Key Takeaways from January 2024: Episode Recap

Coming up on this week's episode of the Doctor's Pharmacy. If you have a swollen joint, it hurts. But if your brain's inflamed, it doesn't hurt. But you get anxiety, depression, autism, Alzheimer's, bipolar disease, OCD, schizophrenia. These are all brain inflammation diseases. Hey everyone, it's Dr. Mark. Time is our most valuable asset and Rupa Health understands that better than anyone. They've created a game-changing solution to simplify lab ordering for functional medicine practitioners like you. With Rupa Health's online portal, you can access over three thousand tests from dozens of labs like Dutch Great Plains, Genova and Access Medical Laboratories, all with just a few clicks. That means no more headaches or administrative nightmares that come with traditional ordering processes. Plus, you'll only receive one invoice for all your tests, making your life easier than ever before. And the best part? It's completely free. That's right, there's no hidden fees or complicated billing systems, just one invoice paid online and upfront. So start saving time and energy by visiting RupaHealth.com, sign up free and take control of your lab ordering process today. That's RupaHealth.com no matter your genetics or lifestyle choices. As humans, we all share the same basic needs like adequate nutrition, for example. But with the industrialization of agriculture and toxins in our environment, it's getting harder and harder to get your body the nutrients it needs through food alone. And that's where AG1 comes in. AG1 is a foundational nutritional supplement that supports your body's universal needs for things like gut optimization, stress management and immune support. Since 2010, AG1 has led the future of foundational nutrition continuously refining their formula to create a smarter, better way to elevate your baseline health. I drink AG1 every morning and I consistently feel more energetic throughout the day. I even recommend it to all my family and friends because of the results I've seen myself. If you want to take ownership of your health, it starts with AG1. Try AG1 now and you'll get a free welcome kit that includes a shaker bottle, canister, and metal scoop, along with 10 free travel packs with your first purchase. Go to drinkag1.com/hymen. That's drinkag1.com/hymen. hyman@hymaninstitute.org. Check it out. And now, let's get back to this.

Week'S episode of the Doctor's Pharmacy. Hi, this is Lauren Fein, one of the producers of the Doctor's Pharmacy podcast. In today's episode, we're recapping key takeaways and powerful moments from episodes that aired last month. Links to each episode can be found in the show notes so you can easily go back to any episode you might have missed. To start us off, here's Dr. Hyman.

In conversation with Dr. Uma Naidoo about how mental health issues are tied to diet. you're at the forefront of a really radical paradigm shift. And I think that people don't understand it in the general public. I think they still misappropriate meaning to certain diagnosis. You're depressed and you're anxious, and that means that it's a psychiatric problem. But it might not be a psychiatric problem. I always say if you have a swollen joint, it hurts. But if your brain's inflamed, it doesn't hurt, but you get anxiety, depression, autism, Alzheimer's, bipolar disease, OCD, schizophrenia. These are all brain inflammation diseases. And, it's really a key part of your new book, which is just so fabulous called Calm youg Mind With Food, really talking about how our inflammatory diet is driving, not the only cause, but is driving so much of the changes we see in our mental health and in this world. And I guess the question I would have for you is, you know, how do we start to change the paradigm? You know, how do we need to think differently about mental health given this paradigm shift in psychiatry? There's people now at Harvard, like Christopher Palmer, your colleague who's written a book called Brain Energy. He's been on the podcast talking about curing schizophrenia with ketogenic diets and using bipolar disease treatments using diet. I mean, this is just a radical concept that food has something to do with that. Sabani Sethi at Stanford has a department of metabolic psychiatry. We're talking about psychedelic and trauma. This whole field is just undergoing this revolution. So, you're at Harvard. I mean, I imagine, you know, your average psychiatrist at Harvard is not thinking like you do. There's a couple of rogue characters like Christopher Palmer and yourself who are trying to pave the way for a new way of thinking about mental health. But, I just want to point to the fact that these drugs that we use, particularly the SSRI drugs or anxiolytic drugs like the benzodiazepines, they're problematic. And I think people don't understand the data around these medication. I think when I took a deep dive on this, it was sort of shocking to see how poorly they worked. They can be helpful for some people with severe depression, but for mild to moderate depression, they really are no better than placebo. and yet they're among the top selling drugs in the world. I mean, the top is statin drugs, the second are psychiatric drugs, and the third category are stomach drugs like acid blockers, right?

That's right.

And these are a huge business and yet, you know, depression or anxiety are not Prozac deficiencies, right? There's something else going on. And the benzos, which we use like Valium and other versions of those are really not great for long-term use because they're highly addictive. They cause long-term side effects. And, you know, was it sort of the Valium generation? I don't know if you've followed the Sackler family story, but they were the Valium people too, not just the oxy people. And they were hugely marketing this in the 60s. It was a way of sedating women so they wouldn't be upset and want to have more autonomy and power. It wouldn't be hysterical. Yeah. Yeah, it was sort of anarchitizing the female population at the time, suburban housewives who were miserable and anxious. So, I think we're now entering an era where we're really entering scientific psychiatry, I would say. We're entering an era where we're actually being able to understand the mechanisms in the biology of what happens in the brain when it comes to these symptoms that we have. And we often, like I said, misappropriate meaning. If you have depression, we typically label people, with the disease and we think the label is the cause of the disease. So we say, oh, I know why you're sad and hopeless and helpless or why you're anxious and why you have all these symptoms. It's because you have an anxiety disorder or you have depression.

Well, depression isn't the cause of those symptoms.

It's the name of those symptoms. Here is Dr. Hyman talking about the importance of protein. We've known for years and decades that protein is a critical part of our diet because they're basically the building blocks for our body. It makes everything from muscles, organs, our skin, neurotransmitters, cytokines, peptides, all all the things that our body is doing to actually run everything. It's really one of the most essential things because we can't get all the amino acids from eating other foods. We have to eat protein in the right amounts and we have to have the right amount of amino acids. Our body doesn't make them. Some are derivatives, so there's some core essential amino acids and we have to make sure we get them from our diet in the right amounts in the right time. And when we look at research on longevity, There's a lot of controversy. Some people say, oh, don't eat protein because it's gonna actually activate mTOR or what is the known as, as the, one of the key regulators of longevity. Uh, if you activate mTOR, it increases protein synthesis. It increases muscle mass. It can actually accelerate even cancer growth. So it's not good in, in, in certain ways. But, if you inhibit mTOR, you actually cause autophagy and self-cleaning and the longevity process. So what should you do? Well, I wrote a lot about this in my book. It's like anything else. You want periods of fasting and not eating, like overnight at least 12, 14, 16 hours, and then you wanna make sure you have enough protein during the day so you actually can do the functions of protein in your body, for example, muscle building and so forth. So, you know, it's not like it's all bad or all good, it's really about how and when and what. So we're gonna get into the how and when and what. And if you look at the biggest risk factor for, for age-related decline, it's loss of muscle. Because when you lose muscle, you increase inflammation, you increase insulin resistance, your sex hormones go down, your cortisol goes down, your growth hormone goes down, means cortisol goes up. So you basically end up in this hormonal chaos of levels of inflammation, pre-diabetes, it's really bad.

Here's Dr. Hyman in conversation with Dr.

Steven Gundry about the brain-microbiome connection. Major depression is a big issue and depression is the biggest cause of disability in this country. And the microbiome of people who are depressed is different. And in 2022, there was a study of microbiomes of over a thousand people with depression and they found changes in about 13 bacteria and these bacteria are known to produce various neurotransmitters. So can you kind of unpack that for us and just give us a little taste of the mood, brain, gut microbiome connection?

Yeah, I guess, you know, I suppose we should have known this, but again, now that we're being able to look at individual bacteria and the compounds that they produce, you're right, brand new studies in the last year or so have shown that depressed individuals have a depressive microbiome and you can constitute these particular abnormal species. What's really interesting is, let me step back one. We've known that glyphosate, which is a lovely weed killer, was actually patented as an antibiotic. And one of the recent findings about glyphosate is that glyphate targets the tryptophan pathway bacteria in our gut. now, why should that be interesting? Is because tryptophan makes 5 HDP, makes serotonin, which and GABA, for that matter. And so glyphosate is really good at knocking out all the feel-good bacterias specifically in our gut. And isn't it interesting that this, that this epidemic? of depression and anxiety correlates pretty doggone good with the advent of glyphosate. And yeah, and now we know, well, you can say, oh, well glyphosate is bad for you, but wait a minute, glyphosate is after the bacteria that are essential for our mood.

And I think that's so key, Steven, yeah.

It's like, what have we done?

Yeah, yeah, it's true. It's the unintentional side effects that happen from things we think we're trying to do good. Oh, weed killer, great. herbicide we needed, blah, blah, blah. But, but these, this, you know, people say, oh, glyphosate, cancer, this, that, maybe. Okay, there's been some, you know, lawsuits that have been successful around non-Hodgkin's and Plomin. I guess if you douse yourself in it. But what's really striking me about glyphosate in really small amounts, it wipes out your microbiome. It doesn't take a lot. It's not like you have to, like, drink Roundup in order to actually mess yourself up. It literally is in small amounts. And that, that has led to maybe an increasing epidemic of low microbial diversity that we're seeing and an increase of all these chronic diseases, including psychiatric disorders, which could be really from this sort of altered, altered microbiome, in part from glyphosate. I mean, there's a million other reasons.

Obviously, xenobiotics and other toxins and other things that are really, really important. This is Dr. Hyman from our Know.

Youw Numbers series talking about magnesium. About 20% of the population is living with overt magnesium deficiency. This is full blown magnesium deficiency. And that's like one in five people. That's a lot of people. Subclinical or insufficiency, not true deficiency, which you see in a lab test, but insufficiency can affect up to 80% of the population. Now, why is this important? Well, unlike drugs, which work with one pathway and one particular reaction in the body, magnesium and most vitamins and minerals, by the way, work on hundreds and hundreds of different pathways. And, and magnesium is involved in over 600 enzymatic reactions in your body. Now, enzymes help convert one molecule to another critical for everything. And it basically influences every single one of our biological systems, which is why it can cause symptoms all over the place, from your brain to your heart, to your gut and constipation, to menstrual issues and cramps and muscles. I mean, it's literally everything. And in low levels or suboptimal levels impact every area of health, increase our risk for chronic disease. So it's not just kind of this annoying symptoms like muscle cramps. It put you at big risk for serious illnesses. Now, it really probably should be considered a public health crisis, but most physicians don't test for it. It's not on your regular blood panel you get every year. If they do agree to test for it, they're likely run at what we call a serum magnesium test. That's what I learned in medical school. But it's not really the indicator of what's happening in your body. It's like this joke I often tell when I'm giving lectures. I say, you know, this guy dropped his keys on the street and his friend comes over and sees him looking under this lamppost. He goes, well, why? What are you looking for? What are you doing? He says, well, I'm looking for my keys. He said, where'd you drop them? He said, why dropping them down the street? But he said, why are you looking over here? He says, well, the light's better here under the lamppost. So that's how medicine is. It's easy to test your magnesium, but it's not the right way to find out if you're low or not. I mean, if it's low on your magnesium, you're really, really low. By the time it gets low, you're in trouble. Now, in a perfect world, I'd have the chance to see millions of patients. But the truth is, I'm just one doctor. Over 30 years of seeing millions of biomarkers in tens of thousands of patients, I've come to understand that much is being missed by conventional health care. we often wait until we have symptoms or diseases, then we get tested. But the transition from Wellness to illness can often be detected decades before any symptom or diagnosis. I want people to have access to their own health data and the ability to engage in self-care and lifestyle practices that I believe can optimize their health and reverse the trajectory of chronic diseases that now affect six in 10 Americans and accounts for over four trillion dollars in health care costs.

Here's Dr. Hyman and Dr. Raja Dhir talking about probiotics and fermented food?

We're not quite yet at the place where we can, you know, go get a poop test and figure out what probiotic we need. But we are understanding the probiotic use in medicine as a valid interventional tool to treat very serious diseases, to optimize health, except, you know, there's so many probiotics out there. you know, you go to the grocery store, you go to the health food store, there's ones in the fridge, there's ones not in the fridge, but this strain, it was that strain, like nobody knows what's going on. Even most doctors have no clue what's going on. So can you define like what's a probiotic and, you know, whether we should actually be taking probiotic supplements? Because, you know, we've been taught, for example, that, you know, when you take probiotics, they don't really take up residence there, they just kind of pass through and do little things and they go on is, do they colonize? Do they not? Does it matter? And, and, and should we be thinking about probiotics from a basic health maintenance perspective? Should we all be taking them? How do we pick the right probiotic? And, you know, should we just be eating sauerkraut and kimchi and forget about probiotics? Can you help us unpack some of that?

I think probiotics are fascinating in the sense that anytime a piece of news or press comes out that says probiotics are don't work or they don't do this, it seems that probiotic usage goes up. And so I can't explain it, but it's people love them, people use them, but the science and the understanding and the development of them is very confusing and varied. And so just to start with some definitions, probiotics are defined as live organisms that confer a health benefit to their host. It's a very simple definition. Gregor Reid chaired the panel at the UN that that wrote it in 2001. At its core, probiotics are not a new discovery or not a new hypothesis. Typically, they were in the early 1900s, organisms that were isolated that were found to be beneficial. And benefit has changed over the years dramatically. I mean, back then it was just keeping your food sterile or safe from pathogens that could be considered a benefit. preventing you from getting sick from what you eat could be considered a benefit today. People look for a lot more complex things. So what is it intended to do and what is the health benefit? That's the question that you have to ask. Anytime you hear the word probiotic, that's what you have to say right back. Say, okay, so it's a live organism, yes or no. You'd be surprised many times they're not live or they're not guaranteed to be live or they don't make it to your colon alive. And so there's a whole spectrum of even that live part. And part two is, okay, so beneficial. What are they beneficial for? What are they going to do? What is the basis for if they are beneficial or not? I think people confuse probiotics sometimes with fermented foods, which have a very different definition. Fermented foods are microbially metabolized food matter that carry a microbial load. And so that actually was just defined by in a nature review this year for the first time. And they're both good. They both can be good or they both could do nothing. It really depends on what you're looking at. So fermented foods are different from probiotics, but sometimes fermented foods can be probiotic and sometimes probiotics can be fermented foods. But it depends on what they are and what you're trying to accomplish.

Yeah.

Classically, Probiotics have been Lactobacillus and Bifidobacterium. Two years ago, the scientific community convened and said, okay, this is way too generic. And so, Lactobacillus actually was broken into about 200 subclasses and was completely renamed. And so, we don't really use Lactobacillus anymore, but there's way more genus and species variation now from what was originally called Lactobacillus. Bifidobacterium, at least Lactobacillus and Bifidobacterium and Streptococcus, I would add, is the third are the three class of probiotics that have been used in food in Japan, in Europe, and predominantly in North America. And so almost every probiotic product that is a microbial product that's standardized will contain or derive some version of these or it's going to come from soil. Hey everyone, it's Dr. Mark here.

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Hyman from our Health Bite series talking about COVID and our immune system.

What do we do to actually help the host, right? So we can give vaccines which artificially jack up your immune system to fight a particular infection or, and maybe not or, maybe and, we can also help our own immune system optimally function better. And that's what I want to talk about. So how does functional medicine look at this problem? How do we understand why we are seeing such an epidemic of inflammatory diseases, not just COVID, but everything, all the chronic illnesses, autoimmune disease, allergic diseases, compromised immune systems. How do we deal with that? Well, we have to look at the modifiable risk factors that we can change. And there's a large number of modifiable risk factors for COVID-19 and for pretty much everything. So this kind of goes across the gamut, but let's talk about how the data pan out around what we can modify in terms of our risk of getting infections, environmental infections, and particularly COVID-19. first is all these chronic illnesses, diabetes, obesity, hypertension, heart disease. These are things that I've written about, talked about for decades. They're fundamentally diseases of affluence, diseases of excess, diseases of abundance, diseases that occur in, you know, where supply of ultra processed diet that's high in starch and sugar, and, and it's a real, real problem. So these are, these are not inevitable things. They're things that can be modified and even reversed. the other thing that really drives our risk is our blood sugar regulation. And I've written many books about this, the 10 Day Detox Diet, Blood Sugar Solution. But blood sugar is a huge factor in your risk, as I mentioned earlier about the diabetes increasing risk for COVID hospitalizations and deaths. And managing your blood sugar is really important. So, you know, cutting down sugar and optimizing your diet to increase more fiber, protein, fat, following a simple exercise program, really important. our diet overall, the diet quality plays a role. So, you know, our, our microbiome, our gut, everything. We'll talk about that in a minute. But all that plays a role in our risk. Environmental toxins. We have less control over heavy metals, air pollution. I just saw a patient yesterday who was in China, and she, she lived there for a while, and her lead levels were off the chart. I've never seen this in all my years of practice, and she literally had just come from China. She had just done her labs, and I was like, holy mackerel. You know, the air pollution is so bad there that it's literally, you're breathing it in, you're getting in your blood, and it's on your food. It's pretty much everywhere. So air pollution, heavy metals, mercury, lead, arsenic, all these things are, are prevalent in our environment, and we need to reduce our exposures. Our nutritional status plays an enormous role, like enormous role in our immune function. because it's not just the food we eat, but it's also the vitamin and mineral levels that play a role. So vitamin D deficiency, I would see be number one. If you can do one thing from listening to this podcast, get your vitamin D tested and make sure your level's 50 to 75. And if it's not, you need to take increasing amounts of vitamin D3 to get it to that level. You know, some people need 2000, 5000 depends on your, your genetics, some people need 10,000, but it's really critical to.

Get your vitamin D level up. Here's Dr. Hyman in conversation with Robert F. Kennedy Jr. Talking about childhood nutrition.

Today, our kids' schools are the biggest fast food system in the country. If you combine McDonald's, Starbucks and Subway, our food system schools provides more junk food than all those combined. And it's really, again, driving so much of our mental health crisis. You know, we didn't see this when we were kids, Bobby. I didn't see kids with depression, anxiety and the mass amounts of ADD in trouble with school. And in the school lunches have really have shifted into be basically outlets for fast food companies. How would you begin to think about that? Because I think that's contributing both to the poor health as well as the mental health crisis we're seeing.

I mean, that's actually something that the Department of Education has a $80 billion budget. And that's one of the things that it ought to be doing is to make sure that school lunches are healthy. and that the food that we're giving to kids is directly related to their behavior, to their moods, to their performance in school. And, you know, to be able to tell people that you're much more likely to have kids who are in a learning atmosphere if they're not pumping up on sugar between, and, you know, and all of these other poisons between classes that are, that are making them behaviorally, you know, that are ruining their moods, their behavior and their learning capacity.

You know, it was Bobby, there was a school in Washington I heard about that was really interesting. It was a charter school started by a very wealthy guy and it was really for kids who were underserved, who came from poor socioeconomic environments, who were often going to be more likely to end up in jail than go to college. And what they did with these kids was they not only just had a great academic curriculum, but they fed them three meals a day. So the kids ate three meals of whole healthy food a day. And these kids do so well, they're going to Harvard, Yale, all the Ivy League colleges, they were succeeding. And then all the parents of the wealthier neighborhoods wanted to send their kids to the school 'cause they're all having such high performance standards on testing. And I think in terms of research, we should be doing that research on what happens when you take school and this one school gets this typical standard school lunches, which is full of junk food and sugar versus a Whole Foods lunch and breakfast and dinner for kids and seeing what the different academic performances is, behavioral issues are, aggression is in schools, what their other issues are on ADD and allergies and autoimmunity, all these things we're seeing, it would be such a simple thing to do, but we've never done it. We've never asked those questions. So I get very excited when I think about you starting to do these things with NIH, you know, in the, in the NIH budget and their whole, you know, 100 plus page budget, food was only mentioned once. And that was in the context of the Food and Drug Administration, which is.

Just makes me kind of crazy because it's the biggest thing that actually we can do to make a difference in our country's health. Yeah, I love that idea. I love, you know, the idea of being able to, I To me, Mark, as you know, kids are the biggest, you know, kids ought to be the focus of everything in this country. We shouldn't be, you know, talking so much about going to war in Ukraine. It's $113 billion we're spending in. We've already committed to the Ukraine war and where, you know, President Biden wants to bring that up to 200 billion. The entire budget for EPA is 12 billion. The entire budget for the CDC is 12 billion. Imagine if we had that money instead of spending it on weapons and wars and making war in another country, what if we brought it home and made a war on bad health?

And here's Dr. Hyman from our Health Bite series talking about hormones and hunger.

It's not your fault you're overweight. There's something going on here. It's not about willpower and white knuckling your way through just just, you know, restricting calories and exercising more and eating less. It's just not how your metabolism works. No, no, nobody's trying to gain weight. And so what's going on here is something that's dysregulating our biology. And there are many things that do it. It could be our microbiome, it can be inflammation, it can be toxins, it could be pesticides, it could be heavy metals, it could be even infections, viruses can be linked to inflammation. So anything that drives inflammation will cause weight. and dysregulate your metabolism. And it's something that can be addressed and fixed. What are hormones? Basically they're the messenger molecules in your body. They regulate so many functions. We know about your pituitary, your hypothalamus hormones, your thyroid, your adrenals, your sex hormones. There's so many hormones, right? So when you have imbalances in these hormones, you have dysregulated appetite and you don't actually feel full. So you tend to be hungrier more and not feel full regardless of whether you're eating. And that has huge adverse effects which makes you gain weight. And then of course, if you're doing that, you're gonna see higher levels of blood sugar, higher levels of insulin, you'll get pre-diabetes, type 2 diabetes, you'll even dysregulate your sleep cycles and circadian rhythms, melatonin signaling, and it's a vicious cycle. So you get, you know, more dysregulation. It's like feeds, it's a feed forward negative cycle. so how do you keep your ghrelin and leptin levels balanced? What do you do? Well, they're hormones that are naturally produced, but, you know, we don't have a particular supplement or food that's going to do it, but there's a number of strategies that actually can help reduce inflammation in the body, that can help regulate your appetite, and that make a huge difference. And there's much research on this. First is, again, not, not rocket science, but eat real food, get rid of all the ultra processed food. We know, for example, from Kevin Hall's NIA study, where he gave people unlimited amounts of ultra processed food, crossover study and other part of the study gave them unlimited amounts of whole real food. And the people who were eating the ultra processed food at the time ate 500 calories more a day. That means basically their appetites were dysregulated, they weren't feeling full, and they were eating all this industrial processed food that was driving imbalances in their hormones. So studies show that also high levels of a fructose are a problem. Fructose is often found in soda, right? And juice and fruit. Fruit is okay, but when you're having high fructose corn Syrup, it's driving huge amounts of leptin resistance, which makes you not feel full, makes you eat more, and, you know, pretty much any kind of sugary stuff will do the same thing. And when you have high levels of fructose sugary beverages or simple carbs like refined starch, it also impairs your ghrelin response. So, your appetite doesn't go down, you don't feel full, and then you kind of, you know, get in this vicious cycle. So eat real whole foods as close to nature as possible. Stuff that I've talked about in my book, Food, what the heck should I eat? And the Pegan diet. Also, another trick is don't eat at night. We should not be eating at night for a whole host of reasons, but don't eat within three to four hours of bed. I heard a guy the other day talking, he leaves eight hours between his last meal and bedtime so he can actually sleep better. So, you know, I think that's hard, but you should not use your refrigerator as a nightlight. And a Harvard study found nighttime eating had profound effects on hunger and the appetite regulating hormones leptin and ghrelin. In fact, leptin levels decreased for 24 hours after indulging in a late night snack, which basically means your appetite control break, the break on your appetite, was turned off. So you basically have no breaks for 24 hours if you eat late at night. So you're going to eat more the.

Next day, you're going to want to be hungrier. Again, vicious cycle. Here's Dr. Hyman in conversation with Callie Means talking about Callie's experience working for one of the most influential lobbying groups in the country.

What was it like being on the inside of the Heritage Foundation, which is a conservative think tank, and what was happening in there as you were working with big food companies and they were working with you to try to shape what was happening on a political level?

The word that comes to mind and the overarching goal is rigging institutions of trust.

Rigging institutions of trust.

Institutions of trust. So you have a company, you have an interest, who are their stakeholders? Their stakeholders are consumers. Obviously you want to impact what they think. You want to impact the media, which has a big impact. You want to impact government leaders. You want to impact research. You want to impact groups like civil rights groups and other medical groups that people trust. So you want to, as a company in the United States, that's trying to get something accomplished. You want to impact all of those groups. And the truth is, the pharmaceutical industry and the healthcare industry at large is the largest funder of government. It's the largest funder of think tanks. It's the largest funder of academic research. It's the largest funder of news funding. It's 50% of news funding. So the objective and they basically infiltrated every They're the largest funder of every single institute. They're the largest funder of medical groups. They're the largest funder of civil rights groups, actually, the NAACP. So every group that we hold sacred, Harvard, the NIH is highly, the FDA, as you've pointed out, is more than 50% directly funded by the pharmaceutical industry. And then food's not far behind. So you literally have the core institutions that set our culture, that set the guidelines. Their bills are paid by pharma. And as a consultant for these industries, that's just the simple question. And these are not really geniuses working at these consulting companies or for the pharmaceutical companies. It's actually very simple. It's like, how do we get money to the right people? How do we fund research? How do we fund the medical groups? How do we fund the politicians themselves? And then the healthcare industry is the largest. I mean, that's five times more money spent by them on lobbying and public affairs than the oil industry. Food is not far behind. And I gotta admit, Marc, and I'm ashamed to say it, it took me many, many years. It took more than a decade out of the swamp to really put all the pieces together.

But- you- were a swamp creature.

I'm a reformed swamp creature and have been out for more than a decade working to start companies.

But.

Looking back in retrospect, it's very interesting and I think very telling that you have one meeting in the morning with the pharmaceutical and the healthcare industry and the next in the afternoon you're meeting with the food industry.

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