Use These 7 FOOD FACTS To Heal Your BODY & MIND Today! | Mark Hyman

The leading cause of death worldwide can be traced to diet.

If you eat highly processed foods, you have, you know, 50 to 100% increased risk of clinical depression.

Patients with colon cancer, those who ate two handfuls of nuts a week actually had a 50% lower risk of death.

What are those things that are impairing the proper function of this defense system and one of those things we can use to actually activate health within it. Great.

So angiogenesis is a term that actually talks about how the body grows blood vessels. Blood vessels bring oxygen and nutrients to every cell in our body. That's what keeps us healthy. They say- But there's 60,000 miles of blood vessels. 60,000 miles of blood vessels. So if you pull out all the blood vessels in your body, line them up, and then you can actually form a line that would go around the earth twice. Unbelievable. So that's one of this enormous organ system, right? So you know it's going to be important. And, we know when you block blood vessels like in the heart, you wind up having big problems with cardiovascular disease, clogged blood vessels lead to heart attacks and strokes. And, if you don't have enough blood vessels, you can't heal your wounds. And, if you actually have too many blood vessels, you can bleed in your eye like in diabetes or macular degeneration, and you can grow cancer. So, this is a system that is required to keep every cell in organ healthy, it's a health defense system. And, if it's out of balance, you wind up either too many or too little blood vessels, you wind up having in trouble. So, what are the things that can damage angiogenesis? Well, it turns out high fat diets damage angiogenesis. Any fat or just-- you- know what? Actually, mostly saturated fats, but I think that it's really high fat, overall high fat diets can be damaging. And, hypercholesterolemia, for example. If you have a lot of cholesterol floating around your blood, like the damaging bad cholesterol, LDL, it actually impairs the function of these blood vessels. second cigarette smoke, tobacco, you know, whether your people shouldn't smoke, but even secondary smoke can actually damage your blood vessel response. And, you know, then you think about heart disease, you think about cancer, things that are your blood vessels out of whack, out of balance.

Although, you know, the fat thing is interesting because a lot of the studies around fat are people eating high amounts of refined oils, and, and it's hard to separate out are the people eating high fat having avocados and almonds and olive oil, or they're having trans fats and toxic fats and inflammatory refined oils.

So, the science actually says is not actually talking about what you actually eat. It's about what the net-net, the effect it's in the body. So, if you wind up actually going from, researchers have studied, for example, in the lab, animals that actually are naturally hypercholesterolemic. These are mice whose blood is milky because it's actually so filled with fat. that's a genetic thing for sure. Right. And those are the subjects that actually wind up having problems with angiogenesis. So I think that we're still trying to figure out what kind of dietary fats are good. We know that, for example, that the that the omega-3 fatty acids are actually good, the polyunsaturated fats are good for you. But I'm talking about after what the body actually processes it, what actually results in your body can be. So what are the things that actually can help restore healthy androgenesis. Well, think about androgenesis balance, like a lawn that's growing, right? Or a garden that's growing. You want to prune the garden, make sure things don't overgrow, pick out the weeds. And if you're mowing a lawn, you're kind of just getting everybody, all the lawn to be kind of in the same level of height.

Yeah.

So you don't wind up having the scraggly lawn. That's what the body does to keep androgenesis in balance. Not too much, not too little. And so the food we eat is actually like a lawn mower. It kind of prunes to keep a perfectly manicured blood vessel lawn in your body. Not too much, not too little. So the things that we do know that angiogenesis balancing foods are like green tea, which is really good soy. Actually, Genistein is a bioactive found in soy is really good. Tomatoes are really good for helping to keep angiogenesis in balance. Many fruits and vegetables also can do that. So the brassinins are really good. So many of the things we already know are good for us, we know actually also help our blood and now we know how. And now we know how.

Yeah. Now, what about stem cells and regeneration? This is a big topic that I think people are hearing about in the news. They, they're confused about it. There's controversy about it. There's laws about it that prevent adequate research. I mean, it's really quite a, a messy area, and yet it's also one of the most exciting areas of medicine that you've been involved in. And, and it's, I don't think something that most people are aware of. that you can activate your own stem cells, that there's things you do in your life that you can screw up your stem cells. And what are stem cells anyway? What do they do? And how do we understand how to stop hurting them and start helping them?

Yeah, well, stem cells are really simple. We're made of stem cells. So, when our moms and dads got together and created, you know, us in the womb, we started out as stem cells. They actually made every single one of us. And then the sperm. And then the sperm got together and they basically decided they would become a stem cell factory. And then pretty much we formed out of our own stem cells. And after we were born, a few of those stem cells stuck around, about 700,000 of them. They stick around and they're mostly in our bone marrow and they're in lining of our intestines and they hide out in our body and they help us regenerate. So, when you and I are growing up, right, in grade school, we learned from our teachers that starfish can regenerate, salamanders can regenerate, but people can't regenerate, right?

Can'T grow a new arm.

Yeah, well, it's true. You can't grow a new arm, but we do regenerate. We regenerate every day. We know that we regenerate because our hair falls out and grows back. Our gut lining grows back. Our livers can grow back. If you actually remove part of your liver, it'll grow back. Yeah, our skin grows back, you know? So we. Our bodies possess the ability to regenerate through stem cells. Now, what can injure stem cells? You know, high doses of alcohol can.

Damage and blunt your stem cells.

So I'm okay with the one tequila I had last night, you know? Having a tequila every now and then is not bad, having glass wine. But, you know, the thing is on balance, what you want to do is people who drink a lot have damaged stem cells. Diabetes is another state, a metabolic state that, you know, it really impairs, it cripples our stem cells.

Sugar.

High blood sugar, cripples our stem cells. So, the excess of anything can be harmful, including to our stem cells. So, what are the things that we can do to help boost our stem cells. This is where it's really become interesting. Before I talk about that, though, let me just affect your stem cells. Stress can definitely affect our stems. High stress will blunt the activity of our stem cells. You know, it's just like stunning them. So they're like, wait a minute, what do I do now? You know, maybe I'm not going to be so enthusiastic in rebuilding our organs. We got to rebuild our blood vessels. We got to rebuild our hearts. You know, our hearts turn around. Like, we actually have stem cells in our hearts and our brains and re-grow our nerves. Every single day, something in our body is regenerating. Actually, a lot of things are regenerating. So, what people are hearing in the news are really efforts by the biotech industry to develop stem cell therapies that you inject into the body. So, taking stem cells like drugs and injecting them. And, someday, that's going to wind up becoming game changing in medicine someday. We're not there yet. I've been involved with some of those efforts and what I've seen is very exciting. But, more exciting to me is the ability for every single person listening to this podcast to be able to actually enhance their own stem cells. And, here's the research. You can actually take-- It's a lot cheaper. And, it's a lot cheaper. And, more enjoyable.

Getting a stem cell injection is like 20 grand or something, right?

Well, you know, I would say, why go out and have to subject yourself to that when you can do it at the dinner table?

Yeah.

Right.

So, the Mediterranean diet, it's been studied by Spain, looked at elderly people on the Mediterranean diet, and those who were on a Mediterranean diet compared to not on a Mediterranean diet had five times the number of stem cells in their circulation, in their bloodstream. So, again, it's not one magic food. it's the pattern of food that you're actually eating. Now, when you, you can actually do the research on specific things as well. So, for example, tea, green tea will increase your stem cells. But guess what? So can black tea.

Right.

So here's what this is.

Japanese live forever.

Well, you know, all the green tea, you know, people in Asia drink a lot of tea. People in Britain drink a lot of tea as well. We used to say green tea is good, black tea is fermented, so it's not going to be that good for you. we're changing our minds. We have to keep our minds open. Black tea can also double the number of stem cells. And then here's another kind of surprise and delight is that there was a study by UCSF in San Francisco where researchers took people with known cardiovascular disease, so they had kind of crappy blood flow, and they gave them hot chocolate.

Yeah, I was gonna say the chocolate stem cell story.

I wanna hear about that. It's amazing, right? So the darker the chocolate, the higher the flavonols. These are the bioactives that are naturally present in cacao.

And, there was a study done. This is the food as medicine. There are literally these chemicals in food called phytochemicals or phytonutrients that actually have these medicinal properties.

They are made by Mother Nature. They're packed in the food, growing on the plant, and every plant-based food will actually have some type of bioactive. So, in cacao, which is a bean, which then you process to actually get kind of the cocoa powder. If you take the really dark chocolate, like 73% cacao, the really dark chocolate, and you make it into a high flavanol hot chocolate drink, and you have it twice a day, this was the clinical study they found in people who wound up actually having drinking the hot chocolate twice a day over the course of a month, they doubled the number of stem cells compared to the people who didn't drink hot chocolate, right? and so, okay, so the question is, is that important? When they measured their blood flow, what they did is they put a blood pressure cuff on them and which, you know, kind of like lowers the circulation of the blood, they let it go. They found that the blood flow was much vastly improved.

Wow.

So here's a functional result that actually means it makes a difference. So who's going to complain about chocolate? Who's going to complain about tea? Who's going to complain about a Mediterranean diet? I mean, you go out to eat. these are the things we love.

Yeah. Well, it's interesting you talk about how drugs sort of block, interfere, inhibit some medical process, some biological process. And there's toxicity to them, there's side effects to them. You can take too much, which will harm you. Whereas foods don't work like that. But you also talk about the dose and the quantity of food. So, food is medicine. What's the dose? Is it one cranberry is it a thousand cranberries? Right.

Well, so my book Eat to Beat Disease, I specifically have a chapter on food doses. It's important to me.

Which nobody talks about.

Well, I know that because when I read about walnuts or blueberries or strawberries or kale, I'm always asking, well, how much should I actually eat? And, that always struck me as something that needed an answer. So, here's how we've approached it. you can actually get food doses. That's the dose of a food that has been found to correlate with something beneficial in terms of our health. The best way to get at that is to look at these big public health studies, these epidemiological studies. There's a couple of them that are ongoing at all times, right? So in Europe, there's something called the EPIC study. EPIC study. And Haines is in the United States. Bottom line is that these are studying tens of thousands, hundreds of thousands of patients. In Europe, they're studying 500,000 patients over 20 years, and they're tracking everything they eat. and they're asking them how much are you eating? And then on the tail end, looking at what happens to their health, what's their cancer rate, what's their heart disease rate, what's their diabetes rate. And when you actually combine those two, the result that we want, lower cancer, less heart disease, and you go back into the research and you figure out what foods they ate, you can actually calculate how much they ate of it.

Yeah.

Right? So, and then you can do smaller clinical studies to also get this. By the way, this is the same kind of mindset that we use to look at drug dosing as well. It's, you know, just having random amounts of stuff not gonna work. You gotta correlate what works with what actually the amount is. So smaller studies, there was a study called the Health Professionals Follow-Up Study done at Harvard, which looked at 70,000 men, and they found that men who had two to three cups of cooked tomato sauce per week that's a half a cup of cooked tomatoes, not that much. You have pasta, lowered their risk of prostate cancer by 39%. So, that's a dose, that's an outcome, and that's a particular food. And, you can do that systematically. You've got to hunt and peck for it, but it's there. And, it doesn't give you the exact answer. It's not like actually, frankly, even penicillin. You don't always get the right result, but you have a good approximation. So, that's the beginning of food doses.

I mean, your book is pretty remarkable because there's a lot of books about the diet and eating healthy and reversing disease. But you go so deep into the specifics and the detail and surprising things that I didn't even know about like fish roe or razor clams or, you know, different kinds of Chinese vegetables or weird foods that actually have these properties that, you know, maybe haven't been studied in large randomized control trials, but have clinical studies, have epidemiologic studies, and, and we can start to include and there's very little downside, right? Unless you don't like clamps.

Well, look, what seems foreign to one person might be very familiar to another. And my approach is really a global approach. My work spans around the world. We're in Asia, Europe, Asia, America, and Americas. And here's what we realize is that there are healthy practices and healthy foods, and no matter where you go, Right? So, what interests me is what are the common denominators? So, for example, you mentioned razor clams. Well, that's actually a category of seafood. We know from most epidemiological studies, including studies in Europe and Asia, that people who eat more seafood, about three times a week, actually have lower all-cause mortality and they just survive longer. So, then you sort of say, well, what could be possibly responsible for that? We do know that there's marine omega-3 fatty acids that are found in things like clams and the things that we like to eat.

What is the omega-3s in razor clams or something else?

There's probably other things as well. I can tell you another example that I was really surprised and delighted to find is that oysters actually not only have some omega-3 fatty acids, but there are polysaccharides and there's even proteins and oysters that boost your immune system. Yeah.

So again, so it's like the mushrooms of the sea, 'cause polysaccharides are what are in mushrooms, anti-cancer compounds. And now they're in oysters?

Wow, I didn't know. And, you know, by the way, these are long sugar chains. That's right. And, and your body digests them. They've actually done studies looking at oyster sauce. So, you know, the kind of sauce, the brown sauce you see in a Chinese restaurant, right? Chinese food, that they study that. in research to show that oyster sauce can enhance your immune system.

Does that actually come from oysters?

It comes from oysters. Yeah, they boil them down and they caramelize them. So again, this is where food is medicine isn't just about the clinical white coat side of things, really. You incorporate the culinary side, the chefs get into it. I mean, this is really, I think, us as a society coming together and saying, what do we love? And by the way, in my book, Eat to Beat Disease, it's really not about what to cut out of your life, it's about what to add to your life. And what do we really enjoy? It's all about our preferences and making the right decisions.

So, this is incredible. So, stem cells are not some weird thing. You have to go spend tens of thousands of dollars and suck out your bone marrow and suck out your fat, maybe get it from some placenta somewhere. You can actually activate your body's own regenerative healing power. And you can do this at any age by taking away some of these injurious things and adding in the things that help activate them. That's so powerful and it's a very encouraging message. Now, let's talk about the microbiome. Now, this is a whole another world that most doctors really are not schooled in. That certainly wasn't part of my medical education. That is something that I've been focused on for almost 30 years in functional medicine because we know the gut is where the seat of your health is. It's what ancient traditions like Ayurveda, Chinese medicine, they all recognize this. We just were like, oh, well it's just poop. just this brown stuff that comes out as waste, who cares, like whatever. And now we're seeing it linked to so many different conditions from autism to depression to cancer to heart disease to obesity to Parkinson's. I mean, the list goes on and on and we probably haven't even finished the list yet. And yet we know very little about it. So could you tell us a little bit about the microbiome and why it's so important and what we can do to protect it, to feed it, to help it, and also what are those things that we're doing that screw it up? Right.

So, the microbiome is an entire new discipline that's going to change humanity. I think that we've always thought of humankind as just humans, but in fact, we're 50-50 with bacteria is really kind of like a moral calculation.

I think it's 90-10.

Well, they've actually done some new calculations on us, right? so it's about 40 trillion cells, about the same number of bacteria as the latest calculation on this is sort of the up to date numbers. And it makes a lot of sense, right? So basically when we evolved as humans, we were hunters and gatherers picking stuff up, you know, nuts and fruits and seeds and picking stuff off of trees that had bacteria in it. There's more bacteria in the planet than living than animals. And when we ate those, the bacteria naturally colonized the body. And by the way, The gut, of course, but not just the gut. Our skin, our mouth, our nose, every orifice has got bacteria and our tears have bacteria. Breast milk has bacteria. Even in the womb, which when you and I were medical school, they said, oh, the womb is sterile. Wrong. In fact, babies get bacteria from the.

Moms in the womb.

Amazing. Okay, so we're beginning to rewrite the playbook of understanding how bacteria get in our body. The next thing about bacteria, I'll tell you about, in terms of the microbiome is in the Middle Ages, bacteria was responsible for the plague. And so we sort of developed this fear and repulsion to bacteria. Fast forward to the 1940s, the discovery of antibiotics that really was a medical revolution. And then everybody went willy-nilly with antibiotics, which can be life saving. Let's be clear about that. But the overuse of antibiotics, not just in humans, not just in children, but.

Also in our animals, Yeah, which is where most of the antibiotics are. We have 24 million pounds of antibiotics that are used every year. 19 million are used in animals for helping them grow and preventing infections.

And getting into our drinking water. So we've sort of invisibly impaired our environment so that we're exposed to antibiotics. That changes the ecology, the coral reef, that delicate ecosystem between bacteria and human cells in our body. so that's one thing is antibiotics. The other thing that actually can really injure our microbiome really is our lifestyle, you know, physical activity.

Yeah.

We know that if you're not active, your microbiome kind of suffers. We exercise on the outside. The bacteria get the benefit, too. They get that workout.

Right.

Stress can change our microbiome. I mean, how many times have, you know, you've, I'm sure you and I have done the same thing. We stayed up all night. We've had to pull some all-nighters. next day you feel like crap. Your gut doesn't feel so good. That's because of microbiomes having a riot. They pulled the all-nighter, too. So, what we're realizing- Dr.

Diet, obviously.

And, our diet plays a huge role.

Putting in pounds of stuff every day in that, too. Yeah.

Well, you know, there's something really interesting. So, when I look at the ingredients of any food that I actually get, and I try to do fresh food, whole foods. But every now and then, you know, you have to take it something and you look at all the ingredients. The stuff you don't recognize, you can't pronounce. Those are the things that we should worry about, actually, that could influence our bacteria.

Yeah. Right.

You pick a mushroom and you eat it, you know that the fiber in that mushroom is going to feed us and the bacteria. Right. The pulp's going to feed us and the fiber is going to feed the bacteria. Right. What we need to worry about is.

Like, what it is that we're.

Putting in that can actually harm our gut.

I mean, there are 3000 food additives in the market that are FDA approved and we don't know what most of them do. Very few have been tested. And it turns out that the unintended consequences is that many of them adversely affect our microbiome.

Well, and you know, the, what they, we all know people that are super healthy, right? So they never get sick. And then we know people that seem to get sick all the time. The difference is probably in their microbiome. In fact, it was an interesting research study that looked at super healthy super agers. You know, these are the people that got to their 70s and 80s and 90s almost without any disease at all. And then they looked at young healthy athletes and they found when they compared their microbiome, they were remarkably similar. They were almost identical. Amazing. So health is clearly governed by our microbiome. So what are the things that we can actually eat that can affect them? Well, we talked about this a little bit earlier. It turns out that pomegranates actually can make a big difference. Cranberries can make a big difference. Nuts, walnuts, pecans, cashews, things that we actually know. Almonds? Almonds, yeah.

And so, I had almonds for breakfast.

I want to make sure I got it. Well, we should all probably, I mean, unless you have a nut allergy, I think nuts are one of nature's most healthful snacks. I don't know if you saw this, but about two years ago, the American Society for Clinical Oncology, the big cancer meeting, they presented this result to say in patients with colon cancer, stage three colon cancer, undergoing treatment, whatever the treatment might be, that those who ate two handfuls of nuts a week actually at a 50% lower risk of death from their disease.

Now, you have to put that in context because when you see a drug that has a 20% reduction, everybody's jumping up and down. It's a billion dollar blockbuster drug. And you're talking about a couple handfuls of walnuts for a few cents. instead of these drugs that can cost $100,000 is actually better?

Well, it's not an either or, it's together. And again, this is where food as medicine really needs to enter the toolbox of doctors. Not just you and me, but we really need to spread the word among the medical education community because if you were taking care of a patient with colon cancer and getting treatment, if you look at that data, it's the same kind of data that's presented at a big meeting where they talk about all the drugs and immunotherapies, I would actually strongly advise patients to have nuts if they can take it. And what do they serve in the hospitals? Again, we're in the middle of a revolution. It's slow but inevitable that we begin viewing food as medicine.

Why don't you tell us how did you come to this idea that we should should be treating psychiatric issues with nutrition and through metabolic approaches?

Yeah, that's a great question. So, early on, I went into, I knew I wanted to do medicine. And when I went into medicine, I saw that there were a lot of conditions that weren't necessarily addressed with nutrition, and there was a lack of training in the medical education system. with obesity as well as nutrition. And with psychiatric conditions, I saw a lot of overlap with nutritional deficiencies and insulin resistance and even higher rates in that population versus the general population. And we know in the general population, it's even, it's pretty, pretty bad already in our country. So the relationship between mental health and metabolic disease is, is bidirectional. which means if you have a mental illness, you're more likely to have metabolic disease and vice versa. And if you have a metabolic disease, you're more likely to develop a mental illness. You're more likely to have a heart attack, for example, if you have depression, and you're more likely to develop depression after you have a heart attack. So these observations that I made really put questions in my mind as to there must be something more to what we're doing that needs further investigation. And I believe that there are metabolic issues that are not necessarily addressed within the field that I think needs to start occurring. I mean, we need to start including that in the way that we diagnose and treat and evaluate disease.

Yeah, I was saying you were talking earlier about this idea of comorbidities, which is a term we use in medicine to describe diseases that occur in the same patients. So if you have high blood pressure, diabetes, depression, reflux, we call these comorbidities. But we were talking earlier about how they may not really be unrelated, that in fact they may be very connected. And sounds like from your observations you made the conclusion that maybe it wasn't a coincidence that the fact that people who were overweight or unhealthy also had mental health issues, maybe there was a relationship, nutritional deficiencies, metabolic issues. You talk a lot about insulin resistance. So how did you come to sort of understand that that was really going on, that the biology of that was something that was real?

So I originally started off with an interest in learning about nutrition and metabolic issues. and obesity, and I wanted to treat obesity. And then I saw that in a lot of the patients, there were psychiatric conditions in those patients. So I started to Veer into the realm of psychiatry and got very interested in that. So what happened was that when I was treating metabolic dysfunction, not necessarily obesity, but metabolic dysfunction, which is problems with blood sugar or insulin resistance, or high blood cholesterol, I saw improvements in quality of life, in mood, in anxiety symptoms, in psychiatric symptoms essentially. And that really got me interested in what is this relationship? Why is this occurring? And it got me interested in treating these patients in a slightly different way than standard of care, really integrating the understanding of what metabolic dysfunction is. And I then started a clinic and I started to do research and that's how my path started. And I started early on developing this clinic in residency training.

Which is incredible because when you look at the the level of mental illness in society. It's one of the biggest causes of disability and one of the biggest costs is depression and anxiety. And I remember when I was seeing patients early on treating them for insulin resistance and pre-diabetes and other issues or gut issues or other factors that were going on related to autoimmune disease or inflammation and we would get them healthy, they would sort of say, wait, you know, my depression went away, my anxiety went away, my panic attacks are gone. my bipolar disease is better, my ADD is better. And I'm like, well, how did that happen? And then you begin to go down the rabbit hole and you begin to look at the biology of what's happening. And one of the, I think, the greatest discoveries around mental health is that it's an inflammatory problem very often, that the brain is inflamed, but the brain can't say, ouch, like you have a sore throat or, you know, a swollen ankle. It manifests as all these psychiatric symptoms. So I'm going to take us down the road of how inflammation is connected to mental illness and what the approaches that you're using to help correct that?

Sure. So that's, you know, quite an important question. And, you know, when we talk about how nutrition affects the brain and specifically focusing on reducing that sugar and processed foods and refined carbohydrates to improve mental and physical health, We know that consuming excessive amounts of sugar, processed foods, and refined carbohydrates lead to obesity, metabolic problems, fatty liver, heart disease, even cancer. There is evidence for this, and the body is really one whole system. And what happens in the body also affects the brain. The brain has a delicate balance of neurotransmitters. or chemical messengers with more sugar and processed foods, these levels really become unbalanced and they're significantly off. So I'm talking about- so wait, so.

Your brain chemistry gets screwed up when you eat processed food and sugar, is what you're saying?

Yeah, yeah. And I'm talking about ultra processed food also in particular, because I do think that there's a difference between processed food and ultra processed food. Ultra processed food is like the real sugar, the cookies, the cakes, the chips, the potato chips, these highly processed things versus minimally processed foods, maybe some oils, vegetables that are frozen, that's a little bit different than ultra-processed food. And so the research is showing differences between those things in the brain. And you need the right raw ingredients for chemical reactions to occur in the brain. and elsewhere, like vitamins and minerals and nutrients, you need proper functioning of the brain, you need proper speed of transmitting signals. Your brain is composed of electrical cells, and it's a complicated web of signaling molecules. Those cells need fat to develop and to function properly, so you need those omega-3s in your diet. And if you eat sugar and ultra-processed foods, the chances are that your likely not getting those important nutrients, those vitamins and minerals, for those important reactions that you need, nor are you absorbing them. The most people with metabolic dysfunction actually have nutritional deficiencies and are malnourished.

So you're saying is people who are overweight and obese often are very malnourished and vitamin and nutrient deficient?

Yes, that's right.

That's sort of a paradox, right?

Right, right.

I think they're eating all this food, why are they nutritionally deficient?

But they're actually among the most malnourished.

They are. They're looking in all the wrong places for the nutrients. They're eating more and more food. I think a study from Kevin Hall and others showed that if you let people eat as much as they want and you give them ultra processed food versus whole foods, they'll eat about 500 calories more a day of ultra processed food because they'll keep eating and they're hungry and they keep driving. And you talk a lot about that in your work about the the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you literally become addicted to these compounds and how that affects you.

Right.

So the rates of obesity and binge eating and addictive like eating are rising alongside the increasing dominance of ultra processed foods in the modern food environment. And there are several mechanisms as to how this works. Some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated and the brain is connected to the body. And we used to learn in medical school that you have this blood-brain barrier that nothing can get across it. But that's not, it's like the Berlin Wall. But in reality, it does leak.

Right.

And there are things that do cross.

And-- It's more like a coffee filter, you know, it's a sip. Right. Yeah.

So ultra processed food and sugar decrease our dopamine receptors and make us eat more compulsively, much like addictive drugs. The highly processed foods, they trigger dopamine reward pathways and they invoke addictive-like behaviors. which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra-processed food, continuing to eat these things despite knowing the adverse consequences to it, and repeated attempts to try to quit, right? I'm describing addiction here basically, and the consumption of larger quantities over time than intended.

You know, people go, it's like emotional eating, it's not really biological true addiction. but what you're saying is this is really a true biological addiction, just like heroin or cocaine or alcohol, that you get withdrawal, you get cravings, you get increased need for more and more of the substance to receive the same pleasure. You downregulate the receptors for pleasure, so you have to take more of the stuff to actually stimulate that reward pathway. And it's really this vicious cycle that people get into, and then they blame themselves and they feel guilty for doing it, and they think they just have no willpower, but you're saying it's much bigger than that.

Yeah, that's exactly right. It's so sugar is an addictive substance. It's not just something we say. It has a straightforward neurochemical basis in the brain just like any other drug. And I think of sugar as a, it's a recreational food. It's not a food that's essential for survival. We make sugar, you know, through the process of gluconeogenesis through other foods. that we consume. And so it's really about excess carbohydrates.

It's not- I call it sugar a recreational drug. I've never heard anybody say it, but I always write down in my book, sugar is a recreational drug. It's like if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America.

Exactly.

Yeah.

And we also, actually I would like to share a story about this. just during the era of COVID since we're in it.

Yeah.

You know, just to give context as to why I wrote about this and why I'm working on this as well and continuing to feel motivated to continue to do my work is the shelter-in-place order had come a couple months back for my county and I'm in California. I live in Menlo Park. When it was announced, my husband, he's an infectious disease physician at Stanford and I'm a psychiatrist and an Eastside Medicine physician, as you mentioned. We both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store and we saw many people loading up their carts with Pop-Tarts, Hawaiian Punch, popcorn, anything ultra processed basically. And they weren't loading up their carts with fresh vegetables or, you know, they were out of cookies at the grocery store.

Yeah.

They were using toilet paper.

And toilet paper, exactly. And there were still produce left in the store. It wasn't like they ran out of produce.

So here I was... It wasn't a run on broccoli.

No.

Here I was at the checkout counter and I was thinking to myself staring at the person's cart in front of me that is full of the recreational food, as I mentioned, food that's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic or helping their immune system and if anything, weakening it. And this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access. That is what motivated me to kind of get that public message out on this topic.

Yeah, you did write a great article on the Hill and I read it. And you really talked about the way in which the pandemic we're facing is much more serious because of the underlying chronic disease pandemic we have in our society where it's driven by this ultra processed food that makes us overweight and sick and causes all these underlying chronic inflammatory issues like diabetes and heart disease and high blood pressure, which are really the same mechanisms. If you look at the mechanisms of high blood pressure, heart disease and diabetes, it's insulin resistance, it's oxidative stress, it's inflammation, and it's the same thing that's affecting our psychiatric illnesses, which is so fascinating. And most people don't think about using the doorway of food to help treat the brain. And you're doing that in your research and in your practice. So tell us some of the kinds of things you're seeing in your patients using this approach, because it's pretty radical. You're going all the way sometimes to ketogenic diets with these patients with bipolar disease, schizophrenia, depression. It's fascinating.

Yes. What I have noticed is that a lot of my patients that come for psychiatric treatment and evaluation, a lot of them have pre-diabetes and diabetes. And when I look up the statistics on this in our country, 44% of adults today in our country are either pre-diabetic or they have diabetes. and I wonder to myself, what is that doing to our brain? We know that affects all these different organ systems, the liver, the pancreas, the heart, but what is that doing to the brain? And so I'm happy to talk more about my research and patient care, but one thing that I felt I didn't completely answer before was how these hormones affect the brain with the addictive piece.

How does it drive inflammation and all that? Yeah. Yeah.

So kind of going back to that, you know, so I was talking about the definition of addiction. And we know that hormones like insulin and leptin which is the hormone that tells us we're full, it sends a signal to our brain, and ghrelin that tells us that we're hungry. These hormones modify natural and drug reward pathways in the brain. I mean, they have so many effects on the brain. Our hunger hormones go awry and it can actually increase the reactivity itself of the dopamine system. And so this happens when we consume that excess sugar and the excess carbohydrates in our diet. And they cause these rapid shifts in blood glucose and insulin levels similar to other addictive substances. So my approach in patient care has been to work on this system to decrease these shifts that occur in our blood sugar and our hormone levels. to kind of go back to the homeostatic state that our body and our brains were meant to be in. And so I treat the metabolic dysfunction and I look at how that improves both metabolic issues as well as psychiatric outcomes.

Yeah, so it's fascinating. So you basically you're treating the body to fix the brain, right? You're dealing with these physiologic changes that have to do with our diet and nutritional psychiatry that most psychiatrists aren't thinking about. I mean, most psychiatrists are thinking about, you know, psycho-emotional issues or thinking about medication and prescribing antidepressants, but they don't really work as well. And I, you know, I just found that the amount of benefit you get by addressing these underlying factors is so much greater than you get with medication, which are marginally effective for most people. I think, you know, unless you have really severe depression, but I think the data is just not that exciting about these drugs, right? I mean, they can be helpful for people and they can be life saving, but there are also other doorways that you're exploring which are seeming to be way more fruitful. Is that your experience?

So, you know, the field has come a long way. There's a lot of research that's been done on the biological piece and neuroscience and looking at, you know, obviously the serotonin hypothesis, but that's the hypothesis and an observation from like 30 years ago. and all these research and money has been thrown on developing drugs, but we're not necessarily addressing some of the root causes of why are these chemicals imbalanced. And so that's an important question that I and others are trying to study through research studies and clinical trials. And like you said, we know that although our medications are necessary and life-saving for many, they have undesirable side effects that can worsen metabolic health. And while it's helping in one domain, it may in some people also be hindering improvement in psychiatric symptoms, especially if the metabolic health is poor. So psychiatric treatment is never going to be a one-size-fits-all approach. Mental health conditions are varied. They're heterogeneous and they have different phenotypes or presentations. We don't have a single mutation or a gene that we can point to or a lesion. There's no smoking gun. It's a complex relationship of multiple genes and environment. And unfortunately, a metabolic assessment is not part of that routine care. And stigma certainly plays a role in this. Obesity stigmatized and so is mental health. Education about nutrition and metabolism is lacking in medical education. most psychiatrists recognize this relationship.

They do. They understand the connection between food and mood.

They're starting to. They understand that there are side effects with psychotropic medications. I think they don't necessarily have the expertise to treat it or address it. They don't know necessarily what to do about it. But most psychiatrists that I speak with, and my department certainly has been very supportive of this idea. And if someone has to do the research and someone has to do the work to kind of move the field forward. There is a growing body of other researchers working on this and we hope that evidence-based research has to be done to kind of change the mainstream's generative care.

Yeah, I mean, you were talking about metabolic psychiatry. I was also noticing that Harvard had a whole department of nutritional psychiatry, which is, you know, seems like bookends on the country. I don't know. The rest of the psychiatric world is thinking about this. But, you know, you, you mentioned earlier that you, you work with Bruce Ames, who's an incredible biochemist and nutritional scientist from California, one of the most published sort of scientists in the world. And, and I spent a lot of time with him, and he talks about this whole idea of a metabolic tuneup. and that so many of our biochemical reactions are regulated by vitamins and minerals, and that each of us have different needs for different components of those vitamins and minerals. I remember one guy, I was sitting in my office one day working on something. I was thinking I might have been working on that book, and I was talking to somebody about folate and B12 and B6. He said, oh yeah, I had really bad depression, and I took some of these B vitamins, and it just went away. and I think there are some people who have a higher need for, for example, folate or B6 or B12 based on these genetic variations that Bruce Ames talks about that really are so prevalent. In fact, one-third of our entire genome codes for enzymes and those enzymes all need helpers, which are vitamins and minerals, and we don't really pay much attention to that. So when I look at depression or psychiatric illness, I see so many different things that are going on there, whether it's insulin resistance and prediabetes or vitamin D deficiency or folate insufficiency or zinc or magnesium. All these various nutrients play a role in brain function and they're not something we really learn about when we learn about psychiatry, right?

Is that changing? I think that is changing. There's a complex relationship between metabolic dysfunction and nutrition, food, mental health. And, you know, I want to start off by saying that the idea of food as medicine is not a new concept in the field of nutritional psychiatry has really grown over the past few decades by several prominent psychiatrists and researchers. However, the focus has largely been looking at specific foods or supplements, eliminating certain things from the diet, the microbiome. You know, we're looking at the Mediterranean diet, for example, affecting depression symptoms. And these are all very important questions, but what I thought was missing and why I named our clinic and our group work metabolic psychiatry is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms. If a majority of us are suffering from obesity, type 2 diabetes, insulin resistance, metabolic syndrome, what is that doing to our brain? We know that these diseases affect multiple things, mental illness rates have increased over the past 20 years, in fact doubled. We know that mental illness like depression, bipolar disorder, psychosis, they're strongly associated with inflammation. That research is really indisputable. And research is also showing that there's an energy deficit in these brain illnesses and the mitochondria, the energy powerhouses of our cells, are not functioning optimally, causing changes in brain signaling itself. and the thought is if we can target inflammation, insulin resistance, the abnormal blood sugar, et cetera, as a method to improve mental health symptoms, then we can really improve our patients' lives further. And again, mental illness has many different causes, but even if we, you know, can 5 to 10% of people have an improvement in these symptoms with this method, then I think that would have that would be a pretty significant improvement of the overall mental and physical health of our country.

I think it's a lot more than 5 to 10%. I mean, when you think about that, the most amazing thing you just said to me is such a paradigm shift, which is that depression is inflammation in the brain. And that when you look at autopsy studies and when you look at the biology of this disease, the brain's on fire and it's also on fire in autism. in Alzheimer's, in schizophrenia, and a lot of these disorders that are, we think of as mental disorders, but are actually brain disorders that are manifestations of inflammation that show up differently in different people. And the question is, you know, what's driving that inflammation? And I think diet clearly is probably the biggest factor, which makes it an incredible thing to use to actually alter the course of these diseases because it's an easy tool to change and actually get a result. And that's what you're talking about, is your therapeutic use of, you know, metabolic medicine to actually fix psychiatric problems, which is pretty amazing. Let's talk about the gut in connection to some of these diseases. We treat something a lot that's called SIBO. Now, when I went to medical school, this wasn't even a thing. But essentially it means small intestinal bacterial overgrowth, which means bad bugs growing in the small intestine where there should be sterile that have an impact on our health. So what are the symptoms? How would people know they have it? And what kinds of problems are they connected to? And let's kind of get deep into what our approach to diagnosing and treating it's going to be. Sure.

So, you know, I just want to be a little cautious here because we're jumping right into talking about a disease. Yeah, right. Well, it's not a disease. It's a phenomenon.

It's a phenomenon that actually causes all sorts of other problems.

We do have to give things labels, but it is a phenomena that's connected to many different parts of our body and getting somebody better involves the whole lifestyle spectrum and it involves us using something in the functional medicine realm that we call the matrix. And the matrix is looking at not diagnoses, but conditions.

Yeah, let's talk about the matrix.

Yeah.

Tell us more about the matrix. What is the matrix?

Yeah.

How does it differ from traditional diagnosis?

And so, why do you use it? For me to tell you about the matrix, you have to swallow the red pill. Which one do you want to swallow? I think I'll take the red pill. Okay, take the red pill. That's the right pill. Okay. So anyhow, now I can tell you about the matrix. So the matrix is basically a construct that we have in our minds where when you start telling me, I have headaches, I have fatigue, I have belching, I have bloating. I have a diagnosis of Hashimoto's thyroiditis.

Migraines.

Migraines. They don't become the endpoint. They become part of the narrative of your disease. And we put together into a story we call the Matrix. And so we look at assimilation, which is the gut. We look at energy that takes us from, you know, an idea of fatigue, we rattle it down on our brain to, what are the things in the body that control energy?

Right?

And so we think about mitochondria. When we think about energy, we think about toxins. How do toxins influence the rest of your well-being? We think about our transport system, our blood vessels, our lymph drainage, and the connection between lymph drainage in the brain and your gut, leaky gut, leaky brain, things that we'll talk about. And we think about the hormonal system. neurotransmitters to adrenals to thyroids. And we place this all in our mind in this matrix, this paradigm of thinking, and then we make the connections. We say, okay, what's SIBO? Okay, well, it's going to be symptoms, bloating, distension. I feel like you've used the term food baby. There's something always in my gut. Yeah, when you have a food baby.

Something and you feel your belly bloat up, that's called SIBO. Right, that is SIBO.

Placebo, you don't feel like you fully evacuate when you have a bowel movement, you're fatigued, you get depressed and you can actually feel your depression and it's related to how your gut feels. I had that food baby, I'm anxious.

I feel depressed, it impacts my mood.

And it can link to all sorts of other diseases, right? Fatigue and then when we think about fibromyalgia, we need to think about the gut and what's been impacted there and we think about Parkinson's, 50% of people with Parkinson's actually have SIBO.

Yeah. Now, asthma.

Right.

And we don't, we don't know. We know there's an observational connection there. We don't know anything about causality, but it's something you have to consider when you're thinking about other diseases. So the fatigue, the brain fog, the potential inflammation and joint pain, the, all of the gut issues, that's SIBO.

Yeah.

And a lot of SIBO, we don't know all the causes. There used to be some some standard ideas what the causes were, but now we know that it's hard to determine. So, the use of proton pump inhibitors.

And other- Acid blockers like Prilosec, Prevacid, all that stuff.

All that stuff. And then we have stress plays a major role. And so, that's some of the cause, that's what SIBO can look like. And now, how do we address it? How do we- I was just gonna back up for a second.

You mentioned these acid blockers because they're giving out like candy. You can buy them in the drugstore, they're over the counter now. and people think they're safe and fine. I remember when I went to medical school, they just came out and we were told by the drug reps, these are very strong drugs. They completely shut down acid in the stomach. You never want to give them more than six weeks. And now people are on them for six decades, you know? And, and what they do is pretty frightening. Literally, they will help your heartburn. But the side effects, which are not really side effects, they're effects. We just don't like them. So we call them side effects. Are bloating and diarrhea and distension, all the SIBO symptoms. And by the way, they cause osteoporosis and pneumonia and prevent B12 absorption and zinc absorption and mineral magnesium absorption. So, they're not exactly the same.

I just have to say this, Mark, and, you know, is that this is my, this is the concern we all have for medicine when we've been unplugged. And, this is the issue, is that we have pharmaceutical companies that provide medications to our patients, support sick lifestyle that perpetuates disease.

Yeah, I love those advertisements on TV where they're like, don't worry, eat your sausage and peppers and don't worry, just take this prebiotic or probiotic, take the purple pill. It's ridiculous.

It is. But on the functional medicine side, here's where the hard work is, changing the lifestyle to make it a healthy lifestyle so people can, you know, be healthy, prevent disease. If they do get sick, then we help them change lifestyle because that can impact disease more than anything else. And then for people who are well or have gotten better, we can use lifestyle to optimize their aging. And again, using a term, I've heard you use age young. And that's part of what we do here at the UltraWellness Center, the whole spectrum, prevent, treat, and then help people optimize and age young.

Yeah, my goal is to die young as late as possible.

So back to the SIBO thing, right? It's that, you know, so once we make that, now how do we make the diagnosis? So I always tell people tests are good, but there's no perfect tests. And, you know, your cognition, your doctor's ability to think through problems is the most important thing that they do.

That's what we do in functional medicine, right? We are thinking differently. My mentor, Sid Baker, who is one of the leading I think medical minds of the last century who's really pioneered a lot of the visionary concepts of functional medicine. He says, we're in the name it, blame it, and tame it game. We name and blame, we name the disease, then we blame the name for the problem, and then we tame with the drugs. So we say, oh, you're sad and hopeless and helpless. You have depression. That's what's wrong with you. No, it's just the name of what's wrong with you. It's not the cause. Then we go, I know what you need. You need an antidepressant. And that's like, it just doesn't make sense. instead of, oh, we're doing functional medicine.

It'S called thinking and linking.

We actually think and link. Everybody thinks you treat the same disease with the same treatment. And in functional medicine, you can have.

10 people with migraines or treat everyone differently.

Everybody's different. Absolutely. 10 people with lupus and everybody's treated differently because you're looking at what the root cause for them is. And I think that's really profound. And I want to get back to the SIBO thing, but I just want to come back to the matrix because that's such a key concept. And, you know, you described all these biological networks, you know, assimilation, which is the gut defense and repair the immune system, energy, how we make energy, detoxification, our transport system, our circulation, our communication systems, hormones and our transmitters, our structural system. And all those are influenced by our lifestyle, right? By our thoughts, our feelings, our relationships, our diet, our exercise, our sleep, all those things. Intrinsic relationship. Yeah. And then, and then they're also influenced by external factors like toxins, allergens, bad bugs, stress, poor diet. And those impact our genes to change the expression. And so we have basically our inputs that are a problem and then our lifestyle and that causes disturbances in these systems. And no matter what disease you have, we use this model and every single chronic disease and even acute, many acute disease are caused by disturbances in our biological functional system. Absolutely. And that is what functional medicine is so unique at diagnosing and treating in a totally new way.

Absolutely. And so it's that constant work around the matrix. And one of the things that I said earlier is functional medicine is hard medicine. It's hard for the doctor, it's hard for the patient.

Yeah, because you think you have to think.

Right. And you're constantly thinking and as you the environment of the patient changes. So you treat, you begin the treatment plan and the patient comes back with a particular response. And that response will be based on what is their lifestyle, what part of their lifestyle have they been able to change? Because it's a real struggle for people to change lifestyle. That's hard work. And then, you know, what are their genetics? You know, and how are their genetics? Because we, you know, use a lot of genetic testing testing here that help us identify that. And so once they come back and they've responded to our first step of treatment, then we go around the matrix again. Yeah. And we rebalance and we look, okay, okay.

It's like tailoring.

You adjust every time they come. It's like a fine watch and you're just constantly working the gears, asking questions, having them tell their story again, retell their story. I can't tell you how many times I have sat in an hour and a half initial visit, only to have the patient come back over Zoom or a physical visit to the office, and I ask them the same questions, and all of a sudden they're in a different place and I get a different answer that opens up a whole new realm of thinking about their disease, their health, and even their goals for their life. So every time I go around the Matrix, I get that person better and better and better.

So we don't treat 155,000 diseases. We work with optimizing our biological systems in the matrix. That is the key to functional medicine. So that in a way, it's very simple, but it's also very unique because each patient's different. And for the patient, some of the changes are hard because we're asking people to change their diet or take different supplements. But the truth is that it's actually, you know, ends so much suffering and helps them so much that people are so excited about it. Oh, they do it. And so It's actually, in many times, very easy for patients to change because they see the results so quickly. So let's talk about the SIBO. Let's get back to SIBO and talk about cases. I think we should share some cases. Give an example of what we're talking about.

Because it's sort of abstract. I would say that very rarely do I see SIBO by itself. And why is that? Because Mark, you've already talked about it's the microbiome. When the microbiome is disordered as it is in SIBO, and you have these bacteria growing or they shouldn't grow. And so you're now changing how food is processed, you're changing where it's processed, and you're changing the body's ability to absorb it. And what we know about the microbiome is those bacteria actually train our immune system. They're very closely related to our immune system, and they will, our immune system identifies antigenic materiaL from the bacteria and the bacteria is able to tell the immune system, here's what you need to be worried about, here's what you don't need to be worried about. And so when we alter that gut immunity, we can create inflammation and we create inflammation, we begin to break down that membrane that's responsible for opening and closing and letting good compounds and good nutrients in and keeping the bad guys out. when that breaks down, we have leaky gut. And now all of a sudden, our immune system starts to see proteins that have not been completely processed down to the peptide level that they're accustomed to, and they start making antibodies against commonly eaten foods. So now this person with SIBO is sensitive to a plethora of foods that they eat every day, which might not be allergic to those foods, but sensitive to them. So now they're not eating. So they're coming in with all these symptoms. It gets exacerbated by almost everything they eat in their diet. And it, because now the disease is-.

They're eating and they don't know what to do not eat because everything bothers them.

Right, right. And so, now they can come in that sick. Now that their immune system's triggered, they have muscle aches, they have joint pains, they have brain fog because now they're having- they have fatigue, their mitochondria being affected, their brains are inflamed, they're being affected. So now this person comes in and they may say to me, I have brain fog. I have this, I have that. I get the whole story and I hear the gut. Always start in the gut, right? So now what do we do? When they tell me there's symptoms, we order a test. It's called a small intestine bacterial overgrowth test. Before you're in the test, I just.

Want to recap because what you said was so profound.

Yeah.

Which is that.

I like being profound, thank you.

No, I mean, it's a total frame shift. So most doctors don't think much about the gut unless you have direct digestive symptoms. And even when you do, they treat it kind of in a very linear way. But what you're saying is when those bugs that should be in our lard intestine migrate up to the small intestine for various reasons, it causes an imbalance in there, and that leads to a breakdown. in the barrier which causes this leaky gut. And then all these foreign proteins and bacterial components leak into the system. Your immune system goes, ah, that's not me. And it starts creating a response. And then you get systemic inflammation, which is why you get brain fog and muscle aches and fatigue and joint pain, all these things. Skin rashes, acne, whatever. And, and, and people think these are.

All not connected, but they're all connected. That's why SIBO is such a great topic. to start with.

Yeah.

Because it connects the entire matrix.

So, tell us how we test for.

It and let's get into a case. Okay. So, testing will be with a breath test. It's called a SIBO breath test and we starve you for a day. Basically, we want to starve out those bacteria that are living in the small intestine so they become metabolically inactive.

And then, you wake up in the.

Morning and you take some lactulose, which is like a non-absorbed sugar. Non-absorbed sugar. But before you do that, you breathe into a little balloon and then we put that aside as you basically slime test, then you drink the sugar drink, and now the bacteria are like, we got some food, we're excited, we were starving out, thought we were doomed, and then they get very metabolically active. And then within 30 minutes or 60 minutes, when they're metabolically active, they start producing the exhaust of their metabolism, hydrogen and then sometimes methane and even sometimes sulfur gases.

So, it's not just the cows that are burping methane?

Nope.

Humans?

Nope. up.

Yeah.

Uncle. Uncle Art's been built.

So if you have SIBO, you're contributing to climate change.

Is that it?

Yeah.

That was gonna be when you, when we get to the magic wand question.

I'll talk about my wife. Anyhow.

So there's also other tests, like urine tests. You can look at metabolites, right? Yep. You can look at.

Yeah.

So, yeah, we can look at or metabolites that will show us markers for dysbiosis in the gut using an Organics test. So an Organics test is we look at all the organic acids that are products of your metabolism. And so we're able to tell, we know what should be in the metabolism appropriately and we can look at organic acids and we do that as a part of our GI workup.

Which is a test that traditional doctors don't do. They'll do the traditional breath test but.

They'Re not gonna do an organic acid test. Organic acid test is something even more advanced called an ion profile that looks at all of your amino acids. And that's important when I do a SIBO workup. because if I look at your amino acids and you're depleted, then I know you're really in trouble with your SIBO because you're not getting good nutrition. You're not absorbing. And then I can see markers of inflammation on the ion test. I can also see the organic acids are really critical because there are things that the bacteria produce that will end up in our urine that indicate to us that, wow, those things are in the urine because you have bacteria overgrowing or don't belong in your gut. And now we find out...

I think you're right. I'm going to jump in with a case that just reminded me of a little girl I saw years ago who was nine years old and she was a pretty little sweet looking girl who was a monster, like a terror. She would constantly get kicked out of class. She literally couldn't make it home on the bus without the bus driver having to stop 10 times to settle her down. She was violent, She would rip pictures of part of her family at home. She would terrorize her sister. And I'm like, what's going on with this girl? And we did a whole workup and we found her organic acid test and we found she had massive levels of overgrowth of bacteria and she had overgrowth of yeast, which is not called SIBO, but SIFO or small intestinal fungal overgrowth. and what I did was I gave her an antibiotic and an antifungal, and literally the girl completely transformed. So you think you're treating a psychiatric disorder. Absolutely. With antibiotics and antifungals. How does that make sense? Well, it makes sense when you understand the connection between the gut and the brain. I mean, this was over 10 years ago, and I remember writing about it in the Ultra Mind Solution. I was like, wow, you know, the gut is so connected. I had another one with OCD, the same thing. She had high levels. ammonia and she had severe OCD, she wouldn't put up anything off the floor. I gave her an anxiolytic and literally she became like a neat freak.

It was the weirdest thing. Oh, you know, so I would, so in those cases, in the cases I've seen, SIBO is very commonly related to neuropsychiatric disorders. So when I have people with memory loss, brain fog, ADHD, just as you've said, I've had multiple patients of mine, autism, right?

Autism.

The first thing we do is treat their SIBO, change their diet, and within the first six weeks, we're starting to see significant change in their behaviors with ADHD and in their verbal abilities with autism kids. So, I was going to talk about a fibromyalgia case, but I will talk about a ADHD. I had a actually an anxiety depression case.

Talk about both of them.

Yeah, I'll talk about them. There's so many cases I could choose from. There is a recent case from a patient from a different part of the world actually came in and they were having lots of difficulties with their child, very bright siblings, but this particular child is having lots of issues with impulsive behavior, attention in the classroom, moodiness, to the point where there was, the child would speak of not wanting to live anymore. And so I went through all their symptoms and the biggest thing that this child had a difficulty with was the bloating and the distension. That was constant. Mom noticed it from almost day one of life. So we did not only the SIBO breath test, but we did something called a GI map test, which we'll look at, it will using DNA and PCR technology, look at all of the bacteria in your gut, the major colonies, the major species, look for Candida, and then also look for markers of inflammation. Those two tests on this patient indicated severe disruption of the balance of the microbiome. The patient was put on a brief elemental diet, which is a diet that takes out most foods.

All the foreign proteins.

All the foreign proteins. and then was put on an autoimmune paleo diet. And very difficult to put a kid on a diet. Which basically starves a lot of the bad bacteria. Absolutely.

Instead of feeding them with all the starch and sugar and carbs, which they love, you're giving them less of that.

And we combined it with a low FODMAP diet to make sure that the child got all the nutrition they needed.

FODMAP is like what?

That's like. So, those are long chain sugars. that get fermented very quickly by bacteria. And when you eat them and you have small intestinal bacterial overgrowth, you get.

A very big food baby.

You start nine months pregnant.

Right.

And the food baby is this basically. You're fermenting food where you shouldn't be. Food's meant to be fermented in the large intestine and that's like Florida, right? But what's happening with small intestinal bacterial overgrowth, bacteria are up in Maine and the food's coming into Maine. Maine's not ready for gas. So now all of all of a sudden, you've got this gas where it doesn't belong geographically, you feel very uncomfortable, and it starts to impact everything we talked about. Your nutrition, your inflammation, and that translates to that gut-brain connection. The brain gets affected. That's why we see so much benefit when we treat diseases like SIBO and dysbiosis in our patients with neuropsychiatric disorders, from ADHD to OCD to anxiety and depression. and you've noticed it. I know we've talked about even like Parkinson's and other disease processes that will stabilize once we start addressing gut issues.

So what happened to this kid then?

So, we had the six-week follow-up and we had started, it was actually not the six-week follow-up but the six-week follow-up, we went over all the testing and we started the second part of nutrition plan. Once we started the nutrition plan, and I use some natural herbs to get rid of some of that overgrowth.

So sort of antibacterial herbs.

Antibacterial herbs that come in different compounds that we use. At the eight weeks later, that child's behavior, the mood swings were completely gone. Completely gone. The impulsivity was drastically reduced and the teachers are saying he was now paying attention in And that was just with food. No stimulants.

That's remarkable.

No stimulants.

It's just herbs like oregano and oregano, berberine and thyme and things like that.

Absolutely.

Yeah, powerful stuff.

Yeah, and so that's the SIBO story.

If someone's listening and they have depression, anxiety, mental health issues, what are the ways of eating that actually cause a problem? And then we'll get into what are the ways of eating that actually can fix the problem.

Yeah, that's such a great question. Let's start with the problem at the end of your fork before we tell you the solution and the problem that you're under your fork. A lot of people know those words that, you know, everybody knows I'm about to say sugar, everybody knows I'm about to say trans fats, everybody knows I'm about to say processed foods. And so, the surprise.

It causes everything. It causes cancer, diabetes, Alzheimer's. Yeah. and depression.

And I think what's really been striking to me as a psychiatrist interested in behavioral change and as an eater and as a parent, how do you change those from being Concepts to being behavioral and action oriented items in your own life? And so what's causing the problem very simply is, is not getting enough of the right nutrients. And I would argue for a lot of Americans missing a set of nutrients. Americans are Americans are not getting phytonutrients because they're not eating plants. Americans are not getting seafood because they eat 14 pounds per year, period. And it's fish sticks. It's not the seafood that we would want them to eat. This is not shrimp ceviche and wild salmon. And they also, there's I think a problem that isn't just around the food choice but is around, I would say, the missing spirituality of food and that people have, we've lost our soul about food. And when you tell people to eat well, there's a notion that, well, that costs too much or it takes too much time or I don't know how to do it. And I think those are our missing lies.

Yes.

And I think it's just, I mean, I have, my mama taught me how to cook and she's taught me that recipes start with olive oil or butter, garlic and onions.

Pretty much.

And then you add in what, you put in some vegetables in that and, and you're good, right? You put in meat in that. You're good. And so, pretty much how I cook.

Yeah.

I mean, I think it, and what I'm, I'm shocked by things like when we make our lentil soup at home, we make a lentils, carrot, celery, and that's it. We put it in a crock pot. And I love serving that dish for people like, wow, what's in here? Right? It's like, it's lentils.

Yeah.

Carrot, celery, a little pinch of sea salt. So anyway, those are what's on the end of the fork that's causing the problem is, first of all, people aren't eating with the fork, right? People aren't taking a deep breath and engaging their digestive system and people aren't in any way offering up gratitude or thanks for the most people. Some of you all are out there doing that. But, the number of times as we did when we were, we had that wonderful dinner with Well and Good and we sat there and I'm sitting there next to Gabby Bernstein and I'm thinking like, I've been out in the Midwest, like you don't eat until you say grace. And, I said, let's have a moment. And, everybody's ready to give thanks and bow their heads for a moment. She said, such a wonderful grace store food for us. So, those kind of things. It's not just that that garbage is on the, you know, it's not even in your fork, it's in the package that you're eating, or that it's on the go. It's that we've lost that notion of where it comes from and valuing that and honoring that. And we're doing a better job as, you know, honoring the farmers who grow it, you know, who are, you know, these silent heroes, you know, talking about a healthcare crisis. I mean, talk about physician suicide. I mean, the biggest threat to farmers right now is farmers suicide. I mean, we're just losing dozens of farmers a day. It's the number actually came out, there was like a little confusion, like what's the top risk group for suicide? Was it farmers or doctors? And I was like, you know, either way, it's just awful.

So is there data, science, proving that sugar and processed foods cause mental illness?

Well, let's talk about the data set that there is. The big data set and there's controversy about this data set is correlational data. And the controversy is that's really misguided us with a lot of nutritional policy per smart folks looking at that. I really like the writing of Gary Taubes and Peter Attia who look at the science behind correlational studies and have some serious questions. But if we're going to think about that data as being useful, that data is very clear. When you eat more processed foods, which means simple sugars, trans fats, and a lot of simple carbs in all those ways that it's not just sugar folks, like, you know, fructose syrup. And, I love corn syrup solids.

Right. Now they changed the name of high fructose corn syrup.

Right. It was like, it sounds like corn, kind of like corn syrup. Corn syrup. Maple syrup. And so, those are the things that certainly we want folks to avoid. And, what does the data say? If you eat highly processed foods, you have 50 to 100% increased risk of clinical depression. If you eat high glycemic index foods, there's a great study that came out, a colleague at Columbia, looking at high glycemic index foods. So those are foods that just spike your blood sugar more. Those have a significant increased risk, individuals have an increased risk of depression, the Women's Health Initiative. So big, big study of women ages 45 plus. And so there's that correlational data and it's just consistent when you look at the meta analyses of it, it's consistent. that the food that we've created in the last 100 years leads to an increased risk or increased risk in that population of depression, same data for ADHD, not as much data for anxiety disorders, which is interesting, but certainly feels true to me clinically. Then we move on to randomized controlled trials. And the reason this is of interest is on the molecular side, like in the mouse models, you know this, in the, I mean, you know, not having enough nutrients and putting lots and lots of fuel in any sort of mouse look like? What does a depressed mouse look like? It's very clear what depressed mice look like because you stick them in little cages and they don't try and you put them into swim. It's a forced swim test. And when mice are depressed, they don't fight to get out. They just stop swimming. They drown? We don't let them drown. But they would drown if you didn't fish them out. Whereas non-depressed mice, they're fighting to get out. that's what a depressed mouse looks like. So the randomized controlled trials that came out recently are exciting because we can say it makes common sense. We can say on a molecular level, it makes lots and lots of sense. We can say it makes sense in the correlational data, but you and I know, Mark, medicine's not going to change until we have randomized clinical trials. And that's where folks like Felice Jacka and Michael Berk and the Food and Mood Centre in Australia, they're really, I would say, the leaders in this, where they've completed a number of trials. Natalie Parletta is also not part of that group, but say part of the leaders in this. And now they're putting down numerous randomized trials and creating resources for patients with mental health concerns like depression to make sure food's part of the equation. And their data looks quite strong. And what I love about this is when the data comes out, it's funny, one of the big leaders in psychiatry, won't mention him by name, but been very critical. it gets really crit, it's funny, there's a big post about how in some, you know, one of these health medicine review websites about, you know, how bad the trial was or how small it was. It's like fighting, and I'm- Everybody's always criticizing each other about the study. And I was like, so when we don't have data, you say there's no data. And then when people do a really good trial, you want to pick it apart. And there's some feeling that it's almost.

Like, you know, folks have really- People.

Don'T like paradigm shifts. Well, I mean, is this how bad it's gotten, Marc, that we're at a paradigm shift? We're suggesting that our patients, our neighbors, our families eat well for things like when they're thinking about their brain and their mood and their dementia risk and their depression. Like we've gotten so far down the rabbit hole of medicine that that's a paradigm shift.

Yeah.

Like that's crazy.

It is absolutely not. And you're right, there's so much data. Like you might be aware of Hiblins.

Work, which was from the NIH show.

Captain Joe.

Captain Joe Hiblins is like a he's a pretty cool guy. He's the leader of the, what he calls himself the, he is the servant, he's the surgeon general, he's a soldier.

In the surgeon general's army. There you go. And he did these amazing studies looking at the rise of omega-3, I mean, the rise of omega-6 fats refined oils and the decrease in omega-3 fats leading to violence, homicide, suicide, and that changed behavior. And I remember once coming back from you know, somewhere and I had a letter on my desk in my office and it was from a prisoner who wrote me a letter, read my book, Ultra Metabolism way back when and said, you know, I was a violent criminal all my life and I realized, you know, that when I changed my diet after reading this book in prison, I don't know how he did that, that he realized he was a very different person. And they've done prison studies where they feed prisoners healthy diets and they reduce violent crime by 56%. If you give them a multivitamin, it.

Reduces crime by 80%.

In prisons.

Yeah, you can just see that the notion that we don't approach that, right? What is criminal activity violence? Some of it's stuff we don't understand, some of it's certainly horrible character pathology, but some of it, when we think that this is a population that in general does not have good nourishment, in general does not learn a lot of mental health skills, there's a way that that Some of what's going on there is certainly just a result of a broken system of mental health care and I would say a broken system of our culture. I've been inspired this month by Benjamin Rush biography and the reason is that I didn't know anything about Benjamin Rush. And Benjamin Rush is one of our youngest founding fathers. He is the second youngest signatory of the Declaration of Independence and I think the only physician signer. And he is our original American physician. the American Hippocrates back in the day. And he's also our original psychiatrist. And he founded the first mental hospital and he helped us found this country on a very, very simple principle, which is that when we think about mental illness, we can't put people in asylums and say that they don't have spirituality or they're sinners or they're bad people, that we as physicians are going to treat them as patients and we are going to care for them. And that has just inspired me to really think about what's happening in our country and how bad our mental health has gotten and how we all know about it. And we're just finally starting to talk about it. But we were founded as a place where we should have freedom to talk about this. I'll get you a copy of the Benjamin Rush book.

Yeah, it's like every doctor should read it. So, Drew, you wrote this paper, was published September 2018 in the Psychiatric Journal. and it was really quite detailed in terms of its analysis of the types of foods and nutrients. So help us take this home. What are the things that you learned from there that are the most important nutrients we need and what are the most important foods to help us get those nutrients and just in general to help us for sure.

And so the simple, the paper is called Antidepressant Foods and folks can check it out and it's an open source article. And I did this with my colleague Dr. Laura Lachance and quite simply It's arithmetic. It's bean counting. And we went through all of the literature looking at all of the essential nutrients, vitamins, and minerals, and did a literature search to say, well, which of these have significant evidence that they can help prevent depression and that they can be used to treat depression? And there are 12 that we found. And I bet you could name all 12, Mark. They're the 12 we would expect: omega-3 fats and zinc and B12, vitamin E, magnesium, Iron. And then iron. And so then we looked at just a simple, what a nutrient profiling system is, is it just tries, it's just a system for looking at what foods have the most of those nutrients per calorie. And then what a good nutrient profiling system does, and Dr. LaChance and I really wanted to create a good one because oddly there are, I think, 27 nutrient profiling systems in the world that have been created. Some people have seen ones like the Andy or NuVal, you know how many have been about mental health?

None.

None. And so what we, a good nutrient trophic line system does looks at food categories. So we're not saying kale, kale, kale, kale. People say, well, I don't like kale. You can't eat too much of it. You'll go into hypothyroidism. Exactly. Oh, no, it's toxic now. It was toxic more. But what we say is leafy greens. And so what we did is we scored, we looked at all of the, all of the, the top foods for these nutrients, scored them and then created a list of the top plant and animal foods. And, first of all, they're the foods that top the list, which I just think are interesting. Oysters, clams, and mussels are in the top five on the animal side. And, the reason we did animal foods is that no nutrient profiling system usually has any meat or any animals in it because it's all based on calories usually and plants always have fewer calories. But, most people eat meat or seafood, so we wanted to give folks a list of which had the the most nutrients.

And, why were the shellfish the top ones?

Top ones because think about oysters, why do they top the list? You got 10 to 15 calories per oyster. So, let's just say six oysters, 60 calories. And, for those 60 calories, you're getting 768 milligrams of long-chain omega-3 fats. You're getting 340% of your vitamin B12. You're getting, gosh, at least a third of your iron. You're getting 500% of your daily need of zinc. I mean, on and on and on, you're getting in some vitamin C in oysters. Okay, let's go get some oysters. Yeah, exactly. All that for 60 calories. And that's just, and on the other side, looking at plants, things like watercress top the list. And why just watercress? Lots of nutrients, no calories or very few calories. And so that's a great example of nutrient density, those foods. And so the food categories that people should be looking for are things like leafy greens, the rainbow vegetables, more seafood, and if you're eating meat and red meat to look more towards wild red.

Meats or grass-fed red meats. So, this is fascinating. So, the diet that prevents cancer, heart disease, dementia, depression, and fixes most chronic.

Illness is the same diet. It's really, well, it's where we got off in medicine. We kind of separated out mental health and brain health from the rest. Like you're saying, kind of like somehow the blood brain brain barrier was like, Thou shall not pass. We didn't think that sure, all those same activities that we think about in terms of our general health and the foods we want people to eat and the things we want people to do, move their bodies, connect, be part of their community, yeah, that's key to your brain health and your mental health.

And the trouble with our food supply is that it's often depleted. if you're eating the best foods, you know, you have an organic farm, the soil matters. It really does. It's in the food. And if you're growing in depleted soils, which most of our soils are, it's more like dust and dirt.

Well, they're just like chemicals in chemicals out. I mean, it's really, you know, if you, if you, if you grow, live, you know, if you, if you live by the food you grow, you don't, you know, you don't do it the way that a lot of food is grown. And even, you know, even organic food, it's funny, as you drive through the produce belt. And, I encourage people to do this and you look out, you know, you'll see organic stuff out there.

Yeah.

But.

It doesn't look like a healthy farm somehow. It's got a lot of food on it but doesn't smell right. The people working it, they don't seem happy in a certain way.

It's because of their big monocrop organic farm.

Yeah, it's big monoculture. You look at a big... You can.

Till the soil, you can produce great soil. go.

They, they, there's a ton of tillage, there's a ton of diesel spent, there's a ton of compaction. And, and it's a real, I think.

It'S a challenge right now.

Industrial organic is what Michael Pong calls it.

It is.

And, and in a lot of ways, you know, that's been a huge Victory because we have a conversation about organic. Right.

It's better that. And organic was just found to reduce.

Cancer by 25 people who had it. This French study.

Right.

I mean, it is, it, so there's, you know, there, there's something there. So it's a step in the right direction. But when you think about where I'm from and you drive around, our soil is pretty rough in Crawford County. But boy, I would say that a lot of places, Mark, where we live, if you take a lot of Americans, they wouldn't know they were in America. Because it's just that whole central notion, that central America or middle American notion of a small farm. and what that looks like and how that functions. Some cows, couple pigs, not a monoculture, a nice garden for all your food and for sharing with your neighbors. That has died in a way. And I think Wendell Berry calls it.

The unsettling of America.

Yeah, and I think that maybe dead is not, that's on life support and maybe we're seeing a shift now.

It seems like it's coming back. There's more small their farms?

I hope so. I mean, it's definitely coming back. You see it on the coasts, you see it around urban centers, but there's still a lot of places that don't, you know, where it's not happening and that kind of combo of, you know, I would say agritourism and interest in food, but also just interest in farms. But I'm hopeful.

So, My question was going down the path of, okay, if our, even organic isn't the best that it could be if the foods have been bred in a way to create more starch, a lot of the phytochemicals have been bred out of it, the nutrients aren't there because of the soil, even if it's the best organic farm. And by the way, Dan Barber and Walter Robb, a former CEO of Whole Foods, would create a seed company to actually reinvent new seeds to breed them so they have flavor and they have nutrient density and they are phytochemical rich. It's a very different idea than breeding them for yield or for pest resistance or water or drought. But they're doing all that too, but they're doing both. So the question is, if that's true, then do we need supplements? And do you use supplement nutritional supplements in your practice to treat mood disorders?

So I think even with the food we have today, you can still get all the nutrients you need. It's actually challenging if you look at all the recommended daily allowance and you think what you would need to eat to meet that. It's a little challenging. It requires some thinking about it. I always tell people, no, just eat nutrient-dense food. You'll be fine. But if you start scratching your head.

And adding up, it can be tough. I had a patient once who was like, I don't want to take supplements. So, I literally looked every food up and I'm like, okay, selenium, It's in Brazil. So, I have two Brazil nuts a day. I have 17 pumpkin seeds. I have two cups of broccoli or whatever it is. And, it was like, okay, fine. If you want to do that, go ahead.

Let's check your nutrient levels. Well, I have that problem where I don't like the idea of turning a meal into a math equation. And so, I myself, I'm 44 and I stopped taking all supplements probably about maybe 10 or 15 years ago. I guess that's not entirely true. I'll take a little Omega-3 sometimes. and certainly in my practice for non-seafood eaters or for individuals who are just kind of eating seafood every now and then, especially for individuals who don't want to try, you know, a medicine and they've never, even for individuals who do, I'll put them on a one to two gram milligram grams of fish oil. I mean, in the trials that, that, you know, fish oils is very in the science, in the sort of studies of depression is one of these things that has statistical significance, but it's not able to show clinical significance in the meta-analyses that you get about a point reduction on a Hamilton D depression rating scale. That said, well, you can't take fish.

Oil and be eating processed oils, which displaces it. You can't be eating piles of sugar.

It's like, you know, and you wonder.

A lot of the studies are designed.

Well, you wonder, one do they control for that? And two, you know, we have all these SNPs now in the elongase in terms of how we process omega-3 fats? Also genetic variations? Yeah, I mean, there's that. There's also, you know, if you have somebody who's a seafood eater versus not. But the bottom line is I think that there are certain supplements that should be tried, especially when people are struggling with traditional antidepressant response. Like a lot of people I'll see, they'll have been on a medicine, it works some, like with cheerfulness or with sleep, but they're not eating well and for whatever reason they're not going to start eating well. So, that's a really good example of somebody who a multivitamin or something with zinc or magnesium, certainly anybody who's low. I mean, I always have that feeling like if you're low, I definitely... Do you test your patients? Yeah, I don't do as extreme or not even extreme, maybe as thorough, but I certainly test everybody. I mean, I think what you were saying earlier, I think any mental health clinician who misses this is malpractice. If you miss a thyroid problem, a B12 deficiency, syphilis, I mean, there's a bunch of biological causes of depression. And, I think you and I see that get missed sometimes where it's like this is not even functional medicine. This is just basic medicine.

It's all good medicine. I mean, in my practice, I see the common deficiencies you're testing are vitamin D, magnesium, omega-3 fats, sometimes iron and the B vitamins, particularly around homocysteine and methylation issues, which is this cycle of folate B12 and B6. And so I find that giving people a multi and fish oil and vitamin D and maybe a little magnesium usually has enormous impact.

And, well, you think it's that even if you're going to get them to change their food right away, there's some, you know, that takes a little bit.

In, in, even we're changing the food, I I feel like we're so depleted.

It's just.

Yeah.

Well, it's hard. And it's also, it's really hard when you're depressed. Yeah. You know? So I think what. And it also gives people something to do.

Yeah.

Because you do. I mean, depression causes a lot of carbohydrate craving and a lot of, you know, we eat. We call it comfort food for a reason because we eat it when we want to be comforted.

Right.

I mean, I know when I'm in.

That bad spot, man, I'm. I'm a mac and cheese guy.

Yeah.

Gives you a little serotonin.

Yeah.

Don't give me any. about carbs. I need like my comfort food. But it's, I think it's something else. The other one that's I think exciting is the L-methylfolate.

It's just exciting in the idea that- which is actually a prescription drug for depression.

Well, it's called Depakote, but yeah, it's a B vitamin that got you served by- am I allowed to say that? It's a B vitamin that got you served by Big Pharma is the way I think about it, which is you have L-methylfolate, which is folate that has a methyl group added onto it. And instead of that being five bucks, $200 bucks.

Yeah. But you can get it for five bucks.

You can get it. But the idea that we're just now, because this is going to be the next Frontier Mark, as you know, which is we're going to start really getting into Precision Psychiatry. I mean, that's my most, my favorite new center at Columbia is the Center for Precision Psychiatry. There is that. There's a center for Precision Psychiatry. There's a center for practice innovation. There's a center for women's mental health. I mean, we, there's, there's going to be, there's a new center for media and mental health that's coming online. And precision psychiatry is just that, which is... I mean, one of the things I think is interesting is there's nobody that's more critical of psychiatry than ourselves. Because nobody sits with the... And sees the failure. Well, nobody sits with it until you sit with getting an antidepressant prescription wrong and then getting it right and knowing that somebody suffered because you didn't make the right choice. When you sit with that, you want to get it right more than anybody else because that's your job. And so it's an exciting time between the new knowledge of the microbiome, the psychiatric genetics, which it's not there yet, but man, it's getting close. We're, I hope, going to see the tide turn on our mental health epidemic. We are going to see the tide turn on our mental health epidemic mark.

So tell us about square roots. How, how do you see a changing the food system? And how do you see it shifting the way we think about farming?

Why? I mean, you've, you've, you know, covered my entire pitch.

Right. All right.

How scary the food system is. And that, you know, that really led me to jump in. Okay, we got to do something about it. You know, what square roots is, in essence, is an urban farming company, as you've said. We build farms right in the middle of the city. And so what that means is we're growing food essentially in the same zip code as the end consumer. We're also able to do that all year round thanks to the technology platform that we've built where we're building these farms indoors. And what that means is that we can control the climates inside these farms and do that all year round. Right? So let's say, for example, basil was your favorite herb.

Yeah, this is some basil right here.

Perfect.

Okay.

So the way that we- smells really good. The way that we would do that is we would say, okay, where in the world do they grow the best basil?

Yeah.

Right. And the answer would be north of Italy.

Okay.

And so we would literally look at the historical environmental patterns in the north of Italy and understand, okay, in the best basil growing season, when does the sun come up? when does the sun go down? Right? What is the temperature? What is the humidity? What is the CO2 level? And then recreate that environment inside a box and basically drop it in the middle of Brooklyn and grow, you know, literally the world's best basil. But do that right in your backyard. Right? Which means when you, as the consumer, get to eat that food, it was harvested like 10 hours ago, right? This morning. As opposed to the industrial food system that you're talking about where this food is being shipped across the planet and is taking days, weeks, sometimes even months to get to us, which is crazy.

If anybody's gone to their garden and picked an asparagus or had broccoli or a tomato, they know how different it tastes than when you get something that's been shipped across the country or across the world. and the nutrient density of the food declines in direct proportion to how far it's gone, how long it's sitting on a truck, a plane, or in the store. And you're talking about getting not only local food, but immediate food.

Oh, I don't know if there's a term for that. No, it's crazy. When we first started studying food systems and we were putting square roots together three or four years ago, I was horrified to find out that the average apple in a US supermarket has been traveling for nine months before it gets there. Not nine days, not nine weeks, nine months.

Nine months, yeah.

And to stop that apple decomposing into a gray ball of mush, it's covered in wax, right? I'm sure you've gone to the supermarket and you buy an apple and the first thing you do is come home and wash it, right? You've got to get rid of that wax, and the reason for that is to stop the thing decomposing in the three quarters of a year that it's traveling. But to your point, during that time, all the nutrients inside are breaking down into sugars. So you think you're making a healthy choice, right? Maybe you're buying that apple for your kid for lunch tomorrow morning.

I mean, it's better than a Pop-Tart, but still.

Well, it's not as good as it could be.

Right.

It's a waxy ball of sugar.

Yeah. Right. And when you say it like that.

I mean, like- Right. And so then they join the dots. that's between, you know, a country where we've got 30, 35% childhood obesity rates in most of our cities, right, who are all at the mercy of this industrial food system. It is crazy.

Yeah, it's pretty big. So, what you're seeing is you've created essentially a very smart system of agriculture that incorporates a lot of data and knowledge and technology to grow just plants in a way that makes it optimal for them in those conditions. And I think it solves a lot of problems, right? So let's talk about the kind of problems it solves. One, talk about the impact, for example, on the nutritional quality of the food, sort of just it, right? Yeah. So can you tell us more about what really do you know about how good or different food that's that fresh and that local and grown in these conditions absolutely.

Well, I mean, I think that the first thing to say is that, again, as food travels, those nutrients break down over time.

Right.

And so a system like Square Roots, where we're growing food in the same zip code as that retailer, as that end consumer. Right. It means our food is traveling for less than 24 hours.

Right.

And so all of the nutrients that are there when the food is, is picked.

Right.

They're still there when you eat it.

Right.

It's like, you know, one day. Right. There's hardly any, any kind degradation there. And then what we'll do to make sure that we understand how good that food is, is lab test it against, you know, the best organic farmers market food that you can buy in New York City. And we're very, very happy at that nutrient quality.

So you're testing what in that in those tests, you're testing like vitamin levels.

Nutrient levels and all sorts of stuff, right? So we want to make sure that we're at the very least as good as best food that you can buy at the organic farmers market in New York, right? However, what we're then able to do is provide you as the consumer with that food all year round, right? 52 weeks a year. Because inside these farms in those controlled climates, it doesn't matter what the weather is outdoors, right? You can have two foot of snow outdoors. It can be the middle of February in New York City, but indoors, it's still the perfect conditions to grow that food, right? With those nutrient levels. with all that goodness that's there and then still get that food to the consumer within a day of harvest.

Okay, the other benefits are sort of disrupting some of the social challenges that face people when they try to eat good food. If you live in a food desert or some people call food apartheid and you don't have access, you can literally put these shipping containers where you grow your food in any neighborhood and provide fresh local produce to that neighborhood in ways that were never accessible to them before.

Yeah, I mean, if I think about what we've got in New York City, for example, you know, our farms are built inside refurbished shipping containers, right? And that means that we can be very creative with existing city infrastructure in terms of thinking where should we put a farm, right? If you have an empty warehouse, boom, I can back in, you know, 20 shipping containers and turn that into a farm, right? In Brooklyn, For example, where our first pilot farm is, we literally have dropped these shipping containers on an underutilized parking lot outside an old Pfizer pharmaceutical factory and turned it into a farm. Right? And what that means then is we're now distributing food, I think, to over 75 retailers across New York City. All of our retailers are within four miles of the farm. And that's mind blowing, right? To think that the seven or eight million people that live in New York City can now have this hyper locally grown food and have that all year round. Like it's a game changer.

Forget about local, but hyper local.

Right, exactly. I mean, literally you can jump on the J or the M at the subway line and come visit the farm. You're here in a beautiful part of town. Our farm is like two miles away from your apartment.

Amazing. So the other benefit is your raising up a new generation of farmers that is absolutely essential because in this country, the average age of farmers 58 to 60, people are aging out of farming. There are really very few supports for young farmers to enter the marketplace. The land acquisition costs are so high, the land has become financialized because corporations have bought it up because it's actually got more land value than agricultural value. So we're really in a situation where Young farmers have a real barrier to entry in the market, but you've created a whole program. It's called Next Gen Farmer Training Program that allows you to bring in people who want to be part of the solution and create a career out of it. Can you talk about why you're doing that? Because you could just be selling herbs.

And vegetables and why would you buy now? Yeah, I mean, you're right. At the beginning of the pod, you were articulating the issues with the industrial food system, right? Chronic waste, terrible for the planet. you know, all of these things, pollution, diabetes, you know, 70% of our food has got pesticides in it. This is all horrific. And then this extra topic that doesn't get as much air time as it should is this demographic time bomb that's about to go off.

Right?

If the average age of a farmer today is 58, like, who's going to grow the food in five or six years time when they retire? It's like frightening. And, but, you know, to your point, very, very hard then for young people to start a career in farming. and quite frankly, if you're 22-23, do you want to live in the middle of the country, in a big farm?

Or in Brooklyn, Brooklyn farmer.

Exactly. And be surrounded by technology and.

Have.

An opportunity to really change the world, right? And so again, when we were putting the business together, we realized first and foremost that if we're going to build an urban farming company, We need farmers at the center of the system. Now, that might sound obvious, right? But there are a lot of entrepreneurs in this indoor farming space who are raising a ton of venture capital money to build robots and automation and AI and all these kind of buzzwords. Yeah, there's literally hundreds of millions of.

Dollars flowing to this vertical farming.

Basically, they're taking labor out of the system, right? Because that's one of the most expensive inputs. and there's a lot of amazing technology on that. Our fundamental thought though, belief really, was that it's the farmer that's at the center of the system, the person that's willing this plant to come to life, that just makes it taste better. It's like when you're cooking, you put.

Vitamin L. Vitamin L. Exactly, exactly.

And I have a PhD in AI. I've spent my whole life in data science. And, you know, I found it very, very difficult to kind of rationalize that, that, that, that answer initially, but I just know that it's true, right? It's the love that the farmer puts in that, that, that makes the food taste great. So we had to figure out how do we provide a pathway for, you know, young people to come in and learn how to be farmers, right? Provide that love in the system. But we also wanted to do that in a way that was creating a positive social impact. on the worlders, right? How can we empower and educate and inspire and get more young people into this local food movement? They can spend, you know, 12 months with us, 24 months with us, and then when they graduate and they leave Square Roots, you know, are they now inspired and do they have the tools and are they ready to set up their own local food companies?

Right?

Because the more of us working on this local food revolution, the better, right? So that was kind of the genesis of Okay, what can we do here to bring more young people into the industry? So great.

It's so important because we do have a crisis in farming and agriculture and we're trying to shift. And there's so many movements. There's regenerative agriculture that is really defining a whole new way of thinking about growing food that restores the soil, that reduces carbon in the environment, that preserves water, that reduce chemical inputs and fertilizers. These are all really essential activities. vertical farming is not going to solve our entire food problem, but it does fill a niche that is really important, which is how do we bring food into urban environments where more and more people are moving to across the globe where there's less access in many areas for healthy food.

And who's going to do that? So that was the reason why we put this NextGen Farmer training program together, which is there aren't the millions of farmers who understand these systems who can make this happen. And so what the NextGen Farmer program is It's a 12 month program. People come and they work with us for a year. We basically surround them with technology and training and a team so that they go from perhaps zero experience growing plants to become a really competent farmer within about four weeks. The technology platform helps them do that. It kind of guides them through their day to day. Okay, buddy, you're in run, you know, this Farm today, you've got to harvest the basil.

You know, here's how to do it.

You run your farm through your smartphone. Yeah, that's exactly right. They literally, like, open an app on the phone and the, and the system is kind of, you know, giving them instructions of what to do today. Right.

Yeah.

At the end of that Harvest day.

Then that food gets aggregated and packed and distributed all across New York. And it's done through bicycles. You basically. That's right.

Yeah.

You know, the carbon footprint is basically whatever the guy who's driving the bike or the woman.

Driving the bike eight, right?

Yeah, it's so fun. We have these little electronic tricycles with climate controlled modules on the front of them, right? So the food literally goes from the farm straight into the climate controlled bike and then boom, we cycle all around.

Town and distribute the food that way. Like a different meaning of the word recycle. Right. Okay, so are you riding the bikes.

As part of your training to get around the city? Of course, yeah. I mean, well, to be fair, actually, we you do that. Every new employee that comes into Square Roots, they spend a month in the farm, right? You've got to learn how to do this thing. And then for sure, they're on the bikes, they're in the stores doing demos. Like, you know, you've got to be able to kind of walk the walk, right? As well as talk the talk.

So let's talk about something that is also an important piece of the food story, which I think there's debate about how this approach impacts that. And that's climate change. It's really clear from emerging research that our food system is the number one source of climate change.

30% of greenhouse gases, right? Yeah, 30%.

But if you add in food waste, you add all the transportation, you add in the whole, not just animal factory farms, but you add the whole value chain, some estimate that it's between 40 to 60%. Yeah, it's frightening. So it's frightening. It's bigger than the energy sector's contribution. So if we just completely stopped fossil fuel use today, everybody switched to electric cars and had zero emissions, we'd still have catastrophic temperatures within two decades. So the only solution is to reimagine agriculture and farming at scale. And the idea of a carbon farm essentially is that soil is a big sink for carbon. It's basically the plants draw carbon out of the environment and store it in the soil. the microbes feed on it and it becomes this wonderful virtuous cycle. And the hypothesis that some have is that if we do this at scale, we can actually draw down carbon, and it's the biggest carbon sink on the planet, bigger than the rainforest. Right now, soil on the planet contains three times as much carbon as the entire environment in the atmosphere. So with industrial farming, it's clearly a problem. Regenerative farming is a promising solution. How does vertical farming, hydroponics, aeroponics, how does it all fit into that? Because there are energy inputs to the system, right? So, yes, you have a container and it's sitting in Brooklyn somewhere in a warehouse, but you have to have lights, it's driven by electricity, you have to have cooling and temperature control, and there's water use, but it's, I think, far less than traditional agriculture. But, so, how do you kind of reconcile that? What does the data show? I know that Cornell, they're doing some to look at all these variables. I don't know if anybody's really figured it out, but I wonder, is it got a positive benefit or is it a negative benefit to the environment?

Yeah, and I think no one has figured it out. And you are going to take maybe years to figure out the exact impact of industrial farming and then to do the comparison with indoor farming. With indoor farming, there's so because it's a technology driven industry, right? There are so many efficiencies that happen every day, literally, right? By the time that five-year study, you know, that's commissioned and is finished, like it's kind of out of date, right? Because the industry has moved on. Evolving. That's a fantastic thing about indoor farming, right? I often- you- could run off solar power, wind power- well, wind power, right? So we're opening a farm in Michigan right now that is wind power, right? Which is absolutely incredible. And you have to think intuitively, right? That if you have an industrial farm where there's, you know, chemicals, pesticides, herbicides, you know, that the, the, the, you know, farmers are kind of over planting to hedge against nature, right? Think of all the resources that that takes, and then you've got to distribute food maybe across the world, you know, the refrigeration costs along the way, et cetera, et cetera.

Oh, yeah.

Intuitively, it's got to make sense. to grow, not all. I would never say this is a complete disruption.

And you can't grow everything in there.

Exactly, right. But I would say perishable produce, your herbs, your leafy greens, some fruits. Let's start thinking about how to do this at scale indoor in the same zip code as the end consumer as soon as possible. Now, I'll tell you this. In the UK where I grew up, the intensive farming techniques that we're using are eroding the topsoil at such a rate that there is only about 50 years worth of harvests left in outdoor soil.

If we continue the current practices.

If we continue the current practices. So you can sit here and pontificate for the next 10 years to figure out, okay, which is the carbon footprint of this better than this. Now we're 10 years closer to that 50-year kind of apocalyptic cliff where we can't grow food outdoors.

So you have to- and it's not just there. I mean, before Obama left, he had people working on the soil issue, and they estimated in the United States, by the end of the century, we're running out of soil. We're done.

So you've got to do something. So the way that we think about-.

No soil, no food, no humans. I get climate change.

Exactly, exactly. so, you know, when we think about resources, right, we think about space, we think about water, and we think about energy, right? So from a space perspective, we're growing using vertical walls, right? So we kind of take that two-dimensional field and we turn it on its end and kind of rack that field inside these boxes, right? So now we're growing food in three dimensions instead of two dimensions, and that means you get a lot more food from the same size footprint. footprint, right? So theoretically now we could think about saving, you know, like an apartment building.

Versus a single levels home.

That's exactly right, right? And so now let's think about, okay, well if we're sort of, you know, saving, you know, acres and acres and acres of farmland because we're growing indoors using this kind of very smart space system, you know, can we, what else now can we do with that outdoor land to do things like take carbon out of the air, right? So you can work in collaboration with the outdoor farmer, right? This isn't just the only part of the solution.

Of course.

On the water side, these are hydroponic farms, so there's no soil. What that means is there's no water runoff, right? Like you would have in an outdoor farm. So these are very, very efficient in terms of water use, right? Some estimates claim that hydroponic indoor farming uses about 90% less water than the equivalent outdoor farm. So that's a good thing.

Which is important because we're running out of water too.

Not just soil, so. Completely. And then the third thing is energy. So yes, we do have artificial lights inside these farms. It's the light that gives the plant the energy that it then turns into biomass to grow. Photosynthesis. Exactly. You need that. What we are able to do though is through studying photosynthesis, you begin to understand what spectrum of light the plant uses at certain points during its growth period. And then the artificial light, we're only pushing into the farm the exact spectrum that the plant needs, right? So often when you look at pictures of indoor farms, there's pink lights everywhere, right? It's kind of red and blue lights because that's the spectrum.

It looks like a disco, right?

That's like the Studio 54 of farming. We've been called many times, right? But the reason for that is is one about energy efficiency, right? Which is if we're flooding this farm with white light, you then have all that spectrum either side of the red and blue that would just be wasted light, right? The plant doesn't use it, wasted light, wasted energy. Let's not do that. Let's hyper focus the spectrum of light to give the plant just what it needs, right? And then finally, as technologists, we're obviously making all of that more and more efficient every single day, right? If I'm an outdoor farmer, I can't suddenly look at the sun and make it twice as efficient tomorrow to half my costs or double my yield. As an indoor farmer, I can look at those lights and make them twice as efficient over time and bring that positive impact to the whole model through technology over time.

It seems like if you can add in the renewables to it, like solar, wind, that you can actually make a real argument that it's 100% actually much better.

We live in a toxic world, right? It's not a matter of, do you have toxins? How many do you have? Persistent pollutant toxins that will just camp out in your fat and just leach into your system on alter how your mitochondria work, alter how your immune system works. Great case case that I had. It's a gentleman who has Alzheimer's. He was seen at a very large institution in Boston, and he was diagnosed at the age of 56 with, you know, moderately Advanced Alzheimer's. Wow. He was, he had a basic evaluation with a spec scan, and he was told he had Alzheimer's. He was given a pill that we know doesn't work for more than 18 months to stabilize it.

Right. Yeah.

We, he was given a, it doesn't work even. Yeah, he is even months. Yeah, I was just trying to be generous.

And then- that's not our opinion. This is basically in the major medical journals, the pill trials and they just don't work.

They just don't work. So then he was given start behavioral therapy and cognitive therapy. Again, hasn't been proven to do anything to slow the progression or improve cognition at all. So at a major institution given those two things to do, he is a very, very active gentleman with a great deal of huge responsibilities in his life. Very dear man. And he comes here for the first visit and he's, you know, he's, you know, he sees these issues and so we start talking and I start testing. So, we do the tests. Let's look at the gut. Let's see if there's toxins. Let's find out about your hormones, right? Let's see if you have any autoimmunity. Let's do some We do some, you know, we do specific autoimmune testing to see if your your body is making auto antibodies against brain tissue. So why would you do that?

Because Alzheimer's is what?

Alzheimer's is a multifaceted, multi causality disease.

It's inflammation in the brain.

It's inflammation of the brain. That's what's driving it.

Right.

And there's and there's lots of things that can cause an inflammation.

Right.

So we're going to look for everything that can cause inflammation. And there's also disruption of normal function, right? That might be distant. So what effect does having a low testosterone have on the brain? Testosterone has a big impact on the brain. It can have an impact on inflammation. It can have an impact on how the pituitary and the hypothalamus is secreting other hormones, how those hormones will work, how your neurotransmitters may work. So here are some of the things we found with this gentleman. He had a mercury of 120.

Oh, wow. Now put it in perspective, like zero is normal.

Zero to four.

And anything over ten I worry about, 20 is bad and like 120 is, you know, a handful of people that you see over the course of decades have 120.

Yeah, yeah, very, very few people. Mercury level. Testosterone level.

From where?

Fish, water, air. But lots of fish eaters. He was a fish eater in his lifetime. And again, you know, he wasn't like an extraordinary fish eater. But if you look at his detox genes, he had a lot of. On his genes, he had a lot of variants that put him. Made him susceptible to not being able to detoxify as well as he should. So, you know, you and I could go eat, you know, sushi the whole week.

Not me. I got those same genes. Okay, you got this.

That's why I got mercury poisoning. All right, right. So I could eat it. I don't have an issue with mercury.

Right.

My mercury wasn't high at all. And I love fish. I eat a lot of fish.

So jealous.

Okay, well, so. So Mercury, his testosterone level was 150. So at his age, his testosterone level should be, you know, 600 on average.

800.

600 to 800.

Yeah.

Right.

So 150 is like nothing about what a woman has.

Exactly. So. So he had his testosterone as though his Mercury was bad. And, of course, the SIBO and he had dysbiosis. So not only did he have.

His gut was all.

His gut was all messed up. And then finally, on top of it, he tested positive for Lyme disease. So that's another thing that we do here at the Ultra Wellness Center is, you know, you can't practice functional medicine without coming across Lyme disease almost every day. You know, it's stealth infections. Lyme disease and the co-infections that can be found with it, along with other viruses, are a big part of what impacts people. He had Lyme disease.

So we had four strikes against him.

And so here's what's really interesting. We arranged for him to get some really intensive Lyme disease treatment at another clinic in Germany where they do hypothermia. Hypothermia and they give IV antibiotics when you're by making somebody really warm, you are able to, that's when the bacteria can be most susceptible to antibiotics. And so at that really high temperature, about 107 degrees, they're going to put an IV infusion of an antibiotic in and fight the infection. I did that. I went to San Diego and I.

Had hyperthermia and I had Lyme disease and Babesia and I had night sweats all the time and I did the treatment and it kind of went away. And I've seen this case after case. Now, it's not something that's available in the United States. but it can be very powerful treatment.

So, in his particular case, we chose that direction because of the degree of the severity of what he was facing. So, we wanted to, let's just hit this hard, hit it fast. It was something we really believed in. So, we arranged for him and I worked with his doctors at St. George Clinic. And then we treated his mercury. We started treating his testosterone using, first, getting him to sleep better, working on his nutrition, I always like to work on lifestyle before I start treating directly with hormones. Then we added in some hormones that would benefit his testosterone levels. And at six months, he had stabilized. So he had not worsened. At six months, actually about the eighth month mark, when we saw where he was at, he was still working and he noticed that his memory had not gotten any worse than it had been. And so we're continuing to work. It's a story that's ongoing, but really, really exciting because- and that's important to.

Say that this is a progressive disease because usually a year later, people are a lot worse, right?

I was thrilled that at eight months, he wasn't worse.

And where his numbers better?

Right. Oh, absolutely. Testosterone levels were up to like 500 at that point. Mercury level was coming down. Mercury can be hard to bring down. It can take a period of time. But I do like to remind people, he was very excited to know there are things I can work on. See, he left a large institution with things to do that weren't going to work, sort of hopeless. So, this is a really important point with functional medicine.

Alzheimer's is a diagnosis. It's not the cause. No. And functional medicine helps you figure out what that is. It doesn't mean everybody with Alzheimer's has those things, although they're common, but tick infections, heavy metals, hormonal issues, gut issues, things you can actually treat. And, I think this is such a big difference between functional medicine what we do here at the Ultra Wellness Center in Lenox, Massachusetts and what people get when they go to a traditional physician. They're not having somebody pull back the hood and look underneath and see what's going on. They go, oh, I know what's wrong with you. You have Alzheimer's. No, that's just the name of the problem.

Now, let's start to figure out what's going on.

And that's beautiful.

We see everything here. We see autoimmune diseases from Hashimoto's thyroiditis to ulcerative colitis, to rheumatoid arthritis. We see Alzheimer's disease, ADHD, autism. We see people with- It doesn't matter.

What diagnosis you have because we treat the system, not the symptoms of diseases. Exactly. And we do that, whatever they have. has a chance of succeeding.

And that's the point I want to make. You know, we see everybody with everything from every age and we end up being able to help them more than the specialists did because we're looking at everything and we're getting to the root cause. And so in a course of a week, I can see a two-year-old or a three-year-old with autism. And I can see a 62-year-old with ALS.

Right.

I can see a woman with depression, no libido, fibromyalgia, and it's all in my purview.

Yeah.

And it's all really exciting. It's a really important point.

People say, well, do you treat this? Do you treat that? I'm like, I treat things I've never seen. I never had a patient with vestibular migraines before. I don't know that much about it other than the basics, what I learned in medical school, but I know how to treat the body. I know how to treat the system. I know how to treat a human being. and look for the root causes. And when you do that, even if you don't exactly understand the disease, it'll often dramatically improve or reverse completely.

Absolutely. But I like to let people know it's hard work. It's good work. It's really good hard work.

It's never not like take this pill in six months, where you change your diet, you have to take care of your lifestyle issues, you have to take things to help reset your system, get your gut, do the hormones, treat the Lyme.

Example, I think, is a good one is my own daughter. She went, you know, she started having, I have permission from my daughter, actually. She said, are you going to say my name? I said, you want me to? She said, yeah. So my daughter isabelle. So my daughter isabelle. So she started having her period. And about, you know, in the first year of her cycle, she was very irregular and she was really getting more and more fatigued. So it was around school time. It was august. She goes to a pediatrician.

Pill.

Yeah, so, no, no, no. Because, you know, my wife goes with her and, you know, my wife is, she, she's very attentive to these, these health issues and nutrition. And so she sat in the visit and she came back and she shook her head. George, she said, I am done. I am so done. I told him that Isabel had fatigue. Never once asked her what she eats, then talked about nutrition whatsoever, basically said, you know, barely asked her about her period other than to know that it was irregular. And really basically said, you know, you just started your period, give it some time. You're an adolescent, you know, you sleep more, you're going to be fatigued. It's sort of the natural process. So I'm like thinking, nope. So I wanted to know, I know my daughter's diet as hard as we try in our home, my wife and I eat whole foods. She will tend towards carbs and sugars outside the home and even inside the home. So I had a lot of suspicion from watching her in our house that she was having issues around her diet and nutrition. So the first thing I wanted to do was find out if she was having any food sensitivities. So we did some IgG antibody testing, which looks at food sensitivities, not necessarily food allergies. So IgE looks at food allergies.

Like if you have a peanut allergy. Peanut allergy. That's anaphylaxis. You'll know it.

You eat it, you turn blue.

But ICG is like, you might not.

Know, you might eat it on Monday and on Wednesday you get a headache.

Right.

Strawberry on Friday night and Sunday you have red cheeks. That's sensitivity. Now you can have sensitivities and you never make the connection to food. My daughter had huge sensitivities to gluten. Gluten. It was a really bad thing. We're gonna talk about it in a second. Milk, egg, and then multiple other foods, which gives that whole leaky gut syndrome. She had a leaky gut. She had a leaky gut. Checked her thyroid. Your TSH should be, you know, in general, you know, if you look at numbers 4.5 or less, hers was 5.8. Yikes, that's like low thyroid. I checked her thyroid antibodies. When the body begins to make antibodies against self tissue, My daughter had antibodies against her thyroid.

Wow.

Again, 14 years old, right?

And she was told-- and most doctors don't check anybody.

They'll just check a TSH and if it's around normal, they'll just say it's fine. Right.

And her CBC, her blood count, we have hemoglobin, hematocrit are two numbers you look at to see if you have enough blood. Blood carries oxygen. Oxygen is required to make energy. Energy gives you energy. And if you don't have it, you're fatigued. And she was fatigued. These tests were done. She was anemic. Her hemoglobin was 9.9. It should be 13 to 14.

Yeah, right. That's like down like three pints.

Now these lab tests were available at the conventional doctor. So now here's my daughter with all this going on. So the first thing we're going to do is we're going to change your diet. But here's the key thing. the gluten piece. See, that gluten sensitivity triggers everything. As we know, gluten is what triggers the, you know, can be a trigger for your gut to make something called zonulin. And zonulin is the molecule that opens and closes those gates in that membrane that protect the lumen, you know, your body from what's in the lumen of your gut.

In the intestines.

Right, in the intestines. So, when you're sensitive the gluten and you start to trigger that, you create this leaky gut. That's when you really open up that door, as we talked about, for autoimmunity and malnutrition. And then on top of that, she was having these bleeds. The last thing I checked, Mark, was her hormones.

Well, before you jump in, I just want to recap that because that's important. So gluten basically damages your gut lining, which then causes leaky gut, but it also prevents iron absorption. Yep. which is why she was anemic. It also triggers autoimmunity, particularly thyroid autoimmunity. So a lot of people have shimmies caused by gluten. So when you sort of dial back, you can get to the root cause and see what happens.

So, so, okay. So. And then on top of that is a quick aside. I checked the hormones, and you can do this ratio between your progesterone and your estrogen. When a woman's irregular like that, you should really check that, because if you have a relative elevated estrogen. compared to progesterone, that's called estrogen dominance. And estrogen dominance can impact your cycle. It can make it irregular and it can make it very heavy. It can lead to a lot of PMS and depression. And it can last for half the month. Yeah. Okay.

So all this was going on. By the way, 75% of women have PMS.

That is not a normal condition.

No, it's not. It's because of our diet, our stress, our lifestyle, our gut, our food, food.

So many different things driving that has hormones in it. You know, we just, you know, the whole, you know, issue with hormones in our food.

And guess what's the biggest driver of high estrogen levels? Sugar.

Sugar and hormones in our food.

And starch.

Exactly. So my daughter is a perfect example of the modern diet, despite, believe me, I gotta say this, parents who eat really well have a garden in the backyard and do this.

Teenagers are temporarily psychotic, so you can't.

It's part of the point I want to make and this is the point, is that she is fortunate to have me as her dad because if she didn't have me, she could have gone a decade or two decades thinking, that's just me. Only in her 30s after a baby or before a baby or in a stressful time to just completely break down and all of a sudden have Hashimoto's or rheumatoid. or some other immunological disorder that could have been prevented.

And this is what happens. I've seen this over and over in patients that start out and you can track their history. We call it the timeline in functional medicine. We track, okay, this person was born by C-section, their gut doesn't get developed in the microbiome. They had antibiotics early on because of ear infections, disrupts their microbiome. Maybe they develop some acne or maybe they got some allergies and you then they get maybe thyroid issues when they're 20. then they get when they're 30s, they start getting autoimmunity like rheumatoid arthritis. And it's the same fricking story almost every time. All the time. And you can track it back. So the fact that you got your daughter early is a huge thing. And that allows her to then maybe develop normally and not develop these autoimmune.

Diseases and so forth that we see in so many. Here's one of the things I want to say about functional medicine. Applying everything that we discover as we ask those questions why we do this advanced testing that you're not going to get at another center. It's not easy, right? And I know firsthand what it's like to have to change a lifestyle. Not only my daughter's, but in my own when I dealt with my brain injury, but with my daughter having to help her sleep better, create a sleep ritual, help her to learn how to meditate, help her to make good food choices. That is not easy work. And so, you know, at the Ultra Wellness Center, we also have coaches. So we have coaches that will come alongside of you and will hold you accountable, will work with you to help you devise strategies over a long period of time to change these lifestyles. We know habits don't change for at least three months. How can we anticipate that some of the most critical things that are going to make you healthy are going to happen in two weeks, six weeks or eight weeks? It could take three years. I like to remind people that.

What's fascinating too is that what I see here is that it's not as hard as you might think because when we put people on a regimen, and I do this pretty aggressively to get them feeling better fast, because I figure if they can have the experience of feeling good, even if there's more work to do, they're going to do it. In other words, in 10 days or two weeks by changing your diet and doing a few simple things, you often see profound differences.

You know, in the 70s, we're talking in, we're talking 40 years ago, in the late 60s, early 70s, actually talking close to 50 years ago, people were saying we have to stop marketing junk food to children. This is really bad. We are teaching young children that soda is a cool thing to drink. Even before they can talk, even before they're even marginally able to understand what's coming at them, we're teaching them soda, sweetened juice, sweetened breakfast cereal, cookies, da-da-da-da-da. These are the things that make life worth living, right? 50 years ago, there was noise being made about that. The Federal Trade Commission, which was on the verge of doing something about it, was effectively silenced. Congress was effectively bought off. No one even raises the issue anymore. You can't even get the national government to talk about this stuff. So now you're relying on things like soda taxes, which are better than nothing, but not much.

Yeah, well it's interesting, Barry Popkin, who I know you know very well, he said to me that in Chile, where they implemented a sweeping policy change around food, including a soda tax of 18%.

And including- Great labeling.

Including eliminating marketing to kids through any media and also on the cereal boxes. So Tony the Tiger is dead. He said, shockingly, when they analyzed the impact of these policies that the marketing restrictions were four times as effective as the soda taxes.

I would imagine that.

And in this country, I read, I think Mary Nesi wrote an article, I think in the New England Journal years ago about Food marketing to kids and said, I think we're one of the only countries other than Syria that doesn't restrict food marketing to kids in some way.

I don't know, maybe in some way. And we do restrict it in some way. But again, these are, to a large part, it's voluntary. Like the industry had said, well, don't worry about it. We won't market junk to kids, which was a total lie. They took one sliver of their marketing budget and moved it somewhere else so they can say, oh, here's this, you know, Saturday mornings we don't sell junk on children's programming.

That's kind of it.

The real tragedy here is that, I mean, suppose we have this conversation, a great conversation filled with interesting things, two intelligent guys, maybe we change a couple people's minds or a few people have insights, fabulous. Meanwhile, the budget for the fast food, junk food industries is in the billions of dollars and they're targeting young kids who can't really say, oh, what a bunch of garbage that is, but say, oh, wow, I can paddle my canoe down a river made of milk and capture Froot Loops in this kind of game that, and aren't Froot Loops fun, or isn't Coke enjoyable, or da, da, da, da. Every year that passes that we are not teaching four-year-olds how to eat well means that 20 years from now, we're gonna have 24-year-olds, and 40 years from now, we're gonna have 44-year-olds, who are struggling with their diets, who are coming to see you and other doctors and saying, gee, I'm overweight, I can't control them. Why is that? Well, the reason is not that you're a bad person. The reason is that you were trained as a young person to eat badly and that you're surrounded by not the most ideal food that you should be eating. In fact, you're surrounded by the opposite of the ideal. And you're every Place you go, David Kessler has always talked about this, this sort of, I mean, the silly scientific term is obesogenic environment, but basically what it means is that we are in a permanent carnival of junk food.

Food swamp.

Food swamp is much better than food desert. Everywhere you go, there's cotton candy and marshmallows and Cinnabon and double cheeseburgers and the, and it's all screaming, eat me. And when you were a little kid, you were being told, this is the cool stuff.

Yeah, I remember.

Not like stir fry with broccoli and.

Tofu, but this stuff. It's tough. And, you know, the average kid sees between six and 10,000 ads for junk food in a year. A year. A year. And if you spoke to your kid three times a day at every meal about healthy eating, you could not compete.

Right.

That would be one. And then I think even today, It's worse because that was based on traditional media. Now we have social media, which is all subversive, invisible, embedded and much harder. Stealth marketing. That's a good...

It's true. If you spoke to your kid three times a day, you'd talk to them a thousand times.

Right. And then my kid... And they'd hate you.

By the way, the kid would hate you.

That's true. And my daughter is fascinating. It reminded me of a story when I was reading about this if kids who are two years old can recognize labeled brand name products before they basically can't even walk or talk, you have to be eight before you can distinguish fact from fiction. I remember my daughter was up at eight or nine, she says, Daddy, how come all those commercials on television, in real life, it doesn't actually kind of match up with what you see? And I'm like, wow, that's very insightful. She kind of had this awakening. like all that crap she sees in the media isn't actually what it really is. And, you know, our friend Kelly Brownell was also sort of pioneering some of this research around food marketing. He said, the worst foods have the most marketing. So the ones that have the most harm and the least nutritional value are the ones that are most promoted.

Right.

Well, unadulterated foods are not very profitable. Yeah, like broccoli is not that profitable.

Yeah, where do you see those Super Bowl ads for broccoli? cashews, you know, like you don't. All right, so let's talk about the, the, the way we can help shift this. And if you were advisor to the president and you were sitting in the White House and maybe this next election cycle and you could help shape that national food policy, where would you focus?

I mean, I would, the two things we've talked about, I would do the antibiotic thing like that. I wouldn't even, you know, It has to be an edict.

And by the way, that would transform animal agriculture overnight.

I think it might, although they've taken.

Antibiotics out of industrial agriculture in Denmark and the Netherlands, and they're still producing a lot of factory farmed meat. So you can do it without antibiotics. It's not a panacea, but it sure starts to solve one public health problem, which is that Our antibiotics are not as effective as they were. And so that's an easy thing. There's great public relations victories, a lot you could talk about. You could use it in tandem with making factory farm to meat better. You're not gonna make it go away by this, but you could, there are degrees of, so I would just, that would be like, okay, you wanna know what I wanna do? It's not the biggest problem. It's not the biggest solution, but it's the easiest thing to, it's like such low hanging fruit. And really, we all, those of us who wrote this call for a national food policy, honestly thought that it would be one of the first things the Obama administration would do. That's 10 years that it hasn't happened, that it could have happened. So that's unfortunate. The second thing I do is start working on marketing, the marketing of junk to kids. I mean, we just talked about that also, but I would just say, what's feasible? What can we do here? Can we make it so that minors can't buy soda without their parents' permission? It's a radical notion, but they can't buy cigarettes. And it's, soda is arguably as harmful as cigarettes. We had no problem with that. It's certainly as harmful as beer.

So, well, I mean, it's now clear that diet and particularly sugar-sweetened beverages kill more people than smoking, war, and terrorism and combined.

Right.

And transportation.

Well, you know, experts are now saying that the leading cause of death worldwide can be traced to diet. So we know that a billion people don't have enough to eat. That's an income issue, and that's a justice issue, and that's an issue that needs to be dealt with in one way. On the other hand, we know that another billion or more people are getting the wrong calories.

Two billion are overweight.

Okay.

Are getting the wrong calories. and are getting chronic diseases from their diet. You know, it could happen, I mean, it could happen to non-overweight people too. So how do we address that? And, you know, until we change our economic system, we're not gonna be directly regulating what food manufacturers can produce, but maybe we can directly regulate what they can sell.

Yeah.

Sell. Yeah, that's- that would be a- so.

What about this sort of dichotomy between the message that meat is bad in the sense of harming the planet, harming people, causing climate change and feedlot factories? And the emphasis, you also place on regenerative agriculture, which necessitates animals being part of the cycle of regenerating soil, holding water, drawing down carbon, reducing climate change. 'Cause it's, I think it's a debate that is dichotomized, but falsely so. It's, if meat is bad, it doesn't mean all meat is bad, right? And how do you explain that to people?

You know, I think you start with the fact that the way we produce meat is mostly bad. And you start, bad is obviously simple term, but it works, I guess. And you start with the fact that we mostly eat too much of this meat that's produced badly. So, if we ate less meat and produced it better and saw our animal friends as a way of keeping soil healthy, as a way of promoting regenerative agriculture and so on, it becomes more of that kind of closed system where everybody has a role. And it's not just we're raising animals as if they were little machines and we're killing them as if they had no life worth thinking about and we're just eating them as fast as we can. And by the way, we're doing it at a rate that the rest of the world can't, but tough luck because we're Americans or whatever you're saying. The latest thing, five years ago or so, Lancet said that people in the West should be reducing their meat consumption by 90%. I don't think they're actually, the latest stuff I think is a little less onerous. But even if it's 50%, that's a lot for a lot of people. I think it's just clear to say we need fewer animals in industrial production. We need more animals on pasture. And we as humans need to be eating fewer of them and paying more attention to which ones we're eating, when and how. I mean, that's a broad overall statement to come out and say, look, we all have to be vegan or we have to reduce our meat consumption by 90% like this. People are just going to shut their ears, I think.

What's fascinating though is if you look at the problem, the price of feedlot meat is pretty low.

It's unbelievably cheap until you get to that true cost stuff.

The true cost thing. So you add in the cost of the fossil fuels to grow, you add in the cost of soil destruction from the corn and soy. I mean, one pound of soil is lost for every pound of corn grown. We have the greenhouse gases, water per pound of meat, that kind of thing.

Greenhouse gas stuff on and on and on public health costs. I don't think you mentioned that. Exactly. Trillions of dollars a year.

Absolutely. So there's a huge cost. So maybe a pound of meat should be $1,000 if it's a feedlot meat.

Right, whatever it is.

Whatever it is. It's not just grass-fed ribeye. On the other hand, your grass-fed ribeye is $70 for a steak. That's ridiculous. But what if the true cost of that was incorporated in terms of the benefits to the soil and the water retention in the soil and the reduction in climate change and the health benefits of more omega-3 fats in the diet from the food they're eating? So we have to equalize that. And we put all these price supports for feedlot meat through subsidies that gross corn and soy, we destroy rainforests and destroy soil. None of that's incorporating the cost. And on the regenerative side, it's very hard for people to start that because it costs a lot of money upfront. It's hard to transition, and a lot of rangelands are not being used in this way but could be restored. I mean, I always talk about how we had 60 million bison in this country before we killed them all off to starve off the Native Americans. and now we have about 80 million cows. We didn't have climate change back then. We didn't have soil destruction. They were actually building tens of feet of topsoil. So how do we sort of rethink that and include that in the equation? So I think to me, policies that that actually help account for the true cost of food and reduce the supports for that in feedlot meat and then having subsidies and support for regenerative ag seems to be like a great solution. Right.

And you put that in conjunction with putting farmers back on the land who want to do the kind of farming that will support the environment, that will produce meat that's raised without torture and so on. And you're beginning to have a kind of comprehensive plan for how to address food. I think a big thing is, I mean, you asked what I would do if I were food czar or whatever. Another big thing that addresses that package that you just raised is how do we make land affordable for people who are going to farm it in a way that will sustain that land, as opposed to scraping off the top layer of topsoil, having the wind blow it away. And that's what happened to the prairie. A lot of it is just gone.

That was the Dust Bowl. We killed the bison and we got the Dust Bowl.

Well, we killed the bison. We killed the bison and killed the original people or moved them in order to be able to scrape the prairie down to the topsoil in order to plant the topsoil in wheat. And then much of that topsoil blew away during the Dust Bowl. And then there was an attempt to reestablish that environment, which hasn't worked that well. And it's certainly not a sustainable dust bowl system now either. I mean, it's only, what, 75? Well, I guess 90 years after the dust bowl, that land isn't repaired and that land is not being used in a sustainable way.

Yeah, it's really all interconnected. And that was what was so great about that article to create a 21st century national food policy, because it connected all these disparate dots and it pointed out a lot of points of light of people actually doing the right things that more support and help. And the truth is we have the potential to change what's going on with simple government policies like the good food purchasing program, for example, in LA is where the local government says we're only going to buy food for our institutional things that we serve as the government that's sustainable, that's high nutrition, that meets all these metrics and it's measured and it's reproducible. So those kinds of initiatives could be huge if we sort of put a little compost on them. Not gasoline.

That is spreading the good for food purchasing policy. And the great thing about it, and this is because of the terrific people behind it, but the great thing about it is that it even talks about the parts of the food system that aren't, again, we're talking about hidden costs for a bit or we're talking about factors that aren't normally associated with it, but good food purchasing policy says, well, we want this food to be grown by people who are treated well.

By.

People who have fair labor practices. So that we want to make sure that workers who are bringing us our food are treated well. That's a novel concept to say.

I.

Mean, you probably know that something like eight of the 10 worst paying jobs in the United States are in the food system.

Yeah. Farm workers.

The people who are bringing us our food, farm workers, food workers, retail workers, people who bring us food often are on food stamps. They can't afford to buy food in the same way that many of us do. So they're being underpaid. They're being paid minimum wage. There's wage theft in a lot of those kinds of jobs. They're being paid less than a minimum wage. They're tipped workers, which is a problem. And good food purchasing policy is a way that cities can say, well, we don't want workers who are in the food chain who are supplying us our food, our city's food, to be mistreated. We want them to be making at least a fair living wage. And that's a food issue. And that's- you- can't say that's not a food issue. It's a huge issue. And it's a big issue.

And the other part of it that people don't think about is that farming farming is the most dangerous occupation in America. And people who are farm workers die at seven times the rate as non-farm workers. And it's because of the pesticides and the chemicals and the farm injuries. And these are often poor, underserved workers who have no health care. And guess what? We pay for that. So all these costs are embedded in the system that aren't reflected in the price of food. we actually don't even talk about them. Hey, it's Dr. Hyman. If you enjoyed this video, you're going to want to check out this next video coming up. Inflammation, which is what I had, right?

Widespread inflammation in my nerves, inflammation in my gut, inflammation in my brain, in my thyroid.

Exactly.

It doesn't qualify as a treatable disease.

Inflammation. Right. That's what I was joking saying.