The Dr. Hyman Show - Is Meat As Bad As We Think: Breaking Down Nutrition Myths with Chris Kresser

Episode Date: August 14, 2019

When it comes to looking at studies on nutrition, we need to ask the right questions. What type of study is it? Who funded it? What kinds of variables were and weren’t accounted for? And so much more. There is a lot of information out there to sort through in order to truly understand what the science says about diet and health. One of the most important things to remember, that is often taken out of context in the nutritional studies shared by the media, is that correlation does not equal causation.  Part of being a Functional Medicine doctor is staying up to date with the latest research from sources I know and trust, and there’s no one better to break down the science than today’s guest on The Doctor’s Farmacy, Chris Kresser. Chris Kresser M.S., L.Ac is the co-director of the California Center for Functional Medicine, founder of Kresser Institute, creator of ChrisKresser.com, and the New York Times bestselling author of The Paleo Cure and Unconventional Medicine. He is one of the most respected clinicians and educators in the fields of Functional Medicine and ancestral health and has trained over 1,500 clinicians and health coaches in his unique approach. Chris and I dive right into this episode, discussing good versus bad research and what to keep in mind when reading the latest news.  Learn more about the ADAPT Health Coach Training Program at kresser.co/kresserinfo

Coming up on this week's episode of The Doctor's Pharmacy. Changing our behavior is the single most important step we can take to preventing and reversing chronic disease. Hey everybody, it's Dr. Mark Hyman here. Thank you so much for joining me for this week's episode of The Doctor's Pharmacy. All right, I have a confession to make. I hate going to the gym. I love sports. I love hiking, tennis, swimming, being in nature, but I do not like the gym. And like many people, I have a very busy schedule, which makes it kind of hard for me to prioritize doing exercise as much as I really want. Now, just like meditation and eating well, I make it my goal to make movement a big part

of my life, which is why I recently bought the Peloton bike and allows me to have this amazing workout from my house in 30 minutes. I have to tell you this, I love this bike. I get this huge workout whenever I get the chance and it doesn't matter if it's snowing or raining or anything. There's so many times when I just can't go out and get the kind of aerobic conditioning that I want and it's just there all the time. So I knew it from my own house, my own living room. And I also joined thousands of people all over the world doing on-demand classes or live classes with world-class cycle instructors and have just so much fun. It also has a lot of cool features I'd like to use, like measuring my heart rate, measuring the resistance, the cadence, so I can actually see how much power I'm putting out. So I'm super excited to share that Peloton is giving my listeners a limited time offer

of $100 off all accessories when you purchase the Peloton bike. So go to onepeloton.com and use the promotional code pharmacy. That's F-A-R-M-A-C-Y to get started. Do yourself a favor, take advantage of the offer. Your health and happiness will thank you. It certainly has helped me and I hope you enjoy it. Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman and that's Pharmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter.

And today's conversation matters to you if you care about what you eat and if you're confused about nutrition because our guest is one of the most knowledgeable guys in the space of health and nutrition. He's my go-to guy when I'm confused about nutrition, because our guest is one of the most knowledgeable guys in the space of health and nutrition. He's my go-to guy when I'm confused about something. I go see what he thinks before I figure out what I think. His name is Dr. Chris Kresser. He's an extraordinary guy. He's my friend.

He's my teacher, inspiration. And he's the guy I go to when I get sick because I want to know what to do. So he's the co-director of the California Center for Functional Medicine. He's the founder of the Kresser Institute. He's creator of chriscresser.com, which is my go-to place for nutrition information. He's a New York Times bestselling author of The Paleo Cure and Unconventional Medicine, which is essentially about functional medicine, which is what we both do. He's one of the most respected clinicians and educators in the field of functional medicine

and ancestral health and has trained over 1,500 clinicians and health coaches in his unique approach. We're going to talk about that more later. He was named one of the most 100 influential people on health and fitness by greatest and has appeared as a featured guest on Dr. Oz, Fox and Friends, lots of other places. He lives in Berkeley, California with his wife and his daughter, who I met, both of them, and they're very sweet and daughter, cute so welcome Chris pleasure to be here Mark okay you and I go way back yeah and we met an event many years ago and literally been fast buddies ever since and have a mind meld on a lot of things and have talked about all sorts of issues and today we're going to cover a lot of ground but I want to start with the news headline which came came up in my inbox today, which was that meat

kills. Meat kills. It was a study published in the British Medical Journal or BMJ entitled Association of Changes in Red Meat Consumption with Total and Cause-Specific Mortality in US Women and Men based on two studies that are massive studies that have been going on for decades called the Nurses' Health Study and the Physicians' Health Study. And these studies looked at populations over many, many years and tracked what they ate and their habits and their lifestyle and tried to see if that was correlated with any bad outcomes. Now, it was fascinating when I read the report on this study that the authors will said, well, you know, this can't prove cause and effect, but it should make everybody eat less meat and eat

more plant-based proteins. So it just seems completely contradictory. And I want to get into the story of meat because we have this incredible dichotomy. You think Republicans and Democrats are at odds with each other. Well, it's this really strange polarization in the food wars between vegans and the paleo folks and everybody else in between. And it's unfortunate because the truth is we mostly agree on everything except for a few little fine points. And that's why I sort of jokingly at this event where I think we actually met, I came up with the idea of pegan, which was a total joke because

I was sitting on a panel with a paleo doc and a vegan doc and they were fighting. And I'm like, you guys, come on. If you're paleo, you're vegan. I must be pegan. So let's get real here about what we agree on. And part of the reason for the confusion, which you have extensively written about, is the problem with research. And when you hear a headline like this, and I'm sure

people are going to have heard this headline in the news that meat kills, it doesn't actually represent what the science says. So the consumer is confused, the media is confused, doctors get confused, and everybody's confused, but it's not so confusing. And you shed light on why it's not so confusing. So let's start with, at first first why we have problems with these studies and why we're so confused and then we'll get into the real data on meat okay yeah so i mean as you pointed out this study along with many others like it i mean i could set my watch by how often these studies come out claiming to show that meat increases the risk of death we We see it all the time. My email box blows up.

Social media blows up. But you said. Yeah, you said. And now at this point, I'm just linking to some articles I've written that has everything there. Not even bothering to write anymore because it's the same response every single time. And the response is, as you pointed out, when you do a large observational study, you're just showing two factors that are occurring together. You're not demonstrating a causal relationship that one factor is causing another factor. And, you know, there are many different examples of this. There's one blog name, I think the guy's name is Tyler I can't remember his last name but

it's called spurious correlations yes and he has basically collected a bunch of correlations that have nothing clearly nothing to do with one another like the margarine consumption is like 99.7 percent correlated with the divorce rate in Maine. Maybe it's connected because, you know, trans fats may affect your brain. I would get a divorce probably if my wife was feeding me margarine. Honestly, my mother used to give me Fleischmann's margarine when I was a kid because that was the 70s and Tang and Fleischmann's margarine were the future foods, right? Right. So it's really tempting to assume that variables are causally related when they're not. And it's not a safe assumption,

especially with the case of red meat, because of something called the healthy user bias or the unhealthy user bias, depending on how you look at it. So for decades, we've been told that red meat is not a healthy food. And so people who on average in studies, if you're looking at the general population, people who tend to eat more red meat also tend to engage in more behaviors that are perceived as unhealthy. Right. So they might smoke more. They might drink more.

They eat fewer fruits and vegetables. They don't, they're not as physically active. They're not as well educated. They're lower income, which has nothing to do with their value as a person. But these are correlated with higher risk of death more strongly than any nutritional factor. And their microbiome is probably not as healthy because they eat lots of processed and refined food.

And researchers try to control for some of these confounding factors, but there's no way that they can ever control for all of them. Another huge problem with nutritional epidemiology is the way that data are collected. So most people are shocked when they learn just how ridiculous this is. But they use these assessments called food frequency questionnaires or other what are known as memory based assessments or memory based measures. Like what did you have for lunch last Thursday? What did you have for lunch last Thursday? How many servings of red meat did you eat four weeks ago, Mark? I mean, you and I think about food probably more than six, five servings.

And you and I think about food more than probably just about anybody, you know. I can tell you what I ate yesterday, but that's about it. Right, right. So, and to illustrate this, some researchers did an analysis of the nurse's health data, which is what these new studies were based on. The nurse's health study that meat kills. And it's not like it was a 10% increase in risk. We'll get into that.

Yeah, we'll get into that. So, they did an analysis of these memory-based assessments and they found that the average that for the majority of people 67 percent of people in these studies reported a calorie intake that was so low that not even an elderly frail bedridden woman could survive on it that's right so these are obese overweight people that are reporting a starvation level calorie intake so that alone just throws out the validity of all of the rest of the data because it would skew protein intake fat intake carbohydrate intake and intake of every other food and nutrient in other words

how they have bad memories of their life like yeah i mean i remember when i was in training we were taught okay whatever people tell you they eat double it and whatever people tell you they exercise cut in half that's right people always report they want to please you they want to please you or they want to do like if they want to report what they think you want to hear essentially that's unless you're like weighing and measuring every single meal every day and writing it down word then you know you're not gonna be able to report what you ate i mean i don't know how much i ate no whatever i'm like i ate a little this had some of that i took a few bites of this like and if you even if you if you had two plates and the only difference you know one had 100 or 200 more

calories visually you couldn't even tell the difference so like you said unless you're weighing and actually specifically measuring them and even then there are challenges on how to do that best to you know it's, in a word. And Mayo Clinic wrote a big review showing how these types of assessments, these memory-based assessments or food frequency questionnaires really weren't valid. And they were so undermining the quality of all the science they're based on. So almost everything we hear about nutrition, almost everything is based on these type of studies which are fundamentally flawed and there's a guy named john ionides you know is a stanford professor who loves to study

studies and he's like 80 of these type of studies become observational or population studies or comparison studies they 80 get proven wrong ultimately when they're subjected to randomized controlled trials, which is a true experiment, right? Yeah. I mean, he's extremely critical of nutritional epidemiology. He's basically said that it's worthless in the way that it's constructed now. And it could be improved by better measurement techniques and using some new technologies to do that more effectively. Maybe like people can picture their food and then it goes into a computer AI system and it measures them. Like that would be cool.

And then they're testing that and that would help a lot. The other problem you also mentioned is in any field outside of nutritional epidemiology, an increase of risk of just 10% would be seen as completely insignificant, meaningless. That you have to see at least a doubling of risk, like a hundred percent increase or a twofold increase or more in order to be able to know that you're not just dealing with chance, you know, indistinguishable from chance. And the guy who published the study, Walter Willard and others at Harvard, and this comes out of Harvard, these are stand-up guys, but they've spent their whole life committed to epidemiology and and they defend it tooth and nail you know and I

remember speaking to Ron Krause who's an experimental scientist who studies cholesterol and heart disease and he's like listen you know those are helpful for generating hypothesis but they don't prove anything and these guys are running around saying that they're proving something are misleading people and and he said you know you need to see a change of at least you know two and walter willard said to me once you know well we found this with smoking that smoking causes cancer but the increased risk was 20 or 2000 percent two to three thousand percent not ten percent yeah so like if it's ten percent and not a thousand or two thousand percent at least a hundred percent yeah it's it's it's it's just worth ignoring and like the thing with eggs that came out recently which were right oh

eggs are terrible but it's like 13 eight percent i mean rarely in nutritional epidemiology do you see any effects uh even over 50%, much less 100%. And usually it's more in like the 10 to 15% range, which is meaningless. It's crazy. And you can also see on both sides of the aisle, you'll see studies that are epidemiology that show that meat's completely safe in the same way. And they're both kind of meaningless.

Yeah. I mean, so, you know, to be fair, it's really hard to do large randomized controlled trials in nutrition because you got to, like you said, you have to lock people in a metabolic ward and keep them there for 20 years because of the effects, especially if we're looking at real outcomes, which rather than just endpoints like cholesterol. There is something called the Bradford Hill criteria, which are criteria that actually I think were created around the time that these smoking studies were done because they're like, look, we can't just do a randomized control trial with smoking. We can't wait around for... Okay, you guys smoke for 20 years. You guys don't smoke. We'll see what happens.

So we need to figure out ways to better determine whether these correlations are actually meaningful and that there might be a causal relationship. And one of those ways is what is the effect size? How much of an increase do you see? Another is, is it monotonic? Like, does it continually go up with with an increased dose is it a linear relationship yeah is there a dose effect response and there are many other criteria that you can use to kind

of get closer to the idea that there's a causal relationship but those are rarely applied in these kinds of studies yeah i mean you know and and you know the truth is that a lot of the times you know when they actually get subjected to research it doesn't pan out like the women's health study is a perfect example it was based on the same nurse's health study that this was data was based on which looked at nurses who took hormones back in the 70s and 80s and it seemed like the women who took the hormones for menopause had less heart attacks and less strokes and less cancer and less dementia and they were better and it was like amazing and everybody was taking hormones and i remember

one patient when i was working at kenya ranch giving a talk questioning this back in the 90s because there was starting to be literature that was starting to like poke holes in this whole idea and i was like paying attention to it wasn't like a big study but smaller studies and they were like my doctor said if you don't prescribe hormones to me that's malpractice and i was like okay and then and then then the women's health initiative came out which was a woman's study was commissioned by bernard healy who was the head of the national institute of health the first woman to head that up she's like many women are different let's just study women it was a billion dollar study hundred and something thousand women and when they actually subject it to an experiment they found that no the the woman who took the hormones had more heart

attacks more cancer more stroke more death oops and and the women who took the hormones back in the 70s and 80s those are the women who cared about their health they went to their doctor they they they want to do everything they could to prevent disease. They exercised. They ate well. They didn't smoke. That's why they didn't have heart attacks, which is pretty amazing. Yeah. I mean, there are many, many other examples too, like antioxidant vitamins, like vitamin A and vitamin E in the diet, you know, reduce the risk of cancer and heart disease and things like that. But then when they're given an isolated high doses in RCTs, they not only don't have that effect, but they actually can sometimes have the opposite effect. Well, yeah, like the carrots, where you take smokers and you

give them super high doses of a single antioxidant like beta carotene, which just speaks to the, I hate to say this, but the ignorance of the researchers that don't understand how antioxidants work which is they work as a team and if you give an antioxidant it becomes an oxidant and so it's like it becomes like a cascade of like a wildfire that you start that makes sense in smokers but that's a great example of why doing this kind of research like we're so obsessed with food quantity and the quantity of macronutrients and the quantity of specific foods like red meat or saturated fat or cholesterol. It comes from our reductionist paradigm. And you're a functional medicine guy. I'm a functional medicine guy. We understand the importance of looking at things from a systems approach. So, what if we instead focused on food quality instead of food

quantity? You can't talk about how healthy red meat is completely out of the context in which it's eaten. You know, if someone's eating red meat in the context of Big Macs and fast food and hot dogs and things like that, do we really think that that's going to have the same impact as someone eating a paleo diet where two-thirds or three-quarters of their plate is vegetables and plants and then they have a steak? It's absolutely not the same. And yet in the research, it shows up as the same. And then in the interviews, I'd say years ago, they looked at vegetarians and meat eaters who shopped at health food stores. So, presumably ate a healthy diet in the context of having meat or no meat. And both of those groups had their risk of death

reduced in half. Yeah. And, you know, I- But no difference between- There's no difference. No, there was no difference. And there's so many studies that, you know, you can argue on both sides,

which is why the debate gets so confusing because there's epidemiology on both sides, but the randomized trials are really hard to do. Well, let me just address that because that's a that's an interesting point um so the only studies that have shown a lifespan difference for vegetarians were the seventh-day adventist studies now talk about healthy user bias and seventh-day advents don't drink they don't smoke they're they're advised to exercise as part of their religion. So, you've got- They have deep community with purpose and meaning. Which actually, there was a study that came out recently that was showing if you don't have

purpose, you die, right? That's right. And so, they have purpose and meaning. So, they are not, you cannot compare that population with people on a standard American diet eating meat. That's comparing apples to oranges. Yeah. If you want to compare them, you got to compare them with another healthy reference population, which I call like neutrovores, let's say. So, like the health food study was one. There are three other studies. I like that, neutrovor. I'm a neutrovor. I'm a heat-seeking missile for nutrients in my food. Yeah, I get nutrients from lots of different foods. So, yeah, there have been three other studies that, aside from the health food study, shopper's study that you're talking about, Epic was one of them.

There was a study out of Germany. And I'm not remembering the fourth right now. But they all looked at people who were making healthier choices. In one, they looked at people who subscribed to health magazines and fitness magazines. So, it was kind of another way of getting at the health food store. People who subscribe to Chris Kresser's podcast. We don't have that yet, but I'd like to see that study. And then there was a study called the 45 and up in Australia. And they didn't select a healthy reference population, but they controlled for just about every potential confounding factor that you can imagine.

And all of these studies showed exactly what the health food shopper study showed, is that neutrovores, or people who are conscious about their health, live longer and don't have as much early death as people who are not. But there was no difference in lifespan with vegetarians and omnivores, omnivorous and neutrovores. Right, so it so depends on the population. So in terms of meat, there's arguments around the meat from various studies that one, it increases inflammation.

That two, it screws up your microbiome and increases something called TMAO, which is a cause of heart attack. We, it's being studied at Cleveland Clinic with Stan Hazen, who we've had on the podcast, that it has saturated fat that's harmful, that it promotes, you know, all these harmful effects. How do you counter that? Well, I think I just did.

Well, that's epidemiology, but like experimentally, like the TMAO study is interesting. And yeah, I mean, it would take, it would take five podcasts to counter all of those and i have readers okay so because i've written a lot about each of these and by the way what is the what is the short link go to kresser.co slash rogan and the reason it's Rogan is because I put this all together. Presser.co slash Rogan. R-O-G-A-N. And I should have created one that's slash Hyman. But this came from, as you know, Joe Rogan invited me on his show to debate Dr. Joel Kahn, who is representing the vegan perspective.

He's a vegan cardiologist. Vegan cardiologist. And I was representing the Nutrivor perspective. Not the eat a Big Mac perspective, but like eat healthy food that could include meat. And so I go, I break down every single one of those arguments in excruciating detail. You can go and read those articles if you want the full report. And I encourage people who really care about this to look at it themselves. Yeah, it's all referenced, peer-reviewed studies you can read the study yourself he links to the study you can read

it yourself you can make your own decision and and and he kind of guides you through how to interpret it right so inflammation it is again a matter of context i'm not aware of any study that convincingly shows that eating red meat in the context of a whole foods diet with plenty of plant foods as well significantly contributes to inflammation that that research just hasn't been done there was once today so i was fascinated it was a feedlot beef versus kangaroo meat and it was done in australia yeah and and there's something called cytokines in your blood which are markers of inflammation when When they eat ounce for ounce, the feedlot meat, it actually caused inflammation. When they ate the kangaroo meat, wild meat, it reduced inflammation.

Exactly. Because of the different fatty acid profiles. So that's what I mean about context. Someone who is buying pasture-raised beef, for example, from a local farmer or a meat CSA, that's going to have a different impact than someone who is eating, you know, commodity CAFO beef. It's confined animal feeding operations, factory farm beef, right? Right. So factory farm beef versus grass-fin finished beef, different animals, literally.

Yeah. The TMAO thing I've written at least three articles about. It's a very interesting hypothesis. I think it does bear further research. But one of the most troubling aspects of it is that fish is by far the highest source of TMAO in the diet then you know red meat doesn't even register on the scale if you put fish next to it and fish and seafood are consistently ranked you know associate again this is you know nutritional epidemiology but they're inversely correlated

with the risk of heart disease it looks like looks like they're protective, eating fish. They're protective. So I haven't heard a reasonable explanation yet for how that could be the case if TMAO in the diet is problematic. The other issue is that the TMAO production of, the production of TMAO from carnitine in the meat, which is how it happens, is highly dependent on the state of the microbiome. So again, if somebody is eating plant foods

and other things that are helping their microbiome, they're gonna be less likely to produce large amounts of TAMO versus someone who is eating a highly processed and refined diet, which we know is antithetical to the health of the microbiome. Not the meat, it's what you eat with it, right? I remember that Stan Hayes ended the study and he basically got these vegetarians or vegans and meat eaters and tested their TMA levels.

The meat eaters really had high levels and the vegetarians or vegans, they didn't. And then he got the vegan to eat a steak, which I don't know how he did that, but that was, that would be interesting. And then he measured and there was no increase in TMA levels. Yeah i i'm you know like i you know i don't want to have heart disease so i'm like i'm eating grass-fed meats and i'm like i don't i don't want to get in trouble so i'm i'm like oh i'm going to test my tml level so i went and tested it now you can get this test yeah at reputable labs and i was like oh my tma level is low even though we eat grass-fed meats and and it's because 70 to 80% of my diet is

plant-rich diet. And that's why the vegan didn't see a big increase in TMA. Right, exactly. So I was only being partially flippant when I said I already answered it, but it is really all about context and about food quality rather than food quantity we have to shift out of this reductionist paradigm where we're just looking at isolated nutrients and foods outside of the the context that they're eaten in so let's talk about like feedlot versus grass-fed beef because you know the real cost of those foods right now don't reflect i mean i mean the price that you pay the price you pay at the checkout counter it doesn't reflect, I mean the price that you pay, the price you pay at the checkout counter,

it doesn't reflect the true cost, right? So if you look at the cost of feedlot beef, it's enormous, right? One, it destroys the environment. You know, the fertilizers that are grown and the pesticides and herbicides that are used to grow their feed, pollutes our waterways, creates dead zones,

destroys biodiversity, depletes ourways, creates dead zones, destroys biodiversity, depletes our soil, depletes our aquifers. It's one of the biggest sources of climate change. It's like a freaking disaster, plus the overuse of antibiotics, causes superbugs. I mean, the literal costs are in the billions, if not trillions of dollars, the secondary costs that we don't actually pay at the checkout counter. Whereas grass-fed beef, on the other hand, restores the soil, protects our water supplies, increases biodiversity, and its cost really should be far less.

It should be $1 a pound instead of $20 a pound and vice versa. Feedlot beef should probably be $100 a pound or $1,000 a pound. So given that aside, okay, because the cost is an issue, and hopefully that's going to change as we shift to regenerative agriculture. But the quality, let's talk about the quality of these two different animals. And does it really matter? Because if you are on a budget and you can't afford a $70 grass-fed ribeye steak, like how bad is it to eat a feedlot cow versus, I mean, if you had to choose between a diet that was,

let's say, a pure vegan diet or a diet that also included feedlot beef if you couldn't afford the grass-fed beef, what's the deal? I wouldn't do a pure vegan diet. I think there are a lot of ways that you can get, so the real question is nutrient density. And if we say we're neutrovores, we're concerned with nutrient intake.

I'm going to steal that. That's really good. I'm going to attribute you for a while and then I'm just going to take it. Well done. I like it. Well, I remember Rick Warren was like, he always said, you know, you hear something you like, you go, so-and-so said that. Right.

And then you go. Now I've covered my. Then you go, it's been said that. It's CYA, yeah. And then you go, I've always said that. Yeah, perfect. You did the CYA part. If I ever come after you, you can point to this.

I attributed it to you. No, so in fairness, I first heard about this from Sarah Ballantyne. I'm not sure who she heard it from, but it's around. So, yeah, I mean, I actually have often say to my patients, it would be better in some way from a nutrient density standpoint to be a vegetarian that eats organ meats and shellfish than a meat eater that only eats lean cuts of meat from a nutrient perspective and the reason for that is that when you look at the liver kidney thymus heart you know all the awful stuff and oysters clams uh and thesefish. Like when you look at nutrient density on a chart, and what density refers to is the concentration of nutrients per calorie of food. Nutrient to calorie ratio. We talked about that in my first book almost 20 years ago.

Exactly. The nutrient to calorie ratio. And organ meats are at the top of the list, and shellfish are very close to being at the top of the list. Herbs and spices are up there too. Yeah, I was shocked when someone interrupted. I was shocked. I looked at the top of the list herbs and spices are up there too yeah i was shocked when i was talking i look at a chart of nutrient levels liver and like all the best vegetables you could eat and they make the vegetables look like junk yeah i was like wow that's amazing yeah and and you know our ancestors knew this like uh even hunter-gathered tribes that

are studied they'll throw the muscle meat to the dogs they'll go right for the liver and all the other organ meats because they somehow they knew even without those charts that the nutrient most nutrient-dense foods were were the organ is that what uh kevin kevin costa ain't in the dance with right kill the buffalo to eat the liver right that's right it wasn't chewing on a steak so yeah i mean most of us don't eat a lot of these foods now, but if a vegetarian or vegan comes to me and they're, you know, anemic and they have a lot of the other deficiencies that can sometimes happen on those diets and they say that they're willing to eat some animal foods, but they want to restrict it as much as possible, then we'll talk about maybe just strategically adding some organ meats and shellfish into the

diet. But, you know, going back to your original question, I think there are also ways that you can work in pasture-raised animal foods into your diet that don't have to be that costly. So, this is like the nose-to-tail eating that has become, you know, in big cities, there are lots of nose to tail restaurants. Now we're going to maybe go out to one. Yes. We're going to have some awful food, some awful foods. Oh, F F A L. Right. So, um, you know, eating the, the more affordable cuts like, uh, the shanks or the oxtail or the Chuck roast, like those are actually very rich in collagen, which i'm sure most people

have heard by now is really important um other side of the protein occasion or equation it's good for our joints it's good for our soft tissues um and you can go to the butcher and you can often get these cuts even if they're pasture raised uh pretty affordably so you don't have to eat the 70 rib eye to benefit. Yeah, it's funny. A friend of mine was telling me he has this ranch called the Mariposa Ranch in California. And he gets, you know, he buys like a quarter of a cow. It's grass fed and it's average is about eight bucks a pound. Which when you think about it, if the serving ounce, serving has four ounces, that's four servings. So it's basically two dollars a serving yeah which is half the price of a big mac totally yeah and that's the way we have

a big chest freezer in our basement the price of a big mac for grass-fed meat that ain't bad absolutely that ain't bad at all so um in terms of the um the other factors in terms of of nutrient quality what else is different between grass-fed and feedlot beef? So, two of the biggest differences are the fatty acid profile and the levels of vitamins and minerals. So, in terms of fatty acid and antioxidants, yeah. So, the fatty acids, pasture-raised beef will have significantly more omega-3 fats. Which is the good stuff.

The good stuff, EPA and DHA, particularly the long-chain omega-3s. What's one of the issues with plant-based diets is they only have the shorter-chain omega-3s like alpha-linolenic acid, and those have to go through an extensive conversion process in the body to get to EPA and DHA. All this plant-based omega-3s, it's good, but it only about 10% converts. No, actually less than one half of 1% of ALA gets converted to DHA. Oh, that's terrible. And that's assuming you have enough of all the nutrients required for those enzymes in that

cycle, which a lot of vegetarians or vegans can be low in. And genetically that you can do it because a lot of people aren't good at it. Exactly. Some people just don't even have the enzymes for some of those conversions. So fatty acid profile, more omega-3s and then more nutrients because grass is actually pretty nutrient dense, but we as humans can't absorb those nutrients i don't recommend eating grass but the cows can eat grass and turn that into nutrients that we can then access in a very bioavailable way yeah so so it's it also has more cla which is a special fat that actually is anti-cancer helps speed up your metabolism yeah it has extra levels of certain antioxidants

that are really hard to get like catalase superoxide dismutase things that are fancy words but they're like super antioxidants absolutely higher levels of iron absorbable iron nutrients iron yeah yeah so uh it's it's quite interesting and and um you know it's also what we ate forever right yeah there hasn't been like a voluntary vegan society on the planet that we know of yeah yeah as a traditional society i mean that in itself doesn't mean that that that the vegan diet is is not healthy or optimal but when you combine that with the modern scientific evidence on nutrient values um and and consider things like bioavailability and then regenerative agriculture and how we could even feed the planet with everybody consuming a vegan diet versus, you

know, there's so much land that can't be cultivated for plant foods and crops, but could be grazed if we're doing a better job of it. So it makes sense from a lot of different perspectives. It's true. I mean, you know, the argument is, oh, well oh you can't do that at scale it won't produce enough cattle it's good for a couple hippies on the fringe or but you know uh alan williams was phd he was an incredible regenerative farmer sixth generation mississippi farmer uh and has you know studied this upside and down and published a lot on this uh and and he he said that he did the math in america

you know we we slaughter about 29 million cows a year and he said we have enough um land that's either unused or minimally used or is available through different things or we could convert the feedlots to the corn and soy fields that are used for feedlots and grazing, that we could produce twice, almost twice as much beef or cows as we do now. And people say, oh, well, you know, you don't get as much meat off of grass-fed cows, a feedlot cow, yeah, because you're not throwing it full of hormones

and antibiotics. But even then, you still got like almost double the amount of cows. It's possible. And around the world, much land is not usable for crop land and it's degraded land and it's land that has plants that only the cows can eat and they're like an incredible conversion factory let them do it i read also fascinating uh as i'm sort of researching my new book food fix that that there are farmers who plant different types of forage grasses and plants that

have different properties so just as you know a blueberry has a different phytonutrient profile than sort of broccoli so do the plants that they forage on and that has different qualitative effects on the meat yeah so it's fascinating so you actually can get like your you know conversion of these phytochemicals into animal foods that can actually improve your health yeah it's fascinating right yeah let that there's six chambers of the stomach do all the work you know we've only got the one yeah oh it's true i was how i got into nutrition i don't know if you know this story but i i was in cornell and i i was kind of this hippie living in this whole group house with a of vegetarians. And you and I both been vegetarian or vegan in the past.

And he was a PhDs to nutrition and he was studying ruminants and the fiber and the microbiome. They didn't call it the microbiome, but he was studying all this stuff and gave me this book called "'Nutrition Against Disease' by Roger Williams." I read in the 70s, 80s.

It just completely kind of set me up for this type of thinking yeah and and when you when you look at this sort of dichotomy um of of vegan and and people who want to eat healthy meat I mean it's sort of a false dichotomy what what disturbs me is when I see you know these massive reports come out like the eat lancet commission report which I'm sure you saw obviously there was a lot of good in it i mean it brought up the idea that you know we should be eating a healthier diet that climate change is driven by our current agricultural system that we need to be eating you know more plant foods that you know factory farmed meat is bad so there were there were a lot of pluses but it was also concluding that we should either cut our meat consumption by 90 or 100 percent. So what do you say to that?

Well, that was like 37 scientists who apparently analyzed all the world's literature and came up with this conclusion of a universal healthy diet. It's really disappointing because their data did not support their conclusions at all. And again, I've written extensively about that. You can, you know, listeners can check it out if they want the detail. did not support their conclusions at all. And again, I've written extensively about that. Listeners can check it out if they want the detail. But we've already basically covered the main problems with that study when we talked about the issues with observational epidemiology. The head author of that study was the guy who just published a study saying that meat kills based on a 10% increase in a population study. And that was really, it was a coordinated media campaign. It was funded by a couple of,

you know, a billionaire couple in Scandinavia. And I remember reading something like the greenhouse gas emissions from all of the flights and their private jet that they took around the world to promote the study were larger than what would be saved by making the diet changes or something like that. Yeah, well, I heard if you fly from LA to London, you'd have to be vegan for five years to compensate for the amount of greenhouse gases produced. Right, right.

But only if you're eating factory farmed meat. Yeah, it's like eat real food and meat is a very nutrient dense food with lots of bioavailable nutrients that can be easily absorbed and has a lot of advantages. And, you know, the amount of it that each person will eat can depend on a lot of different factors. But, you know, again, not to beat a dead horse, like we have to shift the conversation more to quality rather than quantity. And there have been some good studies. Do you remember the one at Stanford? It was a weight loss trial, but they were, they looked at low fat difference between low fat and low carb. But instead of just

changing the carbohydrate and not caring about the quality of food, they put everyone on a high quality diet and then they only change the fat. So, they were qualitarians. Yeah. Quality low fat diet, quality high fat. Real food, low fat, real food, high fat, low carb. And they didn't see much of a difference there. Both lost weight compared to the standard reference diet, but there wasn't a huge difference between those two. And so, you know, that just supports the point that I think we've been making all along, which is that quality is what makes the biggest difference.

Quality and what else you're eating. Yeah. Right. So, we're not saying you should have like a 32-ounce steak every day and one string bean. Right. It's like, you know, 500 string beans and a four ounce or five ounce piece of steak. Yeah. I mean, it's just like the plate.

If you just think about the plate, most of it will be various kinds of plant foods. It could be, you know, non-starchy vegetables, salad, sweet potato. Those are all plants. And then you might have a serving of fish or meat. Yeah. It's pretty simple, really. So, your work is really tremendous, Chris, because you've taken all this disparate information from all these different studies, all the misleading headlines, all the propaganda that's

put out there by various groups, and you've sort of synthesized it in a way that's easy to understand, that's accessible. And so I encourage everybody to go to chrisquestor.com just to go look at the work he's done. He's got lots of reports, lots of books. It's a tremendous resource. If you have a question about anything like, I'm writing a book and I want to know, what does the latest data say about omega-6 fats? Well, I'll go to Chris because he's already read all the studies. He's summarized them and it saves me a lot of work. So thank you, Chris. You're welcome. I don't have time to go on. So let's talk about the approach that we both take, which is really trying to look at the body as a system. And the conversation we just had is really in a

similar way looking at the whole picture. You can't just cherry pick this and that and look at this study or that study. You've got to understand the context of everything. And that's what functional medicine is. It's a science of looking at the root causes of disease. So how did you get into functional medicine? I mean, what happened? Well, like you and many others, it was through my own struggle with illness. So I was traveling in Indonesia, surfing. I was on a around the world surf trip in my early 20s. Sold everything I own, took off to see the world. It was pretty awesome up until that point. And even after that point.

But, you know, I got three parasite infections simultaneously. I was exposed to contaminated water in the surf break, actually. A number of other people got, there were some cows that were defecating in a kind of stagnant pool of water near the surf break, actually. A number of other people got, there were some cows that were defecating in a kind of stagnant pool of water near the river. And the locals dug a trench between that and the river and the river went out into the ocean with all that water. So I had Entamoeba histolytica, Giardia and Blastocystis hominis all together. Triple header. Triple header. Nearly killed me. Had many years of being completely incapacitated. Really just spent a long time curled up in a ball

in pain on the floor during that period. And I saw my conventional doctors and they were well-meaning and they tried to help, but they didn't have the tools to help. And, you know, I saw my conventional doctors and they were well-meaning and they tried to help, but they didn't have the tools to help. And eventually I basically, I stumbled on a, you know, nutrient dense, nutrivor, paleo type of diet, which was a big factor in my healing process. But then I also stumbled on functional medicine. This was the late 90s. So you were practicing functional medicine by then, but one of the few people, I think. Yeah, it was like me and like seven other people. Five other people.

It was not well known. I didn't even know that the perspective I was taking was functional medicine at that time. I didn't know I had a name, but it just made sense to me that addressing the root cause of the problem was the way to go. And then, you know, following in the footsteps of pioneers like yourself, I knew that was the type of medicine that I wanted to practice and, you know, to be able to help others who were dealing with complex chronic illness to recover. Yeah. And your California Center for Functional Medicine is really a pioneering center where people come from all over the world to come see you and your colleagues to help them sort through these chronic problems for which often we don't have great solutions and you know you you've also realized that um you know we have a dearth of one doctors yeah and two

in general and two we have like an incredible scarcity of doctors who know how to practice functional medicine yes and we don't have a health care system that supports it and you and i both know both from our own experiences of healing recovery and from treating thousands of patients and seeing this over and over again this is not the placebo effect this is not just some you know crystal healing with feathers and candles i mean this is hardcore science that is out there and i i don't know chris have you you've seen this new book it's called network medicine no and i have a copy i'll show you it's the first real hardcore scientific text by these researchers at Harvard that maps out the whole

idea of complex systems biology in a clinical way. And it's called Network Medicine. Network Medicine. It's not a read for the average person, I promise you, but you can go look it up. And it is a brilliant analysis of the failure of our current diagnosis system to help address chronic disease and in the thing i respect about you chris is that you you've really taken this problem to heart you say well like this is only able to a few people but what if not just a few hundred or a thousand people could have access this what if millions can how do we and how do we do this like you're not gonna go into medical schools and just completely change the curriculum overnight or if i were king i would do that like in a minute

you're working on it i'm working on a cleveland clinic yeah we like we got there and i met with the dean i'm like hey dean you know like uh what's up with no nutrition in the curriculum here don't you think nutrition should be in the curriculum he's like yeah okay so we like started working on nutrition in the curriculum at Cleveland Clinic, which is, you know, and it's just stunning to me because it's food is the biggest cause of disease. It's the biggest cure for disease and doctors learn nothing about nutrition. So-

And what they learn is 50 years out of date. Right. So you were like, wait a minute, I can't wait to change medical schools. I can't wait to change reimbursement. I can't wait to change healthcare. I'm going to take all this research that I've done, all this clinical experience I have, and I'm going to condense it into a practical training program

for doctors, for healthcare professionals. And it's called the ADAPT program for practitioners. It's the ADAPT practitioner training program. And then you were like, wait a minute, doctors can't do everything or healthcare professionals can't do everything or healthcare professionals can't do everything. It's not just doctors.

It could be any healthcare professional. They need help. And 80% of healthcare doesn't happen in the doctor's office. It happens at home. And you need a coach. So you created a whole ADAPT health coach training program. So tell us your journey to that and give us some detail about what these programs are and who's taken them and what's the impact on their practices and their lives and their

patients. Sure. Absolutely. Yeah. So, you know, it started, I was, after I graduated from school, I started to treat patients. I was having a lot of success. One of the, you know, unintended consequences of that success was that my practice was full and I couldn't see many new patients. And I would get emails every day,

pretty much from friends, family members, other people who were, you know, wanting to come see me asking for referrals to other functional medicine practitioners that also had an ancestral health, you know, perspective as I do. And I couldn't make many, you know, there were a few people that were doing that, but not me. Yeah. There's another guy across the country, you know, and, and so it was really frustrating because I wanted, I'm in this to help people and I couldn't help those people. And so I, I, I realized like we have to train more people. And of course, IFM Institute for Functional Medicine has been doing that in a phenomenal way for the last, what, 25 coming up on 25 years, incredible programs have the highest,

you know, deepest respect for what they're doing. And, um, my learning style is a little bit different. I'm a learn by doing kind of person. And I like that like apprentice style learning, you know, like, and what I was really looking for was something like what we might call a functional medicine residency or internship, where you kind of peek behind the shoulder of someone who's doing it on a daily basis. And I saw that that was not available in the functional medicine training space. And that's the kind of training I would have wanted to have after doing some of the

foundational stuff. Which you and I both kind of did by being scrappy and calling this one and calling that one. What do you do? And what do you do? That takes a long time. It's not that efficient. It took me 20 years. Yeah, exactly. So I was like, how can we condense this? And a one-year program where people get practical, hands-on experience in what lab to order. Not just that you should do SIBO breath testing, but here are the five options. And here are the pros and cons of each. And here's how you interpret the test results. You can't just use the algorithm that they generate. You actually have to know how to interpret it. And here's how you put a protocol together based on those results.

And here's how you don't do something stupid. And here's how you tailor it for someone who's got high methane versus high hydrogen. And so that's not available in academic settings for, because they're often restricted by what they can't talk about specific tests and specific problems. You say, and you go to your doctor, they check your cholesterol. Well, you go to any lab and pretty much check your cholesterol with functional medicine. It's like, no, you've got to go to this lab and you've got to do this test. And your LDL particle number.

We want to know your numbers and your size. Yeah. So, and the same thing with supplements, like you can say can say oh take penicillin or take lipitor right you don't say they say take atorvastatin which is the generic name but everybody knows there's only one of those yeah and and so there's like it's like a game whereas you can't say okay take turmeric well you can't say that you gotta say take this company's turmeric right because it's more bioavailable and this is absorption and yeah so so i'm one of people that just be able to like do a one-year training and get out there and start helping people.

And that's what the adult practitioner training program is. It's for licensed clinicians like MDs, DOs, also nurse practitioners, you know, physical therapist, occupational therapists, RDs, CNSs, you know, people who have a license who are able to order these tests and offer these treatments to patients. It's sort of like an apprenticeship slash training wheels. Yeah. Residency, internship. Where you can kind of start to really use it.

And then we also cover how do you run a functional medicine practice? I mean, you know that's very different than running a conventional medicine practice. Yes, sir. It's a whole different ballgame. And so you could be the best functional medicine clinician out there, but you're just going to be like playing air guitar in your bedroom if you don't actually know how to set up and run a functional practice. So that was launched in 2016 and it's been really successful. We've trained over 400 doctors and other licensed clinicians from all over the world.

We've heard just amazing feedback and input from how it's transformed people's practices and the lives of the thousands or tens or hundreds of thousands of patients that they're touching now. Yeah. I mean, I think the Institute for Functional Medicine is sort of like medical school. Right. And you get the foundational theory and the concepts which is super important and then you get you know this practical application allows you to adapt your practice to functional medicine right yeah and as people often struggle with that

transition of like okay now i understand the basic concepts and theory how do i actually do it yeah yeah and i mean to you and jeff bland and everyone who is instrumental in in um in in ifm's history and getting that education out there i have the highest respect and appreciation for the the way that you've advanced functional medicine in our field it's amazing so by the way it's a it, it's a nonprofit in super functional medicine. It has to adhere to certain guidelines for getting an accreditation medication. So we can't say use this lab or use this supplement or use this medication. And it makes it very difficult and confusing. Okay. CoQ10. Yeah. Which one there's 5,000 of them out there and most of them are crap. And how do you

know? And then to keep the CEU status, they, you'd have to mention all five thousand to to make it you either mention none or all of them okay i don't even know you yeah no you could do all of them do you imagine a slide five thousand little bullet points that poke you down on there um yeah but i can because i'm just i'm one person you know i'm person. You're not offering continuing education. I'm not offering continuing education and that is a potential downside of my program. Well, I think it's about healing people and helping people. Honestly, it's less important. So I did that for three years.

I'm still doing it. We launched it three years, but a couple years in my own practice and in training clinicians and in writing Unconventional Medicine, my last book and in training clinicians and in writing unconventional medicine my last book and doing that research i learned you know what you've already knew i'm sure is like there's going to be a shortage of 52 000 primary care providers by the year 2025 yeah and more and more probably yeah and they're already that's arguably not even enough like what they're defining as enough is not enough to really serve people the average visit with the doctor is 10 to 12 minutes some say now with new residents now it's as low as eight minutes that's barely enough time to say hello and write a prescription it's certainly

not enough time to talk about diet lifestyle and behavior change and the other problem is they don't let you talk like the average uh time before you get interrupted it's 18 seconds yeah 18 seconds 12 seconds i've seen that. Yeah, because that's not necessary. It's just what's the symptom? What drug can I prescribe to suppress that symptom? And so, you know, I realize that most healthcare is self-care. As you said, like at least 80%, if not 90% of healthcare really happens outside of doctor's offices, even a functional medicine doctor's office. So, you know, a patient might come see me three or four times a year, but the other 99.9% of their time-

They eat three times a day. They eat three times. Yeah, exactly. And they sleep every night. And sleep every night and have to manage their stress and deal with all that stuff. And behavior change is hard. That is the reality. And we know this because according to the CDC, about 6% of Americans consistently engage in the top five health behaviors.

And we're not talking about complex stuff like intermittent fasting, keto, cycling. 6%. So these behaviors are maintaining a healthy weight, not smoking, not drinking excessively, getting enough physical activity and getting enough sleep. Okay. You and I are hopefully in the 6%. Yeah, 6%. And Mark, it's not because people don't know. There is a lot of controversy over paleo vegan, all that. There's not a lot of controversy about those five things. Everybody knows that they shouldn't be smoking a lot, drinking a lot. They should get some sleep and they should exercise.

So are they not doing it because they don't know? Of course not. They're not doing it because they don't know how to change and they don't have the support that they need to change. And that's what I want to shift with the health coach training program. But we know from the science very clearly that friend power is far more powerful than willpower

to create behavior change and we talked about this but you know i created this faith-based wellness program in a church where we got 15 000 people to lose a quarter million pounds in a year and get healthy it wasn't a weight loss program was a health program yeah and they did it in small groups with each other without a health coach without a nutritionist, without a doctor. But use the power of love and each other and connection and accountability and feedback and support, which is exactly what a health coach does.

Absolutely. So it's, Rick Warren said it best. He says, everybody needs a buddy. Yeah. So your health coach is your buddy. Yeah. And the science supports this hands down. Absolutely. It's evidence-based.

It's, it's, and it's, it's what's striking me. There was this big study called the diabetes prevention program and, and, and they scaled it up and they, they tested different versions of it, which was sort of a group diabetes program where you learn how to eat and exercise and so forth. And they tested, oh, what if a doctor delivers a program? How well do they do? What if a nurse does? What if a nutritionist does? What if some lay person does, who's another guy in the group? It was no difference. I remember one study, I love this study, which was looking at people who are mentally handicapped, who had obesity or diabetes. And they were challenged. And they gave them instructions on what to do

and then told them to support each other and help each other. They had better health outcomes than getting treatment by the best doctors. So their blood sugar got better. Their weight was like, this is the most amazing study. Yeah know i mean it i'm sure it didn't surprise you that doesn't surprise me but it would probably surprise a lot of people yeah yeah yeah and it's just um the thing that's amazing about health coaching like and this is what i realized with the practitioner program um you know there's only a limited number of people out there who can even do the practitioner training program because you have to have the license and the skill and experience and

qualification to be able to order those labs and perform those treatments. And so that's great. And I want to continue to grow that and expand it. But there's only so fast that that can grow, right? Because it's limited. So there'll never be enough doctors to help people make these changes. And we could argue that doctors aren't the right people to make these changes because they don't get the training and nutrition, as you pointed out. But also, they should be focused on doing the stuff that they are uniquely trained to do, you know, procedures and tests and treatments and all of that. It doesn't make sense for most doctors to spend an hour talking to someone about nutrition.

It's not the most effective use of their time. So, you know, health coaching, if someone is trained properly, and we can talk a little bit about that, they can, you a training in a year and it doesn't require medical background you don't have to be you know go to pre go through pre-med and in in school and do you know med school or anything like that to become a health coach so we can scale that impact and there's so many people out there I imagine quite a few who are listening and watching we're so passionate about health and they want to use that passion to make an impact and maybe who are so passionate about health and they want to use that passion to make an impact and maybe they've had their own health story like you have and i have

or they want more meaning and purpose in their work they want to wake up and feel excited about what they're doing and that they're changing lives and this is like a profession that is just growing hugely it's one of the fastest growing professions that there is in the US now, along with other health professions. It's already like a $6 billion market. And it's just gonna get bigger because the writing is on the wall. Like changing our behavior is the single most important step

we can take to preventing and reversing chronic disease. I'm more convinced of that than I ever have been. It's so true. And it's powerful because people can have a huge impact on each other yeah um and you know if i you know i'm gonna ask you in a minute if if you were king what you would or if you are of the world for a day what would you do but if i were i would i would basically create a million or 10 million community health workers yeah aka health coaches yeah and And I think that would make a difference

because the truth is that most of the things that people need to do, like you said, do not require high-level medical intervention. And you can clean up 80% of the problems without ever seeing a doctor. And we're seeing this at Cleveland Clinic. We use health coaches. And we have these small group sessions um partly because

we have such a big waiting list but was was also was my vision actually when i got there i said i don't want anybody to see a doctor until they've gone through a 12-week program in a group makes sense they might not even need to see one then okay and i couldn't get it going yeah it took like three or four years and then we started it yeah and before they even see a doctor they go into this program it's called functioning for life and they work with each other and yes we have you know coaches and doctors and nutritionists teaching which is great but it's it's the medicine of the group that is the magic and and uh and the results are unbelievable when you think about it

there's this one woman i just want to quickly tell her story janice who was 65 and she was severely obese she had heart failure she had type 2 diabetes on insulin for 10 years she had kidney failure her liver was starting to fail she had high blood pressure she was on a pile of meds and felt like crap all the time and was on her way out she came to the group and just started with the simple lifestyle changes it wasn't like tons of functional medicine testing or tons of supplements or anything it was just like group support lifestyle, and a very powerful anti-inflammatory, low-glycemic, whole foods diet. Yeah, ultra-vore diet. Basically, yeah.

It's based on the 10-day detox diet, which essentially is like mostly plants with some healthy animal foods and not starch or sugar. And in three days, she was off her insulin. In three months, she lost 43 43 pounds but that was not the significant part her heart failure reversed which you never see in medicine her kidney failure reversed which you never see in medicine with any drug yeah her liver failure got better her high blood pressure in a way she got off all her medications and in a year she lost 116 pounds

and stayed that way and what's more remarkable is that she said she saved out of her own pocket, her co-pays for her medications, 20,000 a year. Oh, my gosh. And this is the power of the group and the connection and the operating system. So if you have an iPhone, you can run it. You don't have to understand, you know, how Steve Jobs built it and how it all works underneath, but like, it's pretty intuitive and it's pretty simple and you can do it. And it's the same thing with health coaching. You don't have to like be a PhD in nutrition or, you know, a doctor or have extensive knowledge. But

if you understand the operating system of what we're teaching, like that's what happened in the church. We provided the content, the IP, the operating system, and then it was easy for them to sort of implement it. Yeah. And in fact, that kind of expertise can often get in the way because health coaching is not about telling people what to do. That's the expert approach that comes out of the conventional medical field of time. And there's a place for that. If I break my arm and go to the doctor or the hospital and they tell me what to do, I'm going to listen to that and I'm going to do that because it makes sense in that scenario. But telling people what to do to change their behavior doesn't work.

I mean, look, do you like to be told what to do? I don't like to be told what to do. Most people don't like to be told what to do. We have this natural inclination to resist. And health coaches, when they're properly trained in these modalities like motivational interviewing and character strengths, positive psychology, goal setting, you know, accountability, they become what we call behavior change ninjas or change agents. They are experts in asking powerful questions, helping people to discover their own motivation for change. The why. Yeah, the why. So, a good example of that is like imagine a middle-aged woman who's got, you know, or, you know, maybe in her sixties,

she's got type two, she just got diagnosed with type two diabetes. The doctor says, you need to change your diet. Um, and forget about what the advice is because often the advice is not good there, but let's say it's even the right advice. And the, and the doctor can't figure out why the patient's not changing for that patient, that's not enough of a motivation for whatever reason. But if in working with a health coach and the health coach asking her questions discovers that she just had her first grandchild was just born and she's like loves that grandkid more than anything and wants to see that grandchild grow up and wants to be at her wedding when she gets married. And when she taps into that motivation, that's when everything shifts and she's able,

because for her, that was really it. So, I mean, this is like, you're probably aware of these studies. I saw this recently where something like six or seven out of 10 people who even have recently have a heart attack, don't change their diet or lifestyle after that. Oh my God, I saw that with my stepfather, yeah. Yeah. So he literally had his chest cracked open. He got a chest infection of his chest wall. He was in the ICU with his chest flayed open for a month in the intensive care unit.

And that wasn't enough. Not enough. To make him change his diet. Right, so I mean, this is why we need to get really focused on how can we, from an evidence-based perspective, support people in making successful and lasting change. And that's what, you know, a health coach program like ours that's, you know, there's an organization now called the National Board of Health and Wellness Coaches. And they've teamed up with the National Board of Medical Examiners that you're familiar with in medicine. They determine what you needed to do to get your MD. Yeah. Answer a lot of questions. They determine what someone who wants to be board certified in gastroenterology or cardiology needs to learn. So this is a really legitimate organization. And they looked at the health

coaching field and said, wow, there's a lot of variation out here in terms of the quality of these programs. And some programs that are teaching health coaching are not actually teaching these core health coaching skills that we're talking about. Because it's about behavior change. Yeah. They're just teaching people how to tell people what to do, what to eat, and that doesn't work. So they actually define the training and education that someone should earn to become a nationally recognized credentialed health coach. And then they approve schools that apply. And so we just became an NBC approved school, which I haven't had a chance to tell you. It was just a couple of days ago where we got our approval.

Fantastic. That's great. That's huge. Really, we feel we're so happy about it because we love the work that they're doing to advance the rigor of health coaching. And this will eventually open the door for it to be covered by health insurance, I think. Because if you're a health insurance company, you're not going to cover a health coach session with like Joe Health Coach who just decided, took a weekend course and decided he was a health coach. You're going to want to see rigorous standards for what that what that is just like within the other healthcare profession. So. No, it's great, Chris, what you're doing. I mean, just, just one, taking the time,

I mean, cause you have a family, you, you have a job to work, but taking the time that you take to really sift through the science, to, to understand the nuances of what we know and don't know about health and nutrition, to translate that into protocols and practices and in-depth understanding of how to apply this, to develop a health coach program. I know you and I know how many literally thousands of hours it's taken of you and your time and your expertise and for one i'm grateful that you're out there doing this because i sure as hell didn't want to do it well you got a few things on your plate to be fair but to be honest i actually have the same experience as you i'm like somebody needs to do this and i started to do it at one point and i got like 40 pages into writing it all up and i'm

like i can't do this i gotta do other things i've got 14 other jobs yeah it's true i've made too many jobs but anyway this is just incredible and i i think uh i just want to acknowledge you chris and i wanted to thank you for the work you do and i encourage everybody really to go to chris kresser.com if you have a question about anything just google x and chris kresser and i guarantee you there'll be something he's written about it over the last decade and uh and he's got a great podcast he's at these training programs which i encourage you to check out and uh i check out his book the paleo cure we can go to paleo cure book.com his book unconventional medicine which is

unconventional medicine book.com really great explanation of of um uh functional medicine and i'm i'm one of the characters in it so i like that so so chris uh last question if um if you were king or czar or you know um you know president of the world for a day or as long as you could be uh what would be the changes that you would implement to improve the health uh our nation and our world? It's a good question. Well, I think I would pass laws that reduce the influence of big pharma, big food, and big ag. And I know you're writing a book about half of that equation and that you feel as passionately about this as I do. But yeah, I mean, when you look at the influence that industry has on everything from how medical research is done to subsidies for junk food that create price distortions and create an

imbalance in the food system. Yeah, that's why grass-fed meat is so much more expensive than feedlot beef because we're paying, the government's paying to grow the food for the Yes, why grass-fed meat is so much more expensive than feedlot beef because we're paying, the government's paying to grow the food for the feedlot beef. Exactly. So there's so many distortions that get created there. And the fact that two-thirds of medical research is sponsored by pharmaceutical companies who have a vested interest in the outcome of those studies.

And by the way, more than 10 times as much nutritional research is funded by big food as it is by independent scientists. Right. And, you know, there's whatever people's feelings are on gun control, the pharmaceutical industry spends about 10 times more than the gun lobby does on lobbyists. So second only to the oil industry yeah so they have a massive influence on every level of government and public policy and i think until we address that where our progress is going to be more limited than it should be as you know i i i was i'm writing my book and i'm looking at lobbyists and what they're doing and it's it's staggering there's 187 lobbyists per member of congress it's shocking unbelievable yeah and literally billions and billions of dollars and i remember going to washington as part of the uh affordable uh affordable care act and i and i was you know

trying to get a bill passed that was going to pay for lifestyle medicine. So group programs, exactly what we're doing, that work. And we'd walk into the senator of this or the congressman or the person in the White House or the head of health and healing. I mean, the head of the Health and Human Services. And they'd go like, okay like okay like what lobby group are you from and who do you work for and I'm like uh nobody and just the science and the patient I represent the patients and the science because I want science to become policy yeah and then senator Harkin laughed and he was like good luck that would make too much sense and I had it was

striking to me because they're not used to seeing people who are advocating. And I literally, I had to pay. I mean, I didn't even stay in Washington. The hotels are expensive. It's like 500 bucks a night. I had to pay my own flight. I paid my own taxis and hotel and food. And it was thousands and thousands of dollars because I cared.

And I had access. And I was like, this is crazy. And then on top of that, everybody agreed. And it didn't get in the final bill because it was all this horse trading right it was just it's just that yeah that unless you've got the millions of dollars to get in there and and influence it's going to be hard to overcome that yeah i don't even heard the story of like the hamburger bill it was called the um personal responsibility in food act meaning that if you ate crap, it's your fault. Right.

And you can't sue any food company. And you can't sue McDonald's because you got fat eating McDonald's. Yeah. Right. It was called a hamburger bill. And this guy, Representative Scott, who was from florida introduced this bill and it passed congress by like a two to three like a two-thirds majority wow didn't get through the senate yeah uh although it later passed in like over 25 states with a different name like consumer choice act or

something and and turned out that this guy got $300,000 from a PAC, a political action committee, for his campaign from McDonald's and Wendy's and Burger King. Big surprise. So like, well, what are we supposed to do? Yeah. And we don't recognize that those foods are, they're addictive. I mean, they trigger hard, biologically hardwired mechanisms that protected us in a natural environment.

Like we were programmed to seek out calorie dense and rewarding food, you know, because that helped us survive in a natural environment. And these companies employ biohacking food scientists that know that and make the products maximally addictive. They do brain imaging on toddlers, toddlers to see how to impact and wrong. Yeah, it is. And so if you care about this, uh, and I'm writing a lot about this in my book, food fix, there's a, there's a group called the food policy action network. And if you go to their website, uh, they have a list of every member of Congress and their voting record on food and ag

and policy issues. So you can see who's voting for what. So Chris, thank you so much for being part of the Doctors Pharmacy. It's been a great conversation. If you love this podcast, please share with your friends and family and social media, leave a comment. We'd love to hear from you. Subscribe wherever you get your podcasts

and we'll see you next time on the Doctors Pharmacy. Hi everyone, it's Dr. Mark Hyman. So two quick things. Number one, thanks so much for listening to this week's podcast. It really means a lot to me. If you love the podcast, I'd really appreciate you sharing

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