger and a milkshake.
Starting point is 01:42:14 It's different than eating a, you know, regenerative gas fed beef with tons of spices and marinated with lots of phytochemically rich vegetables and plants. It's a totally different experience for your body. It absolutely absolutely is and when you get into that and get on that it's a very rewarding experience you feel satisfied and you don't have to to eat a lot we had a meal last night and we had a little bit i just had a half a piece of meat and i'm satisfied you know and you have all the greens that we had and the broccoli and so forth. Well, you know, it's interesting.
Starting point is 01:42:46 You know, to summarize what you're saying, essentially, you know, sort of what I sort of tried to get to in the Pekin diet, was a set of principles that are universal that we can agree on, that we should all be eating whole foods, that we shouldn't eat processed foods, that we should eat phytochemically rich foods, that we should eat foods with basically a wide variety and diversity of foods to include all these different compounds that we need for our health. And it doesn't mean you have to be rigid or fixed, and there's a lot of ways to achieve that. But this whole kind of competition or adversarial relationship between vegans
Starting point is 01:43:16 and meat eaters, it just doesn't make sense. I want to sort of dive into something that I think is a little bit controversial, but it kind of blew my mind when I read it in your book, that plants have 20 senses. The plants communicate with each other through these phytochemicals, through messengers that they send through the mycorrhizal fungi. So they might be getting chomped on by a caterpillar, but they might send a message to their neighbor plants, saying, hey, guy, you want to ramp up the production of this phytochemical that caterpillars don't like because i'm getting eaten you know or how they sense everything around them so the question
Starting point is 01:43:53 you know sort of arises you know are where does consciousness begin and what is a sentient being and are plants sentient are they Are they exhibiting behaviors and communication that makes us rethink their value? Because, you know, this is kind of, well, if you want to be ethical, you should only eat plants. Well, I'm not so sure, you know, forget the idea that you're just growing plants. You're going to kill animals through farming techniques that destroy habitats and kill rabbits and birds and we've lost 50 of our bird species for agriculture that that's for sure happening and that not forget the fact that you know with organic agriculture you need to use animal products to grow food like plants right you need you need compost or manure you need bone meal and fertilizer you need various kinds of nutrients
Starting point is 01:44:46 and different oyster shells there's a lot of animal products that are used in organic fish agriculture so forget that just the idea that these plants actually might have consciousness was a really novel idea for me and kind of unpack that yeah that that's how does that work that's amazing that's amazing kind of research that the plant physiologists are doing. And, you know, there was a book written many, many years ago, The Secret Life of Plants. And it was really talking about these kind of ideas, but it got highly, highly criticized back in the days
Starting point is 01:45:19 because there's no science behind all this stuff. Well, now there's top-notch world-class physiologists and ecologists have been studying all these the 20 different senses and books have come out about plant intelligence and behavior and it uh and they can't walk but they do a lot of cool stuff and if you think about it you know if you're confined to one space you probably have to be even more clever right i mean you can't get up and run away. You've got to figure out. And these phytochemicals that we're talking about become the language of the plant, right?
Starting point is 01:45:52 They're the language. They're the ways that they communicate. And so a caterpillar is starting to eat you, and you produce volatiles that send a signal on the other plants. Oh, boy, Charlie's getting eaten over there. I think I'm going to up my – and they do that, literally. I'm joking, laughing a little bit, but they're doing that, you know. And so it starts when you read about the different senses of plants, and they have a kind of nervous system too.
Starting point is 01:46:21 It works more slowly than ours do, but some of the neurotransmitters we have, they have some of the, yeah, and it's slow, but it works on plant time as to what they need to do. And yeah, you just- They can say they can share nutrients, they can do all kinds of things. They do, and they help one another out, right? I mean- Hey, Jimmy, I need some vitamin vitamin c can you give me some it's true yes that's being documented that they do those sorts of things and in ecology i think it's where ecologists went down maybe not so good track historically it was all about competition dog eat dog world everything's competing competing competing and we're thinking all these synergies and how plants
Starting point is 01:47:05 might be helping one another, helping their offspring, sharing resources with one another. It's amazing to get into that. And then you can think about, well, are they clever or not? You know, anybody that's taken classes in biochemistry, and some people take to that more readily than others, but a lot of people think it's pretty tough and biochemistry is probably the most important subject in medical school we all basically didn't pay attention to it ignored and learned for the exam and then we forgot about it right right and you know so but so biochemists um are the ones creating all these genetically modified plants and so forth and so on. But plants routinely outwit these clever biochemists, agro people. And the example I use, there's over 500 herbicide-resistant plants.
Starting point is 01:47:58 You make an herbicide and the plants are going to figure out how to get around it. It's just like antibiotic resistance in humans and in livestock. You put a single compound, right, rather than diverse mixtures of phytochemicals. You focus on one compound. And that's easy for these over 500 herbicide-resistant plants. You just go down the list. Yeah, so who's clever and who's not clever, right? I mean, so if there's this incredible intelligence,
Starting point is 01:48:25 it makes you think about what should we eat? Should we have water or air or rocks? If you really want to be ethical and not kill or injure anything with constitutional sentiments, what should we be eating? You could be like a Jane that you don't eat anything, even a plant, until the fruit falls from
Starting point is 01:48:42 the tree and so forth. But I think another way to think about that, and for me, it's to realize this real irony that for anything to live, something gets consumed, right? It's constant transformation. Your sentence in the beginning of your book was so great. It says the universe is a restaurant consuming itself. I'm like, what a great line.
Starting point is 01:49:03 And you can't get out of this predicament of having to consume, kill, eat life. That's right. And so then does vegan have an impact on, on that? Well, I don't know. Like I think there's a lot of questions that I have about that. Forget the health complications or implications or forget the environmental stuff. Just from an ethical point of view, like what does all that mean? I hope you enjoyed today's episode.
Starting point is 01:49:29 One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey, everybody. It's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my
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