5 Signs You're Not Healthy And How To Fix It

Coming up on this episode of the Doctor's Pharmacy.

Cancer is caused by food. Really? 70%. 70% of cancer is caused by food. And sugar is the number one culprit. Heart disease, diabetes, Alzheimer's, it's the big killers are by sugar and food. So if you change your diet, you should be able to prevent or cure sometimes. Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me, helping patients heal using real food and functional medicine as your framework for getting to the root cause. What's critical to understanding what each individual person and body needs is testing, which is why I'm excited to tell you about Rupa Health. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to optimize health and reverse disease. But up till now, that meant you are usually ordering tests for one patient from multiple labs. and I'm sure many of you can relate how time consuming this process was, and then it could all feel like a lot of work to keep track of. Now there's Rupa Health, a place for functional medicine practitioners to access more than 2000 specialty labs from over 20 labs like Dutch, Vibrant America, Genova, Great Plains and more. Rupa Health helps provide a significantly better patient experience and it's 90% faster, letting you simplify the entire process of getting the functional medicine lab tests you need and giving you more time to focus on patients. This is really a much needed option in functional medicine space and I'm so excited about it. It means better service for you and your patients. You can check it out and look at a free live demo with a Q&A or create an account at RupaHealth.com that's R-U-P-A-Health.com youm know when something is good for you but really hard to stick with? Well, yeah, we do. We all know that. I'm here to tell you about an easy lifestyle change you can do with zero effort every single day. Switching to a bidet. Now, hear me out. Switching to a bidet is an affordable and sustainable way to improve your health the second you use it, and it doesn't get easier than a Tushy bidet. Just clip it onto your existing toilet, install it yourself in under 10 minutes, and you're ready to go. And by go, I mean, well, anyway, you might be wondering what using a bidet has to do with your health. Well, when you use toilet paper, you're leaving a residue of stool and bacteria behind, no matter how much you wipe. For women, toilet paper can perpetuate bladder and yeast infections, and for those with hemorrhoids, excessive wiping can cause a lot of painful irritation. The likelihood of these problems increases with the use of wet wipes, which tend to strip away the natural oils from your skin, plus they are terrible for the environment. Using a bidet solves all of these problems. Tushy's bidet attachment easily hooks up to your water supply, the same water you use to brush your teeth. The nozzle even self-cleans. so you know you're springing your bottom with good stuff. I've been using Tushy for myself for a few years and I love it. Once you experience the just showered clean of Tushy, especially in the sweaty summer months, you're never going to go back to wiping with the dry scratchy toilet paper. But if you can't go without a paper backup, they make soft sustainable bamboo paper too. Save your butt, your money and the planet with Tushy starting at just $99. Now, doctors, pharmacy listeners can get an extra 10% off by visiting helloTushy.com forward slash Hyman. That's hello@tushy.com T-U-S-H-Y.com slash Hyman for 10 off. Now let's get back to this week's.

Episode of the Doctor's Pharmacy. Hi, this is Lauren Fagan, one of the producers of the Doctor's Pharmacy podcast. Chronic health conditions and chronic disease are extremely common and growing in prevalence due to factors such as poor diet, inflammation, blood sugar imbalances, and more. The good news is there are many things we can do from a functional medicine perspective to support the body and even reverse some on today's compilation episode, Dr. Hyman talks to Dr. Lewis Howes, Dr. Elizabeth Boham, Dr. Steven Gundry, and Dr. Casey Means. You'll hear how to reduce inflammation, support the immune system, increase energy, and much more.

Let's jump in. So now we're seeing one in two Americans suffer from either prediabetes or type 2. Or type 2 diabetes. And that is when you eat too much sugar and starch. and every time you do that, it raises your insulin, your body becomes resistant to the insulin, and so it doesn't work as well. So you need more insulin. And insulin does what? Insulin makes you hungry, it makes you store belly fat, it locks the fat in the fat cells, and it slows your metabolism. It's like a quadruple threat for your body to gain weight. So it's why we're seeing, you know, and that goes back to what we're growing, right? So why are we eating all this food? that it's because that's the food we produce. And so that's the other part of the problem. We have the chronic disease, we have the economic impact, and then we're like, well, why do we have this food? So as a functional medicine doctor, I'm always asking why. Well, why are my patients sick? Because it makes money, right? Well, no, yeah, but I'm going even further why I got interested in this because as a, why would a doctor care about agriculture and soil and all this crap? Because as I was thinking about my patients' diseases, most of them were caused by food and can be cured by food. Something, well, how many are most of them? Is this like 50%? 70%. 80% of anyone that comes in to the hospital or your patients. Yeah. Who has some type of disease or some type of sickness? I mean, unless it's like an environmental thing like mercury or lime or mold, you know, most of the time. Or cancer. Cancer. Cancer is caused by food. Really? 70%. 70% of cancer is caused by food. And sugar is the number one culprit. Heart disease, diabetes, Alzheimer's, heart disease, the big killers are by sugar and food. Yes. So if you change your diet, you should be able to cure those. Prevent, or cure sometimes. Sometimes cure, depends how far along things are, I guess. You can prevent heart disease, Alzheimer's. Yes, 100%. I mean, the studies are there. Even people already have Alzheimer's when they improve their diet, They can wait for more functionality back. So you've got me thinking, okay, well if the patient's disease are caused by food, what's causing the food? It's the food system. They're like, well, what's causing the food system? It's our food policies. I'm like, what's causing our food policies? It's the food industry that's lobbying Congress. It's got money. It's the biggest lobby group in Congress is agriculture and food. By far. Like by, twice as much as the next lobby group. By gas and oil or whatever. Yeah, exactly. Right. And it's like, what? So then I began thinking, well, if I'm going to help my patients, I can't do it in my office. Like, I can, it's like, it's like I'm, like, in the boat bailing the boat with a hole instead of plugging the hole. You're not going to the source. Right. So then I'm thinking, okay, well, what do I need to do as a functional medicine doctor? I need to go to the root cause, right? The root cause and why. And then it became clear to me that it's, it's our, our agricultural system that's driving so much of the and what we grow has been based on good intentions that were in the 50s and people were hungry, there wasn't enough food, there was a lot of poverty. And so we figured out a system to produce an abundance of starchy calories so we could have food.

So we can stop food.

And we were great at it. And we have cheap abundant corn and wheat and soy, which are the commodity crops that are turned into industrial processed food. which is now 60% of our diet. And for every 10% of that you eat, your risk of death goes up by 14%. Yeah, so you're basically feeding Americans a diet we know is going to kill them. The research is so clear on this. There's no scientific debate, and yet we don't do anything about it because we have these dysfunctional food policies. And then the way we grow the food causes climate change. We'll get into that, but the number one cause of climate change is our food system. Really? People don't realize that. I didn't know it. I'm like, oh, it's oil and, you know, gas and all this stuff. I'm like, what is it? Is it the trucking? Is it the animal feces? End to end. Okay, so first of all, deforestation is devastating. Not only do we, like, destroy the soil on which we cut down the trees, but the trees are carbon sinks, so we lose that. So they're not sucking in the bad air. They're sucking out good oxygen. Right. I mean, basically plants suck out carbon dioxide. That's what they breathe. We breathe oxygen, they breathe carbon dioxide. So that, A perfect antidote, right? And then the soil also, we're damaging by the way we're farming. We've lost a third of our top soil. It's responsible, people don't know this, but of all the greenhouse gases in the atmosphere, the loss of soil organic matter, like healthy rich soil, is responsible 30 to 40% of all greenhouse gases currently in the atmosphere since the Industrial Revolution. Does that mean, why is that? Okay, why is that? Does it suck up? Does it suck? Because soil, is it can hold more carbon than is in the atmosphere right now. There's a trillion tons of carbon in the atmosphere, which is a lot. I don't know, trillion tons. I don't even know how to measure that. And the soil can hold three trillion tons of carbon. And how does it do that? It's an ancient carbon capture technology that is available all over the world. That's free. Free. That can be more effective than all the rainforests on the planet, than all the forests and trees on the planet. It's called photosynthesis. And if you have grasslands, for example, like we had big prairies in the United States, they suck down carbon, they breathe it, and they put it through the plants, into the roots, feeds the mycorrhizal fungi, which then make healthy soil, feeds the bacteria, and you get this incredibly rich live soil that holds tremendous amounts of organic matter, that is carbon, right? I mean, carbohydrates comes from the word carbon, which comes from carbon dioxide. Wow. Right? Ding, ding, ding, it all connects. And so we've lost. So we don't have the soil for it to consume, then we, it just bounces off back into the air, I guess, and we're just consuming it in other ways. Yeah, and the soil can hold so much carbon. The UN estimated that if we took the five of the five million hectares of degraded farmland around the world. If we took just two million of that and spent 300 billion, which is the total military spend for 60 days around the world, which is not much, 60 days, two months of everybody's military spending, we literally could stall climate change by 20 years. Wow. Because of putting back the carbon in the soil. And not only that, it holds water. You see, you know, in in Iowa and the Midwest, there was floods that just destroyed a million acres of cropland that otherwise could have been fine if the soil could hold the water. But it just sits on the top where it runs through and we lose all this water. So that when you have an organic matter in the soil, it holds 27,000 gallons for every 1% organic matter in the soil per acre. So it's an incredible water sink, it's a carbon sink, and we've lost all these soils. And it's because we're growing these commodity crops, in ways that destroy soil. Soil. We're tilling the soil, we're turning over soil erosion, it runs off into the rivers. We kill all the life in the organic matter by poisoning it with fertilizer, with pesticides, with glyphosate herbicides, and it's staggering. And then we have all these sort of unintended consequences. We started growing all this food and we thought this agricultural revolution was great. All these chemicals are great. you know, fertilizer is great, we can do all this good stuff, tractors, big farms, more food, feed the world. It's backfired on us. And it's producing the worst food on the planet that's causing devastating environmental damage, staggering climate change. So it's the soil loss, it's at the deforestation, it's the factory farming of animals, which should be banned, it's the transportation, storage, refrigeration, and the food waste. I mean, food waste in- A lot of waste. Yeah, well, we waste 40% of our food. We believe that's not a plate, we don't- Imagine going to the grocery store, buying a bunch of groceries, and getting home and throwing 40% of the garbage. The average American wastes $1,800 of food a year, and it's about a pound a day. And that goes to landfills. The landfills, then it rots and creates methane. So you could be a vegan, throwing out your food waste and scraps, and you could be contributing to climate change. if food waste were a country, it would be the third largest emitter of greenhouse gases after the US and China. Wow. Yeah, it's methane to produce, and we need a compost, we need to have community garden, like it's always to fix it. But it's like when you look at the whole end-to-end food system, it is the number one source of climate change, about 50% of greenhouse gases, and people just don't appreciate that. So why, I mean, if this information is public and it's out there and policy makers are aware of it. They're not aware of it. I spent two hours on a sailboat this summer with a senator, a smart senator. He wasn't aware of it. And I literally, his jaw was hanging open the entire time. And then I presented with this research and information. No, because I got so much money sent to him, it's like, well, obviously, probably. Right. I mean, listen, if all the people who are walking in their office are Monsanto and Cargill and, you know, McDonald's and Pepsi and like, and they're all donating millions of dollars, I would say billions of dollars, they're not hearing the other side of the science. And how do you fight that? So, I always said deride a lobbyist, but I plan on creating a food fix campaign, which is a nonprofit, along with an advocacy organization, to start to literally lobby senators, congressmen, key people in the administration around these issues and start to drive policy changes. because in the UK and you were talking about, I think in Australia, New Zealand or in I think in Asia, you were saying that you can't do certain things with the food. Otherwise you'll go to prison, you'll go, you'll get killed. Well, yeah, I mean, in the UK, they don't have a lot of these dyes. Right. Yeah. So it's so funny, you know, the FDA, you know, is so influenced by the food industry. And I was once with the the former head of the federal drug administration, food and drug administration. Peggy Hammer, former. She was, you know, but then she was the FDA commissioner. But now she's former. And I was at the World Economic Forum. I said, Peggy, how come, you know, we have so much trouble with getting advances in food labeling or dealing with toxic chemicals in our food or the antibiotics in animal feed or, you know, it's like, she's like, well, when we try to make too aggressive change, Congress threatens to shut down our funding because of the food lobby. They threaten to shut it down? Yeah. And then what? If they shut it down, what would happen? Well, they're limited in their ability to do their job. And so the FTC, the same thing happened in the 70s. There was a movement by the Federal Trade Commission to have negative education campaigns around sugar and how bad it was. but the Congress says we're gonna pull all your funding and shut you down if you do this. And so they pull back.

So.

You know, for example, you ask the question about Asia, we have this thing called GRAS, which is generally recognized as safe. So the food additives, we have, you know, we have, you know, thousands of food additives, only about 5% have actually been tested for safety. In the US, some of them are grandfathered in, right? So Crisco, for example, trans fat was grandfathered in as a safe food additive. food to eat, but it took 50 years for researchers to finally prove to the FDA that it wasn't safe because it was the basis of all processed food, right? Crisco shortening, you know, it shortens your life. I was like, oh, my gosh. And so they literally had to be sued by a scientist in order to actually turn it into a non-safe substance. And then of course, they gave their food industry years and years to get out of the food. But in this country, there's so many things that are used in our food supply that are banned in Europe, like BHT, butylated hydroxytoluene in food additives, various dyes, and something called azodicarbonamide, which is a softener that makes bread more fluffy and soft. And it was used in Subway sandwiches. Our friend Vani Hari outed them and said, this is your yoga mat material in your Subway sandwich. And they got it taken out. And she got it out. But the FDA still says it's fine to eat. And in Singapore, if you use it and you're a food producer, you get a $450,000 fine and 15 years in jail for putting it in the food. That same ingredient. The same ingredient that anyone can use in the US right now. In the US, yes. And most of the things that are safe, quote, safe here are banned in Europe. So it's like, yeah, they're not doing their job. And then antibiotics, you know, we have 30 million pounds of antibiotics are used in animal feed, we about 37 million total. So about 7 million for humans. to treat disease, and 30 million for animals. Why? For growth. It's a growth factor, right? It makes them fat, and it makes humans fat too, and it is used for prevention from overcrowding. And the FDA says, well, this isn't a good idea. I mean, nobody thinks it's a good idea. But they go, would you please, pretty please not do it? It was a voluntary guideline that the FDA produced, not mandatory. Please don't do it, yeah. You have to have a vet certify that the animal's sick, before you give them antibiotics. Oh man. And now they continue to do it and just laugh. They had voluntary, the FDA, FTC put in voluntary guidelines around junk food market. Would you pretty please not advertise the bad stuff and advertise more good stuff? It was just voluntary and the food industry went ballistic and had it overturned. So even the voluntary guidelines are nullified. Like no, wow. I mean, sugar, I mean, it's like, I'm the first one to raise my hand when I say, like, I love sugar. And it's my biggest vice, right? Everybody's got a vice. I love cookies and candies and cakes and brownies and anything you can think of. I love it, right? We programmed it. I don't know why I don't have diabetes. I have so much sugar I've had in my whole life. You can't be having that much, 'cause you look pretty good. Well, I train hard too. I go through waves. But as a kid, I would drink like 9, 10 Dr. Peppers a day, I remember.

What?

Like some days in the summer you just sit around. I'm not a president, is that what our president is? Exactly. But I would just, I mean, I would run around and work out and play sports, but then I would just drink. Cause I thought that's what presidents do. You were 16, 18, you know, like. And I was like 9, 10, right? So I was like, but it was, you'd see it on commercials like your NBA superstar drinking Dr. Pepper or Sprite or whatever after, on the basketball court. And I don't know if it was just like subconscious or just it tasted good and you didn't think about it. Mostly all, I mean, this is where the food industry is so, I mean, I talk about in my book, Food Fix, but the food industry is so strategic about how it advances its mission and goals. And it does it through multiple channels. And I'm just gonna go through 'em because it's just, people just don't know. The celebrity endorsements, right? Yeah, first, you know, obviously, you know, celebrity endorsements, which is the obvious one. They co-op social groups. So they fund groups like the NAACP and Hispanic Federation. the African American and Latino communities are the most affected by diabetes and obesity, and they co-opt them by funding them. I wanted to show the movie Fed Up at the King Center in Atlanta, and Bernice King, Martin's King's daughter, was all about it, and she was excited. But once we got it scheduled a few days later, I got a call that we couldn't show it. I'm like, why? She said, because Coca-Cola funds the King Center. No. Yeah. I went to Spelman College, which is African American women's college, Atlanta and the dean said to me half of the 18 year olds coming into college have a chronic illness, obesity, hypertension, diabetes, 18 year old women. And I'm like, why is there soda machines all over the campus? Why? She's because Coke funds. No. And one of the people on the board of trustees is one of the highest executives at Coca-Cola. Oh, man. An African American woman. It's like, so they co-op social groups. and that's why they, for example, oppose soda taxes, because they're, they're in the, you know, in the funding of these, these big soda companies. And then, of course, they, they fund research. So they fund 12 times as much research, 12 billion dollars worth of research a year to study nutrition. So Gatorade gets studied by Pepsi. Really? Gatorade's the best thing in the world. It's not. It's just sugar. Right. Right, right. So it corrupts and pollutes science. So people are confused. Why is there so much confusion about nutrition science? Third, they create front groups, call them spin doctors. So they create front groups that seem like they're independent groups like Crop Life or, you know, like Center for Consumer Freedom or the American Council on Science and Health, which by the way is run by a bunch of doctors who suggest that pesticides are safe, that high fructose corn syrup is great for you, that Smoking doesn't cause disease. Why would they do that? Because they get paid a lot. They're funded by Monsanto and big food and Pepsi. Just look at their funders. They spent $30 million fighting GMO labeling in California, this front group. It was all funded by Monsanto. Then you got these front groups. Then you have them co-opting scientists and academies. the Nutrition Academies, the American Heart Association, American Diabetes Association, their funding in large part comes from industry. And so the Academy of Nutrition Dietetics, which is our main nutrition association, 40% of their funding comes from the food industry. You know, they have sponsored lectures at their meetings that are, you know, when people say, well, high fructose corn syrup is good and diet drinks are good and like, It's just completely corrupted. And so these professional societies give guidelines and they're corrupt. And Dr. Ioannidis from Stanford, who's a scientist who looks at carefully at the research and conflicts of interest says, you know, these professional societies like the American Heart Association and Diabetes Association should not be making guidelines. And then you've got all these ways in which they sort of screw things up. And then of course they are aggressive in advertising and marketing, which is illegal in most countries. and then they have lobbyists running around Washington driving policy that supports all what they do. So you've got this massive effort and it's often subversive and illegal and it's, you know, it's kind of shady. Yeah. I mean, here's an example. Like in California, there was a group that, you know, wanted to have anti was to promote GMO labeling and they put in a ballot. What does that mean? Promote GMO labeling. So that you have to label. If you have a food, it has GMO in it, you have to label it. Yeah. So on Coca-Cola Coca-Cola say GMO. Right. Porn.

Right.

Kind of like in a cigarette box where it says like this will kill you. Right. And your plant-based burger would have to say GMO burger. Right. Right. So food industry didn't like that. So the grocery and your facts of America got together. Cause it would really cost them, you know, huge amounts of money. People were aware of this stuff. They don't want to- They stopped buying it. Yeah. And by the way- why don't they label it though? That seems like the smart thing to do. By the way, most countries do have it. Really? Like I think 30 or 50 countries have it, including China and Russia. which are not known for transparency or democracy, right? And they don't-- it's terrible. So they basically tried to put this thing now. The food industry got together with the Grocery Manufacturers of America, which is their trade group. And they're like, We can't have this. So they spent millions and millions of dollars fighting this ballot. And the way they did it was illegal because they got the food companies to donate in a way where it should be transparent for campaign finance. you have to be all transparent. It was all secret. They got caught. The grocery manufacturers of America got fined 18 million dollars, which is the largest fine ever for an infraction for campaign finance violations. But they appealed it and it was down to six million. And of course, the ballot, because they did all that work, it didn't pass. So they were successful. So what's a few million dollars when they have billions at stake? So they're so corrupt. And then in California, it was even worse. There were four soda taxes passed here in the 2016 election in, you know, in many states. It's soda tax. It's soda tax, right? So you pay an extra penny an ounce or whatever for sugar, sweet and drink, which, by the way, has been proven to reduce consumption dramatically. It works. That's why people do it. And it works. And that's why the food industry is so against it. So what the American Beverage Association, which used to be called the American Soda Pop Association, did was they took, this is crazy, they created a ballot measure to prohibit any local taxes from being passed unless it was a two-thirds majority, which would mean that you couldn't fund schools, police stations, fire stations, local stuff, and it would cripple local governments all across the state. It had nothing to do with food. But then they went at the last minute before it was about to pass, and they spent millions pushing this, they went to Governor Jerry Brown, the most liberal governor we've probably ever had in America, Governor Moonbeam, they used to call him, and they're like, look, you pull this, you pass this preemptive law, which means you can never pass another soda tax in California, and we'll pull this ballot measure. So basically they got Governor Brown to pass this preemptive law, which means that you're not allowed to go and pass another soda tax in California. Why? Why? Because they don't want soda taxes. It's crazy. It's crazy. And why did Governor Brown do it? Because he didn't want his entire state, local governments to be crippled by this new ballot measure that was about to pass. So it was all done behind closed doors. You can never tax again? You can't now in California. You can't. No, and they're doing this states can- Will you change the law? back. You could just take more effort. They're gonna have to, you know, but they're doing this in states all across the country. And it's a, it's the Playbook that the tobacco industry used. Wasn't tobacco? I mean, isn't cigarettes have a tax on them now? Or in some states, they do. It's like, there was a huge lawsuit that's, that sort of changed everything.

Right.

There was huge litigation and multi-billion dollar settlements and all kinds of restrictions that did happen. But food is more complicated because it's not cigarette is one thing. It's like, soda, it's processed food, it's everything. So this is all the bad news. The good news is that we can fix these problems. We can reverse climate change, we can reverse chronic disease, we can fix these dysfunctional food policies, we can, and some of the social injustice issues which we didn't talk about is related to food, we can actually help save our economy if we change the way we grow food, the way we process food, the way we Distribute, market, eat it and waste it. And we can do that. It's not like we need to invent some new technology. We have the ability to do it. We know what to do. The science is there. It just is going to take a grassroots movement and some political pressure to do it. What would be the first steps that someone could take to help? Well, I think, you know, it seems like such a big- It is. It is. It is a little bit. So let's talk about some of the solutions. So we know, you know, food is causing chronic disease. It's destroying our economy. It's crippling our economy. It's destroying our environment and killing all the pollinators and all biodiversity and it's causing social injustice because it targets poor minorities who suffer from problems. It prevents kids from learning in school because they're eating all this crap. It threatens our national security, creates political instability. So we know all these things. But the good news is that by fixing the food system we can solve these. And how do we do it? Well, it's going to need citizen action. It's going to need business innovation. and it's gonna need policy change and of course other philanthropists and governments to help get on board. And I think that's what's really exciting to me because there's so much hope. So for example, on a personal level, you can shift what you eat and what you do to drive change in the marketplace. Why are companies like Nestle and Unilever and Danone creating regenerative ag programs within their supply chain? Why are they trying to up the quality of their food and take out chemicals? Because consumers are demanding it. Well, they're buying companies like Primal Kitchen that have like- Like craft, right? Bought Primal Kitchen, which is basically a Whole Foods, really high quality nutritious product with no junk in it. Exactly. Right? So, yes, that's part of the problem. They're buying up these companies. I think they're seeing the change and there's a positive change. I mean, General Mills just came in at a million acres to regenerative agriculture. That's incredible. That happened because people are demanding different things by voting with their fork, voting with their wallet. What do we know about how to create immunoresilience, how to create immunorejuvenation, how to make ourselves an unfriendly host to the microbes that we're exposed to? Because we're all exposed to them, right? I mean, people with AIDS don't die from the HIV virus. The HIV virus cripples their immune system.

Yes.

Which means that they are gonna die from things that we all live with in our bodies, whether it's pneumocystis pneumonia, or whether it's cytomegalovirus, or whether it's, you know, a different bacteria like Mycobacterium avium, tuberculosis. So, we actually are living in a soup of bugs that live in us all the time.

Yes.

And it's not a bad thing. we're just in balance with them. And so when we get out of balance, whether it's a virus like HIV hijacking our immune system, or whether it's the fact that we have a crappy diet and our stress and don't sleep and have nutrient deficiencies and don't take care of ourselves, well, there's a lot we can do about it. And that's what's so great about functional medicine is it gives us a method of evaluating people and where they break down and where they're struggling and where their immune system might not be working optimally. And there's so many different reasons for it. We're gonna get into that in today's podcast. So tell us Liz about some of your patients that you've discovered how to actually work with it. Because it's something I also have seen in my practice. People get sick over and over again and you're just gonna see these people like, why are you always getting sick? And then you start digging and what are the kinds of things you find?

What are out of balance? What's out of balance? So for the first person I wanted to talk about, he was a 10-year-old boy and he was coming in because he was getting every cold and flu that was going around, right? So his mom was getting frustrated because he was out of school almost a couple weeks a year, if not more, because he kept getting sick. And she, of course, had to take off work and it was causing some disruption in their house, but she was also really just worried about him. Why was he picking up every cold and flu going around? I got a good detailed history from him and he had multiple ear infections as a younger child. So when he was, his first few years of life, even up to five, he was getting lots of ear infections. and often treated with antibiotics, right? So he would get an ear infection and he would take antibiotics and then we get another ear infection and he would take more antibiotics. He had a lot of congestion in his nose and- I mean, even when he wasn't sick. Even when he wasn't sick, he was dealing with it. And that's an issue we know because when there's a lot of congestion floating around, sometimes it gets stuck, right? So kids that have a lot of congestion in their nasal passageways and their eustachian tubes, more likely for infection. They have more inflammation and it's more likely to get stuck and then another infection grows and you get an ear infection, for example. So he had these recurrent chronic ear infections.

So wait, wait, so this is just to break it down a little bit. So what you're saying essentially is that if you're living a lifestyle or you have food sensitivities or something that's causing congestion and inflammation in your sinuses and your nose and your throat, that sets the stage for recurring infections. Yeah. Right, so maybe the treatment isn't to.

Fix the infection, it's to figure out why there's this problem. Right, because the congestion gets stuck and then it's as a breeding ground for a virus or bacteria to overgrow and an infection to take hold and for it not to be able to get out of the system. And for him, he had these chronic ear infections, but now is getting everything. So when he had the chronic ear infections, it's important to note that he was given lots of antibiotics. So for his first five years of life, he was on multiple rounds of antibiotics, two, three times a year, getting antibiotics for these ear infections. And that is something we often see, right? We'll see that somebody gets an infection, right? For this kid it was his ear infection, or for somebody else it might be a urinary tract infection or a sinus infection, that you're given antibiotics, but those antibiotics get rid of the infection, but they also can get rid of all that good bacteria that's lining the sinus passageways, the digestive system, the bladder area, right?

The microbiome.

The microbiome.

Right?

So, and we know that those good bacteria, they're like the first line of defense. They're like that army on the front line, right? They can say, okay, virus, don't get into my body. Okay, another bacteria, don't come into my nose, right? Those good bacteria are aligning all the passageways in our body so that when.

We- They're part of our defense system.

Huge part of our immune system, huge part of that innate immune system, that immune system that's gonna attack right away when something new or different comes into the body. And so when we've been on a lot of antibiotics in the past, we will often see people's who, who, whose immune system is not working as well as we'd like it to. So, and I think- so what you're.

Saying is that antibiotics, even though they treat infections, somehow mess, seem to mess up your immune system.

I think they do, yeah, absolutely. And I think there's good studies to show that when, when you, when you get, I mean, sometimes an antibiotic is necessary, but there's definitely been a multiple times with lots and lots of people and of course all the antibiotics in our food supply, they're damaging a lot of that good protective good bacteria that are our first line of our immune system. So absolutely.

And they make you more susceptible on the next round.

Exactly. And that's, I think, one reason why we see these chronic infections with people because they take the antibiotics but then gets rid of a lot of the good bacteria. So it's easier then next time for that virus or bacteria to take hold and to become an infection again. And so we see this sort of cyclical thing going on with people. And so I think that's important for us to pay attention to and say, okay, let's step back and say, do we absolutely need to use this antibiotic this time for this situation? And I think as physicians, it's important that we are making that we're being more careful with the use of antibiotics. But I think that's an area that we see issue with. And I think one reason for him, one of the reasons why he was more susceptible to these colds and flus. But I don't think it was the only reason.

Yeah, what was the other reason?

And I think that that's important to note, right? We always want to find one thing. We always want to say, oh, it's the one reason why somebody's immune system isn't working as well.

But many times it's multiple things coming together. And I just want to stop you for a minute there because in traditional medicine, we were trained to think about the one thing. We call it Occam's Razor. What's the simplest explanation that could explain all of it? And we sort of do that a little bit in functional medicine, but the problem with traditional medicine is very reductionist. It's like this is one thing and the truth isn't body is complex and it's a system. And it's many things. It's more like a web than a razor.

Absolutely.

Right.

And many times there's 10 different things going on that are contributing to why this person's immune system wasn't working.

So, their microbiome, their diet, nutritional deficiencies.

All sorts of things. So, for this child, You know, we realized also because of all of this congestion and frequent infections and a lot of ear infections as a kid, I said, well, you know what? Maybe we need to think about some food sensitivities that may be causing a lot of congestion for this kid and putting him at increased risk for these ear infections as a kid and infections now. Because we do know, we do know that dairy and cow's milk is associated with increased risk of ear infections for some kids.

And also mucus production, congestion. I mean, I know by Derek, I might immediately get runny nose and congestion. It doesn't affect everybody by that way, but it does affect a lot of people that way.

Yep. And he was willing, he was willing to say, okay, I'm gonna, the kid, he was ready to say, I wanna stop getting sick all the time. And so he was willing to go off of, you know, to do an elimination of dairy from his diet. And so that is one of the things we really focused on and we worked on. And it really did help. His congestion decreased. He wasn't getting as sick as much. But we did more than that because we also realized that he, you know, I did some nutritional biomarkers. I realized he was a little low in zinc, which is, you know, not uncommon to find, you know, so I- Zinc is so important for your immune function.

In fact, in COVID-19, they're finding they're actually treating patients with zinc because it helps to interrupt the viral replication and the viral binding to this sort of cells and insertion into the host DNA. So I think it's really interesting to see that, you know, just even in this crazy horrible infection of COVID-19, we're going back to basic principles of what's required to help the immune system, zinc and vitamin C, which are being used intravenously in studies.

Yes. And so for him, you know, we added in like 20 milligrams of zinc and 500 milligrams of vitamin C a day. And that was very helpful too to help him break this cycle. In addition, we found out that he some elevated levels of heavy metals. So his lead was a little bit high. He was living in a home, he'd grown up in a home that was built in the early 1920s or so. So it had more just lead in the water and in the walls of the house. So it had been refurbished, but it's still, you know, his lead levels were higher than we'd like them to be. And we know, right, what we know about heavy metals, we know that high levels of lead are really a problem for both the neurological system and the immune system. But I think we also know that low levels can result in people's immune systems not working optimally.

And also, mercury and lead also affect the gut. So they interrupt the gut function, can cause leaky gut, growth of bad bugs in there. So you've got other reasons for this.

Yes, right. That's true. That's very true. So we also, not only did we pull away dairy from his diet, we put him on a really good probiotic because he had been on so many antibiotics in the and probiotics, there's really interesting studies on how well they help the immune system. I mean, we need to do a lot more research here and figure this out a lot more, but they can really help with breaking some of the cycles for people who are chronically getting sick.

I remember the study I read years ago, it was a pregnant woman who took antibiotics, I mean, who took probiotics, compared to another group that didn't, and the women who took the probiotics during pregnancy, their offspring had dramatically less eczema and asthma. An allergy. Yes. Because the mothers took it. So same thing when you give it to kids, it also helps dramatically with these problems.

Yeah, absolutely. And can help improve the functioning of the immune system for some kids in certain situations. And then of course we gave them that zinc and vitamin C, but then I put them on a detoxification protocol. I really helped with getting these heavy metal levels down. We did a protocol that had multiple different components in it. But that was because we tested and we found that his heavy metals were a little bit high. So we worked to really bring them down with with, you know, glutathione, liposomal vitamin C, some binding agents, things that helped supported the detoxification system in his body. And, you know, that comprehensive approach really helped his immune system improve and it helped him get out of that cycle of getting sick, you know, two to three times every winter. And I think that's It's, it's really, it's really fun to watch and see that because we can see the difference.

I hear there's so many, I don't get sick anymore. My sinuses, I don't get, I, this is the first year I've gone without having antibiotics for my sinuses. I know, right? It's just so, it's so simple. I mean, I remember this kid, he just reminded me of the story when I was in the emergency room years ago and I was working emergency hospital in Springfield, Mass. And the, this woman came in with her toddler who was probably like maybe about two years old and had just so many ear infections, one after the other, after the other. And I said, well, when did this all start? And she's like, well, he was about a year old. I said, what happened in his year old? I switched him from breast milk to regular milk. And that was like, and this is before I knew about functional medicine or anything. I was like, oh, well, that's interesting. Why don't you take him off dairy and see what happens? And the kid was fine. So I think sometimes it's sort of that simple, but I think often it's more comprehensive. 'cause one, you change his diet, you optimize his nutrient levels, and you also went a little deeper to look at his detoxification and his metal burden, which was also a factor. So you did diagnostic tests that can help pinpoint these issues and you can really create a precision approach to each individual. So this is his problem, but there may be somebody else who might have a different reason for their immune system not working. And I think it's really important to understand that we at the Ultra Wellness Center and in functional medicine take a very different lens at looking at these chronic problems. and say, what is the cause? How do we get rid of the cause? And why isn't the body working properly? And when I learned functional medicine, one of my mentors was a guy named Sydney Baker, who was sort of a Yale pediatrician, just brilliant guy. And he was incredibly good at taking incredibly complex ideas and simplifying them into a few principles. and one of the most important principles that guides me every day still today is a very simple question is what do you need to get rid of in your body that's making it unhappy? And what does your body need to get in order to get healthy? So what are the things that are the problems that cause disease and what are the missing factors that you need to have a resilient system? And so this is for the immune system. So this kid, he had too much dairy that was bugging him. you had too many metals or bugging them, so you got rid of those things. And then you added in the things the body needed to function. You added in the probiotics. And you added in the zinc and the vitamin C, and the body knows what to do. It's like when you take out the bad stuff, you put in the good stuff, it's just that simple. And sometimes it's a tough job to figure out what the bad stuff is that you need to get rid of and what the good stuff is that you need to get. And that's where the real meat of functional medicine is being able to investigate those things properly. And we don't learn that in medical school. So functional medicine is we learn how to dive deep into being an expert in what are the things that cause disease and how do you create a healthy human.

And I think that's really the power of supplements. Sometimes people are like, oh, what do supplements matter? Multi, is this helpful? Is this helpful?

Expensive urine.

Yeah, but when you can identify what deficiencies people have or what because of their genetics they need more of, right? When you can really specialize and give a personalized program for somebody, it makes a world of difference. You know, I remember in my undergraduate degree in nutrition and they were like, oh, you know, don't bother with supplements. You know, it was really food first kind of a program. So I never took supplements. I remember the first first time I took a multivitamin, I was like, whoa, this is amazing. And it was a good quality one with good methylated B vitamins. I had so much more energy because I needed that extra methylation because of my genetics, right? So when you specialize and give a personalized approach, it really makes a huge difference for people.

So key, so key. So basically what you're saying is that fat around your belly is not just holding up your pants, that it's an immunologically active organ. It produces these molecules we call adipose cytokines. You've heard of the cytokine storm with COVID Yep. Well, it's that same chronic cytokine storm that's being released from these fat cells in your belly. They're not just average, I mean, you have fat in your legs or your butt, it's not gonna do that. These fat cells in your belly are super inflammatory. So then you get the inflammation, which leads to oxidative stress, which then causes.

What problem with the cholesterol? Right, so when your LDL cholesterol gets oxidized- and what is that? Think of oxidative stress like excessive free radicals or rusting in the body, but we're always making free radicals in many different cellular processes in the body, but when there's too many of them or you don't have enough antioxidants to squelch those free radicals, so if your diet's not rich enough in the polyphenols or those phytonutrients or your vegetables, then what happens is you get more oxidative stress and that oxidative stress can shift that LDL cholesterol. And it's that oxidized LDL that's more damaging and more likely to cause plaque buildup and that will lead to heart disease.

So it's basically rancid cholesterol in your bloodstream. That's the problem that gets oxidized, which is like you said, rusting or apple turning brown or your skin wrinkling from too much sun. These are all signs of oxidation. But this happens inside of you. and it leads to this inflammatory process, this oxidative stress, and that's what causes the heart disease. And some of the interesting studies I've seen, like the Jupiter study, very big trial from Harvard on heart disease, fascinating to me that people who had high LDL but no inflammation had very low risk. People who had high inflammation, but kind of okay cholesterol, they were at risk. And those with high cholesterol and high inflammation had the most risk. So I think we have to be focused on inflammation, what's causing that, and it may be that, you know, the statin drugs turns out the benefits may not have a lot to do with cholesterol lowering, but they're anti-inflammatory. They're very powerful anti-inflammatory drugs, which is called a side effect. Yeah. But, but it actually works. Now, there's a lot of better ways to get rid of inflammation besides taking statin drugs. And so, so when you're talking about people's cholesterol, you know, how do you decide, you know, what to do for each patient? How do you decide from a functional medicine perspective? how to work these patients up to decide whether that should go on a drug or whether you just do lifestyle.

How do you figure that out? I mean, it is a complex process, right? Where we're taking a really detailed history and we're looking at more than just those numbers. We're looking at what are their markers of oxidative stress. We can measure those. We can measure oxidized LDL. We can measure 8-hydroxydeoxyguanosine and lipid peroxides. All of these biomarkers that give us a sense of is there oxidative stress?

And by the way, these kinds of tests are not things you'll typically get at your regular doctor. You know, at the Ultra Wellness Center here in Lenox, Massachusetts, we do functional medicine, which takes a deeper dive into the root causes, into these diagnostic tests which are not available, usually through your traditional doctor, they may not be interested in or know what to do or how to interpret even fasting insulin, which they don't even do. So we really are excited to help people figure out how to look at their risk and design a strategy that's personalized for them. using functional medicine. And we see people from all over the world that the UltraWellness Center is doing Zoom consults now.

So it's pretty easy to get access. And it's fascinating because there's so many pieces to the puzzle. And so when you find somebody with high oxidative stress, you ask that question, why? Why is there high oxidative stress? Is it their poor diet? Is it inflammation? Is it their microbiome? Is it their microbiome?

Is it a toxin? Heavy metals? Heavy metals, like a toxin or some other- Pollution.

Yes.

All the smoke that wildfires in California, that increases risk of cardiovascular disease.

Absolutely, absolutely. So it's really important to think about all the different things that can lead to oxidative stress and inflammation and then try to tease out what is it for that individual person that we need to focus on. So I think that's important. For some people and a lot of Americans, there's so much that's lifestyle related. But for some people, their lifestyle is great and it's It's more toxin related that we really need to work on that. Or like you mentioned, the microbiome is an area that's fascinating and we're learning so much about how it influences inflammation in the body. Microbiome in your gut as well as microbiome in your mouth, right? And gingivitis and how much that we've known for years that that impacts risk of heart disease because of its inflammatory properties. So those are important things that we need to really investigate and look at.

Yeah, so true. I'm just thinking about how we work with these patients. So we look at all these diagnostic tests that may not be looked at. We look at their overall cardiovascular risk, their family history. We may look at diagnostic tests. We may send them for a heart scan, look at calcium, broad ultrasound, look at particle size, look at inflammation markers, oxidative stress markers, the microbiome, heavy metals. We might look at other factors like homocysteine, which looks at B vitamin status. We look at lipoprotein A and a bunch of other factors that give us a more rounded picture. of what's going on. So we're not just focused like a laser on cholesterol. And the reason it seems to me that we are so hyper focused on cholesterol is we have a good drug to treat it. Right? So it's all pharmaceutical driven. Whereas when you look at the data, two-thirds of all people entering into an emergency room with a heart attack have either pre-diabetes or diabetes, and most of them are undiagnosed. Right.

So when you say- so two-thirds of.

Heart attacks are from sugar, not cholesterol issues. And we're just focusing on cholesterol. It seems like we're missing the mark here.

We often are. And we're saying, okay, this is high. I mean, so many people come back with, you know, high on their lab work and it doesn't necessarily, like you've said, I mean, it's anything to be concerned about.

Right.

And then there's so many people who come back without that H, that high level, and they do need to be concerned.

Statins have a role, but Let's talk about the stats for a minute because it's very controversial. Like any drug, there are benefits, there are risks, there are side effects, and there's the right patient for the job. So how do you come to sort of decide what you should do with a patient?

Yeah, I mean, you really want to get a good detailed family history. I think that there are some people who are at very high risk of vascular disease, and for people who have a strong family history, which means that If you have a first-degree relative, which would be a parent or a sibling who has had an early heart attack. So for a man less than 55 or a woman less than 65, that means they've had diagnosed heart disease because of plaque at an early age. You know that those people who have that type of family history need to be more careful.

Were they smokers? Were they very overweight? Did they have diabetes? Like what are the other factors? so I always look at that as well because you have to. I remember my grandfather, you know, everybody in his family, like, I think he had nine siblings. Everybody had heart attacks in their 50s. You know, they all had bypasses, heart attacks, and they weren't, like, significantly overweight, but they were pretty high risk as a family. And he was deaf, so he couldn't hear, so he really, he really couldn't get a, a job, like a white collar job. So he had a a blue collar job, which was basically loading New York Times, big bundles of New York Times onto the trucks from the conveyor belt. So he was constantly working out all day long and was very, very strong and healthy. And every night he would go out in Queens and he would walk down the street and feed all the alley cats. So he walked every night after dinner, which we now know is a very good way to improve your health. And he, he didn't really get heart disease until his 80s. Right. Right. And they all got it in their 50s. So it's and his diet wasn't the best, right? But still, even with simple lifestyle things, it can make a big difference.

Absolutely. So right. So you bring up a great point that genetics and family history is just one piece of the puzzle. It's not what makes us make all the decisions in the world, but we take that into account as well as all their other risk factors, like you mentioned, like type 2 diabetes and are they a smoker? and so we really have to pay attention to all of those lifestyle factors.

High blood pressure, you know, a lot of high blood pressure is a big factor in heart disease. But again, high blood pressure is usually caused by the same thing, which is insulin resistance. So that's a big one. Yeah, it's very, very common. And, you know, I just sort of recall a patient. I'd love to hear any cases you'd like to share, but I just remembered a patient I saw was about 50 years old and he came to see me. He had a little bit of belly fat, maybe 20 pounds overweight. He'd had a heart attack. had a stent and was freaked out, you know, at 50 years old to have his heart be at risk like that. And he was on a pile of medications when I saw him. He was on a statin, a beta blocker, blood thinner, you know, calcium, the whole cocktail, blood pressure pills, you know, pretty much everything. And I said, well, listen, are you willing to sort of make some changes? And so we totally revamped his diet. We got rid of all the junk out of his diet, very, very low sugar starch diet, lots of good fats, lots of fiber, got him on some basic supplements, you know, B vitamins, folate, and also fish oil, got him on an exercise program. And over the course of a year, you know, he lost, I think, I don't know, maybe he was morbid, I think he lost almost 50 pounds. He was able to normalize all of his numbers and his blood sugar was high. his insulin was high, he wasn't diabetic but he was pre-diabetic and they completely missed it. It's staggering to me that after 30 years that I've been doing this, that the literature has been there, that doctors don't check for pre-diabetes on a regular basis, which affects basically one out of every two Americans or more. And so you check that by measuring insulin, A1C, a glucose tolerance test with insulin, there's ways to look at it. And men look at particle number, particle size, and he lost the weight and he was able to reverse all of his numbers, and he was able to get off all his medication, including statins, and his numbers were better off the statins than they were on it by fixing all these lifestyle factors. And he's been heart attack free for the last 20 years. So I just, yeah, I think we are so stuck in this paradigm of treating the symptom, the cholesterol, instead of the cause.

Absolutely. That's critical.

That's a good story. You've had some patients too, right?

Yeah. So, you know, the first one, you know, I wanted to bring up the two cases I wanted to talk about today were people with this in-between cholesterol, like where they were, they really wanted to know what to do. They weren't crazy high risk, but they were told they should go on medication. And they came to me to say, well, Is that the right decision or what else can I do? So the first one was a 45-year-old gentleman who was told his cholesterol was too high. He didn't have a strong family history of heart disease, but his total cholesterol was what? 225. His good cholesterol's HDL was 37.

Which is low.

Too low.

225, right?

His triglycerides were 185 fasting.

Which is high, right?

Too high.

Under 70.

And his LDLs were 145. So, you know, his doctor said, you know what? I think you should start some medication. And he said, well, you know what? I wanna see what else I can do. So he came to see us, which was great. And because, you know, a lot of times with patterns like this, we can make a huge change. So we did that special, we did an NMR lipoprofile. So we looked at those particle sizes and we saw that he had a lot of the small, dense LDL particles. His pattern, they sometimes give you a pattern. Are you pattern A or pattern B? Pattern B being the more concerning, you have too many small dense LDLs and that's what he had. He looked like he had a high risk for insulin resistance, which we knew even before we did the test because his waist to hip ratio was too high, his HDL was too low, his triglycerides were too high. So it was obvious, but that test confirmed that, right? It said you have a high risk for insulin resistance based on your cholesterol panel. And we also- Before you go there.

I just want to point out because this is really a very easy, cheap way to check to see if you have insulin resistance. And it's a far better predictor of your risk of heart attacks than your LDL, which is your triglyceride to HDL ratio. And this guy had a ratio about five. If it's over one, not great. If it's over two, you're in trouble. It was five. And that pattern of high triglycerides, low HDL is what you see in these patients with pre-diabetes even though they might have a normal cholesterol. I mean, his was 225, but I've seen people with, you know, a total of 150, triglycerides of 300, HDL of 29. I'm terrified for these patients. Total cholesterol is 150 and it's absolutely right.

Right, that's where we get really nervous because we know that's such a pro-inflammatory process. And what we know about heart attacks, especially sudden heart attacks, right, there's typically It's, you know, I always sort of draw this picture for my patients of the inside of the artery. And so often we think when somebody has a heart attack, the plaque just keeps building, building, building, building, you know, they're 50% blocked and then they're 90% blocked and then they're 100% blocked and they have a heart attack. But what we know is that sometimes you're only 30% blocked, but if that's inflamed, if that blockage is inflamed, kind of like that can rupture, and then cause a significant blockage.

It's like a pimple popping that then your body protects by making a blood clot and you're a heart attack.

Right, and that's really often what we see when somebody has a sudden heart attack, right? That blockage just ruptures and so it's often missed. People aren't necessarily coming in with years of chest pain and, you know, shortness of breath, those things that we see as people get older, they just have a sudden, rupture of that plaque. So yeah, those are the situations you get really nervous and a lot of times you see a lot of inflammation. So we also did an oxidized LDL with him, which was high and concerning.

That's the rancid cholesterol.

Yep, that's that rancid cholesterol. So we really, for him, with all those signs of insulin resistance, metabolic syndrome, the diet for him was that really low glycemic diet. We needed to work to lower those carbohydrates. to lower the sugar. We know that triglycerides really decrease when you cut out juices, sugars, alcohol.

And they're basically fats that are made in the liver when you eat sugar and starch, right? They're not produced by eating fat.

Nope, nope, sugar. And you can really, you can lower your triglycerides pretty quickly when you pull out the alcohol, the juice, the lots, if some people doing too much fruit.

Flour and sugar.

Flour and sugar, absolutely. sugar, sugar, sugar. So when you cut that out, you can bring your triglycerides down really pretty substantially, pretty quickly. So we really focused on lowering his carbohydrate load, you know, all the bad carbs, right? And, and we also focus on giving him more of the omega-3 fats because we know those omega-3 fats are really anti-inflammatory and they can 2 to 4 grams of, omega-3, omega-3s a day can lower your triglycerides and raise up that HDL.

And this FDA approved as a drug. Absolutely. Flaxseed oil, which is fish oil, which is a prescription that you can buy.

To lower your triglycerides. And you can get it from food, right? Like a can of sardines. Three ounces of sardines is about two grams, has about two grams of the Omega-3s in it. That's what I'm having for lunch. That's my favorite lunch. Sardines on a salad with some walnuts, very heart healthy. So, we made that switch with his diet, you know, and what was amazing and what I loved to see is when in like three months we repeated that NMR lipo profile and he went from having the too many of the small dense LDLs to having he was now considered pattern A. He had more of the big fluffy LDLs. His HDL improved. Now it wasn't yet optimal, but I think it got up to like 47 in three months. His triglycerides came down to 120. So maybe not, you know, this was just three months of doing this. we can see really quick changes in people's bodies with making these changes in lifestyle, which is phenomenal.

Yeah, and I think one of the things I want to talk about, this is a great case, but you're able to change his diet and improve things. But one of the things that we're really bad at in medicine is personalizing care. And there's no place that's more important to personalize your care than dealing with your heart attack risk and cholesterol, because it's different for different people.

That's very true.

And what I've seen, I'm sure you've seen this over the years, is people respond dramatically differently to the same diet. So typically we're told by the American Heart Association that we should have less than 5% of our diet as saturated fat. Although breast milk is 25% saturated fat, so maybe we should ban breast milk according to the American Heart Association. I don't know about that, but it's really important to get saturated fat in your diet because it's a building block for cholesterol, which is not necessarily a bad thing. I mean, your cholesterol makes hormones. It makes the nerve coverings for your nerves. It's part of your brain. I mean, it's really important. A lot of your hormones are made from cholesterol, your sex hormones. And, and what I found is, you know, depending on the person, their responses are very different to diet. Yes. And, and I've talked to Dr. Ronald Prouse, who's one of the world's experts in cholesterol in this. And he says, yeah, there's a lot of heterogeneity. And I've seen this. Just two cases come to mind. One was of a woman who was overweight, who was clearly pre-diabetic, whose triglycerides were 300, which is really high. It should be under 70. Her HDL was like 30, which is terrible. Her total was probably 250-260. It was pretty high. She had a lot of small particles, a lot of overall particles, just way out of range.

Weighted syndrome.

Yeah. And she struggled with weight loss and diet. so I put her on a high saturated fat diet. I put her on basically butter and coconut oil and almost a ketogenic diet. And it was striking. She never could lose weight. She dropped 20 pounds like that. Her cholesterol dropped 100 points. Her triglycerides dropped over 200 points. Her HDL went up 30 points. And you just like, you just can't get that result with a drug.

Nope.

And, and so. so I did that with her and saturated fat was the cure for her cholesterol, not the cause. But another guy was this super fit mid-50s biker would bike 50 miles a day. I'm super healthy. And his cholesterol wasn't great. And he had a genetic issue with his cholesterol and had this sort of more of these small particles. And so I put him on, I tried and said, let's try just do more of a ketogenic diet, see what happens or more saturated fat. his cholesterol turned into terrible. So we had to totally change gears and get him off saturated fat. I think we'll soon be able to do a test, which is a cheek swab or a drop of blood, measure genetics and figure out which one are you? Are you somebody who should be eating more fat and saturated fat or more carbohydrates or more of the right foods, different kinds of fat? We're not quite there yet, but I think in functional medicine and here at the UltraWellness Center, we can on an individual basis really come to learn what is the right thing for this particular person.

That's so important. That's so important because what's really key with diet is personalizing it, right? That's when we get the most benefit from our nutrition intervention. And I think what you mentioned with the first woman, the reason we saw such an improvement with the ketogenic diet is you lowered her insulin so much, right? So we know that the carbohydrates that you eat cause your insulin to spike. So when your insulin is high and you can't lose weight because your insulin is high because it's causing you to put on weight around the belly, when you change to a diet that doesn't cause your insulin to go up, which is like a ketogenic diet, I mean, that's the extreme, right? But you can do some things in between too, but then that insulin doesn't go up and that's when we can see huge benefits for some people in that situation.

Dr.

It's really true. I mean, insulin you know, for the most part, and like the one guy it wasn't because he was so fit and there's genetic variations. But for most people out there, it is really the most common thing. And, and, you know, aside from getting the NMR particle test, getting a measure of your fasting insulin, really great. If you can get an insulin test after you have a sugar load, that's even better. Because by the time your blood sugar goes up, you're down the road, way down the road. And it's a late stage phenomena. Even blood sugar going up fasting, and then two hours after sugar load, you see a little earlier. But I've been doing these tests for decades. I just see this pattern over and over again. You can have perfectly normal sugar, perfectly, I mean, I had this one woman who was really overweight. She had a giant belly and clearly she was metabolic syndrome. She had high triglycerides, low HDL, same pattern. But when I measured her glucose tolerance test and her A1C, perfectly normal. Like her fasting blood sugar was normal. Her average blood sugar was normal. Her one and two hour blood sugar test, like normal. Like her fasting was in the 80s after it was like 110. But I measured her insulin. Now, normal insulin should be under five. It's over 10 kind of in trouble. Her fasting insulin was like 30. Yep. And then we did a sugar load and her insulin up to 200- 250. Yep. And it should be under. 30 after sugar load. So, she was like 10 times normal and it was keeping her blood sugar normal, but it was driving all this weight gain and inflammation and abnormal cholesterol. So, you really have to dig in in a different way than your traditional doctors are digging in.

I think glyphosate has rapidly rose to kind of my number two mischief maker of all time. It is an antibiotic against the earth, in my opinion. It was actually patented by Monsanto as an antibiotic initially. And what we didn't know, what you and I didn't know, is that, yes, it works with this crazy, it works against the shikimate pathway, how plants make protein synthesis. And Monsanto said, don't worry, humans don't use this shikimate pathway, so you're safe. It hurt you. What they didn't bother to tell us was that bacteria and fungi use the shikimate pathway so that when you swallow glyphosate, it actually kills off your microbiome rather effectively. Plus, recent evidence is that it in itself, without any other effect, is a gut wall disrupter. It breaks tight junctions. And in one paper, I show that glyphosate actually interferes with mitochondrial function. and that's actually not too hard to believe because mitochondria, as your listeners know, are actually engulfed ancient bacteria and they actually carry a bacteria signature and they work as a functioning bacteria within all of our cells. So it's actually was not surprising as I was researching this to find out that in fact glyphosate affects mitochondrial function. So it's, and it's everywhere.

I mean, it's on 70% of our agricultural crops. It's the most abundant agrochemical in use today. It's on over 90% of our corn, soy and, and, and cotton. It's kind of scary. It's out there. It's, and it's really being looked at from the, from a legal point of view, there's over 14, 000 lawsuits pending against the herbicide. And I think, and as for its human, human effect. But I think what you're speaking to is something really more important, which is its effects on the microbiome of the soil and also the microbiome of humans, and they're interconnected. And I think we, we literally are destroying the microbiome of the soil, which fills the organic matter and leads to increased greenhouse gas emissions from loss of soil carbon. And then you've got the microbiome effects on humans, which has all the consequences that you just talked about.

Yeah, you know, you're right. We talk about you are what you eat, but you are what the things you're eating. Well, the same thing is true with plants. And plants, as you and I know, have this incredible rich soil microbiome that would normally assist in feeding the plant and allowing the plant to absorb nutrients. And now, as a glyphosate and other biocides, our soil is dead. And so we can we could have a plant that looks like bok choy or spinach, but it does not have the nutrients that it used to have. In fact, our our soil is so depleted of the common nutrients that we need, like magnesium, for instance, that we don't have a chance.

No, it's huge. I mean, and the data on glyphosate is people understand, oh, just Roundup, you're on Roundup Ready soybeans. It's not, it's used on 70% of crops and it's 220 million pounds a year. That's used in the United States. I think since 1974, it's 1.6 billion kilograms have been used on crops in the United States alone. And it's on 70 different food crops, including corn, soy, canola. If you have a slice of bread, a bowl of Cheerios, a sushi roll, a plate of pasta, slice of pizza, chicken nugget, it's probably got a round up on it. And it just, you know, it's scary when you look at the work from the Environmental Working Group, your Cheerios has more glyphosate per serving than vitamin D or B12, which actually have to be added to the cereal to enrich it. It's a big problem. And I think you're right, this understanding of what's role in the microbiome is really quite important. So you've got antibiotics, glyphosate, and there's more chemicals that are a problem, right?

Yeah, I mean, we're surrounded with environmental toxins. You know, one of the favorite old ones was BPA and plastics, and most of BPA has now been banned, but BPS looks to be even more mischievous than BPA. and these are endocrine disruptors, they're hormone disruptors. And one of the things people should realize is that estrogen, for instance, is one of the best fat storage hormones that's ever been invented, as any young woman in her teenage years knows that estrogen is designed to make you store fat. And we now have chemicals that mimic estrogen and we're awash in these things. For instance, phthalates, another very important plasticizer, is present in our food wraps, any plastic food wrap. So you may get your organic pasture chicken breast, and if it comes in a shrink wrap plastic, you'll actually pick up phthalates off of that plastic. and one of the really scary things is that there's really scary correlation between boys penis sizes and the amount of chicken their mother ate during pregnancy. And it's a inverse relationship.

Yeah, that's interesting. So, so you mentioned environmental chemicals and the couples that you haven't mentioned, these are the, these are the sort of we call persistent organic pollutants that are really petrochemicals. driven from oil derivative things, plastics and so forth. But there's another class, which is heavy metals. And for me, that was the massive driver of fatigue. And for many patients, mercury lead are the two biggest. And how do you think about those? That's a great question.

I look at mercury and lead and cadmium and a great number of my patients. I can tell you that the vast majority of people with high mercury levels in my practice are dentists and sushi eaters. Dentists for obvious reasons, sushi eaters hopefully for obvious reasons. But once- Mercury in the sushi. Yeah, mercury. One of the interesting things that at least I see is that heavy metals in general are contained in our fat cells. And it's like a tuna, maybe have toxic levels of mercury, but that tuna is doing perfectly fine because the heavy metals are actually in the fat. It's when people have weight loss that we release those heavy metals from fat. This was actually demonstrated by Ray Walford in Biosphere 2. You and I probably old enough to remember Biosphere 2, the experiment in the Arizona desert where they locked everybody in a geodesic dome for a year to stimulate a mission on Mars. And everybody had to grow their own food and produce their own food. And long story short, it was a horrible failure. People lost about 30% of their weight in six months. And one of the findings was that heavy metals and organo pesticides went up precipitously, very rapidly, and stayed elevated for over a year. before they went down. And it was because those heavy metals were there in these participants' fat cells. And we, as you know, have a horrible system for detoxifying heavy metals. Our liver does a horrible job of it, and they're excreted by our liver into our bile, thinking that we'll get rid of it through our stool, except we're really good at absorbing heavy metals out of our gut. So we actually set up a vicious cycle so we excrete it and then pick it up. And as I talk about in the book, anyone who's actually on a weight loss program really should be supplementing with chlorella and activated charcoal during that time period because they will complex with heavy metals and knock on wood, we've been very effective with those two treatments in bringing down people's heavy metals without the need for chelation.

Yeah, I mean, creation is a bigger term, but it's basically there's ways to up regulate your body's detox system and reduce the inputs. And I think it's so key. And you also mentioned drugs that disrupt your energy. Yeah.

You know, the big driver that I saw in plant Paradox was in sense, non-steroidal non-steroidal anti-inflammatories these drugs are actually one of the best ways to create leaky gut that anybody ever came up with. And this was known about by the drug companies when they were introduced in the 1970s. In fact, it was so well known that by law, you couldn't take these drugs for over two weeks period of time because they were so dangerous with that effect. Now, of course, we eat them like candy. And so anytime we produce leaky gut, we produce inflammation. And that inflammation in turn actually produces more pain. And if you have more pain, you'll take more of these drugs and the cycle continues. So one of the things that I really urge people to do is get these seemingly harmless NSAIDs, ibuprofen, Aleve, Naprosyn out of their medicine cabinets. The second group, in the same.

Box.

Are the PPIs, the proton pump inhibitors.

Yeah.

Now, to take people back to high school biology class, we actually make energy in mitochondria by pumping protons across the mitochondrial membranes. When proton pump inhibitors like Nexium, like Prilosec, like protonix came out, they were a miracle in terms of the treatment of ulcers because we had something to stop stomach acid production. But like any good idea, when we then make them easy to obtain for the treatment of heartburn, what we didn't know was that these things were not specific for the proton pumps in the stomach. They affect all proton pumps. and proton pumps are what drive mitochondrial function. And when we poison the mitochondria in our heart and specifically poison the mitochondria in our brain with proton pump inhibitors, it's no wonder that congestive heart failure strongly correlates with proton pump inhibitors.

Yeah.

And show strongly correlates with proton pump inhibitors, all for the sake of relieving heartburn. So if you want to poison mitochondria, take a proton pump inhibitor.

That's an interesting framework. And we know it inhibits absorption of nutrients and it can affect your GI function and cause your bowel and leaky gut, all kinds of problems. But the mitochondrial story is an interesting one that hasn't really been told. And I think, you know, it all comes down to mitochondria, which is really what we're talking about in terms of energy, right? All these to pick the mitochondria, which are these little energy factories that take food and oxygen and burn them in your cells to produce energy. And all the things you're talking about will have adverse effects, all those chemicals, not only by affecting your microbiome, but also just directly effects on the mitochondria. And the key to really figuring out your energy is healing your mitochondria. And I think some of the shocking data about the microbiome, and I'd love if you could sort of draw this connection a little more. is how the microbiome affects the mitochondria. Because it's really with the subject of your book, I'd love you to sort of maybe tease that out a little bit. Because it's really all about how does the damage to the microbiome and the adverse metabolic gut compounds influence everything, including hormones or appetite mood, brain function, weight, energy, but start with the mitochondria. Because the idea is that the gut has all these bacteria and they get out of balance. and then that stuff happens. So, and what happens?

So again, mitochondria are ancient engulfed bacteria, and they actually talk to their sisters, the gut microbiome, which for the most part are bacteria as well. In fact, we inherit our mitochondria from our mother. Our dad doesn't give us any. and we inherit, if things work out okay, our initial microbiome from our mother via birth and also by being breastfed. Believe it or not, one of the huge benefits of breastfeeding is that a woman's breast milk has huge amounts of bacteria and fungi that are also populating the baby. Okay, so years ago, one of my first times presenting at the World Congress of microbiota in Paris, I met the director, Marvin Endres, and he and I were talking. I had a paper on, and he says, you, know, I'm going to tell you something. He said, the microbiome talks to the mitochondria. And my eyes went up, and I said, well, how do they do that? And he says, well, we don't know yet, but I'm telling you, we're going to find out that the microbiome talks to the mitochondria because they're literally sisters. and I said, well, you know, that's interesting. He says, yeah, they send text messages. Well, lo and behold, Marvin was right because the language, what's called the trans Kingdom communication system of how the microbiome talks to mitochondria and to our DNA was discovered. And it's, it's as big a discovery. as the Enigma Code discovery in World War II, the German code. So what that discovery was is the discovery of post biotics. And post biotics, everybody knows probiotics friendly bacteria. Most people are learning pre biotics, which are the fibers that friendly bacteria need to eat. But when those bacteria eat those fibers, they produce either short chain fatty acids like acetate and butyrate, but more importantly, they produce gases. And they're called gasome messengers or gasotransmitters. And it's these messaging system that's now been discovered that actually talks actually tells mitochondria what to do, whether to make more energy when things are good or whether to throttle back because things are bad down in the engine room. And it's it, you know, the whole discovery is like, holy cow, we are this incredible symbiotic organism. I mean, for instance, the Nobel Prize for discovering how nitric oxide worked and where it came from, you know, was awarded in 1998. And, you know, for years in cardiac surgery and cardiology, we knew what nitric oxide did, but we didn't know how it did it. But nitric oxide is a gas-o messenger. But here's something really wild. So hydrogen gas is a gas-o messenger and part of the fermentation process. of bacteria eating fiber is to produce hydrogen gas. Hydrogen gas is the world's smallest molecule and it diffuses right across our gut wall. One of the shocking things as I was researching this is if you look at patients with Parkinson's disease, they have a microbiome that does not make hydrogen gas, whereas people who don't have Parkinson's disease have a microbiome that produce hydrogen gas. and you can give patients with Parkinson's disease hydrogen water, and that's the water that has hydrogen dissolved in it, and they will symptomally improve once consistently start taking hydrogen water. And so, as I joke in the book, in Boy Scouts, what we used to do, you know, we'd eat beans on the camping trip, and we'd have Bic lighters, and we'd actually we literally light our farts with this blue flame.

I've seen that happen at a campfire a couple of times. Exactly.

That's hydrogen gas. And little did we know.

So methane too, maybe. I don't know. Exactly.

Well, it turns out that is actually a gas-o-messenger as well. As well as hydrogen sulfide, that rotten egg smell. And for years, you and I were taught that hydrogen sulfide toxic gas. But we now know that the effect of hydrogen sulfide is that of a hormetic agent. And a hormetic agent is basically that which doesn't kill me makes me stronger. So that no hydrogen sulfide is not good. A little hydrogen sulfide is good. A lot of hydrogen sulfide will kill you. So a little dab will do you a lot of these things. And so getting back to your original question, the more we feed our microbiome, the foods that they can make these literally text messages that tell your mitochondria to produce energy, the better off we are. And again, you look at, oh, a tribe like the Hansas, who they eat about 165 grams of fiber a day. If we're lucky, the average American may eat 20, probably not. But they're a what?

I think it's eight is the average American. Yeah, if we're lucky.

And half of the five we eat is actually insoluble fiber, which is actually really bad for you in a lot of ways.

Yeah.

So, the long story short, we are so deprived of the energy producing compounds that are available to all of us, if we'll just feed the microbiome what they need. And that's a big part of both.

So, a lot of the key is fixing your gut to get your energy back.

Yeah.

The second key is we are overfed and underpowered. And what the heck does that mean? We in general, Americans eat nearly 16 hours a day, almost continuously from sun up until well after sundown. And we have what's called mitochondrial rush hour, which living in LA is easy to understand, but simplistically, our mitochondria can handle sugars, fats, and proteins. And we use a slightly different system for making energy from sugar, from fat, and from protein. And in the good old days when we ate whole food like you advocate and I advocate, these different components, sugars would arrive first in the mitochondria, they'd be followed by protein, sometimes later, and a long time later they'd be followed by fats. And mitochondria have, if you will, basically a freeway, an energy producing freeway. Now, when these things arrive in a staggered fashion, the freeway moves great. But what happens is with our modern diet with processed foods, with ultra processed foods, we have combined simple sugars, simple proteins, and easily absorbed fats that hit our mitochondria simultaneously. And the mitochondria actually can't handle all these. So we actually have stagnation in the energy producing highways. And we have systems on freeways, okay, we're going to have traffic lights that's going to control the onslaught all this, but we get mitochondrial gridlock. And I use the example. So, okay, let's have breakfast at seven o'clock in the morning. All of a sudden, you're slamming with all three of these components and your mitochondria literally go into gridlock for two or three hours. You begin to get sleepy at 10 o'clock and you say, oh, I need a little pick-me-up I'll have, you know, I'll have a donut and a cup of coffee. And once again, traffic gets slammed. By that time, it's lunch. We slam it again. And so this process of gridlock really never on, never stops until we go to sleep. And even after we go to sleep, there's still two to three hours of backup, if you will, on the mitochondrial freeways. So our mitochondria is really never have a chance. and in researching this book and trying this out on my patients, one of the things that was dramatic was that if I could lessen the period of time that you're asking mitochondria to handle food, the better off you're going to be because they have a chance to recover and heal themselves, if you What.

Actually are all the things that are happening? Because you create a list of conditions that are related to poor blood sugar. What is the biology of what's happening when your blood sugar is out of control? What happens to your microbiome, to your immune system, to your brain, to your hormones? Take us through what actually happens in the body when you are eating the average American diet. Yeah.

So there's sort of four things that I think are kind of worth focusing on. There's the direct effects of high blood sugar. So you eat something and your blood sugar spikes and then there's biological effects of that. And then there's a fourth thing, which is the long-term stuff. So in terms of those short-term things, like you drink a Coke and your blood sugar goes up from 75 milligrams per deciliter, 150 milligrams per deciliter, that blood sugar spike can cause glycation. It can cause oxidative stress. Wait, wait, wait, what is glycation? Glycation is the process where sugar just sticks to things in your body. It's actually just like sugar molecules sticking to things like fats and proteins and DNA, and that can cause dysfunction. It can cause those, you know, cellular parts to be dysfunctional. And so that's an issue. We don't want that. It can generate inflammation immediately, too. This huge surge of sugar is unusual for the body. You know, it's like, what is going on? Why is this big change, this sort of homeostatic shift happening, we don't want that. And then it can cause oxidative stress, which is sort of this reaction where your body's producing metabolic byproducts that are reactive and can be damaging to the cells. So these unpaired electrons that go around and want to bind with things, it's resting exactly. So big glucose spike, you can have immediate effects on oxidative stress location inflammation. And then the fourth thing is this thing that's happening both immediately, but also really has cumulative effects, which is the insulin surge. So when you have that big glucose spike, your pancreas is releasing all this insulin to help you soak up the glucose out of the bloodstream into the cells so it can be processed and bring the glucose back down. And what can happen there in the short term is that if you've got a big spike, so that that big up and down, the insulin can actually sometimes overshoot. It can actually do too good a job in soaking up all that glucose and you can have what's called reactive hypoglycemia, which colloquially is known as the post-meal crash. So if you've had lunch and then after lunch feel tired and you want to have that second cup of coffee at 1:00 PM and maybe you feel a little bit more anxious, that might just be the fact that your blood sugar has gone you've released all this insulin, the insulin's kind of overshot, you've crashed down, and now you're in this dip and the body's trying to get back into balance.

And that roller coaster, which is- that.

Creates a secondary cascade of hunger hormones and cravings. Exactly. And so that's happening in the short term. And then that insulin process, going back to what we were talking about before, can over time lead to that insulin resistance where the cells see that huge surge in insulin so frequently that they actually say, we can't keep doing this. This is too much insulin and we get numb to it and that's insulin resistance. And then what happens is your insulin levels, they start creeping up because your body's trying to overcompensate for that block by producing more. And then that leads to so many of the downstream conditions that we've been talking about. When you've got this high insulin, one of the secondary effects of that, we can talk about obesity, obesity. You know, insulin is a signal to the body that glucose is around for energy. And it's also a signal to the body that because there's so much glucose around, we don't need to use fat for energy. Glucose and fat are the two main ways that we produce energy in the body. And when that insulin's high, it blocks us from tapping in to fat burning. It says to the body, nope, you don't need to tap into fat burning. We've got a bunch of glucose around. And so this is relevant to anyone who is trying to lose weight or who has the excess belly fat because that insulin is a real block on helping us achieve those goals. And so for us to tap into our copious fat stores in our body, we need the insulin to be lower. So by getting off that glucose roller coaster, by eating foods that keep us more flat and stable throughout the day, which is what we want for optimal health both in the short term and the long term, we give our body a break from producing that insulin. And that can have a real significant impact on our ability to lose weight, to get rid of that belly fat, to tap into this alternate metabolic fuel source, and to generate what we call metabolic flexibility, which is this ability of the body to flip between using glucose when it's around and using fat when it's not around. And that state of being able to do both is a really healthy state. It's adaptive, but the average American with the vast majority of our calories coming from ultra-processed foods, and I believe more than 70% of processed foods in the US have refined sugar in them, and we've been told of course to eat six small meals a day. You are on, as an American, this up and down glucose roller coaster all day. And so you're really never giving your body this time in a low insulin state. you really do have to be quite aware and think differently. I mean, the reality is, as an American adult, you're on a treadmill towards being overweight and chronic disease. And unless you are doing something different, you will end up sick. And that's where having a little more awareness, I think, can be helpful. 100%. And all the things you mentioned earlier.

People don't relate to this. They don't relate to blood sugar. They think diabetes is related to blood sugar, but what about cancer and Alzheimer's? and depression and heart disease and so many other issues. Infertility, Gal, you mentioned, sexual dysfunction, acne, I mean, just whatever. It's just unbelievable how much of our modern ailments and how many of those ailments are driven by this single process. And you don't have to treat all these diseases separately. If you dealt with that, then these other things would get better. And I think it's something that I don't know why, but it's just such a dark black hole in medicine. There's a lot of literature on it. There's no lack of science, but in practice, the average doctor doesn't know how to diagnose or treat insulin resistance. You know, one of my patients came to me and said, you know, my doctor, I saw his blood sugar was like 115 or something. I'm like, hey, you're fasting blood sugar's a little high. You're heading towards diabetes. Like, yeah, I said, has your doctor recommended any thing? He's like, well, yeah. I said, what? He said, wait till it gets to be higher and then they'll put me on medication. I'm like, oh, okay. That is not a very enlightened understanding of how our bodies work. And, you know, the biological processes are so central to every age-related disease. I was at a longevity conference once and I was walking with Leonard Guarente, who was from MIT and discovered sirtuins, which are these incredible regulators of our mitochondrial function, our energy, which we were talking about earlier, and that are so important in longevity and aging. And I said, so what's the secret? Like, how do they work? And what's like, this was years ago. And I was like, there's the data we just tried to come out. He says, Sugar. I'm like, Don't eat sugar. It's like, that's what's causing these systems to fail and for us to age and for all these chronic ailments and most people listening are probably, well, you know, I'm not diabetic. I'm like, all right, why should I worry about it? Well, if you have high blood pressure, high cholesterol, if you have any belly fat, if you're even thin but you need a crappy diet, this is going on under the hood. And so tell me why you feel that continuous glucose monitoring, which is sort of part of this whole new movement of what we call biosensors or quantified self or, you know, portable metrics that we, you know, people have the scales that send their data up to the cloud or blood pressure cuffs or the aura ring or Fitbits or now there's continuous glucose monitors. Why are these important and why should the average person even care? Because if you're not diabetic or, you know, pre-diabetic, which most people don't know, by the way, that they're pre-diabetic because doctors don't diagnose it, But why should people care?

Yeah, so I think that we've touched a little bit on why probably more people should care than they maybe realize with 88% of American adults having metabolic dysfunction, this is relevant to the vast, vast majority of us. But I really think it comes down to personal empowerment and really understanding our own bodies. We're not gonna fix healthcare without fixing health. Dr. Justin Mpr. You can't fix health without fixing the decisions that we're making every day about what we're eating, how we're sleeping, how we're stressing, how we're moving, how we're supporting our microbiome, or, you know, all these things. And so choice really comes down to choices. And right now, we don't have a lot of help to understand what choices to make for our own body. And that's where wearables and especially bio wearables, I think can be very, very helpful. I'm not the type of person who wants to be strapped to technology for the rest of my life. That's not really like, it's not my goal to, you know, be a cyborg and be wearing a sensor, but, you know, I'd rather I want to be unplugged in the, in the backcountry, right? Like camping. However, the reality is that the system that we're living in right now is designed to hurt us. It's designed to keep us sick. It's designed to keep us dependent and, you know, come coming back for medications and surgeries and whatnot. So in the world we're living in where our taxpayer money is going towards subsidizing refined sugar and refined corn and wheat and disease-causing foods, I think we need a little bit extra support. And I think that wearables can really help with that. And so that's where I'm really passionate about this is the empowering people to understand their own bodies and to make decisions for themselves in the face of a healthcare system that isn't being really proactive about metabolic health. We, like you were mentioning with your patient, those numbers when we reach sort of the pre-diabetic or diabetic threshold, it's likely that we've probably had issues going on with our insulin for 13 years is one study from the Lancet showed that 13 years before you get that diagnosis. So how can we as individuals have tools that can help us during this time? I mean, if you can keep your blood sugar in a stable and healthy range throughout your lifetime, I'm fairly confident that you're never gonna walk into a doctor's office one year and get a huge bomb dropped on you that you have a metabolic condition. If you're looking day after day, year after year, and knowing that what you're putting in your body is not causing these huge spikes, you have unlocked the door to essentially minimizing your risk drastically of all of the conditions that are killing Americans. And eight of the 10 leading causes of death in the US are directly related to blood sugar.

Absolutely.

And so, so that's- and then the.

Cost and the suffering and on and on and on. Right.

And so I think having a tool in the face of the modern world that we're living in can be great. And I also think that from what I've seen with my patients, when you really understand your body and understand how the environment is affecting your body, it's very motivating. Nutrition has kind of been a black box. It's always been an open loop system where you make a choice and you actually don't really understand what the result is. Often for a long time, Maybe you eat healthy one day and then the next day you step on the scale. That's kind of the lagging indicator. How do you create a relationship between what specific food led to that result? Maybe it's six months from now, you get a blood sugar test or a cholesterol test, but that one-to-one relationship has been missing. And now it's not with these bio wearables. So for me, for instance, you know, I was eating oatmeal for breakfast.

Oh, yeah. I wish I hadn't read my ultra metabolism book then.

Exactly. Yeah. And the box literally says heart healthy on it and good source of whole grains and fiber. I ate it with a continuous glucose monitor on and my blood sugar and I'm talking plain oatmeal, zero sugar, zero fruit, zero juice. Plain, plain, boring oatmeal. My glucose went up about 85 points. For me, there is no chance that that food is heart healthy for me. Because glycemic variability, these ups and down swings like that, I mean, I never really want my glucose to go above 20 to 30 points above my pre-meal levels. This was like 80. So, for me, it is not a heart healthy food. And anecdotally, for most of our members at Levels, it's also not a heart healthy food. We've seen very few people. And, you know, if you look at the advertisements for this food almost universally, It's the oatmeal with brown sugar, with fruit, with OJ, maybe with a piece of toast. I can't even imagine. So I think that's where some of this technology can really help. And I think it honestly can also improve the relationship between the doctor and the patient. I think this is not like people going to Dr. Google and coming in with a bunch of theories and questions. This is real information. It's real objective data. And I think it kind of can equalize that playing field and that power dynamic between the doctor and the patient. You know, I think sometimes doctors will recommend things and patients will try them and it doesn't work. You know, their labs don't get better, they don't lose weight, and there can be a lot of frustration. There can be some mistrust. But if you can use a wearable to help personalize and almost be like a coach to help you achieve your goals, that can really, that can be great. The reality is that 49% of Americans every year try to lose weight. So people are trying.

And probably 75% should be. Right, right.

But that's a huge, that's hundreds of millions of people who are trying, who are making the mental commitment to, I want to do the work. I want to do better. I want to try. And we don't have much to grasp onto to help us. so I'm very passionate about how we can, for all these people who want to do better, give some tools, sort of a lifeline. Here's a secret that most people don't.

Understand, especially around weight, is that the key to losing weight is low insulin. Not necessarily low blood sugar, but low insulin. Because insulin locks the calories and the fat in your fat cells. It's like a one-way turnstile. So once the glucose gets into your fat cells in your belly, it can't get out if the insulin's high, which people don't realize. And so the key really to weight loss is in addition to addressing all these chronic diseases is to really get the insulin low. And the tool of levels, which is just an amazing technology that helped people in real time track their blood sugar, correlate it with what they're eating, with their activity, with their stress, with their exercise, it gives them a sort of a window into their biology that we really haven't had before. And we're just going to get better and better, better at it. Can I ask you, Casey, tell me from the people who've used it, because now it's in beta, right? It's not quite out and it will be soon, by the way, for people listening. There's a closed beta happening now, but there's a wait list of over 120,000 people who want to sign up. If you want to skip the line, You came to the right place because all you have to do, because you listen to this podcast, is get early access through going to levels.link/hyman. That's levels.link/hyman to get to be part of the waitlist top of the line. So you get to cut the line. So in all the people who've used it, tell me what are some of the cases that just were the most instructive. The things that you learn from people's experience. You mentioned a few things, I've mentioned a few things, but give us some real patient stories.

It has been so exciting to see what our members are learning by putting these continuous glucose monitors on and using levels. Some of the most fascinating things, I mean, there's a lot of low-hanging fruit, right? It's like if you drink a soda, your blood sugar often goes through the roof. so that's, these are sort of the obvious ones. But then there's sort of the not-.

You- know what's really interesting is that, sorry to interrupt you, but I just remember the study in the New England Journal years ago where they looked at first degree relatives of type 2 diabetics who were actually healthy. And when they did a challenge with them, they found that they had higher spikes of sugar and insulin than people who didn't have first degree relatives. so even if you look thin and great, you still might not be, you might be headed there, right? If you're not careful. If you're a Pima Indian, you know, even if you were living 100 years.

Ago, if you had a can of.

Coke, you're going to be in trouble. Definitely.

And that's how they got to be the second most obese population in the world after Samoans. Absolutely, yeah. And, but I think, I think even those simple, like, learnings can be really helpful because we kind of know we shouldn't drink soda, although many, most Americans do, but you walk into the grocery store and it's everywhere and it's subsidized by our government. And you might get the impression like, oh, well, if it's subsidized by the government and it's covering Safeway, it's probably okay. But then you see the data and you're like, oh wait, it's definitely not okay. This is going way out of range. But then it gets into some of the more nuanced and exciting stuff. So, One big learning is people realizing that the importance of balancing their meals. And what I mean by that is adding fat, protein, and fiber to their carbohydrates. So people will, you know, eat, let's say, an apple all by itself and have like a pretty significant glucose spike. But they take that apple and they put some almond butter and some chia seeds on it, and they might have a very different response because we know that that additional fat, protein, and fiber from the chia seeds and the nut butter can actually slow the amount, slow at the time to absorb the glucose. It can really change the dynamics. It also impacts the microbiome and so may even make us absorb less of the glucose because we are putting fiber in there. So that's been a major thing that we've seen is fat, protein and fiber.

Another- We call that the glycemic load, which is what is the total effect of the meal. Yeah. And even the timing, right? Have you learned about what happens when people eat what?

Yeah, exactly. The timing has been a huge thing. We've seen that people often find that if they eat something very late at night versus the exact same meal earlier in the day, they'll often have a larger response at night and it can impact their sleep quite a bit.

You have the same meal.

Exactly, same meal. And part of this is because we're a little bit more insulin resistant at night naturally, and this has to do with melatonin. frontal secretion to help- Dr. Have dessert earlier in the day. Basically, I mean, I would say that if people are eating dessert for breakfast. You know, eat your- I do tend to now front load my carbs because of what I- in the day, because of what I've learned from continuous glucose monitoring. And I also know that those ups and down swings called glycemic variability at night can really impact sleep. And we integrate our glucose data stream with sleep and activity tracking so you can start to make some of those higher level insights about how sleep and glucose are related. We've seen a lot of people comment on how when they get less sleep, their glucose is quite a bit more erratic the next day. It's a huge impact. Massive, you know, exercise. Sleep and then of course exercise. So one of the biggest takeaways is people realize that just getting up and walking for 15 minutes after a meal can have a significant effect on your post meal spikes, it can bring your glucose down faster. And if you look at a lot of traditional cultures, getting up and taking a stroll, it's super common. And now we have the biometric data to back up why it makes a big difference. And the last one I think that's been really interesting and again supported by the research is that stress definitely causes people's glucose spikes to be higher. We've had people who are fasting it's first thing in the morning and they have to give a talk to their company or they're on a podcast or something like that and they might get a glucose spike just from the stress alone. And the mechanism of that is really interesting. The cortisol and the catecholamine hormones that are released when we have stress, they tell our liver to actually dump glucose into the bloodstream. And evolutionarily the purpose for this was because When we had a stress signal like a threat, we thought, oh, we're probably going to have to run from something. We're going to have to run from the lion or whatnot. And so the body was like, okay, cool. You need to use your muscles. So we're going to help you mobilize some glucose from the liver to feed the muscles. But now what we're dealing with are mostly these psychological stressors. An email, a honking horn, a stressful phone call, whatnot. And so that glucose from the liver is not actually helping us. It's just sitting in the bloodstream causing problem. So what I'm loving seeing in our members is that this is not just about, okay, put on a glucose monitor and eat low carb and get a flat glucose line. It's about having a holistic picture of your health and all these different lifestyle behaviors that feed into building a body that processes food effectively. And that includes the amount we sleep, how we're responding to stress, how we're moving throughout the day, of course, how we're pairing and timing foods, and all together those things can sort of work to let us have a better glucose response. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in.

Hey, everybody, it's Dr. Hyman. Thanks for tuning to the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to drhyman.com/picks to sign up. That's drhyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger, longer.

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