Transcript for:
The Role of Sugar in Health

let's be clear and honest about this calories are not the issue this is all about that's the problem that's how you lose weight do Robert lustig is an endocrinologist whose firsthand research has explored the role sugar has on fueling the world's most destructive human conditions and answerers how we can regain control of our health if you consume one sugared beverage per day your risk for diabetes goes up by 29% so this is a big problem we also know that if you have high sugar consumption it's got multiple detriments effects such as mental health problems cognitive decline early death we also know it's the primary driver of ADD but the problem is Sugar's addictive and 73% of all of the items in the grocery store are spiked with added sugar by the food industry cuz they know when they add it you buy more you can't believe what they're telling you if they say something is healthy it's usually the opposite and I'm part of numerous lawsuits suing the food industry because they knew that sugar was a problem but they paid off scientists to say it wasn't you've been hacked but a lot of people don't have time to be doing a fine tooth comb over every single thing that they're putting into their body they're not a scientist agreed so what advice do we give that is simple and actionable food can be medicine food can also be poison and the question is how do you figure out which is which so here's the secret congratulations daro gang we've made some progress 63% of you that listen to to this podcast regularly don't subscribe which is down from 69% our goal is 50% so if you've ever liked any of the videos we've posted if you like this channel can you do me a quick favor and hit the Subscribe button it helps this channel more than you know and the bigger the channel gets as you've seen the bigger the guests get thank you and enjoy this episode Dr Robert lustic on the front of your book it says the hacking of the Mind very strong words to use indeed whose mind has been hacked and who is doing the hacking yours mine everyone's who's been doing it well pretty much anyone with a A belief system that's not yours and that's pretty much everybody the bottom line is uh we have been sold a bill of goods we as a society we as individuals have been sold to bill of goods and the idea of the book The reason I put the book together is because it actually makes us miserable it has stolen our Birthright and our birth right is to be happy and we are not if anything we're the opposite of happy we're extraordinarily unhappy just look at the incidence of depression around the world not just in America not just in the UK but everywhere the World Health Organization now says that 5% of all of the people on the planet are clinically depressed and here in America it's at 22% so we're really unhappy the question is why is this if you know our goal is to be happy it's in the Declaration of Independence life liberty in the pursuit of happiness well we're not so why the reason is is because we have substituted pleasure for happiness what's the difference between pleasure and happiness well pleasure is shortlived happiness is longlived pleasure is visceral you feel it in your body happiness is ethereal you feel it above the neck pleasure is taking like from a casino happiness is giving like habitats for Humanity pleasure is experience alone happiness is usually experienced in social groups pleasure can be achieved with substances happiness cannot be achieved with substances the extremes of pleasure whether they be substances or behaviors so substances Like Cocaine amphetamine nicotine alcohol sugar or behaviors uh shopping gambling social media internet gaming pornography in the extreme all lead to addiction there's an a holic after every one of those shopaholic sexaholic chocoholic alcoholic Etc but there's no such thing as being addicted to too much happiness and lastly number seven the one that is the reason for the book Pleasures dopamine happiness is serotonin and they are not the same so two different neurotransmitters two different sets of receptors two different areas of the brain two different mechanisms of action two different clearance mechanisms don't dopamine is an excitatory neurotransmitter what does that mean means when dopamine is released in the area of the reward center the nucleus accumbent it's an actual anatomic structure in the brain which you can see on Imaging when dopamine is released there and it binds to its receptor like so you get the you transduce the feelings of reward okay and reward is good reward is what gets you out of bed in the morning if you don't have reward you know basically you shrivel up and die okay reward is essential to the survival of the species orgasm is reward okay you know you need it it's it's part of daily life but okay too much reward is a different story and the reason is because dopamine because it's an excitatory neurotransmitter it causes the next cell to fire well if it causes the next cell to Fire and Fire and Fire that cell dies neurons want to be tickled not bludgeoned chronic overstimulation of any neuron leads to neuronal cell death so that postoptic neuron with the dopamine receptor it's got a plan B it's got a way of mitigating that negative response it downregulates the receptor so now more dopamine less receptors less chance that a molecule will find a receptor to bind to well that means your the gain the amplitude on the reward is going down more and more for less and less the more law of diminishing returns like an addiction like a tolerance yeah tolerance is one half of addiction and then when the neurons do start to die that is addiction exactly right so dopamine drives addiction and it doesn't matter what the cause of the dopamine release is in the extreme it will be addictive now serotonin does not uh does not downregulate its own receptor because it's not an excitatory neurotransmitter it's an inhibitory one so do you need to downregulate an in inhibitory response no an inhibitory means what well it means puts the next neuron to rest okay instead of stimulating instead of firing it's actually calming okay right so there's no such thing as being addicted to too much happiness because the receptors are still there but there's one thing that downregulates serotonin and that's dopamine so the more pleasure you seek the more unhappy you get and we've been told for the last 100 years that pleasure is happiness neurologically the pathways are entirely different as you say and between pleasure and happiness one of the ways that we have been h h act neurologically and Via our dopamine receptors is through what we eat and your book Fat Chance covers this really profoundly in New York Times bestell the first word in the subtitle there is the word sugar MH I've heard a lot about sugar um I see it in adverts I I I turn over the back of anything I eat and it says this word added sugar is sugar really a problem in society has it really hijacked us yes the answer is not only is it a problem I personally think it's the biggest problem it's not the only problem but I think it is the biggest one now why do I say that from a systemic health issue the biggest problem was trans fats what's a trans fat trans fat is a fat that is has a double bond in it that is flipped so Norm normal unsaturated fats like olive oil like canola oil like rap seed oil like cesame oil like peanut oil okay Etc they all have a double bond in them but the double bond is in One Direction a trans fat has the double bond in the opposite direction one way to make a trans fat is to heat it you put enough heat across the double bond and it will flip by itself so if you heat olive oil too high you can actually make trans fats at home but the food industry used trans fats for food stabilization for to increase shelf life they've been using it in baked goods since the 1920s the scientist who first figured out that trans fats were dangerous Fred Kumo figured this out in 1957 but it wasn't until 1988 that anybody took him seriously and then we started doing research on it and ized oh my God this stuff is killing animals and killing people and finally in 2013 so over 60 years after the initial uh science the FDA finally banned trans fats in our food without question trans fats are the devil incarnate seriously you know consumable poison no if Sor buts is sugar poison sugar is like alcohol so is alcohol poison depends on the dose right the dose determines the poison paracelsus 1537 we have an innate capacity to metabolize alcohol and if we stay below that doesn't do too much damage if we go above it different story same thing with sugar same thing with this molecule the sweet molecule fructose and the reason is because fructose and alcohol are metabolized virtually identically what's the difference between sugar and fructose so sugar dietary sugar the sweet stuff the crystals the uh stuff you put in your coffee the stuff I've got over here yeah like that stuff yeah that stuff the 10 the 5B bag right there that's called sucros okay this is sucrose this is sucrose now sucrose is two molecules bound together one molecule called glucose one molecule called fructose they are not the same now the food industry will tell you they are the same they are not the same the reason they tell you they are the same is because that's the way they assuage their own culpability for what they've done to the food but they are not the same they will say a sugar is a sugar a calorie is a calorie a glucose and fructose both have four calories per gram why should you care oh you care a lot you care a whole lot now glucose is the energy of life every cell on the planet Burns glucose for energy glucose is so important that if you don't consume it your body makes it okay the Inuit had no carbohydrate they had ice they had whale blubber they still had a serum glucose level Inu so the people that live in the uh North Poles and stuff that's right yeah the forly known as Eskimos right but they they didn't have any carbohydrate they off fat but they still had a serum glucose level because your brain runs on glucose they can also run on ketones too but you know your brain runs on glucose my brain runs on glucose and you need glucose because certain um hormones and certain proteins in the body require glycosilation in order to be effective an example LH and FSH when you don't have gly illation of LH and FSH the hormones that tell your testicle and your ovary to work you are infertile it's that simple so survival of the species says you need some glucose but if you're not consuming it you'll still get it because your body will make it it will make it out of amino acids it will make it out of fat gluconeogenesis it's called so glucose is essential it's just not essential to eat fructose on the other hand the a sweet molecule in that bag which is sort of one of the two parts of the the the grain of sugar that I see one one part of it is fructose that's right it's the other half it's the the evil twin if you will what are the two halves again glucose yeah fructose found together I need glucose to live my body will figure that out fructose do I need this you not only do you not need it but in high dose it's toxic now your liver has has the innate ability to metabolize a small amount on the order of about 6 to 9 teaspoons per day of dietary sugar so half of that being fructose so about 12 grams your liver can manage about 12 gram of fructose a day in the same way it can ma manage about 12 grams of alcohol per day without showing any signs of any U metabolic derangement but if you go above that that now you get problems are we above that oh we are so above that we are at 50 gram of fructose per day 100 gram of sugar per day we're supposed to be at 25 we are at 100 we are quadruple our limit and and also just because grams are quite hard to wrap the head around right okay so if I was to get a tablespoon well do teaspoons a teaspoon teaspoons how many teaspoons of sugar what I have to consume to get to that level of fructose CU I say this in part because most of us don't realize that we're consuming sugar that's right because it's hidden in all of the food that's exactly right we don't even know we say oh I never even add sugar to my coffee therefore my sugar consumption is zero wrong that is not true okay because it is hidden in plain sight in virtually every processed food in the entire grocery store 73% of all of the items in the American grocery store and in the British grocery store are spiked with added sugar by the food industry for its purposes not for yours because they know when they add it you buy more and how much does that look like in teaspoons then the upper limit is about six teaspoons of added sugar per day the allowance the re all the re the the upper limit okay the recommended allowance is lower than that yeah okay but the upper limit is about six teaspoons of added sugar per day so in alcohol terms that' be like one drink so if you have a drink a day you're staying below your threshold and all is fine what if you have two drinks per day now it depends on how well your liver Works maybe how much exercise you have how much total body mass you have Etc what about if you have three drinks a day you're going to get pretty tipsy maybe you shouldn't be driving a car right what if you have four drinks per day you know they might have to you know uh scrape you off the floor of the bar with a spatula and what if you have five drinks per day you're a fraking alcoholic is what you are all right the point is the dose determines the poison well the same is true with sugar so we have an innate capacity to metabolize about 12 Gams of fructose per day by the way that's for adults for children it's onethird of that four gram of fructose per day okay four to six so we're talking very little talking very little but when you think about for instance kid in America what you know 29% of kids in America consume the National School breakfast program breakfast in school okay 29% so what is the National School breakfast program breakfast it's a bowl of Froot Loops and a glass of orange juice that is 41 g of sugar the upper limit for children in terms of their metabolism is 12 gram per day they got 41 gam and it's just breakfast what do you think that's going to do now if a calorie were a calorie and if glucose and fructose were the same then you say say well you get got to get your calories somewhere but because fructose is not glucose because fructose is more like alcohol because fructose toxicity has nothing to do with its calories that is a huge overdose and it has metabolic complications has systemic Health complications it has mental health complications and ultimately it has societal complications do you think it has neurological consequences without question it's the it's a primary driver of add it's not the only driver but it's one of them it's a primary driver depression because we have the data as it relates to ADD and ADHD and all those kinds of things how do we know we have functional MRI we have performance uh data showing that when you take the sugar out PE kids scores get better okay we did this ourselves at UCSF we did a study where we took 43 children with obesity and metabol syndrome all high sugar consumers all low socioeconomic status children a Latino and African-American all high sugar consumers and what we did was we figured out what they were eating on their home diet we studied them on their home diet and then for the next nine days we catered their meals no added sugar we took the added sugar from 28 Tas 28 uh uh teaspoons of added sugar per day down to 10 okay so huge reduction we gave them fruit that was the only place they had sugar in their diet otherwise we cut the sugar out now if you do that you're going to lose 350 to 400 calories per day out of your diet all right so the goal was to keep their weight stable because if they lost weight the critics would say well of course they got better they lost weight so we needed to maintain their weight so we had to put something back in that was we caloric we gave them extra starch so in the vernacular we took the pastries out we put the bagels in we took the sweeten yogurt out we put the baked potato chips in we took the chicken teriyaki out we put the turkey hot dogs in so we didn't give them good food we gave them crappy food we gave them Safeway food you know just cpg you know uh uh consumer packaged Goods food you know okay so you didn't give them vegetables just no we didn't give them any vegetables okay but it was no added sugar food okay it wasn't funky food it was just food we bought at Safeway but it was chosen to not be um sugar containing okay and we gave them a scale and every day we'd call them up on the phone what your way and if they were losing weight eat more in order to maintain their weight for the whole 10 days of the study and then we studied them on day 10 every aspect of their metabolic Health improved blood pressure went down blood glucose went down insulin went down their pancreas has started working right again they had a serum lactate level you're not supposed to have a lactate level that means your mitochondria are dysfunctional if you have a lactate level okay their lactate cleared everything got better most importantly for the first 5 days of that 10day window the kids were obnoxious the parents would complain to us my kid is a disaster and the reason was because of withdrawal they were withdrawing off sugar withdrawing off fructose and then like you know Moses the sky cleared and the kids started concentrating better they started doing better in school the parents noticed they were less irritable the teachers noticed they weren't nuisances or trouble in the school anymore the kids noticed they said this the first time my head hasn't been in the clouds 5 days 5 days and in 10 days we could see all of the metabolic benefits even though they maintained their weight even though they maintain their calories sounds like a bit of a scandal when I hear that these kids are getting 30 almost 30% of kids are getting you know almost you know three to four times their recommended daily allowance of sugar from school and that it's having these sort of really adverse consequences on us and the studies are there to prove that the consequences are very real MH it sounds like a scandal in the sense that nobody's doing something about it ah well yes that way it is the point is that the food industry is very powerful and they have you know um swept virtually every aspect of this under the rug for 40 to 50 years they knew back in the 1960s that sugar was a problem but they paid off scientists to say it wasn't and we actually have the documents from the food industry they live at the UCSF food industry documents library and we are doing research on corporate interference in health what do those documents show they show that in 1965 the sugar industry came to two Harvard School of Public Health scientists the head of the Department of nutrition Fred stair and his associate Mark hegstad who became the head of the USDA uh five years later and paid them $50,000 in today's money to produce two articles for the New England Journal saying saturated fat was the bad guy and that sugar was exonerated and they did and they did it that's just one thing they did they also infiltrated the National Institute of dental research n IDR their study sections and their uh executive uh committee to take money away from nutrition research for dental health and put it toward a carries vaccine a what a dental carries a Cav vaccine okay how's that cavities vaccine working for you okay we have all of the data in their own words to demonstrate that they knew exactly what they were doing this is not hallucination this is this is Hardcore fact and we've published this and we now have a um a center at UCSF devoted to understanding the uh uh corporate determinance of health and when we look across Society at the consequences of this sort of corporate interference some of the crazy stats in your book fat chance that I really sort of highlighted were that by 2050 obesity will become the norm not the exception correct what the World Health Organization said that the percentage of obese people globally has doubled in the last 28 years and in the UK 28% of adults are obese and 36% of them are overweight that's not from your book but that's from some research we did on the UK numbers as well well you know the UK is the fat man of Europe yes that's true having metabolic syndrome is equal to losing 15 to 20 years of life that was in your book that's correct um which is startling um and worldwide sugar consumption has tripled in just the last 50 years correct all true now you could say that's correlation not causation but we actually have the causation we have the data we have it in mechanistic terms terms we have it in um uh clinical Interventional uh uh efforts we have it in societal efforts um there's a method for determining proof that doesn't need randomized control trials it's called econometric analysis this is what we have for for instance climate change there's no control group for climate change but we still know it's true this is what we have for tobacco and lung cancer you know you don't have naive people start smoking that would be illegal immoral get you thrown in jail but we still know that tobacco causes lung cancer we know that football trauma causes chronic traumatic Andy opathy okay none of these have control groups but we know it's true through econometric analysis this is a method of using natural history data over time to be able to determine proximate cause and we have that for sugar and diabetes and we have it for sugar and heart disease and we have have it for sugar and fatty liver disease and of course we have it for sugar and tooth decay we're working on sugar and cancer and sugar and dementia we're not there yet in your book fat fat chance um on a on page 120 there was something particularly curious because I think this is a um yeah here we go it says the bottom line is sugar consumption is a problem 33% of sugar consumption comes from beverages yes and the biggest abusers are the poor and underserved indeed so let's talk about beverages to start with then MH diet beverages are they fine and how bad are the sort of fizzy pot beverages that most of us consume every day so let's do the um sugar soft drinks first okay okay they are really bad if you consume one sugared beverage per day your risk for diabetes goes up by 29% wow okay that's and diabetes and that and that's if you have one if you have two 58% and diabetes is now the main cause of death in 40% of death certificates exactly right so this is a big problem so you know that's demonstrating its toxicity at you know shall we say medium dose you know at low dose you can handle it but you know as soon as you go above that dose it's a problem and we have the data for it okay and all of these are factored in these are all econometric analysis we've shown that sugar is a proximate cause of diabetes whenever sugar availability changes in any country diabetes prevalence changes 3 years later and we've also done what's known as advanced Markoff modeling where we go into the future and show that when sugar consumption goes down in any country diabetes levels change in NE you know reduce three years later so it's a threeyear window between the change in the diet and the change in the metabolic Health consequences we have those data and the fact that they work both on the way up and on the way down is like you know take it to the bank now that's for the sugar beverages you asked me about diet beverages I've got one here let's let's uh look at it all right I've covered up the logos cuz I I've never seen this before I wonder what that is um the the data now show I mean for it it took a while for these data to come in but the data now show that the toxicity of one sugared soda equals the toxicity of two diet sodas half as bad half as bad does not mean good half as bad means half is bad well it says zero sugar here so how can it be bad well so because it's bad for a different reason so the yes zero fructose zero calories I agree but that doesn't make it good makes it better than the sugared alternative but it doesn't make it good why number one you put something sweet on the tongue message goes tongue to brain Sugar's coming message goes brain to pancreas Sugar's coming release the insulin so I still get an insulin release you still get an insulin response and the more other food you ate the bigger the insulin response so you will have an accentuated insulin response because you were exposed to the diet sweetener this is work from Yanina Pino um uh 2013 at Wu St Louis and it's been corroborated multiple times since and why does that harm me having an insulin response because insulin is a bad guy so we always talk about glucose being a bad guy in terms of diabetes and it is of course but insulin's a bad guy too glucose causes small vessels to be dysfunctional causes endothelial cell dysfunction it causes high blood pressure because it causes those small vessels to constrict it interferes with nitric oxide uh which is one of the things that relaxes the blood vessel and it will you know basically reduce uh blood flow to specific organs so high glucose is not good for you and it's bad for small vessel disease and that's why diabetics get retinopathy nephropathy neuropathy um uh kidney disease nerve nerve nerve damage and um eye disease but insulin is also a problem because what insulin does is it causes cell growth insulin is a growth factor and it causes vascular smooth muscle growth like in your coronary arteries it causes glandular growth so it is one of the primary drivers of heart disease and cancer so you can be a diabetic a type 2 diabetic and have your hemoglobin A1c measure of your glucose uh uh uh control down near normal near normal range because you're on insulin or oral hypoglycemics or even glp1 analoges for that matter okay and you will die just the same because you will die of a heart attack or of a of a cancer because diabetics uh have a much higher incidence of cancer they also have a higher incidence of dementia as well and the reason is because of insulin because insulin is a bad guy in this story glucose causes microvascular disease the insulin causes macrovascular disease they're both bad you need to control both of them and this controls the glucose it doesn't control the insulin do you drink that stuff of course not just checking is there any other physiological consequences to diet sodas outside of the insulin response indeed so the other thing that we've learned about uh uh uh non-nutritive sweeteners across the board is that they alter the microbiome now the microbiome is the bacteria that live in your gut now you have to feed your microbiome you have to feed your bacteria because if you don't feed your bacteria your bacteria will feed on you it will strip the mucin layer a protective physical barrier right off the surface of your intestinal epithelial cells and when it does that it denudes them and allows for other bacteria toxic bacteria to take up residence and cause irritable bowel syndrome inflammatory bowel disease and the Junctions between the cells become dysfunctional as well and so they cells become permeable and so stuff you know in your intestine the junk in your intestine the you know sh you know what can actually make it through into the bloodstream you can measure the endotoxins and the whole bacteria the lipopolysaccharides in the bloodstream when the intestine is damaged even from diet soda and what that does is that ultimately leads to SU systemic inflammation and that systemic inflammation also leads to metabolic disease mental health problems cognitive decline early death is there a relationship between sugar and our hormone levels of course I mean the main one of course is diabetes I mean you know insulin but um high sugar uh you know I mean if you if you have U uh high sugar consumption it's going to cause changes in insin response at the level of the liver it's going to cause fatty liver disease okay it can change your kidneys uh uh function uh you know which can ultimately increase blood pressure so it's yeah it's got multiple uh uh potential detrimental effects what impact does sugar have on our liver what's going on there so as I mentioned we have an innate capacity to metabolize a limited amount yeah everyone says oh Sugar's energy well yeah but not really not really so let let's disect that the food industry says glucose is four calories per gram the food industry says fructose is four calories per gram therefore they're equal because they're four calories per gram and if calories were the issue then they would be right but calories are not the issue okay the whole issue of calories has has to go down the tubes okay as far as I'm concerned that's the problem and I am here to # kill the calorie as a unit of measure it has no place in our uh in in our dialogue it has no place in medicine calories suck now why do I say that if you take a mole of glucose and you throw it into a bomb calorimeter you will get four calories per that's true if you take fructose and you throw it in a bomb calorimeter you will get four calories per gram that's true we are not bomb calorimeters okay what's a bom calorimeter it's a contraption that explodes the whatever you put in it and measures the heat that's uh given off from it so it measures the amount of calories in something effectively using some that's what calories are is the amount of heat required to raise one gr of water degre Centigrade okay so it's a measure of heat yeah is what it is that's what calories are now we do our burning in these little organel inside each of ourselves called mitochondria this is all about mitochondria and when your mitochondri will work efficiently and well you can burn energy uh uh you know to completion and you can capture that energy in the form of chemical energy in your cell called ATP denzine triphosphate and that's what your cell uses to power all of the functions that the cell needs the little molecular Motors and making stuff and you know basically you know and and also cleaning house you know and recycling junk okay in order to keep your cells Thrive thriving and Alive okay so mitochondria are essential now glucose stimulates mitochondria to work better glucose is actually good it it stimulates two enzymes necessary for mitochondria to work it stimulates an enzyme called amyas which is a the enzyme that actually makes more mitochondria and it's the fuel gauge on the liver cell so it tells the liver make more and it also stimulates an enzyme called HH hydroxy asil COA dehydrogenase which is necessary to cleave two carbon fragments and uh burn them oxidize them for energy too so glucose we can call good because it helps mitochondria fructose on the other hand this sweet molecule in sugar in sucrose it inhibits three enzymes in mitochondria it inhibits that amp kinase it inhibits an enzyme called aadl asilo dehydrogenase long chain it inhibits cpt1 carnitine pidol transferase one that's the enzyme that uh regenerates carnitine which is the shuttle by which fatty acids can get into the mitochondria to be burned so the net effect of fructose is to inhibit mitochondrial function so does fructose constitute energy if fructose is actually keeping you from making chemical energy in your cell this is the conundrum what do you mean by energy if we're talking heat then fructose is energy if you're talking ATP fructose inhibits ATP and that's what we're talking about because that's what leads to systemic health problems not the heat so all of these people as far as I'm concerned anyone who ever uses the word calorie fire them because they don't get it they are part of the problem not part of the solution many people will say that sort of counting calories has helped them with their weight loss goals you tell me virtually everybody who counts calories loses a little bit of weight and then they plateau and then they get um you know tired of their diet and the weight comes rushing back okay 90% of people who try to diet through caloric restriction regain and sometimes yoyo back even higher so are there I don't accept that are there studies that support this idea that sort of the the yo-yo dieting is a BYOD of calic restriction not because of caloric restriction it's a problem of insulin resistance it's a problem of when you gain the weight back did you gain it in the liver as liver fat because now you've got high insulin and Insulin blocks this hormone that goes to the brain called leptin that is in charge of that set point so the higher your insulin goes the less well your brain can see leptin and so the less well you can regulate and so that's what drives your weight up even higher so you don't regain the weight by eating you know fish and vegetables you regain the weight because you you know went for the bread and the rice and the pasta and the potatoes and the sugar what's a better plan then if I'm trying to cut a couple of pounds what's a better approach to take versus sort of calorie counting or these kind of things get the insulin down there is no weight gain without insulin insulin is the energy storage hormone 20 years ago from doing the research on kids with hypothalamic tumors who released enormous amounts of insulin we gave them a drug that suppressed insulin release they lost weight and they started exercising spontaneously because we got their insulin down we showed that the lower we got the insulin the more weight they lost and the better they felt insulin is the bad guy in The Story So numerous investigators you know the world over have now demonstrated that insulin is a primary driver of both obesity and diabetes and metabolic syndrome you got to get the insulin down okay how do you get insulin down best way don't let it go up what makes it go up refine carbohydrate and sugar all the stuff you have over there in that corner just to be clear he's not pointing at my lunch we have a pile of different sugar products that we brought for the interview over in the cor Corner including various things that you find on a shelf everything from apple juice to some popular snacks to um some like some some other things just don't forget the peanut butter The Peanut Butter Cups yeah and even this this is just sort of um it looks like water but it's flavored water where they've added sugar to it right um so yeah all of that stuff over there all that stuff so so get the insulin down all right so cut the refined carbohydrate cut the sugar the dietary sugar that is the single best way to mitigate this process by improving insulin resistance by getting the insulin down and we have done this time and time again basically I turned my obesity Clinic into an insulin reduction clinic for this reason a lot of people at a sort of a prefrontal cortex logical level understand this they understand that they shouldn't be having sugar but it's well they think it's about calories they do some people do think it's about calories for sure but even the ones that know that sugar is not something they should be having still struggle they do it's EAS because Sugar's addictive right they struggle because sugar is addictive we know because fructose stimulates that nucleus cumb yeah when we get stress which is a facet of daily life now that's right we're much more likely to to grab a sugary snack indeed and there's a reason for that too because when you're stressed that actually puts a greater uh uh burden on your amydala and your amydala requires more energy hippocampus too by the way amigdala is the emotional center of the brain the fear center of the brain okay and so you're trying to calm it and so you have to increase the energy available so because you need more ATP and even though fructose inhibits ATP generation you still reach for that because you're trying to mitigate the metabolic consequences acutely when I'm tied I think I have a high propensity to grabbing sugar as well indeed why is that because you're tired you're stressed and your amydala is dysfunctional and so it basically tells you hell with it I I don't have any sugar Cravings in the morning I've come to come to learn I don't feel the need for sugar in the morning it's sometimes when we get later into the evening right after a long day exactly it's when my my Cravings you and everyone else and me too by the way it's not like I'm uh immune to this I I you know am on record I gained a lot of weight while I was a faculty member at UCSF and every day at 400 p.m. I just ran out of gas and so I ran across the street to get a you know large chocolate chip cookie okay and that was without question the primary driver of my wak ging okay it wasn't until I actually started doing the research on this and seeing that the kids felt better when we took the sugar out of their diet that I actually put two and two together for myself so now I don't do that and my energy level stays constant throughout the day what so what advice do we give that is simple and actionable for Jennifer or Judith or Dave who's listening to this now they are you know 40 years old potentially they have a nine-to-five job they're very busy maybe they have some kids to feed at the same time they they don't have time to be like you know looking at doing a fine sort of tooth comb over every single thing that they're putting into their body they're not a scientist agreed it's a it's a problem because the food industry has made the grocery store a Minefield and it's really easy to set off an explosion if you walk in you're basically lost that's how bad it is understood so the the simple rule is eat real food so what's Real Food well food that came out of the ground or animals that ate food that came out of the ground the problem is we all lead busy lives and we're looking for labor saving devices cuz people don't even have time to cook most people 33% of Americans don't even know how to cook anymore so like what are they going to do so we understand this I mean it's a problem agreed we need food that is metabolically healthy for us not metabolically detrimental and the problem is that as soon as you put the added sugar in the food you have made it metabolically detrimental now the food industry will say well there are all these other good things in there like vitamins and minerals we fortify it Etc so I'm here to tell you toxin a plus antidote B still equals Death okay just because they put some vitamins in there or you take a dietary supplement if it's not solving your mitochondrial dysfunction what's the point so you can't believe what the food industry is telling you okay if they say something is healthy it's usually the opposite whatever it says on the package believe the opposite because they have an incentive to put wrong stuff on the package and I'll be honest with you I'm part of you know uh numerous lawsuits suing the food industry for deceptive advertising misbranding mislabeling 70% of all of the items in the American Grocery Store are misbranded or mislabeled in what way they say things that are not true give me some examples well first of all any time they use the word healthy okay um they say no added sugar okay but in fact they put in apple puree or raspberry puree or evaporated cane juice you know they they there are 262 names for sugar and the food industry uses all of them and so they will say that something's no added suar but that in fact is actually not the case okay there's there's a whole you know whole host of this Kelloggs has been sued for raisin brand okay everyone thinks raisin brand well it's just raisins and brand what color are the raisins in raisin brand I've never seen it well I mean raisins are purple yeah you purple brown yeah yeah yeah yeah normally well the the raisins in raisin brand are white why if you take the raisins and raisin brand that's supposed to be 11 gram of sugar but on the side of the package it says that one serving is 18 grams of sugar where' the other seven come from it's the white because they've all been dipped in a sugar solution to make them sweeter as an example okay so post has been sued General Mills their's theirs was uh dismissed um uh mandes a whole host of uh uh of companies are actually under the gun now to change their practices why do you care so much I am a pediatrician my job is to take care of children children are vulnerable in the same way minorities are vulnerable same way prisoners are vulnerable okay they need a voice my job is to give every kid a shot well we now have neonatal obesity we have babies being born Israel South Africa Russia United States four separate studies showing that over the past 25 years birth weight has gone up 200 grams half a pound in all four countries and when you do dexa scanning to look at body composition on those newborns those 200 grams are all fat we have neonatal obesity these kids did not get obese by dieting and exercising by gluttony and sloth they came out of the womb behind the eightball it's my job as a pediatrician to fix the problem that's what I care okay can you just give me a little bit of brief overview of everything you're talking about the um studies you've referenced all of that what is the academic experience background research that you've done that's built all of the foundations of your knowledge I spent the first 20 years of my medical practice you know in Academia basically you know doing what they told me to do you know the way I learned it and I thought calories were the same and I thought that you know it didn't matter and this is not what you do and this is not how you take care of patients you you know do prescriptions and you do procedures and that's how you do it and then I started doing research because I was at St Jude Children's Research Hospital taking care of these massively obese kids who had brain tumors that were treated by surgery or radiation and they became massively obese because of it because their hypothalamus was damaged because they couldn't see that leptin signal that we talked about earlier which is the hunger which it is part of hunger it's not the only hunger related it's more of an energy sufficiency signal okay right it's the energy sufficiency signal anyway when we suppressed their insulin release with that drug I mentioned before they lost weight and they started exercising spontaneously so we did that with adults and guess what same thing happened and we measured their energy expenditure and instead of it going down as you'd expect when you lose weight normally your energy expenditure goes down their expend energy expenditure went up so what this told me was that insulin is blocking leptin and as long as your leptin's being blocked you feel like crap and you're hungry and you don't want to get off the couch and as soon as your insulin goes down now your brain can see the leptin and you're not hungry and you can start exercising what this showed me was that the behaviors that we associate with obesity the gluttony and the sloth are actually secondary to this biochemical phenomenon of insulin blocking leptin and so this put me on the path of understanding insulin as the problem rather than insulin as the result fix the insulin fix the problem and so I've been doing that for the last 25 years and that's what brought you to the subject of sugar because sugar increases insulin levels well sugar causes insulin resistance okay so there are two phenomena in with insulin insulin release yeah which is an acute phenomenon so that's when I eat something there'll be some insulin released which means my I have an insulin Spike right and then it comes back down nicely if I not or not or not depending on how much and how consistently I've been eating sugar exactly right so if your liver has fat in it and 45% of American adults now have fat in their liver and 25% of kids now have fat in their liver and they never did before I mean before 19 uh 80 if you saw fat in the liver that was alcohol but if 25% of kids who don't drink alcohol have fat in their liver how'd the fat get there sugar cuz sugar gets turned into fat in the liver that's the that's the driver of this what that does is that causes a phenomenon called insulin resistance your liver doesn't work right so your pancreas has to make more insulin to make your liver work right you know like you having to put more people on the assembly line when you know people are you know goofing off or you know not not getting their job done right same idea so you have to basically Goose the liver to do its job well that raises insulin levels all over the body and once that happens now you're taking energy from your bloodstream and putting it in fat cells for storage so by getting the insulin down so if it's insulin resistance fixing the insulin resistance by getting rid of the fat in the liver or if it's the insulin release at the beginning by lowering your refined carbohydrate because that's the primary stimulus of that first Spike either way it's refined carbohydrate in your sugar get the insulin down and diabetes is when your pancreas can't keep up okay so it's really so much insulin it goes forget this I'm done right it's the end result of both of these um phenomena which we've now realized is reversible I think there was a school of thought once upon a time that diabetes couldn't be reversed but that's right but it is reversible it is very reversible for a while so let's be let's be clear and honest about this there is absolutely no doubt that what doctors learn in medical school is wrong we are told and I know cuz I was told that diabetes is a chronic progressive unrelenting disease that never gets better and that you will need medication whether it be insulin or oral hypoglycemics or whatever for the rest of your life garbage total complete trash now Vera Health numerous other uh studies of various diets show that you can absolutely reverse type 2 diabetes in order to do so you have to get the pancreas to make insulin properly and the only way to do that is to get the liver to respond to insulin properly one way is to not challenge the liver give the liver a rest well it's metabolizing all that refined carbohydrate and sugar drop the refined carbohydrate and sugar and make your liver work better little kit so a ketogenic diets the extreme version of this it's not the only way but it is a way paleo diet is another version fasting intermittent fasting will give your liver a chance to burn off the fat that's accumulated over the last 16 hours there are many ways to skin this cat calorie counting almost never calorie restriction yes calorie restriction but it's got to be consistent and longterm and we've shown numerous Studies have shown that as you restrict calories that leptin resistance does not get better quickly it takes years for that leptin resistance to finally go away like five years before you change the set point let's take a step back so what does leptin do again it's about energy so leptin is made in your fat cells yeah in response to driving energy into fat the cell will make leptin the leptin will circulate in the bloodstream will go to your brain go to your hypothalamus and say hey I've got enough energy on board okay to engage in expensive metabolic processes so we don't need anym I don't need to eat eat more I can engage in puberty I can engage in pregnancy okay okay both of which are high metabolic uh uh processes okay okay so it is like the servo mechanism like the thermostat on your house okay you have a a floor but no ceiling so when you're when it's cold in your house the heat kicks in but if you don't have air conditioning it can go higher right same idea with leptin floor no ceiling so when your leptin goes below a certain threshold your brain will see that as starvation you get really hungry and so you will get both hungry and you will also sit on the couch okay okay H so that's the way the activity component comes in because your brain's saying listen don't waste this energy exactly conserve okay because we're in trouble here we're we're in trouble down here okay so eat more and don't move that's the biochemistry that drives the behavior why don't they have leptin injections well they do oh really but it turns out it doesn't work in leptin resistance because the problem is not that you're missing leptin the problem is you have too much leptin it's just not working so adding more leptin is like throwing kerosene on the fire the recepto sites have stopped receptor sites are not there either they've been downregulated or they're being blocked one or the other if insulin blocks it okay or they can be downregulated too both now if you're leptin deficient and there are 14 patients with leptin deficiency and quite a few of them by the way are in the UK of the 14 and sadf faruki and Steve O'Reilly at Aden Brook's hos Aden Brook's Hospital in Cambridge are the people who've done the most work on leptin deficiency if you take a patient who's LEP and deficient they basically start gaining weight as soon as they're born by age 6 months they're already massively obese by the age of you know three they they you you can't they can't even fit through the door okay they eat everything in sight and they don't move you give them a shot of leptin because they're deficient you're replacing what's missing and they slim down like that they're genetically leptin deficient they're genetically leptin deficient they have a mutation in their leptin Gene so obesity could be genetic in some very very small cases very small number of patients it is genetic but that's not what's going on in the rest of the population so yes is obesity genetic for a small fraction sure we have leptin deficiency we have letin receptor deficiency we have pc1 deficiency we have melanocortin 4 receptor deficiency we have sim1 deficiency we there a whole host of different genes and nobody has them nobody has them all right like 14 people have them it's very rare for the reason for General Garden variety obesity out in the world to be due to a genetic problem this is an environmental problem in your book you talk about environmental obesogens I've never heard that term before what does it mean so obesogens are chemicals in the environment that actually drive weight gain they cause the differentiation of fat cells or they cause the growth of fat cells now fat cells are complex okay you have a certain number but you can increase that number especially early on in life there's a critical period before Age 2 where you can actually increase fat cell number and once a fat cell is developed it wants to stay filled I mean we got to pause here just for a second because I think most people think that when we eat food we increase the number of fat cells we have no we increase the size of the fat cells we have this was a really I learned this a couple of a couple of years ago and it kind of changed the way I think about a lot of things including liposuction yeah because with liposuction you kind of think that you're taking away fat cells that you've added to your body through diet but actually the fat cells stay the same they grow and Shrink well there's also a problem with liposuction as well um there are three fat Depot okay and they're not the same on the scale they're the same because you weigh a certain amount but from a metabolic standpoint they are not the same so let's take each of the fat Depot separately so that your audience will understand what it is that they're actually concerned about so the first fat Depot is the obvious what we call subcutaneous or big butt fat belly fat as well no that comes later oh that's the second one okay subcutaneous cutanous big butt fat or does this bathing suit make me look fat fat so are you saying that's good or bad it's actually good I agree it's protective the more of it the less likely that you will have metabolic disease it is the place where your body wants to put excess energy because it's safe now most of us have a certain ability to grow that fat to a certain level before it starts becoming a problem eventually you can overload that subcutaneous fat where you will actually make the fat vacu the little pocket of of fat within the fat cell grow so much that it will actually cause the uh border of the V Ule to decompensate and now you've spilled the grease into the cell that will kill the cell and that will cause um uh inflammatory cells to congregate to try to clean up the grease and then they secrete um proteins called cyto coses which end up causing the metabolic dysfunction in any case you can overload your subcutaneous fat but you have to work at it so about how much fat does your sub cutaneous fat have to grow before you become metabolically ill on average about 10 kilos 22 pounds some more some less okay now let's take the second fat Depot belly fat viseral fat this fat here everyone's worst type of fat well yes but not because of Cosmetics because of metabolism in any case the the visceral fat the belly fat is that due to calories is that due to weight gain that is actually due to cortisol that's due to stress and the reason we know that is because you can take patients who are have endogenous clinical depression okay they are anhedonic they don't eat because they generate no reward from Life they generate no reward from eating they are losing weight they have to be admitted to the hospital to keep them from killing themselves so these are with people with suicidal ideation who have to be admitted to psychiatric hospitals you put them in a scanner and it turns out they're losing subcutaneous fat because they're not eating they're gaining visceral fat because the cortisol from the stress that goes along with the depression is actually laying down more fat in their belly why it's what cortisol does because when you're stressed you need an a readily available and metabolically active source of energy in case you're being chased by the lion so that metabolic fat that visceral fat is eminently retrievable rapidly oh okay interesting okay now how many pounds or kilos of visceral fat you have to gain before you become metabolically ill I'm going to guess it's it's not a lot based that's right not a lot so subcutaneous was 10 kilograms that's right now we're talking about two kilograms okay so two kind of bags of sugar yeah pretty much okay now finally the third fat Depot liver fat now how many kilos of liver fat can you acrw before you become metabolically ill live is really small I no idea okay one qu of a kilo half a pound and when you become metabolically ill then all of the dysfunction we talked about previously happens that's right so you can become metabolically ill and be thin because your subcutaneous Fat's okay even your visceral Fat's okay but if you've got liver fat can you measure a quarter of a kilo on the scale no have you had the phrase skinny fat that's this is skinny fat so tofi TFI thin on the outside fat on the inside skinny fat was actually coined by Dr Jimmy Bell at University College London okay neuro imager that's exactly right so just because you're overweight doesn't mean you're sick and just because you're thin doesn't mean you're healthy because of these three fat Depot this is exactly what we're talking about so are skinny fat people typically more stressed if we kind of they often are often are you they often are the question is how did that liver fat get formed the answer is sugar and alcohol because that's where sugar and alcohol go in order to be processed okay and so that's why so many people now have fatty liver disease that never had it before that's why children have fatty liver disease even though they don't drink alcohol because they drink something that is metabolized just like alcohol like apple juice like apple juice I've got a bottle of apple juice here in front of me and on it it says 40 in big letters 40% less sugar than 100% apple juice it says with added vitamins a c and e they've added all three vitamins in there that must be so that's not apple juice that's an apple drink to be to be clear it says apple juice beverage here on the front ah they called it a juice beverage not juice there's a that that's technically correct but there's a you know reason they have to declare that from the FDA why because they can't call it juice if it's not juice if they've done something to it I mean how would I know it says apple juice beverage I well that that's part of the subugu lawsuits they have to call it a juice beverage because they've done something to it okay so I've got this Apple in my pocket mhm this apple here right this is healthy that is healthy but if I blend this down it looks like this no well the question is what was lost in the process of blending it down you took away the good part the fiber the fiber by the way you don't know if that apple is as healthy as it could be and the reason is cuz you don't know if it was sprayed with pesticides was it an organic apple or was it just a standard commercial Apple was a standard commercial Apple you might have to wash it first why because the pesticides can be environmental obesogens many pesticides such as I mean the the famous one was DDT now it's been gone since 1972 Rachel Carson you know Silent Spring you know was all about how DDT was you know environmentally affecting you know the entire world okay we banned DDT in 1972 but you can measure the metabolite of DDT called DDE in pregnant women's urine today 50 years later and that level of DDE in that pregnant woman is predicting obesity in her Offspring 11 years later so let's go over these two subjects then we've got environmental obesogens right I think I've pronounced that correctly um let's finish off on that and then I want to go into fiber so environmental obesogens which might be on this apple what what are they and where where are they so uh an obesogen is a chemical that causes weight gain not because of its calories okay now you say how can something cause weight gain if it doesn't have calories the answer is if it causes the differentiation or growth of fat cells it will cause weight gain unrelated to calories so we have chemicals in our environment that are unescapable you can't escape air pollution you can't escape forever chemicals like for instance pasas what's that polyfloral alal substances Teflon remember Teflon yeah yeah the material the material that non-stick pans were coated with yeah that's pasas that was per floro octanoic acid turns out that causes obesity by itself it causes the differentiation and growth of fat cells tributal tin this is what you paint on the bottoms of boats to keep Barnacles from attaching to the hull it's in all of our food supply all of our water supply all over the world that causes fat cells to grow before you're born exposures to all sorts of things um BPA bisphenol a okay when you get your receipt your paper receipt from Target that's bisphenol a phalates or plasticizers you stick a binky in a baby's mouth a pacifier that's a plasticizer that's got phalates in it that causes obesity parabens in cosmetics will cause obesity vinyl flooring um flame retardance in children's clothing and in mattresses all of these things will drive different receptors in the body and act as what we call endocrine disruptors and those endocrine disruptors will change the um uh differentiation and the growth of fat cells to increase osity so what's an endocrine disruptor so our cells have receptors that way communication from one area of the body to another can occur like hormones binding to receptors well sometimes they're not hormones sometimes they're other chemicals that cause differentiation of different uh uh areas of the body to form different organs for instance this is one of the things that goes wrong in congenital uh defects like congenital heart disease okay receptor alterations so we have receptors on all of our cells for different processes for different chemicals there are things in our environment that basically mimic endogenous signals to our body and basically tell different tissues to do different things than they ought to be doing because those things are present and one of them is obesity in my head I think of it like a remember those toys you used to play with when you were a kid and it shows like a triangle shape and a circle shape and a square shape and you've got to pick up the corresponding piece and Slot it in the hole right I I see it as things in our environment are pretending to be those shapes so they're sort of impacting with our recepto site right which is the whole and causing us to do things that are dysfunctional that's right and this is well known has been known for years we um you know it's one of the reasons for the decrease in fertility the changes in reproductive capacity it's one of the reasons the alligator population in the Everglades is disappearing as endocrine disruptors well it also has effect on neurocognition and brain development and potentially I don't want to you know get too far a field but potentially might play a role in autism we haven't proven that yet I want to make that clear but without question some of these chemicals can cause fat cells to differentiate and grow so if they're everywhere what do I do about it because it's I feels like I can't touch the floor I can't I can't go to a I can't lay in a bed I'm like well you can't do much about air pollution I mean except as a society we can do something we can't do much about uh the Teflon in the in the water or the TBT in the water except to try to pass regulations to control those things but you know get get Congress or Parliament to do that you know that's a that's a real trick is that better water that I can drink sorry just on that point uh well you can try uh certainly uh tap water is going to be a problem but the fact is some of the bottled waters still have obesogens and to be honest with you if there if it's bottled the obesogen might be in the bottle canned foods if you look at the inside of the can what color is it is it silver isn't it silver or is it White H if it's white that's BPA so canned foods have high BPA levels BPA is an estrogen okay and it doesn't take much to be an estrogen 22 angst two hydroxy groups you're an estrogen okay there are a lot of chemicals in our environment that masquerade as estrogens and BPA is one of them and estrogen causes fat deposition just look at the curves of a woman that's estrogen causing fat deposition well BPA can do that too so as an example but there are also things in our food that we think are food and one example is fructose now fructose has calories true but fructose has all these effects on mitochondria that have nothing to do with its calories in the same way that alcohol has calories but alcohol has toxic effects that have nothing to do with its calories so just because something has calories doesn't make it a food what's the definition of food Stephen I will tell you you was going to say don't ask me substrate that contributes to either growth or burning of an organism so here's the question does ultra processed food contribute to growth my colleague Dr arrat manigo Oran who is the chairman of nutrition at Hebrew University of Jerusalem has looked at this question in fact Ultra processed food inhibits growth populations that are exposed to high ultrapress food consumption have lower final Heights than populations that are not so if it's inhibiting growth not a food okay now let's take burning I've already told you that there are three enzymes that fructose which is in 73% of the items in the American Grocery Store it inhibits burning because it inhibits mitochondrial function so if you don't stimulate growth and you don't stimulate burning is that a food no so if it's not a food what is it poison so food can be medicine food can also be poison and the question is how do you figure out which is which when you walk into the grocery store it all looks the same but in fact there are things in there that will contribute to growth and burning and there are things that will inhibit it and we need some method for being able to distinguish those we have it we made it it exists on your computer it will ultimately soon exist on your phone and you will actually be able to order your food to be metabolically healthy without ever having to walk into that mine field of a grocery store ever again how would that be and just buy the stuff that's good for you instead of chancing the stuff that's bad for you it's called perfect and what it does is it will filter out all of the stuff in the grocery store that's metabolically unhealthy for you not for the next guy for you you can apply specific filters that will if you're glutenfree it will take out all the things that have gluten so you don't have to look at the label if you are if you have metabolic syndrome it will take all the refined carbohydrate and all the sugar things out so you don't even have to look at them if you specifically want to avoid the ultr processed food it will take those out by the way that will cut the items that you can see in the grocery store by 80% how many of you started thinking about your long-term Health when you hit 30 for me this was a wakeup moment of me thinking to myself okay I probably need to start paying a little bit more attention now I already felt a change in myself when I hit 30 with things like my metabolism my energy levels so this year is no different Zoe which is a company I've invested in but also a company that are a sponsor of this podcast helps me to make smarter food choices all based on their world leading science and my own test results if I'm ordering food I know how to make my takeaway so much smarter by adding things like a side of vegetables to eat first or choosing the option with the most fiber Zoe helps me to make that choice it guides me and coaches me it's my personalized nutrition coach that I have on me 24/7 and to help you start your Zoe journey and start making smarter food choices I'm giving you guys 10% off when you join Zoe now all you've got to do is use code ce10 at the check out when you sign up enjoy and let me know how you get on let's talk then about fiber we we talked about it briefly but I want to just really close off on the point of f because you said that when we take an apple here like the Apple in my hand and we turn it into this thing in my hand this apple juice right the harm is that they're removing the fiber why does that matter so everyone thinks that fiber is the stuff you throw in the garbage after you've Juiced the fruit we were told forever that the uh uh the juice had the essential vitamins and minerals like the vitamin C or the lopine if you're a tomato and that's true they do but turns out the fiber is essential it's just not essential for you it's essential for your bacteria it's essential for your microbiome that's what your bacteria want to eat you have to feed your microbiome you know always we always say when women are pregnant you're eating for two well we're always eating for 100 trillion okay the 100 trillion are in our intestine and what you feed them matters because if you feed them well you will have what we call bacterial diversity and you will not have one any one species uh overwhelming any other species and that will actually contribute to metabolic Health it will allow for the barriers in the intestine to work properly the mucin layer the tight junctions the uh immunologic barrier called the th17 cells your intestine will present the appropriate barrier so that bad stuff in your intestine won't get into your bloodstream to cause systemic inflammation so feeding your gut is job one and what does your gut like to eat it likes to eat fiber now we humans don't have the enzymes to digest fiber you need specialized enzymes the bacteria have them so the fiber is the food for the bacteria when you take the fiber out of the food you're starving the bacteria now how many grams of fiber are we supposed to eat every day our ancestors ate between 50 and 100 grams of fiber a day the USDA says we're supposed to consume 25 grams of fiber per day how many grams do we actually consume here in America and by the way uke the same mean 12 so we're getting half the amount the USDA says and one qu the amount our ancestors did and the question is does it matter the answer is oh yeah it matters big because what happens is when you feed fiber to the bacteria you get multiple species instead of one that basically crowd out all the others okay and you get this metabolic biodiversity and it basically improves your metabolic Health in addition the uh bacteria will chew that soluble fiber up into a compound called short chain fatty acids acetate propionate butyrate valorate berate is particularly helpful it is an immune suppressant it keeps your immune system in check it's one of the reasons that covid was worse for people who were obese and who had pre-existing conditions like metabolic syndrome and also of course minority populations because of ultr processed food consumption and lack of fiber lack of short chain fatty acids therefore lack of ability to fend off Foreign Invaders because their immune systems were not tamped down where did the fiber go they took it out why the because you can't freeze fiber so that Apple okay yeah okay your homework assignment for tonight y take that apple and put it in your freezer overnight take it out in the morning put it on the kitchen countertop let it thaw try to eat it see what you get what am I going to get mush oh really now why does that turn it into mush the ice crystals that form will mate the cell wall and let all the water rush in okay okay turn it into mush food industry knows that so what do they do squeeze it and freeze it now it lasts forever now you've you got apple juice or frozen concentrated orange juice you have taken a fruit which is food and you have turned it into a commodity storable food which you can sell on the Commodities exchange because it won't go bad so it has a price and that price will fluctuate and you can then bet on the Commodities exchange but you can't sell fruit like that because it'll go rancid by the time you've sold it anywhere so all these people are doing this to us um what responsibility do I have on a personal level because you know if these comp the big companies with all this money trillions of dollars they're all manipulating me bastardizing my food they you know hacking my brain giving me these adverts y I am it's easy to fall into the Trap of thinking listen I'm a victim here well you are because you've been hacked as we started this you know the the podcast okay you you've been told one thing and the real world is actually something else okay you've been hacked you specifically been hacked with the notion that processed food is food everyone thinks that because they called it processed food maybe they shouldn't call it processed food maybe they should call it processed nutrients because the stuff that's in it are nutrients but it's not food because it doesn't do what food does which is contribute to growth or burning so the question is what's your responsibility and what's society's responsibility so this is a very important question and it's a question you know that comes up all the time personal responsibility does it exist well in order to exercise personal responsibility first you have to exercise Free Will that's a prerequisite so we can get into this and we probably would need about 6 hours okay and we don't have it but do we have free will yes or no complicated question it's a complicated question and it's one I've actually been researching this week funly enough for a different project that I'm working on okay and I was trying to find get to a point um where I had a solid answer now there's a couple of schools of thoughts here one school of thought when we look at the neurological um processes might suggest and there's some early studies that suggest that we have much less Free Will than we assume because things happen in our brain before we make a decision there's some studies there um but do we have free will to make our own decisions I think we have a lot less Free Will than we think we have very little free will yeah if at all here's the best way to think of it Arthur shopau famous German philosopher famously said you are allowed to do what you want but you are not allowed to want what you want those things are actually predetermined so you have choice in whether you want the candy bar or the ice cream but you don't have choice about the fact that your nucleus succumbent is Raging saying give me sugar that's the choice the choice is how you satisfy the biochemical drive but the biochemical drive has you know is is Way Beyond Free Will so the question is if you don't have free will how can you exercise personal responsibility because that's a prerequisite in order to be able to do that because personal responsibility says take the risks suffer the consequences but if you can't control the risks or the consequences how can you exercise personal responsibility I have just shown you that the behaviors associated with obesity the gluttony and the sloth are actually secondary to the biochemistry which you have absolutely no control over in fact we have no ability to be able to mitigate that and that's why we have this obesity pandemic and you know diet and exercise hasn't solved it for just that reason so who do we need to point the finger at who needs to resolve the issue well it has to be resolved at several uh levels it has to be resolved for the public that's why you and I are doing this podcast now because they have to understand what's really at issue okay blaming the victim has never worked when did it work did it work for HIV did it work for tobacco it never worked okay every personal responsibility issue becomes a Public Health crisis because personal responsibility hasn't solved any of them it's a loser it's a loser in terms of its mechanism and it's a loser in terms of its uh efficacy doesn't work can I throw a thought into there as well because in some areas of Our Lives where we do have discipline we tend to have a bias towards assuming everyone else doesn't have discipline and that's what they're missing if that makes sense so great way to blame people were listening to this that don't struggle with diet and sugar and all of those things and ex whatever all those subjects their brain will probably be thinking God you can just choose not to I choose not to all the time I choose not to have the can of you know fizzy drink all the time because their nuclear succumbent is not going off like a Christmas tree why is it not going off like a Christmas tree we don't know yet why do some people smoke and some people don't why do some people drink and some people don't look 40% of Americans are tea tolers never touch the stuff 40% of social drinkers can pick it up put it down you know no problem I'm in that category 20% are binge drinkers I sorry 10% are binge Drinkers and 10% are chronic alcoholics what distinguishes the 20% who have a problem from the 80% who don't we don't know yet to this day we still don't know but we know that for that 20% it is a problem we also know there this thing called sugar addiction and there's going to be on May 17th in London the International Conference on food addiction I will be the keynote speaker um to discuss exactly this issue is there such a thing as food addiction and if there is such a thing as food addiction does it portend uh need for societal remediation ra or is this really just a personal responsibility issue well everything that is both toxic and addictive has required some sort of societal intervention okay so you have things that are toxic but not addictive Like Oxygen and water you don't have to regulate those you have things that are addictive but not toxic like caffeine no you don't have to really regulate that either unless you add it to alcohol which case then you have four Loco and then you get arhythmia and then you do have to regulate it but what if you're both toxic and addictive like cocaine or alcohol or nicotine or heroin for those we all have uh uh societal intervention you know rehab for the personal and laws for the societal for sugar for ultra-processed food we have nothing it's the same issue nothing different so you want regulation from the government on sugar I think that the industory has to be told what to do they haven't yet now the question is would it work the answer is yeah it would and actually who found out that it would work the UK you did it it did it back in the 2000s so in 2003 the Blair government brought all of the uh UK uh food manufacturers to the table in secret so wait Rose and Tesco and M&S and you know every other cpg uh purveyor in in uh the UK and had a secret meeting and were told and told them look hypertension is running rampant and stroke is breaking the NHS bank and it's because of the sodium we have to get the sodium levels in ultr proc ESS Foods down so every one of you is going to play by the same rules so that there's no competitive disadvantage and you're all going to reduce the amount of sodium in each of your items by 10% per year over a three-year period so that there will be 30% less sodium 3 years from now in 20 six it was 2007 I think at the time and they all did and they didn't tell the public and in 2011 famous paper in British medical journal showed a 40% reduction in hypertension and stroke due to this public health intervention that the Blair government did without telling the public it works should have told the public no don't tell the public so would this work for sugar so I am working with a company in the Middle East right now okay I don't take money okay it's a um you know I do this because it's the right thing to do uh it's called Kuwaiti Danish Dairy kdd it's like the Nestle of the Middle East and they make all sorts of junk they make flavored milks they make ice cream they make frozen yogurt they make biscuits they make confectionary they make tomato sauce okay like all bad stuff right they came to me in 2020 and said we want to be a metabolic healthy company we want to do the right thing because right now Kuwait has an 18% diabetes rate and an 80% obesity rate and we don't want to be the cause of it can you help us re-engineer our product portfolio to be metabolically healthy and so we com comen the scientific advisory team and we've worked for the past 3 years to develop a set of guidelines a set of principles and we have developed what we call the metabolic Matrix three principles three precepts to turn food metabolically healthy and here they are protect the liver feed the gut support the brain any food that does all three of those is healthy whether it's ultr processed or not any food that does none of the three is poison whether it's Ultra processed or not now why those three organs because if you the data show in the literature if you fix those three organs all the downstream organs also get fixed whereas if you fix other organs those three organs don't get fixed so those three organs are primary and all the data shows that if you fix those three you can actually improve both U morbidity and mortality so that's the the goal that's the rubric protect the liver feed the gut support the brain so could we apply that principle to the food supply can any individual apply it to their own grocery purchases use perfect you'll get it can the government do it yeah they did it in the UK they can do it again it's not crazy it can be done the fact is we're all carrying a belief system around okay and now where did that belief system come from the belief system is that ultr processed food is food yeah where did it come from came from the food industry they told us so the scientists and governments told us so as well though if you look back through history so how do we know the scientists and governments are telling us the truth now that's a very good question that's a super question how do you know what's true where we're in this problem right now I'm worried that in 20 years time I'm going to be sat on this podcast if people are still listening and I'm going to be sat with another scientist and he's going to be saying do you know that the uh Dr Robert lusting who you had on 20 years ago everything he said has been disproved and he's going to say fructose is the key apple juice is really important we found out that uh vegetables are causing autism did you ever see the movie sleeper no Woody Allen 1973 honestly I've seen no movies he wakes up after 200 years and suspended animation and he finds out that hot fudge and deep fat are good for you said oh we you know debunked all the you know stuff from before so I get this question all the time everything we knew 10 years ago is already wrong and everything we know today will be wrong 10 years from now so if everything we know today will be wrong 10 years from now why do anything about it cuz no matter what it is is it's likely to be wrong this is known as the pessimistic meta induction Theory this is how the Dark Ages started the idea of Dogma there's only one Dogma Stephen and the Dogma is that there is no Dogma because everything has to be refined Dogma how do you define the word dogma Dogma means you take it on faith okay you take it on faith okay that's what science is for is to debunk the previous generation's Dogma if we didn't do that okay we'd still be using leeches okay we've debunked that Dogma we would still think that seizures were demonic possession we've debunked that Dogma okay ultimately science is not a straight line it's a zigzag okay but it still moves forward so if I end up being discredited 10 years from now 20 years from now 30 years from now hey I was a cog in the wheel at least I drove the the the vehicle forward that's okay and science is really a process isn't it it's exactly process it's not a religious belief it's not a set of answers it's just a process to uncovering um information I guess but you have to then evaluate each piece of information for its veracity yeah because the problem with information is we are now peppered with disinformation and how do you determine what's real and what's not you say that to achieve contentment you recommend following the four CES for contentment indeed what are the four CES by the way if you follow the four seas you will be a whole lot better off in terms of your understanding information versus disinformation so in my book hacking of the American or contemporary mind I talk about ways to lower your dopamine reduce your cortisol and raise your serotonin and they're all four things your mother told you and they're all free and they're all available to everyone on the planet number one connect now connect does not mean through Facebook connect does not mean digital connection it means means social connection it means what we're doing right now face to face eye to eye now why does Facebook not work why does Zoom not work you're looking at somebody eye to eye they've they've now done the Imaging studies okay there are a set of neurons in the back of your head in the occipital cortex called mirror neurons and they are not just reading the lips of the person you're talking to they are reading the facial uh structure and the muscle movements and they are actually transducing the emotion from the person you're talking to when you're watching on a screen it flattens out you can't tell so you don't get the same information that information ultimately generates a serotonin signal so you get contentment so social connection actually drives contentment so that's number one number two contribute and does not mean to your retirement account it means contribute to others okay contribute with purpose like Habitat for Humanity B basically giving to others because when they when you give to others you feel better yourself okay that generates the serotonin the signal okay so you know lottery winners you know are not happy but people who actually give their money away are that's one of the reasons why we have philanthropy makes people feel better it's quite selfish in that regard then isn't it in well yes indeed it it seems selfless but it's actually selfish which is fine it works just great number three cope and cope is three things it's sleep mindfulness exercise all of which are necessary to Tamp down cortisol because you if you're sleep deprived your cortisol goes through the roof if you are um uh distracted multitasking your cortisol goes through the roof okay and if you're sedentary okay you number one you're eating like crazy and you're also and your cortisol also goes through the roof sleep mindfulness exercise all things to get your cortisol down and finally number four the last C cook why because there are three things that contribute to this dopamine serotonin imbalance the first tryptophane tryptophane is the precursor to serotonin tryptophane is not an ultra processed food it is the rarest amino acid you find it in eggs chicken fish not exactly Ultra processed food number two fructose fructose reduces serotonin okay and there's lots of fructose in in the ultrapress food and finally lastly omega-3 fatty acids and omega-3 fatty acids are in again eggs and in um in uh marine life okay there there's a little bit of Omega-3s and vegetables you know ala which is doesn't reach the brain so that's not a that's not a big winner for uh fixing this problem so you need high tryptophane low fructose High Omega-3s sounds like real food to me so uh connect contribute cope cook it will Tamp down your dopamine reduce your cortisol raise your serotonin improve your mental health improve your metabolic public health and will solve your problem it won't solve societies we have to work on getting the whole world to understand what the problem is before we can fix it Dr Robert leting what is the thing we haven't talked about the most important topic we haven't talked about that we should have wow well we have a systemic Health crisis diabetes metabolic syndrome um dementia cancer we have a mental health crisis depression suicide schizophrenia uh autism add we have a global Health crisis we have cyber bullying we have social inequality we have War we have um climate change planet is ulating all at the same time coincidence or are these somehow inextricably related are these the same thing or are these different things if we believe they are separate we're going to solve try to solve each one individual and never get to the root cause the root cause is our amydala the fearce center of our brain it's under attack from all of the things we've talked about today that dysfunctional amydala is the driver of chronic disease it is the driver of the Mental Health crisis it is the driver of the global health and planetary crisis there are four breaks on the amydala and they're all dysfunctional today and they're all dysfunctional because of the things we've talked about today because of cortisol because of stress because of ultra-processed food because of sleep deprivation because of the um uh change in the environment because of air pollution because of um all the things that ultimately impact our brain's ability to transduce information until we recognize where the problem is we're going to be spinning our Wheels we can do this we can back out the same way we drove into the Stitch but you can't solve a problem until you know what the problem is Dr Robert leting thank you so much we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're leaving it for and the question that's been left for you is here we go let's have a look okay nice question um what would you tell your 20-year-old self that you wish you knew and that would have positively impacted your life and avoided pain I wish I had known that I didn't have to please everyone there's a book called the courage of being disliked it's courageous to be disliked I was afraid of being disliked and because I was afraid of being disliked I was disliked it's such a wish I had known that nugget of Truth early on in my career thank you so much Dr pleasure thank you I have to say your work is exceptional um your books are incredible I've got three of them here but I know there there's many more um I'd recommend them all incredibly highly the hacking of the American mind is a fantastic book that doesn't just apply to Americans it applies to um all Industries around the world um all Western economies around the world which are set up in in very similar ways fat chance and another book that I've been through um in detail is about beating the odds against sugar processed food obesity and disease which covers much of your work in the studies that you referenced today an incredible incredible book and I also have this book called metabolical did I pronounce that correctly you did metabolical the L and the lies of processed food nutrition and modern medicine which is a little bit of a bigger book but it's um it gives more of the foundations around metabolism which I think a lot of people don't understand so thank you thank you for um your your Brilliance in so many ways and but thank you for your life's work because your life's work is Saving Lives it's propelling us forward it's it's driving a conversation forward and you do it in a way that's so unbelievably engaging that it's hard not to pay attention so thank you Robert well thank you and thank you for you doing what you do [Music] a