How To Reduce Inflammation & Prevent Type 2 Diabetes! | Dr. Mark Hyman

More than nine out of 10 Americans don't meet the criteria where they don't have high blood pressure, high blood sugar.

High cholesterol, are not overweight or haven't had a heart attack or stroke. People love hearing your hot takes on all different topics. Speaking of different topics, we had a question that was submitted through our High-Ho.

Community, and this question is from Judith. Hi, Dr. Mark. Quick question on intermittent fasting. I'm hearing too many sides of the story, good, bad and ugly. Can you give us some advice? It's so funny. I was in Washington, D.C. yesterday working on our work with the Food Fix campaign to fix our food system and our food policies. And I was talking to one of the senators and he started asking me about intermittent fasting. I thought, wow, this is really good. We're getting all the way over there. So let's just sort of start with the top.

And Mark, before you jump in, if I could add in a little bit of subtext, Part of what I'm hearing that she's saying is that, you know, you have some people that a few years ago when a lot more research was coming out on intermittent fasting, it's like it's the cure for everything. Everybody should do it. Nowadays, we've done episodes you've had some people on that are talking about how some people have to be mindful of it and maybe women in particular in their prime fertility years. So there's a lot of nuances that are there and I think that's leaving.

A lot of people confused. So we'd love to have you jump in on that. For sure, for sure, for sure. I think let's just start out with what is it? What are the definitions? What does it do? Who is it for? Why is it important? There's a lot of terms thrown out there: time-restricted eating, intermittent fasting, ketogenic diets, fasting, mimicking diets. All of these approaches are attempts to give the body a break from eating, an attempt to trigger these ancient pathways that get activated when we're starving. So our body's really smart because when we're out hunting and gathering and if we would find a big patch of berries or some fruit tree, we just gobble it up and we'd gain a lot of weight and we'd pack it on. And then there'd be a time of scarcity and then we would use our body's ability to burn fat to deal with lack of calories from carbohydrates. to actually activate these healing repair systems. So recycling proteins and recycling parts and using energy from different sources. And it's quite impressive the systems that we have. So all these techniques are designed to do that. So time-restricted eating means eating within a fixed time window. It can be eight hours, 10 hours, 12 hours. So that would be like a 12-hour fast, 14-hour fast, 16-hour fast. That's something you do every day, and we should do every day. Nobody should eat within 12 hours of their last meal after going to bed. That's just a given because it gives your body a chance to repair and heal and clean up and do the work it needs to do at night. That's really key. You can extend it to 14 hours. If you have dinner at 6:00 and you finish then, you eat 8:00 in the morning, that's 14-hour fast. If you have dinner at 6:00, you eat at 10:00 in the morning, that's a 16-hour fast. It's not that hard to do, but some people, it's not ideal for if you're very thin, if you're again maybe trying to get pregnant, if you're having very fast metabolism like some people like I do, if I do two extended periods of that, I'll start to drop too much weight. Probably shouldn't say that in public, but anyway, that's what happens. When you tune up your metabolism, you actually can actually do really amazing things with your diet without having to suffer. So, I'm able to actually learn how to fix my biology in a way that it's very, very active in terms of its metabolism. So, time-restricted eating. Then there's intermittent fasting, which may mean anything from a 24-hour fast to a 36-hour fast to a 10-day fast or a week-long fast, three-week fast. Those are intermittent fasts or prolonged fasts. Then there's fasting mimicking diets, which is essentially an 800 calorie diet a day for five days. It's been studied a lot by Walter Longo, who's one of the leading longevity researchers. A lot of his work's been funded by the NIH. That also seems to have amazing profound effects on reducing inflammation, reversing metabolic dysfunction, cancer treatment, so many different things. They all activate these pathways. How does it work and what should we do and who's it for and who's it not for? Well, I just read a study last week or two weeks ago. It was so depressing. Just as context, when I graduated medical school, not a single state had an obesity rate over 20%. Now, almost all are about 40%, which is scary. 40% of kids are overweight and not even that, but even if you're not overweight, a lot of people are not metabolically healthy. They have high blood sugar, high cholesterol. high blood pressure, they have overweight tummies, they have high heart attacks or strokes. So it's basically only 93% of people, actually 93.2% of people, are metabolically unhealthy. It's more than nine out of 10 Americans don't meet the criteria where they don't have high blood pressure, high blood sugar, high cholesterol, are not overweight, or haven't had a heart attack or stroke. that's terrifying to me as a doctor and as someone who uses food as medicine, it's an emergency. So these techniques really help to fix that problem. They fix your metabolism by triggering these ancient starvation mechanisms. And basically, I think I covered this maybe in an earlier podcast, but there's basically four nutrient sensing pathways. And I just finished my book on longevity called Young Forever. And it was so amazing to sort of understand how these ancient systems are embedded in our genes and our biological pathways. And that by really just smart hacks, you know, little simple techniques you can do, you can activate these longevity pathways that are also increased metabolism pathways. And, and, you know, two of them sense excess calories and food and protein. Two of them sense lack or starvation. So insulin signaling pathways are related to eating too much starch and sugar. Those get activated. And that's really what we have an epidemic of. People just eat too much dark sugar, activates insulin pathway all the time. And so we're always having insulin on. Now, you need insulin to some degree because if you don't have it, you can't utilize energy and so forth. But you don't want it going all the time because it's like the fat storage hormone. It's like miracle grow for your fat cells. So you don't want that on all the time. So making sure you have these periods of breaks where you're not stuffing yourself or eating all the time or having snacks at night or having a lot of carbohydrates and starch, that will shut down the insulin signaling pathway. Then there's mTOR. which you may not have heard about, but essentially it senses protein and as well as carbohydrates and sugar. And again, if you're always flooding your body with food, you can't have a time when this pathway is quieted down. When it's quieted down or silenced, mTOR causes something called autophagy, which is essentially where we eat ourselves. So auto means self and beige means to eat, right? And so basically, It's a self-cannibalism system that recycles old parts, creates these little lysosomes, it's just sort of like Pac-Man, go on to old bits and proteins and cells and kind of re-digest them and then kind of recycle, it's like your recycling plant. And so it's really important to do that, especially if you don't, if you don't get enough food, you have to recycle stuff because it's like, you can't get new stuff from your diet, so you have to recycle. So this is a really important longevity switch. And all these also, when they're, when, when you kind of reduce the, the times of eating, like what I was mentioning, you also activate other pathways. You increase mitochondrial formation, you increase DNA repair, you increase your anti-inflammatory pathways. So you shut down inflammation, which is so linked to everything, especially aging. The other two pathways are sensing scarcity. That has to do with sirtuins. You might have heard about that related to red wine and resveratrol. And that's one of the things that activates NAD. You might have been hearing about NAD as a compound that the body makes from vitamin B3 and other things that actually is involved in energy production, but it also activates sirtuins to do DNA repair, increase mitochondrial production, and also function and also reduce inflammation. And so it also improves insulin sensitivity. So there's all these secondary benefits. And then the last one is called AMPK that is activated by lack of, you know, sugar and stuff. So when you take metformin, for example, this is a drug that's being studied for aging, it activates the NPK, which actually puts in this process to reverse insulin resistance, which is great. So all these things are really important. And when we do any of these things, they're really, whether it's time restricted eating, intermittent fasting, keto diet, fasting, making diet, they all do more or less the same thing. And they all basically activate our longevity and health pathways. So the key is to activate these in the right way. But it's like Goldilocks. You don't want too hot or too cold. I mean, if you're always flooding the body with calories and starch and sugar and protein, you can't repair and heal. But if you don't have enough energy, you're gonna die. And if you don't have enough protein, you can't build muscle. So you kind of have to have, people go, oh, you should be vegan because you're gonna shut off mTOR and that's really great and no protein and it's not so simple because you need to build muscle. Muscle is the currency of longevity. and without it, you can't build muscle, particularly certain vegan proteins are low in leucine. So there's ways to be vegan and be healthy, but it's trickier. So I think that's sort of how I think about it. It's like these intermittent fasting, all these different dietary hacks are all about playing.

These ancient longevity switches. Yeah, I think you said something interesting, which is the Goldilocks zone. I think there's a tendency that when people find out about something, they can go to one extreme. And then sometimes, you know, there's a recent study that was published on fasting where most of the headlines that were covering this study, and we'll link to it in the show notes, were talking.

About.

Intermittent fasting has no impact on weight loss. That was sort of like the study headlines. I don't know if you saw this. This was like a couple of months ago, Mark. But if you dig deeper into the study, you find out that there's actually a lot more nuances. So on one side you have the media that might sensationalize things. On the other side, you have people who can sometimes get a little bit too extreme, and like all things, There's a lot of nuance that's there and we have to personalize it appropriate to us. So if you have some concluding thoughts for Judith, Mark, on just basics of fasting for somebody that's looking to get started, what would it be?

I mean, I think the simplest thing is just try a 14-hour fast and once a week, you know, for a week every day and see what happens. Do you lose weight? Do you feel better? Then try a 16-hour fast, see how you feel. There's no one size fits all for everybody. I think it's really important to see what your body does, how you feel, what your energy is, what happens to your metabolism. And also the same thing with intermittent fasting. If you want to take a longer fast, a 24-hour, 36-hour fast once a week or every couple of weeks, not a bad idea. I just met with somebody who did 10-day fasts. That was amazing. I think there's a lot of ways to actually help people reset, but it's really about listening to your own body. If I do a 10-day fast, I'd be wasted away to nothing. that I have no reserves. But, you know, that's okay for me. I'm happy to be that way. Other people, you know, may be overweight or have diabetes. I mean, they can do a three-week fast if they want to.

So, it's really listening to your own body. Yeah. And, on the topic of listening to your own body, I think another aspect of that is like the seasonality, like the seasons of the year. Right now, we're in the thick of summer. Talk to me about how sort of for you, as an example, you're a very social person. you have a ton of friends, you're traveling a lot right now during the summer, how does your meal time differ in the summer compared to let's say the fall or winter months? Is there any changing? Do you notice yourself eating later? Are you just cool with that because it's just part of the process and it's part of enjoying summer? Yes, absolutely.

I think in the summer, it's interesting, I'm more active but I also eat more fruit because it's like peaches and things that I don't get to eat normally. So, I think there is a sort of a natural increased activity with also increased produce. And, I still don't eat a ton of fruit, but I think I let myself indulge a little bit more in things in the summer because I'm also very much more active and it just sort of naturally all works out.

All right, thanks for that, Mark. We're actually recording this and you're in New York City. You want to give a little context of just what's going on with you? I think people like to hear a.

Little bit about what's going on in your life. Sure. So, I don't know, I was a yoga teacher before I was a doctor. I was a family doctor and I went to a small town in Idaho. I was pretty in shape before running yoga. I was a young doctor, had a family, two kids, and I lived in this house on the top of this mountain. In Idaho, we basically chopped her on wood, everything was like wood stoves. I was stupid and basically carried huge amounts of wood wood in the really bad body mechanic posture out in front of me like 50 pounds at a time back and forth because I was lazy and I didn't want to take too many trips. And it blew out a disc. I blew out a disc. And that was when I was 32 and I had to have emergency surgery and it left me with sort of chronic limp and the surgery kind of went bad and that it kind of the disc got recompressed and I recovered from it. I went to China, I had back back acupuncture. It was quite amazing how much the acupuncture helped. And I've been pretty good. I mean, super fit, I exercise, I ran for most of my life. I stopped probably five, six years ago. Ride bikes, tennis, yoga, hike, water ski. I mean, pretty much ski, do it all. And I've been doing pretty good. And a couple of years ago, I did something stupid again, and chop wood. And somehow I think I need to stay away from wood, fire stoves, and chopping wood. And I had another disc go out. because my back was kind of all funky and because of the first injury because I've been limping for 30 years. And I never let it stop me. I just kept going. And so I had that surgery, but there was a complication and I kind of recovered from that pretty well. I did a lot of rehab, TB-12, and I did a lot of regenerative medicine, which is quite amazing as a therapeutic intervention for chronic orthopedic injuries. And I'll explain what that is in a minute because A lot of us sort of struggle with aches and pains that are arthritis or injuries. Mostly for me, it's my stupidity, but I think the truth is that there's a lot of therapies out there that have been developed in the last few decades that are incredibly different than what you get when a nutritional doctor treats you and are extremely effective. The kinds of things that I, for regular back pain, yoga is amazing. stretching is amazing, moving is amazing. I mean, and also, you know, massage and various kinds of treatments can be very helpful. Acupuncture. So those are really helpful for most people with back issues. But then there's people who have really more serious problems, more serious injuries. I need a little extra help. And that's really where regenerative medicine comes in. And it's sort of an extension of functional medicine. Functional medicine actually helps to regenerate the body's own healing systems. That's what's so beautiful about it. It activates our healing systems. And so the body has all these things in it that are healing systems that get turned on when there's an injury. Like if you cut your skin, how does it heal? I mean, it's not easy to think about, well, how do you make new skin? Or if you cut half your liver out, you can grow it back. How does that work? Well, it works because you have stem cells, and stem cells contain little healing packets of information that that they produce, that they release when there's a problem, and they go and kind of do all the repair. It's like a construction crew that comes in and fixes everything. And inside those stem cells are things called exosomes, these little tiny packets of healing factors that get released. So you can use exosomes in regenerative medicine. They also use placenta. Placenta is just full of healing factors. So nobody dies from it. It's just basically the placenta gets thrown away usually. They say, throw it away. and we get saved. And the compounds in it are so reparative, so anti-inflammatory. They're amazing. We call it Placental Matrix. There's other stuff in the amniotic fluid that they call amniifix. And these are even regular orthopedic surgeons or neurosurgeons sometimes. So this stuff can be injected in any areas of pain, inflammation. So I had a lot of that done. And also there's things like PRP injections, plasma lysates. and even other things like peptides can be injected, ozone can be injected as all therapeutic tools. And then of course there's this really cool technique called hydrodissection which essentially releases the stuck muscles, nerve fibers, and the fascia. So they all get kind of stuck together with inflammation and injury and they can kind of get separated out so that the nerves don't get so irritated and compressed and that relieves a lot of pain. So I've had all that done. It was really like a miracle because I had been on and off in back pain for 30 years and doing that really relieved the pain. What I got going on now was just another injury from scuba diving where I did something stupid and turned wrong and I got a little bit of a disc irritation that I'm getting that dealt with again with some of these regenerative therapies later today. And I think that it's really amazing because it's like we're entering an era of medicine where not only are we able to replace joints, but we're able to actually activate our body's own repair system to activate cartilage regeneration, repair of tissues. And so I'm kind of excited about this whole era because a lot of times people struggle with being active because they have various injuries. And I've never let that stop me because I've always learned how to manage it and how to do things to help me recover and repair. But back pain is really a huge factor in this country and globally, and it costs so much in terms of medical care, in terms of disability, productivity losses. And the beauty of it is there's really simple things you can do to fix it. So there's different kinds of workouts, exercises, stretches, but this regenerative medicine field is just emerging as a really powerful tool. It's not so much covered by insurance.

Yet, but I think it will be soon. Well, thanks for that context, Mark. And obviously, you know, I'm sorry that.

You'Re in a little bit of pain right now, but I know our podcast community appreciates you.

Yeah, so if you see me wiggling around, that's why. Well, I think that was a great overview from what you went through. I'm gonna play this question here on that topic of back inflammation. Let's see, you probably covered most of it, but let's see if there's anything else additional that you might want to add. So I'm gonna pull up that question right now.

Hi, Dr. Hyman. I was wondering if you could address inflammation in the back which causes impingement on nerves. Thank you. And there can be, there can be for different reasons. You can have inflammation that comes from arthritis and bony compression. You can have it from a disc bulging. You can have it from just overall just kind of stagnation in the back. Acupuncture can be extremely helpful. Cupping can be extremely helpful. Various kinds of therapy, physical therapy can be really helpful. I've actually worked a lot with Tom Brady's training and rehab program called TB12. There they have amazing results and I found incredible results using that plus the regenerative medicine. There's a lot to be done and people really don't have to suffer if they really know what to do. Also, magnesium is really important for general back pain and spasm if you have achy backs, Epsom salt baths are great, hot and cold therapy is amazing. So there's a lot of ways to do it, yoga.

I think the very low-cost interventions can really make a big difference. Fantastic. All right, thanks for that, Mark. We're gonna switch from back inflammation over to intermittent fasting. All right, Mark, let's jump into the next question. This question that we have is on type 2 diabetes, right up your wheelhouse. I'm going to pull it up over here. And this question is from Maria.

What are your thoughts about managing type 2 diabetes or pre-diabetes with only eating a large amount of fruits, vegetables, and grains as opposed to the conventional method?

Thanks. You know, I think it's such a challenging space out there because, you know, there's one camp that says the only way to reverse diabetes is to go vegan and eat fruits, vegetables, grains, and and other groups like, well, the only way to reverse diabetes is to go keto. And then there's everybody in between. I'm sort of in the middle. I think there's a lot of evidence that people switching from a highly processed American processed American horrible diet to a whole foods plant-based diet do better. They really do. And if you take out all the junk and you put in fruits and vegetables, whole grains and beans, yes, 1000% people will improve their metabolism, feel better, have more energy. The question is how long can they sustain that and what happens over time if you do that? And how far can you get? I think it's very, very hard to be a healthy vegan. It's very hard. I know this because I see patient after patient struggling with this and struggling with their weight because they're eating in this life, unless you have a personal chef who's creating super nutrient dense, high fiber, high quality protein, good fats, lots of vegetables, what are you going to eat? You go to a restaurant, you go somewhere to buy something. It's hard to buy healthy vegan food, so you're ending up with more starchy carbohydrates, more grains, more refined flours. That just makes everything worse. I think, yes, we need a lot more fruits and vegetables. And yes, half our plate should be, or 75% of our plate should be plant foods. But for diabetics, the science has really crystallized this, and this is really called the carbohydrate insulin hypothesis. And there's a beautiful scientific paper released last year by a leading scientist from Harvard and heads of many, many professional associations challenging the old idea that metabolism and weight loss is about calories in, calories out. And the quality of the calories is what matters the most. In carbohydrate calories, whether they come from sugar or flour, which below the neck are the same, or from whole grains or beans, they do have more starch. So, it's not that they're bad necessarily, but in order to get the same, for example, protein that you'd get from four ounce piece of chicken, you have to eat like two cups of quinoa. So that's a lot of food and most people don't eat that much. And then of course it comes a lot of extra calories and extra starch. So I think, you know, I've been most impressed with the data from the group that was working with Virta Health looking at ketogenic diets. And now you have to understand when you see a 5% weight loss, or a half a point drop in A1C in a diabetic, you think, wow, this is a great intervention. When you use a ketogenic diet, you see 12% weight loss on average. You see 100% of people get off the main diabetes medication, which is oral hypoglycemics, 90% plus percent get off insulin, and 60% completely reverse type 2 diabetes. and I'm talking about people who were not just mildly diabetic, I'm talking about really advanced type 2 diabetics. And I've seen this over and over again. I've written about it in my books. This patient Janice, I always talk about it, had a BMI of 43, type 2 diabetic. And we basically, you know, she was on insulin for years and in three days she was off her insulin, in three months she was off her medication, A1C went from 11 to 5.5, 11 is like, you should probably be in the hospital. And five and a half is kind of normal. It's a logarithmic scale, so it's not like 1, 2, 3, 4, 5, 7. It's 1, 10, 100, 1,000. So that's kind of a scale. It's a different kind of scale. So that's a big, big change. And she didn't go on a keto diet, but she did cut out grains and beans and fruit, except for berries and sugar, and ate lots of good quality fat. It was mostly fat, lots of vegetables, and some small amounts of high quality protein. And it was just amazing to see what happened to her. So I think we see this over and over again if we do the right thing. And there may be variations. Not everybody is the same. Some people do fine with more grains and beans, others don't. I literally had a patient yesterday, I was like, look, he's, I'm a vegan, but I can't lose weight. I got this weight around my gut. And I'm like, okay, well why don't we get a continuous glucose monitor and put it on you and see what happens? Like maybe if you eat lentils, you're fine. but if you eat kidney beans, you're not. Or maybe if you have black rice, you're okay, but if you have brown rice, you're not. So everybody's different and we have to see how you respond. But at the end of the day, if I'm treating someone diabetic, I take them off grains and beans. I put them on fruits and vegetables, high quality protein, lots and lots of fat, avocados, olive oil, nuts and seeds, even saturated fats. Most of these patients can be fine. If it's from high quality grass-fed animals, that's fine. So I think we now know actually how to reverse diabetes. I was in Washington this week, advocating for policy changes. I was talking about, it's with the White House, Congressmen, Senators, the USDA. And it was interesting, talking to one of them, won't name who they are, but it was like, oh, well, really we need to focus on the quality of the food we're delivering. It's not all about just providing calories for hungry people, it's about what calories. and then she's like, well, there's a lot of debate about what quality is. I said, well, not really. I mean, if you really kind of get below the noise, everybody agrees that we should be eating more whole food. Everybody agrees we shouldn't be eating processed food, except of course the makers of processed food. So, I think there's a pretty good consensus on what comprises a healthy diet, and the disagreements are really around the margins.

Okay, Mark, that was great. Let's go to our next question here that we have on the topic of cystic Acne.

Hi, Dr. Hyman. What are your thoughts on the long-term use of spironolactone to manage cystic acne?

And what are the alternative options? Okay, so cystic acne, I think for that question, is a really nasty condition. It's not like regular pimples. It's like deep pimples that form scars and can be really hard and thick. and inflamed. And there's a lot of different causes for it. And if you're talking about was a medication that's used in people with a condition we call PCOS. We've talked about this on the podcast before, polycystic ovarian syndrome, which is really driven through insulin resistance or pre-diabetes we know generally acne is caused by mainly two things. I would maybe kind of add three. One is sugar, and no doubt about that at all, insulin resistance, and PCOS is part of that. Two is dairy, and particularly modern dairy tends to cause a lot of inflammation and acne. And three is, I think, alterations in the microbiome, and often it can be yeast overgrowth or inflammatory bugs. And so those are the main reasons people get acne. So in terms of spironolactone as a medication, it's fine to use sometimes because women who have PCOS have facial hair, they can lose hair on their head, they can get infertility, their periods are wacky. And so it's used as a treatment for acne. I'm not opposed to it, but it's much better to try to deal with the cause. So the diet I just talked about for diabetics would be the approach. So intermittent fasting or chemotherapy and eating, you know, cutting out starch and sugar and carbohydrates, for the most part, eating good fats. I mean, obviously my joke always is that the majority of your diet should be carbohydrates. the most important thing you need for long-term health and longevity. And what I'm talking about is fruits and vegetables. Like vegetables are carbohydrates. Broccoli is a carbohydrate. Asparagus is a carbohydrate. That's fine. But so is a bagel. That's not fine. I don't, I mean, honestly, Drew, I don't, I don't, I was kind of always almost like, I was sort of embarrassed to go to the Senate and the Congress. I was, I was going through the cafeterias and It was terrifying. I mean, it was Dunkin Donuts, Baskin Robbins. There was all this sugary stuff, sodas, chips. I mean, I guess they use it to fuel all the staffers to work 20,000 hours a week, but it was just scary to me. I think everywhere you go, there's all these highly processed foods that are really driving so much of the problem. If you can get rid of all that, if you can actually start to eat the way we talked about my 10-day detox is very, very helpful. It can be great for cystic acne and then you might need other treatments. There's other treatments that can be used more functional medicine approaches to dealing with the microbiome, to fixing yeast issues, dealing with insulin resistance, to improving the overall metabolic health to reduce the acne and obviously getting with sugar.

So, going back to your story about Congress and the cafeteria. So what'd you end up eating?

Me?

Actually, I didn't. I had water. And I actually, for lunch, we ran over to this club. It was a very old club. We've been there for 65 years. It's kind of a private Republican club. And I don't listen. I Democrat Republican. My friend Rick Warren's like, you know, I'm not right wing or left wing. I'm for the whole bird. Otherwise, you fly around in circles. So, like, I had great meetings with you know, Republican centers or Democratic centers and congressmen. So I feel like we just gotta work all together to fix this. But I went to this club and they had, it was this crab salad. And so basically they, you know, they had crab salad and I just got extra crab. And then I'm like, I want extra broccoli, extra asparagus. So I put like extra broccoli asparagus and tomatoes and a few smaller wood on there.

I saw pepper and I eat the crab and was really good. So that was my lunch. Yeah, pretty much anywhere you can go. you can always find an okay salad. I'm not always gonna say that it's great. And you can add protein and fat to it, and that's like pretty much a go-to, like regardless of where you are in the world, except for India. It's very hard to find a salad. They don't keep a lot of fresh greens there, so that's always a challenging thing that I have when I go visiting there.

Thank God, thank God, otherwise you're gonna get like dysentery if you eat there.

I'm Mark.

Why do you cook food when you go to those countries?

Yeah, I hear you on that.

And it's amazing in India, it's really interesting. They have so many spices and the spices basically kill a lot of the bacteria. So it's really, it's actually very smart.

Let's actually follow up a little bit more on your comments about meeting with people and meeting with senators, congress folks. What do you think are some of the key priorities? You know, when you try to eat the whole whale, it's very hard to like make progress, but what are some of the first pieces that could be bitten off to actually start seeing change? Is it schools? Is it changing our health incentives and reimbursement systems? So yeah, what are your thoughts on that? For sure, for sure.

Thanks.

Well, thanks for asking. It was a fun week in Washington. And I was at the White House yesterday and I'm like, we don't want to boil the ocean. We gotta just figure out the winnable win. She goes, well, maybe it's getting so hot out, we can boil the ocean. It's like the temperature records are off the chart this week. I'm part of a group that I started called the Food Fix Campaign, which is a nonprofit educational group and also advocacy group to help policy shift. And we really have a very focused agenda for now. So we have a lot of policy initiatives we're working on. Everything from child labeling of food and regenerative agriculture, which we sort of need to fix just to both improve soils and improve the quality of food and revitalize rural communities and economies. But this week we're going to focus on the agenda for the White House Conference on Hunger, Nutrition and Health. And you have to realize, this is a conference that hasn't happened for over 52 years. The last one was under President Nixon. It established a lot of our nutrition policies over the last 50 years, and we need to update them. And by the advocacy of my friend, Dariush Mozaffarian, the Dean of Tufts School of Nutrition Science and Policy, and my team and others, we've advocated for this White House Conference to bring together all the stakeholders to come up with a set of recommendations that can be implemented through regulatory channels or legislative channels to move the ball down the field and actually update our policies to address the fact that most of the diseases we see today are caused by food that are chronic diseases that are cured by food. So I was very hopeful around that. And we really, you know, focused on a couple of things. So a number of years ago, I worked with my friend Tim Ryan, who's a congressman, Rosa DeLauro, who's now head of the Appropriations Committee in the Congress. And and we got them to commission the GAO, which is the Government Accountability Office, to do a report on what's the state of our policies related to chronic disease and nutrition. I wrote a book about this. I've written about this for I think the first time I wrote about it, I think it was 2005 in my Ultra Metabolism book a long time ago. It's gotten a lot worse since then. I thought, you know, it was bad that there were a lot of policies that didn't work together, there was a lack of coordination, things were across purposes. I was like, okay. When I got to the airport, I was like, holy cow. There were over 200 policies, 21 agencies often completely working in odds with each other. So for example, the USDA says, eat half your plates as fruits and vegetables, but only 0.45% of agricultural supports go for what we call specialty crops. which means fruits and vegetables and most of it's for apples. Or we say, don't eat sugar sweetened beverages and sodas and our dietary guidelines with the USDA puts out, but then with the SNAP program or the food stamp program, we fund $10 billion for the soda or 40 billion servings a year for the poor. So there's all this stuff going on like that. And so we basically got this report and as a result of the report, the Government Accountability Office recommended to Congress they start a federal entity to address chronic disease and nutrition, which has never existed. Believe it or not, we don't have anywhere in government that's addressing the fact that chronic disease and food are connected. It's amazing. Even though it's over 80% of our health care costs, one in three Medicare dollars is on diabetes, it's the biggest driver of all health care expenditures. And yet there's no organization in the government that's trying to address this problem. So we got, based on this report, we worked with Congress and we got this entity established, hopefully with HHS, and it passed through the House. So it was passed through the House bill of appropriations to establish this entity, and then the Senate has to pass it, but I think it will. So we met with a lot of senators to talk to them about it and how we kind of need to move this forward. So that actually will establish an umbrella organization within the government to address all of the challenges we see around our food policy. So it's really, it's like the It's like the big tent that everybody can get in and actually deal with all this stuff. So that's a real key focus. The second we really focused on was integrating nutrition into medical care, whether it's food pharmacies, produce prescriptions, medically tailored meals, whether it's reimbursement for nutrition lifestyle education programs like we do at Cleveland Clinic, there's a lot of levers to pull in that space and we have a whole set of guidelines around that. So how do we integrate nutrition into medical care for chronic disease? you think it would be a thing, but it's not. And the third thing was, how do we change medical education? Because right now, if you've said to doctors, well, I want you to practice nutrition in your care of product disease, they're not going to know what to do. And, and so they're like, well, eat better, exercise less. I mean, exercise more, eat better, exercise more. I'm like, well, that doesn't really help. I, I mean, that is not a useful bit of information. Eat what? And exercise how much and where and So I think we really are trying to build sort of some sneaky ways leveraging for the government's power to induce licensing organizations like medical licensing, nutrition, licensing for physician assistants and various kinds of healthcare providers to have nutrition questions on their licensing exams. Because for example, my daughter's in medical school, and very little nutrition. And so they're just teaching to the test. They're just making sure they can pass the National Board exams, pass their licensing exams. And so they don't really study this because it's not part of the exams. So making part of the exams, all of a sudden the curriculum changes in every medical school across the country overnight. And then we're also focused on the graduate medical education because the government spends 17 billion with a B dollars supporting graduate medical education, like residency programs, fellowship programs, and there's no strings attached. It's like, here's the money, do what you want, and it's federal money. So it's like, well, we could say, okay, look, if you want to graduate primary care specialists, they have to be trained in nutrition and chronic disease, but it's pediatrics or internal medicine, family medicine, some of the specialties like cardiology, endocrinology, you can't get your fellowship or your residency training if you don't include these things. So we're working on all these different levers. And Washington is very tricky because it's like, what can you do? What are the incremental steps you can make to get things done? How do you get bipartisan support? You know, I met with, you know, people on both sides of the aisle, and, you know, it was great. And I just was so hopeful because, you know, I was meeting with a center from Arkansas, the Public Center for Arkansas, I was so supportive of regenerative agriculture, so understood the problem of our refined starchy calories and carbohydrates, really wanted to help and do something about this. And It was just very encouraging to me. So I feel like, you know, we're actually moving in the right direction. I don't think these conversations are going to happen a few years ago. So I'm really hopeful and I think we're going to move the ball down the forward to really implement food sin through our nonprofit as well as regenerative agriculture.

No, that's great, Mark. And I think everybody can follow along. You mentioned Food Fix. We'll have the link to that in the show notes. Yeah. foodfix.org and they can subscribe and stay up to date with all the work that you guys are doing in in Washington, D.C. Yeah, I mean, the conference.

Is going to be, the White House conference is something everybody can help support. And, you know, we put out on the social media post about getting people to give comments. And it was amazing how many people commented on these issues, and that we were able to then present to the White House and present to Congress. And this is what they want to hear. They want to hear constituents. They want to know what the citizens think. And so it's really important to get your voice heard. It seems like it may not make a difference. But it makes a difference. And so we're going to be doing a lot more in the next month to talk about the White House conference, how you can all be involved, how you can watch it online, but how you can communicate with your lawmakers to encourage them to move forward in this direction.

5 to 10% of women are impacted by PCOS. 5 to 10% of women, that's a lot of women.

I mean, listen, if half the population of America is 330 million, and that's the population. Half of that's like 100, let's say 65 million. And 10% of that's like 16 million people. That's a lot of people.

Yeah.

And it is PCOS or polycystic ovarian syndrome is a syndrome that involves irregular periods or not having any periods and androgen excess or changes in your hormone balance. But it is a syndrome. So that means that there's a continuum where some people have all aspects of PCOS and some people just have some aspects of PCOS and we can talk more about that. But so there may even be more than this that we're not even picking up. It's quite common and it's definitely something we're thinking about all the time when somebody's coming in and complaining about irregular periods or not having had their period for a bunch of months. you know, a young woman that should be having regular, you know, periods.

And then you have really heavy periods, they can miss periods, they can light periods. What are the other symptoms that are pretty common?

Yeah, so we see hirsutism, which is the growth of hair.

That sounds terrible.

Yeah.

The growth of hair where women don't want to have it. So on their lip, on their chin, on their abdomen, like in their belly area. So the hair is growing where they don't want to have it. And then they may have hair loss, where they want to have hair. So they may have some male pattern hair loss. They get acne and typically- Wait, wait.

So basically they're losing hair where they don't want to lose it and they're getting hair where they don't want it. And it's because of these high levels of male hormones like DHEA and testosterone that end up causing basically this male appearance almost.

Yeah, their hair growth shifts because their hormones shift. you know, you're starting to grow hair where you don't want it and not having good hair on the top of your head where you want it and all because there's been a real shift in your hormone balance in your body. And so when you check, when we actually check, we see high levels, like you mentioned, of that DHEA in the blood. We may see high testosterone levels or high free testosterone levels. And so those are some of the biomarkers that will show up when you look.

Yeah, and you also get acne, bad acne.

Bad acne, yeah. And a lot of times like in the lower jaw area, acne, and sometimes cystic acne. And then they'll often gain weight. Now, not everybody with PCOS is overweight. We have, there's a lot of women and we can even talk more about that today. There was a lot of women who who don't have the obesity part of it and they're just dealing with irregular periods. But for a good portion of women with PCOS, they gain weight because of the high levels of insulin that are going on. So, you know, if they have high levels of insulin floating around, so with PCOS, typically there is high levels of insulin. And we've talked about insulin so many times on this podcast and you've talked about it. many times, you know, but that insulin is that hormone that helps us balance our blood sugar. So you eat a meal, the body makes insulin, that insulin tells your body to take your food and get it into your muscles so it can be used for energy. And what happens when somebody has insulin resistance is their body's not listening to that insulin as well. And they've got high levels of insulin and that, that high level of insulin will cause people to gain weight around the belly. And so we often see with PCOS that weight gain around the belly, that belly weight.

Yeah, so this sounds like a miserable condition. You get pimples, you lose hair on your head, you grow a beard, you are infertile, your periods are all over the place. This just sounds terrible. And traditional medicine has very kind of weird approach to it, because the way I think about it is that It's called Polycystic Ovarian Syndrome, which makes people think it's a gynecological problem, but it's actually a dietary problem.

Right, right. It's often a dietary problem. And, you know, it's not always dietary, which is so interesting, right? Because we're, you know, we're learning about how toxins from the environment, like BPA and plastics, and we were learning about the microbiome and how that can be a trigger. So there are other, and there is so toxins and, and dysbiosis or imbalance in the microbiome are common.

But toxins that we see- Toxins can cause insulin resistance. Absolutely. And the microbiome imbalances can cause insulin resistance and prediabetes.

So it's all connected. It's all connected. And you're right, and a huge portion of people, it's dietary as well, you know, where they're, but I think it's important to remember it's not always that, right? But there's a huge portion of people where their, just eating too many carbohydrates, too many refined and processed carbohydrates for their body. So, you know, or for anybody's body. But those high levels of refined and processed carbohydrates really can be a trigger for this insulin resistance and weight gain. And then that insulin resistance shifts the hormone balance. And then you get this imbalance in hormones and you get the high androgens or testosterone and DHEA, and then the periods get irregular. But interestingly, as a syndrome, it's important that we pay attention to that individual person because it's very different. You may have 10 women in a room with PCOS and you may have 10 really different reasons for why they have PCOS.

Well, that goes to the root of it.

It's really not all the same, yes. It's really an interesting aspect for functional medicine doctors.

I mean, that just speaks to the whole approach of functional medicine, which is because you know the name of your disease, it doesn't mean you know what's wrong with you.

Right?

Absolutely.

It's just a description of the symptoms, but not the cause. And so functional medicine is about the cause. It's about why, not what. Not what disease you have, PCOS, but why do you have that?

Right?

And traditional medicine, the symptoms are treated symptomatically. So what are the traditional treatments that.

You see with regular doctors giving for PCOS?

Yeah.

So often women will be placed on birth control pills because if they're having irregular periods or they're skipping their period, many times the physician will put them on birth control pills because it will regulate their cycle. They'll put them maybe on Metformin because Metformin improves insulin sensitivity.

It's a diabetes drug.

Yeah.

So, and then that can many times help with the weight gain. It sometimes helps with the acne and the hair growth or hair loss. And they'll often put them on spironolactone, which is another medication that helps with balancing the hormones and can help with some of the symptoms.

It's a diuretic and it just blocks the conversion of testosterone to the kind that really causes the hair loss called DHT. But it's really fascinating, but it really doesn't speak to addressing the root causes. So from a functional medicine perspective, what are the root causes for PCOS and.

How do we start to deal with these? Yeah, so as you mentioned already, diet is huge. Diet has a huge impact when somebody's eating too many of the refined and processed carbs, too much sugar, too many of those coffee drinks with sugar in it, you know, juices, sodas, refined and processed oatmeals, you know, cereals and, you know, pastas and breads and muffins and, you know, those foods that we've been grabbing too much of for some people with some genetics that can really throw off this whole system in their body. Another big common area are toxins. I see this a lot. I see a lot of what I think is toxin related. We know genetics plays a huge role here. We also know that what women are exposed to as a fetus, what has happened to their mom is really when their mom's pregnant with them, that really impacts their hormone balance and their metabolism later in life.

So, what the mom's eating, she's at Dunkin' Donuts all day.

What's fascinating with the frappuccino mocha latte.

Wates, all day long with more sugar than three cans of Coke. I mean, yeah, people don't realize that.

Yeah, so when they're pregnant with their baby, it's really important that they're paying attention to what they're eating because if they're gaining too much weight or eating too many refined carbs or not gaining enough weight, which is kind of interesting. So if they're not gaining enough weight or they're gaining way too much weight or they're eating too many refined and processed carbs and sugars, that really throws off the fetus, that baby's metabolism. And so, you know, sometimes we tell our patients, you can just blame it on your mom.

We call it epigenetics, which in the genes get tagged and messages Jeff Blan's called the Book of Life. And where the bookmarks are in the Book of Life, you've got this whole genetic code, but not all of it gets read. But you can bookmark different aspects of it depending on what exposures you've had. And we know this from lots of research on epigenetics that what the mother does, what she eats, what she's exposed to, her thoughts, feelings, all those tag the baby's genes for what happens to them in the future and whether they get diabetes or heart disease or cancer or obesity. I mean, it's all programmed. But that doesn't mean it's not fixable. You can actually modify your gene expression. And that's what functional medicine is all about, is changing the environment, then the big picture of the environment, meaning your diet, lifestyle, toxins, et cetera, et cetera. How all of those inputs affect your gene expression is what functional medicine is about. It's about modifying your lifestyle and your environment to influence your genes, to change.

Your health in every aspect.

Yeah, so for some people, it's harder. for them than others. Like some people come in and they're like, it's just not fair. I have to be so much more careful than my friend Susie, right? And it's true, you know, because there are some people, yes, there are some people that have to be so much more careful with their diet. I mean, we all should be eating a healthy diet, but some people have to be more careful with the carbohydrates than others.

Yeah, I would say, you know, there are a few people who are better adapted to higher carbohydrate diets. And, and there are a few. Yeah, I know a few of them. And those are the ones who stay skinny eating anything. But when you look at the fact that 88 of Americans are metabolically unhealthy, almost nine out of 10 of us have some degree of insulin resistance.

Yeah.

You know, that should get our attention. It's, it's probably the majority of us who don't do well with a lot of starch and sugar.

Yep.

And there's a Continuum.

Right?

Some can do more, some can do less, some are look at a bagel and they gain weight, literally, because they're think about it and their insulin goes up and they put all the fat on their bodies. I want to jump back to something you quickly talked about, which is toxins. And I want you to explain how environmental toxins and what toxins influence hormones and influence insulin resistance. Because both of those things are going on with PCOS. And I think it's something people don't understand.

Yeah, this was impacting men more than women, but we realized Agent Orange, right? So when men were exposed, there may have been a few women, I don't really know how many women went to Vietnam, probably not very many, right?

Not too many.

Not too many. So when they were exposed to Agent Orange in Vietnam, they had a much higher rate, they have a much higher rate of getting diabetes. with less weight gain, right? So that's when we started to say, oh, this is interesting. There's a real interesting connection between toxins in the environment and our metabolism and our weight. And then we get diabetes.

And they get Agent Orange.

So, Agent Orange exposure had lots more diabetes. Lots more diabetes at less weight gain. So, you know, I'm just gonna make this up here, make up some numbers, but just so people understand, they may have only had to gain 10 pounds or 20 pounds to get type 2 diabetes where a typical American maybe was gaining 50 pounds before they got type two diabetes.

Right.

You know, just for an example. So they were getting type two diabetes with less weight gain, meaning that there was more to it than just the weight gain, right? And that's when we realized that these toxins were damaging probably the mitochondria, right? So that powerhouse of your cells. We also know BPA, that plastic that's.

Been- BPA, that plastic.

Yeah, really well studied. to show there's a connection with insulin resistance.

Yes.

You know, we know we've known for a long time about the connection with breast cancer and BPA, but there's also this connection with insulin resistance and weight gain. So that hard plastic, they use BPA in the lining of cans or on receipts.

Baby bottles.

Baby, I know, right?

Yeah. When you get your credit card receipt, your gas station receipt, people's so joining yourself, I'm like, no thanks. I'm like, you're taking it. Because I don't want to constantly expose.

Myself, gets absorbed through the skin. Yeah.

Yeah.

So, you know, we realized that this toxin caused weight gain, insulin resistance, and I'm sure there's a lot of other toxins that we haven't even, you know, figured out yet that are really influencing.

Well, pretty much all the petrochemical toxins, all the plastics and all the fossil fuel derived toxins are endocrine disruptors. And I read way back when we were at Canyon Ranch, I read a book called Our Stolen Future by Theo Colburn, which was about the ways in which these environmental toxins were disrupting reproductive health of animals and humans. And I was like, oh my God. And so what's going on is that these are not just one exposure. So, you're not just exposed to BPA. You're exposed to literally hundreds of these in our daily life through are modern living and there are ways to reduce it. And I think the environmental working group is a great resource for finding out what household products, skin care products, cleaning products, you know, are food products that you can eat that are not going to be full of these chemicals. And you just go to ewg.org so that's important. So let's talk now about the gut because most people don't really think that your hormones are connected to your gut microbiome, but it's incredibly connected.

Fascinating. It's so fascinating. But they've been, they've shown that there's certain types of molecules from the gram-negative bacteria in our gut. So if the microbiome, if all of those trillions of bacteria are out of balance and there's an overgrowth of some unhealthy bacteria in our, in our gut, that the, they have these gram-negative bacteria have something on them called LPS or lipopolysaccharides that these things can then, these components can get into the body. And they've shown that this can trigger this insulin resistance in our body so that people, when they have higher levels of these abnormal bacteria, will have more insulin resistance.

That's absolutely right. So, you know, we, there's a name for this, we call it metabolic endotoxemia, which is a fancy way of saying that the poison crap in your gut leaks into your bloodstream and your immune system goes, ah, and starts creating an inflammatory response, which then affects your insulin sensitivity. So anything that causes inflammation, right? Anything, stress, bad food, toxins, infections, microbiome nastiness, all that can drive inflammation that can cause insulin resistance.

Yes.

So you don't even have to be eating sugar, right? But if your gut's a mess for various reasons, then you have to fix the gut. And also, there's a lot of effect on insulin resistance, but there's also other effects in the gut around the kind of bacteria that are there and how they affect your metabolic processing of estrogens and other hormones. So it's really important to eat the right kinds of fiber and the right kinds of foods and to feed your microbiome in your inner garden. So we've talked about a lot of things. We've talked about diet, we've talked about stress, we've talked about environmental toxins, we've talked about the gut microbiome. All these things play a role. And so the job of a functional medicine doctor is to dig down and figure these things out. So how do we begin to assess these? And I want to share a little bit about some cases, but how do we assess, 'cause it seems like a lot of stuff that you go to the endocrinologist or the gynecologist, they're not like looking at your poop, Measuring your toxin levels, they're not looking necessarily at insulin resistance very well. What do we look at that's so different here at the Ultra Wellness Center and through the lens of functional medicine?

I mean, I think that's what's critical about functional medicine and what we do is we get a really good detailed history and that gives us a lot of information. So when we take the time to get to know our patient and get all of the history of their life, their timeline of their of their life, what things have happened to them, what illnesses they've had, what disruptions they've had, what exposures they've had, what other things are going on in their body. That really impacts where we go and what we choose to look for. So you get a really good history, first and foremost, and then that informs you what you wanna test. You know, you could test everything, but you know, this ends up being a lot of tests. So what's important is to get a really good history so you know where to really focus. So for one person, it may be, I really gotta look at their gut microbiome. I've gotta figure they've got this sort of history. I think that might be an area that we really have to focus on. I wanna look at what the balance of the good and bad bacteria are. I wanna see if they have maybe some of these lipopolysaccharide components that may be triggering inflammation and insulin resistance. Or maybe somebody else, you know, you've got a sense based on their history and some of their other symptoms, that it's more toxin related. Or somebody else, it may be more lifestyle related. And you've got to just really focus more on breaking that cycle of craving those carbohydrates. Because what happens for a lot of people is it becomes a vicious cycle, right? They eat the carbohydrates, the real refined processed carbohydrates, their insulin goes up, but then they gain some weight, then they crave more and more of them and it becomes this vicious cycle that gets out of hand. And I think that's important. Yeah, it's so important.

And we really don't just look at the hormone levels, which a typical endocrinologist or GY, we look at those too, but because they're very helpful and informative to look at the testosterone levels, DHT and look at DHEAS and all kinds of things that we look at. But we also do looking at toxin load, we're looking at the microbiome, we're looking at nutrient levels, we're looking at insulin resistance in ways that may not be looked at. So tell us about the first patient you had who was 20 and she had these really irregular periods and acne and bad digestive issues. How did that all get started for her?

Right, so she was 20 when she came to see me and she was frustrated with her, she was frustrated with her acne, she was frustrated with her digestion, and her periods were kind of all over the place. She had a lot of ear infections as a child. So she was put on antibiotics and then ended up getting a lot of recurrent ear infections, more antibiotics and more antibiotics. And so I think that really just set the stage for her microbiome to be out of balance. And then when she started having her period when she was 14, it never was regular. So from day one, she had an irregular cycle. So always, you know, one month it'd be six weeks and then two or three weeks, and then she'd skip a month, and then, you know, she'd be eight weeks between periods. So always irregular. And then as, you know, I'm not really that surprised just having done this for so long, but she also then in puberty developed a lot of acne. So, you know, probably because of some of the shifts in the microbiome in her young, young years, and then, you know, just all of these things going on.

And you see that a lot. You see kids, you know, kids a lot of ear infections. maybe she's eating dairy, which commonly can cause a lot of congestion. They throw the antibiotics at the kids and then they get a little older, then they start getting gut issues and they start getting acne and other things. So it's all connected.

Yeah. So what we did is, you know, because of her digestive issues and her acne and her irregular periods, I said, you know, I'm really curious about her digestive system. I really wonder what's going on in there. And, you know, could this be the driver of her insulin resistance? And so we did a test that looks at antibodies against different components in the digestive system. And one of the things it looks at is these lipopolysaccharides, which are on these gram-negative bacteria, which as we talked about has been shown to trigger- these.

Are bacterial toxins essentially.

The insulin resistance. And when we did that test on her, she had really high levels, which means that her levels were high enough to get into the body to trigger these antibody levels to occur. So we also did a stool test. In the stool test we showed, it showed that she had an imbalance. She didn't have enough of the good bacteria. She had an overgrowth of some unwanted bacteria. So she had this dysbiosis. and so I said, you know what? This is where we've got to start. This is where we got to focus to help both your skin, actually all your skin, your digestive system, and your cycles, your periods. We did see when we did hormone testing that she had signs of PCOS, she had some high level of DHEA and her testosterone was a little bit high and her LH/FSH ratio was off, so we did see some signs on hormone testing that she had some PCOS going on.

So Liz, when you treated her, you also took her off dairy.

Yes.

And I want you to talk a little bit about why dairy is bad both for hormones and insulin resistance and acne because she had all these problems.

Yeah, so as you can imagine, dairy is Dairy products, both milk and cheese and dairy products coming from a cow are full of hormones. You know, that cow to make cow's milk has a lot of hormones floating around. Those hormones get into the milk, even if it's organic. Yeah.

And so- and there's more in ones that aren't organic.

Yes.

There's like 60 different hormones in milk.

Yeah. And some people are very sensitive to those hormones. and they will cause acne production. They will cause more acne, more, and then of course, a lot of people are sensitive to dairy. So it can cause a lot of digestive unrest and digestive issues.

And what's also interesting to me is that when you look at people who consume dairy, dairy will spike insulin pretty high. A 300% increase in insulin consuming dairy, which I was sort of surprised at when I looked at the literature.

Especially the lower fat dairy, right? 'Cause that, you know. And so for so long, we were going to the lower fat and then we were going maybe to the lower fat chocolate milk in school, right? You know, all those things that were spiking insulin.

And I would say for women with hormonal issues, I think dairy's gotta go for most of them to start at least to see how it affects them because, you know, whether it's irregular cycles or whether it's PCOS or whether it's acne, whatever is going on, I think it's an incredibly hormonally disruptive food for so many people. A lot of people can tolerate it fine, but if you've got problems, you've got to start thinking about what you've got to cut out.

And I think what is really helpful a lot of times at the beginning when you're dealing with, when you have a lot of things going on and you're not sure how food's impacting you, sometimes to do a full elimination of a food or a group of foods is really helpful because it gives you a lot of feedback. so sometimes if you just sort of cut down, you don't really go, I'm not really eating much dairy. And I get that all the time.

I don't have cheese after dinner. I agree. It's hard for people to understand that a little bit can do a lot of damage. And the way I explain it to people is think about a peanut allergy. Sometimes if you're just exposed to peanut dust, you can get an anaphylactic reaction.

Right?

That's how powerful your immune system it responds to microscopic doses.

Yeah. Right?

So I think that's important to remember. So what happened with her young woman, you treated her?

Yeah, so because we found this dysbiosis or imbalance in good and bad bacteria, we needed to get rid of the dysbiosis. So we used an herbal combination to treat that. We also gave her a lot of good probiotics and prebiotics, the things that feed the good probiotics. And we took her off a dairy.

We.

Also, we did more of a comprehensive elimination diet at the beginning, so we took her off a dairy, but we also removed gluten and a lot of other inflammatory foods and really focused on a phytonutrient-rich diet. And I think sometimes we don't think about how powerful that can be, right? Those phytonutrients, those components from our plant foods that have amazing qualities in our health, from lowering inflammation to helping detox to helping the process of elimination of our hormones that we want to eliminate.

Yeah.

You know, so they really are powerful. And so when you help people get those eight to 12 servings of phytonutrients, which come from your vegetables, some fruits, some seeds. Yes, spices, teas. Really, that can be really powerful for the body.

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Probably a third to half of Americans have some level of gut issues. Reflux, heartburn, irritable bowel, bloating, gas, constipation. These are normal things that are not really normal.

There are signs that their gut's out of balance.