Chris Kresser

00:00move over a little bit I seem alright 3 2 1 yes all right welcome back Chris what's up man how's things happy to be here things are good how many have you yeah what's the latest in the greatest few new book came out yesterday that's always a big one what's called unconventional medicine and give us the what what are those sheets the back sheet yeah called yeah the back sheet that works the biggest challenge we face today is chronic disease and conventional medicines failed to address it so we need a new system that's the nutshell and you're essentially based it's doing nutrition based three components ancestral diet and lifestyle which we've talked about functional medicine and a collaborative practice model that incorporates health coaches nutritionists and other allied providers to to offer more support to patients what does that mean when you say functional medicine so the easiest way

01:05to understand it is it's an approach that is geared towards addressing the underlying cause of a problem instead of just suppressing the symptoms so you go into the doctor you've got high cholesterol usually given a drug to lower it statins yeah you got a high blood pressure those are health right statins are well you know for some people they can be I wouldn't say they're devastating for everybody and they do save lives in certain situations but the idea that they're the first thing we would do in that situation that's what's off right that you wouldn't suggest like altering the diet exactly let's look at why the cholesterol is high in the first place same thing with like high blood pressure you go into the doctor high blood pressure you get a drug to lower it there's rarely any investigation and their wives blood pressure is high and what are the main factors with high

01:54cholesterol because I know that it's a big part of it is hereditary Yeah right genetics play a huge role yeah so that genetics is one for sure but then you have things like poor thyroid function can actually lead to high cholesterol or LDL particle number you've got infections can do that like h pylori which is the bacteria that causes ulcer you've got leaky gut intestinal permeability it's been shown to do that that's interesting that you did you talked about this before but a lot of people are not aware of that that there's actually gut bacteria that causes ulcers yeah yeah there's uh it's a it's a cool story actually so you know twenty thirty years ago the the dominant idea was alters were caused by stress and things like eating spicy foods and a couple Australian physicians presented at a conference this notion that no actually they're caused by this

02:45bacterium called Helicobacter pylori and they were literally laughed off the stage nobody took them seriously they were ridiculed and they kept going you know kept doing this research kept trying to present this idea and nobody would take them seriously finally one of them swallowed a vial of solution that had the bacterium in in in it developed an ulcer as a result and then treated himself with antibiotics and got rid of the ulcer Wow to prove this is how committed this guy was this idea improving this and finally at that point people started to pay attention but it still was another ten years before that theory was widely accepted and then they eventually won the Nobel Prize in medicine as a result of that discovery so that to me that's a great example of how groupthink is such a problem in medicine you know we have a tendency to just like get stuck on the status quo

03:41even though core principle of science is uncertainty well we don't we we come up with a hypothesis we have to be willing to challenge our most cherished views all the time because if we look at the history of science it was the history of most people being wrong about most things most of the time yeah and it's amazing how many people are still operating under information that has been updated many times over the past couple of decades talk to the average person about what you should eat I mean they'll they're looking at like the food pyramid from the dr. Seuss books yeah or another one is you probably saw some articles like stents yes they don't work yeah I just you know I just read that came out they don't work but they're still massively being used in part because they get doctors get paid now that's crazy cuz I thought a stent was like I thought it propped open the

04:33artery I mean what does it do right and but the question is is that actually have the desired effect I mean it was the thing was based on pain resident wasn't it and mammograms prevent we're supposed to prevent breast cancer right they died then we saw you know the huge randomized control trial that showed that they not only do they not prevent breast cancer they may actually increase death either as a result of unnecessary treatments that come from the mammograms so Wyatt yeah how how would you get an unnecessarily if you did a mammogram and you saw a lump well it's not always black or white so it could be a cyst or something like this and somebody gets unnecessary treatment oh that lens that you leads to an adverse event so I'm just saying it's you know we got to be humble and realize that we don't always have the answers and then in ten years it's gonna look

05:22really different than it does now just like a hundred years ago everybody thought they had the answers and you know we look back on them we say how silly you know but we forget that people are hundred years ahead are gonna look back on us with that same you know that you know they're gonna shake their heads yeah it's very unfortunate but that is a tendency that people have when they've been living their life based on like what they think is like certain rigid information like this is absolute this is true and they've been teaching that that's when it gets especially problematic or writing books about that yeah and then they just never want to admit their book is and I think that our education system needs to change medical education because you know you write a textbook and that takes a long time and then you know the textbook is used in in course like the

06:08medical schools are still using the nutrition textbooks that were probably written in the seventies of the 80s or something and then we get all these new studies showing that like cholesterol on the diet makes it has no impact you know on your blood cholesterol for most people I'll say that again because for a lot of people who they're like what did he just say yeah so even the American the the standard u.s. diet guidelines last year a lot of people might have missed this they completely removed any restriction on dietary cholesterol from that from the u.s. diet guidelines they basically said there's no reason to limit cholesterol in your diet anymore now for people who don't know why this is so crazy or how this came to be you need to go to the New York Times article on how the sugar industry bribed scientists and convinced scientists to publish faulty or false

07:03information pointing towards saturated fats and cholesterol as being the cause of heart disease and heart attacks and all these different ailments so that they could push the blame away from sugar and I think they only got paid something like fifty thousand dollars to do it yeah which is amazing think about how many people that's affected yeah and these I mean these conflicts of interest are everywhere it's that's a big conflict of interest I mean that's just that's just crime right but it's some horrible things to people it totally you know it's unfortunately pretty normal in medicine there was a study just came out a few days ago that showed that the more gifts doctors received from pharmaceutical companies the more expensive the drugs they prescribe and the more prescriptions they write in general yeah I would imagine that's true my wife's mom it was a nurse and she

07:54would tell me stories about how they would take them out to nice dinners fancy restaurants and everything on the house and it's human nature I mean you know Upton one of my favorite quotes is from Upton Sinclair he said it's difficult to get a man to understand something when his salary is dependent on him not understanding it mmm that's a great quote yeah so one more time dietary cholesterol has no impact yeah well I'll be more specific so in 70% of people eating you know egg yolks and cholesterol in meat and other things doesn't do anything to your serum cholesterol the cholesterol levels in your blood in 30% of people you'll get a slight raise in your LDL cholesterol or the so called bad cholesterol but you'll also get a raise in your HDL cholesterol which is a so-called good cholesterol which means there's no net clinical impact of that in terms of your risk of

08:48heart disease and this is why the u.s. finally the last industrialized country to actually do this they finally said okay well we really we just can't do this anymore we can't tell you not to eat dietary cholesterol because there's just not any evidence to support that what took so long well I think you just referred to one of the reasons I you know conflicts of interest people that were invested in maintaining the status quo I think also there's probably some concern about losing credibility you know these are government organizations if they told you told us not to eat cholesterol for so long and then they tell us that we can not a problem and they do that with saturated fat you know people stopped listening because they just throw up their hands they're like I don't know who to believe or what to listen to that saturated fat was another one you talk

09:37to the average person they think you should restrict your intake of saturated fat yeah average person most doctors still and you know I I think I think there is some nuance here and I you know maybe we talked about this on the last show but where we're headed in my opinion with diet and nutrition recommendations is from general blanket recommendations that apply to everybody to more personalized recommendations that depend on your genetics your goals your lifestyle you know your health status your age etc so let's take somebody who is a poet for for which is a you know have a certain genetic haplotype and they have you know they're they're they're really sensitive to the dietary effects of saturated fat if you have that genotype and if they eat a common is that not very common at all I can't remember the exact percent it's below 10 percent I think it's 3 3 4

10:39percent or something like that and if those people a lot of saturated fat their LDL particle number which we can define if you want to those are the particles that carry cholesterol can go up pretty pretty quickly and what we know at least from the research that we have is that people who have a much higher LDL particle number can be a higher risk for heart disease and Alzheimer's there's murkiness there because that's just on average you know we don't know if that that risk applies to people who are eating you know paleo type of diet doing Crossfit taking care of themselves in every other way we just know that that the general population in the general population a higher LDL P leads to a higher risk of these conditions now I know people I'm sorry to interrupt you but I know people some people know this but some people don't what is the difference between LDL

11:31and HDL and why is one good one bad well here's here's an example of how things are changing again so historically the idea has been that LDL which stands for low-density lipoprotein and HDL stands for high-density lipoprotein the LDL the idea was it was bad as a number of effects that contribute to the risk of heart disease whereas HDL does a kind of like clean up and repair process and actually reduces the risk of heart disease but just a couple weeks ago there is some pretty influential research published suggesting that HDL may not be actually so protective and it may be more of like a like a bystander effect where people that have lower risk of heart disease just just also have higher HDL and it's not that the HDL is protecting them it's whatever other underlying processes are protecting them happen to lead to higher HDL levels oh and the reason that they think this now

12:35is that they they've done a whole bunch of trials on drugs that raise HDL and guess what nothing happens they don't the people who have an increase in their HDL because of the drugs don't have a lower risk of heart disease and in some cases they've even had to stop the trials because it became clear that there was not only no benefit but maybe even some harm so what kind of harm would there be just more event you know more cardiovascular events or more deaths Wow so it's just another example of something that we just assume for so long it's true we find out that it's not true I had a conversation with a guy was a brilliant guy and we were talking about eggs and I said I'd like to you about four to six eggs a day like what about all the cholesterol yeah and I'm like wow you don't know you don't know that and you're you're a really smart guy like this is kind of

13:28stunning yeah I mean it's and it's gonna take so what I just told you about HDL think of everything that has to change to reflect that new understanding you've got textbooks that need to be rewritten you've got primary care guidelines you've got it's just massive it's almost impossible to get our head around and so the average primary care provider is not going to get this message for right that's right I would say decades not more than years that's crazy yeah so they're gonna be giving out bad advice to people so the average person who works all day and doesn't have the time to do the research that you do or you know maybe isn't informed about all the various blogs and books and just doesn't have time goes to his primary care doctor and ask some questions and he gets terrible information because unfortunately poor health primary care doctor doesn't have the time either you

14:16know they're there they're in a bad spot you know I know a lot of primary care physicians they're all everyone I know went into medicine for the right reason they're trying to help people they're doing their best but they're seeing 2,500 patients that that's how many to have on their roster their average visit is it is between 8 and 12 minutes because they get you know reimbursed based on the number of visits so then in order to make a living they have to the seus or a number of patients a day and the insurance companies often mandate that so in a 10 minute visit patient shows up with multiple chronic conditions taking multiple medications and then presenting with new symptoms that they're concerned about there's barely enough time to say hello and you know figure out what's going on with their meds and make an adjustment and make a new prescription much less to

15:03talk to them in any kind of meaningful way about their diet and their lifestyle and their behavior forget it it's impossible so the the primary care doctors I think are as much victims of our conventional system and the way it's set up as patients are and if they're there busting their butt seeing you know patients eight hours a day every day and then they have all the paperwork to do on top of that last thing they're gonna want to do is go home and fire up PubMed and start reading you know the latest studies that if you know for sure they're gonna exhausted non motivated yeah i'm-a got families you know they have other things to do and and and and there are studies that have shown that the majority of primary care physicians understandably given this situation receive most of their education from pharmaceutical sales reps you know who bring in the

15:52brochures and that you know talk about a particular condition and of course those are that's not going to be unbiased information that's hilarious that they get their information from that Wow yeah because the reps come to the office ya know and so and they have the brochures to the drugs and the brochures talk about the condition and you know they have cartoons with answers in there and showing you the bad stuff happening to your arteries it's it's a crazy such it's a crazy system and it's really it's we're in big trouble I mean that's the message in my book it's like you know this is not just about individual health which is my first book was about you know taking back your own health this book is about taking back health care because we're we're screwed if you look at the numbers and by the year 2040 it's estimated at a hundred percent of the federal federal budget

16:42will go towards Medicare and Medicaid expenses leaving nothing for anything else military 21 with 2040 what's talking about our lifetimes that's real that's real that's if if health care spending continues to increase at its current pace that's insane you're right that does not mean this is why the Department of Defense has has named health care as an existential threat to this country just like you know nuclear war or any other military threat they've named chronic disease as an existential threat that could actually you know threaten our survival as a nation Wow whoever thought of it that way who could have ever imagined that literally all of our budget would go to taking care of people's health by 2040 yeah that's not long it's not long that's 22 million let me give you a few examples just to you know to make this more clear so the cost of treating a patient with type 2 diabetes is

17:45estimated to be $14,000 a year okay so we know now that a hundred million Americans that's like a third of the population have either pre-diabetes or type 2 diabetes what yeah wait a minute CDC just published these numbers 100 million Americans yeah it's insane pre-diabetes or type 2 diabetes one-third one-third and that is crime having a hard time what if you had just asked me like what percentage of Americans have diabetes I probably said like 4% yeah who actually have type 2 diabetes is lower it but I said pre-diabetes or type 2 down there way yeah so so here a couple other stats 88 percent of people who have pre-diabetes don't know that they have it and in the 80% and the average amount of time it takes for someone to progress from pre-diabetes to full-fledged type 2 diabetes is just five years Wow so let's go back to that number $14,000 a year to treat a single patient with type 2

18:53diabetes imagine someone gets diagnosed at age 40 which is totally possible I mean now even eight-year-old kids are being diagnosed with type 2 diabetes and imagine that person lives at another 45 years which is also feasible because we have these and one of the amazing things about conventional medicine and so the technologies that keep us alive probably a lot longer you know then we should be so let's say that person lives forty five years we spend $13,000 a year fourteen thousand dollars a year treating that person that's six hundred and thirty thousand dollars to treat one patient with one disease over that patients you know remaining lifetime now if you start doing some math and you assume you know even 50 million people with diabetes times six hundred and thirty thousand dollars you get a number with so many zeros after it I don't even know what it

19:48is it's like a Google or a googolplex or something so this is why we're we're facing this threat and this is why I wrote the book it's like I people aren't aware the we're at this point where you know like one in two Americans now has a chronic disease one in four have multiplied me in two Americans has a chronic disease one and two one in four have multiple chronic diseases and I know you're a parent so and I am 230 percent almost of kids now have a chronic disease and that's up from just 13% in 1994 so there's been more than a doubling of kids with chronic disease in less than 25 years how is that part of what has changed in the American diet are you tributing it to the american american mental affects all of the above so I would say it's the diet it's an increased sedentary activity you know like sitting for very long periods not moving around not enough exposure to

20:46artificial or not exposure to bright to natural light too much exposure to artificial light not enough sleep you know so all these things come together and now we've got a nation of people with chronic disease and chronic disease is bankrupting our country and it's extremely difficult to treat it lasts for a lifetime and our only hope actually of dealing with this problem and surviving as a country as a nation is to figure out a way to prevent and reverse disease instead of just suppressing symptoms and putting band-aids on it which is what our current conventional medical system does you really scared me with that diabetes number that that's really freaking out I can't believe that when he pulled up Jane more than a hundred million Americans have diabetes or its precursor staggering CDC report reveals and this is just from July yeah Wow in 2015 least

21:471.5 million new cases were diagnosed in people over 18 now a third of the US population has diabetes diabetes the CDC just updated it to obesity statistics now 40 percent of US adults are obese 40 percent four and ten not just overweight obese and 40 percent 40 percent and almost 20 percent of adolescents are now obese now how are they basing this by those body standards body mass index yeah but I'm a beast yeah it's not doctor work it's not perfect but it's not so so imperfect that it's you know we're talking about a 20% difference look at body mass index 5 foot 8 200 pounds I think I'm like dying I think like if you look at the body mass index I think I'm like of terrible health but all you have to do is go to an air you know I just flew down here right now you sit in an airport and you look around yeah you know that statistics are crowded but there's also a lot of people

22:50that lift weights like there's a lot of people that are bigger I would like to know what the you know what am i obese yeah I'm obese come on damn that come on that I mean look diabetes it's just not real it's not that well I don't know I think that statistic I mean what do you think out of 10 people that you see on the street are for obese well if I'm obese now I know that I'm obese all right according to that well you gotta throw that thing out the window that's not a good metric it's not a perfect metric but they have done studies where they have counted for that and they do you do see some variation but you're you're not the norm you're not you and you're you're not you're an outlier I'm aware of that but I think there's probably got to be quite a few outliers out there there are quite a few but not enough more today than ever but not enough to change that

23:46statistic in a really meaningful way it's not gonna you know there aren't 20% of you you know it's not gonna drop that from 40 percent to 20 percent so maybe 40 to 35 is that reasonable still a lot yeah that's I would say maybe 40 to 39 or 38 Jesus yeah so so so here's the deal you know we can't it doesn't matter who so that the whole recent health care debate with you know Affordable Care Act and then the current administration suggesting something different that a whole discussion revolved around how we're gonna pay for health care you know insurance health insurance but we have to understand that health inch Curren is not the same thing as health care right it's a method is a method of paying for health care and my key point in the book is it doesn't matter what method of health that we use to pay for health care whether it's the government whether it's corporations or whether

24:42it's individuals there is no method that's sustainable in the face of the rising rates of chronic disease that we're seeing yeah there's there's nothing fascinating is I am pretty aware of this stuff and I didn't know what you're telling me yeah and I'm stunned I'm stunned at the number of people with chronic disease and I'm stunned at the number of people that are either pre-diabetic or diabetic I really don't know how to digest that yeah that's that's horrific and that could be attributed almost entirely to diet in a lack actually it's a preventable disease that's that that's the crazy thing type 2 diabetes is a fully preventable condition and type 1 diabetes varies in what way yeah that's it's an autoimmune condition and it's strongly genetically mediated so it's which means that it doesn't you know necessarily mean that if you have the genes you're gonna get

25:33the disease but there's you know 50% of the risk I think is the statistics that I've seen of type 1 diabetes is genetic whereas we know now that 85% of the risk of disease in general comes down to environmental and behavioral factors behavioral meaning you die yeah or or you sleep or you're you know your physical activity stress management etc so that means only 15 percent of the risk of disease is genetic you know purely genetically driven whereas the other 85% which is a vast majority is actually under our control I was looking at statistic that made a correlation between sleep and weight loss and saying that people who slept an average of 8 to 10 hours a day had a significant significant significantly less body fat and weighed less and lost more weight than people who did the exact same activity but slept 4 to 6 hours yeah I would say that among people who research

26:39weight regulation sleep is now recognized as being the the second most influential lifestyle factor that determines our weight aside from diet whoa I had yeah I had a physical activity so I got a couple of good ones for you a single night of sleep deprivation has been shown to cause mild insulin resistance even in people healthy people with no pre-existing blood sugar disorders so just one night of not sleeping well can cause a little bit of insulin resistance the next day I mean it's transient it goes it goes away but that's significant there was a study where they they deprive people of sleep for eight nights in a row pretty severely it wasn't you know obviously not total sleep deprivation because they'd be dead but you really be dead for eight nights in a row I think so yeah I mean partials you know partial but significant sleep deprivation for eight nights in a row

27:31these people ate an additional five hundred and sixty six calories a day during that period with no changes in resting energy expenditure so that's equivalent to gaining a pound a week of body weight or fifty two pounds in a year so most people won't have that severe of sleep deprivation but if you just even have mild sleep deprivation you know over a significant period what if you that could account for ten pounds of weight gain a year and over you know ten years you're you're talking about a lot of weight kick yeah so is it because you're sleepy so you just force yourself to eat food like what no it's just a totally screw it totally screws with hormone production and all the hormones that regulate appetite and satiety and things like that Oh desire and appetites higher it's hard to get satiated and it also decreases your willpower and judgment around food

28:31so people are likely to make worse choices when it comes to food I know I do yeah dude if I'm really really tired I immediately go to like cheeseburgers or something it's uh it's it's part of what been documented it happens yeah you like reward yourself with something that's terrible for you yeah yeah and you know probably be in theirs that's also related to the changes in brain chemistry that happened so Wow yeah Wow and and now we know that the third of Americans get fewer than six hours of sleep and outside of like maybe three percent of the population that has a gene that allows them to you know be okay with that that few of hours of sleep the vast majority of people need seven to eight and a half hours of sleep to function properly and that's been clearly documented yeah I had read something about outliers in terms of performance outliers there are a lot of

29:28people that like entrepreneurs guys are killing it out there they're they're getting like four to five hours sleep at night and I was stunned by that I was like how is that possible like how are these people that are you know they're doing all these physical activities working out running their business and then I found out about adderall right so there's that yeah I mean as I said there are some genetic polymorphisms that we at least some research suggests that allow people to you know deal with less sleep than others but yeah I think in that community there's a lot of stimulant use that's driving that and at some point they're gonna pay the price yeah they need to come clean about that like that's the dirty little secret I have friends that are entrepreneurs in Silicon Valley people and the way they describe it it's like like people chewing gum right it's just everywhere

30:19everyone is doing new vigil provigil which are apparently less problematic and then adderall across the board yeah it's crazy I mean we're we're making choices now both you know individually and collectively that are taking us in the wrong direction and you know the this this we've shared a few stats that kind of blew you away and they've blown me away too you know when I was researching the book this is how it all came together for me it was it was like a wake-up call you know so I was six-year-old daughter I know you have kids today's kids are the first generation that are expected to live shorter lifespans than us their parents that's just crazy you know as we based on the statistic about diabetes yeah all this dramatic increase in chronic disease so as long as we've been measuring it and the modern world lifespans just been going like this you know there's been a few blips due to

31:18pandemics like the Spanish flu but for as long as we've been measuring it's just going up up up up and now this is the first generation of kids it's actually expected to start going back in the other direction I showed my kids that sugar Documentary my wife showed it to them it lasted about four months and they were like who gives a let's get back to the ice cream dad you know it's the kids like it's hard yeah we're hard this is where the evolutionary perspective is so important for people to understand we're we're hardwired to seek out foods that are calorie dense and highly rewarding and by rewarding I'm talking about that term in the scientific contact contacts which means eating something makes you want to eat more of it right so potato chips ice cream highly rewarding because you'll keep eating them even beyond the point where your hunger has been satisfied

32:11right a baked potato with no salt or butter not very rewarding you know you'll eat if you're hungry you'll eat it but you won't eat more than you're hungry for and even a steak which is most people like and it's and tastes good when's the last time you heard about somebody binging on a steak well it doesn't really happen because it's not highly rewarding in that way but human beings evolved in an environment of food scarcity so we have these hardwired genetic biological mechanisms that cause us to seek out foods that have a lot of calories and it are very palatable and rewarding because that would signal to us that they have different different nutrients macronutrients flavors etc and we're in an environment of food scarcity that works really well because you know stocking up on calories would allow us to survive a period of you know famine or food shortage or you know unable to

33:09locate food etc so we have all these mechanisms that were originally designed to help us survive starvation in the natural environment that's all well and good when we're living in that kind of environment but what happens when we live in an environment where there is a 7-eleven on every corner and Amazon delivering food your door and in Costco around the you know around the block food is everywhere and so all of these mechanisms actually helped us to survive in our ancestral environment cause set us up for failure in this modern food environment and we capitalized on that with things like the banana split yeah well the thing is the big big food they they hire scientists who understand these mechanisms and specifically designed foods to hit all of those circuits you know what do you think is like probably is there a statistically most addictive food I

34:08don't know actually the answer to that question I mean there's there's a lot of controversy about whether sugar is addictive in the sent in in the true sense of the way that scientists use the term addictive like meth yeah exactly but and there both sides of that debate but I think most of us can have you know just on our own personal experience can kind of assess the effect that sugar has on us or our kids or whatever it's highly rewarding in the sense that it makes us want more and more of it yeah it's not addicted to me in the sense of like I get a detox if I'm not having it but if it's around me and I want it the craving is very creepy right you know like what is this Jamie most addictive foods pizzas number one yeah Wow based on a healthful and calm study I tell you what man this there might be something to that well when we were in New York and you brought over those slices of

35:04pizza god damn those are good they can figure out a way to make that pizza here we'd have real problems well it's interesting that you showed that because the top six foods in the American diet according to the amount of calories that they comprise in our diet are pizza Brad grain-based desserts alcohol sugar sweetened beverages and chicken dishes prime we fried chicken dishes like chicken nuggets from McDonald's those six foods comprise the majority of the calories that the average American eats and then you look at our ancestral diet it was mostly you know meat and fish wild fruits and vegetables not even the domesticated varieties that we eat today nuts and seeds and a lot of starchy fibrous plants many of which aren't even available to us at this point but you know sweet potatoes would be our kind of modern analog of that and so you have a situation where we evolved in the

36:05context of eating those foods which are they're nutrient-dense they're anti-inflammatory and they're naturally low in calories and they're all foods that are very hard for us to overeat again like it's what you don't hear about people binging on broccoli you don't hear about them binging on steak no one you're about to many macadamia yesterday last night I got home and I just had 14 sweet potatoes you know and even if they have sweet potatoes a lot of people but brown sugar on them right something like that which then you might you might over eat them but if in those foods in their natural state we're not going to over eat them we're gonna eat till we're satiated but all the other foods that I just mentioned those top six foods Pizza grain-based desserts like cake bread etc they're all foods that trigger all those reward circuits in a big way and we've all had the experience I'm sure of

36:59overeating pretty or over consuming everything on that list I used to always coming home from jujitsu I would order an extra-large pizza now to eat it myself that was this big it was huge and I would get I would get either pineapple and a double pineapple and double anchovies which I know some people think is disgusting but very delicious or I would get pepperoni and mushroom and I would kill that thing and then afterwards I would literally feel like somebody opened up my mouth like they were trying to force-feed a goose to make foie gras and they just poured cement into my stomach then I just lay there and just feel terrible and feel that insulin spike and your whole body just reacts this sludge that you're forcing it to process it's just dough and and cheese and the other cheese's great though yeah I mean it's step but that's that that it seems to the dough is what

37:52gives you that Paul that's the heavy got bomb yeah the gut bomb yeah why is it so good though cause I'll tell you what those alternatives they suck and not they're not that good they're good food but they'd it's a there's not the same there's no free ride right there's no decadent alternative although I did find a very good cookie there's a company called no do you know no food doesn't seem at go grab one of those things yeah they have all we got right there yeah it's not bad man yeah yeah I mean sugars like for the entire cookie 28 grams 28 grams of sugar it's a big ass yeah I see that and but it's all like I mean and I actually enjoy eating it but if you look at the the ingredients it's all ok here we go with almonds coconuts egg whites flax seed chia seed zero trans fat and 16 grams 18 grams of protein 4 grams net carbs mm-hmm taupe grams of fiber yeah

38:57bad and it tastes pretty good but it's not as not a large pizza with anchovies and pineapple on it not as good as like a mrs. Fields right chocolate chip cookie you know when you eat that you pull it apart in that string of chocolate you know that absolutely I mean those are all good because they they they like I said they trigger all of those hard-wired reward circuits they push all the right buttons yeah they get you it is amazing how many foods there are that are like that if you stop and think about like just going down the street why in a normal street where there's a bunch of stores and restaurants like how much of that stuff is bad for you it's primarily bad for you it's primarily bad and you think the whole modern food environment is that way and that's what I mean we're set up to fail anyone who set who sets out to be lean and and fit and healthy is

39:50swimming upstream yeah you have to be put in some serious action you have to constantly be putting in effort because there's a barrage of Heisman you walk into a grocery store all of those foods are you know they're triggering off those circuits that make us seek and crave those foods because those are evolutionary mechanisms it cannot be consciously overridden very easily and this is why weight loss continues to be a billion dollar you know multi-billion dollar industry because information is not enough it's for most people it's not enough just to know what foods are healthy and which foods are unhealthy because you're we're operating from a much deeper system the limbic you know the the limbic system are kind of lizard brain that is driving our our preferences for food and what foods we seek and which foods we don't seek and that's below the level of

40:41conscious thought that you know where we say okay I know that foods not good and I know this food is good but then that lizard brain just like that you know yeah it pushes you it's almost like if you're walking by like if you have some potato chips or something on the shelf and you walk it by it it's almost like there's an invisible hand on your shoulder pushing you towards you you can't stop pushing stop pushing me or you can go alright yeah you're just kind of given and here's the key thing to understand too that it's not because you're a weak person or you don't have willpower it's because you're a human being and that's how your brain is programmed yeah that is a very important thing to realize that there's a reason why it's difficult for you and in even for people that think it's well it's not difficult for me man well maybe if you've conditioned yourself yeah and if

41:30you condition your body and condition especially your diet there's something that does happen when your gut biome changes where your cravings change absolutely but if you're eating a lot of sugar it is incredibly difficult to get off that because that is what that gut biome wants and there's some sort of a very strange difficult to pin down feeling that what that craving is it's very difficult to sort of intellectualize right like if you have to go to the bathroom it's very clear oh my god I gotta pee yeah it's like there you feel it you know what it is but the weird hunger craving for sugar is almost like you can't grab it you can't like hold on to and go this is what I'm talking about this is that thing right there example I like to use there's a parasite that the whole lifecycle is really interesting you're probably aware of it it it you know ends up in mice and it

42:21changes yeah Toxoplasma gondii changes the behavior of mice so that they are dumber in terms of their ability to evade getting eaten by a cat yeah and then so then they get eaten by the cat and then the Toxoplasma transfers to the cat where and goes to the cat's brain where it normally lives so that's an example of how a tiny tiny little micro but you can't even see with your eye can powerfully control behavior and as you just said we've got trillions of these microbes in our gut that control our behavior and things like our food preferences and cravings we had Robert Sapolsky on the podcast talking about that and he said that some of the mice it actually rewires her sexual reward system makes them attracted to the smell of cat urine right so they're their testes swell and they're there they're literally like horny little zombies running straight towards the cats it completely rewires

43:15their fear of cats that goes out the window yeah and the reason being is that the only way that Toxoplasma can reproduce his inside the cat's gut yeah which is just insane like what kind of a twisted system and how did this evolve over all these years like the gut biome and a gut bacteria it is so fascinating to me well here's a here's a an interesting way of looking at you know Justin Sonnenberg no microbiologist at Stanford really interesting guy brilliant he I'm gonna paraphrase this because I won't get the quote exactly right but he wrote a book about the gut microbiome and he said something the effect of humans are just the elaborate elaborate vessels for the propagation of microorganisms he's basically saying that we're kind of the evolutionary vehicle or tool for for the microbes that live in our gut they've been around a lot longer than us a lot longer they

44:20outnumber us you know that the the number of microbial cells in the body more than the number of human cells so you know there's lots of different ways to interpret that but I think at the very minimum you start to see how important that microbial community is to our overall health and also our behavior yeah and if you really want to get creepy think about how like categorically they don't very individually like there they're essentially the exact same thing in mass numbers acting in the interest of the mass numbers right and then influencing us which vary widely and our different actions propagate them in different ways yeah I'm freaking out it's yeah especially weird too when you think that all of that stuff all of those microorganisms that are in our gut they're not actually in our body so they're not really part of us they're just hanging out there well think about

45:13a tunnel so you go through a tunnel under a river right you're not in the river ooh you're just in the tunnel under the river Ryan our our gut is a hollow tube that goes from our mouth to our anus intersects our body but everything inside the tube is technically outside of the body so they're influenced they're influencing us from inside the tunnel from inside the tunnel they're not really inside of our bodies so they're kind of running the show but they're not really in us so it's like a car inside the tunnel that's controlling the river yeah Jesus Christ and the crazy thing is that they can affect mood you can affect depression they can affect your ambition the way you behave everything I just saw a study on the way down here and you know I get a feed of all the new research and it showed that overgrowth of bacteria in our small intestine which is part of our

46:21gut is associated with heart problems so it's you know and they don't actually know why yet but so so you know something going on and with the cars and the tunnel is really tweaking the river in just about every way you can imagine it's not just about gut as you know affects every system of the body so paul ski was saying that one of the people that he worked with found during his residency that there was a disproportionate number of motorcycle accidents that were attributed to people were infected by Toxoplasma because it made them more impulsive right I could change human behavior as well yeah well I think we talked about this last time but the the prevalent theory now and what causes depression is that it's a disruptive gut microbiome that causes inflammation it it leads to the production of what are called cytokines they're chemical messengers inflammatory

47:12cytokines they travel across the gut barrier they go into the blood travel up into the brain and cross the blood-brain barrier and then they suppress the activity of the frontal cortex which causes all the tell-tale signs and symptoms of depression changes so what if depression which we have always thought about either as a disruption of brain chemistry or something that's purely situational is actually a you know has a physiological cause as a driver now that's not to say that those situational factors don't matter I don't want to be reductionist here and say depression is only caused by gut inflammation I think that's ridiculous but the problem is the average person goes into the doctor with depression they're going to come out of that office with a prescription for an antidepressant there's not going to be any investigation into their gut and whether they have inflammation in the

48:03gut and intestinal permeability there's not going to be a referral to a gastroenterologist to check that out and this is of course one of the problems with the conventional system the way it's set up is we had a doctor for every different part of the body and there's no quarterback that's really overseeing that whole thing the probably ideally that would be the primary care provider but because their appointments or 10 minutes they've got 2,500 patients on their roster there's no time for that yeah you'd have to find a doctor that's very meticulous it's willing to go over your blood work for you and check out what your diet is yeah would take hours and wnl as they say we're not looking so imagine a patient that goes into the doctor and they've got depression let's say they've got eczema or psoriasis they've got digestive issues and they've got you know brain fog cognitive problems like

48:58whole big roster of symptoms and the primary care provider might give them an antidepressant for the depression they give them a steroid skin cream for the skin problem they you know they they leave with the handful of medications but what if there was one thing that was causing all those problems or one underlying cause it was leading to all that so just you know in this example what if that patient had gluten intolerance and they hadn't been properly diagnosed we know now from the research that gluten intolerance doesn't just cause the GI distress a lot of people get it also can cause you know it's associated with dermatitis which is eczema it's associated with all kinds of cognitive and neurological problems so a single food protein could be leading to all of these different symptoms but in the conventional system they might go to the primary care doctor then they get a

49:48referral to the dermatologist they get a referral to a gastroenterologist they maybe get a referral to a neurologist or a psychiatrist they're seeing all these separate people to deal with all these separate symptoms like you know playing whack-a-mole with the symptoms they take you know one drug the antidepressant but then maybe the antidepressant causes constipation so then you go the gastroenterologist and they get a drug for the you know a laxative for the constipation and then before you know it's just this incredibly complex web of all these drug interactions and and all the focuses on suppressing these symptoms with different doctors for different body parts when in this example at least it was something as simple as a food protein they could be easily removed from the diet maybe not easily glutens in a lot of things but taken out and then all of those problems

50:39which seem like they were separate and disconnected go away mmm and that's really the promise of functional medicine because instead of looking at things starting with the symptoms and then working backwards we're starting from the the the inside and working out so you know an analogy I like to use is if you have a rock in your shoe and it's making your foot hurt you go to a canoe the conventional system you'll end up with the diagnosis of foot pain or actually it will be fancier you know they'll be like the Latin name for foot and pain or something so it sounds more official if you know and then you'll get a painkiller and the painkiller will help you know it'll reduce the pain a little bit but obviously it makes a lot more sense to just take your shoe off and dump out the rock and that's really what functional medicine is about now when it comes to gluten intolerance that's one

51:31that gets dismissed because it sounds it sounds frivolous so all of a sudden everyone's gluten intolerant like this is crazy but my belief is that there's varying levels of this and that it's something that people have just dismissed is a weird feeling that you get after you eat gluten yeah and that they're not really in tune with the effect of inflammation and that there's a real difference between the wheat of today and the weed of say the early 1900's it's been manipulated I think there are a few reasons there's misunderstanding about this number one is that there up until recently has not been a an understanding of the difference between celiac disease and non-celiac gluten sensitivity so for a long time the idea was either you have celiac or you're not sensitive room that's it I've heard that no recently yeah there's no gray area that's preposterous anyone who still believes

52:23that has not even done the most cursory search of the scientific literature you can go in and anyone who's what who's listening or watching can go to PubMed gov PU bmed gov in the search field type non-celiac gluten sensitivity or non celiac wheat sensitivity and tell me how many results come up do it it's gonna be a lot okay and it's going to be linking and this goes to the second point it's going to be linking not just to gut problems in diarrhea it's going to link to all kinds of different conditions from depression to anxiety to heart issues to hormone imbalance to cognitive problems etc so that's the second problem is historically how many 650 Jesus and I and and there's lots of others if you use some different terminology you can find more so with celiac disease the initial idea was it it's it just causes diarrhea and you know severe diarrhea and cramping

53:25and so the assumption was that that if you don't have severe diarrhea and cramping when you eat gluten you don't have celiac and you don't have any other kind of gluten intolerance but we now know that the with celiac there's a there are forms called atypical or silent celiac these are forms that do not present with the typical gut presentation and the number of atypical celiac cases out not it's much higher than the number of typical ones so a patient goes to the doctor they're having you know headaches they're having motor problems they're having you know all kinds of other issues the doctor if they think that celiac is only about gut issues and not even gonna think about testing that patient for gluten intolerance what kind of motor issues would you get well there's a there's something called ataxia which is a form of paralysis that can be caused by gluten from spaghetti

54:24yeah you're paralyzed from kids it's called gluten associated ataxia Jesus Christ now and this is for people who are non celiac yeah so so that's the second problem is again W&L we're not looking so the patients go to the doctor they have all these weird kind of complaints the doctor but they don't have gut issues so the doctor then rules out celiac or non-celiac gluten sensitivity because they don't yet know that it can manifest in all these different ways so how is this happening is that the the whatever intolerance that you have for gluten when you consume that gluten the gluten goes into the gut and interacts with your gut biome and then what's the what's the mechanism there's two different mechanisms in celiac there's an autoimmune mechanism where the proteins in gluten the body creates antibodies towards those proteins and also there's like a bystander effect where certain

55:18tissues in the body that have similar protein structures to gluten get attacked as well certain enzymes transglutaminase to transglutaminase 3 and transglutaminase 6 and here's the thing you know related to what we were just talking transglutaminase - is is is typically found in the gut so that's why a lot of people who have celiac have these got issues is because their body is actually attacking the gut tissue and ranking it down it's an autoimmune reaction but now we know that Trent they're that same autoimmune reaction can be directed at transglutaminase 3 which is primarily in the skin which is why something like 30% of people with celiac also have eczema and other skin problems and transglutaminase 6 is in the brain so this if you if person who has antibody production against transglutaminase 6 eats gluten their body attacks their brain whoa and that's why way it breaks

56:15down the enzyme which it has plays a number of important roles in the brain and so this is why celiac and also non-celiac gluten sensitivity is associated with a whole bunch of different cognitive issues like it and also actual motor problems like ataxia because it's attacking the brain the immune system is attacking the brain and that leads to some potentially very serious problems when did they start to alter wheat like what what what year do you know I don't know and I do think that is an issue because I've there's so many people who have gone to Europe you know they eat wheat here and they go to Europe they can eat wheat and yeah it's fine yeah but I think there are some other things that are actually more meaningful and significant and this leads me to the third reason why I think we've underestimated you know gluten sensitivity and why people don't

57:05understand how significant it can be we're not living in a vacuum you know so let's let's say you've got a person who is like a hunter-gatherer they've been living in a pristine environment you know they eat all nutrient-dense you know good food their gut microbiome is thriving because they've been eating plenty of fermentable fiber and you know probiotic cut type of foods and and they're just super healthy if that person gets exposed to gluten they might not have any problem but then you take a person who is living in the modern industrialized world they're sleeping you know five hours a night there they've taken antibiotics you know 30 by 30 courses of antibiotics by the time they're an adult which is not an exaggeration that you know I can't remember the exact number but it's extremely high the average number of courses of antibiotics they were born by

57:57c-section they eat a crap a crappy diet with a lot of processed and refined foods their sedentary they're not exercising so this person is in really bad shape and their immune system seriously dysregulated and then when they get exposed to gluten which might otherwise be a harmless protein it causes problems so I think the reason that more people are intolerant of gluten and intolerant of other foods now is is not just because the foods have changed it's because we've changed it's because we have become compromised you know we should human being should be resilient and able to tolerate these kinds of food proteins but when our immune system breaks down we talked about the gut as a barrier system where everything that's inside the gut is outside the body it's important to understand like in that the purpose of the gut is to serve as a Selective barrier that this that determines what

58:55gets in and what stays out because everything we eat is either absorbed or eliminated as waste and if that barrier becomes permeable in a non-selective way meaning it loses the ability to make appropriate decisions about what gets in and out then food proteins that would otherwise be benign and and you know be broken down into smaller particles and those small particles get absorbed and don't cause any problems the larger food proteins get absorbed before they're broken down and then that initiates an immune reaction that wreaked havoc Wow so if someone has a healthy gut then the insult of some sort of a gluten protein being introduced into their guy's not gonna be as big of a deal as if someone is just drinking Gatorade all day and eating cognizing that makes sense is it's like any other ecosystem so if you think of like an ecosystem that's really healthy and you introduce you know a

59:56predator predator or you know another mall something else that could could potentially throw it out of balance it won't go out of balance because the whole ecosystem is working together to keep that in check mmm but then you know you hear about like those small islands where they introduce a particular you know a predator or or a prey species that then just because the ecosystem of that Island is fragile you get a huge proliferation right you know where it's just all of a sudden there's nothing but deer the island yeah and until they start dying because of that imbalance you know and then it starts all over again so I've seen that before I've seen that in Hawaii on lanai right there overrun with an animal called access deer they're all over the place and for that same reason and so we have the same phenomenon like if we have if if someone's got microbiome is severely

60:48disrupted especially and and that started as a kid and they start they develop gluten intolerance they develop intolerance to corn and soy and dairy and allergy this is why allergies are on the rise and kids is my belief it's it's not because there's some weird you know all of a sudden someone introduced some kind of poison that is causing kids to be more allergic it's because of immune dysregulation right and that's happening because of the sleep issue the food and all of the other aspects of the modern lifestyle so what's the best approach for someone who wants to be healthier if they want to take control their gut biome is it just consuming a lot of very strong probiotic foods so that the first thing is to just eat real food I mean I I really like to boil it down to that three words you know eat real food and buy real I mean not stuff that comes in

61:37a bag or a box you know that the less processed and refined better in some city that came out of the ground or lives on the ground right exactly and you know there are a lot of we tend to get really you know worked up about all the differences between you know there's because you could say eat real food and do vegan you could say you build food and do paleo and you know that that's all great but I I really actually believe that if people just ate real food of any kind we'd be in a totally different place than we are now and do individual health issues should be worked out in the variations of those diets exactly that's where the find freaking comes but we didn't get to this point because you know everyone's eating real food and everyone's doing vegan or everyone's doing paleo we got to this point because people are eating trash essentially so one of the most key

62:26things with the gut microbiome to understand is that our healthy gut bacteria thrive on what are called fermentable carbohydrates or just in Sonnenberg who we talked about before he called the microbiota accessible carbohydrates these are fancy terms that just mean fiber so what what distinguishes fiber is that we don't break it down and turn it into glucose or you know other molecules that we can absorb and use for our own energy it stays in the gut too you know all the way to the colon and then the bacteria eat that fiber so fiber is food for our beneficial gut bacteria and that's what makes them thrive so that's fascinating cuz most people think of fiber they think of it almost is like like a laxative yeah yeah they think of there's something that's gonna clean out their bowels so not all fiber is fermentable by the gut bacteria some fiber just has that

63:19mechanical effect it's more like you know pushing things through the bowels whereas other fiber can actually be used as food by your gut bacteria and that fiber is probably more bad system or the more beneficial sorry are you talking like sauerkraut kimchi think so yeah there's soluble fiber that that's present in a lot of fruits and vegetables you've got non-starch polysaccharides like inulin and fos and things like that that are in like onions and garlic Jerusalem artichokes leeks and then you've got resistant starch which is actually not that's in a lot of starchy plants that we used to eat you know way back in Paleolithic era and some traditional hunter-gatherers still do but resistant starch these days can be found in certain types of starches that have been cooked and cooled like potatoes or lentils some people now are supplementing with resistant starch or

64:15they're eating like green unripe bananas unripe plantains you know what are those those do that because they're unripe it's the start is resistant as they ripen the starch it becomes just regular starch so I cook those like if you wanted to cook up a green plantain you can slice them and then dehydrate them and you make them into chips you can even buy plantain chips now at some how food store plantain chips that's what you're getting you're getting dehydrated getting some resistant starch there oh yeah thing or you can bake a white potato for example and then let it cool and that cooling process is what forms the resistant starch and this is what's really interesting you know most people think of potatoes is something that would spike their blood sugar because they have a lot of carbohydrate but when you cook and cool the potato it won't have that effect because the resistance

65:09start you can't absorb and break that into glucose whoa so so when you cool a potato it's better for you yeah so they're that like a cold potato salad would actually not have the same effect on your blood sugar is eating a warm baked potato that you just cooked in fact crazy you heard of the potato hack no this is probably the most effective diet that I've ever come across for weight loss and this is what I use with in my practice with patients when like nothing else has worked or if someone super motivated and just wants to make progress quickly guy named Tim steel introduced me to this and it was he has sent me some books that he found in the 1880s that reference this diet so this is old-school and what you do is you basically eat nothing but potatoes and you but you don't they're plain potatoes so you can roast them or boil them but you don't you know in the hardcore the

66:12hardest core version you don't even add salt it's just plain baked potato or boiled potato certainly no butter chives sour cream bacon you know because that increases the reward value as we were talking about earlier right the more variety there is the more rewarding of food is okay so you just eat potatoes and let's there are different variations or different ways of doing it you can do it for maybe just three days a week and then you can do your normal diet you know the other four days a week Tim talks about a variation called potatoes by day which means you just eat potatoes for breakfast and for lunch and then you eat a normal dinner but in my clinic and what and from Tim's experience working with a lot of people most people will lose an average of a half pound a day and I think there are two there there there are a few things happening here and why it works

67:05number one it's it's totally playing towards these mechanisms that we talked about before the the the the reward value of food which is called the hedonic system that drives our food craving and preferences and just let's do a thought experiment if you have two plates of food and on one plate you have a steamed potato with no salt or butter or fat of any kind and on this plate on the right you got bag of potato chips or just the plate of potato chips which one are you gonna eat less of I mean it goes without saying right you're only gonna eat the potato when you're when you're hungry and you're not gonna eat probably a bite more than you're hungry for whereas the potato chips all bets are off yeah for most people and so what happens is when you do the potato diet you get a spontaneous calorie reduction and by spontaneous I mean not voluntary you're

67:59not you setting out to say okay I'm only gonna eat a thousand calories today you're saying I'm gonna eat as many potatoes as I want to satiate my hunger but just by definition because of how our brain works you're only going to eat you're going to eat less then you would typically so that's one thing you get a reduction in calorie intake the second thing is that when when you cook the potato people the way they do this diet is they'll just cook like you know all the potatoes that they need for the week on Sunday to make it easy so then I have to cook the potato every time they sit down to eat so they cook the potatoes and then they let them cool and so then each time you can still heat them back up but but they now have a lot of resistant starch even if you heat them back up even if you hit them back up and here's what's really cool about it if you heat them up and cool them again

68:51each cooling cycle form more resistance arch so that by the end of the week if you've if you're heating all of the potatoes back up and then cooling them again each time you're gonna have a potato that's mostly resistant starch which means it will have zero impact on your blood sugar and it will be like a feast for your beneficial gut microbiome and that's another reason this diet probably works we I'm you know all about the studies correlating disrupted gut microbiome with obesity and diabetes yeah so you're basically the way I tell patients is you're basically going on an all fiber diet mmm and you leave the skin to you can eat the skin you should eat the skin Tran yeah yeah yeah skin has vitamins in it right so people will lose up to a half a pound you know between a quarter and a half a pound a day that they're on the potato diet it's amazing so if you

69:42let's say you know you decide I want to I want to lose one and a half pounds a week you do it for three days a week and you do that for six months then by the end of that six month period you've lost a pretty significant amount of weight if you can keep that up if you can keep it off the blandness of it that's another fascinating aspect about diet it's like how much of our life we we were willing to forego health happiness all these different things just for some simple mouth pleasure for a few moments you know I mean if you think about a pizza that you would eat that Pete I mean how long you need it for 20 minutes 20 minutes out of a 24-hour day and you're gonna feel like for at least an hour to afterwards you know if you try to do anything like physical it's gonna be more than two hours before infinitely if you really want to go to the gym or you want to go for a run oh and look I'm

70:32not saying I think everyone should do this I think food should be pleasurable and I think you know the way I eat for example I love the foods that I eat you know it's but and this is why I say I don't suggest that anyone should start here but I think it's interesting because it gets at some of what we've already been talking about how why the modern food environment contributes to obesity and how using that knowledge and understanding of what triggers you know us to eat we can turn that around and use it in our favor so another strategy that similar is to just eat but not quite as extreme eat the same thing for breakfast lunch and dinner for like two or three days in a week so you get bored with it that way exactly mmm that seems like all mental tricks like someone would tell you like someone like Jocko what so I just suck it up and stop you know there it's using

71:22our understanding of our biology and our and our you know behavioral mechanisms to to combat the the way that the modern food environment is working against us what do you think about like pre pre-planned meal programs like there's a lot of companies that sell prepackaged a meal delivery portioned yeah yeah I think those can play a role too because it's kind of a set and forget yeah thing and you know what the portion size should be there's there's another strategy that's very simple that's been shown to contribute to weight loss and and again it plays to these same mechanisms which is to get smaller plates mmm so you know a lot you go Target you buy plates like this big right don't even fit some of the dishwashers yeah and we don't even think it's just something you wouldn't even think about but we have a tendency to fill that plate up yep and just for shredding a

72:13smaller plate and eating off the smaller plates has been shown to have a meaningful impact on weight loss yeah like you ever go to a buffet like when buffet you always take some obligation to get your money's worth you know gorge yourself these are combinations of food that you've never put together in any other contact I know it's all there it's a real problem some people so a is like the Antichrist for our the way our brain works yeah because it's variety it's all like highly rewarding you know palatable foods it's like the absolute worst possible thing but if you think about it our entire food environment is lit it's like a buffet mmm you can go into any store at any time and get any kind of food to trigger any of those cravings yeah do you supplement with any sort of probiotics outside of regular food I will occasionally take probiotics I mostly try to get it through fermented

73:11foods you know because I think that's probably what do you choose sauerkraut is a great one kimchi I do find with full fat fermented dairy like kefir or yogurt sometimes we make our own yogurt and ferment it longer so it has more microbes beet kvass is a lesser-known - beverage comes from Russia in that area it's fermented beets into a juice just know if you like some of these other fermented if you'd like it no I'm just joking around I like kimchi and most people think it's file yeah everyone in my house thinks it's vile now the b-class is good and it's beets are super nutrient dense oh and the fermentation brings out even more nutrients so it's like a super food beverage the fermentation brings more nutrients interesting yeah in what way when it gets the more bioavailable really yeah what on what what nutrients does fermenting well from fermenting creates vitamin K for example so

74:06fermented foods are one of the best source of vitamin k2 and that's why natto which is a fermented soybean product from Japan is the highest you know pound for pound or ounce for ounce is the highest source of vitamin k2 there is that we know of but cheese is another high source of k2 and that's because it's fermented so most fermented foods have vitamin K sit in beer or wine or I'm for I don't think so too bad yeah too bad so kimchi sauerkraut Netto this beet stuff because yogurt yogurt kefir which is like a liquid form of yogurt there are case case certain kinds of cheese cheese doesn't tend to be as beneficial in terms of the amount of microbes that are in it what about kombucha kombucha and there's lots of different kinds of kombucha there's also water kefir which is like dairy kefir but it's it's it's more like kombucha but it's used they use the kefir cultures to make it mmm every

75:09traditional culture almost has a fermented food to it because our ancestors understood even without knowing the science that they were beneficial but yeah they must have just trial and error right now outside of that like what's a normal day in Chris's life like as far as like your diet like what do you do you consume basically the same foods all the time or do you mix it up I mix it up quite a bit lately I've been a lot with Quito and ketogenic diet fasting I'm really interested in fasting right now so like I haven't eaten yet today I just had coffee and some some cream which I do again I do fine with full fat dairy I always do that lately not always but I'm doing that a good solid four to five days a week yeah where I'm doing intermittent fasting about 14 hours yeah I feel great when I do I I love it my like mental clarity the focus and to be honest it's actually

76:08I mean I love food preparation I like to cook but it's nice to be able to have a break from that you know now that's not to worry about what I'm gonna eat and cleaning up and all that stuff and so you know my these days my average day is kind of like no breakfast fasting that I might have wet mark Sisson calls a fat bomb salad for lunch if you know if I have lunch I might have a later lunch so that would be like a salad with a little bit of protein chicken fish etc and then like kava kado and olives and you know really good healthy fats and then if I'm not doing a ketogenic phase I'll have a normal dinner which would look like a portion of protein a lot of non starchy vegetable and like a sweet potato or a plantain or some taro root or some one of these paleo friendly type of starches and if you were going keto how would you switch it up then I would typically have

77:08the protein the non starchy vegetables and either like some zucchini noodles or turnip noodles you can get like a spiralizer and main the noodles really easily and I would put some additional fat on those those you know vegetable noodles or I might just have another non starchy vegetable along with fat or salad so you're essentially just manipulating the fat levels other than that you're eating primarily the same type of foods you just you're manipulating the fat versus carbohydrate levels yeah and how do you feel what it was and do you find it difficult to maintain the ketogenic diet and how do you feel when you're on it versus when you're not yeah so for me because I'm lean obvious the and I have a fast metabolism I can do keto for a couple weeks and feel pretty good I've done it for as long as three months so I've done you know the full experiment and what happens is after

78:03about two or three weeks my exercise tolerance and recovery starts to go down so I start to have less capacity to do like more glycolytic activities explosive movements you know weightlifting even or sprinting high intensity types of training and and and I start my sleep starts actually deteriorate a little bit that's why that's interesting so why would it be beneficial done what's beneficial about it well I think so two things number one not everybody has that response a lot of people just feel better and they they're able to do it for a sustained period of time and they don't have that problem number two I the way I'm trying to do it is kind of replicating what I think was typical in the ancestral environment so most hunter-gatherer cultures that we've studied would have naturally had periods of food scarcity so they're not always starving but because they don't have a

79:027-eleven on the corner or Costco or whatever they would have periods where they weren't successful in a hunt so you know they would go without eating or they would eat less that's just built into our our template I think and so I thing where I'm you know I'll do intermittent fasting for a period and I might do a week or two of ketosis and then I might just eat my normal diet for you know six weeks or two months after that and then I might do another week of ketosis and I don't schedule it I don't plan it I just let my body tell me you know Oh kind of feels like all I want to do that now and are you doing blood tests oh you are doing breath test how you're monitoring you keto no I totally so I have the blood ketone monitor and from all the research that I've seen at this point breath ketone testing is not accurate at higher levels of ketosis it's it's accurate at lower levels but

79:53when you get into the therapeutic range around 2.0 you know 1.5 to 2.0 which is kind of the sweet spot for me then blood ketones are more accurate and the problem with the blood ketone strips is they're super expensive especially if you buy them just like at the drugstore or something like that but I if you you can look around and try to find them in bulk and they're cheaper that way and and frankly at this point and I think that's true for most people once you get used to it you know and you've done it enough you don't need to keep using them over and over you just kind of know when you're gonna be in ketosis right when you're not and I've tracked my my values and I've tracked you know I've treated hundreds of patients where we've done these kinds of experiments and this goes back to the discussion about LDL so for me on a ketogenic diet you know if I

80:42measure my on my typical diet my LDL particle number is about 1,200 so I'll just briefly describe what that is because I think some people might not be familiar with that so if if you imagine that your your your bloodstream is like a highway the cars on the highway are the LDL particles and the passengers in the cars are the cholesterol that are carried by the LDL particles so for years we've measured the the passengers the cholesterol inside the particle and now most research suggests that it's actually the number of particles or cars on the road that is the biggest driver of heart disease risk not the amount of cholesterol inside of them so you can measure this so you know LabCorp and quest they all have the test panel called an NMR where you can measure the number of particles that you have and so my normal diet is around eleven or twelve hundred which is technically hot

81:39it's high normal or you know in a kind of intermediate range I'm not worried about that level but when I go Kido my LDL goes above two thousand which is in like the 99th percentile and and a high high risk range so this is where I was talking before about getting to a point where we can be maybe a little more personalized in terms of the recommendations that we make because not everyone who goes quito experiences that you know some people do and some people don't what do you think that is oh it's just the that in that you know for me you know on a keto type of diet it affects my lipids in that way and no this is a much larger conversation around does that actually increase my risk of heart disease again I said before we know that higher LDL on average in the general population does but if if like let's say I have a doppelganger and yeah genetically some identical to me and everywhere an

82:38identical twin and that one is not eating healthy not exercising not sleeping you know not doing anything to take care of himself and he has a LDL P that's high and I have that LDL P that's high and they're exactly the same do we think that we're gonna be at the same risk of heart disease just because that one number on the paper is exactly the same that's the assumption that's made in the conventional research literature right but I think almost anybody just common sense would say no that's not true there are many other factors that determine the risk of heart disease so getting back to this thing so for me with Kido one of the reasons I mean the main reason I don't do it ongoing is I don't feel well when I keep doing it like I said number two I don't like doing it long to her and I think that's important and number three I don't necessarily want to have an LDL P

83:34of 2,000 but you do think there are some benefits to occasionally doing I think that it was very natural for human beings to be in ketosis at least part of the time and whether you enter into that by just fasting mm-hmm or whether you do it with a ketogenic diet I don't know that that really matters I mean fasting has some additional benefits above and beyond just ketosis like Auto Fuji which is a cellular cleanup and repair process that happens in a fasted state if you think about it if fasting and or being in a fasted State was a normal part of human evolution it makes sense that certain processes would only happen in that fasted State it does make sense but I would feel like when I'm talking to you about based on your experience I would avoid being in ketosis altogether because it sounds like it sucks for you know it doesn't those first two weeks

84:24are really great and great yeah and then it starts to shift over dom D'Agostino said that there's like a there's an adaptation period yeah usually three weeks is the full period for most people but like I said I've done a full you know longer experiment so I know it wasn't just a question of me not being fat adopted I think he was talking about several months in terms of like athletic performance when your performance starts - yeah I think that varies a lot from person to person also varies how quickly someone can get into and out of ketosis I go into it very quickly for me like just the second if I do one day of fasting or one day of keto on the second day I'll generally be at 11.2 which most people say is in a therapeutic range and then by the third or fourth day I'll usually be at - without a lot of effort and do you regulate your protein intake when you're doing a ketogenic diet as

85:16well to avoid protein converting to again that's highly individual from what I've seen from Mia protein doesn't seem to be that significant of a lever I've tried you know I did an experiment where I was just fasting in the morning so I had no protein and I would have three ounces of protein only with the salad at lunch and then I would have a kind of normal sized portion of protein so that's actually pretty low protein for someone of my size yeah and that and then I've done it where I've just done keto where I've had protein for breakfast lunch and dinner it doesn't seem to make a big difference for me but I have patients for whom that's that's actually as big of a lever as carbohydrate yeah I had Tom Bill you on the podcast and he was one of the founders of quest nutrition yeah and he said one of those quest bars would not come out of ketosis right just because

86:04the amount of protein I'm like that's crazy yeah and I think they're only like what is like 18 grams or anything somewhere in the range that's why it's that's why it's so important for us to get over this idea that there's one approach that will work for everyone it's just stupid I know you know Rob Wolfe have you ever seen Rob Wolf's experience that he does on his Instagram yeah and his wife yeah they both eat the same things yes totally different results as far as their blood sugar his wife metabolizes things far quicker than he does now it's really interesting that's really interesting because you seeing two people that live together that you know they're eating the exact same foods yeah and to and you know that he's so fascinated by it himself and makes an interesting - yeah I mean it's it's so it's so necessary for us to take that step because you see so much like you

86:52know wasted energy in my opinion of people arguing back and forth yeah it's often based on like you know Joe Blow goes on a low-carb diet has life-changing experience and becomes like a almost religious zealot for the low-carb lifestyle right and assumes that because it had that effect on him that it's gonna have that effect on everybody else and and just starts you know proselytizing for a low-carb yes not recognizing that first someone else for example many of my female patients go on low-carb and is if they're like you know working and taking care of kids and doing Crossfit several times a week you know that could be a disaster for them it really might not work and so you know we just got a we got to take the next step yeah you have to take into account biodiversity but there's a lot of people that dismiss ketogenic diets because that's not what they've been

87:46promoting yeah that's that's an issue as well like you got to be real careful about someone who's not citing actual science when they're talking and dismissing the ketogenic diet like I read someone talking saying that it was a fad that's hard to get into ketosis that it rarely happens like well that's just not true yeah that's actually factually wrong yeah I've done it many times I'm not in it right now but I do the same thing but for me it's a set of boredom yeah I get bored and I want a peanut butter and jelly sandwich or something then BOOM I'm out well again I think that's that's probably closer to the ancestral pattern of not being in it continually but you know there are some people who need to be in it continually like ketosis can be a life changing intervention for kid with epilepsy for example and those kids benefit from being a deep ketosis so they might

88:39actually even need exogenous ketones on top of the ketogenic diet hmm but they can go from having you know 40 seizures in a day or being on like just brutal anti-seizure meds which are horrible for kids I mean the side effects are so bad to being completely off medication we have ketogenic diet and so for them that peanut butter they're not gonna have that sandwich because it's gonna cause a seizure what was unique in my experience was the cognitive benefits I was like this is really fascinating because I felt so much more clear-headed and from the fog of refined carbohydrates yeah but I think that that is uh I don't know if it's the same or but very close if I just follow a low-carb diet not necessarily ketogenic but eliminate refined carbohydrates but don't eliminate salads or fruit or things on those lines like if I want to pear eat a pear you know but the very strict

89:37application of it one of the first immediate things that I recognized is that my hunger is a very different thing yeah when I'm hungry it's not that big a deal whereas when I was eating a large amount of refined carbohydrates the hunger was ferocious yeah yeah it's almost like like over well like like drums playing in the background and that's the ketones you know because the brain can utilize ketones may even prefer ketones to glucose and so when you're producing those ketones it really does take the edge off of hunger yeah yeah and it also fuels the brain in an odd way I mean I find that before I do difficult tasks mental tasks I like to drink exogenous Kiko ketones I like to take them I think you actually like it though yeah I do you don't mind yeah it doesn't taste bad at all I drink it before I work out you know I like those yeah I don't think they're bad yeah you know and I throw

90:36some alpha brain in there just shake it up and it actually tastes pretty good yeah yeah I think there's definitely a role for for the ketogenic diet and for ketosis in general and you know fasting as I mentioned before has some really interesting benefits above and beyond ketosis that I've been exploring a lot might work with patients have you heard of the fasting mimicking diet no they've altered long ago so dr. Longos at USC Center for longevity superstar scientists and he basically came up with this approach to get you know the idea was to get the benefits of fasting without doing a full water fast and so it's a reduced calorie diet for it's done for three to five days with specific macronutrient ratios and he's done some really interesting research most of it is in animals so you have to you know take that with a little bit of a grain of salt but there has been some

91:30in humans as well and it's shown things like in animals with MS just doing this fasting mimicking diet has led to regeneration of the myelin sheath and which is what breaks down in ms which is just you just don't see that you know no animals got it there's no drug well they have animal models of MS where they created an MS light condition and the animal in order to study it and they show they've shown changes in the brain you know we're actually things re growing and and the the reason for this this it's thought is that this the fasting can promote stem cell regeneration so you can actually through fasting rebuild certain parts of your body according to this research so and then there was the auto fiji which i mentioned before which is like almost you can think of it as like a cellular recycling or cleanup or repair process that happens in that fasted State and so

92:24if you look in the research literature it's really fascinating because they're more older you know older studies that haven't been as much research until recently on fasting but fasting has been shown to be a cure for all kinds of different conditions like you know severe rheumatoid arthritis patient can fast and then be completely symptom free and of course I can't keep that up you can't just fast forever you obviously will die right that alone tells us something interesting about fasting and about food and how food is impacting those conditions yeah that is absolutely fascinating the consumption of carbohydrates dumb the Agostino put something up about it recently about sugar and carbs that they're closer and closer to connecting sugar and carbs to cancer this is a pretty controversial area and I'll say right off the top that I don't consider myself to be an expert

93:17so you know I'll probably just pass on this but I think there's certainly enough research pointing in that direction to continue to look at that and they're you know even he probably talked about this but drugs like metformin which limit the availability of glucose are being studied even by the NIH you know very traditional mainstream scientific organizations as a therapeutic for cancer as is ketogenic diet though I'm studying non and others are as well but I think it's a little too early to say that all cancer is caused by you know high blood glucose levels anybody saying all yeah I don't think I think they're they're saying there's a strong correlation between the two you know when you look at the overall American diet and the number of chronic diseases and all the different various things that we have and you correlate all these factors when you you think

94:11about sedentary lifestyle you think about the lack of sleep and then of course you think about diet and exercise when do you think people are going to recognize or how do we get people to recognize that what they're eating and what the average person is eating is not what the body's designed for and this may very well be what has triggered this whole cascade of effects that's the trillion dollar question literally trillion dollar question because we spend three point two trillion dollars on health care a year so you know I think there's an easy way and a hard way to get there so the easy way is that we continue to raise awareness through books and podcasts and things like this and you know we we make proactive changes to the health care system that support the most important interventions so let's use an example again imagine so so you go into the doctor right now let's say you're one of

95:13those hundred million people that has you know type 2 diabetes or pre-diabetes and they they they test your blood sugar they say your fasting glucose is 96 Joe and your hemoglobin a1c is 5.5 good news that's normal well yeah okay it's in the normal range but it's in the high end the normal range in the current system they'll just tell you it's normal they might maybe maybe not make any kind of dietary recommendations and then send you on your way and the idea is we're not gonna pay attention to this until it's not normal you know we're not gonna pay attention to this until you actually do have pre-diabetes or diabetes and so the wait until you have that and then of course the longer that you wait to treat it the harder it is to reverse and then you and then when when once they do find that you have it they just gave you a drug rather than you know give you any

96:03kind of real support to make diet changes so even if the doctor is it does know what to do or what to tell you about diet which they often don't because they just don't have a lot of training in that area and it's also how few people really have the contents of their body analyzed how many people actually get blood work done percent don't even know they have pre-diabetes yeah but let's assume that they do and let's assume they get to the doctor and let's assume the doctor even knows what to tell them right if they tell them that are they is that going to be enough to make that person successful and changing their diet especially not if their gut biome is programmed to crave that sugar and they have low willpower especially they get very little sleep I've work all the time all those factors all those factors and we know that most importantly information alone is not

96:52enough to change behavior right we I said that before that's well established scientifically just telling someone hey you should eat a healthier diet you know one percent of people are gonna be able to take that information and act on it successfully especially over the long-term yeah but let's imagine a different scenario let's imagine you go into the doctor same thing they test your blood sugar it's you know high normal fasting glucose high normal a1c and they sit down they say look Joe and this is obviously happening in an appointment that's longer than eight minutes right they sit down they say well you're not pre-diabetic yeah but your blood sugar is starting to creep up and I'm worried that if we don't do something now you're gonna get you're gonna become pre-diabetic and eventually diabetic so you know I could give you a drug but that's just putting a bandaid on the

97:39problem so what I'm going to do instead is I'm gonna hook you up with our health to nutritionist and he or she is going to create a recipe for you a meal plan they're gonna come to your house they're gonna clean out your pantry get rid of all the bad foods they're gonna go shopping with you and and show you actually exactly what you need to buy they're gonna help you set up these meal plans and give you recipes so that you know exactly what you should be doing or they're gonna set you up with this meal planning service that we work with and I'm also gonna set you out you're gonna get a gym membership and you're gonna get set up with a personal trainer at that gym and so that you can start getting you know doing becoming more physically active we're gonna give you this online class that talks about sleep hygiene and how to get better night's sleep it's a six-week program you do it

98:27for a half hour a day no problem and here's the good news Joe this is all gonna be covered by your insurance you're not gonna have to pay for any of this that you know that is totally possible and not only that is there any doubt that if even if we spent ten thousand dollars let's say which is more than that would cost even including the health coach and the fees for the gym and the fees for the personal trainer if we spent that amount of money right up front we could put that pert that person's blood sugar back to normal level prevent them from ever getting type 2 diabetes in the first place give them way more confidence in their own ability to take care of themselves and prevent disease make them feel better and probably every other way and save the health care system six hundred then forty thousand dollars over the next forty five years we could have that there's nothing stopping that

99:20from happening the real question is how do you get someone to act that's the question through inspiration I said with the health coach so it's not actually I mean this is well defined we had there's so much research on behavior change and evidence-based principles that support behavior change so there there are techniques like motivational interviewing coaching - strength coaching - strengths yeah so that that means helping people identify and and work with their strengths rather than trying to fix what's broken motivational interviewing is it would be an example that like you have a person works a regular normal job and they've got a big gut they want to lose we have a you have a it's shifting the focus around from what's wrong which is really disempowering like I can't do that I'm this way I'd have no willpower whatever to helping them become aware of certain personality traits or

100:17characteristics that they can then use to make the change that they want to make motivational interviewing is like this imagine a woman who's 55 you know finds out that she has type 2 diabetes and the doctors like you should eat a better diet and she's she would like to but she's overworked and tired and it feels overwhelming and and she's just not really finding the motivation to do that in this you know but she has grandkids she loves her grandkids she wants to see them grow up she wants to be able to play that with them without becoming blind and you know immobile from type 2 diabetes and so the the health coach is trained in motivational interviewing can help her help that that patient to be able to tie that those deeper values and goals and and you know motivations with the health goal so that it's not just eating a healthy diet for the sake of eating a healthy diet its

101:13eating a healthy diet because I really want to see my grandkids grow up and be able to play with them mmm okay so and then there are these principles of behavior change that are that are totally well established so one is shrink the change is a colloquial way of putting it like let's say you're gonna start a meditation practice the way to not do it is to just say okay so start doing it do an hour meditation a day good luck with that you know that's gonna fail in 99.9% of the cases the way to do it might be okay it's step one not even that step one download the headspace app on your phone that's it that's your first step you know step two but get a meditation cushion that's it step three you know open the headspace up and do your first two-minute meditation I mean the headspace app is actually built in this way where they start you very small and you build up

102:07gradually over time because they know about those prince of behavior change we know that behavior change works better in community this is it this is a head spinner to obesity some people have argued is a contagious disease because people who have friends that are obese are more likely to be obese themselves you know what that makes a lot of sense and here's an example of something one of the reasons why that makes a lot of sense we just did this thing sober October me and now that yeah and Ari Shaffir Tom Segura Bert Kreischer and I we took 15 hot yoga classes no booze no weed for a month but because we were doing it all together and we kept checking in on each other it was very motivating yeah and and no one strayed and we all were doing it too we we knew that we had we had all we had a responsibility we responsibilities to the group and that we we knew who we

103:07were motivating each other as well as pushing each other and talking to each other and making each other but at the end of it we were like wow that was great like there's something to that like a lot of us were like I'm never doing yoga again Frank yoga and I'm getting put drunk for a week but the real takeaway from it was there was some measurable motivation and inspiration from having three friends doing it with me absolutely that's and that's again improving in the science and even just having one person like a health coach you know that role and be accountable they can help you you know get in touch with the real motivation for doing it they can actually design a program for you that's life likely to succeed instead of fail or perhaps online groups there's got to be online groups you should get involved with we have the knowledge and the technology to do this

103:59and it's not it doesn't take a long time you can train a health coach in six months or a year they don't need to have nine years of pre-medical you know training and biological sciences and all this they just need to be trained and behavior change you know they need to be people who can form a good relationship with somebody else and build that trust and rapport they need to have some knowledge of course of diet and lifestyle and stuff but like I said imagine you go into your doctor and they actually hook you up with someone like that who has all that training if you think of like how the healthcare population is like a pyramid yeah at the top of the pyramid you've got you know people who are really sick and who are in the hospital or in some kind of acute care setting they absolutely need you know intensive support from the conventional medical system then you go

104:46down you've got another 25% of people who have some kind of pretty debilitating chronic disease where they need to be seeing a doctor regularly but then at the bottom 70% you've got a lot of people who are just overweight they're a little bit tired they're not sleeping very well they've got some gut issues they got some skin problems I my argument is that those people could be really well served by well-trained health coaches and nutritionists who can work intensively with them on diet lifestyle and behavior change and we know that those changes are the single most important step we can take to prevent and reverse disease but we also know that just telling people about it doesn't work right you have to create that support system well our whole food system is so crazy because it's still fraught with peril everywhere you go it's a goddamn minefield design if you're trying to eat

105:36a healthy diet you have to go way out of your way to find what you can consume oh there it is over there whereas if you just want to eat a shitty diet it's everywhere in front of you the the vast majority of the food that's available to us is not healthy yeah yes if you took somebody from our culture and drop them into like there's this group called the seam on a and Bolivia they're a hunter-gatherer group that still follows a traditional lifestyle if you took someone from here drop them in there and just made them live that way they they'd get healthy because they wouldn't have any choice you know they would eat what was there and they'd maybe living outdoors and they wouldn't have iPads that they're staying up and looking at until 2:00 in the morning and you know they would be healthy but lower eyes they'd get killed by a Jaguar right or they get yeah but if you took one of

106:28those people and you drop them into here like Woodland Hills or in New York City or San Francisco or anywhere else is there any question that they what's going to hop the same exact thing that happens to all of us in this in this modern well we see that with the Inuit when that when the Inuit one of the more fascinating things about studying the Inuit was how small the number of people that got cancer was such an incredibly small number and they essentially had no vegetables they were eating fats from seals and whale and right and whatever they could consume extremely limited diet rich environment you know a very harsh environment and but they had adapted to it and then when Western America came into their lives in terms of like cigarettes shitty food alcohol refined carbohydrates cancer which rates went through the roof yeah just through the roof yeah which is

107:23fascinating because their genes hadn't changed right absolutely the same genes they're not gonna change in one generation yeah or even two or three yeah it's it's horrible have you seen Weston Price you're familiar with his work I know the name so he was a dentist back in like the 1920s and 30s and he wrote a book called nutrition and physical degeneration and what he as a dentist his main interest was why did it why there's so many cavities that doesn't seem natural right it doesn't seem normal that we're designed to just develop rotten teeth this is stupid so I'm gonna go around and study all of these traditional cultures all over the world and first I want to find out do they have cavities in dental decay and and like a narrowing of the dental arch and changes in facial structure that we have in in the industrialized world and the second question is if not what is

108:15the common element you know with all of these cultures it's different than our culture and in his book he shows pictures so first of all the answer to the question was no it's not normal for humans to develop cavities in rotten teeth I mean how could it be how could we survive in the natural world if our teeth are all falling out so he went and he took pictures of these people all around the world like in Africa the Maasai hunter-gatherer people people living in the remote part of Switzerland isolated up in the hills that had maintained their traditional diet and lifestyle and all of them had these beautiful teeth big wide round faces don't you know why dental arches you know all of these signs of health but he also in the book had pictures of people from those same areas that had switched to move to the city you know switch to modern lifestyle within one generation

109:08you see people with these wide faces big healthy teeth smiling on one side of the page and on the other side of the page you see people with these narrow faces like mine you know rotten teeth you know totally theirs crooked teeth and the kind of dental problems that we all have where most of us get braces and all this stuff and that happened in just one generation of switching from a traditional diet to a modern what made their face thin so vitamin k2 and some and a lot a number of vitamins are responsible for facial development so if you if you look in the book of Weston prices pictures you see most people in the in in those traditional worlds have these broad healthy dental arches and then in our culture because of nutrient deficiencies and we're not eating the healthy nutrient-dense foods our faces get more narrow our Chin's recede we have our mouths become more crowded

110:04which is why many people can't fit the number of normal adult teeth in their mouth because their dental arch is so narrowly so that's all from a nutritional deficiency Wow I had to get adult teeth pulled when I was a teenager because my mouth didn't have enough room for all of my adult teeth whoa does the rest of your family have similar facial structure yeah largely yeah I mean you can check this out it's really interesting things to do in the airport I liked it you know you just look at people's faces often you'll see like the chin is really receded and not you know not this strong you'll see a narrow face like mine and if you you might see a person from Africa or someone who's more connected to their traditional diet lifestyle they typically have a rounder face a more full face of broader dental arch they'll have straight you know teeth with wider you know wider teeth

111:01and you can anyone can do this anyone can see and look and you can predict like how long has that person been away from their traditional diet and lifestyle wow I never knew that you know that's a fascinating point it's a big variable in martial arts yeah and the ability to take a punch well your face is round it's pretty round yeah you have a broader but it's not just what you're eating if my mom is very wide I have a thick mom's football yeah well it's probably part of why your pop you're probably a good performer is you've got that structure that supports it yeah I'm sure it has something to do with it genetically but the the ability to take a punch is I think directly related to the size of your face yeah yeah guys with smaller jaws and smaller faces they have a much harder time getting hit I wouldn't last long yeah well like Samoans are the best of it

111:58yeah like they've just such a bear original instruction Weston Price has a lot of pictures from people in the South Pacific and not me Jim he's beautiful you should check it you love the book it's really amazing to see the juxtaposition of those traditional faces with the modern ones it's like you I mean a picture's worth thousand words right look at those pictures and you're just like oh my god totally makes sense yeah yeah it is a it's very weird when you think about what we're doing to to the human body yeah and when you're talking about the diabetes levels that you're talking about are pre-diabetes and chronic disease and all the different issues and 40% obesity rate you know all these different factors it's an epidemic that's sweeping through the entire nation and it's largely ignored other than health fads weight loss videos it's like peripherally

112:52examined I like to call it a slow-motion plague whoa because like the bubonic plague you know which was a fast motion plague it threatens us in the same way like it's literally threatening out the health of future generations it's shortening our lifespan it's destroying our quality of life it's that's a big one yeah and if you stay alive the quality of life is being devastated there was a recent article that came out saying that like is you know it was a sign it was it was a paper that looked at what's happening in our older years and saying yeah we have a long lifespan but our quality of life has significantly declined in those later years because we're burdened by all of these chronic diseases you know the average something like one in five or two and five elderly people over 65 are taking more than five medications it's a huge problem and this is the thing you hit on this point so I

113:44want to reiterate it because it's super important we have accepted chronic disease as normal because it's so common but there's a really important difference between common and normal what's common is not you know it's not necessarily normal it's now it's now common for people to have chronic disease but that's not normal right how do we know again the Simone a that's a it's a subsistence farming hunter-gatherer population in Bolivia and recently there's been some articles in The New York Times about them there's some anthropologist medical anthropologists who've gotten and doctors and researchers have gone down there to study them they wanted to see that it's like this is one of the last places on earth where people are still living pretty traditional diet and lifestyle so we better study this quickly you know to see what's normal what's truly normal for humans not

114:34common but normal yeah so they eat you know paleo type of diet you know fruits and vegetables some meat and fish nuts and seeds some plantains other kinds of starches they walk an average of 17 thousand steps a day which is about eight miles so quite a bit they live in sync with the natural rhythms of light and dark you know they don't have a lot of artificial light exposure like we do right they sleep 78 hours in fact the researchers are trying to ask them about insomnia they don't even have a word for it in their language yes they work yeah you know they're living their normal that's as close as we're gonna get to a normal human population right yeah so they study they studied they did blood markers on them for heart disease but not only that they did scan CT scans of their heart you know to see if they had calcification of the arteries they found that the rate of heart disease in this

115:26population was 80% lower than it was in the it is in the u.s. eighty percent lower okay nine and ten saman any adults that they studied had absolutely no plaque buildup in their arteries which means they have virtually no risk of a heart attack as far as we understand it and you know before anyone who's listening this says oh yeah that's just because hunter-gatherers all die when they're thirty five years old you know that familiar argument well this study included people between the ages of 40 and 94 years old what's more the researchers estimated that the average seam on a 80 year old had the same vascular age as an American in his mid-50s whoa there's no almost no cognitive disorders or Alzheimer's disease in the Simoni so that's a really clear example of like what happens when you give human beings the right inputs and they're not exposed to all this crap that we're exposed to

116:28they live long and healthy lives that are virtually free of chronic disease and that's despite the fact that they have much higher rates of infection than we do they live on a river they've got parasites galore like all of them have parasites yeah and yet they still are healthier than us in almost every way you can measure it they have lower body mass index lower blood pressure lower weight they don't get heart disease they don't get you know Alzheimer's and dementia which is not like climbing up the list of causes of death and scribbling I'm glad you brought up Alzheimer's because I read something recently I didn't read the whole article I just read the the title of it was connecting Alzheimer's to gut bacteria yeah absolutely there's a strong that this is actually something referred to as the gut brain axis which is this very well-known connection between the gut and the brain and it

117:20goes both ways so you know the gut can influence the brain strongly and the brain can influence the gut strongly so I mean my point is just that what you said when are we going to realize that just these changes you know making these changes is what we need to do to prevent and reverse chronic disease and we have these examples of people like the Semana that show us very clearly that's the way we're living not our genes that are causing this chronic disease epidemic so the easy way would be to you know write books about it you know have shows like this keep educating people and doing that and that's what I'm hoping for and that's why I wrote my book but the hard way is that our system fails that it becomes so overburdened by the rising rates of chronic disease and the unsustainable expenses of that that it basically falls apart and it becomes you know we respond in a kind of to it

118:23as the crisis that it really is because it becomes apparent at that point that there are way that we've been doing it has not been working and that we desperately need to find a new way and that's another possibility and which one you think is gonna take place kind of depends on whether you're a glass-is-half-empty or glasses to have full type of person yeah well from your own personal point of view if you're listening to this yeah you don't rely on all those things to happen you just try to go out and do something about this for yourself and I think that's how it's really gonna you know my personal view is it's gonna be a little of both actually so I think what's gonna happen is you're gonna start seeing some big changes on the more local grassroots level so we've already seen stuff like this examples of be there's a group called ir a-- health and denver to

119:14primary care group and there they're reversing type 2 diabetes with health coaches now they still see the doctor but they work primarily with a health coach who does all those things that i just said i wasn't making that up they actually go to their house they do pantry clean outs they go shopping with them they teach them how to eat well but more than that they just provide like the accountability buddy you know the other person that call them every week they visit their house how you doing you know how can I help and and that person's totally empowered and they make these changes and they're reversing it without without drugs or with a minimum of medication there's Mark Hyman who's a doctor pioneer and functional medicine he recently they tapped him to start like this Center for functional medicine at the Cleveland Clinic one of the most prestigious international medical

120:00institutions always on the forefront of the the newest changes in medicine and when they first started they were in this tiny little space but within a few months they had like 3,000 patients on their wait list and they moved to 17,000 square foot space and glickman tower which takes up the whole second floor of this building in Cleveland Clinic and they've got patients from nine countries on the waitlist coming from all over the world to do the to do functional medicine because they have you know people know that the system as its set up isn't really effective for chronic disease it's fantastic I mean if I get hit by a bus I want to go to the hospital right I mean antibiotics revolutionize how we treat infections you have anesthesia made surgery like you know imagine surgery without anesthesia it was like a bottle of booze right any sepsis like you know cleaning

120:52the surgical theatre dramatically reduce infections you've got radiology radiologic images so it's improved diagnosis of disease so conventional medicine is amazing and it's here to stay and we need it but it's just the wrong tool for the job first Ronix for chronic nutrition plan for managing yeah using a hammer going around everywhere with a hammer you know expecting not to work hammer works really well when you're pounding a nail and it doesn't work as well with a screw or you know with something else so I mean Cleveland Clinic it's just an amazing proof-of-concept for functional medicine then Rob Wolfe you know you know we both know he did some incredible work with the City of Reno where and the first responders where they projected that just by doing this dietary intervention so what happened was the the firefighters and police cops were having

121:46heart attacks and strokes and because of the way the pension plans you know are set up if they have to if the City of Reno has to medically retire these these people they're going to spend like millions of dollars over the course of their lifetime taking care of them so Rob went in there with this other group specialty health they got them on a good you know type of diet lower carb diet got them doing some more physical activity well the estimate was that they say the City of Reno something like 25 or 30 million dollars just with this simple intervention we're doing a pilot now with the Berkeley Fire Department with our clinic with a similar kind of goal so I think you're gonna see all these kind of examples of things happening on local community level because you can make changes more quickly that way and then over time some of those things are going to scale up and you know we're

122:36gonna start seeing them maybe on the state level or the you know local government level and then eventually at some point that's gonna get attention of people on the federal level who are looking around and going oh my god it's 2025 or 2030 healthcare expenditures are 35 or 40 percent of GDP this is completely unsustainable like we're we're not even exist as a country in 25 years unless we do something about this so I kind of think it's going to gonna go like that well I hope it goes towards the the model of the Cleveland Clinic where businesses sort of rise up and take advantage of this opportunity to get people healthy and to profit I mean it seems like that's the best way to make things happen make makes make it a business or someone can profit off of it you know and as long as it's affordable for the vast majority of people if it's not unreasonable well that's the thing and

123:26you know rob has talked about this a lot for years if you look at economies of scale and and you looked at things like micro micro processors and DNA testing you know the first human genome sequence was like a bill cost like 500 million dollars now you can just go out and pay 200 bucks to have a genome sequenced and you know micro processors when they were first introduced the computers were as big as the room and you know millions of dollars and now anyone can go buy a computer for a few hundred but your phone as many times stronger than exactly from NASA in the 1960 but we don't see that kind of innovation in healthcare right like we see expenses going up instead of going down every year it gets more expensive I feel like there's a lot of hijacking going on with big money and big money in particular in the pharmaceutical industry they don't want anything that you know absolutely

124:15yes this this gravy train of money going right into our pockets when people have diseases and that's the key point I mean Rob we did a what we call it a rally to end chronic disease the other night and Rob came spoken so did Mark Hyman from the Cleveland Clinic and a few others and in Rob's talk he mentioned that health care should essentially be free if if we used if if we allowed the same forces to op that that made micro processors go from being extremely expensive to extremely cheap DNA testing go from being extremely expensive to extremely cheap if we allowed those same forces to work in on health care health care would be extremely affordable the problem is as you pointed out we have a lot of misaligned incentives so insurance companies for example they only benefit when the overall healthcare expenditures rise so the more procedures are ordered tests are ordered

125:11you know treatments are prescribed the more they the insurance company benefit that seems counterintuitive to people because you would think that you're paying for insurance and the insurance company is hoping that nothing goes wrong because then they'll have to pay out far more than you're paying yeah yeah there's a great book called catastrophic care that I recommend for anyone by David gold he'll for anyone who's interested in this it really pulls the curtain back on the whole system and how it's set up then you've got of course pharmaceutical companies well how is it set of the why why do insurance companies benefit from from things going wrong they as the as the whole edifice or the whole system of of health care grows they benefit because they're their recipient they're involved in all of those transactions okay and then you have Big Pharma that

126:02is basically you know their incentive is to sell more drugs and their for-profit corporations and and their duty is to make a profit for shareholders and that's how they do it and so selling more drugs is not always in the same you know aligned with the interests of patients or even of doctors well the real issue to me that stands out as an example of that is these stupid commercials they have for pharmaceutical drugs where people are having the best time ever what you're looking at them in like the how is this is Oh deceptive you're showing me like best-case-scenario grandpa running pushing the bike and the little kids laughing and everyone's having the time of their life like oh I want the time of my life how do I get in on that until the last fifteen or thirty seconds which is like just drive me cause you know Humera yeah where's that stuff it was for remember she said it's like 120

127:04grand for scrap yeah I just think and death is a side effect of that drug death suicidal thoughts contact your physician he'll tell you to yourself wake him up give me some volume on this so we can hear this I thought I was doing okay too but I'm not she's managing still have symptoms of moderate to severe Crohn's disease in clinical studies the majority of people on humerus all significant symptom relief therefore you keep permission tuberculosis serious sometimes fatal infections and cancers including lymphoma have happened as have blood liver and nervous system problems serious allergic reactions and new or worsening heart failure before treatment get tested for TB tell your doctor if you've been to areas where certain fungal infections are common and if you had TB hepatitis B are prone to infections or have flu-like symptoms or sores don't start Humira if you have an infection

128:03just managing your symptoms okay kill it right there why is that lady so sweet and cheery what she's talking about imminent death and the music just does not and look the woman is on a TV set to like she's a successful producer on a television set what a bizarre choice for like what she does for a living like watch her will kill the volume but watch her wander around the office they're like who the works on a TV show like this is we're supposed to relate to this lady how many people work on the set look at her she's got her folder she goes she grabs a cake that's like yeah because even though she has something to do with Crohn's disease what you eat she's gonna die in an explosive imploding rectal or get an infection that you would be totally you know not a threat for you or anyone else but because they had taken a drug that globally suppresses their immune system

129:03can kill you yeah that whole thing like if you you know if you have an infection don't take it like what aren't those pretty common the saying in fact don't get an infection while you're taking Humera it's now like do you ever try to get an infection I mean how do you not try to get an infection yeah this but this is what kills me is the bizarre choice of her being some sort of a director or producer of a television show like that we're supposed to relate well she is so successful maybe yeah maybe if you take you marry you could also there was another one abilify that killed night and it was a antidepressant you give to people that are suicidal while taking antidepressants yeah like what yeah hey let's talk about abilify I think it's the sixth or seventh most prescribed drug in the u.s. it's an anti-psychotic okay so if those two things don't are not resonating

129:59there's a reason for that we don't have that many psychotics in this country where abilify could be the set you know he only uses an anti-psychotic give me some volume let's hear this yeah but other days I still struggles with my depression I was handling it but sometimes she's a cartoon I've been feeling stuck for a long time so I talked to my doctor and she had it abilify to my antidepressant she said it could help with my depression and that some people had symptom improvement as early as one to two weeks I'm glad I talked to her I wish I'd done it sooner now I feel more in control dr. depression worsens all you have unusual changes in behavior or thoughts of suicide antidepressants can increase these in children teens and young adults your elderly dementia patients taking abilify have an increased risk of death or stroke or call your doctor view of

130:52high fever stiff muscles and confusion to address a possible life-threatening condition or if you have uncontrollable muscle movements as these could become permanent blood sugar has been reported with the vilifying medicines like it and in extreme cases can lead to coma or death all the rates of since I've increased cholesterol weight gain decreases in white blood cells which can be serious dizziness understanding the seizures trouble swallowing and impaired judgment or motor skills most of that start where they're talking to you cut this segment of the commercial where the lady comes out the doctor comes out show where the lady doctor is because with it that's like halfway in the lady doctor comes out let me just break this down because this is a drug that's added to a prescription of someone who's already taking any depressants to prevent suicidal thoughts or and but then one of

131:58the first side-effects they said to look out for it's suicidal thoughts yeah what when maybe there'll be a third drug that people who are already on antidepressants and abilify can take for the suicidal thoughts that abilify wasn't able to get rid of from the original antidepressant yeah maybe we're just being cynical depression we just need to trust in that that cartoon lady with the great voice this is amnesia so own loss I mean this is a good example like we've all heard this term evidence-based right yeah and the idea is that conventional medicine is evidence-based and everything else is not well that's total BS because this and abilify is a great example it's an anti-psychotic that's what it was approved for for psychosis and yes we have a lot of people yeah I mean recent events indicate that we do have quite a few psych psych psychotic people mass

132:49shootings etc but not that many you know not enough to make abilify that the seventh leading drug on a sales basis that since that's an insane number yeah so what abilify is prescribed off-label so off-label means a way of using the drug that has never been a study or approved by the FDA for that particular purpose so it's using a drug in a way that was not originally studied how is that legal it's legal doctors have the authority to prescribe medications off-label as long as they're fda-approved as long as they're FDA approved for something that's insane vast majority of abilify prescriptions therefore are off-label which means they've never been studied or shown to be safe or effective for the conditions that it's being prescribed for so your doctor could legally prescribed you birth control pills yeah I mean it would be found upon and maybe if they did not

133:47enough and it was causing problems they would they would have to justify why they were doing it but it's the missing key to vilify for men okay you have female birth control pills like it also means they can use it in a population that hasn't been studied for so for example a drug has been studied and approved for adults did you see that it said not safe you know it shouldn't be used for children in the elderly has never been studied but that doesn't mean it's not being prescribed for children or the elderly it still definitely is but you know antidepressants have been shown to cause to suicidal ideation in adolescents and teenagers in particular and yet they are still often used in that in that group even though they were never studied or approved population what is this one Jamie a bill bill five tops down here seven bill yes the top-selling sorry it's the talks

134:39I'll use yeah it's not this app number seven it's a silly me is an anti-psychotic is that real it's real is it still the top-selling drug whatever let's not even look but in 2014 it was the top-selling drug that is crazy has become the best-selling drug in the United States the alarms about the dangerous and sometimes deadly side effects of antipsychotics affecting children and the elderly among others have been mounting for years Wow that's terrifying yeah and many of these symptoms could be directly related to gut biome bacteria and you might be able to nip it in the bud with a change in diet with addressing the sedentary lifestyle rigorous exercise so let me tell you rest all these things meantime it seems like what you're prescribing like oh come on it can't be that easy I mean let me tell you a story it's actually the first chapter in my book it's about a

135:46kid named Leo that I treated in my clinic furious back he's eight years old when he came to see me his parents were like Iraq one day when they came to the office cuz they you know he had they were just totally worn down he would throw these epic Tantrums where he be you know screaming and crying and riding on the floor for just the most random stuff like trying to get his shoes tied as they were going out the door or you know not cutting the crusts off his bread sandwich in just the right way or getting a stay on his favorite t-shirt he had a super limited diet he had only a handful of foods all of them processed and refined like toaster waffles bread crackers cookies etc you know they were concerned about nutrient deficiency but every time they tried to reintroduce like to introduce a different food he would go ballistic and they didn't have the energy to fight him

136:36at every meal he was really rigid about his behavior in environment so like everything had to be just right the toys in his room arranged in just the right way he'd he'd fly off the handle desks in this classroom you know weren't just the right way he'd fly off the handle he was really anxious in in unfamiliar environment so it was hard for them to leave the house for even a few hours much less travel or go on vacations I mean this seems extreme but there are a lot of kids with these kinds of behavioral disorders now he was not you know he's not alone so they took him to see doctors locally and they started with the primary care doctor then went to psychiatrist and then several behavioral disorder specialist actually down here at USC or UCLA and you know first diagnosed on the autism spectrum then eventually OCD and something called sensory processing disorder which is

137:30like on the autism spectrum where they're really sensitive to you know sense input touch you know sound etc so they the doctors you know they were relieved at first to have these diagnoses but very quickly it became apparent that they were just labels for the symptoms it wasn't anything that actually gave them information about what to do and then the doctor when they asked the doctor what the treatment was the answer was medication so they first started with adderall which you mentioned earlier then riddle in both stimulants and then eventually antidepressants which again have not really been approved as safe or effective in kids and they did help at least a little bit with some of the symptoms but then he got a lot of brutal side-effects gut pain dry mouth irritability headaches and the worst thing was severe sleep disruption and he had two younger brothers and sisters so his parents

138:25definitely didn't need more of that and the crazy thing throughout this entire period not one of his doctors even hinted at the possibility that something in its diet or like a disrupted gut microbiome or nutrient deficiency could even be contributing to his symptoms nobody even brought that up and that's not the exception that's the rule so you know his parents weren't thrilled about I mean they weren't thrilled about medicating him but they did it because they had no other option and nobody suggested that it could be anything other than just you know something wrong with that their their son but unfortunately one of her his mom's friends sent a couple articles for my blog one was on the gut brain axis which we've been talking about another was on all the underlying causes of behavioral disorders and kids so they brought him to my clinic we did a whole bunch of

139:18testing as I do with all my new patients and not surprisingly we found he had a disrupted gut microbiome he had SIBO bacterial overgrowth in the small intestine he had non-celiac gluten sensitivity and gluten was in almost every food he was eating but he also had intolerance of some other proteins like dairy and soy and corn and buckwheat which were in the toaster waffles he was eating every night yeah deficiencies of vitamin D b12 folate and iron because he was eating just flour basically you know flour and sugar and he had high levels of arsenic which is a heavy metal because the only other beverage he would drink aside from water was rice milk and rice milks been shown to have you know higher levels of arsenic so if a kid's just pounding rice milk they could actually start to develop levels of arsenic that could be problematic that's crazy because a lot of people think of

140:08rice as a healthy beverage right right so we start you know we started treating him which wasn't easy because of his OCD like tendencies it was really hard to get him to change his diet so we just started focusing just on those mechanisms that I talked about getting him some more nutrients and treating his gut and and and you know trying to get some of those things out of his food initially just switching those brands of toaster waffles so that at least they were made from stuff that he wasn't clearly reacting to and then gradually over time shifting within within several weeks he was having fewer Tantrums he was less set off by the things that would have done that before about four months into the treatment his teacher called home from school and was like where's Leo you know what have you done with Leo and who's this guy you're sending to school in his place because

140:57it had been horrific for her as his teacher at school and you know to the point where it's parents often had to come pick and bring him home from school because he was so disruptive then I talked to Leo's mom maybe six seven months into the treatment by then we had the follow-up tests back a lot of the issues that we set out to address had been resolved his diet expanded significantly he was eating foods that he would have thrown against the wall just a few months before he was more tolerant you know more affectionate less controlling and rigid and just better adjusted kid overall and at the end of that time his mom said something that really struck me and it's really it's why I wrote the book she said why don't more doctors know about this like there's so many kids out there like Leo who are suffering from these kind of behavioral disorders but neither their parents nor their doctors

141:47are even looking at this other stuff like the diet and the God and all these things so it's not even a consideration and that's why I want to get this book out there because it's like we can't know and and and treat what we're not even looking for what's crazy is what you're saying is revolutionary but it's not right it's common sense yeah me it's food but the idea you essentially restructured the the ecosystem of this child's body and and brought them back to homeostasis you brought it back to some sort of some normal function yeah some and this poor kid was living with a diet that a giant percentage of our country is is consuming a lot of kids are eating sugar cereals in the morning and peanut butter and jelly sandwiches and just white bread and lunchbox with the lunchable all the crap is there you know yeah it's even worse and kids because there's this idea that big food has been very

142:49successful at perpetuating that kids need special kids foods right and they can't just eat what we're eating as adults we have to prepare kids meals you go to a restaurant and there's the kids menu go to a great restaurant that has meat and vegetables and all this stuff on there what is a kid's menu have on it chicken fingers real cheese pasta with nothing on it just total crap and the idea you know when we go out with my daughter they always bring us the kids menu and my like no I don't need to see that I'm ordering off this menu yeah and it's like yeah we don't need breakfast cereal or pop-tart or need this crowd it's just need it's even more important for kids to eat well than it is for us because their brain is still developing their bodies still developing so yeah I mean someday we'll go to the doctor and you have a crunch you know something like

143:34this the first questions are going to be around what are you eating yeah how are you living oh wait let's do some tests to find out how your gut is let's do some tests to see if your nutrient deficient let's let's actually look at the causes instead of just assuming that every chronic disease is it is a deficiency of a medication yeah you have high cholesterol you have a statin deficiency so we better correct that by giving you stop you have high blood pressure you have a diuretic deficiency we're gonna give you that you have depression you have an antidepressant deficiency so we're going to give you that drug that is how it's looked at it's crazy that what you're saying is eat food eat real food eat food I mean I think if people if we ate real food like probably good that could shave off like a couple trillion dollars from the healthcare and look how much more

144:26effective would we be at whatever we're doing and how much healthier would people be how much happier would people be yeah it's not just about health in that narrow sense of the like the absence of symptoms or the body we're talking about your ability to perform at work your ability to relate to your kids to partner I wonder how much of the antidepressant like the people that are prescribed or people that are experiencing depression has to do with their diet I would say a quite a high percentage again I don't want to be right I think there are situational factors that cause depression I mean you know for someone who is poor and lives in an economically and socially depressed area and is fighting you know a systemic oppression there there's good reason to be depressed she wants situation so nevertheless given what we understand now about this inflammatory

145:15model of depression it's also true that that is at the very least going to exacerbate it and make it worse but in some cases may be the primary driver I can't tell you how many patients I've had who've had depression that they thought was it was something wrong with them there's something broken about them you know they can't they just they're not cut out for this world they don't fit in here that sort of thing yeah and then we go in we see oh you've got a severe b12 or folate deficiency that affects your neurotransmitter levels oh you've got a disrupted gut microbiome oh your you got you know blood sugar abnormality oh you're hypothyroid we know 20 or 30 percent of patients with depression have hypothyroid so just correcting that could could correct it so and we address all those things all of a sudden that person is no longer depressed and I've had people say things

146:04like oh my god for the last twenty years I thought something was wrong with me I thought I was broken I thought like I really it was me and then something was just really wrong it's a crazy word - the problem with depression is that it's a diagnosis and that if you just said feel bad like feel bad would not be like oh he's been diagnosed with feel bad you know but that's essentially what depression is it's so blanket it can cover a host of different neurological issues physiological issues or behavioral issues that are there because of your environment your life experiences absolutely and that was not an unintentional thing Joe that was drug companies creating it as a disease so that because diseases require medications to be fixed in our culture and this happens across the board and it's not a you know do you know the story of viagra and how that was

146:54developed it was some sort of a blood pressure medication correct right and Jack yeah so they found like okay this isn't working very well for what we designed it for but what but it's got some pretty interesting effects and so but they knew wasn't enough to just then go out there and start selling it for to God to say hey here's a drug that will help you know make you perform better we're in the bedroom that wasn't enough what they had to do was create a disease yeah that it could be prescribed for because that's and then and and you know how they did that and I heard an advertising agency and the ad agency came up with the term erectile dysfunction no way and created this no way absolutely it's publicly available information agency named a disease this is not the only case where this has happened so they create this disease category and then they get it

147:50out into the world and they advertise it to people and doctors and so all of a sudden people are going in with the magazine they're like this is me I have erectile dysfunction and I know now there's a drug called viagra that I need because I have erectile dysfunction and the doctor has seen them they have their own brochures you know they pull out their brochure and it says erectile dysfunction here are the signs of symptoms okay check check check check yes this patients got erectile ID so here's the drug first okay is it legal for an advertising agency to name a disorder well I'll tell you that it's illegal in every single country in the world except for New Zealand in the United States to advertise drugs to consumers please New Zealand be the first to change because this is the result this is the result of allowing drugs to be advertised is that you get

148:45advertising agencies creating conditions that then require drugs to be treated that is amazing what else has been named by advertising agencies off the top my head I don't know but I will next time I'm on the show I'll definitely have a list for you god damn I can't believe that that's legal it's legal and you know there's a another book I read a while back and the quote in the book was really revealing it was by the CEO of Merck which is one of the biggest pharmaceutical companies in the world and again I'm gonna paraphrase I don't remember the exact words but the gist of it was the real money in drugs is in selling them to healthy people so he had he had realized that you know we basically saturated the market of medications that can be used to treat sick people so the only way we can continue to grow and expand is to come up with ways to sell drugs to

149:38healthy people when did they first started prescribing antidepressants well the SSRIs I think go back to the 80s or late 80s or early 90s but they had other kinds of antidepressants before that called tricyclic antidepressants and other types medication so they've been around for a while but I mean my point is like this creation of erectile dysfunction as a disease was a way of creative selling drugs to healthy people yeah because they create they basically shifted them from being healthy people that otherwise wouldn't see themselves as someone who needed a drug to people who are not who now have a condition yeah from what I understand provigil that was the initial creation of provigil they were trying to come up with a performance-enhancing drug for cognitive function and they couldn't just sell it as such so they had to come up with some sort of a reason why people need it so they went

150:33with narcolepsy right and then you I mean you have people who've been arguing that statin should be put in the water supply what yeah there literally was who the says there's a doctor in the UK that guy's a monster who lit not cuz he goes baby sounds right now monster put in the water supply cube that's poison he's seriously advocated for that and it wasn't a joke it was an exaggeration we use a few years back I can I can't I have a blog article about it oh my yeah because his argument was you know these drugs are so effective for reducing the risk of heart disease that you know we should just be giving them to everybody despite whether they want to take them or not who's a because doesn't that don't they seriously disrupt performance like physically no the bigger question is whether statins actually extend lifespan in people without pre-existing heart disease and a lot of the research

151:34suggests that not that the answer to that question is no or very you know in an almost non insignificant way and then you have to balance that with the potential side effects like the increased risk of diabetes particularly in women and now we have 100 million people with diabetes and then muscle fatigue and myopathy and that sort of thing but yeah I mean I think that's this is I mean we got off on this when we are talking about misaligned incentives and this all of these things we've been talking about are just examples of how what's in the best interests of a drug company is not necessarily in the best interest of us as patients or or as dot for doctors but when it goes back to what you were saying about teeth tooth decay and then fluoride in the water right like how much tooth decay is really because of our diet and it's not because of fluoride it's not because we flora is not good

152:24for you well you look especially in large quantities I mean you can get away with it in some of the quantities it's in our water supply but from what I understand it's not really we don't need it so I know this might sound controversial but do we think that our hunter-gatherer ancestors were brushing their teeth twice a day and flossing twice a day no they probably had horrible breath well here's the thing there's an oral microbiome just like there is a microbiome in the gut and it's what's likely and and they've archaeologists have know that when they you know when they uncover remains from traditional you know our ancestors our Paleolithic ancestors they have great healthy jaws and teeth and not Egyptians you know about that well that was civilization already yeah when I started grinding food I'm talking about further back you know yeah further back in our

153:18history prior to agriculture right now try to presumption of that and so what that suggests is that you know look I brush my teeth and I floss I'm not suggesting that that people shouldn't now and that there hasn't been some improvement but that you know the fact that Weston Price went around all these traditional cultures and found that they had beautiful healthy teeth and why dental arches they weren't brushing their teeth twice a day and flossing twice a day but they had root you know underlying foundation of health and a healthy microbiome not only in their gut but an oral microbiome that led to healthy teeth even without that kind of dental you know hygiene and dental care and you know there are now oral probiotics dental probiotics which are chewable tablets that you can just you know you pop one in your mouth after you brush your teeth you chew and I've had

154:13patients who had been having you know recurring cavities dental issues period you know periodontal periodontal issues that just by chewing one of these dental probiotics twice a day have had like a complete reversal in their dental health where you know they go from having like a cavity every time they go to the dentist having no cavities at all cuz that's one of those whew subjects for people go car you crystal hippie yeah well you start talking about fluoride in the water but do we really I mean we definitely need to somehow or another clean the water of bacteria and treat the water so that it doesn't have pollutants in it but that can be done with filtration systems you know people in the wild not in the wild meaning like the Tremonti but people that live in camps for months at a time like friends of mine they go on these backcountry trips they use water filters now they

155:04use they'll take a walk they'll take like a wallow that like an elk have been stomping around in muddy water and they'll put this water through this filtration system and make it so you could drink it yeah and there's SteriPEN 's they have these pens that you could spin the pan around the water for a predetermined period of time and it kills everything that's bacteria you know all the bacteria in the water there's a bunch of different filtration systems pumps that they use on creeks to keep beaver fever what's that stuff called Giardia it's ready in from beaver in the water so this all can be done without chemicals that wasn't my point yeah so the chemicals that we have in the water there might they they might be terrible for you they're not necessary and especially in terms of fluoride it might be completely misguided have you read I forget the book on just you know big thick book on

155:57fluoride Bryson I think this is the last name of the author it's a yellow cover no I haven't read it I think he mentioned something about how and this this comes up in other contexts too where companies that have something that's toxic that they would otherwise have to pay for to dispose of I've figured out ways to actually sell that stuff to the food industry or to another industry that that then puts it in some products so industrial seed oils like soybean oil cottonseed oil those kinds of things originally we're not considered foods they were waste products agriculture from you know text growing those crops and then the the brilliance of those you know I thought those companies at that time was figuring out a way to turn those things that would have otherwise been seen as waste into like a food product that they could then sell and make money off of really though

156:53and those those are like amongst the worst those are you know those are ubiquitous in the American diet like if you pick up any packaged food you're gonna see you know soybean oil corn oil cottonseed oil etc there's all these highly processed and refined omega-6 vegetable oils and those vegetable oils are very difficult for your body to process well there first of all they're almost completely devoid of nutrients they have you know some of them have vitamin E but they have almost no other nutrients at all and historically humans had consumed a balance of omega-6 and omega-3 oils that was somewhere between you know one to one ratio or maybe a four to one in favor of omega-6 but the amount of omega-6 oils that we consume today is much higher you know sometimes like a twenty to one ratio of omega-6 to omega-3 Jesus and this is a controversial topic there was

157:45just a research study published that was seemed to suggest that these oils actually may not be as harmful as as we thought they were but I haven't had a chance to read the full text of the study yet and you have to look at the overall weight of the evidence you know if you've got forty studies showing that they're harmful and then one that shows that they're not well okay but you gotta consider that in the whole context yeah yeah and you gotta find out who funded that study and there are a lot of questions to ask and and whether even the studies said what it what people say it said which is often not the case when you look into it that fluoride one is really freaking me out now that we're talking about it because I wonder how do you how would you ever stop that what's the in determined connections or correlations between fluoride and low IQ that sounds familiar but again it's not

158:36topic I've looked into in detail so I don't want to say something that's not correct but that's the difference in you and me I heard fluoride exposure and you know link to your IQ invented study says can you go scroll up a little bit there Jamie yeah increased levels of prenatal fluoride exposure may be associated with lower cognitive function function and children new study says published Tuesday in the Journal of Environmental Health Perspectives evaluated nearly 300 sets of mothers and children in Mexico and tested children twice for cognitive development over the course of 12 years fluoride has not added to public water supplies in Mexico but people are exposed to it through naturally occurring fluoride in water and fluoridated salt and supplements Wow yeah and I mean this highlights something else that we haven't talked about much at all in terms of aspects of

159:30the modern environment its problematic which is toxins things like mercury bisphenol A BPA which is in the plastic water bottles needs and what's this thousands of US locales were that poisoning is worse than so where's lad yeah did you see that new study on India I think it was New Delhi I forget what what but pollute our pollution in India at an all-time high and they showed these photographs of this city and it is insane yeah you just can't see anything can't see anything you can't see a building a hundred yards ahead of you yeah so I mean air pollution has been linked to obesity and cardiovascular disease and stuff you wouldn't even think not just respiratory yeah things like systemic inflammatory conditions and the problem with toxins is our initial understanding of toxic toxicity was only like acute toxicity like what happens if you get so much

160:27mercury in your body so quickly that it causes like an acute problem and we assume that you know if you don't see acute toxicity then there's no problem like there's nothing in between acute toxicity and just normal right we know now that like there was a really interesting study a couple of years back I wrote about this on my blog I think the title was something like mercury fish consumption and kids studio came up today this is a really bad air pollution caused car accident pile-up in New Delhi these people are trying to get people out of that car in just a couple seconds it's just like a snowstorm here in America another car comes slamming into them oh you're gonna tell them to hurry up and get the out of there before another one comes in happens like three or four times in a row right here oh my god so these people so these people are standing there and

161:20they can't see oh my god this is on a freeway oh my god oh my god they gotta get the out because another one to come in yeah it's insane oh my god this is all just air pollution there oh my god this is incredible this is like they're in the fog on a mountain road and they're on the highway this is what is the name of this video so we can watch on Twitter I had to find on Twitter it's literally going around the decile right before the show start that's oh my god New Delhi car accident air pollution oh my god this is insane and they're telling these people get out what do you do like you go up to try to warn people it's they can't see you there either yeah and then what if someone takes a turn and hits those people to the side oh god this is horrific I spot where it ends right here oh my god yeah so I mean these are like so the mercury thing you know the idea

162:23for a long time was if your blood levels below ten parts per million you're fine there's no evidence you know there's nothing there's no issue so this new study came out and they looked at kids and they looked at cortisol levels which and in inflammatory markers and they found that kids that had mercury levels that were even as low as one so you know almost ten times lower than the level of concern had higher levels of cortisol and higher levels of inflammatory markers and they ma so that totally turned things on their head it was like all of a sudden you know lower levels of the talks of these toxins than we thought were problematic are actually problematic and when they dove in and look deeper they found you know some of the kids were affected had certain genetic you know polymorphisms like there was something that made them more susceptible or maybe

163:17they had nutrient deficiencies that made them less able to detoxify the mercury as they normally should be able to and you know what further complicates it is that the symptoms that you see with high levels of a toxin can actually be different at low levels so let's say researchers design a study to see the toxic effects of mercury when when the exposure is is severe and they're looking for certain studies and then they start lowering the dose of mercury to see when those effects go away they will completely miss the effects that are caused by the low doses of mercury because they're different than the effects that they were studying at the higher doses so this causes a problem for years where it was assumed that the low doses were harmless because they weren't observing the same effects they saw at the high doses and now they know this and so they redesign studies to

164:09look just cast a wider net and see what's happening and sure enough at those lower levels of toxins they're seeing all kinds of effects that are actually in some cases opposite of the effect that you see with the high dose of the toxin have you adjusted like where you live or anything because of all this well I you know when we are we just bought a house a couple years ago and we just you know we had a choice of where to live we wanted to live in Berkeley that's where my office is and so we ended up living up on top of the hill and that was about what intentional for me it's right near Tilden Park which is a you know outdoor Regional Park space with a lot of green area and stuff and and there are parts of Berkeley that you know where the air quality is really really bad like surprising if you don't if you don't know that area if you go online to some of these air quality

164:57rating sites you can see that parts of Berkeley are like c-minus or D there's so much industry there and the Chevron plan and stuff but this is where it gets really you know the inequality is is brutal because guess who ends up often living in the areas that are most toxic are the people who are you know economically disadvantaged and they're the least influential when it comes to any kind of political power to change make changes in those areas so it's unfair it's it's and they're disproportionately affected by that because they nobody's watching out for them yeah well there's a lot of factors we could talk about in but I think it's just it's so important that there's people like you out there that are highlighting these things or writing books about these things and talking about these things on podcast so thank you so much man thank you for your book

165:48and thank you for the pleasure last time you were here we learned so much to tell people one more time the name of the book where to get it yeah it's unconventional medicine you can get in on Amazon and also unconventional medicine book calm you can actually download the first three chapters for free do it get on it change your health folks get your together thank you Chris really appreciate it always great great see you too man thank you