Why Ultra-Processed Foods Are So Addictive

Coming up on this episode of the Doctor's Pharmacy. Certain foods may seem like they're minimally processed, or maybe some protein powders that are okay, or protein bars from whole ingredients, canned beans, frozen vegetables, those are all fine, but be very wary about what you're eating, even if it comes from Whole Foods or ArogaN or some.

Great natural food store that you're shopping.

At, it can still be fraught with all sorts of problems. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real-time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hymen Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website, Supplement Store, for a summary of my favorite and tested products. hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to the Doctor's Pharmacy. Every week I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in. Let's talk about what exactly are ultra processed foods? What are the characteristics? How do we define them? Well, there's something called Nova classification. I'll get into a minute, but essentially it's deconstructed food. you basically take raw materials from things like corn, wheat, and soy, you deconstruct them chemically in a lab, you all structurally alter them so they're not actually the same chemical structure. And our body, remember, gets messages from the outside environment and regulates this biology through chemical signals that depend on the structure and shape of the molecule to create a signal in the body that does good or bad, right? It's really important. So these are funky, weird, Franken molecules, and then they're turned into food-like substances that come in every color, size, and shape. of chemically constipated yuck, basically. Now they're super energy dense, usually. They're high in calories. They have pretty much no nutritional value, usually. They're high in sugar. I mean, they may have added vitamins. You know, you get your cereal or fruit loops with added vitamins. Well, that's not exactly healthy. They are high in sugar. They come from all different sources, high fructose, corn syrup, dextrose, maltodextrin, cane sugar, fructose. There's a million different names of sugar. You can Google it and see. We'll put a link to all the different kinds of names of sugar, but they hide the names of sugar on the label so you get confused. Doesn't just say sugar. It's also high in refined grains. So these are highly pulverized grains that mostly wheat that are chemically altered and are not resembling their original form. And they're maybe from corn, from wheat, from beans like soy. Also high in unhealthy fats, usually trans fats still in the market, refined oils and so forth. They contain often excess salt. They're hyper palatable. They're easy to overeat. They're low in fiber, typically low in protein. They're low in vitamins and low in minerals. So all the things you need to thrive, they don't have. They also tend to spike your blood sugar a lot. They also don't make you feel full. So people who eat ultra processed food eat 500 calories more a day. This was a controlled study at the IH with Kevin Hall. Really impressive data. So basically people who were allowed to eat whole food versus ultra processed food as much as they wanted, the ones who ate the ultra processed food ate 500 calories more a day, 3,500 calories a week. That's a pound a week. If you keep doing that all year, that's 52 pounds of weight gain in a year. So what are the examples of ultra processed food? Well, it's potato chips, crackers, pretzels, candy, microwave popcorn. Don't ever eat that. Muffins, donuts, sandwich breads, cookies, flavored yogurts, puddings, Jell-O, breakfast cereal, granola bars, things with added sugar, food dyes, natural artificial flavors, colors, preservatives, gums, emulsifiers. Oh my.

Right?

It's a lot of stuff. So don't eat that. It's not food. Ready to eat meals, instant noodles and soups, frozen TV dinners, canned ravioli, pastas, packaged meal kits, nasty. Unless they're made from whole food. Processed meat and dairy. Again, we eat a lot of this stuff. Hot dogs, deli meats, fish sticks, which I don't even know what they are. Often they're not fish. Chicken nuggets, most chicken nuggets have like 35 ingredients, only one of which is chicken. Processed cheese slices are not allowed to be called cheese because it's not actually cheese and not 51% cheese. Various spreads, flavored milks, non-dairy coffee creamers, various protein shakes you have to be careful of, like isolated soy protein is deconstructed soy, potentially very cancerous. So we're careful of that flavor. So it's a soy, a soy shake. And that's like maybe really bad for you. Flavor, sweetened nut milks often can be problematic. You have to watch what's in them. And of course, sugar, sweetened beverages, soft drinks, lemonade, iced tea, soda, food drinks, punches, energy drinks, flavored coffees, all this stuff is just nasty. So you want to stay away from that. When it comes to a healthy diet, we hear a lot of these terms, ultra processed food, processed foods. Most people have no clue what they are. And I think it takes a little bit of education to understand. how to navigate this landscape of processed and ultra-processed food. Now, what does it mean? We're going to talk about the difference between ultra-processed food and other types of processed food. For example, Doritos versus a can of sardines. They're both processed, but highly different in their effect on your biology. It's one worse than the other. How do we tell the difference? We're going to get into all of that. Part of the problem today is that most people need a PhD to understand nutrition labels. And many must fall into the trap of convenience and just sort of get whatever seems good or whatever package looks like it's going to be healthy. And basically there's a health claim on the label. We think it's good for us, but that's basically one of my rules of eating. If it has a health claim, it's not good for you. In other words, gluten free potato chips or sugar free this. When it says that, it's always something bad that's added. So these are made by big food in order to allure you in and get you sucked in and trapped. As a result of that, we have a nation and a world increasingly where more than half the calories come from this hyper palatable, easy to overeat, ultra processed food like substance. And you have to look at the definition of food. Food is something that supports growth and life. The truth is these so by definition, they are not food. Just look it up in the dictionary. If you can convince me that these things are food, well, good luck, because they're not. And they don't meet any definition of what food should be like. And it essentially is a substance that helps support life and growth and ultra processed foods do neither. In fact, they do the opposite. Now, I'm not just making this stuff up. There's an amazing study. Now, it's a, it's an observational study, but it's, it's a very well done study. Recently published just news just out in the British Medical Journal. They looked at 45 different pooled meta-analysis involving 10 million people. The hook here is that these were studies that were not funded by ultra processed food companies. You know, we might have heard me talking the other day about artificial sweeteners and how there's a large study that showed artificial sweeteners are not harmful at all. But when you look at the funders of the study, it was the American Beverage Association, formerly known, my friends, as the American Soda Pop Association. Clearly, we need to look at data that is not corrupt. And when you look at studies that are funded by the food industry, it's eight to 50 times more likely to show a positive impact for their food product, whether it's dairy or artificial sweeteners or whatever. And when they looked at the data from this large pooled meta-analysis, I looked at people who ate higher amounts of ultra processed food, there was a 50% increase in the risk of cardiovascular death. It was a 48 to 53% increased risk of anxiety and other mental health disorders like depression. Now think about that. the risk of having heart disease and a heart attack and mental illness are the same from eating ultra processed foods. We, we get that, you know, these foods can cause obesity and diabetes and heart disease, but mental health crisis is also driven by these ultra processed foods. We did a whole episode on this. I think it's really important to go back and listen to it. We'll link to it in the show notes. There's also a higher risk of type two diabetes and many, many other conditions. Uh, they go through many conditions, autoimmune disease, inflammatory disorders. The evidence also show that there was a link between ultra processed food and a greater risk of death from any cause and a 40 to 66% high risk risk of heart disease related deaths, obesity, type 2 diabetes, sleep problems, and a 22% increase risk of depression. We're seeing this mental health crisis, obesity crisis, diabetes crisis, heart disease crisis, autoimmune crisis. I mean, the list goes on. Chronic disease is the number one driver of our health care expenditures. It's the number one driver of death globally. Why is this happening? We never had these problems. You know, I saw something on Instagram the other day. There was a video of from 1930s film, and there was not one person who was overweight in the entire video of people walking down New York, big change from then to now. And this has led to the epidemic of chronic disease that's driven by this ultra processed food. We're going to get into it. We're going to go deep in this topic and we're going to learn about how we begin to determine what is ultra processed food, what we should avoid, and hopefully maybe we'll live in a day when food labels are clear. I'm working on that in Washington with my food fix campaign on clear labeling and child friendly labeling. Let's get started with a case example of what an ultra processed diet can do to our bodies in as little as two weeks. You think, oh, this takes years and years to develop problems. Well, not really, my friends. You see, the results very quickly. Now, Tim Spector and a scientist from King's College in London performed a short term study on a 24 year old set of healthy twin girls. This is a different twin study than the vegan twin study. Now, one twin was assigned to eat an ultra processed diet, which included a typical breakfast of pancake syrup or cereal with a blueberry muffin, pretty much our average diet. Lunch was a peanut butter and jelly sandwich on white bread with chocolate milk and chips, and dinner was either a cheeseburger and fries or a meatball sub with cheese, crackers and a diet coke. The other twin ate a minimally processed Whole Foods diet. Now, each diet, and this is really important, each diet was controlled for calories. So they ate exactly the same amount of calories. I'm gonna say that again. They added, they ate exactly the same amount of calories. They also had the same amount of fat, same amount of sugar and fiber. But the difference was the processing of the food. Now, we're gonna get into what this means in a minute. What was striking about the study after just two weeks, that the twins eating the ultra processed diet had higher blood cholesterol and lipids, higher blood sugar, they gained more weight. Now, remember, they had the same amount of calories, friends. So It's not all about the calories. It's what the calories do to your biochemistry, to your hormones, to your immune system, to your inflammation, to your gut microbiome. It's not just calories in calories out. It's more complex than that. Also, the study showed they looked at their microbiome had a really negative effect on the gut microbiome. Now, we know that if you swap out in animals a healthy microbiome for a microbiome, for example, an obese mouse that the other mouse eating the same amount of food will gain weight. So we know that it's not all about calories, how they're processed, how they're metabolized and so forth. Now, none of these changes, these adverse that were in the twin eating ultra processed diet were seen in the twin eating the whole food diet. She actually lost weight. So one twin again eating the same amount of calories gained weight on ultra processed food. The other twin lost weight. Just register that for a minute. Now the results aren't published yet. Hopefully they will be. Again and again, I see my practice over and over again how ultra processed foods wreak havoc on our health and they do it very fast. The good news is you can reverse it very quickly too, right? So eating real whole foods can reverse these effects. That's what I did with my 10 day detox diet. And we saw amazing results in thousands of patients and often talked about this one patient I had in three days three days was off insulin simply after 10 years of diabetes on insulin, three days of eating this way completely eliminated her need for insulin. Now, how did this happen? How did this become 60 of our diet, 67 of kids diet globally? It's increasing everywhere. Well, the industrial Revolution spawned a whole bunch of advancements in food processing technologies and the mass production of canned goods and refined grains. And it was seen to be a boon to humanity, and it did help a lot. We got to preserve food, we got to store it longer, we got you know, be able to feed people who couldn't be fed. We have the hunger. So it wasn't all bad. In World War I and II, there was a huge catalyst for ultra processed food production because there was a huge demand for non-perishable foods shipped to soldiers overseas. And, and so it needed to be something was stable. It could be sent to the battlefield. It wouldn't rot. One of the basic rules of all the eating is only eat food that rots. I don't know if you saw, it was something I saw once. I don't know if there's a movie or something, but some guy had a forgotten like a Big Mac in his pocket. for years and it was fine. It hadn't degraded, it hadn't decomposed, it hadn't gone moldy. It was just fine. Now, you want to eat food that rots. That's a good, that's a good concept. So after World War II, you know, the economic growth and lifestyle changes that happened, women entering the workforce, there was an increased demand for convenience foods, fast food, TV dinners. There was a gathering of all the fast food and processed food makers in the, in the late 50s, as I recall. This was written about in Salt, Sugar and Fat by Michael Moss. We had, he was my first podcast guest, actually. And in that meeting, all these companies were like, we have to fight this trend towards eating real food, which there was another sort of group of people promoting that. They decided to make convenience king. And so they created a culture of convenience. They disintermediated people from the kitchen. They invited Betty Crocker to get recipes of junk food in the house. So you apply your Ritz crackers on top of your broccoli casserole or the Velveeta cheese or your can of cream of mushroom soup from Campbell's all in your recipes. So it was a lot of processed food in the recipes. And there was no Betty Crocker. She was a made up person. I thought she was a real person. My mom had The cookbook, but anyway, in the eighties and nineties, the food companies began engineering foods even more and, and they were engineering foods at an accelerated pace using all such technologies, a lot of them with additives, preservatives, emulsifiers, which are terribly damaging for your gut and microbiome. There's like 600, 000 of these products out on the market and start sugar, refined grains and processed oils became ubiquitous in supermarkets, vending machines, fast food outlets, and are basically what we call the SAD or the SAD diet, the standard American diet. Now, as I said, it's, you know, 60% of diet here, 67% of kids diets. It's more than half the energy in high income countries, even like Canada, the UK, Australia. It's nasty. The studies are clear on this. And we're linked, by the way, we're linking to all the studies. Everything I'm saying is evidence-based, is backed by references. You can just go to the show notes, you'll see them all. So studies show that the more ultra-processed foods that make up your diet, the less nutritious their diet quality tends to be overall. And the greater risk they are of developing chronic inflammatory diseases, heart disease, obesity, diabetes, cancer, high blood pressure, stroke, dementia, autoimmune diseases, depression. I mean, the list goes on and on. And according to CDC, more than 70% of deaths or 1.7 million deaths a year in the US are caused by chronic diseases, mostly caused by our processed food diet. This is a kicker. I've mentioned this before, but for every 10% of your diet that comes from ultra processed food, the risk of death goes up by 14%. This is from the Global Burden Disease Study. We'll talk about that in a minute. And that's enormous. So if you think of 60%, right? So it's six times 14. That's a big number. Increases your risk of death, not just getting a disease. Now, what's really scary is that the government is funding this. They're funding the subsidies that go into the agriculture that produces the commodity crops that are turned into ultra processed food, you know, benefiting from the incredible food stamp program, which is great, except that 75% of the SNAP benefits are used for ultra processed food and 10% are used for soda. It's about 10 billion a year. We're working on trying to change this in Washington and we have a bill now in to prevent ultra processed food from being purchased with SNAP dollars if you're a kid, because we know these deadly for kids. The data is so clear. Now, what's the difference between ultra processed food and just regular processed food? I read an article in a nutrition journal years ago about defending processed food as being something as old as humans. We've been, you know, drying food and preserving food and fermenting food and curing food for a long time. So what's the big deal about processed food? If you look at the funders of it, if you look at the journal, it's just funded by the food industry. It's so corrupt, my friends. It's so corrupt. I wrote about that, I think, in my book, Food Fix, or, you know, one of my other books, but it's a pretty lightening thing. Unless you just pick an apple from a tree and eat it or just eat a raw egg, most food is processed to some degree. Cooking is a form of processing, right? It's not really that processing is bad. It's what is the processing? So minimally processed foods are fine. We've been doing it for thousands of years. Olive oil is processed food. Yogurt, but hopefully from A2 cows or goat or sheep, right? That are generally raised. Cheese is a processed food. Canning foods, so sardines, canned tomatoes, fermented foods, sauerkraut, miso, frozen foods, beef jerky, dried foods. Basically, those are all processed foods. but they're fine. If you can recognize the ingredients, if you know where they are, if you can see the number of steps it took to get from farm to your fork, it's okay. If it doesn't have a list of weird Franken ingredients, that's okay. It depends on how they're processed. Certain foods may seem like they're minimally processed. There may be some protein powders that are okay or protein bars from whole foods, canned beans, frozen vegetables. Those are all fine. But be very wary about what you're eating, even if it comes from Whole Foods or Arawon or some natural food store you're shopping at, it can still be fraught with all sorts of problems.

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 Continuing to eat these things despite knowing the adverse consequences to it and repeated attempts to try to quit. I'm describing addiction here basically and the consumption of larger quantities over time than intended.

People go, it's emotional eating, it's not really biological true addiction. 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 down regulate 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. Sugar 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 that 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. Yeah. You know, just to give context as to, you know, why I wrote about this and why I'm working on this as well and continuing to feel, you know, motivated to continue to do my work is the shelter in place order had come, you know, a couple of 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 a UCSD 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. 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... 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 car in front of me that it's full of the recreational food as I mentioned, the 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. is 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 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?

Right?

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 of that? Yeah. Yeah.

So going back to that, 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 their 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 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, they're thinking about medication and and prescribing antidepressants, but they don't really work as well. And 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, 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, you know, a long way. They've, 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 of 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's 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 mentioned earlier that 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, I spent a lot of time with him and he talks about this whole idea of a metabolic tune-up 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 that 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, you know, 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 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. It's 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 in our group's work, metabolic psychiatry, is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms. Yeah.

There's nothing more disruptive to the healthcare system than a child learning metabolically healthy habits. And what do you have? You have the media that's funded by pharma not investigating why pre-diabetes and obesity is skyrocketing among kids, but actually saying it's anti-science to question a pharmaceutical protocol. They're actually saying it's fringe and anti-science to talk too much about nutrition, to talk too much about meditation, to talk too much about exercise. actually, that's actually refereed as Fringe by the media.

What is interesting, though, because if you look at the guidelines from most professional societies, like the American Heart Association, American Diabetes Association, National Heart, Lung, and Blood Association, the first step of therapy for any of these cardiometabolic diseases, whether it's heart disease, diabetes, high blood pressure, is diet and lifestyle. It's the first thing that's recommended. Yet it's not Fringe. It's actually part of the essential guidelines. And, you know, the, the, I want to get into sort of how to fix this in a minute, but I just want to dive deeper into how corrupt this system is that you're really so good at articulating. There was a sort of investigative reports that use FOIA, which is Freedom of Information Act, to get emails and direct correspondence from food industry companies like Coca-Cola, for example.

And.

They were really so egregious in their behavior and was so clear that they had a coordinated strategy. And this review in Critical Public Health how food companies influence evidence and opinions straight from the horse's mouth. They said, the results provide direct evidence that senior leaders in the food industry advocate for a deliberate and coordinated approach influence scientific evidence and expert opinion. The paper reveals industry strategies to use external organizations, including scientific bodies and medical associations. Right? I think they, I think the, American College of Cardiology has 192 million or the American Heart Association, $192 million in funding from food and pharma a year. They influence scientific bodies, medical associations as tools to overcome the global scientific and regulatory challenges they face. Challenges of what? Not selling their shitty food. The evidence highlights the deliberate approaches by the food industry to influence public policy and opinion in their favor. And that is really the crux of this whole thing. And so the question is, you know, if we're for battling billions of dollars, literally billions of dollars of money that's spent on either influencing public opinion through coordinated campaigns, through media, through co-opting the advertising on television and other channels, through lobbying, through these front groups, through corporate social responsibility, the co-opt social groups, through co-opting nutrition research, I mean, co-opting universities and medical experts. How do we battle that? Where do we start? And I want to hear what you're doing because I think it's really important to look at not just the problem. I think, and I've defined the problem well in Food Fix. I think we need to talk about the fixed part as opposed to the food, I didn't call the book Food Apocalypse, I called it Food Fix. And I think we're kind of in a food apocalypse, but I think we.

Need to think about the fixing part. Well, let's dive into solutions. I want to be really clear because it's bottoms up and top down, but I want to be clear. I think we'll dive into some top down. There's a big bottoms up empowerment message here. And my message here from being inside the room with these industries is that it's worse than you think. And these people are not smarter than you. They're not impressive. They are rigging the system and we're buying into it. We're still buying into it when there's a Harvard peer reviewed study. We're still letting these studies convince us that glyphosate essentially a neurotoxin that's banned in most of the rest of the world is fine to give to our kids. We're letting them convince us of this. And my message from the bottoms up is trust yourself, is that the system has completely let us down on managing and preventing chronic conditions. And we need to take much more responsibility for our health and our kids' health there. And frankly, listen to the experts but not give them the benefit of the doubt. out and that humans and animals we've domesticated are the only animals that have systematic metabolic dysfunction. Like animals in the wild. There's cats. There's cats and dogs.

So there's real obesity in these animals.

But there's not many obese wolves. The obesity rate among dogs is over 50%. By all measures, the depression rate is actually off the charts among dogs. It's like over 50%. There's not a lot of obese depressed wolves in the wild. There's not obese giraffes, there's not obese tigers, right? Every single animal in the world.

I did see some pretty fat hippos when I went to the zoo.

So technically, by their measure, everyone breaks that up. Technically, they're not obese.

They're made to have some extra fat.

So you don't, you just, every animal is born, including humans, with an innate sense of what's right for them and they gravitate to natural food, they gravitate to sunlight, they gravitate to movement. We, the experts, are beating that out.

Of humans and we we, we, we.

We, we Rob our domesticated animals of that. So I really do think there's a spiritual crisis, a Bottoms Up situation where we need to get back to understanding where our food comes from and trusting ourselves and, and giving a little less Credence to the experts. But I want to be clear, we need to change the top down. There are trillions of dollars of incentives against the American people. I think we are entering a big year in 2024 where I think people are waking up and there are specific easy things that we can do.

Yeah, I think it's amazing how unaware most policymakers are of these issues. They're so co-opted. And like you were talking before about how they're influencing policy. Well, it even goes deeper than that. They literally show up in Congress with white papers and research and graphs and charts proving why All their facts, quote, facts are right. And then they, not only do they suggest policy, they literally write the policy. They write the legislation and they give it to the congressmen and the senators and have them submit it into bills. And so literally our policies are often being written by the industry. And I was talking to Sam Cass who worked in the Obama administration on food issues with Michelle Obama. and he said, you know, Mark, nobody came from the good guys. All we heard was from the food industry with these big briefing books and all this convincing data and the congressional staff and the members of Congress don't have time to study this and learn about it. And so they basically just kind of buy it and move forward with it. And so he said, we need to hear from the good guys. And you and I are not from some big lobby organizations with billions and millions of dollars behind us, but we've been actually hitting the street on her own dime, going into meeting with members who are open to meeting with us actually, and talking about these issues. And I've been sort of shocked at how interested they are, how much they get it once you unpack it for them, how they begin to kind of their light kind of comes on in their eyes and they go, holy cow, we need to do something about this. And then they recognize it from their own lives because, you know, guess what, they're American too. And if one in six in ten Americans are chronically ill, probably six in ten congressmen or more have chronic illnesses and their families do. And so it's starting to become something we can't ignore. It's not too big to fail, but too big to ignore. And so let's talk about some of the kinds of policies that might be effective. Now, some things I think I would do if I were king that are gonna be challenging to get through legislation. So let's talk about things that are maybe aspirational and things that are really practical that we can be doing. Let's say if we got a new president who is aware of this and we're in a political campaign year. So we have a number of people talking about this from the Trump campaign, RFK, whether you believe what he says or not in terms of his overall strategy, either of those candidates, I'm not proposing for one or the other. What I'm just saying is this is the first time I hear on a presidential campaign some of these issues being talked about. And I think it's so important. So what are you kind of hearing about this out there on the field and what do you think would be the sort of first steps that we could take to start to shift these policies?

There are six things a new president could do from either party that I think would have 90% support among the American people and could be done in a matter of days. and dramatically improve the health of Americans. I think one lie we've been fed is that solutions are complicated to this issue or that things won't change quickly. I don't think Americans are systematically trying to give themselves diabetes to miss walking their daughter down the aisle, to miss like my mom did meeting her grandchildren and dying early. I think Americans want to be healthy and incentives are stacked against us. And if we can change them in a systematic way, Americans are gonna get towards the right decision. So there are six things. The first thing, RFK, others have talked about this, but I think it's really important to understand, it's banning pharma ads on TV. Now, I think there's misunderstanding.

What about food?

Okay, so let's get, food is very important.

Junk food marketing.

Food companies aggressively lobby the Federal Trade Commission to have processed food ads on Nickelodeon. It's the number one ad spender on Nickelodeon. and looking at YouTube Kids content, it's all processed food garbage. And we're one of the only countries in the world that allow that type of marketing to kids. So food is a big issue. But let me unpack real quick a misconception about pharma ads. So this is the key point here. And this is from working with the pharma companies. Everyone needs to understand this. The point of pharma ads is not to influence consumers. It's to influence the news itself.

Yeah.

Okay. So you see these goofy ads with the people dancing and it's like, okay, okay, that does bleed in and that does lead to consumers to want those drugs. The key point about pharmaceutical ads is that they're paying the bills of the news itself.

Right.

So again, we talked about this at the beginning, but we have to get our heads around this. More than 50% of TV news spending comes from pharma. It is an astronomical number. And it's so simple that if your bills are paid by an industry, you are not going to criticize that industry. You're gonna self-censor. You talk to any politician. The media is supposed to be asking tough questions. The media is supposed to be holding institutions to account. I have not seen on mainstream media an examination of what is clearly the largest issue in the world of our kids being poisoned by toxic food and every chronic disease skyrocketing among children. Is there an examination of the root causes?

Of that?

No, the media right now is referees criticizing anyone who even dares to question pharmaceutical solutions, calling them anti-science. The second, you can do this tomorrow.

The office- well, let's just talk about this, because I think it's important in this thing about the advertising. It's both the advertising of pharmaceuticals and also food. And the pharmaceutical ads, I think do you know, drive what the media puts on the air or not. And I've noticed I've been censored on different shows because of my views. And I remember one time, and this is related to sort of a food thing where I came up with this idea for the Today Show, which was talking about 100 calories foods. And there's this 100 calorie snack, 100 calorie cookies, 100 calorie whatever. and I was like, are they the same? Is 100 calories of blueberries the same as 100 calories of Oreo cookies? And basically, this is what the food industry was trying to push. And I got through a producer, I don't think it went through the hierarchy of approval, and we got on the air and then talent got on and she immediately kind of noticed what was going on and she tried to deflect and change the conversation and make it about something else. And then I never got asked back on the show. And I think, you know, I was on the Martha Stewart show and they were having a show about health and nutrition, and they had her trainer on, and the show was supported by the Dairy Council, and they had literally cue cards for her trainer of what the talking points were from the Dairy Council. Now, when you're a talent on television, you don't get cue cards, you don't get a teleprompter, you have to know your stuff. And so she was literally reading out the Dairy Council, and I said to the producer, why are you doing this? She says, well, this is not factually right. I said, Here's all the research to show why this is wrong. And I send him all the research, well, I'm sorry, but we have to do this because of the Dairy Council. And I think you're right, it controls It controls a narrative, it controls what's on TV, it controls what people are saying, it controls things like what's on 60 Minutes where Fatima, Dr. Fatima, what's her last name? Stanford. Stanford from Harvard was basically saying that all BC is genetic. It's nothing you can do about it. You have to take these drugs. I mean, and she's now on the Dietary Guidelines Committee, which is very concerning to me. And so I think these are highly disturbing to me. Oh, 100%. No, I just think and the other issue is the amount of direct targeted marketing at children in the research. research on that is staggering. It's literally billions and billions of dollars that are spent on targeted ads towards kids, not just through television, but now through social media. There were, I think, over five billion little ads targeted to kids just on Facebook for a game programs that are embedded in the game programs. And so it's kind of everywhere. It's insidious, it's invisible. And now you can't just say, don't watch television because kids are on their screens and it's all getting in there. even even know the half of it. So then we've got the food industry having having all these experts on social media touting the benefits of junk food and how artificial sweeteners are good. And, you know, they basically pay huge amounts of money to these these groups. And it just it's it's sort of frightening to me. And I think, yeah, yeah. Anna Hadd O'Connor, a reporter at the.

Washington Post, who's the best food reporter in the country, should win the Pulitzer Prize.

He actually helped me with my book, Food Fake.

He's amazing. I mean, he he is incredible. He's fearless. And he traced all of these nutritionist influencers on TikTok and Instagram, undisclosed payments from food companies to say that processed food is good and attack anyone probably attacking you for people. These folks are attacking you and they're talking attacking other doctors who are saying, frankly, having the gall to say that we should eat whole natural food. That's literally There's a coordinated effort paid for by food companies to do that. I was recently speaking to Jillian Michaels who's a partner with her companies at True Med, exercise fitness companies. She was recently, I believe, on CNN and viciously attacked by the anchor for being anti-science for suggesting that Ozempic wasn't the real root cause treatment for obesity. And her saying that exercise, they actually attacked her for being anti-science for saying that exercise might be a better root cause intervention Of course, right after that segment was an ad for Ozempic. They're individually the fourth largest advertiser for cable news. Novo Nordisk sponsors 60 Minutes that ran that segment unquestionably saying that obesity is a brain disease and genetic and not tied to what we eat or exercise. So from the swamp, from my early days in DC, I know a lot of these folks that work at the large mainstream media stations, and they've told me privately, it is an absolute moratorium on anything critical of processed food or anything critical or examining why people are actually getting sick. There were not many segments on COVID essentially being a metabolic condition. If you were metabolically healthy, you had an almost 0% chance of dying of COVID no matter what age you were. The best thing that we could have done in rally the country to do was become more metabolically healthy, there was not an examination of that on mainstream news. So I think there's nothing conservative, there's nothing liberal, there's nothing ideological about letting this industry buy off the news. It's a day one solution. The Office of Prescription Drug Promotion at the FDA has control over this. It's an executive agency. And just as we had dramatic and quick and robust actions to defeat and combat COVID. We've got a bigger issue than COVID right now. Our kids are absolutely on a downward trajectory, and tomorrow the president can issue a directive to the Office of Prescription Drug Promotion and say, we're not gonna let the pharmaceutical industry buy off the news.

And we're the only country other than New Zealand that allows this.

It is absolutely unprecedented and it controls our information.

But it also actually influences doctors too, because the science shows really clearly that when a patient asks for a drug they see on TV, 60% of the time they get that drug.

Well, of course, once you get someone under chronic disease treadmill, again, not impugning any individual motivations, that's great for the system. Ozempic, they're literally, you couldn't create in a lab a better economic model where you have to, somebody has to both take a injection for the rest of their life, and that injection implicitly sets that patient that they don't need to eat healthy. It's perfect. They're inevitably going to keep coming back to the doctor's office again and again. They have to for read prescriptions.

Yeah.

And by the way, the pharmaceutical approach to chronic disease can be useful sometimes, but it really isn't the solution. And people who are listening obviously know the focus of functional medicine and how much of a better root cause analysis that is in a system for getting to the real problems and fixing those problems often without medication. I think it is huge. I also think, you know, maybe we can't limit, you know, marketing to everybody for junk food, but we surely, you know, have eliminated television ads for cigarettes. We surely could eliminate ads for ultra processed food to children. And I think, you know, we're one of the few countries that also allows that. And I think in Chile they had an incredible example of how they basically repealed that ability for food industry to market to children. There was no ads between 6:00 AM and 10:00 PM. on any media. They removed all the cartoon characters from all the cereal boxes and they basically put sort of warning labels on the food. And what they found was that the biggest impact was removing the ability of these companies to market to these kids and to hijack their brains. And I think, you know, whether, whether, you know, you know, it, it, you know, it's, it's a free speech, First Amendment thing. I think we do really clear. The data is so clear on how Ultra processed foods harming us and how it harms kids. For every 10% of your diet that's ultra processed food, your risk of death goes up by 14%. It's the number one killer globally on the planet. It causes depression, it causes obesity, it causes all sorts of chronic diseases. It dysregulates our appetite. There's no lack of evidence. And I think if we could also, I would say, add to that executive order, the restriction of food marketing to kids, it would be huge. I don't know if the president can do but I think that's a congressional thing.

There's a potentially aggressive act the president could take. I would urge a president to get a aggressive lawyer. I think we are in an emergency right now, and that is an executive agency. So I think we need strong leadership from the only politician in America who's responsible for everybody, which is the president. And I think that is a potential executive executive action.

They're calling this a national emergency. It is.

Well, we are in a national emergency. And I think you want to be careful about abusing that power. But if there is one national emergency of our generation, it is that we are taking children and absolutely annihilating their metabolic health and microbiomes with these toxic foods. I mean, again, it's not a free speech issue.

If you say metabolic health, I would also add their mental health.

The mental health. Well, the microbiome is highly tied to mental health. It's where serotonin is produced. Ozempic is now being investigated by the EU for causing a sharp increase in suicidal ideation. Why? Because it's gut dysfunction. It's messing with your, literally with your microbiome, with your gut, which produces 95% of your serotonin. You know, the brain-body connection. Of course these things are connected. So, I don't think many people think we should be advertising cigarettes kids. And as you made the point, you do a brain scan of a kid with highly processed food, with sugar, it's a very similar dopamine response. And there's absolutely case law that it's okay to have some limitations on advertising highly addictive substances that are very harmful, that are causing millions of unnecessary deaths and early deaths to kids.

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