The BITTER TRUTH About Sugar! (How It CAUSES CANCER) | Jason Fung & Mark Hyman

So the environment, which is predominantly diet and nutrition, plays a huge, massive role in the development of cancer and something which very rarely we talk about.

Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman, and that's Pharmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. and if you or someone in your family or someone, you know, has had cancer, this conversation is going to matter a lot because it's with an extraordinary physician, Dr. Jason Fung, who I know is a friend. He's a physician, he's an author, he's a researcher, and he's done some groundbreaking work uncovering the root causes of disease in science-based books about diabetes and obesity. You might have heard about them. The diabetes code, the Obesity code, the complete guide to fasting, which is fantastic. And I recommend that a lot for people who are interested in intermittent fasting, time restricted eating, long-term fast. He sold over a million copies and really challenged the whole idea that diabetes should be treated with insulin, which is actually I agree with, which is a problem because it's too much insulin that causes type two diabetes and we keep giving more, which actually causes worse problems. He's the co-founder of the Fasting Method. It's a program to help people lose weight and reverse type two diabetes naturally with fasting. He has been featured on CNN, Time Magazine, the Atlantic, Forbes, the Toronto Star and lots of other groups. And his new book, the Cancer Code, a revolutionary new understanding of a medical mystery is out now. This is an incredible book. It looks backwards on here, but don't worry about that. It's an incredible book that is leading the way in a new understanding of how we have to think about cancer, because so much of our thinking about cancer is really outdated. I call it the poison, burn and slash method, which is essentially how we treat cancer. Pretty archaic. We're gonna look back in 20 to 50 years and realize that we were on the wrong track. So welcome to the Doctor's Pharmacy, Jason.

Thanks for having me, Mark. Great to be here. Yeah.

So let's get right into it. So cancer is one of those things that is challenging to address and it's something people really fear. I mean, heart disease we understand, diabetes we understand, even Alzheimer's, you know, for the most part, we do understand it. Cancer is still a mystery for many and still even for science and how we approach it from a scientific point of view. And there's been lots of theories about it. A lot of them have turned out to be wrong and our approach has been misguided, which is why, you know, 50 years after the war on cancer, was started by President Nixon. We still really haven't won.

Right?

And so we really, what is cancer? What makes it develop? What causes it? And why is it so common? I mean, one in three people, right?

Yeah, it's, and these are actually great questions because the thing about cancer is that there's all these paradoxes. So we get stuck in this sort of genetic paradigm where, oh, it's this random mutation that causes cancer. That's sort of the that I've used for 50 years. And it leaves a lot to, you know, a lot of sort of unexplained problems. So I approach it sort of trying to see where we've come from and then where we sort of are taking it. So, you know, getting back to the slash and burn sort of thing, it's like I call that sort of the first sort of paradigm of cancer. And that was that cancer was a cell that basically grew too much. And that was our thought. So the logical treatment therefore, is to find ways to kill cells. And that's really what gave us surgery, which is cutting and radiation, which is burning and chemotherapy, which is basically poison, right? And that's why it worked, actually. It worked very well in some cases, but there's a lot of side effects, right? People were, you know, their hair was falling out, they're throwing up and all that stuff, right? And then in the 1970s, the paradigm sort of shifted. So we needed to understand cancer sort of at a deeper level. So we said, okay, well, yes, we know that cancer cells are growing. but why are they growing?

Right?

That's the real question. And as we started to unravel sort of DNA and genes and chromosomes, we said, aha, this is the answer here. It's a genetic defect. So if you have growth genes, well, if you have a mutation, a random mutation in a growth gene, you can get cells that grow too much. So that's where the whole paradigm shifted. And it's important because it changes the whole treatment. So now instead instead of trying to find ways to kill cells, we switched and we said, let's fix those genetic problems. And so through the 80s and 90s, as you know, we worked on these and some incredible successes. So we had imatinib, which was used for a type of leukemia and really a game changer, like just fantastic stuff, right? The mortality from chronic myelogenous leukemia just fell. And then there's trastuzumab, which was for breast cancer. to new receptor. And so it also changed the game. Like it was a fantastic drug. And so we thought, okay, you know, this is great. So all we're going to need to do is sort of figure out the one or two mutations in breast cancer, one or two mutations in colon cancer, we're going to find the drugs, we're going to cure cancer, right? And that was the thought through most of the 90s and so on. And then the problem was it didn't work out that way. So, as we did in 2000, we completed the human genome project and we sequenced all the genes and we thought, okay, well here we go. We've got the roadmap to curing cancer, but of course it didn't. So then we embarked on an even more ambitious program, which was the Cancer Genome Atlas, which sequenced not just one human genome, but the cancerous. So we took the cancer from 33,000 samples. and we took all the genomes, like sequenced the entire genome and said, okay, great. Like we've got a thousand cases of breast cancer. Let's compare them. Let's figure out what kind of mutations we have. Let's get the first top one or two. We'll solve the problem. And of course, what we found was not one or two mutations. So for breast cancer, for colon cancer, for these common cancer, there's like 50 to 100. It was just complete bedlam, right? So you'd have a patient in your oncology which was, you had patient A with breast cancer, 100 different mutations, and patient B with the exact same looking cancer, 100 completely different mutations. So that's not gonna work because the whole idea of, you know, giving a developing 100 drugs was just, that wasn't gonna work. And that was sort of the death of the sort of genetic sort of paradigm. And that's really why we made so little progress from sort of 1980 to sort of 2010 when this whole thing began to fall apart. And that's really the problem. So we've been stuck in this paradigm and now we've started to shift into a whole new paradigm of cancer, looking at it from a sort of evolutionary standpoint. And the whole idea of sort of this genetics, I mean, it still persists. If you go to the American Cancer Society and so on, it says, oh, it's a genetic disease of gene mutations. and so on. But that whole process failed because you can measure it by how much useful treatments there are. And really, the number of useful genetic treatments is probably countable on like one hand sort of thing, like all the early stuff we got. And this is why cancer medicine has really fallen way behind almost every other area of medicine. If you look at heart disease in 1960, for example, so the number one and two killers of Americans is heart disease and cancers. That's always been number one and number two. In 1960, heart disease killed about twice as many people as cancer. And now they're like neck and neck, which means that we've made way more progress in the treatment of heart disease than cancer. Cancer is just almost as bad as it was when we started the war.

That's true.

And this is the thing is as we move into this new paradigm, and this is what I get into, it's a really interesting story.

I've had two members of my family that died from cancer, so I get it. and my sister had cancer twice.

Yeah, and that's terrible. But the thing about it is this new paradigm we talk about is important because when you talk about evolutionary medicine, now you talk about the importance of the environment because that's what really drives evolution, is the environment that you're in. And for so long, we've thought about this as a disease of genetic mutations. We concentrate on genes and not on other things that are going to increase your risk of cancer. so the environment, which is predominantly diet and nutrition, plays a huge massive role in the development of cancer and something which very rarely we talk about. Like, yeah, so I reviewed the study. It was, so in 1981, the US Congress said, okay, we need a study. Let's figure out what causes cancer. So they got the best people as updated in 2015. 2015 and they said, okay, let's calculate the population attribution fraction, which is basically how much of cancer is due to, say, tobacco smoke. So about 35% of cancer is caused by tobacco smoke. Well, diet is actually at 30%. So it's like it's almost as high as tobacco smoke and way above everything else, like the pesticides and the chemicals, all the stuff we worry about, you know, wood dust and asbestos. Those all do cause cancer, but on a population relaxation basis. It's almost all tobacco smoke. And we know, of course, to stop smoking, but also diet is huge.

Yeah. You know, Jason, I remember in 19, it was 1985. I think I was on my rotation in Oncology as a medical student. And I said to the, the cancer doc, the oncologist, I said, so because I, I was always interested in nutrition. And actually, I remember in college, I took a nutrition course and I had a little manual of scientific studies that was on nutrition and cancer back in 1985. 80, right? So I was sort of paying attention already back then. And I said to the attending physician, I said, so tell me, what do you think is the percent of cancers that are caused by or made worse by diet? And I thought he would say, oh, 10%. He said 70%. And I was like, whoa. And I think when you, you know, when you think about functional medicine and the approach you're taking, It's a very different model of thinking about cancer. So yes, if you have a tumor or something, you might need to get it cut out or you might need radiation or you might need some chemo at some point. But the question that never really gets asked is one, why did the cancer develop in the first place? And how do I change those conditions? And two, how do I actually create a healthy immune system and a healthy soil and to actually make sure that the cancer can't grow? and I, and as a functional medicine doctor, I often say we're very much like regenerative farmers where we focus on soil health.

Yeah.

As opposed to industrial farmers, which use a lot of chemicals, pesticides, basically antibiotics and glyphosate and herbicides to make the plant healthy. And I, I remember being at this conference on nutrition. I don't know why they invited me. It was all the big food companies, the big ad companies. And I, I was invited to give a talk, which I did and I didn't hold back anything. I'm sitting next to this guy at dinner. I'm like, so, you know, what do you do? He says, well, I'm in plant medicine. I'm like, plant medicine? I said, what is that? He said, well, we make pesticides. So I think, okay, got it. So I think, you know, this whole idea that you're bringing forth is so important. So talk about this analogy of the seed and the soil and cancer and why we're ignoring the soil conditions in the body and the environmental issues. diet and also lifestyle and stress and environmental chemicals, all those factors.

So the idea of the seed in the soil actually goes way back. I mean, it was written about sort of like 60-70 years ago, but then of course everybody forgot about it because the point is that, you know, genetics, this whole focus we had on finding mutations in genetics really talks about the seed, right? It doesn't talk about the environment that you're in. and if you have a seed, of course, it has the ability to grow, but it needs the right conditions, the proper soil to grow. And what we always seem to not talk about is how certain populations that live a sort of traditional lifestyle almost never get cancer, like other than the ones that we know that are say virally caused. But if you go back, so Dennis Burkett was this sort of legendary Irish surgeon. And he went to Africa and, you know, he discovered Burkett's lymphoma and stuff. And it's very interesting story. But, you know, he looked at these Africans were eating a traditional diet, living a traditional lifestyle. And he said, boy, these people just don't get cancer. And the whites, of course, were getting colorectal cancer. the same rate as they were in the UK, for example. And so they called these things diseases of civilization. So obesity, type 2 diabetes, and cancer would come as people changed their lifestyle. But you see this actually all over the world. So the Inuit in the far north, some people used to call them Eskimos. So again, eating a traditional diet very high in, say, animal whale meat and seal blubber and stuff. That's their traditional diet. They never get those cancers that we get. I mean, they get some viral cancers, but they don't get colorectal cancer, breast cancer. In fact, the University in Ontario, Canada, used to send an expedition to the Arctic Circle every year to find out why these people were immune. But of course, they weren't actually immune because as soon as in the 60s, 70s, and 80s, they changed their lifestyle to Western sort of lifestyles with the sort of bread and sugar and all that sort of processed foods that we ate, then you started to see all the cancers. So clearly it wasn't a genetic problem because the gene pool of these Africans or these Inuit were not changing. But it was the soil that, and it comes back of course to diet and lifestyle, which is the most important thing because that's the main thing that's changing in these people. come over. That is what is the biggest determinant of cancer. You know, these inally go from being considered immune to cancer to high rates of cancer. Of course, they're eating sugar all the time, right? There's tons of smoking and all this other stuff. And you see this everywhere. So you see this, say, in Japan, where you can look at a Japanese woman in Japan compared to a Japanese woman in San Francisco. And of course, the person in San Francisco has about double or triple the rate of breast cancer compared to the Japanese women in Japan. So it's like, so this is clear evidence that the most important thing we need to focus on is not the genetics of the problem. It's the soil problem, right? The seeds.

Yeah, my favorite story is the Polish women who are from Poland eat 30 pounds of sauerkraut a year and they have almost no breast cancer. and it affects their microbiome because it's a pre-probiotic food. Plus cabbage has all sorts of phytochemicals that fight cancer. And when they move to the United States, they get cancer at the same rates as American women because they stop eating all the sour cream.

Yeah, absolutely. And these are the things that are really important because if you can figure it out, of course, then you have the ability to do the opposite. You could take a woman in San Francisco and cut her risk of breast cancer by a factor of two or three. Imagine how amazing that would be. I mean, with genetics and all this stuff, we're talking about, you're making progress in inches compared to diet and lifestyle where you're talking about huge leaps and jumps. You're not talking about 10% higher risk. In medicine, how we go, oh, it's statistically significant. There's a 10% lower risk. It's like, these people just never get cancer, right? It's crazy the magnitude of improvement you can get. On the other hand, instead of 10%.

It'S 200 or 300%, right? It's like a totally different scale.

It's a totally different order of magnitude. And yet we focus all of our resources on saying, oh, let's figure out this genetic condition, which might affect 1% of these cancer patients. try and figure it out. It's like, okay, let's not do that. Let's try and figure out the other stuff. Like, what is it? Is it sugar? Is it fermented foods? Is it processed foods? Like, what is that? Because that's so important, but unfortunately it gets so little sort of research money and you start talking to people, people want the other stuff, right?

So people are listening and wondering, okay, this whole soil thing makes sense, right? We want to create a hostile environment for cancer to grow. How do we build that hostile environment instead of a fertile one that most of us have for cancer?

Yeah, that's a great question. And so I talk about in the book about, like, what is it that makes cells grow? And what's really important is sort of growth factors. Our body contains natural growth factors that increase the rate of growth. And one of the big things of the last sort of 15-20 years has been the realization that our body contains nutrient sensors, which are hormones that go up when you eat, but they also are precisely the same hormones that our body uses as growth factors. So the most important one is insulin. So insulin, of course, is a well-known you know, metabolic hormones. So you eat and insulin goes up, assuming you're eating carbohydrates and protein, sort of a mixed meal. You eat, insulin goes up. But more importantly, what it is, is a nutrient sensor. It tells your body that food is available. And the reason that's important is because your body only wants to grow when nutrients are available, right? So you don't want to, you're so you don't want more cells to continue to grow if there's no food available. that's not a good survival strategy. So the body links them. In fact, if you look back in evolutionary times, insulin was not a metabolic hormone. It was actually a growth factor. So, as we evolved, we actually used the same molecule that we use as a growth factor for nutrient signaling as well. So we know that insulin is a very potent growth factor. There's this thing called insulin-like growth factor, or IGF-1. 1.

And.

Walter Longo actually described this group of Ecuadorian dwarves, the Laron dwarves, who actually have almost no IGF-1, so they're very short. Turns out they're also immune to cancer because if you don't have that growth signaling, then the cells can't grow and the cells that are going to be the most affected are those cancer cells. What you have to do, of course, is say that, okay, if we have too much insulin, then that's going to be a signal to our body that we need to grow. So what can you do to sort of reduce that insulin signaling in the body by reducing nutrient availability, which is two things. One is getting rid of the hyper-processed foods, which tends to really amplify the insulin response. So sugar, for example, is especially bad because it causes all this insulin resistance, which causes hyperinsulinemia. A lot of the refined foods are very bad because they sort of take away all the other natural components and you're left with this big spike of insulin. Like if you eat cookies, for example, well, you know, it's just gonna, your insulin is just gonna spike up. And the other thing, of course, if you eat very, very frequently, you're going to keep insulin high all the time. So intermittent fasting is another strategy that you could use to produce insulin. And that's so it's what you eat.

And when you eat.

Yeah, exactly. So it's what you eat and when you eat. Because if you eat a high carbohydrate diet, which people did, like people in China, for example, used to eat a ton of white rice, but almost zero sugar and they were okay.

So it's not necessarily just the carbohydrates. Well, they, I lived in China for a while. You're Chinese. I mean, I traveled around, remember 1984? I mean, they had no accoutrements of modern living. I mean, they had to cut a board. They would use a saw. to create boards. They would to grind the flour, they would literally walk in circles for hours with the grain in between two giant stones. They would work in the fields for 14 hours a day with hard labor. And yeah, you can eat a lot of rice if you do that.

Yeah, that's true. And it's also like it was very, it was like rice and vegetables. Like every day it was just rice and vegetables, rice and vegetables.

The land of milk and honey, the Chinese phrase for it is the land of fish and rice. So it's really what they think of.

Yeah.

So you're talking about what is the problem, which is the incredibly high amount of starch and sugar we consume. And you've talked about this in the diabetes code, the obesity code. This is a central driver of almost all chronic Western diseases, heart disease, cancer, diabetes, Alzheimer's, high blood pressure are caused by this phenomena of insulin resistance or too much insulin which is driven from our diet, basically a highly refined processed carbohydrate diet, and also this constant eating pattern, this thing called snacking, which I think is a modern invention. We have a snack food industry. But, I mean, I don't snack. If you eat properly, you're never hungry. I mean, if you don't have these spikes and insulin going up makes you hungry. But what's fascinating is that what you're saying is that insulin actually fuels the cancer growth. and sugar fuels the cancer growth.

Yeah.

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So all of these diseases are actually diseases of too much insulin. So if you look at obesity, for example, if you were to measure the levels of insulin, people who are more overweight tend to have higher insulin. Same with type 2 diabetes. Hyperinsulinemia and insulin resistance are really sort of two sides of the same coin. So one causes the other sort of hyperinsulinemia can cause insulin resistance, insulin resistance and cause hyperinsulinemia. So they're really the same thing. And again, the same thing applies to sort of cancer. And this is the pattern that was noticed so many years ago that there are these diseases of sort of too much insulin, which is that sort of they all go together, the heart disease. And you don't see that in people eating traditional diets because they're not eating all the time. So I remember there was this NHANES study, which is a big sort of American survey of lots of things, but they included dietary habits. So in 1977, they found that most people ate three times a day, so breakfast, lunch, and dinner. And by 2004, it was almost up to six times a day, right? So it's like, wow, that's crazy. And it was never this sort of deliberate, hey, there's good scientific evidence that we should eat six times a day. It just sort of crept in And I think part of it was of course the snack food companies wanted to promote it and you know, people thought it was a good idea. So then it was sort of, it became almost gospel, oh you have to eat six meals a day, right? And I remember thinking about it a while ago and thinking, where did that suddenly sneak in? Did we have a big randomized control trial that I missed somehow? Because I don't think so. It was just this gradual change in attitudes and you saw it because I start to think back to my upbringing. in the 70s, right? So I grew up in the 70s and, you know, if you wanted a sort of after school snack, your mom said, no, you're gonna ruin your dinner, right? And if you wanted a bedtime snack, your mom would say, no, you should have ate more at dinner. And it's like, that's just the way it was. And of course, people would have this sort of natural fasting period from after dinner, which was, six o'clock, because people ate a bit earlier back then to, like, say eight o'clock. So 14 hours of fasting every single day without even.

We call that breakfast.

Yeah, exactly.

Breaking the fast.

Breaking the fast. That is the word that we use. And it's like somehow we went from that where people didn't have the Obesity problems, type two diabetes problems, because they have this natural fasting period built in that has always been there. It's even built into the English language. And then it's like, oh, you gotta eat all the time. And it's like, oh, you can't ever skip your breakfast. You got a snack all the time, right? You see it in schools, for example. Oh, they go to school, they get a mid-morning snack, then they have a lunch, and then they have their after school, and then they have a dinner. Then, you know, you're playing soccer and.

They think that they need to have a snack in between the halves of soccer. You know, I played. Well, Jason, you've written a lot about, you've written a lot about fasting and, and the effects of either time restricted eating, which is, you know, 12, 14, 16 hour hour fast every day or taking a 24 or 36 hour fast a week or even longer fast for diabetes. And, and, and I'd love you to sort of share why around cancer, this is so important. And on my podcast soon, we're going to have Dr. Patrick Hanaway, who is my colleague and friend, was the medical director at Cleveland Clinic who had cancer and used fasting as an approach to his cancer treatment. He still got radiation. but he also did it in a way that actually reduced all the side effects to almost none, has kept him healthy now for well over a year, and this cancer was not a great one, and let him go through the process with really no issues, which was really staggering and really went on a ketogenic diet in order to do that, which is both using fasting and ketogenic diets to drop insulin levels to almost undetectable so can you talk about this whole idea of fasting, cancer, ketogenic diets, why it's so important, and how it connects to this whole idea of insulin resistance and insulin high insulin levels?

Yeah, so both fasting and ketogenic diets have the same sort of goal at the end, which is trying to lower insulin, because the difference between a ketogenic diet, say, and a low-carb diet is that, you know, you're sort of low carb, ultra low carb for the keto, but sort of moderate protein, because protein can also stimulate insulin, whereas some of the older low carb diets were very high in protein. You take protein shapes or whatever it is. That's generally not. Yeah, like Atkins. And so high protein is not always the best idea because you can get high insulin, but you also get this high mTOR, which is sometimes not so good for cancer as well. But the idea is to really drop your insulin levels. And if these are diseases of too much insulin, then that's going to be a very useful adjunctive treatment. So fasting is actually fascinating because there's all these different things we're discovering. So one of the things is sort of autophagy. So as you fast, of course, your nutrient sensors go down, so mTOR insulin go down, and then you activate this process called autophagy, where you actually start to break down some of your subcellular organelles and stuff. So basically, your body's just trying to clean house.

It's like Pac-Man coming around and cleaning up all the garbage.

Yeah, exactly. People think it's a bad thing.

Maybe people know who Pac-Man was, but that was the original video game that we all played back in the 70s.

Pretty simple.

It was very exciting, though. Yeah, I don't know what Pac-Man is anymore.

You can still find them sometimes. But the idea is that people think that this sort of breakdown process is really bad for you, but it's actually really good for you. And in fact, it's sort of one of the keys to rejuvenating the body. That is, you want to break down all your old stuff and then sort of rebuild the stuff that you need. So the whole idea of fasting is you're trying to put the body into this sort of regenerative maintenance mode. Because what we've recognized over the last little bit is that your body sort of has sort of, you know, you can go into growth mode or you can go into sort of the cell maintenance repair mode. And it really depends on your nutrients availability. When nutrients are available, you want to grow. When nutrients are not available, you don't want to grow and you want to go into this sort of maintenance repair mode. And everybody thinks growth is good, but growth is not always good, especially as an adult. So I always say think about a car. Like if you have a sports car and you rev that engine and you're running it fast all the time, you're going to go fast, which great, but it's going to burn out much faster. So you can't just keep revving that engine, keep redlining it. You've got to sometimes bring it to the shop, put it in the garage, let it rest and all this stuff.

A pit stop.

Yeah, exactly. A little pit stop. So that's the point of the human body, too. You can either go for growth or you can go for longevity or cellular maintenance repair. But you've got to have a bit of both. It's a balance there. It's not all growth. and this is where you say, oh, EDDDD. Well, you're going to put your body, your nutrient sense are going to go up, your growth factors are going to go up. You're going to put yourself in growth mode, but you don't want to do that, especially for a disease such as cancer, which is a disease where cells are growing too much. You're basically feeding into that growth, and that's going to be very, very bad for you. So what you do instead is you do the fasting and you put yourselves into this sort of maintenance repair mode, and it actually allows you to undergo both the chemotherapy and probably the radiation therapy better because chemotherapy, we have a couple studies on fasting and chemotherapy where what you do is you fast just before and during and just after your chemotherapy. And what they've noticed is that those people tend to get a lot less side effects from the treatment because what you've done, of course, is taken the cells of your normal body and you've sort of put them into a more quiescent state. They're not trying to grow, they're actually trying to slow down. And chemotherapy, the general way it works is it kills the fastest growing cells, which are usually the cancer cells, but it also kills like the hair follicles because they're fast growing cells. It kills the lining of the GI tract, so you get nausea and your hair falls out. So, if you can put those cells into sort of a quiescent sort of repair mode, it's not going to sustain as much damage from the chemotherapy. And instead, the cancer cells, which can't stop their growth, they're always trying to grow, they can't do that. So therefore they're going to sustain full damage from the chemotherapy while your body is relatively protected. And that's one of the things that might be very interesting to use as an adjunct to sort of standard treatment. I would never advise not to take the standard treatment because of course, you.

Know, there's a lot of interesting work by Dr. Mukherjee, Dr. Mukherjee and others, looking at ketogenic diets and cancer. And I've heard him present on this. It's just fascinating. He wrote the Emperor of All Maladies. It's about cancer. I'm sure you've read that. And he said that to me, he said, Mark, you know, we figured out the solution to cancer. I'm like, what is it? It's this big discovery. It's like, and the cause. And I'm like, what is it? He's like, it's sugar. I'm like, yeah, you know, I guess that's not really news, but maybe it's good you know that now. And then he said, we've been studying ketogenic diets. and seeing incredible results with pancreatic cancer, melanoma, stage four cancers that weren't responding to anything else. They're animal models. They literally were curing cancers with ketogenic diets, and now they're doing human trials. Can you talk a little bit about some of that research and how it might be applied to people who are struggling with cancer? Yeah.

So, this was the sort of big discovery of Dr. Lou Cantley who's discovered sort of this whole pathway, the PI3K pathway that links sort of insulin and growth and cancer. So the important thing is that insulin acts as that growth factor and therefore acts as a sort of pro-growth and therefore a sort of pro-cancer agent. Sugar, of course, plays a big role in the hyperinsulinemia. And it's interesting because Dr. Lance Cantley in several of his articles or whatever, he goes, Sugar scares me. Here's this guy who studies cancer for a living and he's like, yeah, sugar just scares me. And that's the same sort of thing that Siddhartha Mukherjee is talking about too. And that's the whole point is that with ketogenic diets, with fasting, and of course fasting, you have to cycle it because you can't obviously fast. You can't fast forever, as opposed to ketogenic diet. which is sort of very low carbohydrate. You could sustain that for years and years. You can't fast forever. You need some some some food at some point. But the idea is the same. What you're trying to do is really reduce those insulin levels. There's, of course, studying this in terms of drugs or trying to develop these blockers to the whole pathway of PI3K and so on. I think they've they've developed a couple of companies for that. But, you know, just like anything else, it's like, why would you want to do it with a drug when you can do it with your diet? You know, what's so striking, Jason, is.

That, you know, often when people go get cancer treatment, their doctors make sure you keep your weight up, eat ice cream, eat milkshakes, have cake, you know? And I'm like, what are you telling them that for? I mean, that is death. And yet it's, it's, it's, it's, I mean, I actually had a radiation oncologist as a patient who worked at MD Anderson. and he was very aware of these studies and these issues and he tried to tell his patients do the right thing. He said, all the nutritionists, and this is like the number one cancer hospital in the world, are telling their patients to eat a lot of starch and carbohydrates and sugar to keep their weight up. And it's just such an unfortunate situation that is going on right now. So when we talk about cancer, we're clearly talking about some of the risk factors, right? Sugar. There's other risk factors. And one of the things that I think is very concerning to me is these these obesogens, which are environmental chemicals that not only are directly toxic and carcinogenic, but they're actually causing insulin resistance. So they're really creating a double whammy, pesticides, herbicides, additives, all these environmental chemicals that we're exposed to, 80,000 of them that have been developed over the last 100 years. What's your perspective on that and how do we reduce our risks?

Well, I think that stuff is really hard because they're not adequately studied. I mean, there's so many chemicals and what do we know about the effect on the human body for most of these? Like very, very little, right? I mean, you know, they have this classification as generally recognized as safe, but, you know, I mean, that just means it doesn't kill you within a month, right? I mean, that's about it. And all of these chemicals, like the, you know, even the ones that we eventually find out are really bad for us. I mean, they were originally approved and, you know, for you. So, you know, we trust our government to sort of keep us safe from all these sort of chemicals. Very rudimentary. Like you do it in a, you test the toxicology in some rats and it doesn't kill them and, hey, nothing, you know, you get out there and it doesn't kill people right away. So, hey, you're good. that's the sort of idea that we have. But, yeah, I think that, unfortunately, it's hard to know exactly what to say because, one, there's just so many of them. They're changing all the time. I'm okay.

Was that thing?

Yeah. So, like, the classic sort of pesticide was like DDT. Remember it was. Yeah, I date myself here a little bit, but DDT was this big, big time pesticide was amazing. Killed everything.

Right.

Turned out it was. super, super bad for us and, you know, causing cancer all over the place. Right. There's all kinds of stories like that. Now, of course, there's all these other chemicals in there, and we don't even know what they are. I mean, they're not. Yeah.

I mean, the government did write, the government did write a whole report on the environmental chemicals and how they're linked to cancer. So I think that's a big thing. And I, I encourage people to check out ewg.org, which is the environmental working groups website where they have guides on how to reduce your exposure through your food, through household cleaning products, through skincare products, and many other ways to reduce your exposures, household cleaning products. So I think, I think the more we can do to reduce our intake of these chemicals is a good idea. So, so let's talk about how to reduce your risk. What can people do who are listening that you talk about in your amazing book, the Cancer Code, a revolutionary understanding of the medical mystery. I encourage everybody to get a copy, the Cancer Code. It's out now. because it really is a revolution and understanding of cancer that I think could help so many people. So tell us, what can we do to reduce our risk of getting cancer?

Yeah, I think the most important thing is to go after the sort of hyperinsulinemia because we know it's such a big risk factor. So you can't always test it, but you'll know because if you are overweight, for example, then you want to try and get back to a normal weight. And there's lots of different ways to do that sort ketogenic diets are not the only way you can do, you know, all kinds of different diets and, you know, vegetarian diets and sort of paleo diets. There's all sorts of good ones. And then the other one, of course, is the sort of reintroduction of intermittent fasting into sort of the normal schedule. And I think that's really important because what we've lost, of course, is that balance between feeding and fasting, right? We've gone to a sort of feeding all the time model, which is not so good for growth because we all, you know, you're always telling your body to grow more. And of course, if you have type 2 diabetes, which is becoming a huge, huge problem. So if you look at pre-diabetes and type 2 diabetes in America, it's like it just skyrocketed over the last 15 years. And that too is a sort of massive, massive risk factor for the development cancer. The World Health Organization actually classifies 13 different types of cancer as obesity related cancer, so including breast and colorectal. So that's a huge- and prostate and colon, liver, pancreas. And interestingly, if you look at the types of cancer, so we've actually been doing really well for most cancers over time as you track them through the years, most cancers actually slowly declining. except those obesity related cancers. They're actually going up. So pancreatic cancer going up, liver cancer going up, all of these cancers are going up. And they're not rare diseases. So breast cancer, for example, is very, very common. Colorectal cancer, very, very common. And I think that this is one of the things that we hadn't recognized. So I went to medical school in the 90s. We never talked about diet and, you know, cancer. It just wasn't even on the radar screen. It was crazy, except maybe a few people who are really into it. But for the most part, people just, we just didn't talk about it. And then it wasn't until sort of 2003 that the first large papers started to come out that said, hey, this is a big risk factor. And then you multiply it by the millions of people who have it, and that's why it's such a big risk factor. So staying to a normal weight, you know, which includes getting your diet in order, cutting out sugar, cutting out the processed foods, for the most part, adding back the intermittent fasting, which is part of a normal sort of regimen.

When you say that, what do you mean? You mean time-restricted eating, right? You mean 12 hour or 14 hour fast?

12 to 14 hours should be your sort of baseline because that's just 1970s style eating when we didn't have so much obesity. Now, if you're trying to lose weight or if you have type 2 diabetes, and you can extend it to say 16 hours, which is time restricted eating, or you can even go further 24 hours or even multiple days of fasting. And, you know, people always worry about that, but, you know, that's why I talk about it a lot because a lot of the stuff that we worry about simply isn't true. People worry about, oh, they're going to lose muscle, they can't work, they can't concentrate. I'm like, all you're doing when you don't eat is that making your body rely on your body's own store of calories, which is sugar, right, or body fat. That's how your body stores calories. So you're literally using the body fat for precisely the reason that you carry it. So what could be wrong with that? What is more natural than that? If your sugar is high and you don't eat, you're going to use up the sugar and your sugar will fall. Now, that's great news if you have a high sugar and type 2 diabetes. which of course that high sugar drives a high insulin, which drives, you know, cancer risk and so on. So something like that is a completely natural way to get this, all of this back in order. And if you're too far along the scale of, you know, you have too much insulin, you don't have to stop at 14 hours. There's nothing to stop you from taking your fast out to, you know, a couple of days at a time. Right. And that's the thing is, it's a free intervention. It's a natural intervention. It's been used for 1000s of years, right? Every culture and history has used it. It's crazy that we don't use this sort of thing.

Well, what you're talking about is just something so extraordinary and effective and the side effect is that it also prevents heart disease and diabetes and dementia and depression. And I'm like, pretty much everything. So it's like a one-stop shop. for staying healthy, which is cut out the starch and sugar and practice eating in a way that we're designed, which is take a break after dinner and don't eat till breakfast or a little bit later in the morning. It's so simple, it's so obvious, and it's so different than our current thinking. But if you have cancer, like if you already have cancer, and we can do this to reduce our risk, what about the screenings, the cancer interventions, the treatments? that we have now. Should we still do those? Do we, do we, do, how far can this go to really have an impact?

Screening is a very interesting problem because it sort of gets down to the sort of seed and soil idea. So all our, all our cells in our body actually have the potential to become cancer. Right. So your heart can get cancer, your liver can get cancer, even your placenta can get cancer. Your, you know, it's crazy that every single cell in the body can become cancerous, so. the point is that that seed sort of lies everywhere and that aggressive screening we found, you know, may or may not be that useful. So this is the reason why people are sort of backing off a little bit on sort of aggressive screening. Works very well in some cases like cervical cancer, for example, but taken too far, it was useless of the thyroid cancer as an example where they screened people and so Korea for thyroid cancer found a ton of ton of thyroid cancer. It was like everywhere. So the the the the incidence of new thyroid cancer went up sort of 11 fold because of screening. But the mortality was still just about the same. It didn't impact it because most of those didn't need to be treated. So that's the point is that you have to there's a limit to the screening. But, you know, there's there's well-established protocols that, you know, people have studied so breast cancer, for example, for example, mammograms have been studied, but they're rolling sort of, they used to say, oh, maybe you should start at age 40. And they've actually recently been sort of moving it back down to maybe age 50. Same with colonoscopy, for example. One of the big successes of screening has been colonoscopy and removal of sort of early cancers has made a big difference in terms of reducing colon cancer. But they're also talking about, you know, maybe you don't need it. They actually just rolled, I think just last two weeks ago or something. They actually said we should start earlier in part because I think that they're worried that with the obesity epidemic, they're actually getting more and more. So if you look at these obesity-related cancers, we're actually finding them younger and younger because the younger and younger populations are getting more of this obesity. So I think they just recommended instead of age 50, they actually rolled it down to like age 45 or something. to get colonoscopy. So I think it's still a good idea to do screening because one of these cautious things. But you have to be wary. So certain things didn't pan out the way we thought. PSA is super controversial for prostate cancer. Thyroid cancer didn't turn out to be useful. But you pick and choose. The big ones are going to be breast and colorectal, of course.

So given what you've learned about in this research that you did for the cancer code, which is an amazing book. And everybody needs to get it, a revolutionary understanding of a medical mystery. What does the future look like for cancer? Because it feels to me as a doctor, you know, someone says, I have diabetes, I have Alzheimer's, I have heart disease, I have an autoimmune disease. I have this, I'm like, great, I got that cancer. It's like, you know, not so easy. So what is the future look like in terms of prevention and treatment of cancer?

I think there's two different things. In terms of treatment of cancer, of course, a lot of these things that we talk about are not applicable once you have the cancer. Like, you can't just use diet. Like, I would never say to somebody, you know, just use the diet or just use fasting. It's like, no, you need to get that surgery or the radiation or the chemotherapy or whatever they're recommending for you, because by that time, you have a high risk of other issues. You can use it as an adjunct. But the treatments have come a long way because again, we've moved past now that sort of idea that we need to find the genetic cure for all these cancers. And now we're sort of moving into the age of immunotherapy, which is taking this idea that cancer is sort of this evolving sort of new species and saying, well, let's use our immune system to try destroy it. So we've been seeing some sort of incredible successes from a therapeutic standpoint with these new agents, these sort of checkpoint inhibitors and CAR T and some of these other things. So really very hopeful. Of course, that depends on a lot of research dollars or very high tech sort of stuff.

Yeah.

It's more exciting from a prevention standpoint because the, you know, the only real successes we have in cancer medicine are really in prevention. So stopping smoking, for example, is sort of so far ahead of anything else we do for cancer. But it's all through prevention. Same with colonoscopies and for colorectal cancer, really you start to see as these things, as you do more and more screening, so as you go from the 70s to the 80s, to the 90s to the 2000s. For example, you can see that as people start to accept that they need to do the screening, that colorectal cancer mortality is slowly coming down. And that's where the future lies. I'm hopeful because we're starting to bring into a clearer picture that, hey, all of these things, these dietary things that we talk about are so important, like stuff that you write about for so well, that, hey, this is great news that people are paying attention to it because those are the cancers that are rising in terms of numbers, right? Those are practically the only cancers that are rising in numbers.

Yeah.

Those are obesity-related cancers. So, if we can understand that, if we can make people aware of that, of the dangers of sugar, so for example, sugar intake, I think we peaked it around year 2000. But prior to that was really going up very high, right? You know, we're drinking their Gatorade and stuff, you know, they were like, oh yeah, I just worked out, so I'm gonna have a Gatorade. We're just full of sugar, right? People don't do that anymore. Like, you know, I look around, like, you know, how- you-'d be surprised.

You live in Canada, people maybe are better over there. I think here in America, it's still, sugar palooza.

Yeah, probably, probably. I think that plays a big role.

I mean, look, 88% of us are metabolically unhealthy and, and the translation of metabolically unhealthy means you're insulin resistant. Think about that. Almost nine out of 10 Americans are on track for these diseases caused by too much insulin, including cancer.

Yeah, including cancer and all those other diseases you talked about Alzheimer's and all that sort of stuff. But, you know, and, and part of it, I think, is, you know, if you look at the total number, like total amount of sugar, it has been going down, but it's still very high. I think that's the big problem. There's a lot of sort of corporate interests and so on. Like, you know, a few years ago, Coca-Cola was revealed as giving like a million bucks. Remember this story? They gave a million bucks to the University of Colorado to develop the global energy balance network or something like that.

I wrote about that in my book, Food Fix. Yeah, it was a big scientific mess.

It was a horrible story because here you have a university taking millions of dollars from Coca-Cola, which obviously is peddling something very unhealthy, and was ready to go to war against people like you and me who keep saying, Look at food as medicine and what you put in your mouth is super important. Like, they're, you know, the universal- It's.

Not just calories are all the same, right?

Exactly. Like, who? Like, this whole calories is the same. Like, that always gets me all riled up because it's like you're telling me that 100 calories of cookies is the same as 100 calories of broccoli. That's the dumbest thing, like, honestly.

Well, it's just because of the law of thermodynamics, right? So, the idea is that it's calories a calorie because when you burn it, it releases the same amount of energy. And that's true. It's absolutely true in a vacuum. But now when you eat it, because when you eat it, it interacts with your microbiome and your hormones and your brain chemistry and so many different factors.

That drive benefit or cause harm. Honestly, it's crazy that we believe it because if you take a hundred calories of cookies and eat it and versus the salmon, for example, or egg or whatever, the hormonal response is completely and utterly different between those two foods. Same calories, different foods, completely different hormonal response. Like insulin shoots way up with the cookies, right? And, it's like you have to pretend that that's completely irrelevant. Like, that's, this is physiology, right?

Jason, I just reviewed the Endocrine Society position paper on obesity and prevention and treatment that was published in 2018. and they were very clear that a calorie is a calorie is a calorie, and weight loss is about energy balance. And I'm like, what is going on here? Are they not paying attention to the science? Because these are top scientists at the major medical universities. And these paradigms get so entrenched and so stuck, and we just get so off track. It's really unfortunate. You know, it takes a long time for paradigms to shift. It took 50 years from the time that the Semmelweis discovered that we should wash our hands before surgery to prevent childbirth fever, death in women who are giving birth because of infection, 50 years before they actually started washing their hands before surgery. And the guy died in disgrace with his theories completely ridiculed because it just doctors couldn't believe that they would be causing an illness. They would not, they would never want to harm their patients. So how could it be that they were causing it by not washing their hands? So there was just, we're, we're in, you know, in a tough situation. It literally decades for paradigms.

Not just that. But remember the whole 1980s, the low fat era. Right. So I, I sort of did all my training through that era. And there's those step one and step two diets, if you remember from. Yes, of course.

And it's like, so if you had.

A heart attack, you go on this low fat diet. If you had another one, you had an Ultra low fat diet.

Right.

And, and then it's like, that made things worse. And the things worse. Absolutely. And we talked about the French Paradox. about how these French are eating full fat milk. It's like, oh my God, how can--.

Butter and cheese and cream and right.

How are they not having heart attacks? And they're actually having like a third of the heart attacks of Americans. And then of course it was crazy because that whole paradigm took like 20 years before people started to say, oh hey look, you know, here's some studies on nuts which are high in fat and they're really good for you. And fatty fish, really good for you. And avocados, they're really good for you and olive oil. And it's like, it took took 20 years of us demonizing all kinds of fat before we finally said, oh, it's a healthy fat. Right? It's like, okay, that took a lot longer than you think it should have taken. It's the same idea. Like, it's the same thing with sugar, right? Sugar was fine because it was low fat. Right. And that was the thing that you could find in the 80s and snack well, cookies. But it wasn't just that. The American Heart Association was out, had, like, saying, oh, Cut the fat, but eat the sugar.

And it's like, oh, it's still. It's still in our recommendations. Even our dietary guidelines are so contradictory. On one hand, they say we shouldn't worry about fat anymore. On the other hand, they have all these promotional education materials like the go slow foods, like, which are saying low.

Fat and still recommend low fat milk and school lunches. Remember all those, you know, those sugary.

Cereals, and they all had that health check on it. Oh, my God. American Heart Association, yes. Fruit loops and Trix are for kids and Cocoa Puffs are all heart healthy because they have no fat.

Yeah, and it's like they have like 50 grams of sugar in one serving, right? It was ridiculous. So, these take a long time and I think that calories thing, I'm sort of disturbed a bit to hear that they're still thinking that.

Yeah, I mean it's true. It's true. Well, your contribution on understanding of cancer has been so great with this book, the Cancer Code. I encourage everybody to get a copy of it. It's really fantastic. Jason, you've really inspired me to even eat less sugar than I already do and feed myself right and create a healthy soil because that's the key here. We know how to create a healthy soil and it's the obvious thing. It's not just not eating sugar, but it's also eating phytochemical rich food, lots of fruits and vegetables, lots of good fats, nuts and and seeds, whole foods, getting rid of all the ultra processed stuff, exercise, sleep, relaxation, stress reduction, all these things are the things you need to create a healthy soil and also getting your nutrient levels up, right? A lot of us are nutrient deficient in vitamin D, which has been linked to cancer incidence and fear deficient. So, your book covers all this stuff. It's just fantastic and could everybody get a copy? Jason, thank you so much for being on the Doctor's Pharmacy. It's been really a pleasure to have you. You'll love this podcast. please share with your friends and family on social media. I bet they want to hear it. And if you want to leave a comment, I'd love to hear from you and your thoughts about your journey with health and maybe cancer. And of course, subscribe wherever you get your podcasts. And we'll see you next time on the doctor's pharmacy.