The Joe Rogan Experience - #842 - Chris Kresser

Episode Date: September 5, 2016

Chris Kresser is a health detective specializing in investigative medicine, blogger, podcaster, teacher and a Paleo diet and lifestyle enthusiast.

No? Three, two, one. I always wonder what you base your countdown on, Jamie. You got two things going. Is it an accurate countdown or are you just roughly guessing? It's like a five count because we have a connection to the thing and then the thing and the thing. Okay. Well, we're live. Chris, what's up? Good to be here. Thanks for doing this, man. My pleasure. We were just talking about the term paleo. Like I put up that we're going to, you know, talk about nutrition and diet and all that good stuff. And then somebody went to your page and it says, you know,

paleo and lifestyle expert. As soon as you have that word paleo, people go, fuck serious baggage it's true i mean every day i think about oh i kind of wish i never would have used this word you know yeah well it's mark sisson went with primal yeah he uses that primal blueprint yeah you know that's his sort of yeah distinction of it i like that i mean they're both just words is what it really comes down to. Yeah. And I thought about, I wrote a book that has the word paleo in it. And I thought about even before I published the book, I was thinking, you know, what I'm talking about is not really what people mean when they say paleo. It's a lot more inclusive and a lot less dogmatic. And if I use this word, there's going to be pros and cons. The pro is

people recognize it. It's one word that points at a whole way of thinking. I could have called it the nutrient-dense ancestral nutrition book, but that's not too catchy. There have been like five people that read it. But on the other hand, paleo has a ton of baggage, as you said. People get a certain idea when they hear that word. And for some, it's good. For others, it's kind of neutral. They don't know anything about it. And then for still others, it's like instant turn off. And why should we be emulating our paleo ancestors' lifestyles? They all died when they were 30. This is stupid. Right. You know, why should we do this? So it's a totally loaded term. I think we just need to get past it as, as, uh, you know, an idea or a term and look at what it's

really pointing at and evaluate it on that basis. Yeah. I think that makes a lot of sense. And also there was the issue with the term paleolithic, like using the term Paleo. And then there were some articles written about the actual diet of the Paleolithic people where they ate everything they got a hold of. And if they got grains, they ate a ton of grains. Yeah, absolutely. So, I mean, we know they weren't eating cheese doodles and drinking Big Gulps, right? So it's kind of easier to talk about Paleo in terms of what it didn't include. Right. So it didn't include processed and refined bread, flour, pizza, chicken dishes, which are primarily fried chicken nuggets,

forgetting the other two, but it's all crap. That's the primary foods of America. Those are the six primary foods of Americans. It's just completely nutrient-depleted junk. So we can all agree that our Paleolithic ancestors weren't eating those foods. Yeah. And then we know it's pretty clear that they were eating a lot of meat. Well, I'm sure we'll talk about that meat and fish, wild fruits and vegetables, not the domesticated varieties that we're eating today, but wild fruits and vegetables, nuts and seeds,

and some starchy plants. So so, so those are the two extremes if we bracket it. And then things like grains and legumes were more of a question mark. Like there's some recent evidence that shows that legume consumption was probably pretty more common than we thought amongst our paleolithic ancestors. They came later onto the scene, but if they were there, they probably ate them. Is that based on geography, like where legumes are present? Exactly, and what other food sources were available. It's pretty clear that they weren't the first option.

You know, if they were able to slaughter an animal, they would have done that and eaten the organs and the brain and probably thrown the muscle meat to the dogs. Really? Yeah. Yeah, we have it backwards. I mean, when you look at traditional hunter-gatherers and the way they eat animals, they go just like wild animals do. When a wild animal kills another animal,

it goes straight for the organs. Right. And that's because the organs are way more nutrient-dense than the muscle meats. And so traditional peoples, they knew the same thing even without having access to science and knowing even what a nutrient was. They just over generations figured out that eating the liver and the kidneys and the spleen and the brain was going to give them more energy, make them feel better, make them more fertile than eating the muscle meats.

But did they eat the muscle meats at all? I mean, it seems to me that they probably did. They're probably hungry. Yeah, they used every part of the animal. But it was clear that the organs were the favored thing to eat. And how do we know this? Just anthropological studies of hunter-gatherers, contemporary hunter-gatherers, you know, in the 60s, 70s, 80s. There aren't many extant hunter-gatherer groups that we can even study now because they've you know they've all been basically assimilated um but you know like the hadza hunter-gatherers in in africa and there are some groups that are still living a lifestyle that's relatively close to what they were living

for the last 10 000 years and we can learn a lot by studying those groups and that's a pretty common theme in all these traditional peoples is they they focused on eating the organ meats you know second would be probably meat and other animal products in terms of nutrient density they ate a much broader variety of plant species than we eat like they you know across the world most people eat you know four to eight plant species in their diet. Traditional hunter-gatherer groups, it was over 100. Wow.

So just whatever was edible. Huge diversity of plants. And that, of course, increased the nutrient density, increased the fiber that they were eating, which we now know feeds your beneficial gut bacteria, which has all kinds of benefits for health. And again, they weren't eating the foods that we are now eating way more than we're eating anything else. And when I say we, I mean just Americans or people living in the industrialized world in general. And that's a problem because of this concept of a species-appropriate diet. We know that all organisms evolve in a certain environment, and they're adapted to survive in that environment.

And when their diet or lifestyle gets too far from what they evolved for, this mismatch occurs, and that mismatch is really responsible for all modern disease. Yeah, that is something that I thought was really interesting about reading some of your work and some of your articles, that you had it sort of narrowed down to, I believe, the eight different factors that contribute to ill health that are a lot of times ignored when diseases are, when someone gets diagnosed with an illness, almost immediately there's a drug prescribed to treat the illness,

but there's not like sort of backing up of the process to find out, okay, how did you get to this position? Like what is your diet like? Are you getting enough sleep? What kind of stress are you under? Is your body, um, exposed to toxins on a regular basis? Like, do you work with paint? You know what I mean? Are you, are you near something that's really bad for you to breathe? Yeah. Yeah. I mean, an algae I like to use is you have a rock in your shoe and it's making your foot hurt. You could take Advil, right? And it's going to, you'll

probably feel less pain, but you could also just take your shoe off and dump out the rock. That would be a better idea, right? I think we can all agree on that. And our medical system is the equivalent of taking Advil when you have that rock in your shoe. If you have high blood pressure, you go to the doctor, you'll get a medication to lower it. If you have high cholesterol, you'll be prescribed a statin. And those can be effective at bringing those numbers down, but there's rarely any investigation into what's causing that symptom in the first place. And, you know, the problem with that is if you take the high blood pressure medication, it lowers your blood pressure, but then you have no libido.

And so what's the solution there? Another drug that increases your libido, you get Viagra, but then Viagra, you know, causes some other side effect. And then you get prescribed another drug to deal with that side effect. And then by the time you're 65 or 70, you're taking seven or eight medications. And the statistics actually bear this out. You know, most people at that age are taking two handfuls of pills just to, you know, to, uh, to be able to get by. And that's, that's really not, um, the way that human beings evolved and are designed for. It's also, it becomes a problem because there's a lot of money being made on selling those things. Absolutely. And the pharmaceutical industry is this gigantic monster of a business where they're just making billions and billions of dollars.

And there's so much momentum when you have a big industry like that. Absolutely. And they realized a while back that the big money in drugs is not in treating sick people. It's in treating healthy people because there are way more healthy people than there are sick people. And so once you get done with making drugs to treat diseases, you need to start making drugs to give to people who are fundamentally healthy, but maybe have like some one lab marker that's out of range. So take statin drugs, for example. You know, there's only a certain number of people that have already had heart attacks and are in danger of, you know, high risk of having another heart attack. So if for

statin drug sales to grow, they need to expand beyond that population and start, you know, prescribing them to people who aren't necessarily at high risk for heart disease, but maybe have slightly high cholesterol. And that's where the real money is made. Wow. So people that don't have really health consequences of this, like if you have high cholesterol. Now, high cholesterol is a lot of times associated with diet. Yeah. But the reality of cholesterol and like cholesterol rich diets and blood lipids is that it doesn't really move

the needle, does it? Yeah. It's so much more complex than that. What is the cause of like, if a person has high cholesterol, what are the potential causes? So diet is definitely one. Genetics or another, just, you know, certain genetic polymorphisms that make you more susceptible to having high cholesterol. But there are a number of causes that are lesser known. So poor thyroid function is one cause because thyroid hormone, not frank, full-on hypothyroidism, but just a little bit of a problem with thyroid, your cholesterol can be high. And in fact, back in the 80s or 70s, before statins became a bigger part of the treatment of high cholesterol, doctors used to use low-dose of thyroid hormone to treat high cholesterol. So they

knew this at one time. Disrupted gut microbiome and leaky gut, which I know you've talked about before on the show with other guests. LDL is actually an antimicrobial substance. So the liver will make more LDL particles if there's endotoxins getting into the bloodstream from the gut, infections can raise cholesterol, LDL, and toxins can do that too. So there's studies showing mercury toxicity, for example, can raise cholesterol. So these are all the potential underlying causes of high cholesterol. So if someone comes to see me and they have that problem, I'm going to test for all of have that problem, I'm going to test for all of those things and I'm going to address those first. And then we see what happens. And if their lipids normalize after that, great. You know, we've done our work and then they avoid taking

a drug that they never needed to take in the first place. If we retest and they're still, and their levels are still high, then we have a bigger conversation about what the actual risk is, given their level, their age, their sex, their family history, the absence or presence of other risk factors like high blood pressure and inflammation. So it's really complex. And there's this idea that there's just an arbitrary number for total cholesterol, and if you're higher than that, you need to take a statin, and if you're lower than that, you don't, is, I can't think of a good comparison right now, but it's ridiculously oversimplified. And it also has some effect, or your amount of exercise and your overall amount of what you put your body through as far as like stress, exercise, activity.

That has some sort of an effect on it as well, right? Absolutely. Cholesterol is a repair substance too. So if there's any kind of damage, endothelial damage in the arteries, the lining of the arteries, cholesterol can be moved to that site to repair the damage. Lifestyle choices definitely play a role. So, you know, we need, I think getting back to your, you know, to the original point here, we need to be thinking more holistically about what causes disease and how to treat it instead of just using band-aid approaches that suppress symptoms. I mean, we don't really have health care. We have disease management. And that's a fundamental difference that we need

to understand. Like, if you think of disease as a spectrum where, you know, the far end is death and here is perfect health, very rarely do people go from perfect health straight to death. I mean, that happens in trauma, accidents, and things like that. But usually we progress along that spectrum. And our conventional medical system is designed to intervene at the far end of that spectrum, when we're already kind of past the point of no return. We know, we have these drugs that suppress symptoms. We have pretty amazing trauma care. Like if I get hit by a bus, I want to go to the hospital, you know. We're starting to be able to

restore sight to the blind and do these incredible things, but they're all at that far end of the spectrum. Conventional medicine is really lousy at preventing disease in the first place or treating it at this end of the spectrum when it's closer to health. And it's really bad at promoting health. In fact, in most medical school textbooks, there's not even a definition of health. It's just basically the absence of disease. But I think we can do better than that. Yeah, it just seems logical.

Yeah, it just seems logical. I mean, it seems that that should be an approach that everyone should consider when you're looking at the broad spectrum of illnesses and diseases and injuries and all those different factors that are involved in making someone ill, that this is what you're saying seems so common sense, but it's not common at all. Not common at all. It does seem common sense to me. And I think part of the problem, I mean, you hinted at it before with Big Pharma. It's like there's little incentive for Big Pharma to promote this kind of approach. Why? What's their interest in doing that? I mean, it means less sales for them. They're for-profit corporations that are publicly owned and it's in their best interest of the shareholders to do things that grow the company and grow the business, right? Unlimited growth, really. That's how it is. That's how our system is. And, you know, that's a whole other discussion, but it's problematic when it comes to healthcare because,

you know, the way it really should work is if you go into your doctor and you have high cholesterol, high blood pressure, your doctor sits down and asks you a whole bunch of questions about what you're eating, how you're living, are you sleeping, are you exercising, are you taking care of yourself, are you managing your stress? And then they do a whole bunch of testing. They don't just test your blood pressure. They don't just test your cholesterol. They test your stress. And then they do a whole bunch of testing. They don't just test your blood pressure. They don't just test your cholesterol. They test your gut. They test your HPA axis, which is what governs your whole stress response. What is HPA? Hypothalamic Pituitary Adrenal Axis. So it's this, the brain, basically the connection between the brain and the adrenal glands, and it governs our stress response. So there are ways that we can test it to see how you're being affected by stress.

So if you're under a lot of stress, that's causing hormonal changes in your body. It can affect every aspect of your health. We can test for this. So they would do a lot of testing up front, which would be more expensive initially, but down the line it would save thousands or hundreds of thousands of dollars per patient. So let's take someone with full-fledged type 2 diabetes. Depending on the estimate that I've seen, it can cost anywhere from $60,000 to $80,000 to $400,000 to care for that patient over their lifetime to the insurance company, because insurance is paying

for a lot of these procedures. They develop, let's say, retinopathy later. They go blind. They, you know, they require multiple operations and surgeries. They're taking expensive drugs. All of this stuff adds up. But let's say we could have spent $1,500 right off the bat before they even developed type 2 diabetes, to identify what was happening and catch it before it happened and intervene then, yeah, you spend a little bit more up front, but you end up saving tens if not hundreds of thousands of dollars over the lifetime of the patient. So I think eventually the insurance companies are going to realize this because they're also for-profit businesses and they're interested ultimately in things that can save money.

They just don't yet see functional medicine, which is what we're talking about right here, as something that could potentially save them a lot of money. They see it as something that they have to spend money on because the testing is more expensive up front, but they're not looking at the long-term game. because the testing is more expensive up front, but they're not looking at the long-term game. I wonder if pharmaceutical companies are just going to buy up the insurance companies and use it like as a write-off. A cynical person might have that thought. I might be cynical. I mean, if I was a pharmaceutical company, I saw the writing on the wall like,

hey, people are having way more access to information about health than ever before, and they're going to start to make these healthy choices. And we're kind of, fuck, guys. Listen, what we've got to do is we've got to get in there early. Stranger things have happened, Joe. There's a lot of problems with this in terms of, like, doctors. When you're a doctor, you have a line of patients waiting to get into your office. And you're a doctor.

You have a line of patients waiting to get into your office. And you have a standard model of treatment that you've been sort of practicing for a long time. So to deviate from this path and to say, hey, you know, this whole rock in the shoe analogy that you brought up, which is brilliant. It's a perfect way to describe it. This all makes sense and it's logical and everything like that. But, you know, hey, insurance is not going to cover all these different tests. We have a giant issue also in getting people to be proactive, to actually do something. How many people do we know, I know a bunch, that are fat, that talk about being fat, that have poor diets, that drink too much and eat too much sugar

and are constantly eating crap and not exercising? They're 100% intellectually aware of this. And they don't do a goddamn thing about and not exercising, they're 100% intellectually aware of this and they don't do a goddamn thing about it. Yeah, you're right. It's a systemic problem. So if we break it down, you know, on the doctor care provider side and the patient side. So the care provider side, I mean, they're as much victims as we are, as patients are too, to this whole system that's been set up. Because as you pointed out, like the way the system works,

most doctors who are working in an HMO type of setting have like seven to 10 minutes spent with the patient. That's so crazy. That's not enough time to have the kind of conversation that you need to have, even to get beyond saying hello and writing a prescription, which is basically what happens in most of those encounters. And then you also mentioned the standard of care. So they're legally required to take certain actions in certain circumstances and their medical license and their whole career could be at risk if they don't do that. So even if they question, for example,

prescribing statins to a patient who has a total cholesterol of 240, but no other risk factors, if they don't do that, then they could actually lose their job. And so I'm not being critical of individual doctors here. I'm criticizing the whole system that we've created. I know many doctors. I train doctors, and I know many doctors, and I can say that most of them are aware that the way that we're doing things is not working. And they want to change it as much as anybody else, but they feel constrained by the system. And then the other problem is, you know, us as individuals, like the level of responsibility for our own health that we take. And I think, you know, we all ultimately are responsible. So let me just say that. But it's also true that

we're influenced by the system that we are a part of. And so, you know, you get this whole culture, which is basically oriented around disease management and suppressing symptoms with drugs, that's what patients come to expect. And so I've heard from many doctors, and there have actually been studies on this, that patients will go in to the doctor and they'll request a drug. And they won't be satisfied unless they leave with a prescription for that drug, whether it's indicated for them or not. And this is because we're one of only two countries in the world that has direct-to-consumer drug advertising. unless they leave with a prescription for that drug, whether it's indicated for them or not. And this is because we're one of only two countries in the world that has direct-to-consumer drug advertising. The U.S. and New Zealand are the only two countries in the whole world that allow ads in magazines that are targeted towards consumers for drugs.

And the risk in doing this is exactly what we're talking about now. You get someone who's seen a drug ad in a magazine. They're like, I need that drug. They go into the doctor. They ask for it. The doctor knows it's not right for them, but the patient's not going to be satisfied unless they get that prescription. So the doctor caves and gives them that prescription. I did not know we were one of two countries in the whole world.

I thought New Zealand was a little more on the ball. It's surprising in a way that New Zealand is the other one. I'm disappointed in you, New Zealand, that you're as stupid as we are. But, yeah, that's a giant problem. That advertising model. Well, advertising is a giant problem, period, for people because we're so susceptible to influence. And they've shown this with food in particular that, you know, there's big pharma and there's big food. And big food, capital B, capital F, is this whole industrial food production system that is invested in selling us crap.

And they are well aware of how, you know, they study how to do this. So they have food scientists on staff that study the palatability and reward value of food this is like technical stuff like how food stimulates the the reward centers in our brain and that that you know pringles ad hope bet you can't just eat one they will win that bet because they have scientists on staff that have engineered that food to make sure that you do eat more than just one because they study things like mouthfeel and all of the different things that go into stimulating the reward centers in our brain to make us eat more than we should. And so we are being manipulated.

And we have a responsibility to see that and to get beyond it. I'm not saying, it's not a cop-out that, you know, people aren't responsible for their actions, but it's, you know, there's more to it. We're in this environment where we're being consistently manipulated every day. It is very sneaky, the Pringles things in particular. Absolutely. I mean, they're right. How dare you put that out there? Think about like, if you had a plate and there's a, you have a baked potato with no salt or butter on one plate, and then you've got another plate and it's potato, it's Pringles. What do you think you're going to eat more of? I mean, it's just,

these are hardwired evolutionary mechanisms. We were, we're, We're hardwired to seek out novelty, variety, because it would ensure in a pre-industrial food environment, that kind of hardwiring would actually be a selective advantage, meaning it would help us survive in a paleolithic type of environment because we would seek out foods that had a variety of flavors. Usually different flavors means different kinds of nutrients. So someone who had that kind of programming would be more likely to survive. But when you take that evolutionary programming that was designed

when we were living in a Paleolithic type of an environment, and you transfer that into this modern environment that we live in, where you've got a 7-Eleven on every corner with Doritos and Big Gulps and candy and all this stuff. It's a total unmitigated disaster. Well, that environment, the environment of like a 7-Eleven where you go in there and there's just zero healthy choices. And all of it is sugar, drinks, and these fucked up snacks that have no nutrients in them. It's such a bizarre commonplace that you can just pull into any one of those things. There's so many of them, and they're just overwhelmed with unhealthy choices.

All over the world, too, now. We've exported our crap to all of these other countries in the world. Pretty much any country. I mean, in my 20s, I traveled all over the world surfing. And I was shocked at, you know, I'd be in this really remote place in Indonesia. And I'd see like a Coca-Cola barge going by from island to island in this little archipelago where there was nothing, you know, just huts on every island. But then you come up to this little hut and there'd be like a thing of Coca-Cola bottles, you know, crazy. And we've managed to export this everywhere. And it's just, you know, people, it's hard to go against evolutionary programming because it's real, it's unconscious. It's below

the cognitive center of our brain where we can rationally think about it. I mean, you mentioned before people who are overweight but don't make healthy choices. That's not because they don't intellectually understand that they need to make healthy choices. It's that they're fighting against this deeply hardwired programming that is totally incompatible with the modern food environment that we have. And for whatever reason, some people are more successful at getting past that than others. About being able to detach, intellectually detach from the instincts where you know for a fact that all these things are definitely bad for you, even though there's a compelling desire to take them in, you have this ability to step back.

Yeah. That's sort of a learned thing. It's a learned thing. You know, it's not a natural thing. I mean, what's more natural is to see something that you crave and to eat and to eat it or drink it. I mean, that, that is a natural animal human experience. What's less natural is to see that, feel it, and then have a thought that says, no, this is actually not going to be good for me. And so I'm going to make a different choice. I mean, that, that's a, that's, uh, and, and I don't think it's

the same. I don't think we even experience those cravings in the same way. Like there are, I mean, for example, if someone has a really screwed up gut and they've got a lot of bad bacteria or they have fungal overgrowth or something going on in there, those bacteria we now know and yeast can produce chemicals that actually affect our brain chemistry. So that someone who's got a disrupted gut microbiome might experience those cravings way more strongly than I do. And so it's harder for them to intervene and stop that because it's almost like they have an alien presence in their body that is craving these foods. And it's really hard to overcome that. I'm glad you brought that up because that was one of the things I was going to bring up next. The idea that your gut biome actually controls your cravings and controls your, your desires for things.

And also when you cure that up or when you, you heal it and you start taking in healthy probiotics, your desires for different foods sort of emerge. Uh, for me over the last few years, like, uh, say three years plus,

I've really gotten into, uh, probiotics, got really heavily into drinking kombucha on a daily basis. And then I started eating a lot of kimchi and a lot of fermented cabbage. And then it became kefir and a lot of other different things. And now I take an Onnit Total Gut Health Package with every food that I eat, every time I eat something.

And I think that really concentrating on probiotics has boosted my immune system. I'm very rarely sick. And if I'm sick, even though I travel so much, if I'm sick it's for a very short amount of time. And then I'm very rarely sick. And if I'm sick, even though I travel so much, if I'm sick, it's for a very short amount of time. Right. And then, uh, I snap back pretty quickly. Yeah. And my desire for sugary foods is almost non-existent unless I'm drunk or, uh, I just want to indulge. Yeah. But like, I used to have this massive desire all the time to eat like a sandwich or eat a bowl of pasta or, and now I look at it and like, that's not even really food. Like it, my, my mind has sort of

like reached a tipping point. And then also my, my gut biome, I believe, I mean, I'm just guessing has changed where like, if someone is a piece of cake laying around, I don't look at that piece of cake and go, God, I got to stuff that in my face. I look at it and go, that is a lot of problems. That's a lot of sugar. That's a lot of not good for you. I'm going to, it's going to give me some mouth pleasure and then I'm going to feel fucking terrible in about an hour. Right. Yeah. No, I think that's all, all true. All supported by the research. There's a lot of research now on the gut brain axis, which recognizes the bi-directional connection between the gut and the brain.

So in other words, the health of our gut and our gut microbiome directly influences brain chemistry. Likewise, our brain chemistry directly influences our gut. So it can work in both directions. Wow. So if you're under severe stress, for example, I think most people recognize the phrase, there's butterflies in my stomach before you go on stage and perform. You feel that.

I don't know if you experience that now since you perform so much. Do you still get that? If something's really important, like I'm going to do a comedy special that I'm going to film or something like that, I get a little nervous. Most of the time, it's a heightened sense of you know like okay here we go right it's not right but when you're about to do something that's scary shit your pants right there's another less refined uh example of the gut brain connection so it's been in our lexicon for a long time so i think like on a popular basis we most people are like duh yeah i know my brain's connected to my gut. But it's

only been in the last, you know, 20, 30 years that the research has really come around to, you know, clarifying what those relationships are. So we know that changes in the gut microbiome can affect our brain chemistry. And in fact, the prevailing theory now of what actually causes depression is called the inflammatory cytokine model of depression. And so it's not this thing where your serotonin levels are different and that's why you're depressed. It's that you have inflammation primarily in the gut and the inflammatory cytokines travel from your gut through the bloodstream up into your brain across the blood-brain barrier, and they suppress the activity in the frontal cortex, which basically causes the symptoms of depression. So this is totally mainstream, not fringe science, where they recognize that depression may be caused, and anxiety may be caused by inflammation in the gut.

So this is where the direction of science has been heading. And then, you know, it stands to reason that if you take probiotics, you eat fermented foods, you eat fermentable fibers that grow, help feed the beneficial bacteria that are already in your gut, you can influence that brain chemistry. And so not only change your mood, you know, potentially heal depression and anxiety, and then even, you know, cognitive behavioral disorders, ADHD and things like that. But you could also profoundly change the cravings of food that you have because if pathogenic bacteria feed on sugar. So you may not just be dealing with your own cravings when you're craving sugar. You're dealing with the cravings of those pathogenic bacteria.

We know there are examples in nature of bacteria and microorganisms changing the behavior of their host in order to propagate their own survival. So I'm probably going to butcher it. I don't remember the exact species, but it's a parasite that gets into a particular insect. It's an aquatic worm. There's that. And there's one, a land one that causes it to crawl up to the top of a blade of grass where it can then be eaten by the ultimate host that that parasite wants to get into. Yeah. And I'm not remembering the exact species, but there's a, you know, biologists know that microorganisms can, can change our, our behavior. And, and we like to think that we're not animals, but we're subject to these same influences. We're special. We've evolved beyond being animals. It's cute. I mean, it's nice to think and it's nice to separate ourselves because we're conscious and we're aware of our actions.

And those are all absolutely correct. But we're just a heightened state of animal life. Absolutely. At the end of the day, we're subject to the same influences, right? I think so. And I think it causes a lot of harm to see ourselves as separate. I think you're right. The term leaky gut, what does that mean? When people hear leaky gut, they've heard it a bunch of times. It's something that gets talked about a lot when people deal with, you know, in quote unquote, gut health or probiotics. Like what does leaky gut mean? So this is an interesting example of what happens in research over time.

So, you know, 20 or 30 years ago, if you were at like a medical conference and you used the term leaky gut, you would have been laughed out of the room. You know, it was really the province of alternative medicine providers and quacks. providers and quacks. And yet today, if you go search on PubMed, you know, the major clearinghouse of medical studies, you can find thousands and thousands of articles on leaky gut. It will be actually talked about with the term intestinal permeability. And so what this means is, it's kind of interesting to think about this, but your intestine is basically a hollow tube that goes from your mouth to your anus, and anything inside the intestine is technically outside of the body. Really? It's weird to think of that way.

But if you have a tube that's going all the way through your body, then anything that's inside that tube is not actually inside your body. Whoa. Whoa. Yeah. And so the tube's job is to decide what gets inside of the body and what stays out. Because anything that doesn't get absorbed just gets eliminated as waste without ever getting into your body. And we couldn't survive if we didn't have this ability to discern friend from foe.

It's supposed to let nutrients that we need in but keep toxins and other wastes out. So that's one of the fundamental purposes of the gut is to be a barrier. Hence diarrhea when you're not well. Exactly. Clear that stuff out. Let's go. Everybody out. Everybody that stuff out. Your body's like, let's go. Everybody out. Everybody out right away.

So the gut is primarily a barrier. It's a barrier system. And when that's working well, it opens and closes appropriately. And so, oh, nutrient, okay, open, let that in. Toxin waste, close, don't let that in. You know, toxin waste closed, don't let that in. And so everyone's gut is permeable in an appropriate way, right, when it's working well. Because if it wasn't permeable, we would die.

We wouldn't be able to absorb nutrients. But the other side of that spectrum is if it stops being permeable at the right times and starts letting things in that shouldn't be in there in the first place, that's what's called leaky gut. You basically have an inability to keep out stuff that's not supposed to get into your body. And then like, so some examples would be large protein molecules. Typically, we digest protein into small peptides that our immune system doesn't recognize as foreign invaders and is able to use to grow muscle and do all the things that protein helps us to do. But if large protein molecules that have not been properly digested sneak into the bloodstream, our body sees those things as foreign presence and creates antibodies to attack them.

And that's why we develop food allergies or food intolerances. Another thing that gets through the gut that shouldn't is called endotoxins. So these are toxins produced by certain species of bacteria, things like lipopolysaccharide. And they can get through the gut barrier. And then our body produces antibodies to them and attacks them as if they're foreign invaders, which they are in that case. They shouldn't be in there in the first place. And all of this basically creates a systemic inflammatory response. So whether it's food antigens that are getting in there that shouldn't be, or whether

it's bacterial endotoxins that are getting in there that shouldn't be. Leaky gut leads to this chronic low-grade inflammation. And basically all modern diseases that kill us, like diabetes, heart disease, even some of the ones we've already talked about. Depression doesn't necessarily kill us, but all of the mental and behavioral diseases, kill us, but all of the mental and behavioral diseases, autoimmune disease, which now affects one in four women and one in six men, which is crazy given that they don't really exist in traditional hunter-gatherer societies. All of these are inflammatory conditions. So something that contributes to inflammation is going to significantly increase our risk of acquiring one of these diseases and then eventually dying from one of them. Now, when we say inflammation, that's another term that people hear a lot,

but I don't think they necessarily understand. It's along the lines of leaky gut. So, like, you did an awesome job clearing the leaky gut thing out. And for me, too, it solidified it. But inflammation, why is inflammation caused by sugars? Why is it caused by simple sugars and corn syrup and things on those lines? Too much simple carbohydrates. What is causing that?

So there was this great paper published a few years ago by a professor from New Zealand, actually. Ian Spreadbury, I think is his name. Forgive me if I'm not getting that right, Ian. But he distinguished between two different types of carbohydrates, acellular and cellular. Acellular meaning lacking cell membrane. And acellular carbs are carbs that have been heavily processed where they're natural cells that would be found in a plant, in a whole plant, like a start, like a sweet potato or, you know, a potato or something like that have been broken down in the processing. So you have white flour, for example, you know, originally came from a whole wheat plant that had its cells intact, but then it's been the seed or the kernel of the whole wheat has been removed and you just have the starch

with no cells anymore. And what that means is with cellular carbohydrates, our body has to really work to break those down. And the actual glucose, the carbohydrate itself is relatively inaccessible because we have to work so hard to digest it and get at it. If you think of an analogy like a nut, like a whole walnut, you have to do a lot to get to that. So it's going to be hard to overeat those in a kind of traditional setting because there's so much work involved at getting at it. Whereas if you have a bag of walnuts from Trader Joe's that have already been shelled and they're just sitting there salted, you can just pound a whole bunch of those. So with this acellular carbohydrate, it's basically the equivalent of removing the shells from the nuts and just making those carbohydrates super accessible, not only to us but to the bacteria in our gut and so his argument was that when we eat a lot

of processed and refined sugars that are highly accessible to us and also to our gut bacteria we basically create an imbalance in the gut where you have a proliferation of bad pathogenic bacteria that thrive on sugar and a reduction of good bacteria that we need to be healthy. And that imbalance then creates an inflammatory gut microbiota. And as I described before, those inflammatory cytokines that are produced in the gut, they can travel out from the gut and affect the whole body systemically. So, you know, 2,500 years ago, Hippocrates said all disease begins in the gut. He didn't know, you know, he didn't have any of this modern science that we have now that shows that this is true, but it turns out that he was right. That's fascinating that people have these ancient sayings like follow your heart, you know,

and then we found out like fairly recently within the last few decades that the heart is filled with neurons right and that you know there might actually be some sort of memory or thinking you know quote unquote going on in your heart and then having a sense of purpose is associated with greater longevity and better health which is also following your heart yeah it's very the very strange sort of sentiments that turned out to be, you know, like you think of them as just sort of old tales or old things that people say, old expressions. But they turned out to actually have some basis in fact almost instinctually. I think we're kind of recovering lost knowledge at this point in a lot of ways. But we're recovering it in a different way.

lost knowledge at this point in a lot of ways, but we're recovering it in a different way. Like we're using modern scientific tools to validate or clarify ancient wisdom that's been around for a long time. And I think they both have a place. And I personally think it's fascinating to learn what the mechanisms are that explain that wisdom and those sayings. But I think we can sometimes be too quick to dismiss that wisdom as being silly or stupid or non-scientific. Right. Yeah, I definitely think, well, I think it's very important that we today, in this day, have the tools to use science

to sort of explain unequivocally why these things are factors and why these things exist. And that we've proven in these studies, these are peer reviewed. Here we go. Here's the studies. It showed that, oh yeah, well, there's neurons in the heart. Oh yeah.

Well, that makes sense. You think that way. Oh, there's biome. There's a, there's actually like organisms. And I think the way you described it is great that there's like an alien living inside you that wants sugar. Cause it really kind of is that there's organisms in our body. Like I heard it explained once and I never forgot it, that there's more E. coli living inside your gut than there have ever been people ever. Right. Yeah. And there are more microorganisms in our gut than there are stars in the universe i think something crazy stuff

so that's where i step in um how's that possible doesn't make any sense the universe is infinite right well there is that i mean i think that was the the early conception they're not they maybe haven't read about the multiverse theories yeah because like someone who's like enormous like ralphie may he has more cells, right? So he's a bigger universe? How does that work? Well, what you said about science is really true. I mean, I love science. I spend most of my days interacting with science in some way.

And I think it's worth pointing out that there are some real problems with the way science is conducted today. And I think we run the risk of worshiping the randomized clinical trial at the expense of other kinds of knowledge that can be just as important or more important in certain ways. Well, one of the things that you brought up that I think is very important is who is funding some of these trials on pharmaceutical drugs and the efficacy of them and how they profit off of it and how many studies are sort of thrown out that don't fit the narrative. The file drawer phenomenon. Yeah. Yeah.

Explain that. Well, so two-thirds of medical research is funded by big pharma. And that makes, yeah, two-thirds. So, you know, this is just human nature. Upton Sinclair said it's difficult to get a man to understand something when his salary depends on him not understanding it. It's one of my favorite great quotes because it explains a lot, right? And so you can look at it just in terms of basic human nature. Like if you're a researcher, you're being funded by a pharmaceutical company, you know, you know, even if it's not conscious, there's a subconscious

thing there where you, you know, that if, if your results are negative and don't support the drug, you're less likely to get the next, you know, your next project funded. And you're a human being, you want to have a job, you want it, you want your work to be funded. I mean, that's, there's, it's really easy to understand, right? It's not like these are bad people who are all like in conspiracy to, to push drugs on us. I think most researchers are good, good people and trying to do the right thing. I think most researchers are good people and trying to do the right thing. But it's the way that the system is set up

that's the problem, where they need to depend on pharmaceutical companies for their funding. And it's really hard. You know, don't bite the hand that feeds you. It's just, it's a time, you know, the age-old saying, and there's a lot to that. Up until recently, I think there have been some recent changes here, but

researchers were not required or pharmaceutical companies were not required to publish negative results. So if they did a drug trial and the results didn't support the drug, it turned out that placebo was more effective or, you know, their drug had side effects that made it not usable, those studies just basically go into the file drawer. They wouldn't actually be published in a journal. And there's been a movement to change that to where, you know, if a study is conducted, it needs to be registered. And then no matter what the results are, they need to be published so that people have a chance to see not just the positive results that support the drug trials, but the ones that didn't. It'd be nice if that was retroactive. Right. But then there are other problems like

fraud. So there was a pretty big study published in JAMA a little while back by- Who JAMA is? Journal of American Medical Association, a very prominent, prestigious journal. And it was a guy named Charles Seifert. And he basically looked at the FDA monitoring of drug trials. So the FDA's job, one of their jobs, is to make sure that the trials being done to determine whether medication

is effective are done the way they should be. And that, you know, there's no falsification of patient data and that patients are being, their health is being protected adequately and there's no fraud going on. So what he found was that in a shocking number of cases where there was fraud, where the FDA actually did identify fraud and it was serious enough that they took action. In 96% of cases, the action that they took was not reported in any scientific journal. So let me give you a few examples. Like in one case, a researcher changed patient data to hide that the patient had pre-existing kidney and liver problems. And they gave this guy chemotherapy treatment and he died.

And the researcher ended up spending six years in jail. And that was never mentioned in the study that was based on that trial data that was later published. So that's one example. Another example. Why did they do that? What was the motivation? There's no, the motivation is to get the drug approved. Why would they hide the fact that this guy-

The FDA doesn't require companies, pharmaceutical companies to publish that data. And because they say in their language, and according to Seifert in this paper, it's more, essentially more important to the FDA to protect the commercial interests of these companies than it is to protect public health, even though this is an agency that is ostensibly there to protect public health. So there was this guy. So maybe I'm getting it wrong. He had preexisting liver disease? Liver and kidney issues and cancer. And the researcher falsified his data and covered up that this was known when he was given this chemotherapy drug. But why would they do that?

I just don't understand why they would cover up the fact that a guy was already sick. Like, wouldn't you think that there would be the opposite? Let me use another example, because I think this will help show what's happening here. So there was a Chinese site, you know, most drug trials, they take place at different sites. So they have multiple, you know, locations that are testing so that they can get data on different populations, not just in white Americans, also Chinese people. And so they do it at different centers. And so there was a trial for an anticoagulant drug, and they found that this Chinese center had falsified a whole bunch of patient data and changed the results. And if they took that Chinese center's data out of the equation, the drug would have failed. It wouldn't have been more effective than placebo.

But even though the FDA busted this group in China, the study that was published on that drug still included that data from the study in China. And even studies that were being published 18 months later still included that data in the original data set. So the FDA busted them. It was clear that they had falsified the data, and yet that data is still being included in the studies that doctors are relying on all over the world to make decisions about whether to prescribe these drugs. So there's fraud happening, whether it's from financial interests or just human error,

that's not actually being reported and translating into clinical decisions that doctors are making. So there are a lot of, and then the whole peer review process, you mentioned peer review too. There are a lot of, and then the whole peer review process, you mentioned peer review too. There was a pretty big study where a paper was submitted to BMJ, British Medical Journal, another big medical journal, with eight major errors. And not a single one of the 221 scientists that were asked to review the paper caught all of the errors. And only 30% recommended rejecting the paper. And this was even more problematic because half of those scientists were warned in advance, we're going to give you a paper that has a lot of errors. And the ones who

were warned didn't get any more of the errors than the scientists that weren't warned in advance. They broke them up into two groups. Is that just a lack of time to do the research? And I mean, people being overwhelmed by a workload? I think that's probably part of it. But it's not really an excuse. I don't know. I mean, it's just, it's a problem with peer review because it is a big part of the scientific method to have the results validated by somebody else or to review the work and make sure that it's sound. But what this paper indicated is that a lot of findings that we take to be true and valid might not actually be true and valid. And you may have heard about this. It actually made the news. There was a recent, the Open Science Collaboration did a review of 100 psychology studies that had never been replicated.

Replicating findings is really important in the scientific method, too. Like if you design a study and you do it and you find a certain result, in science it's not really considered to be valid unless I do it and confirm your results. Or someone else does. It's independent of you. And in a shocking number of studies, this never happens. And so this group went back and looked at 100 psychology studies and tried to replicate them using the, you know, almost identical conditions from the original studies. And they were only able to do that in 35% of cases.

And they were only able to do that in 35% of cases. Another group looked at pre-cancer clinical studies and found they could only replicate 11% of those. It's a well-known saying in the pharmaceutical world that more than half of the drug trials can't be replicated. And a group of researchers from Bayer, from a pharmaceutical company, tried to do that in 2011. They took a bunch of trials and tried to replicate them. Less than one quarter of them, they were able to replicate the results. So what this means is, you know, a study can be done. It's never validated. And then a whole bunch of other studies are done that refer to that study.

And whole fields of scientific research are spawned on a study that was never confirmed or validated. So it's like a house of cards built on a foundation of falsehood. So, you know, science is great. We need to keep improving science, but there's a lot of problems with the way that studies are performed right now. And it's both, you know, conflicts of interest that are based on money and it's just also human error. And is it also just the overwhelming number of studies that are being done and how many people would have to be there

to validate all these different things? Yeah, money. The amount of work? Money, basically. Like I talked to some research, I was just talking to some researchers about this and they said, look, nobody wants to be the second person to discover something.

It's just not as cool. I mean, it's not as prestigious for your career. So going around replicating other people's studies is not as exciting as doing your own original study. Yeah, exactly. You're a cover band, and it's hard to get funding to replicate studies. And it's hard to get funding to replicate studies. Whereas if you have an original finding, especially one that's tied to potential therapeutic use and a drug that can be made out of that, that's where the real money and interest is. So that's one of the big problems.

And another one is just how long studies are done for. Like omega-3 fats, we've all heard about that these are good for us and fish oil and all of that. When you look at studies, most of those studies are really short-term. And back in the 70s or 80s, some longer-term studies that were like eight or 10 years were done that found really different results. And what they showed is that early on the results were one way, but the longer the study went on, the results started to go back in the other direction. For omega-3s? Yeah.

Really? We can come back to that in a second. Yeah, please do. The point is, like, something that happens in two weeks is not necessarily what's going to happen over four years. But the problem is the typical studies only last for two or three weeks, especially if they're a randomized trial, because they're enormously expensive. To isolate all of the variables and make sure that patients are not changing too many different

things and are just doing the intervention and to do everything that needs to be done is incredibly expensive. And so we have a whole bunch of research findings that are based on two-week periods that aren't applicable to how we live our life. That is also, I think, an issue with some anecdotal reports that people have about changing their diet. There's a lot of people that change their diet, and short-term, they feel fantastic, and they start having all these benefits.

But then over the course of maybe three, four, five years or so, they started having real issues. And they don't necessarily tie that to the diet because they remember feeling so much better when they first switched to it. So they don't think that what's happening three or four years later could be the cause of their problems. I see this all the time with vegetarian and vegan diets. That's exactly what I wanted to talk to you about. all the time with vegetarian and vegan diets. That's exactly what I wanted to talk to you about. Yeah.

In terms of that, because most people who switch to a vegetarian or vegan diet, you're going to see some instant benefits because of the fact that you have much more nutrient dense foods. You're eating a lot of vegetables. You're changing your diet in a lot of ways to the positive or towards a positive away from what you were talking about. Those primary foods that americans tend to eat all the processed sugar all the just nonsense and chicken tenders and all that crap that people eat which is just so goddamn common right so automatically over that you're

going to see some long-term benefits but one of the things that i've been reading is about people that have found that over the long term the lack this is contrary to what a lot of people think, lack of saturated fat and cholesterol, dietary cholesterol and saturated fat, leads to hormonal imbalances, leads to your body having a harder time producing sex hormones, and all these different issues with your health where your body almost starts robbing itself

to make up for the nutritional deficiencies of your diet. Yeah. Yeah. I mean, we talked about this before, but humans are animals. Yeah. We're omnivores. Wait a minute. I saw a video on YouTube.

There's a guy that says there's no way that we are herbivores. I saw a video on YouTube. There's a guy that says there's no way that we are herbivores. And then if we are, some fucking wacky dude was saying, if you're really an omnivore, you should be able to eat a squirrel, just grab it and eat it raw. Yeah. No. The most bizarre.

There's some strange arguments out there. Arguments, yeah. Like we shouldn't drink milk because we're the only animal in nature that drinks the milk of another animal. Yeah, well, we're the only animal in nature that uses iPhones too. I have a whole bit about that. It's hilarious that you said that. Yeah. What else do only people do?

Fly planes, make movies, call each other on the phone and tell each other how awesome milk is. It's a ridiculous argument. So, yeah, getting back to- They're ideological arguments more than scientific. Absolutely. It doesn't stand up to scrutiny. But with a vegetarian or vegan diet, so there's lots of different ways to look at this. So starting with an evolutionary perspective, which I was getting at, omnivores are opportunistic. They will eat whatever is available and they'll eat the most nutrient-dense foods that are available if they have a choice. And that's just, again, that's survival. You know, an animal that is able to utilize the

nutrients that are available in its environment to its maximal advantage is going to survive compared to one that doesn't. That's basic evolutionary theory. So if you study traditional peoples, as far as I know, still, there's never been a traditional group that has ever been identified that voluntarily followed a vegan or even vegetarian diet that I know of. So that should tell you something right there. And ironically, the fact that you and I are even having this conversation, this wouldn't even be happening if humans had not learned eating meat, basically. and the development of tools that could crack bones to give us access to the marrow, which is super nutrient dense, or to slice meat, which allowed us to be able to digest the meat more quickly, number one. And then two, the development of fire, which allowed us to cook meat,

and cooking makes the nutrients in meat more bioavailable, allowed us to spend less time foraging for food. allowed us to spend less time foraging for food. So most large primates like gorillas or chimpanzees spend over 80% of their day foraging for food because most of the foods they eat are really not nutrient-dense. So they have to eat a boatload of stuff and just sit there and chew on the plants all day to get enough nutrients. And so this evolutionary theory is that we learn to

extract and harvest much more nutrient-dense foods from animals, fats, and other nutrients in the meats and organ meats. And we could then spend a lot less of our time going around getting food, which allowed us and then develop bigger brains and become human and have this conversation where we're talking about vegetarian and vegan diets. Yeah, it is kind of interesting. And it's also important to differentiate the difference between what you're saying is essentially the science behind the development of the human animal versus the moral and ethical debates that lead people to become... And environmental debates, which is also moral.

We can talk about that, too. Which is what influences people to become vegetarians and vegans, which I totally respect. I understand what they're saying. The real problem is when they distort the reality of the scientific findings of the human animal and diet. And that's an issue with a lot of people that are vegetarians and vegans that go on about how healthy they feel and about how awesome,

but they're not doing blood lipid profiles. And when they do, like Sam Harris, who is, for ethical reasons, has tried a vegan diet, and his health is suffering. He's having real issues with his blood lipids. What can someone do? If they want to follow that diet like what what is imperative as far as healthy fats as far as getting making sure that your body? Doesn't have you're not taking in too many simple carbohydrates like what what what steps need to be taken place This is obviously not saying that you shouldn't follow vegan diet or shouldn't follow vegetarian diet

You should do whatever you want to do. But there's got to be some ways to mitigate some of the health consequences, right? Yeah, there are. And I believe that. I agree with you that people should be free to make their own choices. I've never pushed a particular diet. People sometimes ask me, how do you convince someone to go paleo? I say, I don't.

I don't spend my time doing that. If someone wants my advice and asks me, I'll give it to them. But I'm not going around proselytizing for a particular way of eating. So, yeah, let's break this down. We talked about the evolutionary argument for eating animal products. And there's a scientific argument, which now is what we're talking about. The issue with, and we should even kind of distinguish between vegetarian and vegan diets

because they're actually quite different. And I think it is possible for some people to be healthy with a vegetarian diet. I think it's a lot less likely with a vegan diet. And I guess I would say it this way. If you're a vegan and you're eating a vegan diet, you need to have a perfect vegan diet to be healthy. And you need to know what you're doing in terms of supplementation and how to meet the nutrient needs that aren't being met through diet.

And at least in my experience, there are very few that actually do it right. When it's done right, I think it's possible for some people to be healthy and thrive. And that's obvious because there are people like Rich Roll, who's like out there, he's a vegan triathlete who's out there, you know, doing centuries and killing it. Yeah, ultramarathons. He is just an amazing athlete and he's vegan. And so, you know, you can't say that it's not working for him. If you try to say that, you're going to... He also looks like he's 30. He's older than me. He's like, yeah, he's a great guy. I've met him

a couple of times. And so certainly it works for some people, but there are a lot of factors that determine whether it's going to work. So one is how well you do it. Two is, you know, whether you know what you're doing with supplementation in terms of getting the necessary nutrients. Three is genetics. So there are genetic differences that determine how well we convert precursor nutrients into the nutrients that we actually need. And let me give three examples to make this more real. So one is EPA and DHA. These are these long chain omega-3 fats that we've heard so much about that are crucial for brain function, cardiovascular

function, et cetera. And primarily you get them by eating fish. There are no sources of those in a plant-based diet except for algae. And algae is not that bioavailable, right? No. And how many people do you know that eat algae i don't know very many well you can you can there's that famous green supplementation stuff yeah okay you can use it as a supplement but very few people are eating it so um but you but there is something called alpha linoleic acid which is in walnuts and flaxseed, that's an omega-3 plant fat. And humans, in theory, can convert some of that plant-based omega-3 into this long-chain EPA and DHA that we need. But here's the thing. Only about 5% to 10% of that gets converted into EPA and even less to DHA,

like 2% to 5%. So you have to be chugging tablespoons of flax oil in order to get as much EPA or DHEA that you would get from eating just a little bit of fish. And that's if everything is going well. Because if you have deficiency of any nutrients that are involved in the enzymatic conversion of those plant-based fats into the long-chain fats, then you won't make those conversions at that optimal rate. It'll be even less. And ironically, many of those nutrients are nutrients that are not well represented in a vegan or vegetarian diet. So that's one example. Another would be vitamin K2, which is a different form of vitamin K that's recently been discovered. And it's really important for cardiovascular and bone health.

It basically makes sure that calcium gets in our bones and our teeth and our hard tissues where it belongs and keeps it out of the soft tissues like our arteries where calcium would make our arteries hard and increase the risk of a heart attack. So K2 is only really in animal foods with the exception of some fermented foods like natto, of some fermented foods like natto, which is a Japanese fermented soybean product that most people cannot stand. It's of strong taste. Not very many people are eating it here.

Kefir and sauerkraut and kimchi have K2 in it. Did I say kefir? I've been saying kefir my whole life. That's how it's said. I've never heard it said. That's how they say it where kefir is from. Ah, well, I think you're probably right. But every other person I've ever met says kefir, so don't worry about it. Kefir.

I'm saying kefir from now on. Ari Shafir. You'll be in the select few. I'd love to be in the select few. I feel good about it already. So, yes, you can feel superior now. Can I stop you real quick? Yeah.

Just because I want to get a little bit onto this track of what you were describing about fish oil and the conversion and the difference between flaxseed oil. What can vegans take in order to sort of— I recommend that vegans take microalgae because it has preformed DHA in it. So you bypass that whole conversion issue. If they do take microalgae, is that sufficient? Or how much difference is that than eating fish? Well, it's quite different because fish have a lot of other nutrients aside from EPA and DHA. They have protein.

They have selenium. They have a lot of other bioavailable nutrients. And the other disadvantage is you have to take a boatload of algae supplements. What's a boatload? Give me a coffee cup filled with food. No, I think so. Different products have different amounts, but I think you'd have to take six to nine capsules a day

of the average algae supplement in order to meet your DHA needs. That's not bad. That could be done. It's absolutely possible. But that would be a good way to be healthy with the vegan diet? That would be one way to address the shortcoming of lack of DHA on the vegan diet. There are other shortcomings, other nutrients like B12, which are... That's an issue.

That's a big issue. And vegans need to be supplementing with that. There's a myth out there that there are some plant sources of B12, like seaweed and spirulina and nutritional yeast, but those actually contain kind of phony forms of B12 that can block the absorption of true B12, which is only found in animal products or supplements. So a B12 supplement would be really important as well.

And what's the source of a B12 supplement? It's synthetic? It's synthetic, I think, but there's three forms of B12. There's hydroxycobalamin and methylcobalamin, or four forms that you can supplement with, cyanocobalamin and adenosylcobalamin. And cyanocobalamin is a synthetic form, and then the other ones are natural forms of B12 that you would encounter in food. So people can supplement with any of those. The natural forms are better to supplement with because they're more bioavailable.

But definitely if a vegan, I would recommend supplementing with B12 because there aren't any sources of it in the diet. And studies have shown that 68% of vegetarians are deficient in B12, 83% of vegans are versus just 5% of omnivores. Wow. So it's a big difference. We're not, you know. And that's a factor in many

different issues, right? It's a factor in the production of muscle. Yeah. Production of all red blood cells depends on B12 and folate. And so, I mean, that's pretty fundamental, right? And then the myelin sheath requires B12. And this is why B12 deficiency can mimic the signs of Parkinson's or Alzheimer's disease in people who are aging. B12 deficiency happens in elderly people not because they're on a vegan diet, but because they have low stomach acid and they don't absorb the B12 as well as we do when we're younger. And so a lot of people who are elderly who have symptoms of Parkinson's or Alzheimer's, they can sometimes be misdiagnosed with these conditions

when they're actually just B12 deficient. So it's a really important nutrient. Now, how can vegans be assured that the B12 that they're buying does not have animal products? Or do they have B12 when you buy in a supplement form? Not typically. It's usually synthetic? Yeah. I'm not the best person to ask about that because I'm not a vegan myself. I was a macrobiotic vegan at one point. What does that mean?

What's the difference? That's deep. You went deep. Macrobiotic vegan. It's like a vegan and macrame. I mean, macrobiotics is a whole other system of way of looking at food. It's a Japanese approach. way of looking at food. It's a Japanese approach. And the whole reason I came to do what I'm doing now is I got really, really sick in my 20s. I almost died. And I spent about 10 years just

trying to get back to health. And what did you get sick from? I was in Indonesia. I mentioned earlier, I traveled around the world and I was surfing and I got the classic tropical illness like amoebic dysentery, giardia and blastocystis hominis. So two parasites and an amoeba and was just, you know, coming out of both ends, delirious, didn't remember really anything for three days. Luckily, there was one other Australian guy in the village that I was in who had some antibiotics in his medical kit that kind of brought me back from the brink. But between the parasites and then the multiple rounds of antibiotics I had to take to get rid of the parasites after that, it just wreaked havoc on my gut. And it took me basically 10 years to recover my health. Whoa. Yeah.

10 years? 10 years. It was like the last decade. Now, was it 10 years because you approached it incorrectly and you could do it better now? Or was it just such a devastating round of disease that... I think a little of both. I mean, so I'm 42 now and I was 25 when this first happened and we didn't know anything

about the gut and the microbiome compared to what we know now. Like there was very little awareness on these topics at that point. Yeah. Just in 15 years, it's just, or 20 years, it's, it's crazy. So, you know, I took way more antibiotics than I would have done, uh, in retrospect, because that's what the doctors were prescribing and saying, look, you've got these parasites, we've got to get rid of them. This is how you do it. And I think the antibiotics could have been like the treatment was probably worse than the disease for me after the number of courses of antibiotics that I took. Wow. So along that path, I tried just about every special diet you can possibly imagine, including becoming a vegetarian and a vegan and then a

macrobiotic vegan and then raw food vegan. I've been there, done that. And so I'm completely sympathetic. And I'm also a longtime meditator and Buddhist. So I understand the ethical argument very well. Many of my friends don't eat meat. I'm sympathetic. I care about the environment. I'm sympathetic to that argument. I'm certainly not, you know, I'm coming to this from a place of, I think, a pretty balanced viewpoint. For me, the reason why I eventually brought animal products back into my diet was that it became clear that I needed to do that for my own health. And I was able to reach a level of understanding about the moral, ethical, and environmental choices that I was making that I felt good about. Sam has brought up mollusks. He was saying that one option that vegans might want to consider is mollusks, and that mollusks, what a weird word, clams, mussels, things along those lines, are so primitive that the argument can be made that although they have movement,

where they open and close that they lack pain sensors they lack like the fundamental things that make us distinguish the difference between animal and plant life and that people might want to consider the consumption of mollusks the same way they consider it you know like people eat mushrooms mushrooms which are in a vegan diet are healthy are closer to an animal than they are to a plant. They actually take in oxygen, they breathe out carbon dioxide, and fundamentally, they resemble living organisms that we consider like animals more than they consider plants, more than they resemble plants. This is a really good point. And the lines start to get blurry

because we know that some plants, for example, when they recognize that they're being eaten by a caterpillar, they secrete toxins to protect themselves. Not just recognize that they're being eaten, but they've played recordings of a caterpillar eating a plant next to a plant. And it's changed the actual taste of the leaves to the point where animals find them disgusting. And it causes some animals to starve to death. Yeah. That's some level of awareness. I mean, you may not call that intelligence or sentience, but it's some, you know, what's the difference there between a mollusk, for example, who that like you described, lacks pain sensors. What should we be prioritizing in that situation if we're using an ethical argument against eating meat? There's even a thornier issue,

which is there's no system of food production that does not involve the death of animals. And so if you think about monocropping, big tiller with blades going through these fields, you're killing voles, you're killing rabbits, you're killing snakes, you're killing all kinds of small animals. And is the value of a small animal life less than the value of a large animal life? life. Some philosophers or people who look at this morally have actually argued that killing a large herbivore like a cow that can feed many people is superior ethically or morally than a method of food production that kills many small animals and won't feed as many people from a nutrient density perspective. I don't like to look at that because it's inconvenient,

but I have friends that, I have a good buddy of mine who has a farm in Iowa, and he says when they run the combines over corn and grain and when they chop down all the different things that they grow, you'll see vultures and crows and all these things circling the fields because there's all sorts of animals that get chewed up in that process. And in fact, more animals get chewed up to create a pound of grain like more animals more more insects more i mean when insects are animals by the way and when there there are a life form um and more different things get chewed up in creating that than would be if you got a

pound of meat because as you said one cow could can you know a lot of people consume it over the course of a year and the nutrient density is far superior to a pound of grains yeah or even an equivalent amount of weight of grains but you don't hear that argument you hear the opposite argument where a cow consumes so much grass it needs so much land to graze and that argument unfortunately, unfortunately, has actually been distorted. I had some guys on from the documentary Cowspiracy, which I don't think they were intentionally trying to deceive. I think they're really good guys and they're making, they think they're making a really good point. But when you talk to ranchers and you get the actual number of how much acreage it takes to feed a cow. It's not as much as they thought it was.

No, we can talk about that too. But the ethical argument is really interesting too for all of these reasons. But then you think about the method of death, right? a humane slaughterhouse where there's a lot of care and consideration that goes into how the animals' last moments are and how they actually slaughter the animals so that it's painless and quick. I can hear the vegans going crazy right now. This is jumbo shrimp. This is military intelligence. Versus, let's see, this combine that goes through the field decapitates the mother vole

and her babies in the nest die of starvation because their mother is not able to provide food for them. That's a, that's a arguably worse way for an animal to die. Right. Or even any of your rancher friends know what it's like, you know, they've found one of their animals that's been killed by a predator. And if you go on YouTube and watch how like a hyena kill an animal, the animal will still be alive while it's getting disemboweled. Yeah. That's not a very nice way to die. Right. And that's what wolves will do. And that's what, I mean, that's a, that's a giant issue. The difference between the way a predator kills something, the way a person does. But

on the other hand, of course, it's impossible to deny the real issues with factory farming, the inhumane methods that are so common. When you're buying these chicken nuggets, I guarantee you these are not ethically sourced, ethically and humanely raised chickens. They're just not. And when you're driving down the highway and you see those trucks that are stuffed full of chickens and the chickens, literally their little faces are poking out of the side of the truck, that is, in my opinion, a bigger issue. Absolutely.

And this is, I mean, interestingly enough, this is something where I think I have more in common with vegans than I do with, like, the average person. We both care about how food is produced. We care about, you know, I don't eat factory-farmed meat. I don't eat factory-farmed vegetables. You know, like, I try to eat I try to eat meat that's from local. I buy it from local farmer.

I'm lucky that where I live that that's accessible. I buy produce from the farmer's market. We grow a lot of produce in our backyard. It's this whole food system that needs to change, both in terms of conventional agriculture and the monocropping of wheat and corn and soybeans and plant foods, but also the mass production conventional animal operations need to change as well. So I'm not arguing for that. I think that's absolutely a losing argument. I'm not arguing for that. I think that's absolutely a losing argument. But there is a lot of land, two-thirds of the surface land in the world is not suitable for crop production. But it is possible to feed the world with maybe not the amount of animal products that the average American is eating now, but we can utilize the available land in a much smarter way to produce nutrient-dense foods.

And we need to consider the whole cycle. We like to remove ourselves from the cycle of life and from nature, saying we're not animals, we're humans, we're separate from it. But when you consider that whole cycle and when you consider like the soil, for example, if you think of it as a bank account, when you plant crops, you're withdrawing from that bank account. And if you want the soil to be healthy and continue to be able to support life, you need to put input. You need to make a deposit back in that bank account. And the way we've been doing that in conventional agriculture is with chemicals. And those chemical fertilizers, they do kind of make a deposit in some way, but they also make the soil less able to sequester carbon. They cause all kinds of problems with runoff and toxicity in water

and local watershed systems. And any organic farmer will tell you that the best way to add those inputs back in is the poop of animals along with their blood and their bone. And so that's that cycle of life where the animal inputs go into the soil. Those inputs, you know, the urine adds water to the soil. The poop adds microorganisms that help the soil sequester carbon. So that studies have shown that pasture raised animals are either net neutral in terms of carbon output or they actually even help sequester carbon. So you could even argue that raising animals and eating animals is necessary for the benefit of our soils and our ecosystems in general. Yeah, so if someone has a large, you know, 20-acre plot of land,

and they're using it to grow alfalfa or something that people eat or soybeans or something along those lines, if they're not in some way contributing some sort of animal product to that soil, the soil is going to become nutritionally deficient And then the people who eat the plants that come out of that soil are going to get nutritionally deficient plants Minerally deficient in particular that it's a giant issue with United States farmlands There's a book that's received a lot of criticism, but it up some interesting points it's called dead doctors don't lie it's this guy dr joel wallach a lot of his the things that he said have been rightly criticized and but what's interesting about what he's saying is when he's talking about minerally deficient plants and soil and that the united states is known you know when they've done studies on farmlands in you know the, the 1930s and 40s, that there is an issue with mineral deficiency.

And so that's where they started adding nitrogen from the Haber method, you know, into soil. And it helps and you can grow crops. The food that you're getting that is grown with chemical fertilizers that address some of the issues like you're talking about versus the traditional method of compost and manure and animal products. You're getting a way healthier plant. And when you're consuming it, you're getting a far more nutrient-dense plant. Right. Not to mention the environmental implications of chemical fertilizers and pesticides i know a guy who got bone cancer right because he grew up next to um a golf course yeah and the pesticides and all the shit that they would pump onto the golf course to keep the weeds from growing

got into the well system and a bunch of people in his community like a huge amount got cancer right i want to go back to something you were saying about, you know, vegans and vegetarians and how to kind of optimize if you're doing that diet. So two things that I wanted to address. One was you asked about mollusks. Yes. And I've actually argued that a vegetarian diet with shellfish and organ meats would be better than a paleo diet with no shellfish and organ meats. Interesting. And that's because of what we talked about earlier.

Muscle meats, organ meats, and shellfish are the two most nutrient-dense classes of foods. I've just been finishing the curriculum for my clinician training program where I'm going through systematically every nutrient and I'm looking at in nutrition data what the highest food sources of those nutrients are. And I wish I had the thing to just lay it out and show you, but in almost every case, it's an organ meat or a shellfish that's the highest source of that. Whether you're talking about B12 or iron or copper or zinc or folate. It's always beef liver, chicken liver, clams, oysters, et cetera. And so if someone was a vegetarian who's willing to fudge a little bit and eat just organ meats and shellfish,

I think that would be a healthier approach than someone who's just eating lean muscle meat. Organs get tossed out a lot. think that would be a healthier approach than someone who's just eating lean muscle meat. Organs get tossed out a lot. It's a real problem in the hunting world where when people gut an animal, they leave the gut pile. And there's even a gutless method that a lot of people use when they take on a big game animal like an elk or something like that. They leave it behind. They leave the heart. They leave the liver. But i saw this documentary on wolves and what was really fascinating was one of the ways that they distinguish who the alpha is in the wolf pack is the the alpha wolf is the one who eats the liver gets the liver yeah fascinating there are other animals that that's true with yeah and i think that was true in hunter-gatherer societies

as well and someone was trying to say to me, well, livers process toxins. Don't you think they'd be filled with toxins? That's a common misconception. The liver processes them, but the fat stores them. So if you're concerned about toxins in food, you should make sure that you're eating, you know, pasture-raised organic fats like butter and cream and things. If you eat dairy products, animal fats. Grass-fed butter.

Grass-fed butter. Grass-fed grass-fed butter milk if you eat lard or tallow or anything like that it should come from pasture-raised animals because the fat is where toxins are stored the liver processes them um so when you're i'm sorry to interrupt so when you're eating anything that comes from an animal that's been fed grain you're dealing with an animal that has the same sort of inflammation issues that a person has from processing things that it's not naturally supposed to process, like processed wheat and bleached flour and things like that.

Pesticides, chemicals, antibiotic residue. Right. Yeah. So when you're taking in those animal products that we traditionally do, whether it's butter or milk or dairy or cheese or things along those lines, when you're taking in those animal products that we traditionally do, whether it's butter or milk or dairy or cheese or things along those lines. When you're taking in those from an animal that's eating grain, you are actually getting the fats. So it's less healthy than actually eating the liver of that animal. Yeah, it may be.

I mean, the liver is more nutrient dense anyways. But pasture-raised animal fats have a lot more nutrients than conventionally-raised fats because the animals are eating grass, and grass is way more nutrient dense than the grains that conventional animals are fed. Also, the omega-3s and 6s are different, right? Yeah. The ratio, omega-6 is the same, but omega-3 is three or four times higher in pasture-raised animals. Why is omega-6 the same? It's a good question. It used to be the kind of consensus was that omega-6s would be higher and omega-3s would be lower, but it actually looks like omega-6 is constant and omega-3 is higher.

The omega-3 is higher because the grass probably has more alpha-linolenic acid, which is the plant-based form that they then, the animal does the conversion. I mean, that's the thing that's really interesting to consider here too, is humans are really inefficient at making these conversions of these less active nutrients to the more active ones. We started to talk about it with EPA and DHA. Vitamin K1 is what's converted into K2. Cows are experts at doing that. They're really good at it. Humans, not so much. So when we eat the animal, the animal's basically done the work for us. We get the preformed final nutrient that we need rather than having to do those steps ourselves. Sorry to interrupt you, but is this

a function of the adaptation of people developing while eating these animals? I think so. Yeah. Beta carotene is another example. That's a precursor to active vitamin A or retinol. And beta carotene have some benefits in our bodies, but retinol is the real thing, you know, what we need more than anything.

And that conversion is as low as three to 5%. And some people, in fact, there are some who don't make the conversion at all. And those are the people who turn orange after a carrot juice fast. Have you ever seen anyone with like the orange palms? But it happens. My friend Andy used to drink so much carrot juice that the inside of his hands and his skin would turn orange. Yeah. So he probably wasn't good at converting beta carotene into retinol because we should be able to do that, but some people can't. But isn't just the mass quantities? Yeah, I mean, it could be that too.

But the retinol is only really present in organ meats and pasture-raised fats. It's not even really in muscle meats like lean ground beef or boneless chicken breast. So in order to get retinol, we need to consume these pasture-raised fats or we need to consume organ meats. And as you pointed out, organ meats have really fallen out of favor in the U.S. And this is only recent. I bet you our grandparents ate a lot more organ meats than we eat. Still in many parts of the world, they still eat organ meats more than we do.

Liver and onions is a very famous dish. Beef heart. And so you'll see within the paleoprimal kind of world that organ meats are making a comeback because we understand now what the nutrient density of these foods is. And there's less now, even in the mainstream world, there's less of a solid argument that can be made about these having cholesterol or, you know, high levels of saturated

fat that would prevent us from eating them. Now, what would be the difference in terms of the nutritional density of mollusks versus organ meat? So like if you were trying to, if you had a vegetarian or a vegan who's on the fence and, you know, you made these arguments that are very rational and logical and you said, look, mollusks are essentially a very, very primitive form of life that doesn't feel pain. And you could argue that there's more evidence that some plants feel pain and plants also have some very intense level of communication where there, there, there's a really interesting edition of Radiolab recently where they went into this, where they sort of are trying to understand the difference between the, not the difference rather, but the complicated relationship between these different

plants and the mycelium in the soil and all of the different fungus in the soil that also acts as sort of a transportation method for various nutrients and minerals. And they're actually pulling these minerals out of the rock and they're getting sugars from the plants and they're exchanging them for minerals. And that there's this really complex interaction that we have sort of just looked at and said, oh, there's dirt and there's plants. But there's a lot going on between these various life forms and one of them being fungus, which again is closer to an animal than it is to a plant, but is imperative for the life of

these plants. Right. And then somehow or another, they're actually even sharing resources where if they find or they're allotting resources to certain plants that are more deficient or they're trying to channel resources to them. So there's some form of communication and exchange here. Yeah, that's intelligence right there. I mean, Paul Stamets has done amazing work on mushroom fungus in general.

Yeah, I would say that that's a really good option. I mean, when you look at nutrients, like specific nutrients, it goes back and forth between liver and, you know, organ meats and shellfish. And some nutrients, organ meats are higher, like vitamin A or iron. And other nutrients, shellfish are generally higher, like with zinc or copper. But certainly even shellfish are higher in almost all of the key nutrients that we need than a lot of the plant-based food alternatives that they would be choosing from. And so if a vegan was willing to eat mollusks, I would say that that would be a great idea. And the benefit there is you don't need to eat a lot. Like three ounces, a single serving uh can meet your copper requirement

for the entire week oh wow just one time one time yeah oysters and same with iron i think if i'm going off the top of my head i'll iron and zinc it can nearly meet your entire weekly requirement so it's not like you have to eat a ton of these things you you know you have a serving of clams once a week and you have a serving of oysters once a week, on top of getting as much nutrient density as you can. That's B12, that's iron, that's zinc, that's copper, EPA and DHA. The long-chain omega-3 fats are in these mollusks as well. And they're typically low on the toxicity scale too. They don't tend to have a lot of mercury. They don't bioaccumulate a lot of toxins

compared to some other predator species of fish that are higher in the food chain that accumulate a lot of toxins. Is there any benefit to eating them cooked versus raw one way or the other? Well, there is the chance of disease in, you know, eating raw oysters. I think it's pretty minimal compared to some other risks, but it is there. And cooking, you know, mitigates that definitely.

I think, in general, cooking makes the nutrients in meat and animal products more bioavailable rather than less. And that's in vegetables. It's it depends on the vegetable and the method of cooking. But it's a mix. It's more of a mixed bag. But with meats, it generally improves the bioavailability. So it really is in a lot of ways an ideological issue where it's sort of framed that, you know, you don't want to contribute to suffering. But these things really don't suffer.

Yeah. But even there, you know, as we talked about. You're going to contribute to suffering. You're going to contribute to suffering and potentially more if you're looking on the scale of individual lives. And it might sound like this is nitpicky, but it's not. We're talking about actual lives, you know, and then you have to start evaluating, like, is a cow more sentient or worth, you know, the life of a cow worth more than the life of a rabbit or a vole or the kind of animals that are

being killed in the, you know, in the production of these plant foods? It's a real question. in the production of these plant foods. It's a real question. And then you have insecticides, and you have the amount of insects that get killed when you're processing crops. There's just no getting around. If you're buying anything that is from large-scale agriculture, you're involved in the death of some sort of animals or insects.

And I know the argument is like like there's an argument about intentionality and whether, you know, like if I intended to kill this animal to eat it is different than if you didn't intend to eat it. To me, that's I'm not so sure about that. It's a sketchy argument. Yeah, because it's almost like willful ignorance that these animals are being killed and the production of these plants that I'm eating. I mean, I see the argument, but I'm not sure I buy it. I do as well. And I see the willful ignorance argument up until the point where it gets explained to you. So as soon as someone explains to you like you've just done about the combines and how they're chewing up all these animals.

And by the way, fawns, too. It's a huge issue with deers because if you've ever seen a baby deer out in the wild, there's one of the weirdest things about them when they're very young, they do not move. So in the face of danger, they have this instinct to freeze. So you can literally go up to a fawn and they'll be tucked up on the ground and they're healthy, completely healthy. And you could walk right next to them. Fawn in the headlights.

Yeah. You could stomp on the ground next to them they don't move they sit around they wait for their mother to return it's really interesting they get chewed up by combines it's really I mean because these animals bed in these fields all the time and if something happens to the mother especially if she gets attacked by a coyote or something along those lines and then the the babies just get chewed up by the by the combines yeah there's another interesting question here too which is by a coyote or something along those lines. And then the babies just get chewed up by the combines.

Yeah, there's another interesting question here too, which is more around like privilege. And again, like whether we see ourselves as part of the ecosystem and the food cycle or as separate from it. Right. Do you think about like Native American or traditional hunter gatherer

or even contemporary people living in, let's say, in Afghanistan, and all they have is a goat, you know, or a poor family in India who has access to a backyard cow. Should they not eat, you know, milk and butter and those animal foods because of a moral or ethical argument against that? Or it seems like an argument coming from a tremendous place of privilege for us to say that the choices that they make are somehow wrong or immoral because we can afford to make these different choices. In defense of vegans, I never hear that argument, honestly. I think I hear the argument that in America today, you have the choice. And in westernized countries, you have the choice.

And so that you can choose to contribute less to suffering, which I think ideologically makes a lot of sense. The problem is when you deal with the reality of it that you've sort of described about large scale agriculture, you're not, I mean, you're not immune to the suffering of animals and the death. It's just, it's just not the case, especially when you talk about insects. Right. I mean, it's just, there's no way it's just, and insects at least, I mean, in my mind, are more complex and more complicated than mollusks. Yeah. I mean, certainly if you look at some of the studies on insect behavior,

I think that would be borne out. Yeah, but we have these weird hierarchies. We love bees. Bees are super important. Well, bees are another species that gets totally decimated by factory farming. Pesticides. Yeah, the pesticides are really, really harmful for the bees. Yeah, I mean, I agree with you.

I think there is, you can say we have this, because we have that privilege, we have the imperative not to cause more suffering. But I think what I get out of looking at those cultures is it's more clear to me how intertwined with with nature and the natural food systems that humans are in those circumstances they're less removed from the basic cycle of life yeah and it seems natural when you you know for the masai pastoralist people to to drink the blood of the cows and eat and drink the milk and eat the meat because that's inexorably intertwined to their culture and their way of life. And it's why they survived. Absolutely. Yeah.

Yeah. So, you know, I think this is a really nuanced, complex topic, and there's a lot more to it than is typically shows up in the internet debates that just go back and forth. But at the end of the day, from what I've seen as a clinician working with a lot of patients, a lot of ex-vegans, a lot of ex-vegetarians, is that some people can pull it off for a relatively long period of time. And I think this is because they have the genes and the preexisting nutrient status that allows them to make those conversions of the less active nutrients to the more active forms

better than the average person. Then you see someone who goes on a vegan diet and falls apart within a couple of months. And this is the person who does not have the genes to make their poor converter. And they also probably had pre-existing nutrient deficiencies, which made them less able to make those conversions. And so this kind of solves the question of, or addresses the question, you hear some people say,

well, why does that person, that person does a vegan diet and he's pretty healthy, you know, your rich role. So it can't be problematic. Well, look, we don't all respond the same way to the same choices. Yeah, of course. The difference in the way human beings respond to various foods can obviously be exhibited really quickly and easily with allergies, food allergies. Absolutely. I mean, how many people, I mean, we all know someone who has,

like my friend Brian, his mother, if she eats a Brazil nut, she's dead. Right. She will just die. Anaphylaxis. Yeah, I can chew those things all day and nothing happens other than I get bored with them. Yeah, especially if she has to pay 600 bucks for an EpiPen. Yeah, yeah. There's a lot of different things that show the biodiversity of just human beings.

When we come from different parts of the world, our ancestors came from different parts of the world. They developed and evolved under different diets. And that's where I think paleo has kind of fallen, like maybe has been less successful as a concept than it could have been otherwise. I really believe there's no one size fits all approach to diet or life in general. But, um, you know, if you take two different people, for example, like a person who's primarily sedentary works in an office, 60 pounds overweight,

you know, pre-diabetic, um, you know, not doing really any physical activity. And then you take someone like Michael Phelps, who's super athlete training, you know, burning calories every day. It's clear to me that they're going to need a completely different dietary approach. Even if we talk about within a certain template or, you know, choice of foods, you know, Michael Phelps is going to need a lot more carbohydrate. He's going to need a lot higher calorie intake in general. He's going to need more nutrients. He's going to need to be eating more regularly. You know, intermittent fasting is not going to work for him probably. But it's amazing to me how often that is completely left out of the equation. When there's discussion of diets, you see, you know, the books on everyone should be on a low

fat diet. Then the next craze is low carb. Everyone should, you know, the books on everyone should be on a low-fat diet. Then the next craze is low-carb. Everyone should, you know, carbs are toxic. We shouldn't eat carbs. And then, you know, everyone should be on paleo and never touch another grain or legume or dairy product for the rest of their life. You know, that's just stupid. That's not the way it works. Yeah, really important when you're talking about people like ultramarathon runners or people michael phelps that are just burning off massive amounts of calories when you think about how much energy is involved in those sprints that he's doing across the pool and the training for those which

is just unbelievably grueling yeah i read this thing about him eating like several pizzas at night and you look at him and he's shredded he does zero body fat like obviously his body's doing something with that. It's kind of important. I think that is very important also when you're talking about sedentary lifestyles contributing to diseases and factors like high blood pressure and clogging of the arteries. Your body is less likely to be healthy when you're not doing much with it, period. Absolutely. And I think that can work both ways.

On the one hand, Phelps would probably be better off choosing a different calorie source than pizzas, arguably. I don't know. So he can get away with a lot more than most people can. I would say that he should be doing anything differently when he's the most successful swimmer? Isn't he like the most successful Olympian of all time? I think, yeah. I don't think anyone's won any more gold medals, so what the heck do I know?

Keep on doing whatever you're doing. It's working. No, but I think genes play a role. For sure. Coming back to people like Michael or Rich, I think Rich could probably eat almost, could eat a lot of different diets and still be, you know, still be phenomenal. I've had Rich on the podcast before and he sort of explained his transition to being a vegan and it came from being really unhealthy and eating a terrible piss poor diet to eating super healthy. Right.

And eating really nutrient dense vegetables constantly and only that primarily and you know obviously had a massive benefit from changing from the standard american diet that you outlined to this vegan diet right makes you wonder what he you know what might have happened if he had done switched to like a paleo diet oh don't say that right now. Shut up. Nobody wants to hear that, right? It's like, it's not, it's, it's one of those things that gets, uh, there's an ideological wall that cannot be crossed.

And so no one even wants to look at the possibility of it being physically beneficial. You just say that is not an option. I am a vegan and this is what I do. That's fine. You know, I don't, like I said, I'm not invested in changing anyone's mind about that. Nor should you be. Yeah. I want to go back to two things.

One thing I want to go back to was your talk about talking about fish oil, like the long-term negative aspects of consuming fish oil. Like what were those? Yeah. So early on, I mean, the history is kind of important to see how, because it illustrates a number of principles that we've been talking about. So early research, you know, they looked at traditional Inuit people and said, wow, these people don't really have heart disease. What is it about their diet that could explain this? Wow, they eat mostly seal blubber and they have enormous intake of omega-3 fats. So it could be omega-3 fats and then they

start doing research and they find that there is an inverse association between omega-3 fat consumption like in seafood and cardiovascular disease risk in other words people who eat more fish have fewer heart attacks and die of cardiovascular disease much less. Okay, so pretty promising so far. So then it's like, okay, why don't we then give people fish oil supplements? And so they give people fish oil supplements. They do some research on that that's short-term and find that, yes, there do appear to be some benefits from fish oil supplementation short-term. But then over a longer period of time

and meta-analysis of longer term studies, they find that the benefits of fish oil have probably been significantly overstated. And then, in fact, in some cases, high doses of fish oil for an extended period of time actually appear to cause harm. And so there are a few important principles here. Number one is the folly of looking at one super isolated, unusual population, like the traditional Inuit who live in a really marginalized environment, and looking at their diet and then extrapolating that to us, who don't live in the Arctic and don't have their diet or lifestyle. And didn't evolve up there. Didn't evolve up there. And, and interestingly enough,

some recent studies have found that the Inuit have certain genetic adaptations that allow them to thrive on very high doses of omega-3, which we don't have. So that illustrates the problem with saying, oh, this works for the Inuit, so it should work for us. It doesn't actually work that way. And now we know why. It's because of the genetics. The second folly, and this happens all the time, and it's kind of a uniquely American thing, is oh a little bit is good well a lot must be even better that's me as he stirs his bulletproof coffee over there yeah so yeah I I think what is becoming more clear is that eating fish is good taking really high doses of fish oil for a long period of time may not be. Now, what were the negative health benefits or negative health effects, rather?

Well, an increase in cardiovascular disease risk in some cases, an increase in some inflammatory markers. The thing to understand about omega-3 fats is they're very fragile. So fats have different levels of susceptibility to something called oxidative damage, which means they combine with oxygen and the fat becomes damaged and rancid and then can be harmful. And that's a brief description without going into the science. And so saturated fats, because they are saturated with hydrogen atoms, they're not susceptible to oxidative damage and they're relatively stable. They can tolerate the application of temperature like when you cook with it or light. So if they're stored in a clear jar, they're not going to decompose and become rancid.

Whereas polyunsaturated fats are lacking in hydrogen atoms. They become more susceptible to oxidative stress. And the most unsaturated fats are the long-chain omega-3 fats. So this means that they, this is why you don't cook. You never hear anyone saying that you should cook with fish oil. You know, if you cook with it, you'll damage the fat, so it'll become rancid and oxidized. This is why fish oil is stored in opaque bottles to protect it from light, because if light hits it, it will oxidize and become rancid. And the suspicion is that if we eat, we take these high doses of unsaturated fat, we actually increase the risk of oxidative stress, which can cause inflammation, which in turn is the root of all chronic, you know, disease. So

what I advise my patients is, you know, just eat fish. And if for some reason you can't eat fish or won't eat fish, then taking some fish oil, I prefer cod liver oil because it has vitamins A and D in addition to EPA and DHA, but at a relatively low dose, a moderate dose, maybe like a teaspoon a day, rather than going for like 20 grams or 15 grams a day of fish oil. So the real issue is in the oxidative stress. real issue is in the oxidative stress. So, and also the, so the potential of something being rancid sort of mitigates or diminishes all the positive effects from it. But if you can be assured that there was no rancid. Well, no, because it can become damaged in your body. So there's two types of damage. It can be damaged by heat or light outside

of your body. That's less of an issue because storage, you know, people know this, the producers of these oils know it. So they store them in opaque bottles. And when you get the fish oil, you're instructed to put it in the refrigerator and preserve it. But inside of your body, the fats can become oxidized too. And historically, when you look at traditional diets, you see that the majority of fat comes from saturated or monounsaturated fat. And there's only a small amount of fat that's polyunsaturated that they would get from eating nuts or seeds, which are pretty high in polyunsaturated fats.

Olives, olive oil has some. Avocados has some polyunsaturated fats, omega-6s. But there weren't, you know, there wasn't really an opportunity for them to be getting really high doses of polyunsaturated fat that you would get from taking like multiple fish oil capsules in a day. fish oil capsules in a day. So that's the issue. And that's also actually why industrialized seed oils are bad for us. Things like corn oil, soybean oil, sunflower and safflower oil, like all the stuff that's in chips and crackers and cookies and restaurant foods primarily, is that when those oils get heated, they become rancid and those rancid oils can be harmful.

Wow. That is really important information. You know, it's also interesting. You're bringing up cod liver oil. Like that's more like sort of ancient knowledge. That's old school too. Grandma and grandpa. Yeah.

I mean, people would have you take a tablespoon of cod liver oil. It's for your health. But they were right. We talked about retinol, vitamin A, the active form of vitamin A, and how it's not found in very many foods, just organ meats and pasture-raised fats. And cod liver oil is from liver. It's from cod livers. And the oil is very high in vitamin A.

It's also high in vitamin D, which a lot of people are deficient in. And it has EPA and DHA. So, again, this is traditional wisdom. Our ancestors knew they had, you know, they may not have scientifically understood what the benefit was, but they knew through trial and error. That is really interesting. Here's another thing that I wanted to bring up that we talked about earlier. The misconception that saturated fats and cholesterol are bad for you. Yeah. This is something that you hear vegans talk about all the time. They'll do videos about it. Saturated fats are terrible for you.

And it's just not true. Yeah. Unfortunately, they're not current with the science. I mean, even the U.S. dietary guidelines now have no restriction on dietary cholesterol. So the most recent version of dietary guidelines, if you look at them, there is no restriction on dietary cholesterol. So the vegans are aligning themselves with science that's decades old at this point. And they're out of step even with the conventional totally vanilla mainstream dietary guidelines i don't think they care i think it's an ideological thing i think this is something that they have they have their bullet points right and saturated fats bad yeah

and they go to a saturated fats consumption of animal products bad cholesterol bad so this is based on a an old understanding of how heart develops, which is kind of the pipe analogy, we can call it. Break it down for us, Chris. Saturated fat and cholesterol are like gunk that clog up your pipes, right? That's kind of how we all were taught. We all conceive of it. So you eat a burger and egg yolks, and that just gradually will build up and, you know, as gunk in your arteries and eventually those arteries clog and the occlusion of the arteries is what causes a

heart attack because blood can't get through to the heart and it causes an ischemic event, no oxygen, heart attack. Or, you know, plaque forms and then the plaque ruptures and it blocks the artery and blood can't get to the heart and you have a heart attack. So that's kind of the dominant idea. And it turns out it's not actually true. For one thing, there was actually just a study published that reviewed all of the randomized clinical trials that looked at substituting polyunsaturated fat for saturated fat. So they took away people's butter and gave them corn oil and soybean oil, which I don't know how they found the people willing to take that trade. Vegans.

Yeah, this is the time where saturated fat was seen as harmful. And they probably gave them margarine, you know, and some of that other stuff. Remember when that was supposed to be good for you? Yeah. Isn't that amazing? I can't believe it's not butter, right? God, that stuff's so terrible for you. It's hard to find it now.

And so they reviewed 10 studies, and they found that only one supported this notion. One of 10 supported this notion that replacing saturated fat with polyunsaturated fat was good for you. fat with polyunsaturated fat was good for you. And even that study was flawed because a much higher percentage of people in the control group were smokers and had some other characteristics that would have made them more susceptible to having heart disease, independent of whatever was going on with their diet. Was that intentional? No, it was a poorly designed study. Or I don't know.

I mean, I guess it depends on whether you think those researchers were trying to get a particular outcome or whether you think it was just poor design. So the early studies suggested that if you ate more saturated fat and cholesterol, the cholesterol level of your blood would go up. And they use that as a way of, and then everyone knew that high cholesterol in your blood causes heart attacks. So if A plus B and B plus C equals C, you know, C, then A equals C, right? So, but that turned out to not actually be true on two counts. Number one, when they just looked at the direct relationship between saturated fat intake and cholesterol intake and heart disease, just taking blood cholesterol completely out of the equation. Like, let's forget about the mechanism.

Let's just see if people who eat more fat and cholesterol actually have more heart attacks. When they did those studies, no difference. have more heart attacks. When they did those studies, no difference. People who eat more fat and more cholesterol did not have more heart attacks than people who ate less. So that was a huge problem. And then more recent studies have found that on average, saturated, certainly dietary cholesterol intake has nothing to do with serum cholesterol levels for the majority of people. 70% of patients won't see any change in their diet, in their blood cholesterol levels for the majority of people. 70% of patients won't see any change in their blood cholesterol levels by changing their dietary cholesterol levels, one way or the other. And how do you account for the other 30?

They're called hyper-responders, and that may be genetic. So they may have a certain APOE genotype that predisposes them to be more susceptible to the effects of dietary cholesterol. They may be hyperabsorbers of dietary cholesterol. So they actually absorb more through their gut than a typical person. But even those hyper responders, they found that both their total cholesterol went up, but that was because both their good and bad cholesterol went up at the same time. So the effects were seen as being not clinically relevant because although you saw an increase in the total, it was driven by good going up as well as the bad going up a little bit. So it wasn't thought to be clinically significant.

Is it possible that, like what we were talking about before, long-term studies would reveal more because we were talking about certain nutrients when you eliminate them from the diet, it takes a long time to find the effect? Or what we were talking about with fish oil, that maybe if a long-term study showed increase in dietary cholesterol, you could see negative effects? Yeah, I think long-term studies could certainly reveal different effects. I think the biggest question here is, should we be looking at blood cholesterol levels as the sole arbiter of whether something is good or bad for us? You know what I mean? Like, let's say someone switches to a nutrient-dense, low-carb diet from that standard American diet, and let's say every single thing about their health improves. They lose weight. Their insulin levels decrease. Their blood sugar levels go down. Their blood pressure levels go down. Their inflammatory markers go down. By the way, this is not a theoretical thing. This is something I see

every day in my practice. But their total cholesterol goes up. Is that a bad thing? Is that a good thing? You know, should they go back to the standard American diet that they were eating? I'm sorry to interrupt you, but if you could, can you explain what is the difference between bad cholesterol and good cholesterol to the people that are listening to this? So this is a really big oversimplification.

And it was created, I think, by the drug companies to make it seem very simple. Like, you know, good cholesterol, good. Bad cholesterol, bad. Our drug lowers your bad cholesterol. Good. You know, that's how simple they want it to be. It's not actually that simple. So-called bad cholesterol actually has some important roles that it plays. It wasn't actually just there to give us heart attacks, contrary to what that model would assume. And what's even more wrong about referring to cholesterol is we're not actually—what's important is not really how much cholesterol we have. What's important is the lipoproteins. So let me see if I can use an analogy here. So imagine your bloodstream is like a highway.

And the cars on the highway are the lipoproteins. And the passengers in the car are the cholesterol that the lipoproteins carry around the body. passengers in the car are the cholesterol that the lipoproteins carry around the body. And lipoproteins also carry fat-soluble vitamins like vitamin A and vitamin D and triglycerides and other things that our body actually needs. So they're like a taxi service that carries cholesterol and fats and other nutrients all around the body and takes them to the cells where they're actually used. So for years, it was thought that the amount of cholesterol inside the lipoproteins was the big issue. And that's what's measured when you go and you get a lipid panel and you get your total cholesterol, your LDL, and your HDL cholesterol.

They're essentially measuring the passengers in the cars, like how much cholesterol is inside of those particles. And that was thought to be the driving factor for risk for heart disease. We now know that it's not really the cholesterol inside of the particles that makes the difference. It's how many particles you have. So to use, come back to this analogy, if you have a highway and you've got a whole bunch of cars on the highway, it's a lot likely that one, more likely one of them's going to go off the road and crash, right? And they'll crash into the artery, the endothelial wall of the artery, and they'll damage the artery. And that's what initiates this whole process of plaque formation that

eventually leads to heart disease. So it's literally like volume? It's a gradient-driven process. So if you have a high number of particles in the luminal space of the artery, they will try to diffuse across the lumen. So is it an issue with overeating? No. So what we're talking about here is the number of particles. Right. And all of the things that I talked about earlier that raise cholesterol, what I was actually referring to is things that raise LDL particles. I just didn't want to go into all of this nuance at the risk of confusing people.

But LDL versus HDL. Yeah, so you have LDL particles and you have HDL particles. LDL stands for low-density lipoprotein, HDL for high-density lipoprotein. And traditionally, LDL particles have been viewed as bad. That's the bad cholesterol. And HDL particles have been viewed as good. And there's definitely something to that. The single most important risk marker from a blood lipid standpoint,

or the two most, would be LDL particle number and another lipoprotein called lipoprotein little a. So coming back to our analogy, if you have a whole lot of LDL particles or a whole lot of cars on the road, there's more of a chance that one of them is going to damage the artery, and then that whole process of plaque formation is going to occur. And that's what increases the risk of heart disease. So the name of the game is to keep your LDL particle number down. And when we talk about the things that increase it, going back to early in the interview, genetics do play a role. Diet definitely plays a role, but then also things like thyroid function, infections, inflammation, and leaky gut play a role. So it's not happening

in isolation. You know, it's our, it's once again, we have to look at our whole health, you know, our diet, how we sleep, how we live, whether we have infections or inflammation or gut stuff going on. And I have many patients, often guys who come to me, their only complaint is that they have high cholesterol. Now, I don't know if they're not, if they really are 100% healthy and that's their only complaint. We test their LDL particle number, it's high. They say they have no gut issues, they have no fatigue, no other health problems at all. But then I test their gut and I do all these testing and we find issues. We address those issues and their LDL particle drops by 30, 40, even 50% sometimes. Wow. Which is more than

you would expect from a statin. Yeah. So this again, this is another one of those things. It's way more nuanced than it's made out to be. And it is true that LDL particles play an important role in how heart disease develops. But this dominant paradigm notion that saturated fat and dietary cholesterol are the main things that influence our LDL particle number is false. My friend Anthony Bourdain was taking statins because he used to eat a lot. He still eats a lot. And he was developing high blood pressure and, you know, all the issues that we're just outlining. He started training every day doing Brazilian jujitsu, like got really obsessed with it. No longer has to take statins.

Right. Changed his cholesterol profile, which is like really kind of fascinating. I'm sure he's eating healthier. Yeah. But to me, that's a very strange thing. Like what is happening that's causing his cholesterol to drop because of exercise at 58 years old? Did he lose weight? Lost a lot of weight.

Lost 30 pounds. The fastest way you can normalize your cholesterol profile and really your LDL particle number, which is even more important, and your blood pressure is weight loss. Why is it a contributing factor? pressure is weight loss. And why is it a contributing factor? It's just, there's a whole constellation of metabolic changes that happens when we become overweight that include insulin resistance and leptin resistance. All the gut issues you outlined. All the gut issues, inflammation, and this creates like a milieu that leads to dyslipidemia, which is this. which is this. So each particle, so we talked about this, the cars on the road, a car can only hold so much, so many passengers, right? And if you have a lot of fats, the fats will take up all the space in the cars and you will need more cars to carry a given amount of cholesterol around the

body because we need cholesterol for sex hormone production and other things that you mentioned earlier in the show so if you have a lot of triglyceride a lot of fat in your liver the the liver will make more ldl particles because it needs more particles to carry the amount of cholesterol that needs to get around the body so that's actually what's happening that That might have been too much detail, but that's why when you're overweight and you have more fat, you actually have a higher LDL particle number. And when you lose weight, the converse happens. You need fewer particles to transport the same amount of cholesterol.

So your LDL particle will go down. Your insulin and leptin sensitivity will improve, your gut may improve also, and your blood pressure will typically go down because the heart doesn't need to work as hard to pump as much blood. Makes sense. The terminology of bad cholesterol versus good cholesterol is kind of problematic, isn't it? Because doesn't LDL play some sort of beneficial roles? Like you don't want to eliminate LDL. No. I mean, some have argued that it should be zero, but I don't think that that makes much sense biologically. One role that it plays is it's antimicrobial. LDL particles are antimicrobial. So that if toxins do get into

the bloodstream, like lipopolysaccharide, for example, LDL particles will be manufactured to deal with that. And that's one reason why chronic infections increase LDL particle number, because the body's attempting to deal with that infection and the toxins. As I mentioned as well, the LDL particles are like a taxi service that carry nutrients to different parts of the body, fat-soluble vitamins and fats like triglycerides and antioxidants too that we need to function properly. So I think it's a question of balance. You know, we want to keep our LDL particle in a range that contributes to health and doesn't increase our risk substantially for

heart disease. Yeah, it's one of those things that it's so oversimplified in the way people describe them that it sort of leads people to think, well, I just need to take a statin. Well, I just need to take a pill. And this is the way it's being described to people that have these issues by doctors and these very brief seven minute meetings that they're having with their doctors for the next person in line gets in. This is a it's a really bad system. It's a really bad system that and look, we're having this conversation and I'm a person who obviously I didn't go to school for this. who obviously I didn't go to school for this. And I'm trying to take all this stuff in over a period of years of reading and watching documentaries and talking to people like you and Dr. Rhonda Patrick and, you know, so many different people,

Rob Wolf and so many different people that are experts in nutrition and the way the body processes nutrients. And I'm still baffled by a massive amount of it, given the many, many, many, many, many hours I've been paying attention to it. It's incredibly complex. It's so complex. I mean, it's like any other pursuit, I think. The more you know, the less you know. You realize that you could spend your lifetime learning about this and you would still have many lifetimes to go before you felt like you really could master it. Yeah. I think Dennis McKenna had a great way of describing learning something and realizing how

little you learn that when the bonfire of understanding increases, it illuminates the surface layer of ignorance greater. Yeah. I love that. Yeah. That's exactly how I feel about this. At the same time, I think our knowledge is advancing and we are in a different place even just 10 years ago than we were 10 years ago.

Yes. We understand things. So I think- But maybe some doctors know, right? Like there's a lot of people that would talk to their doctor and a doctor go, oh, that's nonsense. Right. Oh, oh, that's nonsense. Oh, well, these guys are these so-called experts.

And they'll go on about it. I mean, here's the interesting thing about that. Number one is that there's a real lag time between what's in the scientific literature that anyone can access now. You know, I mean, they may not, you may, average person doesn't have access to the full text, but anyone can access now. You know, I mean, they may not, you may,

average person doesn't have access to the full text, but anyone can go to pubmed.gov and pull up abstracts from the hundreds of thousands of scientific studies that are published. And you will see if you do that, I mean, if you're inclined to do that, that there, you know, the vast majority of recent research suggests that dietary saturated fat and dietary cholesterol are not major risk factors for heart disease. But the time it will take for that knowledge to per long it took for the idea that saturated fat and dietary cholesterol were bad for us to get hammered into our heads. I mean, that started in the 50s and it didn't really sink in, I don't think, until the 80s or the 90s, you know, with the boneless chicken, skinless chicken breast and the bagels with no butter, cream cheese. And, you know, like

that was my generation, like that, you know, pasta and carb loading and that whole thing. That was 30 years after this whole campaign started. And unfortunately, I think it's going to take another couple of decades. Hopefully it will go faster this time. And then there are some signs that it is going faster. But the average primary care provider,

they're seeing patients 30, 40 hours a week. They have families, they have other, you know, their own health to consider. They're not going home at night and reading scientific literature. They are trying to take care of their patients, trying to live their own life. And they only know what they were taught in medical school, which, you know, unless they're doing continuing education and the medical school textbooks are out of date as soon as they're printed. And they're based on studies that were done 50 or, you know, 40 or 50 years ago. So this is a huge problem in medical education is that the current research, you know, the public, the policy and the standard of care is not based on the most recent research and the peer reviewed evidence that we have available to us now.

It's based often on research that's decades old. This stuff takes so long to process. People have these podcasts and they go over them three or four times and start taking notes and just try to make these changes in their life. If you wanted to give someone advice as to like, what is the best way to proceed? If someone's listening to this podcast, they say, okay, obviously I really need to know what's going on in my gut. I need to know what's going on with my overall blood lipids, my health, my nutrient density. What does the average person do? Yeah. So I think the first, the very first thing is to, I can sum up in three words, eat real food. And, you know, you can talk about paleo, primal, paleo template.

Okay, that's, you know, I would argue that that's a step above. But just eating real food, like avoiding things that come in a bag or a box, you know, butter comes in a box. All right, let's not get too hung up on that. But you know what I mean when I say that, right? Actual food. Actual real food. Vegetables that come out of the ground. Vegetables that come out of the ground and fruits and nuts and seeds and some even, you know, some tubers, sweet potatoes. I think white potatoes get a bad rap and they're fine for most people as long as they're not, you know, fried in crappy oil. And the skins are actually really good for you. The skins are good for you and, you know, eat some good pasture-raised, you know, organic, if possible, animal products and wild-caught fish, if you can do that. And I really think

that that would solve like 80% of people's problems. If you're already doing that or you've already got that down and you've already got that down, and you're still having additional issues, this is where functional medicine comes in, which we've kind of touched on at various points along the way. But this is a relatively new and fast-growing branch of medicine that is focused on addressing the underlying cause of illness, you know, taking the pebble out of the shoe instead of just suppressing symptoms. And there are several training organizations out there. Institute for Functional Medicine has been around the longest and is pretty well known. I have Kresser Institute, which just started. We're training the 200, we have 200 doctors and

other healthcare professionals in the program now. And you can go to these websites and look for practitioners that practice functional medicine. And unfortunately, it's not yet at the level where there's one on every corner, like a yoga studio. Right. But it's changing fast. And, you know, for example, Mark Hyman, who's a nine-time, number one New York Times bestselling author, doctor, health expert, he recently was tapped to start the Center for Functional Medicine at the Cleveland Clinic, which is a very prestigious medical institution. And they already have a six-month wait list, and it's just blowing up. So I think the tide is turning, and pretty soon a lot of people will be seeing functional medicine practitioners. But these are the practitioners that are likely to be knowledgeable about how to properly test your gut, how to assess your HPA axis, your stress tolerance and resilience, how to look at your functional, your blood chemistry panel. So look at your blood sugar, your lipids, your metabolic function, your vitamin D, your

B12 levels. Take all that information and then create like a customized individual plan for you based on all of your lab test results, your current symptoms and signs, your health history, your family history, and your lifestyle. Put all of that together and then make a plan for you. And as you can imagine, that takes time. You know, the typical first appointment is more like an hour and a half than seven minutes. And it also can be more expensive because there's a lot of lab work that's done up front to try to figure out what's causing the problems. But I would argue that it's less expensive over the long term because when you address the root of the problem, the treatment is going to be way more effective and it's going to be way longer lasting.

effective and it's going to be way longer lasting. And I think I can say from my own personal experience from someone who's changed their diet and eliminated almost all sugar in terms of like added sugar, very, very little do I take in a daily basis. I eliminated almost all simple carbs. My energy levels are so much better. I don't crash like I used to. I feel like overall my health is better. I talked about my, um, increase over the last few years of probiotics made a giant benefit made. It's made a huge impact in terms of my ability to recover from illnesses, my ability to avoid illnesses. And I have little kids. So my kids are in school, I travel. Airplanes are just like disease vector labs, you know. But I survive them so much better than a lot of my peers who don't take care of themselves the

same way. It just, it makes a big difference in that overall quality of life difference is so significant and it has such an impact on your productivity, on your energy levels, your happiness, because you're not constantly fighting diseases and illnesses. And that is another thing that people I think ignore or maybe are not really aware of is the function of your health and your immune system and your gut biome and how it translates into your actual personality. That's a huge point. I'm really glad you brought that up. And it does that in a couple of different ways. One is just the actual chemical influence that we talked about, your gut bacteria, how it influences your brain chemistry and can affect your mood. But the other, I think, is more related to just how you experience your life

when you feel good versus when you feel crappy. Like you pointed out, your productivity increases, you're just happier, you have more time to be effective, and you're probably able to be more present with your kids if you're in a relationship with your partner. And I mean, it's a dramatic difference. I think one of the downsides of how adaptable we are as human beings is we can get used to some pretty heavy stuff. And a lot of people, I think, are sick, or at least they're not well. They're not really healthy.

And there's a kind of normalization of that that happens in our culture. It's just common that people are taking drugs. People are taking more than one drug. They don't feel well. They're not sleeping well. That's common, but I don't think it's normal. There's a really important difference between what's common and what's normal. I think that's an awesome point.

And I think this has been a great conversation. I really, really thank you for coming in here. And thanks for your awesome website. There's so much data and so much information there. ChrisKresser.com for people that are interested. There's a ton of articles up there. ChrisKresser.com for people that are interested. There's a ton of articles up there. And if they want to follow any of your other work, where can you direct them? Yeah. ChrisKresser.com is the main place. I have a podcast called Revolution Health Radio

on iTunes. And then for any clinicians that are interested in learning more about this approach is KresserInstitute.com. Thank you, Chris. Appreciate it, man. This was awesome. I'm going to do this again. Love to. Take it in, folks. We will be back tomorrow. Who's here tomorrow? What's that? Tony Hinchcliffe, the golden pony. Unhealthy, cigarette-smoking

little fuck. He'll be here tomorrow. See ya. Bye. Love you guys. That was great.