STOP EATING These Foods To Burn Belly (Visceral) Fat TODAY! | Mark Hyman

Sugar and starch and this belly fat is the number one cause of aging and age-related diseases. So if you want to die early, get a belly fat.

And we're gonna jump right in with two, two of the top foods or food categories that we can stop eating or be more mindful around or limit or minimize when it comes to their role of increasing belly fat. So Mark, what are these two categories and what do you want to say about them?

Well, we're going to we're going to learn a lot about belly fat on this podcast. But the truth is it's the most dangerous thing in your body. If you have belly fat, it is a risk factor for every single age related disease, period. So it is forget about smoking. This is the killer. One of the two things that are the worst one is liquid calories. Well, liquid calories. I don't mean like a protein smoothie. What I mean is soda, juices, even nut milks, which you think are healthy, can be spiking your sugar. Sweetened coffee, sweetened teas, energy drinks. You know, we are living in a sea of liquid sugar, and it's. It's really different than regular sugar. I mean, regular sugar is bad enough, but this seems to just accelerate the development of belly fat by being quickly absorbed, spiking blood sugar, spiking insulin, and that just leads to this whole cascade of belly fat. It's really bad. So if you can do a single thing to dramatically improve your health is get rid of liquid sugar calories. The second is flour, which is everywhere. And it turns out that flour is worse than table sugar when it comes to raising your blood sugar, which when you raise your blood sugar, you raise insulin, you raise insulin, you sweep all the fuel out of your bloodstream and throw it into your belly fat cells. It's basically what happens. So it's like insulin basically opens the gates, all the fuel, fat, sugar, carbs, everything goes flooding into your fat cells, and then the gate closes like a one-way turnstile on the subway, you can't get back out. So it's really, it's really bad. So flour and sugar. Now, do I eat flour occasionally?

Yes.

Do I try to eat flowers that are better? Yes. I'll have coarsely grain flour or I'll have flowers that are full of extra fiber lignans. I'll have buckwheat flour, Himalayan buckwheat flour, which is actually full of phytochemicals and low glycemic load and high protein, high minerals and microbiome enriching fiber. So there's ways to hack it, coconut flour, almond flour, those are all fine. I'm talking about wheat flour. or grain flours, even brown rice flour, all these healthy, quote and gluten free snacks, they're actually often worse than regular flour because they're just so highly processed and it quickly absorbs. So those are also huge things. And, you know, it's different eating a whole grain versus whole grain flour. Even if you eat whole wheat bread, it's still a problem. So I would stay away from flour and sugar, except on occasion as a treat. And make sure you have a meal that includes protein and fat and fiber so you actually can mitigate the effects of the flour on your blood sugar.

So Mark, let's break down the basics. What is belly fat and what are we learning about why it's so problematic for our long-term health?

So, you know, most of us were taught that, you know, oh fat is just fat. It's like this inert thing. You know, it's just they're holding up your pants. It doesn't really do much. Not good to be fat or have fat on your body too much, but it's not a thing really. that's how it was when I was in medical school. But now we've learned that the fat cells in the belly, we call visceral fat or belly fat, it's essentially the fat around your organs, around your liver, kidneys, intestines, all this fat is very different qualitatively. And when you see someone with a big belly or even who's skinny with a little big little belly, that is a sign that they're accumulating this belly fat. And what these cells are are a whole nother organ. they produce cytokines. You've heard of the cytokine storm. Why is it that people with obesity are at the highest risk of hospitalization and death? Because their belly fat cells produce what we call adipose cytokines. One in particular called interleukin 6 or IL-6 is one of the key cytokines that's driving the cytokine storm in COVID. So that's why we're seeing this problem is because of belly fat. Why people are dying from COVID is because of belly fat. that is important to understand. If everybody in America was thin and had no belly fat, really, to speak of, COVID would be like a non-issue, right? Unless you're really old or have a chronic disease or something terrible. But 88% of us have some degree of belly fat that's driving this problem. So that's one issue. They also produce all kinds of hormones. So you see all kinds of changes in people's bodies. For example, women, when they have a lot of belly fat, will get acne, they'll get facial hair, they'll lose the hair on their heads. Men will, the opposite will happen. They'll get high estrogen levels because the fat converts testosterone to estrogen. They'll get breasts, they'll lose all the hair on their body, they'll get soft skin, you know, like a woman. So these are real things that happen. They also change your brain chemistry and they affect your hormones and your mood and your appetite. There's literally hundreds of molecules that are being produced by these fat cells. They're not just storage units for extra calories. They're literally organs that are dangerous organs that are producing inflammation, screwing up your hormones, screwing up your brain chemistry, and making you sick and causing all the diseases of aging.

So Mark, talk about how actually belly fat and fat as a whole, but specifically belly fat might have been used as a survival mechanism, but now it's kind of gotten completely out of whack in the way that it's around with this 24/7.

Yeah, well, you know, Drew, we, we evolved in a sea of scarcity. Now we live in a sea of abundance, and our genes are adapted to scarcity very well. So we are very good at accumulating and storing any excess calories. So I remember going to Alaska a few years ago with my daughter, and we were watching this grizzly bears hunt the salmon in the early part of the summer, and we were told by the guide that they eat the salmon, they do fine, but they don't really gain a lot of weight. And then they go up into the mountains in the end of the summer and they eat berries and they will gain 500 pounds of fat by eating sugar essentially. And they gain all that weight and then what do they do? Then they hibernate. So they lose all the weight through the winter. That's why they don't get high blood pressure and diabetes and just continue to have problems. we just keep eating all winter. That's the problem, you know? And, and I think the, the challenge with our modern diet is the absolute excess of calories, the absolute excess of sugar and starch in our diet, and the, and the endless ability to overeat. We, we're producing between 500, 700 more calories a day per person in America than we did in, when I was born. So I, I think we have to really take, take a good serious look at the, the, the way our bodies are adapted, which is to store as much fat as possible, as quickly as possible, when we have an excess of calories or we have an excess of sugar calories. That's a good thing in the context of these feast famine events that happen throughout human history. The problem now, we just keep eating. So we have to actually stop this process of overeating and eating the wrong foods that's driving this belly fat, because it is the single biggest thing that's driving disease. So at one point, it was an adaptive mechanism. Now it's a maladaptive mechanism.

Yeah, there's a great new book out and you're doing an Instagram live with the author and I believe the book is called Nature Wants Us to Be Fat and it's Dr. Richard Johnson and he's one of the top researchers in the space of uric acid and belly fat. And he, through his investigations in hypertension, discovered that, you know, the theory is that millions of years ago, human beings develop this ability to basically use fruit, high amounts of fruits, just like you were talking about other animals like bears to pack on all that fat and survive the winter. It's a fascinating Instagram live. We're gonna tune in to watch it and the book is really interesting as well. Well, think about it.

The fruit trees all come in at the same time. So what are you gonna do? I mean, they didn't have canning. They didn't have like freeze drying. They just had to eat as much as they could while they could get it. And that's basically what we're designed to do. and then the more you want, the more you eat it, the more you want it. So that's how it works. So your body is triggered into overeating when there's an abundance of sugar. It's just how your body's set up and designed. It's not a design flaw. It's actually a good thing, except it's only a flaw when we have highly.

Processed industrial food system. Talk a little bit more about liquid sugar. Why is it that liquid calories, specifically liquid sugars, again, sodas, large amounts and frequent use of fruit juices, especially on an empty stomach first thing in the day, like the classic American orange, orange juice, energy drinks, over-sweetened and highly sweetened coffees and lattes that people are getting from places like Starbucks. Why are they so problematic and how is it that they produce so much more belly fat than other foods that people are consuming?

So as I said earlier, sugar calories are bad and liquid sugar calories are worse. And the reason is they're unpacked from the matrix of food that they're in. They're not in a matrix of fiber or protein or fat. they're just pure sugar. And often it's pure fructose, which is, you know, when you eat fruit juice or if we have, for example, high fructose corn syrup, that's up to 75% fructose in sodas. What those liquid calories do is they get quickly absorbed because there's not anything buffering their absorption. They spike your blood sugar. That creates a spike in insulin, and that creates the flood of all the available fuel that's in your bloodstream into your cells. so it goes right into your belly fat cells. It doesn't go in your butt or arm or your earlobe. It goes right into your belly fat. And that is why the liquid sugar calories are the single biggest correlate with obesity in America. If you look at one of the things that people do that are most linked to obesity is liquid sugar calories. And people are clueless about the amount of sugar they're consuming. Most people don't know that, for example, they have their Starbucks mocha frappuccino latte or whatever. It's got up to twice as many sugar calories as a Cola. as a can of soda. So, and you think, oh, I'm eating something healthy or it's got milk or it's got whatever, it's definitely bad news. So I think there's a single biggest thing you can do to improve the quality of your health is get rid of liquid sugar calories. Occasionally a glass of wine is fine. Beer, not so much. I mean, occasional beer is fine, but not a staple shot of alcoholic tequila. Okay. But more and more research is coming out that alcohol may not be really that great for us. So I think we have to really.

Be cautious about it.

But those tend to be less of a problem, but they're still bad.

So I'm gonna pull one of the.

Studies that our team member, Melanie, listed for us that are on this topic. And I'll just ask you to maybe expand on, you know, what the connection might be there. So here's a study out of the European Journal of Preventive Cardiology, Coronary Heart Disease Incidence in Women by Waist Circumference Within Categories of Body Mass Index. And the study, which looked at hundreds of thousands of women, found that waist circumference, which is part of belly fat, increased the risk of coronary heart disease looked at over a period of 20 years. How could that be possible? How is that your waist circumference and belly fat could be connected to heart disease?

Oh, that's easy. So this is what I've been spending my whole life doing. So thank you for that easy question. You know, people say, How do I know if I have this or not? What do I do? I always joke, I say you could do the mirror test is where you jump up and down in front of a mirror without your shirt on. If your stomach jiggles, you have it. Okay? It's basically that. You can take a tape measure and you can measure around your belly button, around the widest point in your hips, and you divide your waist by your hip. And if it's over 0.9, if you're a man over 0.8, if you're a woman, you're in trouble. If your waist is bigger than your hips, that's bad. If your hips are bigger than your waist, that's good. It's just obvious. Now, why is it a problem? Well, as I said, when you have this belly fat, it's driving insulin resistance, inflammation in the body, and also what we call atherogenic dyslipidemia, which is a medical word for really crappy lipid or cholesterol profile that's causing heart disease. What causes this profile? What is this profile? It's small cholesterol particles, it's small HDL, small LDL, a lot of particles, and a large fluffy triglycerides that are full of fat, which is not good. And it leads to this horrible problem of high triglycerides, low HDL, small particles, which is the big driver of heart disease. If your cholesterol is 300 and your HDL is 100 and your LDL is 70, or let's say your LDL is 150, I'm not that worried and your triglycerides are normal. If your cholesterol is 150 and your triglycerides are 300 and your HDL is 30, that's terrible. I'm really worried about you. Even though one cholesterol is 150, one is 300, I'm much more worried about the 150. So you have to look at the quality of the cholesterol. You talked about your NMR profile, your lipid profile. This is really key. So we have to look at the right type of cholesterol. And when you have this belly fat, it causes the wrong type of cholesterol. the second thing is that it drives inflammation, which we know is at the root cause of heart disease. And without inflammation, you don't get heart disease. The third thing it does is it makes your blood clot. So if you have too much sugar and starch, it makes your blood thick and it leads to this increased clotting risk. And the heart attack is a blood clot in the heart. A stroke is a blood clot in the brain. So basically, that's why you don't want to have belly fat, and it's why It's so bad to eat these liquid sugar calories or anything that's gonna cause belly fat. And by the way, it's a linear correlation. So it's like this, the more your waist to hip ratio goes up, the more your risk of heart attacks and death.

Powerful, powerful reminder. Let's take another category that people are familiar with, and that is dementia, cognitive decline. And there is a study that we'll link here in the show notes. And the title of the study in the Journal of Neurology is Central Obesity and Increased Risk of Dementia more than three decades later. And I'll read out the conclusion for you and you can expand on it. Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. 50% of adults have central obesity, therefore the mechanisms linking central obesity to dementia need to be unveiled. Why would something like belly fat be connected to dementia?

Well, basically the bottom line is bigger belly, smaller brain. The bigger your belly is, the smaller the hippocampus is. It literally shrinks, which is the memory center in the brain. And the reason this happens is you get a phenomenon we call diabetes of the brain, type 3 diabetes, we're calling Alzheimer's now, or insulin resistance in the brain. And it's gonna happen independent of cardiovascular disease. so we know that as I said earlier, that sugar and starch and this belly fat is the number one cause of aging and age-related diseases. So if you want to die early, get a belly fat. If you want a heart attack, get belly fat. If you want a stroke, if you want cancer, if you want Alzheimer's, if you want high blood pressure, belly fat's your ticket. So you don't want that going on in your body because it leads to all these metabolic changes. So this is this whole phenomenon of insulin resistance or diabetes in the brain. is what's driving this problem. So it's not just about heart disease, it's not just about high blood pressure, it's not just about diabetes or being a little overweight. It's really about the quality of your life and what's gonna happen to you as you grow older. And often people don't understand that this is a 100% reversible problem. 100%.

Mark, I'd love you to talk about and you've been talking about this for years, but I'd love for you to talk about it in the context of this podcast. you have a few articles on the internet saying that when it comes to belly fat, there are two aspects. Number one, we have to understand that it's not your fault. And for the people that are listening or watching on YouTube, I'd love you to explain what do you mean by that, that it's not your fault? And then along with that, there's so much that's in your control that you can do. Let's start with the first piece of it. Why is it not your fault? if you are carrying a ton of belly fat or excess fat from a medical standpoint?

From a medical standpoint and from a scientific standpoint, from a nutrition standpoint, the dogma is really clear. Calories in, calories out. The reason you're overweight, the reason you have belly fat is because you eat too much and you don't exercise enough. Hashtag, you're a lazy glutton. Okay? That is just a bunch of malarkey. and here's why. We know that all calories are the same in a laboratory. So you say, oh, you say all calories are not the same. Dr. Hyman, who are you to say that this is, you know, the first law of thermodynamics is all energy is conserved. And so calories in, calories out. This is the way it is. This is just science. And I'm like, well, yes, you're right. In a vacuum. So what, what the first law of thermodynamics says, for those of you who are not up and up on your physics, is it says that energy is conserved. quote, in a system, meaning a closed system like a vacuum. When you drop a pound of feathers and a pound of lead off a bridge, the feathers float through the air and the lead goes crashing down. If you drop them in a vacuum, they drop at the same exact rate. Why? Well, they don't have to contend with air. The feathers have to contend with air. When you eat food, it has to go through your metabolic processes. It has to deal with your microbiome, it has to deal with your genetics, it has to deal with your hormones, it has to deal with your brain chemistry. It's interacting all with that all the time. So if you eat a thousand calories of broccoli or drink a thousand calories of soda, they're gonna have very different effects on your body versus if you burn them in a laboratory, they release the same amount of energy. I mean, a calorie is defined as basically the amount of energy required to raise the temperature of one liter of water, one degree centigrade. That's it, right? So, yes, in the lab, they're the same. So the message that it's about eating less and exercising more misses the central science, which has overturned that theory that all calories are the same. And this is what we call the carbohydrate insulin hypothesis. And the key proponent of this has been Dr. David Ludwig, who's a colleague and friend of mine, who's one of the most published, researched and esteemed scientists in the field of nutrition today from Harvard Medical School. And he's written, you know, really in depth about this. You can read his articles on Medium. You can go to PubMed and find his work. He wrote a very extensive review of this called the Carbohydrate-Insulin Hypothesis and essentially shows through the science that when you eat a carbohydrate-rich diet, if you are genetically susceptible, which is most of us on the planet, okay, some aren't, but probably 80% of us are. You are carbohydrate intolerant. And when you eat X amount of carbohydrate in the form of sugar or starch, not talking broccoli carbohydrates here, it raises your insulin more than someone, for example, like me who doesn't have that problem. So it's really important to understand that if you are consuming starch and sugar in any form, that you are driving this pathway of weight gain, central weight gain, inflammation, oxidative stress, blood clotting, hormonal dysregulation, brain chemistry changes. And it's really based on the information in the food because food is not just calories, it's information, it's instructions, it's code. It can upregulate your genes or downregulate them. It changes your microbiome, it changes your immune system, it changes your hormones, your brain chemistry. we have tremendous power to understand now the quality of our food determines the quality of our health. The quality of the information, the food is what changes the messages that get turned on or off in your body that regulate everything, not just your weight. So it's so important people understand that when they're eating food, not only are they eating calories, but they're eating information. The second thing around it's not your fault, your fat, is we live in a toxic nutritional landscape. It's almost impossible to go out there and hunt and gather in America and find stuff that's not gonna kill you, right? I mean, I travel, I go to airports. I mean, they've gotten better for sure, but I never travel without my emergency food pack in my bag. I carry protein and fat in my bag for at least a day's worth of food so I don't have to get stuck in a food emergency. But it's rough out there in America and we are living in a toxic nutritional landscape where the easy choice is the wrong choice and the hard choice is the good choice.

It's such an important reminder for everybody who's watching because I think there's so many individuals and Mark, I'm sure you've had patients and I'd love to talk about a case study. There's one that comes to mind, somebody who suffered tremendously with excess weight and specifically belly fat and what they did to get better, but there's so many people that carry around the guilt because they've been told their whole life through the media, maybe even their doctor, their well-intentioned doctor who's just repeating what they learned, that they need to finally get some willpower and get their life together. And so many of these people have tried so hard. They tried so hard and they tried so many different things, but because they are trying the standard advice, which is just eat less and exercise more, which is the same advice that they gave to the people on the show, the biggest loser. I'd love for you to talk about that and what we've found out from that experiment. They feel like it's not working. So talk a little bit about the biggest loser and then we'll go into a case study.

Well, the biggest loser was a problem because people were motivated by money. They were given extremely low calorie diets. They were pushed beyond their limits in exercise and they were able to achieve significant weight loss, which you will do. and the problem is when you do that, you know, it's, it, your body is in a, a state of crisis. And as soon as you stop, it's going to rebound and you're going to gain back that weight and often more. Because often when you lose fat, you lose fat and muscle. When you gain back, you just gain back fat. So you could be basically the same way as you were when you started your diet and actually burning less calories. That's, that happens to people and you see all the people who are really overweight or struggle with yo-yo dieting their whole life. They go, I don't really eat that much. I don't know what's going on. And they're right. They're right. Their metabolism has slowed down so much because they've lost so much muscle and they've screwed up their metabolism.

So, you know, if you lose weight.

You have to work on your muscle mass, which is important, and it has to do with the quality of the food you're eating. But the, the whole idea that you can go on these crash diets and, I mean, I never put people on a calorie restricted diet. Never. I never say count your calories, cut your calories, don't eat too many calories. I don't even say the word calories. Like, I don't, it's just so irrelevant. And I've had people lose hundreds of pounds. And it works because when you use science, not willpower, it's easy. People aren't hungry, they feel nourished, they feel satisfied, they don't feel deprived, it's sustainable, they want to continue it, they feel good. You've got to use science, not crazy, crazy amounts of of external force or internal force like willpower to actually get you to do it.

So Mark, let's get into that case study and is there somebody in mind that you want to talk about and what they did to radically reduce the amount of belly fat, which then besides looking better and everybody cares about looks, it actually reduced their risk of many of the chronic diseases that we talked about earlier.

Well, this is a great example. through because it illustrates all the bad crap that can happen to you if you eat sugar and starch your whole life, really. And then it illustrates how quickly it turns around if you change. Because, you know, think about it. We spend 40, 50 years getting sick. It can take a few months to get better, which people don't realize. It's really dramatic. So, you know, it takes a while for food to kind of screw you up, but it can take very quickly for you to get fixed by it. And this woman was named Janet. She came to see us at Cleveland Clinic. She was 65 years old. and she had every kind of chronic disease except cancer and dementia. I mean, she had high blood pressure. She had pretty bad heart disease with needing stents and all kinds of procedures. She had heart failure because her heart muscle was damaged. She had type two diabetes on insulin. Her kidneys were starting to fail. She was getting fatty liver. So pretty much her whole body was starting to shut down, and she came in pretty desperate. and she was a fairly well educated woman, but her family just had no food sense and they grew up on junk and she thought this is just what you eat, processed food. She never knew how to cook or do anything. And so within, within three days and she was on insulin for 10 years, within three days of changing her diet to a whole foods, anti-inflammatory, phytonutrient rich, high fiber, high quality fat diet, essentially the 10 day detox diet, which I wrote a book about in 2014. Essentially, within three days, she was off insulin. In three months, she was off all her medication, her heart medication, her blood pressure medication, her diabetes medication, and her numbers normalized. Her blood sugar went from way out of control, A1C of 11.4, I think, to 5.6. So just to put a perspective, if a drug causes a one-point drop, It's a blockbuster benefit. Like, wow, this is amazing. This drug, new drug lowered A1C by one point. Like that's how of a sensitive scale. It's what we call logarithmic scale. So it's not a linear scale. It's like exponential scale. She went down from 11 to 5.6. You don't see that with medication. There's no drug that can do that. Second, her, her blood pressure normalization. She got her blood pressure pills, her heart failure, which we measured on a echocardiogram reversed, which you never see. Like you just don't see that in traditional medicine unless you get a heart transplant. her kidneys got better, her liver got better, and she lost like 45 pounds in three months. And then she went on to lose 116 pounds and looks like a completely different person. And she was on her way to the graveyard by way of a heart transplant and a kidney transplant. And then she avoided all that and is doing amazing. And back to being a powerful contributing member of her community. So that's the power of food when you understand that. And she had this giant massive belly and you could see her face before and after. It was just red and inflamed and that inflammation is what's driving all the obesity and everything else.

And if anybody wants to see a photo of Janice with her approval and also how her numbers improved over time, we have the link to that inside of the show notes that Dr. Hyman has put together. So, Mark, let's go into the portion of the podcast where we take some audience questions, some questions from your community. Here's the first question. What about belly fat after menopause? Is there a difference and is it more dangerous?

I don't think it's different, but it gets more dangerous as you get older for sure. So often women are in a hormonal chaos in that time of their life. They get thyroid dysfunction, adrenal dysfunction from too much stress. Their blood sugar and insulin are often more deranged because they're more stressed. They're in that sandwich generation between like getting their kids launched and their parents getting older. and very busy career time. And it's just a disaster. You see this terrible triad of sex hormone dysregulation, insulin resistance, thyroid, or four things, insulin resistance and adrenal dysfunction. And that leads to increased belly fat and metabolic issues. It's not inevitable. There are many 50-year-old women or 55-year-old women who manage it and who eat well and exercise and take care of themselves in ways that actually prevent this. But you have to be more vigilant. You have to be more careful. and it'd be more on top of it. Like I'm, you know, 62 years old, so I have to pay way more attention to my health than I did when I was 32 or 42, just to be able to do the same thing. So if I go for a couple weeks without exercising, it's a lot worse now than it was when I was 25. It takes me a little more time to get back to where I was. So really important to understand that you need more inputs as you get older, but you can still maintain vigorous health and strength. And they've shown that with the research that actually you can stay vital in health and helping fit very, very long into your later life.

All right, next question. What's the challenge with eating late at night? Regularly having dinner at 9:00 PM, 10:00 PM, or even eating late night snack at 11 or midnight, maybe even 30 minutes, 10 minutes before people go to bed?

One of my first books, Ultra Metabolism, I wrote about what we call the Sumo Wrestler Diet. and basically the Sumo wrestlers, the way they gain weight because you've got these little Japanese people who are not genetically prone to being obese. And, how do they get them to be those huge Sumo wrestlers? Well, they basically wake them up, they do their routine of exercise and training, and then they eat a humongous meal called chanko nabe, which is basically like it's really actually healthy stuff, but it's a massive amount of food. food and protein and fat and rice and it's like this massive meal. I love it actually, I love to eat it. But it just makes him gain a lot of weight. So they basically had this giant lunch and then they go to sleep and take a nap. And then they do the same thing. Afternoon they may wake up a little exercise, big dinner, go to bed and sleep with a big full stomach. That will make you gain weight. Why? Because when you're sleeping, your body's in repair storage mode. see all these hormones change from day to night and the hormones at night are storage hormones. So you're gonna store all that food as belly fat. So you don't wanna eat before bed. Three hours at least. I mean, occasionally if you go out to dinner or whatever, it's fine. But like if you're on a regular schedule, like I eat, you know, five, six o'clock bed, you know, nine, 10 o'clock, give myself three hours to digest my meal and don't have snacks. It's, I mean, snacking, first of all, is the worst invention of humanity. It's, you know, we was like we all of a sudden got six, 700 extra calories a day per person and the food industry was, what are you gonna do with that? Well, let's make it all these fun snacks and convince America they need to snack and never be hungry. It's like, it's the worst thing. So snacking is terrible and, and you should really eat in a shorter time window. You should definitely not eat before bed. And if you do, I promise you.

You'Re going to gain weight. Yeah, one of the thing that the sumo wrestlers do is they drink a big pint of beer in addition to that meal. I was watching a documentary on sumo wrestlers.

Oh, yeah.

And I was talking about this with Dr. Richard Johnson we mentioned earlier. You're saying, yep, that flood of uric acid that comes in and that's signed to store up the belly fat. So, yep, don't live like a sumo.

Wrestler is the moral story unless you want to look like one. That was basically yeah. from ultra metabolism way back when.

Here's another question from our community. If insulin drives weight, why are diabetics put on insulin?

Great friggin question. Here's the thing. Most doctors know this. Most average people don't know this. When you have a diabetic and you put them on insulin, what happens? Do you know?

They gain weight.

Their blood sugar goes down, but they gain weight. their blood pressure goes up and their cholesterol gets screwy. So it's like a whacK-A-Mole. Yes, it keeps the sugar down, but what you actually learned, and that this was a huge study, was called the Accord Study of 10,000 diabetics who were in aggressive blood pressure management. In other words, they like, let's get these people's sugar as close to normal as possible. Let's give them lots of insulin, lots of drugs. Let's drive their sugar down. and let's see how they do. And you think, oh, well, if sugar is the problem with diabetes, if they got their sugar normal, they'd be fine. Turned out the opposite was true. The lower their blood sugar, the worse they were. The more heart attacks, the more deaths. Why? Because they use a lot of insulin. And insulin makes you die. It makes you fat. It kills you. It's, it's, it's the worst thing when it's in excess. So if you, and I often, by the way, Drew, I see type one and type Type 1 diabetics often getting double diabetes. In other words, they are have type 1, but then they get type 2. So here's how that works. Normally you should make about 20 units of insulin, 15-20 units of insulin a day to manage your blood sugar. That's the average person. What happens if you're a diabetic type 1, if you, let's say you want to eat cake and ice cream and cookies and whatever, you can do it and you can keep your blood sugar normal, but you need to give yourself more insulin. And so they keep giving themselves more and more insulin and they get insulin resistant, which means they need more and more insulin just to keep their sugar normal. So they might be using 50, 60, 100 units of insulin. That's terrible. So you can get double diabetes by eating too much crap and using insulin to manage your blood sugar. So the key is to keep your blood sugar as low as possible. And a friend of mine is a type 1 diabetic and she uses a ketogenic diet. and she basically uses one or two units of insulin a day, which is like ridiculously low because if you eat fat, you don't need insulin. And that's why ketogenic diets work so well for type 2 diabetes where they cured 60% of people or 95% or 100% got off the main medication, over 90% get off their insulin or reduce it dramatically. It leads to the most weight loss of any study I've ever seen, which is about 12%, which doesn't sound like a lot, but most studies get 5% everybody's jumping up and down and super happy. it's more than double what you see.

With a normal weight loss study.

Right.

And there's a way to do cleaner versions of keto, there's ways to do dirty versions. We're obviously talking about the cleaner ones that are plant forward, plant rich at the base of it to get all that. We don't want to just be eating.

Bacon all day and-- no.

Olive oil, avocados, nuts and seeds. Yeah, there's plenty of ways to do keto in a clean way. All right, couple more questions here before we wrap up today's podcast on Belly Fat. why is it so important to practice stress management techniques to help with losing belly fat? Is there a connection between the mind and the body when it comes to belly fat?

Well, yes, stress makes you fat, relaxing makes you thin. Okay, it's that simple. Here's how. I actually, I had a patient, I learned this from her. She was a woman who had a daughter living in Israel, and it was during the time of like maybe 15 years ago, whenever they had the infantada, it was really bad. And she was terrified for her daughter and she was so stressed and she could not lose weight. She was like 40 pounds overweight and she struggled, struggled, struggled. Her daughter moved back to America, 40 pounds went away. And what happens is when you're stressed, you make cortisol and you send all sorts of signals through the vagus nerve and the sympathetic parasympathetic nervous system to your fat cells. So, so basically every cell in your body is wired to your nervous system. So you're, you're eating, you're, trying to metabolize your food, your fat cells are listening to your signals from your brain and they're telling it what to do. And it turns out that the wiring that goes to your fat cells when you're under stress tells the fat cells to store fat. And that's, wow, okay, so you never want to eat a meal if you're stressed. You want to stop, take a breath, you know, why do people say grace, have a prayer, take a moment? It's to reset your nervous system. And I think there's a simple practice called take five that you can do before you eat. where you take five breaths, five seconds in, five seconds out, five times. Just like that, through your nose ideally, but just five deep breaths and you'll see your body will change, your physiologically will change, your pH will change, your brain chemistry will change, and your body will be more in a state of relaxation that receives eating. Also, you can actually absorb nutrients as well when you're stressed. So there's a lot of, there are a lot of issues around stress, but between the innovation of the fat cells that makes them store fat and the high levels of cortisol, by the way, cortisol is a drug also that we use called prednisone or steroids. Your body makes it and you need it, it's there, but when it's in excess, when people are taking it, for example, what happens to them? So there's actually a word for it, it's called Cushingoid. They get looking like Cushing's patients, which are people who have a tumor that's making too much cortisol. So they'll get really big bellies and belly fat, they'll get skinny arms and legs, They'll lose, they'll get high blood pressure, they'll get diabetes, they'll get all the things that we see from people who have too much sugar. But it's from the cortisol that raises blood sugar, raises insulin and all these secondary effects. Because you want that, right? If you're running from a tiger, you want your blood sugar to be as high as possible so you don't run out of gas if you're running from the tiger. You wanna know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly news that are Mark's Picks, where I share my favorite tips for health, longevity, well-being, and lots more. Check it out and the link below.

All right, last question that we have here, Mark, and then we'll do a little bit of a recap for today's episode. What is the role of fasting or intermittent fasting when it comes to losing our belly fat? And are there techniques or resources that Dr. Hyman has to make it fasting easier or less scary is what I'm reading into the question.

Yeah, yeah, yeah, yeah, yeah. Okay. So time restricted eating, intermittent fasting, fasting mimicking diets, ketogenic diets, they all do the same thing. They basically give your body a break, a period of non-eating or appearance of not eating. If you're eating keto, you're not eating carbs but you're still eating, but the body doesn't register it as anything that's driving insulin. So if you could drink a liter of olive oil, on empty stomach, your insulin will not rise one bit, even if it's a million calories. It just doesn't go up, right? But if you eat that fat with sugar, it's a problem. So the key to fixing the belly fat is to lower the insulin and to turn on all the other signals that make you burn fat. And the way to do that is, and there's a lot of ways to do that, but one of the ways to do that is to do time restricted eating. So you eat within an eight hour window. So let's say you eat dinner at six, you can eat the next morning at 10. It's not that terrible. I mean, if you eat at eight, you can't eat till 12, whatever. But you really need, you really need a break from eating. And if you really have a lot of belly fat, the eight hour window to eat is really effective. And it turns on all the signals that repair your body, reduce insulin resistance, get rid of belly fat, build muscle, reduce inflammation. increase your antioxidant enzymes, improve your brain function and cognitive awareness. So it's really beneficial. You can also do periodic fasts like a day fast, 24 hours, 36 hours. You can also do other things like fasting mimicking diets where you restrict your calories for five days, like Valter Longo has talked about and it's been on the podcast talking about that. Or you can go on a ketogenic diet, which, you know, basically you can do with time restriction or not, but that also does the same thing. so when you think it's scary, it's because you think you'll be hungry. But the truth is, if you, if you learn how to eat with the right composition and information, the food, it will make you feel full, satisfied, you won't be hungry. And there's hacks. You can drink a lot of fluids. You can sometimes use a MCT oil because that won't kick you out of ketosis. So you can really, you know, use a lot of techniques, but it's very safe, it's very effective, and it's actually not that scary because it's, it's not that hard for most of us. Now, if you're really underweight. If you got cancer to something, you know, stuff like that, you don't want to be doing the too much of restricted eating. I mean, I know for me, I can do. I can do 16 hours. If I go more than that, I'm in trouble. Like, I I get in trouble. So I I just, you know, I have very low body fat, and I'm probably too stressed, but I don't really feel stressed, but I think my adrenals have beat up over my life. But I've been trying to recover from my life. But I. The truth is, you know, you.

Your body.

Usually does really well if you have any visceral fat doing time-restricted eating, intermittent fasting, or ketogenic diets. Hey, YouTube, if you like this video, you're gonna love the next one.

Now, deep belly fat is really inflammatory. What we realized is that deep belly fat produces all sorts of inflammatory markers, interleukin-6 and tumor necrosis factor. So it actually results in increased inflammation in the body. and it is associated with increased insulin resistance. And that high level of insulin and the high level of inflammation, those two things, and I'm sure there's more, are really drivers for all of these processes to get out of whack in the body. For the cholesterol to get out of whack, for your inflammation in your arteries to get out of whack, for cancer to like to grow, And that inflammation.

Drives all these things.

That deep fat, that's absolutely, absolutely. And so, and that deep fat is not just hanging out. It is metabolically active, as we've talked about before, and you always like to talk about it's metabolically active. It's not just sort of sitting there. It's really doing- It's not just holding up your pants. It's an endocrine organ. It's doing- no, right? It's actually doing things. And it's producing all these chemicals and and hormones, and it's increasing the inflammation in your body. And so, if there's one thing that people can focus on, like if you're, you know, you kind of, sometimes people get overwhelmed with all these messages in health, right? Like, oh my goodness, what do I do? What diet do I follow? What should I work on? Where do I focus? And sometimes people get overwhelmed and they almost give up. We see that all the time. and this is like the basic thing that everybody can focus on. You know, even for myself, like I'm like, you know, I do a lot of these self-care things right. I try to all the time, right? But, you know, this is an area that we can all focus on that can improve our health if we just pay attention to what's our waist circumference and what's our waist to hip ratio, because that's telling us how much belly fat we have.

Yeah, so I think that's right. I often joke and say there's a simple test you can do to figure.

Out if you have this problem.

It's called the mirror test. You take off your shirt, you look in the mirror, you jump up and down, and if your stomach jiggles, you probably have it. And, the truth is 88% of Americans have it. They're metabolically unhealthy. That's because they have this visceral fat that's making them unhealthy and causing all.

These other problems that we see as separate, right? oh, I have high blood pressure. Oh, I have high cholesterol.

Oh, I have high blood sugar. But they're all the same problem. Or I have low sex drive or low testosterone. Or I have, you know, pimples and poor periods and sleep apnea and whatever the things are that we're suffering from. We see them as all separate, but they're all connected by this. And with, with COVID now, the vulnerability of this population with visceral fat is just, it's just been highlighted. you know, 63% of hospitalizations could have been prevented if people had better metabolic health and ate better food. So the real question is one, you.

Know, let's talk, we're going to talk.

To them about what causes it and how we start to diagnose it. But what are the ways we can diagnose it properly?

You mentioned the waist to hip ratio.

That's a simple test. Tell us about that. And then let's talk about some of the blood tests that you see. It may seem like other stuff, but are clues to you having bigger belly fat.

Yeah, you know, the waist to hip ratio is a great measurement that we can all do and repeat on our own. So what you do is you get your waist circumference and to find the right place for your waist circumference, it's in between, you know, you find your lowest rib and you find your upper hip bone and then you put this You put the tape measure in between and that's considered your waist circumference. So if you find that lowest, your last rib and your hip bone and go in between the two, that's considered your waist circumference.

It's like your belly button.

And then your hip circumference. Yeah. You know, some people's belly button hangs down or is in a different place. So it's not always the belly button, but it is around that area. Yeah. And then their hip circumference is, it's considered over the greater trochanter. But if you don't know where that is, I always say to people, go over the largest part of your hip because that just makes your number look better. So you want to get the biggest hip circumference as you can have. Not that you want to be overweight, but you pick the biggest hip circumference to determine your waist-to-hip ratio if you can't figure out where that greater trochanter is. So, for the goal for Caucasian people, for Caucasians, is to have a waist circumference less than 35 inches for women and less than 40 inches for men. For Asian and Indian ethnicities, it's stricter, less than 31 inches for women and less than 37 inches for men. And that waist to hip ratio is a great measurement to do. So, for women, you want to be less than .8 and for men less than.9 is the waist to hip ratio you want to have. So you want, you know, a smaller waist than hip, of course. And, and the neat thing, this is a really simple test you can do and something you can check every month. You know, you can redo your waist tip ratio every month and watch your progress and say, okay, what am I doing? What do I need to do? And, It's a really inexpensive way to figure out, is this a problem for me?

Yeah, that's really huge. And I think it was also important what you said in that people who of Indian or Asian descent can have significant visceral fat and all the complications from it at much lower weights. So they may, if you look at.

Their weight, their weight might be perfect.

It might be less than 25, 23 in their body mass index. which 25 or more is overweight, but they may be full of this visceral fat and they can be diabetic, they can be thin and they look thin, we'll call them skinny fat. So they have the same issues as someone who is overweight, but they're just over fat.

Yes, or toffee, right? Thin on the outside, fat on the inside. So, you know, if you are a smaller person, then that's where also that waist to hip ratio can be really helpful. and you're right, you're right. None, no test is ever perfect. So for some people, the waist circumference or the waist hip ratio isn't giving us all of the information. There's a lot of other biomarkers that of course tell us that somebody has too much visceral adiposity, that somebody is carrying too much weight around the belly. You know, if we see a high C-reactive protein or marker for inflammation, it makes us wonder, Okay, do they have metabolic syndrome, insulin resistance, visceral adiposity? If we see that fasting insulin greater than five, that's when we say, okay, this is something we have to pay attention to. If we see too many small dense LDL cholesterol particles, we've spoken about that before, that's a sign that somebody has insulin resistance or visceral adiposity. If we see, we also check for things like oxidative stress, too many free radicals being produced, that's a sign. If their liver function tests are high or they have signs of fatty liver, that can also be because of this visceral adiposity, or gout, high uric acid, that can also be because of this, or that pattern in cholesterol, the high triglycerides, low HDL, all of these things can give us a sign, give us information and say, okay, this person is struggling with metabolic syndrome, insulin resistance, or probably because of visceral adiposity.

And you often notice all these things at normal at the same time, right? So you see a pattern and it's really pretty easy to diagnose when you know what to look for. So you get inflammation, you get high blood sugar, high insulin, lots of oxidative stress, your liver. I mean, these are all things that seemingly are treated like separate problems, but they're all connected to this visceral fat.

And what's amazing is to watch them improve when we make shifts or changes in somebody's lifestyle, you know, or, you know, there's lots of things that can contribute to this, from toxins in the environment to shifts in the microbiome to poor diet, you know, having a nutrient poor diet, eating too many refined and carbohydrates and simple sugars, not getting enough exercise, poor sleep. too much stress can all contribute to it. But when we shift somebody's lifestyle and when we make shifts in these issues that they're dealing with, we see these markers, these biomarkers improve significantly. So it's really fun to watch. We see it improve all the time.

Hey, everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do. and introducing you to all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else I promise. And all you have to do is go to DrHyman.com/picks to sign up. That's DrHyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this week's episode.

So I'm gonna get into, you know, the causes a little more deeply in a minute, but there is another test that we often do, which I like a lot. And, it's sort of the gold standard. It's called a DEXA body composition test. And, it's like a x-ray, very low dose x-ray. I mean, you have to basically take 50 of these to equal one flight across the country from New York to California in terms of radiation. And, it measures the compartments of your body, your arms, your legs, your belly, and can tell you what the fat is, where it is. And, it's pretty compelling. There's also MRI technology that does a CT technology. liver fat measurements. So, there's a lot of ways to.

Look at this, but it is really.

The central problem of our time. And, there are many causes, but the major cause is our ultra-processed high starch sugar diet. That's the biggest cause because that drives insulin and insulin drives all the available fuel that you've eaten into your fat cells in your belly. and then it keeps the fat there, prevents this breakdown process called lipolysis of your fat, and it produces all these inflammatory compounds, and it screws up your hormones, and it makes you hungry all the time, and it slows your metabolism. So it's the worst possible thing, and it's really driven predominantly by that.

So we know that a high carbohydrate.

In the sense of starch and sugar diet, because vegetables are carbohydrates, so you can eat as much of those you want. is the biggest driver of this.

But there are other causes, right?

And you mentioned a few of them.

So let's kind of go through some.

Of the unusual things that might be driving this, whether it's the microbiome, toxins, and other things that drive inflammation.

You know, I always, just in terms of the most common cause, right? I get so concerned when I see, you know, a young child, maybe like eight or nine, and their parents are buying them a, you know, a muffin and a sugary coffee drink, or sugary, you know, beverage for breakfast. And I'm like, oh, no, you know, it's just a setup. It's a setup for them to have problems for their whole life, you know? And, and I think that, that it's, it's, it's important that people take care of those, those Basics, like you mentioned. But we always look for, you know, sometimes, sometimes people are doing, or they feel like they're doing everything right, and there's, there's hidden reasons for why they start to develop visceral adiposity and that belly fat when they're really doing a lot of things correctly. And one of the things that I find that people don't realize is what happens when they start to lose lean muscle mass as they get older. So, you know, we might be exercising a good amount every day, but if we're not working really hard to maintain that good lean muscle mass, what happens after the age of 25 is we slowly lose lean muscle mass. And then it's just so much easier for the body to put on excessive fat. And we know that having good lean muscle mass and exercising really keeps our insulin sensitive. And so that's one thing that people that slowly catches up with people and they become more insulin resistant over time. And you mentioned toxins.

Yeah.

You know, unfortunately, there's been multiple toxins associated with this visceral adiposity.

So, I want to underscore what you just said. I want to underscore what you just said.

Yeah.

Because you basically said something really important.

Absolutely.

Around muscle loss when you get older. And, and muscle loss is really could be thought of as replacing muscle with fat. So you could be the same weight at 65 than you are 25. It'd be twice as fat. And that fat in your muscles, it's not, not just in your belly, is also this poor metabolic fat. And it leads to this increasing phenomena with all the consequences that we see of disease.

So I feel like this is a.

Really important thing that people understand. So exercise, basically strength training, building muscle and aerobic exercise, even interval training, will help improve metabolic function and help keep this insulin resistance at bay as we age. Because it is something that affects almost everybody as you age unless you do.

Something actively about it. So let's talk about toxins.

You do have to work really hard at it. I mean, it's so easy to maintain. Well, I don't know if it's so easy, but it's so much easier when you're younger to maintain your lean muscle mass. And as you get older, it's really work. People are like, I do go for a walk every day. And I'm like, it's not enough for you right now. And getting in two days a week where you really are working on resistance type exercise. There's so many ways you can do that. that, you know, that really can make a big difference. So, yes, so toxins, you know, BPA is a toxin that's been unfortunately associated with visceral adiposity, fatty liver metabolic syndrome, and BPA, bisphenol A, is that hard plastic that is pervasive, unfortunately, in our environment and has been associated with, you know, breast cancer, but it's also been associated with insulin resistance. so, so I think it's important that we recognize that there are a lot of toxins out there that are impacting our insulin sensitivity and, and possibly through how it damages our mitochondria. And, you know, it's just really, it, there is more to it sometimes than, than just our food intake. And we always really have to dig and look for that when we're working with our patients.

For sure.

We call these things obesogens. You know, they're petrochemical toxins. They're even heavy metals I've seen. So, we really have to be alert to people are not losing weight and they're not successful doing the basics stuff of diet and lifestyle change.

What else is there?

And, there are other things like the microbiome. So, maybe we can share a little.

Bit about that and what we're learning. The microbiome, I think, is so fascinating, right? I mean, there's so much information there that we're learning and there's going to be so much more that we're going to learn over time. And, I don't, and there's going to be so much more that we're going to learn over time. And, I don't think we have obviously all figured out, but we know that there's certain bacteria in our digestive system that are associated with less inflammation and a healthier weight, and there's certain bacteria in our digestive system that are associated with more inflammation in the body and having an easier time with weight gain. So it's fascinating the association between the microbiome and this whole process of insulin resistance. And so, you know, when somebody comes in, and we're trying to figure out what's going on with them, we want to work on all angles here. And we want to ask those questions of what's going on in your digestive system and how are your bowel movements and how do you feel after you eat and are there foods that you're not tolerating? Because we can work to manipulate that to help improve somebody's metabolism.

Yeah.

And also, anything that causes inflammation.

Right?

Could cause weight gain. So, people might be having food sensitivities that are causing it. Or, they're exposed to mold in their environment. Or, they have latent infections. Because anytime there's inflammation, it drives insulin resistance independent of the cause. So, the biggest cause, just not to get too down on that rabbit hole of these things, the biggest cause obviously is sugar and starch. Those are the two biggest things that are driving inflammation. but there are a lot of other things that people need to think about that also do it. Now, people listening might be going, okay, yada, yada, yada, okay, all this great science about belly fat, what it does, and why it's bad, and how to test for it, and, you know, what causes it, but how do I get rid of it? That's the big question. How do you actually get rid of it?

And.

I think it's so gratifying practicing functional medicine, and at the Ultra Wellness Center where we work, it's so gratifying seeing this because this is one of those kind of slam dunk, idiot proof things for most people. And it happens so quickly and it's so striking because people are always struggling with this. And like, well, if you understand biology.

And how the body works and how.

It functions, which is really the foundation of functional medicine, which is understanding how to work with the body rather than against it, you can drive these biological changes really quickly. and really change the quality of the fat dramatically.

And the fat, and just give you a quick example and then we'll go.

Into what to do about it. This is one of my favorite studies.

That I've read recently is a study.

Looking at gastric bypass surgery.

Basically they said, well, you know, gastric.

Bypass works because it causes all these, you know, amazing changes in hormones and appetite and blah, blah, blah, blah, blah, blah.

So there's all these theories about why it works.

Well, somebody decided maybe we should test this theory. So they took a bunch of people who are really overweight and they gave me gastric bypass on half of them.

The other half just ate the diet that the gastric bypass people ate after they had the surgery. And there was no difference.

But very quickly, within days of changing.

Their diet, the quality of their fat.

Changed and it went from being inflammatory fat that's driving all these problems to really shifting that. And so it can happen pretty quick.

Even if you're still a little overweight.

You can still have the metabolic and health benefits.

Of course, you still need to get the weight down, but I think it's.

Just an interesting phenomenon.

So, I kind of love that study. So, let's talk about what do you.

Do and some case studies that you've.

Had that really sort of illustrate the.

Ways in which we can use this strategy of functional medicine and the science to drive real change for these patients in their not only their belly fat, but all the other biomarkers and health issues and consequences that come from having this belly fat.

Absolutely. Like we were talking about the visceral adiposity, that belly fat is associated with high levels of insulin in the body and insulin resistance. And that means that the body isn't listening to its insulin as well as it used to. And so that high level of insulin, as you mentioned earlier, causes us to store calories and to just gain weight. It makes us more hungry, but it also makes it much harder to lose weight. So one of the things we really, when you were talking about, okay, how do we really work with our physiology, is we want to prevent insulin spikes because we know that higher levels of insulin are what's really driving us to gain this visceral adiposity. And so, as you mentioned, It's those refined carbohydrates and sugars that drive up insulin levels in the body. And we know that if we just ate just fat, we wouldn't secrete a lot of insulin. And protein, we secrete some insulin, but not as much as with carbohydrates. So what's really important is bringing down the percentage of calories that somebody's getting from carbohydrates, especially the refined and processed carbohydrates, that cause that insulin spike. And so I always talk to people about that, having that balance of the good healthy fat and lots of fiber and some protein at every meal and just pulling away the simple sugars and refined carbohydrates because that brings the insulin down and makes us less likely to hold on to that weight around our belly.

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