The Rich Roll Podcast - Balancing Your Hormones With Neal Barnard, MD

Episode Date: January 13, 2020

A predominant theme of this podcast is the profound impact of nutrition on long-term well-being. Less discussed is the importance of hormonal health. Most would be surprised to learn that certain maladies -- including infertility, menstrual cramps, weight gain, hair loss, breast and prostate cancer, hot flashes, and many others -- have one thing in common: they are fueled or influenced by hormones hiding in everyday foods. The good (and surprising) news is that proper nutrition can also help restore endocrine balance, often with benefits that rival popular medications. To provide insight on how hormones wreak havoc on the body, and how specific diet and lifestyle changes can help alleviate years of stress, pain and illness, I'm joined today by my friend Neal Barnard, MD. Making this third appearance on the podcast (check episodes #242 / #296), Dr. Barnard is a pre-eminent authority on diet, nutrition and its impact on illnesses such as atherosclerosis, diabetes, cancer and Alzheimer’s. In addition, he is the founder & president of The Physicians Committee for Responsible Medicine (PCRM), where he leads programs advocating for preventive medicine, good nutrition, and higher ethical standards in research. Dr. Barnard is also an adjunct associate professor of medicine at George Washington University and has authored over 70 scientific publications as well as 18 books, including Power Foods for the Brain, 21-Day Weight Loss Kickstart, Dr. Barnard’s Program for Reversing Diabetes and The Cheese Trap. Hitting bookstores February 4 and currently available for pre-order, Dr. Barnard's latest offering -- and the focus of today's discussion -- is entitled, Your Body in Balance: The New Science of Food, Hormones, and Health. A powerful step-by-step guide to better understand what you can do to feel better fast, it covers the important hows and whys of striking hormonal balance for optimal wellness. Today we dive deep to better understand the mechanisms of optimizing hormonal health. We begin with a deconstruction of recent science on the implications of eating meat on human health. We then turn to a wide-ranging discussion on the endocrine system. The impact of testosterone levels in men. And how diet and lifestyle impact fertility and menstruation in women. We examine how left unchecked, hormone imbalances can lead to everything from autoimmune diseases, hyperthyroidism, adrenal fatigue, depression and anxiety. And we conclude with the many simple things you can do to prevent such imbalances and thrive. You can watch it all go down on YouTube. And as always, the conversation streams wild and free on Apple Podcasts and Spotify. I love this man. This is a fascinating discourse. And I sincerely hope you enjoy our exchange. Peace + Plants, Rich

Our bodies are fragile. Things go wrong with it all the time. Just like your car, it's not going to last forever for any of us. But we've got some tools that are so cool. And my message and the message of Your Body in Balance is let's use foods to get you into balance. Not a pill, not something else. Let's use diet and lifestyle. My goal is, if we don't do this, your kids are going to grow up thinking it's normal to gain weight, it's normal to feel rotten, it's normal to be on medication when you're 30, it's normal to be in poor health. And if I just give you a metformin prescription for your diabetes and a Synthroid prescription for your thyroid issues, I'm not helping anybody other than you. If we can change the way the family eats, you're affecting everybody together. If we can change the way the family eats, you're affecting everybody together.

And rather than using people as recipients of prescriptions, even though we may need those sometimes, let's instead work with people as partners to help them to put the best fuel in their body and see if we can't get better. And I want to see an investment in that kind of research that is bigger than what we've had in the past. That's Dr. Neil Bernard, this week on The Rich Roll Podcast. The Rich Roll Podcast. What's up, people? How are you guys doing? What's happening?

My name is Rich Roll. 2020 is definitely happening, and I am still your podcast host. Welcome. So, my good friend, Dr. Neil Bernard, MD, is on the pod today, dropping in for his third appearance. Check episodes 242 and 296 if you missed them the first time around. if you missed them the first time around. And today's discussion is focused specifically on the perils of unbalanced hormones on human health. But first, Australia.

This is my first on-mic appearance since I got back from a month down under. And as you might've heard me mention in my recent podcast with Julie, I think it's fair to say I was in desperate need of an extended break. I hadn't taken any legitimate true time off in honestly seven years.

So I made a commitment last year around this time to carve out the entire month of December. So I worked my butt off the entire year and basically ended up doubling my workload in October and November to bank a ton of episodes. So I could take the entire month of December off and keep the show rolling in my absence. And I accomplished that. It was an incredible gift. I realize I'm very blessed to be able to have been able to have this opportunity an entire month in Australia. No work, no email. I wouldn't say it was a 100% digital detox. Those who follow me on social media know that I did post here and there only when I felt like it. But otherwise, and thanks to my amazing team who handled getting the show up on time in my absence

without any hiccups whatsoever, I was really able to, for the very first time in a very long time, as far as I could remember, to let it all go. And it was absolutely glorious. Three weeks in Sydney, I was staying right in Bondi Beach, which was just perfectly suited to everything that I wanted to do, swimming every day at the beach. I also spent a week up in Byron Bay with

my family, which I got to say is probably my new favorite place in the world. I'd never been there before. It was just phenomenal. And I've returned with a certain clarity. I'm refreshed. I'm renewed, energetic, and really enthusiastic for the year ahead. And I have to say, though, that I decided last year that I wanted to go to Australia, not knowing what would be occurring in this beautiful country. And the whole experience was a bit tempered, I should add, due to the horrendous fires that are debilitating Australia. Something like 200 fires have been blazing for over four months at this point. An area twice the size of Belgium has been devastated. I think it's the worst brush fires that have ever been recorded.

And I think it's fair to say perhaps the most apocalyptic human-created climate crisis of our time. Over 500 million animals dead. Some are citing perhaps a billion. There are horrible images of koalas and kangaroos that have been sacrificed in this, if you're looking at the news or on social media. Untold thousands of people displaced, human lives lost, countless firefighters and rescue workers' lives have been imperiled. And there's no end currently in sight, although I do believe there was a bit of rain the other day, so that's great. From what I understand, the smoke plume is wider than the size of Europe. I just saw the other day that some of the smoke from the fires has reached Chile, which is unbelievable.

And I didn't actually witness any fires firsthand. Most of my time was spent in Sydney, but I did experience air quality in Sydney that was at times just basically unbreathable. Like you couldn't go outside. I was in the city and you could barely see across the harbor. You could barely see the bridge. It was just unbelievable. I mean, the devastation is unimaginable. It's horrendous. My heart breaks for everybody who's been impacted by this. It's hard to wrap your head around it.

And it is not normal. I posted about this on Instagram the other day, but just to reiterate, I think that this kind of dystopia can leave one feeling helpless because I think governments and policy have failed us. We're seeing this firsthand and it is indeed time to demand change. And my hope is that this event will finally galvanize the social and political will that's required to snap collective denial and face the uncomfortable truth of our ways and hopefully set

in motion the global policy changes and seismic innovation from the private sector that I think we require to forge a sustainable world for ourselves and future generations. But here's the thing. All of that said, change still starts at home. And we can't just resort to blame and finger wagging alone. And we've got to all take responsibility for creating this better world for ourselves and future generations. So why not begin 2020 with what we can all do to be part of the solution by eliminating or limiting our intake of animal products, by significantly reducing our dependence on unsustainable energy, by ending our addiction to things like single-use plastics and fast fashion, and educating ourselves, which is part of why I do this podcast.

I think also in terms of things that we can do now to support what is happening, let's support the groups on the front lines that really need our help right now on the fire. So I listed a few in my Instagram, like Wildlife Rescue, the Victoria Fire Service, the New South Wales Fire Service, the Red Cross. You can find those links on my Instagram page at Rich Roll. Find those links on my Instagram page at Rich Roll. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And

with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because unfortunately, not all treatment resources adhere to ethical practices. It's a real problem, a problem I'm now happy and proud to share has been solved by the people at Recovery.com, who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs. Thank you. Simple, search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you.

I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful, and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. So let's talk about Dr. Neil Bernard, shall we? A preeminent authority on diet, nutrition, and its impact on illnesses such as atherosclerosis, that's heart disease, diabetes, cancer, and Alzheimer's, Neil is the founder and president of PCRM, the Physicians Committee for Responsible Medicine, where he

leads programs advocating for preventive medicine, good nutrition, and higher ethical standards in research. He's also an adjunct associate professor of medicine at George Washington University and has authored over 70 scientific publications as well as 18 books, a few of which we have discussed in past episodes, like Dr. Bernard's program for reversing diabetes and the cheese trap. And his latest coming out February 4th is entitled Your Body in Balance, the new science of food hormones and health. It covers the many ways that hormones and hormone health and hormone balance and imbalances can affect the body and basically forms the basis of today's conversation, which covers many topics,

including the impact of testosterone levels in men and how diet and lifestyle impact fertility and menstruation in women. We talk about how hormone imbalances driven by diet and lifestyle choices can lead to anything and everything from autoimmune diseases like hyperthyroidism, adrenal fatigue, depression, and anxiety, plus many other subjects. It's a fascinating deep dive, so let's get into it. This is me and Dr. Neil Bernard, MD.

Delighted to have you back on the show, your third appearance on the show. I think the last time you were on was at least about a year and a half ago, I think. It's been a long time. At this point. Lots has happened since then. You've got this new book coming out, which we're going to talk about, Your Body in Balance, which is all about hormone health and the impact of nutrition and lifestyle on hormones and the downstream impact of that on everything that we're interested in here. But before we dive into that, because it's so topical and top of mind, even though we're recording this well in advance of this coming out, I think it's important to talk about this, which is this study that came out recently that made headlines across the world

that in so many words basically said, keep eating meat. There's no link between your meat intake and any kind of disease. So walk me through this study, how those headlines came to be and your response to it. It was such a crazy scenario. What happened was the Annals of Internal Medicine published six articles from one research group headed by a guy named Bradley Johnston in Canada. NutraRex, right? NutraRex, whatever that is. So the first four of these six articles were meta-analyses.

So there's nothing new. What they do is they took existing research and crunched it in a new way. And what they found in these four articles was if you reduce your meat intake, you actually do cut your risk of cancer, cut your risk of a heart attack, cut your risk of stroke and diabetes, and that it's not chance. It's statistically significant, meaning it's very unlikely that this is just some chance result. However, he did a fifth article where they looked at preferences and values,

and they looked at prior studies of meat eaters, and they concluded meat eaters like meat. Right. And in fact, they think they need meat. Of course, you know, a lot of meat eaters, where do I get my protein, that kind of thing. So then they did a sixth article, which was, what do we recommend? And what they recommend, I'm not making this up. They said the reduction in cancer and heart attack and stroke and diabetes isn't worth it if you have to give up meat. And so they recommended continue eating meat, including the

most unhealthy forms like sausage and bacon, the ones that are clear-cut human carcinogens. And I have to say, I'm going to point a finger of blame at the journal, the Annals of Internal Medicine, because they were the one that back in, I think it was 2014. You remember Time Magazine had that cover story with butter on it, a big swirl of butter? Yeah, I think it was 2014. You remember Time Magazine had that cover story with butter on it, a big swirl of butter? Yeah, I'll never forget that cover. It said, eat butter. Butter is back. Same journal. Same journal. And they published an equally not so good meta-analysis saying they couldn't sort out the risks of saturated fat. So go ahead and eat butter. And then in 2016,

2017, they published another article saying sugar is okay. And that was, by the way, the same author. It was Johnston. It was him again. Johnston or Johnston? Johnston. Johnston, right. And it then came out that he was taking money from the food industry. It was like a whole battery of conglomerates that included Coca-Cola and ConAgra, et cetera.

He did disclose it. Did he make the disclosure with that study though? Yes, I think so. I think so. But somehow it was sort of reported in the press and it was a while before people got onto the fact that, if you're going to say that Dr. Pepper is good for you, look who's paying for it. So they were kind of disgraced.

So then this new thing came out. And the reason I'm going to blame the journal is that the Annals of Internal Medicine did not say, these meta-analyses show that reducing meat would actually help you. And if you want to reduce meat, it will help you. Oh, by the way, this was just the benefit of reducing. What if you stop eating it completely? The benefits are even greater. And they didn't dive into things like, yeah, meat eaters might think that they need it or it's a source of protein, but there was nothing about what if you educate people?

Is it not true that people are in fact changing their diet? I mean, look at the marketplace, veggie burgers and everything is just taking off. So anyway, they issued a press release and the press picked it up saying new guidelines, there were no new guidelines, this was just for Johnston's idea and that you can just continue eating meat for good health.

And I have to say, I contacted the editor and she said, you know, you're right. We went a little too far with that. We'll change it. I don't think they did change it at all. Well, a couple of things. First of all, wasn't there an initiative or an effort to prevent that from being published

in that journal ahead of time? Because I think I'm on that email chain that I believe you're on as well from David Katz. And there was like, how can, before it was published, there was an awareness that this was gonna be coming out and an effort to let this journal know that this was gonna be irresponsible. The journal sent out this press release.

The journalists started calling experts. The experts were disgusted by this. They said, you're completely misinterpreting the science here. And so David Katz and many others, lots of others, wrote to the journal and said, think this through a little bit before you say that people should keep eating meat. Look at your own science and look at the body of science. They just ignored it. And I don't know if it was clickbait or if there's some other reason. Journals do want a lot of controversy in the press. They like to have their name out there because it improves what they call their impact factor

compared with other journals. But then when we dug into it a little deeper, the New York Times did a story saying, hey, wait a minute, this was the same guy who was funded for the sugar. It's like a couple of weeks later this article came out. Right, but what didn't come out at the time and what did not make the headlines

is that just six months before this article came out, Bradley Johnston had signed a deal with Texas A&M University's AgriLife program, which oversees all their beef promotion programs. And I know that your listeners have never heard of this, but it was very troubling. Texas A&M University in Texas, they promote beef. And the head of that group is a guy named Patrick Stover, who signed an agreement with Bradley Johnston and came onto the project and became a co-author. And when you look at their disclosure forms, when you do research,

you have to disclose your conflicts of interest. And they say things like, are you getting money from anywhere? The answer is no. Is there anything even aside from money that could look like a conflict of interest? like you run beef promotion programs, for example. No, they wrote no, none of that. None of that came out. Yeah, sorry to interrupt, but as I recall from that Times article, the letter of the law was that you have to disclose any conflicts of interest in the last three years. And he had had a deal, that same deal that he had that was with respect to that sugar study that he did that had expired shortly beforehand.

So it was a little bit outside of that window. So his response was, well, that was more than three years ago. I wasn't required to make that disclosure, but that's not in the spirit of what this provision is, which is to basically say, listen, is there anything that you've done that could potentially compromise these findings? That's right. And this new thing was totally current.

It was current at the time. And that was not in the New York Times article. The New York Times didn't pick it up. What I'm saying is the beef industry signs, or not the beef industry, Texas A&M University, which gets beef checkoff money and promotes beef heavily, signed an agreement with Brad Johnson's group. Six months later, they come out with this study saying, eat beef. You don't want to give up beef, do you? And then the press goes, well, new guidelines, I guess. And it was really a sad situation. So maybe I'm mistaken, but wasn't part of the study based on this built-in assumption that people are typically only eating meat like three times a week.

So for their guidelines to suggest like keep doing what you're doing is disingenuous because most people are eating meat like 20 times a week. I mean, they're eating it probably twice a day. They may be. And their own research did show that if you reduce meat consumption or you eat very little meat, you do better than if you eat a lot. And our research and that of many, many other teams show that if you just throw out the meat completely, replace it with healthier foods, you do dramatically better.

So there was really not much question about getting away from meat is a good idea, but it was just the way that they characterized it in the guidelines they came up with, which were really meat friendly. So in the wake of this article getting published in this journal, there was a bit of a kerfuffle, that resulted in these New

York Times articles. But also, I think there was like 12,000 physicians that came out against this American College of Cardiology. And of course, you at PCRM, you guys filed a petition with the FTC. So explain to me what that's all about. The Federal Trade Commission regulates advertising and a press release that goes out to the press to sell your journal and sell your website, that's advertising. So we went after the Annals of Internal Medicine. We filed a complaint with the Federal Trade Commission

to say when you advertise yourself, saying you've got new guidelines that you can keep eating all the meat you want, whatever, we said that that's harmful to people and it's also false. Now, it may sound like it's a bit reaching to try to get the annals to be dragged to the FTC. However, we did exactly this with the dairy industry

some years ago when they were advertising, if you're trying to lose weight and dairy is part of your diet, you'll lose more weight than if you're trying to lose weight and dairy isn't in your diet. You might remember these ads that dairy helps you lose weight. Well, there just was no good science behind that.

And the Federal Trade Commission ruled in our favor on that. So we're gonna do the same now. Right, so what's the status of that at the moment? At the moment, the FTC has it on their desk. We'll see what we hear. It's so crazy. I saw a tweet the other day from the Dairy Council or some milk-affiliated organization that said something along the lines of,

milk is better for hydration than water. To me, I don't understand how that could possibly be, but that seems like a flagrant violation of FTC guidelines regarding advertising. There's lots of goofy stuff. And I have to tell you that goofy stuff comes out on a cycle. If it's a five-year like 2000, 2005, 2010, 2015, 2020, that's when the goofy stuff comes out. Because the dietary guidelines for Americans are reformulated every five years. And so what we've been seeing is these articles saying, new studies show that eggs are good for you,

there should be no restriction on dietary cholesterol, dairy is good for you, eat butter. So that was in 2014 going up to the 2015 guidelines revision. So what they're trying to do now, this Dietary Guidelines Advisory Committee, this meeting in Washington, and they're gonna say what kids should eat in school and everywhere else. And so the beef industry, the dairy industry, the chocolate

manufacturers, everybody is pushing on them with their guidelines that emphasize their product. And then the reporters dutifully parrot this message and the public goes, oh. That's a problem. I mean, that's interesting. So it's very much like a presidential campaign. Here we are in the lead up to this 2020 scenario in which the guidelines are gonna get revamped and there are vested interests that have a lot to gain or lose based upon what ends up in those recommendations.

I'm pleased to tell you that Ukraine was not involved in this so far. We don't know. I know, but I have to say it is disheartening because we all imagine journal editors are sort of above the fray and they just want to have the truth come out and that they're not out there hawking an idea

and whatever, but it's been creepy to see, I have to say. Yeah, well, if there's one thing I've learned from our social media infused culture, it's just how hyperbolic the diet and nutrition wars are. And the front lines are being waged on Twitter and you see these, the vitriol that goes back and forth between these respective tribes and camps. And it's, you know, as somebody who's relatively steeped

in all of this, I get confused. And I wonder like, who's, you know, who is being buttressed by who and who's telling the truth? And can we really know with nutritional science, what with any sense of veracity, what is fact and what isn't? And so for the average consumer, I mean, confusion is the product.

Like the average person is just gonna be left thinking like, I can't trust any of this stuff because everyone's slinging arrows at each other all day long. Yeah, which confusion sells. The tobacco industry proved this. The jury was in and out. There was no question that tobacco caused cancer.

But if the tobacco industry could have some studies saying, well, there's some doubt here, some doubt there, they don't have to prove it's safe. Confusion is all you need to sell. And if you can say, well, what they did say in this case, bacon, sausage, these are the things that slam dunk the World Health Organization said they cause colorectal cancer, period. These new articles said, well, we're not 100% sure, the data are limited and whatever. So confusion really sells. Yeah, what do you make of this whole carnivore movement? Have you been paying attention to this at all?

Probably more than it deserves. I think this too shall pass. Yeah, it's fascinating what's going on right now. And I think it's more incumbent than ever before for all of us to pay closer attention and read the news with a critical eye. And also look for consistency of findings. If somebody tells you vegetables are not good for you

or an apple is gonna hurt you or beans, whatever. I mean, there's certain common sense things that we know. And the scientific studies are so clear and so uniform from observational studies to randomized clinical trials and everything that a plant-based diet is a healthy diet. The closer you get to an entirely plant-based diet, the better off you're going to be. Well, here we are. You're on the precipice of releasing. This is like your 15th book, right? Yeah.

You're a busy guy, which is amazing. So explain to me what drew your attention to hormonal health and why you've chosen to put a lens on this at this time. Rich, I stumbled into this completely by accident, because we think about food as affecting your weight or your cholesterol, but I was sitting at my desk one day and my phone rang and it was a young woman who said,

Dr. Barnard, I can't get out of bed. I said, what's the problem? And many women have some menstrual pain, but for maybe one in 10 or so, it's off the scale, cannot function for a day or two days. And this was her. She said, my mother told me I should call you and you could help me. And so I said, well, I can give you some painkillers for a couple of days.

But I started to think about what are cramps? And menstrual cramps, to put it simply, are the lining of the uterus is being thickened up every month in anticipation of pregnancy. And it's hormones, it's estrogen that does that. And if you have extra estrogen, female sex hormone, that uterine lining thickens up a whole lot more, and at the end of the month it all disintegrates in menstrual flow.

But as it disintegrates, that thick lining releases prostaglandins that cause cramping. So she's telling me her symptoms and I thought, wait a minute, I wonder if you got too much estrogen in your blood somehow. And it ran through my mind that I remembered from Physiology 101 that your liver has a way of removing estrogen. It takes it out of the blood. Your liver filters your blood. It pulls it out and sends it down through the bile duct into the intestinal tract. And as long as there's plenty of fiber in your intestine, it just flushes all that estrogen away, the excess. If there's not fiber in your digestive tract,

because you ate Velveeta for lunch, then those estrogens go back into circulation and your estrogen level stays too high. So I said to her, how about this? Let's try an experiment. I'll give you painkillers for a couple of days, but for the next month, would you like to try a diet that might help? No animal products, keep oils really, really low,

foods as natural as possible. Four weeks later, she called me back and said, this is astounding. My period came, zero symptoms, nothing. And then in the months that followed, same story. But then she loosened up her diet a little bit. The pain came back. So I thought, okay, that's one person. So I connected with our friends

at the Georgetown University Department of Obstetrics and Gynecology. And we did a research study. We brought in a large group of women. They all had moderate to severe pain every month. We split them into a placebo group effectively and a vegan group. And it works. The first thing they noticed is that PMS was different. Bloating and water retention cut way down. And then mood changes that they had been bothered by were reduced. And then when we tracked their pain, it was fewer days and less, noticeably less intensity.

So we thought, okay, that's really important. But Rich, I got to tell you something. In the course of this study, we told all the women, please don't take any hormonal preparations in the course of the study because it's going to goof up our results. And that includes birth control pills. So if you're sexually active, please use some other method because we don't want the hormones to interfere. One of the women said, don't worry about me.

My husband and I gave up trying to have a baby years ago. It's not him, we've been tested, it's me. I don't ovulate. She just was not releasing eggs on any kind of predictable basis. The second month that she was on the vegan diet, she came in and said, "'Dr. Barnard, I've got bad news and I've got good news.' I said, "'What is it?'

"'Well, I'm leaving your study because I am pregnant.'" And she was pregnant. And about eight years later, I was giving a lecture in a different city and I didn't realize she had moved. She came to my lecture and told me about her three kids. What I'm saying is that hormones affect pain, they affect fertility, they affect hormone-related cancers like breast cancer, prostate cancer, so many things.

And everybody is whirling these dials on their hormone levels by the food choices they make every day without having any conception of what is happening. So the reason I wrote Your Body in Balance is I thought, well, let's get your body in balance. Because all of these things make people miserable. In some cases, they just make you miserable. In other cases, like hormone-related cancers, they can kill you. So let's get this information out there.

And yes, if people want to buy prescription drugs, fair enough. If you need to have a hysterectomy for endometriosis, maybe. information out there and yes, if people wanna buy prescription drugs, fair enough. If you need to have a hysterectomy for endometriosis, maybe. But if we can just change your lunch and your dinner and do it like that, let's do that. Yeah, I mean, those are some pretty dramatic results. So walk me through, I mean, the first example that you gave was the impact of increasing fiber into that person's diet.

But then the study that you conducted was going full vegan. So those are two different things. So let's maybe talk about just nutrition in general and its impact on hormonal health and kind of differentiate between those two things. Okay. The reason that we went full on vegan is I gave you one example of fiber, but it's not all there is to it. This whole area started being studied 20 years ago, maybe more, for cancer patients. Breast cancer patients have one thing on their mind, which is I don't want my cancer to recur.

And so researchers have looked at dietary changes that reduce estrogens for cancer patients. And they found two things. The first is fiber, which I mentioned earlier, a high fiber diet flushes these estrogens away, quite literally. But the other thing is fat, animal fat, and even oils, vegetable oils. For a reason that I don't know the mechanism, we haven't figured it out. If I take a group of women and I put them on a fatty diet, their estrogen levels rise. And you can do both together. You could say high fiber, low fat, high fat, low fiber,

and you can see estrogen levels going up and down and up and down very rapidly. So we thought, okay, I don't want any animal fat in your diet at all. That means it's vegan, but we went a step further and kept oils low. So what that means is that everything you're eating has fiber. Everything you're eating is from a plant. There's nothing in your diet that's not a plant. And so you're getting abundant fiber, very little fat, and we thought that would work the best and it does.

Right. So high fiber, low fat, basically whole food plant-based diet. And over the course of this book, you kind of go through a whole battery of different, you know, maladies that I think are really affecting so many people right now. I mean, breast cancer is like one out of eight women or something like that. Like prostate cancer is one out of every nine men.

Infertility rates are insanely high right now. There's lots of opinions about what's contributing to that beyond hormonal health. Weight gain, thyroid, moods, hot flashes, you know, endometriosis, which you mentioned, menopause, acne, fibroids, like the whole thing, right? So you make this decision to divide this book up into basically a couple different categories.

The first is related to sex hormones and fertility and ovulation. The next relates to metabolism and mood. So why don't we just like go through it? I mean, we're talking a little bit about sex hormones right now. But this fertility thing is super interesting i mean i know i'm sure you know you know tons of couples that are having trouble conceiving and ivf and the like are are you know things that you're just hearing about more and more and more all the time um and i think there are a variety of contributors and some may have nothing to do with diet, that's possible,

or they may have to do with chemicals you're being exposed to without being aware of it. But diet is a big part of it. One of the obvious things is that people are gaining more weight than they used to and they're gaining weight earlier. We see a lot of kids where childhood obesity has become a thing. And if you look at what weight is your fertility the best, it's actually not when you're a little bit overweight. A person might think, wow, if I'm overweight,

that's going to be helpful in some way. Uh-uh. When fertility for women is at its highest, it's on sort of the thin side of normal. You don't want to be overly thin. That's not good. But you definitely don't want to be overly thin, that's not good, but you definitely don't want to be overweight, fertility is impaired. And why would that be?

Because fat cells are not just little lifeless bags of calories, they are hormone factories. And this is also true in men. If you go to the beach, you see overweight men with their shirts off and they've got some breast development. And that is because as they've gained weight, their own body fat is making estrogens causing breast tissue formation. So in a woman, you need a certain amount of estrogen. You don't need a huge boatload

because that'll interfere with fertility. And then there's a dairy connection, which completely blew me away. The dairy, in this case, there are hormones in dairy. As you know, there are estrogens in dairy and that's probably part of it. But the sugar in dairy products, lactose, breaks down in your body to release galactose, it's a breakdown product, and that's toxic to the ovaries. It's linked to ovarian cancer, it's linked to infertility. breakdown product and that's toxic to the ovaries. It's linked to ovarian cancer, it's linked to infertility. And the most amazing thing, if you look at countries that have the least dairy intake,

they tend to have a pretty good preservation of their fertility. In a woman who's from her late 20s to her late 30s, she's going to tend to maintain her fertility. You go to a place like the United States where people consume a lot of dairy. There's this enormous drop in fertility between the late 20s and the late 30s. And it goes right along with galactose intake. So my point is dairy doesn't do the body good.

Yeah. Wow, that's amazing. So in terms of addressing that, you have dietary protocols, but there's also life studies like, look, you got to exercise, you got to lose a certain amount of weight. There's a whole section on chemicals, which I want to get into as well, because I think that's a big part of this that people don't talk a lot about. But what was amazing is the reversals that you're seeing. I mean, this book is filled with all these anecdotes of patients that you've treated where the turnaround times are really quite rapid.

One, yes, they are. In the menstrual pain study that I described briefly where the women, their pain improved, that was in the second cycle, you know, eight weeks time. Will you get better if you go to 12 weeks? Sure, 16 weeks, yeah, absolutely. But the changes are quick. And one of the stories, true story,

that I have really been struck by was that of a woman named Catherine Lawrence, who was in the Air Force, went to Iraq in 2003. She designed military bases. And when she got back home, her friend said, Catherine, what all did you miss when you were over in Iraq? Which foods did you miss? And she missed cheese.

So she had a friend who gave her, I'm not making this up, 48 boxes, those little blue boxes of macaroni and cheese. For 48 days straight, she ate mac and cheese dinners that her friend gave her. So anyway, she gained weight and she started to get pain in her abdomen and it got worse and worse and it worsened with her cycle in particular. And so eventually her doctor did a laparoscopy where you look into the abdomen with a little scope and he gave her a diagnosis. And the diagnosis is endometriosis. That's where the lining of the uterus is shedding cells

that travel up and implant all around the abdomen. And they cause pain because they swell with your cycle, but they also will strangle the fallopian tubes, causing infertility. Anyhow, a lot of women will have a trace of this. For some women, it is... Debilitating. Yeah, miserable.

I'm talking about fistfuls of ibuprofen don't get you through the day. And hysterectomy is basically the protocol often, right? That's what was recommended to her. And if painkillers and hormonal treatments don't work, that's kind of your option. And in fact, she scheduled her hysterectomy. However, before she could have it, a friend of hers said, Catherine, let's try a diet change.

Maybe this'll help you. Well, she went low-fat vegan. That was basically it and started almost immediately to get better, like you were saying, Rich, that it wasn't a long time. And week by week, she was feeling better and better and better.

She went back and had another laparoscopy. So the doctor looked around in her abdomen and then sewed her up, and the doctor went out to the waiting room to find her husband and said, this is really amazing. The doctor said, her endometriosis has effectively disappeared. And her husband said, I'm not surprised. You know, she went vegan, completely changed her diet, and she's been feeling better and better and better. And the doctor said, no, no, no, no, no, no.

It can't be that. It can't be that, the diet doesn't cause it. If something was wrong with you, it would definitely be because of the vegan diet, but if something's good, it can't be that. The doctor said, there's only one explanation for this. This must be a miracle. So the doctor I think wrote miracle in her chart

and she doesn't have endometriosis anymore. It went away. She never had the hysterectomy. She has three children now. And in fact, she joined the Physicians Committee's Food for Life group. And Catherine Lawrence lives in Dallas and now teaches other women how to take back their health. Now, let me be clear. I do want to say a word for not everybody necessarily gets better. Life is not fair and there are some people who may have endometriosis or cramps or fertility issues or whatever where a diet change only does so much good or maybe not at all. Those people should not feel ashamed.

They're not doing it right or something. Our bodies are fragile. Things go wrong with it all the time, just like your car. It's not going to last forever for any of us. But we've got some tools that are so cool. And my message and the message of Your Body in Balance is let's use foods to get you into balance, not a pill, not something else.

Let's use diet and lifestyle. I was just speaking with somebody the other day, a woman who is struggling to lose weight and she feels like she's doing everything right. And she was telling me how she was gonna go get a hormone panel done to try to figure out if there was something else that she wasn't seeing or wasn't being addressed. So talk to me about the implications

of your hormones being out of whack, hormone haywire as you call it, on weight gain and the inability to shed pounds. We've done a number of research studies where we've compared various kinds of diets. And the one that seems to cause the most consistent weight loss is one that has really two characteristics. One is it avoids the animal products.

But the other thing is we do have to keep oils really low. And that's an important message because many people will look at what I'm going to call good fats, like avocados and nuts and things, and they are good fats. But if a person is struggling with their weight, those foods happen to be really calorie dense and it's super easy for your body to absorb it. Some people can eat those foods with no difficulty at all, but some others, they'll just find that their weight loss starts

when those foods are really minimized too. Another piece of this though, there's some folks who, they go to the doctor. They say, I've really had this unexplained weight gain or I just can't lose it. And my energy is not hot, not really very hot.

And my hair is changing. There's something wrong with how I feel. The doctor says, I think we need to do a blood test. And the doctor comes out with a diagnosis of hypothyroidism. And your thyroid is at the base of your neck and your thyroid regulates your metabolism. If your body needs more energy, your thyroid is the one that's going to give it to you. And if your thyroid is not behaving, you just don't have energy, your metabolism is stuck in first gear, and 99 times out of 100, you get a prescription for thyroid hormone. And what I'm going to say is that we know a lot now about what actually is causing this,

and it's not a deficiency of that prescription. So what is causing it? If you look around the world, the biggest reason not a deficiency of that prescription. So what is causing it? If you look around the world, the biggest reason is a lack of iodine. And in America, it's a little bit different, but just looking worldwide, it's a lack of iodine. And iodine is in the ocean and seaweed has lots of iodine in it.

And so if you're eating your seaweed salad or you're having your vegan sushi, that nori around it or the wakame in your miso soup, you're getting all the iodine you could ever want. Around 19, in the 1920s, there was a lot of hypothyroidism in the United States that was solved by iodized salt. The Morton Salt Company said, let's put iodine in it. And that kind of wiped it out for the United States. However, it didn't eliminate hypothyroidism from other causes. And the biggest cause now is actually an autoimmune reaction where your body thinks there's some invader and you're like a bacterium or a virus. And so your body is making antibodies

to destroy whatever that invader is. Your body will make antibodies if a virus comes in and you knock them out. But in this case, there isn't a virus and there isn't a bacterium. There's something that got in your body that you're reacting to. And those antibodies then go to the thyroid and attack your own thyroid gland. It's the same as in rheumatoid arthritis. You're making antibodies to something and those antibodies destroy the synovial lining of your joint. And these autoimmune reactions, there are many, many of them, they can affect your skin, all kinds of stuff. So we started to discover that there were people whose thyroids

were clearly off. I mean, they were hypothyroid. They then make a diet change, and they're leaving certain things out, and their thyroid condition goes away. Now, this is a completely new frontier. I have to tell you, about a year before I wrote this book, I would not have said that this is possible, except that I've now met so many of these people. And here's what we believe is happening. What we believe is happening is that the dairy proteins

and other proteins are regarded by the body as foreign. They are foreign. And so your immune system recognizes them as foreign, develops antibodies against them, and those antibodies end up attacking you. It's the same process in type 1 diabetes. A little kid, an 8-year-old kid, is fed cow's milk. Not mother's breast milk, milk from a cow.

The body says, wait a minute, that's foreign, I need to attack it. It makes antibodies to attack those foreign proteins. Those same antibodies then destroy his own insulin producing cells in the pancreas. We need more research on that, but there's a lot of evidence that that's in fact the case. Kids who don't consume cow's milk have a lot less risk of type one diabetes. So in the case of the thyroid, these antibodies do two things. They can turn it off, hypothyroidism. In some cases, they turn it on too much, hyperthyroidism. So what I think we need to do

is a lot more research studies now, where we go into endocrine offices and instead of handing out prescriptions left and right, we take six weeks, eight weeks, 12 weeks and just see to what extent getting that junk out of the diet can cool down this autoimmune reaction. Yeah, it's interesting that there isn't more research on this. I mean, you open the book by saying,

these are very recent findings, a lot more work has to be done. It's not a disclaimer, but you're saying like, look, we're learning as we go here and this is kind of a new frontier but it seems like this would be something i mean hypothyroidism is something that afflicts a lot of people all these things are and in certain areas that we've talked about we have plenty of information um diet and breast cancer i would view now that it's a slam dunk, that a woman diagnosed with breast cancer would do very well to follow a completely healthy plant-based diet. And frankly, before the

diagnosis ever occurs, we should use that kind of diet to prevent it. With regard to the menstrual pain that I described, we have done a very careful randomized clinical trial that shows the diet works. So I don't think anybody's going to say that that's not true, but some of these areas like thyroid and also mood, how foods affect... Everybody knows that hormones can affect your mood and those moody days of the month and all that kind of stuff. We did a research study at GEICO, the car insurance company,

because their headquarters... Yeah, they're in D.C., right? Or Virginia? They're in D.C. They're about three blocks from my office. And so years ago, we decided to do a study together where anybody at GEICO who wanted to do a vegan diet to lose weight or to improve diabetes, we'd help them do it. And in the course of it, it was an 18-week study, and people, just what you expect happened.

I mean, they lost weight, their diabetes got better. But along the way, we asked everybody to fill out just questionnaires on how they felt. They didn't know what we were looking at. But what we were looking at was mood, depression, and anxiety. And both of those seemed to remit to quite a substantial degree. They weren't brought in for that reason. These were just people who wanted to do better. Now, part of that could be that I'm losing weight, my diabetes is in better control, I feel better. That's true. The other thing though is that diet affects your gut,

your microbiome. And if I repopulate your intestinal tract with friendly bacteria, those bacteria are no longer making nasty stuff that kind of affect the brain. Yeah. Well, the nexus between the microbiome and the brain is really fascinating. And that seems to be on the vanguard of emerging science. And it's pretty cool to see what's coming out from people that are looking at that. I hope that we look into it much, much more. There have been some very good researchers who have put this to the test independent from what we have done, bringing in people and tracking their mood and changing their diets in a variety of ways. And I have to say, here again, I think we need more research,

but what we have seen is quite consistent evidence that people on plant-based diets do feel better, specifically with regard to reductions in anxiety and reductions in depression. We also found reduced absenteeism. But the ketogenic diet seems to have the reverse effect where people seem to feel worse. Now they're glad if they're losing weight or something like that, but it's not a diet to get the brain back into better function.

One of the things that you go into in detail, in addition to increasing your fiber in your diet and reducing the fat, you get real specific on the oil thing. You know, we're in a moment right now where there's a lot of confusion about oils and healthy fats and this is a healthy oil as if we're suffering from an olive oil deficiency

or something like that. Widespread acceptance of this notion that coconut oil is a health food. So talk a little bit about that. And also this part where you discuss omega-3s is problematic, which I thought was interesting. And I hadn't seen anybody kind of talk about that in that way. Because we all think about omega-3s is problematic, which I thought was interesting, and I hadn't seen anybody kind of talk about that in that way.

Because we all think about omega-3s as the healthy fat that we need, that we're, you know, if anything, that's the one we're trying to get more of. Well, they are. You need, the body has a need for two fats. One is alpha-linolenic acid, and that's an omega-3. The other is linoleic acid, and that's frankly everywhere, so you're not going to get low on that. But alpha-linolenic acid is in lots of seeds and plants of various kinds

and your body lengthens it into the other omega-3s that you need, like DHA for the brain. And so some people have said, well, you know, that lengthening process is pretty slow and so maybe I should take fish because the fish have the preformed DHA in them. And they've been trying to sell this for all kinds of stuff. And frankly, it hasn't panned out very well for the fish oil salespeople because DHA supplements don't really seem to reduce heart risk.

And at least so far, they haven't been very effective against Alzheimer's and whatnot. heart risk and at least so far they haven't been very effective against alzheimer's and whatnot um however uh researchers have discovered something really kind of frightening which is that if you have too much dha in your blood um or or if you're supplementing for men prostate cancer risk goes way up and at first this seemed like a fluke because funny things can happen in studies that you don't expect. But it has shown up consistently enough that the researchers now believe it's real. But we don't know why and I can't explain it. But the bottom line is if a person is supplementing DHA,

we suspect that at least for men that their cancer risk is going to be higher. And they might say, okay, would I rather get cancer or would I rather get Alzheimer's? And honestly, I don't know the answer to that question yet. But I think nobody can fault you for saying, all right, the healthy omega-3s, they're in plants. And if I consume those and I don't consume a lot of competing oils... The sixes. Yeah, potato chips, Anything that's got cooking oil

soaked into it, those things compete with your natural omega-3s for the enzymes that lengthen them. So you don't want to have a lot of other oil. And in fact, if you use no oil at all in your diet, no added oil, there's still natural traces of oil even in green vegetables that are proportionally very high in omega-3. So if you're eating lots of greens, you don't think of that as being an oil source, but it's a source of the natural oils your body thought you're going to have. Right, so then as a takeaway, no supplementation of omega-3 or an algae-based one, or do we not need to do that? If a person does supplement DHA, and a case can be made for supplementing it,

and some have made the case, and the case is this, that if you look at people whose blood tests show they're low in DHA, they're at higher risk for Alzheimer's than other people. So some people would say, you can get tested, you can call up laboratories and send them a drop of blood. If you in fact just Google DHA testing, they'll send you a test kit and you put a drop of blood on it and they'll tell you if you're low or high.

If you decide to supplement DHA, I would definitely do it with a vegan source. If you go online, there is vegan DHA that's as good or better than the fish ones and it doesn't make you smell like a fish market. But whether it's gonna help or not is something that future research is gonna have to show that we don't know yet. All right. Let's talk about testosterone.

You know, I'm 53 now and in my peer group, I've got lots of buddies who are either taking exogenous testosterone or considering it. And this is like a thing, right? So walk me through what's going on with men's hormonal health in the sexual context. Yeah, well, a lot of things are going on.

The first issue is not even testosterone. It's that men are exposed to estrogens a lot. The guy goes to the fertility clinic. We're having trouble. Could you evaluate me too? And if you check Hank's sperm count, if he's a big cheese eater, he'll tend to have lower sperm counts

than his friend who doesn't eat any cheese. And what's that about? It's not that he's low in testosterone. He might think that's it. It's not. It's because the cheese has estrogens that came from the pregnant cow. At least that's what we believe is going on because you see reduced sperm count, poorer morphology, which is the shape of it, and poor motility. The sperm just

don't go where they're supposed to. They don't swim very fast. They don't swim in a consistent direction. They're having trouble getting organized. And it starts with a relatively small amount of cheese, just a serving or two of regular high-fat cheeses per day will do that. And so some guys will say, well, it's got to be soy, that soy gave me the man boobs and all that kind of stuff. And soy gets a completely not guilty verdict on this, as I'm sure you know, that first of all, women who consume soy have about 30% lower risk of developing breast cancer than women who don't have soy. And women who have had breast

cancer, who consume a lot of tofu and tempeh and miso and whatnot, they have about a 30% reduction in their likelihood of dying of their cancer. So soy is a cancer preventive. It does not cause man boobs. If anything, soy is sort of a brake on estrogenic function. Soy has isoflavones that attach to estrogen receptors. But just like your car has a gas pedal and a brake pedal, soy, although it will attach to the estrogen receptors, it's not stepping on the gas. It seems to be stepping on the brake. So what about testosterone? I honestly don't know what

to make of this yet. And science is marching forward because a lot of guys are taking testosterone and you'll see commercials. Do you have low T? Could this be why your investments aren't rising? Could this be why you're having a bad hair day? I mean, I'm kidding, but it's about like that. Like if you just take more testosterone, everything's going to do better. And what we've been worried about is are we going to be fueling prostate cancer by injecting or by having guys take testosterone? And I don't know yet whether that's true or not.

I would say this, that in theory, a high fiber diet, you would think it would reduce testosterone levels because your body filters out extra testosterone, sends it down the intestinal tract, fiber should carry it away. Except for the fact that when you look at guys on healthy high fiber diets, their testosterone levels are high.

Stay tuned, we're gonna start this out at some point. We know that erectile dysfunction is an early arbiter of atherosclerosis, but let's, for the sake of conversation, assume there's an individual, their heart is perfectly healthy, they don't have any arterial damage, but they're experiencing erectile dysfunction or they have low libido.

What is the hormonal interplay there and what have you learned about that? Yeah, testosterone does play a role there, that's for sure. But to tell you the truth, it really is cardiovascular disease in the vast majority of cases. The guy goes to the doctor and says, Doc, I can't raise the flag. People have wonderful euphemisms for all this. There's something wrong with my nature.

And the doctor can give out a Viagra prescription, but that is a complete mistake if the doctor doesn't also give him a description of what's going on in his body, which is that atherosclerosis affects all the major arteries of the body. And the arteries that go to a man's private parts just happen to be smaller, narrower than the ones that go to the coronary arteries that go to the heart muscle or the carotids that go to the brain. So people will correctly describe erectile dysfunction as the canary in the coal mine. It's a sign that something is wrong.

And so if a man has, a man in mid-50s, starts developing erectile dysfunction, this is not performance anxiety. And it's probably not a hormonal issue. It's probably the beginnings of atherosclerosis in that area and it means he's got it in his heart too and he's got it in his carotids going to his brain. And so that is a man who needs to read Caldwell Esselstyn's book

or Dean Ornish's book and reverse that. In our research studies where we put people on vegan diets for diabetes or whatever, the men start raising their flags at home. Hopefully not out in public. Yes, the point being that when you reverse arterial disease, erectile dysfunction gets better too. One of the things that you talk about in the book that I had never heard before was that lower back pain is indicia of arthrosclerosis.

And that freaked me out because I got a little lower back pain. Well, there's lots of reasons to have lower back pain and you're entitled because you're an athlete. I hope it's not that. Well, you have punished your body more than just about anybody else. But as you know, you break it down

and build it right back up. But yeah, this started, it started out with smoking. That researchers looked at smokers and they have more back pain than non-smokers. You think, wait a minute, cigarettes are not heavy. What the heck could this be? And it just makes them lazy and they're sitting around all day.

What it is, researchers did autopsy studies on people who had had lower back pain in life. And after they died of an accident or whatever, they looked into their lower back and what they found was amazing. The aorta comes off your heart and it rises up and then it does a U-turn, goes right down your back and right in front of your spine.

And your aorta gives out a blood supply to your spine. The lumbar arteries feed every lumbar vertebra. The very first place where atherosclerotic changes occur is in that lumbar aorta. And by around age 18 or 20, a lot of people have paved over, completely paved over one of their lumbar arteries. It's just gone.

So smoking encourages atherosclerotic changes, so does meat eating. And so if you don't get blood supply to the lower back, then the discs that are the leathery cushions between the vertebrae, they are in a precarious position, they get fragile and just like a pillow, the inside smushes out because it's now fragile. It's like a rupturing pillow. And then that the contents of the disc push against nerves and give you pain.

So my point is if we don't smoke and eat a healthy heart, healthy diet, it can reduce the risk of lower back pain. Yeah, it's amazing. Cause you hear about, oh, I have a ruptured disc or my disc rupture. And I always pain. Yeah, it's amazing. Because you hear about, oh, I have a ruptured disc or my disc rupture. And I always thought, well, that's because of your posture

or the way you're sitting or some kind of muscular atrophy or imbalance in your body. I mean, it can also be sitting in your Rambler at a stoplight and a semi-tractor trailer runs into you. All these things can happen. But your ability to heal is impaired if you don't get blood and oxygen and nutrients into your tissues

and you need a good blood supply to carry toxins out. Right. So, yeah. Let's talk about skin and hair. I know, you know, I've heard many anecdotal stories over the years. When I got rid of dairy, my skin cleared up which seems to make common sense because you're removing a product from your diet that is infused with natural hormones and probably artificial ones as well uh but talk to me about uh you know the

hormonal systems that contribute to to the health of those two things back in the 1960s, 70s, Japan had a diet based on rice. And if meat was used at all, it was not in these big hunks. It was little bits that were used just to flavor the rice or flavor their noodles. And then when McDonald's arrived and the other fast food chains arrived and meaty business lunches became the order of the day, the rice content of the diet diminished and it gave way to meat and to cheese. And researchers started to notice a bunch of things. There was more breast cancer, more diabetes, more weight problems,

but also dermatologists started to report that there was more hair loss. And wait a minute, what is all this about? And we still don't know all the details on it, but it looks like it might be aggravating the age-associated hair loss. The hormonal changes from diet are aggravating age-related hair loss. Is that true? Who knows? My mother used to always say, Neil, out of my four boys, you're the only one who kept his hair. And I said, that's because you're a vegetarian.

All your brothers are bald? If they're listening, they have a very... Don't worry, they're not listening. They might be. Yeah, I kept my hair longer than they did, and I still got a fair amount of it. It's looking pretty thick. Every time I see you, you get younger. So whatever you're doing is working.

I'll keep saying that, Rich. Anyway, who knows? It's looking pretty thick, every time I see you, you get younger. I'll keep saying that, Rich. Anyway, who knows? The skin is strongly affected by what you eat, the hormonal changes with hair loss could be part of it, but then with regard to the skin itself, I think it could be something different, I think it could be not so much estrogens and testosterone, I'm guessing it could be more inflammatory conditions.

If you look at acne, it's just little inflammations all up and down. And a number of people have found that when they follow a healthy plant-based diet, it goes away. Now, I want to stay tuned on this because I will see some people where they go on a vegan diet and especially getting away from dairy, their skin just clears up miraculously. I've seen some other people who say they feel that for them, it's salt or it's oils or other things.

So I think it's good to be open to different things contributing to these, but it's quite clear that it's a response to something and a diet for many people. The case study that you use in the book is Nina and Randa. They wrote their own book. They did. Basically teenage girls, mutual friends of ours.

And the acne that they had was pretty severe, right? And the reversal was profound. They were miserable with it. And I mean, any kid is self-conscious, but they were also performers, musicians. And they thought, oh, we're not gonna have a good stage presence. But for them,

the answer was vegan and low fat. So they scrupulously got rid of the fats and that seemed to help them enormously. So what can you say? I encourage people to just put it to work and try it out. Because when you look at cultures that have not westernized, there are very few left, but they did not seem to have much acne until the cheeseburgers and that kind of stuff comes out. Yeah. One of the things that I've been struggling with lately is sleep. Like I've been traveling a lot. I'm waking up in different places all the time. I'm on the move.

I'm waking up in different places all the time, I'm on the move and my sleep, despite best efforts and this crazy routine that I have to ensure a restful night is becoming more and more elusive. And I know that it has to be related to my hormonal health or something being out of whack. So what have you learned about not only the importance of sleep, but how lifestyle and diet impacts sleep and what's going on kind of hormonally with that?

Yeah, there's a bunch of things going on. Let me maybe start, and I'm not going to talk about you, I'm going to talk about other folks because some of this won't apply to you. First of all, people are having all kinds of trouble sleeping. You are not alone. But for anybody else, I'm going to say, number one, start with caffeine and look at that. Because even if all you have is a cup of coffee in the morning, different people eliminate caffeine at different rates. And for a lot of people, about a quarter of that cup of coffee is still circulating in your brain at nine o'clock at night. And so it doesn't mean

you can't sleep, but what it means is your sleep will be lighter and it'll be more easily disrupted. And then number two is alcohol. A lot of people will unwind with a glass of wine and that will make them fall asleep. But in the middle of the night, your liver transforms alcohol into something else called an aldehyde, acid aldehyde. And it's a stimulant. And so four o'clock in the morning, you'll wake up and it's kind of driving the brain. And it's a certain kind of awaking. It's not that beautiful. Isn't the early morning hours, isn't this wonderful? It's this kind of creepy feeling of having poison in your system. And the more a person drinks, the more this happens. So those are just

things I would recommend to anybody else to think about. But physical activity is really important. None of this relates to you, Rich, because you're very physically- The caffeine does. I drink caffeine in the morning. I have a cup of coffee right here, because now I'm in that thing where it's like, I didn't sleep well last night. So now you need to pump it up. I'm like, Neil's coming. I got to be on my game. Oh, thank you. That's so nice. Yeah. Physical activity is important. I mean, there are some people where all day long, all they do is this. We're going to thumbs on their handheld and they get no exercise. They're

reading a book and then they close it and try to sleep. If your muscles are tired, they demand sleep. Sleep is not just for your brain. It's for your muscles to allow you to stop moving. You're supposed to just be turned off and let's repair. So if a person has not had physical activity, I encourage them to do some squats, some pushups, something to just strain your muscles a little bit before you go to sleep and you'll find it helps. The next thing, and this will sound completely cuckoo,

but bear with me. If you look at your dog or your cat, it's getting toward evening and they stretch out their leg and they do a big yawn and then they curl up and they go to sleep. And you look at your child, does exactly the same thing.

They go through all this thing. They're stretching, yawning. They do this kind of preparatory thing for going to sleep. I don't know why it works, but as adults, what do we do? We're watching TV, we click it off and we put our head down and we don't go through that. So, when nobody is watching, if you're having trouble sleeping, when nobody is watching, do this a half hour before your sleep time, stretch out your arms in a huge stretch and open your mouth and make a big yawn.

It will be totally fake, it won't be real, but you're just doing it, going through the motions. Do that four times and it will become real. And you will notice that for some reason it turned on the sleep mechanism. But now, I know that sounds cuckoo, but try it, you'll see. And the last thing, let's talk about neurohormones in the brain,

neurotransmitters. One of these is called serotonin. And serotonin is involved in mood, it's involved in sleep. If a person eats a lot of protein of any source, it prevents serotonin from getting to work. And so you'll find that you have more trouble sleeping. And this is why people discover it on their own, that if they're having a kind of a carb heavy meal in the dinner, they sleep better. So if I have pasta and I have rice, but I'm not

having super high protein things, I sleep better. And the reason is that a high carbohydrate diet allows serotonin to become active in the brain and improve sleep. Yeah. It induces that food coma, basically. Kind of. Yes. Part of it is all the blood going to your digestive system, is it not? Partly. But you know, some of the food coma is a different thing.

When people talk about, say, the post-Thanksgiving dinner food coma, that is not from the tryptophan in the turkey creating serotonin. That's because they ate all that grease that got into their blood and their blood is now so viscous, their brain can barely be oxygenated. That's really that kind of food coma. But let's say you wake up in the middle of the night, it's two in the morning, go to the fridge and just pull out some bread

and have a couple slices of just plain bread, lie down and the serotonin will just be formed and you'll doze right back to sleep. How dare you suggest we eat bread? I think bread, it beats the heck out of sleeping pills. Well, let's talk about- Any kind of carbohydrate will do the same thing. Let's talk about grains.

I mean, grains have been demonized. There's this idea out there that we should be removing all grains from our diet and eating this low carb protocol. So what say you? I say nonsense. First of all, if you look at the populations around the world that live the longest, the blue zones,

where this comes from Dan Buettner's great work, where they marked in blue all the places on the map where people lived a long time, their dietary staples are never meat, not even fish. It's always some kind of grain product, legumes and so forth. I'm talking about Okinawa, Costa Rica, Loma Linda, California, where there are lots of vegans. And then if you look even further back, we are not carnivores. We are great apes, along with chimpanzees, gorillas, orangutans, bonobos, they are not eating ice cream.

They're not eating pork chops. They don't eat meat at all with rare exceptions. They eat phenomenal amounts of fruit. That's their big thing and they'll eat leaves and so forth. So we are designed in my view to be herbivores. Now, the fact that people can lose weight on a ketogenic diet is simply a sign that carbohydrates are a lot of what we eat. If you take all that away, you are going to lose weight.

If you take away anything you eat, you're more likely to lose weight, but it's not a healthy way to do it. We touched on mood a little bit ago, but I think it's worth diving a little bit deeper into depression because we are mired in a bit of a mental health crisis. Depression rates are through the roof and there's lots of ideas around what's generating this loss of connection and community and our addiction to our devices and our sedentary lifestyles, et cetera. But what does it look like from a hormonal perspective? First of all, it should be said that while it's true that stresses can work on our brains,

there's no question about it. And life is stressful for lots of people. But depression is not just something psychological where my feelings were hurt or I've had a loss and so I'm miserable. Depression can be just flat out physical. And we learned this decades ago with a drug called reserpine. It's an anti-hypertensive drug to lower blood pressure. And people were put on this drug, their blood pressure came down, but their moods would sometimes just collapse.

And what's that about? Well, it turns out that the compounds that affect blood pressure, like norepinephrine, for example, will also affect mood. And you take them away, it's just like letting the air out of your tires. So that led us torine, for example, will also affect mood. And you take them away. It's just like letting the air out of your tires. So that led us to think, all right, if it's not just life events,

but it also can have something to do with physical things, well, what am I dosing myself with more than anything else? You're dosing yourself with foods. And one of the most shocking research studies came out of Scandinavia, where they looked at women who had postpartum psychosis. This is an off-the-scale serious mental problem.

The woman has given birth. Two or three days later, she starts to become delusional. She's hallucinating. Her brain is just unplugged. Very, very serious condition. And the researchers discovered through blood tests that the women had what are called casomorphins in their blood.

Casomorphins come from milk products. And we've identified them in cheese. If a woman eats cheese or milk, the casein protein breaks down to release these morphine-like compounds that attach to the brain and can cause a variety of effects. In this case, it was the woman's own breast milk that they had given birth, their body started making breast milk, and some of it was leaking into their blood,

breaking down to release casomorphins that were poisoning their brains and causing them to be wildly, wildly psychotic. So the take home message here is not don't give birth. The message here is that casomorphins are serious business. So I just described a really off the scale, bizarre situation. What about the person who's just dosing themselves with these things a little bit every day, two or three dairy servings. There are some caseomorphins in milk. When milk is turned into cheese, there's a lot more of them. And if you look at the rise in cheese consumption over decades, it parallels the rise in obesity and the rise in mental health issues and all kinds of other things.

I'm not saying there aren't other contributors, there are, but I have been struck by the fact that people are eating foods that, frankly, cheese is loaded with saturated fat, so it slows you down. It's going to interfere with your athletic ability because your muscles just can't oxygenate if you've got vaseline in your blood, but the chemicals in it can affect the brain directly. the chemicals in it can affect the brain directly. Have there been studies that have directly looked at the implications of certain types of foods on levels of depression? Yes, there will have been, not enough,

but there have been studies that started out as observational studies, looking at kind of like our GEICO trial, where we brought in people for other reasons and just noticed their moods get better. Researchers have brought in people specifically looking at their mood and found that if you compare a person on a vegan diet, a person on a pescatarian diet, a person on a meat-based diet,

the vegans tend to have lower levels of depression and lower levels of anxiety. There's still all kinds of reasons to be miserable. Particularly if you're vegan, every five seconds someone is going to say, where did you get your protein? You're going to get tired of anxiety. There's still all kinds of reasons to be miserable. Particularly if you're vegan, every five seconds someone is going to say, where did you get your protein? You're going to get tired of that. And so there are reasons why vegans... It's going to make you depressed? We labor with these things. But the vegans tend to do better and then researchers have done it

as randomized clinical trials. Not big enough, not long enough in my view, but what they have found is that when you start a person who is not on a plant-based diet on a plant-based diet and you don't tell them what you're looking at, but you track mood, it tends to improve and improve rather rapidly. There are a lot of people, myself included, who are running and gunning all the time,

feel like it's indulgent to take a minute for yourself. And this results in kind of a persistent state of chronic exhaustion that we kind of colloquially call adrenal fatigue. But what is adrenal fatigue? Like what do the adrenals do? What is adrenal fatigue? And how can we address that or sidestep that? Well, the adrenals are, they get their name

because they're adrenal. The renal is your kidney and adrenal means they're on top of it. So they make a variety of hormones that affect, they make sex hormones and they make other compounds that regulate your body chemistry. And the theory is that you're under stress and so your adrenals are running out of gas just trying to keep up with you

and that eventually they just collapse um from what you're doing and so the answer is to win the lottery quit your job move to to bali and everything's going to be great um maybe the next best thing is to to eat in a more in as healthful way as we can. I do think that food is also not all there is to it. I think we do need to sleep. We do need to get some exercise, but then give our bodies a chance to just recoup. We do need a certain amount of fun in life.

I say this as a person who's abysmal at practicing these things only because I face the same challenges you do. But I do have some rules that I live by. And one is always vegan, keep it low fat. And no matter where I am or what I'm doing, when the clock strikes 10, I go to sleep. Yeah. You can hold yourself to that? It's a really hard thing to do, but I'll get up early if I need to. It just really helps. Because what you discover is if you're up till 11.30

and it's 12 and it's 12.15, you will discover if you track, the next day you are not on your game as well as if you'd gone to sleep at 10. Yeah. I found as I age that I'm a little less resilient. I'm very much a creature of my habits and my routines. And when I'm at home and

I can control my environment a little bit better that I do really well. And it used to be, oh, if I go out of town and I'm kind of thrown off my thing, like I could roll with it. But I'm finding that I'm becoming less and less able to do that. Like I have to be much more conscientious about these things and create healthy boundaries when I'm on the road or when I'm in circumstances where I don't have as much domain over my schedule. Yeah. And you're not alone in that. Although I have to say, if you look at kids, kids sometimes do terrible with that. You put them in a different time zone, they're just comatose. They can't deal with it at all. But they'll have sleepover parties and stay up all night and they'll be kind of fine.

You know, like they get over it quick. Yeah. So anyway, I think it's important to respect these diurnal variations that we have. Yeah, other than making sure you're in bed by 10, what are some of your other habits and routines around self-care? Well, that's it.

I always have breakfast. I always cook myself breakfast. And one other little trick that I might mention, for some people, even though fruit and other carbohydrate-rich foods, I think are perfectly fine for health. For some folks, I find that there's a mood boosting effect to having specifically some plant protein

early in the day and early in the meal. What I mean is this. Let's say my breakfast, I started off with some grilled tempeh or some tofu or something like that, and then follow that with some green vegetables or some oatmeal or whatever it might be. I find that I personally feel more balanced than if I didn't have that plant protein ahead of it. And people can try this and see if it works for them. And the opposite example is in France, where people start every day with just a pastry or something like that. And a really dysfunctional way of doing it is to do it with sausage or bacon,

where it's protein, but it's a big mixture of protein and animal fat and cholesterol and galop that does more harm than good. But with plant protein starting off earlier in the meal and earlier in the day, I find that my energy is better for the rest of the day. Not a lot, just a tiny little bit. Right, I like that. I'm gonna try that. I mean, I found something, if I eat,

I can't do some kind of very carbohydrate rich meal early in the day. I feel like it takes a lot of energy for my body to digest that. And I just don't feel ready for that. But if I eat something that's higher in protein, it doesn't give me that heaviness and I feel more energetic more quickly. Yeah, my go-to breakfast, it sounds crazy.

If I'm on somebody's program other than yours, Rich, and they ask me, what did you have for breakfast? I have to sort of make it up. Blueberry pancakes, something that sounds normal. But the truth is I'll start off with some grilled tofu or tempeh and then I'll have broccoli or Brussels sprouts and I load them up with brags or vinegar, something like that. And then I'll have a papaya,

which growing up in North Dakota, I never had papayas. And so I'm making up for a lost time now. And the papaya is very high in carbohydrate. The tempeh is very high in plant protein and the green vegetables are kind of in between there. Right. And I do that every single day. That's so exotic.

I like it. It sounds goofy, but I find it works for me. Let's talk about the chemicals section in this book. I thought this was super interesting. Some of it, you know, kind of conventional, not conventional wisdom, just sort of widely accepted common sense. But some of them are a little bit, you know,

kind of askance in that I wasn't super familiar with them. So it starts off with you talking about the perils of BPA, which we all know, like all the plastic that proliferates in our daily lives. So talk a little bit about that. Yeah, it started out with Progresso soup. You know, Progresso is good soup. You know, it sounds a little Italian.

It's gotta be a notch better than the other soups in this soup aisle. You know, the cans are even bigger. So Progresso ought to be good. So researchers gave a can of Progresso soup to some research volunteers and they had them eat it every day. And they found BPA in their blood, I'm sorry, in their urine at 10 times the normal level. Well, BPA is, as you said, it's a compound that's used in plastics,

but it's also in the resin that lines the can. Yeah, it's in the liner of the can. And separate researchers have said, if you look at men who consume a lot of it, they seem to have more sexual dysfunction. And the idea is it's probably an endocrine disruptor. So Progresso has heard about this. And by the way, they're not alone. If you go to the health food store, you'll see cans marked BPA-free can. And all the others that don't say that probably have the BPA in them.

But Progresso has issued a statement saying, okay, okay, okay, we'll transition toward the BPA-free cans. But that is the... Oh, well, I got to tell you one other thing. You go to the store and you buy your BPA-free can of green beans or soup and you walk out holding the receipt that you had signed for your credit card. The thermal paper has BPA in it too. And it passes right through the skin.

And so researchers have looked at people who are like a cashier, where every five seconds, you know, they're handing another receipt to somebody else and their BPA levels in their body will rise from that. So from now, I'm sure that everybody now is going to go to the store and they're going to freak out about a can that's not marked BPA free and they will refuse to take their receipt from the cashier. Throw that away, I don't want to touch it. By the way, it's not just receipts, it's ATM tickets.

Everything that's printed in that way, right? That kind of shiny thermal paper, that's BPA. But that's not all. Frankly, I'm just concerned about what people have talked about for years, which is just pesticides. Pesticides are used a lot and you can see why. You go to the grocery store and every orange is identical and they look fabulous and they're beautiful

and there's no insect damage to them because they've been treated by pesticides. I think it does pay to buy organic. I don't think it's even a question. Some people say, is it worth it to get organic? Wait a minute, someone's gonna give you this food that has chemicals in it and this food that doesn't. What's the choice? And the chemicals used are used specifically to kill things,

kill life on the plant. And I think there's this idea that if you wash them, it's fine, but this seeps into the root systems and it's absorbed by the plant. It's inside the very plant itself. Yes. Now, the Environmental Working Group has done a good job of saying, all right, which are the worst foods? And the list will change from year to year,

but if you go to the Environmental Working Group's website, you'll see the latest list. But the rules of thumb are that if it's a fairly fragile plant, one where you could imagine the insect going to the spinach leaves and just tearing them up as opposed to maybe a cantaloupe where they have more difficulty, the more fragile plants are the ones where you really want to get organic because that's where the farmers are using pesticides to stop the ladybugs from going to them. And the other thing is if it's a plant where you throw away the peel, it is true that in some cases it's inside the plant. In other cases, sometimes things are added like waxes to kill

fungi and things like that. Those are on the surface. And if it's a grape, you're eating that skin. If it's an orange, you're not. So you can use these kinds of decision makers. But if there's organic, always, always, always, I always get that. And the extra value of organic products is, by law, organic things cannot be GMO. So you get organic tofu. It is not GMO.

If you get chicken, that chicken has been eating GMO soy. That chicken has been fed all her life. Yeah, and you can be GMO free and not organic conversely. Yes. So it gets tricky. But I agree with you. I mean, if you want to learn more about that list, you can go to ewg.org, I believe is the website. It's called the Dirty Dozen.

You know, strawberries are always going to be at the top of the only buy organic list. Whereas like an avocado is gonna be something that's gonna be a little bit more safe if it's conventionally grown. Right, exactly. And by the way, if you cannot get organic, that does not mean you should not eat vegetables. If inorganic vegetables are the only ones you can get,

if the asparagus there just happens not to be organic, it beats the heck out of spam. One of the things I have a hard time wrapping my head around is, and I've heard you talk about this, I've heard Dr. Michael Greger and Caldwell Elsiston talk about this, is the benefits of frozen fruits and vegetables, because they're, I guess, because they're frozen shortly after being picked

and somehow that locks in the nutrient value of them. But to me, it just seems like weird to buy frozen vegetables and fruit that are in plastic bags, as opposed to, I guess if you can't get organic or, you know, I don't know if that's not available to you, but what are your thoughts on that? I agree that getting, if something is frozen shortly after harvest,

that it may retain better nutrition compared to something that was picked a long time before you're going to use it. And that's in some kind of long distribution cycle before it ends up in your grocery store. Now, some things aren't going to disappear. If you get some greens, and i don't care how old they are or whether they're frozen or not the calcium in them is not going away the iron in them is not going away those are elements and they don't degrade uh what does degrade is um some of the antioxidants like vitamin c it's fragile and it will degrade over time the other thing is for me

i'm at home for a day and a half and then i'm gone again. So I find it handy to have frozen broccoli in the- Right. You don't come home with the brown kale in your pantry. I find it handy for that reason. And you can get frozen things that are organic. And so it works fine. Talk to me about citric acid. This was news to me.

Yeah, this was news to me too. Citric acid is something that you would think... Well, first of all, it's in everything. Yeah, that's the thing. It's everywhere. Well, it gives a little tangy flavor and you think that comes out of a lemon or something like that. What it does is it comes out of fungi in China.

It's a genetically engineered product and most of it comes from Chinese factories and it's believed to be potentially toxic. When we first started to notice this, I was doing some migraine studies. This isn't funny, but it just blew me away. There were people in our studies who said it's citric acid. I thought, no, they have a soda with citric acid, it triggers the migraine. That cannot be because we imagine it coming from Florida,

it comes from a lime or something, it doesn't. It's this weird... The issue here is that there's citric acid in it, but it's contaminated with mushrooms that are used as part of the... The genetic modification of it? Yes, part of the GMO production of it. And so the belief is that that's what you're reacting to. So then you decide, well, I don't know if it's healthy or not.

I'm going to try to avoid it. And then you will be blown away by the fact it is in everything. So anyway, stay tuned. I think we're gonna learn more about that. Right, but walk me through, like, what does it do? Do we know what it's doing? I mean, what is the hormonal dysregulation that's being caused by ingesting this?

With regard to migraine, we don't know exactly, migraines used to be thought to be related to um the circulation of the brain will change rapidly that the blood this is completely naive but the blood vessels tighten up and then they relax and you get this terrible headache we now know that has nothing to do or that's not the whole story if it's part of the story at all we now believe it has to do with perhaps changes in the electrical function of the brain if it's part of the story at all. We now believe it has to do with perhaps changes in the electrical function of the brain, the depolarization of the brain.

And our question is whether citric acid is tinkering with that mechanism. Who knows, stay tuned, but there's no need for it in the diet, just in the same way as there's no need for BPA in your soup. I think some of these chemicals will probably get a not guilty verdict. Others will be. But I think it's good to err on the side of caution.

One other thing I think should be said, there are some people who are worried about chemicals so much that they think that if they just have a steak that doesn't have chemicals or they have cheese that doesn't have some added chemical, that that must be okay. Reality check. The animal products are bad for you whether they have added chemicals or not. And then the sprinkling of additional chemicals, that aggravates the problem. Well, if they're feeding on GMO crops all day

and feed that has been you know, been grown in fertilized soil, then even though they may not be, you know, sort of, you know, injected with hormones, they're still a vehicle for that. There's that, but yes, and I agree with you completely, but there's one other thing beyond that. And that's, think of this. A cow is a machine. A pig is a machine. If we start with, let's say we start with soybeans and I can take those soybeans and I can grind them up and make soy milk and I can drink that. And a person might say, that's processed. You took the soybeans, you sent them to a factory, the factory ground them up and put them in a carton. I could take the same soybeans and I put them in a trough and I let a cow eat them.

And the cow eats them and it goes down the cow's esophagus. It gets into the cow's intestinal tract, which processes it in its own way. And then it turns it into milk. And so milk ends up in the cow's udder. This is a machine producing this milky goo with estrogens added and cholesterol and fat and other things and lactose sugar. And then it comes out and then you eat that. My point is we recognize a factory as a machine. The cow is a machine in her own right too. And I don't mean to be disrespectful to cows, but the most processed food of all is dairy and is meat. You take a chick or a chicken

and you feed the chicken grains and whatever, and then the chicken lays an egg and whatever was in that grain ends up getting dramatically changed into feathers and beaks and a liver and all kinds of stuff. And then my point being that animals are factors. No, I get it. And fish are a great example of how they can consolidate and condense the toxins that

are in our ocean and then store them in their bodies and deliver them to human beings when they eat them in these toxic forms because they're so consolidated. Dairy is the same way, that toxins tend to get into dairy, into milk. And the same thing tragically happens in a woman's body. If she's been eating lots of chemicals, it will end up in her breast milk. And her first child is going to get a big load of chemicals that she has stored up over the years. Yeah. What was the most surprising thing that you discovered or learned writing this book? How many people are struck by these problems and how quickly they get better. Lindsay Nixon, who maybe you know. She did the recipes in the book. She did

the recipes in the book. And she's a genius in the kitchen. She does such a wonderful job. And working with Lindsay was just super. And she has books of her own that people should pick up. So anyhow, I called up Lindsay. I said, I want to work with you. Let's do some recipes. Great, great, great. So we did that. She said, by the way, I'm one of your women examples. I couldn't get out of bed. I had all kinds of menstrual symptoms, menstrual pain. When I went completely plant-based, totally vegan, I improved dramatically. And I am just hearing so many people who have had these issues and then so many other people who have the same issues now, but never tried to put it to work, to put a healthier diet to work. So my message is this, whether a person tries your body in balance, reads it and

tries it, or they just decide in their own way to get the animals off their plate, to have as healthy a diet as possible. So many people find that for the first time in years, they're going to feel good. But my goal is a little bit bigger than that. My goal is, if we don't do this, your kids are going to grow up thinking it's normal to gain weight. It's normal to feel rotten. It's normal to be on's normal to gain weight. It's normal to feel rotten. It's normal to be on medication when you're 30. It's normal to be in poor health. And if I just give you a metformin prescription for your diabetes and a synthroid prescription for your thyroid issues, I'm not helping anybody other than you.

If we can change the way the family eats, you're affecting everybody together. I think that's a good place to end it, but I do have one more question for you. Okay. What is the study that hasn't been done yet that you would like to see be done that could really help reveal certain truths that we're aiming at right now? I think we need to do more cancer studies.

And there was a real tragedy done a few years ago. This is really bad. The Women's Healthy Eating and Living Study brought in a group of women, more than 3000 women who had breast cancer. And they randomly assigned them to two groups. One group got five a day vegetables and fruits. And that was supposed to be the normal group, no change.

Because everybody eats five vegetables and fruits a day vegetables and fruits. And that was supposed to be the normal group, no change, because everybody eats five vegetables and fruits a day. The experimental group was eight a day plus juices. And then as time went on, they found that when they looked at who lived and who died of their breast cancer, all the women had breast cancer to start with. And then some of them went five a day, some went eight a day.

And at the end of several years, they found that it didn't seem to matter a whole lot which group you were in. And the researchers said, well, I guess the diet change doesn't really help. I said, wait, wait, wait, wait, wait, wait, wait. You've got women who all have had breast cancer. They volunteered for a study where you told them we're testing what vegetables and fruits do and they weren't eating five a day before none of them were. And you're telling them to ramp up their vegetables and fruits,

and you just go, I think it's reasonable to say that five or eight, who cares? But to add this to your diet is really important. And the study had a lot of benefits from both diet change and exercise, even in the control group that were good. But because, here's the tragedy, because the eight-a-day group wasn't dramatically better than the five-a-day group in their survival, a lot of cancer researchers started thinking, let's forget it.

Let's not look at food. Let's go back to drugs of various kinds. And the desire that women with breast cancer have, that men with prostate cancer have, that families have if somebody is attacked by one of these conditions, their desire to get healthy is so strong that we can put that to work. And rather than using people as recipients of prescriptions, even though we may need those sometimes,

let's instead work with people as partners to help them to put the best fuel in their body and see if we can get better. And I want to see an investment in that kind of research that is bigger than what we've had in the past yeah good well thank you for coming and talking to me well thank you rich for all you do i have to say people listen to to what you've said and you'll never know how many people you inform and intrigue and inspire um and any any given day a doctor might see 20 patients 22 patients to help some of them and any given day, a doctor might see 20 patients, 22 patients, help some of them. And any given day, you see a whole lot more than that.

I don't see that. You don't see that. I guess they might be hearing it. They see you. Yeah. You will never know how many people you have touched their lives, but it's huge. And I appreciate your time. I appreciate that.

Well, you have the exam room podcast now. So you've dipped your toe into this world a little bit, right? We're learning from your example. So check that out. The new book is called Your Body in Balance. It hits bookstores everywhere. February, do you have it? February 4th. February 4th. Please check it out. You can learn more about Neil and our previous two podcasts. I'll link those up in the show notes. Or you can go to pcrm.org, right? That's it. All right, thank you. Come back again.

Thank you, Richard. I really appreciate it. All right, appreciate it. Peace. Plants. Okay, we did that. What'd you guys think? It's pretty great, right?

I always enjoy my conversations with Dr. Bernard. Hope you did as well. Be sure to check out the show notes on the episode page to dive deeper into Dr. Bernard's world and show him some love on the socials. dive deeper into Dr. Bernard's world and show him some love on the socials. Let him know what you thought of today's podcast by hitting him up on Twitter at drneilbernard and on Facebook at neilbernardmd. Lastly, don't forget to pick up his new book, Your Body in Balance. You can pre-order it now. It hits bookstores February 4th

and I'll put links to all of that stuff, of course, in the show notes. If you'd like to support the work we do here on the show, subscribe, rate, and comment on it on Apple Podcasts. That really helps us out, helps with discovery. Share the show on social media. Tell your friends about it. Subscribe to my YouTube channel. Hit that subscribe button on Apple Podcasts, Spotify, Google Podcasts, wherever you listen to this. And you can support

the show on Patreon at richroll.com forward slash donate. Special thanks to Neil Bernard and Carbon Works for the interstitial music in today's episode. And of course, as always, huge shout out to everybody who helped put on the show today. Jason Camiolo for audio engineering production, show notes, Blake Curtis and Margo Lubin for videoing the podcast. Jessica Miranda for graphics. Allie Rogers for portraits. DK, David Kahn for advertiser relationships and theme music by Annalema.

Appreciate the love you guys. See you back here next week with the great Lauren Fleshman. We're gonna talk about running, coaching, the state of women's sports and all things female empowerment. It's super awesome. Here's a clip to take you out to whet the appetite.

And until then, peace, plants, namaste. I've always believed that telling personal narrative is the better way to help people understand the complexity of something. And so I kind of offered myself out there, even though I knew it would result in some skewering. I ended up getting a call from an old competitor right when it came out who chewed me out. I remember taking that call and just being like, okay, here we go. Like, why did I even bother telling that story? Is it going to be any good? But I do think

that it helped contribute to a public conversation, a public understanding. It's just one of many stories that contributes to like the dialogue around this, the importance of really fighting for ethical and clean sport, of learning what is and isn't okay and what we want that to look like in the future. The past is what it is, but I still do believe clean sport is possible. It's going to be hard, but it needs to be nuanced, our understanding of the past. And yeah, we rely a lot on whistleblowers too. So no one's going to come out and talk about their experiences if we have this black and

white view on everything. Thank you.