Reversing Metabolic Disease

Coming up on this episode of the Doctor's Pharmacy.

When you go to the doctor, you know, they've got the standard, you know, what's the blood pressure? Are you diabetic? What's your cholesterol? And then we treat those individual so-called risk factors with separate medications. Yeah.

The overlying theme is metabolic disease. Hey, everybody, it's Dr. Hyman. So many of my patients ask me how I manage to work multiple jobs, travel frequently, spend time with my family.

And still focus on my health.

I know it can seem hard to eat well when you have a lot going on, but the trick is to never let yourself get into a food emergency and to stay stocked up with the right things to support your goals. When I keep nourishing snacks and the right supplements to optimize my health at home and at the office, I know I'm helping myself make good choices in the future. And recently, I discovered some products from Paleo Valley that I keep on hand to grab and go. They help me stay full and energized even when I'm super busy. Their grass-fed beef sticks and pasture raised turkey sticks are some of my favorites as a quick go-to snack and I love mixing their grass-fed bone broth protein into my morning smoothies or coffee. Another one of Paleo Valley's unique products that I really love is their grass-fed organ complex. When our ancestors ate animals, they used all the parts and that included the extremely nutrient dense organs like the liver, heart and kidneys. Now, I know that not everybody is crazy about preparing organs in their own kitchen, so this supplement is the perfect solution. The Organ Complex from Paleo Valley is an incredible natural source of vitamins A, B2, B3, B5, B6, B9, and B12, and minerals like selenium, iron, zinc. It's also rich in the amino acids glycine and proline that benefit connective tissue joint and digestive health, and you'll see on their site that it has some really amazing reviews, plus it's completely tasteless. This supplement is the perfect way to eat nutritious grass-fed organs without having to prepare them yourself. Right now, Paleo Valley is offering my listeners 15% off your entire first order. Just go to paleovalley.com/hymen to check out all their clean Paleo products and take advantage of this deal. That is paleovalley.com/hymen. I definitely recommend trying the grass-fed beef sticks, bone broth protein, and the organ complex. All right, let's get back to to this week's episode.

Hi, I'm Kasia Perowietz, one of the producers of the Doctors Pharmacy Podcast. Things like your blood pressure, cholesterol, triglyceride levels, average blood sugar and waist circumference are all reflections of your overall metabolic health. A recent study showed that only 12.2% of the U.S. population is considered metabolically healthy. Our poor metabolic health is driving our current chronic disease epidemic and skyrocketing healthcare costs. Dr. Hyman recently explored this topic in his conversation with cardiologist Dr. Aseem Malhotra.

My goal as a functional medicine doctor is to make my patients more metabolically resilient. If you have diabetes, you are not metabolically resilient and you don't have many degrees of freedom in that. But if you, like you said, if you're doing exercise and you're eating healthy most of the time and you want to have a little pasta, for a piece of bread, it's not going to kill you and you'll be fine. You'll be able to handle it. But if you look at my patients who have severe metabolic disease and diabetes, they need aggressive treatment. And some of our colleagues and friends are using ketogenic diets, which basically eliminate all the carbohydrates from the diet, which is 5% carbohydrates.

It's very, very low.

And they're seeing reversal of diabetes, which is not something we learned about in medical school. You can't reverse type 2 diabetes, but it actually can be reversed, but it requires an extraordinary and often heroic change in diet, which is not easy for people. But if you've spent your life getting there in decades and decades of ruining your metabolism, it actually doesn't take that long. Within six months to a year, you're going to be really good if you do that.

Yeah.

Even within some of my patients, Mark, I'm sure you've seen it as well. Even within a few weeks, I've seen people send their type 2 diabetes into remission in 28 days.

Oh, yeah.

I think that's a really important message with COVID is that if people do these changes now, They are going to be metabolically more resilient, their immune system is going to be more resilient within the space of a month.

Or less.

And that's something I think we need to talk about is, there are things you can do which can rapidly reduce one's risk and really reverse a metabolic syndrome. I think maybe it's a good opportunity for us to really talk about what those five metabolic markers are because it's not something that is part of conventional practice in medicine. You know that when you go to the doctor, they've got the standard, what's the blood pressure? Are you diabetic? What's your cholesterol? And then we treat those individual so-called risk factors with separate medications. The overlying theme is metabolic disease. And just to give you some perspective, there's some very good data from the United States, which I referenced in my article in European Scientist, only one in eight Adult Americans are metabolically healthy. I mean, that is extraordinary. Seven out of eight are not.

You're right.

And I want to, before we get into the assessment of how we look at that and what we can do, I want to dig a little bit more into the data on how obesity is linked and overweight, not just obesity, and even what we call metabolically obese normal weight, which is, I refer to as skinny fat. You look thin on the outside, but you're fat on the inside. You're metabolically unhealthy. And that is up to 20 to 40% of thin people who are metabolically unhealthy. So when you think 75% of our weight and then 30 to 40% of the rest of the 25% of people are less than quarter of the population is not great. You're talking about like 90%.

Mark, you're right. And I think that the most severe metabolic disease can affect absolutely 20 to 40% of people with normal BMI. But in a more sensitive way and on sort of the latest definitions, And that again is a very interesting paper that shows, you know, looks at American data over several years. The most recent data shows that less than one in three people, less than one in three people with a normal body mass index between 18 and 25 are metabolically healthy. That means two-thirds of people of a normal weight are metabolically unhealthy, which basically means, as I've said before, there's no such thing as a healthy weight. only a healthy person. And I think that also brings us onto the discussion briefly. I think that there is still a bit of a misperception or misunderstanding there that you can be fat and fit. Sorry, you can't. The data shows that even if you exercise, if you've got excess body fat, you are at higher risk. And I think that message also needs to get out to the public because there still seems to be a lot of misinformation that you can outrun a bad diet. and as long as you're working out, I'm sure you see it in America's probably lots of people who are overweight or obese who are exercising now. We're not saying don't exercise. Of course, it's a good thing to do for you, but actually, you'd be doing a lot better if you also.

Changed your diet and got your weight down. Yeah, I mean, I always say you can't exercise your way out of a bad diet. That is far more an impact. And yes, if you clean up your diet and you exercise, that's ideal. And I do both, but if you you see so many people who are very overweight, who exercise a lot, it's because their diet is not right. So that's the key. And what's interesting, it's not just any fat, it's a certain type of fat and a certain location of fat. So can you talk about this uniqueness of this type of belly fat that's causing the problem?

Yeah, it's a visceral fat, isn't it? It's a fat that really surrounds the vital organs, the liver, the pancreas. That is what causes the also the dysfunction, if you like, of those organs that link to You know, dysregulated metabolic control of glucose, insulin resistance. And over time, this is what causes all these, always at the root of all these chronic diseases, heart disease, high blood pressure, type 2 diabetes, probably also cancer and Alzheimer's disease as well.

Now, people say, well, you know, it's their poor diet, they should take care of themselves, they don't pay attention.

But you've written a lot about how.

This whole idea of blaming the victim, personal responsibility, is fundamentally flawed. Can you really talk about why we shouldn't be blaming the people who are eating the bad food?

Yeah, Mark, I think, yeah, so personal responsibility, I think we have to define it first. To exercise personal responsibility, two basic things you need is knowledge, you need the right information, and you need choice. You need to have access, it needs to be affordable, it needs to have access. So ultimately, because the food environment is really what drives our behavior more than anything else in terms of what we eat, and ultra-processed foods have become unavoidable. It's very difficult, so it's much more difficult to exercise personal responsibility and more than 50% of what we consume in the UK, and I'm sure that it's similar in the US, is ultra-processed junk food, Mark. 60%? 60% of our calories is junk.

Yeah, it's not a competition we want to win, but it's 60%.

The prevalence of our sugary, starchy, ultra-processed food landscape has reached crisis level. These foods are nearly unavoidable, and even with the knowledge of how to avoid them, access and affordability issues are a major concern and disproportionately affect poor and Black, Brown, and Indigenous communities. Yet when armed with knowledge, accessibility, and the right supports, phenomenal change can rapidly occur. Dr. Hyman discussed this in a recent interview with functional medicine practitioner Chris Kresser.

There's this one woman I just want to quickly tell her story, Janice, who's 65, and she was severely obese. She had heart failure. She had type 2 diabetes on insulin for 10 years. She had kidney failure. Her liver was starting to fail. She had high blood pressure. She was on a pile of meds and felt like crap all the time and was on her way out. She came to the group and just started with the simple lifestyle changes. It wasn't like tons of functional medicine testing or tons of supplements or anything. It was just like group support, lifestyle change, and a very powerful anti-inflammatory, low glycemic, whole foods diet.

Yeah.

Basically, yeah. It was based on the 10-day detox diet, which essentially is like mostly plants with some healthy animal foods and not starch or sugar. And in three days, she was off for insulin. In three months, she lost 43 pounds, but that was not the significant part. Her heart failure reversed. which you never see in medicine. Her kidney failure reversed, which you never see in medicine. With any drug, her liver failure got better, her high blood pressure in a way, she got off all her medications, and in a year she lost 116 pounds and stayed that way. And what's more remarkable is that she said she saved out of her own pocket her co-pays for her medications, 20,000 a year.

Changing our behavior is the single most important step we can take to preventing and reversing chronic disease. I'm more convinced of that that than I ever have.

So true. And it's powerful because people can have a huge impact on each other.

But telling people what to do to change their behavior doesn't work. I mean, look, do you like to be told what to do? I don't like to be told what to do. Most people don't like to be told what to do. We have this natural inclination to resist. According to the CDC, about 6% of Americans consistently engage in the top five health behaviors. And we're not talking about complex stuff like intermittent fasting six percent. So these behaviors are maintaining a healthy weight, not smoking, not drinking excessively, getting enough physical activity and getting enough sleep. Okay, you and I are hopefully in the six percent.

Six percent.

So, and, and, and, and Mark, it's not because people don't know. There is a lot of controversy over paleo vegan, all that. There's not a lot of controversy about those five things. Everybody knows that they shouldn't be smoking a lot, drinking a lot. They should get some sleep and they should exercise. So are they not doing it because they don't know? Of course not. They're not doing it because they don't know how to change and they don't have the support that they need to change.

But we know from the science very clearly that friend power is far more powerful than willpower to create behavior change. And we talked about this, but I created this faith-based wellness program in a church where We got 15,000 people to lose a quarter million pounds in a year and get healthy. It wasn't a weight loss program, it.

Was a health program.

And they did it in small groups.

With each other, without a health coach.

Without a nutritionist, without a doctor, but use the power of love and each other and connection and accountability and feedback and support, which is exactly what a health coach does.

Absolutely.

So it's, Rick Warren said it best, he says, everybody needs a buddy.

Yeah.

When we join up with others who have the same values, struggles, and goals, some really amazing things can happen. We are actually more strongly impacted by our peers and social networks than by our genetics. This is a key learning when it comes to improving our health. Friend power is truly more important than willpower. And group-based healthcare solutions are starting to gain more traction. Not only does being a part of a group help people achieve their health goals, Having a sense of community with strong relationships is linked to living longer, being happier, and staying physiologically and physically healthy. COVID-19 has certainly introduced unique challenges when it comes to surrounding yourself with community support, but it has also created many new possibilities to virtually connect with communities who share your same values and health goals. The first step in reversing metabolic disease may very well be joining or creating a community to support your health. Thank you for tuning in to this episode of the Doctor's Pharmacy. If you enjoy this episode, please be sure to check out Dr. Hyman's full-length interviews with Dr. Asim Malhotra and Dr. Chris Kresser. Please also consider sharing this episode with a friend and leaving us a comment below. Until next time. Hi everyone.

I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make.

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