FAT: A Documentary 2 (2021) - full transcript

Camera speed, Vinnie 4.
Take one, Mark.

The 20th Century gave us
so many misconceptions
when it came to health.

One egg equals
five cigarettes.

Eggs cannot legally
even be called safe.

Cutting down on meat
is a good idea.

So, is the pendulum
swinging back

in the opposite direction?

Where are we since
the last movie came out?

Is there progress?

Has meat made a comeback?

In some cases, I can say yes.



I swear by the ketogenic diet.

I hear more doctors
talking about it.

The low carbohydrate
keto community
is based on science.

And I can see a few things
moving in a direction

that people want to see it
move into.

There is a bottom-up
revolution going on.

But then I see
the other side of it.

There was another
vegan propaganda movie

that came out
in this past year.

Surprise, surprise, there was
a product hooked to it.

The impossible burger
is the world's only burger

that looks, handles,
smells, cooks and tastes

like ground beef from cows.

People are becoming
guinea pigs.



Completely replace animals

as a food production technology
by 2035.

InFat, part one,
we talked about the war
for information.

But I actually think we also
live in a war with ourselves.

It's almost like we're gaming
the system of our own bodies.

We're trying to get
our system to do

what it's not supposed to do.

"Eat this, eat that,
don't eat this,
don't eat that."

Our program is known
as a starch-based diet.

"Take this supplement,

"it'll make your muscles
grow bigger."

We have more questions
than ever.

And the world always speeds up

and it gets more frenzied
all the time,

and sometimes even people
who are so-called experts

don't know what's going on.

You suck it all up.

Mmm.

"This study says this."

"That study says that."

"Well, that study
wasn't done correctly."

"This is healthy."

"That's not healthy."

The answers we're searching for

seem to have
these long winding roads

that eventually
lead to nothing.

But maybe it doesn't have
to be so hard.

In this movie
we're going to expand

on what we talked about in
Fat, part one.

We're going to talk to
the same experts
you saw before.

-But let them
stretch out a little bit.

-Great.
We're going to discuss

why some of the things
we believe are wrong.

Fat tends to cause you
to be fat.

We're going to
also get into why

some of these things are right.

Based on the research,

we cannot say
with any certainty

that eating red
or processed meat

causes cancer, diabetes
or heart disease.

And also why
there's so much confusion
between the two.

It doesn't have to be
that divisive.

My name is Nina Teicholz.
I'm a science journalist

and author of book called
The Big Fat Surprise.

I'm also the executive director
of a group

called the Nutrition Coalition,

which aims to ensure

that our nutrition policy
is evidence-based.

Nina Teicholz
was a one-time vegan.

She crossed over.
She crossed the aisle.

And that led her into
ten years of research.

She went through
all the papers,

she went through
all the studies

to come back to figure out
where we had gone wrong.

And it's the work
like her book,

The Big Fat Surprise,

that has led a lot of this
pendulum swing,

in my opinion, to start moving
in the right direction.

I got into this field
just completely by accident.

I was doing a series of
investigative food articles

for G ourmetmagazine

and one of them
that was assigned to me

was on trans fats.

Well, what are trans fats?
I had no idea.

Researching that story

really plunged me into
the whole world of dietary fat,

which is the subject that
Americans and nutrition

have obsessed about most.

And that really led me
down the rabbit hole.

For nearly a decade,

I researched everything
I could find

about dietary fat
and cholesterol.

When I started
doing my research,

I couldn't believe
the kind of reactions

that I got from
interviewing scientists.

I mean, I'm the daughter
of a scientist

and in my father's
"dreams" journal,

if you open up,
there are math equations.

I always thought that science
was full of people like him,

who rationally, soberly,
would discuss interesting ideas

and consider other ideas
and change their minds

based on
the scientific observations.

And instead,
in nutrition science,

I couldn't believe
what I found.

People who were afraid
to talk to me.

People who said,

"If you're going to take
that line on dietary fat,
I can't even talk to you."

There is some huge story here.

If people are afraid
to talk to me,

that means there's
a really big story here.

Saturated fats,
butter, lard, cheese,

fatty beef
and poultry with the skin on,

all said to be
bad for your heart,

but you should replace
most saturated fats

with more monounsaturated
healthy fats

which help reduce your risk
of heart attack and stroke.

Limit red meat,
dark poultry meat,

or poultry with the skin on

to a serving the size of
a deck of cards per day.

In good science,
you try to do
everything you can

not to go public prematurely

because as soon
as you go public,

as soon as you claim
you've discovered
something you haven't

or you've realized something

that you don't have evidence
to support,

all these consequences kick in

and make it virtually
impossible to back out of.

My name's Gary Taubes,

I'm an investigative journalist,

co-founder of a not for profit
research organization

called the
Nutrition Science Initiative,

author of Good Calories,
Bad Calories

and Why We Get Fat,
of The Case Against Sugar.

Gary Taubes is largely
considered a lightning rod.

Gary has never shied away
from media.

He will go up against anyone

because what he has on his side
is a little thing called facts.

I often asked myself
when I was writing
Good Calories, Bad Calories,

it's like, I have friends

who sort of have
conspiratorial turns of mind

where they think
people do things

because they're venal
and they're getting
paid by industry.

And I just think, "I don't see
any conspiracy there."

I don't really think
the industry

had much to do with that.

The food industry was given

this enormous gift
of this bad science.

And these people just literally
could not have caused more harm

if there had been a conspiracy.

At least if there had been
a conspiracy,

enterprising
Washington Postreporters

could have interviewed

the right people in garages
in Washington and exposed it.

My name is Dr. Eric Westman.

I'm an associate professor
of medicine

at Duke University
Medical Center in Durham,
North Carolina.

The US government got involved

in creating guidelines
for what people should eat.

And it was not based
on science.

What can you say
about Eric Westman?

You know,
the original Atkins Diet

has been around
since the early 1970s.

But when they wanted
to update it,

they had to find a doctor
to write that.

Eric Westman is that guy.

He wrote The New Atkins for the New You.

He also started
his own little obesity clinic

over on the east coast.

The guy is just phenomenal.

I was involved in
research communities

where we would look
at a guideline

and see that as a straw man,

as something to either prove
or disprove.

So unfortunately, the research

that was going to support

and back up
the low fat guideline

never proved
that it was healthy.

What's the information people
are getting about their health,

because everybody wants
to know what does it
mean to be healthy?

And that's sucha difficult question to answer.

They're interested
in their health,

they've been searching
for answers.

And they found an answer

that has actually done them
more harm than good
in the long run.

Bret Scher
was this great guy I met

when he came on my
Fitness Confidentialpodcast.

And just fell in love
with this guy.

He's a cardiologist

who doesn't believe
that red meat will kill you.

He also feels the same way
about saturated fat
and cholesterol,

which is a paradigm shift
when you think about it

because there are not
many cardiologists out there

that are thinking that way.

Hormones in our body
play a huge role.

So, things that raise
our insulin

are going to encourage
our bodies to store more fat.

So just because you're taking
fat out of something

and then you're enhancing it
with increased
carbs and sugars,

that is actually making
this problem worse,
not helping it.

Clearly this idea that
we are supposed to avoid fat

has been a major factor

in causing, paradoxically,

the obesity epidemic.

That's the big myth,

the idea that it's dangerous
to eat natural foods

with fat and cholesterol in it.

Andreas Eenfeldt is a great guy

who noticed that

the more medicine
he handed out,
the sicker people got.

And he felt that there
had to be a better way.

So he started
working with food,

pulling certain things out
of people's diets,
adding other things.

And the certain things
were junk foods, and sugars,

and grains,
and this sort of thing.

And he started adding in
red meat, and fish,

and more fatty foods,
and noticed that people
were healing right up.

If you avoid fat,

you end up being hungrier

and you have to eat more

of something else

to feel satisfied.

And that something else

is carbohydrates.

Obviously, aside from
the way it looks,

you end up eating a lot more
sugar, processed carbs.

That is probably the cause

of the obesity epidemic today.

By this point,
everyone knows
there's an obesity epidemic.

And while we can argue all day about fat versus low fat,

pretty much everyone agrees
that sugar is bad for you.

Sugar makes insulin work better
and cures diabetics.

Well,
almost everyone.

But we'll get to that later.

BMI is one of the most
commonly used measurements

to determine if you're obese.

But the newest research says
that BMI may not be reliable.

The biggest problem
with getting useful data

has to do with
doing the math honestly.

We actually have a problem
of philosophy with science
right now.

We have a replication crisis
where things
can't be replicated.

We have people who do research

that do something
called P-Mining.

The P is sort
of the statistical

significance of your study.

You can actually get your data

and then find
the statistical model

that fits best to prove
that your data is working.

I'm Dr. Drew Pinsky.

I'm an internist
and addictionologist.

Dr. Drew, look, like everyone
else in LA, we love Dr. Drew,

all those years of Loveline.

But the fact that he does what he does with addiction medicine

and the lives he has saved,

I'm happy to call
Drew Pinsky a friend.

The way we examine populations,

we're looking at sort of

average effects on the mean.

So people on either end

may have
very different physiologies

that have very different sorts
of interventions

that we're completely missing.

There's really a crisis coming

in the philosophy of science.

Intelligent people
should know

the difference between

causality and correlation.

And weirdly enough,

in this field of nutrition,

because it's so hard to do
the necessary experiments,

what you end up with
are correlations between
health and disease.

And one of the correlations
is that people

who consume
a lot of artificial sweeteners

tend to be
more obese and diabetic
than people who don't.

Artificial sweeteners have been a staple for dieters

since the 1980s.

And there's a real debate
about the harm they cause.

The problem is, if you think
about who uses
artificial sweeteners

are the people
who have weight problems,

the people who can't control
their weight drinking

full sugar sodas.

And so, you have no idea
which way the causality runs,

whether these people
are unhealthy

because they consume
artificial sweeteners

or whether they consume
artificial sweeteners

because they're unhealthy
and they're predisposed
to get fat.

The major points about
your diet really sort of

hover around two things,
fat, fruits, and vegetables.

You've got to really get your
saturated fat and trans fat

as low as you possibly can.

And we know that if we do that,
you can actually decrease

your risk of coronary
heart disease 40/50 percent.

There is a correlation between
obesity and heart disease

in that people with obesity
often have other risk factors

like high blood sugar,
high blood pressure,

dyslipidemia, meaning
bad cholesterol profile.

And all these things increase
the risk of heart disease.

It's so easy
to blame heart disease
on fat.

Let's take a hamburger
for instance.

They'll say, "Well,

"red meat is bad for you
because it's in a hamburger."

They won't take into account
that there was ketchup,
mayonnaise,

a big breaded bun, and all of the other condiments around it.

And guess what? Most people
never eat a hamburger
without French fries.

But they never blame it
on the seed oils,

they never blame it
on the bread,

they never blame it on any
of the goop that's put on it.

They just go to the meat
and say,

"Meat, bad.
Meat causes heart disease."

It makes no sense.

It's black and white thinking

combined with numerous studies coming out of respected names

like Harvard that lead people
to believe that things
may not be true.

What does Harvard
have to do with this?

The role that Harvard plays

in the nutrition story

is a sad and powerful one.

Extremely powerful.

If you compare butter
with calories from
refined starch and sugar,

it's going to be
pretty much a wash.

They'll both have adverse
impacts on metabolic factors

and on risk of heart disease
and diabetes.

Harvard is home
to two of the largest

nutritional epidemiological
databases in the country.

What is that?
That's a kind of science

where they take
a large group of people

and they follow them for years.
And they ask them what they eat

and then they see who dies
or has a heart attack
or gets cancer.

This is a kind of science
that is so fundamentally weak.

Right? I mean, people are asked

how many cups of spare ribs did you have in the last year,

or how many peaches,
or how many plums

did you eat
on average per week?

Hundreds of questions.

First of all,
people lie about what they eat.

They want to please themselves
or they want to please
the interviewers.

And this has been
documented in science.

Secondly, that dietary data,

even when they try
to validate it,

they find that
it is highly unreliable.

So you're talking about
very, very weak evidence.

Right? And then
this kind of science,

epidemiology, can never prove
cause and effect.

It can only show
an association.

So it was only ever meant
to generate hypotheses,

which then go on to be tested.

The way you test
something properly,
to show cause and effect,

is to test it in a randomized,
controlled, clinical trial.

This weak science that Harvard
has been publishing on

dominates the whole
nutrition landscape.

And it is what is echoed
throughout all of the media.

"Oh, this is only association
but not causation."

But then they just breeze
right by that

with headlines that say things
like, "Coconut oil kills you,"

when that headline should read,

"Coconut oil, we have found
a small, weak association

"between coconut oil
and increased risk
of cardiovascular disease."

People who eat
a lot of red meat,

who are those people?

Those are the people who have
ignored their doctor's orders

for the last 35 years.

That means they do a lot
of other unhealthy things.

They probably drink too much,
they don't go
to cultural events,

they don't follow
their doctor's orders,
they don't take their medicine.

They don't have
happy family lives.

Maybe they live next to
a toxic waste dump

because they're poor,
or whatever.

And then they come out
with a finding that said,

"Red meat eaters,

"people who eat
a lot of red meat,

"tend to die earlier."

Well, was it the meat?
Was it the unhealthy lifestyle?

Was it the excessive
binge drinking?

It could have been any one
of these other things.

But that is why this science
is so fundamentally weak.

Your overall lifestyle,

food just being one factor,

is going to determine
your overall health.

If you eat well,
change your habits,
don't smoke,

maybe start exercising,

well, you'll be healthier.

The problem is that
studies get done

where people get healthier
by changing everything
about their life,

and then the results are touted as food being the reason

they got healthier.

This is especially rampant
among vegan studies.

There have been some
studies in the past,
some small studies,

that have had some problems
with them,

that have been propagated
over and over again

showing that diet
can reverse heart disease.

And a big one was
the Ornish studies in the '90s.

If you eat more calories
than you burn,

then you gain weight.

Fat tends
to cause you to be fat

because fat is very dense
in calories.

Fat has nine calories per gram,

whereas protein and carbs
have only four, less than half.

So an optimal diet is low
in fat, low in the bad carbs,

high in the good carbs,
and enough of the good fats.

And then again,
it's a spectrum.

When you move
in this direction,
you're going to lose weight,

you're going to feel better
and you're going to
gain health.

What's frequently lost
in that is that

that was a whole
lifestyle program.

So they got people
to quit smoking, exercise more,

manage their stress,
and follow a vegetarian diet.

But what's come out of that

is that a vegetarian diet
reverses heart disease.

And you can't say that
from that type of a study.

A vegan approach,
a vegetarian approach,

is consistent with
standard dietary guidelines.

And the question is,

"Is that really
a healthy approach?"

I'm Dr. Jeff Gerber.

I'm a board certified family
doctor from Denver, Colorado.

I've been a doctor
for over 30 years.

About 20 years ago,

I realized I didn't know much
about nutrition.

So I took it upon myself
to learn more.

And I use nutrition as a tool

to treat
and prevent chronic disease.

I look at Jeffry Gerber
and I think, "Hero."

He looked around
and went,

"Wait a minute.
I'm healing people with food.

"What I'm doing,

"what I was taught in school
is not working."

Instead of just going down
the road the way the AHA
or the ADA does,

where they just
keep spewing the same lies
hoping for different results,

Jeffry Gerber looked around
and said,

"Hey, we need to do
something about this."

We think,
especially with vegan diets,

it's quite a challenge
because you're often deficient
of macronutrients

that you would get
from animal-based proteins.

Most people tell me
they feel great
when they go on a vegan diet

only to feel bad later.

My view has always been,

well, when you go
on a vegan diet,

you're cutting out
a bunch of crap,

a bunch of processed food
in your life.

But at some point,
it's not sustainable.

I think there are lots
of different approaches

that can be healthy.

You could even do an extreme
diet like a vegan diet

and feel great because
you're not having sugar.

You're reducing the starches

that raise the blood sugar.

But in my experience,

some people will blindly follow
certain diets,

including the vegan diet,
and gain 50 to 100 pounds

and never even think
that the vegan diet

might be the cause because
they know it's healthy.

Because everyone else says
it's healthy,

it must be the plastic
in my bottle that's
causing the obesity.

It must be the microbiome
or that I'm not sleeping,

when actually it was the food
that they were eating.

As a cardiologist,
I've come across

a number of patients
who are vegans.

And of course,
I read the literature every day

that supports a vegan diet
for heart health.

Unfortunately,
for a lot of vegans,

it takes a lot of work
to maintain a vegan lifestyle.

You have to think about food
all the time,

you have to prepare your food
all the time,

you are hungry all the time.

A number of people
have decreased energy.

So I think that is a downfall
to the vegan way of life,

not that there can't be
healthy vegans.

Of course there can.

But the question is,
"For how long?"

Today we're going
to explore all
of the vitamins and nutrients

you might need on a vegan diet.

Vitamin b12, calcium, iron,

choline, Omega-3 fatty acids,
iodine, zinc, selenium.

They don't make
a very good argument.

And especially like,
they want to come after meat

as being unhealthy
in multiple ways,

leading to heart attack
and to diabetes.

And you have to understand
that a lot of their comments

are based on the ethical
treatment of animals.

And we feel the same way,

that we do want to
treat animals ethically.

But that has nothing to do
with health.

Can we prosper and thrive by

feasting, in effect,
on animals?

And that worries me
personally as well.

Part of the movement
is driven by the idea

that eating animal products
are unhealthy,

which I think
is just bad science.

But unfortunately, the leaders,

the proponents of
the vegetarian/vegan movement

don't like the argument
we're making

'cause we're saying...
Not only are we arguing that

the problem isn't red meat
and animal products,

but we're arguing that people
can be very healthy,

and perhaps healthiest, eating
animal product rich diets.

One of the questions today
is why we're so anti red meat.I've really wondered about that.

It goes back to the 1970s

when really
the kind of burgeoning

of the vegetarian movement
in the United States,

in my hometown,
Berkeley, California.

That was the time
the peace movement...

We had just come out
of two World Wars

and we wanted to make peace,
not war.

Meat has always, throughout all
of history and every culture,

been associated with virility.

It's the food of warriors.

It's the food of people
who make war.

And it gives men and women
muscle mass.

It makes them strong.

For instance,
in the Maasai warriors,

who were studied rigorously by

the University of Vanderbilt
scientists in the 1970s,

they found that
the warrior class,

but not the women,
the warriors
consumed only meat.

Meat, milk, and blood
was their entire diet.

So now we're being told...

Americans are being told
in the 1970s,

not to eat meat because
we want to make peace instead.

This was sort of our modern
idea of masculinity.

And it totally makes sense
for a culture

that does not want
to be at war.

It is so interesting if you
look at the way we used to eat

before the obesity
and the health epidemic.

And red meat
was plentiful then.

And then, when things changed,

with the McGovern Report,

with Ancel Keys'
Seven Countries Study,

with President Eisenhower's
heart attack,

with that conglomeration
of events,

now fat being demonized
and red meat being demonized,

that's when everything changed.

And it happened to coincide

with the health epidemic
that we're having now.

Red meat is back
in vogue again.

I mean with the paleo diet,
you have low carb diets,
you have Atkins...

You even have
my very own
"no sugars, no grains"

approach to eating.
All allows red meat.

So everything is back
on the table again.

But it wasn't always that way
for red meat.

One of the factors
that did emerge

as being related to cancer risk
was consumption of red meat,

especially processed red meat,

in relation to risk
of colorectal cancer

and some other cancers.

I think the bias
against eating red meat

has come
from nutritional epidemiology.

These studies look
at the associations

between what people eat

and then look at the effect
on the health

over a long period of time.

But in the clinical
research world,

these are thought of
as relatively weak studies.

And the association level
has been really low

for red meat and cancer
for example.

Why can't people
eat meat and vegetables?

Why is this controversial?
It's food.

Both are real and both
can fit into your diet.

This "either or" argument
that's going on

has nothing to do
with health

and more to do
with ideology.

They were yelling like,

"Don't eat chickens,
don't eat meat."

And I was like,
"Well, I love chicken."

These are two distinct
phenomena I think.

One is this identification
with a group

and tribalism around which

diet is yet another
manifestation of that.

But this need to move

from fad, to fad, to fad,
that's consumerism.

That is us needing a solution
to how we're feeling

or looking or how we think
about ourselves

with something now.

Buy something now,
do something now,

and fix everything,
fix how I'm feeling now.

And fad diets
suit that beautifully.

I think the media
has a lot to do

with our ill
psychological well-being.

To blame diet
and sedentary lifestyle...

I mean, I've heard blame on TV
my entire life.

But it's us. I mean, look,

people that create mediaonly create stuff that we watch.

It's us that
they're creating it for.

If we didn't watch,
they wouldn't create it
the way they do.

So we need to watch
ourselves and learn
how to train ourselves

not to consume this garbage
in such a unthoughtful way.

Bad news for bacon
and sausage lovers.

The World Health Organization
says those foods

can cause colon
and stomach cancer.

Again, a lot of this
information does come
from media,

who loves to tout institutions like Harvard

whenever they put out
dietary findings.

"Harvard said this,
Harvard said that.

"Why shouldn't
we believe Harvard?"

Walter Willett
of Harvard University

is widely considered to be
the most influential person

in nutrition science today.

He presides over

the largest two

what's called epidemiological
databases in the country.

And those databases,
you have to understand,

all I need to do is
to find an association.

It's just a whole bunch
of statistics

in there they get from
dietary questionnaires.

And they can just, like
a mimeograph machine,

they can just
pull out anything.

Like meat is associated
with this outcome,

or vegetables are associated
with this outcome,

or French fried potatoes lead
to more this kind of cancer.

They can run
those statistical tests
all the time.

Right? Those associations...

So they're publishing
all the time.

Well, in science, sort of

the frequency of publication
is part of what
makes you powerful.

Um, and compare that
to somebody who's
doing clinical trials.

They might do a clinical trial
and it takes them two years.

And that's where they're
actually feeding people
and they...

They change their diets,
and they give them counseling.

They get one paper
out of that.

Walter Willett really believes
a vegetarian diet

high in whole grains,

is the diet
that is the healthiest

and he wants everybody
to follow that diet.

One, I think,
important concept

that's developed over
the last decade or so

is that diet quality,

the combination of foods,
the pattern of foods,

uh, is important in directly
influencing disease risk

but also in helping us better
control our body weight.

So, these we used to think
were sort of separate things.

But now they're intertwined.

And the kind of
dietary pattern

that Dr. Hu was talking about,
like a Mediterranean Diet,

that has lots of
fruits and vegetables,

low amounts of red meat,
whole grains,

that actually makes it easier
for us to control our weight

than eating a diet
of refined foods

that's directly unhealthy
but also makes it

more difficult to control
our weight.

What I found in my research
is that Harvard

has also received
a great deal of money

from one of the largest
vegetable oil manufacturers
in the world

called Unilever.

Willett is a scientific advisor

to numerous industry
backed consortiums

that promote
grain consumption.

Like Old Ways

and the International Carbohydrate Quality Consortium

all funded by Barilla Pasta
and Kellogg's

and all these carbohydrate
makers that have Willett

on as their top spokesperson
or top advisor,

organizing conferences
for them.

In 2013, I think,
when Naturemagazine,

when they had a rare
editorial kind of critique

of Walter Willett, they said

one of the things
that he did

was that he continually
simplified his data
and published data

that really ought
not to be published.

How could we find out
who to trust
besides your book.

There's overload
of information.

Anybody can set themselves up
as being an expert.

Uh, and the public is
understandably confused.

It's interesting that

there's such a crusade against red meat versus other meats.

And this really comes down
to the fact that

red meat has saturated fat

and that we've been told
that saturated fat is bad.

Is there a scenario
where we shouldn't
eat saturated fat?

There's no reason
to fear saturated fat.

It's just fine to eat.

It's not an issue for health

if you look at
the medical studies

that have tested
this hypothesis.

If you take them all together
and look at all of the data,

there's no effects
on health really.

People have been
warned for years

about the dangers of eating
too many saturated fats

and the risks they pose
for heart disease.

But a new analysis
of more than 70 studies

finds that saturated fats

do not necessarily lead
to greater problems

with heart health.

My strength
and my background
is in clinical medicine,

using a keto diet to help

fix obesity, diabetes, and
many other health problems.

I've learned a lot

by reading the books
Good Calories, Bad Calories
by Gary Taubes

and The Big Fat Surprise
by Nina Teicholz.

And one of the things
I've learned

is that the emphasis
against saturated fat

is also a political emphasis.

So, that because
America doesn't make

lots of saturated fat
kinds of products

and because the
nutritional epidemiologists

are funded by other companies

that make products that
don't have saturated fats,

there's a bias against them
which is not scientific.

If saturated fat
raises your cholesterol,

and if cholesterol
can in some situations

be related to
increased heart risk,

then anything
that is a saturated fat

must be related
to increased heart risk.

It's this line
of illogical thinking

that has led institutions

like the
American Heart Association

to demonize anything
that's a saturated fat.

Yeah, nothing against
medical doctors.

It's just that when,

you know,
when you're in a club

and they keep telling you
the same thing in the club,

and this is
the only way it is,

and you never see
any other viewpoint,

you just start believing.

Religion works like that.

You know, um,

you will be in one religion
at the expense of
every other religion.

And even though they all say
pretty much the same thing,

some people will look
at their religion and go,

"Your religion's not good
because mine's the best."

I tell people
who are in my clinic,

who are working
with other doctors

and cardiologists
in particular,

to just tell them

they're doing a Modified
Mediterranean Diet.

And the other doctor will go,
"Oh, well, that's fine."

And they won't ask any more

because they're
not really sure

what the Modified
Mediterranean Diet is.

But they know it's good.

So, I know it kind of plays
the politics a little bit,

but we're in that space
where, um,

doctors sometimes
knee jerk against things

that they don't know
and using familiar terms

can actually make it
easier for my patients

to not get pushback
from other doctors.

I guess the other
question though,

is it something magical
that's going to help everybody

shed pounds
and feel wonderful.

And the truth may
not be that far either.

But it's important
that we can't go out

and demonize one type of food

simply because
we think there's a theory

that it might be
related to something.

I mean, people listen strongly

to the recommendations
of these guidelines.

The vast majority
of the calories

are really coming
from bad stuff.

And so, if you're
looking at red meat

and don't specify
the comparison,

you may not see
much with red meat

because you're comparing it

with a lot of other
bad stuff in a diet,

a lot of refined
starch, sugar,

uh, partially
hydrogenated oils.

Epidemiology, you always
find at the bottom of
one of the Harvard papers,

"Oh, you know,
our caveat is that
it's only in association.

"It does not prove causation.
More studies are needed."

But if you look at the press
release that accompanies it,

uh, the headline
is almost always like,

you know, "Oh, coconut oil
causes heart disease."

Well, there's nothing wrong with coconut oil.

It's perfectly safe

and actually very healthy

to use in your diet
and in cooking.

Good for your skin,
not good in your body.

But we always hear about

these controversies
coming out

and it only has to do
with the fact that

other industries who are
making hydrogenated oils

don't want this
pure natural oil

to be anywhere
near their product.

The big problem
with coconut oil

is it's high
in saturated fats.

And as the American
Heart Association tells us,

saturated fat can increase
your bad cholesterol,

and that can lead
to heart disease.

Coconut and palm oil
have definitely been

polarizing oils
over the past few years,

and it's so interesting
to see why.

You know, they're...

First, they're
vegetarian based oils.

So, based on that,

you would think that
they should be healthy

if the myth of vegetarian
being the best diet is true.

But because they have
saturated fats,

the American Heart Association
came out against them

cautioning their ingestion

because they have
saturated fat.

So, it's that transitive
property of math

that doesn't always work.

I was invited once to speak

at a palm oil conference

by the manufacturers
of palm oil.

And they explained to me that

they were having difficulty
getting through

a sort of taboo or cartel
against palm oil

because of the saturated fat
in the food.

And because we know
saturated fat is bad
and all that.

And I think it was
in Nina Teicholz's book

where I first learned that.

The whole campaign against
so-called tropical oils,

which is coconut oil
and palm oil.

In my research, I discovered

that this was

something of just a trade war
between industries.

And it's been going on,

uh, actually since
the 1920s and '30s.

Palm oil, I think
it was at the time,

started being imported
in increasing amounts
from Malaysia.

And the vegetable
oil industry said,

"We can't have this happen.
They're talking over
our market share."

And underwent
this huge campaign

basically to just
slander these oils.

And actually I think that
what they did is they put
a tax on it at that point.

They got the government
to tax these oils

because they didn't
want the competition.

Fast forward to 1980s.

There's a rise
in the use, again,

of coconut oil and palm oil
because they are solid,

safe fats, so they're good
for popping popcorn
in movie theaters.

They were used by all
the packaged food companies
like Kraft.

Nabisco used them
for their cereals

and anything that
needed to stay safe

and solid on a shelf
in a supermarket.

So, there started to be
this increase in
the importation again

of coconut oil and palm oil.

Well, that really threatened

the makers of soy bean oil

and the soy bean industry

because soy bean
is far and away

the biggest oil that
Americans consume.

So, they started a campaign

against coconut oil
and palm oil.

They call them
the tropical oils.

And this was a campaign,
really a trade war campaign

sort of in the shroud
of a health concern issue.

So, if they're going to say
something like that,

they should have
very strong evidence
behind it to back it up.

And there is no evidence

to demonize these oils
the way they have.

They can be a very good part
of a healthy diet

and there's no reason at all

to be worried about them
as has been proposed.

There's a lot of bad science
that I think implicates

saturated fat
and leads to this idea

that we should replace it
with vegetable oils.

"Oh, those must be
good for us because
they're vegetables."

In fact, they're
not from vegetables,

they're from seeds and beans.

So, sunflower, safflower,
corn, soy bean,

they're all beans and seeds.

And you have to use high heat

and a heavy metal chelate

in order to get the oils
out of them.

Winterized, deodorized
and stabilized.

I mean, they initially
come out of this gray,
disgusting liquid.

And then they have to be
turned into something

that might seem like
it could be consumed
for humans.

And they've also gone
through name changes.

Now they're trying
to call them plant oils
I think,

to seem even more appealing.

If you compare saturated fat
with healthy plant oils,

uh, using those
healthy plant oils

will definitely reduce
the risk of heart disease

while they're improving
blood lipids at the same time.

You know, healthy people
tend to eat vegetable oils.

It's the jest of the problem
when you do these studies,

what you do is you
tell people how to eat.

So, in the 1970s,
you tell them they should
avoid saturated fat

and eat vegetable oils
and then you follow them
for 30 years

and lo and behold
you find out 30 years later

that healthier people
have indeed been doing exactly

what you told them to do
because they're
health conscious.

By the end of the 1980s,

between that campaign
and various other efforts
to get rid of tropical oils,

most of the tropical oils
had been taken out
of the food supply.

And so, they're
avoiding saturated fats

and using vegetable oils
to cook with instead,

and they're healthier.

But that doesn't mean
they got healthier

because they used
the vegetable oils.

You know, I do wonder
if the recent outcry
against tropical oils

that you've seen by
the American Heart Association
and by Harvard,

I really wonder to what extent
we're seeing just a redux
of this same trade war.

I know that Harvard is funded

by vegetable oil companies

that compete

with tropical oils.

So, one really has to wonder

if they're now sort of
trotting out scientists

to protect the domestic
American soy bean
and soy bean oil industries.

So, there are two changes
that I think are necessary.

First, we need to get away
from this idea that

saturated fat is bad for us.

It's really not
a major factor.

We need to accept that
saturated fat can be part
of a healthy diet.

Second thing,

we need to get away
from is this idea
that it's all about calories,

that just by counting calories,
eating less,

and running more you would
magically sort of lose weight.

It's really not effective for
the vast majority of people

and we need to focus more on

the hormonal regulation
of weight,

live in a way that
makes our body

normalize the hormones

including the fat storing
hormone insulin,

so that it becomes much easier
to maintain a good weight.

The fact of the matter is
exercise is very important.

I always call it
the fountain of youth.

The problem is that it's
not good for weight loss.

We've been teaching people
you have to exercise,

you have to exercise.

And I've had people
who can't exercise

because of a bum knee
or just they don't like it

and they don't even
try to lose weight

or fix their diabetes

because they've been told
they have to exercise.

In fact, this is perpetuated
by a lot of doctors as well.

And because
it's worked for them,

they think it'll work
for other people.

Now, I'm a big proponent
of exercise

and I think exercise
is crucial for a healthy
overall lifestyle.

But it's not the go-to way
to lose weight.

It was in the best interest
of these snack companies

and the companies making
the high carbohydrate,
low fat foods.

It was in their
best interest to say

as long as you're exercising
and as long as you're
burning calories

then you can eat whatever
you want and however
much you want.

That's what padded
their bottom line.

And that's what
sold more products.

And that's what helped
perpetuate this myth

that exercise was
the best thing you could do
for your health

and you could exercise away

any amount
of poor dietary indiscretion.

In theory, the idea makes a lot of sense.

You burn calories
through exercise,

which must lead to fat loss.

The laws of thermodynamics
is a good idea.

It just doesn't work here.

You cannot outrun a bad diet.

So, modern
nutrition science begins
in the late 1860s

with the invention
by German researchers

of devices called calorimeters

that allow you to measure
the energy expended

by a large animal
like a dog or a human.

So, you live
inside these rooms

and you can get a measurement
of how much energy's expended.

And so, by the 1860s,

the nutrition community,
for the first time ever,

can measure the energy that
people consume in foods

and burn the foods in what's
called a bomb calorimeter.

And you measure
the heat released

and that tells you how much
energy was in the foods.

And now you can measure
the energy out.

And for the next
50 to 60 years,

all of nutrition science...

All of nutrition science

was basically measuring
energy in and energy out

and vitamin and mineral
deficiency diseases

and protein requirements

and a little bit
about things like fiber.

And so, by the early 1900s,

when researchers,

clinical investigators,
physicians
interested in these problems

are trying to come up
with a hypothesis of obesity.

And related to
the food we consume,

all they have are
energy in, energy out,

vitamins, minerals,
protein, fiber.

And they can't figure out
a way that vitamins
and minerals

and protein and fiber
can play a meaningful
role in obesity.

So they end up with
energy in and energy out.
That's it.

That's because that's what
they can measure.

And that becomes
a theory ever since.

And it gets locked in.
And it stays locked in.
That's the weird thing.

And 1921-22,
the hormone insulin
is discovered

and the science
of endocrinology,

of hormones
and hormone related diseases
starts to explode.

But you still can't measure
the impact of food

on the hormone levels
in the blood until the 1960s.

So, it's only in the 1960s,
that you have another way

that you can study
that food influences

what our body is doing.

And by that time we've
had 50 years of thinking

of obesity as an
energy balance disorder.

We realize that

if you change
the hormonal status,

elevate insulin levels,
depress glucagon levels.

You know, growth hormone
is playing a role

and our foods
are influencing all of that.

Nobody cares.

It's just too complicated.

This energy balance idea
is too big to fail.

And then diet book doctors
get involved.

First Herman Taller
writes a book called
Calories Don't Count

and then the infamous
Robert Atkins.

And they read the research
and they say,

"Wait a minute.
Wait a minute.

"It's not about
how much you eat.

"It's a hormonal thing.

"It's the carbs are the problem.Get rid of the carbs."

And now the research community
doesn't like this idea

'cause it's coming
from these cowboy
diet book doctors.

And they don't want to
listen to them.

Some very petty
human emotions

feed into this idea that
we should continue

to tell people to do
the wrong thing.

And they should
do the wrong thing,

and if it fails
we can blame them.

Never think that
our advice is wrong

'cause we've got
the laws of thermal dynamics
propping them up.

We always
get into this argument over

what's the best fuel
to put in your body.

One thing everyone agrees on
is that sugar is bad for you.

And when I say everyone,
I mean almost everyone.

Some doctors, including one
who proposes a vegan diet,

says sugar is not
the major cause of diabetes.

You really have to
see this to believe it.

Carbohydrate, including
pure white sugar,

increases the sensitivity
to insulin.

It was published by Brunzell

from the
University of Washington

in The New England Journal
of Medicinein,
I think, '78.

Brunzell is his name.

He took Type 2 diabetics,

he made a synthetic diet...

45% sugar
and then double, white sugar,

multi-dextrose,
plain table sugar,

doubled it to 85% white sugar.

Every aspect of
the diabetes improved.

Walter Kempner
back in the '40s and '50s

published his results
on treating Type 2 diabetics

with rice,

table sugar, fruit and juice.

And Kempner knew
back in the '50s

that sugar makes insulin work
better and cures diabetics.

But you see, we've got it
entirely backwards these days

thinking sugar
causes diabetes.

It's just,
it's so backward and bizarre.

Nobody stands a chance.

I didn't think
we would have to clarify

what sugar does to your body.

But here are
just a few reasons

why it's bad for you.

Some people easily understand

that sugar is bad.

And they can avoid foods

that have sugar
or the sugar free things.

And the problem is,

it doesn't explain
all of the carbohydrate effect
on the blood sugar.

So starches,

including the breads, pasta,
rice, fruit, those things,

raise the blood sugar
just like real sugar

or actual sugar
and even honey,

natural sugar,
raises the blood sugar.

One of my favorite things
when you walk in to
Eric Westman's office,

and I've never walked in,
but people who have,

apparently there's a sign
on the wall that says that

fruit is nature's candy.

The reason that
sign is up there

is that most people
don't realize

that having fruit
can raise the blood sugar,

can make diabetes worse,

can lead to obesity.

It raises your blood sugar,

increases
the fat storing hormone insulin

and puts the body
into fat storing mode,

fat in the liver.

If you eat a lot of sugar,

you would end up
with a fatty liver

and that increases,
um, fasting insulin levels.

You get insulin resistance

and high insulin levels
all through the day.

Sugar is addictive.

And it may not be
addictive for everyone,

just like alcohol isn't
addictive for everyone.

But it's addictive for
a large number of people.

I mean, I've been spending

the past at least 17 years
as a psychiatrist

talking to people,

thousands and thousands of
people hearing their stories.

And when I talk
to people about food,

there are many clues
to addiction in their stories.

My name is Georgia Ede.
I'm a psychiatrist.

Georgia Ede, the only words
I could come up with
for her is pioneer.

She's a psychiatrist.
She's a medical doctor.

And as a psychiatrist,

the first thing that happens
if you go to one of these
people with a problem

is they're looking to
put you on a medication.

Georgia, not the same thing.

Georgia is there,

uh, trying to figure out
if she can heal you,

number one,
without medication,

number two, which is
as important as number one,

let's try to do it with food.

Being preoccupied with food,

feeling guilty after eating
food that they think is,

"bad for them,"

and spending a lot of time

thinking about food

that would be better spent
doing other things.

And I think that it's
one of the things

that people really
want a lot of help with.

When I'm talking to
people about food,

I hear the same patterns
as if I'm talking to somebody

with any other
substance abuse disorder.

For the average person,

that reward is enough
to keep you going,
keep you going.

And I can tell you personally,
when I get off carbohydrates,

I've known this for years,
you have a withdrawal.

I get all the same symptoms,

milder, mind you again.
So, I don't like

too powerful a connection
with addiction per se.

It minimizes the misery
of my patients.

But when I come
off carbohydrates,

get irritable, discontent,
I have pain,

I have sleeplessness,
I have anxiety.

Opiate withdrawal,

I have full on
opiate withdrawal
for three days every time.

That's what we're
trying to protect
against on a keto diet,

to try to stop that
raise of blood sugar

to prevent diabetes
or treat it

and to prevent
the insulin rise,

which is the hormonal state
of creating obesity.

We'll go
into depth about the
ketogenic diet momentarily.

But we first
have to understand

that most of our problems
stems from what industry
is doing.

And as I said inFat,
part one,

industry is a machine.

It's not a person.

It's a thing that's
designed to make money.

And that's it.
It's not good or bad,
it just is.

It's tough if you're
the sugar industry.

But the beverage industry
was always happy

to sell artificially
sweetened beverages

because artificial sweeteners
were cheaper than sugar
if nothing else.

They didn't care what
people drank as long as
they drank their products.

Grain industry, they could
create grain that's got
a lower glycemic index.

You have a lesson of

the 1980s when we told people
to create low fat foods,

they were happy to do it.

And they changed
the way we eat.

The problem is they
changed the way
we eat for the worse.

I think the tide is starting
to shift somewhat.

People now realize that

added sugars are not good.

I mean, there was a point,
it sounds ridiculous to say,

but there was a point where
people didn't quite realize

added sugars
were unhealthy for you.

Eating sugar
is not essential whatsoever.

And in fact, our body
will make sugar at a certain
point from eating protein.

The institute of medicine

itself acknowledges that

there is no essential need

for any carbohydrate.

The body needs a certain
amount of glucose

for the functioning of
its brain and its eyes.

But your body is
able to make that

glucose through a process
called gluconeogenesis

from the protein
that you consume.

Gluconeogenesis
is the process

by which your body will take
excess protein and convert it
into glucose.

Many people wonder

if there's a need for
carbohydrate in
the diet at all.

In other words, is there
an essential carbohydrate,

meaning the body
can't make it,

so you have to eat it.

That is in debate.
It's not clear.

One of the most
unbiased sources
of nutritional information,

the Institute of Medicine,
actually says pretty clearly,

"There is no
essential carbohydrate.

"You don't have
to eat carbohydrate."

Based on that, I wrote
a letter to the editor
some years ago

just questioning whether
carbohydrate was essential.

It's interesting that,
that letter has been cited
many, many times.

It was just a letter
to the editor.

Um, the science,

in regard to how you create
an essential nutrient

and what you
call a macronutrient.

So, when you're
on a keto diet,

your macronutrients
are proteins and fats.

The idea that
sugar had any benefit

actually stems from fallacies
propagated in the 1970s.

Ads in magazines
saying things like,

"Sugar can be the will power
you need to under eat."

There's a famous headline
for an FDA study that
hilariously reads,

"Government gives sugar
a clean bill of health."

That clean bill of health
was that the amount of sugar

that the FDA was estimating
we were consuming at the time,

which they said was 40 pounds
per capita, per year,

which was probably, uh,

40 to 60 pounds less
than we were consuming.

And then they said
we don't know what would happen

if we were to actually
consume more than
40 pounds per capita.

Virtually, the year that
they made that claim,

sugar consumption
then starts to skyrocket.

The reliable data you have
is on what's called

food availability.

How much sugar is
being made available

to the American public

by the industry and by imports.

And that number around
1800 was four pounds.

By 1984,
when the FDA said it was 40,

the food availability numbers
were already about
120 pounds per capita.

And they estimated
that we were consuming
about a third of that.

They're taking
what they know,

which is how much
is made available.

It's a reliable number
you could use to
compute trends from.

And then they're creating
this estimate of how much
we actually consume.

And then say, "Well,
40 pounds doesn't
sound like a lot."

But it's kind of
a meaningless number

because you have nothing
to compare it to.

It's certainly
ten to 20 times larger

than what we were consuming
150 years earlier.

They started doing this
in the 1940s

during World War II 'cause
we had to know how much food

was available
and what we could expect

to deal with food rationing
during the war.

And they kept it up
religiously since the 1940s.

And they backdated it to 1907

to get a feel for
what had happened

in the previous war
and World War I
to get this history.

And so if you accept
the backdated data from 1907,

it looks as though
we used to be eating
a lot less meat then.

And then we added
meat to our diets.

We added animal products,

and it went along
with this epidemic
of heart disease

that appeared to emerge
after the 1920s.

And the arguments
I make in my book
is both the USDA data

is faulty, and perhaps

what you have is
a correlation again
between two things.

Change in diet over time

and change in health status.

And it doesn't tell you that
there's any causality
between the two.

It just tells you
they're correlated.

Now you can
generate a hypothesis

and say we think
meat consumption

causes heart disease.

And then you can
do an experiment,

which is called a randomized
controlled trial

to test that hypothesis.

And that experiment
has never been done.

As we discussed
in the last film, money
has a lot to do with this.

When you don't spend
the money on the studies,

it's easy to say,
"There's no study
that says keto works."

These studies are
extremely expensive,

and there have been
enough good studies done

to support our
moderate approach,

which is looking
at balanced foods,

vegetables, fruits, grains
and lean meat
and dairy products.

How do you
know it doesn't work

if there's never been
any large scale studies?

Back before I wrote my book
Fitness Confidential,

I only had my clients
in LA who I worked with.

After the book came out,
and then the podcast
got popular,

now it wasn't just
20 or 30 students.

It was first hundreds,

and then thousands and then
tens of thousands.

So once you have

that many people
doing N=1,

and it's working, well,
it's not an N1
experiment anymore.

It's actually been
known for a long time
that the root cause

is eating too much,
and specifically,
carbohydrates.

So, um, 150 years ago,

the first treatment for obesity

was actually a low carb
ketogenic diet.

It was written about
in England,

and I find myself, um,

in a curious situation
where I'm just
reminding people

of something that
we've known
for 150 years.

That one, you know,
solution for the obesity
and diabetes epidemic

is a low carb,
ketogenic diet.

If you go back
to the 1970s,

Dr. Atkins
was considered a kook!

I remember the big
joke back then was,

"Do Atkins.
You'll lose weight,

"and then you'll be
a really good looking corpse

"because you're gonna
die from this diet."

Telling people that,
you know, beef is good

and so on is, you know,

or that butter is good or,

you know, telling people
what they want to hear

is a good way to sell books.
It's a good way to,

you know, magazines
are hurting for business
now on the Internet.

Everyone's looking for
something controversial

that they can tell people
what they want to hear,
and I understand that.

But it does people
a tremendous disservice.

The low carbohydrate
keto community is
based on science,

and I understand that
there are lots of ways
to be healthy.

You don't have to do
a low carbohydrate
ketogenic diet

if you don't have
carbohydrate tolerance.

Or if you don't have
insulin resistance,

you can eat lots
of different things.

And it's this insulin
resistance that can
drive so many

downstream markers
of inflammation

and glycation and other

detrimental processes
in our body

that can then lead
to heart disease.

So whether obesity
itself causes heart disease

or whether it's this
constellation of
health problems

that occur in people
who are obese,
that seems more likely.

People will say
to me emphatically,
"Well, keto is bad,"

and I'll ask them why,
and there's no answer.

They'll just go, "It's bad.
My doctor said it was bad."

And it throws your body
into a state of emergency.
That's what ketosis is.

As we said
in the first movie,

ketosis and ketoacidosis
are two completely
different things.

Nutritional ketosis is
quite a different scenario.

Blood sugar's
absolutely under control.

The patient is healthy
in every single way.

Electrolytes, insulin, glucose.Perfectly, perfectly controlled.

We have now trained the body

to switch over from
burning carbohydrate

as the primary fuel.

Now the individual
becomes fat adapted,

and that's really
the difference between

a very unhealthy and
a very healthy state.

If we're going
to even pretend
we're on the same page,

we need to know
that basic fact.

A lot of the times
when even medical
professionals especially,

TV nutritionists describe
in essence what ketosis is,

they always point out
completely harmless

and sometimes
unproven things
to get you to not do it.

There are some
really interesting

side effects that
come with it.

Your autophagy process
is totally out of whack.

Disaster pants.

Zero calorie restriction
on a ketogenic diet.

Keto crotch.

If you have a sandwich
or something right now,

you might just want to go
ahead and put that down.

Animal fats
and animal proteins.

Unless you have epilepsy,
I'm not seeing a whole lot
of upside to this.

They're just...
They're desperate.
They're just desperate.

Bacterial vaginosis.

Rich in saturated fats.

Um, so, actually have not
done keto myself,
as you might guess, but...

The keto diet is

the sort of latest thing

which is already promoting
pushback from the community.

Like they're trying to tell
people don't even try it

because it's gonna give you
bad breath or constipation.

And therefore, you know,
if you weigh 300 pounds,

you should just continue
weighing 300 pounds.

Because if you lost 100, but

your breath smelled
like ketones,
that would be a tragedy.

Get all the benefit over here.
None of the negatives
over here,

and all the benefits
over there.

For a ketogenic diet is
a particularly, um,

I want to use the word
magical diet for many

neurological conditions.

Many brain and, uh,
body nervous
system conditions.

When you eat
a ketogenic diet,

you're using fat
primarily for energy,

and the brain is using,
uh, to a large extent,

ketones instead of glucose.

It can't use 100% ketones,

but about two-thirds
of its energy
can come from ketones

if you're eating a fat based
diet as opposed to
a carbohydrate based diet.

So we're not entirely
sure why this diet is so
healthy for the brain

and has been able to,

you know, help people
with early Alzheimer's disease

and Parkinson's disease
and seizure disorders,

but it stands to reason that

if these diets, which have
been used to treat epilepsy
now for almost 100 years,

perhaps longer,

if these diets can
be helpful in calming
brain chemistry in that way,

uh, perhaps they could be
helpful for other brain
disorders as well,

including
psychiatric disorders,

which have a lot in common
with neurological disorders...

Psychiatric disorders are
neurological disorders.

It's simply that
they manifest, um,

as changes in behavior
and emotion

as opposed to changes
in the sensory motor system

with the muscular system,
for example.

So the ketogenic diet,

with the way we think
it works is that

ketones burn cleanly
and more efficiently

than glucose does in the brain,

so you create
less oxidation,
less inflammation.

So I tell my patients
to think of refined
carbohydrates,

in particular, sugar, flour,
fruit juice, cereals

as mood destabilizers.

I think that there's a lot
of potential benefit here.

The science
is very, very new

when it comes
to psychiatric disorders
and ketogenic diets.

But it's emerging,
and it's all pointing
in the same direction.

It's very, very promising.

If we get this message out,
I think that there are
many doctors out there

who really want
to understand this

and would be open minded

and would be curious
to incorporate some
of these principles

into their practice
because we have

so many patients who
do not respond to medication

or who get side effects
from medication

or who don't want to take
medication or can't
afford medication.

And so isn't it wonderful

if we have something else
to offer those people?

When I got
into this field
in the early 2000s,

the sort of medical orthodoxy,

the dominant hypothesis

in the nutrition establishment

was that fat, saturated
fat, uh, cholesterol,
are terrible for health.

And if you believe otherwise
or if you wrote otherwise,

you would really
suffer as a scientist.

If you said
anything against that
orthodoxy in the field.

So here I come along, saying,
"Oh, you know, but this paper,

"the conclusions
don't reflect the data.

"Can you explain
that to me?"

Or, "This doesn't
seem to add up."

And people were terrified
to go on the record

saying anything against
this dominant hypothesis.

Because the cost to them...
There are real costs

to a scientist in challenging
that orthodoxy.

People who couldn't get
their papers published,

uh, because they had
said something that was
challenging to this orthodoxy.

They were disinvited
from expert conferences,

they could not get research
grants or their research
grants were canceled.

Scientists learn
to self-censor because

what they want to do
is they want to do science.

That's their job.
And if they
can't get money,

and if they can't
publish their papers

because they're talking out
in ways that their seniors
disapprove of,

then they can't
do their science.

So they really did not
want to talk about this issue

that was so deeply
risky to them.

But I've been told that
in order to get NIH funding,

they actually look
at how many times

your name appears
in the news media.

So there's this incentive
to make your studies

into this kind of click bait,
which is completely
irresponsible.

You know,
consumers don't know.
They're completely confused.

One of the clever kind
of rhetorical things that
Harvard and others, uh,

somebody like David Katz
at Yale do is they always
say like,

"You poor consumers,
you're so confused.

"And all these
Internet crazies out there,

"and book authors are
making you confused."

We are here,
assembled in Stockholm,

and all seem to agree

that we need a more
plant based diet

and they're talking
about how to achieve it.

And yet the public is
fascinated by the currently
prevailing meme

that we should all eat
more meat,
butter and cheese.

We have lost
the faith of the public.

We are like firefighters
who bicker among ourselves

about who has
the right caliber hose.

The mission is to get
there from here, and there
is a beautiful place,

the place we want
to bequeath to our children.

What is making people confused

is the publication of this
weak epidemiological data,

which almost 100%
of the time turns out
to be wrong.

I mean, what is the list
of things that epidemiology
has been wrong on?

Vitamin E supplements,
vitamin A supplements,

vitamin C supplements,

hormone replacement therapy
turned out to be killing women.

Uh, dietary cholesterol caps,

why we all ate egg white
omelets and avoided shellfish
for all that time.

That turned out to be
wrong and was retracted.

The low fat diet.

The government and
the American Heart Association

have backed off
the low fat diet.

Why were we eating
a low fat diet?

Because of epidemiology.

So the people confusing us

are the epidemiologists,
the experts themselves.

Most of the current
social media argument
is over extremes.

Go all vegan

or go all meat.

No one knows
who to trust,

and then both messages
get commercialized
and bastardized.

Now you're in fad diet land.

Now it's de facto quackery.

Because if it wasn't quackery,

why would you need this
cardiologist in New York,
this gynecologist in Brooklyn

writing about it instead
of it coming out of Harvard
or Cornell or Yale?

They've been fighting
this thing for 50 years,

and the longer you fight it,

again, now we're into
the cognitive dissonance,

the more you have to be right.

I have a lot of patients
who are confused,

or, at least tell me
about, uh, the vegan diet

and how, especially
among young women,

uh, my daughter included,
one of them,

um, it's very fashionable
to be a vegan,

and you feel like
you're doing the right
thing for animals,

but as a scientist,

I wanna promote
or recommend a diet

that's actually
healthy for humans,

not just for animals, right?

So I'm here to help
the person in front of me
in a clinic.

So I want the diet
to be as healthy
as possible,

and it's possible
with a vegan diet

to have, uh,
nutritional deficiencies.

Some of the nutrients
of concern in the vegan diet

include vitamin B12,
iron, calcium, vitamin D,

Omega-3 fatty acids,
including EPA and DHA,
and protein.

We found that
some of these nutrients,

which can have
implications in
neurologic disorders,

anemias, bone health
and other health concerns,

can be deficient
in vegan diets.

Low carb diets
for a vegetarian is possibly a successful approach.

We actually have
low carb vegetarians

who, um, perhaps can add

dairy or eggs or fish
and chicken to the diet.

And in this way, um,

they can lead a healthy life.

But I think it is fair to say
that, uh, we are omnivores

and animal based proteins

as well as plant based
proteins can be healthy for us.

You know, you can say
what the science says,

and then you can say what
people actually do
and actually stick with.

And you want a diet,
a nutritional program

that's gonna make
you feel good,
give you energy,

make it so you're not
hungry all the time,

so you don't have to think
about food all the time.

We get a lot of pushback
from the vegetarian community

where I think they,
I wish they would see
they were all arguing.

We all want people to be as
healthy as humanly possible,

and we want the ethical
decisions to be made on

the correct implications.

So if I'm going to risk
my health for the health of...

other species,
I want to know
that's what I'm doing.

I don't wanna
have the misconception
that I'm gonna be healthier

because that's what
I'm, you know...

Also that the ethical decision
is also the one
that's supported,

by, you know,
medical science.

All we do is talk and talk and talk about health

and at the same time,
we're just getting fatter
and more unhealthy.

If America is so worried
about its health,
how did we get so fat?

Because we have such
big problems with obesity,

Type 2 diabetes,
high blood pressure,

all kinds of diseases,
it's not surprising

that people
are more interested

in their health than ever
because they have to be.

You don't have to be
interested in your health

if everything's
all right, right?

It's only when you have
a problem that you need
to do something about it.

The myth is that, is that
the health care system

is the best place
to go to get healthy.

That's another
terrible myth

that so many people
are falling into that trap.

And, you know,
if you're acutely ill,

if you need a surgery,

if you have a bad infection,

the health care system
is fantastic.

But when it comes
to these chronic diseases
we're facing, unfortunately,

it is a myth that the health
care system is the best place
to address those.

There's a lot of information
today on the Internet.

It's a wonderful thing,
and it's a terrible thing.

There are people
who have their own
agendas to promote,

saying the darndest things,
and my patients watch those
and read them,

and I have to try
to correct them.

Based on the research,
we cannot say with
any certainty

that eating red or processed
meat causes cancer, diabetes
or heart disease.

The study recommends
adults continue

current red and processed
meat consumption.

It's a finding that's
prompted calls
for a retraction.

The most prominent critic,
Harvard School
of Public Health,

which labeled that conclusion "irresponsible and unethical."

It's crazy because
the more that we learn
that meat is healthy

and people are getting healthy, with these hundreds
of thousands

of N1 experiments,

the more the chasm grows
between the meat eaters
and the vegans.

I was watching one vegan
propaganda film about
a year ago,

and they were claiming
that eating one egg
is equivalent

to smoking five
cigarettes a day.

One egg.

I never really
thought about eggs much.

I just thought of them
as a standard part
of a healthy diet.

But then I found a study
suggesting that eating

just one egg a day
can be as bad as smoking

five cigarettes per day
for life expectancy.

In that case,
I'm smoking a pack
every morning.

It makes absolutely no sense.

The problem is, is people are
gonna watch these movies
and believe this.

Researchers found
a stepwise increase in risk

the more and more eggs
people ate.

Even just a single egg a week

appeared to increase the odds
of diabetes by 76%.

The reality is that a food
that has just fat,

or an egg, for example,

doesn't raise
the blood sugar at all.

It has a glycemic
index of zero,

and so if a site is
claiming that

the egg has a glycemic effect,
it's just not true.

Uh, eggs don't cause diabetes,

not unless you're eating
carbohydrates and you
put it all into

one mix together.

But, uh, the interesting
thing when you look at

the glycemic index
of different foods

is that the foods that
have no carbohydrates
are not on that list.

So oils, butter, eggs
have a glycemic
index of zero.

There is a fear,

unfounded fear
of the cholesterol
going up,

eating more fat,
more eggs.

And we now know that
it is an increase in
good cholesterol as well,

and a reduction
of the bad cholesterol
called triglyceride

or bad fats in the blood,
for example.

So the extreme case
of some people being
told not to do this

even though there're clear
benefits, based on a worry

about a long term
effect of cholesterol

is just sadly wrong,

and through the lens
of today's understanding
of the science.

So you look at who
gets heart disease.

You look at how many
eggs you're eating
and lo and behold,

people who eat eggs get more
heart disease
than people who don't.

They're probably not
as health conscious
as people who don't eat eggs,

'cause for 50 years
we've been told
don't eat eggs.

So very health conscious
people in the '90s...

I probably boiled
10,000 eggs in the '90s,

and I probably threw out
10,000 yolks.

Okay? Because the yolks
have fat and cholesterol

and we were taught
they were killing people.

So you do these studies,
and lo and behold,

you find out that people
who eat eggs have a higher
rate of heart disease.

That's a correlation.
And then you pretend

correlation is causation,
because that's why you did
this study to begin with.

And then you make this claim,
and then you have this
whole world,

then the people
who want to believe
that's true,

embrace the claim
and act like it's true

because they had a single
published study

that said it's true.

I don't think

these people really care
that much about whether

it makes us healthier.

Maybe they do.
I think they care
about the animals,

and that's a wonderful cause.

But that's not what
I'm trying to do
at the moment.

The group
says that activism
isn't violence,

and that they have
a love-based approach.

Not everyone's like you
that don't care about animals.

I do care about animals.

-You care about animals?
-Yeah, absolutely.

But you condemn them
to a slaughterhouse

when you eat them.

But if somebody
gives up meat

and goes vegetarian
or vegan and gets healthy

and they can control
their weight and they control

their blood sugar,

you know, then geez,
that's the greatest
thing in the world

and I'm happy for 'em.

But if they can do it
by eating a, you know,

a low carb, high fat diet,
which clearly people can,

then I think we should be
happy for them
and support it.

A high fat diet
is not unhealthy on its own

and should not be avoided,
even if you're
a green-only vegan.

Unless, in fact,
you don't like the food.

The myth still persists
that fat is going to kill you

or at the very least,
make you fat.

It's what I call
the tragic homonym.

The fat in bacon
is not the same
as the fat on your hips.

It's different, and another
idea that is just

deeply ingrained in us
is this idea that you know,

all green things are good,
all vegetables are good.

And vegetables
are good.

But again,
it's not "either or".

What does a doctor
say about adding fat?

Well, it sure seems logical
that the fat in the food

would become the
fat on your body,

you know, on your
bottom, for example.

But it turns out that it's
the insulin hormone inside

that creates the situation
for you to be able
to deposit the fat

and insulin is actually
generated by eating
carbohydrates.

So it's actually the dietary
carbohydrates, the sugars

and the starches
that are fattening.

But the confusion
comes into play because

if you're eating
carbohydrates and fats,

then you will get fat.

But it's not the fat
that caused it.

It was the carbohydrates
that led to the insulin

that caused the fat
to be fattening.

So another part
of the confusion is that
low fat diets work.

And, the problem is that
they cause excessive hunger

for most people,

and so they don't practically
work for many people.

And we've seen that
to be true because

the US has been advocating
low fat diets
for the last 30 years,

and it hasn't worked
practically for most Americans.

It's not that it can't work.
It's just that it hasn't been
a practical solution.

I've always thought
that our government

should operate according
to the principle,

like medical doctors,
when they swear an oath
to their profession,

that they should
at least do no harm.

You know, when they started
off the dietary guidelines,

they didn't even
have to know what to tell
Americans what to eat.

They just simply said,
have seven to 11 servings

of bread every day.

That was what
they told people.

Then they actually went
and told the food industry,

"You must go out and create
thousands of more low fat,

"and therefore high carb
food products for us."

The defenders of the nutrition
establishment say,

"Oh, we could not have
anticipated that people
would eat more sugars."

"It's not our fault that
they all went out and scarfed
down SnackWell cookies."

Well, the government told
the industry to make
those foods.

New SnackWell's
reduced fat candy!

Yes, like luscious
chocolate caramel,
not clusters.

And the American
Heart Association
was also putting its,

you know, heart healthy
check mark on, you know,

Frosted Flakes and Cocoa Puffs and all these foods

that were super
high in sugar.

But because they
didn't have a lot of fat,

they were considered healthy.

The only measure of health was
that it didn't have fat in it.

What a creamy
way to cut the fat.

Is the pendulum swinging?
That is a big question.

I think clearly it is,
in that there is a bottom-up
revolution going on.

The people who end up
in an obesity medicine

clinic like mine

happen to be the ones
who have the bad metabolism,

where a very small amount
of sugar or starch or grains
can be detrimental.

And so that's why
we're very strict

about teaching people
how to stay away
from those foods.

Teaching people
to have great foods,

things that they thought
they couldn't have,

like bacon
and pate and brie

and, you know,
depending where you live,
there's just

a wide array of foods
that don't have carbohydrates,

that are very
tasty and healthy.

It takes motivation
to do a diet.

And I've not really
been very motivated

to make a dietary change
the last few years.

I don't know why.

I don't know,
my head wasn't in that space,

but this is one
of the important
psychologies about dieting.

You have to decide
to make a change,

and I was doing
a podcast about
health and fitness,

so I thought,
"Walk it like you talk it,
so I better do it."

But I remember
it was a moment.
It's like any major change.

There's a moment
where you go,
"Okay, I'm gonna do this."

A lifestyle that
you can stick with,

that is going to help you
control your hormones,
your insulin hormones,

your fat storage hormones,

that's gonna be the best way
to lose weight in the long run.

Because we don't care

if you're gonna lose
weight in two weeks,

four weeks, six weeks.
That's not where health is.

Where health is, is permanently
reversing any metabolic damage,

making you healthy
on the inside,

and then weight loss
will follow.

You have to be ready to do it,
just like stopping smoking,

anything else.

If you're ready to do it,
you have to do it.

The great thing about
this diet is it's painless.

The diet itself is painless.

And once you make the change,
you feel so good,
it's self-sustaining.

You want to stay with it,
you want to optimize it,

and you certainly don't
want to lose what you've got.

There is a Credit Suisse
report that came out
a little while ago

saying the market
is going to shift on fats.

So you know, telling business,
"Get ready for this.
It's gonna change."

You know, we see butter sales
going through the roof.

We see meat consumption
actually increasing.

There are, there's signs
in the market

that consumer driven
demand is changing.

So there seems to be
somewhat of a groundswell.

You walk into grocery
stores and things.

There's now paleo,
the way things
used to be vegan.

You walk into bookstores
and there's books on low carb

and the computer is just
full of all of this stuff.

Look, I get it. We live
in a society where everyone
wants everything fast.

Just tell me what to do. You want no sugars, no grains.

Eat bacon, eat beef,
eat an avocado.

That's NSNG.

NSNG, you have gray areas.

-I know you want
the whole 30 right?
-Yep.

-It's like either you're in,
or you're out.
-Yeah.

-Eh.
-Yeah.

NSNG, you could mess up
at noon time,

and you're right back
in that evening, you know?

And you just go with it.

As long as you're
cutting out sugars
and grains,

you're on point.

I've done well over
1700 podcasts at this point,

and I use one line in
each and every podcast.

Your good intentions
have been stolen.

I'm just here to try to help
you get them back.