The 5 NUTRITION TIPS To Fix Your Health & LIVE LONGER! | Mark Hyman

If you're eating processed food, sugar, starch, bad fats, it's going to be a problem. You're not going to get better. You can listen to all the nutritional advice you want, but pay attention to how you feel. Your body's going to tell you you're eating pounds of food every day, and that is what's landing in your gut and feeding your bugs. And if you're eating processed food, sugar, starch, bad fats, it's going to be a problem. You're not going to get better. So you need a Whole Foods diet. I call it the Pegan diet, which is kind of a joke, but It's like less extreme, more inclusive, but whole foods focusing on quality, not so much worrying about quantity. And sometimes eliminating things like gluten and dairy and other things that can trigger food sensitivities. And combined with the diet and this protocol, within a few weeks people started to feel significantly better. And then it takes about three months to really kind of reset the whole thing.

When somebody has a stubborn problem, like Lisa's, is insanely disciplined. If you tell her to do something, she's going to do it for sure. Her diet is clean. In fact, I would probably consider that one of the things that became her problem was...

It was too restrictive.

Too restrictive. And then once the SIBO kicked in, once she encountered the parasite and had the threshold event, it's like the weed, seed, and feed thing. I don't know that we've ever gotten Perfect. Is there any particular thing that creates a stubborn problem when the person is being disciplined, but it continues to go away?

Absolutely. Almost 30 years ago, I had another problem, which was mercury poisoning, and that messed up my gut big time. And I got a triggering event, which was some bug I picked up somewhere in a lake in Maine. And then my entire gut broke down. And I literally had diarrhea, bloating, pain, for years. And I developed chronic fatigue syndrome, my whole system broke down. And it wasn't until I got rid of the mercury that my gut sorted out. So if she has mercury poisoning, if she's mold toxic, if she has a tick infection, some underlying thing, it can impede people getting fully better.

So now let's say that we've identified the problem, we've done the weeding, what should somebody be eating? So obviously in your new book, What the heck? You go into, it's all whole food based, but there's obviously a lot of whole foods in the world, so what should people be aiming at?

Well, here's the thing. There's so many diet wars. Nutrition is often based on ideology, not on good science. And there's so much conflicting information and people are buffeted about by the media. One day it's bad, then it's good, one day eggs are bad, then they're good, then they're bad. I mean, it kind of makes people crazy and give up. what a scientist is doing and it's just a mess, right? But I've been studying nutrition for 40 years and I've been not only studying it in a book, I've been using food as medicine for 30 years as a doctor. And I'm humbled by it because I realize everybody is different. Everybody needs different approaches based on their genetics, their preferences and so forth. But there are some common principles. I call them the Pegan principles that are universal that no one will argue with. And I was sort of joking because I was on a panel with a friend of mine who was vegan. It was a cardiologist, another guy was a paleo doc and they were fighting and I was in the middle. And I'm like, well, if you're paleo and you're vegan, then I must be Pegan. And it was like just kind of a goofy joke. And I realized, wait a minute, they agree on about everything except where you get your protein from. So they all agree that we should be eating whole foods. They all agree we shouldn't be eating any industrial processed foods. They all agree we should be eating a ton of vegetables, lots of good fruit, lots of nuts and seeds, lots of good fats. Everybody agrees that. The things that are different are should we have our protein from animals or from beans and grains? That's the only difference. And I thought, you know, well, not everybody has a problem with beans and grains, and not everybody has a problem with animal protein. In fact, it can be a very important source of food for most people. The question is what, right? What grains? what beans, what meat, what fish. And so that's really what those principles are about, it's focusing on quality. So for example, do you want to eat a feedlot burger? Heck no.

Because they're raised on grain?

For many reasons. One, they're raised in a way that is inhumane for them. They're raised on foods that create bad metabolic profiles in the animal. So you're eating a lot of inflammatory stuff. They feed them chicken shit, they feed them candy, they feed them corn. And then there's how they grow the food for the animals, which creates massive environmental destruction. Loss of biodiversity in the soils and animals, loss of water resources because of all the irrigation to grow the crops for the animals, the deforestation that results, the destruction of our soil, the use of fertilizers, pesticides, the fertilizers runoff and destroy all their rivers and lakes and oceans and create dead zones the size of New Jersey in the Gulf of Mexico that killed 212,000 metric tons of fish a year. And there's 400 dead zones like that, the size of Europe around the world that are in coastal areas that are killing the food supply for half a billion people. You know, that's because of the consequences of how we're growing our food. And not only that, it's a giant source of climate change for all those reasons. so no, but he should be eating factory farmed animals. On the other hand, you look at regenerative animals, which means regenerative means you farm or grow animals in a way that is bringing the ecosystem back to health, which is restoring soils, reducing water use, reducing or limiting fertilizer, pesticides, herbicides. And there was an interesting analysis. Everybody's into these plant-based burgers now. And, you know, I think, yeah, it's better that we eat plants. and that's great, but what plants should it be a highly industrial product like Impossible Burger, for example, is GMO soy. So it's grown in a way that you're getting lots of glyphosate, which is not good for you, it destroys your gut. The food is grown in big monocrops intensively with fertilizers, pesticides, herbicides, destroying the soil, using up water and so forth. It's way better than a feedlot beef, but when you compare it This was done by an independent life cycle analysis company, Quantis, that looked at both Impossible Burger and a regeneratively raised beef burger from White Oaks Farms in, I think, Missouri. And they found that you literally had to eat one regeneratively raised burger to offset the carbon emissions of a plant-based Impossible Burger.

To offset it.

In other words, the soy burger added three and a half kilos of carbon in the environment, the grass-fed burger took out three and a half kilos of carbon from the environment. Because soil is the biggest carbon sink on the planet. It can hold three times the amount of carbon in the entire atmosphere if we took care of it and built organic matter in the soil, which only happens through the use of animals.

Right.

That dig and pee and poo and move around and chew down the grass, and that builds soil. And that doesn't use fertilizers, doesn't use pesticides, doesn't use herbicides, uses rainwater, so you're not using 1800 gallons for every pound. It's called green water and producing higher quality meat with high levels of antioxidants, high levels of omega-3 fats, better for the animals, and you're not destroying ecosystems. When you grow soy, you're destroying ecosystems. You're destroying the habitat of animals and rabbits and mice and birds when you're making these giant mega farms. So, I mean, probably eating a regenerative grass-fed burger is probably the most vegan thing you can do. So, you know, it's like-- and I think it's just we get this false dichotomy. I mean, like, all meat is bad or only vegan or, you know, oh, you should only eat paleo. It just doesn't make sense, right?

That's really interesting. The green argument is fascinating, seeing sort of the balancing out that's going to happen between whether there is some amount of farm raise that's actually necessary. I've heard you talk about the topsoil before and that that's actually something that without animals, you're going to erode the soil and that in and of itself causes some dramatic issues.

We lose 200,000 tons of soil every hour.

Every hour.

Every hour. We lose a country the size of Nicaragua or North Korea of soil every year. We have 60 harvests left according to the UN before we run out of soil and can't grow food. No soil, no food, no humans. Forget climate change.

This is that sounds relatively problematic.

And by actually using the strategy of regenerative agriculture, we can draw down carbon, not add to the carbon in the environment. Even if we stopped all fossil fuels tomorrow, we still would be screwed. We need strategies that draw down carbon out of the environment, and the food system is the number one set of solutions.

Let me ask you, so even just forgetting anything ecological, why plants? So, when you were saying everybody agrees we should eat more vegetables, obviously I would say Stephen Gundry probably doesn't agree that we should eat more vegetables. Maybe if it's the right vegetables. Right, the right vegetables.

Do you have a take on that? What's your vibe about lectins? Yeah, yeah, okay. So, I think it's really personalized. And so, for some people who have serious illnesses, getting off of inflammatory foods, including lectins, can be helpful. But look, 60% of our diet is ultra-processed food. that's the first priority to have is get people off that stuff. Don't restrict vegetables, you know, because like unless you're really sick and you wanna try it as a therapy, fine, but I'm really not, you know, a big fan of telling people to not eat vegetables, because I think there's so much value in them and I think if we actually have the problem of restricting unnecessarily for people, it's not great.

Well, let's talk about, so what do you think about the carnivore diet? Is there any logic there?

Well, you know, it's interesting. I mean, you know, like Jordan Peterson's doing that and his daughter did it to cure autoimmune disease. And yes, if you are really sick, sometimes it can be profoundly helpful. I mean, if you have autoimmune disease, if you have severe obesity, I mean, there can be real benefits. But again, you know, we used to eat 800 species of plants as hunter-gatherers. We ate animal products when we could find them, you know, or hunt them. And it was a part of our diet. It wasn't a staple. Some cultures like the Plains Indians, like the Lakota, they lived mostly on buffalo. And they were the longest lived people in history. They had more centenarians per capita than any other population at the turn of the century.

Yeah.

So, you've talked about one thing that medicine really has got to start doing is looking at the laws of biology. So, physicists are looking at the laws of the universe. What are the laws of biology? I'd love to hear what are what are some of the laws of biology? How does that play out in terms of plants? Because I can walk you through, it's admittedly like a lay person's understanding, but when I walk through the notion of the plant paradox and you start thinking of a plant as having a basically a chemical evolutionary advantage or the way that they stop predators is by creating these chemicals that either upset their stomach or they're bad for them or they are bitter tasting or whatever. It's like, oh, that makes sense. When you have something, it has to have a mechanism against predation. And humans are one of the predators. And so, okay, it didn't develop claws or whatever. It developed like these chemical signals. You've talked about food being signals more than just calories. So it's like, okay, well there's actually some logic, whether it's true or not, is a totally different question. But there's a followable chain of logic to why plants potentially have issues. And so it's like, is there anything that they all share that for somebody with the sensitivity, they're an issue? Or no, no, no. There's so many other nutrients in vegetables. If you're not eating them, you're committing a cardinal sin of the laws of biology.

Well, if you're eating nose to tail, like you're eating the liver, which has more vitamin C, more vitamin A than any vegetable on the planet, right? You can get by, but... You can.

Get by or it's ideal.

I don't think it's ideal. I mean, I think you're your gut, the microbiome feeds on carbohydrates, feeds on phytochemicals. So it feeds on fiber, right?

Which is- It does happen to your.

Microbiome if you're only eating carnivore diets.

Nose to tail.

It changes.

But in a bad way? Potentially, potentially. I think, you know, there's some interesting experiments. I think we're still in the exploration of like what happens when you eat different diets. But I have a little different view about vegetables. And I call it symbiotic phytoadaptation. Fascinating concept. But essentially, yes, there are defense mechanisms in plants that help the plants, but also can help us. So for example, we don't make vitamin C. We get it from plants. We need things to help us detoxify. So when you eat broccoli, you upregulate the glutathione, the pathways of detox in your liver. through phytochemicals called glucosinolates. Your microbiome loves the polyphenols in pomegranate and cranberry, right? So I think we have evolved, co-evolved with plants, so we use these compounds, these phytochemicals, to regulate all sorts of biological functions from inflammation to our microbiome to detoxification to brain function neurotransmitters and so on. There are plants you wouldn't eat. You don't eat poison mushrooms. You don't eat foxglove, which will kill you. But there are a lot of plants that we've evolved with that we use in our bodies to regulate our biological functions and I think they're really necessary.

Talk to me about soy. I heard you say something, which I'd heard before, but I don't know there's something about the way you said it that really hit me that you see women drinking or young girls drinking soy milk, like it's going out of style and then it it will put them into premature.

Yeah, it happened to my stepdaughter. You know, soy milk was the big rage and she liked to drink, I mean, she was allergic to dairy, so she just like drank, you know, quart of soy milk a day and she ended up like at nine years old getting little boobs.

Whoa.

And we're like, oh. Because it's upping her estrogen. Yeah, so soy is a very controversial topic for many reasons. There's all the environmental issues, obviously, of big monocrop fields, of tearing down rainforests in Brazil, of all the consequences of climate change and all that. But from a dietary perspective, it's been a staple in diets for millennia in Asia, and it's always been processed in a way that makes it more digestible. Tofu, tempeh, miso, soy sauce. Those are traditional foods. When you start making soy hot dogs and soy burgers and eating all these processed things, even soy milk is not something we used to consume. You get one trouble with digestion, two, increased risk of allergy, and three, you get extra hormonal effects when you have these massive quantities of these things.

Yeah, thinking of food as a signaling molecule and then all the talk around soy, what is the mechanism that's happening that makes soy trigger an estrogen response? I've never understood that.

All food is information, not just calories. It's all information. It's instructions. It's literally like code that programs your biology with every bite. At like an epigenetic level? In every level.

So every bite of food you take.

Can change your gene expression across a whole range of genes. So you drink green tea or eat broccoli, you upregulate the gene called glutathione S-transferase that helps you detoxify heavy metals, environmental chemicals, metabolic toxins. So it regulates your genes. It regulates your hormones. So if you lose starch and sugar, it increases insulin, lowers testosterone, increases estrogen, for example. It affects your brain chemistry and what your hunger hormones are, your craving levels are, and what foods you're attracted to. It affects your immune system. It regulates inflammation or it's anti-inflammatory. It regulates your microbiome with every bite. So every single system of your body is regulated by the quality of the food you eat. and when you realize you shouldn't just focus on calories, you should focus on quality and the information you're eating changes everything. So that's really what I have people focus on and I think when people do that, then you have a different relationship to your food. You go, well, I'm eating, am I going to eat toxic information or am I going to eat healing information?

So if you were to put together a few groups of, the sort of healing signals, what would they be? Like, what would be if you were so in investing, there's this thing called the all-weather strategy. And they say, okay, look, I'm sort of blindly talking to my grandchildren. I'm gonna pass away, and all I can leave behind is a strategy that will work in any environment. But if you had to just put together an all-weather eating strategy, what would the ideal in air quotes.

I wrote about it.

I wrote a whole book about it. It's called Food, what the Heck Should I Eat? And it's about these principles, I call them the Pegan principles. And it's really focused on quality first, right? Nobody thinks we should be adding additives and hormones and antibiotics and pesticides and.

Glyphosate to our food.

Like it's in it, but nobody's like, yeah, it's fine. And we avoid it at the grocery store. You know, if you look at the label of something, if it has something you can't recognize pronounce, then you shouldn't have it. Or if you don't have it in your cupboard at home, like butyrate hydroxytoluene, which is in almost every processed food, is BHT, it's illegal in Europe. You wouldn't sprinkle that on your salad, would you?

No.

So that's a good rule. The second principle is, you know, we should be eating a plant-rich diet, and across the spectrum from fruits and vegetables, to.

Do you treat fruits and vegetables as sort of one in the same or.

No, it should be vegetables and fruit, right? So it's like we should, you don't want to be consuming only fruit because that's full of sugar. And, and if you're diabetic or you're overweight or have issues, you might want to cut back on the sugary fruits or eat berries, which are less glycemic. Lots of nuts and seeds. Everybody agrees we should be eating lots of nuts and seeds. You want to soak them, reduce selectins.

That's fine.

If you're going to eat beans and grains, Pick low-starch ones, right?

And also- Give us a few examples.

So like black rice, which is like the blueberries of rice, quinoa. What does that mean? Well, the black rice is called the emperor's rice or forbidden rice, and it's full of these dark, it's black. So anytime you see color in nature, there are polyphenols and phytochemicals in there. So it's got more antioxidants per serving than blueberries. And then you want to make sure if you're eating grains, gluten grains are interesting. So most of the gluten we eat is wheat. It's 133 pounds per person per year. That's a pharmacologic dose. It is worse for your blood sugar than table sugar.

Really?

Yes.

What?

Yes. When you look at the glycemic index, which is how much the fixed amount of the food will raise your blood sugar, table sugar is 80, bread is 100. Whoa, I had no idea why. Because it's so processed and so quickly absorbed. And if you want to eat like, if you're not gluten sensitive, you want to have farro or einkorn wheat or, you know, spelt, you might tolerate those because those aren't highly altered genetically. But the new, the wheat we eat is super starchy, has a lot more gliadin proteins, create more gluten sensitivity, is sprayed with glyphosate at harvest to defoliate the plants, and it's also has preservative called calcium propionate which causes autism in animal models and is shown to cause behavioral problems in kids. So ADD, all that stuff could be all the flour. So I'm not a big flour person, plus it's just like sugar. So if you want to have other grains, if you're not going to say like rye or barley, that's fine. And then beans again, you know, lime beans, kidney beans, if you're, if, look, 75% of Americans are overweight. So most people should be eating a lot of starch and that, you know, you have to eat three cups of beans to get equivalent of like four, six ounces of protein. So I have this lentils and things like that, which are lower starch beans, the zucchini beans, other kinds of beans I talk about in my book. And then if you're eating animal products, you want to animal products that are not going to hurt the animals, not going to hurt you and not going to hurt the environment.

Right.

So for beef, it should be regeneratively raised, ideally, which is hard to find, but you can actually get more and more. of that around and there's ways to do it by looking online to get it. Thrive Market is a great resource for a regeneratively raised beef. And again, chicken should be pasture raised, pork and all that should be raised in ways that are more organic or sustainable. Fish, you want to eat fish that's sustainably harvested or, you know, sustainably organically aquacultured because we over harvest the fish and then we don't eat big fish that's like full of mercury and tuna.

And swordfish.

Just because they've lived longer? Well, what happens is the coal and all the fossil fuels go in the ocean, go into the algae, it's stored in the algae, that the little fish eat the algae, then the bigger fish eat the little fish, and it goes on up the food chain. And you got a swordfish or a tuna, and these are monster fish, and they bioaccumulated all this. And so you want to eat the.

Right animal products, you want to eat the right grains, the right beans, the.

Right vegetables, the right fruits, the right nuts. Give me the right vegetables. Are we just looking for color symmetry? So non-starchy vegetables. If you want to cut out nightshades and get rid of lectins, I mean, I don't care, but I love tomatoes. I'm not gonna do that. And they don't make me feel bad. So, there's no point in restricting your.

Diet necessarily if you're not sick, right? Talk really fast just because you mentioned that you eat nightshades, which are problematic.

For a lot of people. I've heard you say that your body is the best doctor. What do you mean?

Yeah, exactly.

So, man, you listen and watch my stuff. I'm impressed. So, the whole idea is that you can listen to all the nutritional advice you want. but pay attention to how you feel. Your body's gonna tell you if you go vegan and you stop having your period, you lose muscle, you feel tired, you're B12 deficient, you feel like crap, you develop autoimmune diseases, you gain weight, whatever, maybe it's not for you, right? I mean, I literally just did a whole analysis on a very well-known celebrity and he's a vegan and he's massively nutritionally deficient, no omega-3s, extremely low vitamin D, extremely low B vitamins, extremely low zinc, selenium. I mean, it was frightening to see in a young guy how depleted he was. But other people it works really well for. And then see how you feel. If you get rid of gluten and dairy, do you feel better? So I have people do a detox, essentially a dietary cleanse, which is get off all the junk, get off all the sugar, get off all the processed food, eat whole foods, get rid of gluten and dairy, even getting rid of grains and beans for a while and see how you feel. And if you don't feel good, you know, try to add things back. If you feel amazing and your autoimmune disease goes away, your digestive problems clear up, your brain fog is clear, your migraines are gone, well, then that's probably.

A sign that your body likes that way of eating. So you think living a vegetarian or vegan, fully vegan or vegetarian lifestyle, that it's hard to gain muscle mass? I think it's hard. It's hard. It's not impossible. I mean, if you really work at it and really work out, and there are great vegan athletes out there, but there's never been a historically voluntary vegan society ever. And when you look at... Really? Yes. When you look at... Blue zones or... No, they were never exclusively vegan. Really? They always had some animal food, right? Fish or something. Yeah. And you know, as hunter-gatherers, we ate 800 species of plants. So we had a very plant-rich diet. But we also included wild animals. when we can catch them.

Right, exactly.

And so it's part of our evolutionary history and our bodies are well adapted and the protein in vegetables is different. So for example, there's something called leucine, which is an amino acid that is the rate limiting amino acid for muscle synthesis. In other words, in order to build muscle, you need this amino acid. And it's very low in plant proteins, very high in animal proteins.

Right?

So, why not just live a plant-based diet and then have the supplements? You could.

You could.

And I, you know, I have patients who are vegans, monks. I mean, I'm not going to force people not to eat it, but it's much harder to do and you have to know what you're doing. And I see people over time, initially, when they switch from a processed American diet to a whole foods vegan diet, they are going to get so much better.

Of course.

Yeah.

But the real issue is compared to what? Right.

Right.

What we really need to do is.

And they've looked at over time these big studies looking at animal and plant proteins and stuff over time, looking at what people do. There's a vegan vegetarian omnivore study, which was 245,000 people. It was an observational study, but they didn't find any difference in outcomes. Another study, 42 country study, looking at food pattern consumption over long periods of time, showed actually the people had animal fat and protein did far better than people who focus on cereal grains in their diet, less heart disease. Another study, the PURE study, just came out recently, 135,000 people, five continents, I think 18 countries, 10 years.

And there was actually an improvement when.

People had more saturated fat and more good fats and less cereal grains and more animal protein. More animal protein or?

More animal protein.

Yeah.

It was not a risk factor. Now, these are difficult studies to interpret sometimes because they're observational. But you look at interventional studies where you intervene by giving people high fat, protein diets, with lots of plant foods, people do better metabolically.

Really?

Yeah, it's very hard to eat a low glycemic diet if you're a vegan. You can, but it's very hard. I have a friend who's a keto vegan and she's a type 1 diabetic and she's rocking it. But you have to know what you're doing. It's so disciplined. It's super disciplined, super smart about it. That's challenging.

Yeah.

So I think, you know, and the data on meat, honestly, which I go into the book in great detail, is confusing for people because it all depends on the factors of the meat. Yeah. When you get it, the environment it's in, how it's fed, how it's raised, the stress of it. Exactly. How it's processed, everything, right? Totally, right. So, you know, people go, we shouldn't be eating meat because it's bad for the animals, it's bad for the environment. Yes, we should not be eating factory farmed meat. This is really bad. It's bad for the animals, it's bad for the planet, it's bad for us because the quality of the meat is very poor. But let's say a wild elk or a grass finished bison or even cow, very different. And it turns out that these animals actually have higher levels of omega-3 fats and higher levels of antioxidants and minerals and nutrients and beneficial fats and actually are a great source of protein and don't have the harm that we think they do. When you look at the studies that showed there was harm, the reason they show that is because when you do a study, observational study, you give people a questionnaire. every year. So you take 10,000 people, 100,000 people, and every year you give a questionnaire, what'd you eat? What'd you eat last week? If you can remember. And people answer according to what they think they should answer a lot of times, right? So if meat is bad, they're going to underestimate the amount of meat they're eating. So during the time of these studies, meat was considered bad. So people who ate meat didn't really.

Care about their health.

So they smoked.

And the data show it.

When you look at the factors of these people, their characteristics, which you can read in the studies, which I read, They were overweight, they smoked, they drank, they didn't eat fruits and vegetables, they didn't exercise, they didn't take vitamins, they ate more processed food, more sugar. Of course they were sicker.

Wow.

Yeah.

Now, what are the three basic food.

Rules that you live by?

Me? Yeah.

Well, you know, I always joke because I used to teach a lot of churches and I go, ask yourself one question when you're shopping. Did God make this or did man make this? Did God make a Twinkie?

No.

Did God make an avocado?

Yeah.

Pretty simple rule. And you can even take that to its logical extreme. Did God make a feedlot cow?

No.

Did God make a grass-fed cow? Yes. So you can kind of go down the line on all that.

That's the first principle.

Second principle is which we're eating mostly plant-based diet. We call it plant rich. We got 80-20, right?

Yeah.

80%, 70% of your foods on your plate should be lots of vegetables, nuts and seeds, fruit, whole foods. And the third principle is we need a lot of good fats, avocados, olive oil. I think there's controversies about certain things, nuts and seeds are good, but then there's the whole saturated fat debate, which we can get into where refined oils. But essentially we need a lot of good fats, low starch and sugar, plant-rich diet, and stay away from processed Yeah. Now, should that be true for everyone or does it depend on your body type, your blood type, your genetics? So, I jokingly call this the Pegan diet, right? Because I was sitting on a panel with friends of mine, one was paleo, one was vegan. They were fighting and I'm like, listen guys, you're paleo, you're vegan, I must be a Pegan. And I was joking. And then it occurred to me that there was more common than there was different. And we could come up with these general nutritional principles that nobody's going to disagree with, right? Nobody thinks we should be eating a lot of starch and sugar. Everybody thinks we should be eating more plants. Everybody thinks if we eat animal protein, that we should eat only sustainably raised or harvested or grass finished protein. That we should eat fish, but it should only be fish that's low in mercury and toxins. That doesn't overfish the oceans. If it's farm raised, it should be sustainable. We should eat lots of good fats. I mean, there are a few outliers who still are holding on to low fat dogma, but the train has left the station on that one. And so there's these simple, that nobody thinks we should be consuming pesticides and herbicides and GMO. that we should be having three pounds of food additives per person every year. I mean nobody thinks we should be eating those things. Like nobody's gonna say, okay, I think you should have more butylated hydroxy toluene with your salad. Right.

Right.

Or red dye number 40, right? Right. These are things that are sort of inserted into our diet. So those are principles that I've sort of outlined and it's adaptable. What about grains and beans? Well, you know, some people do well on them, some people don't and it really is individual. But I talk about if you are going to, Here's the things to know about. Here's the grains to eat. Here's what you should or shouldn't do.

Gluten, why is it a problem?

Who is it a problem for? Is our current wheat, the wheat we used to eat? No, it's not. It's not. So that has an impact. What should we focus on? Could you have rye, which has gluten in it, but it's probably, if you're not gluten sensitive, a much better food. So it goes through every single chapter. I go through meat, poultry, fish, eggs, vegetables, fruit, nuts, seeds, beans, grains. I talk about the controversies. What are the people fighting about? What does the science say? What do we know? What do we not know? There's still stuff we are learning, right? We're still discovering every day. So, it's really kind of a foundational principle book. It's not extreme. It's sort of the middle of the road. This is kind of the Bible for you then. Kind of. All the things you've learned. Pretty much. 40 plus years now. 14 books.

Yes, it is.

It's actually different than other books I've written because the other books are more topic specific. You're on the brain or they're on metabolism or diabetes or sugar. this is really, if you're an eater and there's about 9 billion of us, it's probably something that'll help.

And I also talk about how do.

You eat not just for your own health, right? But what is the overall footprint of the food you eat? What's the health footprint, the economic footprint, the carbon footprint, the environmental footprint, the educational footprint, the national security footprint, and even poverty and social justice footprint of what you eat because there are things we can't change. as individuals. We can't end nuclear war. We can't single-handedly end climate change. But we can change what we eat because we do it all the time. And the choice we make matter. I mean, I was just with the Vice Chairman of Pepsi, who's my new best friend. You can imagine. We had a great time together. And we don't agree on a lot of things. But it was fascinating listening to him talk about what's happening in company as they're trying to shift to meet the consumer demand.

Really?

So they're like, how do we create special? And he introduced me to this engineer who was working for him. How do we create special types of packaging that's compostable, but that keeps the food fresh? We don't need to use preservatives or artificial ingredients, and we can have whole foods that we distribute globally. I'm like, wow, that's a great thing to be looking at. Right. So they're thinking, and he said, I was also asked to talk to the USDA. annual meeting, the agriculture department. And I'm like, yes, Pepsi. But they, they, he's talking about regenerative agriculture. He's talking about how we're losing water by our farming practices. We're losing soil. We need to change that. And they have enormous power because they're, you know, count their bottling facilities. Yeah. That they out. They're probably the number one food company.

In the world up there with Nestle.

Right.

And they are interested in doing this. And I'm like thinking, wow, here's the vice chairman of Pepsi talking about regenerative agriculture. I'm like, holy cow. You know, that's pretty cool.

Yeah.

It doesn't make an impact. Yeah, they can have an impact, but it's, they're responding to the demands of the culture. They're responding to people who are voting with their Forks. So it's a hopeful message. You not only get to change yourself, but you get to impact everything. I mean, imagine if everybody in the world for one day had an eat-in where they only ate real, fresh, whole food, and they didn't shop or buy anything in a package that's processed in any way and didn't go to any fast food restaurants and just ate at home and cooked a meal together. Game changer. Totally. Just for one day. Imagine if we did that for a week or a month. The whole system would change. Wow.

Yeah.

Now, as a functional medicine doctor, I believe that you have. You're more of like a therapist for a lot of people, too. They come to you with all their challenge. They feel pain in one thing, but there's something else affecting them. Right?

Yeah.

What do you think is the main thing that feeding themselves, maybe that's not food, that affects them on the pain or their body or... Yeah, I think people are feeding their feelings a lot of time. I mean, it's a, you know, food has such an effect on mood. It's so connected to how we think and feel. And so when we're feeling sad or depressed, we can stimulate our biology through food, whether it's caffeine or alcohol or sugar or other chemicals in food that actually stimulate our brain to sort of feel better for a minute. right? And so we do that and we're human and we don't understand the difference and we don't know what's going on. We don't see we're in this vicious cycle. And it's tough and people have hard lives and hard situations. But I believe in the power of community. I believe in the power of each other to help support the change. It's got to happen that way and that's what we do. We work with communities. We work in churches. We help people become empowered in schools to actually start to do this together and it's so much more fun. It holds people accountable, it inspires people to change, and it works. And if we look at behavior change, which is the biggest thing we're talking about here, the hardest thing to do is on your own.

So hard.

I would say friend power is far more powerful than willpower. It's way easier to stay consistent with something with someone else supporting you, an accountability partner, a coach, whatever it may be, than trying to do it on your own. Absolutely. It's almost impossible to do it on your own. Right, and that's why people listen to your podcast and seek out these things because they're looking for some connection into something that they can hold on to that inspires them, that uplifts them, that gives them an idea of how they can be better. What's the biggest challenge you face in your life right now that you could improve on or get better at? Health-wise? Anything? You're this top expert, super credible doctor, Cleveland Clinic, seems like you got it all figured out, but what's the thing, either personal or fitness or emotional or... Yeah, I mean, that you can improve on? Well, I recently got married and I have the most amazing wife and I'm just growing and growing and learning. And how do I be like the best version of myself? How do I be fully expressed and honest and in integrity and like value what's actually happening? And I think that's like my most important work. A lot of my career, I just focus on my work, work, work. And I'm like, wait a minute, you know, this, this, something else here going on. Right. So what's the biggest challenge you face with this new chapter? I think my phone. So I actually.

I'm giving her for.

Our anniversary present a box, which is a little like sealed box that I'm gonna put my phone in when we're together. For what, an hour? No, for a weekend or longer. you know, and I'm going to tell my assistant if she needs anything to call her phone. It's an emergency.

Yeah.

But I'm like, I, it's a, it's a symbolic, but it's like, and it's sort of invasive. And I'm like, you know, nothing is that important that should interfere with our human connections.

Right, right.

There's one other thing that I'm working on. It's struggling. It's, it's a struggle for me because, you know, I, I feel like I've been lucky enough to see the emerging patterns that are changing in medicine and how we've come to think about disease quite differently based on the science called functional medicine. But it's taking a long time to get it up to running in scale. And that's a challenge to figure out how to do that well. And the second thing is the food system, because I feel like if we can all get how powerful we are as individuals, as communities, when we band together to do something around the food system, It's bigger than anything we could ever do because, you know, for example, civil rights, that affects one group of people. Women's rights, a large group of people. Gay rights, a large group of people, but small. Food affects everybody and people don't understand how our food system is keeping them down and is limiting our ability to thrive and succeed as individuals or as a society. And that's my real, I think my next phase of my work is figuring out how do we empower people around the food system to understand these connections, to understand how to become empowered, how to activate movements in communities to sort of change the way we do things and to then inspire policy change. Because all has to come to that. Right now, our food policies, I mean, just a farm bill alone, which is every 10 years, it's about a trillion dollar bill. There's 600 lobbyists that spend half a billion dollars funding and lobbying Congressman on this farm bill. And I remember when I went to Washington during the Obamacare era and I was advocating for funding for lifestyle interventions so we could incentivize doctors to do the right thing, not just do medicine or surgery. And everybody was like, this is the.

Greatest idea, greatest idea.

And they would say, what lobby group are you from? Like, who are you from? I'm like, nobody. It's just, here for the patients and the science. Like I'm lobbying for the science. And it was flabbergasted. All these staffers and the congressmen, the senators we met with, they were like they didn't understand it because they don't experience individuals advocating and not as part of some big massive lobbying. That's interesting. I'm curious now, when did you become a doctor? When did I go to medical school? 40 years ago. I graduated medical school 31 years ago. 41 years ago. 31 years ago. 31 years ago. I graduated from medical school.

Yeah.

But you got into it 40 years ago.

Yeah.

Well, I got into nutrition when I went to college. Okay. So, 31 years you've been, is it called licensed doctor or what do you call certified doctor? I got my MD degree 1987. Okay. 31 years ago. I'm curious, what were the beliefs that you had going in 31 years ago that was industry standard? that was like this is the belief of medicine or food or the body. That you believed in so wholeheartedly but now you've realized 31 years later is completely false. Well, actually I have ODD. You know what that is? What's that? I'm odd. And I was weird from the beginning. So, I was a vegetarian in college. I was a yoga teacher before I was a doctor. I studied systems thinking in college. I studied alternative systems of healing and medicine from around the world. My thinking was already there. And I was studying herbal medicine. I wasn't going to go to China. I spoke Chinese. I was going to go to China and study Chinese medicine, but I didn't want to grow up in a communist dictatorship. So I basically said, I'll try medical school and see if I like it. And I was fascinated with the body. And I really never went away from it, although I did really take it all in. I had to suspend all my criticism, disbelief, and just learn it as a system. Then I could unpack it. And so then I began to sort of unpack it and discovered functional medicine early on. And since then, I've just been focused on that as the new model for thinking about the body as a whole dynamic system. Was there any belief that you had after you learned everything from medical school where you realized you believed in something that became debunked over the last 31 years. Yeah, I mean, I really believe that there were these diseases that we label and name and that they were real things. Just like, you know, when you get TB bacteria, that's a real thing that you get tuberculosis when you have TB bacteria exposure. But chronic disease isn't like that. So we've created these categories of disease like dementia or diabetes or cancer or rheumatoid arthritis or irritable bowel, whatever it is. And we group people according to symptoms.

Not according to causes.

You know, I was just with Thomas Insel, who was the former head of the National Institutes of Mental Health. And I'd asked him before, I said, what do you think of the DSM-5, which is the diagnostic category for psychiatric illness? He says, I think it has 100% accuracy, meaning it groups people according to depression or anxiety. It's very good. but has zero percent validity. I mean, it's not valid because it doesn't describe the why, only the what. And that was a big aha for me to understand that all these diseases I learned about in medical school as these finite things, they weren't something you get. You don't get heart disease. You don't get diabetes. You don't get dementia. You can get a cold, but you don't get these things. And it's a very different way of thinking about it's a systems problem. It's how the body is out of balance. It's a way of working with the body that looks at the body as a whole dynamic interacting ecosystem that you can change by taking out the bad stuff and putting in the good stuff.

Ghrelin is really an interesting hormone. And it is secreted from the stomach, mostly stomach and part of the small intestine. And it goes to the brain. and then it says to the brain, okay, you better eat, you're hungry. So it is that hormone that makes us feel hungry. And so when we eat, typically our ghrelin levels go down. And we'll talk about this a little later, sometimes our food composition, what we eat in a typical meal impacts our ghrelin levels differently. So when we eat, typically our ghrelin levels go down and it says, okay, now you're full and you can stop eating. And so one of the reasons people always say, don't eat too fast, or if you're hungry, take a few minutes to make sure you still want to get seconds, is just to give the body time for the hormones to shift and for that ghrelin level to go down. So the other reason we know a lot about ghrelin is because when people lose weight, they often feel more hungry. And I always explain this to my patients. I'm like, they need to and want to lose weight. and when they do, sometimes they feel more hungry for a period of time. And I think that's a really natural, normal thing. And we sometimes have to work through that to continue to get to our goal if we're working to lose weight. So we've got a lot of hormones that have an influence on what we choose to eat and when we choose to eat.

Yeah, it's so critical because if we don't understand how those are regulated, it's really a big deal. I think, you know, when you're not eating and when you're losing weight and when you haven't eaten for a while, your body will naturally produce this hormone in your stomach that makes you hungry, which is a good thing.

So we don't starve to death, right?

Right.

And so, you know, it goes down if you eat and, you know, and so forth.

But if you have.

A diet that's causing dysregulation of that hormones. It can really create a problem. And I think, you know, we mentioned the microbiome, which also is key, but so tell us about how from a lifestyle perspective we're affecting ghrelin and what we can do with our diet, with our timing of eating, with sleep and other factors that are really driving a lot of issues.

Yeah, one of the things we know is when we have a meal that has sufficient amount of protein in it, that our ghrelin levels decrease and we feel less hungry with that type of a meal. So it's really important, you know, we've talked a lot about how insulin can trigger hunger too, right? But ghrelin also, so when we eat a meal that's balanced, that has sufficient protein and fat, along with all the good healthy carbohydrates, that helps with making us feel more full and not as hungry. So it's really important to think about each of your meals in your day and say, okay, did I have sufficient protein there? And remember, protein is like your your eggs and fish and chicken and beef and beans and legumes and nuts and seeds. And that protein will help when you consume it, help that ghrelin go down and make you feel more satiated after a meal. And ghrelin is one of those reasons that that occurs. You mentioned also with lifestyle, sleep. Sleep is critical. When people are sleep deprived, ghrelin levels go up and they're more hungry. And so we're seeing an epidemic of sleep deprivation in this country and worldwide even, right? So we're seeing this epidemic of sleep deprivation, which is one thing that's driving higher levels of ghrelin. And we wanna make sure that we're getting adequate sleep. If somebody has this process called sleep apnea, if somebody has interrupted sleep where they are, they're having episodes where they're not getting oxygen into the body. That's what sleep apnea is. They're having episodes where either they're somewhere in their nasal area, their back of their throat that's preventing oxygen from getting into the body, then the body has to wake itself up to take a deep breath. So people will often be snoring and then will stop breathing for a period of time and then take this really big deep breath. They might not even realize they're having these episodes of apnea or not getting oxygen into the body. But what we're learning is that when you have sleep apnea, ghrelin levels are higher. So people who have sleep apnea have higher levels of ghrelin. And again, one reason why that drives this vicious cycle of weight gain, obesity, weight gain, obesity, fatigue, hunger, hunger, hunger, right? So it drives this vicious cycle. They know that when people have sleep apnea, their levels of ghrelin are higher than the same group of people that even have the same body weight. So even if both groups are overweight or obese, if you have sleep apnea, your level of ghrelin will be higher. And so it's really important that we pay attention to the sleep, work with our patients and find out, you know, are they getting adequate sleep, first of all, and adequate hours of sleep that is, and of the hours of sleep that they're getting, are they restful? Are they sufficient? Is there any concern about apnea or something that would be disrupting their sleep?

But, you know, Liz, it's really true.

That, you know, sleep apnea is a big factor. And I remember a patient I had who was a lawyer and telling me about his struggle to lose weight and he needed to lose about 50 pounds. He says, nothing you could do about it. I said, well, tell me about your life. What do you do? He said, well, I'm a lawyer. I'm like, what do you do? I'm gonna do this and that. But I have to stand up on my desk every day to to work. Otherwise, I fall asleep at my desk. I'm like, oh, well, maybe you have sleep apnea. So we tested him. He had severe sleep apnea. We put him on a CPAP machine, and he lost 50 pounds like that. And I think, you know, most people don't understand the connection between sleep. But it's not just sleep apnea. If you're not getting enough sleep, and you and I both, as doctors, know that when we were on call and we're working all night or we don't sleep, that we tend to crave more food. We crave carbs, we crave sugar. and our appetite's so screwed up. And I remember this one study, it was healthy young 20 year olds who weren't overweight, who were sleep deprived on purpose compared to a control group. And they found that the sleep deprived group were much hungrier and they were.

Craving more carbs and sugar.

So that's an interesting phenomenon. That's why we see such an incredible consumption in this country. These products were sleep deprived as a nation. And we have poor quality sleep. And, you know, there's 70 million people that suffer from some sleep issue, which is a lot of people. I think maybe even more actually. It's a lot of people. And so it's not just sleep apnea. But it's all the sleep deprivation. What about other foods like protein and fiber and fat? How do those affect ghrelin?

Right.

Well, they'll trigger ghrelin levels to go down after you consume them. So it's really important. We work with all of our patients to say at every meal, each meal you have, make sure you've got a good source of protein, a good source of fiber, which is all your vegetables and beans, legumes, nuts and seeds, ground flaxseed, and healthy fat, and every meal, because that's going to help you feel more satiated. It's going to help those ghrelin levels go down. I mean, we also know things like cannabis, right? Can cause ghrelin to increase. And that may be why people get the munchies, right? And so it's important to understand what things you're doing and how they're impacting your hunger. in your body.

Yeah, I think that's right. And I think, you know, obviously people small pot, they get the munchies, but sure. And that drives appetite. So how do we work with people who have these problems?

How do we sort of help? And by the way, you know, one.

Of the things that I wanted to sort of mention was, was sort of the theory about gastric bypass. One of the theories about gastric bypass is that since grilling is producing the stomach that when you have a gastric bypass, it shuts down the grilling levels. but I'm not sure if that's the only thing that's going on. And, I think the reason I say that is it was a recent randomized controlled trial comparing people who had gastric bypass with those who were matched to them but who didn't have a bypass but just went on a bypass diet. And, they both lost the same amount of weight. Now, I don't know what their appetites were like or if there was a difference, but they basically went and lost the same amount of weight. So, I'm being very curious actually to look at the pineal gland study, see if the people who didn't have the bypass or hungrier they just starved them and lost weight, or if it was that they actually cut down their diet and they actually were able to accommodate to a lower caloric intake.

Yeah, I think it's really important what you just said is that, and prior actually, prior to working with you at both Canyon Ranch and the Ultra Wellness Center, I worked in a practice where we worked with surgeons who were doing gastric bypass surgery. So I saw a lot of patients who were going through the surgery and I saw a lot of the side effects and the negative side effects of the surgery. as well. And what I think is what you mentioned is really so critical to understand is that when we can help people get off of this vicious cycle of hunger and eating and hunger and eating and hunger and eating, when we can help them break that cycle, they can be successful at getting to where they want to be in terms of their intake of food. So you're right, maybe at the beginning for that group of patients who didn't have the surgery, that first couple of weeks may have been really hard of saying, okay, I'm going to really cut back on the amount of calories, the types of calories that I'm eating, the balance of my nutrients, and they might have felt really hungry for those first couple weeks, but we see this all the time. Once people get through that time, they start to feel better. They don't have that hunger anymore, that drive to constantly eat and snack and choose unhealthy foods, and then they can kind of start to be successful. The surgery prevents, makes it so you can't eat for those first few weeks and then that just spirals into, yeah. But then of course you're dealing with all the side effects of the surgery, unfortunately. So, that is an interesting thing that we see. You're right.

Fascinating. And you've seen patients with this and you've had, I remember many patients who have struggled with this and you get their numbers dialed in and you kind of sort through everything with them and they do so much better. So can you tell us about this patient as a 45-year-old guy who was like hungry all the time, was overweight and struggling with this sort of appetite and hunger?

Yeah, you know, I mean, so he came to see me and he was really trying to be healthier. I mean, he was working hard to be healthier and really frustrated that he couldn't get his weight to where he wanted it to be. And he had gained 25 pounds over the last couple of years. He was feeling hungry all the time. He didn't have the same level of vibrancy anymore. He was just feeling kind of sluggish and low energy. We noted when we did his vitals and his physical exam that he had really gained a lot of weight around his abdomen and around his belly, right? That visceral adiposity, that belly fat that's really causes a lot of inflammation in the body, causes high levels of insulin, and is associated with all of those negative things like heart disease and stroke and cancer. So he had gained a lot of weight around his belly. His waist-to-hip ratio was one, which is higher than it should be. And when you look at his diet, he was trying to be healthier, but he was grabbing coffee, drink for breakfast, at lunch, he was having orange juice. He had switched that out instead of soda, sandwich and chips. He did have a few beers at dinner, and then maybe snacked on crackers and popcorn after dinner. So, he felt like he was trying to make the healthier food choices, but we saw a lot of issues when we really delved deeper in terms of his diet where we needed to do some work. And we also, when we got his full history, realized that he was a snorer. So he was snoring frequently. And we talked about how snoring can be a sign that you may have sleep apnea. I mean, there's lots of other signs too, high blood pressure, weight gain, fatigue, falling asleep during the day, or when you don't want to fall asleep. so, so, but because of all this, I really encouraged him to get a sleep study. And we found out that, you know, he did end up having sleep apnea. So, but what we saw with his blood work, we saw high levels of fasting insulin. They were, they were 10. We saw a C-reactive protein, that marker for inflammation was really high. We saw that his, he had low levels of vitamin D. And we know vitamin D is critical for, for so many things in our health, including insulin sensitivity. We saw that his omega-3 fat levels, you can do something called an omega quant, which looks at the amount of omega-3s in the red blood cell membrane. And we saw that his omega-3 levels were low. And we know that omega-3s are really important for resulting in, you know, helping lower inflammation in the body. We can also do some special testing of something called an organic acid testing. And we did that for him. And we saw that his mitochondria, which are the powerhouse of your cells, needed a lot more support. And one of the reasons that people develop problems with hunger and weight gain and insulin resistance is when you have issues with their mitochondria. And we saw that we needed to really support that. He had high levels of free radicals or oxidative stress. And so there were a lot of things we needed to work on with him. One of the first things we did is we got him his sleep apnea treated. He got a CPAP machine and he started to feel better right away. Patients resist this a lot, but we see that when they really do jump on board and start using that CPAP machine and it's fitted right, many times they just feel so much better. Their energy is better. And one of the reasons, and their hunger decreases because that ghrelin decreases. Because remember we said, that if you have sleep deprivation or sleep apnea, your ghrelin's going to be higher and you're just going to you're going to just be wanting to eat and eat and eat. So that was one of the first things we really, really helped him do. And it really was very helpful for that, that decreasing his hunger and that drive to just eat and eat. We also really supported him nutritionally with cutting way back on his carbohydrates, getting more vegetables in his diet, more nutrient dense foods. we gave him some supplements that supported his mitochondria like CoQ10 and B vitamins and alpha lipoic acid. And he did really well. I mean, with some of these simple shifts, he started to lose weight. After like six months, he got down to his ideal weight. After about four months, his waist-to-hip ratio got to 0.9, which is really where we wanted to see it. And he just started feeling better and he was having more energy and not hungry all the time. And he really understood what foods to choose. And then most importantly, from my perspective, was that we just really decreased his risk of all sorts of diseases, right? Because we know that that insulin resistance pattern drives heart disease and stroke and cancer and dementia and diabetes. And so we really, that was really great that we were able to intervene at this age. and I think help prevent a lot of diseases for him in the future.

With people who are struggling with hunger and cravings, I think one of the books that I really loved about this is called Always Hungry by David Ludwig, who's a friend of ours, brilliant book. He's a Harvard professor and he's really studied the biology of hunger. And he showed that you can literally retrain the brain to not be hungry by regulating what you're eating, by increasing fat, protein, decreasing starch, your sugar, timing eating when you're eating. not eating late at night, making sure you have a little period of fast, snacking is probably the worst thing in the world. When you go to the grocery store, most of the food is snack food, which is crazy. It's just like I don't even go into those aisles, but it's mostly just snack food. It's just striking to me how we've kind of gotten this culture of eating all the time and snacking and hunger and ups and downs and something that we can really manage by addressing these underlying biological systems. and paying attention to the simple daily rhythms that we need to follow in order to regulate our appetite. And then, you know, I just noticed in my own biology when I am dysregulated, I get hungry, I get cravings, I want this, I want that. When I'm eating well and I'm eating whole foods and I'm giving myself the nutrients I need, I don't feel hungry. I don't want. I'll tell you something, before dinner, I'll get all hungry, that's fine. Or if I'm working out a lot, I'll get all hungry, but it's not this crazy, oh, I want to eat muffin or I have to have something bad. so I think there's a real science of hunger and people should be more on this topic. I'd encourage them to read his book called always hungry. He's got a great cookbook that goes along with it. But, you know, this is something we see all the time, Liz. We see so many people struggling with weight and with metabolism and hunger and Cravings and, and people feel discouraged. But, you know, I found people within days can change quickly their biology and, and get rid of the Cravings, get rid of the hunger. Just remember this one woman who came to one of my workshops. years ago in Ultra Metabolism, I think. And we basically put people on a, you know, really simple Whole Foods diet. We even broths and protein shakes and lots of vegetables and good quality protein, good fats. And she was like, look, I'm never gonna be able to do this. I've been craving sugar my whole life. I have to eat it. I don't know what to do. I'm really worried about it. I'm so stressed. I'm like, look, just try it for a couple of days, see what happens.

And.

And the design of the program was really to design to regulate these hormones to regulate the and to regulate the insulin and to regulate the blood sugar and the brain chemistry. And within two days, she's like, I can't believe it. I don't have any cravings anymore. I don't want this. I don't want that. So she's, like, so happy.

And I think people don't realize just how close they are to feeling good and getting rid of all those. So I would say to, you know, any American listening, whether they have a pre-existing chronic medical condition or not, the single most effective intervention that they can take today, you know, besides not smoking, obviously, especially now, is to not overload their body with that excess sugar and the highly refined carbohydrates. It causes a lot of damage to the body and we really should be encouraging improvements in health and immunity in every way possible. And we should look to other ways to increase our dopamine, for example, and improve our immunity. Sleep is really important. Physical movement, we may not necessarily have the same access to the gyms that we do before, but even if you can just move, that's going to be helpful. And getting connected to close friends or family and not feeling that loneliness or the isolation, physical distancing is different than social distancing.

Yeah, I know it's true.

We are, I think, needing to think about different ways to raise our dopamine.

I think that was a really brilliant.

Thing you just said.

And dopamine is the pleasure stimulating amino.

Acid in the brain.

It's a neurotransmitter. And we look to stimulate it a.

Lot of different ways.

And most of our society uses sugar and starch and processed food to stimulate it. But things like love and connection and exercise and sleep, meditation, yoga, all those things.

Food and the right kind of food, right? That also is so interesting to me.

When you look at the brain biology of what happens to the pleasure center in the brain when you eat starch and sugar and processed foods, your ability to receive pleasure goes down the more you eat it. So you need more and more of it to get the pleasure, which is really the sort of definition of addiction, right?

Right.

I drink a glass of wine and I can barely walk up to my room at night.

And some people who are alcoholics can.

Drink a bottle or two and they're fine.

And I think that's what's really going.

On in our society. Now, if I have a sugar load, I'm like, oh, I feel pretty wired. But it really is a matter of redesigning your biology.

And what do you see in your patients? How long does it take them to sort of break out of the the.

Sort of pattern that they're in and see the changes. Does it take months? Is it days, weeks?

Yeah, so it really depends on the individual and what they are coming to me with. There's a wide variety of different complications and symptoms. So usually within a couple weeks to a month, there's significant improvement in their health. But there are patients that have a little bit more trouble because they've had past trauma or significant adverse childhood events still affecting them today. And I do think that that takes talk therapy, as you said, psychotherapy, to kind of even get them ready to make any changes in what they're eating, for example. And so for some people, weight can be protective. Weight can be protective for them to feel more secure and because of past trauma.

That's real.

I mean, those are issues that really have to get sorted through. But the food part is an interesting therapy that goes along with the talk therapy and other modalities to help people deal with these psychological issues.

And it's often not used.

In my experience, it just accelerates people's progress. Like if, you know, I always sort.

Of joke as if you're, you know, if you're, eating junk food or if you're, you know, if you're, if you're thyroid not working or you're gluten sensitive.

And you're eating gluten, it's a lot harder to talk through your issues until.

You get your brain working properly.

Yeah, that's exactly right.

So, what do you think about things like ADD and nutrition? I think you have a number of papers on your site looking at, for.

Example, artificial colors and additives and Omega-3s and stuff.

And just in terms of general nutritional.

Quality in ADD, are you seeing this sort of epidemic of ADD and autism.

Connected to our diet?

I do think it's connected to our diet. And, you know, like I mentioned before, that these conditions are heterogeneous. And I think that the number of cases of autism over the last 20 years has doubled, even maybe tripled, both autism, ADHD is just rising. And I don't think that we're giving our brain, we're not feeding our brains the right fuel. And that does affect attention, that does affect memory, that makes our brain cells more lazy or tired, not working properly. And so those are conditions that require behavioral changes with autism and improvements in memory and concentration is really important. I think what you're eating is so important for that.

I don't know if you said you mentioned you read my book, the UltraMind.

Solution, and you saw the case of.

This little boy who had ADD and.

His handwriting before and after he got treated.

Changed.

That was really what got me to.

Write the book was when his mother.

Brought in his handwriting before and after, two months later after he started changing.

His diet and fixing his nutritional deficiencies.

And, his handwriting went from completely illegible.

To really perfect penmanship.

And, I thought, well, how did his.

Brain go from being totally chaotic and.

Asynchronous and uncoordinated to being coherent and functional? And, I thought, wow, this is incredible if that is really true. Because, you know, people can talk about.

Their behavior and their mood.

It's more subjective, but when you see.

This objective reality of handwriting before and after, and it wasn't like he took penmanship lessons.

What's actually happening in the brain? And when I went back to look at this kid's history, it was fascinating because he had a lot of inflammation. So, if you look at all these comorbidities that he had, he had asthma.

And allergies and eczema and hives, and.

Plus he had irritable bowel, and he had all these sort of physical issues. that were inflammatory, but they were coming from his inflammatory diet. And the kid never had a real.

Food in his life. He never even probably saw a vegetable in his life.

And he had high levels of trans.

Fats in his blood.

He had no Omega-3s he had very.

Low levels of B6, he had low levels of zinc and magnesium.

And, you know, it was really pretty striking when we just cleaned up his diet and we got him on some.

Basic supplements, just a multi and fish oil and vitamin D. his literally, his brain completely changed within just two months.

And he became functional and his ADD.

Went away and all his asthma went.

Away and his gut issues went away. And, you know, it's years later now.

And he, you know, he graduated astrophysics.

From University of Colorado or something.

You know, it's like, you go, you know, this kid got kicked out of kindergarten. He was on Ritalin for years. And yet this is not something that.

Most psychiatrists even think about doing with.

Their patients, which is It's so frustrating to me because as a family doctor.

And someone who does functional medicine, this.

Just seems so self-evident.

And your work is just such an example of how things are really changing.

Do you find that your colleagues are.

Like, what are you doing, Shivani?

Or are they like, this is interesting, or are they giving you a hard time?

No, so I completely believe that story you told me. I can believe that a patient with ADHD has significant improvement after what you treated him with. And my colleagues have been pretty supportive actually and very interested to learn more and very open to making that change. In fact, even just last week, we have different clinics based on subspecialties like neuropsychiatric clinic or mood disorder clinic or depression clinic. and the Depression Clinic and the Bipolar Clinic and this Women's Wellness Clinics, they all reached out to me and want to collaborate. And I think one of the attendings told me last week that 40% of his patients have metabolic issues and talking about weight gain. And most likely, I think a lot of people have nutritional deficiencies. And we already know this general population has a lot of nutritional deficiencies. So if we look at the population, and mental health, we're going to see even more. So I do think that this is something that's going to change. I'm optimistic. I think you can tell.

Yeah, well, you're changing it. You're clearly at the forefront.

Are you a lone wolf out there?

Are there other people out there in.

The psychiatric world who are on your same path?

I think there are other people out there on the same path. I think that metabolic dysfunction, per se, is not this necessarily looked at as much compared to nutrient deficiencies or specific vitamins and supplements, for example. But I do think that, you know, the combination, these are all important, all important topics and all important things to, to work on.

So, so let's, last question. Looking forward five, ten years, how does.

It feel to Psychiatry change?

How would you like to see it change in how we treat mental illness based on what learning in your research?

So I would like to see the change actually across the board, even in medicine, to focus on nutrition and metabolism. And I think over time we need to really include that as part of the assessment in the initial, you know, history that we take and we have to have a careful intake history about nutrition and what people are eating for breakfast, lunch, dinner, snacks, their drinks, I mean, how they're sleeping, you know, how they're looking at food. So I think that should change. And I also think that the treatment of insulin resistance and detecting insulin resistance, because I often find that it's not being detected and I'm not necessarily the doctor that sees them as frequently. And so that's something that I feel needs to change within our whole system. We need to think about, aside from just looking at blood sugar every now and then and thyroid, we also need to look at some, like their fasting insulin level. What is their consumption? What is that early process? The things that make us sick later, start early.

Yeah.

And it's a gradual process towards decline. And what if we intervened earlier, detected things earlier, asked about things earlier so that we can prevent what happens later? We know what happens later, right?

So, so this is just a radical idea, right?

The doctor should ask their patients what they eat.

That's the future of medicine. We need, actually, No one can come to see me in my practice unless.

They fill out a three-day diet record. And then on top of that, you can't get an appointment unless you agree.

Also to see the nutritionist because if food is medicine, I can't practice without a nutritionist. And the other thing you said was.

Really important is that the most common.

Disease in America, insulin resistance, the most common problem that affects hundreds of millions of Americans, is not diagnosed 90% of the time by the doctor. That's a shocking stat.

I think we're missing a lot of it, unfortunately. I think we're missing a lot of it and I think we don't necessarily know how prevalent it is as a medical society perhaps as a whole. We don't necessarily know how common it is. And it's really common. And every time I mention that statistic, people are shocked. Yeah, and with kids now, too. So, I mean, it used to be that the majority of liver transplants in this country were done because of alcohol cirrhosis. And now the majority are being done because of fatty liver caused by fructose and high consumption of sugar.

Even in young adults, which is terrifying.

I mean, I was at an obesity conference. and there was this guy there who.

Was a pediatric gastroenterologist.

I'm like, what are you doing here?

He says, well, we see a lot.

Of fatty liver in kids, five-year-olds. I'm like, really? That's what we used to see in old people with diabetes, right?

Yeah, that's very sad.

So make sure you do your five, three-day diet record. And the other thing is ask your doctor for a fasting insulin. This is something I've been measuring for 30 years. and I almost never see it done by most physicians. And it's probably the most important test because your fasting insulin goes up way before your blood sugar. And that's something you can easily detect.

By checking your blood test.

And it's an easy blood test. And if your insulin is over five, you're heading towards trouble. If it's over 10, it's not great. And if it's way more than 10, you're in trouble. So that's an easy thing to measure, and it's something that'll tell you where you're going. affects your mental health. So I would say to people who are listening, if you have mental health.

Issues or you know someone with mental.

Health issues, you should really think carefully.

About the role of food nutrition and.

How that plays a role in what's going on and experiment because there's really very little harm to cutting out processed food and sugar. In fact, there's only benefits. And there's even trying something more aggressive like a ketogenic diet, often with the.

Help of a physician or someone who knows what they're doing can be helpful.

These are simple things that have low risk, high benefit, and they're actually being validated in the research. And your work is just so exciting to me. Shomrani, I think this is really the future of psychiatry and mental health in this country.

And I hope that you can become.

A bigger voice than you already are.

Because I think the world needs to hear this. I think our government needs to pay attention to this in terms of our policy of funding research in this area.

So if I can help you get millions of dollars from the NIH, I'm.

Gonna do what I can.

That would help. I do need some research funding.

If anybody's listening, you can find it.

Go ahead.

I did want to just say, I had a comment to what you were saying is that because people are listening, I want to make clear that it's not just people with obesity that have insulin resistance, but people who are even just normal weight can have this insulin resistance. And so it's really important to to think about that as you decide whether you want that assessment. Because you may not even know that you may be insulin resistant and you may not know that you have a high blood sugar and you think you're eating healthy, but there are a lot of foods out there that you think are healthy that are not and have a lot of added sugar in these things. Well, that's a really important point because there's a lot of people walking around.

Saying, well, you know, I eat a lot of sugar, but I'm skinny, so it doesn't matter.

It doesn't affect me.

It does. In fact, about 20 to 40% of skinny people are metabolically unhealthy, meaning they're what we call skinny fat or metabolically obese normal weight.

So, you look thin on the outside.

But you're fat on the inside and you're maybe not overweight, but you're over fat and especially around your belly fat.

Which is what the dangerous fat is, it drives all the insulin resistance.

So, it's important to really have a real look at this for yourself. And, I think I'm so encouraged by this conversation. I can't even tell you, I've been waiting for you for 30 years to talk to you. and now you're doing this incredible work at Stanford and it makes me so happy.

That's very sweet. Another just comment is that with excess weight and that visceral fat that you were getting at leaks inflammatory molecules and causes damage in the body as well. And so how much of that is contributing towards mental health and mental health symptoms is also an important question. So, I just wanted to mention that because sometimes that fat is not fat you can actually see. It's fat that's built around the organs and around the arteries and things like that.

We've gotten in a world where we are over consuming ultra-processed foods in ways that make us the most obese nation in the world and are staggeringly undernourished, even though we're overfed.

Overfed and undernourished.

We have significant increase in efficiencies in this culture. forget about phytochemicals. So, I think probably 99.9% of Americans are deficient phytochemicals. To have less than 9% of the recommended amount of fruits and vegetables. That is a minimum, like five cups is minimum, five servings, which is basically two and a half cups. I would say people should eat more like eight or nine cups of fruits and vegetables a day.

Right.

So, we've lost that.

And.

The and, you know, and these, these, these compounds we're, we're not getting and we don't know we need, but we're so deficient in our diet. And the, the Cravings we have and the overeating we do often is an attempt to try to replace those nutrients that we're not getting from our food. And one of the studies by Kevin Hall and some others was fascinating to me. You talk about it, which is that when given an unlimited amount of Ultra processed food to eat or a whole food diet, that the people who ate the whole foods felt satisfied on far less food.

They ate 500 calories less a day.

Now, that is a massive amount of calories. If you were 100 calories off for 20 years, you're going to gain 20 or 30 pounds. So 100 calories, let's say 3,500 calories, right?

Right, right, right.

Which is basically a week.

Of the.

Calorie excess would be equivalent to a pound of weight gain a week.

Yeah.

Excess food. So that's why we're so overweight.

Because we're looking for love in all the wrong places. You know, we're looking for nutrients in nutrient depleted food. Forget about phytochemicals. Like, the whole idea of phytochemicals regulating our appetite and our desire for food was something I just, you know, didn't fully understand until I read your book. And the thing that struck me was some of the experiments you did. where you help explain how flavor and nutrient needs and the animals feeding behavior are all related. So they will find the foods that they need and will eat enough of those to meet their needs and then they'll go eat something else. They won't eat too much or too little. They have this natural intelligence and that flavor is associated with these phytochemicals. something most people understand. When you eat like a wild strawberry, it's an explosion of flavor in your mouth, even though it's the size of a pea.

Yes.

You eat a big fat strawberry you buy in the grocery store. It tastes like cardboard, you know, and there's no real flavor there. And Dan Barber has done a lot of work around this as a chef and created a company called Row 7 Foods, where he's hybridizing plants, not GMO, but just. breeding plants for flavor. He's not thinking about phytochemicals. I'm thinking as a doctor about the phytochemicals because the phytochemicals are what give the plant flavor. So that whole relationship between plants, animals and humans and their dietary preferences and plants and animals is something most people don't understand. So can you explain the way in which these flavor feedback loops help regulate animal feeding behavior? and how it might inform as humans what we should be eating and how we need to reclaim and listen to our own nutritional wisdom.

That's so important. That was something that really blew my mind. I wish there's a way that we could make these come alive for people there to realize that liking for flavor is being mediated by these metabolic feedbacks hormones, neurotransmitters, peptides, all those things are those signals are coming from cells and organ systems as a function of their need. And so that's changing liking as a function of need. And when you're eating wholesome foods, then that's going to be in sync with what your body needs. It can that system can be hijacked. Yeah, we looked at a little video last night. I showed you a sheep and one group of sheep had been when they ate a really a straw, which is not a nutritious food at all, we would put either water in one group of sheep directly into their stomach or an energy, a blast of energy. And the sheep that got the blast of energy, they'd love that straw. Right?

That's what- Can you give them a little maple syrup or- yeah, that's what.

The food industry is doing with the refined carbohydrates. You get a flavor and you follow that with a blast of energy and you immediately form a really strong preference.

So, Zoe, stop there. So basically what you're saying is you take straw, which is like eating processed food, right? Cardboard, no nutrients. You add sugar on it and they go, oh, sugar, that's good. I want energy. And they eat the straw even though it has no nutrition.

Right.

Which is what we do as humans. We eat ultra processed food, fast food, which has no real nutritional value, but it has tons of energy. So they add sugar and all these flavorings to it in order for us to start craving it. So we associate the boost in energy with the flavor. The flavor of the fruit. But it's actually kind of mismatched.

It is. And what we were showing is that it's that feedback. And the way you do that is to give the flavor of straw. So we would make maple flavored or apple flavored or whatever it is. and you've got this straw that's worthless. And you have to emphasize that it's, it's not nutritionally anything. But when you follow the ingestion of that straw with, with nutrients in the gut, put the nutrients directly in the gut, that's the cells work. You know, those nutrients are getting absorbed.

And cells know, oh, this is great.

And it's feeding back to make you say, oh, I love maple flavored straw.

I love it.

And it's not even the taste because you're not, you're not letting go.

You're not giving the maple. That's right. You're getting in their stomach. that's the, to try to get that through and then to realize, you know, none of this is conscious. As we were talking, it's, nobody thinks about which enzymes to release to digest the food they're eating. And it's the same thing with these feedbacks. It's happening automatically. Yeah. And that's where, if you're eating wholesome foods, it works. The system is as solid as it can be. But if you get on the altered process, you, it gets hijacked and the food people in the food industry have really learned how to do that well. And then to put not, you know, not wholesome herbs and spices, let's say, as a flavoring agent, it's all these 600 million pounds a year, whatever.

600 million pounds of artificial flavorings are added to our food every year. That's frightening.

Yeah.

And it's caused this disconnect between our natural inclinations to eat foods that nourish.

Us.

With our ability to sort of pick those foods. And we tend to eat foods that are associated with these artificial flavors because they've scientifically figured out how to hijack our brain chemistry and our hormones and our metabolism. And so we tend to crave all the wrong stuff.

Rather than the phytochemicals we've been talking about, We use artificial flavoring agents. And so we're not getting, just as you were saying earlier, all those things that our bodies evolved with over the years and that regulate all these systems inside our body, we're not getting that. Yeah.

And these animals seem to have profound ability to sense what's going on, not necessarily through even taste, although the flavor plays a role, is even the levels of these metabolites of plants in their bloodstream can regulate their eating behavior. So you talked in the book, for example, about eating sagebrush. For example, elk in the winter eat sagebrush, which is not the greatest food, but it has nutritional values in the winter when they can't get other stuff. And it has high levels of these things called terpenes, which are potentially toxic to these animals. They will stop eating when their levels of the blood of these terpenes gets to a certain level and they'll go eat something else.

Yes.

But you kind of hijacked that through a study, studying this process where you infused the terpenes into their blood. So they never even kind of, it wasn't like they were tasting it and eating it. It was like their body knew innately that it was time to stop eating that.

Yeah. And if the guests in the audience can just picture, so there's an animal that's, they're eating. We were working with sheep on those studies and it's eating its meal. and we're slowly, slowly infusing terpenes into the bloodstream to look at detoxification and elimination processes. And when we reach a level that's enough for the particular animal, they'll just lie down and stop eating. So we would stop infusing at that point, but it's the animal is associating the food that it's eating with the feedback signals. They're so in tune with that it's amazing actually when you start to watch it, if you can picture it and it just changes. absolutely changes your views of nutritional wisdom of the body, how that's working.

So basically we've gotten this predicament of a food system that's producing food in a way that depletes the plants of the phytochemicals and the nutrients that it's needed to feed animals and humans in a way that destroy the soil microbiome in a way that has hijacked our own ability to know what's good for us or not good for us. because our innate nutritional wisdom has been hijacked by these industrial chemicals and starch and sugar and food that has completely disconnected us from our ability to have any nutritional wisdom. And for anybody listening, if you've ever done a detox or an elimination diet where you get rid of all the junk, all the processed foods, even like my 10-day detox diet, you'll very quickly start to reclaim your natural wisdom. You'll start to crave the things that are good for you. I don't crave starch or sugar or processed food. In fact, I can walk by the candy aisle and it just looks like a rock to me. I'm like, why would I eat that? It doesn't even look like food or a muffin or something.

It's like I was at a coffee.

Shop today in Montana and I was getting some coffee. Although coffee is the richest source of phytochemicals in the American diet, which is not a good thing, by the way, because we just drink coffee and don't eat me flash. But they had this, like, sugar cookie and this banana bread and lemon bread. And it was like, I was like, oh, I want to eat that. But I was like, no, actually, don't. Like, I looked at it. It sounded good, but then I looked at it. I was like, no, that doesn't look, like, edible to me anymore.

And.

And I think I used to eat wanting that stuff. I think if we can kind of.

Reclaim our own bodies, it doesn't take long to do that.

No, that's right.

And I have a story for you. When Sue and I really, many years ago, got moving more and more in this direction of getting all of that out of our diet, we decided, look, that stuff's really hard to resist when you're on it, right? I mean, you don't have a lot of hope. Yeah, you're hooked and sugar can be addicting and all those things. So we said, the place to stop it is at the grocery store. It doesn't go into the basket. It does not go into the basket because you don't get it home. But I love to tea-soup. And I was in the store a while back, and so we'll go down the aisle where all that stuff is. I grabbed this huge old cake and stuff, and this older lady was watching me, and she knew what I said. And I put that, and I put a couple of these, and then she came back to the basket, and it was just so fun to watch the old lady, because she get that out of here, you know, it's the older lady. But it's a key point, though, you know, you can't surround yourself with that stuff and think that you've got the, quote, willpower to avoid it. It's in your house. And so at Christmas time, when we get really, you know, gifts from other people. Yeah, it's bad. And we, yeah. And we hate that. We, we accept them nicely, but Sue throws them away. She just says, because, you know, it's.

I don't, I don't want to go to a food bank because, you know, you know, it's like, you don't want other people eating that.

No, you don't. It's, it's not. So, you know, that's one of the, the things that, that we did anyway, was to, to say, you've got to get on wholesome foods and let your body start to, to tell you what you, what you need from day to day. I'm like Claire Davis says, kids, you know, and sometimes they say, eat this or eat that or eat something. I don't want it today. My body does what you, you know, okay. I don't, don't need, don't need that particular thing today.

My body's not telling me that.

Well, one of the things that so.

Struck me from your book was the discussion of the intelligence of your cells and organs that's beyond your brain and how those cells and organs are constantly sampling their environment and deciding what they need or don't need and regulating your behavior. It's almost like a decentralized brain. I don't, I just, it blew my mind. And one of the stories you tell to illustrate that is a woman who had a, I think, a liver transplant or heart transplant, heart and lung transplant.

Heart and lung transplant.

And she was a pretty healthy year before, and all of a sudden she's like wanting KFC and wanting junk food and was so confused. So tell us about that story and the implications around how our cells and organs are also intelligent and how that works.

It's, it blows your mind because it'll make you stop to think, who is this person I call me actually? It'll really make you stop to think that when you realize how all these cells and organ systems are interacting to influence all that you do. So the book A Change of Heart by Claire Sylvia, it's an old book now, but it's so worth reading because so here's this 40 year old woman, one of the first people ever to get heart and lung transplant, and so doctors, no one understood much that what would happen. And I remember one part in there related to what you were saying, where she was saying, man, I'm just, I'm a different person now that I've got these heart and lungs. It wasn't only food. It was a whole bunch of, so it set her on this quest to try to find out where these organs come from.

It was like football.

Yeah, exactly. Where did these organs come from? And the book is telling of this story. And she finds out it's a young man named Tim that was in the late teens was killed in a motorcycle accident. And that's the heart and lungs she got. And so she's telling these doctors about all this stuff. And I remember one, the doctor said, you know, the heart's just a damn pump. And she said, no, it's not just a damn pump. You don't know, it's not in your body. You don't, it's your you're not experiencing what I'm experiencing. And the lungs aren't just a way to get air into your body. And then the part, you know, so she's, since she was one of the first people to do that, there was great interest. And the press was there about the time she's getting ready to be released from the hospital. One of the reporters asked her if you could have anything you want right now to eat, what would you like? And she said, actually, I'd like a beer. And she said, the minute she said that, she wanted to take the words back for two reasons. One, it was a flippant response, but two, I don't even like beer, she said. And so that got her started thinking about this whole deal. And then, like you say, it just went on and on, things that she never liked before, green peppers and on a KFC, she came to like. And so her dietary habits broadened out. She didn't quit liking the things that she once liked. she still liked those, but they broadened out. And then she's asking the family, Tim's family, what did Tim like to eat? And they're saying, oh, we just love KFC. And she said, Chicken McNuggets. She said, first time she could drive, her car nearly steered off the road when she went by, by a McDonald's.

But how do you kind of reconcile.

That with the promise of reclaiming our nutritional wisdom? Because if the programming of our cells and organs is so intense by the processed food industry that it survives death, you literally give someone else your heart and lungs if you die. And you also give them your all your bad habits.

Right, right.

How do you undo that?

Yeah, I think, like you say, I think you, you have to really, you have to radically change what you're doing.

She has to retrain the new heart and lungs.

You have to retrain. You to retrain them. This isn't, and, you know, I know people that I visit with quite a lot that were really born, you know, raised on, on ultra processed foods and those sort of things. And it's a lifelong battle for them. They tell me, you know, I still struggle with that. And we just talk about where you just can't, I guess, like alcohol. What if once you're an alcoholic, you just leave that stuff alone, right? And you, you put wholesome things into your diet that you're right. But it lets you know the deep level, right? The deep, deep level of which all of this is happening. And then the amazing level, that well, there's far more, there's far more after feeding up to the central nervous system than, like, it's all the same nerves growing from the central nervous system down to the body. They're so huge. Many, many times. Yeah. Many, many more times ascending than descending, right?

In terms of so basically your cells and your organs are all talking to your brain and giving information to them about what to do or not to do, what to crave and what to want.

Absolutely right. So if you look at the taste system, nerves for taste converge with nerves from throughout, like the vagus and so forth, those nerves right here in the brain stem, and then they synapse and relay throughout the central nervous system. They converge with nerves for smell and so forth. and so on. So, yeah, we know we understand a good deal about the basic anatomy and physiology of those systems. And now we're learning that the microbiome is also sending signals, right? I mean, that's the- you-'re not eating.

Only what you crave.

You're eating what your microbiome craves.

Right. Well, it's like the whole thing has got to be fed, right? It's got to feed itself. And so, and the part that makes me a little bit sad is the microbiome, and it's important. Absolutely. It's getting so much press. we're saying, well, the microbiome is sending these signals to the central nervous system. But there never gets a word said about all these other organ systems, cells and organ systems. They're doing the same thing. Yeah, everything has to be fed and the brain has certain needs and the lungs and the liver and they're all, it's a democracy, I guess you would say, huh? They're all feeding into, yeah, and that's where it's humbling too, for me. then you think, so an animal eats a meal, tens of thousands of compounds, and these feedbacks are mediating all of that to meet needs. And I think you realize at that point that we can study up to a degree, and then it just points you in a direction, right? That you either come to appreciate that all that's going on and that, you know, this diversity that we're talking about of wholesome foods is what matters, and then you figure, that complexity the body knows. And the more we understand it, and it helps us to appreciate that.

Right.

But then there's a humility for me at this point where you say, it's incredible. It's incredibly complex. And, and sometimes in our reductionist approach, and I did this for years, you know, we, we went down that path. What compound is causing what? What's what? Yeah. Yeah. And no, it's not how it, it works. so, I mean, we learned from that, but, but I've back so far away from that. It's about the richness of all that and the combinations. And I've heard you talk about it, Mark, and really appreciate it, you know, so you could say, well, meat's bad. Meat's bad for you. I mean, epidemiological kind of book. But it ignores something we learned really early on is that you've got to think about all the other things that are in the diet, right?

Yeah.

And how they're, how they're synergizing with one or in good ways or in bad ways to influence. It's not is meat good or bad, it's the whole diet.

Right.

It's like what you eat in combination with it.

It's like, you eat fries and a burger and a milkshake, it's different than eating a, you know, regeneratively grass-fed beef with tons of spices and marinated and with lots of phytochemically rich vegetables and plants.

It's a totally different experience in his body. Yeah, absolutely is. And, when you get into that and get on that, it's a very rewarding experience. You feel satisfied and you don't have to eat a lot. We had a meal last night and we had a little bit, I just had a half a piece of meat and I'm satisfied, you know, and you have all the greens that we had and the broccoli and so forth.

Well, you know, essentially, you know, to summarize what you're saying, essentially, you know, sort of what I sort of tried to get to in the Pegan diet, was a set of principles that are universal that we can agree on, that we should all be eating whole foods, that we shouldn't eat processed foods, that we should eat phytochemically rich foods, which means you eat foods with basically a wide variety and diversity of foods to include all these different compounds that we need for our health. And it doesn't mean you have to be rigid or fixed, and there's a lot of ways to achieve that. But this whole kind of competition or adversarial relation between vegans and meat-eaters, it sort of doesn't make sense. I want to sort of dive into something that I think is a little bit controversial, it kind of blew my mind when I read it in your book, that plants have 20 senses, that plants communicate with each other through these phytochemicals, through Messengers that they send through the mycorrhizal fungi. So then they might be getting chomped on by a caterpillar, but they might send a message to their neighbor plants. Hey, guy, you want to ramp up the production of this phytochemical that the caterpillars don't like because I'm getting eaten, you know, or. how they sense everything around them. So the question sort of arises, you know, are, where does consciousness begin? And what is a sentient being? And are plants sentient? Are they exhibiting behaviors and communication that makes us rethink their value?

Because, you know, this is that kind.

Of, well, if you want to be ethical, you should only eat and plants. Well, I'm not so sure, you know, because forget the idea that you just growing plants are going to kill animals through farming techniques that destroy habitats and kill rabbits and birds. And we've lost 50 of our bird species for agriculture. That that's for sure happening. And that not forget the fact that, you know, with organic agriculture, you need to use animal products to grow food like plants.

Right.

You need, you need compost or suit manure. You need bone meal and fertilizer. We need various kinds of nutrients and different oyster shells. There's a lot of animal products that are used in organic vegetable agriculture. So forget that. Just the idea that these plants actually might have Consciousness was a really novel idea for me.

And you kind of unpack that.

Yeah, that, that's, how does that work?

That's amazing. That's amazing kind of research that, that the plant physiologists are doing. And, you know, there were, there was a book written many, many years ago, the Secret Life of plants. And it was, it was really talking about these kind of ideas, but it got highly, highly criticized back in the days because there's no science behind all this stuff. Well, now there's top-notch world-class physiologists and ecologists have been studying all these 20 different senses and books have come out about plant intelligence and behavior.

And it, and they can't walk, but.

They do a lot of cool stuff. And if you think about it, you know, if you're confined to one space, you probably have to be even more clever, right? I mean, you can't get up and run away. You've got to figure out. And these phytochemicals that we've been talking about become the language of the plant, right? They're the language. They're the ways that they communicate. And so a caterpillar is starting to eat you and you produce volatiles that send a signal to the other plants. Oh, boy, Charlie's getting eaten over there. I think I'm gonna up my. and they do that literally, joking, laughing a little bit, but they're doing that, you know? And so it starts to, it starts when you read about the different senses of plants and they have kind of nervous system too. It works more slowly than ours do, but some of the neurotransmitters we have, they have some of that. Yeah, and it's slow, but it works on plant time as to what they need to do. and, yeah, you just, they can say.

They can share nutrients, they can do all kinds of things.

They do. And they help one another out, right?

I mean, hey, Jimmy, I need some vitamin C. Can you give me some?

It's true.

Yes. And it's being documented that they do those sorts of things. And in ecology, I think it's where ecologists went down, maybe not so good track historically. It was all about competition. Dog eat dog world. Everything's competing. competing, competing, and we're thinking all these synergies and how plants might be helping one another, helping their offspring, sharing resources with one another. It's amazing to get into that. And then you can think about, well, are they clever enough? You know, anybody that's taken classes in biochemistry, and some people take to that more readily than others.

Yeah.

A lot of people think it's pretty tough. Yeah.

It's probably the most important subject in medical school. We all basically didn't pay attention to it, ignored and learned for the exam and then we forgot about it.

Right, right.

So.

Biochemists are the ones creating all these genetically modified plants and so forth and so on. But plants routinely outwit these clever biochemists. Agro people and the example I'd use, there's over 500 herbicide resistant plants. You make an herbicide and the plants are gonna figure out how to get around it. It's just like antibiotic resistance in humans and in my stuff. You put a single compound, right, rather than diverse mixtures of phytochemicals, you focus on one compound and that's easy for these over 500 herbicide resistant plants. You just go down the list. Yeah, so who's clever and who's not clever? Yeah, right.

I mean, so if there's this incredible.

Plant intelligence.

Makes you think about, well.

What should we eat?

Do we have water or air or rocks? If you really want to be ethical and not kill or injure anything with consciousness or sentience, what should we be eating?

You could be like a Jane that you don't eat anything, even a plant, till the fruit falls from the tree and so forth. But I think another way to think about that, and for me, it's to realize this real irony that for anything to live, something gets It's consumed, right? It's a transformation.

Your sentence in the beginning of your book was so great. It says, the universe is a restaurant consuming itself. I'm like, what a great line. And you can't get out of this predicament of having to consume, kill, eat life.

That's right.

And so then does vegan have.