EVERYTHING You Know About Nutrition IS WRONG! Here’s Why | Mark Hyman

Now meat shouldn't be the staple in your diet, but it should be a side dish in the face of a lot of good quality plant foods that help you to deal with the need you have for phytochemicals. It turns out that you find in the meat of some of these high quality grass-fed meats or goat or whatever, that there are as high levels of phytochemicals in there as you find in plants. You are what you eat and you are whatever you are eating has eaten. Yeah, that's exactly right. and on my podcast at Doctors Pharmacy, I had this incredible rangeland scientist Fred Provenza who wrote a book called Nourishment, talk about the emerging research from Duke University on phytochemicals in grass finished beef. So if animals are left to forage on hundreds of varieties of plants, they're literally eating the medicines in all of those plants all the time and they're seeking out different plants for different properties in terms of medicine or in terms of the nutrient density or the vitamins and minerals. And so it turns out that you find in the meat of some of these high quality grass-fed meats or goat or whatever goat milk, that there are as high levels of phytochemicals in there as you find in plants. For example, goats who are eating certain shrubs and left to forage around in the wild will have as high levels of catechins, which are in green tea as green tea. which is really remarkable, like to think about, wow. So I think back to the question of what about meat? The studies about meat, most of the studies on meat were done on obviously feedlot beef, not grass finished beef or wild beef, right? And there's a great study on a kangaroo meat in Australia where they fed people the exact amount of kangaroo meat versus feedlot beef and they found that with the feedlot beef inflammation in their body went up. with the kangaroo meat, it went down. And it's because it's a different quality of the information in the food. And so most of the studies on meat are really done on large populations. They're what we call observational studies. They don't prove cause and effect. They look for correlations. And when you looked at the studies on meat, the big studies that were done with a million people, half a million people, this was done in the era when meat was considered bad to eat. We were told, don't eat meat. It's got saturated fat. It's bad for you. So people who were health conscious, They need it. That's called the healthy user effect, meaning.

People aren't doing bad stuff to themselves.

It's not the meat that's the problem. It's that they're not smoking, they're not drinking alcohol, they're exercising, they're eating whole foods, and that's why they don't have less heart disease. It may not be the fact that they're not eating meat. On the other hand, when you look at the people who did eat meat in those studies, they had really bad habits. They didn't care about their health. They were far more overweight. They ate 800 calories more a day. they smoked more, they drank more, they ate less fruits and vegetables, they eat more processed food and junk food. So, of course they had more disease. And the one study that I love is when they looked at two groups of people, meat eaters and vegetarians who shopped at health food stores, their death rate went down in half for both groups because they were eating meat in the context of a whole foods diet. Now, meat shouldn't be the staple in your diet, but it should be a side dish in the face of a lot of good quality plant foods that help you to deal with the need you have for phytochemicals.

So what do you think about the carnivore diet?

Well, I think it's problematic. I mean, a lot of people are trying it and I think people get rid of all the bad stuff in their diet and that can often help. So if you go from eating a traditional American diet with processed food and 60% starch and sugar and processed calories, to eating only meat, you're cutting out all the gluten and the dairy and the sugar and the processed food. So, that's going to make you feel better. Over a long period of time, I think it can be problematic because it's devoid of certain phytochemicals and nutrients and it can affect that microbiome in ways that I don't think are that healthy. So, we are not lions. We are humans and have evolved on an omnivore diet. So, I think I believe that phytochemicals are really important for human health and I don't see how you get those just on a carnivore diet. Although it has helped people with autoimmune disease, like I said, because you're cutting other stuff out.

Yeah, you know, I have no problem with it as the ultimate elimination diet. In fact, some people have actually accused me of being the father of the carnivore diet because you're eliminating lectins out of your diet. So, no, I don't want to be the father of the carnivore diet. But anyhow, so what about fish and poultry? Same rules apply?

Well, in every, in every area and every category of food, I think the key is focus on quality and, and understand the source of what you're doing. So if you're eating, for example, fish, you know, a lot of fish we have now is contaminated with mercury, microplastics, and it's challenging. And there's farmers fish, but there's problems with those. So there are sort of organically, sustainably raised farm fish. And, and you can Source those. And there's a great resource called cleanfish.com where you can go and look at what those fish might be. The second, and there's, and there's great sources, for example, like vital choice Seafood and other companies that provide, you know, well-sourced seafood. The second is poultry. You know, poultry's a mess because, you know, we have so many names, organic, there's grass-fed I mean, there's pasture raised, there's cage free, there's free range, there's whatever. And it's all a bunch of nonsense. The key is you want animals that are truly pasture raised, that haven't been out in pasture, that aren't in cages, that run around, that eat all the grubs and the worms and whatever stuff they find around a farm. Those are the ones you want to eat because they have less of the bad stuff, more of the good stuff. They're not grain fed, which is their Omega-6 levels are lower. they have more nutrient density. If you take a chicken and look at the eggs from a chicken that's running around in the wild, eating pasture, the eggs are dark, dark yellow. If you look at one of those factory farm eggs, it's a pale yellow color. It's almost a bright orange sunset if you look at the real eggs that are like that. I think we want to always focus on quality. I think pasture-raised is ideal for eggs and poultry. Of course, organic is sort of the next best, but even that may be problematic. So, I think we have to just do our best to find the best quality and not be fanatical about it, but understand that it's a hierarchy of needs. Getting off a processed food is key, and eating more plant foods is key. And, the rest, you sort of kind of can look at the fine print of how do we navigate what is the best source of fish, what is the best source of meat, what is the best source of poultry? And, I go through all that in.

The Pegan Diet and explain that in great detail. I know you're down on dairy in general, but you do like grass-fed butter.

How come?

Well, I think ghee is my favorite.

In terms of that. I think we can tolerate saturated fat for most of us. I think again, it's another one of those big topics that's gotten a lot of bad press, but it's actually the science doesn't support it being universally bad for everybody. I think there are some people who respond badly to saturated fats, but it's an individual thing. You have to just check your lipids. But for most of us, a little bit of ghee or grass-fed butter can be fine. Grass-fed butter, while it does still contain some of the casein and whey that's in milk, very, very little. If you don't want that, you can get ghee. But the grass-fed butter has higher levels of vitamins, for example, vitamin A and carotenoids, and it's much darker, yellower. Also, it contains something called CLA, which is a conjugated linoleic acid, which is a powerful anti-cancer compound and metabolism booster. you don't get that in regular butter.

Yeah, there's also a nice amount of vitamin K2. And I agree with you, if people are going to use grass-fed butter, and they should be aware of casein A1, use grass-fed ghee. That's really the best choice.

That's pretty much what I do, yeah.

All right, now there's a lot you admire about the vegan diet. So what are the shortcomings that you note in the book? Well, you know, it's interesting.

I just had a patient which sort of brought it to forefront for me again because if you're not really smart about it, if you don't design it very well, it can be really problematic.

And this one patient I saw was.

A young 26-year-old woman who was feeling tired and had a lot of inflammation in her body and lots of pimples and acne. And she was relatively thin but just struggling with her well-being and health. and we did extensive nutritional testing. She was significantly protein deficient, really depleted in amino acids and protein. She was massively B12 deficient, vitamin D deficient. She was completely devoid of any omega-3 fats. She never ate fish. And these are not kind of insignificant nutrients. These are significant things that affect the quality of your health in your life and every system in your body. So, if you are smart about it, you can be accommodating by making sure you're designing your diet in a way that maximizes protein, for example, but you're not going to—I don't think you're going to get it as a vegan unless you jack up protein shakes. So, there's a shake that I just saw in a health store over here, which is a Garden of Life Sport Shake. But it's very interesting because they jacked up the amino acids that you need for protein synthesis. They jacked up the amount of protein because you need more protein if you have vegan protein. so, you know, where, you know, four, six ounce piece of, of chicken or fish will be equivalent to two or three cups of beans. You know, like, one, it's hard to eat that many beans. And two, you're also getting, like, 100 plus grams of carbs in there. I mean, you're getting fiber, you're getting minerals, and, you know, there's other issues around lectins. But I think that the, the issue is, is how do you, how do you actually get the right, the right amount of of high quality nutrients, protein, zinc, iron, vitamin D, B12, omega-3 fats. These are the common deficiencies we see in vegans. So you either have to take supplements with it or you have to really design your diet. The other thing is that people should not be focused on dogma. That's the whole point of the book. The dogma gets people into trouble. I'm going to be a vegan because I believe in it, and it's good for me and it's good for the planet. Well, one, It may not be good for you. If your health declines and you feel depleted and you're a woman and your menstrual cycle stops, you have infertility, your libido goes down, or you're tired, or you have all these other issues, you may not be the right diet for you. Where somebody else might thrive on a guy like Rich Roll who can run an Ironman triathlon and vegan diet and he's great. But that doesn't mean it's good for everybody. In the same way, eating meat is not great for everybody and it makes them feel bad and has adverse consequences. So, I think we have to really get off the dogmas. And that was really the purpose of the title, which is kind of a joke, you know, the Pegan diet, kind of poking fun at the, at these diet extremes.

You know, that brings up a good point. Like in my Paradox books, I have a food pyramid and you have a food pyramid in this book. Can you talk about what that looks like? How do you build your food pyramid?

Well, it's pretty simple. The bottom of it should be predominantly plants. I mean, we should be eating plants, a plant we call plant forward or plant rich diet. I don't think the term plant-based is the best for most people because it means only plants. And I think there are needs for certain nutrients that we're only really getting from animal foods. But the idea is to eat a lot of plants. And then second would be, getting a lot of your protein and fat from good quality food. So it would be nuts and seeds, it would be good oils like olive oil, it would be avocados, it would be nuts like macadamia nuts, which I love, or sort of like the olive oil nuts. And then of course high quality protein, chicken, fish, meat, lamb, whatever, then it's sourced properly. And then so we move up the pyramid and sort of include a little more things like nuts and seeds and grains and beans, but in a very specific way. I'm very careful about which grains and which beans you want to be eating. I don't think we should all be eating gluten because even if you're healthy, it does cause a leaky gut, even microscopically. So, even if you don't have gluten sensitivity or celiac, it's still causing a little havoc down there. And, there may be grains that are great like that. There's a new discovery of a grain called Himalayan Tartyary Buckwheat, which is actually a very ancient grain that was sort of been rediscovered and is grown by a friend of ours, Jeff Bland. up in Upstate New York because they just got the first batch. I got my, I flower here. I'm gonna make my bugweed pancakes. But they are probably the most powerful phytonutrient rich superfood on the planet with over 100 and, I think, 50 phytochemicals, some of which are found in other plants. It's got probably two or three times the protein content of most other grains. It's got the special fibers that are incredibly good for the microbiome. So, that's a very different thing than eating some dwarf weed that's sprayed with glyphosate that preserved with calcium propionate that has extra glide molecules that are more likely to trigger autoimmunity and have amyloid amyloid, I'm sorry, amyloid pectin A, which is a super starch that's worse than sugar. So, like, that's a very different range. I make my pancakes from one or the other. I have very different effects on my body. So it's really about which, which of these things we should be eating. And then, of course, at the top, there's, like, recreational things, like a little bit of alcohol, a little bit of sugar. but very limited. Can you have it every day?

I mean, could you have a square.

Chocolate every day if you're metabolically healthy?

Yeah.

If I ride my bike 20 miles and I work out for half an hour in my trainer and I eat healthy and I'm not worried about a little bit of chocolate or some sugar. I think it's the amount we're eating. I always say sugar is a recreational drug. It's like tequila. I love it, but I wouldn't have it every night. I wouldn't have I wouldn't have it for breakfast, lunch, and dinner, which is basically what we're doing in America. We eat sugar for breakfast, lunch, and dinner, either in the form of flour or directly sugar.

No, you're right. I love to ask this. What was the most interesting or surprising thing you learned researching and writing the Pegan Diet?

Well, it really has to do with this idea that when we eat well for us, it's also connected to how we grow the food.

So.

There'S a chapter in there called How to be a Regenitarian, How to eat like a Regenitarian. And what that means is how do you eat in a way that regenerates human health and regenerates the soil health and the health of the ecosystems on the farms. and it turns out they're intimately connected. You know, you talk a lot about the microbiome, but there's a microbiome in the soil, which we've deployed through glyphosate and through over-tillage and through lack of COVID crops and crop rotations and monocrop fields, and that's destroyed the soil, which has led to food that is highly nutrient depleted because there's no nutrients in the soil. And it's led to a set of farming practices that really destroys the climate, the environment, our water resources. I mean, we literally, if you put end to end our food system, it's the number one cause of climate change. You know, we've lost a third of our topsoil by tillage and everything else, which has actually put all this carbon in the atmosphere. So a third of all the carbon right now in the atmosphere, not from fossil fuels, it's from loss of carbon in the soil. And that we can actually regenerate all that soil and we can use less chemicals or no chemicals. limit our water resource use because the soil that's got organic matter can hold 27,000 gallons per acre of water. And we need to stop destroying the waterways by the runoff of nitrogen fertilizer, stop, you know, causing all the chemical damage to endocrine systems from the pesticides and herbicides and the glyphosate. I mean, it just could go on and on. So it's kind of a win-win-win where you connect the dots between really where does healthy eating start? It starts on the farm. and how do we regenerate human health and how do we regenerate planetary health and ecosystems and climate change? That's really was sort of shocking to me to really learn how connected those things are.

Let's talk about the RDA. So the current RDA, which is the recommended dietary allowance. Correct. And that was based on studies that we know were flawed, right? Those were based on nitrogen-based studies of 18-year-olds that we wanted to, or they wanted to provide an amount which would stop disease per, you know, it's baseline for disease.

It's not the minimum amount you need so you don't get sick. It's not how much you need to be healthy.

Correct. So we came up, or they came up with a number, not me, way before my time, unless my Botox is that good, but not having any lately. The RDA is 0.8 grams per kilogram, and that spans from anyone ages 18 and beyond 18. 50, 60, 80. Okay? That is the minimum amount. There is 30 years of data to support that the minimum amount is not adequate. We know that as you age, you need double the RDA. For body composition, you're looking at double the RDA.

You mean for building more muscle?

For anything in obesity, we know that the higher your diet is in protein while calories are controlled, the more lean muscle mass you can maintain. And we spoke, when we started talking about this, we talked about why muscle was so important. And this obesity epidemic isn't quite an obesity epidemic. It is really an epidemic of poor muscle mass, low muscle mass, obesogenic sarcopenia, loss and destruction of tissue. We are largely domesticated. So what's happened is we have- what.

Do you mean we're largely domesticated?

We ride in cars. We're not doing physical movement. We are eating in a way that is not supporting our current existence. And actually red meat consumption has gone down by 29% since 1975.

But chicken's gone up.

Chicken has gone up. Dairy has gone down. Yeah. The concept that we are eating too much protein, the average American eats between 60 and 90 grams. Women are around maybe a little bit above 60 grams, and men are around 90 grams. So that's the average American. Heart disease, Alzheimer's, obesity, hypertension, all of these comorbidities and diseases are on the rise. Protein is not the problem. Protein's never been the problem. Protein is the defining nutrient for a high quality diet.

So you've been studying protein science in a way that I don't think many people have. And you say there's 30 years of research that kind of contradicts a lot of the perspectives that people have and shows the importance of protein for longevity, for health, for preventing disease, and yet at the same time we're hearing that if we eat meat, it's going to kill us. That there's this huge sort of media push around eat less meat, eat less meat for health, eat less meat to save the planet. It's a problem. So how do you reconcile those two things? And you mentioned, you know, that there are extreme groups that are pushing this, but it's not just extreme groups. There was a major report on E. Lancet and Lancet about the need to actually reduce our global meat consumption, that there isn't enough land and agriculture to support this for the growing population of the world. And in my mind, I also believe that we do need the right kinds of protein in the right ways, but it's hard for me to reconcile these two things. So how do you explain that?

I'm really glad you brought that up. Now, the 30 years of research clearly isn't my own. I'm not that old. I have been, though, trained by some of the best people. And one of them in particular, my mentor, Dr. Donald Layman, who is a professor emeritus at University of Illinois, has published multiple studies and is certainly one of the world leading experts. And we have these discussions over coffee all the time. And you do bring up a very good point, especially when it comes to greenhouse gas and sustainability. Let's look at the US. The US, and this is from the EPA. Some of the data is from the EPA. The US contributes 15% to greenhouse gas. 15%.

From?

Out of the entire world, right? That we contribute 15%.

Total from everything.

From everything. That includes transportation, agriculture, land waste, all of that. Our contribution in the United States is 15%. Out of that 15%, 9% is agriculture. I'm going somewhere with this. So out of the entire world, we are 15%. Out of that 15%, 9% is agriculture. Out of that 9%, 5% around 5%, 4.6% is fruits and vegetables, what it's taking to grow and decompose and that 4.5%. Cattle and dairy, 3.6% out of all.

Of... And that's feedlot stuff. That's not regenerative ag.

It is, it's everything. The greenhouse gas, so for greenhouse gas, all of cattle, all of dairy contributes 3.6%. So if you were to say go meatless Monday and let's say we were gonna cut that in half, it's, you still have to have some protein, you can't become protein deficient. So let's say we reduce, kill all, you know, we eliminate all the cows and We're now at 3.6%. We cut that in half. What is that, 1.3%?

That's in America though.

That's in America.

Globally, there's a lot of meat being grown.

So, I mean, yes, and we should discuss that, but I can tell you in America that if you also look at that 9% of agriculture, you have a component that comes from waste and a component that comes from overfeeding. So we are in an obese, obesogenic environment. 10% is of this contributing factor to greenhouse gas is waste and overeating. So overeating is one part of it.

Food waste, we waste 40% of our food, right?

So we're wasting and we contribute. So out of that number, that 9%, we're contributing one third of that, just that 9%. One third is food waste, another 10% is overeating. So while the discussion is somehow targeted on cattle, which make cattle and dairy, which make up 3.6%, that is not the big target for our 15%. We have electricity, transportation, transportation, I think 29%, electricity, another 30%. So all of everything outside of that 9% is largely controllable by us. When you look at the number, and this is not for the world, but this is for the US, if we wiped out all of the United States and all of the cattle and everything, our contribution to sustainability, climate change is 15%. that is very small. Yeah.

Well, it's significant, but it's. Yeah.

In the whole scheme of everything, it is.

But globally, it said that, you know, our, our agricultural system as a whole is responsible for a third to half of all greenhouse gas emissions.

Our Global system, the, the world, you mean, the world.

Yeah. But, and that, and that includes everything.

And 50% of that is. Natural. So we have wetlands and termites and rainforests and things that 50% of all greenhouse gas is naturally produced. Climate change is certainly happening.

However.

There is a natural aspect to some of these things. We live on a green planet. If we didn't, we'd be in Mars. Greenhouse gas is, you know, it's kind of like that all or nothing thinking. that this concept of turnover and natural ecological processes are all bad. That's not necessarily true. I mean, we are certainly contributing 49% of that.

So what you're saying is pretty radical. You're saying that our meat production and animal production is not a big contributor.

No.

Even though a lot of data seems to contradict that.

But what data? If you look at the EPA and if you really look at the factors. Donald Layman wrote a great paper on sustainability less than a year ago about this topic. You really tease out all the numbers, just like the whole protein controversy. It doesn't hold up. A lot of the discussion about how protein causes cancer, how protein is bad for you, it's all epidemiological based data.

Yeah, so let's talk about that. So the first issue is, is it a big factor in climate change? What about feedlot versus pasture? regenerative ag because it's not just the feedlots. It's all the corn, the soy we grow, the rainforest we cut down, the soil erosion. All that's true. All that is a huge issue.

So, it's not just the cows themselves.

It'S what we do to grow the cows. All of that is absolutely true. And, regenerative ag arguably will draw down carbon, which means grazing cattle, but you can't grow as many cattle on grazing and rangelands as you can in feedlots. So, the volume of meat that we need to produce to have 90 grams or 12 ounces per person per day globally is a lot of meat. And even if it was the healthiest thing on the planet, how is that sustainable?

I think it's a great question and I certainly don't have the answer. I think we should control what we can control and see if we can't regulate those things otherwise, really decrease our transportation, eat locally, stop shipping our foods, which all of these things are having a great impact on greenhouse gas and climate change and impacting the globe. Why not do that first rather than sacrifice our health? We know excess calories are bad. We know excess carbohydrates are bad. We know this drives insulin. We know insulin drives cancer. So you have these really big glaring things that can be fixed. Why go right for meat? Why don't we clean up our end? Let's eat local. We don't need to be getting avocados from Mexico.

That's true.

I don't need to have kiwis from New Zealand. I'm gonna eat local. I'm not going to maybe fly as much or I'll use public transportation. And also the other thing with cows is we use their leather and all kinds of other things. So we're not just talking about meat. In addition, if we wanna talk about cattle, cattles are upcyclers. they're upcyclers of food. So for every one gram of poor quality protein, for every, I'm sorry.

It'S.

For every 0.6 grams of poor quality protein, which we know with a deficient in amino acids, plants, those kinds of things, they make one gram of high quality protein. So why not, again, I mean, I feel very passionately about this because we are completely misled. So we should take care of the fundamental things that we can handle. while maintaining our health. And probably ultimately the health is going to be a blend of plant and animal. But rather than just attack this one small area, let's do the things that we know. Stop overeating, stop wasting your food, and stop traveling and stop eating stuff from a different country when you live in Manhattan.

Yeah, that's true. So that brings up the other issue and you sort of mentioned it in what you just said, which is quality of protein. not all proteins created equally. Yet, you know, the argument that is being made is that we should eat more plant-based proteins. We should eat more rice and beans. And what's wrong with that as a way of getting your protein?

That's a great question. Well, if you're 20, you could probably manage that. But with rice and beans comes carbohydrates and excess calories. Let's just take quinoa. And actually, remember I was up at Lenox a couple of years ago and I did a talk about the protein perspective for the crew and I, and I had a chart that broke down what plants you would have to eat to match a chicken breast.

Okay, let's get into it.

Okay, so for one chicken breast, one small chicken breast, maybe four ounces, you would need about six cups of quinoa to equal that about amino acid profile. Plant protein and animal protein are not created equal. It would be wonderful if people wanted to eat plants and could sustain a healthy metabolism. If you are, so you've got one chicken breast, it's 150 grams, and now you've eaten quinoa, six cups or so, which is a lot, maybe four to six cups. Now you've eaten 600 calories to try to get that amino acid profile at one time. It's not that, that clearly is not sustainable. Rice and beans, that is not a sustainable way for a population that is aging. And when I say aging, I mean anyone over the age of 20.

Yeah, well, it's interesting. There's a movie coming out called Game Changers. You might have heard about it by James Cameron, where he documents the power of vegan diets for athletic performance and shows world-class Olympic athletes being vegans and actually having massive muscle amounts.

And, do you know, that's a great point. You know why that is, why that can happen? Muscle is stimulated two ways. Number one, resistance exercise or exercise.

Yeah.

And number two, dietary protein. If you grossly reduce one of those things, which in that crew was dietary protein, their exercise balances that out.

So you can be a vegan as long as you hit the gym five days a week for an hour.

At least.

Like a crazy person. Yeah. You know, and then we also have to think about there, you know, there, there is a percentage of the population that can do well being vegan. But the NHANES data, which is a huge data set, that's the best that we have. It's a survey data, shows that actually vegans and vegetarians are one half of one percent.

Of the population.

Of the population. This is a very small group of people that can maintain and do well. Plant protein and animal protein are totally different. They have different levels of amino acids. Animal protein has the building blocks required for muscle tissue, not to mention bioavailable zinc B12.

So you say also that leucine, you talk about leucine as one of the key amino acids that is needed to reduce muscle. It's sort of the rate limiting amino acid. If you don't have enough of that.

You can't make- well, you stimulate that the protein kinase pathway, which is mTOR. And there's been a lot of talk, a lot of discussion around mTOR about how this is a cancer, this is a key component in cancer, and that's why you shouldn't eat protein because you're gonna stimulate mTOR.

Right.

Well, mTOR is also stimulated by exercise. It's also stimulated in all other tissues, pancreas, heart, all these other tissues, largely by insulin. Carbohydrates are the problem, not protein. MTOR signaling, which is a, it allows our body to nutrient sense, has been maintained since the beginning of time. Growth is not a bad thing. Growing bigger, growing stronger, growing bone, growing muscle, growth is not a problem. And when you think about cancer, cancer is a disease of the genome.

Right?

And it is an inability to then begin to repair and regulate. There is not something that is actually, protein is not causing the cancer. Now, if you have cancer, certainly you push that mTOR pathway. That can be a bad thing and that's perhaps where a ketogenic diet comes in. But the concept that upregulating a pathway, which has been beneficial throughout Creation is completely erroneous. Let's talk about risk ratios, relative risk. Can I just throw that out there?

Yeah, well, this is part of the story around meat because it seems like every week there's a new study that comes out, says meat's going to kill you if you eat more meat, it's going to be a problem. There was one just last week. How do we interpret those as scientists, lay people, eaters?

So hard. So hard. I will tell you that really finding good scientists that you trust are key. There was a big paper that came out that linked IGF to animal protein and, you know, aging all of this stuff.

And there IGF is a growth factor that comes from often eating carbs and sugar, also stimulated by protein that actually has been linked to cancer and other things.

Right.

So this article in Cell came out and it really talked about how people should have 30 to 40 grams of protein a day, which is a protein deficiency essentially. It's now below the RDA. The leading scientists in the world wrote a letter to the editor that went through all the flaws of the paper and how it was hand selected data, how it was very unethical, and they had statisticians and it was signed by the top world leading experts. who have dedicated their life to studying this, who are not agenda driven, they are not funded by meat, they're not funded by these boards, but they really truly care.

National Cattlemen's Association.

It never got published.

It never got published because one of the researchers was an editor of the journal. And I've posted that on my website. It's available, this letter to the editor.

It's like censorship, scientific censorship.

Exactly like scientific censorship. So it becomes very difficult to get the- Counter the argument. Counter the argument. And listen, everybody wants to talk about protein or they wanna talk about cancer and IGF1.

So why are those studies not true then?

If all these studies come out that show the- But they're not all those studies. If then if you go and you look back at the research, it doesn't hold up. So now you have the mouse with the microphone. So why doesn't it hold up? So let's talk about risk ratio. Let's talk about relative risk. Relative risk is what is your risk of doing this thing and getting this disease? And it is a standard of- so.

If you eat eggs, what's your risk of getting heart disease?

So this is the standard of looking at good data. When you look at the relative risk of smoking and cancer, that's 12.

Or 20. Right.

In order for something to be considered a risk. It needs to be above two. And this is something that has been in the scientific literature for since it's been around.

So in other words, if a study comes out and the ratio or the risk ratio is less than two, which in other words you could say is 200% increase, right? Then it's kind of meaningless.

It's meaningless.

Right.

So then if you go, so now we know that cancer and smoking is a 12. And by the way, when we talk about cancer, you know, there's lung cancer, number one, and that the mortality hasn't changed. We haven't been able to really do much in that area in the last 60 years. And then you have the other cancers. You've got prostate, breast, colon, which are all have links to obesity.

Right.

And that is very clear if you look at the cancer, you know, National Cancer Association, any of these journals. Anyway, so if you go back, so when we say cancer blanketly, we really have to be, what are we talking about? So we go back to the risk ratio. The risk ratio over and over and over again of protein and cancer, guess what it is?

1.1.

1.1 to maybe 1.3. This is the data. There has never been anything that has ever come out to show that the risk ratio is higher than that.

In other words, instead of 12, it's .12 or.3.

It's.3.

It's.12. It's.3. It has to be two to be significant. That is where people have to understand there can be.

So they say your risk goes up by 30%. What that means is it goes from, you know, from one to 1.3, not 12.

No, it's still, it's not relevant.

Right.

So it becomes a talking point. The media says meat kills. Right. But it's actually not even relevant.

It's irrelevant. So, you have these small studies that are hand-picked, NHANES data, epidemiologic, which we know is poor at best.

So, it never proves anything, by the way, just for people who aren't familiar with science. There's two kinds of main studies. One is an experiment where you take 10,000 people and you feed them steak every day for 20 years. And the other group, you feed them rice and beans for 20 years and you see what happens. that study is never gonna happen.

Never gonna happen.

It's billions and millions of dollars. It's too difficult to implement. People eat whatever they want. So they look at big populations. They follow these people for 20 years. Every maybe five or six, 10 years, they give them a food questionnaire. They say, what'd you eat last week?

Right.

And then they try to correlate it with different outcomes and they try to control for variables, but it's very difficult to do that. And, and then that means that when you look at these questionnaires, first of all, these have been invalidated by a lot of science that they're not really accurate, that people over-report good stuff, they under-report bad stuff, depending on what the meme of the day is. If meat is bad, then people aren't going to say they eat as much, or maybe if they're healthy, they may not eat as much. So if they're healthy users, it's this effect where if you're conscious about your health and you exercise and you eat great and you don't smoke, and you hear that meat's bad for you, you're gonna avoid meat because you don't wanna get sick, even if that's not true. So it looks like they let eat less meat and they get less heart disease or cancer, but it's actually not because of that.

It's a, it's a, it's a, it doesn't. And like you said, it doesn't account for other things like total caloric intake.

It doesn't account for obesity, smoking, drug intake, drinking. Yeah, they try to control these factors, but one of the biggest studies on meat that I reviewed in my book, Eat Fat, Get Thin and Food, what the Heck Should I Eat? was the NIH ARP study, which is National Institute of Health. What is it? The ARP, the elderly thing, which I try to avoid when I get their throw it in the garbage when I get their thanks for me because I'm over 50. They said it was half a million people and they found that there was a significant increased risk of all these diseases, cancer, heart disease and everything with people who eat more meat. But when you actually looked at these people in the studies, The ones who ate more meat ate 800 more calories a day or more overweight, smoked more, drank more, didn't exercise, ate less fruits and vegetables, more sugar, processed food, didn't take their vitamins. Of course they had more disease. It wasn't because of the meat, it was because of all this other stuff.

So I think that you are highlighting something that is so essential to understand. Things are not that confusing. It's again, it is small groups with a lot of funding and a lot of money that is agenda driven. Do we probably need to consume high quality protein while doing it responsibly? Yes. Do I know what the answer is? I don't think anyone knows what that answer is. But again, rather than attacking the high quality protein source that we have, because ultimately that is at first going to affect those with lower income. I mean, that's going to be the first people that that affects. The people that maybe can't afford grass-fed or eating high, and they're already, we know that lower socioeconomic status, you're also dealing with comorbidities, obesity. So focusing on this cattle protein argument as something deleterious to health is absolutely incorrect. We know the PRODH study came out and we know that that that requires protein study was a group, was a study that had all the world leading experts come together and do a position paper.

Yeah.

Saying that as you age, protein intake is clearly, the needs are clearly higher. A minimum of 30 grams per meal. You know, really, you're looking at 30 to 50 grams per meal, which is.

Four to six ounces of per meal. It has to be animal protein.

Well, if you can now, this is Another important point is you can use lower quality protein, but you have to augment with branched chain amino acids. That is a possibility.

So, you can easily be a vegan, but you have to take high leucine protein supplements.

Well, you want to take the whole branched chain. So, it's leucine, isoleucine, and valine. You want to take that together because the way in which the system works is it's not giving, I mean, they usually work together. It's part of the branched chains. You wouldn't wanna give one and push the system away and deplete the others. If you are vegan and vegetarian, vegan or vegetarian, or having a lower protein meal, let's say a fish that is 15 grams of protein, add in five grams of branched chain amino acids. That is certainly a solution to not wanting to eat a higher protein diet. But please understand that the RDA is the minimum. And it will not protect, it won't protect my dad. It's not gonna protect my mom. I mean, typically when you think about what a better recommendation is for protein, it's what is your ideal body weight? What is your ideal body weight, Mark?

Oh, what I have now.

Perfect, what is that?

185.

Your protein intake should be 185 grams, around 185 grams divided throughout the day. And obviously you could go less. That's a lot. Well, is it or is it an optimal protein diet?

So that means I gotta eat, oh, wow, a pound or more of meat a day.

Yeah, it'd be interesting to see how you felt. Maybe we could at least, you could probably get to 150 and still be great. But if you're eating 90, you're too low. Protein need is based on muscle mass. It's not based on sex. It's based on muscle mass and age.

And there's no danger to it in terms of cancer, kidneys, all this stuff we hear.

Show me. No one has ever shown that to be true. When they talk about heart disease and protein and red meat, it is not accounted for. It's saturated fats. They've never, you know, it's epidemiological data based on saturated fats. There was a recent article that came out that showed high fiber and protein. And when calories were accounted for, there was no difference.

I remember being in medical school, and this was 30 plus years ago, we were told, be careful, don't overuse antibiotics. This is a big issue. And it's even kind of worse now. So how is this one of the most important public health threats we face today?

Well, one of the things I love about you, Dr. Mark, is we share the same passion of regenerative agriculture. In fact, I own about five, I co-own 5,000 acres of organic land, some in Tennessee, some in Missouri, where we do something myself and Jordan Rubin, it's called Permaculture, creating food for us. We're really working on healing the planet. It's incredible. I mean, if we would not be focused on the short term, but focused on the long term, even financially, we could feed the entire world if we focused on doing food forest where we're growing more things like apple trees and walnut trees and more perennial plants rather than soybeans, wheat and corn. It literally changes the environment. And so all that being said, I think it's so important just to note, one, it's better for the planet when you follow these farming practices. But what we're doing today is we're giving a lot of these animals, we're feeding them genetically modified corn, soy and wheat. that's the base of their feed. And then we're putting antibiotics in there just consistently. And what happens is 80% of the world's antibiotics are not given to humans, they're given to livestock. 80% of antibiotics, it's crazy. So what's gonna be happening is when we consume those antibiotics via those animal tissues or dairy or other things, what that's going to do is that's going to damage a lot of our So, you're going to get microbes, okay? It's going to kill off a lot of those good bacteria. You're going to have more overgrowth of a lot of the bad bacteria. And that's a massive part of your immune system. This is a big, you know, big cause of things like leaky gut syndrome, which is the root cause of autoimmune disease, weakened immunity, migraine headaches, food sensitivities. And one of the things I do talk about in my book, Eat Dirt, I really get into, you know, how we have sometimes over sanitized. in many cases. And I think that's important, even in the world of COVID today, it's important to keep in mind we want to practice proper sanitation. We absolutely do. And I think there are some natural things that can help us do it. There are really powerful essential oils like tea tree oil and others that I think are good to use on a regular basis. But studies show we need to be deeply connected with the earth, you know? And so with that being said, There are studies showing if you live on a farm, you actually have a stronger immune system, a healthier immune system, less food allergies, less food sensitivities. They've shown in studies, if you have a dog or a cat, actually by 49, you have 49% less food allergies, food sensitivities, food sensitivities and a stronger immune system. What else is unique is I read a study, this is out of Japan, and they showed that if you're eating foods that are more local in nature, they talked about seaweed over there, that you're getting different types of soil based organisms, whether it's from the sea or the land, and those actually work with your immune system at driving out bad bacteria, helping modulate your immune system. You know, when we hear of immunization, Dr. Dr. Mark, a lot of times people first their head goes to a shot. But the truth is, like I've got an eight and a half month old daughter now, and we will support her immunity, we will support her naturally, you know, naturally immunize her through getting her exposures to certain things. In fact, local honey, you know, a lot of times people talk about, oh, take local honey for allergies. The big benefit of local raw honey is that it contains over 200 microbes. And if you do that year round, you're getting pollen and all these exposures. It's, it's, it's a form of a natural immunization. I'm not saying it's the only way to do, obviously, there's many, but it's one of the ways we naturally strengthen and boost our immune systems. So I think we've really lost that sort of ancient of being deeply connected to the outdoors and our environment and in that way strengthening our immunity and our bodies.

Absolutely. Well, let's talk about food as medicine and how so much of our chronic illness is caused by the foods we eat and also can be healed by eating different foods.

Yeah.

So, you know, obviously I think we know this and if anybody is listening to your podcast, they know this, but obviously, you know, the big culprit all burgers or sugar. It's a lot of the refined grains. Again, the corn and the wheat, soybeans, it's a bean, but that's in there as well. So getting a lot of carbohydrates from there, the hydrogenated oils, we want to stay away from that stuff. And a lot of the things that contain genetically modified organisms or animals eating foods that they shouldn't. Okay, so the dairy byproducts, the meat products, you know, we use that principle, right? You are what you eat. So, what they ate, okay? So, if they're eating a lot of grains, their tissues are full of omega-6 fats versus a lot of grass, omega more omega-3s, you're gonna have more bouncer that's gonna help your body heal. But one of the unique things that ancient practitioners recommended, Dr. Mark, and I think this is fascinating and it's absolutely true, is when you in order, like knowing what foods to eat based on your sick, here's what the ancient physicians recommended. They said, okay, what the food looks like, if the food looks like a body part, it supports that. What is the food's flavor as well and what's the food's color? And they would look at those three things and say, that's how you know it to eat. So for instance, a walnut looks like your brain. In fact, you crack it open, it has two hemispheres. We know today that walnuts are loaded with choline and vitamin E and some omega-3 fats so they're good for the brain. A coconut as well looks like your head. Coconut has all these medium chain triglycerides which are good for your brain and actually a water inside that almost looks like cerebral spinal fluid that's actually good for your body's fluid and systems. We've got beets that actually look like blood when you're cutting them. And they have known to increase nitric oxide in the body and improve your cardiovascular health. So celery looks like your bones. Celery is probably the most alkaline vegetable. And so it actually supports your bones in especially supporting vitamin K and calcium levels. And then I could keep going on a few others.

It's so fascinating.

Yeah, Rishi mushrooms look identical to your kidneys and adrenal glands. So do kidney beans, you know, onions are amazing for your cells. Those are loaded with quercetin and things that actually support mitochondrial function, all kinds of things. So, you know, one of the things I go through that in the whole book, I have these big pictures and graphs going through, here's all of those foods so we know that. And then flavors, five flavors support five different, what they considered organ systems that work together. So sour foods really activate and support liver detoxification, bitter really affects the heart and the blood, you've got umami which affects the lungs and colon, you've got sweet which is more the pancreas and stomach, the upper GI, and then you've got salty which is your kidneys and your adrenals and and then certain foods like green is very good for liver gallbladder. But anyways, that's how the ancient is new. And I really believe that God created, you know, our food here. I don't think he made it real complicated like, Hey, I'm gonna make it really hard for them to figure out what to eat. I think some of the stuff, I'm not saying everything is simple, but I think some of the times using food as medicine isn't really complex if we are, you know, able to to start thinking and learning about some of these things.

Yeah, it's true. I love your sort of title of your book, Ancient Nutritionals, because I often thought about how is it that we're eating such a mono diet? Our diet is mostly three crops, 60% of our diet is three crops, wheat, corn, and rice around the world. Another maybe nine or 10 crops make up the rest of it. We used to eat 800 species of plants. agriculture, you could argue, was one of the most destructive things to be discovered or invented because it led to, you know, you know, we used to be an average height of 5'9 as hunter-gatherers. And then when we started agriculture, it went down to 5'3 for men. Why? Because they were so malnourished, they were starting to eat single crops. They were only eating rice or they were only eating whatever they could grow. And they weren't to have this massive diversity of plants and animals and bugs and whatever that they ate back then. And we've dumbed down our diet to these very few ingredients that's led to these massive nutritional deficiencies. I mean, you just listed some of the common foods. Some of them are less common like reishi mushrooms and so forth. But, I'm here in Hawaii and I feel like I'm a pretty well-traveled, well-educated guy. And I go to the farmer's market here and I'm like, what is that? And what is that? And what's a Surinam cherry? And what's a... I don't even know what these things are. I've eaten things I never even saw before. And I'm thinking, wow, you know, we are, we are so deprived of all medicines in food and that we've evolved actually to use these compounds with our biology to regulate different functions of our system, which you sort of were mentioning. And, and we've lost that understanding. It's not just about calories, it's not just about taste or flavor. And what's really amazing, I don't know if you actually know this book, Josh, it's called nourishment by a guy named Fred Provenza. And you, you should listen to that podcast that I had called meat medicine with this guy. He's this old guy with big beard. He's like this, sort of looks like a mad scientist who's a rangeland scientist. But he talks about how animals seek out different flavors of different plants and have different properties that are used as medicines and that have nutrient density. But when animals are left to their own, they forage all these incredible variety of plants that provides all these incredible incredible nutritional needs we need just through their natural intelligence. So what you're talking about is these different flavors, these different tastes, these different colors. They're not just, you know, decoration. They're not just for our personal enjoyment. They're actually designed to heal our bodies and to regulate all the functions of our body, which is just so brilliant. And that's what your book really goes into. I encourage people to go get a copy. It's called ancient remedies. Secrets to healing with herbs, essential oils, CBD, and the most powerful natural medicine. in history. The most powerful natural medicine in history.

What is that?

Well, the natural medicine history, I really go through, actually it's more personalized medicine. That's the most powerful medicine in history I get to in the book because, you know, different herbs are good for so many things. You know, I cover stuff in the book, like for instance, if you've got an immune system issue, in ancient Chinese medicine, actually an herb we rate, some people use here, but I don't see, I've actually heard you talk about it, but probably one of the top five herbs in Chinese medicine was astragalus. Like astragalus today, what it's known for is actually helping repair a leaky gut or your gut related immune system. You know, that's super powerful. A lot of people don't even, they haven't even heard of astragalus but has all of these benefits. We know herbs like Galangal, you know, that cousin of turmeric and ginger has all of these anti-cancer properties. Andrographis, there's some great new research on Andrographis and its ability to fight viruses. And so anyways, yeah, I think it depends on the person. One of the things I do love, Dr. Mark, about ancient Chinese medicine is it was really the first form that I've seen documented of personalized medicine. It's kind of like, you know, it's kind of almost started off. It also includes your personality profile. So if anybody's ever done like an Enneagram test or Myers-Briggs or DISC profile, sometimes when you read those, you're like, wow, that's, you know, almost every time you're like, wow, that is really straight on. That's my personality. well, they did that in Chinese medicine. It's called the five elements. And so they really know, hey, here's your personality. But they said, based on your emotions, I think this is really incredible. Based on your emotions, that tends to be the biggest driver of what causes disease in which organ system. Because why is it today? Most people would say genetics. Like, why does one person get diabetes, but another person could be eating almost the same diet, but that person ends up with more heart disease and high blood pressure and cholesterol, another person thyroid issues, and another person, what they say is different emotions affect different organs. So for instance, and we know this is true, the emotion of fear, if you're fearful, maybe fear of failure, fear of disappointing loved ones, that actually causes adrenal issues. Or if a child gets really scared at night, nightmares cause fear that actually affect the kidneys and they can wet the bed. the emotion of worry specifically affects the upper digestive system, the pancreas and stomach. People say, oh, my stomach feels like it's tied knots if they worry a lot. The emotion of grief most affects the lungs and colon, which is your immune system. So, or unforgiveness, something that's happened in the past, a hurt, a trauma, you haven't been able to let it go. That's completely affecting the immune system can trigger things like autoimmune like issues and that sort of thing. And the thing about heart anxiety that's related to your heart, your blood pressure raises. So they would actually say in Chinese medicine, food is important, but more than 50% of health conditions today are experiencing negative emotions. So they always say, hey, you've got to address that negative emotion to completely heal.

Absolutely. I think it's so critical. And I think, you know, your book is just full of practical suggestions and really wonderful tips on how to incorporate some of these ancient principles. into everyday life to optimize our health and to sort of fix our biology. I sort of want to get into sort of the role of spices and herbs and other things like CBD and essential oils and healing mushrooms around our immune system. Because right now with COVID-19, we're all a little bit scared of getting it. And what I believe is that, and this is sort of goes back to this ancient debate between Louis Pasteur and another scientist at the time who's mostly been forgotten, Claude Bernard. And Louis Pasteur, for those who don't know, was the guy who figured out there's microbes. And he discovered bacteria and looked under microscope and saw these things and connected them to pneumonia. For example, strep bacteria causes strep pneumonia and so forth. Claude Bernard had a different theory. He said, it's not just the microbe, it's the host that matters. He called them the biological terrain, the state of your health that determines your risk of getting sick or not and how sick you will get. And I think people are not discussing this around COVID, which is just devastating to me because there's so much we can do to rejuvenate our immune system, become immune resilient, and to reduce our risk if we get sick of getting very sick and even to reduce our risk of getting sick at all. And we know from other studies you can literally inject cold viruses directly into the nostrils of people and not everybody will get sick. Yeah.

It depends.

And one of the studies where they just look at their stress score, the more stress they had, the more likely they were going to get sick. If you weren't stressed, you were less likely to get sick. And that's just one component. Your diet plays a role. And, and what's also really exciting about the book that you've written, Ancient Remedies, is that you include a lot of remedies that can help rejuvenate and build and boost your immune system so we can become more immune resilient and actually do better in this pandemic, which I fear will be lasting for quite a while, not just another year or so.

But much, much longer.

Yeah.

Well, Dr. Mark, first off, I love that reference because I've talked about that before, you know, between Pasteur and Bernard and really terrain and the terrain of your body. So first off, I just think that's a perfect example to talk about in in terms of COVID and fighting viruses today, you know, really the thought, I want to go back to something Hippocrates said.

He.

Said that the body heals itself. He really, you know, talked about this, that listen, it's not a food that heals you. A lot of times we think broccoli heals me or turmeric or another herb, really your, if you get a cut on your hand, your body heals that. Now, your body's going to use these herbals and these foods as the building blocks to repair itself. but what herbs do is they change the environment more than anything. They put your body in a better place where it's better able to heal itself. And so with that, you know, as we're talking about immunity, you know, I think it's really, really important. And again, think about this. Also, think about your body as a bucket. Okay. If it's clean, if it's healthy, it's not going to attract any bugs. Essentially, that's what some of these things are parasites, viruses, bacteria. yeast, some of these things that we can get inside our body. We had a flood years ago in Nashville and afterwards, Dr. Mark, I had so many patients coming in with mold toxicity because they didn't get it cleaned up properly. Mold was a huge issue for years in Nashville. All that being said, but in order for mold to grow, it has to be in a very specific environment. It has to be damp. The way you get rid of it is you have a lot of airflow and light. and you dry it out, okay? The same thing happens in our body in Chinese medicine, they call it dampness. But essentially, in our bodies, if our body gets too damp, and our body also gets in a bad environment, that's what allows these bugs to thrive. And so you just need to change the environment. That's what these do. One of the things people should notice is that most herbs that you take for fighting a virus, are bitter. Bitter drives out dampness and phlegm and Candida and Chinese medicine. In fact, Andrographis, which is one of the herbs now most prescribed in Asia and Japan for something like COVID, it's known as king of the bitters. It is the most bitter or have you days that you're like, this is the most bitter thing I've ever had in my life. But if you try Echinacea, that's really bitter. That's another good one. A lot of these are olive leaf, these are all very, very bitter. Those herbs are gonna help drive out and actually have a lot of those antiviral properties with those things. And then I would also say things that are going to just activate the immune system. So you have the ones that help drive the bad stuff out and the ones that strengthen your organ systems in your own body to better fight off the infection. Astragalus is a great example of one that really strengthens your own system. so you can better fight off a virus. So what I recommend, Dr. Mark, let me talk about nutrients. First, nutrients, number one is vitamin D. I know I've heard you say the same thing, but vitamin D, the most important nutrients we need to support our immunity right now. And number one, get the sun as much as you can, but if not, take vitamin D. Number two, from what I've seen in working with people is zinc. You know, I think even when people are losing their sense of taste and smell, you can go to the medical literature, you can read about it. Most of the time, a lot of times, that's it's more severe will take longer if you have a zinc deficiency. So that's the next big one. Those are the two biggest ones I've seen vitamin D zinc, and then there's other things I think that vitamin C to a degree can be good, but I don't even think that's the biggest one. I think vitamin A in some cases or even nutrients like quercetin are more important, but I would say zinc and vitamin D you want to take those and in terms of herbals, I really like astragalus for long term prevention of strengthening your immune system. if you get something, I like Andrew Graphis, Echinacea, and then to a degree, yeah, those are probably the, I mean, I could mention a bunch more, but.

I think those are the big ones. You have that gut-brain connection and it's like a two-way highway in their, they're basically communicating, the brain's talking to the gut and the gut's talking to the brain. And then you also have the enteric nervous system. And, and some people sort of forget about the enteric nervous system. And that's the intrinsic nervous system to the gut. So literally, if you, if you sever the the spinal column and there is no connection to the gut and the brain. The gut still works. You can still poop fine if you sever the spinal cord.

It's got a mind of its own. That's what you're saying.

It's got a mind of its own. Exactly.

Right. But, Todd, I want to come back to what you said, which is really important. You said, we categorize irritable bowel as with constipation or diarrhea or whatever, and there's a whole classification system that is driven off of symptoms. And the difference between functional medicine and conventional medicine thinking about any disease is that it's not focused on the symptoms, it's focused on the causes. So just saying people have irritable bowel doesn't tell you anything about the cause. It tells you they feel uncomfortable, they're bloated, they have diarrhea, their bowels are weird, they're uncomfortable, cramping, whatever the symptoms are, is irrelevant when it comes to trying to figure out the cause. I mean, yeah, okay, you have irritable bowel, but That's when you start to think about the problem. In traditional medicine, you name the disease, you stop thinking. You know, our colleague, Sid Baker, always had this great term. He says, you know, traditional medicine is naming and blaming. You name the disease and then you blame the name for the problem. Oh, I know why your stomach hurts. You have irritable bowel syndrome. No, that's just the name of the problem. Exactly. But he talks about thinking and linking, which is functional medicine, right? Yeah. think about the problem and the cause once you get the diagnosis and you link everything together to see what the factors are. And, there's no such thing as irritable bowel syndrome. There's irritable syndromes. Like you said, there's 31 flavors and each one is different and each one needs to be treated differently.

Exactly, exactly. Yeah, it's so, so, so true. And, there is this web-like interaction in the body and it's very important to understand the whole inter connectedness of it. It's very, very important.

So, so typically go to the doctor and you have your little bowel. What do they tell you to do? Well, you know, they, they, you know.

They'Ll, they'll often tell you, you know, take some Metamucil and I'll see you later.

That's, that's, yeah, eat more fiber, drink more water.

Yeah, that's, that's essentially learn to live with it. And, yeah, that's essentially what they're dealing with stress.

Yeah.

That deal with stress. Yeah. And they'll, the interesting thing, this is, I had a patient just the other day. who I was seeing for GI symptoms. It wasn't specifically Irdal Wal. And the patient's GI doctor said, Diet has nothing to do with your symptoms. I mean, it was unbelievable that a GI doctor told her, Diet makes no difference.

I couldn't believe it.

I just, I like- actually, I was.

On a consult with a patient yesterday and she said, I went to my gastroenterologist and I wanted to show my stool test. He says, oh, gastroenterologists don't look at stool. I'm like, well, then who does if you're a doctor? And I'm like, you know, that just doesn't make sense. You don't look at what goes in and you don't look at what comes out. How are you supposed to know what's going on in there?

Right?

And that's the difference in functional medicine. Yeah, exactly. Yeah, it's a little bit mind-blowing. And, you know, you talk about like, you know, with going back to Sid Baker and sort of name it and and claim it kind of a thing is-- Blame it. Yeah, name it, name it, blame it. Is that-- and then tame it with a drug. Right. And then I always tell my patients, you know, I went from being a medical student to a student of medicine. I'd like to always learn about things. I love that. And yeah, and it's a very important thing that you have to remain open-minded and I think you also have to remain curious because every patient's different. That's actually the joy of actually practicing functional medicine is it's not boring. by any means. It's, it's, you're constantly growing and learning and helping patients with the latest Diagnostics, the latest Therapeutics to, to personalize their treatment. And that's the fun part. I mean, doing functional medicine is a wonderful profession as opposed to regular mainstream medicine, where most doctors are burned out. You know, they really are. They're just, they're unhappy. They're, they're burned out. They're, they're doing rubber stamp medicine. You know, I'll see you. Here's your Proton Pump Inhibitor next patient. That's it.

So, you know, doctor sees you, you have irritable bowel, they give you metoclopramide.

What else can they do sometimes? Well, sometimes they'll give prescription medications. I think one of the older ones that they used to do for IBS was Zelnorm. Remember that one? Yeah. They took it off the market because.

It was like really hurting people. I think people were getting- Librium was the other one. Remember that?

That was like a Valium. It was basically taking Valium. Is it Valium for the gut? Yeah, Valium. They're actually, in certain patients, there were some benefits from that because it did sort of calm down the nervous system, I think.

Anybody taking valium?

You're gonna feel good.

Couple shots of aquila, a little librium.

I feel good. Right.

But that's really not what we do with natural medicine. You were talking before about how you never know what the issue is when someone comes in. I was thinking about it's much like forest gump medicine. Forest gump has a box of chocolates. life is like a box of chocolates. You never know which one you're gonna get. And I think in traditional medicine, you got irritable bowel, it's a thing, you treat it all the same. Functional medicine is not like that. We see some with irritable bowel and then we go, wait a minute, what is the cause of their irritable bowel? And like we were saying before, it's very personalized. So how do we start to think about identifying what their particular issues are? Because before we can even treat it, we have to understand the why. And that is what I always say, functional medicine is the medicine of why and regular medicine is the medicine of what, what disease and what drug.

And I think the big thing is time, taking the time to talk to a patient and, you know, what?

Talk to a patient.

Actually, and listen to the patient.

Wow, listen to the patient.

That's actually, you know, that actually, and sometimes the less I talk during an interview and, you know, evaluation of a patient, the better I do. Because, you know, oftentimes we want to jump in and ask this question. They'll say something and we ask a question. You know, I think in the average doctor's office, a patient speaks for like 30 seconds and the doctor interrupts them.

Yeah, no, actually there was a study published years ago in JAMA, it was 18 seconds.

18 seconds. 27 seconds.

Before the doctor interrupts.

Exactly, because we're trained to probe the questions and they have their own sort of path of thinking going down that. But I think the big thing is we spend a lot of time listening to the patients and getting a history and a story. And an important thing is, interesting thing in terms of IBS patients is that babies who have colic and they've actually looked at what is it that causes colic in babies? You know, you know, yeah. The latest evidence is that babies that have colic have high levels of Klebsiella. Klebsiella is a bacteria. And we know that Klebsiella is actually associated with other inflammatory conditions and autoimmune conditions. So Klebsiella excess in the gut is actually associated with ankylosing spondylitis, which is inflammatory bowel disease, which manifests systemically with arthritic symptoms. So, getting a history of colic is important. Listening to the history of, you know, were they vaginally birthed, were they breastfed, what type of diet did they have as a kid?

And, when did they get food introduced?

Yeah, and all those things can play a role in terms of early gluten.

Yeah, exactly.

Dairy. Yeah, exactly.

And trigger you got it.

Exactly. And just there's really listening to the patient, antibiotic use, did they have a lot of ear infections? Did they have a lot of strep throat? Did they get a lot of antibiotics? What's going on in the family? Did anybody else in the family have any digestive issues? So just taking the time to get that history allows you to sort of play detective and try to figure out what are the things that are potentially playing a role in driving this and what might have triggered it, and then personalizing. diagnostics and treatment and everything else. It's all about personalization.

I think it's very, very different what you're saying. This approach really is being a medical detective. Absolutely. And it is relevant whether you're breastfed or, for example, or vaginally birthed because that affects your gut flora and the development for your whole life. I recently read a study that showed bottle-fed babies have a high levels of a, what we call a short-chain fat which is made by the good bacteria this one is called propionic acid. Now, this is not such a good one, and it's been shown to induce autism in animal studies and has been associated with autism and ADD. That is increased when you're bottle feeding. When you breastfeed, you get increase in butyrate, which is the beneficial short-chain fat that actually heals the gut and reduces inflammation. There's all sorts of good things. So we think, oh, what's the difference? Bottle-fed breastfed. That's not to make people feel guilty if they have to bottle feed. You have to do sometimes, but you can fix that by making sure they have the right prebiotics and the right probiotics. Because breast milk has undigestible fibers that are prebiotics and sugars that are prebiotics for the good bugs that aren't actually digested by humans.

So, breast milk knows that. Exactly. And the other interesting thing about breast milk, I mean, if we could sort of bottle breast milk, it's very, very powerful stuff. There's a thing in breast milk called milk oligosaccharides and these are very, very complex sugar moieties. sugar chemicals. And they're actually so complex that for a long time, science didn't even study them because they were too complex. It was like this, you know, a Lego set. There was this incredible building blocks. And what they've done now, there's a couple of companies, one company in specific out of Europe, has actually synthesized one of the oligosaccharides in milk, and there are actually hundreds of them. And these act like fertilizer for the good bacteria. So these things that are found in breast milk are very, very powerful things. Yeah, yeah, so powerful.

And so we dig down into this story and figure out when did it start and what's connected to it? Did you have foreign travel? Because people often have post-infectious irritable bowel syndrome. People can get it after antibiotics, people can get it after any kind of stress or trauma. And people don't realize that it's connected to so many different things. So let's talk about what are the causes and then we'll go into sort of a case of how he would deal with this. So what are the top causes that you found in functional medicine that are driving irritable bowel syndrome for people?

Well, a lot of irritable bowel also is probably misdiagnosed, I think, as sort of SIBO. I think a large number of and SIBO is this diagnosis of small intestinal bacterial overgrowth.

So a bunch of people there will have SIBO or bad bugs growing where they shouldn't be in the small intestine.

Exactly. yeah, and I think that we're sort of finding that a lot of these people that we're diagnosing with this catch all term is real, they're really having potentially small intestinal bacterial overgrowth. There are tests that you can do for that.

We do the, that's also known as a food baby. When you eat food and you get a big bloated tummy right after, and as a food baby, that's what SIBO is.

Right, 'cause what's happening is the, you know, there's, we have bacteria on our skin, we have bacteria in our mouth, we have bacteria in our stomach. small intestine, large intestine. Most of them sort of live in the colon. But there are times when the colonic bacteria start migrating upwards and they go higher up and it's sort of like, you know, invading a neighborhood. That's, you know, and they mostly sterile up there. Most, it's, yeah, it's, it's, yeah, it's not, it's, it's, I think, not necessarily that we've always thought it was sterile, even the stomach has bacteria.

Right.

And, but it's just much less and they're all, different kinds of bacteria. So the lower bacteria are more fermenters. They ferment things. And that's where we get, I think I have talked about that. And I've seen this a couple of times, the auto-brewery syndrome, where patients, in fact, I just recently had a patient, a fantastic case. And he actually heard me on one of the podcasts where I was talking about auto-brewery syndrome. So I did a consult with him and he ended up going and buying a breathalyzer.

Yeah.

And he confirmed that he has auto-brewery.

Syndrome because he was producing alcohol.

He was driving over the limit.

He was driving.

He was just short of the limit. It saves your money on beer for sure. It was actually quite interesting because he actually was doing a very strict low-carb, no-sugar diet. And even with a really good diet, he was pushing making alcohol. It's really quite interesting. So yeah, but anyway, so talking about, you know, how do we diagnose this? you can do stool testing. I like the GI map test where you can do quantitative PCR for bacteria, yeast, fungi, pathogens.

That's looking for the genetic material of the different bugs.

Yeah, it's like CSI. Yeah, CSI, I find it to be a very, very helpful tool. You can also do the hydrogen methane breath test. Although the thing about the hydrogen methane breath test is that I've had some patients who have significant irritable bowel, SIBO type symptoms. They're bloating and they're negative. And, I think based upon my reading and literature is that they're probably producing hydrogen sulfide. And, I think that when you just sort of get a history of they past very foul smelling gas, it smells.

Like rotten eggs, that's usually the people that are producing hydrogen sulfide. People don't realize it but cows just don't produce methane. Humans can produce methane if you have this and we measure that coming out in your breath, we measure hydrogen, we have to take this drink. And that's really a clue that there may be these bugs growing in there and they have to be treated directly.

And that can really help a lot of people. Oh, huge, huge amounts. And it's often missed. It's very much missed and you also have to do the test properly because everybody produces small amounts of hydrogen and methane. It's just that you want it lower down in the colon and it really doesn't become as much of a clinical issue. The other thing is to also think about in those types of patients is to make sure that they have sufficient amounts of stomach acid. Stomach acid is very, very important at helping with the proper digestion. So you can actually do testing for gastrin levels. And I've been surprised at how many people have high gastrin levels. So when you don't have enough stomach acid, your body produces more gastrin, which is the hormone to pump out more hydrochloric acid.

But it's like slogging a dead horse.

Exactly, absolutely. And I would venture to say that most people's issues are not high acid in the stomach, it's low acid.

It's low acid. And we're taking more of these acid blockers, which by the way also cause irritable bowel.

So they help your heartburn, but they cause trouble bowel. And now there is a role for short-term use of these acid blockers like in the ICU. The studies have been shown they've been very helpful to prevent stress-induced ulcers and hospital-acquired pneumonia, but they're really to be used short-term. And when you start using them long-term, they are very toxic.

Yeah.

They are very toxic. They produce increased intestinal permeability. They cause malabsorption of nutrients, vitamin B12, iron, other trace minerals.

Zinc, yeah.

And they cause bacterial overgrowth.

And they cause osteoporosis and malnutrition.

Oh, yeah.

Huge, huge, huge.

And I actually, I am really surprised that these things are over the counter. They really should not be over the counter.

You know, I remember, I've talked about this before, but I remember when I was in medical school, school, the rep, these just came out and the drug rep was like, these are super powerful drugs. You never want to give them more than six weeks. They're designed to treat ulcers. After six weeks, you gotta stop 'em. Don't take 'em long term. And now people eat 'em like candy all day long, every day. And I'm like, this is not good. And we see so many complications from that. So if your irritable bowel is there and you have these acid blockers that you're taking, there might be a correlation. So we talked about SIBO and we, we talk, we can talk about how to treat that, but essentially it's killing.

The bad bugs and re-seeding the gut.

And what other things are driving your bowel besides that?

Well, also you can also potentially have problems with part of the intestine that causes peristalsis. So normally you think of the gut as like this conveyor belt that's always moving things through. So you eat and within about 24 hours everything should sort of move through. And there are some patients, especially with the patients who have problems with constipation that will have problems with motility. or really motility disorders.

And there's a, you're just not moving down.

Not moving down. And there's a part of the intestines which is called a migrating motor complex. And you can actually test for antibodies against the migrating motor complexes called IBS-SURE test.

And I'll do that in the future.

It's almost like an autoimmune thing. Yeah, it's a little bit like a paralysis, if you will, or a weakening of the gut. And we talked about that earlier how you, in some cases, you'll have patients who have Lyme disease. I actually had a very good integrative gastroenterologist who brought my attention to this is that he had a lot of patients who had refractory SIBO. So, SIBO was one of those things where it sometimes can come back and oftentimes does come back. And what he was finding is that some of his more difficult patients with refractory SIBO actually had underlying Lyme disease. And Lyme disease affects the nervous system. He tied the two together because there is a paper, it's called Bell's Palsy of the Gut. In fact, Bell's Palsy is where you get facial paralysis. I'll never forget this, when I was in my private practice, the first time I saw a real acute case of Lyme disease, the patient presented with Bell's Palsy. Her face was paralyzed and I did testing on her and the patient had acute Lyme disease. That is one of the known complications. It's thought that also that Lyme disease can actually affect the gut and you get paralysis and decreased motility of the gut.

Yeah, so that is a very important point because there are the typical things that go on, food sensitivity, gluten, dairy, some people react to the chemicals in food that are food additives, food colorings, sugar alcohols, emulsifiers, all these things that are in our junk and processed food do have a huge impact on people. There's obviously the SIBO, so many people get parasites.

Yeah, we have little microscopic hitchhikers.

Yeah, and there's one called Blastocystis, which is really common. It doesn't cause a horrible disease, but it can cause you bowel in about.

30% of people with IBS. Oh, yeah. I'm going to venture to say that I have picked up a lot of these. I call them little microscopic hitchhikers. And when you actually look in the mainstream literature, they basically say that a lot of these you don't need to treat it. So, there are times when somebody can, they have dientamoeba histolytica and blastocystis and sometimes endolimax nana. And sometimes people will have these and they'll have a small amount of them and they may not cause any symptoms whatsoever. But if I find them in the, in the stool test and patients are.

Having symptoms, I treat them. Yeah, absolutely. And then, and then there's also other things. People have, like, enzyme deficiencies we can see on stool tests. They're not digesting their food well. Yep. And also, you know, for me, I, I had terrible irritable bowel. almost 30 years ago, it was for mercury poisoning because mercury affects all your enzymes. It basically interrupts the enzyme function of many different enzymes throughout your body, including your gut. And, until I got rid of the mercury, my irritable bowel wouldn't go away no matter what I did. I just ate turkey and broccoli and.

Brown rice for six months and nothing worked.

And, so you have to keep being a detective and thinking about what are all the variable causes and, we look at the stool testing, we look at breath testing for bacterial overgrowth, we look at organic acid urine testing to see if there's markers of bugs in there. And we sometimes dig down deeper to look at things like metals or lime or other tick infections. So there is a real deep thinking about what is going on with this person. And it's guided by their history, right?

Exactly, yeah. And it's personalized. It really is. It's totally personalized and it takes time to figure that out. And sometimes it may take several visits. You and I have had patients where we've been seeing them for a long extended period of time and they make some progress, they get better, they may backslide, then they'll have incremental things, so we sort of uncover, as you say, the layers of the onion.

Yeah, no, it's true. I had a very bizarre case once that just reminded me of who was suffering terribly from digestive issues for years and years was overall systemically inflamed. And it turned out he had Babesia, which affected his gut. He also had histamine intolerance.

That's another one.

There are histamines in food. And so we put him on a low histamine diet. We treated his Babesia and his symptoms got better. So, it sounds like it's a little bit of a roundabout way to think about it. But what case have you seen in your practice that sort of stood out.

For you around irritable oh, I recently had a patient who came in with the diagnosis of urtibol. You know, that was, that was the official diagnosis. And interestingly, she gave me through the history that, you know, her symptoms seem to have been triggered when she had Lyme disease. And her Lyme disease also was complicated by pots, which we've talked about before, which is postural orthostatic tachycardia, which basically means that you have autonomic nervous system dysfunction as relationship to Lyme. So, that sort of means when you.

Stand up, you get dizzy.

Yeah, when you stand up, you get dizzy and your heart starts going really fast. And so, there are a couple of things that make me think about Lyme disease. So, when I have a patient who's got POTS, and sometimes people just come in and that's their only diagnosis is POTS, I said, okay, well why do they have POTS?

I love medical terms, postural orthostatic hypotension, which is called POTS. It sounds like a fancy diagnosis. What does it mean? It means when you stand up, your blood pressure drops. It doesn't tell you anything about why or what caused it. And it's just, it's like so frustrating to me that nobody keeps thinking about what's going on here with these patients.

So they can actually fix the problem. Right, right. So this lady had this history of Lyme and pots. And then she ended up having cancer of the uterus and went through radiation. She was supposed to get like 25 rounds of radiation. She had to stop at 12 because she developed diarrhea.

And.

Radiation colitis. Radiation colitis, radiation enteritis. Exactly. And believe it or not, you know, the doctors who were treating her said, oh, that has nothing to do with your symptoms. I mean, they literally, you know, they didn't want to.

They didn't want to, you know, admit.

That it was from the radiation. Exactly. Exactly.

Yeah. Yeah.

And then she came in and she actually had had some testing done previously, and what I. What. And I think the doctor who actually did the testing didn't know what.

What.

How to interpret the test properly, but the patient's calprotectin was elevated. Calprotectin is a biomarker in the gut. I call it like CRP of the gut. We have this compound which is called high sensitivity C-reactive protein. When it's elevated, it is a biomarker of systemic inflammation and it's also highly correlated with heart disease. Calprotectin is found in the gut and it's sort of like the CRP of the gut.

So when you see that- and you.

See it's high inflammation. Yeah, exactly. So it tells you, and usually for classic, what we call irritable bowel syndrome, you don't usually have inflammation per se. There's not really dramatic inflammations. There's dysfunction, but there's not inflammation. So her irritable bowel was actually partly inflammation. And I think that was one of the big things that was driving it. the other thing in this particular patient is that she had on her testing undetectable acromancy, misenophilia.

That's a big word.

All right. So this is a, it's a mucus loving bacteria. And what we found is that higher levels of this is correlated with leaner body mass, less chance of obesity, less chance of diabetes. And it's also, you want to have higher levels of this because it's a protective good bug. it's not a probiotic.

It's an immune disease. Yeah, let's look at the risk of cancer. Yeah.

So, and it's not a bug that you can go out and get a pill for, at least not yet. Eventually we might, because it's so beneficial. But what we find out is that this particular bacteria feeds on fibers, specifically polyphenols.

What are those?

Polyphenols are those compounds that are phytonutrients found in lots of colorful foods and vegetables like pomegranate and green tea and cranberries. Cranberries, yeah.

So, your little bugs like cranberry pomegranates and green tea.

Exactly, they love that stuff. This is their, you know, I call it the miracle grow. You know, that's a miracle.

You put this stuff on there and the good bugs flourish. There's a fairly new understanding, you know, because we thought, okay, you need prebiotics, you need probiotics, but I think the polyphenols are also critically important to optimized in your gut for the three P's.

Yes, exactly. And, the other thing which I always come back to when I think about the digestive tract is it's a beautiful visual is the rainforest. And, for anybody who knows about rainforest, rainforests are full of biodiversity. There's lots of flora and fauna. There's frogs, there's birds, there's all different plants, insects, worms, and the more biodiversity that you have in your personal internal rainforest, the healthier you're going to be. And, there's tons of studies that have shown this and it's non-linear, it's very, very complex because there's this whole ecosystem and there's this cross-feeding and interaction that happens when you have a diverse internal rainforest.

Yeah, it's so true. I was talking to a professor at Harvard who's a psychiatrist and also runs the Department of Nutritional Psychiatry and she's written a book called this Is yous Brain on Food talking about the microbiome and its effect on psychiatric illness. Absolutely. So, we used to think that the crazy person would have the gut problems. Turns out the gut problem people have the crazy thing upstairs because of the gut thing and fixing the gut fixes the depression, anxiety, OCD, all these crazy things that we thought of our psychiatric illnesses. Turns out they're really related to the imbalances in the microbiome and the lower diversity and Western societies have increasingly lower diversity.

Oh, huge, huge. Yeah, exactly. And it happens very, very early on is, and what typically will happen is, you know, there are some people that, you know, they're very picky eaters and they'll be eating the same food over and over and over. And, you know, I always tell patients that, you know, you want to try to increase your intake of diverse fruits, vegetables, you know, try to eat and see it right now in the Berkshires, you know, we have lots of great vegetables that are available that you may not get year round. And, you know, eating, I call it, you know, you want to eat a Crayola crayon box, the more color you.

Have in your diet, the healthier your diet is going to be. And I want to come back to something you said before about this inflammation in the gut. There's a whole new phenomenon we call pre-inflammatory bowel disease. So we thought irritable bowel wasn't inflammatory. It turns out even if you can't always detect it, it tends to be very inflammatory. And, there are cases like you saw people with this pre-IBD. So, it's like pre-Crohn's or pre-colitis.

Yeah, it's not like one night you.

Wake up and all of a sudden you've got Crohn's disease. Yeah, so there's this level of this marker we check and it's often elevated and people have not full-blown Crohn's disease, but something's going on in there that's driving inflammation. You have to deal with those factors. Exactly.

Yeah, exactly.

So this patient also had elevated gluten antibodies, right? So she had this low acrylmannia, she had elevated gluten antibodies and this high calprotectin. And so this is a sort of a perfect setup for having a messed up gut.

Absolutely, yeah.

So how would you take care of this patient then who came in with the gluten issues, the low acrylmannia and the calprotectin?

Well, I mean, to address the inflammation.

And by the way, these are something that your traditional doctor will never look for that we usually look for in functional medicine at the Ultra Wellness Center, sort of standard operating procedure for us to really look at these things. Yeah.

So, you know, to treat inflammation, I always like to check the omega-3 fatty acids. When you have low essential fatty acids, you're a setup for inflammation. So, in this particular patient, the patient had suboptimal omega-3 fatty acids, which are related to eating cold water fish. So, I got her to take some supplemental omega-3 fatty acids, had her increase her fish intake. I used an anti-inflammatory supplement called Ultra Inflammax, which has a powder curcumin and other things to help decrease inflammation in the gut.

Ginger, rosemary.

Exactly, ginger and rosemary, exactly. And then also used Enteragam, which is a immunoglobulin that helps with patients who have sort of, you know, diarrhea type. That's actually a prescription medication.

So tell us more about what is this immunoglobulin stuff?

Because you hear a lot about it and. Yeah, it's, it's Serum Bovine derived immunoglobulin. And it's basically colostrum.

Yeah.

You can think of it as, like, colostrum. And, yeah, colostrum is, you know, colostrum is the stuff that in Mother's Milk that is before the milk comes on. And it gives immunity to the baby. Exactly. Yeah, it's, it's passive immunity, so it's the mother's immune system that's passed down to the child. So, which is really quite amazing when you think about from an evolutionary standpoint that the mother's immune system has evolved and learned what to deal with and how to deal with it. And then that immune system gets literally transferred in the breast milk to the baby.

Until the baby can actually develop its own.

Exactly. Exactly. And the interesting thing is our immune system has to learn. It's got to be, it's got to go to school. And that's why, you know, when you see these little kids who are crawling around on the ground and they're putting stuff in their mouth, we're developing what's called mucosal tolerance. It's the immune system learning to deal with the planet Earth. And it realizes that, okay, you're going to be around a lot of these things. You don't want to overreact to it. And, you know, we always talk about, you know, what is a healthy immune system? Well, a healthy immune system is a tolerant immune system.

Yeah, it doesn't overreact or underreact.

Exactly. That's the key thing. And I always say to people, I want a strong immune system. Well, if you have a too strong immune system, that's called autoimmune disease. Right. When your body's reacting to everything and it's like overreacting. So, having tolerance and mucosal tolerance is really, really important. And the other thing, which I, and in some of the lectures I do, and I like to emphasize this is, you can think of, you know, we have the Boston Symphony Orchestra and unfortunately, Tanglewood is is not open this season because of COVID But in the Boston Symphony Orchestra, you have the conductor. And the conductor balances the woodwinds and the strings and everything, and they sort of keep everything in balance. And, in the immune system, we have cells called the T-reg cells. And, the T-reg cells regulate the immune.

System between the various parts of the body.

So, like, make sure it's not too hot, not too cold. Exactly, exactly. And, guess what? helps with T-reg cells.

Fiber. What?

Fiber. Yes. So that when you're eating lots of fiber, you upregulate your T-reg cells. Other things that can do that, vitamin A can do that too, but fiber is probably one of the biggest things.

That helps with the T-reg cells. Yeah. And functional medicine is really practical too because when you have a patient with any condition, particularly with gut issues, which is often driving so many things. So even if you don't have quote, bowel, a lot of health conditions are driven by imbalances in the gut. Like we talked about psychiatric issues, heart disease, obesity. But we have a very specific framework called the 5R Program, which we use to methodically treat and restore gut function. And we've been doing it for decades, even before people called it the microbiome. Our goal is to really optimize the microbiome as a way of treating all sorts of diseases. So how would we do that in this patient?

Obviously, you've got rid of the gluten.

Mm-. Right?

Yeah, yeah, obviously in a patient to decrease inflammation, you can decrease the foods that typically drive inflammation. So things like trans fats can drive inflammation. Sugar drives inflammation. Dairy, big thing, especially cow's milk. Sheep and goats tend to be less inflammatory. I'm not sure why that is.

This is the A2 casein.

Oh, ETKs. Okay, that's it.

There you go. A1 casein is very inflammatory, which is all the modern cows, all the heirloom cows and sheep and goats still have A2 casein, which is less inflammatory.

It tends to cause less digestive issues for people. Yeah. And then gluten is a big driver. And then other things that, you know, are found in foods, like we talked about things like emulsifiers and artificial processed foods. Processed foods. Exactly. If you can't read it on a label, don't eat it.

Yeah, yeah.

Yeah, you don't need it. Another one, which is, I'll mention this, is titanium dioxide.

Yes, I was just reading about that.

Exactly.

Tell us about that.

Yeah, it's bad. It's the thing that they add to food to whiten, and they'll use it in a lot of products, gums, they use it and such.

It's in a lot of vitamins you.

Get at the drugstore too. Exactly. And titanium, your body does not like titanium. It's a metal and your body can react to it. It's almost like a nanoparticle metal that you're putting in the body and it's been shown to, the gut does not like it.

Yeah, one more reason to not eat processed food. Exactly. All right, so we've gotten, we're removing the foods, we're removing these processed ingredients, removing trans fats, gluten, dairy, other food sensitivities. I had a patient, for example, had diarrhea for years and years. She had a sensitivity to eggs.

It wasn't an allergy, she got rid of the eggs and her diarrhea went away. Yeah, you know. And then there are some times where, you know, doing a strict elimination diet to try to tease out, 'cause food is complex. there's lots of things when you're eating food. There are also some patients that you, I know you've probably done it yourself, where sometimes you've got to put them on what's called an elemental diet. You basically give them a, a, pre-digested. Pre-digested. Exactly. And that helps to sort of calm down and quiet the gut. In fact, mainstream doctors will do that for patients where they'll, they'll actually put them on parental nutrition where they just.

Give them it through the, they sort of rest the gut. Yeah. I mean, we're going to be having a podcast with one of our nutritionists. We're going to be talking about elimination diet and why we do it and how we do it. And, there's lots of different versions, particularly for IBS, the FODMAP diet, there's a specific carbohydrate diet, there's traditional elimination diet. So, I think this is a really important thing is to get rid of the things that are causing the problem. And, then we look for parasites and.

Other bad bugs, SIBO, breath testing.

So, we actually clear out all the bad stuff.

Yeah.

Take out the bad and put in the good.

What's the next step for how to repair the gut on the 5R program? Well, you can reinoculate. Sometimes you can use probiotics along with prebiotics. We call that synbiotics. The big thing you got to watch out with that, and you've probably seen this, is if you add that in too soon, you can actually sometimes flare up bloating symptoms.

It's like a war between the good guys and the bad guys. You got to clear out the bad guys first. I call it the weeding, seeding, and feeding program. First you got to do the weeding.

Then you got to seed the good guys, and then you got to feed them. Exactly. Yeah, that's exactly right. And then the other thing that's also important just that sort of helps with digestion is, and I've been using this more and more, is stimulation of the vagus nerve. So the vagus nerve, we have the autonomic nervous system in the body and there's like, my analogy is the gas pedal and the brakes. And the gas pedal is a sympathetic, so it sort of gets things going and the brakes sort of slow things down. So the stimulating of the vagus nerve is resting and digesting. and that's what you want to be doing. You want to be in a relaxed state when you're, when you're digesting your food. And we tend to have a sympathetically driven Society, you know? Yeah. Running, going. We're, you know, always on the go.

That's why people say prayers or Grace before eating to calm everything down.

Yeah. Right.

Yeah. And we just kind of eat on the Run, eat on the car. Yeah.

People walking down the street.

And we're all guilty of that.

People watching TV. Yeah. That, the worst thing is actually, I call unconscious eating, you know, it's like you're sitting in front of watching a movie and you got the popcorn all.

Of a sudden the big bowl's gone. They actually did those studies where they literally have a secret trapdoor on the bottom of the bowl and they fill.

It up from the bottom and people just keep eating and eating. Exactly.

Unconscious eating, it's like it doesn't stop. Exactly, exactly. Okay, so the 5-R Program is basically remove the bad stuff, basically replace the things that are missing. Digestive enzymes, digestive enzymes and prebiotics, reinoculate and then repair, which is the next phase, which is how do you fix a leaky gut?

Right.

Yeah. And that, that's, you know, you talked about butyrate. Butyrate is one of the things that's very helpful for leaky gut. And I've been using that in, in supplement form. Yeah. I also encourage, you know, fiber, fiber use. And glutamine can be very helpful. Aloe is, can be really helpful. Quercetin or other, other things that vitamin A, zinc, zinc. Yeah. Zinc in the form of zinc carnosine is also there's some really interesting studies on that with leaky gut because when you take things like Advil or Aleve, those things cause transient leaky gut. So, you're going to develop leaky gut and for people who are taking them chronically, they've shown that just taking zinc will help repair the gut with the NSAIDs.

That 1961 American Heart Association policy was the first time anywhere in the world that people were told cut back on meat, cheese, eggs in order to prevent a heart attack. And that was the beginning of it all. So it's really important to say that at that time it wasn't a low-fat diet. They didn't say reduce fat overall. It was just saturated fat.

No, in fact there was a lot of evidence around that time that carbohydrates were driving obesity and carbohydrate restriction was a standard recommendation for weight loss.

Yeah, and also for controlling diabetes. It was in the early 1900s, and actually there was a large amount of science in the early 1900s, mainly in Austria and Germany, and the story is that that science disappeared with World War II. Those scientists kind of were dispersed. But they had done the science on showing how weight gain is really not controlled by energy and energy out calories and calories in. It was really controlled by hormones.

Yes.

And they understood that. They didn't at that point understand that it was the insulin hormone, which turns out to be the most powerful hormone for fat deposition. But they understood there was something going that was controlling fat deposition that was not about calories. And then all that was lost.

Yeah.

That science. It was all written in German, and then the whole field of nutrition moved over to the United States, didn't read the German articles, and then it was just lost. So instead, Center Stage is Anselm Keyes and his colleagues, and they become the most influential nutrition scientists of the 20th century. They're very closely tied in with the National Institutes of Health, that they're the people with all the money for all the research grants. They kind of take over the whole nutrition establishment, really. They're the editors at all the major journals. They're the top people at all the expert conferences.

And they support depressed dissent.

Right?

Like John Yudkin was another scientist at the time that was showing that sugar was really the driver of all the cardiovascular risk factors. Yes, so they completely silenced him and he ended up sort of dying in disgrace at the end of his career, basically kicked out of his lab in London and the high fat crew didn't do well and the low fat crew ascended.

Well, there were, these were, you know, so these were like Yudkin, as you say, he was a professor in London, at a London University, his theory was that it was sugar that caused heart disease. And there was another man, MD in the US called Stefanson, and he had traveled all over with the Inuit in the Arctic, the Canadian Arctic, and he saw them being devastated by carbohydrates. So it was his theory that it was carbs and sugar. So there were these other thinkers with other hypotheses, and it is true. that they were silenced. I mean, which is a shorthand way of saying they were criticized, they were told that, you know, really in the same way that we see today. They're accused of being backed by industry. Their science was attacked. They were attacked. They couldn't get their papers published in journals. I mean, that's the way that science is silenced.

And the data that that Dr. Keys used was based on looking at patterns of consumption of foods in a certain number of countries in Europe. There were seven countries. And it was just looking at correlation. And most people don't understand that science is not all the same. Science that shows correlation doesn't prove anything. It just shows a correlation. I could wake up every morning, the sun comes up, they have nothing to do with each other, but there's 100% correlation.

I'd like to think the sun shines because of humor.

Oh, thank you. I don't think that's it. I don't believe that. And I think that they tried to follow up on that research because they believed the theory and they saw this association. But when they did the follow-up research, it was fascinating because they did a study that could never be done today. It was unethical. It was 9,000 patients in mental institutions who were captive. They gave half of them high-saturated fat diet and half of them vegetable oil or corn oil. and they were sure that the corn oil group would do better, have less heart attacks, less deaths. And in fact, their cholesterol dropped on the corn oil, but their heart attack rate and death rate was dramatically increased. For every 20, 30 point drop in cholesterol, there was a 22% increase in heart attack and death. And they suppressed that data for 40 years because they didn't believe it and they didn't want to publish it. And it was just published a couple of years ago.

So, yeah, that's the Minnesota coronary survey. Ansel keys was one of the primary investigators. And you're right. It was the biggest, most ambitious test ever funded by the National Institutes of Health of his hypothesis.

Right.

And they, and, and at the end of that study, what happened was they did actually publish it in 1979. But the, but that was 16 years after they had finished the study. So they study results come out. They don't publish them for 15 years. And they finally put it in this little out-of-the-way journal that they know nobody will read. And when one of the investigators was asked, why wait so long? Because it is, of course, a form of cheating in science not to publish your results. And he said, well, there was nothing wrong with our data. We were just so disappointed in the way it turned out.

But wasn't there more data that came out?

So then, yes. So then in 2015, these researchers at NIH went back to that study, and they went back to the son of the investigator, and they found out that in the basement there were these magnetic tapes from the study that had never been fully analyzed, and they analyzed them and used special machines to try to get the data off of them, and they discovered that they had never published the full results. And so in 2015, they published the result that actually the more the men lowered their cholesterol, the higher their rate of dying from heart disease. so everything that, so, and there's the exact opposite.

And the butter group did better, basically.

And the butter group did better, right? And so, you know, it's, and actually, so the story is, the bigger story is that that study, the idea that study results are ignored, not published, that is not the only example of that.

I mean, and this was a randomized controlled trial, which is the highest level of evidence. It's not like a population study where you can see a pattern, but you can't prove anything.

This data is more convincing. Right, so this is the kind of data, randomized controlled clinical trial, gold standard of evidence. It's where you can demonstrate cause and effect, right? That's what they do for drug trials. They have to do a trial to show cause and effect. Otherwise, as you say, it's just this kind of weak observational data. That data relies, its data relies entirely on people recording what they ate. You know, these food frequency questionnaires. It's like, how many peaches did you eat in the last six months? Now, how many pears did you eat in the last six months? And then, like, and repeat that for.

Other 200 items on the list.

And then, as a- Somebody asked me what I ate yesterday. I can't even remember. I can't remember what I ate this morning. So that data has been shown to be just notoriously unreliable, right? And they can't, and they've actually done tests on it, you know, see what do people actually eat, and then what do they remember they ate? People, it's all confounded. Like the fatter you are, the more likely you are to lie about the data.

I mean, it's really fascinating, but the point-: It also depends on what the prevailing view is. If you think meat is bad and.

You eat meat, you're going to minimize your reporting of how much meat you ate. Right, and you minimize your, they've shown.

That people will underreport how much sugar they eat.

They overestimate the exercise and underreport the diet. Well, that just sounds like human nature to me, but I think that the point the point is, is that's really unreliable data. And that was the data that Ancel Keys used as the foundation for that first American Heart Association policy. But then, you know, and that was in 1961. So what I want to say is that the, what kind of happens after that 1961 policy is the government, the US government and governments around the world realize, okay, we have to test this more rigorously. So they did these trials, these government funded trials, including this Minnesota coronary survey. They actually tested like more than 75 5,000 people all over the world in a number of randomized controlled clinical trials. That's again, gold standard of evidence. And I describe these trials in my book. I mean, they were, as you say, many of them, the kind of experiments you couldn't do anymore because they were in mental hospitals. You're not allowed to do that anymore. If you like force people, their food. But they were really, that makes it very what we call well controlled, meaning you're controlling everything that everybody's eating. It's not like giving somebody a diet book and saying, you know, eat this, right?

Yeah.

And then you don't know what really happens. And none of those experiments could show that replacing saturated fat with vegetable oils was able to prevent heart disease or cardiovascular death, right? None of them. One of them that was done in Australia showed that the men on the corn oil diet died at much higher rates than people on the regular diet. And none of those, I think the kind of the blockbuster thing to me, which I didn't even really know until after my book was published is that none of those studies, the billions of dollars spent by governments around the world, none of those studies have ever been reviewed by our dietary guideline committees, which is our expert bodies making our national food policy. Extraordinary. They've just ignored all those trials.

The best possible evidence on fat and saturated fat was completely ignored.

Paid for by taxpayers everywhere.

Right. And it's absent from our guidelines, which we're going to talk about. So back to Dr. Keys because I think this is a fascinating story. He, at the end of his life, changed his mind, didn't he?

He did on cholesterol. He decided that dietary cholesterol, which is why you have egg white omelets instead of regular omelets, in the late 1980s, he said, I don't think cholesterol is such an issue. And he recanted on that part. I don't think he ever recanted on saturated fats that I know.

And the data from that study, you went back and looked at it. And what was fascinating to me was that the signal that came up even far stronger than fat was sugar.

Yes.

So this is going back to the Seven Countries Study where they looked at what people ate in seven countries and then they looked at to see who died and who had heart attack. And what he decided was that it was a saturated fat consumption that was most closely correlated with your likelihood of death, right? It turned out, or cardiovascular death. So I went and looked at that study in a lot of detail and one of the things that I found was that later on when they re-analyzed the data, they found that sugar and sweets were actually much more highly correlated with cardiovascular death. And I actually asked some of Ancel Keys' colleagues, well, why did you not report on sugar? And they said, well, we had discussions about it, but Keys was just so opposed to the idea that it was sugar that caused heart disease and he was very, sure of his own idea that it was fat. So, I mean, one of the things about Ancel Keys is- so much for.

The purity of science and independent researchers. I mean, honestly, Nina, when I was in medical school, I thought that science was this beautiful, pristine, honest field full of integrity and truth. And as I've learned and as I read the data, it's highly influenced by the food industry. highly influenced by bias. It depends on the design of the study and who's looking at it, who's paying for it. It's fascinating. And, Marion Nestle is writing a new book about how the nutrition science that we have is corrupted by the food industry, which basically obfuscates the truth. And they try to promote basically false science, like fake news, like soda doesn't cause obesity and dairy is great for your bones and all sorts of ideas that we have pretty much taken on in the society are often corrupted by the food industry. So science is not this pure field of truth. It's essentially a often corrupt thing and you have to know how to read it and think about it. And that's what's impressive in your work is that you really go through the nitty-gritty and you don't just look at the headlines. You go between the lines, you look at the data, you look at the appendices of the data, you look at the appendices of the appendices of the data, and you really kind of find.

Out what's going on. It's very impressive. Well, thank you. I mean, but like you, I started off thinking like science was this sober, reasonable, rational processing. My father is a scientist and was a professor at Stanford and, you know, his journals, like you open up his journals and there's like math problems on the page. Like, I mean, I just grew up in this world thinking this is, you know, science is about responding to observations honestly, and then if you're, if your explanation doesn't explain the observation, then you have to change your hypothesis. But the thing about nutrition science is, you know, the food industry is huge and they have a stake in what nutrition science says. If there's a study coming out that says that, you know, five walnuts a day helps, you know, lower your risk of heart disease, you can be sure the walnut industry is probably behind that study, but it makes a big difference for them. Like, what can they put on their packages? And, you know, can they claim they lower heart disease? so the food industry is really, and they know how to corrupt science at its very source, right? They know how to fund studies and get them, get, you know, how to distort the, even the study design so that they can get a favorable response. But I think in this field, there's another factor playing at play, which is maybe even stronger, which is that the scientists and experts themselves, I don't believe that they were, you know, Going back to the 50s, 60s, and 70s, I really don't believe that they were corrupt. I didn't really find evidence of that so much as I found that they fell in love with their own ideas. They were really just unable to see data to the contrary, and they couldn't accept it when there was contrary data. And Ansel Keys kind of did the opposite of a scientist, which he believed that he was right until proven wrong.

Yeah. Science like you-'re supposed to prove yourself wrong.

You're supposed to prove yourself wrong. And then like only after you gradually accumulate data, do you think like, well, maybe I'm right, but let me see how I could prove myself wrong again. You know, that's the way science is supposed to work. So, and then I think the other factor is that these ideas became institutionalized, right? Once they're adopted by public health institutions, medical institutions, the entire government, and then you have this thing where the institutionalization of science. Institutional science is almost like an oxymoron because science requires self-doubt, the ability to change according to data, the ability to be flexible. Institutions just need the exact opposite, right? They can't flip-flop on their publics. They need constancy. They need it for their credibility. They can't be changing. So it's very hard once this was adopted by the US government, the idea that you should not eat fat and cholesterol, it just became so hard to reverse out of those positions. That's true.

I mean, I work at Cleveland Clinic and Steve Nissen is there who's one of the leading cardiologists in the world. He's the head of cardiology there and the vice chairman of cardiology, cardiothoracic surgery also had these discussions with me that, you know, they think that the whole idea that fat is bad is wrong and they maybe even saturated fat and that's bad is wrong. And yet at the Cleveland Clinic, when you go into the hospital for heart surgery, you are prescribed a heart healthy diet which is high carb, low fat, even though they know that's a problem. It's just so institutionalized and embedded, it's hard to change.

It's really hard to change.

Yeah, so true. So when you wrote the book, we had a certain set of beliefs that were pretty prevalent around fat and saturated fat. Have you noticed anything change about our beliefs about fat and carbs in the last few years since you wrote the book?

Yeah.

I mean, what's, has the conversation changed? You know, when I, so when I started my book, of course, I was a vegetarian eating a low-fat diet. And then that was in the early 2000s. I used to track what, you know, do a word search on saturated fats to see what the conversation was about saturated fat. That debate has really changed in the, in the scientific literature. So there's now like eight major review papers from teams of scientists all over the world saying that saturated fats have no effect on cardiovascular mortality. So in the scientific community, there is debate over that. I don't think it's really changed so much. You've seen many, many more articles in the lay press about it. But there's so I was- It's an open question. I would say it's sort of a wobbling open question now. And that was not true before. Before 2014, that really was just, it was like, sealed settled science and now it's unsettled science. And there have been two changes that I think will probably really surprise.

Your.

Audience'S mind, which is how many people know that there's no more caps on dietary cholesterol? In other words, eat as many eggs as you want, don't worry about shellfish, eat liver if you like it. That is no longer, there are no more caps on cholesterol. We had them for 35 years.

I love what I heard about that. One of the people on the guidelines committee said, you know, you know what? We never really looked at the science. We just thought it was bad. So we eliminated it for 35 years and told people to eat egg white omelets and, oh, sorry, and they call it no longer a nutrient of concern, which is pretty amazing to me.

And they did kind of, so that was in 2015, the dietary guidelines dropped that limit and the American Heart Association did the same thing a couple of years before. And that went all the way back to Ancel Keys, right? That was his idea. Nobody really ever looked at the science too hard. But they did kind of tiptoe away from that advice. I mean, there were no big headlines. There wasn't a big, there was no press release around it, right?

It's not a nutrient of concern.

And we were wrong. And we're just not gonna, we don't.

Wanna talk about it anymore.

So true.

But the other amazing thing is that they no longer recommend a low-fat diet.

Yeah, that's pretty shocking. And again, there was no headlines about it. No, they didn't, they just removed removed the limit. It used to be 30%, 35%, now they were like, it doesn't matter, right?

Now they're like, we don't talk about it. So what they did is actually they did a little, it's a little bit of a rhetorical jujitsu, I think, which is that they just stopped talking about the low-fat diet. If you go to the Dietary Guidelines American Heart Association, you search low fat, it's like it's gone. Like, wow, that was my life. And then what they've done is they've shifted over to talking about dietary patterns. so now we have dietary patterns, which are all fruits, vegetables, whole grains, nuts, seeds, fish, low-fat dairy, and lean meat. And they don't talk about how much fat you should eat.

And they talk about lean meat, and they also talk about low-fat dairy, and they also talk about low-saturated fat.

Yeah, there's still a cap on saturated fats. So that's why you're supposed to have lean meat and low-fat dairy is because of the saturated fats. but the low-fat diet is gone. But again, no press release, no announcement, nobody knows that they should stop avoiding fat.

Right. I mean, it's still news. I still go everywhere, I see egg white omelets and skim milk everywhere. And I think people haven't got the news. I'm like, I said this guy was getting coffee, I'm like, why are you having the skim milk? He says, well, isn't fat bad? And I'm like, no, that's old news. It's pretty amazing. So, one of the things in your book I loved was this sort of taking us back in history and looking at populations and what they ate. And the truth is that there's never been a voluntary vegan society in the history of humanity. And in fact, there's been varying amounts of animal food that we've eaten. You know, we often ate a lot of plant foods. Average indigenous cultures ate up to 800 different species of plants, but they also ate a lot of animal food. And some of the stories you tell, for example, about the Plains Indians who pretty much consumed only buffalo, or the Masai had incredible health and longevity. Could you talk about that a little bit?

Yeah, I mean, I include a bunch of examples in my book of populations that ate a lot of fat. Like, okay, so one of them is the Masai warriors who were studied quite rigorously by a biochemist from the University of Vanderbilt named George Mann who went and looked at them in the 1970s and discovered they were eating, the warrior men ate nothing but meat, like five pounds of meat a day, and milk and blood. That was their diet. Total, no fruits, no vegetables, total failure by our standards. And they had extremely low levels of cholesterol. He measured their cholesterol, they had low levels of low blood pressure, their cholesterol did not rise with age, which was just assumed to be normal, and their blood pressure didn't rise. And then he did electrocardiographs, so 600 of them could find maybe a slight indication of a heart attack in one person. So they seemed to be, they had seemed to have excellent cardiovascular health, even though they were eating a diet that was the very opposite of what we're told to eat.

And then- and it wasn't just the average meat or milk or blood. It was grass-fed, it was organic, it was heirloom.

It was very different than where you eat. It was what they could hunt.

Right.

So it's not coming from a feedlot. That's definitely true. But, you know, high in saturated fat. I mean, their diet was like 60-70% fat. A lot of it was saturated. They didn't drink lean milk or low-fat milk. And then there was the Plains Indians who lived, you know, their main food source was buffalo. They also had some root vegetables. And they ate a lot of meat and they were known to be very long there were more centenarians living in the Indian populations, according to an anthropologist report, than there were anywhere in the world. So they seemed to be really long lived. And I include these examples not to say you should eat a diet of milk and meat and blood or buffalo, although it seems likely that you could and be healthy, and I'll tell you one more example of that in just a second. But I include those examples just to show show, these are data points that are contrary to our thinking, right? So, if you have a theory or hypothesis, you have to explain this. How can these people even be alive according to our theory? They should all be dead. The same thing in the South Pacific.

They weren't having animal food, but they were having coconut fat. 60% of their diet was saturated coconut fat, and that's the most saturated fat we have. And they had no obesity, heart disease.

Their cholesterol, their blood sugar, it was all It was all fine. It was all fine. And there's-- what I wanted to tell you that there was actually a year-long experiment by that MD, a doctor I mentioned named Stefan Son, who had gone to the Arctic to study the Inuit. And when he came back to New York, he decided, along with a colleague, to eat nothing but meat and fat for an entire year. And they did this experiment. Part of it, they actually stayed at Mount Sinai Hospital, and they stayed under a team of supervised by doctors. doctors. And then they were allowed out for the rest of the year eating nothing but meat and fat. At the end of that, they were, they were, had every test they could think to give them. There were six peer reviewed papers published out of that study, and they were found to have absolutely been perfect health. They could find no deficiency. Not even, you think they would have like vitamin C deficiency because they weren't having, I mean, thought, but somehow from the, you know, they ate every part of the animal. They ate the brain, the the whatever. So they were getting, it wasn't just the muscle meat, so they got all the nutrients that they needed to live.

So let's go into this because there are a lot of people out there who strongly believe that meat is bad and that being a vegan is the way to long life and health and that we should really be eating no animal foods because they promote heart disease, cancer, diabetes, and this is a huge debate out there. And I think, I used to be a vegetarian for 10 years, you're a vegetarian for 20 years. How do you address this debate in literature? Because there are studies that show that people who eat more vegetables and eat less meat do better and live longer. There's a seventh country, I mean, the Seventh Day Adventist, there's Dan Buettner's work around Blue Zones. How do you sort of address that?

So, I just want to acknowledge that people don't eat meat for ethical reasons or they don't want to eat animals and that is a whole, I mean, I respect that and that's your own, that's a different, I want to just like, let's just address the question of health.

Health, yeah. And we can leave environment on the side because we have to address that, but I don't think anybody agrees that we should be eating factory-formed animals of any type because of a lot of reasons for the environment, other effect.

So putting all that aside, let's just address the health claims. So, So, there's kind of two sides to this. One is that, you know, is meat bad for health? And, you know, originally it was convicted because it contains saturated fat and cholesterol. So, cholesterol is no longer a nutrient of concern, saturated fats wobbling, we can't have, there's no rigorous science to show saturated fats have any effect on cardiovascular mortality. So, meat has kind of been exonerated on those counts, right? And now it's There's an effort to kind of convict it based that it causes cancer or maybe diabetes. And all of that data is that weak observational data that we talked about, right? So relies on food frequency questionnaires, really, really unreliable data. And then here's the other thing.

There's a lot of contradictory data. A lot of studies show it helps. Some studies show it hurts.

Yeah.

And it's very confusing.

So, and then when they actually, like, what do they actually find? They find people who eat processed meat have a 0.18 greater risk of, I mean, their numbers are tiny, tiny, tiny, and they're so small that they are not really, they're not considered reliable by, you know, standards of the field. So, and just a tiny other, like.

Sort of- Just to help people understand that for a minute, because this is important in science. If you do a regular randomized control trial, that can prove cause and effect, and you may not need a lot of numbers. If you look at studies that are observational studies, which are looking at populations over time and tracking what happens and what doesn't happen, you have to have a big effect to really consider there's any cause there. For example, smoking was a 20 or 30 fold increased risk of cancer with smokers. Whereas me, you're talking about a 0.18 or 0.2 increased risk, which sounds like a lot when you say it's a 20% increased risk. But in terms of these types of studies, unless it's two or three or four, it's not really relevant.

Right. I mean, and the ones in meat are all below two. So again, 0.18 versus 20 to 30.

Right, exactly.

Yes, smoking causes lung cancer. Does meat cause cancer? Data don't support that.

Four pieces of bacon a day. for your whole life increase your risk from 5 to 6% of getting colon cancer. Yeah.

Which based on if you even believe the data, which is... And the other thing about that data that makes it unreliable, especially with regards to meat, is who has been eating meat over the last 30 years? Okay, these are people who don't listen to their doctor's orders, obviously. They've been shown to be people who don't exercise as much, tend to be fatter, tend to drink more, tend to do everything wrong. They're what we call in science, the non-adherers. They do not adhere to anything. They don't wear their seatbelts, you know? So those people, they knew it was.

Bad and they still did it. They didn't care about their health and.

They had all these bad habits. So that's what you're measuring in meat eating. So if you see any greater risk of disease, if you're seeing it, it could be any one of these factors and they can't really control for them in these studies. They can't go around and saying, you know, Tell me about your risky behavior. So that's also makes that data unreliable. So I don't see any rigorous, by that I mean clinical trial data, showing that meat is bad for health. In fact, there are a bunch of clinical trials that I've just been reading that show that looking at lean meat versus regular meat, not lean, so all of your cardiovascular risk factors look better on regular meat.

If you love that last video, you should definitely check out the next one on Food is Medicine. Even gun violence, it's connected to our diet because our diet shapes our thoughts, our feelings, our moods, our brain function, and activates the fight or flight response. Literally, when you eat junk food, you activate cortisol and adrenaline. It's literally like you're being attacked.