AVOID THIS Diet To Prevent FATTY LIVER DISEASE! | Mark Hyman

Fat actually can heal a fatty liver.

It can develop very quickly. What's great to also understand is that it can resolve quickly.

It seems as though prevalence of fatty liver is really because of our high starch sugar diet. I mean, the average American eats about a pound of sugar and flour every single day. You know, 150 pounds of sugar, 133 pounds of flour a year. that's an enormous amount of flour and sugar every single day. And what that does is it drives the pathology of fatty liver. And when you think of fatty liver, people are like, oh, if I eat fat, I'm gonna get a fatty liver. Well, it's actually not true. It's the opposite. Fat actually can heal a fatty liver, such as a ketogenic diet or even high levels of MCT oil. But with fatty liver, the real cause is the carbohydrates and the sugar. So, it's the starch and the sugar that drive insulin that lead to fatty liver and cause high triglycerides and cause low HDL and cause inflammation and more insulin resistance, and you end up with this vicious cycle. And, the problem is, from a nutritional point of view, we're good at diagnosing it, but not great at, well, we're not even that good at diagnosing it. We know how to diagnose it, but we're not really skilled at treating it or reversing it, which is kind of stunning because it's like, oh, well, just, you know, take these drugs or, you know, have, have better control of your blood sugar or let's lose weight. That's another one. I'll just lose weight. It'll get better. Well, that's an easy thing to say to people. It's a hard thing to get people to do. And a lot of people who have fatty liver are pre-diabetic insulin resistant or diabetic. And, and again, 88 of Americans are metabolically unhealthy, which means that 88 of Americans are at risk for fatty liver because they have some degree of metabolic dysfunction and that metabolic dysfunction is caused by sugar and starch and processed foods and it's driving the insulin resistance that causes the metabolic dysfunction which is defined as high blood sugar, high cholesterol, high blood pressure. So, this is such a common issue and then when you add on alcohol on top of that and you add on medication on top of that, let's say people are taking Tylenol, which is damaging to the liver, you end up with not a very fun environment for the liver. And on top of that, you have all the environmental toxins that we're all exposed to, the pesticides in our household cleaning products, in our skincare products, in our food, in our water, we're constantly inundated with compounds that are putting a stress on our liver and making it work harder to detoxify. So, you add all that together and then you go, wow, we're in a big problem. so why are we seeing so much fatty liver? People think, oh, it's alcohol. Alcoholics have big livers, they have liver failure, it's hepatitis. But what is the most prevalent cause by far of fatty liver in America?

I mean, so right, so you can have alcoholic fatty liver disease. So you can get fatty liver because of drinking too much alcohol. And we'll talk about that and what is too much. But really what we're seeing, why we're seeing such a skyrocketing of the amount of fatty livers because of the non-alcoholic fatty liver disease, which is the major reason is this drive and this increase in insulin resistance, metabolic syndrome, which is connected with everything as we always talk about, but also fatty liver disease. And it's prevalent, right? So we know with non-alcoholic fatty liver disease, it's about there's studies saying 10 to 46% of the people in the United States have it, or even six to 30% of people worldwide. So somewhere in that quarter to half of people are dealing with fatty liver disease and it's increasing, it's increasing worldwide and we're seeing it with our children too. So as we know, how does that really impact their overall health and development and risk of death as they get older? So fatty liver is when the liver cells, the cells in your liver, are replaced with fat cells. So fatty liver just means that some of the cells in your liver have been replaced with fat cells. And so there's fat deposited within your liver. Why do we care? Because then that means your liver can't work as well because it doesn't have all those liver cells doing the job that the liver does, right? So the liver really helps our body detoxify, metabolize chemicals from the environment. metabolize our own hormones, metabolize and get rid of toxins. And so we definitely don't wanna have an under-functioning liver, that's for sure. And this is the prevalence of fatty liver disease is really, really high. And unfortunately, it's increasing. But about 90 million people in the US have fatty liver disease. And so, It's increasing in this country, it's increasing worldwide, the amount of fatty liver we are seeing.

So Liz, tell me more about a patient that we've had, because I think some of those patient stories are really helpful and instructive and give us a sense of how we do things differently at the Eltravo Center here in Massachusetts and Lenox and what you found and what you were able to help him with and how it all worked.

Yeah, so I had a 50 year old gentleman who came in to see me and he was told by his primary doctor that his liver function tests, his ALT and AST were mildly elevated. And so he came in because he was frustrated with his weight. He wanted to lose some weight. He was about 25 pounds overweight. And he just mentioned to me that his doctor had said his liver function tests were a little elevated and that they were going to be rechecking them in a few months. and so, you know, we really got a good detailed history from him and we got a sense of what he was, what his diet was like and, and, and, you know, what his, what his alcohol consumption was like because, you know, that's one of the first things, of course, we think about with, you know, fatty liver or, or these elevated liver function tests were like, okay, how much alcohol is this person consuming? And what was interesting to me about him was, you know, he was, he was, he was pretty moderate in his alcohol consumption. He was having about two glasses of wine a night. And so not for a man, you know, that kind of almost falls within what's considered moderation. So I was, you know, he was not a binge drinker. He was not overusing alcohol from the, from the criteria we were talking about earlier. But I think the amount of alcohol he was consuming in, in connection with his diet and probably his genetics and many other things, like his microbiome that we've spoken about, you know, that altogether was really impacting these liver functions for him. And so, you know, we noticed with his diet, it was, you know, not rich enough in vegetables, that's for sure. And, you know, really, that was probably the biggest thing, I would say, with his diet. It was just, you know, devoid of a lot of vegetables. And you were talking about some of the things, supplements we use for helping the liver. You know, one of the things we think a lot about is sulforaphane, right, which comes from your cruciferous vegetables that helps and encourages this the production of glutathione in the body. And so one of the things we really worked down with him is making sure he got some cruciferous vegetables every day, broccoli, cauliflower, cabbage, kale, brussels sprouts, you know, really to help support the liver and help it heal essentially. We also had him take a break from alcohol, you know, we said, you know, let's just pull away alcohol for a period of time, really help that liver calm down and let it give us some time to heal. And as I was mentioning earlier, we really can see the liver function tests go down pretty quickly for some patients. We can see if somebody did have fatty liver, you can watch it improve within a few weeks of cleaning up the diet and decreasing alcohol intake. So it can be, especially if it's not too far progressed, we can see changes pretty darn quickly. And, you know, so with him we really focused on cruciferous vegetables, lots of the sulfur-rich vegetables like onions and garlic, we gave him turmeric, we gave him dandelion root to help his liver and gallbladder work better, lots of green leafy vegetables. We made sure he was eating enough protein. We know that protein is really important for the detoxification process in the body. We need to be eating enough protein to do that. And so we made sure he was getting enough foods that were rich in fiber to bind toxins, things like the beans and legumes and nuts and seeds, ground flaxseed. And I did, I gave him some N-Acetyl Cysteine, some NAC. I gave him some liposomal glutathione and milk thistle. We put him on a really good multi that had methylated B vitamins in it. I gave him a little bit of an extra methylated B vitamin and really focused on those nutrient dense foods so that he wasn't wasting his calories. because he was 25 pounds overweight and we needed to cut back on that weight. So we really needed to pull away those foods that were not nutrient dense. So things that are just people are eating way too much of that are getting into our diet that are not giving us all of the nutrients the body needs to work properly.

Yeah, so incredible. So I feel like we see this so prevalently as so misdiagnosed or underdiagnosed. It's such a huge impact on your long-term risk factors for all sorts of chronic illnesses from heart disease to cancer to diabetes and more. And, and it's something that traditional medicine doesn't really deal with very well. And you might have been told your liver function tests are elevated or don't worry about them or they're not that bad or, you know, whatever, you know, we'll watch it. That is just not a good idea. And, and I, I don't, I don't think we are equipped in our traditional training with understanding how to actually figure out what to do for these patients with abnormal liver function tests and I certainly was never trained. But the beautiful thing about functional medicine is that we have a way of evaluating the liver differently. We have a different diagnostic test we use. We have different therapy options and we see tremendous improvements in liver function and quality of health. And it's not just about the liver. It's like when you treat what's going on with your patient, it's like everything gets better. His hormones get better, his liver gets better, he loses weight, his sex drive improves, you know, like everything gets better. Blood pressure goes down. and all of a sudden you've got a person who's instead of going on a trajectory towards increased risk of disease and death to actually having more vibrant, healthy life. So it's super encouraging when you see these kinds of patients because they're really relatively easy to diagnose and treat and yet traditional care just doesn't cut it for the most part.

Yeah, I mean within four months on the plan, his liver functions came down to totally normal. You know, after he lost a 10 of those pounds and then within a few more months he lost another 10 pounds. And his fasting insulin came down to normal, his liver function tests, his markers of inflammation in the body improved. And then eventually, you know, I've been seeing him for a while. So at this point he does have one or two glasses of wine a few days a week. Like he does drink some alcohol at this point. He never, as I said, he never had a problem with alcohol abuse or alcohol overuse disorder. It just was he was drinking too much for his body. And so at this point in time, he's having a little bit of alcohol and doing okay with that. And it's not causing a bump in those liver function tests or some problem with his weight or insulin resistance anymore. So he did really well.

So why is fatty liver a problem? I mean, so my liver is a little fatty. Who cares? Why is it an issue for people? Why do we care to fix it? Other than the fact that you can get cirrhosis and die from liver failure. That's not a common thing. Other than that. But that's a late stage thing. The other problems are not late stage and they happen to a lot of people and they're unrecognized as related to fatty liver.

Right. I mean, they can happen quickly. Fatty liver can develop quickly. They know that within two weeks of heavy drinking, having one and a half to two ounces of hard alcohol every day for two weeks, you can start to see signs of fatty liver, which is, you know, it can develop very quickly. What's great to also understand within a lot of this research is that it can resolve quickly. So when somebody has fatty liver because of alcohol and you take them off of alcohol, that you can see resolution of fatty liver within four to six weeks. So, you know, that is, it can progress, unfortunately, quickly if we're not taking care of ourselves. And then it also regresses when we start to make some shifts. And, you know, as you were mentioning, we're seeing this huge rise in fatty liver, not only because of alcohol, but because of how high blood sugar, high levels of insulin, toxins like glyphosate and all the other toxins you mentioned, medications that people are taking all are putting stress on our liver and making it so then our liver can't do what it needs to do to detoxify. So it becomes this vicious cycle of we're inundated with toxins that are impacting our liver, but then the liver can't work as well and so then we can't get rid of the toxins that we're inundated with. So it becomes a vicious cycle of having issues with our detoxification system in our body. And as we've spoken about before, the liver is such a critical organ within the body's natural ability to detoxify and handle all the toxins we're exposed to. You know, maybe we weren't put together to handle all of these toxins, unfortunately, that we're exposed to, but we do have this ability to handle toxins and we want to take care of our body so we can handle the toxins that we are exposed to. And so it's really important that we take care of our liver. and so what is considered, you know, what's considered normal for alcohol intake, you know, for, for men, it's less than 10 drinks a week, and for women, it's less than five drinks a week. And so we know that, that problems with the liver can occur when we're drinking too much. So we see problems when, when, when people are binge drinking or consuming more than 14 drinks a week for men or more than seven drinks a week for women. So I think it's important we also talk to our patients about what is moderation with alcohol? How do we take care of our liver both from all aspects of nutrition and lifestyle?

So there was also an interesting study came out recently looking at cancer and alcohol and showing that there's a dramatic increase prevalence of cancer, even a little bit of alcohol may actually increase the risk of cancer. So it's not just fatty liver, but it was a Japanese study with 63,000 adults where they looked at people who are drinking alcohol and it was a concern. But that aside, besides just the overload on your liver, besides just the stress on your liver's ability to deal with all the normal toxins we have to deal with, what happens when you have a fatty liver is it drives inflammation in the body and it's linked to heart disease, to cancer, to diabetes, to even dementia and all sorts of things that we don't think necessarily related to a fatty liver. So fatty liver is sort of an early warning sign and clue that there's something wrong in your body and it's causing a risk, an increase, dramatically increased risk of all these other problems. With that said, how do we know if we have fatty liver?

You know, one of the first ways we find out is with general blood work. So if you do a metabolic panel, comprehensive metabolic panel on a patient, and we look at these markers like the AST and the ALT, and if they're elevated, either high end of normal or elevated above the normal range, that's something we really have to be thinking about is, is this fatty liver? Should we go on and do an ultrasound of the liver to see if we are seeing some fat deposition in the liver? And so that's one of the ways we start to see it most frequently with our patients.

Yeah, absolutely. And so there's other tests you can use, which I've had personally just because I've sort of biohacking kind of like to check everything, but you can do an MRI, and look at liver fat, you know, and it should be less than two percent. And many people have very, very high liver fat. I, I thankfully have less than two percent. You can also, they're actually also doing fiber scans, which look at the fibrous content, the fiber, sorry, the, the scar tissue from the fatty liver. And they can use ultrasound scans, and those are good for measuring the degree. You can deliver biopsies. And I think, you know, what we see is is really in functional medicine a roadmap for healing the liver in ways that just doesn't exist with a traditional medicine or conventional medicine. So talk about what are the ways that, you know, in addition to the testing we talked about, we'll look at insulin resistance, we'll look at particle size, we'll look at inflammation, we'll look at a lot of things that traditional doctor wouldn't look at. What are the beginning things we do.

From a dietary lifestyle and supplement perspective to reverse fatty liver? I mean, one of the first things, one of the first things we do, right, is of course we get a good a good detailed history from our patients and try to get a sense of what's going on for them. Get an understanding of their timeline of their health. And that can help us find out what may be driving health problems in that person. So if there is concerns about fatty liver, you want to get a sense of what their toxic load has been in their lifetime. What is their weight? What is their nutrition? What are they eating? and what is their microbiome like? And so we can really evaluate all of that and get a sense of how best to help this patient, that individual patient improve. Because we know that for some people it may be more focusing on toxic load, for somebody else it may be focusing more on alcohol intake, for somebody else it may be more they're eating way too many carbohydrates, refined sugars, soda, you know, coffee drinks, muffins, and not exercising enough in that whole metabolic syndrome process. So we want to really help focus the treatment plan on that individual patient. And I think that's what's so special about functional medicine is it's really looking for that underlying root cause for that underlying patient so that they can reach their optimal health. And we know that problems with the liver and fatty liver impact our immune system and how well we fight off infections. It impacts our how we can digest food, metabolize food, it impacts our nutritional state in our body. So there's so many reasons why we really want to look deeper here.

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Absolutely. And, I think in addition to the dietary stuff and getting rid of the environmental toxins that we can sort of decreasing our overall toxic load, and we've talked about this in other podcasts like the Environmental Working Group's guide to how to reduce your exposure to toxins in food and household cleaning products and personal care products. But, there's also a lot we can do from a dietary perspective to upregulate those pathways in the liver that boost glutathione, all the brassica family, the some garlic, all the spices that we can use and even herbs that can be very helpful like milk thistle and others to help improve the liver function. And then, there's a whole bunch of nutrients that the liver needs to function. And, in fact, you and I were both trained in traditional medicine and we worked in emergency rooms and people come with total overdose. We give them this drug called Mucamist, which is actually N-acetylcysteine. It's a supplement you can go over the counter. What it does is it boosts glutathione and helps the liver to regenerate glutathione, which is what's depleted often with fatty liver and in intestinal liver damage from overdose. And, and so there's a lot of things you can do to boost glutathione. You can take glutathione, you can take N-acetyl cysteine, lipoic acid, milk thistle, curcumin. We use a lot of herbs. We use also the B vitamins, zinc, selenium. Amino acids and we do a lot of things to help the liver heal. And what's amazing is when you use this cocktail of substances, things like milk thistle, ipoic acid, n-acetyl cysteine, glutathione, and so forth, livers will come back. And it's striking to see the drop in liver function tests, the improvement in fatty liver content. And I encourage people to really think about, one, checking to see if they have it, two, thinking about how to actually upregulate your your lifestyle so that you can protect your liver and live a liver healthy lifestyle, which is a lot of, you know, what we do in functional medicine.

My doctor says I have a fatty liver and I should stay away from fat. But do high fat foods cause a fatty liver? And you got any tips to help me with my fatty liver? Well, a fatty liver is a dangerous disease and it's highly misunderstood. Now, some of you may have heard of foie gras. Foie gras is that French term for fatty liver that's used to describe a delicacy made from duck or goose liver. What happens to the livers of these animals as a result of the controversial practice of overfeeding is what you could be doing to your own liver without knowing it. For those people who have fatty liver, which is about, by the way, 70 to 90 million Americans and is now the number one cause of liver transplants. It's essentially what they have is like foie gras liver. They have a liver that's full of fat and it's a major cause of chronic disease, of inflammation in the body, of heart attacks. You see, foie gras is made by force feeding ducks or geese, not fat, but sugar in the form of corn and starch. It's a really sad horrible practice. In the body, this sugar turns on a fat production factory in the liver. It's a process known as Lipogenesis or the genesis or birth or making of fat, which is lipo, which is the body's normal response to sugar. In fact, fructose, which is the sugar in high fructose corn syrup, actually ramps up the lipogenesis response like crazy. Fatty liver creates a whole cascade of issues. It causes inflammation in your body and this inflammation creates insulin resistance and pre-diabetes. which causes your body to deposit fat not just in your liver but also around your organs and your belly. It's called organ fat or visceral fat and it's the dangerous fat. This dangerous belly fat that's caused by sugar and starch in your diet then creates even more problems. It causes you to have high triglycerides and low good or HDL cholesterol and it causes you to have these small, dangerous LDL or cholesterol particles that are really the cause of heart attacks. In fact, having a fatty liver puts you at great risk for having a heart attack and most people have no idea they have it. And shockingly now we see 12-year-old boys who lived on soda for years needing liver transplants from fatty liver. Now that's pretty scary. We really need to think about what we're doing to our kids by feeding them these toxic substances. So you don't want to end up with a fatty liver or a liver transplant. You don't want to end up needing to be on medications to fix the complications of fatty liver, like high blood pressure and diabetes and heart attacks and high cholesterol. You want to get to the root of the problem. The good news is there's hope. As you now know, unlike sugar or refined carbs, even a little bit of protein, dietary fat does not cause insulin to be secreted by your pancreas. So the fat you eat gets burned, not stored, unless of course you eat it with carbs. That's bad news. That's called sweet fat. You don't want that. That's like a bagel with butter or a donut or a french fries, right? Fat and carbs. When you eat more of the right fat, you increase the speed of your metabolism, you stimulate fat burning and you cut your hunger. Fat turns off. Now get this, fat, eating fat, turns off the fat production factory in your liver so no fatty liver and no liver transplants. Considering that fatty liver is caused by too much sugar and carbs and is now the most common liver disease and a leading cause of liver transplant, cutting the carbs and boosting the saturated fats may be part of the solution. Now, I know it seems kind of confusing, but repeatedly the research shows that it's carbs, not fat, that causes more fat in your body and in your belly and in your liver and bad cholesterol. So you see, it's actually the carbs that trigger inflammation through the liver. We've all been so focused on saturated fat as the bad guy that we missed the real bad guy, which is sugar and fructose. Our government tells us to limit our saturated fats to 7-10% of our calories while at the same time telling us it's okay to have up to 25% of our calories from sugar. Really? One quarter of our calories from sugar? Now, The good news is the 2015 Dietary Guidelines said we should reduce added sugar to less than 10% of our calories. This was a big advance. Now, I go into this research in my new book, Eat Fat, Get Thin. But the take-home message here is that saturated fats lower inflammation when, only get this, when consumed with a low refined carb and low sugar diet. It's also high in fiber, lots of veggies and nuts and seeds. and that has a lot of omega-3 fats, which is like sardines and fish oil and so forth. Now there are blood tests available that can detect a fatty liver. You can also see it on an ultrasound or a CAT scan. And if your test comes back abnormal, you're kind of in trouble. But even if your test comes back normal, you might not be out of the woods. It's important to know that a liver function test does not always detect a fatty liver. An ultrasound can be more sensitive The bottom line is, if you eat a lot of sugar and flour, if you have a little bit of belly fat, or if you crave sugar and carbs and starch and sugar, you probably have some degree of a fatty liver. Now when you have a fatty liver, you need to think about the damage it's causing. You don't want to end up with a liver transplant. You don't want to end up needing to be on tons of medications to fix the complications of a fatty liver like high blood pressure and diabetes and heart disease and bad cholesterol. you want to get to the root of the problem. So there's some really simple things you can do with your diet, with exercise, and with supplements to help heal your fatty liver. First, cut out all high fructose corn syrup from your diet, period. 100% cold turkey, no exceptions. If you see it on any label for any product, whether it's salad dressing or ketchup or tomato sauce or yogurt, don't eat it. Now think about it, most servings of tomato sauce you buy in a jar have more sugar per serving than two Oreo cookies. Get rid of all that high fructose corn syrup from your diet, 100% no exceptions. Also, reduce or eliminate starchy foods. Get rid of white processed flour, even whole grain flours can be a problem. It's common to find too much of these starchy foods in the classic American diet or what we call the sad diet, that's standard American diet. All those things are going to produce a fatty liver. Next, add some good things to your diet to help heal your fatty liver. Good quality vegetables, non-starchy, nuts and seeds, some fruit, some good quality animal protein like chicken, fish, grass-fed meat, and good oils like olive oil, macadamia nut oil, avocados, nuts and seeds, coconut butter and fish oil because in fact MCT oil, which is in coconut oil, has been shown to reverse fatty liver in animal studies. That's impressive. Even while they were still giving them a liver toxin alcohol, which causes fatty liver, when they gave them MCT oil, their fatty liver got better. Now that doesn't mean you should drink a lot and take MCT oil. It just means you should take MCT oil. Good fats like these are really anti-inflammatory and they help repair your liver. There's also some supplements you can take as well. to help your fatty liver, which I talk about in my book. Now, the plan in my new book, Eat Fat, Get Thin, is the perfect way to reset your body for optimal health. You can also improve your metabolism through exercise. Now, this is a fabulous way to improve insulin resistance and reduce fatty liver. And, of course, use the right supplements. Now, these things help boost something in your liver called glutathione. I encourage you to read my blog on glutathione. This is a powerful antioxidant and detoxifying compound that your body makes and you can help make more of it when you take certain supplements including an acetyl cysteine, lipoic acid, milk thistle and some of the B vitamins. Now we also use other things like B vitamins and magnesium and all these things help repair and heal your liver. There are also detoxifying liver repairing superfoods that I recommend eating. Focus on the broccoli family. I love this family of foods. I try to have at least a cup or two every day. Kale, collards, cabbage, brussels sprouts, broccoli, arugula, daikon radish, all these are wonderful foods that can help repair and heal your liver. Also garlic and onions are great. They're full of sulfur. It's a great detoxifier. I promise you, you do not want a fatty liver. You need a healthy liver to help you deal with all the junk and chemicals in our environment.

I have a fatty liver. What do I do about it?

What's causing it?

And do I have to take drugs or can I exercise or change my diet or take supplements to help fix my fatty liver? So many of you are probably wondering, what is a fatty liver? Now, for those of you who've ever been to a fine French restaurant, you might have heard of foie gras, which is French for fatty liver. It sounds way better in French than in English. And essentially it's a liver that is full of fat. So how do we have a country where fatty liver is the single most common disease in America that you've probably never heard of? 70 to 90 million Americans have a fatty liver and almost none of them know they have it. In fact, you might have it as well and not know it. What causes it? Well, in order to get a fatty liver and get the foie gras, which is basically duck or goose liver. They take the ducks and they force feed them corn, starch. They feed them sugar in the form of starch. And this sugar turns on a fat production factory in the liver. We call that lipogenesis. This is a very normal common thing that happens when you have sugar. Fructose actually even makes it worse. So high fructose corn syrup, fructose and in our processed foods is the single biggest cause of fatty liver. In fact, sodas is the biggest single cause of fatty liver. In fact, sodas are the number one source of calories. High fructose corn syrup, the number one source of calories in the American diet. It's pretty scary. So when you have this fatty liver, you get this fat production and you get a fat liver. And why is that a problem? it creates a whole cascade of issues. It creates inflammation in your body. The inflammation creates insulin resistance and pre-diabetes. And that makes you deposit belly fat, not just in your liver, but also all around your organs, all in your belly. So that dangerous belly fat is caused by the sugar and starch in your diet. And then it creates even more problems. It causes you to have high triglycerides and low HDL, the good cholesterol. It has caused you to have small LDL, dangerous cholesterol particles that cause heart attacks. In fact, having a fatty liver is a huge risk for having heart attacks and most people don't know it. It's common in prediabetes and diabetes. Certain populations like Latin Americans, Latinos are much a higher risk for having fatty liver. And we now even see 12-year-old boys who have been living on soda for years needing liver transplants from a fatty liver. That's pretty scary. And we need to think a little bit about what we're doing to our children in terms of feeding them these toxic substances. When you have a fatty liver, you need to think about the damage it's causing. You don't want to end up with a liver transplant. You don't want to end up needing to be on medications to fix the complications of a fatty liver, like high blood pressure and diabetes and heart disease and abnormal cholesterol. You want to get to the root of the problem. And it's simple. It's what you're eating. So the first thing you can do is simply cut out all high fructose corn syrup from your diet. Any label, any product, whether it's a salad dressing, ketchup, or tomato sauce, I mean, think about it. Most servings of tomato sauce that you buy in a jar have more sugar than a serving of Oreo cookies. so we want to get rid of all that high fructose corn syrup in our diet. Number one. Number two, reduce the amount or eliminate the amount of starch depending on how bad your liver is. So you want to get rid of processed flour, white flour, processed flour, even whole grain flour is going to be a problem. Too much rice, white rice, starch, all those things that we eat in our diet that are the American classic diet or we call the SAD diet, the standard American diet, all those things will promote a fatty liver. It's not actually fat that makes you fat. It's not fat that causes a fatty liver. It's hard for people to get this. It's actually sugar that causes this. And I've written a lot about this in my book, the Blood Sugar Solution. I encourage you to take a look at it and learn more about this. You can also, besides actually just cutting out the flour and sugar in your diet, you can begin to add good things to your diet. You can add lots of fruits and vegetables, nuts and seeds, You can add lean animal protein, chicken, fish. You can add good oils, olive oil, macadamia nut oil, for macadamia nuts, coconut butter, great fat. The actual good fats in your diet are anti-inflammatory and they help heal and repair your liver. The omega-3 fats from fish also really great and you can take fish oil supplements.

There are also other things you can.

Take and it's important to know that you might not actually even see abnormal liver function tests if you have a fatty liver. You might see your liver test if you go to your doctor, they might say, oh, your liver tests are abnormal. That's not a great sign. You don't want to get to that point. But even if you don't have the abnormal test, you can still have fatty liver and you can pick it up on ultrasound. But the fact is, if you're eating a lot of sugar and flour, if you have a little bit of belly flat, if you crave belly fat, you want a belly flat actually, if you crave carbs and you crave starch and you crave sugar, you probably have this. So how do you fix it besides getting rid of flour and sugar? Exercise, fabulous way to improve insulin resistance, to reduce fatty liver by improving your metabolism. And then of course there are many other things we use as supplements and I do a lot of this with my patients and I find it very effective. We give them herbs like milk thistle, we use things like lipoic acid, powerful antioxidant, and acetyl cysteine. These things help boost something in your liver called glutathione. I encourage you to read my blog which we've linked to here in the blog on glutathione talking about how this wonderful substance, that's a detox substance in your liver, can be regenerated by certain supplements. And we use other things like B vitamins and magnesium. All these things will help your liver repair and heal. And then we use superfoods that are detox foods. Things like broccoli family. I love this family and I try to have at least a cup or two every day. Kale, collards, cabbage, brussels sprouts, broccoli, arugula, kohlrabi, all wonderful foods to help repair and heal your liver. Garlic and onions also full of sulfur, great detoxifiers. So there's some really simple things you can do diet wise, exercise wise, supplement wise to help heal your fatty liver.

The thing that I really wanted to usher in and bring to the to the forefront because it sounds the most like ghostly, it sounds like cast with a ghost, like it's not even a real thing is inflammation and how inflammation has an impact on your body composition. And the data exists, it's just that a lot of folks don't know about it. And the way that it really manifests when we're talking about inflammation is that it has this very detrimental impact on our organs that are related to our body's production. and utilization of our fat kind of fat loss related hormones. So namely, let's take our liver, for example, your liver is incredibly important in regulating your metabolism. You know, we're talking about a relationship with how it manages insulin, even the production of fat takes place in your liver to the storing of glycogen can take place in your liver. You know, if your liver is if your body's overburdened by glucose, your liver can literally convert that into fat right there on the spot. And so if something is damaging your liver, it's going to inherently damage your, your endocrine system and your process of metabolism. So inflammation, and I've just kind of shared some of the data in the book, damaging your liver. And what this is one of the most fast growing issues in our country is non-alcoholic fatty liver disease. Yeah. This is really a kind of chronically inflame in inflamed situation taking place in our liver. And also, how do we get fatty livers?

Because I think people should know, we go to fancy restaurants and they give you foie gras, which is French for fatty liver. And how do they get the ducks to be like that? And how do they get us humans to have 90 million Americans with fatty liver?

Everybody should know by now. Very simple. The fastest way to damage your liver and to create that fatty liver, by the way, it's called non-alcoholic fatty liver disease, because we associate it with alcohol, but sugar.

Sugar, absolutely. Sugar, starch, flour, it's so bad. It's so bad, particularly high fructose corn syrup.

Your liver has to take on the brunt of it because your liver is really, even the name, liver, it's responsible for so much. Like every minute, it's filtering your entire blood supply. You know, it's so important.

That's right.

To take this one step further and I'll just drop this little nugget so we can move on to the other topics. But also the master regulator often referred to, of course, you know, I've even taught this in my conventional university setting, but your hypothalamus, all right, your hypothalamus is one of the major regulators and communicators with your thyroid, with your liver, with your adrenals, all the organs related to fat loss and fat storage. the governing kind of master gland. It's called the master glands or hypothalamus.

That's in your brain.

Right.

And now we've got data that this new term, neuroinflammation, inflammation specifically regarding the function of your hypothalamus, can damage what's happening with your metabolism. But nobody's talking about that in these cookie cutter diets that you need to address the inflammation in your brain in order for you to lose weight.

Right?

So these are all the beautiful part is it's possible. It's not just possible, it's probable when you have the right information and we avoid the things that create the inflammation. And namely, you just mentioned sugar, but we go through a whole subset of the different things.

Dr. Yeah, in functional medicine, we also look at, you know, food sensitivities and environmental toxins and the microbiome and all there's so many things that drive inflammation. And if you're overweight, you're inflamed. And for those listening, you know, think, oh, you know, I'm a few pounds overweight, a little extra belly fat, you know, maybe I need to lose 10, 20 pounds, or maybe you're over more overweight or obese. You should really pay attention to what Sean's saying, because right now, during this COVID pandemic, what we're finding is those people who are overweight or obese or have even a little bit of extra fat are much more likely to get sick, much more likely to end up in the hospital, the ICU, and to die. from COVID-19 because of poor metabolic health. And what's so beautiful about the body is that you think, oh my God, I've taken years and years to get here. Within a couple of weeks, you can change all of that. You might not lose all the weight in a couple of weeks, but you can change your inflammation markers, your hormones, your brain chemistry, literally in a couple of weeks of changing your diet and following the principles that are in Eat.

Smarter, which is Sean's new book, which you should all get a copy of. Thank you, Mark. And just to reiterate, reiterate what you just said. It's so important. You know, the CDC's recent report found that about 90 folks, 94% of the folks who lost their lives had an average of 2.6 chronic diseases or comorbidities, you know, and we've got to get our citizens healthier. And the big thing in the beginning of this was, well, we can't get people healthier overnight.

When?

When are we going to start? And truly, it's up to us in conversations like this. So I just wanted to share that. But also, leaning into this topic and just, you mentioned environmental toxins, but I'm going to share something that's a little bit controversial. And this has to do with supplements because there's been a big shift taking place that it went from about seven percent to 20 of hospitalizations related to liver damage are related to supplements because this is because, like, Mark, when I was trying to turn my health around, I became a natural pill popper first. I didn't get it with the food. And so I'm taking, I've got like my grandma's like pill full of like 20, 30 different things that I'm trying to take to get these nutrients. And so, yeah, not to say that the right supplements aren't helpful, but it's a largely unregulated field on top of that.

Yeah.

But also we need to target and understand that your liver is responsible for Metabolism of all these supplements, and it's also responsible for drug metabolism. And now we've got about 70% of the United States population on pharmaceutical drugs right now, and your liver is responsible for that drug metabolism. So just want to throw those things out there. But to shift gears to go from inflammation, that's one of the major causative factors behind an inability to lose weight. And the other one is hormone dysfunction. Yeah. And your response. This is where the real magic happens. This is where the show is going on. Your hormones are like the little chemical Messengers that are communicating with all the cells in your body and really create communicating a message on what they need to do. And so there are hormones that are specifically related to fat storage, and there are hormones specifically related to fat utilization. Yeah. And just to give a super overarching Look at this insulin. Insulin is our body's major kind of energy storing hormone. It's a beautiful thing. Insulin's not a bad guy that is storing energy slash fat. It's helpful. We need it. It's part of our evolution to have it. Now it's being hyper utilized and put to work chronically and it can get overworked and it can just be like, I quit. So we've got insulin, but on the other side, insulin has a brother. glucagon. Glucagon really does the opposite. And they're both produced at, you know, from their loving mother, Miss pancreas. And so they each have opposing roles, but glucagon can't do its job unless insulin sits down. You know, that these two things is a binary process. But insulin literally triggers the cell to open up to use that energy. And there are specific nutrients involved in these Communications and these Pathways. and nutrients that make these pathways kind of suppressed and create hormonal clogs. So a big mission with the book is taking folks through and teaching them about all of these fat loss and fat storage related hormones to give them really good education, but in a way that's fun and it makes sense. You know, we get a conversation about thyroid hormone, your adrenals, all those things. So hormone dysfunction, regardless of what diet you're on, we have to find ways to optimize what's happening with your hormones.

And then they play a huge role in regulating your metabolism, as you said, and they're driven in large part by what you eat. People don't understand their testosterone levels and your sex drive is controlled by what you eat. If you're a guy, if you're a woman, your level of estrogen and fat is determined by what you're eating. Certain foods increase estrogen like sugar and alcohol. That's why they give estrogen to male steers to fatten them up, marble their fat before they take them to market. There's no lack of science about this. We just don't understand. And then of course, there's the appetite issue, which is such a big thing for people.

Yeah, oh Mark, and this is so important. This goes back to when I mentioned Dr. Lulu Hunt Peters impressing upon society that hunger is related to weight loss. And unfortunately, millions of people still believe this. and hunger is a biolot, like biofeedback, it's biological feedback that something is awry here, all right? And this could be a nutrient deficiency. This could be related to some form of like habitual, you know, addictions, things like that. But our hunger isn't the issue. We want to make sure that we're not hungry because that hunger is associated with overeating, of course. And we could try to battle our biology but eventually it's going to win out against our willpower, which is finite. And so with that said, let's get folks educated on how our appetite works. And now these terms that we've been talking about, you and I probably for over a decade at least, but now a lot of folks know about the power of leptin and the power of ghrelin. These are kind of the major players, but we go deeper than that. And now we know that leptin, for example, leptin is your body's major satiety hormone. and it's actually produced by your fat cells. Now, here's the catch. Folks, and this is one of the studies that I put into Eat Smarter as well, and this was published in the New England Journal of Medicine, found that folks who are overweight and obese.

Actually have plenty of leptin that should make them satisfied.

Well, they have leptin resistance.

Exactly.

And inflammation causes leptin resistance. Exactly. It all starts to go together. They're still getting the DM. The leptin DM is being sent. but it's going to spam. You know, it's just like been. So. And so that's what creates that leptin resistance.

Yeah.

That's just one aspect. And then, garelin is this glorified hunger hormone. There are specific things we can do with our nutrition, obviously, that encourages leptin sensitivity and really helps to get ghrelin in check. But there's so many other players. Adiponectin is one that you're going to be hearing a lot more about related to satiety. And adiponectin has been found to help to move more of the kind of troublesome body fat in the visceral fat area and actually transfer that to the subcutaneous fat area, which makes it a little bit more protective. We still want to address both of these kind of white adipose tissues. But the visceral belly fat is what's really dangerous, the most dangerous from the.

What's fascinating about adiponectin is that when you have high levels of adiponectin, you can't actually mobilize fat. And what causes high levels of adiponectin is insulin resistance, which is prediabetes, which is eating too much sugar. So it all comes down to the starch and sugar. So your book is just filled with wisdom and information about these key mechanisms about how different foods and nutrients affect your brain function, about the microbiome, how it affects relationships, how it impacts our communities and stress levels.

I mean, it's just, it's so full.

Of beautiful things that are far beyond just what to eat. You talk about love languages in the book. It's such a fantastic book. And I just want to sort of close by talking about the research around sitting down for a meal with people you love and what that does to your health, your food choices, to your body composition, because we've kind of lost that. I think the idea of a family dinner, the idea of cooking together, eating together, being together, it's like I think the average family has dinner together a couple of nights a week, usually all while eating different foods made from different factories, heated up in a microwave that are eaten while watching TV or being on their phone. not exactly conducive to health. So tell us about this, this research about eating together.

Yeah.

And this is incredibly powerful because it's not just what we're eating, but it's also how we're eating and who we're eating with has a major impact on our overall health. And I share this story in Eat Smarter that I grew up. It might sound a little far-fetched for some folks. It's like people aren't sitting down to eat together. I can count on my hands how many times I sat down and ate a meal with my family growing up. Wow.

All right. Wow.

This was an incredibly rare occasion. This is usually, if it wasn't a holiday, by the way, holidays a little bit different, but it's usually just a free-for-all. We might eat at the same time, but we're not eating together and/or we're eating in front of the television or playing a video game or something like that. And so this is not abnormal, by the way. This is really shifting to be the norm. and here's some of the healing factors of this. Researchers at Harvard University uncovered that folks who consistently eat dinner with their families frequently consume more fruits and vegetables and less processed foods and sodas. And one of the most, I think this can get overlooked in the study, they found that folks who consistently eat dinner with their families also had higher intakes of some of the most important nutrients that regulate our fat storing hormones and your fat burning hormones as well. So things like calcium, folate, B vitamins. Also, they found they had a generally higher lower intake of dangerous compounds, you know, like trans fats and yeah, yeah, and toxicants in our food. So this is really powerful. But one other study, and this is the most important for myself personally in this mission, and this was published in the Journal of Nutrition, Education and Behavior. and they found very similar results. And now it gets into numbers. They found that folks who eat with their family, and this can be any meal of the day, breakfast, lunch or dinner, just four times a week, dramatically increased consumption of fruits and vegetables and reduced consumption of soda and chips. And what was so beautiful about this study is that this was done on folks who would be considered higher risk. which was minority children, minority families. So this isn't just about fixing the environment around the thing, it's the personal responsibility as well knowing you have leverage because the simple act of eating together as a family helps to increase, improve the health outcomes for the children and the adults as well.

It's so true. My friend Laurie David who was involved with the movie Fed Up that I was in years ago, I wrote a book called the Family Dinner and she talks about the research on if you have family dinners where you're eating food together and you're making it together and you're enjoying real food, that the kids have less likely to have obesity, eating disorders, violence, do better in school, have less drug use. I mean just so many benefits that you wouldn't even think, I mean better grades, I mean just by eating dinner together. So I think that's really important and I think It's beautiful how you combine the understanding of the deep science around food and how to optimize your metabolism with the science around relationships and love and connection. And that's really what food's about. It's about joy and pleasure and connection, but it's also about having us live our best lives because the tagline in the book title, Transform youm Life, actually is true. And food has the power to do that.

And eating smarter We'll teach you how to do that.

Fat is the key to sustained weight loss.

Yeah, who would have thunk it, right?

Aren't we not supposed to have fat in our diet?

Isn't it bad for us? Doesn't it create heart disease and high cholesterol and all these other things that are bad for us? Or is it actually... That's what we.

Were all taught, right? That's the whole line. Our government told us to eat 6 to 11 servings of bread, rice, cereal, and pasta today. To eat a low-fat diet. and fats and oils were sparingly only at the top supposed to be eaten. And yet that advice led to the worst obesity epidemic and diabetes epidemic in the history of mankind.

That's like the food charts that we.

All saw in school, right? Completely opposite of what we should be doing. And so the science has caught up with this bad advice. And the advice, unfortunately, Louis, was based on really shoddy science, on very weak evidence, on a few population studies, not really experimental studies. In fact, all the experimental studies that told us to eat low-fat diets, they actually didn't tell us that we should be doing that. They were actually contradicting the recommendations that were developed in 1980 by the UK and the USA. Really? So basically, if you looked at the actual randomized controlled trials, there weren't that many, but there was a few of them, they all said that eating low-fat wasn't beneficial.

But the... Outside of the US trials?

No, trials all over the world. Trials in the US? They just didn't look at that evidence. So the guideline committees who were working on it, They sort of dismissed that evidence and they had this theory and they went with the theory because it made sense, right? If you look at calories, for example, fat has nine calories per gram, carbs and protein have four calories per gram. So you think, well, gee, if it has more calories per gram, if you eat less of it, you're going to lose more weight. It's logical. But unfortunately, metabolism is not a math problem. It's a metabolic problem. It's a hormonal problem. energy balance, the whole idea of calories in, calories out. This is the biggest crock of you know what that's been pushed on the American public because there's a message implicit in that which is if you just told someone to lose weight by eating less and exercising more, if they don't do it, it's their fault. Just eat less, exercise more. If you don't, you're a lazy glutton. So it's your fault you're fat. But the truth is that it's not. It's not just about calorie balance. In fact, that's what the Global Energy Balance Network, which was actually funded by Coca-Cola, and they actually funded university scientists to kind of be the front people for this nonsense that's all about calories in, calories out, has been completely discredited. The New York Times wrote a big expose of this. What we've been taught is that all calories are the same. They're actually not. So food is not just energy, it's actually information. It gives instructions.

Right?

So this is like a big breakthrough in science, right? So food is not just calories, it's actually information. So the information in food communicates with your body every single minute. So every bite you take, it turns on or off genes that create health or disease, that make you lose or gain weight. It turns on or off hormones that make you lose or gain weight or create health or disease.

It's like a feedback for you.

It's direct instructions and it works minute by minute. It's not something that takes a long time. It regulates inflammation. It regulates your hormones, as I said. It regulates your brain chemistry. It regulates even your gut microbiome, all the flora in your gut that we now know are linked to everything from weight gain, diabetes, to heart disease, to cancer, to autoimmune diseases, and so many other things. Dr. Even depression. And ADD and autism may be linked to changes in your gut flora. So, we now know that when you eat food, it's not just about the energy in it. Because if that was true, then you could just survive on soda all day and it wouldn't matter as long as you only eat 1800 calories of soda. And I had this argument with the vice chairman of Pepsi. We had dinner together. I'm telling you. No way. Yeah, we had dinner. And the guy in between us, because I was in here sitting here, the guy was like being in the middle of a war zone. and I said to him, how can you say that eating 1800 calories of soda is the same as having 1800 calories of broccoli or almonds? He says, well, as long as you have that amount of calories, it's not going to be any different. I said, this is just not how the body works.

You're not getting the nutritional value from that, right?

Right. So just look at 1000 calories, let's say 750 calories of broccoli is 21 cups, 35 grams of fiber, half a teaspoon of sugar. and tons of phytonutrients, phytochemicals that upregulate your genes that actually help you prevent cancer, that improve hormone metabolism, so many things, right? Same calories from a big gulp, 750 calories, 46 teaspoons of sugar, high fructose corn syrup upregulates your liver to turn on a fat production factory that makes high triglycerides. Stores fat more, right? Stores fat, lowers triglycerides. I mean, raises triglycerides, lowers good cholesterol, causes a fatty liver, raises hormones that make you, in women, make them grow hair on their face and have lost hair on their head. Men, they drop their testosterone, they have no sex drive and they lose their hair on their bodies. All this from the same calories, right?

The number of calories.

Calories are the same, but the information in the food is very different. So now we have this concept that is actually really about the hormonal, I call it the hormonal hypothesis. this is what I talk about in Eat Fat Get Thin, which is how do you change your hormones so you're not hungry all the time? Because that's the key. The typical advice, you eat low fat and your fat actually makes you satisfied. Because if you eat fat, you're not craving all the time, you're not hungry, and it actually is a brain actually food because it actually stops the addiction center in the brain from turning on. So you never feel hungry or have any cravings. It also speeds up your metabolism. Fat speeds up your metabolism.

Yeah.

So it helps you burn more fat.

It releases fat from the fat cells. Interesting. Right, so it makes you less hungry, it makes you burn more fat and it liberates the fat from the fat cells. So it's really a powerful whereas if you eat sugar, the opposite happens. You get hungrier because you increase insulin.

You eat...

I used to have so much sugar. It's terrible. I was addicted to it. All of us were. I mean, I was too. I was a vegetarian. like tons of, you know, whole wheat bread and sugar and honey and everything. I mean, grape nuts and ice cream for breakfast. That was my life, right?

So when did you stop? When did the research become known or the facts or the data become known? Not even. It's honest.

That's why I'm asking. Because you're a doctor and you were eating sugar.

It's not even. When did you start to realize it? When did this information about fat become, you know?

Well, it's been mounting for decades. Right? So it's building on a mountain of evidence. And in the book, I reviewed over a thousand studies or 500 quoted in the book that I referenced. They wouldn't let me put more because there was no room in the back of the book. Yeah, yeah. And it's all well documented. And the science of this is very powerful. One of my colleagues, David Ludwig, wrote a book called Always Hungry. He's a Harvard professor. He's done a lot of the research that this is based on where he, frankly, gave two groups of people same calories, Same calories but change the percents of fat and carbs. And it was a very well controlled study and in the first group, you know, they had 60% carbs, 20% fat, 20% protein. The other group switched it. 60% fat, 20% carbs, you know, 20% protein. So it's the opposite. And the group that had the high fat diet burned 300 calories more a day.

By doing nothing at all.

Really, just by having more fat. By eating more fat, their metabolism sped up 300 calories.

Same amount of calories though.

They ate the same amount of calories in. But they burned 300 calories. Right, because their metabolism sped up. Interesting. Right, so in other words, it's like running an hour a day without getting off the couch. Interesting. That's powerful.

Very powerful.

Yeah, and I know for me, as I've seen myself and my patients, transformation is amazing and their cholesterol gets better. It's totally contradictory. Right? Fat is supposed to raise your cholesterol, right? Eating cholesterol is supposed to raise your cholesterol. But for the first time since the Dietary Guidelines came out in 1980, the US government in 2015 completely reversed their stance on fat. There's no more restriction. Like January, first week of January 2016.

This year.

This year.

Like a few weeks ago.

A few weeks ago.

They just changed this.

They changed this completely. The whole guide completely. Really. So, the first time, they said, forget about fat. You can use as much as you want. No limit on fat. This is the government. The government, the Dietary Guidelines Advisory Committee established these recommendations. This is a scientific group that establishes guidelines for the government, helps them shape policy. And then the government makes the policy. They kind of based around this research. They said, you know, don't worry about fat, don't worry about cholesterol, eggs are back. eggs are back. Forget about the egg white omelets, just eat the whole egg. No way. Completely. And they said, it made me laugh. They said cholesterol is no longer a nutrient of concern. Nutrient of concern. Like, well, we got it wrong for 35 years.

No way.

It's totally different. And they also said that we should, for the first time, they said we should reduce sugar. Now, the policy advisors who are the scientists said, we should limit sugar-sweetened beverages because they're proven to be linked to obesity and diabetes. But the government, because of the food lobby, changed the wording to say, no, we should be restricting added sugars. So we should eat less added sugars. Now, what's an added sugar? It doesn't say added sugar on the label. So how do you know? Because the food labeling from the FDA is also influenced by the food lobby. So which is say added sugar on the label, not just sugar. So you don't know. It's designed to totally confuse people. The truth is that this is a huge advance and now we actually have come to realize that this is not true. The science around fat and how your body burns fat and what makes you fat is all really clear now. It's all based on this hormone idea of insulin, which is a fat storage hormone. So anything you eat that increases insulin, which is sugar, refined flour. I mean, white flour raises your blood sugar more than table sugar. So if you had two slices of white bread, it raises your blood sugar more than a tablespoon of table sugar. You're like, I mean, whole wheat bread. It's just as bad. Unless the bread is so, like, dense that you can stand on it without.

It squishing, then you shouldn't eat it.

You shouldn't eat it.

No.

Like the German Rye bread.

I love bread, though.

Yeah. Everybody.

Challenge.

The bread we eat isn't the bread we ate, right? So our ancestors ate very different. It's not the hard bread.

It was very coarse, and we only.

Had the the grain mills that started in the 1800s. Before that, we couldn't eat refined grain. And now even whole wheat is super refined.

It's just... And are all grains bad.

As well, in your opinion? No, I don't think all grains are bad. I joke, I say in the book, I talk about an induction plan, like basically a way to get quick start to change you from just being storing fat to burning fat to eating fat.

To makes you thin.

And that's a 21-day plan. And after that, I talk about how you transition to what I call a Pegan diet. Pegan as opposed to Paleo or vegan. It was kind of a joke because one day I was sitting in between. Yeah, I was sitting on a panel with two friends of mine. One was a vegan cardiologist and the other was a Paleo doctor. And, I was like, well, I don't know. I guess they must be a Pegan.

Because I'm in the middle here.

What does a Pegan diet look like? So, Pegan diet, you know, it's amazing, Louis, is that the principles of Paleo vegan are often very similar. Both groups believe that we should be eating whole, unprocessed, unrefined foods. We should get rid of food additives, hormones, preservatives, everything. No antibiotics, no hormones, no pesticides, no GMO. We should be having no MSG, no artificial sweeteners, no high fructose corn syrup. Everybody agrees that that's true. We also agree that everybody should be eating lots of fruits and vegetables. Yes.

Right?

Heavy on the plant foods. Basic principles. Both agree that we shouldn't have dairy, which is interesting.

Yes. Right?

We'll talk about that. Paleo, no dairy as well.

No dairy, right? No dairy.

I guess there's some of them that say like some specific cheeses or something. Yeah, you know, grass-fed butter, you know, like there's some things, but you know, but it's, but the proteins in dairy are very inflammatory and the dairy again we eat isn't the dairy we ate. We've hybridized our cows, all fertilized by one bull. It's not organic dairy. And it's not organic, it's not raw, it's not how our ancestors ate it. Right. Even organic cows, they milk them when they're pregnant and they're just full of hormones. So, also, you know, it's just not always tolerated well by many people. And then, what else did everybody agree on? Everybody agrees that we should be eating foods that are phytonutrient rich, that are nutrient dense, and we should be lots of nuts and seeds and lots of good oils like avocados and olive oil.

What's phytonutrient?

What does that mean? Phytonutrient is a is a chemical that's in plant foods. Fito means plant. And it's not a vitamin or mineral. It's not a protein, fat, or carb or fiber. It's something else. So for example, like broccoli has glucosinolates, which upregulates detoxification.

Okay.

Catechins are in green tea, which are powerful detoxifiers of metal, powerful antioxidants. Tomatoes have lycopene, which is a powerful cancer preventer for prostate cancer. Okay. so anthocyanidins, you're going to have black rice which has anthocyanidins which are powerful antioxidants that are in black rice. It's emperor's rice, love that. It's also very low glycemic.

Sure.

So, I think the things that they disagree on are basically beans, grains and meat, like where you get your protein from. Everything else is the same.

Paleo and vegan is the same except.

For meat, beans and protein. I mean, beans, grains and protein. beans, grains, approach. Okay.

Right.

And, I mean, you know, like, you know, meat. Right. And so, you know, what I realized is that, you know, I think many people who, who are sick do better when you take out certain things that can be inflammatory or high glycemic. So if you're, for example, carbohydrate intolerant and you're a diabetic, which affects a lot of people, I talk about how do you find out if you're carbohydrate intolerant in the book, which is, as a questionnaire, you can tell if you actually know if you're someone who's carbohydrate intolerant, like someone who's gluten intolerant. That means if they eat a lot of starch, if they have like two cups of rice, even if it's brown rice or two cups of beans, it can adversely affect their sugar. So I talk about like having less, like having smaller portions of beans and grains and non-gluten grains in particular because gluten can be very inflammatory for many people. I think for some people who don't react to it, it can be fine but not in large amounts.

And then I think, you know, meat is a big, is the big issue, right?

To meat is the big issue.

So should we be eating meat? We just had dinner the other night.

We both had meat, right?

We had fish.

We had fish.

Black cod. Yes.

Which was awesome.

I had a mahi-mahi. You had a black cod, is that what it was? Yeah, I had the black cod.

Yeah, I had the black cod.

The guy next to me had meatballs. Got next to me at carne asada. But you know, so the issues around meat also, I think, are everybody agrees and fish, everybody agrees that if anybody eats meat, it should be humanely raised, it should be sustainably raised, it should be grass-fed, it should be not Harm in the environment, the ethical and the environmental issues around animal eating are big and they're real. I have many Buddhist patients. I have a Buddhist monk who's like an abbot who's a diabetic and he's never going to eat an animal. So I need to help him understand how to never eat an egg, how to eat a higher fat protein diet which is low glycemic. So we can do that. More nuts and seeds, less rice, more beans, you know, just there's strategies for doing that.

Sure.

And he did great. He lost 35 pounds reversed his diabetes and now I have like tons of bun people, you know, praying for me. That's great. Yeah. And then the meat thing is tricky because, you know, it's also an environmental risk if you're eating factory farmed animals. There's antibiotics in that and is runoff from the pesticides and fertilizers that damages our water supply. and rivers and lakes. There's climate change that happens from the methane produced. It's more, more toxic to the environment than carbon dioxide.

There's so.

And there's high energy use. One-fifth of all our fossil fuels are used for growing animals for human consumption. You know, our water is, is being used up at incredible rates for, for feeding animals. There's, there's basically, I think, 70 of all water use, and basically only five percent of the world's surface is, is fresh water. Usable. It's fresh water. Right. One percent is in Russia. Wow. And at least four percent for the rest of us. And, and 70 of that is being used for feeding animals for human consumption. So there's real environmental issues.

Sure.

So I think, you know, a factory farming just should be not supported in any way. And we need to change that. And that means we need to, to change our patterns of consumption around me. We need to downsize our meat consumption. I call it having condiment. Condiment. Condiment, as opposed to like a condiment, like condiment. You know, it should be a side dish or a dressing if you're gonna eat it.

Sure.

And I think, not a full plate of steak, you mean? You know, I think there's three issues with meat, right? There's environmental issues, there's moral issues, and there's health issues. So, we kind of talked about the moral. I think that's, People are entitled to their beliefs and they should be able to follow whatever they want and be healthy. The environmental issues are real and I think everybody would agree whether they're paleo vegan that we need to stop harming the environment and I think even if you're not paleo vegan, everybody really believes that. In fact, the Dietary Advisory Committee that was advising the government said we should limit meat consumption because of the environmental impact. Now, if you have grass-fed meat, if you have sustainably raised meat, there's no It's not as abundant. You can't produce as much. And so we all have to eat less of it. It's more expensive. That's okay. And I think that from a health point of view, when I really looked at the literature and I did this in Eat Fat Get Thin, I looked at all the research that I could find on meat. I was like, well, I don't know. I want to know for yourself, too. Yeah, I'm recommending to my patients.

I'm human, too, and I want to.

Live a long time and I don't want to be doing something stupid.

Yeah.

So I wanted to find out what does the science tell us about meat? So you did all the research?

So I looked at all the research.

And I wrote 8,000 words in the book on meat.

Wow.

There's a lot of research in there. And I address all these issues, you know, environmental, moral, and the health issues were quite interesting. You know, when we look at the studies on meat and anybody can quote anything saying anything, right? Right. So you want the paleo people like a meat's healthy, here's all the research. And the vegan, like, meat's gonna kill you, here's all the research. So it's like, and then And the average Joe, you're totally confused. And your average doctor, you're totally confused.

Because we have no training in nutrition. They haven't done the research themselves.

So they're going off of their opinion or their theory. Yeah, they're like average people like the rest of us in terms of nutrition science. They don't know because it's not what we learn, right? I mean, I just am at Cleveland Clinic and we implemented a nutrition curriculum for the first time in the medical school there that's integrated in, which is so great. I helped Tim Ryan, who's a congressman from Ohio, introduce Tim. He's great. Has he been on your show? He's been on here, yeah. introduce a bill called the Enrich Act, which was a bill that is funding $15 million to fund nutrition in medical schools. Nutrition education for doctors. That's what we need the most because.

Doctors, a lot of the time, I feel like could heal a lot of.

Their patients with food.

Oh my God. Well, food is the cause of most chronic disease.

It's the cure for most chronic disease and yet doctors know nothing about food.

And they just medicate a lot of the time.

I mean, listen, that's so bad. I mean, I use food as medicine. That's what I, food is the most powerful drug on the planet. I mean, that's why last week I was in Cleveland at the hospital teaching 300 black women how to cook in a cooking class. Like, that's what doctors should be doing.

That's how I'm gonna get. That's real medicine. That's real medicine. Now, just, just a quick side note.

What is your involvement with, what is functional medicine and what is your involvement at the Cleveland Clinic? Can I, can I finish my meat? Yes, go ahead. I was still, I was still rolling on the meat. We'll talk about functional medicine. Then we'll Perfect, perfect. Because people want to know, like they're like, well, what about meat? They're like probably listening.

Yeah, let's do it.

So the science, 8,000 words. I'm not going to give you 8,000 words. I'll give you a few hundred. So the science of meat was fascinating. So when I looked at the studies that showed it was harmful, here's what they were. They were mostly population studies, meaning they looked at groups of people, followed them, and then they asked questions of them. What did you eat last year? What did you last week? What did you last, you know? month, you know, and they basically do these food frequency questionnaires, and then they correlate that with the risk of disease. And I try to control for all the confounding factors, but it's very tough. So the people who ate meat, yeah, they had more heart disease and more cancer and more death.

But what else was there?

Smoking, they're drinking. Exactly. So they're sleeping. Exactly. So if you look at the data, they, they ate 800 more calories a day. They almost eat no fruits and vegetables, tons of sugar, they had tons of sugar and processed food, lots of fried foods, drank more, smoked more, didn't exercise and didn't take any vitamins and minerals.

Well, guess what?

They weren't as healthy as the other people. So most of the studies were like that. Now, there was a few study that were interesting. I found one was a study of 11, 000 people who shopped at health food stores, and they found there were, like, a lot of vegetarians and a lot of meat eaters. Like, so who are the people who are, you know, like, healthy meat eaters who only eat grass-fed meat or who? Because most these studies were not on grass-fed meat either. They were factory farm meat, right? So then again, how do you generalize that? Sure. But then there were these 11,000 people and they filed them for many years and they found that the meat eaters and the vegetarians, there was no difference in their health outcomes. Exactly the same. So if you're a meat eater who basically eats a healthy diet and has grass-fed meat versus a vegan or vegetarian, no difference in that. And you have a healthy lifestyle. Healthy lifestyle, then there's no difference. So there's other factors like how it affects your gut flora and so on and I think you know, those are more complicated issues. I address all of them in the book, but at the end of the day, I think it's okay if you have no moral issues and you can eat sustainably raised meat and not in great quantities and as part of your.

Diet, I think it's okay.

Hey, YouTube, if you like this video, you're going to love the next one.

Click on it to check it out today. Functional medicine is about getting rid of the things that impair health and putting in the things that help the body thrive.

And then the body can take over and with its amazing intelligence can repair.

And heal from all sorts of things. Oh totally, yeah. And that's what we do.