You’ll NEVER Reverse Insulin Resistance Until You FIX THIS... | Dr. Robert Lustig

Ultimately, it's not what's in the food, it's what's been done to the food that matters. Everything fructose does to the mitochondria is designed to inhibit its functioning. It's metabolic health that drives what we should be doing, because if something is not metabolically healthy, we shouldn't be doing it, because it means it's killing us. "Rob," I want to get started today talking about insulin and insulin resistance, and the latter being such an important topic because it's affecting so many people these days. Oftentimes, people don't know they're affected by it till way later on, years even. And

it's something that if people know about it, they can prevent or reverse. So, before we get into the chronic state, insulin resistance, let's set the stage here and talk about what insulin is, and then we'll move into that. Right. Absolutely. Insulin is where the action is. Insulin is the bad guy in the story. And when you understand insulin and insulin resistance, you understand all of these chronic metabolic diseases. But I will tell you that insulin resistance is actually downstream of something even more important that we will talk about called mitochondrial dysfunction. So, mitochondrial dysfunction is...

where all of these diseases conglomerate, all of the diseases that we are talking about in this thing called metabolic syndrome. So, type two diabetes, hypertension, dyslipidemia, cardiovascular disease, cancer, dementia, fatty liver disease, polycystic ovarian disease, the diseases that affect 75% of the population and cost 75% of today's healthcare dollars. Are all the diseases of mitochondria. And when your mitochondria don't work, you get insulin resistance. Now, let's go back to insulin. Insulin... is the diabetes hormone. That means that diabetics take shots of insulin. Indeed, they do. And they need to take shots of insulin in order

to lower their blood glucose. And having a high blood glucose is bad for you. But having a high blood glucose is a manifestation of the problem, not the problem itself, because if you didn't have the mitochondrial dysfunction, you wouldn't have the high blood glucose. So the high blood glucose is downstream of the actual problem, and insulin is a way to, shall we say, cover up the problem. So, yes, diabetics take shots of insulin. So insulin is known as the diabetes hormone, really what insulin is, is the energy storage hormone. Insulin takes glucose from the blood

and also fats from the blood in the form of triglyceride, and stuffs it in cells for a rainy day. So it will take glucose and put it into cells of the body, including fat, and it will take circulating triglyceride off "VLDL" and activate the enzyme on the surface of the fat cell called lipoprotein lipase, which will snarf lipid out of triglycerides and store it in fat. So basically, insulin does everything it can to increase your fat. Insulin makes fat, period, full stop. More insulin, more fat. So insulin is a bad guy in the story for

just that reason. Now, normally, normally, when you eat something and your blood glucose goes up, your beta cell, the insulin secreting cell of your pancreas, senses that the glucose went up. And it is trying to clear that glucose to put that glucose into storage for a rainy day, your rainy day hormone, if you will, to save up for when you need it most. Alright? And so glucose will make insulin go up. That is true. But that insulin should put that glucose into fat cells where it can't do any damage. If your mitochondria are dysfunctional, then

that's not working very well and you're not burning very well. And so when insulin then shoves... energy into organs, in particular fat, it's not doing a very good job of it and it's not clearing it. And so the levels of insulin have to go up in order to make the rest of the cells, especially the liver, do its job. That's insulin resistance... Now, the question is, why... are the mitochondria not doing their job? Why is the cell not responding to insulin? That's the issue. Different tissues, different reasons. But the main one is the liver... And

what we've learned is that the primary driver of insulin resistance is liver fat. Fat in the liver. Now, once upon a time, 50 years ago, if you have fat in your liver, you were an alcoholic, period. That was the only thing that caused fat in the liver. Today, 45% of the US population has fatty liver disease. Now, notice I didn't say 45% of the obese us population. I said 45% of the whole us population and 25% of the children. And notice I didn't say obese children, I said all children have fatty liver disease. Back in

1975, no one had it other than alcohol. This is the biggest pandemic of all, okay? This leaves "COVID" in the "friggin" dust in terms of incidence and prevalence. It just doesn't kill you in five days like "COVID" did. Instead, it kills you in more like 15 to 20 years... But this is truly the biggest pandemic. Now, why does the liver store more fat? Why is the liver not burning that energy? And therefore, why does the insulin have to go up? And that's what this is really all about why are the mitochondria not working? Because if

they were working, then, number one, you wouldn't be storing the liver fat. Number two, your liver would remain insulin sensitive. And number three, your pancreas wouldn't have to make enough insulin, that much insulin to make the liver do its job, in which case, then you wouldn't be shunting sugar to fat. It's just that simple. So what caused the mitochondrial dysfunction? The answer to that is multiple things. But the one that is sort of front and center, the one that is sort of everywhere, the one that you can't seem to escape... is sugar. Dietary sugar. The

fructose molecule, the sweet molecule in sugar, the molecule we seek, the molecule that makes it taste good, the molecule that is, in fact, addictive. I just went and had a look at the latest "YouTube" stats, and just under 90% of the people that are watching this channel are subscribed. We're making headway, but we still have a long way to go. If you haven't subscribed yet, please do so below. Just takes a second. Helps the community continue to grow and helps the show continue to bring on the biggest guests. Thank you ahead of time. Continue to

enjoy this episode with "Rob." Well, there's a lot of moving pieces with this story. I want to make sure we stop and kind of recap where we're at before we continue here. So we have... the insulin resistance piece, we have the fatty liver, we have the mitochondrial dysfunction, and we're trying to get to the root of all this, which is the mitochondria, and the problem there, which has led us to sugar and fructose. So I'll have you take the story and continue it there. Just wanted that little recap. You bet. There are a lot of

things that can damage the mitochondria. Poor diet in general will damage the mitochondria because mitochondria are made of fats, but they're made of specific fats. And if you don't get enough of those specific fats in your diet, essential fatty acids in your diet, you can't make good mitochondria, and they go bad easily, in which case you have mitochondrial dysfunction because you didn't eat the right fats. Not all fat is the same. There are seven classes of fats, and the ones that you care most about here are the polyunsaturated fatty acids and in particular, the omega-3s.

They make the mitochondria work better, but they're in very short supply in our diet. So... even before sugar, you have to actually make good mitochondria. - Another thing that causes mitochondrial dysfunction is radiation. Radiation will cause mitochondrial dysfunction. And this is actually a problem up in outer space. Because we have now learned from metabolomic studies on blood and urine of people who've been working on the space shuttle. That they have inherent mitochondrial dysfunction just from the ambient radiation because they're not protected by the earth's atmosphere. So can you imagine what's going to happen on a

Mars mission? They'll be lucky if they can crawl out of the capsule when they get back home because their mitochondria is going to be so dysfunctional. So how do you protect people up in outer space? This is actually a big issue for the National Space Agency. And I've actually consulted with them on this. - Other things that cause dysfunction of the mitochondria. Various obesogens, various toxins in the environment that inhibit mitochondrial function, cause weight gain that have nothing to do with calories... So flame retardants, parabens, chlorpyrifos, glyphosate, insecticides, all of these ultimately damage the mitochondria

to one extent or another. And we're exposed to all of these as well. So it's a lot of things. It's not one thing. Oh, air pollution. Forgot about air pollution. Particulate matter causes generalized inflammation, causes insulin resistance, too. There's a whole bunch of things that lead to this. -- - Some of them we can do something about, and some of them we can't. But the one that I think is the biggest problem, the one that I think is the most egregious problem. And the reason I think it is because kids are getting these diseases of

mitochondrial dysfunction when they never did before... The one I think is the biggest one is sugar. And that's the one that would be eminently fixable if we chose to, because that is purely the food industry's causation. They could fix this if they wanted to, but they don't want to. Well, let's take some time with each of these, because you've named about four or five different ones there total. And I've heard you talk a lot about sugar. We got into sugar a lot on our last chat. And I do want to dedicate a good part of

this conversation to that as well. But let's start with the fatty acid piece. Let's make sure we get all the different pieces here and give people their best chance at mitochondrial health. So we know the polyunsaturated fats are the piece of this that we want to address omega-3s. Is it enough to get them through dietary means? Are you a big fan of supplementing them? Let's talk about how somebody goes about getting enough and getting good quality ones. Right, now understand there are seven classes of fats in our diet seven. And some of them will save

your life and some of them will kill you. There's a big spectrum all the way from one end to the other. Let's take them in order so that people can understand what they are and how they work and where do you find them. So the most important and the most valuable fatty acid is omega-3 fatty acids. Omega-3s are heart healthy. They are anti-inflammatory. They are anti-Alzheimer's because they contribute to neuronal structure and function. And it has been shown that when you are omega three deficient, you get multiple diseases, including cardiovascular disease and depression. And omega-3s

are very sparse in our diet. We don't get enough. The question is, where do you get omega-3s from? Well, there are two places you can get omega-3s from. Okay? You can get them from vegetables. So vegans can get... one kind of omega-3? There are three. They can get one kind and you can get one called alpha linolenic acid, or "ALA." And "ALA" is good. I'm not saying it's bad, it's a good thing. It is anti-inflammatory and so it actually affords cardiovascular protection, and that is good. However, the other two omega-3s, one is called "EPA" or

eicosapentaenoic acid, which is necessary for neural transmission. And the third one is called "DHA," docosahexaenoic acid, was necessary for neuronal structure, membrane stability. Those only come from marine life. They only come from fish. Now, do the fish make omega-3s? No, the fish eat the omega-3s... So what makes the omega-3s? Algae. Algae make the omega-3s, the fish eat the algae, we eat the fish. We are getting our omega-3s thirdhand. Now, vegans don't eat fish. So the question is, how are vegans going to get the "EPA" and the "DHA?" And they need the "EPA" and the "DHA"

because the conversion of "ALA," which they do get to "EPA" and "DHA," which they don't get, is extremely poor. "ALA" almost doesn't get converted to "EPA" and "DHA" and you need "EPA" and "DHA." So I worry about vegans... So they need to supplement. Vegans need to supplement. And the question is, will they supplement? Because fish oil still comes from fish... And so that's a problem. And not only that, but... you have to take fish oil capsules from fish that ate algae. Well, that means wild fish, because farm fish don't eat algae. Farm fish eat corn.

And corn is filled with omega-6s, and we're going to get to that at the end. Remember we said there are seven classes. That's number six. That's like, on the worst side. All right, so omega-3s are super important. They contribute to mitochondria, they contribute to neuronal membrane stability, they contribute to suppression of inflammation, cardiovascular stability. There are a whole host of things that omega-3s do for you that are positive, that are in your best interest in terms of health. And we don't get enough. Number two. - Monounsaturated fatty acids. Oleic acid, found in olive oil. Now,

this is a very good fatty acid... And the reason it's very good fatty acid is because it is the endogenous ligand. Oleic acid is the endogenous ligand for a receptor in your liver called PPAR-alpha peroxisome proliferator-activated receptor-alpha. And this is the fuel gauge on the liver cell, basically telling the liver to work more efficiently and work better... And so it has a lot to do with energy dynamics. And so when you are low in PPAR-alpha, you don't burn energy as well. It has an effect on mitochondria. So olive oil is a good fatty acid. The

only problem with olive oil is that the bond, the double bond that caused it to be monounsaturated, because that's what we referred to when we talked about unsaturated, is the double bonds in the fatty acid, which is a long chain of carbons. There are two kinds of fatty acids. There are cis fatty acids and there are trans fatty acids. You want cis fatty acids. And the reason is because we don't have the enzyme to break a trans double bond. Olive oil is cis fatty acid. That's good. But if you heat an olive oil, if you

heat oleic acid past its smoking point, which is relatively low for olive oil, 310 degrees Fahrenheit, 165 degrees Centigrade, which is easy to do in a sauté pan, what you do is you put enough heat across, enough energy across that double bond that it will actually flip. And now you have created a trans fatty acid right in your skillet, and that is poison. We're going to get to that as number seven. So you got to be careful about olive oil. Olive oil is meant to be consumed at room temperature. Number three, polyunsaturated fatty acids. So

polyunsaturated fatty acids are also good... They are good for several reasons. They are good because they are anti inflammatory, but... they also can flip their double bonds. And there are more double bonds to flip. The good news is most of the polyunsaturated fatty acids have a higher smoking point. So it's a little harder to make that, trans fat switch. That's true. But it's also been shown that if you consume too many polyunsaturated fatty acids, you're going to end up with immune problems, problems with your immune system. Number four, saturated fatty acids. Now, everyone thinks saturated

fatty acids are the devil incarnate. They think that is the worst of all the fatty acids. And the reason they think that is because that's what we were told for 45 years... That's what "Ansel Keys" told us back in the 1960s and 70s. Saturated fat was evil and why we all needed to go low fat. Because saturated fat was bad for you. In addition, because saturated fat is animal fat comes from lard and from pigs and from cows and saturated fat, if you get rid of saturated fat, that means you're getting rid of the cows

and the pigs and the goats and everything. And the vegans would like that very much. So there's sort of a feed forward... problem there. Turns out saturated fat is not one saturated fat there are two. There's even chained saturated fatty acids, which are what's in red meat. And then there are odd chain fatty acid, saturated fatty acids, which are what's in dairy. Turns out the odd chain saturated fatty acids are metabolized differently than the even chain. And also the odd chain saturated fatty acids have a different phospholipid signature. They have a tail on the end,

which makes them polar, which makes them actually do very different things in the body because they can basically bind to other things and activate other things. That phospholipid is very important. And it turns out that that phospholipid signature is anti inflammatory. So it turns out the dairy saturated fat is actually anti-inflammatory, whereas red meat saturated fat is not but it's not pro-inflammatory either. -- In converse to what "Ansel Keys" told us. So saturated fat, neither good nor bad from that standpoint. And dairy saturated fat, actually good. Number five, medium chain triglycerides. So these are very

short triglycerides, usually on the order of about 10 to 14 carbons long, whereas a standard fatty acid would be 16 to 20 or 22 even carbons long. So ten to 14 carbons. Turns out these are metabolized differently, they are absorbed differently, they are not absorbed in micelles and go through the lacteals and lymphatic system, they end up going straight to the liver... Now, lots of people are excited about medium chain triglycerides because they're relatively high in coconut oil, and coconut oil is on every paleo and every vegan... menu as being a primary fat to cook

in. And there may be some value to that. But the problem is that when your liver is presented with both saturated fat and medium chain triglycerides, you're basically overwhelming your mitochondria's ability to oxidize. And so you can end up laying down more liver fat, and that can be a problem too. So medium chain triglycerides are sort of a good news, bad news deal, depending on what else you're eating. Number six, omega-6 fatty acids. Now, omega-6 fatty acids are what are found in seed oils, so soybean oil, et cetera. - They are pro-inflammatory... Omega-6s are the

precursors, like linoleic acid is omega-6. Remember, the other one's alpha linolenic acid, "ALA." This is linoleic acid, "LA," they are not the same. They are very different. Okay, one's omega-3, the other one's omega-6. They sound the same, but they're not. --- - They are the precursors of arachidonic acid. And arachidonic acid is the precursor to all of the pro-inflammatory cytokines, thromboxanes, icosinoids, leukotrines, all things that generate inflammation. Now, you need inflammation, otherwise you'd be eaten by the maggots. You need inflammation to be able to clear an infection. So in an acute situation, omega-6s are good

because they will help you get rid of whatever is trying to invade your body. But you certainly don't want that inflammation to be going on willy nilly without an acute stimulus. And the problem is, the more omega-6s, the more chronic inflammation, and that's bad for you every which way and will ultimately lead to early demise... So keeping the omega-6 levels down is wise. And omega-6s basically have taken over our entire diet. We talk about the need for an omega-6 to omega-3 ratio of about three to one. Optimally, it should be one to one, but we

can do with three to one or even four to one, and still be reasonably healthy. The problem is, our current ratio in America is somewhere between 20 and 25 to one. Way too many omega-6s, way too few omega-3s. So we need to boost those omega-3s... and try to bring down the omega-6s. Now, bringing down the omega-6s is a little bit controversial. Like, for instance, "Dariush Mozaffarian" thinks we don't need to do that. We do need to raise the omega-3s. He thinks that's enough... I'm not so convinced. I think we do need to get those omega-6s

down. And then finally, number seven. The devil incarnate trans fats. And lots have been written about that. And the very first trans fat was synthesized in 1902. "Crisco" was the first one that was patented in 1911. By 1920, they had appeared in virtually all baked goods in America. They are the reason for the ten year old "Twinkie." And the reason is because bacteria can't digest the trans fats because they can't break the trans double bond. Well, guess what? Our mitochondria are refurbished bacteria. We don't have that enzyme either. We can't cleave that trans double bond

either. So, basically, a trans fat sits in your liver, never comes out, ultimately leads to fatty liver, cardiovascular disease. Basically, it's basically like consuming poison because you can't get rid of it. So there are your seven fats, and we are getting way too many of the wrong ones and not nearly enough of the right ones. And because of that, we are experiencing mitochondrial dysfunction just on that basis alone. That's a great overview, and I got a lot of nuance I want to get into within that, starting with the trans fat piece... The way I understand

it, trans fats have been at least largely banned in the food supply. We did talk about how if we're cooking with certain oils, we can create them within our own kitchen. How much of a concern are they within the food supply these days in the US? Well, the good news is that the FDA finally woke up. Took them a long time to wake up. Took a long time to ultimately do something about trans fats. And the reason was because the food industry was pushing, lobbying nonstop for them. And the answer to that is because if

you put trans fats in the food, no depreciation, you can increase that sell by date to three years later, like those "Hostess Cupcakes." Take a look at the sell by date. They're still good, right? They're not good. They're never good, but at least they're consumable. In 1957, the first paper on the toxicity of trans fats was published, published by a guy at the University of Illinois, champagne Urbana, by the name of "Dr. Fred Kummerow." And he is a hero in this story, and he is a hero to me. - And he died not too long

ago, maybe about two years ago at age 101 or something like that. Probably because he never ate a trans fat, by the way. But... he wrote about this in 1957, and basically it got lost. No one paid any attention to it. No one understood what was going on here. It didn't get resurrected again until 1988, when somebody else started working on it. And then "Kumaro" basically was still around. And he contributed greatly at that point because he knew and other people started to know. But it took the "FDA" 25 years, from 1988 till 2006, before

they would do anything. And the first thing they did was they said, all right, let's put the number of trans fats on the Nutrition Facts label. And then finally in 2013. So 25 years after they reappeared in 1988, 25 years later, finally the "FDA" agreed that they needed to be banned from ultra processed foods. So they are disappearing. And for the most part, trans fats have disappeared from the American food supply, which is good. Are they still able to sneak in a small amount if it falls below a certain limit, or how does that work?

Yes, you're absolutely right. So on the label, they are allowed to say that if they have less then, if they have zero point 49... grams of trans fat per serving, they can call 0 point 49, zero. They round down. They should not be allowed to round down, but the "FDA" allows them to round down. So if you eat four "Hostess Cupcakes," you have gotten enough trans fat to kill you. Because... you have gotten basically 2 grams of trans fat, and you were told you got zero. So, yes, they lie with numbers. Okay, so given the

fact they lie with numbers and they can still be a problem in the food supply for somebody that is tuning into this and they're going to ditch ultraprocessed foods, are there any other sources? Or if somebody's eating real food, are they going to be clear of that? I'm assuming it's just something from processing. So people should be fine if they avoid those. Well, milk has very little natural trans fat. You can measure it in milk. So some saturated fat will be trans fat, but it is exceedingly small. And for the most part, not to be

worried about if it's real food. Really trans fat is a synthetic... phenomenon that the food industry puts in specifically to increase shelf life. So I think that we can ignore the inherent trans fat and real food and focus on just what the industry does. To sell their products. And that's what the "FDA" is worried about. Let's stick on that milk piece because this isn't a really important, interesting fact about saturated fat that not a lot of people are talking about the fact that there's two different kinds, and you mentioned in red meat, there's a type

that's basically neutral within milk or dairy. There's the saturated fat that has possibly even a little bit of a benefit because it's anti-inflammatory. Potentially, yes. Is that just in cow dairy? And is there enough of a pro, not pro anti-inflammatory effect in there in that special property that it's worth people consuming to get that, or it's just there for, you know what I mean? Is there enough pro to consume dairy? Is what I'm getting at. Is there a good reason to drink milk? All right, so the answer to that is. I believe the answer to

that is yes. Now, this is a little complicated. Milk generates an enormous amount of visceral reaction. So let me unpack it. Let me take it apart for you. - There are some people who are intolerant to lactose. Full stop. Stay away from it. There are some people who are intolerant to certain milk proteins and develop a milk protein allergy. Stay away from it. You will know, because if you consume milk and you end up having enormous "GI" side effects, that's probably a problem. Okay, if that's true, what you should try to do is you should

try to take some lactate, so lactase as a supplement and see whether or not you still have it. And if you still do, just stay away from it. That is probably, those two things, lactose intolerance and milk protein allergy is probably about 20% of the population. So not insignificant. There are a lot of people. African Americans have a significant increased risk of lactose intolerance. Jews have an increased risk of lactose intolerance. But that can be mitigated by taking lactase by mouth. By the way, I do. That's how I consume dairy, is with lactate, because I'm

Jewish that's the way it is. - Okay, now the rest, what about the rest of this? Is there something in milk that's worthwhile? Number one, there's lots of amino acids, and that's good. Number two, there's lots of fatty acids, including some essential fatty acids... So that's good. Number three, there's a lot of calcium. Now, here's the problem with the calcium story... Everyone says you need calcium. You do. You absolutely do, no question. Calcium for bones, calcium for... muscle functioning. Calcium for hormone release. Calcium is essential... And milk is a very good source of calcium. So

you would say, well, then you should drink milk because of the calcium. And we tell postmenopausal women to drink milk because of the calcium, right? We give them vitamin D, too, right? Wrong. This is the mistake. And the reason is not because there's not calcium, there is, but because there's way more phosphorus in milk. In order to absorb calcium, you have to have a calcium phosphate product that is conducive to absorption. And the problem is that the phosphorus phosphate binds the calcium, so it becomes calcium phosphate, or calcium biphosphate or diphosphate, and makes it unavailable

for absorption. So in other words, in order to absorb calcium, you have to have calcium without phosphate. And that's not milk. That's other foods, but it's not milk. So, in fact, the calcium that's in milk is, for the most part, unabsorbable. And that's one of the reasons why giving milk to people with osteoporosis doesn't seem to benefit them. In fact, might even hurt them. Now, can you give calcium pills? Yes, you can give calcium pills, but does that fix osteoporosis? No, that doesn't fix osteoporosis either. And the reason is because the calcium just gets absorbed

and goes right through you, does not end up in the bone. You have to do somme things to the bone in order to get that calcium into the bone. And unfortunately, vitamin D is not the answer to that. That's why all of these trials of calcium and vitamin D in postmenopausal women have failed. So the notion that you can actually reverse osteoporosis by drinking milk, which is, of course, this common urban myth that's out there, does not work... As a pediatric endocrinologist, I... used to take care of multiple children with hypocalcemia, low serum calcium levels.

And look, these kids sick, they have George syndrome, or congenital hypoparathyroidism, or autoimmune hypoparathyroidism, or host of different diseases leading to hypocalcemia. And we had to boost these kids serum calcium levels to keep them from having seizures and tetany and stopping of the heart and what have you. This is a big deal. In order to do that, we had to give them calcium and we had to make sure that the calcium was absorbed. So we actually had to take away the milk. We had to take away dairy. We had to give the calcium with no

phosphorus. We had to increase the calcium to phosphate product. - In whatever they were eating. To four to one, four calciums to one phosphorus, whereas milk is one to two, one calcium to two phosphoruses. So we actually had to take away the milk and give them calcium without phosphorus. We had to give them calcium supplementation in the form of calcium glubionate or calcium chloride or something else very specifically to increase the absorption. So this notion that milk is important because it has calcium is actually not correct. In addition, milk does not have vitamin D in

it until or unless you irradiate it. So standard store bought milk will be irradiated, and that's how it has high vitamin D. So you can buy "unvitamin D" milk if you buy it from a local farmer or whatever, but that is not a good method for supplementing your vitamin D. So there are all sorts of issues with respect to milk. And then finally, let me address one last myth about milk, and that is, that it causes cancer. And this all came from one book. That book is called "The China Study," written by "Campbell" and "Esselstyn."

What they did was they looked at the population of China and they did an epidemiologic analysis, 500 pages of single univariate correlations and snapshot in time. No time component in the analysis. And what they came up with was that the consumption of dairy correlated with increased incidence of cancer. And so they said, therefore, milk causes cancer. And they said, the casein, the protein in milk, the primary protein in milk, was the bad guy. - Number one, this is not how you determine causation. Univariate correlations are not the same as multivariate correlations. And multivariate correlations are

not the same as causation. In order to determine this, you'd have to have a time component, which they do not have. And also, there's this thing called reverse causation, where it might be, actually people with cancer might have altered food intake, and it might also be that... there's intermediate causation. Something else is causing both of those things and has nothing to do. Like, for instance, ice cream consumption correlates with drownings... Is it that ice cream causes drownings, or is it that survivors of drownings bury their heads in a banana split? Well, neither, okay? - -

Ice cream usually is consumed when it's hot outside. People swim when it's hot outside, and some people who swim drown. Okay? So, yes, ice cream consumption is correlated with drownings having nothing to do with any causation linking those two things directly. Rather, there's an antecedent that leads to both of those separately. That's called an epiphenomenon. So it very well may be that what they were studying in China was an epiphenomenon, not a primary causative phenomenon. There's no data that suggests that drinking milk increases the risk for cancer. Let's stick on "The China Study" here for

a little bit. That book seems to have a lot of legs and continues to get brought up time and time again. And the reason I want to stick with it is there any data that they gain from that study... that we can use or because of the variables that you talked about there and the way it was done, there's only associations made and there's nothing we can really take from it. There's only association. And there's a lot of mumbo jumbo in nutrition based on association. And nutrition has been derided by multiple scientists as being basically

the dark arts of medicine. And to be honest with you, if you use it wrong, they're right. They're correct. "John Ioannidis" of Stanford, who know perhaps the biggest statistical guru alive today in terms of how to interpret data, basically says we should stop all nutrition research. Because it's all bullshit. - Now, I think that's a little severe. Personally. Although you are trying to kill the word nutrition. I'm trying to kill the word calorie. Okay. I thought it was nutrition as well. Nah, I'm not trying to kill the word nutrition. I'm trying to put it in

its proper place. So actually, let's go there for a minute. I think we've beaten calcium and milk to smithereens here. Let's go there for a minute. There are three words, and they get equated frequently, three terms, and they're not the same. Got it. Those three words are, three terms are. Food science, nutrition, and metabolic health. Now, what is the difference between those three terms? I know because I've heard you talk about this. Okay, well, for your audience, food science is what happens to food between the ground and the mouth. Nutrition is what happens to food

between the mouth and the cell. Metabolic health is what happens to food inside the cell. So they're all related, but clearly they're not the same. Metabolic health is the only one we really care about. It's metabolic health that drives what we should be doing, because if something is not metabolically healthy, we shouldn't be doing it because it means it's killing us. And in fact, the World Economic Forum appropriately put out a white paper this year, which, by the way, I had something to do with. Called The True Purpose of Nutrition. And turns out the true

purpose of nutrition is metabolic health. Now, nutrition can only inform metabolic health. It is not the same as metabolic health. It can inform it, but it's one step divorced from it, because it's only what's in the blood, not what's in the cell. Food science is two steps divorced from metabolic health. And unfortunately, that's the only thing that the food industry is telling you. So ultimately, the science of what goes on inside the cell is what matters. Metabolic health is the true purpose of nutrition. It's the only reason to study nutrition is metabolic health. Well, we

have ignored that for 50 years in favor of this thing called nutrition. So it's not that nutrition is useless. It's that it's an adjunct to understanding metabolic health. It's an adjunct to figuring out what gets presented to the cell so then we can determine what goes on inside the cell. So I'm not saying get rid of nutrition. I'm saying deemphasize it. It's not the whole picture. It's not even remotely close to the whole picture. You mentioned wanting to leave milk, but you did bring something up there that has a couple of little nuances I want

to tease out before we fully part ways with it. And that's the calcium supplements. And you mentioned them not being effective. Have you heard of them clogging up the blood vessels? I know there was some people talking about that. I don't know how much hard science there was behind it, but for people out there that are taking those, we're learning that they're not effective. But the way I understand it, they can actually be detrimental. - In certain patients if they don't clear the calcium. Well, yeah, they could. Now, some people need them. I have to

take a calcium supplement at night myself because I get leg spasms in the middle of the night unless I take calcium. And I have been checked for hypoparathyroidism or some metabolic problem, and I don't seem to have one. And when I take a calcium supplement, the leg spasms go away. So I'm treating them symptomatically, and I don't know why I have these, but I do. And what's interesting is my mother had them. So is it genetic? Is it we eat the same crap? Is it something else? I don't know. --- I've talked to endocrinologists about

it. I don't know if the calcium works good. But, yes, I have heard that as well, and it depends on how well it's cleared. Okay. And the other piece that ties into that, the way I understand "K2," is it helps the calcium go to where it needs to be in the body and deposit in the right area. I'm not aware of that. And you could teach me there. I know about "K2," but I've not heard that. Okay. All right, before we pull out of fats, we're going to zoom back out of milk now and calcium.

A couple more little nuances there in that part of the conversation I want to make sure we address, one being the first piece you started with was talking about "EPA" and "DHA" and the importance of those. Another one of the seven was polyunsaturated fats. And the way I understand polyunsaturated, the "EPA" and "DHA" fall under that category. Is that true? No, "EPA" and "DHA" are omega-3s. I thought omega-3s fell under the polyunsaturated fats. Well, they are, but they're a very specific kind of polyunsaturated. We keep them separate. Got it. Yeah -- I just want to

tease that nuance out. Okay. No, I mean, omega-9s are polyunsaturates. Yeah, yeah. We don't consider omega-3s the same as omega-9s. And the last piece within fats, and before we leave, is for somebody that isn't vegan, you mentioned the fact that that can be problematic when it comes to the. Because they're not going to directly be getting any "EPA" and "DHA." They need to convert, or they got to go back to the algae source and get that from that but The conversion is pretty low, it's like less than 1.5%. Exactly. But they can go all the

way back to taking an algae oil, the way I understand it, and then get the "DHA" and "EPA" that way. No, not quite. Almost, right. But let me correct that, "Jesse." Algal oil, I know a lot about algal oil. We have researched it in part for this big study we did in Kuwait, which I'm sure we will get to. -- Okay. Algal oil is "DHA." Algal oil is "DHA." And "DHA" is important for neuronal structure. No question, no argument. So if you're not getting your "DHA" from anywhere, then algal oil is a way to get

"DHA." But algal oil is not a source of "EPA." Now, "EPA" is necessary for neurotransmission. "EPA" is the thing that makes fish oil smell like fish. "DHA" is pretty clean, so it's easy to add "DHA" to stuff. It's easy to add algae oil to stuff. But "EPA" is another story because "EPA" carries that fishy smell along with it. So if you are grinding up salmon livers to get "EPA" and "DHA," you'll get both. But if you're going to just take the algae and basically develop this clean, colorless, tasteless, odorless algal oil that you basically can

add to food. They've had to remove the "EPA" for that reason. So, in fact, algal oil provides an important source of "DHA," but it is not a significant source of "EPA" for that reason. So that remains a problem. I didn't realize that, important information here, because I think a lot of people that are on a plant based diet or vegan diet assume that if they're taking that supplement, the algal oil, that they're getting everything that somebody would get from a fish oil. You can get your "ALA" from your vegetables, you can get your "DHA" from

algal oil, but you're still going to be "EPA" deficient. And now that we're on that vegan topic, and we know there's this hole within the diet and supplementing any other concerns for somebody on that diet, things that they're not getting or things that they're getting too much of that are causing problems. And let's relate it to the mitochondria and metabolic health, if we can use that as our common thread today. - Sure. Well, not so much the metabolic health. I mean, I think mitochondrial health is probably reasonable otherwise, but obviously, you need those omega-3s to

make those mitochondria function at peak efficiency. But there are two things that are low in a vegan diet that are an issue. And there are two amino acids up, tryptophan and methionine. So tryptophan is the rarest amino acid and methionine is the second rarest amino acid. And for the most part, vegetable protein is relatively low in both tryptophan and methionine. And you need both. Tryptophan is the precursor to serotonin, and serotonin is the contentment, happiness neurotransmitter does a lot of things and your gut bacteria make serotonin, but they need tryptophan in order to do it.

And if they don't have the tryptophan to do it, then you get all sorts of issues in your gut, including gut inflammation and also the lack of carriage of serotonin up the afferent vagus nerve to the brain. And so tryptophan depletion is associated with irritability and depression. And also methionine. Methionine is a primary source of methyl groups. And you need methyl groups because you have to methylate proteins. It's essential. And also because -- there's sulfur. -- - So methionine, both methyl and also sulfur. And you need the sulfur as a reducing agent, an antioxidant, in

order to prevent oxidation. And so methionine is a primary contributor to S-adenosyl methionine, which is necessary to create glutathione. And glutathione is the liver's endogenous antioxidant. So if you're methionine deficient, you're going to be glutathione deficient, in which case your liver is going to have decreased oxidative capacity, which is not good because that's a great way to damage your liver, too. For somebody that's consuming some meat in their diet, is the tryptophan and methionine ever an issue for them, or do they typically get enough? No, they get plenty. They get plenty. Okay. And then what

about the omega-3 piece? The best place, by the way, for tryptophan and methionine is fish. - If I could wave a magic wand, I would basically... provide every vegan in the country with the knowledge that if they just ate a little bit of fish to go along with their veganism, they could solve all their nutritional problems. Which brings me to my next point. Can we get enough omega-3s from fish? As somebody who is eating meat, because that fish oil is a really popular supplement, it's something I'm currently taking. Can we get enough from food alone?

Yes, you can. But you can't get enough from vegan food alone. No, but the average person that's eating a mixed diet and having fish periodically, do you feel like because we've stressed the importance of those omega-3s, do you feel that they're important enough that we should supplement on top of a healthy diet or we can get enough from the diet alone? Well, it depends. When you say eating a little bit of fish, what does that mean? Are we talking once a week? Of course. Well, talk about what we would need to do. If you ate

fish twice a week, you'd have more than enough if you eat fish once a week, kind of depends on where you go for your fish, because if it's farmed fish, no. If it's wildfish, probably yes. And early in the conversation, when you named off a bunch of different variables when it comes to the mitochondria, we just went heavy into the fat piece. We're going to get to sugar. That's an area that, again, you talk a lot on. And we're going to get there. We have time. - "Jesse," we are an hour into this, Yeah. and

that's the first time the word sugar has been mentioned. Well, this is good because you've done a lot of interviews, and you've talked a lot about sugar, and I want to make sure that we don't rush any of this other important knowledge that you have to share. And we can always have a third, 4th conversation and get into sugar if we need to. And we've covered it before, so we're going to get there, though. But before we do, let's talk about the radiation piece, because you only address that from going into outer space. So how

much of a concern is that for us down here on Earth? Oh, it's a concern. It's a concern... First of all, our atmosphere is not nearly as good at catching those ionizing radiation as it used to be, the whole hole and the ozone layer and all that stuff, although the ozone layer is improving... But there's also other stuff that causes mitochondrial dysfunction aside from radiation. So, obviously, the higher up you live, the more ionizing radiation you're exposed to. So that's an issue. On the other hand, the higher you live, the lower the oxygen tension. The

lower the oxygen tension. That in of itself is an inducer of mitochondrial biogenesis. So you make more mitochondria when you live higher, and you burn energy faster when you live higher. So that's one of the reasons why, for instance, people in Switzerland who eat a German diet have half the incidence of heart disease and diabetes than the people in Germany who eat a German diet. So they eat the same diet, the Swiss and the Germans, but the Swiss have half the diabetes, half the heart disease. And the reason is because they have increased myocardial biogenesis...

Here in the United States, we have a similar phenomenon, because in Colorado, we have the lowest incidence of obesity compared to the rest of the country. If you look at all the maps that the "CDC" puts out, they always have the lowest of obesity. And the reason that the state of Colorado says they have the lowest incidence of obesity is because they have an outdoor culture. Garbage, garbage. The reason they have the lowest incidence of obesity is because they're the highest. They have the highest altitude. Okay, so they have the most mitochondria. And, of course,

we know this because that's why every football team that goes to Denver to play the "Broncos" loses. In Denver. - -- Because they are acclimated. That's why all of these distance runners train at altitude for just this reason, because it ups their mitochondria. So it's just junk. Outdoor culture, my ass. So the other area you mentioned that are destroying the mitochondria, obesogens, air pollution, what are the biggest areas? Because obviously, this is a big category, and a lot we could get into. Let's talk about the top offenders in that area and then things we can

do when it comes to air pollution. Somebody who's living in a big city right now, and that's a problem, like is getting an air filter in the home enough? Obviously, it's... not going to be perfect. But. Particulate matter, it's called "PM" 2.5. Particulate matter 2.5 is it. Microns, seems to be particularly pro-inflammatory. And, yes, an air filter will help, but you're outside, too. What we have seen there are epidemiologic studies that demonstrate this. Again, snapshot in time. So you got to take that with a grain of salt. - People who live closer to freeways, have

a much higher incidence of diabetes and heart disease. Now, people who live close to freeways also tend to be lower socioeconomic status, and they have other potential reasons for why they might have an increased risk of diabetes and heart disease. But these studies factor those in. So complicated. But we think the particulate matter is particularly important. Famous study called the "SALIA" study, done in Germany, so not in America, that demonstrated this. But, of course, people who live close to freeways usually are low socioeconomic status everywhere. All right, let's come back to the food piece, how

we opened up here. We were talking about the mitochondrial dysfunction being at the top, further down, being the insulin resistance. We talked about sugar being a player in all of this. Yeah, I'll have you take that and run. Well, fructose, the sweet molecule in sugar, is not glucose. Glucose actually increases mitochondrial function. This was shown by "Samir Softic," working in "Ron Khan's" Lab at "Joslin" Diabetes Center several years ago. Glucose activates two enzymes that increase mitochondrial function. It activates "AMP" kinase, adenosine monophosphate kinase, which is sort of the fuel gauge on the cell to make

more mitochondria, because "AMP" is a signal to the cell that it's becoming energy depleted, and we need to generate more energy because "ATP" goes to "AMP." So when your "ATP" goes down, that means you're energy depleted. And then the "AMP" fits in the active site of the enzyme and induces signals that increase mitochondrial biogenesis. So "AMP" kinase is the fuel gauge, And it also increases another enzyme called "HADH," hydroxyacyl-CoA dehydrogenase, which helps break the fatty acids into two carbon fragments so that they are oxidized. Okay? So glucose, for lack of a better word, is good

because it increases mitochondrial function. Fructose, on the other hand, is not. Fructose inhibits three enzymes that are all necessary for adequate mitochondrial functioning and they're all inhibited. The first enzyme that's inhibited is "AMP" kinase... It turns out a metabolite of fructose called methylglyoxyl, "MGO," binds right in that active site and because of its methylglyoxyl it's an aldehyde. And that aldehyde moiety binds to arginine in the active site, forms a covalent bond and therefore it can't be extracted out of that active site. And so basically it's not just inhibiting that enzyme, it's actually killing that enzyme,

it's inactivating that enzyme permanently until a new one is made. Okay, so number one, you're killing the fuel gauge, you're just taking a hammer to the fuel gauge. In addition it inhibits another enzyme called "ACADL," acyl-CoA dehydrogenase long chain, which is necessary for those cutting up of the two carbon fragments. And finally, indirectly increased fructose causes an increase in uric acid. This is the work of "Rick Johnson" at "U" of Colorado. He's shown that fructose drives uric acid formation. And the reason is because you're taking "ATP" and going down to "ADP" and then "AMP," then

"IMP" and then uric acid. And so that uric acid is the endogenous inhibitor of an enzyme on the outside of the mitochondria called Carnitine palmitoyltransferase 1, "CPT 1." Now what is that? That's the enzyme, enzyme that regenerates carnitine. And carnitine is the shuttle that brings fatty acids from the outside to inside the mitochondria so they can be burned. The fatty acids don't just show up in the mitochondria. They have to be chaperoned in, they have to be escorted in. And carnitine is the molecule that does it. And every time the carnitine chaperones a fatty acid

in for oxidation, it gets phosphorylated and then it has to be dephosphorylated in order to work again to recycle it. And uric acid inhibits the enzyme that does that. So everything fructose does to the mitochondria is designed to inhibit its functioning. So you look at glucose, it's a winner. When you look at fructose, it's a loser. Sugar is both. Which one wins out? Clearly the fructose because it's killing those enzymes. You just mentioned something there. I wanted to highlight the fact that sugar, table sugar, sucrose is both of these together. So you're mentioning the fact

that glucose good, fructose bad Right. Oftentimes Fructose way badder than glucose is good. - And the thing what I'm trying to highlight here is even in nature, things like honey or agave syrup, which agave is not really that natural, but these things are often found together, so Well, they're always found together. There's no such thing as fructose without glucose in nature. - Would grains... be a starch, that would just be glucose though? Grains are starches. They're polymerized glucose. Okay? Meaning, further elaborate on that. There are two kinds of starches. There's amylose and there's amylopectin. Not

the same. Amylose is a string of starches, like, end to end. It is a string of glucoses bound together by what are known as alpha-1,4 linkages. And in order to break that amylose starch up into glucoses, free glucoses, so that they can either be burned or stored, you have to cleave the bonds. Those linkages, those alpha-1,4 linkages, you need an enzyme to do that. That enzyme is called alpha-1,4-glucosidase. It's in your intestine. So it breaks the amylose, but it can only break the amylose on the ends, can't break from the middle. It's got to break

on the ends. And so every time the enzyme works, you generate one more glucose. So that means that when you're metabolizing amylose, your blood glucose goes up slowly. It goes like this, and then comes down. And what that means is you're not getting a peak, you're not getting a big rise. So you're not generating much of an insulin response because your blood glucose isn't changing that much. This is one of the phenomena inherent in this concept called glycemic index. Amylose has a lower glycemic index. Now, amylose, because it needs that called alpha-1,4-glucosidase. And some people

don't have that much called alpha-1,4-glucosidase when they eat things that are high in amylose, which by the way, are beans, lentils, legumes. What happens is they can't cleave as much as they would like, which means that that's available to the bacteria, to the microbiome, which means that they are going to chew it up for their own purposes, which is... good, except that one of the side effects is increased carbon dioxide and sometimes hydrogen sulfide, ie. gas. So it's either fat or fart. But the point I was trying to stress is the fact that beans, legumes,

lentils, rice, they are just glucose, right? Not rice. Rice is in the other category. Okay -- But there are grains and different plants that are just glucose. That's amylopectin. They're all just glucose. But fruit has fructose as well. No, fruit is not grains. - No. I'm just trying to make the distinction that sometimes in nature, we can find glucose, and then sometimes we can find glucose and fructose. Right. So in fruit, we see both. In grains, we see only glucose. But that glucose can be arranged in two forms. It can be arranged as amylose or

amylopectin. So amylopectin, let's finish that up. Amylopectin looks more like a tree. That's what I was getting at. Instead of a string, it looks more like a tree. It's got branches. Now, the branch is not an alpha-1,4 linkage, it's an alpha-1,6 linkage. So one glucose can go this direction and it can also go down this direction. And so you end up with a tree with multiple branches. Almost looks like a globule. And what that means is that you can have multiple enzymes attacking that molecule of amylopectin all at once, because it's not just working from

the ends. And because of that, you can liberate glucose much more rapidly. And so you get a much bigger glucose response, you get a higher glycemic excursion in your blood, and that means that your beta cell is going to see that, and it's going to release more insulin. And so people say amylopectin is more insulinogenic, therefore more obesogenic, than amylose. And this is the concept behind glycemic index. So you want things that are low glycemic index. However, I am not a fan of this concept. I am a fan of the concept of keeping your insulin

down that I am a fan of... But there's a much easier way to keep your insulin down and it's called fiber. So all those grains come with their inherent fiber. Okay? They all come with their inherent fiber. Wheat comes with its inherent fiber. It's called husk... rice comes with its inherent fiber. It's the husk of the rice kernel, brown rice, quinoa, et cetera. They all come with their inherent fiber. Fiber reduces the rate of absorption of both amylose, amylopectin. And so you end up with a lower glycemic excursion, no matter which it is amylose or

amylopectin. And so fiber is much more important. Now, that concept is called glycemic load. And all real food is a low glycemic load food. And so that's what I'm for, but I am for keeping the insulin down. And that's sort of a standard mantra amongst the scientists in the obesity field. So it sounds like... the solution to all this is to stick with food in its whole form, get the fiber, yep -- yep ---- yep slow down digestion. Glucose spikes are going to be less, and our body's going to be able to handle things and

absorb them in a healthier way. Yep Absolutely. And you're going to feed your gut. So what we've learned is you have to protect your liver, which we've been talking about, and you have to feed your gut. And what does the gut want to eat? It wants to eat fiber. Fiber is the food for the bacteria. Well, let's take that to the extreme and talk about somebody who is fasting or somebody that adopts a carnivore diet or primarily meat diet, and they're seeing certain health benefits in that realm. Is that only temporary, or is there exceptions

when we go to those extremes when it comes to the gut? So fiber is the natural food for the intestine, and the bacteria in the intestine can chew up fiber for its own purposes. And one of the things it will do is it will turn that fiber into a secondary product called the short chain fatty acids, "S-C-F-A's." And those short chain fatty acids have effects on us. They are anti-inflammatory, they keep inflammation down. And gut inflammation is one of the primary sources of chronic metabolic disease. So keeping your gut placated and generating short chain fatty

acids is part and parcel of improved metabolic health. So fiber is the primary driver of that. However, there are other things that bacteria can do to metabolize the nutrients it needs and also generate short chain fatty acids. So fiber is necessary to keep your gut happy, but your gut will secondarily be able to chew on amino acids and... other organic acids that you can find in meat and other foods that will do just as well. - I am not against a carnivore diet, and I've not been against a carnivore diet for a long time. I

don't advocate it, but I'm not against it... I don't know if you can see it. I'm going to move here. But do you see that chair over there? There's a lot of stuff on it right now. Okay. I do. But you see that chair? That is a very important and special chair. Okay. That chair... belonged to a man by the name of "Vilhjalmur Stefansson." "Vilhjalmur Stefansson" was an explorer. He was born in North Dakota from to icelandic parents, didn't speak English until he was 17, went to "Harvard" though. Ultimately went to the arctic, was shipwrecked

amongst the Inuit for two years before he was rescued and recognized that the Eskimos, the Inuit, had no diabetes, no heart disease, and no cancer. And so he was a little bit of an anthropologist as well as being an explorer. He was one of the founding members of the Explorers Club. He wrote many books, one called "Cancer A disease of Civilization." And he trained the ski troops during World War II for the Brunner Pass. "Vilhjalmur Stefansson" was an American hero. That chair behind me was "Vilhjalmur Stefansson's" "Harvard" chair. And my mother's late husband's brother in

law was "Vilhjalmur Stefansson." And we owned "Steffenson" Farm for many years in Bethel, Vermont... Really very fascinating story. Bottom line, "Vilhjalmur Stefansson" knew that you could live on whale blubber, you could live on meat and be perfectly healthy. So he and his... partner in the Arctic exploration checked themselves into NYU "Bellevue" back in 1926 and lived on the metabolic ward at NYU "Bellevue" for a year and ate only meat, only meat for one solid year. And it turned out at the end of the year, they were healthier than the investigators who were studying them. Of

course, this got written up in the Journal of Clinical Investigation, 1928, multiple papers about it. And it's one of the reasons he wrote the book "Cancer A Disease of Civilization," et cetera. Point is, you can be on a ketogenic diet, you can be on a carnivore diet, and it will work. It will work. Okay. And there are many, many tribes that consume nothing but meat and milk. The Rendille, the Tokelau, the Maasai, the Inuit. And they are fine because this is their indigenous culture and because you can get enough out of a carnivore diet to

be able to maintain health. You can also get enough out of a gatherer diet to maintain health, but in order to do so, you have to eat the requisite fiber. And you mentioned there the fact that the gut bacteria can actually feed on other things besides fiber when somebody's consuming only meat. Yes That's right. Exactly. So there are ways, different ways to do it, and I'm not married to either one. I'm very agnostic in terms of this. People get to choose. But the one diet that never works, not in the history of mankind, is the

standard American diet. That's the diet that doesn't work. I realized when I threw that last question to you, I lumped together carnivore plus fasting. And obviously, the nuance of your answer there, the fact that gut bacteria can feed on meat and not necessarily just fiber, leaves the fact that what happens when we fast? - What it does is it makes the gut bacteria want to grow. It makes them want more. And if you don't feed your gut bacteria, your gut bacteria will feed on you. So it will actually strip the mucin layer right off your

intestinal epithelial cells so it will find its food. And now your intestinal epithelial cells don't have the physical protection that it needed to keep the gut microbiome at bay. I mean, your intestine is a sewer at every level. There's a lot of in your intestine, and the goal is to keep that in the intestine and not in your bloodstream. So there are three barriers in your intestine to separate you from the junk. The first is the physical barrier, the mucin layer. And like I said, if you don't feed your gut, your gut will feed on

you. The second barrier is the biochemical barrier. They are called tight junctions. They are proteins that link the intestinal epithelial cells together so that things can't get through. But there are things that can poison those tight junctions, and then they come apart, and things can get through. That's called leaky gut. And the things that can damage those tight junctions are, wheat gluten, in people who are gluten allergic, they're called celiac disease. Those tight junctions, the example of that is zonulins. That's what goes wrong in celiac disease they go like that. - But it turns out

fructose nitrates those tight junctions and renders them ineffective also. So glucose can sorry fructose can basically generate leaky gut all by itself. And then third, the third barrier is the immunologic barrier. So your intestine has more immune cells than the rest of your body put together. It's got all these things called Peyer's patches, where all the lymphocytes hang out. And those lymphocytes are special kinds of lymphocytes. They are "TH 17" cells, and they make a cytokine called "IL 17." And their job is to basically patrol the entire gut and make sure that stuff doesn't get

across. Recent paper out of "Ivanov's" group at "Columbia" showed that on a regular whole foods diet, those Peyer's patches, those "TH 17" cells that "IL 17" is all functional working, and the barrier is intact. On a ketogenic diet, a high fat diet, low carbohydrate diet, it's also intact and keeps all the junk out. And the "TH 17" and the "IL 17" is fine the minute you add sugar to the fat. Now, that barrier is not there. The immunologic barrier has been broached, the "TH 17" cells are missing, the "IL 17" is way down, and fat

from the intestine starts... conglomerating on the other side and gets into the bloodstream, which can then cause inflammation. And then tying back to what we talked about before, sugars in nature are going to be found with fiber, and this is going to form this lattice work that I know you've talked about before on the show on our first conversation, and I've heard you talk about it on other podcasts, where the soluble fiber and insoluble fiber, they mesh together and form that barrier, which is going to slow down digestion. - So that's the man made barrier,

as it were, or the food barrier. So there's really four barriers, but three are inherent in the intestine, and one is dependent on the food. And the bottom line is, the goal is to keep your barrier intact, and we're not. We are basically destroying that barrier, therefore generating gut inflammation, therefore generating systemic inflammation, therefore generating mitochondrial dysfunction and insulin resistance. Well, as we come up on time here, let's make sure we get really practical, tie everything together for people. We know fructose is a big part of this problem. The biggest. - It's not the only

part, but it's the biggest part, and it's the part we could fix tomorrow. Okay So, in a practical sense, we know that fructose can be found in nature and things like honey or fruit. Let's get really practical with people. We talked about all the negative downsides of fructose. How do we, in a practical way, eat in a way where fructose isn't going to damage our mitochondria, which, again, is at the top of this whole chain, and then all the problems are downstream. Very simple. Eat fruit. But that's it. - In terms of fructose content, you

need to look at the added sugars on the side of the label. Fruit doesn't have a label. That's okay. Food that doesn't have a label hasn't been processed. Food that doesn't have a label has its inherent fibers still there. The minute they do something to the food, now they got to put a label on it. So whenever they have a label on it. You have to look at the degree of processing. And one of the ways to do that is to look at the number of grams of added sugar that's now listed on the label.

And the higher that is, the more you don't want it. It's just that simple... The goal is to keep your consumption of added sugars below 25 grams a day. That would be six teaspoons. That's about what your liver can handle. Very similar to, by the way, to what your liver can do with alcohol. That's about as much as your liver can handle alcohol, too. And the reason is because alcohol and fructose are metabolized the same way. So it makes sense that about six teaspoons of fructose. Sorry, of sugar, therefore, three teaspoons or 12 grams of

fructose, 25 grams of sugar, because they're 50 50, would be sort of the maximum. If you eat whole food, you have nothing to worry about. Because if you eat whole food, your fructose content beyond fruit is minimal. And the fruit has fructose, but it's not very much, and you're not going to absorb it because of the fire. So, -- the goal is to eat as unprocessed a diet as you can. And whether you want to go more toward the plant based or whether you want to go more toward the animal based, I think that's up

to you. What do you prefer? Okay, I don't have a horse in the race. Either one will work. Either one can be healthy. Now, if you go extremes on either side there might be problems, depending on how you do it. So you might need supplementation. But if you stick in the middle, you can go either way. I personally think a pescatarian diet is like the best diet... That's the one I would choose if I could get everybody to recognize that fish has some really good things in it and things you can't get pretty much anywhere

else. And so you want to eat mostly vegetables? Fine. Great. Terrific. Add a little bit of fish so you can get your omega threes and your tryptophan and your methionine, and we're good to go. Are you a pescatarian? - I eat meat. I shouldn't say I'm a pescatarian because that suggests I don't eat meat. I'm sort of a flexitarian, is really what I am. Let me be honest. I love fish... I eat fish as often as I can, but I do eat meat. - You might see me barbecuing. No question... I consider myself a flexitarian

more than a pescatarian. I know we're coming up on time, but I want to hit on two quick things before we part ways. One being that when we think of fructose being a problem, the way I'm hearing you say it is that it becomes a problem when it's out of its whole food form. But the thing I want to caveat and add to that is the fact that we can process things in our own kitchen through juicing and blending, pulverizing fruit up into very fine bits when it comes to a blender or juicing, then we're

no longer. Even though that food didn't have a label originally, we're no longer talking about it from this perspective of having that safety net of fiber. That's right. As soon as you've juiced it, as soon as you've pulverized it, as soon as you've smoothied it, it's not whole anymore. And you'll notice... if you buy an orange at the store, it doesn't have a label. But if you buy an orange smoothie. In a bottle, it does have a label. Okay, maybe nothing's been added, but something's been removed, it's been processed, and now it needs a label.

That's the way you need to look at it. So every label is a warning label, and you have to look at the label to determine how much of a warning it is. It might not be that much of a warning, or it might be a very big warning, and there are ways to figure it out, and they're in my book, "Metabolical," and they're on the Internet, and I've posted on this many, many times. Ultimately, it's not what's in the food, it's what's been done to the food that matters. And sometimes you can't learn that from

a food label. All right, I know, again, we got to part ways, but we'll end on this. We started talking about insulin resistance, and then we went upstream from there to the mitochondrial dysfunction. I want to make sure we come full circle and address the insulin resistance piece, make sure we hammered that home, how it fits into all of this. So can you take that and make sure we fully explain how that fits into this? When it comes to the mitochondria and working its way down. Keep your insulin down. The best way to keep insulin

down is don't let it go up. Well, what makes insulin go up?.. Refined carbohydrate and sugar. So, refined carbohydrate is carbohydrate without fiber, and sugar is sugar. Those are the things you have to watch. Those are the things that you have to be careful about. Unfortunately, those are the primary components of processed food. So the less processed, the lower the insulin. The lower the insulin, the less mitochondrial dysfunction. The less mitochondrial dysfunction, the healthier you are. All right, "Rob," really enjoyed the conversation. Glad we could come full circle there. At the end, we're going to

link up your books, your social media, your website, everything in the show notes, and I just want to thank you. The work you're doing is just so important, and I really enjoy our conversations. Doing our best. Doing our best. We need everybody on board. --- It's a big nut, and so everybody has to be speaking with one voice. Thank you, "Rob." All right, pleasure, as always. Now that you're done my conversation with "Rob," you're going to want to go back and watch my previous conversation we did together. Even if you've watched it already, it's time

for a refresher. We go deep into sugar and how it's poison. I'll see you over there. It's poison. And it actually detracts from metabolic health.