Sicker than ever: How our ultra processed diets are harming our metabolic machinery

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Processed foods are wrecking metabolic havoc in your body. To diffuse today’s food confusion, Dr. Ca...
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- This is the first-order issue of our time. Over the past 50 years, we have seen food confusion skyrocket. People have no idea what to eat, and chronic diseases have exploded.
The same root cause issue is underlying 9 of the 10 leading causes of death in the United States right now. - That's Dr Casey Means, a Stanford-trained physician and co-founder of the rapidly growing health company, Levels. Today on the show, we'll explore the complex and often confusing world of personal nutrition and well-being.
Then a little later, we'll take a trip to sunny California, where we'll visit a restaurant that's changing the traditional fast food landscape by offering fresh and nutritious meals at competitive prices. Stay tuned for an in-depth conversation as we examine our current health crisis, the nefarious systems at play, and most importantly, discuss the tools and habits that will assist us in taking control of our health. The only way to solve our biggest problems is to have the audacity to try.
Welcome to "The Arena with Evan Baehr. " Dr Casey Means, thank you for being with us today. - Evan, thank you so much for having me.
Please, call me Casey. - You are a powerful diagnoser of the challenge we're facing today. You are saying we are sicker, fatter, and more depressed.
What are the factors that lead you to make that claim? - Yeah. So what people are unfortunately not clear about, both doctors and patients, is that all of these problems are rooted in the same core issue: which is metabolic dysfunction.
There's three main foods that are directly damaging our mitochondria, our key metabolic machinery, and all of these foods have been created industrially over the past hundred or so years and entered our food system. And the millions of years of human history before this, they never existed, they never touched the human body. And those three foods that are damaging our mitochondria are refined industrial seed oils, refined added sugars, and ultra-processed grains.
So those now make up the vast majority of the calories that we eat in the United States. We are no longer eating the vast majority of our calories from meat, from beans, from legumes, from fruits, from vegetables, from herbs and spices. So it's the emergence of these three foods that has been the key disaster for the human body.
Currently, 50% of American adults have type 2 diabetes or prediabetes. These are conditions that, as of 50 years ago, less than 1% of the population had type 2 diabetes. And now, over half of American adults do, and 25% of teens are prediabetic.
So right there, the majority of our country has a diagnosable blood sugar problem, which is a metabolic condition. We've got depression rates, and anxiety, and mental health issues exploding, with 25% of adults on a mental health medication, with suicide being one of the leading top three causes of death in young people. And infertility rates are rising rapidly.
1% per year, we are becoming more infertile. This is untenable. Sperm counts are down 50% in the last 30 years.
So you look at some of these statistics and it's easy to sort of have your eyes gloss over, like these are big numbers, what does this mean? But what it really means is that the cellular function of the American body right now is being decimated. - The stat that just jumped out to me was going from about 1% to I think about 50% of the American population either having diabetes or being prediabetic.
For those of us not fully in the know of what that means, give us the basics there. - Yeah, so prediabetes and type 2 diabetes are sort of our core, most overt metabolic diseases. What they actually mean is that the body's having trouble processing blood sugar, processing glucose.
Metabolism, fundamentally, is how we convert food energy to usable energy in the human body. So taking sugar, glucose, and converting it to a form of energy that we can use in the body, which is called ATP. So we need this currency, this converted currency of energy to basically power the trillions of chemical reactions that happen in our body every single second.
And diabetes and prediabetes are essentially a big problem with this happening. The cells are so overwhelmed and their metabolic machinery is so damaged that the cell basically says, 'No more glucose can come in here because we cannot convert it to energy. ' And so what happens is that blood sugar rises.
This is your cells saying that they cannot process the food you're putting into your body into energy, which means that your body cannot power itself appropriately. And an underpowered body is never going to be able to function properly. We have 37 trillion cells in the human body, and every single one needs energy to do its work.
And what we're seeing with all these different chronic diseases today that we know are related to type 2 diabetes, prediabetes, metabolic dysfunction, is that they are rooted in the cells not powering themselves properly. And that can look like so many different diseases that are downstream of prediabetes or type 2 diabetes, things like Alzheimer's, cancer, fatty liver disease, chronic kidney disease, things like erectile dysfunction, depression. All these different conditions we know are very associated with type 2 diabetes and prediabetes.
And that is fundamentally because they are all an expression of the body not making energy properly anymore. And when you think about it this way, you see how it's fairly illogical to just treat these conditions with medications that lower blood sugar. So let me give you a concrete example of this: As an ear, nose, and throat, head, and neck surgeon, almost every condition that I was treating was inflammatory in nature.
So in the medical practice, the term -itis at the end of the word is the suffix for inflammation. So sinusitis is inflammation of the sinuses. So we say, "Okay, this person's body thinks there's a threat, and it's getting swollen, it's forming puss.
So what am I gonna do about it? " I'm either gonna give a medication, which is a steroid or an antibiotic, which basically hammers down on inflammation. It's a medication that says, you know, stop.
And if that doesn't work, I'm just gonna bust a hole in this piece of the body and drain whatever's backed up there. - It doesn't seem to be really addressing the root cause of why it started. - Well, this is the key thing.
We all say, "What's the cause of this? " The cause is inflammation. But that's not really the cause.
What's the cause of the inflammation? And inflammation is an issue with the immune cells that are circulating in the body. There's no scalpel or drill that can change what's happening with those immune cells.
And so, it's like, wait a minute, is it possible that this patient in front of me that has diabetes, heart disease, some dementia, and sinusitis, that maybe there's something going on in their whole body? The only way that you can truly generate that type of health in the body, the ability of a metabolically functional body to convert sugar to energy, is through diet and lifestyle. There is no medication that can create metabolic functionality in the body.
There are certainly medications that can decrease blood sugar, but they're not creating true metabolic health, which means we remain underpowered and we lose our health capital. - A key player at the table here has to be the healthcare industry. You're a doctor, you went to med school, what are the incentives that are driving how healthcare is delivered?
- The healthcare system is a $4-trillion business that is designed to grow. And currently, the business model requires that we have more sick patients to generate more revenue. Every doctor, I know, is a good person.
They went into healthcare for noble reasons- but incentives are incentives. And at the end of the day, we actually make more money as physicians if we have patients for a longer period of time, we see them more often, and we do more things to them, and we get them in and out out of our offices as quickly as possible. - I'm feeling a little conflicted.
Can I tell you about it? - Please. - So I love capitalism.
I love competition. I love markets. I love the idea of financial incentives driving innovation.
I also really like individual choice. I like people being responsible for the actions they're choosing, of what they eat and how they exercise. So I'm feeling a little confused about how we have this massive, multi-trillion dollar, for-profit, capitalist ecosystem and a few hundred million Americans, and somehow all these people are doing things that, in other markets, generate great outcomes, here, it's like killing us.
What's happening? - I am a believer in capitalism. I'm a believer in free markets, but that's not actually what we have here.
And I think a lot of it has to do with the overreach of public policy, I would say. So you've got 31+ billion dollars of the farm bills that's almost entirely going to wheat, soy, and corn, which get turned into these three products that I talked about. And you have literally less than 5% going to what are called 'specialty crops,' which are fruits, and vegetables, and other foods that actually build beautifully healthy, well-functioning bodies.
And what that does is it actually makes these foods that are very detrimental to human physiology the cheapest and easily accessible foods to get, especially for the populations that are more strapped for cash. And so, you couple that with policies like the allowances for what our public assistance food programs are allowed to be spent spent on, so things like WIC and SNAP, and the number one line items on some of these public food assistance programs is soda. So you've got these systems that are basically allowing people to buy food that is directly harming their bodies.
And I think a second issue is that we've got a huge conflict of interest in our nutrition guidelines. 95% of the people who make the USDA guidelines have conflict of interest with industry. And so, it's just, you know, a lot of these people, I'm sure, are good people, who are not looking to see the downfall of the American population.
But unfortunately, incentives are incentives. And then I'd say a third really key issue is that our institutions of trust, like academic universities that are putting out these nutrition studies, are compromised. What we see is that food companies spend 11 times more on nutrition research than the NIH, and this is not because of philanthropic goodwill.
They wanna see outcomes that are gonna support their business. So as we spend more money on nutrition research, as we have more peer-reviewed publications, health outcomes are getting worse and the percentage of processed foods as a total amount of our diet is growing. - What feels particularly pernicious is when we think about not just subsidies but actually the food stamp program, and so you think about low-income Americans who, in many ways, have the deck set against them, the fact that our government is not mandating but really rigging the system so that they regularly and only have access to food that, it's not just making them obese, it's setting them up to atrophy in their human capital, to not perform mentally, to not have the physical energy to go out and succeed in society- that's dark.
- I think it's incredible because it is by far negatively impacting the poor and children more than anyone. And I think a lot of it has to do with just really deeply entrenched political industry interests that play off of each other to grow these industries. And the way that you get them to grow is you use the cheapest foods, which are the commodity crops that are directly hurting our bodies, and you get more patients in the hospital system, which means more sick patients.
And so, you know, there's a lot of opportunity here and I'm actually, like, hugely optimistic because I think people are starting to wake up to this and demand a different system. You hear a lot more about metabolic health. You hear a lot more about people wanting to understand their own health.
But unfortunately, it's not yet happening in the populations that need it the most, which is poor and children who are having the largest increased rates of chronic illness of really any population. And it's very sad to see. - Let's take a break for a moment and travel to Los Angeles, where we'll visit Everytable, a company on a mission to make nutritious meals accessible to everyone everywhere.
- Hey, how are you? - Hi, welcome. - Thank you.
- This is Rajwinder, a regular Everytable customer we met while filming. - Have you been to Everytable before? - Yes.
I come here almost every day. - All right. And this is Timothy Reardon, vice president of culinary research and development at Everytable.
- The Southwest Chipotle is my favorite, and I like the Trap Curry. Love the Taco Bowl- and your Breakfast Sandwich. - And the Breakfast Sandwich?
- I love the Chia Pudding. That's my go-to. - That diverse assortment of meals Rajwinder just listed are delivered fresh daily to Everytable locations around the city, providing her the option to eat healthy between her demanding schedule as a nurse.
- After 10 hours of work, 12 hours of work, I don't have time to go to the grocery store. It's convenient, it's fresh, and it's affordable. So this is absolutely life-saving.
- Affordable, accessible, convenient, and healthy- these were the driving forces behind the creation of Everytable, founded by Sam Polk in 2016. And its secret lies in a special ingredient, their business model. - Everytable has created a really innovative system to take ingredients directly from farms, turn them into fresh, healthy, delicious meals, and then give them to people at prices that are often less than it would cost if you cooked it yourself.
And the way we get to these fast food prices is really about this centralized kitchen. - Good morning, Maria. This is where we prepare all of our food every day from scratch.
Good morning, chef. - Hi. - We have our senior chef, R&D Chef Jess, here working on some recipes for future development.
At Everytable, we don't believe that you have to rely on salt, fat, and sugar to make food taste good. And so, we rely on good quality, raw, premium ingredients, chef techniques, flavor development, using fresh herbs and using spices, ingredients that are bold in flavor but don't impact our nutritional outcome negatively. So we're working, we got some garlic and some onions, a little browning.
- Yep. - So I develop our menu and our pipeline with a team of talented chefs and start with a concept. We leverage seasonality and try to use ingredients that are going to be able to allow us to deliver on that accessibility on the pricing.
This is our new Calexico Chicken Salad we just launched. So this is a Tajin Chili Lime-Spiced Chicken with a cilantro, honey lime dressing, a five-rice grain blend, pickled onions, crispy tortillas, and a salad blend base. This is something we do frequently, just kind of taste our food, give an honest kind of thought around, are we delivering to expectation?
Going from a four-ounce portion to a hundred-pound recipe is kind of what happens between the test kitchen and what we see here. One comment I might make is maybe it's a little light on the Tajin seasoning. What do you guys think?
Once we all feel really good about the flavor and the nutritionals, then we go into a commercialization and scale-up phase. So this is where our food is prepped, cooked, trayed up, and then cooled down, and then packaged into bins for our team in the assembly room to then put into our meal kits. And then the meals are loaded onto our trucks and shipped out directly to our stores for our customers that same day.
- Everytable is really this hypothesis that says, 'If you can make truly delicious, healthy, fresh food that everybody can afford, will everybody eat it? ' And so far, the answer is 'yes. ' - I was born in India, so I grew up on healthy foods.
Healthy foods shouldn't be a cardboard food, it should have a flavor. So I see the Trap Curry, I see Chipotle Chicken, I see different ethnic groups food. Those flavors are great.
It's a party in your mouth. - In addition to storefronts, Everytable maintains a subscription business, smart fridges located on hospital and university campuses, as well as partnership programs that provide medically-tailored nutritional meals. Everytable has also devised a variable pricing model, another innovative approach that allows 'em to offer discounted prices specific to the income level of the zip code where the store is located.
- The thing that's really exciting about Everytable is that our most profitable stores are our stores in food deserts and underserved neighborhoods. It's not about charity, it's about creating a profitable system that works for everyone and is inclusive of everyone. - Always a pleasure, thank you.
- Really important and impactful work. - Bye, thank you. - Let's head back to the studio with Dr Means and discuss the various ways we can reclaim our health.
Pick up in your journey, on year nine of medical school and residency, and I think had your own sort of awakening, what was that like? - Yeah, to sum up the sort of reflection that I was having at that time, I did, I had a real philosophical break from the system, based in everything that we've talked about. I'm looking at my patients in the operating room, who are putting all of their trust in me, Dr Means, looking to me for answers for health, for salvation.
And what I started to realize after five years in the surgical world is that the problems that were generating, their health conditions, were not things that I could actually solve with surgery. So I put down my scalpel and I vowed that I would not cut into another patient and profit hugely off that act until I really understood if there was anything I could do to keep patients out of the operating room, to empower patients to actually generate health rather than just waiting for them to get sick and then treating disease. So I started a company called Levels, which is completely focused on empowering individuals to understand their own bodies.
And our premise is simple: We give people a biosensor, called a continuous glucose monitor, that they wear on their arm, that tells them, 24 hours a day, 7 days a week, what's happening with their blood sugar. - I know many of the recommendations are based on the specific user on the Levels platform, but could you generalize, what are some common interventions people pursue that improve their metabolic health? - There's seven main elements that I think are the most important levers that we can pull to improve our mitochondrial health.
And so, those are food, adequate sleep, movement and exercise, stress management, toxin avoidance, getting the appropriate temperature exposure, and actually managing the light that we're exposed to. So food, that one's pretty obvious. You know, we need to stop barraging our cells every single day with these industrially-processed foods that directly hurt our cellular health.
Exercise is also pretty obvious. For muscles to contract, they need ATP. And so, it's basically just pulling glucose and using it to convert to ATP.
So the more muscle you have and the more muscle you use, the more you're churning through that excess that's in your body of glucose and actually using it. Stress management is actually a really interesting one. The body has this fascinating evolutionary design where, historically, if we had a threat, like we were being chased by a lion, our body would release huge amount of stress hormones.
And that actually signals to the liver to dump all this glucose into the bloodstream to feed your muscles so you can run as quickly as possible. And of course, now, our stresses are very different. We're not being chased by a lion.
We're usually responding to an email, or a text message, or someone's honking- but we're not actually using our muscles in that stressful event. So what happens is the liver dumps the glucose, it raises our blood sugar, and it just sits there. The fourth one I mentioned was sleep, which is profoundly related to blood sugar regulation for a similar reason as the stress piece.
If you are sleep-deprived, your body will release stress hormones that can keep your blood sugar elevated. Our sleep quality is being decimated by all the blue light that we're looking at in our screens in the evenings. And we're sleeping on average about two hours less than we were a hundred years ago.
And then the three that people often don't think about is toxins, light exposure, and temperature. Toxins is one that I'm really passionate about. There are over 80,000 new industrial chemicals in our food, water, and air supply that have basically just been created by industry, by factories over the past hundred years, virtually unregulated.
And what we are now starting to learn after the fact is that many of these go into our body through water, through food, through air, through the products that we interact with every day, like furniture, and mattresses, and the electronics; they can go into our cells and directly cause problems. So this is one we really need to think about because unless you're really protecting yourself and unless you're filtering the things around you, you become the filter, right? You are the filter.
These things go into your body and have to be processed. - And you have to imagine, so much of that would correlate with income and socioeconomic status. So yet again, it's a human rights issue- - It is.
- That low-income, especially children in decrepit, water-damaged housing, with clothing, with processed foods, just on a daily basis, encountering all these things. These poor kids' bodies are becoming filters, and yet we hope them to have the same chances the kids in the wealthy suburb at succeeding in life. - Right- it's shocking.
And one of the most pressing issues that is a result of this is what is happening between chemicals and our fertility. We know that so many of these chemicals are endocrine-disrupting chemicals, meaning that they actually impact hormone receptors. And so, one of the big reasons we think that sperm count is plummeting right now is because of the way that these chemicals are affecting hormone receptors, which both directly affect sex hormones but also affect energy production in our cells, and together, are basically making our bodies not be able to make sperm, or healthy eggs, or healthy placenta if someone does get pregnant.
So the toxin piece is so fascinating, and one that we need to really think about from a public policy standpoint because it's becoming so pervasive that it's almost impossible to protect yourself fully. - It doesn't take a PhD to conclude that if we've done something to our bodies such that as an organism, we can no longer make more of ourselves, something probably isn't working. - Yeah.
- So you've encountered this really difficult problem. You're a really smart person. You're looking at your toolkit.
You've got a number of tools. You could run for office, or write a book, or continue on a career in medicine- and the tool that you picked up was entrepreneurship. Why did you pick that one?
- It came down to entrepreneurship for me because of a core philosophical belief that I really believe in people. I believe in empowering individuals to have agency and a sense of power in their life. And entrepreneurship is beautiful because you're bringing something into the world that is for people to use in a way that they want to, and a way that they see fit.
So this is exactly what we see with Levels now. You know, you've got all these different people wearing this sensor, creating their own solutions in their own lives that work for them. They get joy from that ownership.
And so, creating a product that then people can take into the world and use in their own life gives me deep satisfaction and aligns with my philosophical beliefs generally. - One of the incentives sort of staring us in the face is the incentives that I would have as a person to live a long and healthy life. And tools like Levels, and the media, and the books, and the content in your work, and the adjacent work, I've noticed it myself, has created incentives.
They're not as powerful as, "Gosh, those lucky charms are awesome in the morning," it's a longer time horizon. But I'm just beginning to connect some of those incentives to imagining life as a 90-year-old with grandkids- but it's kind of hard to connect those dots. How do you think about that for individuals that are trying to make good decisions?
How do you put some meat on the bone around the incentives for you taking care of your body, connecting to living a long and prosperous life? - Yeah. A big piece of this that I think we need to capture in our culture is actually going back to just having profound awe for the human body.
And one of the ways that I think you can start to do that is by understanding how you work better. So that's why awareness and education is so important to me. And one of the things I love so much about Levels and about people having better access to these personal understanding tools, there's a lot of direct-to-consumer brands, you know, you've got 50 million Americans with wearable trackers, they understand the cause and effect of what's going on with their heart rate, and their activity, and their sleep, and I think all of this together actually gets us more rooted into understanding that the choices that we're making every day have a distinct impact on our lived experience of this life.
And so, what really motivates me and the incentive for me is to essentially get the most out of this incredible, short period of time on the planet, and really a deep sense of understanding that completely comes down to me and the choices I make every day. - Dr Means, Casey, thank you for being here today, but more importantly, for some really radical steps that you took in your own life, risks that you took, raising money, and building stuff, and putting yourself out there to do bold things that so clearly can drive my own flourishing and that of the nation and the world. Appreciate you being with us.
- Thank you, Evan.
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