Ask Mark

Hey, everybody, it's Dr. Mark. How y'all doing today? I'm so excited to be with you. It's time for our new live Q&A show that I'm doing for my community. We're calling it Ask Mark, and it's where I take questions from my text community and invite those people to join me live and ask their question. So today we have about 10 to 12 people that are gonna join us to ask their question. And if you wanna ask a question in the future, just text me at 413-225-5555. 8995 and use the hashtag AskMark and my team might pick your question in the future. So that's good. Now, I can't give medical advice, but I can give big picture advice on how I would think about any health challenges, which is kind of fun. And today, I'm really excited because our sponsor for the show is Thrive Market. Now, Thrive was one of my favorite places to get high quality organic nutrients at wholesale prices. I mean, really 25 to 50 20% off the normal retail price. You can get an extra 25% off your first purchase and a free gift if you join Thrive Market today. It's thrivemarket.com/HymanFB. That's thrivemarket.com/HymanFB. So let's jump in with our first guest, who is Kylie. Hi Kylie, how are you doing?

I'm doing well. How are you?

Good, good to see you.

Yeah, you too.

Thank you. All right, so what's your question?

So my question is, I'm curious on how much grass-fed, grass-finished beef do we actually need to reap the benefits?

Well, that's an interesting question. The benefits being what? Meaning protein, meaning the phytochemicals in meat that we're discovering, the essential fats, the minerals, all of it probably is what you're asking.

Yeah, I mean probably. I'm just wondering, is it something that.

We should consume daily, monthly, weekly?

What does that look like?

I would say it depends. You know, my new book, the Pegan Diet is coming out in a few weeks, and in there I talk about, you know, meat and what we should be doing, what we shouldn't, and the benefits and so forth. But it really is individual. Some people don't do well with meat. Some people do great. And I think it's really about listening to your body as the first step. But with that said, in terms of protein needs, our protein needs change as we age. So typically we need about, you know, the minimum that, which, which is what the nutritionists recommend, is 1.8 grams per kilo, which is not actually that much. So, let's say you're 50 kilos, that's like 40 grams of protein, right? If you're 70 kilos, that's a little bit less 60 grams of protein, but that's a minimum amount to just preserve muscle. If you want to build muscle, as you age, you may need more. Some people, if they're athletes, may need 1.2, 1.6, 1.8, or even two grams per kilo. So it really depends on your activity level, like your age. And as we age, we need more high quality protein. So it turns out a lot of the plant proteins are not as good at building muscle as animal protein. And as you age, it's really important to make sure you have the right protein so you can actually have really the level of amino acids that you need to actually build muscle. And there are certain amino acids that are preferentially found in meat, which is leucine and valine and isoleucine, which are essentially these branched amino acids that are necessary for protein synthesis. So typically what I tell people is based on their size, a palm size portion of protein is most of what we need during the day, probably up to three times a day. Now, it doesn't have to be all animal protein. It can be plant proteins, it can be fish, it can be chicken, it can be meat. But I think it's important that we understand that we don't want too much protein, but we also want enough. And I think you'll see, you know, vegans often very low in protein, low in amino acids, and they struggle with a lot of different issues because of that. Now, a lot of vegans have figured it out and they jack up the plant protein. So you might have to two or three or four times more protein to get what you need if you're having plant proteins, right? So if you're eating beans or eating grains, so you might need two cups of beans to equal four ounces or so of chicken or fish, right? So it's a lot of beans. Yeah. And again, as we age, we need more. Now there's interesting things about grass finished beef, which we're learning about. And of course, there's better profiles in terms of fatty acids. There's more omega-3s, less omega-6s. How much does that make a difference clinically? I don't know. There's higher levels of something called CLA, which is very important. It's conjugated linoleic acid, which is a very important fat that has properties around anti-cancer, also helps with metabolism, diabetes, and that's preferentially found in, for example, grass-fed meat and also dairy. And then there's also other nutrients that are higher levels, certain antioxidants like catalase and and glutathione peroxidase and other things that are in the meat that are naturally found in grass-fed meat much higher levels and also higher levels of vitamins and minerals. However, what we're learning now is that there's this whole class of compounds called phytochemicals, which are essentially plant compounds that are we know from like green tea or broccoli or blueberries, right? These colorful plant compounds, but they're also being found in meat of animals that are grazing on a wide variety of forage, many different plants with different medicinal properties and different healing medicines in them. So In fact, I was just corresponding with a professor from Duke who's doing a lot of this research at Duke University. And it's fascinating to me because I never really understood that before. So it turns out that if we eat really high quality animal food, we might be getting the benefit of a lot of these things. Even if you're eating wild elk or wild deer, you also probably are doing the same thing. So I think there's a real learning that we're doing now about what is in grass-fed meat and the properties of it and how it affects us. I mentioned before in other podcasts, I think that there's some interesting research, for example, around the different quality of meat. So, if you're eating feedlot meat versus, let's say, in Australia, they look at kangaroo meat because they have a lot of kangaroos and they harvest those. And so, they found that if you eat the same amount of meat from kangaroo or feedlot, the effects on the body are totally different. So, if you're eating feedlot meat, you're driving up inflammation in your body. If you're eating the kangaroo meat, you know, ounce for ounce, inflammation goes down, which is pretty amazing when you think about it, right?

Right.

So I think it really speaks to this whole idea of what I've written about in my book, the Pegan Diet, which is a food is medicine that not all food is the same. If you, you know, meat is meat, isn't meat. This is like broccoli isn't broccoli and broccoli. Like it's really about, you know, where it came from, how it was grown, how it was raised, what was the soil like, what were the conditions like. and all that plays a role in affecting the quality of the ingredients and the amount of medicine in the food. So, I think we're kind of at this interesting point. But the bottom line is I don't think you need to eat meat every day. I don't think you have to have it every meal, obviously. But on the other hand, I mean, I just talked to someone the other day who was a carnivore who addressed all their autoimmune issues by just eating only meat. I think that's a bit extreme and I don't think it's a long-term strategy, but essentially, cutting out all that stuff can make a big difference. So I think, you know, to answer your question, I would say think about getting a palm-sized piece of protein every day at every meal. If you can, it can be tofu, tempeh, nuts, seeds, you know, animal protein. But it really is important, particularly as we age.

Well, thank you so much for clearing that up.

Of course. And we have another question coming. from Jamie. Are there-- oh. Hi.

Hi.

How's it going, Jamie? Oh, you're Jessica.

You're not Jamie.

That's why I was confused. Oh, sorry. Okay. I think they gave me a different name as the next question, but I got it. Okay.

That's okay. I'm a huge fan, so I'm really excited to be on with you. I'm really excited for the Pegan diet. So my question is that my husband has been on a low FODMAP diet for his IBS symptoms, which we kind of figured out less than a year ago. And he's seen really, really great improvements just cutting out the FODMAPs and gluten and dairy for a while. And we're wondering if it's possible if his gut bacteria will eventually be able to accept some of those FODMAP foods that he's been extremely sensitive to for a long time.

Yeah, so my approach in functional medicine is to always address the root cause. And often people say, well, you're sensitive to this, you should eliminate it. But my question is more, why are you so sensitive in the first place? What has created a disturbance that has led to the sensitivities? So in your husband's case and in your case, what happens is that there's overgrowth of bacteria in the small intestine, which really shouldn't be happening. It migrates up from the large intestine and that causes all sorts of inflammation in the body. That creates a lot of bloating and distension. You've got these bugs fermenting all the food you're eating. You feel like you have a food baby afterwards. You probably know what I'm talking about.

If you have that.

And it's very annoying and it's uncomfortable and it's kind of miserable. And the question is, why is it happening? Right. So some people, I mean, I've seen some people having neurologic issues with their gut because of tick infections, right? Like Lyme disease, right? That could be a cause of it. And you need to get rid of that. Or it could be just because maybe there's been some stresses or insults or antibiotics over time. And that's why. So it's really about finding out why and then resetting the system, so. my approach is generally to make people more resilient, not more restrictive. How do you do that? Well, you first have to repair the gut. You obviously have to eliminate the foods that are triggering it. You have to get rid of the bad bugs in there. You might need antibiotics or antifungals. You might need herbs to clear it out. Then you need a repair program to rebuild the gut and prevent a leaky gut. So it's really a stepwise process that we use in functional medicine to unpack what's going on for each individual, and everybody's really different. so it's really, it's really important for us to sort of think about, you know, how do we, how do we get back to balance? And, and that's really what functional medicine is about rather than saying, oh, I'm going to be off of these Foods forever. It's like, what, what do I really need to do to reset my system? And again, you know, if your husband has SIBO, sometimes just one treatment and clearing it out can help. You know, he might really is having struggles. I don't know if he's taking a breath test if he looks and see if he has bacterial overgrowth. He's got methane or hydrogen, but that can be really helpful because if he's got, for example, a lot of methane, he might need a very different treatment than if he had a lot of hydrogen in there with herbs or different medication or if he had a lot of fungal overgrowth. So there are many ways to sort of figure out. Maybe he's got fructose intolerance or other issues that people aren't diagnosing. So, he has histamine intolerance that's causing this. So, we sort of go down the rabbit hole of figuring how one of the factors that are causing this for people. And then we sort of slowly address each one systematically. And often people can then go back to living a pretty normal life.

Okay, cool. Yeah.

Is that helpful?

Very helpful. Thanks.

Good, good. All right, I think now we might have Jamie.

Hi, how are you?

Hi, how are you?

I'm good, thank you.

Good.

So I have a question. I've been listening to your podcast and I especially like Dr. Bush's podcast that you had with him and the building of the making of the connection. And so I fully agree with what he shared. And I'm also doing research on how I could possibly take supplements to help with detoxing the metals in my body. We eat pretty cleanly. We, you know, and I know that you said that that's a big, big part of it, but I was also wondering if there were any safe supplements that could be taken.

Well, I think I heard the question is freezing a little bit, but I think she wants to know how we can detox from heavy metals and. Yeah.

Yeah. So. Can you hear me?

Yeah, I think I got the question. I think your basic question is how do we detox from heavy metals and what supplements can we use? So, I think I'm going to try to jump into that because your connection is a little wobbly. But, I think that we are in a society where we're all exposed to environmental chemicals and very much so heavy metals, particularly lead, arsenic, and mercury. and I personally have had mercury poisoning, so I know a lot about it and I know a lot of how to deal with it, unfortunately. And I've treated tens of thousands of patients with heavy metals. And I think there's a, there's a couple of things to think about. It's really got to be a four step process. First is identify and remove the source. Right? So one, you just want to make sure you're getting rid of all the big fish that you're eating. You want to make sure if you have dental fillings or, they're not mercury fillings and get rid of those if safely if you have them, if there are medications or things you're taking that could have mercury, you might want to get rid of those as well. There's some sort of prescription drugs that have potentially in certain vaccines like the flu vaccine might still have mercury in it. So you want to really be careful. The second thing is you want to mobilize the mercury and the heavy metals from the tissues, and that is done through activating a lot of these sort of pathways like chelators such as DMSA, which is a prescription drug that we use for chelation. EDTA is another one we use for lead. Those can be very effective for removing metals. And then of course there's the increasing the detoxification of those. Once you start to liberate them and move them out of your system, you want to take certain things that can really help. And a lot of that can be food. so it can be broccoli, family, collards, kale, Brussels sprouts, cabbage, et cetera. Those help to upregulate glutathione, garlic and onions do the same thing. Rosemary, cilantro, these are very detoxifying things, artichoke. There's a lot of foods you can start to eat. And then their supplements can be really helpful. So you wanna optimize all the pathways to get things out of there. So you need all the B vitamins like B12, folate, B6. You definitely need the things that help boost glutathione like N-acetyl cysteine and lipoic acid. very, very important to help boost glutathione. Sometimes other liver support herbs, things like turmeric and ginger and milk thistle can be very helpful. And then you want to, you know, increase circulation. So you want to make sure you're sweating and pooping and peeing and moving things through so that if you can get rid of, eliminate everything. And I think it's important to use binders. We'll use silica. We use, you'll use different kinds of alginate and things to help bind the metals in the guts so you don't completely reabsorb them and get sort of circulating around and around in your system. So, it's really important to identify the source, to get rid of it, to help to mobilize it from the tissues, to increase the circulation, to get moving out of your system, to upregulate all the detox pathways, and then sort of eliminate it from your system. So, you might have fiber and you want to be pooping and peeing. So, saunas are great, fiber is great, and these other supplements that can really help. mobilized. And there's a lot of research on how these work and then I find them extremely effective. So we use a lot of glutathione or lipoic acid, vitamin C, detox herbs, binders like silica or alginate. These are all the things we people tend to use as we get people to get their metal levels down. But it's important to make sure you do it properly and safely, otherwise you can make people pretty sick. okay.

Thank you so much.

That answer your question? All right, I think we have Matt. Hi, Matt. How's it going? Good. How are you doing? Just fine. I'm very much looking forward to February 23rd here. Got the book pre-ordered my wife. Oh, thank you so much. My mom does, too, actually. So, yeah, the whole family's great on it. No. Fantastic. Also, looking much for the support. Yeah, looking forward to the webinar too, coming up about the COVID vaccine. I did get the email about that. That looks very well. My question is about allergies. I'm undergoing allergy shot, process of allergy shots right now. And I was wondering what the view from a functional medicine perspective would be for the treatment of allergies and your thoughts on allergy shots. Yeah, so there's, you know, allergies is a big topic. So essentially there's a, you know, a fair bit of research on why we develop allergies. If you look at most developing countries, they don't have any allergies or autoimmune diseases. They just don't. They don't have eczema, asthma, allergies, you know, hives, all that stuff, autoimmune diseases. And it turns out that we've lived and grown up in such a sterilized environment that our immune systems are a little confused and started attacking things. So we either overreact to things outside of us, that's an allergy, or we overreact to things inside of us, our own tissue, that's called an autoimmune disease. And when we look at the reasons for it, people grew up on farms or grew up in rural areas are less likely to, for example, have allergies. Why? Because they're interacting with the dirt and their immune systems are kind of getting educated. But when we put people in a bubble and we pretty much live in a bubble right now, we live in sterilized environments and we're washing our hands all the time and we're like, paranoid about germs. Turns out the germs help us to educate our immune system to be less reactive to things. Right. So what's happened is when you develop allergies, you've gotten a real disturbance in your body's own ability to sort of recognize what's friend and foe. Like, why should you be reacting to dust or to mold or to a cat or to pollen or to eggs or whatever it is? And turns out, and in my, this is my experience, I don't know how much research there really is on this, but. A lot of my patients who have environmental allergies, when we fix their gut and we address the food sensitivities and heal their leaky gut, a lot of their allergies just go away or get better. And so my approach would be to really focus on that as opposed to just the traditional method is just sort of suppressing immune system with any histamines or taking allergy shots which sort of help to reduce the effect. And they can be helpful. I'm not against them. but it sort of misses the boat of like, why are you having allergies in the first place? Right? What is going on here? And how do we get to that root cause? So in from a functional medicine perspective, I would look at your stool test. I would look at food sensitivities. I look at gluten, I look at dairy, I look at eggs. I look at the common triggers that people have, corn, soy, and so many of the nuts and seeds people react to. So I really look very carefully at what they're eating and fix their gut. I would do an elimination diet, and I think I would provide certain supplements that can be really helpful. versaTEN and other things that can really help to calm things down. There also is a really other sounds like a wacky treatment, but there's a lot of scientific research going on in this right now. And, there's a wonderful book about this topic called the Epidemic of Absence, or another one's called Missing Microbes. And, it's about how we have really killed a lot of the good bugs in our gut. through C-sections, antibiotics, through chronic stress, through poor diet, through lack of good foods that feed the bacteria, like the fibers. So, we have this situation where we are really in a lack of the good guys in our gut. And so, this really drives so much of the inflammation throughout the body and healing the microbes and healing the gut can often make a huge difference for people in terms of their allergies. I think getting the gut fixed and figuring out all the other pieces of the food sensitivities can really just calm things down. One of the things that's done to help reset the gut is using worm therapy. They talk about in this book, the Epidemic of Absence, and there's different kinds of worms. The idea is that historically we had all these things we used to be in contact with and our immune system was managing it all. but now it's kind of got nothing to do. So it starts looking for trouble, right? Getting looking for other things to react to, other allergens and so forth. So, you know, there's a number of people are using worm therapy, something called HDCs or, which is a kind of a rat tape worm that doesn't live in you. It just essentially goes through and, like, a tourist changes the environment in your immune system. But that can be a very effective therapy for people with allergies, and I've seen dramatic results in my patients using it in very select patients who have really bad allergies. Pretty can and miraculous. So I think there's a range of things we do from a functional medicine perspective for allergies that's quite different and helps us really get to the root cause of everything. Interesting. Thank you. Yeah, sure. Thanks, Matt. Okay, I think we got Stacy. Hi, Stacy.

Hi there. Thanks for having me on. So my questions are primarily around metabolic flexibility and kind of three prongs. Like, I was hoping you could help me understand more what exactly it is and how to identify metabolic flexibility, you know, in myself, and finally how to enhance it.

Great question. So what do you mean by metabolic flexibility? Because I have a certain idea about that. so just what do you mean by metabolic flexibility?

What the body's using for energy, is it using carbohydrates? Is it using fat? Like how do you, how do you.

Maximize kind of the fat burning capacity in the body? Okay. That's a little bit different question than I thought you were gonna ask, but, you know, I would think more about metabolic resilience and metabolic flexibility means can you adapt to eating carbohydrates or to fats and how do you do that? That's more of a sort of a keto strategy because it takes about three weeks to adapt to get your body to burn on fat preferentially. So, there's a bit of an adaptation process and that's when people switch to keto, that's what they have to go through. And then you have to takes two or three weeks and they have to make sure they take plenty of fluids and electrolytes and magnesium and make sure they don't get what they call the keto flu, which is when you start to switch over and you're not actually replenishing some of the things that you might be losing because as you, stop the sugar and starch and your increase of fat, the insulin levels drop dramatically. And when insulin levels drop, what happens is you just dump a ton of fluid. So a lot of insulin creates a lot of fluid retention, a lot of inflammation. That inflammation, that fluid retention goes and guess what? All the water dumps out. So when people hear, oh, you lost water weight. Yeah, that's true. And that happens initially. But that's a good thing. And and that's sort of one aspect of metabolic flexibility. But what I like to think about is what I call metabolic resilience.

Right?

So, metabolic resilience would be someone who's super fit and healthy, and if they have a bowl of ice cream or a piece of cake, it doesn't have any adverse effects. They're able to manage their blood sugar. They don't get adverse hormonal effects. Their appetites don't get wiggly. They don't get addicted. They're able to sort of function in a range of flexibility. Health is really about flexibility. It's really about resilience. It's really about what we call metabolic degrees of freedom. And I think what many of us are is in a restricted metabolic state. We are metabolically unhealthy. And 88% of Americans, it turns out, are unhealthy metabolically. That's almost 9 out of 10 of us have poor metabolic health, some obviously worse than others. And even thin people who think I'm thin, I'm not gaining weight 'cause I'm eating crap and I'm eating sugar and soda, but I'm not gaining weight. well, some people don't gain weight for various reasons, genetics, but they also can still have the same adverse effects inside their body as if they were diabetic. So they look like they're skinny on the outside, fat on the inside. We call it skinny fat or toffee, thin on the outside, fat on the inside. And I, as opposed to tofu. Right. And I think that, that we need to sort of understand that, that for those people who are, have poor metabolic flexibility, They need a period of more restricted eating in order to reset their metabolism. So, if you are a diabetic, you just kind of look at a cookie and your blood sugar spikes and your insulin spikes and you get all this sort of hormone, it's like Pavlov's dog, where they just ring the bell and the dog salivates. Well, it's the same way when we think of food, right? If we think of food, we can anticipate food. We think about a bagel or cake. And if we have a problem with our metabolic flexibility or our resilience, we will tend to spike hormones like insulin, even before we eat. So it's kind of bad news for people. So the idea is how do you become more insulin sensitive? How do you become more metabolically flexible, resilient? And the key is to, if you are sort of on the spectrum of poor metabolic health, which I said is about nine out of 10 Americans, is to do a reset until you really regain your metabolic health. And that can be six weeks, it can be three months, it can be a year, depending or longer, depending on, you know, if you start out at 400 pounds or you start out at five pounds over weight, there's a big difference, right? So I think that getting people to sort of hit the reset button is a really good idea. And that's why I've created something called the 10-day reset, which is a simple diet program that eliminates all the inflammatory foods that is very low in starch and sugar, that upregulates all the pathways for detox, that's designed to feed your microbiome properly. So all these things can make profound effects on actually getting your system to be more metabolically flexible to repair a lot of the pathways that are damaged for hormonal pathways and neurotransmitter pathways and the metabolic fat burning, carb burning pathways. So I think that's really important to think about doing that kind of thing. The other thing is really can help is in terms of metabolic flexibility and freedom. is exercise. And, you know, two kinds of exercise play a big role. One is strength training and the other is cardio training, right? And interval training particularly. So if you do wind Sprints or high, we call high intensity interval training, that trains your, your cells to actually run faster. So in other words, you will burn more if exercising less time, you'll burn far more calories throughout the day because the effects of this revving up your metabolism. So interesting. So you can do these, you know, like short Sprints, basically, you know, 30 seconds a minute as fast you can, you know, maybe three minutes walking slow. Do it again. Do that for half an hour. You can do it on a bike. You can do it on a. I mean, I ride my bike and go up the hills, and I Sprint up the hills, and I get my interval training. But when you do that, it just speeds up everything. The second thing is muscle building because muscle is mitochondria. And those are your energy factories. so it's really important to build muscle. So to sort of answer your question, most of us have not a lot of metabolic flexibility, and most of us need to do some kind of reset to sort of get there. And it can be 10 days, six weeks, three months, depending on where you are. And then once you are, you know, adding an exercise can really help you maintain metabolic flexibility. So I'm sort of, you know, noticed over my life when I'm sort of more attentive to the diet and the exercise, I pretty much have no problems. I can eat anything and I'm usually my metabolism stable. I don't have swings all over the place where I used to like I used to. So, I think it's really about understanding how your body works and it's really why people should try a 10-day reset diet and then go to getpharmacy.com with an F G T pharmacy with an F.com and learn more about it because it's one of those things where if you've never tried it, you don't actually know how bad you're feeling until you start feeling good. So I think, you know, people say, oh, this is my normal. I mean, I just had a little kid who was having all these issues. He was constantly having colds. He had headaches. He had stomach aches. He had earlobe bowel. He was tired all the time. You know, he was just kind of a mess. And, you know, within a few months, he's, like, just getting his diet clear, eliminating his diet, fixing his nutritional status. He's not been sick at all. He's feeling great. No headaches, stomach aches, has energy. So it's really quite striking to see, you know, what happens when you start to shift people out of their, out of their diet.

That's great. Thank you so much. You really answered my question and then some. So I appreciate that.

Yeah. Cool. Of course. Oh, thank you. And we have a next question from Jen. Jane. Jen. Okay. I think you're on mute, Jen, and you're frozen. There you are in your car, maybe. I don't know if this is going to work. You might need a better bandwidth.

So.

I'm not really hearing you, Patrick. I'm not sure if we need to. Can you. Bump.

Hear me?

Maybe try a little bit. Let me see if we can get you.

Can you hear me now?

Yes, but it's cutting out.

Well, thank you for taking my question. Okay. Can you hear me?

It's a question about autoimmune disease and what's the best way to manage it? I was wondering if you could tell.

Me a little bit about how What kind of... Exactly, yes.

Yeah. So let me sort of answer that. So, you know, often people think about what they're eating.

Yes, that's exactly what I was wanting to know.

And not so much about what they're putting on their body. So I always say, if you, whatever you put on your body, if you can't eat it, you shouldn't put it on your skin. And here's the reason why. if you look at, you know, just as a doctor practicing medicine, I mean, what do we do in the emergency room when people come in with a heart attack? We take a toothpaste tube full of nitroglycerin, and we put it on their chest. We slap a scotch tape over it. Why? Because the, the nitroglycerin will go right through the skin and immediately act in the body. If you can't get an IV, women use hormone patches. Men use hormone patches. There's nicotine patches, right? medicine goes through the skin all the time. It's a vehicle for delivering drugs. So why would you think that if you're putting toxic chemicals on your skin that it wouldn't have a bad effect on you? Well, it turns out it does. And in fact, I have tested people with environmental toxins and we see the levels, for example, of parabens and other things from just sunblock or whatever they are putting on their skin. causing a lot of problems with their health. So we are flooded with petrochemicals. There's 80,000 new chemicals in the market since the 1900s. Most of them have not been tested for safety. Skin care and other products are often even sort of at the other end of the spectrum of being unregulated because people think, oh, it's on your skin, so it's not a big deal. But actually, if you're putting it on your skin, again, it's something you should be able to eat. if you're going to put it on your skin. So I really encourage people to be careful about their skincare products and their household products. And I'm on the board of the Environmental Working Group, and we are very focused on identifying in a scientifically robust way the ingredients in various products, scoring them based on whether or not they're toxic based on the science and literature. And I feel like we really have this obligation to ourselves to make sure we are aware of what we're doing. And so you can go to EWG and they have a great database of things, even an app called Skin Deep, and you can look up any of your products. You can find which are rated better. And it's really a wonderful way to actually increase the quality of the stuff you put on your skin. So I encourage you to check out Skin Deep and see what they're doing. Also, I would encourage people to check out the Household Product Guide as well because you know, we don't want to be using stuff in our home that's also toxic that we shouldn't be exposed to as well. And all those things can have an effect on us.

That's great information. Thank you.

Yeah, of course. All right. I think our next question is from maybe Jane. Let's see. Jane. Good. All right, Jane.

Hi, Dr. Mark.

Hi, how are you?

I'm great, how are you?

Good.

Good, it's so nice to meet you and I'm a huge follower and a big fan.

Thank you.

And thank you for leading the way and educating people on really how to regain health and happiness in their lives. And I too am a huge proponent of food is medicine. And often I'm advocating that myself for my Community. I too have a health and wellness business called the Remedy that that I launched last year. So it's my mission, just like you, to help people reclaim health and vitality in their life.

Yeah.

So thank you so much. Yeah, my question today is, what are the best and easiest ways to introduce a Pegan diet into the household?

Well, that's a good question. I think we are, you know, really a culture of, Fair bit of, I would say, ignorance about what to eat and no fault of our own because the media is so confusing about what you should eat. One week this is good, one week it's bad. Doctors aren't any better. Nutritionists learn often from the Academy of Nutrition Dietetics, which is really run by the food industry. The government advice is often influenced by politicians instead of science. And so it's really a challenge for the average person to go, what the heck should I eat? Right? Which is why I wrote a book called what the heck should I eat? And, my new book, the Pegan Diet, is coming out very shortly, which essentially is about a simplified version of practical principles and a guide to what to eat. So, depending on if you have a family, you can gamify it a little bit and you can say, well, let's go through here and find out what's in our kitchen that we shouldn't be eating. Stuff that's not food. Let's go on a treasure hunt for bad ingredients. and so you start to look at labels, you look at what's in everything. If you find any preservatives, additives, hormones, colors, if you find, you know, things that are preservatives like butylated hydroxytoluene or, you know, azodicarboxamide or weird things like maltodextrin, like, maybe I shouldn't be eating that, right? So you start to sort of get a big black garbage bag and dump everything in, and then you sort of, like, let's go find on a treasure hunt, what else we can find that is, is a suitable substitute a replacement. So you're getting a salad dressing that's full of high fructose corn syrup and refined oils and preservatives and gums and fillers and additives that cause inflammation in the body. Or maybe you're going to Thrive Market and you're finding at very great discount, great products with ingredients that are clean, that you recognize and can pronounce. So I think it's sort of doing a kitchen in a fridge biopsy. in a pantry biopsy and seeing what's in there and then getting rid of the stuff that's not health promoting, why would you do it? For example, if you have little kids around, you wouldn't have a cabinet full of dangerous drugs around that they could get into and take, right? But when you look at the effect of diet, it kills more people than any medication or smoking or anything else. It's 11 million people around the world just from not eating a good diet. and I think it's an underestimate. So I think just making it fun is really important. If you have family and kids, I would take them shopping. I would get them in the kitchen cooking with you, making fun stuff, making recipes, getting them to be sous chefs. I think getting people excited about food and then making really yummy stuff together because when people actually get to taste what's really good, they're going to go, wow, this is way better than that stuff that comes in a box or package or can. so I think for families, it can be, it can be challenging to shift, but if you can make it an adventure, I think people often take to it a lot more. And then I think, again, you know, finding really yummy things that go, like, I had dinner the other night with a bunch of friends here. Nobody knew it was sugar free, gluten free, dairy free, grain free, being, everybody like, this is just good food, right? We just had this incredible, like, fish that I made with Thai basil, lemon. We had beets with dill and parsley and cilantro. We had an incredible salad that was made from the farmer's market with avocado and kohlrabi's little crunchy things and watermelon radishes and tomatoes. That sounds amazing. I think we had something else too that was really good. Yeah, I had mushrooms. So, I think just make it yummy and then people will want to eat it. And, I think the principles of the Pegan diet are really designed to be guidelines. They're not to be extreme rules are just meant to guide you and stuff. If you're going to eat any ingredient, you should always focus on a couple things. And this could be educating your family. It's like a treasure hunt for the medicine and food. Like, what is, what does this food do to us? How does it affect our bodies? You know, what are the medicinal properties of it? You know, what are the phytochemicals in there? What are the good fats and what do they do to ourself? What are there? Prebiotic fibers in there that help fertilize the good bugs in our gut? So you can kind of make it fun and interesting. And when I go shopping, I literally go to the grocery store, I think of it as my pharmacy with an F because I literally see, because I know all about the foods. I go, I know this food contains this and I'm going to eat this because of that. And, you know, I'm going to have the polysaccharides that are in these mushrooms that are good for my immune system because COVID or I'm going to have this kohlrabi because I know it's good for my detoxification. We'll help get rid of the heavy metals in my system or, you know, so I kind of do that in my head. But I think, you know, having, having a real understanding that, that within each, each food that you're eating the quality is the most important. That if you focus on what to eat, you don't have to focus on how much you're eating. People focus on quantity and calories and it's a mistake. We should be focusing on information and the quality of our food. And so in the book, the Pegan Diet, I go through in terms of vegetables, fruit, nuts, seeds, beans, grains, meat, whatever, eggs. What is the best quality in each category and how do we find those foods and how do we cook them and how do we enjoy them? and everything is not the same. So if you have feedlot beef or if you have a wild elk, it's very different, right? Or grass-fed beef. If you have a wild blueberry or a commercially raised blueberry, very different in terms of their taste, nutritional quality, and other benefits. So really doubling down on the idea that food is medicine, that the quality matters, that food is information, that you're literally communicating with every cell in your body and every system in your body with every bite. That's the way to get people to start to think about it. Because people don't connect the dots between how they feel and what they eat. You know, and I think it's just so important for us to do that.

Thank you so much. Of course. That really answered my question and I can't wait to get the book.

Thank you.

Yeah, so thanks again. Great to meet you.

Okay, all right. And I think there's a Teresa next. How are you doing?

Can you hear me?

Yes, I can.

Okay, good. Okay, it's nice meeting you, by the way. Do you think somebody with hereditarily high LDL cholesterol can lower it within acceptable ranges, numbers without medicine?

Yeah, great question. So, you know, there are genetic reasons for high cholesterol. And sometimes there's something called familial hyperlipidemia and there's different types of it. And for those people who have that, these people are often seeing heart disease when they're much younger. There's family history of heart disease. And so these people might need more aggressive treatment medication. For most of us though, I think diet and lifestyle can really have a huge impact on our lipids and our cardiovascular health. And it's not just cholesterol to look at, right? Everybody's focused on LDL cholesterol, which is what statins work on. But it turns out that overall, there's a pattern of things that go wrong that are more predictive of heart disease than LDL cholesterol. For example, your blood sugar and your insulin is so important. In fact, two-thirds of all heart attacks occur at people who have abnormal blood sugar metabolisms, pre-diabetes or diabetes. And many people, 50% of people come into the heart with a heart attack to the emergency room have normal LDL cholesterol. So, it's really about the size of the particles. It's the HDL, which is a good cholesterol. It's the triglycerides. All those play an important role. And then there's inflammation. Is there a lot of inflammation going on in the body which you can measure through things like C-reactive protein. So I do talk about how do you come up with a really good view of your overall metabolic health in your lipid status by not just looking at the LDL cholesterol? Because it's a very small part of the whole story. In fact, your total to HDL cholesterol ratio is more predictive than your LDL for an attack, and that's dependent on your HDL, which is really related to carbohydrate and sugar. Same thing with triglyceride to HDL ratio, more predictive than LDL. except there's no drug that can just fix that, which is why we focus on LDL because it's a drug that can fix it. So really it's important to look at how do you address that. And there are people who do tolerate a wide variety of fats. Some people are really good with saturated fat. Other people, it's not so good for them. So you have to really watch what happens with your own numbers as you start to shift your diet. But I'll often see as people cut out sugar and starch and they start to up the good fats, even ghee or butter, and coconut oil, their cholesterol will come down dramatically. Other people, it might go up depending on your genetics and your overall health and metabolism. I'm really focused on helping people personalize the approach. I've written a lot about this actually in my book, Eat Fat, Get Thin. I write a lot about cholesterol and about LDL. It's probably worthwhile to go back and check out that book if you want to learn more about it. You know, I think if there's the bottom line, if there's real genetic factors around lipid disorders, you probably need to get that treated. For the rest of us, I think most of us do well just focusing on the fundamental factors that address the root causes. And far more than fat, it's sugar and starch that are driving most heart attacks.

What about that injectable? I can't think of them off right now. The 4% cholesterol. the name escapes me. I mean, listen, the things that help.

Lower cholesterol naturally are things like fiber. So even just having psyllium husk or, or there's something called cognac root, which is very good. You can get the shirataki noodles, which are made from the special Japanese root, or you can take the powder or capsules. These can be very effective in, in binding cholesterol in the gut. So fiber plays a big role. I think there's also certain supplements like red rice yeast, which is so it has a natural low dose statin in it. It comes from sort of China, like you go get the barbecue pork or that kind of red duck that's called red rice yeast. They use it as a coloring, but it's also very effective in lowering cholesterol. And there's other supplements that can often be helpful. There's plant sterols that come from various things like soy and others that can really help. So it really depends on what's going on with you and your metabolism, but including these foods in your diet, including the restrictions on starch and sugar make a big difference and that can really help normalize your blood sugar and lipids.

Thank you.

Of course. Well, thank you so much. I'm so glad we had this chance today to be having another episode of Ask Dr. Mark. That's it for our show today. If you want to ask me a question in the future, you can text me at 413-225-8995. use the hashtag AskMark and my team might pick your question for one of our future calls. Also, I'm super excited that Thrive Market, our sponsor, was able to be part of our show today. They always provide the highest quality products at the lowest cost. It's sort of like, I don't know how to compare Costco meets Walmart meets Amazon meets Whole Foods. So it's pretty awesome. They've been so supportive of my new book, the Pegan Diet. They even created a special Pegan Diet with a ton of my favorite foods from Thrive, plus they're offering my community exclusive offer to get an extra 25% off your first purchase, plus a free gift when you join Thrive Market today. Just go to thrivemarket.com/hymenfb. Thrivemarket.com/hymenfb. If you missed the livestream, don't worry, we'll be airing it on the Doctor's Pharmacy podcast soon. So thanks for joining us. I really appreciate having you all and we'll see you next time.