How Your Diet Affects Your Behavior, Risk Of Disease & What You Should Do About It w/Dr. David Perlmutter EP 1211

This is episode number 1211 with New York Times bestselling author, Dr. David Perlmutter. Welcome to the School of Greatness. My name is Lewis Howes, a former pro athlete turned lifestyle entrepreneur. And each week we bring you an inspiring person or message to help you discover how to unlock your inner greatness. Thanks for spending some time with me today. Now let the class begin. [Speaking of] Welcome back, my friend. Today's guest is Dr. David Perlmutter, who is a board certified neurologist and five time New York Times bestselling author. He received his MD degree from the University of Miami School of Medicine, where he was awarded the Leonard G. Roundtree Research Award, and he currently serves on the board of directors and is a fellow of the American College of Nutrition. He's written a new book called Drop Acid: the Surprising New Science of uric acid, the key to losing weight, controlling blood sugar, and achieving extraordinary health. In this episode, we dive deep about how your diet can contribute to your behavior, the real reason most people are addicted to sugar, how to reduce the risk of Alzheimer's and other diseases, the emerging science behind uric acid and everything you need to know about its effects on the body, and so much more. I'm excited about this one. I hope you really enjoy it. Make sure to share this with someone that you think would be inspired by this message as well, as we are all about helping improve the quality as many people's lives as possible. So, please share this message if you find it helpful. And a quick reminder, this is your first time here. Please subscribe over on Apple Podcast or Spotify to the School of Greatness to stay up to date. We've got over 1200 episodes from some of the biggest minds in the world, some of the greatest athletes, doctors, nutritionists, scientists, leaders, all about how to improve your life. So, make sure to subscribe and stay up to date on this podcast. And I want to give a shout out to the fan of the week from Ro who said, Lewis, highlights all self-help topics and more in this can't miss podcast. He and his guest experts offer insightful advice and information that is helpful to anyone that listens. So big thank you to Ro for being a fan of the week and leaving us a review over on Apple podcast and very excited about this one. So in just a moment, I bring you the one and only Dr. David PearlmuttEr. I definitely have my favorite type of workouts. But I think we can all agree that changing them up often makes it easier to stay excited for our fitness goals each day. Of course, it can be hard to always come up with new types of workout routines, which is why I love Peloton. They are always coming out with new stuff to help switch up your exercises, especially right now to ring in the new year. The Peloton Bike and Bike+ are releasing new classes, new music, and new ways to keep your workouts fun and motivating. And guess what? I'm super pumped about this. Peloton is adding boxing to their workout lineup. No gloves needed. I've recently gotten into boxing and let me tell you it's an incredible and super fun way to get your exercise in. Even if you've never boxed before these classes will have you working up a sweat while working on the fundamentals of form, footwork and fun combos that will keep you on your toes. For a limited time try the Peloton app free for two months then $12.99 per month after. New members only visit onepeloton.com/app to learn more. That's two months free at O-N-E-P-E-L-O-T-O-N.com Offer expires January 31st, 2022. Terms apply.

What are those main foods or ingredients that keep us in fear-based brain activity.

As opposed to the- Excellent question. So it's really foods that threaten metabolism. In other words, refined carbohydrates, foods to which you may be sensitive as a unique individual, and foods that tend to elevate uric acid. so, and these are the foods of the day. By and large, the biggest issue for us is fructose leads to uric acid and turns on inflammation, turns on oxidative stress, does other things that we'll talk about. But beyond that, through the lens of what that's doing to our thinking process and locking us into amygdala-based behavior, it's a big deal. It's, we're watching it play out around the world. You feel the shift. There was always conflict in the world, but there's never been the polarization like we're seeing now.

I know.

And the lack of compassion for your fellow human. The Dalai Lama said that if you want others to be happy, practice compassion. But if you want to be happy, practice compassion. So it works. That's tapping into your prefrontal cortex.

It's funny, I was just interviewing a therapist psychologist, Dr. Ramani Durvasula, who is the leading expert on narcissism and narcissism personality disorders and all things narcissists. And I'm curious if part of narcissism are these fear-based, you know, reactive thoughts and emotions could be diminished by the things people eat and be less narcissistic because most narcissists are- We have chapters.

On that exact topic. Oh yeah.

In the book.

Not in that book.

Okay.

In the book I'm going to send you brainwashing.

Wow.

But you are correct. So narcissism is really just the amygdala doing its thing. That it's all about me. It's all about ultimately my fears. So it's a very fear-based program from which the brain operates and reality is seen and doesn't really have the door open in any way for the feelings of others and what I might do to be helpful for that other person. Really? And so as I described, food, because it separates, it segregates the a prefrontal cortex from the amygdala.

The amygdala is the fear-based part of the brain, right? But it dictates behavior. The amygdala dictates behavior. That's right. So, if it's turned on and fear-based.

All the time, it's pretty hard to have a compassionate, calm behavior. You're locked out from that. You're kept out of God's kingdom. Wow. So, this prefrontal cortex exercises the control, reins that in and says, Hey, you know, I know you want to eat this food now. I know you want to do this. I know you want to be a bully and hit somebody. But we're going to rein that in because there's a better purpose here in life, you know? And that's what we, that's our gift as humans. The opposable thumb and this prefrontal cortex, right?

Yes.

And that, so that super highway, that communication that's bi-directional we really depend upon to get the job done as humans living together on this planet. When that is compromised for any number of reasons, we don't have that ability and we're locked into that other mentality, clearly a mentality that's based on a reptilian brain. That is feasting, that's fear based and reproduction, basically that's it. It's all about my needs and what I want. What I want and right now.

That's the amygdala.

Yeah, and what threatens this disconnection One of the most powerful threats is the process of inflammation. And that takes us back to your question. The foods we eat which fan the flames of inflammation by disrupting our metabolism separate us from the input of the adult in the room and lock us in. And it's a feed forward cycle, meaning that the more that you've locked out the prefrontal cortex, the worst decisions you make as it relates, for example, to the foods you eat. You continue to eat those bad foods, and then inflammation is augmented.

You keep making bad choices in your life. You're reactive.

You spiral down and now you're in a...

So how do you get out of that?

Well, so we offer it up, what are the off ramps? A whole program based upon what you can do to choose to meditate for a few minutes a day. We'll expand that with time, getting out in nature, getting enough restorative sleep, perhaps being a little bit more proactive about following your blood sugar. In that book we didn't talk about continuous glucose monitoring. We have a whole section in this book about that. But talked about those foods, if you could give us one week, we're going to help you redirect.

So in Brainwash, you have a couple chapters on narcissism, specifically.

Well, actually, when you really read the book, you're going to realize that it's throughout the book. It's a commentary about where we are how we got there and what you can do now to get us away from that.

Well, it's, I mean, with social media and using, I think everything is a tool. I think everything is a tool. You can use social media to benefit people or you can use social media to benefit yourself with this selfie culture, right? Of me, me, me, look at me, me, me. And I'm curious how that plays in with our eating habits and nutrition habits based on the, I guess, the psychological seeing yourself all the time and getting attention for how you look all the time on social media from random strangers as opposed to when you just used to walk out in the street and get attention but now it's just like in a moment you can get this dopamine hit.

The original term for that was Snapchat dysmorphia where you had to cultivate your social media appearance not so much your real appearance of what people will experience face to face in terms of not not just what you look like, but what do you got underneath it? Which is truly what matters, right? It's really less about what you look like. It's about what you portray, how you interact, what is your message, what is the message, what is your contribution. That's what to me, I think, really seems to matter. But that stuff is so underrated now. It's all about what you look like, and it has to be within the first three or four seconds, and that's end of story.

So in brainwash, you're talking about social media, narcissism and all these different things. How are those affecting us in what we choose to eat as well? Is it part of the cycle when we get these dopamine hits for looking good or our social media? Do we then choose to eat certain foods from that? Or what is that?

No, I think that that's an excellent question. I think that the answer is no, because I think we either eat what we want to eat or we eat what we know is good for us. Now what we want to eat, what's deep in our brains is sugar. Yes. So we are deeply programmed. Every person walking in the plant, you're laughing because you know exactly what I'm talking about. That's my advice. You know, I don't drink, I've never.

Been drunk in my life. I don't drink alcohol, I don't smoke, I don't do drugs. But sugar is a thing that when I'm disciplined, I can be completely off of it.

When the prefrontal cortex is in the.

Driver'S seat, when the adult is in the room, But when I'm not disciplined, I can just be like, oh, let's just eat as much as you want. So it's always been an opportunity for growth for me, let's say. Where there's seasons of life where I'm extremely clean and other seasons where it's like, ah, you know, just have as much as you want. And it always affects me. What are the main risks of sugar in the first place? And why should they be aware of it before figuring out how to get it under control?

Well, let me go back to just the notion of your sugar. desire. You are like I would say seven plus billion people, meaning it's what let us survive. Our desire for sweet. We're deeply programmed. It's not learned. It's not an app that we picked up along the way. It came when you bought that computer. It was built into the hard drive that we will seek out sweet. Why? Because sweet tells us that a food is safe. It tells us that it is ripe, meaning highest in nutrients. It's good for the fruit because that's when the seeds of that fruit need to be dispersed. So everything works together. But it also tells us that winter's coming, which means it tells our bodies to shift metabolism and start making and storing fat. It turns out that the danger signal that winter's coming, the signal that tells your body to make that happen, involves uric acid. And this is something that happened to our ancestors around 14 to 17 million years ago when the Earth became cool. And certain primates who developed mutations in the genes that dealt with an enzyme called uricase that breaks down uric acid, they developed mutations that turned that enzyme off so they couldn't break down uric acid, so uric acid levels would elevate they survived. Not that they got fat, but they stored just a little bit more fat so they might survive whereas the other primate might not, and then they would pass the genes on. And that comes to us. That's why we make fat when we're exposed, for example, to fructose. It was a powerful survival mechanism and we carry it today. The problem is now fructose is everywhere and every food we eat so we're suffering from this evolutionary environmental mismatch. I mean, that's the premise of the paleo movement. Let's try to emulate an environment that our Paleolithic ancestors must have experienced in terms of lifestyle, exercise activity, and certainly food and sleep. So it's not that the gene is necessarily bad, it's the context of today bombarding that gene pathway with the signal that says you better make fat and make it fast because winter's coming and you need to be ready. You need to lay down some fat. You need to raise your blood sugar to power your brain because there's not going to be any food. You need your brain so that you can forage and find some food. That's our ace in the hole. That's our high card. So that's why there's all this excitement then about the relationship between fructose, the downstream metabolite which is uric acid, making more sugar, making more fat, and really a central player in our metabolic mayhem.

And how much does sugar affect the brain?

Well, the brain does run on a form of sugar called glucose. There is even some suggestion that the brain can metabolize a small amount of fructose. That's really kind of recent data. But how it, the brain is not tolerant to any significant degree of disruption of our metabolism, this what I call metabolic mayhem. Because this disturbance of our metabolism sets the stage then for inflammation. And that is the underlying cornerstone of brain degeneration. Alzheimer's is an inflammatory disease, like coronary artery disease, type 2 diabetes, obesity. These are inflammatory conditions. So, you know, Alzheimer's is very much the brain on fire, which is what the word inflammation inflammation means to be on fire. So we've got to do everything we can to put the fire out as an intervention.

And to prevent it as well.

Yeah, and to have there been cases.

Not to go off topic here, but have there been cases of-- We're deep.

Into the woods, we're good.

Have there been cases where people have had Alzheimer's that have reversed it? Is that possible?

Yes.

Really?

There are. There are books written about it. In fact, I wrote the foreword to a book by Dr. Dale Bredesen who is here in LA at UCLA. And he has reversed it now in over 100 patients who have oh, absolutely. Early stage or is this like- Early to moderate, yeah.

Wow.

Yeah, he's gotten people back to work. So, we live in a world, Western medicine of monotherapy and we're going to create a magic pill for you that will take your diabetes away, for example. I was giving a talk in New Jersey to 500 mainstream doctors, why they chose me, I don't know. But I said, how do you treat diabetes? And people would raise their hands and say, oh, I use such and such a drug. I use this or that. And then I said, well, what happens when you stop using that medication? They said, well, within a day or two, the blood sugars go up. So I asked the question, did you really treat the diabetes? And then I presented data from a Dr. Sarah Hallberg where using a ketogenic diet reestablishes insulin sensitivity and people don't need medication. Published research. That's treatment. So again, we're not treating diabetes with the drug and we don't have a drug for Alzheimer's. Doesn't exist. I wish there were such a thing. We know what happened with this ad duhelm drug that was put out in February of this past year. And finally, mainstream neurology said, you know what? This isn't working and challenges the notion that this accumulation of beta amyloid is the cause of Alzheimer's. Getting back to Dr. Bredesen, he's identified 36 different inputs that can affect the brain in different ways and identifies in each patient what is disrupted. Is it brain energetics, meaning the brain's inability to use glucose as a fuel? Is it inflammation? Is it toxic? Is it infectious? Is it previous trauma? What is going on in the brain? Let's work on that rather than one size fits all. You're gonna take this pill and lo and behold you're gonna get better. So it's a paradigm shift. And I was in the intro to his book or the forward, I said, you know, this is on par with washing your hands before delivering a baby. You know, it's that big of a deal.

What would you say, based on all the research you've done and also with these other doctors you've worked with, would be the three or four or five key things to eliminate or to do to prevent Alzheimer's or to start reversing it in the early stages?

So again, I think the most important thing is to realize that it begins a lot earlier than you think.

How early?

30 years before clinical symptoms, at least. That's what our peer-reviewed literature is telling us. And I'll tell you why, because a study that appeared in the journal Neurology looked at, created what's called an inflammatory composite score, and they looked at people, they did blood work, and they created a marker of their level of inflammation, and then they went back and evaluated them 28 years later, and they perfectly correlated who got Alzheimer's with how high their inflammation score was 28 years before.

Oh my gosh.

Now we've seen the same thing with waist circumference. Three decades. We've seen the same thing with brain scans that look at glucose utilization are predictive long before people began to forget their grandchildren's names. So the point is, when does it begin? Does it begin in the 30s? and I would submit it begins a lot earlier that when we see adolescents now that are diabetic, that are obese or significantly overweight, when we see teenagers in high school experiencing head trauma from contact sports, these are issues that are profound. We know that inflammation, the set point of inflammation to some degree is determined before a child is even born. based upon the gut bacteria.

Oh my gosh.

Of the mother. And we know that, for example, how a child is even born, vaginal birth versus cesarean birth, plays a huge role in determining that child's level of inflammation, immune function, risk for autoimmunity, and even risk for obesity later in life.

Based on how they're delivered.

How they're delivered. If a child is born by C-section, doesn't pass through the vaginal birth canal, doesn't get those bacteria that are there to anoint that child. Passing through the birth canal puts bacteria in the mouth, in the nose, in the eyes throughout the body of that child that then are the seeds to create that microbiome for that living being. Wow. As opposed to picking up bacteria in the operating room because mom had to have a C-section. There is a time and a place for a C-section, but a third of American births are C-section right now. Right.

So, you're saying if there's like, this is an extreme complication, we've got to do a C-section, that's when you say, Hey, yeah, we want everyone safe.

The umbilical cords wrapped around the child's neck, whatever it might be, but as a matter of convenience or not wanting to, whatever.

Not dealing with a certain amount of.

Pain or whatever it is. And I think that the narrative that that's given to mother and father to be is, you can either deliver or we'll do a C-section, let's say Thursday at 11:00 a.m. How does that work for your schedule?

Yeah, convenience.

Yeah, and how big will my scar be? Well, we need to have a discussion that C-section delivery has lifelong implications for your child. Significant increased risk for autoimmune conditions like type 1 diabetes, for autism, for celiac disease, all increase in kids born via C-section. And, you know, that's published literature.

Is there a way to, let's say, you know, there was an extreme complication and, you know, there was going to be an issue if there was not a C-section for whatever reason. There's a way to get that bacteria into the child. That would help you.

How would you do it?

I'm asking you, I don't know. Is there a way to do that? Is there a way to I have no idea.

In fact, it's a wonderful question. I like where you're thinking. So if you were a research clinician, you'd fall asleep tonight thinking, what could we do? The child should get this array of bacteria from passing to the birth canal, but they're bypassing that. What can we do? Maybe they would, I don't know. Go ahead.

I was thinking, well let's inject them with something.

Close. So here's what the research at NYU has looked at and that is taking a cotton swab, swabbing the vaginal canal.

And then putting it all in there.

And then when the baby's born, covering their face with it.

So that's already being done.

Does that work? It's in the early stages of, you know, people want to play it out for a few years and see what it does. But that's exactly what it does.

Right, right, yeah. Swab it around and put it on their whole body and you bet. Put it in their mouth a little bit.

They're definitely in the mouth. No, no, no, yeah. See if it works, I guess. And the reason they're doing this is because the gut bacteria and in fact the microbiome in the entire body, not just in the gut, is really central. We have this relationship with these trillions of bacteria that are involved in our mood, in our immune function, in our set point of inflammation in our bodies. It's really quite profound when we humble ourselves and recognize that our day-to-day thought process is highly influenced by the gut bacteria. bacteria.

I know.

That, you know, the bacteria that live within us, that the array of bacteria living within us change our gene expression moment to moment. They're changing our life code. They're altering which parts of our genes are turned on and which are turned off to suit their needs. And in turn, they create an environment for us to be healthier or not, depending on how we treat them. When we bombard our gut bacteria with unnecessary medications with eating the foods that destabilize them, they're not able to do their job. Our guts become leaky, we increase inflammation and that's as we've talked about what we don't want to do. So, you know, I'll send you a book everywhere called Brain Maker. It's all about the microbiome in the brain.

Please. What would be, this is all fascinating because I was asking about the things that we could do to prevent or start to reverse Alzheimer's. And you said, well, it all goes back to actually childbirth and making sure we have the right, I guess, bacteria for the gut and the body and the brain and the immune system to be aligned so we don't have these issues later. And you're saying it's 30 years before you can tell based on the waist circumference and based on the foods you're eating and things like that. So What would you say are those, let's talk about things you should eliminate. If you could eliminate three to five things to set yourself up for the best possible of prevention, without having head trauma and all these other things, but food, environment, you know.

I wrote an article about this this morning. I got pinged by a national magazine wanting exactly this article. So I got up extra early to write it.

I got hired in all of a sudden.

Crazy. But if we understand that the worst thing for the brain is chronic inflammation, anything we can do to target that is going to help. So that's where diet comes in. A diet with lower levels of refined carbohydrates, things to add to the diet like good fat. We know that there's some all-stars out there that really are really important for brain health like the omega-3 DHA, docosahexaenoic acid. generally from fish oil, although there's a vegetarian form of that. But I think that the biggest lever that can be pulled, provided a diet is reasonable, would be aerobic exercise.

Really?

So this is profound. So this is an epigenetic player. This turns on the genes that make something called BDNF, brain-derived neurotrophic factor. factor, which is fundamental for healing damaged neurons, but also for nurturing them, allowing them to do what they can do and should do, but also stimulates what is called synaptogenesis, where brain cells connect to each other and even allows the human brain to grow new brain cells. Who knew?

When you're doing aerobic exercise.

Yes.

So even if you have, let's say, not the cleanest diet and you have some sugar here and there, maybe you have some wine or some alcohol or whatever it is, you're saying doing consistent aerobic exercise will help defend against all those things as well. Could help.

Well again, it's not that your guest today is saying that. That's what the literature shows. It's profound. So the work, the original work is done by Dr. Ericson at University of Pittsburgh.

Okay.

And fascinating research looking at two groups of individuals, several hundred in each group, One group got a stretching program and one group got an aerobics program. Now, I'm not knocking stretching. I mean, that's very important. But the aerobics part, pushing up your heart rate, is what seems to be very important for augmenting this production of this BDNF.

How long is the heart rate up for? Or how long is the program, like 20, 30 minutes?

It was variable, but my recommendation is minimum of 20 minutes.

Okay.

What should that heart rate be? depends obviously on the person. I typically say 180 minus your age as a ballpark. Now that might be too low for some people, too high for some people. But, you know, that's where you use a wearable and you see where you're comfortable. I typically say you should be, breathing hard, but not hard enough that you can't have a conversation with somebody.

Okay.

I mean, these are kind of, you.

Know, a hard jog.

Yeah, depending on what, you know, it may be walking. for somebody. Maybe an elliptical machine at a certain rate, who knows? But once that happens after a period of time, so this BDNF starts to get produced, and what did the study show that I'm quoting? They followed these people for a year. Those who did the aerobics had, instead of declining size of their brain's memory center called the hippocampus, it actually increased during the course of one year. I mean, we expect everything's going to be on the skids but here it actually increased and memory function improved. Wow. It is a wow. I mean, that's not supposed to happen.

Is that daily? Is that three times a week? What is that?

This was five days a week.

Five days a week.

But interestingly, in 2017 in the journal Neurology, the Green Journal Neurology, which is put out by the American Academy of Neurology, they're the group that says that you're a board certified neurologist, they do the test, you know. So it's our most revered neurology journal. They had a practice guidelines section asking the question, what does science validate us being able to recommend for patients who have what's called MCI, mild cognitive impairment? That is one step beyond what's called subjective cognitive impairment. Subjective cognitive impairment is, you know, I can't remember the Wi-Fi code or whatever, the gate code, you know, I can't remember where I put my phone. Who does that, right? That's why Apple now makes those things, right? Anyway, that's subjective. You go to the doctor's office and they administer a test and everything's okay. So you just have subjective issues, senior moments, if you will. Mild cognitive impairment means you've gone to the doctor's office they test you and you're already showing some areas that are not dementia-like but they're not, on the other hand, normal. So you're starting to decline and that's when the intervention needs to happen. So the question that was asked in the journal, what can we recommend? They went through, I think, 14 different interventions. This drug, that drug, you know, the approved drugs for Alzheimer's. They made one recommendation, only one this is a mainstream journal. There's only one thing that has any scientific support that you can recommend for your patient. And it's a drug called exercise.

Wow.

They said that's the only thing that stands the test of scrutiny that can actually slow the decline in patients who've established mild cognitive impairment. That's where that new drug out, aduhelm, was targeting patients with mild cognitive impairment and it failed. So yet how many neurologists will say you've got to exercise. Where's the ad on television saying, you know, I'm glad my dad is taking this drug or that drug because he has Alzheimer's. But the drugs aren't working. We've got to recommend lifestyle changes. Get enough sleep. Sleep issues are related to profound increased risk for Alzheimer's for a number of reasons, including increasing inflammation, including problems with increasing blood sugar and dramatically increasing your risk for type 2 diabetes just because you're not sleeping well. If you get type 2 diabetes, you have quadrupled your risk for becoming an Alzheimer's patient, a disease for which there is no simple treatment. So we've got to focus on metabolism. We've got to keep people from becoming diabetic. We've got to get the willies when we know that the prediction is that by 2030, 50% of American adults will be obese. 2030 is eight years from now. You used to think, oh, 2030, you know, the glaciers are melting that sometime in the distant future. Thank you, Al Gore. It's eight years from now. Think about it.

So they're predicting 50% of the US population will be obese.

Adults. It's already one-third of American adults that have high blood pressure. It's already 10% of children between the ages of 12 and 18 that have high blood pressure that require medication.

What was it like 30 years ago?

Things were better, but that's just about when things changed. And what happened? What happened was we were all told, not just doctors, but the lay population as well, that fat was the enemy, right? Low fat, everything. Fat free.

Fat free this.

Low-fat Oreos with that white stuff in the middle that we all loved, right? Who wouldn't? And what happened was because we all went fat free or low fat as best we could, there was far more carbohydrates and simple carbohydrates than diet. Sugar consumption skyrocketed. So between 1970 and 1990, fructose consumption went up 1,000%. Fructose was looked upon as being a safer sugar than table sugar per se or certainly than glucose because fructose in its metabolism doesn't require insulin, doesn't mess with the insulin issue. So it was looked upon, it was even recommended by the American Diabetes Association. And yet, fructose consumption directly leads to insulin resistance. that's the harbinger for future diabetes. So it is about the worst sugar we could be consuming, and yet we're consuming it, you know, left, right, and center these days. Wait a minute.

So the American Diabetes Association, is that what you said? They said fructose. They recommended fructose was a way to prevent type 2 diabetes.

No, that if you needed a sweetener, fructose is a better choice. In other words, high fructose corn syrup, which is 55% fructose, fructose and only 42% glucose because glucose was the problem, right? Your blood glucose goes up with diabetes, so we've got to limit that, eat more fructose. Bad idea, bad recommendation. So our government to this day supports the growth of corn to make fructose to the tune of $500 billion a year. And our USDA food nutrition recommendations that are issued every five years have continued to say when they were just released last year that we can get up to 10% of our calories per day from sugar, despite the fact that over 99% of the scientists who weighed in and gave the USDA information said that's way too much. So I wrote along with another doctor an open letter in MedPage to President Biden saying, Look, that's not what the science is telling us. It's going to break the bank to take care of these people with the obesity, the diabetes, the hypertension, the dyslipidemia, and all the downstream issues, the coronary artery disease, the Alzheimer's, the cancer, and again, type 2 diabetes, that are the consequences of these dietary recommendations. We've got to rein in our sugar consumption and we all have a sweet tooth. And it's good business to sell a lot of sugar. Close to 70% of the prepackaged, the labeled foods or the ones that carry a barcode of the two million foods sold in America's grocery stores have added sweetener. And by and large, it's high fructose corn syrup. It's super sweet. and it's really cheap.

Tastes good, it's cheap.

Yeah, it tastes great and less filling. And it is, it's less filling, it.

Doesn'T-- which means you keep eating more.

And more of it to fill yourself up. So fructose, as a survival mechanism for our ancestors, didn't tell them to stop eating. In fact, it played with this satiety hormone called leptin and blocked how leptin works in the brain. So we would eat and then want to eat some more and then keep eating.

And help us store fat.

You bet. To survive.

But now it's making us sick.

It's very much making us sick. And we're supporting it. And it's, you know, clarion cries from a few of us out there. You know, the Robert Lustigs, the Gary Taubeses, you know, those of us who are really recognizing what is going on here, that, you know, the sweetening of our foods and the sense that it's natural.

Did you used to eat a lot of sugar yourself? Growing up or as an adult?

I think as a kid we always had soda. We had black cherry soda. And so we drank a lot of that. That would be the primary source. And we did drink a lot of orange juice growing up in Florida. So that's about the worst thing you could do. It's just a lot of sugar. Such a high load. quickly of fructose in your system. So I said from that perspective, yes.

But you weren't big on sweets and candy and cakes and cookies and...

I would say no more than anybody else. Yeah. Do I still want it and desire it? Absolutely. Really? Oh, yeah.

How do you manage it?

I... Do you have it some?

Do you have it seasonally?

I definitely eat some fruit. I can't tell you when I had a glass of juice, it's not even in my memory anymore, I will say that I had some gingerbread and loved every bit of it. I don't know how much sugar it contained recently, but it's generally off the table for me. I mean, I don't want to become diabetic. My father died of Alzheimer's. I have a continuous glucose monitor. I know darn well moment to moment what my foods are doing to me. and I'm keeping my blood sugar under control.

You have a monitor on your. I'm traveling right now, so I don't have it on.

Okay, I got you.

But you usually have it on your shoulder.

Left shoulder, yeah. I usually have it right here, CGM.

And so you check. Oh, you need to get that. We'll get set up. Oh, I know. Like Asprey and all these other guys.

Have them and Sergey Young and all these people. I'm like, Ah, do I want this in my body? Do you feel it a lot? Is it not painful? So this is not a needle in your body. Okay, what is it?

It's measuring it in what's called the.

Interstitial fluid, which which is right in the top layer of your skin. You put the patch on, you don't know.

It's not the bulky plastic thing or.

Is it like-- no, it's a tiny little patch, but then you put a patch over it to keep there, that way you can get it wet, you can shower. Wow. In fact, I think I arranged Sergei to get his. Really? Oh yeah.

Okay, cool. Yeah, we had Sergei on here as well. So what does that do for you?

To know like-- It tells Lewis specifically what Foods will make you. And then you have to tell me. Not only you're gonna post it. But you'll become a part of the tribe that's monitoring your blood sugar level. And you've mentioned people that you probably respect. They're both close friends of mine. I respect them both. And what's really valuable is they know how important this is. So there's a Dr. Casey Means who I'm hoping you get on your program.

Okay.

I'm gonna have dinner with her on Saturday night. And she is the founder of a company called levels.

Okay.

Yeah. Levels is the software for understanding what this CGM continuous glucose monitor is telling you. How important is CGM? It's so important that I put it in the new book, actually. I put a whole chapter. Actually, Casey means help create that chapter. It's really important. and moving forward, there may well be a day when that same patch is going to give you other information like your uric acid levels so you can know how the foods you're eating are affecting uric acid because it's equally valuable.

So, you kind of shifted your identity to just saying juice and certain sugary foods are off the table. You're not even tempted. You might be tempted, but you're like, there's no chance I will have this.

Professionally and personally, I've seen what Alzheimer's does. And that's the big threat for me. I mean, I have a family history of it, so I'm at increased risk. Generally, not as much risk it would have been if my mother would have had Alzheimer's. It would have been a much greater risk. And I don't carry one of the risk markers called the APO4 allele. I don't carry that. But it is to say that is an allele of predisposition, not determine it. It doesn't mean if you have APOE4 or you have two APOE4s that you're definitely going to get it. Your risk is increased dramatically as much as 12-fold if you have both 4 and 4. But again, you know, in that situation you do everything you can to chart your destiny, change your destiny and say that, that the APOE4 allele works in concert with other things over which you do have control. you know, you don't have control over your genetic legacy. It's a gift from all of those who came before. And there may be some upside to carrying the APOE4 allele. If there weren't, then why would it persist? If it was always a bad thing, then why would it still be present in our population? You know, to extend some populations, and you know, 20-30% of the population carries at least one APOE4 allele. It's got to do something positive. maybe not in today's world, but maybe in our Paleolithic ancestors or even more recently, it was protective, maybe because it has a role to play in inflammation, which can be a good thing. Inflammation can be life-saving. But excessive inflammation, chronic inflammation, chronic or acute severe inflammation in COVID, there's something called this storm, the cytokine storm, where the body is basically on fire from these inflammatory chemicals that destroys tissue, the lungs, the heart, the brain. But we have to consider a notion of another term, the cytokine drizzle, where you have just a slight uptick of these cytokines floating around your body all the time. You know, the Grand Canyon wasn't formed by one huge flood cytokine storm. It's that slow river going through it for hundreds of thousands of years and look what you get. So we've got to rein in inflammation through our diets, through conscious awareness of the role of our gut bacteria, keeping in mind the notion of gut permeability or leakiness, how lack of sleep augments inflammation, all of these things. And I don't want this to sound too compelling, right? I mean, you've talked to really wonderful people whose focus has been raining in inflammation, whether it's getting into really cold water, or doing the things Sergey Young talks about. And certainly you've talked a lot about diet and how important that is. But diet is more than just macro and micronutrients. It's information. The foods that you eat are speaking right now to your DNA, changing your gene expression. That's heady. I mean, when I was in medical school, DNA was locked in a glass case. And it determined everything about you. what your body would be like, what you'd be allergic to, you know, your destiny was there. And now we know that we interact with our DNA aggressively, that, you know, more than 90% of the genes that code for health and longevity are under our control to some degree based upon what we choose to do. I mean, the moment you want to binge watch something and you stay up really late to watch the 12th episodes of suits or whatever it is, and you didn't get up, you had to get up in the morning and you're not right, that changes gene expression. Obviously not for the better. Increases, does other things, increases your body's production of cortisol, a stress hormone. That's toxic to your hippocampal neurons, you know, increasing inflammation, decreasing your ability to detoxify so much of what's around us. And yet we have the data, we can use our prefrontal cortex to say, maybe that wasn't a good idea. And no one is perfect. I mean, no one can be perfect because no one fully understands the exact program for them through what is called personalized medicine. That would be the right thing for you, for me. You know, what's right for me at my age, in my body type based upon my previous experiences is clearly going to be different from what would be best for you. That said, there are the broad strokes which, you know, we can challenge and I know 10 years from now when I come back on your podcast, we may have a different story. That's a good thing. Really? Oh yeah. I mean, I was parroting the low-fat narrative 30 years ago. Really? Oh yeah, absolutely.

What do you think will change in 10 years? Based on historical evidence, based on trends, based on the new science and research that's coming out, Well, I think that.

The exciting thing for me is something called genetic reprogramming. And I think you mentioned that you've interviewed David Sinclair.

Yep, yep. Jason Fong and Sinclair and all that.

Yeah, so that's what his research is all about. It's the ability that is being developed to revert cells back to a more primitive, less defined phenotype or how they look and then allow them to start over again. And he is demonstrating it in rodents where he has crushed their optic nerve and then uses this technique of genetic reprogramming. They regain their vision.

That's crazy.

It is crazy. But until that time, I think looking at how we're understanding this epigenetic control that we have, how we can harness that to reduce inflammation, to increase our detoxification functionality, to allow brain cells to replicate and to connect better. That's something we talked about earlier. This control over the BDNF that I mentioned via exercise is an epigenetic intervention. You're changing the epi over genetic control over that genome, that part of the genome that regulates our production of this chemical brain derived neurotrophic factor. But important that, yeah, BDNF's a player, but as a trophic hormone in the brain, but so is insulin. And everybody, you know, is talking about insulin in terms of, well, we need insulin and adequate amounts and functionality to keep our blood sugar in check, No argument. But insulin does other things in the body. Just because we learned about its role in blood sugar doesn't mean that's all it does. Insulin, like BDNF, is a trophic hormone for brain neurons. So we need insulin to do its job to be around and we control how our bodies and our brains are able to interact with insulin based upon our lifestyle choices. So when we become insulin resistant, by eating the wrong foods, not exercising, not getting enough sleep, the brain doesn't like that at all. Because fundamental to brain degeneration is what is called the bioenergetic theory, which means how do brain cells use energy. That is the most predictive measurement of brain degeneration. We talked about earlier when we should begin thinking about the Alzheimer's Prevention Program. You can do a brain scan using what's called fluorodeoxyglucose, which is a radioactive, transiently radioactive glucose, injected into a person and do a brain scan, a PET scan, and that will show glucose utilization in the brain. And you can see areas in the brain that are not up to speed, the temporal parietal regions if you must, that are not using glucose that predicts brain function decline two decades, three decades in the future. Even more exciting is you can now image the brain in people with ketones and demonstrate that the very same areas that are dysfunctional as it relates to their ability to use glucose, the brain neurons are perfectly fine when they're using ketones as fuel. meaning that these neurons, it's not that they're not using glucose because they're no longer functional, they're no longer functional because they're not using glucose. Give me another fuel and I'll come right back into the game. Put me in coach, just give me the right fuel. So give them ketones, the brain scan looks great, those temporal parietal areas are now lit up and you know that is the reason that there's there's so much research looking at ketogenic diet as an intervention for Alzheimer's treatment. There's a Matthew Phillips in New Zealand who has published reports now of improving brain functionality.

With the keto diet.

Keto diet in Alzheimer's patients who are well along and also Parkinson's patients. Same kind of thing. That there's improvement putting patients on a keto diet in Alzheimer's patients, who knew?

Is it because of the things that are added in a keto diet or the things that are eliminated in a keto diet?

I think it's both. But one thing I would say, this is an important point, kind of one of those bullet points, is if you're keto and therefore you're limiting carbs, don't eliminate fiber. So that's the a huge issue because plant foods, fiber itself, is a carb. That's what fiber is. So you don't want to eliminate that. So this is groundbreaking work done on keto and the body, keto the brain, people like Dominic D'Agostino, and then this Dr. Matthew Phillips. Really groundbreaking. There's a sense that in our primate and certainly paleolithic past, when we didn't have foods and now we like to fast for a couple days, we want to trigger those things, but our ancestors didn't necessarily choose to fast. That was what happened.

They were forced to fast.

When they didn't have a grocery store nearby. And hunting and gathering didn't mean hunting down a convenience store or gathering up the Doritos. So that's what their physiologies allowed them to do, is to shift, they were metabolically flexible, which we can become easily enough, and they could shift over to ketones and power the brain and do those things and then tap into their fat reserves quite readily and create those ATP molecules with less free radical production and survive.

If someone's trying to fast now, will the body actually, will the metabolism change or will they store the keep the fat because the body's saying, well, you're not eating, so I'm going to keep the fat here and not burn it as quickly.

Actually, they'll burn the fat.

They will.

And they'll burn it readily once glycogen stores have been depleted.

How long does that take?

It depends, but it actually happens fairly quickly. You begin generating those ketones early on within 12 hours. Okay. So it depends, of course, on your level of physical activity. You know, it's generally said that if you're a runner, around 13 miles is when glycogen stores are depleted. Then you need the sports drink or whatever it is that you're drinking. Carbs or something like that. Sugar. Or if you're keto adapted and metabolically flexible, then you can begin to tap into a huge resource of calories and energy.

We've had a lot of fasting experts on. We just had Dr. Valter Longo on and he was doing a consistent 12 hours a day fast, like consistently every day, is what his research suggests is the best approach. There's other people that say the 16 and 8, and there's other people that say go 24-hour day fasts. What have you seen based on fasting research?

Well, I think his work is really very powerful. And, you know, he's certainly done a lot more than simply talk about what's great for you from a metabolic perspective. I mean, he is deep into the role of fasting and immune function as it relates to cancer. So, doing some breathtaking work. So, I would say that the notion of time-restricted eating, perhaps more popularized by Dr. Satchin Panda, would tend to indicate that a little bit longer in terms of the fast and then compressing the feeding window might be a little bit more appropriate.

So, like a 16 18, 16 fast, 8, 8, 8.

There's really nothing. Well, I shouldn't say that. I think for some people maybe it would be, but that's more of a behavioral modification. Because early on, let's say you do 12 and 12, you'll adapt very quickly, especially as you shift over to more fat and less carbs. Fat is incredibly satisfying in terms of hunger. And people say, well, mom said breakfast must important meal. You shouldn't skip breakfast. I'm fine with that. I think Mom was right. But Mom sort of emphasized what you had for breakfast.

Yeah. Don't eat some sugary cereals.

Yeah. And some Pop-Tarts. Yeah. Which we love.

Yeah.

So maybe there were some more sweets in my youth than I'm happy to. But it's really not just about what you eat. It's when you eat. And you say, well, I skip breakfast. Well, no you don't. Nobody on the planet skips breakfast ever because we all break fast eventually. Whether it's 40 days and 40 nights or it's, you know, a two-day fast or whatever it may be, we all break fast. We all end up having our break fast. So, you know, for me, that's usually one or two in the afternoon.

So that's when you start to eat.

Yeah, that works for me. I do have coffee in the morning. So technically, Rhonda Patrick would argue that that might not be early fasting.

She's great, too.

I know darn well that I'm producing ketones. I measure, I see what's going on, I check my blood sugar. So, I'm getting some benefit. If I didn't have anything but water in the morning, two things would happen. It would be a more truthful fast, but I'd be not the most pleasant. I'll tell the world I need that lift in the morning. It does great things for me. And knowing that coffee can consumption is associated with reduced risk of Alzheimer's, I think is a real plus. And also the fact that it lowers uric acid is also something I'm dialed into.

Rhonda, I think a week ago talked about some new research about coffee, the benefits of coffee, which has been researched for a while, but something around, I can't remember specifically what it was based on, but she loves that research as well. And I think she's got the levels, the model.

Oh, I think she has a level. patch, but yeah, she said when I.

Interviewed her, she was said that I said, what's one food you would eliminate from a child's diet?

She said grapes.

And I go, huh, interesting. She goes, because I, my kid had like a bag of grapes and then I ate one when I had the monitor on. I can't remember she had a monitor here or here, but, and she was like, it just skyrocketed something, her glucose levels or whatever it is.

And she was like, the kid shouldn't eat and grapes anyway. And yeah, because you'll choke on them.

Right, right.

Sorry, we're sugar. But she was like a sugar bomb.

So that was her recommendation. But do you think these wearables, for some people listening or watching might be like, gosh, this is just so much to every day check something and see the levels. Can I just live a natural life and just, you know, sensibly, do I need to measure?

I don't know what that means. Yeah, yeah. So it, you know, back to where we started, and that is what does that mean? More importantly, what does it mean for Lewis to eat sensibly? And so how do you define sensible? Well, sensible would be a diet that's not spiking your blood sugar as an example, or doesn't have a dramatic effect on the area under the curve of what your glucose levels are over time. More important. And I don't know what sensible is for you. I know some broad strokes that are pretty likely going to affect your blood sugar, I think we all know those, but should you be compulsive about it? Yep, you should be.

Because you want to prevent it sooner than later.

Yeah, I mean we live in a world of reactive medicine and I would prefer to be proactive and preventive. You know, there's a great quote from John Kennedy, it's that the time to fix the roof is when the sun is shining. And for, you know, you're in great health right now and I want to keep it that way.

Not at the top.

I want to come back in 10 years and do your show again.

Yes.

And you'll be healthy still. Yeah. And you've done all the right things. But how would you know? Would you know because you went to your doctor and every year she checks your blood sugar and says, well, it's okay. You're not diabetic yet. Or maybe it's trending upward. You need a lot more information than that. Now, there was an op-ed in the Journal of the American Medical Association several months that said, you know, people shouldn't, non-diabetics shouldn't be checking their blood sugars with CGM because they're just going to become compulsive and neurotic and all that. Maybe that's true, but I would prefer to recommend erring on that side where people have information and at least have the opportunity to choose whether they're going to do something about it or not. Right. And how would you know?

The more information, more frequent information, the better. At least you have the knowledge. Okay, I'm doing something that's affecting my body, my blood type, everything else, right?

Yeah. I mean, even sleep. I wear an Oura ring. Yeah. And I learned a lot about, I'm generally, that's one thing I do pretty well, sleep.

But I, do you usually wear it throughout the day or just at night?

No, I use my Apple Watch during the day. Yeah.

Track everything.

Yeah. But, or a ring at night just because I like it. And I've learned that a real benefit for me in terms of the restorative aspect of sleep, because I get a good night's sleep, but the restorative parameters that are measured is walking after dinner. We never did that before. And it's a, you know, my wife and I, we exercise in the morning pretty aggressively, and then, but the idea of taking a walk after dinner, it's a great thing. I mean, we see people out walking, their dogs are just walking. So it's a nice thing to do anyway, but it really helped me with my pulse heart rate variability, which is a tied into how well you recover during sleep. And so my heart rate variability went up quite a bit. Now, I think I'm fearful that viewers are thinking, what is all this crap? What are these guys talking about? And I don't want to do any of that. Give me some bullet points. So, you know, I would say that it's time to avail yourself of this biotechnology. I think it's really great. But the broad strokes are again back to the simple things that you've got to exercise. You've got to make every effort to get a good night's sleep.

It's so important. Matthew Walker, when we had him on talking about sleep and just how One hour less of sleep can change so much with focus and attention and memory loss and all these things. And if you couple that every day more and more, it's just going to hurt you long term. That's right.

And what his research has more recently demonstrated, getting back to the whole notion of brain health, is that his lack of sleep and how it increases the presence of beta amyloid, which is if you buy into the amyloid hypothesis of Alzheimer's, and I think it plays a role, I don't think it's the end all. As we talked about, Dr. Bredesen has looked at a lot of different parameters that are influential in terms of brain health and risk for decline. But who wants to have a brain load of amyloid, not me, and therefore yet another reason. with lack of sleep, increasing your insulin resistance, increasing your blood sugar, increasing your cortisol, threatening your hippocampus, increasing your risk of obesity or at least significant weight gain, increasing your uric acid as a powerful metabolic marker. So yeah, and you know it's important to look at the parameters that you can modify to help you get a better night's sleep, but you may not know. You may next morning you wake up, gosh, I went to sleep at 10 o'clock, now I'm waking up and I slept all night. You might not have. You might have awakened four or five times, you didn't know it. Well, you remember the one time you got up to pee, but what about the other four times when you didn't fully awaken but you dropped out of those restorative levels of sleep? You won't know that. You won't know how much time you spent in REM or deep restorative sleep unless you're using a wearable and it's the ticket. So try it out. What is there to lose? You wake up in the morning and you download the information into your smartphone.

It's already in your phone. You just open the app.

I have it in my phone right here. I can look and tell you what my sleep is like. Did you do well? And if you did well, you say, Gee, now I'm going to have a great day or I got a crappy score, I'm gonna have a crummy day, that's the risk. But if you had a crappy score, you say to yourself, maybe it was that glass of wine, or maybe I shouldn't have had dessert, or we ate too late, or I didn't exercise. I had cappuccino at four o'clock in the afternoon. For me, I can do that, and it doesn't seem to affect my sleep, gratefully. But for others it may. Kombucha, which I think I like kombucha, but it's made from tea. So you have kombucha to drink with dinner, maybe that's a factor. You just don't know, and it's good to be thinking about what your choices are. And lovingly and slowly you modify things until you get a solid eight hours and you're killing it on the deep sleep and the REM sleep and the latency, how long it takes you to drop in and your other things, your heart rate variability. and then you've got that checked off. And can you become neurotic about it? I guess so, but I'm willing to take that risk.

It's better to be neurotic than to have no information.

Yeah, and to do what modern medicine wants you to do, and that is come to us when you're having a problem, then we'll talk about it. But meanwhile, do whatever you want. Live your life, come what may, eat whatever whatever the heck you want. You have that big dessert and then you take your diabetes pill. You didn't cure your diabetes with that pill, as I mentioned earlier. So we've got to be our own advocates. It's very clear. Mainstream medicine again is going to be there if you need them in an accident or to have surgery, great. But in terms of keeping you healthy, you've got to be your own advocate. The only way you can you can do it is by getting at least a modicum of information.

So what would you say are the foods or the liquids that are off-limits for you? Or maybe that are very rare that you'll consume something, whether it's a gingerbread.

All- so we were watching Rick Steves on public television. And it was obviously a couple years ago because no one was wearing masks. He was in Europe and it was for Christmas. he ate gingerbread. And it was, my wife and I looked at each other and we went, what's the deal? We got to eat some gingerbread. So I was able to find some, but so that's, so from time to time having something that's sensible, that's not really, you know, killing it. But I think this the high fructose foods and the high sugar foods, you know, understand that table sugar is 50% fructose.

Okay.

Sucrose, this table sugar, that is the ingredient. You know, that two tablespoons of sugar along with the refined flour and some vanilla and next thing you know, you've got dessert. It's somehow it's alchemy. It creates something new, de novo, out of these ingredients. Pizza the same way. Somehow, well, it's pizza, but no, it's made from flour, highly refined carb, flour dough, refined flour, and then you put tomato sauce in the, Mushrooms, it's now not that anymore. It's a new thing. It's pizza, therefore it's good.

What's off limits for you then? What's like you don't have?

Well, one thing I don't ever eat is liver. I'm not saying it's bad food. I just can't eat it. I hate it. Off limits are soda, fructose containing sauces, condiments, fruit juice, that's for sure. Anything that's got a lot of sugar.

Is off the table.

Table.

Sweets, candy and all that stuff.

That's not for me.

You don't eat it? No.

It's completely out of your. No, I won't say completely. I might have a mint. You might have. Okay. In fact, there was a. So I remember them. I had a mint that was in the. Our rental car that the. That hurts put there for me. Ate that. But generally, that's not who I am. I don't eat. I don't need it. And do I feel guilty afterwards? Probably not. I.

Maybe I. --You're eating a mint, you mean? --No, I don't.

I don't feel guilty. I mean --Well, because you have it once a year or something. --I know. I mean --You remember the last time? --So, I don't, you know, I don't obsess that I had a mint or that I tasted somebody's key lime pie. But sodas are gone, that's for sure. And sugar in the coffee and all that. I will say that I had a post on Instagram recently and it was honey. I'm sorry, will you forgive me? Oh, you can't have honey? Well, here's the thing. Oh, no. People thought I had messed up with my wife and I was asking for her forgiveness. That's funny. And it was the biggest Instagram post I think I've ever had. And I'm not taking credit for it. One of our team members, Jonathan Jacobs, if you're watching this, he created it. And it was because there is evidence that honey actually can help lower uric acid. And that, but beyond that, it may more importantly be not a huge metabolic threat, though it contains fructose. It doesn't mean that agave is on the table. It is not. Agave is something I would never touch. I would never go near agave. No, and I also would not be ever consuming artificial sweeteners like aspartame, for example, because of the threat for gut bacteria. The other thing that I'm super careful about would be any medication that might be prescribed for me like an antibiotic. I really go through a lot of cogitation if I'm injured or had an operation for example and there's a need for an antibiotic. I break the doctor's orders generally. Now I don't want your viewers to say, oh, I've never taken an antibiotic. but these are weapons of mass microbial destruction in your gut. And you know every time a child has a sniffle, goes to pediatrician, they prescribe the liquid, whatever it is, antibiotic. That's just inappropriate in my opinion. Really? Yeah, it really is. Ear infections can oftentimes get what's called tincture of time, meaning wait it out. Now I'm not, you know, there's got to be a disclaimer here. people make their own decisions, talk to your health care provider. But that's one of the biggest issues of our time, the effects of medications on the gut bacteria, like proton pump inhibitors taken by 14 million Americans, profoundly disrupt the gut bacteria and are associated in the journal Stroke with an increased risk of dementia and a dramatic increased risk of stroke. by taking these acid-blocking drugs. They also raise uric acid and they are over the counter. You think you ate something you shouldn't have, you go into a store and you buy this acid-blocking drug. You take it all the time because you just think you need it. I'd say change your diet first of all if you're not tolerating certain foods.

Right. And this surprising new science of uric.

Acid We haven't talked about that book. I think we're going to do a virtual or need to talk about it later. But I want to say one other thing as it relates to foods that are really important to be aware of, and it's fat. And therein lies an important discussion because the good fats are a blessing. Eat all the extra virgin olive oil you can put your hands on, organic. Fats like good sources of omega-3s, but by all means, you really want to avoid the processed vegetable oils. Canola, corn oil, soybean oil, these soy especially, these need to be avoided. These are used structurally in your body to create cell membranes. That is where all the action is in terms of how cells work, even brain cells, importantly, how they are able to transmit information from one brain cell to the next. Those receivers and transmitters are built by the fats that they have access to, which are the fats that you consume. They don't come from the air. So being really careful about the fats you consume, I think, is fundamentally important.

What are the good oils then?

Well, there are a lot. I think coconut oil to some degree, extra virgin olive oil, strange as it may sound, we travel with a bottle of extra virgin olive oil. Extra virgin olive oil based on- Organic.

Which is different than what other type of olive oil? Well, there are more, there are olives.

That are not necessarily extra virgin. Okay, gotcha. So are heated in the processing. And there are plenty, you know, if you ask for olive oil in a restaurant oftentimes they're allowed to call it olive oil if it's 51% olive oil. What is the other 49? Is it canola? What is it? you don't know. And you know, I've, I can taste the canola oil now. Interesting, Italy is the largest importer of olive oil. So they import olive oil and then they manufacture what passes as olive oil by this 51% rule. So you really want to be super careful where you're getting your olive oil, making sure that it's treated appropriately, that it's not been heated, that you keep it closed in a cool, dark place if you can. That sounds a little bit compulsive, but we did. So we live in Florida, here we are in California, right? First thing, went to a health food store, bought a bottle of olive oil. We take it to the restaurant when we go to dinner.

Nobody seems to care.

Pour a little bit on and put it in. If they did care, that would be interesting. I wouldn't bother me in the least. We have a bottle of olive oil. I mean, it's not, they don't charge you a corking fee like they would charge you you bought a bottle of wine, right? And that's a really, and just pour it on. I try to have a liter of olive oil myself a week. Really?

Dr. Gundry talks about that too. He says have a liter a week of olive oil for the gut bacteria, the microbiome.

Well, he's talking about it. He too focuses a lot on inflammation. His idea that lectins are a powerful cause of inflammation. because of through the mechanism of disrupting the gut lining and other, even to some degree, blood-brain barrier. But his call for EVU, extra virgin olive oil, again deals with its role in helping tamp down inflammation, but also helping allow our bodies to build parts of the body that are made from fat, like cell membranes, from good things. So supplying raw materials.

What are you pouring it on? if you're not pouring on the bread and the eggs.

I pour it on everything. I mean, I have it on, I do it on my eggs, which I have most days. I often have salad for breakfast, or I'll have avocados and have extra virgin olive oil. Just pour it on there? Yeah, I mean, if I'm, and that's usually like around noon or one, so you can get away with having salads. No one's gonna say, well, you're having that for breakfast? Who does that, right? I do it at the restaurant. I mean, at the hotel, That's what I want for breakfast. They have it. All right, well it's not on the menu, but you'll manage. I know you will.

You can get some lettuce out there, yeah.

Yeah, I mean sometimes if I'm busy, I'll have an avocado, take the seed out and fill that little reservoir with olive oil. Problem solved.

There you go.

Wow. And maybe use a plate, but that's about as aggressive as I get sometimes.

I wanna go over this a little bit.

That's why we're here today.

Yes, because a lot of people, since a third of Americans are obese and it sounds like in 10 years half is the predictions. Most people today want to learn how to lose weight, but they don't want to do the work. They don't want to give up the things that they really enjoy and they don't want to work out as much as they probably should. And they probably don't want to go to bed earlier to sleep so that they can burn more fat they're sleeping, all these different things. So what is this surprising new science of uric acid? What is uric acid? What do we need to know about it? And how do we use it to lose weight?

Uric acid is the downstream end metabolite of fructose.

What does that mean for someone like me?

It means when you eat fructose, it goes into your body, it's absorbed through your intestinal lining, it undergoes a series of changes sugar until it reaches uric acid, at which point that uric acid, some of it stays in the bloodstream, some of it is excreted.

So, sugar turns into uric acid at some point. Fructose turns into uric acid.

Fructose, okay, it's not sugar. Right. Well, fructose is sugar, but this is unique. Fructose and glucose are totally different.

I would say apples and orange, that's confusing. Apples and candy bars, yeah. Where is fructose and where is glucose for those that aren't sure?

That's right. So, fructose, the name comes from fruit sugar, fructos. In biochemistry means or in chemistry means sugar. And this is what is found in fruit and this was what allowed some of our ancestors to survive.

Okay.

Who could eat fruit in the late summer, early fall, and had a little advantage that they would make more fat, such that when food was unavailable, they would survive and those who didn't make that little bit more fat would perish. We didn't get their genes. We got the genes from the ones.

Who survived who could produce a little more fat.

A little bit more fat and became a little bit more insulin resistant so that their blood sugar would go up just a little bit allowing their brains to help them avoid the two things that were their biggest threats, starvation and predation. Starvation, not having enough food, predation getting eaten. Both of which are not really threats to most of us these days. It's not like we're going to be walking down the street and a lion's going to come and eat you. In which case, you'd want to be smart so you could do what you need to do to get away from the lion.

And then glucose comes from... Glucose is.

Also found in foods and certainly table sugar. Glucose and fructose bound together is what is called sucrose. That is table sugar in a 50-50 ratio. I'm not going to say that is the natural way, but I would like to say it in the context of this unnatural combination where the fructose is naturally increased to create what's called high fructose corn syrup, which is incredibly pervasive in our world today. That's 55% fructose. That 5% makes a big difference. So we, as Americans, are consuming 17 teaspoons of sugar a day.

How many should we have?

I don't know. We don't need sugar.

We don't need sugar.

We need zero. We need sugar. The human requirement is zero.

So how much sugar do you have a day?

Hard to say, not very much. Where is there sugar? I don't know. I have very little.

You don't eat fruit?

No, I do eat fruit. So there's going to be some sugar in fruit, and there is a modicum of sugar in my kombucha, but I dilute it down. usually with about two parts water and then one part kombucha. I don't use sweeteners except occasionally. I've been trying a little bit of allulose as of late. Allulose is a new sweetener that actually has been demonstrated to improve your blood sugar. So it has positive metabolic activities. And if somebody is making something for me that's using monk fruit, I will think that's acceptable. But, you know, there's sugar in vegetables. So there is definitely going to be sugar in my diet, but not 71 grams per day, which is what the typical American gets. So, you know, and this is a relatively recent phenomenon.

So you can eliminate, I mean, you'll have minimal sugar, but very little.

In the 1920s, we would consume about 15 grams of fructose a day. Now it's 55.

So what does that do to burning fat?

Fructose says don't burn fat. Fructose tells your body winter is coming. Get ready. Make fat, store fat, lock it up. That's the signaling mechanism. So when we look at this metabolism we have to look at it through the eyes of our evolution. And again, we never had fructose like we have now. We had it in small amounts or if we would gorge on the blueberries, whatever we found, which we should have done only in a small window of the year when we would make enough fat that would allow us to get through. Animals that hibernate Just gorge on fruit. Yes. I mean, what does a hummingbird consume prior to, you know, flying across North America? Nectar. Sugar water. If you want to have a hummingbird in your backyard, you put out sugar water. They will hone in on that like nobody's business. And the hummingbird might be one of the fattest animals on the planet.

Huh.

One, you know, when they are storing fat for their long journey, 40% of their body weight can be fat. You know, we think of whales as having a lot of fat. Yeah, and of course they do. They're, you know, obviously. But, you know, whales use body fat a little off topic, sure, for energy, but also as their source of fresh water. So when they, and you metabolize fat, you're creating gram for gram water. When you metabolize one gram of fat, you make one of water. So for our ancestors, what a powerful tool to survive not just in food scarcity, but water scarcity as well. To keep from becoming dehydrated, that little bit of body fat would help them make water as it was metabolized. They could survive.

So what does uric acid tell us then as the key to losing weight? Is it because it's linked to sugar?

Yeah, so this person that you described who's not going to exercise, not going to get enough sleep, going to eat garbage, all the stuff, keeping their uric acid level under control. First of all, it's not really going to be possible because a high level of fructose is going to keep your uric acid level elevated. Number one, number two, they have overridden all the benefits of uric acid. We're targeting people who are trying and not really hitting the mark. They're doing their best to eat right, they are getting some exercise, and they're still not losing the weight they want to lose. Blood pressure's still a little bit elevated. Still, blood sugar might be a little elevated. This is another tool, a brand new tool, a powerful tool in the toolbox. Know your uric acid level.

How do you know it?

You go to the doctor and get it checked or you get a monitor. Is this a blood test? It's a finger stick. A finger stick. Oh, at the doctor's office, it's a blood draw, but for you, and the monitor I will send you, it's a finger stick. It's a levels monitor or a different monitor?

It's like a blood sugar monitor. Okay, gotcha. Gotcha. So you prick it and then it tells you your uric acid levels, is that right? That's right.

And so do we, what does that information do for us? Or how do we use that information? Much like you optimize it by going on a specific diet to help lower your uric values, L-U-V, the love diet.

I like the love diet.

Love diet's right on the COVID And that is a diet specifically designed to help you accomplish the task, lowering uric values. You will take quercetin 500 milligrams a day, which targets an enzyme that's involved in uric acid production. You'll pay attention to your sleep. You will reduce fructose and be conscious of other two inputs to uric acid which are alcohol and purines. Purines are found a lot in organ meat, for example, in small fish like sardines and anchovies. Doesn't mean you can't have them, but you're now going to start to see how they affect your uric acid level.

Interesting.

And you want to get your uric acid level below 5.5. And you're going to have this next week and you'll text me. Okay, I will.

Get a blood test. below. And what if it's, what's, what's high level then?

Above 5.5. That's high. When you go to the doctor and they, you ask what's normal, they're going to tell you seven. But that's a uric acid value that relates to something called gout, which is really the context that they look at uric acid. Oh, my gosh. Yeah, that's, it's only looked at by mainstream medicine in terms of gout. There is 20 years of robust medical research. We have 400 in this book, looking at uric acid as the central player in metabolic dysfunction.

So if you get it below 5.5, that tells you what? That this person has the ability to burn more fat, to lose weight.

You're going to shift more towards burning and less storing of fat and help you get your blood sugar under control. It will very likely help you rein in your blood pressure. It may even help you with your lipids, your HDL, LDL, triglycerides as well. So these things are all influenced by having an elevated uric acid. So is it the end all? No, but is it yet another powerful arrow in your quiver? You bet. And these days, you know, when you think you're working out however many times a week, you're eating the best you can, you know, no one's perfect. And, you know, this is just another piece to that puzzle, but it's a powerful piece. And, you know, the science is taking off. This is not the last time you're going to hear about uric acid. Really? Oh, my gosh.

And this is what you, to check this, you prick your finger once every week or once a month, or you do this.

Well, it depends. You know, for me, it's every couple of weeks, two to three weeks, I run around 4.5, 4.6.

Can you be too low?

Probably not. We do see very low values in elderly people with very little muscle mass because they're not breaking down any more muscle. They don't have muscle to break down, therefore they don't liberate what are called purines. So there is some discussion that uric acid may have some antioxidant properties, but I think that we're moving past that. It's not really setting up for scrutiny. And I think keeping it below 5.5 should be the goal. Again, a doctor may say, hey, below 7 is what we're looking for because of gout, but I would say that's a situation to be kind of people being down on what they're not up on. Right.

Well, I know a lot of people want to have extraordinary health and so I'm so grateful that you decided to create the book on this. and create a process with a plan, the diet, everything in here, the love diet, which I think is really cool. We'll have to do another episode sometimes.

We didn't really get to the book, but that's okay because we were into some good areas.

I think it's beautiful. I have a couple final questions for you. This is called the Three Truths. I ask everyone this question at the end of the interview, and it's a hypothetical scenario. So imagine it's many years away, but it's your last day, last day on earth. And you get to choose the day, you get to live as long as you want, but eventually you got to turn the lights off for this world. And you have accomplished every dream you could think of. You've lived a life that you want to, you have the relationships, you have the accomplishments, the impact, it's all there. But for whatever reason, every piece of work or piece of content you've put out into the world has to to go with you or go to another place. We don't have access to this information anymore. So this book, everything you've created, for whatever reason, it's gone. Again, hypothetical world. But you have a piece of paper and a pen and you get to write down three things you know to be true about life, about your experiences, about what you've learned that you would want to share with the world. And this is all we would have to be reminded by your message. What would you say are those three truths for.

Number one, and I'm not going to rank them, but number one that comes to mind is there is nothing constant except change. Number two is the golden rule. Do unto others as you would have them do unto you. And number three would be don't sweat the small stuff. I remember who said that to me the very first time, it was a freshman in college. And oddly enough, his name was John Kennedy. not John Kennedy, but that was his name. And it was very meaningful. I didn't get it at first.

He said, Don't swear the small stuff.

But over the years, I've gotten it. Right.

Isn't the book, Don't Swear the Small.

Stuff, and it's all small stuff? Doesn't that the-- oh, yeah, you're right.

It's not worth it. It isn't worth it. What do you wish you would have learned and implemented 30 years ago for yourself that maybe you didn't implement yet?

That now you know. From a practical point of view, view, I would have said, don't get as much sun.

Really?

Oh man, I really overdid it in paying the price now. Number two, floss more regularly. Yeah. Number three, I would say don't sweat the small stuff. Yeah, interesting. Because it took a while to learn that.

I mean, obsessing over every little thing that was like...

I know I'm a driven individual. I know that and that's just who I am. And when that starts to, you know, bleed out into relationships and other things.

Sleep and health.

Everything. So it's about focusing on what really matters. And the older you get, the more you realize, A, what really matters and why did you invest so much into.

Things that-- Meaningless things, whatever. What really matters to you now?

I have a gift and I'm not trying to be bombastic with that. And my gift is to be able, to have the ability to take complex information and present it to many people who may not have the ability to access that information by virtue of its complexity.

Right, like everything in the back of the book that's just, you know, citations of research papers. I'm never gonna read this.

Yeah, I mean everybody has a gift. I feel very fortunate that I'm able to identify mine. and exploit the heck out of it because the word doctor doesn't mean healer, it means teacher. And that's at this stage in my life what I'm doing and that is getting out information that I think is going to be helpful. Because there's a lot of misinformation out there. We've talked about a lot of that today about that you can eat sugar and fat is the all the things that we've been told and I think it's important for people to hear the other side, the science validated, scientific validated truths for us, that may change. Things may change, rule number one. So that's the mission. And I think it's very comforting to be on mission for me, day to day. Yeah.

So you wish you would have flossed more and you wish you would have got less sun.

Yeah. I mean, I'm not saying getting some sun is bad, but it's not good. Oh my gosh.

Did you have just some skin issues or challenges?

Yeah, I mean really.

Well, being in Florida every day too.

I guess, growing up is... Yeah, I mean in my last year of high school and then early in college, I built houses in Florida Keys. Oh man. The whole thing, no sunshine. Mr. Tough Guy. So, you know, I think getting it some sun is a good thing, but yeah, you gotta be careful. And nowadays, being much more careful, of course, making sure my vitamin D levels were at needs to be. But as a general rule, if you don't want to have your face acid washed, which was no fun, yes, because of all the skin, you know, things, be careful in the sun.

Your book is coming out, Drop Acid, the Surprising New Science of Uric Acid, the Key to Losing Weight, Controlling Blood Sugar, and Achieving Extraordinary Health, which I believe is something a lot of people want, extraordinary health. so I highly recommend you guys all get a copy of this book. It's going to give you some powerful tools. And for me, I love that you say that you make the complex simple or at least simple to understand. Maybe some of these things are challenging changes to make for people, but easy to understand so you have at least with the right wisdom and the knowledge to take action in an easier way, hopefully.

That's right.

People can get this everywhere. Where else can we go to support you? Social media?

I think the clearinghouse is drperlmutter.com, drrperlmutter.com, and that's sort of the launch pad for everything else that I do. I mean the book has a dedicated URL, drop acid book, but I think drperlmutter.com is home base. Yes, home base.

It's got all the links to everything, all your other previous books which I got to check out, Brainwash, I think that one's going to be fascinating for me as well. I'll get your copy. Brainwash. Now, the more people that have these wearables on, I'm gonna have to start getting this stuff, I'm sure now. So I'll talk to Dr. What's her name again?

Casey Means.

With levels, you recommend that where?

I'll talk to her later today.

Okay, you'll connect me. I'll get the text intro. Before we go to the final question, I want to acknowledge you, David, for showing up vulnerably, for showing up and being true, authentic, honest. And I think it's beautiful to see someone who is as intelligent and accomplished as you still connected to your heart and caring about people so deeply and so compassionate about helping people and serving people at a high level to not have to experience the type of pains and sadness and challenges that you went through and that so many of your clients went through for many years. And a lot of people going through. So, I really acknowledge you for being honest and authentic and vulnerable with me. And one final question for you. What's your definition of greatness?

I think greatness is recognition and exploiting your gift.

There you go.

What is your gift? And then, you know, doing your very best to get as much out of it as you possibly can. Yeah.

Awesome, David. Thanks, man.

Appreciate you.

Thank you.

Appreciate it, man. Thank you so much for listening. I hope you enjoyed today's episode and inspired you on your journey towards greatness. Make sure to check out the show notes in the description for a full rundown of today's show with all the important links.

And also make sure to share this.

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The most.

And if no one's told you lately, I want to remind you that you are loved, you are worthy, and you matter. And now it's time to go out there and do something great.