The #1 diet change to make today to fight chronic disease | Dr Mark Hyman

Welcome to Zoe Science and Nutrition, where world-leading scientists explain how their research can improve your health. At the turn of the 20th century, surviving to your fifth birthday was an achievement. And if you did make it into adulthood, your eventual cause of death was most likely to be an infectious disease. Today, thanks to the incredible power of vaccines and other public health interventions, These diseases are no longer the leading cause of death. However, a new category of illness has stepped in to fill that void. Chronic diseases like heart disease, diabetes and obesity are now the biggest killers. Three out of four Americans have a chronic condition. And more than half of Americans have two or more chronic conditions. And the UK is not far behind. And worryingly, these numbers are still rising. in this episode we're joined by dr mark hyman md a practicing family physician who's been a new york times best-selling author 15 times over he believes that real food is the answer to health and that big food conspires to keep us sick also joining me is tim specter one of the world's top 100 most cited scientists medical doctor professor of epidemiology at king's college london and my scientific co-founder at Zoe. Together, we explore the concerning rise of chronic diseases in the West and the dark industries that have brought us to this point. By the end of the episode, you'll understand how the modern world is driving these conditions and what simple changes you can make to protect yourself today. Mark, thank you for joining me today. My pleasure. And Tim, thanks for being here too. It's great. So we have a tradition here at Zoe, Mark, where we always start with a quickfire round of questions from our listeners, where there's very strict rules. You can say yes or no, if we have to, a whole sentence. Mark, are chronic conditions like heart disease and diabetes increasing in the West? Yes. Tim, can lifestyle interventions reduce your risk of these diseases? Absolutely. Mark, are poor food choices to blame for the rising chronic diseases? A thousand percent. Tim, are chronic diseases mostly due to our genes? No. That's controversial, but I'll say no. Not at all controversial. He's being British. I like that. So finally, Mark, what's the most common misconception surrounding chronic diseases? That it's chronic, that it has to go on forever. Heart disease, diabetes, dementia, metabolic dysfunction, autoimmune diseases, things people think they get and they have to have forever. mental health issues bipolar disease schizophrenia depression these don't have to be chronic if you understand the root cause and address it they can be reversed that's amazing so you're saying all these things that are describes chronic meaning you sort of have them forever that's right actually you can in many cases make changes that mean you stop having absolutely i've seen it over and over and over in my practice i'm a practicing physician it's not like a theory so i absolutely want to get into that. What I'd like to do is just maybe just start with the basics. We just mentioned this word chronic conditions and chronic diseases, but I'm a bit fuzzy about what exactly that means. I mean, the main chronic diseases that people suffer from are cardiovascular disease, heart disease, diabetes, type 2 diabetes, dementia is increasing, cancer can be chronic, although it often kills people, autoimmune diseases, mental health issues like depression. People have often chronic digestive issues, whether it's irritable bowel or reflux, I think is chronic and permanent. There's a whole long list of things that people suffer from that are basically affecting six out of 10 Americans and causing massive amounts of disability, dysfunction, loss of life, and quality of life, more importantly. And traditional medicine is maybe okay at managing some of the symptoms, but doesn't have a model for getting to the root cause and understanding the drivers of them and how to reverse those conditions. And so when we use this word chronic, that means once you've got it, you've got it forever. I mean, I learned in medical school, if you have type 2 diabetes, it's a one-way street. If you have hypertension, it's a one-way street. If you have cardiovascular disease and plaque injuries, it's a one-way street. If you have autoimmune disease, it's a one-way street. At this conference where we are, I had a woman come up to me who was a patient of mine 20 years ago who had rheumatoid arthritis that was very severe. She's perfect now. She just wanted to give me a hug and say, thank you. It's lovely. But if you were to ask a rheumatologist, is rheumatoid arthritis 100% reversible, they would go no, because they don't know how to do it. If you go to an aborigine in Australia 100 years ago and say, can you build a rocket ship, they're going to go no. But it doesn't mean it can't be done. And so coming back to this question about genes that we had right at the beginning, from your perspective, Mark, are these conditions sort of written in my genes when I'm born? and I have to do something very clever to avoid getting this? Your genes may predispose you to things, but they don't predestine you to things. And the best example is in America, in the Native American population, the Pima Indians. 150 years ago, they were thin, they were fit. There was no diabetes, no heart disease, no obesity. Now 80% of them have diabetes by the time they're 30. Their life expectancy is 46. They're the second most obese population in the world. They were adapted to a different environment. So what determines your outcome of your health is not your genes, but what happens to your genes throughout your life. We call this the exposome, not the genome. The exposome is what your genes are exposed to, what you eat, your activity, movement, exercise, sleep, how you navigate stress, your microbiome, environmental toxins. pretty much anything you can think of that you're exposed to is washing over your DNA and turning on or off genes that regulate chronic disease or create health. So that's really important to understand for people because it means you have agency and that you can change your destiny. My grandfather is a great example. He was deaf. He couldn't hear. And so all he could do was manual labor. So he worked at the New York Times and would throw the big sacks of newspapers was on the truck. And his brothers and sisters, and he had about eight of them, all had early heart disease in their 50s and had bypasses and heart attacks. And he didn't start getting it until he was in his 70s and 80s because he was very physically fit. And he took a walk every night and he was thin, right? So even though you might have a predisposition, you can modify your risk by understanding what the risks are and what to do about it. Now, Tim, as we're listening to this and Mark talking about in the US, I think you said six out of 10 people are living with chronic conditions. As you think about the rest of the world, is it different? No, I mean, the UK is pretty much the same. Most of the English-speaking world's the same. The US is leading the way, there's no doubt, the first to change its food system and change a lot of the society. But the trends in all the other countries are, unfortunately, going that same way. Yeah, we've created the worst diet on the planet and exported to every country on earth. In China, and I lived in China, I was first visited in 1984, the rate of type 2 diabetes was 1 in 150. There was no McDonald's, there was no fast food, there was no KFC, there was nothing. You know, I went back years later, 20 years later, just junk food everywhere. And now the rates of type 2 diabetes are 1 in 10. 1 in 10. Did they genetically change? Or what happened? So basically, the American food arrived, and diabetes went to less than 1 in 100 people. Yeah, we got iPhones, they got diabetes. The success story, that's why medicine thought it was doing the right thing, is that infectious diseases went down massively. So from the 1960s, massive drops in people dying from infectious disease, from dying from pneumonias, gastroenteritis, all this kind of stuff, because we'd have this invasive medicine. But as that dropped, then you saw all these other diseases which didn't exist in underdeveloped countries suddenly coming into play. And in a way, some people think those two things are linked. that we're not getting exposed to infections. And actually, that's part of our problem. We've just got weak immune systems and added to our terrible environment. This is causing this real mismatch. And I think this, I read recently that the world now has more people suffering from obesity than from malnutrition. 100%. It's about over 2 billion people are overweight or obese versus about 800 million who go to bed hungry. It's staggering. We now see globally often the double burden of disease. We see starvation, obesity, plus type 2 diabetes all in the same populations. And globally, twice as many people die from chronic preventable lifestyle diseases than die from infectious disease. It's amazing. Even on a global basis, it's the same story now that basically something really quite depressing has happened there. Because I do feel like when I was growing up, it felt like there was this wonderful rise in life expectancy. And people are saying, well, people are just going to live more years and more healthy years. It's getting better and better. And it feels like we've had all of these successes. We're better at treating, for example, heart attacks. People survived them they didn't before. So this is despite all the advances medically, we're losing the battle because more people are coming into the funnel than they can possibly cure. And so when we look at the number of healthy years that people are having in the States, for example, or the UK, what does that mean? What's been happening to the number of healthy years over the last few decades? The last 20% of people's life is spent with poor health. Their health span doesn't equal their lifespan. Your lifespan is how many years you're alive. your health span is how many years are healthy. And that doesn't have to be that way. You can have a health span that equals your lifespan, meaning you live a full life, you enjoy your life right to the end, and then you just have dinner with your family, go to bed and check out. And it's the same in the UK. So the UK, we've seen a slight increase in longevity, although it looks like it's going to start dropping. And I think it's already started dropping in the US. But the health span has got shorter. Today, people are having fewer healthy years than 20 years ago. Yeah, disease-free years just is really rare to find people. All this high-tech stuff, it's doing nothing to stop these graphs and these stats. Why is this happening? Why has there been this huge rise in these non-infectious diseases? And Mark, I know you're just republishing your book, Food Fix, which helps us, I think, to understand some of that. What's been going on? For decades, we've been led to believe that the brain is completely separate from our body. We thought low mood was just chemicals and that cognitive decline was an inevitable part of aging, a roll of the dice we had no control over. But at Zoe, we know the science says otherwise, and the truth is far more revealing. There's growing evidence to suggest that our brain doesn't act alone. It's in a constant partnership with our gut. If you've been feeling that afternoon fog or noticing that your memory isn't quite what it once was, it might not be age. It might just be your menu. Your diet is actually one of the most powerful ways that you can protect your brain's lifespan and improve your energy levels. So how do you use this science to get a 10-year head start on a healthier brain? We put everything you need into a new guide called Eating for Better Brain Health. Inside, you'll find five strategic, easy-to-implement tips from my Zoe co-founder, Professor Tim Spector, along with science-backed recipes designed to feed your gut and your mind. And the best part? It's much easier than you think to make a change. Longevity isn't all about luck. It's a strategy, and it starts with the next thing you put on your plate. Most people wait until they notice a decline to start caring about their brain. But longevity isn't luck. It's a choice you make before you need it. Don't leave your cognitive future to chance. Go to zoe.com slash brain health right now to claim your guide. That's zoe.com slash brain health or click the link in the show notes. That's a great question. I realized sitting in my office treating patients that I couldn't cure diabetes in my office. It was cured on the farm, in the food manufacturers, factories, in the grocery store, in the restaurants, in the kitchen. and I recognized that it was our food system that was making people ill. There's other things like environmental toxins and chronic stress and many other things, but predominantly the driver is food. And the Global Burden of Disease Study, which is a big study done in 195 countries, found that food was the number one killer now on the planet exceeding smoking. Food is the number one killer? 11 million people a year, and I think that's a way underestimate. it. Because 75% of the deaths globally are from chronic disease. And most of those are from lifestyle modifiable factors. And those are like, smoking is a big one, obviously, but take out smoking. Obesity and food-related causes are the biggest drivers of chronic illness. And then I began to say, well, why are we eating this food? And then I was like, well, it's our food system because it's producing all this high-starch, high-sugar, ultra-processed foods that everybody's consuming, which is now 60% of the diet in America, it's 67% of kids' diet. It's 73% of what's on the store shelves in the grocery store. Why do we have these foods? It's our food policies. It's our policies of agriculture and our food policies that drive the food we have in our environment. And I'm like, well, why do we have the food policies we have? Oh, it's the food companies, the food industry, which is the single biggest industry in the planet. It's over $16 trillion dollars a year, employs more people than any other industry. Why? Because everybody eats. So they deliberately, maliciously, intentionally have created a food system and co-opted every single sector society that has anything to do with coming up with a different solution. And they have driven massive efforts to lobby, which they're aggressively trying to stop what's happening right now in America with awareness of chronic disease and attempts to change the food system. They co-opt science. There's 12 times as much science funded by food industry about nutrition than by independent scientists or the NIH or the National Institute of Health. So if a dairy company does a study on dairy or a soda company does a study on soda, they find, oh, the soda doesn't cause obesity. They fund the professional societies like the American Heart Association, the American Diabetes Association, American Academy of Pediatrics, Academy of Nutrition, Dietetics. 40% of their budget comes from the food industry. If you go to one of their conferences. It's just junk food everywhere. If you look at the American Heart Association, $192 million a year comes from food and farm industry, $192 million a year. If you look at the front groups they create, these fake groups, the American Council on Science and Health, which sound very noble, but if you look at what they are, they're funded all by the food industry and the ag industry. And then they attack people like me. They have a very deliberate campaign to create misinformation They co social groups like the NAACP and Hispanic Federation For example I was in a movie called Fed Up which was about childhood obesity And we wanted to screen it at the King Center Martin Luther King Center in Atlanta I met his daughter Bernice King She was very excited. And I said, great, let's screen it. We had set the date. She called me a few days later, said, we can't show the movie. I'm like, why? She goes, Coca-Cola is in Atlanta. It funds the King Center. And I went to Spelman College, you know, Women's College in Atlanta, Black Women's College. 50%, 50% of 18-year-old women entering the college have a chronic disease. and everywhere is Coca-Cola because Coca-Cola funds a lot of the campus. And if you look at the board, it was the vice chair of such and such from Coca-Cola who's on the board. They literally block every single avenue of good science information. The land grant college is established by Abraham Lincoln to improve agriculture, funded mostly by the pesticide, herbicide, fertilizer companies. So they don't allow farmers to understand how to do a different kind of agriculture that's more regenerative, that's good for the land, that produces better food, more food, that restores the soil, prevents the loss of biodiversity in pollinators, that doesn't pollute the water, that doesn't use and deplete our aquifers, that produces more nutrient-dense food, that produces more money for the farmers. They don't want anybody to know about that. So there's so many ways in which our whole system has been co-opted by, when I say the food industry. I mean, agricultural companies, seed, chemical, fertilizer companies, and pesticide and herbicide companies, the processed food industry, and the fast food industry. And it's only a couple of dozen CEOs that control all this. And Mark, why do they want to do this? Because we buy everything in our life from big companies who make things for us. And I think we normally think that the idea of capitalism is that these companies are incentivized to make something good for us because we buy the best thing and therefore they would go and do something better and you can freely choose to switch and that this is you know something that is good and you're painting a picture you said that word i wrote it down it was like maliciously and intentionally co-opted society why shareholder value i mean denise morrison was the head of campbells and tried to improve campbells she got fired indianne was at a pepsi tried to improve them got fired Mark Schneider, head of Nestle, tried to move towards regenerative and improving Nestle's food supply, got fired. It's a litany of dead bodies in this industry. I'll give you an example of a malicious behavior. There are a couple. One, in California, there was a number of years ago, there was a number of cities like Berkeley started with soda taxes, which was very threatening to the food industry. And then a bunch of other cities started soda taxes. And they work, and they work, and they improve a lot of the people in those communities because the money is then used to improve those communities, education, various programs. They went to Governor Jerry Brown and they said, we're putting together a ballot initiative, which they launched to prohibit any law from being passed in the state of California unless it was a two thirds majority. And they were putting millions of dollars behind this campaign to pass the ballot and convince voters to vote for it. Had nothing to do with food. It would have crippled the government of California and they knew it. So they went to Governor Brown and there's a picture of all the food industry guys with Governor Jerry Brown. Who is the most left kind of progressive governor in America that I think has ever been voted into office? And they said, if you don't put a stop, the soda tax, if you don't put a prohibition against any further soda taxes in California, we're going to pass this ballot. So he did that. He did that. In Washington state, there was a GMO bill to label GMO foods. I mean, I think every country except Syria and the United States levels, including China and Russia, which are not known for transparency. And a number of the big food companies and trade associations got together and colluded illegally to put together a campaign to make people vote against this ballot initiative to label GMO foods. The attorney general found out about it and then basically sued these companies. They don't care. It was the biggest, I think, settlement ever. It was like $18 million, which for them was like nothing. And they defeated the GMO labeling law. So there's just story after story after story like this. And why can they make more money selling us stuff that's really bad for us? That's, I guess, what I'm curious about. If I compare that with other industries, I feel that... I mean, how much profit can you make on a carrot? But if you make a carrot chip and you fry it in oil and you sell it in a bag, you can probably make 10x the money, right? So processing food, very cheap ingredients that are industrially produced at scale, that are funded by the government, I mean, is so cheap. And that's why we get cheap food. But it's not cheap because the price we pay at the checkout counter is not the true cost of the food. Prince Charles, now King Charles, gave a speech about this called The Future of Food. I think it was at George Washington or Georgetown University years ago. And he wrote about this. What is true cost accounting? And the Rockefeller Foundation put together a report a number of years ago that there were $3 in collateral damage for every dollar we spent on food. $3. So you spend a dollar on food, but the food industry is not covering those costs. they're passing on to the taxpayer and the citizens and the government and the environment. So chronic disease, the burden of that, who's paying for that? The food industry is not paying for your healthcare bill, right? There's the damage to the environment from the loss of soil, the loss of our aquifers, the loss of biodiversity, the dead zones that are 500 around the world. The one in America in the Gulf of Mexico is the size of New Jersey where there's no fish because the fertilizer runoff causes eutrophication and kills everything. So they basically don't pay for that. They don't pay for the social costs of what happens to our kids. Our academic performance in America is frighteningly low. It's such a low standard. I think we're 30th in the world. And why is that? Because kids are eating crap and they can't focus, they can't think. Mental health problems don't get counted in those figures because they say, well, that's physical and mental. We have this weird idea that they're separate and we know they're not but in the uk i think the they said just the health bill alone was 200 billion of the cost of bad food in a little country like the uk yeah and that's not counting all the agricultural damage the environmental stuff and the mental health conditions because we're having a mental health epidemic in young people yeah i don't know what it's like in the us but in the uk so many people are never working they're just going on disability benefit because they're depressed and anxious. And a lot of that is down to diet and terrible food in schools. Yeah. And this is so important, what you're saying, Tim, because now at Harvard and Stanford, there are departments of metabolic and nutritional psychiatry, meaning that people who have insulin resistance, which is this phenomenon that you get when you eat a lot of sugar and starch, where you get resistant to the effects of insulin. Insulin is a fat-sortized hormone. Your body makes more insulin. You store more belly fat, and it's a vicious cycle. You crave more food, and it leads to ultimately diabetes, heart disease, cancer, dementia. Dementia is now called type 3 diabetes. This whole field now is exploding to understand how nutrition plays a role in mental health. And the costs are staggering. There was a macroeconomic analysis that was done a number of years ago looking at what are the costs over the next 35 years of chronic disease, $95 trillion in direct and indirect costs. And the biggest was mental health, not because of being hospitalized, but because of the loss of quality of life years lost. And Tim, I know this is something you study a lot. How do you understand today the way in which all of this sort of cheap food, very industrialized that Mark's been talking about, actually leads to all the health problems that we've been talking about? Well, given that they want to make profit above all, and they don't care what they put in the food really, as long as people buy more of it, their aim is to get people to eat more of it. and pay more for those products. So in doing that, they engineer the food to have properties that make it sort of unnaturally irresistible. So they are super tasty. So they'll combine combinations of salt, fat, and carbs in exactly the right ratio to override your normal instincts and make you overeat it. So that's probably the number one thing. You know, a study show makes the same food you'll overeat about eat 25% more of it calorie wise than you would if it was not with that perfect combination and they'll do anything to make it cheaper so like you take out normal milk which can be expensive in some ways and so they take that out and and or make it low fat and then they can just use powdered milk and instead of the fat they add in lots of cheap other stuff all that stuff is starchy mazes and things like this which are also bad for you there's never any fiber in because that's expensive to make and it keeps retains the nutrients so it's much cheaper than to strip it off and store this stuff for years so it never goes off and then add in a few cheapest vitamins they can just to get the label right and you put all that together and then you've also got the chemicals that they're doing the artificial sweeteners the emulsifiers the preservatives the glues that stick all this fake food together they are really bad for your gut microbiome and so So that gives you dysfunctional microbiome, which would make you more likely to get diabetes and cause these metabolic problems. So it's not just one thing. It's the whole package, and it's all driven by this endless desire for us to eat more, and they make more money. Yeah. I mean, you're so right, Tim. Michael Moss wrote a book called Salt, Sugar, and Fat. It was an investigative journalist from New York Times and interviewed over 300 industry executives, food scientists. and he found that these companies created taste institutes where they hired craving experts. These are their internal terms to create the bliss point of food to create, quote, heavy users like a drug addict. These foods are biologically addictive. They put even two-year-old kids in functional MRIs to look at what's going on with their brain when they're shown different images or when they respond to different foods. They are designing these foods to be addictive. And I'm not saying addictive in a metaphorical way. They are biologically addictive. The animal studies are clear on this. There's withdrawal. There's cravings. And the estimate is that there's 14% of the global population that's addicted to these sugars and ultra-processed food and 14% of kids. Now, 14% of people are alcoholics. So it's about the same except it includes kids. These companies hire craving experts. Experts, yes. Well, they are the best food experts in the world. So they can pay top dollar to get the very best food scientists. That's who we're competing with. They want to create chemicals, mixtures, textures that make it hyperpalatable, soft as you can so you can eat it as fast as possible before your body has time to feel full. They have this enormous box of tricks, unlimited budget, and they know that they can keep creating food that humans will just be irresistibly drawn to. I mean, you can eat a kilo of steak, but you can eat a kilo of cookies, right? I mean, one of the things that I'm struck by is that the average food in the US is significantly sweeter than even in the UK. And the UK has a big problem with all of this. This is, again, very different from being in, say, Italy or something. But just all the food has sugar added to it almost as just a standard expectation of a level of sweetness. Salad dressing. It's hard to buy a yogurt that doesn't have vanilla in it as a minimum or artificial sweetness. And this comes from like almost just – is this from the food industry just sort of resetting everybody's taste expectations? Well, part of it was a long legacy of how we came to believe that fat was the enemy and sugar was fine. And this was a very deliberate effort to kind of vilify fat and to glorify sugar. And that's what happened when we were told to eat a low-fat diet in the food pyramid in 1992 to eat 6 to 11 servings of bread, rice, cereal, and pasta a day and fat sparingly. And that led to the hockey stick of obesity and type 2 diabetes in America and chronic illness. That's how I was brought up. The pyramid had lots of potatoes and bread and all the rest of it and maybe a tiny little bit of plant somewhere on it. Could you explain for a minute both of you why that's bad? Because I think lots of listeners will say, well, I understand that adding sugar and this weird Frankenstein food, that sounds bad. But like what's bad with a potato or like eating lots of bread? Well, we now know. Well, we actually – not we now know. We knew 20 years ago, but the guidelines haven't really moved that much. The fact that the advice to eat lots of rice and bread and potatoes is basically just giving you more sugar because most people don't realize they are essentially sugar. they're starches, which is a form of carbohydrate where you store the sugars. But as soon as you cook it or eat it, that sugar is released. Turned into glucose. And it's exactly the same. People just think, oh, well, I'm not having extra sugar, therefore it's okay. But they don't see that in its stored form, this is all these foods. So we've been told in the UK and the US to be eating much more of these. And the perfect healthy plate had these healthy starches. We always think white rice is healthy and a nice crusty bread, if it looks nice and attractive, that's a healthy food because they look real. They are real and a lot of the world lives off them. But this was giving us a huge amount of available glucose when we were getting very little fiber. And this was stressing our bodies, causing inflammation in the system and overstressing all these insulin pathways Mark's talking about, leading to type 2 diabetes, insulin resistance, obesity, and all those other complications, as well as the inflammation triggering things like mental health issues because, you know, the whole body is stressed. dealing with this constant overload of sugar all the time. And it was just the wrong balance. We weren't meant to be eating that much starch without a balance from the fiber. You're so right, Tim. Below the neck, your body can't tell the difference between a bowl of sugar and a bowl of cereal. You might as well just be eating a bowl of sugar. And that so many people don't realize. And we've created an agricultural system that is producing massive amounts and quantities of these refined starches. I absolutely love that. Below the neck, your body can't tell the difference between a bowl of cereal and a bowl of sugar. And I guess that's partly because the sort of cereal that we have, you know, which I could say a bowl of rice and a bowl of sugar. You first published Food Fix in 2020. You're just bringing out an updated version. And I'm just curious. So that's like five years. Have things been getting better since that first version? Things have, from a health perspective, gotten worse. From an awareness perspective, have gotten better. Whatever your politics or your like it or not, the fact that Robert F. Kennedy said, hey, everybody, we got a chronic disease problem. We have to pay attention to this. It wasn't part of the narrative or conversation. No other presidential candidate had ever said this And I known many of them and I tried to get them to say this and like no no no we can say this And this is a pivotal moment where I think Americans and increasingly the world is realizing that yes we have a problem Like, we have a problem, and we have to face it and deal with it, and what is the solution we need to figure it out? We need to address the food supply, the food system, the food we grow, how we produce it, how we process it, what's in it. We need to think about, you know, our guidelines and dietary guidelines, what we're recommending. All these things need to be reconsidered. So the policies are complex. I was friends with the Congressman Tim Ryan, and I said, listen, I don't think anybody's looked at all of our nutrition policies and how they affect our health or the economic impact of that. And as a congressman, he could ask the government, what they call the Government Accountability Office, which is basically the watchdog over Congress, to do an analysis of all the policies. And I thought it was bad, but the report came out in July of 21. It said there are over 200 different policies and 21 agencies and departments, most working at cross purposes with each other. So for example, the US dietary guidelines say we should reduce our added sugar and sugar intake. And yet with our SNAP program, which is our single biggest food program, our food stamp program, which is now I think up to $125 billion, 10% of that is soda. 75% is junk food, and that includes the soda. But 25% is meat, vegetables, whatever. So the government is paying for the people who are underserved to eat the worst food without any guidelines. And it doesn't have to be that way. They have another program called Women, Infants, and Children. There are strict guidelines on what mothers and infants can buy and purchase with these dollars that they get through this program. But they can apply that, the same thing, to the food stand program. They don't want to because the industry is so powerful. And they have all these, quote, hunger groups like Feed America Now and others. And they are vociferously opposed to any changes in the SNAP program, the food stamp program. And when you look at who is funding those hunger groups, it's the food companies. That's fascinating because I can see an argument about like, you know, when you're on low incomes, it's a challenge to look after your family. I find it hard to understand the case that you should be spending it on soda. And given that this is clearly. And now with this movement, I have a nonprofit called Food Fixed Campaign. I'm working with a woman who, for the last five years, who now is the first lady of West Virginia, her husband's a governor. And they were the first state to ask for a snap waiver, which means they asked the USDA, the Agricultural Department in America, to allow them to prohibit the purchase of certain things on the food stamps, like soda. And now many, many other states have followed suit. And thank God the U.S. Secretary of Agriculture has said, okay, let's see how it goes. So I think we're starting to see a revolution in this, but it's really unconscionable. And I'm actually planning to do very soon a demonstration of how on a food stamp budget of what you would get if you were on food stamps, how you can eat a delicious, healthy meal and do this for a week and show people how to do it. Because it's not that it can't be done. It's that people don't know what to do. They don't know how to cook. They don't know what to buy. I mean, you're not going to buy a $70 regeneratively raised ribeye steak, but there are cheaper cuts of meat. There are cheaper cuts of chicken. There are cheaper vegetables. I mean, my mother, we were Russian Jews and my mother used to make this soup, which was onions, carrots, cabbage, cheapest vegetables with flanken. We call it flanken, which is short rib, one of the cheapest cuts of meat and cook it with you know, a little bit of raisins for sweetness and boil it up. And it was delicious. And it's, you know, probably, I don't know, 50 cents a meal. And I make a big pot and I have it for the week. So there's many ways to learn how to do this. And I've done this with families who worked and lived in some of the worst food deserts in America. One family was in easily South Carolina. It's part of the movie Fed Up that you can watch on Netflix. And they were family of five that lived in a trailer. They had a thousand dollars a month for food on disability and food stamps. The father was 42, already on dialysis for type 2 diabetes kidney failure. At 40? 42. The mother was 100 plus pounds overweight. The 16-year-old son was almost diabetic. And I said, look, let me not give you a lecture, but let's go shopping. I gave them a guide on how to eat well for less. It's called Good Food on a Tight Budget. And it shows you which foods to buy and recipes and things. We made turkey chili. We made salad from actual, not iceberg lettuce, but real lettuce and olive oil and bitter dressing instead of this stuff. and I showed them everything that was in their kitchen and in their cupboards. It was all frozen. It was all packaged. It was all canned. It was processed. It was all full of all these ingredients we were talking about. They never cooked anything in their kitchen. And I showed them how to make a meal. We had this delicious meal together. And I said, listen, here's the guide how to do this. Here's my cookbook. You can try this. And a week later, the mother texts me, she says, we lost 18 pounds. I already lost 200 pounds as a family. The father lost 45, got a new kidney. The son lost a bunch of weight. The mother lost 100 pounds. So I get the chills just like telling that story because it shows that it's not that it can't be done. It's that we don't know how to do it. The American food industry has disenfranchised people from their kitchen. They've insinuated themselves in every aspect of our lives, and they've done it deliberately on purpose. Michael Moss talks about this in his book, Salt, Sugar, and Fag, about how General Mills aggregated all the food companies back in the late 50s and 60s because there was a movement to eat better and healthier food. There was a woman named Betty who was a home ec teacher, was trying to teach families how to cook and do all these things. And they invented Betty Crocker. Now, I don't know if you know what Betty Crocker is in the UK, but it's basically a cookbook that everybody had in the 60s and 70s. And Betty Crocker was a fantasy. She was an imaginary character that they made up. And then they put the recipes, add one can of Campbell's cream of mushroom soup to your casserole, or add one roll of Fritz crackers to your broccoli casserole, all the crap they had in the recipes. They were all industrial food. And so they basically created a whole paradigm where, you know, if women's lib and you've got to liberate yourself from the kitchen and cooking is drudgery and all this was a deliberate attempt to disrupt the American home, to get women out of the kitchen, to stop having home-cooked meals and to insinuate their products, I mean, in everyday life. And I mean, I grew up on TV dinners, Swanson's TV dinners. It was a big fancy thing. You have a TV dinner and you heat it up and then you kind of, you know, open it up and it was like Salisbury steak and these boiled green beans and it was awful, you know? And yet that's sort of got even worse and worse over the last 50 years. That's funny. I mean, we've never taken our daughter to a McDonald's, but that somehow hasn't changed the fact that the idea of going to McDonald's is really exciting for her, right? So she's picked that up still through like the marketing around her. And now these food companies have gotten so smart now in social media and they're insinuating themselves everywhere. So Facebook games, all our food companies are all funded by them these kids see literally billions of ads the average kid sees you know you know so many ads every day from all sources that if you're a parent you can't compete by eating your kids these are kids are just being brainwashed and these companies know how to target these kids it's like joe camel with the cigarettes they do the same thing with food the cigarette companies bought a lot of the food companies in the 1960s and 70s and they know a prediction and they know how to keep the money rolling in that's right people anyone listening it's not just a u.s phenomenon the lobbying is exactly the same in the uk it's in a way less transparent because we don't have to declare things like how much people spend on lobbying and you know it's not i mean i say transparent it's relatively transparent in the u.s you can ask for those data and the things like this and see who which congressman has been you know taking money from so and so we don't have that transparency in the uk and we know that lobbying goes on at all levels particularly anything to change our guidelines uh our national health dietary guidelines do not mention uh ultra processed food at all and uh every two years they meet and so should we say anything well evidence is not really that strong that you know heavily processed food is bad for you wonder why well you know a lot of that group of deciding it are also paid by the food industry and they have to also get advice from the food industry before anything gets changed in law it's crazy and do we see the same thing also in in the uk and elsewhere in terms of the taxes because i think there's definitely been the same situation across the globe around talking about taxes on like highly processed foods and you know the english-speaking countries are way behind the rest of the world so uh scandinavian countries South American countries have started to have rules on advertising for children. Packets of cereals aren't allowed. Cartoon characters, which you can understand is totally the wrong thing to be telling kids. They have black dots on things you should be avoiding. And they have taxes that are showing that you can use tax to reduce just the way, you know, we got cigarette smoking down just by incremental changes in tax. And we know we can do it. At least a dozen other countries that are leading the way on this, some in Asia, Scandinavia, and particularly South America, where they've just seen their economies absolutely go to shit because everyone's drinking sodas and getting diabetes and they can't afford it. And they've started to make changes, and they're having an effect. But in countries like ours, that change is being blocked by the food industry and the lobby. It's quite amazing what happened in Chile, which was the first kind of country, because there was a president who was a pediatrician, a doctor, and it was Michelle Bachelet and Dr. Picard, who was a vice chair of the Senate in Chile. And they had the reins for a minute. And they're like, okay, we're going to do it now. They put in 18% soda tax. They restricted food marketing from 6 in the morning, 10 at night for kids. They got rid of all the junk in schools. They got rid of infant formula advertising. They put these stop signs, literally with black warnings for salt, sugar, fat, and calories on the front of packages. So if you go down there, it says, don't eat this, basically you're going to kill you. And it worked. Michael Bloomberg has spent a lot of money helping support this effort and researching it with Barry Popkin from UNC Chapel Hill. And they basically have shown that this really works, that the population gets healthier, that this consumption goes down, that people stop buying it. So we know the policies that can make a difference. But the amount of resistance to those are so massive. I mean, in America, you have the First Amendment, which is free speech. You say, well, you can't restrict advertising. But we have to protect our children. That shouldn't apply to our children. And the argument is not valid because you don't sell vodka and cigarettes to four-year-olds, do you? No. And for you both, I think what I'm hearing is like the sort of food products that have been made by these big food companies just shouldn't really be treated like food in a way. They should be treated like some product that's been created by anybody else. A leisure drug. If they are a leisure drug, okay. But the problem is the food industry is so good at brainwashing everybody, including the healthcare system. It's all about calories in, calories out. It's all about moderation. It's all about exercising more and eating less. Bullshit. It doesn't work. We have to find ways to protect our population. And if another country was doing to American kids what we're doing, we'd go to war to protect them. I mean, our kids are really struggling. 40% are overweight. 20% are obese. The rates of ADD and behavioral issues are skyrocketing. Depression. Suicide is the third leading cause of death in these kids. They did a study I talked about in my book in a juvenile detention center where they got them eating real whole food. And there was a 97% reduction in violent crime, I mean violent behavior in the institution. There was a 75% reduction in restraints. There was 100% reduction in suicide, which is the third leading cause of death in that age group, in teenage boys. That's remarkable, right? And the data is there. Same thing in prisons. If you take prisoners and you feed them healthy food, their violent crime goes down dramatically in prison. Yes, 56% reduction. And if you add a multivitamin, it's an 80% reduction. The data is there. It's not like we have to do more research. And this comes back to what you were talking about before about just how strong the links is between this sort of ultra-processed food and mental health. Yeah, and the food is just all your fault. It's your willpower. They basically shame you and say, well, you're overweight because you can't control yourself. It's just you're lazy and a glutton. Nonsense. When your brain chemistry, your metabolism, your microbiome, your hormones, your immune system is hijacked by the food that we're eating, you're helpless. If you have a friend or family member who you think might be interested in improving their health, share this episode with them now. These insights could change their path, and I'm sure they'll be grateful. It's all incredibly powerful. I'd love to talk about what a listener could do for themselves, because you always talked a lot about society-wide forces. is. What about someone who's listening and saying, well, wow, you know what? I eat a bunch of those foods because who doesn't? So I'd love to talk about your overarching principles for eating healthily. The general consensus among nutrition scientists, except around the margins, is pretty much the same. Eat food. In fact, if you look at the dictionary definition of food, I encourage everybody to go on chat GPT or Google or whatever and ask, what is the definition of food? And there's various definitions in different dictionaries, but essentially it's a substance that supports the growth and nourishment and health of an organism. Well, these are by definition, not food. They do the opposite. They actually harm us. So the first thing that people should do is don't eat ultra-processed food. Don't eat food that's got ingredients you can't pronounce, they're in Latin, that are full of things like high fructose corn syrup and trans fats and additives and colors, because they're generally not going to be good for you. So eat real food, vegetables, fruit, nuts and seeds, whole grains, beans, animal products. And meat is not bad if you eat meat in the context of an oral healthy diet, fish, omega-3 fats. It's not that hard. And the problem is that people just don't know what to do anymore because we've raised a generation of people that don't know how to navigate the kitchen anymore, don't know how to navigate a grocery store. And we need to relearn that so we can actually start to support our health. key things you would add on top of what mark describes from a health point of view think of what food would your gut microbes like to eat just it's a simplistic way of thinking about it but i think once you do that it's naturally you can get all these these foods to fit the right pattern and the first one is eat a rich diversity of plants hit your 30 plants a week the second is to eat the rainbow because brightly colored things rather than beige most of the uk the us population just go for one color and we need to get people thinking that's bad there's definitely something about when you're a child i know something to do with safety or something that is like they quite easily want to give up these things and something about the bread and the pattern things these are like the things we train them we train them what kids eat in japan raw fish and seaweed and pickles. It's what you train a kid to eat. It's not because they are naturally eating that. In fact there a great book called Nourishment by Fred Provenza He one of the most incredible scientists He a rangeland ecologist who studied the relationship between the soil and plants and animals and humans and the interactions And he talks about how animals naturally will go and eat all the different kinds of plants they need. They'll go and seek even medicinal plants that they need to upregulate their health. And there was a study done, I think it was in the 20s or 30s at an orphanage where they took these kids who had no parents and basically fed liver and brain and organs and kidney and all this stuff. And these kids naturally were eating the things that were going to optimize their health. They weren't going for the candy and sugar. They were eating the stuff that was – because we've lost our natural intuition and our natural nutritional wisdom about what to eat. Well, we feed them formula milk, and then they get these pouches. And so they never have to chew or eat anything. And everything they're seeing that is reassuring is this sort of creamy, browny, sort of soft, gooey color. and they'll carry on the rest of their life in that comfort zone. In the US, the formula is so bad that the average formula contains the equivalent of a full Coca-Cola soda drink for a baby. So very early on, they're getting hijacked and it's in the form of corn sugar as opposed to lactose, which is what milk is supposed to be having in it. And there are formulas now that are using lactose and there are companies now that are emerging to actually create better quality organic formulas for babies. But that may be part of why we're seeing this rates of obesity in kids and why these kids are hijacked very early on. And the companies, they know this. So, you know, the big companies like Nestle and others that are going into hospitals, giving free pouches and formulas, sort of dissuading women from breastfeeding and getting them hooked onto this food long term. And this is absolutely the worst, you know, excess of the food industry. And they're setting them up for life. So they've become addicts. The other thing I'd say is fermented foods. All the studies show that if you get three portions a day, you'll be able to reduce your inflammation by about 25%. It can really improve your gut microbes, helps things like mental health, you know. And it may be acting a different way to some of the other mechanisms. So it's sort of additive and agreeing on the ultra-processed foods. But I wouldn't cut them all out because that's too drastic. You know, 65% of the U.S. diet is these ultra-processed foods. Some of them just have – they're classed as ultra-processed, but they might just have vitamin C in it or something. So I think we need to be a bit more smarter about what we're calling the worst ones, and that's why we've got our app now that does a risk score and really highlights the 25% of the worst ones to avoid. And I think we should be focusing on the sort of medium-high-risk ones first rather than banning everything. Because they're not all equally risky. They're not all equally risky. There's a huge difference. I mean, you can go to, you know, you get on an aisle, you know, three peanut butters that look identical, have the same government stickers on it for health and sugar and whatever. But, you know, one will be zero risk, one will be medium, one will be high risk. That's right. And it's really hard for the consumer to tell that difference. So I think that's a real area. So we need to be fight the clever, you know, companies are trying to make them all look the same. And we need to use things like AI and technology and apps to fight that. And I think that's really important. And Marcus, you hear Tim talk about the sort of the microbiome side and like the 30 plants and the fermented foods, which is obviously like the complete opposite, I guess, of what you've been talking about with these big food companies. You know, what are your thoughts? A hundred percent. I think, you know, you've got as many or more cells of bacteria in your body than you do. You've got a hundred times as much bacterial DNA as your DNA. basically they're running this show and they're producing all sorts of metabolites and byproducts and that regulate your health in a good or bad way and they actually can cause diabetes they can cause inflammation they can cause autoimmune disease or they can create health and we know that what you're feeding them is critical so you're not just feeding yourself you're feeding a whole army of bacteria in there that are determining everything about you including your mental health your immune health your metabolic health your cardiovascular health i mean it's it's quite astounding, even your cancer risk, all determined by your microbiome. So if you don't understand how to take care of those little critters, your health is going to suffer. And so yes, fiber, yes, fermented foods, yogurt, sauerkraut, kimchi, miso, all the stuff that other countries have been using for centuries that are just part of their natural diet. I mean, there was a study in Poland where women who moved from Poland to the US dramatically increased their risk of breast cancer. In Poland, they eat about 30 pounds of sauerkraut. And kefir as well. Yeah. So it's like, yes, the microbiome is incredibly important. And it is part of what the root cause is of why these foods cause such a problem. Many of these foods have emulsifiers, which now are understood to disrupt the lining of the gut that allow bacteria and food proteins to leak in and your immune system starts reacting to this and creates this inflammation. And all these chronic diseases that we talked about at the top of the show, they're all inflammatory diseases. So our bodies are on fire, our metabolism are on fire, our gut's on fire, and our brains are on fire, and the heart's on fire, and that's what's causing chronic illness. And a lot of this is coming from the gut microbiome. Now, one thing we always get asked all the time is what's Tim's favorite breakfast? But since I've got you here and you've been talking about this so eloquently, what's your go-to breakfast? It depends. If I'm home and I'm working out in the morning, I like protein shakes. I'll often use regeneratively raised goat whey. Whey protein is, as I'm 65, I'm an old guy. And as you age, you need more protein to maintain your muscle mass. And so I like to get a good load of protein in the morning. Most people have sugar for breakfast, bagels, cereals, muffins, French toast, pancakes. It's dessert for breakfast, but it's important to eat protein and fat for breakfast. And so I have a protein shake. I put in some frozen fruit. I put in some creatine, a few other things I use for my microbiomes and probiotics. I put in urolithin A, which is actually a postbiotic that comes from promegranate. If you have a healthy microbiome, which most of us don't, and probably people listening out there, I can't imagine there's anybody out there listening that hasn't taken an antibiotic in their lifetime. And that destroys that. So I basically have that for breakfast. If I don't have that, I mean, I'll have an omelet or I'll have eggs, or I might have a regeneratively raised sausage with eggs. Or sometimes I'll have like a sheep yogurt with lots of nuts in it, and that's got a full-fat yogurt with nuts in it. Well, I'm here in the U.S., people saying they won't eat any milk products. You know, we have an industrial cow system in America, like we have an industrial meat system or grain system, and these cows are hybridized. They're not genetically modified, but they're just bred to be these hyper-milk-producing cows. They're Holsteins, typically. They have a form of casein, which is the milk protein called A1 casein, which is way more inflammatory, causes more gut disruption, more inflammation, more autoimmune disease, type 1 diabetes, and potentially even cancer versus A2 casein, which comes from goats and sheep and some cows like Guernsey or Jersey cows or more heirloom cows, which are better tolerated. And those are the ones that if you go around the world to these remote places, those are the kind of cows they have. They don't have American dairy. Plus, they pump them full of growth hormone and other things. They milk them when they're pregnant, so they're full of hormones. There's over 60 different hormones in milk. It doesn't sound very appetizing. It's nature's perfect food. If you're a half. There was a huge ad campaign in America called Got Milk, and it was funded by the government and the food and dairy industry that got together through something called a checkup program to promote agricultural products. You had secretaries of health and human services in them. You had sports athletes in them with the milk mustache. And the FTC said, there is no data to support this at all. This is scientifically incorrect. It's not helping your bones. It's not doing all the thing you say is you've got to take these ads out. And if you want to learn more about milk, go to the New England Journal of Medicine website, nejm.org, and type in milk and health. It's an article that was written by David Ludwig and Walter Willett to the top nutrition sciences at Harvard, reading all the literature on milk and dairy and showing how harmful it is. In fact, it increases the risk of hip fractures. And Tim, I know you have a view about like milk versus like fermented milk. Yeah, I'm not a fan of milk anymore. I mean, And, you know, once you're no longer a baby, there's no evidence that it's useful. And overall, I'm agreeing with Mark about, you know, milk and fractures. And it's vastly overhyped for probably commercial reasons. But once you ferment it, it's a different matter. So fermentation means you transform it with microbes into something that tastes better, preserves longer, and is better for your health. And so if you look at regular cheese eaters, for example, they always do better in health outcomes than people who don't eat cheese. We're talking about proper cheese. All these ferments seem to have a benefit. So you can convert something like milk into something much more interesting by fermenting it. And this has health advantages. and you're then perhaps getting the advantage of the microbes in the food, but also you may have broken down some of these proteins into much smaller ones that don't cause that same irritation as well. So in the same way that sourdough bread cuts down the gluten into smaller bits so it's less irritant for anyone who's intolerant. So fermentation is a great natural way to make unhealthy food healthier. So I'd love to leave our audience maybe who's listening to this and saying, I'd like to make a change. Mark, if you were going to say there's one piece of advice to somebody who they can maybe start doing today, who's worrying about this burden of disease, what would it be? That's easy. Dramatically cut down starch and sugar in your diet. Think of it as a recreational drug. If you want to have a tequila on the weekend, great. If you have tequila for breakfast, lunch, and dinner, it's a problem. And we're having this for breakfast, lunch, and dinner. So So a treat, not a staple, starch and sugar in all forms. So it's anything, unless it's a whole grain like brown rice or buckwheat or beans. I'm talking about any refined grain or sugar in any form. If people say, well, what about honey? What about maples? As Shakespeare said, rose is but a rose. Sugar is sugar by any other name. And there's 100 names for sugar. Amazing. I'd like to do a quick summary of what we've covered. But hearing this, it always makes me think about what people must have said about tobacco, probably before I was really born, who were saying this is really bad. And everyone was like, this is ridiculous. Like my mom was told to smoke when she was a child. How can this possibly be bad? And so it makes me believe that it's possible to make some shift. But, you know, the big thing on my mind is you just sort of said big food is maliciously and intentionally damaging society, including our children. It has people like cravings experts. figuring out how to build exactly the most addictive food that you can imagine. And I think you gave me the statistic, maybe like 14% of people are addicted to food. It's just sort of similar to what happens with alcohol, which we know is very dangerous for some people who aren't able to manage it. That as a result of this, we started 100 years ago, massively increasing our health span and lifespan as we dealt with all these infectious diseases. And now, you know, the last 20% of our life, which is a lot, right, is spent sick, unable to enjoy it. And actually, our health spans, it sounds, if I understand rightly, in both the US and the UK are actually shrinking. I think you said this thing like food is the number one killer globally, which given that we have to eat it in order to live, there's something deeply wrong about it. It's actually technically not food. And you mentioned that because you said what's food like food is something that supports growth and nourishment of an organism. And so if this is stuff that like actually just hurts. It doesn't really deserve to be cold food. I love that. You also said something which I loved about, you know, if you eat a bowl of rice or a bowl of sugar, like below the neck, you can't tell the difference because you both explained just how rapidly this stuff is being turned into sugar. And therefore, you know, it's fine as a little bit of your diet, but if you're eating that all the time, and I used to think for many, many years that white rice was really healthy and I've made this great choice, that there are some countries that are fighting back, which I think is really interesting. We're all living in this English language environment. And I'm struck that you talked about between you both like Scandinavia and Chile, like really having an impact, whereas I think we're living in this English language bubble and we feel that it's impossible to make any change. And then to finish, you talked about what to eat. And I think it was really interesting that you not only agreed, I think, a lot on the problem, but actually there's a lot of alignment on the solution. So start by eating real food. So you really want to cut out this ultra process, this high-risk processed food that is harming you, cutting down the starch and sugars. And I know that includes like these sort of sugary drinks that you talked about, so many people buying on low incomes. And then like positively, you know, I think we heard Tim, 30 plants, eat the rainbow, eat fermented food, eat like these real foods that are out there and allow us therefore hopefully to restore. And I think maybe that, you know, finish back to where you're beginning, this idea we're not stuck with our genes, it's possible. And if I'm listening to this and I'm 65 years old and I've been eating this diet since I was one, Mark, is it too late to make any change? Hell no. I mean, quick story. I had a patient at Cleveland Clinic, 66 years old. Her BMI was 46, which is huge, huge. 30 is obese and 40 or that is severely obese. She had type 2 diabetes for 10 years on insulin, heart failure. She had hypertension. She had multiple stents in her arteries. She grew up only on processed food. We put her in a program, a group program. Three days, she was off her insulin. Three months, she was off all her medication. Her A1C, which was her average blood sugar, went from 11, which is near death, to like five and a half, which is normal. Her heart failure reversed. Her hypertension normalized. Her fatty liver reversed. Her kidneys normalized. And she lost 116 pounds in a year. So it's possible at any age. I'll end this episode with something I think you'll like, a free Zoe Gut Health Guide. If you're a regular listener, you know just how important it is to take care of your gut. Your gut microbiome is the gateway to better health, better sleep, energy and mood. The list just goes on. But many of us aren't sure how to best support our gut. I wasn't sure before doing Zoe, which is why we've developed an easy to follow gut health guide. It's completely free and offers five simple steps to improve your gut health. You'll get tips from Professor Tim Spector, Zoe's scientific co-founder and one of the world's most cited scientists, plus recipes and shopping lists straight to your inbox. We'll also send you ongoing gut health and nutrition insights, including how Zoe can help. To get your free Zoe gut health guide, head on over to Zoe.com slash gut guide. Thanks for tuning in and see you next time. Bye.