Full transcript
0:00in your book Fat Fat Chance um on on
0:03page 120 there was something
0:05particularly curious because I think
0:07this is a
0:09um Yeah, here we go. It says the bottom
0:12line is sugar consumption is a problem.
0:1433% of sugar consumption comes from
0:17beverages.
0:18>> Yes.
0:19>> And the biggest abusers are the poor and
0:21underserved indeed.
0:23>> So let's talk about beverages to start
0:25with then.
0:26>> Mhm.
0:28Diet beverages, are they fine? And how
0:31bad are the sort of fizzy pot beverages
0:33that most of us consume every day?
0:37>> So,
0:39let's do the um sugared soft drinks
0:42first.
0:43>> Okay. Okay. They are really bad. If you
0:47consume one sugared beverage per day,
0:50your risk for diabetes goes up by 29%.
0:56>> Wow. Okay, that's and diabetes
0:58>> and that and that's if you have one. If
1:00you have two, 58%.
1:03>> And diabetes is now the main cause of
1:05death in 40% of death certificates.
1:07>> Exactly. Right.
1:09So this is a big problem. So you know
1:11that's demonstrating its toxicity at you
1:14know shall we say medium dose. You know
1:17at low dose you can handle it but you
1:20know as soon as you go above that dose
1:21it's a problem and we have the data for
1:23it. Okay. And all of these are factored
1:26in. These are all econometric analyses.
1:28We've shown that sugar is approximate
1:30cause of diabetes. Whenever sugar
1:32availability changes in any country,
1:35diabetes prevalence changes 3 years
1:37later. And we've also done what's known
1:40as advanced markoff modeling where we go
1:43into the future and show that when sugar
1:45consumption goes down in any country,
1:47diabetes levels change in ne, you know,
1:51reduce 3 years later. So, it's a
1:53three-year window between the change in
1:56the diet and the change in the metabolic
1:58health consequences. We have those data.
2:01And the fact that they work both on the
2:03way up and on the way down is like, you
2:05know, take it to the bank.
2:07>> Mhm.
2:08>> Now, that's for the sugar beverages. You
2:11asked me about diet beverages.
2:13>> I've got one here.
2:15>> Let's Let's uh look at it.
2:20>> All right. I've covered up the logos cuz
2:22I don't want to call I've never seen
2:23this before. I wonder what that is.
2:27>> Um the the data now show I mean for it
2:32it took a while for these data to come
2:33in but the data now show that the
2:35toxicity of one sugared soda equals the
2:40toxicity of two diet sodas. Half as bad.
2:45Okay.
2:45>> Half as bad does not mean good. Half as
2:48bad means half as bad. Well, it says
2:50zero sugar here. So, how can it be bad?
2:52>> Well, so because it's bad for a
2:54different reason. So, the yes, zero
2:57fructose, zero calories. I agree. But
3:02that doesn't make it good. Makes it
3:04better than the sugared alternative, but
3:07it doesn't make it good.
3:09Why? Number one, you put something sweet
3:12on the tongue. Message goes tongue to
3:14brain. Sugar's coming. Message goes
3:17brain to pancreas. Sugar's coming.
3:20Release the insulin.
3:22>> So, I still get an insulin release.
3:23>> You still get an insulin response. And
3:25the more other food you ate, the bigger
3:27the insulin response.
3:28>> So, you will have an accentuated insulin
3:31response because you were exposed to the
3:34diet sweetener. This is work from Yanina
3:36Papino um uh 2013 at Wu St. Louis. And
3:41it's been corroborated multiple times
3:42since.
3:43>> And and why does that harm me having an
3:45insulin response?
3:46>> Cuz insulin is a bad guy. So we always
3:48talk about glucose being a bad guy in
3:50terms of diabetes and it is of course
3:53but insulin is a bad guy too. Glucose
3:56causes small vessels to be
3:59dysfunctional. Causes endothelial cell
4:02dysfunction. It causes high blood
4:05pressure because it causes those small
4:07vessels to constrict. it interferes with
4:10nitric oxide uh which is one of the
4:13things that relaxes the blood vessel and
4:16it will you know basically reduce uh
4:19blood flow to specific organs. So high
4:22glucose is not good for you and it's bad
4:24for small vessel disease and that's why
4:26diabetics get retinopathy, nephropathy,
4:29neuropathy, um uh kidney disease, nerve
4:32nerve nerve damage and um eye disease.
4:37But insulin is also a problem because
4:40what insulin does is it causes cell
4:42growth. Insulin is a growth factor and
4:45it causes vascular smooth muscle growth
4:47like in your coronary arteries and it
4:49causes glandular growth. So it is one of
4:52the primary drivers of heart disease and
4:55cancer.
4:57So you can be a diabetic, a type 2
5:00diabetic and have your hemoglobin A1C
5:04measure of your glucose uh uh uh control
5:08down near normal near normal range
5:12because you're on insulin or oral
5:15hypoglycemics or even GLP-1 analoges for
5:18that matter. Okay? And you will die just
5:21the same because you will die of a heart
5:24attack or of a of a cancer because
5:27diabetics have a much higher incidence
5:30of cancer. They also have a higher
5:32incidence of dementia as well. And the
5:35reason is because of insulin because
5:36insulin is a bad guy in this story.
5:39Glucose causes microvascular disease.
5:43The insulin causes macrovascular
5:45disease.
5:47They're both bad. You need to control
5:49both of them. And this controls the
5:52glucose. It doesn't control the insulin.
5:57>> Do you drink that stuff?
5:58>> Of course not.
6:00>> Just checking. Is there any other
6:02physiological consequences to diet sodas
6:06outside of the insulin response?
6:07>> Indeed. So, the other thing that we've
6:09learned about uh uh uh non-nutritive
6:12sweeteners across the board is that they
6:13alter the microbiome.
6:15Now the microbiome is the bacteria that
6:18live in your gut. Now you have to feed
6:21your microbiome. You have to feed your
6:23bacteria because if you don't feed your
6:25bacteria, your bacteria will feed on
6:26you. It will strip the mucin layer, a
6:29protective physical barrier right off
6:32the surface of your intestinal
6:34epithelial cells. And when it does that,
6:36it denudes them and allows for back
6:39other bacteria, toxic bacteria to take
6:42up residence and cause irritable bowel
6:44syndrome, inflammatory bowel disease.
6:46And the junctions between the cells
6:50become dysfunctional as well. And so
6:52they cells become permeable. And so
6:55stuff, you know, in your intestine, the
6:58junk in your intestine, the, you know,
7:00SH, you know what, can actually make it
7:03through into the bloodstream. You can
7:04measure the endotoxins and the whole
7:07bacteria, the lipopolyaccharides in the
7:10bloodstream when the intestine is
7:13damaged even from diet soda. And what
7:16that does is that ultimately leads to
7:18systemic inflammation and that systemic
7:21inflammation also leads to metabolic
7:24disease, mental health problems,
7:27cognitive decline, early death.
7:29>> Is there a relationship between sugar
7:32and our hormone levels? Of course, I
7:35mean the main one of course is diabetes.
7:37I mean you know insulin but um high
7:40sugar uh you know I mean if you if you
7:43have u uh high sugar consumption it's
7:46going to cause changes in insulin
7:49response at the level of the liver. It's
7:50going to cause fatty liver disease.
7:53Okay. It can change your kidneys uh uh
7:56function u you know which can ultimately
7:59increase blood pressure. So it's yeah
8:00it's got multiple uh uh potential
8:03detrimental effects.
8:04>> What impact does sugar have on our
8:06liver? What's going on there?
8:08>> So as I mentioned we have an innate
8:11capacity to metabolize a limited amount.
8:14>> Yeah.
8:16>> Everyone says oh sugar's energy.
8:20Well yeah but not really. Not really. So
8:25let let's dissect that.
8:28The food industry says glucose is four
8:31calories per gram. The food industry
8:34says fructose is four calories per gram.
8:36Therefore, they're equal because they're
8:38four calories per gram. And if calories
8:40were the issue, then they would be
8:42right. But calories are not the issue.
8:45Okay, the whole issue of calories has to
8:49go down the tubes. Okay, as far as I'm
8:51concerned, that's the problem. And I am
8:54here to #killthealorie
8:57as a unit of measure. It has no place in
9:01our uh in in our dialogue. It has no
9:04place in medicine. Calories suck.
9:08Now why do I say that?
9:11If you take
9:13a mole of glucose and you throw it into
9:15a bomb calorimeter, you will get four
9:18calories per gram. That's true. If you
9:20take fructose and you throw it in a bomb
9:22calorometer, you will get four calories
9:23per gram. That's true. We are not bomb
9:26calorimeters.
9:28Okay.
9:30>> What's a calorometer?
9:32>> It's a contraption that explodes the
9:35whatever you put in it and measures the
9:38heat that's uh given off from it.
9:40>> So it measures it the amount of calories
9:42in something effectively using some
9:43explos. That's what calories are. Is the
9:45amount of heat required to raise 1 g of
9:48water 1° centigrade.
9:49>> Okay?
9:50>> So, it's a measure of heat.
9:51>> Yeah.
9:51>> Is what it is. That's what calories are.
9:54>> Now, we do our burning in these little
9:58organels inside each of our cells called
10:00mitochondria.
10:02This is all about mitochondria. And when
10:04your mitochondria work efficiently and
10:06well, you can burn energy
10:10uh uh you know to completion and you can
10:13capture that energy in the form of
10:15chemical energy in your cell called ATP
10:18adenazine triphosphate and that's what
10:20your cell uses to power all of the
10:22functions that the cell needs the little
10:25molecular motors and making stuff and
10:28you know basically you know and and also
10:30cleaning house you know and recycling
10:33junk.
10:34Okay, in order to keep your cells
10:36thrive, thriving and alive. Okay, so
10:39mitochondria are essential. Now, glucose
10:44stimulates mitochondria to work better.
10:48Glucose is actually good.
10:51It it stimulates two enzymes necessary
10:54for mitochondria to work. It stimulates
10:57an enzyme called AMKinase
11:00which is a the enzyme that actually
11:02makes more mitochondria
11:04and it's the fuel gauge on the liver
11:06cell. So it tells the liver make more
11:10and it also stimulates an enzyme called
11:12HADH hydroxyasal COA dehydrogenase which
11:15is necessary to cleave two carbon
11:17fragments and uh burn them oxidize them
11:20for energy too. So glucose we can call
11:22good because it helps mitochondria.
11:26Fructose on the other hand this sweet
11:29molecule in sugar in sucrose
11:32it inhibits three enzymes
11:36in mitochondria. It inhibits that
11:38amkynise. It inhibits an enzyme called
11:40aadel asco dehydrogenase longchain. It
11:43inhibits CPT1 carnitine pul transferase
11:461. That's the enzyme that uh regenerates
11:49carnitine which is the shuttle by which
11:52fatty acids can get into the
11:53mitochondria to be burned. So the net
11:56effect of fructose is to inhibit
11:58mitochondrial function.
12:01So,
12:03does fructose constitute energy? If
12:07fructose is actually keeping you from
12:10making chemical energy in your cell,
12:17this is the conundrum. What do you mean
12:20by energy? If we're talking heat, then
12:24fructose is energy. If you're talking
12:27ATP, fructose inhibits ATP.
12:31And that's what we're talking about
12:33because that's what leads to systemic
12:35health problems, not the heat. So all of
12:38these people, as far as I'm concerned,
12:41anyone who ever uses the word calorie,
12:44fire them
12:46because they don't get it.
12:50They are part of the problem, not part
12:53of the solution.
12:56Many people will say that sort of
12:58counting calories has helped them with
12:59their weight loss goals.
13:01>> You tell me virtually everybody who
13:05counts calories loses a little bit of
13:07weight and then they plateau and then
13:10they get um you know tired of their diet
13:14and the weight comes rushing back. Okay.
13:1790% of people who try to diet through
13:20caloric restriction regain and sometimes
13:23yo-yo back even higher. So
13:26>> I don't accept that.
13:27>> Are there studies that support this idea
13:29that sort of the the yo-yo dieting is a
13:32byproduct of calorific restriction?
13:34>> Not because of calor caloric
13:36restriction. It's a problem of insulin
13:39resistance. It's a problem of when you
13:41gain the weight back. Did you gain it in
13:44the liver as liver fat? Because now
13:47you've got higher insulin. And insulin
13:49blocks this hormone that goes to the
13:51brain called leptin that is uh in charge
13:54of that set point. So the higher your
13:57insulin goes, the less well your brain
13:59can see leptin. And so the less well you
14:02can regulate. And so that's what drives
14:05your weight up even higher. So you don't
14:09regain the weight by eating, you know,
14:12fish and vegetables. You regain the
14:14weight because you, you know, went for
14:17the bread and the rice and the pasta and
14:19the potatoes and the sugar.
14:20>> What's a better plan then? If I'm trying
14:21to cut a couple of pounds, what's a a
14:24better approach to take versus sort of
14:26calorie counting or these kind of
14:28things?
14:29>> Get the insulin down. There is no weight
14:33gain without insulin. Insulin is the
14:35energy storage hormone.
14:3820 years ago, from doing the research on
14:42kids with hypothalamic tumors who
14:44released enormous amounts of insulin, we
14:46gave them a drug that suppressed insulin
14:48release. They lost weight and they
14:50started exercising spontaneously because
14:52we got their insulin down. We showed
14:55that the lower we got the insulin, the
14:58more weight they lost and the better
14:59they felt. Insulin is the bad guy in
15:02this story. So numerous investigators,
15:06you know, the world over have now
15:08demonstrated that insulin is a primary
15:11driver of both obesity and diabetes and
15:15metabolic syndrome. You got to get the
15:17insulin down. Okay, how do you get
15:21insulin down? Best way, don't let it go
15:24up. What makes it go up? Refined
15:26carbohydrate and sugar. All the stuff
15:28you have over there in that corner.
15:31>> Just to be clear,
15:33He's not pointing at my lunch. We have a
15:35pile of different sugar products that we
15:36brought for the interview over in the
15:38corn corner, including various things
15:39that you find on a shelf. Everything
15:41from apple juice to some popular snacks
15:44to um some like some some other things
15:46that just
15:47>> Don't forget the peanut butter cups.
15:48>> The peanut butter cups. Yeah. And even
15:50this, this is just sort of sugar. Um it
15:52looks like water, but it's flavored
15:54water where they've added sugar to it,
15:56>> right?
15:56>> Um
15:58>> so yeah, all of that stuff over there.
15:59>> All of that stuff.
16:00So get the insulin down. All right. So
16:04cut the refined carbohydrate, cut the
16:06sugar, the dietary sugar. That is the
16:09single best way to mitigate this process
16:14by improving insulin resistance by
16:18getting the insulin down. And we have
16:19done this time and time again.
16:21Basically, I turned my obesity clinic
16:23into an insulin reduction clinic for
16:26this reason. A lot of people at sort of
16:28a prefrontal cortex logical level
16:30understand this. They understand that
16:32they shouldn't be having sugar. But it's
16:35>> well they think it's about calories.
16:36>> They do. Some people do think it's about
16:37calories for sure. But even the ones
16:39that know that sugar is not something
16:42they should be having still struggle.
16:45>> They do because sugar is addictive,
16:47>> right? Yeah.
16:48>> They struggle because sugar is
16:50addictive. We know because fructose
16:52stimulates that nucleus incumbent.
16:53>> Yeah.
16:55When we get stressed, which is a facet
16:57of daily life now,
16:58>> that's right.
16:59>> We're much more likely to to grab a
17:00sugary snack.
17:01>> Indeed. And there's a reason for that,
17:03too. Because when you're stressed, that
17:05actually puts a greater uh uh burden on
17:08your amydala. And your amydala requires
17:10more energy. Hippocampus 2, by the way.
17:12>> The amigdala is the emotional center of
17:14the brain,
17:14>> the fear center of the brain. Okay? And
17:17so, you're trying to calm it and so you
17:20have to increase the energy available.
17:23So, because you need more ATP and even
17:26though fructose inhibits ATP generation,
17:31you still reach for that because you're
17:33trying to mitigate the metabolic
17:35consequences acutely.
17:37>> When I'm tired, I think I have a high
17:38propensity to grabbing sugar as well.
17:41>> Indeed.
17:42>> Why is that?
17:43>> Because you're tired, you're stressed,
17:45and your amygdala is dysfunctional. And
17:48so, it basically tells you hell with it.
17:52I I don't have any sugar cravings in the
17:53morning. I've come to come to learn I
17:55don't feel the need for sugar in the
17:56morning. It's sometimes when we get
17:58later into the evening, right, after a
18:00long day.
18:00>> Exactly.
18:01>> It's when my my cravings
18:02>> You and everyone else and me too, by the
18:04way. It's not like I'm uh immune to
18:06this. I I you know am on record.
18:11I gained a lot of weight while I was a
18:14uh faculty member at UCSF and every day
18:19at 400 p.m. I just ran out of gas. And
18:22so I ran across the street to get a, you
18:25know, large chocolate chip cookie. Okay?
18:28And that was without question the
18:30primary driver of my weight gain. Okay?
18:33It wasn't until I actually started doing
18:35the research on this and seeing that the
18:38kids felt better when we took the sugar
18:41out of their diet that I actually put
18:43two and two together for myself. So now
18:46I don't do that and my energy level
18:49stays constant throughout the day. What
18:51so what advice do we give that is simple
18:53and actionable for Jennifer or Judith or
18:57Dave who's listening to this now? They
18:59are, you know, 40 years old potentially.
19:02They have a 9 to-five job. They're very
19:04busy. Maybe they have some kids to feed
19:05at the same time.
19:06>> They they don't have time to be like,
19:08you know, looking at doing a fine sort
19:12of tooth comb over every single thing
19:13that they're putting into their body.
19:15They're not a scientist.
19:16>> Agreed. It's a It's a problem because
19:19the food industry has made the grocery
19:22store a minefield and it's really easy
19:25to set off an explosion. If you walk in,
19:29you've basically lost. That's how bad it
19:31is.
19:33Understood? So the the simple rule is
19:37eat real food. So what's real food?
19:41Well,
19:42food that came out of the ground or
19:44animals that ate food that came out of
19:45the ground. The problem is we all lead
19:47busy lives and we're looking for
19:48laborsaving devices cuz people don't
19:51even have time to cook. Most people, 33%
19:55of Americans don't even know how to cook
19:57anymore. So like what are they going to
19:59do? So we understand this. I mean it's a
20:02problem. Agreed.
20:04We need food
20:06that is metabolically healthy for us not
20:10metabolically detrimental. And the
20:12problem is that as soon as you put the
20:15added sugar in the food you have made it
20:18metabolically detrimental. Now the food
20:20industry will say well there are all
20:21these other good things in there like
20:23vitamins and minerals. We fortify it
20:25etc. So, I'm here to tell you toxin A
20:27plus antidote B still equals death.
20:32Okay? Just because they put some
20:34vitamins in there or you take a dietary
20:37supplement, if it's not solving your
20:39mitochondrial dysfunction,
20:42what's the point? So, you can't believe
20:46what the food industry is telling you.
20:48Okay? If they say something is healthy,
20:51it's usually the opposite. whatever it
20:53says on the package, believe the
20:56opposite because they have an incentive
20:58to put wrong stuff on the package. And
21:02I'll be honest with you, I'm part of,
21:05you know, uh, numerous lawsuits suing
21:07the food industry for deceptive
21:10advertising, misbranding, mislabeling.
21:1270% of all of the items in the American
21:15grocery store are misbranded or
21:17mislabeled.
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