No. 1 Sugar Expert: You've Been Sold A Lie About "Healthy" Food!

People say, oh, Alzheimer's is genetic. Garbage. That genetic component is only 5%. So that means 95% of Alzheimer's risk is environmental. Air pollution, microplastics, ultra-processed food. And a paper just came out showing that sweetener consumption

correlates with dementia. And we think we know why.

And you've not talked about this publicly yet?

No.

Let's talk.

Dr. Robert Lustig is a world-leading sugar expert. Who's teaching the world how to reclaim their health from the industry that profits off your vulnerability.

73% of the items in the American grocery store are poisoned because sugar is hidden in all the foods. For instance, there's 262 names for sugar and the food industry uses all of them. Because they knew when they added you buy more. But the problem is, it's providing people with a dopamine hit, and that dopamine is addictive. And that's when you actually have a biochemical

and medical problem. And we have data to show that ultra processed food has been associated with dementia, diabetes, cancer, every single mental health disease. So the question is, how can you buy healthy food and not be tempted by the bad stuff? So first, if a food has a label, it's a warning label.

Second thing, if any food has a sugar in the first three ingredients, it's dessert. And then when they go to the store, don't go hungry.

And what about exercise?

Well, it doesn't really impact your desire to reach for sugar. It has its own metabolic benefits. But if you think exercise is going to make you lose weight, you are deluded. And we can talk about that.

So with all of this in mind, if I've got a sugar problem or if I've got an addiction problem, what is the remedy?

I will tell you that this is one of the things I did in my obesity clinic. So the only way you're going to be able to fix the problem is...

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you.

Dr. Robert good to have you back.

Oh my pleasure.

I am particularly fascinated by this term hostage brain I know you're in the early stages of working on a book about this subject, but for anyone that doesn't understand, so when I look at this word, the hostage brain, I think of all the times that I've been out of control. And when I say out of control, I'm gonna let you define it,

but when I say out of control, I mean, there's so many things I want to do as it relates to my health, my fitness, other aspects of my life, whether it's avoiding eating the cookie at 2am in a hotel room somewhere, or other areas of my life where I want to have greater elements of control. What do you mean by

the hostage brain? All of us want to be in control, Stephen. I mean, it's the nature of humanity. We want to be in control. We want to be in control of our lives. Unfortunately, many of us want to be in control of everyone else's lives, as we've seen play out on grand stages lately. Okay, everyone wants to be in control. And the reason we want to be in control

is because then we can mitigate threat. When you're in control, then threat is low because you're in control. Problem is, we're not in control. The more in control, the more a specific area of your brain is basically glomming on. And that area of the brain is known as the amygdala.

The amygdala is your fear center. It's also your 24-hour sentry. But really what the amygdala is, it's the point guard on your basketball team. Okay? So it surveys the entire court, sees the offense and the defense, and has to make split second decisions, who's going to score. Now, a lousy point guard takes all the shots. A good point guard passes off to the guy who has the best shot.

A great point guard is going to be able to figure out if he's going to score or if he's going to pass it off to somebody else. If you're in control, your level of threat goes down. But really, your control is an illusion. You really don't have control. And the more you try to exert it,

the more you realize you're not in control. And what that does is that generates an enormous amount of stress and an enormous amount of pain. Now, that pain can turn inward, and we call that depression.

And right now, 29% of Americans are depressed and 4.4% of the entire world is depressed. These numbers were infinitesimal a generation ago and they are basically, you know, just pushing up further and further. And the reason is because of this inappropriate illusion of control.

And it's causing an enormous amount of pain. How do you mollify that pain? How do you basically deal with the psychological pain of lack of control that you yourself put upon yourself. Well, we have loads of ways. Cocaine, amphetamine, nicotine, alcohol, sugar,

gambling, social media, internet gaming, pornography. Pick your poison. That's dopamine. Dopamine basically provides you with a little bit of pleasure on top of a whole lot of pain. The problem is that dopamine is addictive.

And so when you apply a set of pleasures to try to deal with your pain of lack of control, that puts you into a never-ending cycle of consumption and misery. That's the hostage brain.

What do I need to understand about dopamine in order to, because I think sometimes awareness is step one in being able to do something about a problem that you might have. So what do I need to understand about what dopamine is and what it's doing in my brain

and how it's sort of associated with addiction to then be able to do something about it, which I consider step two?

So dopamine basically has two functions. The first is learning. There's no learning without dopamine. Anytime you learn something, whether it's positive or negative, it's because there was a dopamine release.

When you put your hand down on a hot stove when you were three years old and went, ah, I'm never doing that again, that was dopamine that did that. And what it did was it went to your amygdala and it rewired it.

That was a rewiring of your amygdala due to the excitatory neurostimulus of that dopamine affecting an area of your brain called the basolateral amygdala. Okay? And it laid down and it set up a circuit,

and that circuit is still working in you right now.

Okay?

So dopamine is the learning neurotransmitter. It can be for negative learning, it can be for positive learning, either way. Dopamine is also, when it's going to another area of the brain called the nucleus accumbens, which is the reward center,

that is a stimulus for reward. That is the stimulus for reward. That is the motivation for reward. That is, in one word, foreplay. Okay? That is the excitement, the reason for continuing any given behavior.

Okay? You get both out of dopamine. Okay? You get both out of dopamine. Okay? And in short, small bursts in the right venue, that's how we navigate life. We navigate it through learning, and we navigate it through reward.

You can't do it without dopamine. Dopamine is good, unless it's bad. And as you know, everything in science is both good and bad. The problem is chronic overstimulation of any neuron leads to neuronal cell death.

Dopamine is a chronic stimulator. And so if you have chronic dopamine being released, what's gonna happen is you're gonna kill the next neuron. Now, that neuron doesn't wanna die. So it downregulates the receptors for dopamine so that it's less likely that one dopamine over here

is gonna find a receptor over here to bind to because there are fewer of them. So what this means is more and more for less and less. And we call that phenomenon tolerance. More dopamine, more tolerance. So the law of diminishing returns.

So you get a hit, you get a rush.

It'd be a sugar, alcohol, whatever it might be. Pornography, yeah.

Pick your poison, doesn't matter. You get a hit, you get a rush, receptors go down. Next time you need a bigger hit to get the same rush, receptors go down, and then you need a bigger hit and a bigger hit and a bigger hit until finally you get a huge hit to get nothing.

That's called tolerance. And then when the neurons actually start to die, that's called addiction. So tolerance is the start of addiction. And the problem is more dopamine, more tolerance, more tolerance, more addiction.

So people that are getting addicted to unhealthy foods and sugars and those kinds of things, what's like going on in their brain?

So at first, the first time they taste it, you know, whatever it is, whether it's a Fruit Loop or a, you know, a Candy Corn or a Frappuccino or, you know, pick your poison, you get this big, you know, sort of, you know, sugar bomb going off in your head. And you go, wow, this is great. you know, I want some more of this.

And what is that sugar?

And then you down the whole frappuccino, okay. And what you've done is you've basically hit your nucleus accumbens with a big slug of dopamine and you go, wow, that was great. And then an hour later it's gone and then you go, God, I need that again. Okay? So the first time you got it, you liked it.

The second time you did it, you wanted it. And the third time, you needed it. So that's the difference between liking and wanting and needing. Okay, because liking, we all do. And no one wants to take away liking.

Wanting gets into problems, because you can over abuse things. Needing is when you actually have a biochemical and medical problem.

So with all of this in mind, if I've got a sugar problem or if I've got an addiction problem, I'm addicted to insect poison, what is the remedy? Just avoid it for a while?

And then if that is the remedy, what's going on in my brain? Is it fixing itself?

There are many remedies, okay? And they can all be used in conjunction with each other. Ultimately, the only thing that's gonna work is getting those dopamine receptors back up. Remember I told you dopamine down-regulates its own receptor.

The only way you're gonna be able to fix the problem is for the dopamine receptors to come back up. There's a trend going on right now out in Silicon Valley you may have heard of called dopamine fasting.

Ah, okay.

Yeah, I've heard the word.

Basically, people lock themselves up in a hotel room for three weeks. Don't take a shower. And basically, take the TVs out of the room and try to commune with themselves and with nature with no stimuli, with no external stimuli

in order to bring their dopamine receptors back up. Particularly true of cocaine addicts because their dopamine receptors back up. Particularly true of cocaine addicts because their dopamine receptors are way down because after all, cocaine is a dopamine reuptake inhibitor. So it's flooding the zone with dopamine. Therefore, those receptors are down in the sewer.

Now, do you have to be that severe? No, of course not. But does it work? Takes three weeks. You can do it for three weeks, then it works. Other ways, you know, you can wean yourself off,

you can do abstinence. And if you can do abstinence, that's a good idea. Hard to do, especially when it's, you know, staring at you and when it's available 24-7, 365, like sugar is. It's everywhere, it's on every street corner.

When I fast or when I do the ketogenic diet, I lose my apparent cravings.

That's right, exactly right. And the reason is because no sugar in a ketogenic diet. So you're basically removing the offensive stimulus.

I was so shocked. I love those cinnamon roll things. Not that I probably want every two years, but I love them nonetheless. I'm like a big admirer, even though we don't have a relationship anymore.

And when I did the ketogenic diet for about, I was four weeks in of not having any sugar or carbohydrates, and I walked up to this concession in Cape Town with all these amazing cinnamon rolls, they're like specialists, and I looked at them, and there was zero part of my brain that was interested in any of it.

Zero part of my brain. And I was like, wow, my brain has been rewired or something just because I've removed sugar from my diet.

Yeah. like rewired or something, just because I've removed sugar from my diet. It happens, but it takes a while. It's not something that, you know, you can turn on and off. It takes a fair amount of time. I will tell you that, you know, this is one of the things I did in my obesity clinic, you know, on a daily basis,

was getting people off their sugar addiction. And sometimes you have to basically babysit them. You have to work with them and work with their parents in order to basically turn over the entire pantry because the sugar is hidden in all the foods. I mean, there's 262 names for sugar

and the food industry uses all of them. This is why we are trying to get sugar addiction and ultra-processed food addiction codified by the WHO and by the American Psychiatric Association as a bona fide diagnosis so that we can get remediation and therapy for people.

One of the things that was one of the most popular parts of our conversation last time, Robert, was there's a section where we talked about the different types of sugar and diet cokes and Coke Zeros and all these kinds of things. You know, I can see a couple of cans on the desk over there where Jack is, in the darkness that I can vaguely see, and these cans of fizzy drink, they all have some kind of sugar substitute. Are those sugar substitutes harmless?

No, of course not. A paper just came out like three days ago in Annals of Neurology, basically showing that non-nutritive sweetener consumption, so diet sweetener consumption, correlates with dementia. And we think we know why.

Why?

Reactive oxygen species. So oxygen radicals, little chemicals that are given off from various substances that cause changes in energy metabolism in cells and also cause damage in cells. ROSs, reactive oxygen species.

The famous ones are spartame and sucralose. Now, do monk fruit extract, do stevia, does allulose also cause reactive oxygen species? I very specifically looked for data on those, could not find it. But for aspartame and for sucralose,

the two biggest ones that are available today, the ones that are used in a lot of diatrinks, huge amounts of ROS generation. So reactive oxygen species generation. So anything that generates ROSs contributes to dementia.

Is the evidence strong at this stage?

Yeah, it's pretty darn strong. I'm actually giving a talk about this next week in San Diego.

I heard you've got a new theory on the causes of Alzheimer's dementia. That's somewhat linked. This is it.

This is it, yeah.

Can you explain that to me? And you've not talked about this publicly yet. You're set to talk about it in

a couple of days, I hear. Let me take it back a step. Okay. There's this organelle inside our brains called mitochondria. You've heard of mitochondria. For your audience, mitochondria are the little energy burning factories inside each of our cells. What they do is they take food energy and turn it into the chemical energy that your cell can actually use to power itself.

Okay, and that chemical energy has a name, it's called ATP. Now, if you took biology in high school, you've heard of ATP, adenosine triphosphate. The energy is in the phosphate bonds. So ATP will give up its energy and go to ADP, diphosphate,

which will then give up its energy and go to AMP, monophosphate, which will then finally go to adenosine. And adenosine binds to the adenosine receptor and makes you go to sleep. By the way, that's where caffeine works. It blocks the adenosine receptor, keeping you awake so that the adenosine can't bind

to the adenosine receptor. So that ATP is the currency of the cell. That's what makes the cell run.

Anything that depletes ATP is gonna put the cell at risk.

Okay, because it doesn't have the energy it needs to run. Yeah, it's like gasoline.

It's like gasoline.

So what happens when you start running out of gasoline?

Well- You break down.

You'll break down. So brain fog, difficulty concentrating, irritability, and ultimately all the way to depression. So the amount of ATP within any given neuron is the approximate cause of neuronal dysfunction that we see as neurocognitive and neurobehavioral change.

Now, how do mitochondria and how do ROSs fit into this? Mitochondria make ATP, but every time they make ATP, they may also make ROSs. There are 11 steps in mitochondria and they may also make ROSs. There are 11 steps in mitochondria and they all give off ROSs. Now those ROSs are gonna damage the cell.

They have to be gotten rid of. They're like toxic fumes. They gotta be gotten rid of. And so we have a pathway in each cell of our body to get rid of the toxic ROSs. Okay, they're called antioxidants,

like glutathione, vitamin E, vitamin C, host of other flavonoids. Okay, those basically quench those reactive oxygen species. They go to die. If you do that, then the ROSs basically just get funneled away and all is well and the cell can keep working. But if for some reason those antioxidants aren't up to par,

if for instance you've been eating ultra processed food and you can't make your antioxidant complement, then the ROSs feed back and what happens is the ROSs are basically telling the cell, hey, you're shunting too much energy down this pathway because I can't clear them.

So there's too much stuff. So shut it down. And so what happens is that instead of funneling the glucose into the mitochondria to generate more ATP, it diverts it and it goes off into other directions like glycogen, which is in the brain is not good,

or fat, which is even worse. And bottom line, your cell is now not energy producing like it used to be. And bottom line, your cell is now not energy producing like it used to be. It has now been reduced in terms of its energy capacity. What's that gonna do? That's gonna reduce ATP generation.

Okay, that's step one. Now step two. There's this stuff called cortisol. Cortisol comes from stress. Cortisol comes from stress. Cortisol comes from sleep deprivation. Cortisol comes from exogenous glucocorticoids, like steroids being given to people for autoimmune

disease or for other illnesses. illnesses, okay? That cortisol causes neurons to increase in metabolism, causes them to burn energy faster. Okay, so now you have an increased ATP utilization. So you have a decreased ATP generation. Now you have an increased ATP utilization. Now you've got an energy crisis inside each cell.

Now your ATP can't keep up with the needs of the cell. And when that happens, now you've got symptoms. Whether it's brain fog or irritability or all the way to frank depression. Okay, now, step three.

There are these proteins inside each neuron called amyloid precursor peptide, APP. Okay?

So normal protein in all cells. Every cell in your body has APP. It needs to stay in solution. And in order for it to stay in solution, energy has to be applied to it in order to keep it in solution.

The minute the ATP in the cell goes down, they come out of solution and they start forming aggregates, which we call plaques.

Yeah.

Okay? And those plaques damage the cell, which then start an inflammatory process in the cells next door called the microglia in order to clean up the process. And now you've got plaques and an inflammation, and now you've got neuronal cell death.

That's dementia.

So it starts with an ATP energy crisis, moves through plaque and inflammation to generate neuronal cell death. Well, this is problematic to say the least. And by the way, anything that generates ROSs has been associated with Alzheimer's Anything that increases ATP utilization like stress glucocorticoids fever autoimmune disease

Also increases Alzheimer's so anything that increases step one anything that increases step two ultimately leads to increase step three and Alzheimer's.

So to simplify this in a couple of sentences for someone that has no scientific understanding and we're going to have to cut a few corners here scientifically in order for them to have a framework to understand it. How would you give me some sort of an analogy for it? Maybe in the context of I guess a petrol station in a car.

Yeah, so I mean if we're basically doing petrol, we're talking energy only.

Yeah.

Okay, so bottom line, your car runs on petrol, okay? The petrol comes in, that's the glucose, and the engine, okay, powers pistons, and the pistons then power an axle and the axle then powers wheels and you go.

Yeah.

Okay, but there are a lot of things that have to go right for all of those things to happen. Like for instance, your energy, the gasoline has to get into the engine in the first place. What if you have carbon deposits on your intake manifolds? And if you have a problem with any one of those steps,

you're gonna end up with a jalopy instead of a sports car.

I mean, that's what we're seeing in the United States. Over 7 million Americans live with Alzheimer's, and this is expected to double to almost 13 million in the coming decades.

Indeed.

Because we haven't solved the problem.

That's the mechanism. What is the cause?

Right, so we know, we know that the cause is environmental. Now, people say, oh, Alzheimer's is genetic. Garbage. There is a genetic component to Alzheimer's. I'm not arguing that. There is.

This is a thing called ApoE4. And if you have two copies of ApoE4 on your genome, your risk for getting Alzheimer's is nine times the general population. That is absolutely true. I don't disagree with that.

So ApoE4 is not a good thing. I'm not arguing that. Once upon a time in evolution, having two copies of ApoE4 was good because it meant you got fat up to your brain pretty fast. But we don't need that right now.

That's kind of an old news kind of issue. People who have double doses of ApoE4 are at higher risk. There is absolutely no question about that, but they can mitigate that risk if they change their diet. Okay, they can eat a very low fat diet and improve their risk down to the general population.

Okay.

Everything else in Alzheimer's is not genetic. By the way, that genetic component is only 5% of all Alzheimer's. So that means 95% of Alzheimer's risk is environmental. Now the question is, what in the environment? Well, air pollution, ionizing radiation, microplastics. Okay. There's nothing you can do about any one of those three. That's baked into the cake.

You can't do anything about those today.

What other things? Sleep disordered breathing, medications, ultra processed food. Okay, what about ultra processed food? Fructose, my favorite, you know, hobby horse. You know, the sweet molecule in sugar. Low omega-3s.

So no, you know, fish, eggs, chicken. Lack of fiber, because fiber suppresses inflammation. Presence of emulsifiers, B vitamins, lack of B vitamins, particularly B6, B12 folate. Those things are all associated with an increase

in reactive oxygen species. You can manage those, you can mitigate those, thereby increasing mitochondrial function, increasing ATP generation, and preventing that cellular energy crisis, so that you don't end up behind the eight ball and you don't lose your neurons.

When people tell me that Alzheimer's is associated with having a sort of energy crisis in the brain, I'm increasingly hearing people talk about ketones. It's just, it's remarkable the improvement in cognitive performance that I feel when I'm fasted or I'm in a ketogenic diet.

Whereas if I'm in a, if I've been eating a lot of carbohydrates or sugar, it's like my brain is like, like backfiring. Yeah, it's like stumbling over itself.

I'm not surprised. You know, the food industry tells you, well, carbohydrates are energy. Actually, that's not true. Carbohydrates inhibit energy production.

How do you mean?

So, there's this thing called a bomb calorimeter, and there's this thing called a mitochondria. They are not the same. A bomb calorimeter, you throw food into the bomb calorimeter, it explodes and it gives off heat.

Okay, and there's, you know, captures the heat, measures the heat. And that's how we know, for instance, fat burns at nine calories per gram, protein burns at four calories per gram, carbohydrate burns at four calories per gram,

which is why fat is more energy dense than protein or carbohydrate, which is how we all determine that fat made you fat.

And the bomb calorimeter is also how they determine if a bag of crisps or chips, whatever you call it here, is 200 calories, because if you put them in there, it will release 200 calories of energy.

Because a calorie is that amount of energy that raises one gram of water, one degree centigrade. So it is a measure of physics. It's a measure of heat generation. Mitochondria are not bomb calorimeters. They are not capturing heat.

They are giving off heat. They are capturing ATP. No bomb calorimeter captures ATP. Mitochondria capture and generate ATP. Now, turns out 35 to 40% of what mitochondria generate turns out to be heat.

That's why you have a body temperature. It's from that. And so you will never have a 100% energy efficient mitochondrion, because if you did, okay, you would have a body temperature of, you know,

room temperature, okay, and you'd be dead. That's not the way it works. Bottom line, that transfer of food energy to chemical energy loses energy in the process, okay? The bomb calorimeter can't tell the difference, but your mitochondria can.

Ultimately, it's how efficient are your mitochondria at converting food energy to ATP. The bomb calorimeter can't tell you anything about that. So these two phenomena, you know, the concept of calories as fuel and the concept of calories as generators of ATP ATP have really very little to do with each other. And it turns out that there are individual things in food, the famous one is fructose,

but there are others, lectins and others, that actually inhibit the mitochondrial generation of ATP. So they actually inhibit your ability to turn food energy into chemical energy. If that's the case, even if they have calories per gram in a bomb calorimeter, if they're interfering with mitochondrial function, are they food? What is the definition of food? Substrate that contributes either to growth or burning of an organism. Well, I just told you, fructose actually inhibits burning.

Turns out, fructose also inhibits growth. It inhibits cortical bone growth, trabecular bone growth, cancels bone growth. Bottom line, people who eat ultra-processed food end up shorter. We have the data for that.

So, if a substrate that passes your lips does not contribute to growth and does not contribute to burning, is it a food? I guess not.

I guess not. What is it then?

It's a poison.

And how much of our diet do you think is poison? I threw them out. Ultra processed food is loaded with them. Real food is not loaded with them. You can still find them, but not loaded with them. Ultra processed food has, in my opinion, okay, five things wrong with it. Too much sugar, which poisons your mitochondria.

Not enough fiber, which is necessary to suppress inflammation. Not enough omega-3 fatty acids, which are necessary to build your brain and conduct neurotransmission. Too many emulsifiers, which leads to gut inflammation and therefore systemic inflammation. And then we can throw on top of that the food dyes and food additives,

which are mutagenic because they're petroleum-based. systemic inflammation. And then we can throw on top of that, the food dyes and food additives, which are mutagenic because they're petroleum-based. That's ultra-processed food. Ultra-processed food has been associated with every single one of these diseases, including every single mental health disease,

especially dementia, as we now have seen. Ultra-processed food is specifically associated with dementia and even diet sweeteners are associated with dementia through this reactive oxygen species pathway.

The sugar industry can't be your biggest fan.

They're not.

I'm trying to help them though. You know, I am trying to help them. Last year, not too long after we had our previous session, I was the keynote speaker at the fourth international sugar reduction summit in Atlanta, Georgia.

You know, Daniel in the lion's den. And you know, like, why would they invite me? I am, you know, I'm their conscience. I told them, I said, I don't want to be your enemy. I want to be your conscience. I want you to do the right thing.

Okay, ultimately, look, ultra processed food is not going away. As much as I would like it to, it's not going to go away. And I'm not even sure we want it to go away because we've got to feed 10 billion people by the year 2050 and we're not going to have enough land and ocean to do it. Ultimately, ultra-processed food is here to stay. It is baked into the cake.

But the question is, can we make ultra-processed food healthy? Right now, they're not. Right now, what's going on in the US food industry is doing the exact opposite. It's making food disastrously disease-producing.

The question is, could you change that? And the answer is, yes, you can. In fact, we've done it. We have been doing it. Five years ago, I started working with an offshore food company, Gratis, by the way.

No money, changed hands. And so they came to me and they said, look, we know we're part of the problem. We want to be part of the solution. We know that Kuwait has an 18% diabetes rate and an 80% obesity rate,

and we don't want to be the reason, we want to be the help. Can you help us figure out how to make metabolically healthy processed food? So I convened a scientific advisory team of five members and we worked for the next three years,

looked at every single process, every procedure, every vendor, every ingredient, every product, sent them all for biochemical analysis to figure out what's going into the food, what's coming out of the food, is the food metabolically healthy?

What has to be done? How does it need to be re-engineered to lead to something that is metabolically healthy? And we came up with a set of principles, which we published in Frontiers in Nutrition in 2023. We call it the metabolic matrix.

We basically collapsed it down to nine words, three clauses, nine words, protect the liver, feed the gut, support the brain. That's it. Those three things. Anything that passes your lips,

that protects the liver, feeds the gut, supports the brain is healthy, whether it's ultra processed or not. Anything that passes your lips that does none of the three is poison, whether it's ultra processed or not. So it's actually not the ultra processing, it's whether or not it contributes to metabolic health.

So then we started re-engineering products in the KDD line, and they have 180 items in their portfolio. We have re-engineered 10% of them, 18 products, to become metabolically healthy. And we have tested them on people in Kuwait to demonstrate their metabolic benefit.

And they are on the shelves now. But isn't there, is there a trade-off there because those products might sell worse now that you've removed the stuff that makes them addictive?

No.

So we didn't tell the public that we were doing this. We just did it. And they just re, they just introduced them tell the public that we were doing this. We just did it. And they just re, they just introduced them to the public and didn't tell them. And they didn't miss a frigging beat in terms of sales and in terms of profits.

Don't tell them and it works.

Logically though, the bad stuff often makes the food more addictive.

And that's why this is so cool. It didn't change consumption and it didn't change profits. And that's what they care about. Ultimately, they don't care if consumption changes as long as profits don't. This can be done by other food industries.

We're trying to get them on board. And, you know, I have lots to say about RFK, but he has at least convened a discussion on what's wrong with ultra-processed food. And we're hoping to be able to enter that conversation.

RFK is the health leader, I guess.

Well, head of health and human services here in the United States.

You have a lot to say about him.

I have boatloads to say about him. Most of which you can't print.

What's your general opinion of him and his role in what he's doing etc?

I've been asked to serve in this administration four times and I've said no each time. And it's not because I don't want to be, I do, but it's because my opinion and his opinion would basically get me thrown out after about five seconds. What's the difference? I wouldn't last a second.

What's the difference in opinion?

All right. RFK has five buckets in his portfolio. Food, I'm on board. Pharma transparency, I'm on board. Chemicals in the environment, I'm on board. Chemicals in the environment, I'm on board. Water fluoridation, I'm partially on board.

You could get the fluoride out of the water, but first you got to get the sugar out of

the food.

You can't just take the fluoride out of the water or everybody will get Mountain Dew mouthful at the same time, and that would be a complete and utter disaster. Has to be done in a coordinated public health, PSA driven campaign with everyone on board, including the food industry and the medical profession and government.

And to explain that, there's fluoride in the water in the United States because there's so much sugar.

There's so much sugar in the food. You wouldn't need fluoride in the water if you didn't have sugar in the food. Just explain this. So the United States put fluoride in the water to stop dental caries. Which protects people's teeth. Which protects people's teeth. The point is that only half the countries in the world have fluoride in the water. The others don't. And the reason is because they don't have sugar in the food. The only reason you need to put the fluoride in the water

is because the sugar in the food causes the dental caries. Now, the fluoride reduces the prevalence of dental caries by about 30 to 40%.

Dental caries.

Cavities. Cavities. By about 30 to 40%. Dental cavities. Cavities. Cavities. By about 30 to 40%. Now the problem with fluoride is at high dose, it can be a neurotoxin. Now the goal is for public fluoridation to stay way below that. Now do they? Not really. Sometimes they go above.

So, normal fluoride concentrations, when you're doing it as a public health effort, should be between 0.3 and 0.9 parts per million. Sometimes it goes up to 1.5 parts per million. At 1.5, it becomes a neurotoxin. So it's a purely dose issue.

But one of the reasons why people are screaming about getting fluoride out of the water is because it can be a neurotoxin. It's not supposed to be in doses that are appropriate. But, you know, people don't look at the data. Point is, you could get the fluoride out of the water.

But if you got the fluoride out of the water and didn't take the sugar out of the food, you know, we'd have more dental caries, we'd have more anesthesias, we'd have more teeth pulling, we'd have more sepsis, we'd have more dental abscesses, we'd have more soldiers dying in the field.

It's a matter of national security. So you can't just do it. It requires a coordinated effort.

Is there anything else you disagree with him on?

And then finally, bucket number five, vaccines. I am a pediatrician. I am not a vaccine expert, to be sure. I am not an immunologist, to be sure. But I am a pediatrician, and I know a I am not an immunologist to be sure. But I am a pediatrician and I know a lot about vaccines

and I know a lot about the infectious diseases that those vaccines were set up to basically prevent. And I have taken care of all eight of the diseases that we have child immunizations for. Mumps, measles, rubella, diphtheria, pertussis, tetanus, H flu, polio. I've taken care of all eight of those. And I will tell you right now, when I take care of those,

it's because of someone who didn't get vaccinated. And when I take care of those, okay, the chances are 90% that that kid's going to die. RFK has not. RFK says he can tell whether someone has mitochondrial dysfunction just by looking at them. I'm a mitochondriologist. I can't. Ultimately, RFK's view of vaccines is, shall we say, his and his alone. And it's not shared by the medical community.

And I will not be part and parcel to 3,000 measles deaths because of a blanket disdain for vaccines and vaccine technology, which has worked beautifully to save 154 million people on this earth over the last 50 years.

Yeah, you know, I don't talk about this stuff a lot, but I was, I'm pretty sure at least one of my siblings were saved by vaccination when we were in Africa and we had malaria. I think if I'm accurate here, I had malaria, my brothers had malaria, and I think I was the one that didn't get the malaria vaccine and then I ended up in hospital at a very

young age with malaria. I was like hallucinating and stuff like that. And obviously as someone that was born in Africa, I think you probably have a clearer understanding of the role that vaccines can play in good health. You know, it's quite concerning because when you speak to any scientist,

like all of, the majority of the leading scientists, they're very, extremely pro-vaccine.

We've seen both sides. We've seen what happens when there's no vaccine and we've seen what happens when there is

vaccine. And this is not to say that there can be side effects to vaccines. The vaccine manufacturers and scientists talk about those side effects as well, but the thing that I think people should focus on is the net good that vaccines have done for the last centuries in eradicating illnesses and avoiding disease. My concern, just to close off on this point, is my concern is if there is to be some kind of outbreak anytime soon. We're in such a cloud of misinformation around vaccines

that I worry people might make the wrong decisions. Interestingly, there was a measles outbreak in Texas recently and RFK at one point did eventually prompt the federal deployment of MMR vaccines and expressed support for them because there was a big outbreak of measles in Texas very recently.

I'm going to tell you something now that I have not talked about in public. I had a half an hour with RFK on the phone, one-on-one, back in December of 2024, after the Trump election, and RFK was starting to convene his team, and I was asked to join it. And so I got a half hour with him, and I will relate to you now for your public so that they understand what that conversation entailed. Basically, two threads. By the way, we're supposed to talk about food.

We didn't talk about food, we talked about vaccines. And here were the two threads. First thread, there are three papers in the medical literature that say that vaccines do more harm than good. And he quoted them at me.

And I wrote them down. And I went and looked them up afterwards. And indeed, they say what he says they said. That it's unconscionable that vaccines do more harm than good, and we're giving them to newborns.

Now, it is true that those three papers do say this. There are 50,000 that say opposite, okay? Second thing he said, a woman gives birth to a healthy baby. That healthy baby gets a shot under the skin, and now that baby is not healthy anymore.

That's a tort, a legal tort. And in fact, you could argue that that is in fact a legal tort because duty, negligence, all the way down to damages. What's the remedy for tort? I said lawsuit. He says, right, but that mom can't sue because of the Vaccine Indemnification Act of 1986. So that mom basically has a damaged baby and no recourse. That's unconstitutional. Those were the two threads of our half hour discussion.

Now, everything he said is absolutely true and irrelevant. They demonstrate basically confirmation bias

and he's a lawyer. He believes in precedent. I'm a doctor. One straight, basically, confirmation bias.

And he's a lawyer. He believes in precedent. I'm a doctor. I believe in probability. There's always a risk benefit ratio, unless you're a lawyer, in which case there's only

risk.

And that's how he sees the world. He sees the world as risk.

I don't.

I wouldn't have lasted five seconds.

I think we're both on the same page in terms of making sure people have the right information as it relates to probability. We, you know, everything we do in our life is a factor of probability. Whether I got in a taxi to come here this morning, I understood the probability of that taxi crashing into another car, but I decided to get in the car and come here anyway.

We all deal with these risks every single day.

I want to say on this point of vaccines that there's obviously, it's almost, it's become quite a political issue and there's two sides. And one side, which is more of the RFK side is incredibly skeptical and they have their opinion. Then there's the other side which tends to be dominated

more by the scientists. I interview scientists a lot so I know that pretty much everyone I've interviewed that's a scientist would agree that know, there are side effects, but net vaccines are very positive.

It depends on how you look at it, okay? If you look at it through a public health lens, okay, the vaccines do more good than harm. And if you look at it from a purely individual lens, then you say, wait a second, I didn't get the disease, but I got the shot and I have a vaccine injury.

Therefore, I have been subjected to a tort.

I would just like to close this section by telling people that if there is a health crisis in the near future, some kind of viral outbreak, like we saw with the pandemic, to make sure you get your information from sources that are highly credible and those sources should not include, they should not include, frankly, they should not include podcasts.

No, they shouldn't.

They should not include social media, they should include places like, I'd recommend checking out a website called Consensus. I have no affiliation with them. But Consensus allows you to type in a question you have about health, vaccines, whatever it might be, and it shows you what the sort of peer-reviewed studies say and what the consensus is. So for example, I was using the website a couple of days ago to try and understand something.

And I typed in, is this particular thing healthy or unhealthy? And it comes up with this bar, the team will show it on the screen. And it shows you how much of the scientific research supports that idea.

So it said like 70% of the scientific research says it was positive. It said 25% said it was neutral and 5% said, we kind of don't know or negative. And I think that's a really great tool because there's so much information out there and there's so many studies

and there's one study that says this and another that says this. So using tools like that, I think is a much better way to make your health decisions than podcasts like this or TikToks or Instagrams or tweets, because another thing I wanna say is you might not know this,

I'm just speaking directly to my audience here, but you're currently in an algorithmic echo chamber. And if you want to know what I mean by that, is the algorithm that you have on any of your feeds has been personalized to give you more of the stuff that either scares you, frightens you, concerns you, et cetera.

And if you want to prove this, go and ask your best friend or someone else, a member of the public, to look at their feed. I had really, I remember probably two years ago, I asked my best friend if I could just look at his Twitter feed,

and it was completely different from mine. For one, there was no Manchester United and it was all Liverpool, but then all of the information was completely different as well. And so we're living in these echo chambers where misinformation or things we believe

is being reinforced positively or negatively. So you need a strategy for information, especially as it relates to health.

I couldn't agree more. The fact of the matter is, these algorithms are designed to keep you engaged. They are not designed to keep you informed. It's just that simple. The other problem of course is confirmation bias.

If you have confirmation bias, you will only seek out the information that reconfirms your bias.

And that's what's about to happen.

That's what we didn't used to have, but that's what we have now.

That's what's about to play out in the comment section whenever we talk about subjects like vaccines is, there'll be a group of people who have their own opinions on it, and you're entitled to your own opinion, and they will go at war to confirm and prove that opinion.

And there'll be another group of people that have a different opinion, and they'll go at war to confirm that opinion. What I love, and hopefully, what I think my audience understand me for is I try and remain open minded. And that's like a really fucking hard thing to do these days.

It's hard to do.

I saw a journalist the other day, they said, they were trying to place me politically and they said, we think Stephen is apolitical. And I think that's probably an apt description of my opinions because I have...

I would consider that a high compliment.

It's an amazing compliment. I have views, but I don't sign up to any particular, like, cult, is the way I'd describe it. And you know you're in a cult when your views 99% represent the person who's also in the cult because logically that should never be the case.

That should never be the case. I agree. Cults are a part and parcel of society, unfortunately.

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And they have me and you in their ears and they know That sugar is bad. They know ultra processed food is bad. They still are struggling with a little bit of fat, other sort of diseases. They're probably on the trajectory to some form of chronic disease,

maybe Alzheimer's, maybe dementia, maybe a form of cancer. What do we have? If we're talking direct, let's name her or him. Let's call her Jenny. Jenny's listening right now.

Jenny and Dave, they're both sat there. They're the average American. What do we say to Jenny and Dave to get them to change their lives?

The first thing that you have to say to them is, who are you? Do you know? Do you know? Do you know who you are? Because if they don't know who they are, then nothing else is going to matter.

They have to be comfortable in their own skin, and they're not. The reason that they have glommed on to ultra-processed food is it's providing them with a dopamine hit. And it's probably the only thing that even remotely gives them pleasure.

And if that's all the pleasure they get in their lives, you're never going to fix it, because that's all they've got. So the question is, sorting your priorities at the individual level, what's important to you? What's of primary importance?

Love, relationships. What's of secondary importance? Pleasure, food, drugs. Okay, if you don't have any of the love, relationships, stability in your life, there's no amount of food or drugs

that's going to be able to make up for that. So who are you? What is it that really matters to you? And until you answer that question honestly and affirmatively, you're never gonna get past this.

So let me role play as Jenny and Dave. You've asked me, who am I? I am 30 years old and I work this job. I don't, job's okay. I don't love it. It's not lighting me up.

I'm single, I'm living in this city, and yeah, I'm just, you know, trundling along. Kind of like on the treadmill of life.

And how much stress are you under?

A lot of stress. A whole lot of stress. Every time I open my phone, it's stressful, my emails, my work, there's this thing going on with this person. I think my mom's got a problem with this thing and her health is deteriorating.

So imagine what that's doing to the ATP in your brain.

What's it doing?

It's depleting it like crazy. Number one, you have mitochondrial dysfunction from all the shit you ate and from the, you know, unfortunately from the air pollution you've been breathing and from the microplastics, you know, that have basically taken over your brain. 1,200th of your brain right now, Stephen, is microplastics,

whether you like it or not. So Jenny and Dave probably have more, okay? And you eat well, they don't, all right? So here we are. This is the substrate, this is the base. The question is, how are we going to improve

their ATP generation? How are we going to improve their mitochondrial function? How are we gonna get their neurons to start responding properly? That's the question.

And do you aim at stress as part of the solution?

Yes, of course, you have to. How can you not? Let me give you another quick clinical vignette. Recently, I had the opportunity to have an extended conversation with a hero of mine, Dr. Vivek Murthy, who was the former Surgeon General of the United States. And we were in London together, and I finally sat him down and I said, you know, Vivek, I love your, you know,

espousing of love, that we ultimately need to love each other to get over these systemic societal travails, that we, that love is what's missing. Here's the problem. You can't love if your brain is inflamed. You can't love if your brain is inflamed.

Of course, the reason for the inflamed brain is the ultra-processed food and all the things we talked about, the reactive oxygen species, the cortisol, etc. that we talked about before.

So are you saying people that are metabolically unhealthy, that have inflamed brains, that are under stress, have a reduced ability to love?

Yes. That's exactly what I'm saying. They can't love themselves and they can't love anyone around them.

Explain the science there.

Serotonin. What is serotonin? Serotonin is a neurotransmitter that is necessary for eudaimonia, for being able to be content. Oxytocin is the love neurotransmitter, the reproduction neurotransmitter, the safety neurotransmitter. Okay, the cortisol causes the methylation of the oxytocin receptor, so now the oxytocin can't work,

so you can't feel safe. And the serotonin is necessary to basically suppress that inflammation in the amygdala that's actually causing the buckshot, that the inability to surgically strike like we talked about before, being that lousy point guard. So I said to him,

you can't love if your brain is inflamed. And he thanked me and he, I thought that was the end of that and I'm not gonna bother him anymore. Two weeks ago, I got an email from Vivek saying I've thought about what you said

and I'm halfway through your book and let's talk.

You can't love if your brain is inflamed. I was just looking at a study that says high cortisol levels in a mom during pregnancy can affect the baby's oxytocin receptors, meaning they'll feel less safe.

Exactly right.

And it's epigenetic, it happens even before birth.

I'm trying to play out, so I'm trying to form a couple of hypotheses here around what this might mean in practice. So I mean in the case of the mother, if the mother was under a lot of stress that resulted in cortisol, then the baby's oxytocin receptors, which are the bonding chemical within humans,

the bonding hormone, is gonna be depleted. So if I had a really stressful mother during my conception, whatever that-

During pregnancy. During pregnancy.

During gestation, yeah.

There's a probability, there's a causal probability that I might be less good at bonding with people.

There we are. That's exactly what we're saying.

But I guess also that can take place after pregnancy, whereas if I'm chronically stressed.

It's a continual process. The question is, can it be undone? And the answer is yes, but with a lot of work. And you have to have the baseline substrate to be able to do it.

There's a bit of, what's the term when something becomes a little bit self-fulfilling, where it kind of-

Tautology.

What I'm saying is is if someone's lonely, extremely lonely, and they are in a single apartment alone, which is increasingly a lot of people...

Yes.

Then...

Basements, basements.

Yeah, but even in major cities like London and New York, etc. So many people live in a little shoebox alone.

Yeah.

And I saw the studies that show the average person used to have X amount of friends to turn to in a time of crisis. Now they have on average, it's like one or zero. So loneliness is up. And then I also saw some research that said when people are lonely,

their body goes into a state where they sleep worse, they're more stressed, they're more bitter to people. And I can't remember the term for that, but it's like this heightened sensitivity. And the thesis is that once upon a time and in an evolutionary context,

if you lost your tribe, you would have to be more on edge to survive.

That's your amygdala.

And if that's the case then, it means that it would suggest that if you're lonely, you're higher stress. Yes. But if you're lonely, you're higher stress. But if you're higher stress, you're more likely to be lonely.

That's right. Which is the vicious cycle.

A vicious cycle, that's the term I was looking for.

That's the vicious cycle. Absolutely, I couldn't agree more. That's what we're trying to undo. So here's a question for you, quiz. All right, and you know the answer. Okay, because I've mentioned it already on this podcast. All right, you ready? Yeah. What is the difference between loneliness and solitude?

Loneliness is a lack of human connection and solitude is being alone.

Well, both have a lack of human connection.

I don't know. Tell me the answer. What's the answer?

Serotonin. Okay. If you're serotonin depleted, you're lonely. Well, both have a lack of human connection. I don't know, tell me the answer. What's the answer?

Serotonin.

Okay. If you're serotonin depleted, you're lonely. If you're serotonin replete, it's solitude. You're comfortable in your loneliness. You're happy that you're lonely. Because you're not really lonely, you're alone.

And how does that happen that I become lonely? And in terms of the serotonin mechanism?

Well, you choose to be alone when you're in solitude, but the point is, that's what you want, that's what you chose. You could be with other people, you've chosen to be in solitude. When you're lonely, okay, the reason,

even when people are coming at you, even when you're lonely, okay, the reason, even when people are coming at you, even when you're at a party and you are clearly not lonely, you feel like you are. You feel like you're there all by yourself, even though all these people are around you.

What is serotonin?

And that's because you're serotonin depleted. Serotonin is a neurotransmitter. It's made from a amino acid called tryptophan. Tryptophan is the rarest amino acid in all of the proteins that we ingest. It's the rarest amino acid on the planet.

It's found in eggs, chicken, fish, not exactly ultra-processed food. So people who eat ultra-processed food at high rate are going to be tryptophan deficient and therefore serotonin deficient are going to be somewhat irritable and also somewhat lonely.

And what it does is it inhibits the next neuron. It causes the next neuron not to fire instead of dopamine which causes the next neuron to fire. They are very different. And serotonin, when it's at normal dose, gives you a feeling of contentment.

Not necessarily happiness, but this feels good, I don't want or need any more.

So it's almost the opposite of dopamine.

It's the exact opposite of dopamine. Dopamine is this feels good, I want more. And serotonin is this feels good, I don't want or need anymore.

And serotonin is predominantly made in the gut, 90%?

So 90% is made in the gut. The question is, does the gut serotonin get to the brain? And the answer is through the afferent vagus nerve. So that afferent vagus has to be functional and it has to basically conduct information from the gut up to the brain in order to be able to transduce that.

That is what we call intuition. That is called gut feeling.

So I need my vagus nerve to be healthy.

Yes, you do. And there are a lot of things that are causing that vagus nerve not to be healthy, including all of the gut inflammation that we talked about from the ultra-processed food.

So how do I make my vagus nerve healthy?

Eat real food.

What about those vagus nerve stimulators that everyone's banging on about?

So they're interesting, and they do have benefits for seizure control. Okay, for seizures, the vagus nerve, for some reason, transduces information up and down that help mitigate seizures. No one's been able to demonstrate, to my knowledge,

that you can use a vagal nerve stimulator to actually change emotion.

I was looking at the research and it says exactly what you described that a meta-analysis and long-term follow-ups show a 30 to 50% reduction in seizures for patients who use vagal nerve simulation. But outside of that, in terms of depression, the evidence is modest.

Meager. Meager, yeah. Around 15 to 25 percent show

Which is above placebo

So it's small and then with anxiety. It's the same. There's not there's any low quality and small scale work

They do say though that implanted vagus nerve stimulators show the strongest evidence for epilepsy and depression, but the bottom line is It works well for seizures as you said and there's still a lot unproven as it relates to stress and focus.

I wish they worked.

I mean it would be an easy... you know, one thing you learn from doing what I do with this podcast is you learn that in life there are really not many shortcuts, and everything that appears to be a shortcut, some device, some contraption that's going to fix things, actually either doesn't work, is a scam or has some hidden trade-off. And so it goes back to this really important principle that I think everybody listening

should embody which is there's no free lunch in life. If it appears to be the fast way, it's probably a fast way to something else. And the slow way is the fast way. The hard way is the fast way. This is kind of what I've learned. Like I can try all these things to try and trick,

to try and not, you know, to try and be able to eat sugar, but be healthy. And there's always some fucking trade-off. Like even a Zempac. Exactly. Everyone's talking about Zempac. It's a Band-Aid, not a fix. What do you think of a Zempac?

How much time you got?

All right, well, depends what you think.

People ask me this all the time. I wear three hats, okay? So I'll put my first hat on, my clinician hat. I'm glad they're here, these GLP-1 analogs. They do work. I'm not saying they don't, they do. And God knows if you have a BMI of 40 to 45 and you have tried everything else and nothing else works

and it's a matter of life and death, then I am glad they're here. All right, now let me put my second hat on, my scientist hat. Okay, why do they work? They work in two places.

They work actually at that nucleus accumbens, which I mentioned before, the reward center. It actually seems to reduce reward. It's one of the reasons why GLP-1 analogs are not just being used for obesity, but for alcoholism, for drug addiction,

for many things, because they're basically putting that reward system to rest, which is a good thing. Now, we had a drug that did that back in 2006, put that reward system to rest. It was called remonibant, a trade name, Accomplia. And what it was was an anti-endocannabinoid.

It was an endocannabinoid. It was an endocannabinoid receptor antagonist. It was the anti-marijuana drug. It was the anti-munchies drug. And so it caused weight loss. And it got released in the European Union. The EFSA approved it in 2006.

And within two months of its hitting the market, there were 21 suicides. Okay, and the reason is because if you suppress reward, ain't no reason to get out of bed in the morning. Okay, now, the good news with these GLP-1 analogs is we've been looking for the suicide signal

and haven't seen it. But we also looking for the depression signal and haven't seen it. But we also looking for the depression signal and we see that a lot. So it does seem to be having the same effect, maybe not as severe as Romanoban, but nonetheless, that's a downside for sure.

Okay, now the second place it works, GI tract. It delays gastric emptying. It slows food going through the alimentary canal, especially the stomach.

Okay?

That's why it works. Because you can't eat more if your stomach's still full because it didn't move it along. Okay, that's good, sort of, except it gives you all the side effects. The nausea, the vomiting, the pancreatitis,

the gastroparesis, stomach turns to stone. 3.4% of all people who take GLP-1 analogs get gastroparesis. And guess what? When you stop the med, the gastroparesis doesn't go away. And there is a lawsuit against Novo Nordisk right now

over gastroparesis from GLP-1 analogs. Not so good. In addition, you lose weight. Okay, what kind of weight? Turns out half muscle, half fat. Now losing fat's good.

Losing muscle is not. Losing muscle is actually a risk factor for early demise. Sarcopenia is a risk factor for early demise. Sarcopenia is a risk factor for early demise. Now, what else causes loss of equal amounts of muscle and fat? Starvation.

And that's how the damn medicines work. They're causing you to starve. Well, that's not the best way to do this, people. Also, only one third of people who take GLP-1 analogs actually respond. Two-thirds don't. They don't tell you about those. They're only telling you about the responders. And as soon as you stop taking it, all the weight comes rushing back plus some because you've only

band-aided the problem. You haven't fixed the problem. Also, not such a great thing. And then finally, let me switch to my third hat, my public health advocate hat. Now, I did say these drugs work. 16% mean weight loss.

True.

If everyone in America who qualified for a GLP-1 analog got it, that would be $2.1 trillion to the healthcare system, which is currently $4.1 trillion. So that would be a 50% surcharge over what we're currently paying, and Medicare's gonna go broke by the year 2029, anyway, without it.

So you're gonna put another 50% on top of that? How the hell are you gonna pay for that, for a 16% weight loss? Conversely, if we just got added sugar out of the diet, out of the American diet, to the level of USDA guidelines

of 12 teaspoons of added sugar per day, no more, we could get a 29% weight loss and save $3.0 trillion. That's a $5.1 trillion swing for double the weight loss and no side effects. Which one do you think is better?

Yeah.

That's how I feel about it.

There was a recent animal research study that suggested that things like a Zempec semi-glutides reduced cocaine self-administration in rats by roughly 30% during treatment and cut their drug-seeking behavior by 62% after a period of abstinence, which speaks to some of the things you were saying there about GLP-1's and Zempec's role in the reward pathways in the brain.

So it's interesting.

It's interesting. It's interesting. Very interesting. But what is that saying? It's saying that if you, in these rats, if they were given these GLP-1 antagonists, these Zempeks, these semaglutides,

they were less likely to be addicted to things.

Yeah, I mean, I wouldn't say less likely to be addicted. They're already addicted. They're basically choosing not to continue to consume. We don't know if they're addicted. They're rats. But their behaviors suggest that they're reducing the consumption of the addictive substance.

And what is this suggesting? This means that the GLP-1 is doing what?

Well, number one, maybe the reason that they're not consuming more is because their stomachs aren't moving. If your stomach's not moving, you don't want to take any more, do you?

Maybe, yeah.

Maybe it's that, we don't know. That's one possibility. There's no question that the nucleus accumbens has GLP-1 receptors. The ventral tegmental area has GLP-1 receptors. The ventral tegmental area has GLP-1 receptors. And I actually gave a talk at the California Society of Addiction Medicine on Ozempic.

So we know what the data show. We're still researching this and trying to investigate and figure out what it is. That also wouldn't explain the alcohol story because alcohol is not food. It's liquid. So it's a little different

and it definitely reduces alcoholism, alcohol consumption. So there does seem to be an effect.

Understanding what dopamine does from what you said earlier, it would appear that then these like GLP-1s, the Zempeks are dampening dopamine's release in some way because the rats, when you talked about motivation and dopamine, the rats are less motivated to go and get more cocaine.

Correct.

And that very well may be a good thing. And for certain people, I think we can absolutely use that phenomenon to assist them.

Is that, could that be?

Perhaps that will be a good way to help with drug interdiction.

Did that also mean that I become less motivated period?

Yes.

Ah, that's not good.

Yes, that's what I'm worried about.

Going back to Jenny and Dave, Jenny and Dave both have a little bit of extra weight on them. We've talked about really interestingly, the whole idea that serotonin connection, love plays in a tremendous role, and stress.

And so Jenny and Dave now, they're going to be thinking about their relationships and friendships and going to that run club as a way to help them downstream with addictions and other things they're struggling with. Is there anything else that Jenny and Dave who represent the typical American need to know

to maybe shed some of that body fat?

Number one, ultra processed food is obesogenic. Now, if Jenny and Dave are under stress, if Jenny and Dave are under financial stress, if Jenny and Dave are under time stress, it's going to be really hard for them to turn away from ultra processed food.

So don't expect their weight to get any better until they fix their diet. The one thing I am very sure of is that if you keep eating the same shit, don't expect anything good to happen.

But it's hard.

It's very hard. Some practical types of things. The first thing is that when they go to the store, don't go hungry.

Okay, love that.

That's the first one.

I make that mistake a lot.

Right?

The second thing...

Why?

Let's give some context there. Oh, because if they're hungry, all bets are off. They're done. Because they're more likely to reach for the bad stuff. The bad stuff. Because the bad stuff's calling to them. And by the way, the bad stuff's on the end caps of each of the aisles of the grocery store. And in the middle? In the middle, well, any, if you've gone into the aisles, you've gone off the rails, because that's where the ultra processed food is. So shop around the outside. You have to shop around the outside, which is where the real food is.

The fridges and-

The fridges and the produce and the meats and the dairy.

Okay?

Not to say that there isn't, you know, ultra-processed food and sugar hiding in those places too, but if you've gone into the, you know, standard, you know, aisles, you know, that's where all the ultra processed food is hiding and 73% of the items in the American grocery store

are poison. So if you go into the grocery store, you already have a problem.

So the first one is don't go hungry. The second one is to-

Stay on the outside of the supermarket.

Yeah. Anything else for Jenny and Dave?

And most importantly, you know, I don't want them to have to read food labels because that's kind of, you know, out of bounds. Okay. But they should basically, if a food has a label, it's a warning label. That's how they should look at it. Okay, and if any food has a sugar in the first three items,

the first three ingredients, it's dessert. That's how they should look at it. So, you know, Chinese chicken salad is dessert.

Do you know, the other day I looked at, my friend was drinking a can of Coca-Cola and I picked it up and I thought, I've not seen one of these in a while. I looked at the back of it and it said the sugar quantity in it was something like 40% in that region?

It was 39 grams in a can, yeah. That's right.

I see, so 40% of it is just sugar.

Correct.

And people are just...

There you go.

No wonder.

That's why we have a fatty liver disease pandemic.

And sugar's fundamentally linked to things like cancer as well, right?

Yes, absolutely. And we know why now. We know how. You know, through what mechanisms?

What are the mechanisms?

For cancer?

Yeah.

Okay, so first of all, anything that makes insulin go up increases your risk for cancer because insulin's a growth factor. Okay, secondly, because insulin causes mitochondrial dysfunction.

It increases these other phenomena like for instance, the pentose phosphate shunt and the Randall cycle and the de novo lipogenesis, which is what cancer cells need to be able to multiply and divide. So it's basically feeding the cancer.

Number three, certain cancers, particularly pancreatic cancer, multiply and divide. Okay, so it's basically feeding the cancer.

Number three, certain cancers, particularly pancreatic cancer, have an enzyme in them called transketolase. And what that can do is that can take fructose and turn it into glucose in the cancer cell only so that when you're actually consuming sugar,

you are feeding the cancer specifically. Yet, what do we give cancer patients? Ensure, which is like straight fructose. So you are actually feeding the cancer. So that's like ridiculous, okay? In addition, because fructose interferes

with mitochondrial function, okay, that sends a feedback mechanism to the rest of the cell to divide. Because dividing cells are in growth phase, they don't have mitochondria. That's why cancer cells don't have mitochondria,

that's why fetal cells don't have mitochondria. Anaerobes don't have mitochondria, they grow the fastest. You know, provided that the conditions are right. So, bottom line, anything that interferes with mitochondrial function puts you at risk for cancer.

And are we seeing cancers growing? There's the incidence of people getting cancer, is that growing?

Absolutely, and people getting cancer earlier and earlier, especially colorectal cancer. My God, you know, the mean age of colorectal cancer used to be 50 to 55. It is now, we are seeing patients with colorectal cancer in their 30s and early 40s.

This is why.

Because of sugar.

That's a huge problem.

It is a huge problem.

So that's what I would suggest Dave and Jenny do to start. Okay, but ultimately they have to get their sugar and ultra-processed food consumption under control. And the question is, can they do it alone? Chances are, to be honest with you, they probably can't. The reason is because they're sugar addicted and because the food industry has basically

made it impossible for them to avoid. That's what we have to fix. We have to allow them the capability of being able to access real food. This is why I'm so upset with what's going on with this argument here in the United States over SNAP.

Are you familiar with SNAP?

No.

SNAP is the Supplementary Nutrition Assistance Program, SNAP, also known as food stamps, okay? I actually testified in front of Congress, in front of the House Appropriations Committee last year, to fix SNAP. Now, to get soda off SNAP,

because soda is like the worst thing and it's also the thing that most people use their Snap dollars, you know, their Snap vouchers to purchase. And it's killing people. And so I don't think soda should be on Snap.

And so what I did was I testified, basically explaining the science, you know, in Congress, and I said that what we need to do is take the money that by banning soda sales on SNAP, if people want to spend their own money on soda, that's their business,

but we shouldn't be, you know, using a federal government subsidy program to subsidize their death. We should take the money that's saved from the soda sales and utilize it to improve the nutrition of those same people. You know, real vegetables, dietary supplements, fiber, water, okay, things that will be healthy

for them. In other words, divert the monies. They didn't hear that. things that will be healthy for them. In other words, divert the monies. They didn't hear that. The Republicans are trying to basically gut-snap. They're trying to get rid of it as an entity entirely. And if they can't gut it,

they will basically make it so that they take the soda away, which is good, except it's not gonna improve the rest of their nutrition. Because they're basically just gonna take that money and repocket it. So how you, you know, set these legislation agenda items up is super important. And right now this government's not doing it.

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The messages and emails that you get from people that have heard you on podcasts or have read your books or seen your work in other places, what is the typical question that those people ask? If you had to summarize the question into one question, what is it that people ask you the most?

Is juice healthy?

Really?

Seriously.

That's probably the most common question. You say sugar is bad, but isn't juice healthy?

Is juice healthy?

Juice is not healthy. Fruit is healthy. So what's the difference between fruit and juice? The fiber. Okay, fruit has fiber. The fiber reduces the rate of absorption

from the gut into the bloodstream. And in doing so, you reduce the insulin response, you reduce the glucose response, you basically protect the liver. And because you've prevented its early absorption, it goes further down the intestine

where the microbiome can chew it up for its own purposes, thus feeding the gut and generating short-chain fatty acids, which are therefore metabolically beneficial, anti-inflammatory, anti-Alzheimer's. And the fiber acts like little scrubbies

on the inside of the colon to get rid of colon cancer cells. So you get all sorts of benefits from the fiber in the fruit. But as soon as you juice it, you've thrown the fiber in the garbage.

And so all you now have is sugar water. So eat the fruit, don't drink the juice. Problem is, that's not what the food industry is selling.

What if I put the fruit in a blender and then instead of throwing out the gunk, I keep all the little bits in there?

So what happens is that the blades in the Breville or the Vitamix or the Nutribullet or whatever you use to make your smoothie. Those blades are shearing that fiber into smithereens, into such short pieces that it can't actually act as a lattice work to sequester and prevent that absorption. So the rate of absorption in the intestine is just as fast, and so the fructose and the glucose

will still get to the liver just as fast as it did before when it was juice. So that's not the answer. So making a smoothie out of it is not the answer.

I was looking at the top comments from our last conversation and they're all extremely, I'd say similar, but they're all incredibly inspiring. Someone has written the top comment, which I shall record the screen so Jack can throw it on the screen.

It says, Stephen, I discovered Robert three years ago after my doctor told me I was pre-diabetic. Three years on, my blood levels are completely normal and everyone tells me how good I look recently. This man should be on every TV in the world, but the food industry is trying to shut him up. Follow the work and you will change your life

like he changed mine. Stuart J, 59 years old, male in the UK.

That's very heartening, I'm glad to hear that. Good for you, Stuart.

My friend was diagnosed with stage four prostate cancer and given one year to live. He found Dr. Lustig and rigorously followed his advice. Keto diet, intermittent fasting, regular walking. That was two years ago. He's now in remission.

The cancer is gone. I was diagnosed with prediabetes, fibromyalgia, and decided to cut out all the sugar, including fruit. Not only did I lose 60 pounds in under a year, but my pain went from 10 to a one to two. I had more energy, my A1C dropped to normal levels

and I went from being fully disabled to going back to work full time, cutting out all the sugar is hard, I won't lie. It's also a constant, constant battle, but it is so worth it. And lastly, I listened to this podcast last year. I made a decision on December 28th, 2023 to stay away from all candy, brownies, maple, walnut, scones and all desserts. You get the idea.

It is now approaching December 28th, 2024. And besides re-watching this video, I have made another commitment to do the same thing I did last year. It's a shame that 73% of what's in the aisles in the grocery store have hidden sugar in it and so I haven't gotten radical about it but the changes I've made have made me feel terrific. Dr. Robert is the cat's meow. And he has a giant part in me getting me back purring. I'm 68 and play five days a week, two to four hours a day pickleball.

I love the choices I've made. I love you, doctor.

You know what? I love you too. And I'm 68.

Well, that's Leslie. She's quite a pretty.

Oh, very nice.

How does that make you feel?

Very heartened.

I can see the emotion in your face.

Yeah, very heartened, I can see the emotion in your face. Yeah, I'm very heartened, but you know, the problem is not fixed. The problem is fixed for each of these people, but the problem is not fixed. And because the problem is not fixed, I still have a job to do. So it gives me more strength to do it, it gives me more purpose and gives me more reason to do it. But, you know, the problem's not fixed.

Do you think one of the most impactful things that we could all do for our health is just to reduce our sugar consumption?

That'd be, that's job one, okay? There are many things, but without question, that's the easiest one. And to be honest with you, the food industry should be helping us do that. The only reason the sugar's in the food

is because they wanted it there. They put it there on purpose because they knew when they added you buy more.

And exercise, how does that impact my decision to reach for sugar or not reach for sugar?

Well, it doesn't really impact your desire to reach for sugar or not reach for sugar? Well, it doesn't really impact your desire to reach for sugar. It has its own metabolic benefits. Totally for exercise, don't get me wrong. I am completely for exercise. Exercise does many good things, but burning calories is not one of them. Okay, people think, oh, you know, exercise to work off the donut that I ate. Wrong, forget it, that's not what it's about. What does exercise do? Exercise increases mitochondria, and that's good

because you need increased mitochondrial reserve in order to make all that ATP. Exercise increases brain trophic factors which are necessary for cognition. And it's been shown now that exercise is one of the primary methods

for mitigating risk for dementia. Okay, it increases brain derived neurotrophic factor, it increases leptin, all of these are necessary to promote synaptogenesis and even increase neurogenesis, more neurons, you know, so that they don't die. So I'm all for exercise.

Exercise also increases muscle mass, and muscle mass, you know, is a mitigating factor for early demise. Like I said, sarcopenia is a risk factor for early demise. So exercise is the way to undo that. Having said that, none of that had anything

to do with weight loss. Okay, so if you think exercise is going to make you lose weight, you are deluded. You are under a delusion. You have adopted the calorie hypothesis. I am here to dispel, I am here to destroy

the calorie hypothesis. A calorie is not a calorie.

So many of the people that are listening to this conversation right now, if they're in the United States or if they're in other parts of the world that have similar health stats, are diabetic or pre-diabetic. One in 10 people worldwide have diabetes, and in the United States, one in three to four of adults that are listening right now are pre-diabetic, even if you don't have a huge amount of fat on your body.

You can- It's actually 40%, four out of 10.

Which is crazy.

Yeah.

That's right.

It means that almost half of the people listening right now, whether you know it or not, could well be pre-diabetic if you fit into the statistics that we have here.

I mean, terrifying?

Oh yeah.

So for those people that are pre-diabetic, that have just found out, because there was, I asked this question because there is a guy here that says his doctors just told him he's pre-diabetic and he's listening to the show probably again. So I wanted to offer him something. His doctors just told him that he's pre-diabetic. What should he be doing?

All right, first thing, get rid of all ultra processed food from your diet. Okay. And in the process, you will have gotten rid of all the sugar from your diet. That's the first thing. See how that works.

Okay, spend two weeks doing just that. If that works, fantastic. If that doesn't work, add some exercise.

Walk.

Walk your dog.

Okay, so on the first point, should he be using a glucose monitor to help him? some exercise, walk, walk your dog.

Okay, so on the first point, should he be using a glucose monitor to help him? Because people can get on Amazon or these other websites, very, you know, $20, $30, you can get a glucose monitor for your arm.

Yeah, so I am for glucose monitors. And the reason is because they are a substitute, a proxy for insulin. When the glucose goes up, that means the insulin goes up. And it's the insulin that really makes the difference. So we have documentation of the fact that by monitoring

your own glucose concentration, you can see improvements in metabolic health down the line. You can food log, you can use the glucose monitoring, you don't need to do glucose monitoring, you can just do it with the food logging and it will still work. Bottom line, there are a whole bunch of scientists who are against using glucose monitors for non-diabetics and they write about this routinely.

They seem to write about it always in the New York Times. I am completely 180 degrees opposite on that. I think it is a very good idea. The reason that they say it is a bad idea is because if you're using the same outcome variables as for diabetes, time in range, time above range, time below range, well, these are non-diabetic.

So, of course, all of those numbers are going to be in the center. They're going to be in the time in range, time below range. Well, these are non-diabetic. So of course, all of those numbers are going to be in the center. They're gonna be in the time in range. So it looks like there's no benefit to that. Okay, that's not the point. The point is the downstream outcomes,

which come three months later. They're not looking at that. We have those data. We are looking at that. And the data are very good.

Do you know what, Joe, what I think is really, really useful with those CGMs, those continuous glucose monitors that you can buy online super cheaply, is they just educate you on the impact that different foods you might've thought were healthy, like the juices we talked about.

Like rice.

Yeah, like, oh my God, white rice. That's actually one of the big things I learned. There's two things that shocked me, three things that have shocked me over the last couple of years that I thought were healthy. So I grew up thinking that orange juices were healthy. I remember being a young kid and getting the Sunny Delight out of the fridge

and like glugging it because I'd seen on the advert, it said vitamin C, good, glug it. I've come to learn. That was their subterfuge and you were a victim. I was a victim and I would like compensation, Sonny D.

I think the entire UK population, US population deserves compensation.

There's a young lady in the comment section who watched our conversation last time. She said a quote from this doctor that I loved and I've never forgotten is, "'Any food that is linked to a television commercial "'should not be consumed,' brilliantly said,

"'and a great boundary to put in place.'"

Yep, that's right.

"'Any food that is linked to a television commercial "'should not be consumed,' it's so true. "'They don't put cucumbers in television commercials. Nope.

Not enough marketing money, not enough margin.

So Sunny D, the orange juices generally, I don't drink any juices anymore. Haven't for years now. The other one was white rice. I thought that was healthy growing up. Thought it was really, really healthy.

And then I did a continuous glucose monitor with a company that I'm an investor in called Zoe. And it gave me this, it was like, it was horrific, the impact on my gut microbiome and my glucose levels. And the third one was tomato ketchup. I didn't know there was so much bloody sugar

in most ketchups.

In fact, Heinz ketchup is half high fructose corn syrup.

Madness.

And that's the, I think that's the value of getting a continuous glucose monitor, even if you just run it for 14 days, is you'll learn your relationship with these things you frequently eat. And most of us are frequent eaters,

we eat the same kind of things. And you can make some trades. What is the most important thing we haven't talked about that we should have talked about, Robert?

I know what we haven't talked about. Psychedelics. What would you like to talk about with psychedelics? Psychedelics are serotonin. A big dose, a big glug of serotonin all at once. What serotonin does is it provides you with this sense of complacency, of eudaimonia, of contentment. Serotonin is necessary to rewire areas of the brain. You can actually see it on MRI. It's actually leading to synaptic rewiring. Think of it this way.

Can I just confirm that, just on one point? You're not saying that psychedelics create serotonin, you're saying that they are the

same- No, they're a serotonin mimicker. Okay, yeah. They mimic serotonin. Yeah. Think of it this way.

You live on a mountain, okay, with snow. And you have to, every week, go down to the general store at the base of the mountain. And you ski down there, and you ski down there, and you ski down there. And the snow falls, and you ski down there. And soon, what you've done is you've created ridges

in the snow for you to get down the hill and they freeze and soon the only way to get down the hill is through the ridges that you've created. You are now basically in a rut. You have trapped into that path. There's no other way out your house

other than those ridges that have frozen in place. That's what's happening in your brain. You can't unthink your way out of it because that's the only way you know. Psychedelics are like a huge, enormous blizzard filling in the ruts, filling in the ridges.

So you end up with a pristine, you know, snow bank for you to be able to basically ski any which way you want. It's your way out of your rut. And what we have in America, and UK too, is a whole lot of people with a set of belief systems that have put them into ruts that they

can't think their way out of. Now, can this be done without psychedelics? Absolutely. But it's hard. Psychedelics are a way to, shall we say, hack that belief system concept and allow

you to rethink your own life and the life of the people around you and how you interact with them. And we need more research in this to solve mental illness and also improve the well-being of,

you know, sizable proportion of the population. I'm a big fan of the research taking place with in the psychedelic field. I actually spent a year of my life in what I believe is the biggest psychedelics company in the world as an investor and then as a director in a capacity where I was helping to drive fundraising through marketing and then the company

is now a public business that's doing a lot of the clinical studies.

Which one is it?

It's the Thai Life Sciences. I've obviously compassed pathways as well. I'm an investor in that company and I'm a big fan of what MAPS are doing as it relates to using these molecules for mental health disorders and treatment resistant

depression, PTSD, anxiety, et cetera. And it's so shocking to me that, it's taken so long to...

Yeah, well, they got a bad rap from Nixon, back in the 1970s. And I understand why. By the way, no one should do psychedelics alone. You do them with a guide, you do them with someone you completely trust,

where safety is paramount, and they can be really remarkable.

And we talk about set and setting, which is, hopefully they'll be done in clinical settings with a, as you say, with a practitioner.

Yes, that's the only way they should be done.

Dr. Robert, we have a closing tradition on this podcast where the last guest leaves a question for the next, not knowing who they're leaving it for.

I knew it was coming.

Yes, you did.

Looking at your life and the lives of others, how would you describe the journey of life and how to approach it?

When you come out of the box, when you're born, you already have neurons and synapses and neural pathways that have developed even though you've had no experience. The experience will either solidify those or destroy them. Ultimately, those turn into belief systems. Almost every belief system that you thought you understood about how the world works is wrong. You have to be open to the fact that

all the things you thought were true aren't. And if you are that open with yourself, you will know yourself. And if you know yourself, you can be happy. But if you, you know, believe your belief systems and you never question them,

you're never going to get there.

Amen. Robert, thank you so much. I mean, I say to some people sometimes at the end of these podcasts that they're doing good in the world, but you're quite frankly saving a lot of people's lives. I mean, the fact that all the top comments on the video seem to be dominated by the same narrative that you've saved someone's life, you've improved their life is, I mean, is there any higher work one can do with their life than improve the quality and duration

and health of someone else's life? And that's exactly what you're doing. It's what you've done through your public advocacy work. I know you recently spent some time with Prince Charles in the UK, which is incredibly exciting, the King of England,

talking to him about health outcomes and all of the work that you've been doing. And it's what an honor it is to be invited by him to him asking for your opinions and your perspective on health, which I need to say is something that's quite close to the heart of the King.

And then through these books, these incredible books that I have in front of me here, which I'm going to link all of them below. This one's new, right? So this one's a new right? So this was it's coming out September 16th. Okay, so that'll be out by the time the conversations I believe and These incredible books. I mean there's so many of them that I can't pick a favorite child

But they're all incredible depending on what where people are at in their lives and what they're trying to understand Robert. Thank you so much

It's been my pleasure

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