The Dr. Hyman Show - America’s Food Supply Is Rigged—Here’s How to Opt Out | Vani Hari & Dr. Shebani Sethi

Episode Date: February 10, 2025

Ultra-processed foods (UPFs) are identified as the leading cause of preventable death globally. These foods are chemically altered, stripped of their natural structures, and filled with additives, sugars, unhealthy fats, and preservatives, resulting in products that offer little to no nutritional benefit while contributing significantly to chronic disease. In this episode, I talk with Vani Hari and Dr. Shebani Sethi about why ultra-processed foods are not just a health risk—they are a public health crisis. Vani Hari is the food activist behind FoodBabe.com, a NY Times best-selling author of 4 books, founder of the organic products brand Truvani, and was named one of the “Most Influential People on the Internet” by Time magazine. Hari’s viral testimony before the US Senate sparked a massive movement to stop American food companies from poisoning their own citizens with ingredients they don’t use in other countries. Hari founded Food Babe to spread information about what is really in the American food supply. She teaches people how to make the right purchasing decisions at the grocery store, how to live an organic lifestyle, and how to travel healthfully around the world. Vani has gathered hundreds of thousands of petitions to change the food system and influenced how major food giants like Kraft, Subway, Chipotle, Chick-fil-A, and Starbucks create their products, steering them towards more healthful policies. Dr. Shebani Sethi 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.  Full length episodes can be found here: Why the Last Thing that Should Ever Eat is Ultra Processed Foods How To Be A Food Activist In Your Own Kitchen How Does Ultra-Processed Food Affect Our Mental Health? This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%.

Coming up on this episode of the Dr. Hyman show. I'm just going to say it really clearly, unambiguously. Ultra-processed food is the number one cause of death in the world today, period. This is not my opinion. This is from the global burden of disease study of 195 countries. The data is very clear. Too much of that crap and not enough real food. You know, I often remind people that sleep is not just a luxury, it's a necessity.

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episode I'd like to note that while I wish I could help everyone via my personal practice there's simply not enough time for me to do this at scale and that's why I've been busy building several passion projects to help you better understand well you. If you're looking for data about your biology, check out Function Health for real-time lab insights. And if you're in need of deepening your knowledge around your health journey, well, check out my membership community, Dr. Hyman Plus. And if you're looking for curated, trusted supplements and health products for your health

journey, visit my website, DrHyman.com, for my website store and a summary of my favorite and thoroughly tested products. What's ultra processed food? What's not? So let's talk about what exactly are ultra processed foods? What are the characteristics? How do we define them? Well, there's something called NOVA classification. I'll get into a minute, but essentially it's deconstructed food. Basically take raw materials from things like corn, wheat, and soy. You deconstruct them chemically in a lab. You structurally alter them so they're not actually the same chemical structure. And our body, remember, gets messages from the outside environment and regulates this biology through chemical signals

that depend on the structure and shape of the molecule to create a signal in the body that does good or bad. Right? It's really important. So these are funky, weird Franken molecules. And then they're turned into food like substances that come in every color, size and shape of chemically construed yuck, basically. Now they're super energy dense usually, they're high in calories, they have pretty much no nutritional value usually, they're high in sugar.

I mean, they may have added vitamins. You know, you get your cereal or fruit loops with added vitamins, well, that's not exactly a health food. They are high in sugar, They come from all different sources. High fructose corn syrup, dextrose, maltodextrin, cane sugar, fructose. There's a million different names of sugar. You can Google it and see.

I'll put a link to all the different kinds of names of sugar, but they hide the names of sugar on the label. So you get confused. It doesn't just say sugar. It's also high in refined grains. So these are highly pulverized grains that mostly wheat that are chemically altered

and are not resembling their original form and they're maybe from corn from wheat from beans like soy also high in unhealthy fats usually trans fats still in the market refined oils and so forth they contain often excess salt hyper palatable they're easy to overeat they're low in fiber typically low in protein they're low in vitamins and low in minerals so all things you need to thrive they don't have they also tend to spike your blood sugar a lot. They also don't make you feel full. So people who eat ultra processed food eat 500 calories more

a day. This was a controlled study at the NIH with Kevin Hall. Really impressive data. So basically people who were allowed to eat whole food versus ultra processed food as much as they wanted, the ones who ate the ultra processed food ate 500 calories more a day, 3,500 calories a week. That's a pound a week. If you keep doing that all year, that's 52 pounds of weight gain in a year. So what are the examples of ultra-processed food? Well, it's potato chips, crackers, pretzels, candy, microwave, popcorn. Don't ever eat that. Muffins, donuts, sandwich breads, cookies, flavored yogurts, puddings, jello, breakfast cereal, granola bars, things with added sugar, food dyes, natural

artificial flavors, colors, preservatives, gums, emulsifiers. Oh my. Right? It's a lot of stuff. So don't eat that. It's not food. Ready to eat meals, instant noodles, and soups, frozen TV dinners, canned ravioli, pastas, packaged meal kits. Nasty. Unless they're made from whole food. Processed meat and dairy. Again, we eat a lot of this stuff. Hot dogs, deli meats, fish sticks, which I don't even know what they are. Often they're not fish. Chicken nuggets. Most chicken nuggets have like 35 meats, fish sticks, which I don't even know what they are. Often they're not fish. Chicken nuggets, most chicken nuggets have like 35 ingredients, only one of which is chicken. Process, cheese slices are not even allowed to be called cheese, because it's not actually cheese,

they're not 51% cheese. Various spreads, flavored milk, non-dairy beverages, coffee creamers, various protein shakes you have to be careful of, like isolated-soap proteins, deconstructed soy. Potentially very cancerous, so be careful of that. Flavor, so it says soy, very cancerous. So we're careful of that flavor. So it says soy, a soy shake. And that's like maybe really bad for you flavors

sweetened nut milks often can be problematic. You have to watch what's in them. And of course, sugar sweetened beverages, soft drinks lemonade, iced tea, soda, food drinks, punches, energy drinks, flavor coffees, all this stuff is just nasty. So you want to stay away from that. When it comes to a healthy diet, we hear a lot of these terms, ultra processed food,

processed foods. Most people have no clue what they are. And I think it takes a little bit of education to understand how to navigate this landscape of processed and ultra processed food. Now, what does it mean? We're going to talk about the difference between ultra processed food and other types of processed food, for example, Doritos versus the Candace sardines. They're both processed, but highly different in their effect on your biology. There's one worse than the other.

How do we tell the difference? We're going to get into all of that. Part of the problem today is that most people need a PhD to understand nutrition labels. And many of us fall into the trap of convenience and just sort of get whatever seems good or whatever package looks like it's gonna be healthy. And basically there's a health claim on the label.

You think it's good for us, but that's basically one of my rules of eating. If it has a health claim, it's not good for you. In other words, gluten-free potato chips or a sugar-free this. When it says that, it's always something bad that's added. So these are made by big food in order to lure you in and get you sucked in and trapped.

As a result of that, we have a nation and a world increasingly where more than half the calories come from this hyper palatable, easy to overeat, processed food like substance. And you have to look at the definition of food. Food is something that supports growth and life. The truth is these don't. So by definition they are not food. Just look it up in the dictionary. If you can convince me that these things are food well good luck because they're not and they don't meet any definition of what food should be like, and it essentially is a substance that helps support life and growth,

and ultra-processed foods do neither. In fact, they do the opposite. Now, I'm not just making this stuff up. There's an amazing study. Now, it's an observational study, but it's a very well-done study. Recently published, news just out in the British Medical Journal,

they looked at 45 different pooled meta-analysis involving 10 million people. The hook here is that these were studies that were not funded by ultra-processed food companies. You know, you might have heard me talking the other day about artificial sweeteners and how the large studies showed artificial sweeteners are not harmful at all. But when you look at the funders of the study,

it was the American Beverage Association, formerly known, my friends, as the American Soda Pop Association. Clearly, we need to look at data that is not corrupt corrupt and when you look at studies that are funded by the food industry it's eight to fifty times more likely to show a positive impact for their food product whether it's dairy or artificial sweeteners or whatever and when they looked at the data from this large pooled meta analysis I looked at people who ate higher amounts of ultra processed food

there was a 50% increase in the risk of cardiovascular death. It was a 48 to 53% increased risk of anxiety and other mental health disorders like depression. Now think about that. The risk of having heart disease and a heart attack and mental illness are the same from eating ultra-processed food. We get that these foods can cause obesity and diabetes and heart disease,

but mental health crisis is also driven by these ultra-processed foods. We did a whole episode on this. I think it's really important to go back and listen to it. We'll link to it in the show notes. There's also a higher risk of type 2 diabetes and many, many other conditions. They go through many conditions, autoimmune disease, inflammatory disorders.

The evidence also showed that there was a link between ultra processed food and a greater risk of death from any cause and a 40 to 66% higher risk of heart disease related deaths, obesity, type 2 diabetes, sleep problems and a 22 percent increase with depression. We're seeing this mental health crisis, obesity crisis, diabetes crisis, heart disease crisis, autoimmune crisis.

I mean the list goes on. Chronic disease is the number one driver of our health care expenditures. It's the number one driver of death globally. Why is this happening? We never had these problems. You know, I saw something on Instagram the other day. There was a video from 1930s film and there was not one person who was overweight

in the entire video of people walking down New York. Big change from then to now. And this has led to the epidemic of chronic disease that's driven by this ultra-processed food. We're gonna get into it. We're gonna go deep in this topic and we're gonna learn about how we begin to determine what is ultra-processed food, what we should avoid.

And hopefully maybe we'll live in a day when food labels are clear. I'm working on that in Washington with my food fix campaign on clear labeling and child friendly labeling. Let's get started with a case example of what an ultra processed diet can do to our bodies in as little as two weeks.

You think, oh, this takes years and years to develop problems. Well, not really, my friends. You see the results very quickly. Now, Tim Spector and his scientists from King's College in London performed a short-term study on a 24-year-old set of healthy twin girls. This is a different twin study than the vegan twin study.

Now one twin was assigned to eat an ultra-processed diet when included a typical breakfast, a pancake, syrup or a cereal with a blueberry muffin. Pretty much our average diet. Lunch was a peanut butter and jelly sandwich and white bread with chocolate milk and chips and dinner was either a cheeseburger and fries or a meatball sub with cheese crackers and a diet coke. The other twin ate a minimally processed whole foods diet. Now each diet, this is really important, each diet was controlled for calories. So they ate exactly the same amount of calories. I'm going to say that again, they ate exactly the same amount of

calories. They also had the same amount of fat, same amount of sugar, and fiber. But the difference was the processing of the food. Now we're gonna get into what this means in a minute. What was striking about the study, after just two weeks, that the twins eating the ultra-processed diet had higher blood cholesterol in the pits, higher blood sugar, they gained more weight.

Now remember, they had the same amount of calories, friends. So it's not all about the calories. It's what the calories do to your biochemistry, to your hormones, to your immune system, to your inflammation, your gut microbiome. It's not just calories in, calories out. It's more complex than that. Also, the studies show they look at the microbiome had a really negative effect on the gut microbiome. Now we know that if you swap out in animals a healthy microbiome for a microbiome, for example, an obese mouse that the other mouse eating the same amount of food will gain weight. So we know that it's not all about calories,

how they're processed, how they're metabolized and so forth. Now none of these changes, these adverse changes that were in the twin eating ultra processed diet, we're seeing in the twin eating the whole food diet. She actually lost weight. So one twin again eating the same amount of calories gained weight on ultra processed food, the other twin lost weight. Just register that for a minute. Now the results aren't published yet. Hopefully they will be. Again and again, I see my practice is over and over again how ultra-processed foods wreak havoc on our health

and they do it very fast. The good news is you can reverse it very quickly too, right? So eating real whole foods can reverse these effects. That's what I did with my 10-day detox diet. And we saw amazing results in thousands of patients. I often talk about this one patient I had who in three days was off insulin. Simply after 10 years of diabetes on insulin,

three days of eating this way completely eliminated her need for insulin. Now how did this happen? How did this become 60% of our diet, 67% of kids diet? Globally it's increasing everywhere. Well the industrial revolution spawned a whole bunch of advancements in food processing technologies and the mass production of canned goods and refined grains. And it was, seemed to be a boon to humanity. And it did help a lot. We got to preserve food, we got to store it longer, we got to, you know, be able to feed people who couldn't be fed. We have hunger. So it wasn't all bad. In World War I and II, there was a huge catalyst for ultra-processed food production,

because there was a huge demand for non-perishable foods shipped to soldiers overseas. And so it needed to be something that was stable, that could be sent to the battlefield, that wouldn't rot. One of the basic rules of healthy eating is only eat food that rots. I don't know if you saw, it was something I saw once, I don't know if it was a movie or something, but some guy had forgotten like a Big Mac in his pocket for years and it was fine. It hadn't degraded, it hadn't decomposed, it hadn't gone moldy. It was just fine. Now, you want to eat food that rots. That's a good concept. So after World War II, the economic growth and lifestyle changes that happened, women entering the workforce, there was an increased demand for convenience foods, fast food, TV dinners. There was a gathering

of all the fast food and processed food makers in the late 50s, as I recall. This was written about in Salt, Sugar and Fat by Michael Moss. He was my first podcast guest actually. And in that meeting, all these companies were like, we have to fight this trend towards eating real food, which there was another sort of group of people promoting that.

They decided to make convenience king. And so they created a culture of convenience. They disintermediated people from the kitchen. They invited Betty Crocker to get recipes of junk food in the house. So you apply your Ritz crackers on top of your broccoli casserole or the Alvalita cheese or your can of cream of mushroom soup from Campbell's all in your recipe. So it was a lot of processed food in the recipes and there was no Betty Crocker. She was a made up person. I thought she was real because my mom had the cookbook. But anyway, in the 80s and 90s, the food companies began engineering foods even more. And they were engineering foods at an accelerated pace using all such technologies,

allowing them to additives, preservatives, and mulsifiers, which are terribly damaging for your gut and microbiome. There's like 600,000 of these products out on the market. And start sugar, refined grains, and processed oils became ubiquitous in supermarkets, vending machines, fast food outlets and are basically what we call the SAD or the SAD diet, the standard American diet. Now, as I said, it's 60% of diet here, 67% of kids diets. It's more than half the energy in high income countries, even like Canada, the UK, Australia. It's nasty. The studies are clear on this and we're linking to all the studies. Everything I'm saying is evidence-based is is backed by references. You can just go to the show notes You'll see them all so studies show that the more ultra processed foods that make up your diet the less

Nutritionist their diet quality tends to be overall and the greater risk they are of developing chronic inflammatory diseases heart disease obesity diabetes cancer high blood pressure, stroke, dementia, autoimmune diseases, depression, I mean the list goes on and on. And according to the CDC, more than 70% of deaths or 1.7 million deaths a year in the US are caused by chronic diseases,

mostly caused by our processed food diet. This is a kicker, I've mentioned this before, but for every 10% of your diet that comes from ultra processed food, the risk of death goes up by 14%. This is from the Global Burden Disease Study. We'll talk about that in a minute. That's enormous. If you think of 60%, right? So it's 6 times 14. It's a big number. It increases your risk of death, not just getting a disease. Now what's really scary is that the government is funding this. They're

funding the subsidies that go to the agriculture that produces the commodity crops that are turned into ultra-processed food, benefiting from the incredible food stamp program, which was great, except that 75% of the SNAP benefits are used for ultra-processed food and 10% are used for soda. It's about 10 billion a year. We're working on trying to change this in Washington, and we have a bill now in to prevent ultra-processed food from being purchased with SNAP dollars if you're a kid, because we know these are deadly for kids. The data is so clear.

Now what's the difference between ultra processed food and just regular processed food? I read an article in a nutrition journal years ago about defending processed food as being something as old as humans. We've been drying food and preserving food and fermenting food and curing food for a long time. So what's the big deal about processed food? If you look at the funders of it, if you look at the journal, it's just funded by the food industry. It's so corrupt my friends. It's so corrupt. I wrote about that I think in my book Food Fix or I think on one of my other books, but it's a pretty frightening thing. Unless you

just pick an apple from a tree and eat it or just eat a raw egg, most food is processed to some degree. Cooking is a form of processing, right? It's not really that processing is bad. It's what is the processing? So minimally processed foods are fine. Like you've been doing for thousands of years. Olive oil is processed food. Yogurt, but hopefully from A2 cows or goat or sheep, right? That are generally raised. Cheese is a processed food. Canning foods, so sardines, canned tomatoes, fermented foods, sauerkraut, miso, frozen foods, beef jerky, dried foods. Basically, those are all processed foods, but they're fine. If you can recognize the ingredients, if you know

where they are, if you can see the number of steps it took to get from farm to your fork, it's okay. If it doesn't have a list of weird franken ingredients, that's okay. It depends on how they're processed. Certain foods may seem like they're minimally processed. There may be some protein powders that are okay or protein bars from whole food ingredients, canned beans, frozen vegetables. Those are all fine, but be very wary about what you're eating. Even if it comes from Whole Foods or Arowan or some great natural food store that you're shopping at, it can still be fraught with all sorts of problems. Now, what does the science say about what is an ultra-processed food versus what is not? And there are many classification systems. The most reliable and the most common and most well accepted is something called the

NOVA classification. It's kind of the most comprehensive version and it has some flaws, but it's still pretty good. So it just gives us a rough idea. There's basically four classification of food with NOVA. The first is minimally processed and unprocessed food. So it's basically peanuts, right? Taking the shell off of a peanut is processed food. Any kind of husking, shelling, drying, crushing, grinding, roasting, boiling, pasteurization, refrigeration, freezing, these are fine. They often can be placed in containers or packages without having to add sugar, salt, oil or fat. Things like whole grains, beans, fruit, veggies, nuts, seeds, milk, meat, these are all fine.

And I wanna say milk, I'm being, you know, I stand on dairy, I'm being very specific. It should be A2 casein dairy, it should be regeneratively raised, it should be either goat or sheep ideally. So you wanna make sure you're eating the right dairy. The second classification is NOVA group two. It consists of processed culinary ingredients derived from nature.

Oils, fat, sugar, salt. So it could be pressing olive oil. It could be grinding of flour or milling. It could be seasoning and cooking of foods that are in group one. So if you want to put a chicken in the oven and bake it for 20 minutes, that's processing, right? So that's group two. And things like olive oil, butter, flour, salt, vinegar, these are all NOVA class two. The NOVA class three is more processed foods. You're adding things to it. You're adding salt and oil and sugar to group one and two foods and they make them more durable, more palatable, more enjoyable, last longer. So it could be canning, smoking, fermenting that extends shelf life. And it may include adding other things like salt, sugar, fat. So you can add salt and for example, sugar to beef jerky.

Well, you may not wanna do that. I like the South African Biltong. It's just pure dried beef with some spices on it. We've been processing food for as long as we've been human. Cooking is a form of processing. Fermentation is a form of processing like sauerkraut, yogurt, cheese, canning, jarring vegetables, I used to do that when I was in college.

We'd jar vegetables in the winter, fruit, vegetables, pickles, olives, cans of tuna, cans of chicken cans of chicken salmon cured meats cheeses these are all processed but often without bad stuff but sometimes with bad stuff right added salt because one is the best and two three you have to be smart but you can get away with it now class four is what really is the boogeyman here this is the ultra processed food category and it's a series of industrial formulations of five more ingredients could be less but it's generally more five. This is something that's not actually considered food. I don't think they should call it food. They shouldn't call it ultra processed food. They

should call it ultra processed science projects or food like substances or non-food edible things or something. I don't know why. But ultra processed foods are really made from whole foods originally, right? But then they're broken down, they're mechanically altered, they're chemically separated, and they're changed to, you know, isolated sugars, fats, oils, protein, starches, fiber extracts, to make food look and taste good and make it resemble food, but it's not food. And they're dearly derived from commodity crops that are funded by our industrial agro-cultural system. Corn, wheat, soy, sugarcane, beetroot, they're the basis of these foods. You know, I mean, corn is hundreds of different things that are made from it. they're all highly processed,

and I think 5% of the corn that is grown in America for quote human consumption is actually corn of the cob, or corn things that we eat, it's mostly turned into junk food. And now they'll add a whole variety of bad stuff. They'll add, if you're a manufacturer, will make really bad stuff, and they'll reassemble them into food-like substances.

They'll add high-fructose corn syrup, different kinds of sugar, maltodextrin, lactose, dextrose, various oils that are often hydrogenated, soy protein isolates, they'll add extra gluten, casein, mechanically separated meats, flavors, and most fires, gums, very thickening agents and basically makes your product look good, have a good mouth feel, be hyper palatable, create a highly profitable product. There's a cheap product to make with long shelf life. They mark up something hugely to enormous price. So the profit margins are huge. I mean, think about it. This is the most significant industry in the country. When you combine food and healthcare, I think it's $10 trillion. That's a lot of money. And a lot of

this is just driving us a sick and disease society. Now there's some limitations to the Nova, right? It's qualitative in nature. It basically assigns food products to groups and sometimes it's a little subjective and maybe a little ambiguous and maybe inconsistent, but it's still helpful. As for example, minimally processed foods may be high in natural sugars or fats,

while some ultra processed or processed foods may be okay, but probably not. Minimally processed foods for sure. It doesn't really adjust portion size or eating pattern. When you have mixed meals, the classification isn't really straightforward. So these nuances can lead to real challenges in implementing food policies or regulations due to misinterpretation among consumers, but all processed foods are unhealthy when some may be okay, like whole food protein powders or protein parts from whole ingredients or grass-fed meats or pasture-based

turkey sticks. I like venison sticks. Tofu is a processed food. Dairy alternatives, canned fish, they're obviously processed, but they're whole foods. They're made from real ingredients. Now machine learning technology may be the future of predicting food processing. And this is interesting actually.

We use AI to help figure this out. In a 2023 paper, which we'll link to in the show notes, researchers created a machine learning algorithm that takes nutritional measures into account to predict the show notes. Researchers created a machine learning algorithm and takes nutritional measures into account to predict the degree of food processing and what NOVA group the food falls into. It's done in reproducible scalable fashion. And based on this data, it predicted that 73%

of the US food supply sold your process. So even more than the 60%. So it's almost three quarters of what we eat is crap and not food. Then one day we're also sick and overweight. Now what does this stuff do to us? I mentioned early on some of the things, but in addition to being loaded with sugar, starch,

processed carbs, oils, additives, the reason they're often bad is they need to have a long shelf life. What they do is they put it in packages, plastics and different kinds of packaging that often contains BPA, phthalates, PDAS, microplastics, nanoplastics that end up in our food. So stuff not even that in the food when you originally produced it, even if it's a highly

processed food or ultra processed food, it's actually what it's delivered in, what it's stored in, what it's sold in is plastics and packaging that can leach into the food. Now this is a big deal. As a result of this food processing, there's other things that happen, right? Toxic compounds can be produced in the very act of this processing. For example, like heterocyclic amines,

which are highly carcinogenic, polycyclic aromatic hydrocarbons or PACs, ages or advanced glycation end products, which are changing the chemical structure, causing glycation, which is where sugars and proteins bind up to various proteins in your body and create a lot of inflammation. It includes trans fats that can be formed, acrylamide, which are really bad, cause many,

many health issues. Many, many animal studies and human studies have shown these compounds to cause disease in humans. Animal studies have shown that food additives have a really bad effect on mental and physical health due to their bad impact on the gut microbiome. That can lead to inflammation, it can lead to DNA damage. This is just kind of a mess. And it's, you know, often when the research is done on various ingredients, they only

look at one. For example, look at one element of the processed food diet, but they won't look at this whole cocktail of additives in these foods and their combinational effect on our health. And that's a problem because these are not just one ingredient that we get. Like we get all sorts of these things and our body doesn't know what to do with them. We eat about three to five pounds of additives a year per person.

And that's not including all the ultra processing of the food, of the raw materials. So it's just the additives. We eat three to five pounds of these compounds from emulsifiers, colors, additives, artificial sweeteners. Many of these things that are in our food supply in America are banned in Europe.

Things like titanium dioxide classified as a 2B carcinogen according to the committee in Europe that determines what's carcinogenic. Azodicarbonamide, it's a bleaching and defoaming agent and it's a potential carcinogen. Common in yoga mat ingredients and was in Subway sandwich brand for example. What is the impact on ultra processed foods on our risk of chronic disease? Studies really clearly link the NOVA class four foods to an increased risk of bad cholesterol profiles in kids,

to an increased risk of poor cardiometabolic health, including obesity, type two diabetes, cardiovascular disease, and what we call all cause mentality in adults, which means death from any cause. Just to recap that new British Medical Journal study, which I think is an important study, it's sort of a landmark study.

Again, it's observational data, but it's massive amounts of people looking at significant trends, and I don't think we can ignore this. And when they looked at ultra-processed food, they found a 50% increased risk of heart disease-related death, 50 plus percent increased risk of anxiety

and mental health diseases like depression, 12% higher risk of diabetes, 21 percent higher risk of death from any cause, up to a 66 percent increased risk of death from heart attacks and obesity, type of diabetes, sleep issues and a 22 percent increased risk of depression. Now that's a lot and it's a lot of suffering, a lot of cost, a lot of death and it's totally preventable. I'm just going to say it really clearly, unambiguously, ultra processed food is the number one cause of death in the world today, period. This is not my opinion. This is from the global burden of disease study of 195 countries.

The data is very clear. Too much of that crap and not enough real food. As a doctor, I know how vital sleep is for your health. Sleep is the foundation of everything. If you're lying awake at night or waking up tired, I've been there too. That's why I recommend Sleep Breakthrough from Bioptimizers. These capsules are scientifically designed to help you fall asleep fast, stay asleep all night and wake up refreshed. With no melatonin, they're a natural side effect free solution that's perfect for travel

or regular use. Transform your sleep and your health. Visit bioptimizers.com slash Hymen to get 10% off your order today with promo code HYMAN10. Try it risk free with Bioptimizers 365-day money back guarantee. The chemicals that have entered the food supply are largely there only for one reason and they're not to improve nutrition or improve our health. They're actually just there to improve the bottom line of the food industry because we live in a capitalistic society and our government doesn't really regulate the food system like

we think they should or we are under the assumption that they are. I mean there's this underlying assumption, I believe, along with a lot of people, that the FDA is this big, you know, big, huge part of government that's independently testing all of these different chemicals and overseeing all of these food companies

and what they're producing and what they're putting in the food supply, but they don't have the manpower to do it. They've never had the manpower to do it. And they don't usually act unless they're putting in the food supply, but they don't have the manpower to do it. They've never had the manpower to do it. And they don't usually act unless they're sued by a third party organization or a nonprofit that sees some issue with some of these chemicals. And so, you know, you see right now there's big lawsuits happening. There was one big, very, very big lawsuit that happened actually

with artificial flavors. There were seven artificial flavors that were linked to cancer. Many of them found in every single candy that kids eat. And it took organizations like the NRDC and others to point this fact out to the FDA to finally get them banned. But they gave these companies two to four years to make these changes. So we just gonna allow these chemicals that cause cancer in our food for two to four years, even though it's been proven that they cause cancer.

And so we are in a situation where we don't have a lot of regulation around the food system. And once you understand that, that we don't have the regulation. Or we don't have the regulation or supervision, right? Or the supervision. I just interrupt quickly. I was in the hospital and I got a creamer for my coffee and it was full of hydrogenated

fats which five years ago the FDA ruled is not safe to eat and mandated the company to remove from the food supply. Gave them a little bit of a runway in window, but they're still there and they're not safe to eat. And the FDA said that, but there's no FDA police going around supervising all the grocery stores. And the worst part is when things are banned like trans fats, food companies find other chemicals that act the same way as trans fat.

So one chemical that you'll see in tons of bakery bread products and other things that have to stay on the shelf for a really long time is monodiglycerides. That is actually a minute amount of trans fats in every single molecule of that. And so it's still clogging up our hearts, still clogging up our arteries. And you know, trans fats are linked to like 20,000 deaths or 7,000 deaths, 20,000 heart attacks a year. I mean, that's from the CDC. Yeah.

But we still allow these chemicals in our food and even allow food chemists to come up with different ways to continue to include them, which is just very frightening. And so once you understand that the food isn't regulated, then you also need to understand that the information that we get in the media is being largely manipulated by the food industry and front groups, groups that seem very, you know, reputable, like the American Heart Association, or, you know, the Center for Science and Public Integrity, or the International Science Center. American Council on Science and Health, right?

Yeah, exactly, you took it out of my mouth. You hear all these organizations, you're like, oh, they're looking after our health. They care about our heart. These are organizations that are made up of doctors and specialists and experts. And when you look behind the scenes, you find out they're being manipulated by big industry, they're getting money from these chemical and food companies and they're really just PR spokespeople for these food companies to continue operating by selling us food that is truly harming our health. And so once you recognize those two pieces of the puzzle,

you kind of understand, wait a minute, so food's not regulated, the information I'm getting being told is being manipulated by the food company so it benefits them, not me and my health. You start to realize the only thing that you can do is to take control of your health and understand what you're putting in your body.

And once you understand that, you start reading ingredient labels you can do is to take control of your health and understand what you're putting in your body and Once you understand that you start reading ingredient labels, and then you go aha I get it I understand why I need to eat real food Yeah, I mean we obsessively should be reading not just the nutrition facts but the ingredient list and and you and your book provider really detailed explanation of how to and you and your book provider really detailed explanation of how to read those ingredient lists and pick out the things that are bad for you and that you shouldn't be eating. And it's not that hard.

And just to sort of loop back on your, how industry is influencing public health, the American Heart Association gets about $190 plus million dollars a year in funding from industry, both pharma and food industry. So how are they an independent group? And Dr. Ayanaiti, who's a professor at Stanford, has written about these a lot and has talked about all these professional societies, whether it's the Academy of Nutrition Dietetics, American Diabetic Association, American Heart Association, said they

should not be making recommendations about what to eat. For example, the American Heart Association says tricks are for kids and lucky charms are heart healthy foods. Why? Because they're low in fat despite that they're full of additives, chemicals and tons of sugar. Oh, you hit on a sore subject for me, cereal. Well, I'm a cereal killer. I hope you know that.

I like, with a C-E-A-R, you know. Yeah, definitely. You know, one of the most unethical companies out there right now is Kellogg's. It's a company that back in 2015, they said that they would remove artificial food dyes for children in all their cereals. And they said they'd do it by 2018. I wondered at the time why it was going to take them three years to do it because they were already selling Fruit Loops and Apple Jacks and all their famous cereals overseas without artificial

food dyes. It wasn't like they had to reinvent the formula or come up with a new recipe or anything like that or invent a new way to make something blue or red. They're already doing this to avoid a warning label that Europe requires that says may cause adverse effects on activity and attention in children when a product has an artificial food dye. They're avoiding that warning label so they know this affects children's health so completely unethical they already know how to make the products better and safer and they're not doing it for their own citizens so not only did they not do

it by 2018 it's now 2020 and they've invented four new cereals with artificial food dyes a whole line of waffles with artificial food dyes directly targeting children directly targeting toddlers you have a toddler at with artificial food dyes, a whole line of waffles with artificial food dyes, directly targeting children, directly targeting toddlers. I have a toddler at home. I have a three-year-old and she loves that song Baby Shark. Of course, they come out with a Baby Shark cereal full of artificial food dyes. I actually started a petition.

If anyone's watching this, you can go sign it. It's foodbabe.com slash baby shark to finally get Kellogg's to, to, to uphold their commitment to remove artificial food dyes and to stop making these new products that are harming our children. And you know, they're, they're coming out with these products in the middle of a pandemic, you know, and, uh, you know, we're in a situation right now where we need to take our health very seriously. If anything about the world's events today show you is that government is not going to save us. We need to save ourselves.

And so we're going to have to save our kids and we're going to have to save our families. And so we have the responsibility to learn about these chemicals in food and make a choice not to obviously buy these products and support these companies and vote with our dollars. I'm a little more hardcore than you. I'm like, don't buy anything with a label. I love it. I love it. If it ain't made by God, don't eat it. If it's made by man, don't eat it. You make sure you don't eat it, right? Yeah.

So you want to make sure if you look at a food, you recognize what it is. An avocado is made by God, but a Twinkie isn't. Lucky Charms are certainly not made by God. So that's an easy thing. It's hard to do because people want convenience, I understand. But we really have a crisis in this country because you're saying Kellogg's And other companies have really not stepped up to the plate to do things which they know our integrity which they can do which Are not going to add to their cost but actually are going to provide better health for it for the population

That's as I make cereal is healthy Even if you took out all that crap because I don't think it is because it's full of sugar But that that's that's that But that's another story. We're up against a mega PR campaign too against our health. And I'll just give you the example of Kellogg's. We'll just go on this one. When they came out with their new waffles, there was press up the wazoo. Every single mainstream media outlet reported on the fact that Kellogg's has created this new unicorn mermaid waffles for kids right but when my friend who was very famous just you know him too Jesse Itzler the husband of Sarah Blakely one of the you know billionaire women in this world that owns banks he challenged the CEO of

Kellogg's to $100,000 live 15 minute interview on Instagram. He said he'd give $100,000 to any charity of the CEO of Kellogg's choice. And not a single media report on this. Not one single anything, but you watch the mainstream media report on all sorts of garbage and yeah You know interesting news

But this is like real news that could affect children's health and a debate or you know even an interview About these new products that they've created and no one's challenging these companies And it's just you know we're in a really you are You are. Five feet, whatever you are. The other thing about Calog I want to ask you about was that they recently announced that they were going to get glyphosate out of their products by 2025. Is that a smokescreen?

Is that real? Do they plan on doing it? I don't know. They announced a lot of things that they say they're going to do and I haven't seen it done yet. So I'll believe it when I see it for sure. You definitely and that's another thing. There's this assumption when these companies announce these changes that they're going

to actually go ahead with them. A lot of times they change leadership or they realize that oh they'll lose too much money or oh people suddenly don't care about this issue anymore because it's not a hot button topic in the media. The glyphosate issue was very hot-button topic because a bunch of different reports that the environmental working group put out about glyphosate in food and the GMO debate at the government level. But once that and those issues became less important or people forgot about them, these

companies think they can get away with murder. Yeah, it's pretty bad. All right, so your book, The Food Babe Way, Feeding Lives, and the new book, Food Babe Kitchen, which everybody should get, it is the unbelievable- This is in your mailbox at home, Mark. It's such a beautiful book. It's full of incredible recipes.

It helps you take Vani's ideas about how to eat and create health and puts them in to delicious recipes that are easy to follow that are nourishing and yummy and they're even your kids will love. So everybody get that book. But one of the things you help us understand is how to read labels and how to be a smart consumer because unless we're paying attention and I even get duped sometimes and as I'll I'll pick up some and look healthy and I'll forget to turn the ingredient list over and I'm like I get home like oh god this is terrible why would I even want to eat this so how do you how do

you pay attention to what is important what should you look for I mean if it says natural flavors, that sounds like great, right? It's like healthy, right? But is it really? And one joke I always tell is that one of the natural flavors they use is vanilla natural flavor, and that comes from beaver's anal glands.

So I think we've got to be very careful. And also, why should we be wary of fortification of foods? Yeah, all great questions. So in the first 55 pages of Food Babe Kitchen, I actually show you how to read labels, take you through every grocery store aisle so that you can stock your kitchen like a food babe. And everything from how do you prepare your foods

to how you warm them up and everything is in this book at the beginning. And then, of course, 100 plus recipes with color photos for each one. So, just so excited to have this book out and so happy. I know you've written many cookbooks, Mark, and you know, this is my first one. So, it's the first of many though, because I've got, I've definitely got more recipes than me. But I think what's really important about reading labels is that there's this kind of three question detox that I talk about at the end of Feeding You Lies, and this is kind

of how you start the process of really training your mind to eat real food. You start with the question, the first question, what are the ingredients? So you have to know kind of everything that you're eating. And so if you sit down for a meal and you don't know the ingredients, stop eating that meal and find out. And once you read the ingredients and look at them, do you understand them all? Are they real food? Are they, you know, is it an apple, cinnamon, and sea salt? Or is it TBHQ and, you know, blue number one? TBHQ, by the way, is a very popular synthetic preservative that they use in very popular products.

And, you know, Reese's Peanut Butter Cups comes to peanut butter cups comes to mind. Oh no, I used to love those. Oh yeah. This is actually an ingredient that negatively affects your T cells in your bodies and promotes allergies. So if you have an allergic, just an allergy to anything, it can just increase your immune response to that allergy and you can have a very adverse reaction. And if you eat a lot of foods with this, it's been linked to vision disturbances, stomach

cancer, behavioral problems in children, all sorts of things. And this is a preservative that's in a lot of things. But you know, when you read that on a label, TBHQ, you have to ask yourself, what is that? And so that comes, that leads you to the second question, which is, are these ingredients nutritious? Is TBHQ nutritious? Hell no.

No, hell no, right? And so then you start to realize, why am I eating these non-nutritious ingredients? And maybe I need to choose something different. And then the third question you ask yourself is, where do these ingredients come from? Are they made in a laboratory in a chemical factory? And in the case of natural flavors that you mentioned,

yes, they are. People see the word natural and think it's coming from nature. Yeah, it starts in nature. But the way they manipulate, for example, a strawberry in a laboratory or they can manipulate some other substance that comes from nature and make it act like a strawberry or taste like a strawberry or create the one millionth best part taste of something so that they can put it in a product that normally would not taste good on the shelf that lasts there For you know, that's nine to twelve months

They could put it in a product and it would taste like a real strawberry even though it has no real strawberries in it and And that's what natural flavoring is and so it tricks your brain into thinking you're eating real food when you're not and so it tricks your brain into thinking you're eating real food when you're not, but your body is still wondering where the nutrition from that strawberry is coming from, so you start to crave more than you should. And so natural flavors are one of the most evil ingredients, I believe, in our food supply because they trick your brain and they hijack your taste buds and they continue that craving so you eat more than you should and with obesity, heart disease and diabetes

is our biggest issue in this country and cancer, you know, we have to take control of our taste buds and the only way to do that is not to allow the food industry to control them. And so removing natural flavors from your diet is like the number one thing I think. And it's so, you know, even though there's many more chemicals that are many more, much more harmful to you, almost 99% of the products on product shelves at the grocery store have natural flavors. So if you avoid natural flavor, you avoid many of those. And it's actually one of the reasons I started my company Truvani.

I just want to mention because there are so many supplement companies out there, protein powder companies and supplement companies that use these natural flavors. Yeah. And I wanted to create a line of products that were made from real food and non-synthetic substances. It didn't trick your brain into craving a flavor more than it should. I want people to be able to turn off their normal mechanism to crave food. It's one of the reasons why we're doing what we're doing at True Health. That's so important what you're saying is

because these chemicals and some of these things are not put in there necessarily as a preservative, but they're put in there deliberately to hijack our brain to make us eat more, crave more, want more. One of those is MSG, which has got 50 different names or more. So it's hidden and you doesn't say necessarily MSG or monosodium glutamate because people are are hip to that. They change the name like hydrolyzed yeast protein or extract. And that actually is what's used in research to fatten up rats or mice to study obesity. So they give them MSG as a way to increase their appetite, make them eat more and get fat. And I remember

once I was talking to a nutritionist who lived in Samoa, which has the most obese population in the entire world and most of them are diabetic. And she said for breakfast they had ramen noodles, sugar, they had MSG. They put Kool-Aid powder on it, which has all these artificial colors, and they put MSG powder on it. So it's extraordinary. That's their breakfast. Basically Kool-Aid MSG and ramen noodles. And that's why they're so obese because they can't stop eating. And I think your book really points out a lot of these chemicals and goes through details about which one you should pay attention to, what they are, what they're doing to our biology,

in fact where they're banned in other countries and why do we have them here? It's really powerful. And I encourage people to check it out because there's very few other places where you can get this kind of information that tells you exactly what you should be looking for. Even my books, I don't go into as much detail

because Vani's an expert on this food additive thing and she's been taking down large companies based on her work and I think it's pretty exciting. So one of the things besides the companies I think we want to talk about is the government and how the government affects our food choices and they have different programs that they do this with that we think are you know government programs for the public good but they're actually helping companies not improve public health, but private profit. And one of these programs is called a checkoff program.

Can you talk about that? Because you write about in your book, and it was very enlightening to read about. Yeah, absolutely. So, you know, in Feeding You Lies, I kind of go off all of the different, like, I guess, phases of things that the government has done in terms of trying to help, you know, in terms of, you know, when we look at the root cause,

and you know this Mark, so the root cause of a lot of our issues is because of where our subsidies and our agriculture producers are basically being given subsidies so that they produce really cheap commodities for America. And those cheap commodities like corn and soy are what make up the majority of processed foods. And so these checkoff programs actually give the corn and soy and canola industries power in the government to make decisions,

whether it's something that makes a decision on my plate, which the government creates to kind of give guidelines to children and schools on how their plate should look at the end of the day, if dairy should be on there or not be on there, how much of grain should be on there versus not be on there. And you've written a lot about in your detox books and other books about how some of these ingredients, the things that we make the most of, corn and soy, have been very detrimental to our health because not only the glyphosate that's sprayed

on the majority of those crops that is linked to cancer, but also the fact that it imbalances your omega-3 to omega-6 fatty acid ratio in your body. And for people to understand, those corn and soy, you can eat corn and soybeans, that's not the problem, but about 1% of the stuff grown actually is eaten as the whole food. Most of it's turned into industrial products food products commercial products Gasoline, I mean, it's it's just an enormous problem in terms of our government strategy So keeps you so keep going and tell us about the checkup program Yeah

so, you know we have and then and this also happens within the meat industry too and so there's so many different abuses in terms of the the different checkoff programs. And it all stems from this one organization within the government. It's the, um, government accountability office, or it's called the, the gal, the USDA gal. And it basically oversights all of these checkoff programs where they allow these food companies to continue to market Food to us even though it's unhealthy. Yeah, so, you know think about the look

So people kind of make sense of it, you know programs like, you know, what's for dinner or you know Pork the other white right work the other white meat yet got milk. These are all not industry funded programs. These are programs that are funded in collaboration with the government. So the government is actually pushing these products into the marketplace through advertising and marketing. What the money is supposed to do is for the research and understanding, not be marketing dollars to pay for ads that make these companies

billions of dollars. So when the Milk ad was out there, it was so popular, they had every celebrity in it, everybody had the white mustache, they had all these health claims, you know, it's going to make stronger bones, it's going to be great for sports performance, it's going to do this, it's going to do that, help you lose weight. And what happened was another branch of the government started paying attention to this, can do that, help you lose weight. And what happened was another branch of the government started paying attention to this, the Federal Trade Commission, which regulates truth in advertising. And they were like, hey, guys, there's no data to back up what you're saying in these

ads. You've got to stop these ads. That's why you don't see got milk ads anymore, because basically they went got proof and there was no proof. Yeah, exactly. And I'm thinking of another one, you know, the whole grain, the grain society too, was doing that a while with, you know,

by saying whole grain was heart healthy. Yeah, whole grain cookie crisp cereal. White flour and everything. My favorite is the whole grain cookie crisp cereal with like, you know, seven teaspoons of sugar. It's ridiculous. If you let people eat as much as they want and you give them ultra processed food versus whole foods they'll eat about 500 calories more a day of ultra processed food because they'll keep eating and they're hungry and they keep

driving and you talk a lot about it then in your work about the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you literally become addicted to these compounds and how that affects you. Right, so the rates of obesity and binge eating and addictive like eating are rising alongside the increasing dominance of ultra processed foods in the modern food

environment. And there are several mechanisms as to how this works, some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated and the brain is connected to the body. And we used to learn in medical school that you have this blood brain barrier that you can get across it. But that's not it's like the Berlin Wall. But in reality, it's it does leak, right? And there are things that do cross and it's more like a coffee filter. You know, it's a sip. Yeah. So so ultra processed food and sugar decrease our dopamine receptors and make us eat more

compulsively. Much like addictive drugs, the highly processed foods, they trigger dopamine reward pathways and they invoke addictive-like behaviors which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra-processed food, continuing to eat these things despite knowing the adverse consequences to it,

and repeated attempts to try to quit. I'm describing addiction here, basically, and the consumption of larger quantities over time than intended. People go, it's like emotional eating, it's not really biological true addiction. What you're saying is this is really a true biological addiction, just like heroin or cocaine or alcohol, that you get withdrawal, you get cravings, you get increased need for more and more of the substance to receive the same pleasure, you down-regulate the receptors for pleasure, so you have to take

more of the stuff to actually stimulate that reward pathway. And it's really this vicious cycle that people get into and then they blame themselves and they feel guilty for doing it and they think they just have no willpower. But you're saying it's much bigger than that. Yeah, that's exactly right. So sugar is an addictive substance. It's not just something we say. It has a straightforward neurochemical basis in the brain, just like any other drug.

And I think of sugar as a, it's a recreational food. It's not a, it's, it's not a food that's essential for survival. We make sugar, um, you know, through the process of gluconeogenesis through, through other foods, um foods that we consume. And so it's really about excess carbohydrates. It's not- I call sugar a recreational drug. I've never heard anybody say it,

but I'm probably, oh, he's right down in my book. Sugar is a recreational drug. It's like, if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America. Exactly, yeah. And we also, actually, I would like to share a story about this. Just during the era of COVID, since we're in it, just to give context as to why I wrote

about this and why I'm working on this as well and continuing to feel motivated to continue to do my work is the shelter in place order had come a couple of months back for my county and I'm in California, I live in Menlo Park. When it was announced, my husband, he's an infectious disease physician at Stanford and I'm a psychiatrist and a state medicine physician as you mentioned.

We both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store and we saw many people loading up their carts with Pop Tarts, Hawaiian Punch, popcorn, anything ultra processed basically. And they weren't loading up their carts with fresh vegetables or, you know, they were out of cookies at the grocery store.

Yeah, they were using toilet paper. And toilet paper, exactly. And there were still, you know, produce left in the store. You know, it wasn't like they ran out of produce. No. So here I was. I wasn't going to run on broccoli. No. Here I was at the checkout counter and I was thinking to myself, you know, staring at the person's cart in front of me that was full of the recreational food, as I was at the checkout counter and I was thinking to myself, you know, staring

at the person's car in front of me that is full of the recreational food, as I mentioned, the food that's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic or helping their immune system and if anything, weakening it. And this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access. That is what motivated me to kind of get

that public message out on this topic. Yeah, you did write a great article on the Hill and I read it and Amy, you really talked about the way in which the pandemic we're facing is much more serious because of the underlying chronic disease pandemic we have in our society where it's driven by this ultra-processed food that makes us overweight and sick and causes all these underlying chronic inflammatory issues like diabetes and heart disease and high blood pressure, which are really the same mechanisms.

If you look at the mechanisms of high blood pressure, heart disease and diabetes, it's insulin resistance, it's oxidative stress, it's inflammation, and it's the same thing that's affecting our psychiatric illnesses, which is so fascinating. And most people don't think about using the doorway of food to help treat the brain. And you're doing that in your research and in your practice. So tell us some of the kinds of things you're seeing in your patients using this approach, because it's pretty radical. You're going all the way sometimes to ketogenic diets with these patients with bipolar disease, schizophrenia, depression.

It's fascinating. Yes. What I have noticed is that a lot of my patients that come for psychiatric treatment and evaluation, a lot of them have pre-diabetes and diabetes. And when I look up the statistics on this in our country, 44% of adults today in our country are either pre-diabetic or they have diabetes. And I wonder to myself, what is that doing to our brain? We know that affects all these different organ systems, the liver, the pancreas, the heart, but what is that doing to the brain? Right. And so I'm happy to talk more about my research and patient

care. But one thing that I felt I didn't completely answer before was kind of how these hormones affect the brain with the addictive piece. How does it drive inflammation and all that? Yeah. Yeah. So kind of going back to that, you know, so I was talking about the definition of addiction and we know that hormones like insulin and leptin, which is the hormone that tells us we're full, it sends a signal to our brain and ghrelin that tells us that we're hungry.

These hormones modify natural and drug reward pathways in the brain. I mean, they have so many effects on the brain. Our hunger hormones go awry and it can actually increase the reactivity itself of the dopamine system. And so this happens when we consume that excess sugar and the excess carbohydrates in our diet. And they cause these rapid shifts in blood glucose and insulin levels similar to other addictive substances. So my approach in patient care has been to work on this system to decrease these shifts that occur in our blood sugar, in our hormone levels, to kind of go back to the homeostatic state

that our body and our brains were meant to be in. And so I treat the metabolic dysfunction and I look at how that improves both metabolic issues as well as psychiatric outcomes. Yeah, so it's fascinating. So you basically you're treating the body to fix the brain, right? You're dealing with these physiologic changes that have to do with our diet and nutritional psychiatry that most psychiatrists aren't thinking

about. I mean, most psychiatrists are thinking about, you know, psycho emotional issues, they're thinking about medication and prescribing antidepressants, but they don't really work as well. And I just found that the amount of benefit you get by addressing these underlying factors is so much greater than you get with medication, which are marginally effective for most people.

I think, unless you have really severe depression, but I think the data is just not that exciting about these drugs, right? I mean, they can be helpful for people and they can be lifesaving, but they're also other doorways that you're exploring, which seem to be way more fruitful. Is that your experience? So the field has come a long way.

There's a lot of research that's been done on the biological piece, the neuroscience, and looking at, obviously, the serotonin hypothesis, but that's the hypothesis and an observation from like 30 years ago. And all of these research and money has been thrown on developing drugs, but we're not necessarily addressing some of the root causes of why

are these chemicals imbalanced? And so that's an important question that I and others are trying to study through research studies and clinical trials. And like you said, we know that although our medications are necessary and lifesaving for many, they have undesirable side effects that can worsen metabolic health.

And while it's helping in one domain, it may, in some people, also be hindering improvement in psychiatric symptoms, especially if the metabolic health is poor. So psychiatric treatment is never going to be a one size fits all approach. Mental health conditions are varied. They're heterogeneous and they have different phenotypes or presentations. We don't have a single mutation or a gene that we can point to or a lesion.

There's no smoking gun. It's a complex relationship of multiple genes and environment. And unfortunately, a metabolic assessment's not part of that routine care. And stigma certainly plays a role in this. So obesity is stigmatizedized and so is mental health. Education about nutrition and metabolism is lacking in medical education.

Most psychiatrists recognize this relationship. They do? They understand the connection between food and mood? They're starting to. They understand that there are side effects with psychotropic medications. I think they don't necessarily have the expertise to treat it or address it. They don't know necessarily what to do about it. But most psychiatrists that I speak with, and my department certainly has been very

supportive of this idea, and someone has to do the research and someone has to do the work to kind of move the field forward and yeah there is a growing body uh you know of other researchers working on this and we hope you know that evidence-based research has to be done to to kind of change the mainstream standard of care yeah i mean you're you're talking about metabolic psychiatry i was also uh noticing that harvard had a whole department of nutritional psychiatry, which is, you know, it seems like bookends on the country. The rest of the psychiatric world is thinking about this, but you mentioned earlier that you work with Bruce Ames, who's an incredible biochemist and nutritional scientist from

California, one of the most published sort of scientists in the world. And I spent a lot of time with him and he talks about this whole idea of a metabolic tune-up and that so many of our biochemical reactions are regulated by vitamins and minerals and that each of us have different needs for different components of those vitamins and minerals. I remember one guy, I was sitting in my office one day working on something. I was thinking I might have been working on that book and I was talking to somebody about folate and B12 and B6. He said, oh yeah, I had really bad depression and I took some of these B vitamins and I

just went away. And I think, you know, there are some people who have a higher need for, for example, folate or B6 or B12 based on these genetic variations that Bruce Ames talks about that really are so prevalent. In fact, one third of our entire genome codes for enzymes, and those enzymes all need helpers, which are vitamins and minerals. And we don't really pay much attention to that. So when I look at depression or psychiatric illness,

you know, I see so many different things that are going on there, whether it's insulin resistance and pre-diabetes or vitamin D deficiency or folate insufficiency or zinc or magnesium. All these various nutrients play a role in brain function and they're not something we really learn about when we learn about psychiatry, right? Is that changing? I think that is changing. There's a complex relationship between metabolic dysfunction and nutrition, food, mental health. And, you know, I want to start off by saying that the idea of food as medicine

is not a new concept in the field of nutritional psychiatry. It's really grown over the past few decades by several prominent psychiatrists and researchers. However, the focus has largely been looking at specific foods or supplements, eliminating certain things from the diet, the microbiome, or looking at the Mediterranean diet, for example, affecting depression symptoms. And these are all very important questions, but what I thought was missing and why I named our clinic and our group's work, Metabolic Psychiatry, is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms. If a majority of us are

suffering from obesity, type 2 diabetes, insulin resistance, metabolic syndrome, what is that doing to our brain? We know that these diseases affect multiple things, mental illness rates have increased over the past 20 years, in fact doubled. We know that mental illness like depression, bipolar disorder, psychosis, they're strongly associated with inflammation. That research is really indisputable. And research is also showing that there's an energy deficit in these brain illnesses and the mitochondria, the energy powerhouses of our cells are not functioning optimally,

causing changes in brain signaling itself. And the thought is if we can target inflammation, insulin resistance, the abnormal blood sugar, et cetera, as a method to improve mental health symptoms, then we can really improve our patients' lives further. And again, mental illness has many different causes but even if we you know can five to ten percent of people have an improvement in these symptoms with this method then I think that would have that would be a pretty significant

improvement of the overall mental and physical health of our country. I think it's a lot more than five to ten percent I mean when you think about the most amazing thing you just said to me is such a paradigm shift, which is that depression is inflammation in the brain. And that when you look at autopsy studies and when you look at the biology of this disease, the brain's on fire. And it's also on fire in autism, in Alzheimer's,

in schizophrenia, and a lot of these disorders that are we think of as mental disorders but are actually brain disorders that are manifestations of inflammation that show up differently in different people and the question is you know what's driving that inflammation and I think diet clearly is probably the biggest factor which makes it an incredible thing to use to actually alter the course of these diseases because it's an easy tool to change and actually get a result. And that's what you're talking about, your therapeutic use of metabolic medicine to actually fix psychiatric problems, which is pretty amazing.

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