The Dr. Hyman Show - What To Eat For Better Health

Episode Date: March 2, 2020

Eleven million people die every year from a bad diet. In America, six out of ten Americans have a chronic disease; four out of ten have two or more chronic diseases. And this is not just an American problem. Eighty percent of the world's chronic disease and obesity is in the developing world. We know that food is driving the majority of this death and disease but no one is really talking about it.  In this mini-episode, Dr. Hyman explores the global chronic disease crisis being driven by food and the food system. He also breaks down the principles of his “Pegan” diet, a middle ground between vegan and Paleo, focused on whole-foods; primarily colorful, high-fiber vegetables like kale, cauliflower, peppers, and radishes; healthy fats like extra-virgin olive oil and avocados; some low-glycemic fruits like blueberries and blackberries; free-range meats and eggs, used more like condiments than as the star of the plate; anti-inflammatory nuts and seeds, and flavorful herbs and spices.  Learn more about these all of topics in Dr. Hyman's new book, Food Fix. FoodFixBook.com

Coming up on this episode of The Doctor's Pharmacy. The ultra-processed foods, corn, soy, and wheat that we subsidize through our government agricultural policies are turned into sugars, starches, refined oils that are the building blocks of processed food. 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 if you or anyone you know has some chronic illness, and this conversation is going to matter to you, because we're going to talk about the root causes of our chronic illness in America and globally, and how we can fix it. And it's based on the research that I've done through my new book, Food Fix, how to save our health, our economy, our communities and our climate, or actually our planet, one bite at a time. In my new book, I talk about the real issues that are facing our society today, the issues around chronic disease, its economic burden, issues of environmental degradation, climate change, social injustice,

challenges with our kids' education, challenges with national security because our kids are too fat or unfit to fight. And all these are connected by food. And that's really the subject of my book, Food Fix. One, what are these issues? How are they connected? It's really one problem. And what are the solutions? We have real solutions that are available to us today if we take advantage of them. And today, in this mini-sode of The Doctor's Pharmacy, we're going to focus on chronic disease and what the solutions are to solve this epidemic. But first, we have to really understand the scope of the problem and the cause of the problem. In America, six out of 10 Americans have a chronic disease. Four out of 10 Americans have multiple chronic diseases. It affects more than every other person in America. And globally, it's increasing. 80%

of the world's chronic disease and obesity is in the developing world. So this is not just a first world problem. This is a global problem. And a recent study, the Global Burden of Disease Study, which looked at populations all over the world, 195 countries over a 27-year period, found a remarkable thing. One, that 11 million people die every year from eating too much of the bad food, not enough of the good food, right? Not enough whole, unreal, unprocessed foods and too much of the bad stuff, processed foods, ultra-processed foods, sugar, sweetened beverages, refined grains, trans fats, and so forth. And not only did it account for 11 million deaths, but 255 million years of disability and life years lost. What was striking was not only was it the presence of the bad foods, but it was the absence of the good foods that contributed

to the problem. Now, if there was a disease like Zika or Ebola that was killing 11 million people a year, there'd be a global effort to solve this problem. There'd be businesses, scientists, policymakers, philanthropists, everybody would be pouring resources into this. But this is silent. Nobody is focused on dealing with the issue of food. I was recently at a conference, a Milk and Global conference, listening to a panel of leading thinkers and actors in healthcare, people I have tremendous respect for, the head of the National Institutes of Health, the CEO of the Bill and Melinda Gates Foundation, the head of the Center for Medicare and Medicaid Services, the CEO of Kaiser Health Systems. These are giants in the

field of healthcare. And they really spoke about a lot of important things, eradicating polio, malaria, and AIDS, gene editing, really amazing technology to cure rare genetic diseases that affect few people but are devastating. Improving the interoperability of medical records so that we have complete transparency and access across all different medical records no matter where you are in the world. Data sharing to improve medical science and improving medical payment systems to pay for outcomes and value. These are all essential things we need to do in healthcare, but it ignores the biggest problem facing us, the big elephant in the room, which is the fact that the biggest killer globally is food. And yes,

we have to deal with all these other issues, but food is the biggest driver of disease, period, on the planet. And yet no one's really talking about this or how to address it on a global level. Part of the problem has been that this epidemic has come on like a juggernaut over the last 40 years and has blindsided scientists, doctors, healthcare systems, governments. And we're just sort of like a deer in the headlights, not knowing what the heck to do. But the truth is, we know what to do. We know now that the food we eat or the food we don't eat is the single biggest cause of death worldwide, exceeding tobacco and every other known risk factor. I mean, historically, it was infections, poor sanitation, what we call

communicable disease. But now 70% of deaths worldwide are from what we call non-communicable disease, things like heart disease, obesity, diabetes, cancer, dementia, but they're not really non-communicable because they actually are affected by the social conditions that we live in. We know that we blame people for these diseases. We say, well, you know, malaria, TB, AIDS, you know, it's not really your fault, so you're the victim. But with food-related illness, we kind of blame the victim. We said, you know, you choose what you put in your mouth. You choose what you're eating. So if food is causing you to be sick, it's your fault. Why should it be my problem?

But as it turns out, the social conditions we live in are driving the diseases we have. Paul Farmer calls this structural violence, the social, economic, political conditions that drive disease. You know, if you live in a world where our food system produces mostly disease causing foods, where it's a food carnival that makes it really almost impossible to make the right choice, where our government supports the production and sale of these foods, and where fresh foods are biologically addictive, then personal choice is a fiction. The science is clear. Non-communicable diseases, it turns out, are very, very communicable. You're more likely overweight if your friend's overweight than if your family's overweight. Depending on your neighborhood, your life expectancy may be 20 or 30 years shorter than folks from another country, a city, or state. Simply moving an

overweight diabetic, based on this research that was published in the Journal of the American Medical Association, moving an overweight diabetic from a low socioeconomic neighborhood to a slightly better one leads to weight loss and improvement in blood sugar and diabetes without any other intervention. It turns out your zip code is a bigger determinant of your health than your genetic code. Now, this is way more than just personal choice and behavior. Yes, we have to take responsibility for ourselves. Yes, we have to change our environment if we can.

But often it's very difficult. I mean, I remember this girl from Cleveland I talked to. It was a young African-American girl who told us of her story of her family with diabetes. Her aunts and uncles, her parents all had their legs amputated from diabetes or on dialysis. Her mother was desperate to prevent her family from this. And her mother had to take two separate buses an hour each way just to buy some vegetables for her family. So when you talk about personal choice, it's far more than that. When people live in food swamps, not just food deserts, where everything available is disease-causing. So the author of that big-lances study of 195

countries said, there is an urgent and compelling need for changes in the various sectors of the food production cycle, such as growing, processing, packaging, marketing. Our research finds the need for comprehensive food system intervention to promote the production, packaging, marketing. Our research finds the need for comprehensive food system intervention to promote the production, distribution, and consumption of healthy foods across nations. Basically, our whole food production system from field to fork is bent on producing foods that make us sick and fat and causes us to die early rather than foods that make us healthy and prevent disease and help us live a long, productive life. So sadly, both the intended and the unintended consequences of our global food system provide too much of the bad

stuff and none of the good stuff, and it's killing us. Other data really supports this. We've talked about on the podcast, 60% of our calories are from ultra-processed food in America. When you have 10% of your calories as ultra processed food, your risk of death goes up by 14%. These are disease causing foods. There's no doubt about it. But the good news is there is a way out of it. Just as the wrong foods can cause disease and death, the right foods can actually reduce and reverse disease and prevent death. There's so much evidence that food is medicine. I've talked about it. Food is not just calories, it's information. It literally changes the expression of your genes, changes your hormones, your immune system, your gut microbiome, your brain chemistry. Every single

bite of food changes your biology. It upgrades or downgrades your biology with every single bite. And we've seen the dramatic effect of this. There was an incredible project by Geisinger Health Systems, which is in Pennsylvania, where they took the most food insecure diabetics, people who were super poorly controlled. They lived in very poor circumstances. They were really underserved and their blood sugars were just out of control. And they were costing a ridiculous amount of money, the healthcare system, about $248,000 per patient in this group. And they said, let's focus on them. And so not only did they change how they were managing them, they actually did

something pretty radical. They paid for free food for the patients and their family for a long period of time, for over a year. And they gave them social support. They gave them coaching and they had to meet with a nutritionist and they had social workers and they dealt with some of their socioeconomic issues. And what happened was striking. Within a year, there was an 80% reduction in healthcare costs. That's 190 something thousand dollar decrease per year, per person. Now, not all patients cost this much and not all are this sick, but just think about this. So 5% of the patients cause 50% of the healthcare costs in our healthcare system. We focus on those using food as medicine. The results could be

astounding. And not only that, their blood sugars normalized, their health got better. Dr. Mazzafarian, who's been a big advocate, he's the dean of the Tufts Center for Nutrition Science and Policy, said, the idea of food as medicine is not only an idea whose time has come, it's an idea that's absolutely essential to our healthcare system. So we have to reimagine our food system and our healthcare system based on the idea that food is medicine. But part of the problem is that we don't produce enough of the good food to feed everybody. In fact, so many people are nutrient deficient. 78% of the world's population doesn't eat the minimum five servings of fruits and vegetables a day. The government's dietary guidelines tell us to have

50% of our plate as fruits and vegetables, yet only 2% of the land in America is used for growing fruits and vegetables. It's kind of a joke. We should probably be eating 15 servings, eight cups of fruits and vegetables a day. Even worse, the ultra-processed foods, corn, soy, and wheat that we subsidize through our government and agricultural policies are turned into sugars, starches, refined oils that are the building blocks of processed food, which is made into every size, color, and shape of extruded food-like substance, but is essentially the same garbage. These foods hurt us twice. First, they damage the environment by depleting our soils, our water, and our oil resources because it's a fossil fuel dependent agricultural system. It's also the largest source of greenhouse gases, our whole food system. Second,

they're the greatest cause of human suffering, disability, and disease and death, far greater than any genocide we've ever seen. We produce far too many calories for the world's population, but not enough real nutrients found in whole foods that are needed to create health. I think of these foods as biological weapons of mass destruction. If there was an existential threat to our society where 40% of our kids are overweight, where we're seeing 60% of our population ravaged by some horrible thing,

we'd be at war fighting this, but we are complacent. And that's really why I wrote this book, Food Fix, so we can start to learn about this, think about it, and start to take action. So if we refocused our agricultural system and our national and global food policies on the production of foods that support human health, that also restore natural capital, right, the health of the soil, water, air, and an agricultural system that draws down carbon out of the environment,

that limits the fossil fuel use, et cetera, we would go a long way toward reducing the economic, social, and human burden of chronic disease and improving the health of our soil, water, and climate. Now, we ought to start thinking about this pretty soon because not only are we getting sicker, but for the first time in human history in America, our life expectancy has gone down three years in a row, which is like, what? Children born today are expected to live shorter, sicker lives than their parents. The average child born today is going to live five fewer years than their parents. And if they're poor or socially disadvantaged, they're going to live 10 to 20 fewer years than their parents. One in three children born today is

going to have type 2 diabetes. Now, these trends have been going on and on over every year getting worse. And this frightens me because unless we start to figure this out, we're going to be in trouble. Yes, there are big causes. The opioid epidemic is an issue, 70,000 deaths a year. And that number is real and the suffering is real, but that number pales in comparison to the 700,000 deaths we see every year from lifestyle diet-related cardiovascular disease alone. So maybe we should have a national emergency to deal with diet-related disease, not just the opioid epidemic. Now, I always get asked, what should I eat? What's the best diet for me? And I've done a lot of thinking about this. I've been studying nutrition for 40 years. I've treated tens of thousands of patients using food as medicine, done millions of lab tests looking at

so many data points about nutrition and metabolic health. So while I'm not a researcher, I do have a good sense of what's going on in the space and what the science says and what it doesn't say, and more importantly, how people respond and how variable the population is. But what I can tell you is this. There are certain foundational principles that I think everybody will agree on. It constitutes a healthy diet that allows for great flexibility,

that allows for you to be vegan if you choose or eat meat if you choose, but do it in a way that's good for you, good for the planet, good for the animals, and good for everything else that's connected to our food system. And that's the beauty of Food Fix. If we fix one problem, we fix all the problems. If we grow and produce and make and eat the right food, it will solve our climate crisis. It will solve our environmental crisis. It'll solve our chronic

disease crisis. It'll solve our kids' poor academic performance. It'll solve behavioral issues. It'll solve even lots of poverty and violence and social injustice. It's going to be a win-win-win-win-win for everything by simply understanding that there are certain principles that if we all followed in terms of how we grow, process, produce, and eat our food, we're going to be in way better shape. So I've written a lot about these ideas. I've written about them in Food, What the Heck Should I Eat? and Food, What the Heck Should I Cook?, which is what you should cook. But I just want to sort of summarize these principles. I jokingly call them the vegan diet, which lasts a little bit at the fanaticism of paleo and vegan and all the diet wars and all

the diet camps. So there's a lot of confusion out there, but there are some basic simple principles that I think everybody would agree on that I jokingly call the pecan diet. It's basically, you know, not exactly paleo vegan, but it's just making fun of it, right? So the first principle is we should eat mostly whole plants, Not plants, whole plants, right? Because a Twinkie is a plant food, right? Coca-Cola is a plant-based diet. Chips are a plant-based diet. That's not exactly what I think most people have in mind.

There's no argument that everybody should be eating a plant-rich diet, not necessarily plant-based. I mean, French fries, Coke, Twinkies, Lucky Charms, those are all plant-based, right? So I think we should actually have at least five, but probably more like 15 servings or seven, eight cups of fruits and veggies a day. And that's mostly veggies and ideally mostly non-starchy veggies, but that depends on your

metabolism, your activity level and so forth. Eat fruit. Now, fruit should not be fruit and vegetables. It should be vegetables and fruit. If you're very overweight or diabetic or have insulin resistance or a fatty liver a lot of fruit may not be the best thing for you, especially liquid fruit. I mean fruit juice that should never be on the menu but whole fruits can be fine as part of a healthy meal. Stick with the lower glycemic foods. The next principle

almost everybody agrees on is eat foods with lots of healthy fats. Things like nuts and seeds and avocados, extra virgin olive oil, avocado oil, even virgin coconut oil, omega-3 fats from fish. Some debate whether you should have saturated fat or not from coconut oil or from animals, but if you include saturated fat as part of your overall diet, you're going to be fine. 100% grass-fed, grass-finished, sustainably raised meat, grass-fed butter, ghee, those are all fine. With that said, some people are sensitive to saturated fats and may not be advised to include them in their diet. But for most of us, we can tolerate it.

By the way, olive oil is 20% saturated fat, and that's been proven to reduce heart disease and have so many other health benefits. Next, eat lots of nuts and seeds. They've been universally shown to prevent disease. If you're eating animal products, and here's the key, you want to eat animal products that are better for you, better for the animals, and better for the environment and the climate. You can actually eat animal foods as part of a system called regenerative agriculture, which helps to draw down carbon out of the environment,

restore ecosystems, preserve water, reduce the need for chemical inputs, and essentially produce more food that tastes better, that's better for you, that's more humane to the animals, without having any environmental damage. In the resource guide at foodfixbook.com, you can find lots of resources on how to find these regeneratively raised products or food that's grown sustainably in your local area. If you're going to eat fish, eat ones that aren't over harvested over fish that are sustainably farmed or harvested that have low levels of mercury and toxins. So small fish, I call them the smash fish, salmon, mackerel, herring, anchovies, and sardines. Those

are all great. I love them. You might not like them, but I love them. If you're going to eat grains, eat whole grains, not processed grains. Even whole wheat flour raises your blood sugar more than table sugar. I just want to make a quick comment about wheat. Now, gluten can be tolerated by some people, but I would prefer you eat heirloom gluten. That might be a little bit better tolerated because the new hybrid strain of wheat has a number of problems, including number one, it contains amylopectin A, a super starch that raises your blood sugar more than table sugar. Two, it has much more gluten proteins or gliadin proteins because of how they breed the plant together. Three, it's sprayed with glyphosate at harvest, which means the residues of glyphosate are

roundup, which is toxic to your gut bacteria, may cause cancer, and has long-term epigenetic effects based on the research, is in your bread. And four, it's preserved with something called calcium propionate, which in placebo-controlled crossover trials has caused kids to be irritable, restless, and have trouble focusing and sleeping, and has been linked to things like ADD and autism. So unless you're eating heirloom wheat berries or farro or something like that, I would probably stay away from wheat most of the time unless it's a very special kind. Try spelt, try chiticale, try kemet, other forms of wheat-related products if you're not sensitive to gluten. Beans are also great, but again, you want to make sure you cook them properly

and stay away from the super starchy ones that can add more starch than you need. Think of sugar as a recreational drug. Some is fine, too much is not fine. Don't drink your sugar calories, probably the most important diet advice you'll ever get. Also stay away from refined oils. They're unstable, easily oxidized. They're processed with heat and toxic solvents. They can be inflammatory.

Stick with whole food fats in their original form, right? Just like flour, stick with the whole grain, stick with the whole fat. Dairy can be fine, but stick with sheep and goat traditional dairy may have issues because of the amount of hormones antibiotics used the type of casing in there tends to cause more lactose intolerance which affects 75% of the population also when you can try to stay away from pesticides herbicides antibiotics food out as hormones GMO foods lots of issues there so So I think nobody wants to say, well, let me add some more pesticides to my salad, right? I think we just need to be clear that these are not adding

anything to us and actually are likely to be harming us. And we can be more judicious about what we're eating. Next, when you're eating, eat for you and the planet. So the good news is that eating well for you is also good for the planet in terms of eating whole foods, foods that are raised organically and regeneratively, foods that help to draw down carbon out of the environment, reverse climate change, reduce the use of pesticides, fertilizers, herbicides, save trillions in health care costs. I mean, it's kind of a win-win-win. If you want to get more detail, you can check out the book Food Fix.

You can look at my previous books, Food, What the Heck Should I Eat? and Food, What the Heck Should I Cook? to get more information about exactly how to do this. But it's a set of principles that I think it would be difficult to refute by anybody. Although there's controversy on both sides, I think this is a balanced, sane approach to eating. It's inclusive, not exclusive, but that's focused on quality, quality for you, quality for the planet, quality for the animals. And lastly, I just want to talk about some amazing initiatives that are helping solve this problem. You know, it's been clear that if we provide nutritious foods through Medicaid and Medicare patients, that actually their healthcare costs are going

to go down. There's initiatives like the MANA group, the Metropolitan Neighborhood Nutrition Alliance in Philadelphia that delivered healthy meals to people with diabetes, heart disease, and cancer, and other chronic illnesses. And over 12 months, the patients in the nutrition meal group visited the hospital half as often and stayed 37% less time. And their healthcare costs went down by 50% or $12,000 a month per patient. Now, that is a lot of money simply by giving them some pretty inexpensive medicine known as food. In California, through the Medi-Cal program,

which is their Medicaid program, they provided 1,000 sick patients, very sick patients, with food. And they found a 32% reduction in healthcare costs and a 63% reduction in healthcare costs and a 63% reduction in hospitalization. So a third of our healthcare costs in America would be like over a trillion dollars. I mean, that's a lot of money. So what are the things that can be done besides just the government paying for those things? Well, a lot of things. One, you can be an activist in

your community, change what you're eating in your home. Clean out your kitchen. Start a compost pile. Start buying food in a way that's good for you and good for the planet, which we just talked about. Be an agent of change in your community. You can start a faith-based wellness program like we did with the Daniel Plan with Rick Warren and his church where we got 15,000 people to lose a quarter million pounds in a year by helping each other support each other to live healthier lives. How about your workplace? You could be an activist in your workplace by trying to clean out all the junk and provide healthy food and maybe start a lunch group where you rotate who brings in healthy lunches. Super important things that we can do. We'll get into more of that. I've created a complete action guide that you can get online at foodfixbook.com that outlines many of these ideas of how to

actually change the food system personally and also how you can advocate for a better food system. There's also amazing other options that we can do that are healthcare innovation. How about we start paying for food as medicine through medical insurance and Medicare and Medicaid through all programs? The data is so clear that this works. Simply providing medically tailored meals to sick patients, reduce hospital nursing home admissions, and save $9,000 per person per year after giving free food. It's starting to happen. The new farm bill, which has problems, has a $25 million produce prescription program. In California, they're providing $6 million in supportive food prescriptions and medically

tailored meals for chronic disease. They can reduce healthcare costs by 55%, reduce hospital and long-term care admissions. I mean, the data is there. We talked about the Geisinger effort. Lots of things that can be done to actually change that. We can create a food savings account. Imagine like a healthcare savings account where you put in money that you can only buy healthy food. If you wanted to buy junk food, you'd have to use your own money. Also, we could fund research and change reimbursement to pay for functional medicine. You know, I've been advocating for functional medicine for almost 30 years now. It's a powerful way to deal with root causes, to use food as medicine. It's the primary therapy we use. We treat the body as a system,

and we can put patients and communities at the center of health healthcare. It's a very powerful model. If we want a healthy nation, we need to help people change their behavior and their environment. We could also integrate nutrition into healthcare. Imagine providing nutrition education for doctors in medical schools. Maybe we should change the licensing exams

to include nutrition, which would change what doctors have to study in medical schools and would change the curriculums. We could reimburse for nutrition visits for chronic disease. We can actually integrate nutrition into the electronic medical records. So if you don't document that you've talked about nutrition or focused on it, you won't get paid. So there's all sorts of options that we can use to help change healthcare, change our individual behavior, and even business innovations. There's been over $2.3 trillion annual investment in sustainable food and agriculture over the last years. This is an incredible amount of money that's using to

create a boom in investment in food, ag, and healthcare solutions that solve many of these problems. So these are all things that we can support and encourage, and I think will have a huge impact on changing our healthcare system, changing our food system. Yes, there's a lot to do, and yes, the problem is overwhelming. But there are fixes and there are solutions. And that's why I wrote Food Fix, How to Save Our Health, Our Economy, Our Communities and Our Planet, one bite at a time. You can get on Amazon or anywhere you get your books. I would encourage you to go to foodfixbook.com. That's foodfixbook.com to get extra resources. You can watch videos that I've created to help you learn how to do this as well as a complete action guide

on how to implement changes in your life and become politically active to make the changes we need in policy. I hope you've enjoyed this little mini-sode on my new book, Food Fix, how to save our health, our economy, our communities, and our planet one bite at a time. Stay tuned for next week

when I'll talk about another aspect of our food system and how to fix it on The Doctor's Pharmacy. And if you love this podcast, please share with your friends and family on social media. Leave a comment. We'd love to hear from you. Subscribe wherever you hear podcasts. And we'll see you next week on The Doctor's Pharmacy.