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Nov. 8, 2017 - The Joe Rogan Experience
02:46:11
Joe Rogan Experience #1037 - Chris Kresser
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chris kresser
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Speaker Time Text
chris kresser
Move over a little bit.
I see him.
All right.
joe rogan
Three, two, one.
Yes.
All right.
Welcome back, Chris.
What's up, man?
How's things?
chris kresser
Happy to be here.
Things are good.
joe rogan
Happy to have you.
chris kresser
Yeah.
joe rogan
What's the latest and the greatest with you?
chris kresser
A new book came out yesterday.
That's always a big one.
joe rogan
What's it called?
chris kresser
Unconventional medicine.
joe rogan
And give us the...
What are those sheets?
The back sheet?
chris kresser
What's that called?
Yeah, the back sheet.
That works.
The biggest challenge we face today is chronic disease, and conventional medicine has failed to address it, so we need a new system.
That's the nutshell.
joe rogan
And you're essentially doing nutrition-based Three components.
chris kresser
Ancestral diet and lifestyle, which we've talked about, functional medicine, and a collaborative practice model that incorporates health coaches, nutritionists, and other allied providers to offer more support to patients.
joe rogan
What does that mean when you say functional medicine?
chris kresser
So the easiest way to understand it is it's an approach that is geared towards addressing the underlying cause of a problem instead of just suppressing the symptoms.
So you go into the doctor, you've got high cholesterol, usually given a drug to lower it.
joe rogan
Statins.
chris kresser
Yep.
You've got high blood pressure.
joe rogan
And those are devastating to your health, right?
Statins or...
chris kresser
Well, you know, for some people they can be.
I wouldn't say they're devastating for everybody, and they do save lives in certain situations, but the idea that they're the first thing we would do in that situation, that's what's off.
joe rogan
Right, that you wouldn't suggest, like, altering the diet.
chris kresser
Exactly.
Let's look at why the cholesterol is high in the first place.
Same thing with high blood pressure.
You go into the doctor, high blood pressure, you get a drug to lower it, there's rarely any investigation into why the blood pressure is high.
joe rogan
And what are the main factors with high cholesterol?
Because I know that a big part of it is hereditary.
chris kresser
Yeah.
joe rogan
Right?
Genetics play a huge role.
chris kresser
Yeah.
So the genetics is one, for sure.
But then you have things like poor thyroid function can actually lead to high cholesterol or LDL particle number.
You've got infections can do that, like H. pylori, which is the bacteria that causes ulcer.
You've got leaky gut.
Intestinal permeability has been shown to do that.
joe rogan
That's interesting.
Did you talk about this before?
A lot of people are not aware of that, that there's actually gut bacteria that causes ulcers.
chris kresser
Yeah, yeah.
It's a cool story, actually.
So, you know, 20, 30 years ago, the dominant idea was that ulcers were caused by stress and things like eating spicy foods.
And a couple of Australian physicians presented at a conference this notion that, no, actually they're caused by this bacterium called Helicobacter pylori.
And they were literally laughed off the stage.
Nobody took them seriously.
They were ridiculed.
And they kept going, kept doing this research, kept trying to present this idea, and nobody would take them seriously.
Finally, one of them swallowed a vial of solution that had the bacterium in it, developed an ulcer, As a result, and then treated himself with antibiotics and got rid of the ulcer.
This is how committed this guy was to this idea and proving this.
And finally, at that point, people started to pay attention, but it still was another 10 years before that theory was widely accepted.
And then they eventually won the Nobel Prize in medicine as a result of that discovery.
So to me, that's a great example of how groupthink is such a problem in medicine.
We have a tendency to just get stuck on the status quo, even though a core principle of science is uncertainty.
We come up with a hypothesis.
We have to be willing to challenge our most cherished views all the time.
Because if we look at the history of science, it was the history of most people being wrong about most things most of the time.
joe rogan
Yeah.
And it's amazing how many people are still operating under information that has been updated many times over the past couple of decades.
chris kresser
Absolutely.
joe rogan
Talk to the average person about what you should eat.
I mean, they're looking at, like, the food pyramid from the Dr. Seuss books.
Exactly.
I mean, really.
chris kresser
Yeah, or another one is you probably saw some articles like stents.
joe rogan
Yes.
chris kresser
They don't work.
joe rogan
Yeah, I just read that.
chris kresser
It just came out.
They don't work, but they're still massively being used in part because doctors get paid for that.
joe rogan
Now, that's crazy because I thought a stent was like...
I thought it propped open the artery.
I mean, what does it do?
chris kresser
Right.
But the question is, does that actually have the desired effect?
joe rogan
I think it was based on pain, wasn't it?
chris kresser
And mammograms were supposed to prevent breast cancer, but then we saw the huge randomized controlled trial that showed that not only do they not prevent breast cancer, they may actually increase Death as a result of unnecessary treatments that come from the mammograms.
joe rogan
What?
chris kresser
Yeah.
joe rogan
How would you get an unnecessary treatment if you did a mammogram and you saw a lump?
chris kresser
Well, it's not always black or white.
joe rogan
So it could be a cyst or something on those lines?
chris kresser
Yeah, and then somebody gets unnecessary treatment and it leads to an adverse event.
So I'm just saying we've got to be humble.
And realize that we don't always have the answers and that in 10 years, it's going to look really different than it does now.
Just like 100 years ago, everybody thought they had the answers.
And we look back on them and we say, how silly.
But we forget that people 100 years ahead are going to look back on us with that same...
That, you know, they're going to shake their heads.
joe rogan
Yeah, it's very unfortunate, but that is a tendency that people have when they've been living their life based on, like, what they think is, like, certain rigid information.
Like, this is absolute, this is true, and they've been teaching that.
That's when it gets especially problematic, or writing books about that.
chris kresser
Yeah.
joe rogan
And then they just never want to admit that their book is bullshit.
chris kresser
And I think our education system needs to change medical education because, you know, you write a textbook and that takes a long time.
And then, you know, the textbook is used in course, like the medical schools are still using the nutrition textbooks that were probably written in the 70s or the 80s or something.
And then we get all these new studies showing that, like, cholesterol on the diet has no impact.
You know, on your blood cholesterol for most people.
joe rogan
Now, say that again, because for a lot of people, they're like, what did he just say?
chris kresser
Yeah.
So, even the American, the standard U.S. diet guidelines last year, a lot of people might have missed this, they completely removed any restriction on dietary cholesterol from the U.S. diet guidelines.
They basically said, there's no reason to limit cholesterol on your diet anymore.
joe rogan
Now, for people who don't know why this is so crazy or how this came to be, you need to go to the New York Times article on how the sugar industry bribed scientists and convinced scientists to publish faulty or false information pointing towards saturated fats and cholesterol as being the cause of heart disease and heart attacks and all these different ailments.
So that they could push the blame away from sugar.
And I think they only got paid something like $50,000 to do it.
chris kresser
Yeah.
joe rogan
Which is amazing to think about how many people that's affected.
chris kresser
Yeah.
And these, I mean, these conflicts of interest are everywhere.
It's a big problem.
joe rogan
That's not just conflict of interest.
I mean, that's just crime.
chris kresser
Right.
joe rogan
They did some horrible things to people.
chris kresser
It totally, you know, it's unfortunately pretty normal in medicine.
There was a study that just came out a few days ago.
It showed that the more gifts doctors receive from pharmaceutical companies, the more expensive the drugs they prescribe and the more prescriptions they write in general.
joe rogan
Yeah, I would imagine that's true.
My wife's mom was a nurse, and she would tell me stories about how they would take them out to nice dinners, fancy restaurants, and everything on the house.
chris kresser
It's human nature.
I mean, one of my favorite quotes is from Upton Sinclair.
He said, it's difficult to get a man to understand something when his salary is dependent on him not understanding it.
joe rogan
That's a great quote.
So, one more time, dietary cholesterol has no impact Yeah.
chris kresser
Well, I'll be more specific.
So, in 70% of people, eating, you know, egg yolks and cholesterol and meat and other things doesn't do anything to your serum cholesterol, the cholesterol levels in your blood.
In 30% of people, you'll get a slight raise in your LDL cholesterol, the so-called bad cholesterol, but you'll also get a raise in your HDL cholesterol, which is the so-called good cholesterol, which means there's no net clinical Impact of that in terms of your risk of heart disease.
And this is why the U.S. finally, the last industrialized country to actually do this, they finally said, okay, well, we just can't do this anymore.
We can't tell you not to eat dietary cholesterol because there's just not any evidence to support that.
joe rogan
What took so long?
chris kresser
Well, I think you just referred to one of the reasons, you know, conflicts of interest, people that were invested in maintaining the status quo.
I think also there's probably some concern about losing credibility.
You know, these government organizations, if they told us not to eat cholesterol for so long and then they tell us that we can and it's not a problem, and they do that with saturated fat, you know, people stop listening because they just throw up their hands.
They're like, I don't know who to believe or what to listen to.
joe rogan
Saturated fat is another one.
You talk to the average person, they think you should restrict your intake of saturated fat.
chris kresser
Yeah, average person, most doctors still.
I think there is some nuance here, and maybe we talked about this on the last show, but where we're headed, in my opinion, with diet and nutrition recommendations is from general blanket recommendations that apply to everybody to more personalized recommendations that depend on your genetics, your goals, your lifestyle.
Your health status, your age, etc.
So let's take somebody who is ApoE44, which is a, you know, has a certain genetic haplotype, and they have, you know, they're They're really sensitive to the dietary effects of saturated fat if you have that genotype.
How common is that?
Not very common at all.
I can't remember the exact percent.
It's below 10%.
I think it's 3-4% or something like that.
And if those people eat a lot of saturated fat, their LDL particle number, which we can define if you want to, those are the particles that carry cholesterol.
Can go up pretty quickly.
And what we know, at least from the research that we have, is that people who have a much higher LDL particle number can be at higher risk for heart disease and Alzheimer's.
There's some murkiness there because that's just on average.
We don't know if that risk applies to people who are eating paleo type of diet, doing CrossFit, taking care of themselves in every other way.
We just know that the The general population, in the general population, a higher LDL-P leads to a higher risk of these conditions.
joe rogan
I'm sorry to interrupt you, but I know some people know this, but some people don't.
What is the difference between LDL and HDL, and why is one good and one bad?
chris kresser
Well, here's an example of how things are changing again.
So historically, the idea has been that LDL, which stands for low-density lipoprotein, and HDL stands for high-density lipoprotein.
The LDL, the idea was it was bad, has a number of effects that contribute to the risk of heart disease, whereas HDL does a kind of like cleanup and repair process and actually reduces the risk of heart disease.
But just a couple weeks ago, there was some pretty...
Influential research published suggesting that HDL may not be actually so protective and it may be more of like a bystander effect where people that have lower risk of heart disease just also have higher HDL and it's not that the HDL is protecting them, it's whatever other underlying processes are protecting them happen to lead to higher HDL levels.
And the reason that they think this now is that they've done a whole bunch of trials on drugs that raise HDL, and guess what?
Nothing happens.
The people who have an increase in their HDL because of the drugs don't have a lower risk of heart disease.
In some cases, they've even had to stop the trials because it became clear that there was not only no benefit, but maybe even some harm.
joe rogan
What kind of harm would there be?
chris kresser
Just more cardiovascular events or more deaths.
joe rogan
Oh, wow.
chris kresser
So it's just another example of something that we just assume for so long is true, and then we find out that it's not true.
joe rogan
I had a conversation with a guy who was a brilliant guy, and we were talking about eggs, and I said I like to eat about four to six eggs a day.
He's like, wow, what about all the cholesterol?
And I'm like, wow, you don't know?
You don't know that, and you're a really smart guy.
This is kind of stunning.
chris kresser
Yeah, I mean it's and it's gonna take so so what I just told you about HDL think of everything that has to change to reflect that new understanding you've got textbooks that need to be rewritten you've got primary care guidelines you've got it's just massive it's almost impossible to get our head around and so the average primary care provider is not going to get this message for decades right I would say decades not more than years that's crazy yeah so they're going to be giving out bad advice to people So the average person who works all day and doesn't have
joe rogan
the time to do the research that you do or maybe isn't informed about all the various blogs and books and just doesn't have time, goes to his primary care doctor and asks him questions, and he gets terrible information that could lead to poor health.
chris kresser
The primary care doctor doesn't have the time either.
They're in a bad spot.
I know a lot of primary care physicians.
Everyone I know went into medicine for the right reason.
They're trying to help people.
They're doing their best, but they're seeing 2,500 patients.
That's how many they have on their roster.
Their average visit is between 8 and 12 minutes.
Because they get reimbursed based on the number of visits.
So in order to make a living, they see a certain number of patients a day, and the insurance companies often mandate that.
So in a 10-minute visit, a patient shows up with multiple chronic conditions, taking multiple medications, and then presenting with new symptoms that they're concerned about.
There's barely enough time to say hello and figure out what's going on with their meds and make an adjustment and make a new prescription, much less to talk to them in any kind of meaningful way about their diet and their lifestyle and their behavior.
joe rogan
Forget it.
chris kresser
It's impossible.
So the primary care doctors, I think, are as much victims Of our conventional system and the way it's set up as patients are.
And if they're busting their butt, seeing patients eight hours a day every day, and then they have all the paperwork to do on top of that, last thing they're going to want to do is go home and fire up PubMed and start reading the latest studies that have come out.
joe rogan
Yeah, for sure.
Going to be exhausted, non-motivated.
chris kresser
Yeah, and they got families, you know, they have other things to do, and there are studies that have shown that the majority of primary care physicians, understandably, given this situation, receive most of their education from pharmaceutical sales reps.
You know, who bring in the brochures that talk about a particular condition.
And of course, that's not going to be unbiased information.
joe rogan
That's hilarious that they get their information from that.
Wow.
chris kresser
Yeah, because the reps come to the office.
Yeah, of course.
And they have the brochures for the drugs, and the brochures talk about the condition.
joe rogan
And they have cartoons and pictures in there showing you the bad stuff that's happening to your arteries.
chris kresser
It's a crazy system, and we're in big trouble.
I mean, that's the message in my book.
This is not just about individual health.
My first book was about taking back your own health.
This book is about taking back health care.
Because we're screwed.
If you look at the numbers, by the year 2040, it's estimated that 100% of the federal budget will go towards Medicare and Medicaid expenses, leaving nothing for anything else.
Military, education.
joe rogan
By 20 what?
chris kresser
2040. What?
Talking about our lifetimes.
joe rogan
That's real?
chris kresser
That's real.
If healthcare spending continues to increase at its current pace.
joe rogan
That's insane.
chris kresser
You're right.
joe rogan
That doesn't even make sense.
chris kresser
This is why the Department of Defense has named healthcare as an existential threat to this country.
Just like nuclear war or any other military threat, they've named chronic disease as an existential threat that could actually threaten our survival as a nation.
unidentified
Wow.
joe rogan
Who ever thought of it that way?
Who could have ever imagined that literally all of our budget would go to taking care of people's health by 2040?
That's not long.
chris kresser
It's not long.
joe rogan
That's 22 years from now.
chris kresser
Let me give you a few examples just to make this more clear.
So the cost of treating a patient with type 2 diabetes is estimated to be $14,000 a year.
So we know now that 100 million Americans, that's like a third of the population, have either pre-diabetes or type 2 diabetes.
unidentified
What?
chris kresser
Yeah.
joe rogan
Wait a minute.
chris kresser
CDC just published these numbers.
100 million Americans.
joe rogan
That's insane.
chris kresser
Pre-diabetes or type 2 diabetes.
joe rogan
One third?
chris kresser
One third.
That is...
joe rogan
I'm having a hard time with this.
If you had just asked me, like, what percentage of Americans have diabetes, I probably said, like, 4%, 3%.
chris kresser
Yeah, well, the percent who actually have type 2 diabetes is lower.
But I said pre-diabetes or type 2 diabetes.
joe rogan
Well, they're on their way.
chris kresser
Yeah.
joe rogan
A third.
chris kresser
So here are a couple other stats.
88% of people who have prediabetes don't know that they have it.
88%.
And the average amount of time it takes for someone to progress from prediabetes to full-fledged type 2 diabetes is just 5 years.
joe rogan
Wow.
chris kresser
So let's go back to that number.
$14,000 a year to treat a single patient with type 2 diabetes.
Imagine someone gets diagnosed at age 40, which is totally possible.
I mean, now even 8-year-old kids are being diagnosed with type 2 diabetes.
And imagine that person lives another 45 years, which is also feasible because we have these...
One of the amazing things about conventional medicine is the technologies that keep us alive probably a lot longer than we should be.
So let's say that person lives 45 years, we spend $13,000 a year, $14,000 a year treating that person, that's $630,000 to treat one patient with one disease over that patient's remaining lifetime.
Now, if you start doing some math and you assume, you know, even 50 million people with diabetes times $630,000, you get a number with so many zeros after it, I don't even know what it is.
It's like a Google or a Googleplex or something.
So, this is why we're facing this threat, and this is why I wrote the book.
It's like, people aren't aware that we're at this point where, you know, like, one in two Americans now has a chronic disease.
One in four have multiple...
joe rogan
One in two Americans has a chronic disease?
chris kresser
One in two.
One in four have multiple chronic diseases, and I know you're a parent, so, and I am too, 30% almost of kids now have a chronic disease, and that's up from just 13% in 1994. So there's been more than a doubling of kids with chronic disease in less than 25 years.
joe rogan
What has changed in the American diet?
Are you attributing it to the American diet?
Or is it environmental effects as well?
chris kresser
All of the above.
So I would say it's the diet.
It's an increased sedentary activity.
We've been sitting for very long periods, not moving around, not enough exposure to natural light, too much exposure to artificial light, not enough sleep.
So all of these things come together, and now we've got a nation of people with chronic disease.
Disease is bankrupting our country, and it's extremely difficult to treat.
It lasts for a lifetime.
And our only hope, actually, of dealing with this problem and surviving as a country, as a nation, is to figure out a way to prevent and reverse disease instead of just suppressing symptoms and putting Band-Aids on it, which is what our current conventional medical system does.
joe rogan
You really scared me with that diabetes number.
That's really freaking me out.
I can't believe that.
What are you pulling up, Jayme?
More than 100 million Americans have diabetes or its precursors.
Staggering CDC report reveals, and this is just from July.
chris kresser
Yeah.
unidentified
Wow.
joe rogan
In 2015, at least 1.5 million new cases were diagnosed in people over 18. It means that now a third of the U.S. population has diabetes or pre-diabetes.
chris kresser
Let me throw a couple others at you.
The CDC just updated its obesity statistics.
Now 40% of U.S. adults are obese.
joe rogan
Oh, my God.
chris kresser
40%, 4 in 10. Not just overweight, obese.
joe rogan
40%?
chris kresser
40%.
And almost 20% of adolescents are now obese.
joe rogan
Now, are they basing this by those body standards?
chris kresser
Body mass index.
joe rogan
Yeah, but I'm obese then.
chris kresser
Yeah, it's not perfect.
joe rogan
That doesn't work.
chris kresser
It's not perfect, but it's not so imperfect that we're talking about a 20% difference.
joe rogan
Look at body mass index, 5'8", 200 pounds.
I think I'm like dying.
I think, like, if you look at the body mass index, I think I'm, like, of terrible health.
chris kresser
But all you have to do is go to an airport.
You know, I just flew down here.
You sit in an airport and you look around, you know the statistics are correct.
joe rogan
But there's also a lot of people that lift weights.
Like, there's a lot of people that are bigger.
I would like to know what the, you know, what am I, obese?
Yeah, I'm obese.
Come on.
chris kresser
Damn.
joe rogan
That...
Come on, son.
chris kresser
I mean, look, but you don't have diabetes.
I have 10% body fat, too.
joe rogan
It's just not real.
chris kresser
That's not real.
Well, I don't know.
I think that statistic, I mean, what do you think?
Out of 10 people that you see on the street, are four obese?
joe rogan
Well, if I'm obese, now I know that I'm obese, according to that.
You've got to throw that thing out the window.
That's not a good metric.
chris kresser
It's not a perfect metric, but they have done studies where they have accounted for that and you do see some variation, but you're not the norm.
You're an outlier.
joe rogan
I'm aware of that, but I think there's probably got to be quite a few outliers out there.
chris kresser
There are quite a few, but not enough to change that statistic in a really meaningful way.
There aren't 20% of you.
It's not going to drop that from 40% to 20%.
joe rogan
So maybe 40 to 35?
Is that reasonable?
Still a lot of people.
chris kresser
I would say maybe 40 to 39 or 38. Jesus.
So here's the deal.
We can't It doesn't matter who, so the whole recent healthcare debate with, you know, Affordable Care Act and then the current administration suggesting something different, that whole discussion revolved around how we're going to pay for healthcare, you know, health insurance.
But we have to understand that health insurance is not the same thing as healthcare.
It's a method of paying for healthcare.
And my key point in the book is it doesn't matter what method of health that we use to pay for health care, whether it's the government, whether it's corporations or whether it's individuals.
There is no method that's sustainable in the face of the rising rates of chronic disease that we're seeing.
There's nothing that we can do.
joe rogan
What's fascinating is that I am pretty aware of this stuff and I didn't know what you're telling me.
And I'm stunned.
I'm stunned at the number of people with chronic disease, and I'm stunned at the number of people that are either pre-diabetic or diabetic.
I really don't know how to digest that.
That's horrific.
And that could be attributed almost entirely to diet and a lack of exercise.
chris kresser
It's a preventable disease.
That's the crazy thing.
Type 2 diabetes is a fully preventable condition.
joe rogan
And type 1 diabetes varies in what way?
chris kresser
Yeah, it's an autoimmune condition, and it's strongly genetically mediated, which means that it doesn't necessarily mean that if you have the genes, you're going to get the disease, but there's 50% of the risk, I think, is the statistic that I've seen of type 1 diabetes is genetic, whereas we know now that 85% of the risk of disease in general comes down to environmental and behavioral factors.
joe rogan
Behavioral meaning your diet.
chris kresser
Yeah.
Or your sleep or your, you know, physical activity, stress management, etc.
So that means only 15% of the risk of disease is genetic, you know, purely genetically driven, whereas the other 85%, which is a vast majority, is actually under our control.
joe rogan
I was looking at a statistic that made a correlation between sleep and weight loss and saying that people who slept an average of 8 to 10 hours a day had a significant Significantly less body fat and weighed less and lost more weight than people who did the exact same activity but slept four to six hours.
chris kresser
Yeah.
I would say that among people who research weight regulation, sleep is now recognized as being the second most influential lifestyle factor that determines our weight aside from diet.
joe rogan
Whoa!
More so than exercise.
chris kresser
Ahead of physical activity.
So I got a couple of good ones for you.
A single night of sleep deprivation has been shown to cause mild insulin resistance even in healthy people with no pre-existing blood sugar disorders.
So just one night of not sleeping well can cause a little bit of insulin resistance the next day.
I mean, it's transient.
It goes away.
But that's significant.
There was a study where they deprived people of sleep for eight nights in a row pretty severely.
It wasn't, you know, obviously not total sleep deprivation because they'd be dead.
joe rogan
Would you really be dead for eight nights in a row?
chris kresser
I think so.
Yeah, I mean, partial but significant sleep deprivation for eight nights in a row.
These people ate an additional 566 calories a day.
During that period with no changes in resting energy expenditure.
So that's equivalent to gaining a pound a week of body weight or 52 pounds in a year.
So most people won't have that severe of sleep deprivation, but if you just even have mild sleep deprivation, you know, over a significant period, that could account for 10 pounds of weight gain a year.
And over, you know, 10 years, you're talking about a lot of weight gain.
joe rogan
Yeah, so is it because you're sleepy so you just force yourself to eat food?
chris kresser
No, it totally screws with hormone production and all the hormones that regulate appetite and satiety and things like that.
joe rogan
Oh, okay.
chris kresser
So your appetite is higher?
Yeah.
joe rogan
Appetite's higher.
It's hard to get satiated.
chris kresser
And it also decreases your willpower and judgment around food.
So people are likely to make worse choices when it comes to food.
joe rogan
I know I do.
Dude, if I'm really, really tired, I immediately go to like bullshit cheeseburgers or something.
chris kresser
Absolutely.
It's part of what's been documented that happens.
joe rogan
Yeah, you like reward yourself with something that's terrible for you.
chris kresser
Yeah.
Yeah, probably that's also related to the changes in brain chemistry that happen.
Wow.
And now we know that a third of Americans get fewer than six hours of sleep.
Outside of maybe 3% of the population that has a gene that allows them to be okay with that few hours of sleep, the vast majority of people need 7 to 8.5 hours of sleep to function properly, and that's been clearly documented.
joe rogan
Yeah, I had read something about outliers in terms of performance outliers.
There are a lot of people that are like entrepreneurs, guys are killing it out there.
They're getting like four to five hours sleep at night.
And I was stunned by that.
I was like...
How is that possible?
How are these people that are doing all these physical activities, working out, running their business?
And then I found out about Adderall.
chris kresser
Right.
So there's that.
joe rogan
Yeah.
chris kresser
I mean, as I said, there are some genetic polymorphisms that we, at least some research suggests, that allow people to...
Deal with less sleep than others.
But yeah, I think in that community, there's a lot of stimulant use that's driving that.
And at some point, they're going to pay the price.
joe rogan
Yeah, they need to come clean about that.
That's the dirty little secret.
I have friends that are entrepreneurs and Silicon Valley people.
And the way they describe it, it's like people chewing gum.
It's just everywhere.
Everyone is doing NuVigil, ProVigil, which are apparently less problematic, and then Adderall across the board.
chris kresser
Yeah, it's crazy.
I mean, we're making choices now, both individually and collectively, that are taking us in the wrong direction.
And, you know, I've shared a few stats that kind of blew you away, and they've blown me away, too.
You know, when I was researching the book, this is how it all came together for me.
It was like a wake-up call, you know.
So I have a six-year-old daughter.
I know you have kids.
unidentified
Yeah.
chris kresser
Today's kids are the first generation that are expected to live shorter lifespans than us, their parents.
That's just crazy.
This is based on the statistic about diabetes and chronic disease.
Yeah, the dramatic increase in chronic disease.
So as long as we've been measuring it in the modern world, lifespan has just been going like this.
There's been a few blips due to pandemics like the Spanish flu, but for as long as we've been measuring it, it's just going up, up, up, up.
And now this is the first generation of kids that's actually expected to start going back in the other direction.
joe rogan
I showed my kids that sugar documentary.
My wife showed it to them.
It lasted about four months, and they were like, who gives a shit?
Let's get back to the ice cream, Dad.
unidentified
Well, you know, the kids, it's hard.
joe rogan
It's hard.
chris kresser
Yeah, because we're hard.
This is where the evolutionary perspective is so important for people to understand.
We're hardwired to seek out foods that are calorie-dense and highly rewarding, and by rewarding...
I'm talking about that term in the scientific context, which means eating something makes you want to eat more of it.
Potato chips, ice cream, highly rewarding because you'll keep eating them even beyond the point where your hunger has been satisfied.
A baked potato with no salt or butter, Not very rewarding.
If you're hungry, you'll eat it.
But you won't eat more than you're hungry for.
And even a steak, which most people like and tastes good, when's the last time you heard about somebody binging on a steak?
It doesn't really happen because it's not highly rewarding in that way.
But human beings evolved in an environment of food scarcity.
So we have these hardwired genetic biological mechanisms that cause us to seek out foods that have a lot of calories and that are Very palatable and rewarding because that would signal to us that they have different nutrients, macronutrients, flavors, etc.
And in an environment of food scarcity, that works really well because stocking up on calories would allow us to survive a period of famine or food shortage or unable to locate food, etc.
So we have all these mechanisms that were originally designed to help us survive starvation in a natural environment.
That's all well and good when we're living in that kind of environment.
But what happens when we live in an environment where there is a 7-Eleven on every corner and Amazon delivering food to your door and Costco around the block?
Food is everywhere.
And so all of these mechanisms that actually helped us to survive in our ancestral environment Set us up for failure in this modern food environment.
joe rogan
And we capitalize on that with things like the banana split.
chris kresser
Yeah, well, the thing is that big food, they hire scientists who understand these mechanisms and specifically design foods to hit all of those circuits.
joe rogan
What do you think is probably, is there a statistically most addictive food?
chris kresser
I don't know, actually, the answer to that question.
I mean, there's a lot of controversy about whether sugar is addictive in the true sense of the way that scientists use the term addictive.
joe rogan
Like meth addictive.
chris kresser
Yeah, exactly.
And there are both sides of that debate.
But I think most of us can, just in our own personal experience, can kind of Assess the effect that sugar has on us or our kids or whatever.
It's highly rewarding in the sense that it makes us want more and more of it.
joe rogan
Yeah, it's not addicted to me in the sense of like I get a detox if I'm not having it, but if it's around me and I want it, the craving is very creepy.
chris kresser
Right.
joe rogan
You know, like, what is this, Jamie?
unidentified
Most addictive foods.
chris kresser
Oh, yeah.
joe rogan
Pizza's number one?
unidentified
Yeah.
joe rogan
Wow.
unidentified
It's based on a Healthline.com study.
joe rogan
I'll tell you what, man, there might be something to that.
When we were in New York and you brought over those slices of pizza, goddamn those are good.
If they could figure out a way to make that pizza here, we'd have real problems.
chris kresser
Well, it's interesting that you showed that because the top six foods in the American diet according to the amount of calories that they comprise in our diet are pizza.
Bread, grain-based desserts, alcohol, sugar-sweetened beverages, and chicken dishes, primarily fried chicken dishes like chicken nuggets from McDonald's.
Those six foods comprise the majority of the calories that the average American eats.
And then you look at our ancestral diet, it was mostly, you know, meat and fish, wild fruits and vegetables, not even the domesticated varieties that we eat today, nuts and seeds, and a lot of starchy, fibrous plants, many of which aren't even available to us at this point.
But, you know, sweet potatoes would be our kind of modern analog of that.
And so you have a situation where we evolved in the context of eating those foods, which are, they're nutrient-dense, they're anti-inflammatory, and they're naturally low in calories, and they're all foods that are very hard for us to overeat.
Again, like, you don't hear about people binging on broccoli, you don't hear about them binging on steak, you don't hear about them...
joe rogan
No one eats too many macadamia nuts.
chris kresser
Yeah, oh man, yesterday, last night I got home and I just had 14 sweet potatoes.
You don't hear about that either.
joe rogan
And even if they have sweet potatoes, a lot of times people put brown sugar on them.
chris kresser
Right.
Like maple syrup or pecans or something like that, which then you might overeat them.
But if those foods in their natural state, we're not going to overeat them.
We're going to eat until we're satiated.
But all the other foods that I just mentioned, those top six foods, pizza, grain-based desserts like cake, bread, etc., they're all foods that trigger all those reward circuits in a big way.
And we've all had the experience, I'm sure, of overeating or overconsuming everything on that list.
joe rogan
I used to always, coming home from jujitsu, I would order an extra large pizza and I would eat it myself.
It was this big.
It was huge.
And I would get either pineapple, double pineapple and double anchovies, which I know some people think is disgusting, but it's very delicious.
Or I would get a pepperoni and mushroom, and I would kill that thing.
And then afterwards, I would literally feel like somebody opened up my mouth, like they were trying to force-feed a goose to make foie gras, and they just poured cement into my stomach.
And then I'd just lay there and just feel terrible, and feel that insulin spike, and your whole body just reacts to this sludge that you're forcing it to process.
It's just dough.
chris kresser
Dough.
And cheese.
joe rogan
Yeah, the cheese is great, though.
chris kresser
Yeah.
I mean, it's...
joe rogan
But it seems that the dough is what gives you that...
That's the heavy...
chris kresser
The gut bomb.
joe rogan
Yeah, the gut bomb.
Why is it so good though?
Because I'll tell you what, those alternatives, they suck.
They're not that good.
They're good food, but there's no free ride, right?
There's no decadent alternative.
Although I did find a very good cookie.
There's a company called Know.
Do you know Know Foods?
chris kresser
No, I haven't seen that.
joe rogan
Go grab one of those things.
Yeah, they have...
Oh, we got one right there.
Yeah.
It's not bad, man.
They're fucking delicious.
unidentified
Oh, no.
chris kresser
K-N-O-W. You know that?
Yeah.
joe rogan
Yeah, I mean, sugar's like for the entire cookie.
28 grams.
28 grams of sugar.
It's a big-ass cookie.
chris kresser
Yeah, I see that.
joe rogan
But it's all like...
And I actually enjoy eating it.
But if you look at the ingredients, it's all...
Okay, here we go.
Almonds, coconuts, egg whites, flaxseed, chia seed, zero trans fat, and 16 grams, 18 grams of protein, 4 grams net carbs, 12 grams of fiber.
chris kresser
Yeah, not bad.
joe rogan
And it tastes pretty good.
But...
It's not as good.
chris kresser
It's not a large pizza with anchovies and pineapple on it.
joe rogan
But it's not as good as like a Mrs. Fields chocolate chip cookie, you know, when you pull it apart and that string of chocolate.
You know that?
chris kresser
Absolutely.
joe rogan
A nice glass of milk.
chris kresser
And those are all good because they, like I said, they trigger all of those hardwired reward circuits.
They push all the right buttons.
joe rogan
Yeah, they get you.
It is amazing how many foods there are that are like that.
If you stop and think about just going down the street, in any normal street where there's a bunch of stores and restaurants, how much of that stuff is bad for you?
It's primarily bad for you.
chris kresser
It's primarily bad.
And you think the whole modern food environment is that way, and that's what I mean.
We're set up to fail.
Anyone who sets out to be lean and fit and healthy is swimming upstream.
joe rogan
Yeah, you have to put in some serious extra effort.
chris kresser
You have to constantly be putting in effort because there's a barrage of advertisements.
You walk into a grocery store, all of those foods are triggering all of those circuits that make us seek and crave those foods because those are...
Evolutionary mechanisms that cannot be consciously overridden very easily.
And this is why weight loss continues to be a multi-billion dollar industry, because information is not enough.
For most people, it's not enough just to know what foods are healthy and which foods are unhealthy, because we're operating from a much deeper System, the limbic, you know, the limbic system, our kind of lizard brain that is driving our preferences for food and what foods we seek and which foods we don't seek,
and that's below the level of conscious thought that, you know, where we say, okay, I know that food's not good, and I know this food is good, but then that lizard brain is like, you know.
joe rogan
Yeah, it pushes you.
It's almost like if you're walking by, like if you have some Potato chips or something on the shelf and you're walking by it.
It's almost like there's an invisible hand on your shoulder pushing you towards.
You can kind of go, hey man, stop pushing.
Stop pushing me.
Or you can go, all right.
You just kind of give in.
chris kresser
And here's the key thing to understand, too.
It's not because you're a weak person or you don't have willpower.
It's because you're a human being and that's how your brain is programmed.
joe rogan
Yeah, that is a very important thing, to realize that there's a reason why it's difficult for you.
And even for people that think, well, it's not difficult for me, man.
Well, maybe if you've conditioned yourself, and if you've conditioned your body, and conditioned especially your diet, there's something that does happen when your gut biome changes, where your cravings change.
chris kresser
Absolutely.
joe rogan
But if you're eating a lot of sugar, it is incredibly difficult to get off that because that is what that gut biome wants.
And there's some sort of a very strange, difficult to pin down feeling that what that craving is.
It's very difficult to sort of intellectualize, right?
Like if you have to go to the bathroom, it's very clear.
Oh my God, I gotta pee.
It's like there, you feel it, you know what it is.
But the weird hunger craving for sugar is almost like you can't grab it.
You can't like hold on to it and go, this is what I'm talking about.
This is that thing.
chris kresser
There's an example I like to use.
There's a parasite that the whole life cycle is really interesting.
You're probably aware of it.
It ends up in mice and it changes the behavior of mice so that they are dumber in terms of their ability to evade getting eaten by a cat.
So then they get eaten by the cat and then the toxoplasma transfers to the cat and goes to the cat's brain where it normally...
So that's an example of how a tiny, tiny little microbe you can't even see with your eye can powerfully control behavior.
And as you just said, we've got trillions of these microbes in our gut that control our behavior and things like our food preferences and cravings.
joe rogan
We had Robert Sapolsky on the podcast talking about that, and he said that some of the mice, it actually rewires their sexual reward system, makes them attracted to the smell of cat urine.
chris kresser
Right.
joe rogan
So their testes swell, and they're literally like horny little zombies running straight towards the cats.
It completely rewires their fear of cats.
That goes out the window.
And the reason being is that the only way that toxoplasma can reproduce is inside the cat's gut.
chris kresser
Yeah.
joe rogan
Which is just insane.
What kind of a twisted system and how did this evolve over all these years?
The gut biome and gut bacteria, it is so fascinating to me.
chris kresser
Here's an interesting way of looking at it.
Do you know Justin Sonnenberg?
He's a microbiologist at Stanford.
Really interesting guy.
Brilliant.
I'm going to paraphrase this because I won't get the quote exactly right, but he wrote a book about the gut microbiome, and he said something to the effect of, humans are just the elaborate vessels for the propagation of microorganisms.
unidentified
Ooh.
joe rogan
He's probably right.
chris kresser
He's basically saying that we're kind of the evolutionary vehicle or tool for the microbes that live in our gut.
They've been around a lot longer than us.
A lot longer.
They outnumber us.
You know, the number of microbial cells in the body are more than the number of human cells.
So, you know, there's lots of different ways to interpret that, but I think at the very minimum you start to see how important that microbial community is to our overall health and also our behavior.
joe rogan
Yeah, and if you really want to get creepy, think about how, like, categorically, they don't vary individually.
Like, they're essentially the exact same thing in mass numbers, acting in the interest of the mass numbers, and then influencing us, which vary widely, and our different actions propagate them in different ways.
I'm freaking out.
chris kresser
Yeah, it's especially weird too when you think that all of those microorganisms that are in our gut, they're not actually in our body.
So they're not really part of us.
joe rogan
They're just hanging out there.
chris kresser
Well, think about a tunnel.
So you go through a tunnel under a river.
You're not in the river.
You're just...
In the tunnel under the river.
And our gut is a hollow tube that goes from our mouth to our anus, intersects our body.
But everything inside the tube is technically outside of the body.
joe rogan
So they're influencing us from inside the tunnel.
chris kresser
From inside the tunnel.
They're not really inside of our bodies.
So they're kind of running the show, but they're not really in us.
joe rogan
So it's like a car inside the tunnel that's controlling the river.
chris kresser
Yeah.
joe rogan
Jesus Christ, I can't do this anymore.
Freaking out.
unidentified
It's a head spinner when I first thought about that.
joe rogan
And the crazy thing is that they can affect mood, they can affect depression, they can affect your ambition, the way you behave, impulse control.
chris kresser
Virtually everything.
I just saw a study on the way down here, and I get a feed of all the new research, and it showed that overgrowth of bacteria in our small intestine, which is part of our gut, is associated with heart problems.
And they don't actually know why yet.
So, you know, something going on with the cars and the tunnel is really tweaking the river in just about every way you can imagine.
It's not just about gut, as you know.
It affects every system of the body.
joe rogan
Sapolsky was saying that one of the people that he worked with found during his residency that there was a disproportionate number of motorcycle accidents that were attributed to people who were infected by toxoplasma because it made them more impulsive.
chris kresser
Right.
joe rogan
Like it changed human behavior as well.
chris kresser
Yeah.
Well, I think we talked about this last time, but the prevalent theory now on what causes depression is that it's a disrupted gut microbiome that causes inflammation.
It leads to the production of what are called cytokines.
They're chemical messengers, inflammatory cytokines.
They travel across the gut barrier, they go into the blood, travel up into the brain and cross the blood-brain barrier, and then they suppress the activity of the frontal cortex, which causes all the telltale signs and symptoms of depression.
Jesus.
So what if depression, which we have always thought about either as a, you know, disruption of brain chemistry or something that's purely situational, is actually, you know, has a physiological cause as a driver.
Now, that's not to say that those situational factors don't matter.
I don't want to be reductionist here and say depression is only caused by gut inflammation.
I think that's ridiculous.
The problem is the average person goes into the doctor with depression, they're going to come out of that office with a prescription for an antidepressant.
There's not going to be any investigation into their gut and whether they have inflammation in the gut and intestinal permeability.
There's not going to be a referral to a gastroenterologist.
To check that out.
And this is, of course, one of the problems with the conventional system, the way it's set up, is we had a doctor for every different part of the body, and there's no quarterback that's really overseeing that whole thing.
Ideally, that would be the primary care provider, but because their appointments are 10 minutes, they've got 2,500 patients on their roster, there's no time for that.
joe rogan
Yeah, you'd have to find a doctor that's very meticulous, that's willing to go over your blood work for you and check out what your diet is.
chris kresser
Yeah.
joe rogan
It would take hours.
chris kresser
And WNL, as they say, we're not looking.
So imagine a patient that goes into the doctor and they've got depression, let's say.
They've got eczema or psoriasis.
They've got digestive issues.
And they've got...
You know, brain fog, cognitive problems, like a whole big roster of symptoms.
And the primary care provider might give them an antidepressant for the depression.
They give them a steroid skin cream for the skin problem.
They leave with a handful of medications.
But what if there was one thing?
It was causing all those problems or one underlying cause that was leading to all that.
So just, you know, in this example, what if that patient had gluten intolerance and they hadn't been properly diagnosed?
We know now from the research that gluten intolerance doesn't just cause the GI distress that a lot of people get.
It also can cause, you know, it's associated with dermatitis, which is eczema.
It's associated with all kinds of cognitive and neurological problems.
So A single food protein could be leading to all of these different symptoms, but in the conventional system, they might go to the primary care doctor, then they get a referral to the dermatologist, they get a referral to the gastroenterologist, they maybe get a referral to a neurologist or a psychiatrist.
They're seeing all these separate people to deal with all these separate symptoms, like playing whack-a-mole with the symptoms.
They take one drug, The antidepressant, but then maybe the antidepressant causes constipation.
So then you go to the gastroenterologist and they get a drug for the, you know, a laxative for the constipation.
And then before you know it, it's just this incredibly complex web of all these drug interactions and all the focus is on suppressing these symptoms with different doctors for different body parts when, in this example at least, it was something as simple as a food protein.
It could be easily removed from the diet.
Maybe not easily.
Gluten's in a lot of things.
But taken out.
And then all of those problems, which seem like they were separate and disconnected, go away.
And that's really the promise of functional medicine because...
Instead of looking at things, starting with the symptoms and then working backwards, we're starting from the inside and working out.
So, you know, an analogy I like to use is if you have a rock in your shoe and it's making your foot hurt, you go into the conventional system, you'll end up with a diagnosis of foot pain.
Or actually, it will be fancier.
You know, there'll be like the Latin name for foot and pain or something.
So it sounds more official.
And then you'll get a painkiller.
And the painkiller will help.
You know, it'll reduce the pain a little bit.
But obviously, it makes a lot more sense to just take your shoe off and dump out the rock.
And that's really what functional medicine is about.
joe rogan
Now, when it comes to gluten intolerance, that's one that gets dismissed because it sounds frivolous.
It's like, oh, all of a sudden, everyone's gluten intolerant.
This is crazy.
But my belief is that there's varying levels of this and that it's something that people have just dismissed as a weird feeling that you get after you eat gluten and that they're not really in tune with the effect of inflammation.
And that there's a real difference between the weed of today and the weed of, say, the early 1900s.
It's been manipulated.
chris kresser
I think there are a few reasons there's misunderstanding about this.
Number one is that there, up until recently, has not been an understanding of the difference between celiac disease and non-celiac gluten sensitivity.
The idea was either you have celiac or you're not sensitive to gluten.
That's it.
joe rogan
I've heard that even recently.
chris kresser
Yeah, there's no gray area.
That's preposterous.
Anyone who still believes that has not even done the most cursory search of the scientific literature.
Anyone who's listening or watching can go to pubmed.gov, P-U-B-M-E-D.gov.
In the search field, type non-celiac gluten sensitivity or non-celiac wheat sensitivity and tell me how many results come up.
Do it.
It's going to be a lot.
unidentified
Okay.
chris kresser
And it's going to be linking.
And this goes to the second point.
It's going to be linking not just to gut problems and diarrhea.
It's going to link to all kinds of different conditions from depression to anxiety to heart issues to hormone imbalance to cognitive problems, etc.
So that's the second problem is historically.
How many studies have we had?
650. Jesus.
And there's lots of others.
If you use some different terminology, you can find more.
So with celiac disease, the initial idea was it just causes severe diarrhea and cramping.
And so the assumption was that if you don't have severe diarrhea and cramping when you eat gluten, you don't have celiac and you don't have any other kind of gluten intolerance.
But we now know that with celiac, there are forms called atypical or silent celiac.
These are forms that do not present with the typical gut presentation.
And the number of atypical celiac cases is much higher than the number of typical ones.
So a patient goes to the doctor, they're having, you know, headaches, they're having motor problems, they're having, you know, all kinds of other issues.
The doctor, if they think that celiac is only about gut issues, they're not even going to think about testing that patient for gluten intolerance.
joe rogan
What kind of motor issues would you get?
chris kresser
Well, there's something called ataxia, which is a form of paralysis that can be caused by gluten sensitivity.
joe rogan
From spaghetti.
chris kresser
Yeah.
joe rogan
You can get paralyzed from spaghetti.
unidentified
In kids.
chris kresser
It's called gluten-associated ataxia.
joe rogan
Jesus Christ.
unidentified
Yeah.
joe rogan
And this is for people who are non-celiac.
chris kresser
Yeah.
So that's the second problem is, again, WNL. We're not looking.
So the patients go to the doctor.
They have all these weird kind of complaints.
But they don't have gut issues.
So the doctor then rules out celiac or non-celiac gluten sensitivity because they don't yet know that it can manifest in all these different ways.
joe rogan
So how is this happening?
Is that whatever intolerance that you have for gluten, when you consume that gluten, the gluten goes into the gut and interacts with your gut biome.
And then what's the mechanism?
chris kresser
So there's two different mechanisms.
In celiac, there's an autoimmune mechanism where the proteins in gluten, the body creates antibodies towards those proteins.
And also, there's like a bystander effect where certain tissues in the body that have similar protein structures to gluten get attacked as well.
Certain enzymes, transglutaminase 2, transglutaminase 3, and transglutaminase 6. And here's the thing, you know, related to what we were just talking about.
Transglutaminase 2 is typically found in the gut.
So that's why a lot of people who have celiac have these gut issues is because their body is actually attacking the gut tissue and breaking it down.
It's an autoimmune reaction.
But now we know that that same autoimmune reaction can be directed at transglutaminase 3, which is primarily in the skin.
Which is why something like 30% of people with celiac also have eczema and other skin problems.
And transglutaminase-6 is in the brain.
So if a person who has antibody production against transglutaminase-6 eats gluten, their body attacks their brain.
joe rogan
Whoa.
chris kresser
In what way?
It breaks down the enzyme, which plays a number of important roles in the brain.
And so this is why celiac and also non-celiac gluten sensitivity is associated with a whole bunch of different cognitive issues and also actual motor problems like ataxia because it's attacking the brain.
The immune system is attacking the brain and that leads to some potentially very serious problems.
joe rogan
When did they start to alter wheat?
What year?
Do you know?
chris kresser
I don't know.
And I do think that is an issue because there's so many people that have gone to Europe, you know, they eat wheat here and they go to Europe and they can eat wheat and it's fine.
Yeah, I've had experience.
But I think there are some other things that are actually more meaningful and significant.
And this leads me to the third reason why I think we've underestimated, you know, gluten sensitivity and why people don't understand how significant it can be.
We're not living in a vacuum.
So let's say you've got a person who is like a hunter-gatherer.
They've been living in a pristine environment.
They eat all nutrient-dense good food.
Their gut microbiome is thriving because they've been eating plenty of fermentable fiber and probiotic type of foods.
And they're just super healthy.
If that person gets exposed to gluten, they might not have any problem.
But then you take a person who is living in the modern industrialized world.
They're sleeping, you know, five hours a night.
They've taken antibiotics, you know, 30 courses of antibiotics by the time they're an adult, which is not an exaggeration.
You know, I can't remember the exact number, but it's extremely high, the average number of courses of antibiotics.
They were born by a C-section.
They eat a crappy diet with a lot of processed and refined foods.
They're sedentary, they're not exercising.
So this person is in really bad shape and their immune system is seriously dysregulated.
And then when they get exposed to gluten, which might otherwise be a harmless protein, it causes problems.
So I think the reason that more people are intolerant of gluten and intolerant of other foods now is not just because the foods have changed, it's because we've changed.
It's because we have become compromised.
Human beings should be resilient and able to tolerate these kinds of food proteins.
But when our immune system breaks down, we talked about the gut as a barrier system where everything that's inside the gut is outside the body.
It's important to understand that the purpose of the gut is to serve as a selective barrier that determines what gets in and what stays out.
Because everything we eat is either absorbed or eliminated as waste.
And if that barrier becomes permeable in a non-selective way, meaning it loses the ability to Make appropriate decisions about what gets in and out, then food proteins that would otherwise be benign and be broken down into smaller particles and those small particles get absorbed and don't cause any problems, the larger food proteins get absorbed before they're broken down.
And then that initiates an immune reaction that wreaks havoc.
joe rogan
Wow.
So if someone has a healthy gut, then the insult of some sort of a gluten protein being introduced into their gut is not going to be as big of a deal as if someone is just drinking Gatorade all day and eating cookies.
That makes sense.
chris kresser
It's like any other ecosystem.
So if you think of an ecosystem that's really healthy and you introduce a predator or something else that could Could potentially throw it out of balance.
It won't go out of balance because the whole ecosystem is working together to keep that in check.
But then, you know, you hear about like those small islands where they introduce a particular, you know, a predator or a prey species that then just because the ecosystem of that island is fragile, you get a huge proliferation, you know, where it's just all of a sudden there's nothing but deer on the island.
Until they start dying because of that imbalance.
And then it starts all over again.
joe rogan
I've seen that before.
I've seen that in Hawaii on Lanai.
They're overrun with an animal called Axis deer.
They're all over the place for that same reason.
chris kresser
For that reason.
And so we have the same phenomenon.
If we have...
If someone's gut microbiome is severely disrupted, and that started as a kid, then they develop gluten intolerance.
They develop intolerance to corn and soy and dairy and allergy.
This is why allergies are on the rise in kids, is my belief.
It's not because...
There's some weird, you know, all of a sudden someone introduced some kind of poison that is causing kids to be more allergic.
It's because of immune dysregulation.
And that's happening because of the sleep issue, the food, and all of the other aspects of the modern lifestyle.
joe rogan
So what's the best approach for someone who wants to be healthier if they want to take control of their gut biome?
Is it just consuming a lot of very strong probiotic foods?
chris kresser
So the first thing is to just eat real food.
I mean, I really like to boil it down to that three words.
You know, eat real food.
And by real, I mean not stuff that comes in a bag or a box.
You know, the less processed and refined, the better.
joe rogan
Stuff that either came out of the ground or lives on the ground.
chris kresser
Right.
Exactly.
And, you know, there are a lot of...
We tend to get really, you know...
Worked up about all the differences between, you know, because you could say eat real food and do vegan, you could say eat real food and do paleo, and, you know, that's all great.
But I really actually believe that if people just ate real food of any kind, we'd be in a totally different place than we are now.
joe rogan
And there were individual health issues who'd be worked out in the variations of those diets.
chris kresser
Exactly.
That's where the fine tweaking comes.
But we didn't get to this point because everyone's eating real food and everyone's doing vegan or everyone's doing paleo.
We got to this point because people are eating trash, essentially.
So one of the most key things with the gut microbiome to understand is that Our healthy gut bacteria thrive on what are called fermentable carbohydrates.
Or Justin Sonnenberg, who we talked about before, he calls them microbiota-accessible carbohydrates.
These are fancy terms that just mean fiber.
So what distinguished is fiber is that we don't break it down and turn it into glucose or other molecules that we can absorb and use for our own energy.
It stays in the gut.
All the way to the colon, and then the bacteria eat that fiber.
So fiber is food for our beneficial gut bacteria, and that's what makes them thrive.
joe rogan
That's fascinating, because most people think of fiber, they think of it almost as like...
chris kresser
Like a laxative.
joe rogan
Yeah, yeah.
They think of it as something that's going to clean out their bowels.
chris kresser
So not all fiber is fermentable by the gut bacteria.
Some fiber just has that mechanical effect.
It's more like, you know, pushing things through the bowels.
Whereas other fiber can actually be used as food by your gut bacteria.
joe rogan
And that fiber is probably more beneficial.
chris kresser
That's the more beneficial fiber.
joe rogan
So are you talking like sauerkraut, kimchi?
chris kresser
So yeah, there's soluble fiber.
That's present in a lot of fruits and vegetables.
You've got non-starch polysaccharides like inulin and FOS and things like that that are in like onions and garlic, Jerusalem artichokes, leeks.
And then you've got resistant starch, which is actually not...
That's in a lot of starchy plants that we used to eat, you know, way back in Paleolithic era.
And some traditional hunter-gatherers still do, but resistant starch these days can be found in certain types of starches that have been cooked and cooled, like potatoes or lentils.
Some people now are supplementing with resistant starch, or they're eating, like, green, unripe bananas, unripe plantains, you know.
joe rogan
What do those do?
chris kresser
Because they're unripe, the starch is resistant.
As they ripen, the starch becomes just regular starch.
How do you cook those?
joe rogan
Like if you wanted to cook a green banana?
chris kresser
A green plantain, you can slice them and then dehydrate them and you make them into chips.
You can even buy plantain chips now at some health food stores.
joe rogan
So if you buy plantain chips, that's what you're getting?
You're getting dehydrated?
chris kresser
You're getting some resistant starch there.
joe rogan
Ah, interesting.
chris kresser
Or you can bake a white potato, for example, and then let it cool.
And that cooling process is what forms the resistant starch.
And this is what's really interesting.
You know, most people think of potatoes as something that would spike their blood sugar because they have a lot of carbohydrate.
But when you cook and cool the potato, it won't have that effect because the resistant starch, you can't absorb and break that into glucose.
unidentified
Whoa.
joe rogan
So when you cool a potato, it's better for you.
chris kresser
Yeah.
So a cold potato salad would actually not have the same effect on your blood sugar as eating a warm baked potato that you just cooked.
unidentified
Wow.
joe rogan
That's crazy.
chris kresser
In fact, have you heard of the potato hack?
unidentified
No.
joe rogan
No.
chris kresser
This is probably the most effective diet that I've ever come across for weight loss.
And this is what I use in my practice with patients when, like, nothing else has worked, or if someone's super motivated and just wants to make progress quickly.
A guy named Tim Steele introduced me to this, and he has sent me some books that he found in the 1880s that reference this diet.
So this is old school.
And what you do is you basically eat nothing but potatoes, but they're plain potatoes.
So you can roast them or boil them, but in the hardest-core version, you don't even add salt.
It's just plain baked potato or boiled potato.
Certainly no butter, chives, sour cream, bacon, you know, because that increases the reward value, as we were talking about earlier.
unidentified
Right.
chris kresser
The more variety there is, the more rewarding a food is.
joe rogan
Okay.
chris kresser
So you just eat potatoes, and there are different variations or different ways of doing it.
You can do it for maybe just three days a week, and then you can do your normal diet, you know, the other four days a week.
Tim talks about a variation called potatoes by day, which means you just eat potatoes for breakfast and for lunch and then you eat a normal dinner.
But in my clinic and from Tim's experience working with a lot of people, most people will lose an average of a half pound a day.
And I think there are a few things happening here and why it works.
Number one, it's totally playing towards these mechanisms that we talked about before.
The reward value of food, which is called the hedonic system, that drives our food craving and preferences.
Let's do a thought experiment.
If you have two plates of food, and on one plate you have a steamed Potato with no salt or butter or fat of any kind.
And on this plate on the right, you got a bag of potato chips or just a plate of potato chips.
Which one are you going to eat less of?
I mean, it goes without saying, right?
You're only going to eat the potato when you're hungry and you're not going to eat probably a bite more than you're hungry for.
Whereas the potato chips, all bets are off for most people.
And so what happens is, when you do the potato diet, you get a spontaneous calorie reduction.
And by spontaneous, I mean not voluntary.
You're not setting out to say, okay, I'm only gonna eat a thousand calories today.
You're saying, I'm gonna eat as many potatoes as I want to satiate my hunger.
But just by definition, because of how our brain works, you're only gonna eat, you're gonna eat less than you would typically.
So that's one thing.
You get a reduction in calorie intake.
The second thing is that when you cook the potato, most people the way they do this diet is they'll just cook like, you know, all the potatoes that they need for the week on Sunday to make it easy so they don't have to cook the potato every time they sit down to eat.
So they cook the potatoes and then they let them cool.
And so then each time you can still heat them back up.
But they now have a lot of resistant starch.
joe rogan
Even if you heat them back up?
chris kresser
Even if you heat them back up.
And here's what's really cool about it.
If you heat them up and cool them again, each cooling cycle forms more resistant starch.
So that by the end of the week, if you're heating all of the potatoes back up and then cooling them again each time, you're going to have a potato that's mostly resistant starch, which means it will have zero impact on your blood sugar, and it will be like a feast for your beneficial gut microbiome.
And that's another reason this diet probably works.
You know all about the studies correlating disrupted gut microbiome with obesity and diabetes.
And so you're basically, the way I tell patients is you're basically going on an all-fiber diet.
joe rogan
And you gotta eat the skin too.
chris kresser
You can eat the skin.
joe rogan
You should eat the skin, shouldn't you?
chris kresser
Yeah.
joe rogan
Yeah.
Skin has vitamins in it, right?
chris kresser
So people will lose up to a half a pound, you know, between a quarter and a half a pound a day that they're on the potato diet.
joe rogan
That's amazing.
chris kresser
So if you, let's say, you know, you decide, I want to lose one and a half pounds a week.
You do it for three days a week and you do that for six months, then by the end of that six month period you've lost a pretty significant amount of weight.
joe rogan
If you can keep that up.
chris kresser
If you can keep it up.
joe rogan
The blandness of it.
That's another fascinating aspect about diet is like how much of our life We're willing to forego health, happiness, all these different things just for some simple mouth pleasure for a few moments.
I mean, if you think about a pizza that you would eat, I mean, how long are you going to eat it for?
20 minutes?
20 minutes out of a 24-hour day, and you're going to feel like shit for at least an hour or two afterwards.
If you try to do anything physical, it's going to be more than two hours.
chris kresser
Definitely.
If you really want to go to the gym or you want to go for a run, Oh, and look, I'm not saying I think everyone should do this.
I think food should be pleasurable.
And I think, you know, the way I eat, for example, I love the foods that I eat, you know.
But, and this is why I say I don't suggest that anyone should start here, but I think it's interesting because it gets at some of what we've already been talking about, how, why the modern food environment contributes to obesity, and how using that knowledge and understanding of what triggers You know, us to eat, we can turn that around and use it in our favor.
So another strategy that's similar is to just eat, but not quite as extreme, is to just eat the same thing for breakfast, lunch, and dinner for like two or three days in a week.
joe rogan
So you get bored with it that way?
chris kresser
Exactly.
joe rogan
That seems like all mental tricks.
Someone would tell you, someone like Jocko would say, just suck it up.
chris kresser
No, it's using our understanding of our biology and our behavioral mechanisms to combat the way that the modern food environment is working against us.
joe rogan
What do you think about pre-planned meal programs?
There's a lot of companies that sell pre-packaged meals, pre-portioned.
That's not a bad way to do it, right?
chris kresser
Yeah, I think those can play a role, too, because it's kind of a set-and-forget kind of thing, and you know what the portion size should be.
There's another strategy that's very simple that's been shown to contribute to weight loss, and again, it plays to these same mechanisms, which is to get smaller plates.
So, you know, you go to Target and you buy plates that are like this big.
joe rogan
Right, right.
chris kresser
If it don't even fit in some of the dishwashers.
Yeah.
And we don't even think about it.
It's just something you wouldn't even think about.
But we have a tendency to fill that plate up.
joe rogan
Yep.
chris kresser
For sure.
And just getting a smaller plate and eating off the smaller plates has been shown to have a meaningful impact on weight loss.
joe rogan
Yeah, like you ever go to a buffet?
Like when you go to a buffet, you always take more food than you're going to eat.
chris kresser
You feel like some obligation to get your money's worth, you know, and just gorge yourself.
joe rogan
And eat like a monster.
chris kresser
And eat like bizarre combinations of food that you would never put together in any other context.
joe rogan
I know, but it's all there.
It's like variety.
It's a real problem for some people.
chris kresser
The buffet is like the antichrist for the way our brain works with food.
Because it's variety.
It's all highly rewarding, palatable foods.
It's like the absolute worst possible thing.
But if you think about it, our entire food environment is like a buffet.
You can go into any store at any time and get any kind of food to trigger any of those cravings.
joe rogan
Yeah.
Do you supplement with any sort of probiotics outside of regular food?
chris kresser
I will occasionally take probiotics.
I mostly try to get it just through fermented foods, you know, because I think that's probably...
joe rogan
Like, what do you choose?
chris kresser
Sauerkraut is a great one.
Kimchi.
I do fine with full-fat fermented dairy, like kefir or yogurt.
Sometimes we make our own yogurt and ferment it longer, so it has more microbes.
Beet kvass is lesser known.
It's a beverage.
It comes from Russia in that area.
It's fermented beets.
That sounds disgusting.
No, if you like some of these other ferments, I think you'd like it.
joe rogan
No, I'm just joking around.
I like kimchi, and most people think it's vile.
Everyone in my house thinks it's vile.
chris kresser
No, the beet kvass is good, and its beets are super nutrient-dense, and the fermentation brings out even more nutrients, so it's like a superfood beverage.
joe rogan
The fermentation brings more nutrients.
Interesting.
In what way?
chris kresser
What nutrients?
It makes them more bioavailable.
joe rogan
Really?
chris kresser
Yeah.
What nutrients does fermenting Well, fermenting creates vitamin K, for example.
So fermented foods are one of the best sources of vitamin K2, and that's why natto, which is a fermented soybean product from Japan, is the highest, you know, pound for pound or ounce for ounce is the highest source of vitamin K2 there is that we know of.
But cheese is another high source of K2, and that's because it's fermented.
So most fermented foods have vitamin K. Is it in beer or wine or any of the other...
I don't think so.
Too bad.
joe rogan
Yeah, too bad.
So, kimchi, sauerkraut, netto, this beet stuff.
chris kresser
Beet kvass, yogurt.
Yogurt.
Kefir, which is like a liquid form of yogurt.
There are certain kinds of cheese.
Cheese doesn't tend to be as beneficial in terms of the amount of microbes that are in it.
joe rogan
What about blue cheese?
chris kresser
Kombucha.
joe rogan
Kombucha, I love that stuff.
chris kresser
And there's lots of different kinds of kombucha.
There's also water kefir, which is like dairy kefir, but it's more like kombucha.
But they use the kefir cultures to make it.
Every traditional culture almost has a fermented food to it because our ancestors understood, even without knowing the science, that they were beneficial.
joe rogan
How bizarre.
Well, yeah, they must have just trial and error, right?
Now, outside of that, what's a normal day in Chris's life as far as your diet?
Do you consume basically the same foods all the time or do you mix it up?
chris kresser
I mix it up quite a bit.
Quite a bit.
Lately I've been experimenting a lot with keto and ketogenic diet, fasting.
I'm really interested in fasting right now.
So, like, I haven't eaten yet today.
I just had coffee and some cream, which I do, again, I do fine with full-fat dairy.
joe rogan
I always do that lately.
Not always, but I'm doing that a good solid four to five days a week where I'm doing intermittent fasting about 14 hours.
chris kresser
Yeah.
joe rogan
I feel great when I do it.
chris kresser
I love it.
I like the mental clarity, the focus.
And to be honest, it's actually, I mean, I love food preparation.
I like to cook.
But it's nice to be able to have a break from that, you know, not to worry about what I'm going to eat and cleaning up and all that stuff.
These days, my average day is kind of like no breakfast, fasting, then I might have what Mark Sisson calls a fat bomb salad for lunch.
If I have lunch, I might have a later lunch.
So that would be like a salad with a little bit of protein, chicken, fish, etc.
And then like avocado and olives and, you know, really good healthy fats.
And then if I'm not doing a ketogenic phase, I'll have a normal dinner, which would look like a portion of protein, a lot of non-starchy vegetable, and like a sweet potato or a plantain or some taro root or one of these paleo-friendly type of starches.
joe rogan
And if you were going keto, how would you switch it up?
chris kresser
Man, I would typically have the protein, the non-starchy vegetables, and either like some zucchini noodles or turnip noodles.
You can get like a spiralizer and make the noodles really easily.
And I would put some additional fat on those vegetable noodles.
Or I might just have another non-starchy vegetable along with that or a salad.
joe rogan
So you're essentially just manipulating the fat levels.
Other than that, you're eating primarily the same type of foods.
You're manipulating the fat versus carbohydrate levels.
And how do you feel?
Do you find it difficult to maintain the ketogenic diet?
And how do you feel when you're on it versus when you're not?
chris kresser
Yeah, so for me, because I'm lean, obviously, and I have a fast metabolism, I can do keto for a couple weeks and feel pretty good.
I've done it for as long as three months, so I've done the full experiment.
And what happens is, after about two or three weeks, my exercise tolerance and recovery starts to go down.
So I start to have less capacity to do more glycolytic activities, explosive movements, weightlifting, or sprinting, high-intensity types of training.
And my sleep starts to actually deteriorate a little bit.
That's one of the biggest...
joe rogan
That's interesting.
So why would it be beneficial then?
What's beneficial about it?
chris kresser
Well, I think two things.
Number one, not everybody has that response.
A lot of people just feel better and they're able to do it for a sustained period of time and they don't have that problem.
Number two, the way I'm trying to do it is kind of replicating what I think was typical in the ancestral environment.
Most hunter-gatherer cultures that we've studied would have naturally had periods of food scarcity.
So they're not always starving, but because they don't have a 7-Eleven on the corner or Costco or whatever, they would have periods where they weren't successful on a hunt.
So, you know, they would go without eating or they would eat less.
That's just built into our template, I think.
I do a thing where I'll do intermittent fasting for a period and I might do a week or two of ketosis.
And then I might just eat my normal diet for six weeks or two months after that.
And then I might do another week of ketosis.
And I don't schedule it.
I don't plan it.
I just let my body tell me, oh, it kind of feels like I want to do that now.
joe rogan
And are you doing blood tests?
Are you doing breath tests?
How are you monitoring your ketone?
chris kresser
So I have the blood ketone monitor.
And from all the research that I've seen at this point, breath ketone testing is not accurate at higher levels of ketosis.
It's accurate at lower levels, but when you get into the therapeutic range around 2.0, you know, 1.5 to 2.0, which is kind of the sweet spot for me, then blood ketones are more accurate.
And the problem with the blood ketone strips is they're super expensive, especially if you buy them just like at the drugstore or something like that.
But you can look around and try to find them in bulk and they're cheaper that way.
And frankly, at this point, and I think this is true for most people, once you get used to it, you know, and you've done it enough, you don't need to keep using them over and over.
You just kind of know when you're going to be in ketosis and when you're not.
And I've tracked my values and I've tracked, you know, I've treated hundreds of patients where we've done these kinds of experiments.
And this goes back to the discussion about LDL. So for me, on a ketogenic diet, you know, if I measure on my typical diet, my LDL particle number is about 1,200.
So I'll just briefly describe what that is because I think some people might not be familiar with that.
So if you imagine that your bloodstream is like a highway, The cars on the highway are the LDL particles, and the passengers in the cars are the cholesterol that are carried by the LDL particles.
So for years we've measured the passengers, the cholesterol inside of the particle.
And now most of the research suggests that it's actually the number of particles or cars on the road that is the biggest driver of heart disease risk, not the amount of cholesterol inside of them.
So you can measure this.
LabCorp and Quest, they all have a test panel called an NMR, where you can measure the number of particles that you have.
And so my normal diet is around 11 or 1200, which is technically high normal or in a kind of intermediate range.
I'm not worried about that level.
Um, but when I go keto, my LDL goes above 2000, which is in like the 99th percentile and, and a high, high risk range.
unidentified
Wow.
chris kresser
So this is where I was talking before about getting to a point where we can be maybe a little more personalized in terms of the recommendations that we make.
Cause not everyone who goes keto experiences that, you know, some people do and some people don't.
joe rogan
What do you think that is?
chris kresser
It's just that for me, on a keto type of diet, it affects my lipids in that way.
This is a much larger conversation around Does that actually increase my risk of heart disease?
Again, I said before, we know that higher LDL on average in the general population does.
But if, like, let's say I have a doppelganger, you know, genetically identical to me in every way or an identical twin, and that one is not eating healthy, not exercising, not sleeping, you know, not doing anything to take care of himself, and he has a LDL-P that's high, And I have an LDL-P that's high and they're exactly the same.
Do we think that we're going to be at the same risk of heart disease just because that one number on the paper is exactly the same?
That's the assumption that's made in the conventional research literature.
But I think almost anybody, just common sense, would say, no, that's not true.
There are many other factors that determine the risk of heart disease.
So getting back to this thing, so for me with keto, one of the reasons I mean, the main reason I don't do it ongoing is I don't feel well when I keep doing it, like I said.
Number two, I don't like doing it long term, and I think that's important.
And number three, I don't necessarily want to have an LDLP of 2,000.
joe rogan
But you do think there are some benefits to occasionally doing it?
chris kresser
I think that it was very natural for human beings to be in ketosis at least part of the time.
And whether you enter into that by just fasting or whether you do it with a ketogenic diet, I don't know that that really matters.
I mean, fasting has some additional benefits above and beyond just ketosis, like autophagy, which is a cellular cleanup and repair process that happens in a fasted state.
If you think about it If fasting or being in a fasted state was a normal part of human evolution, it makes sense that certain processes would only happen in that fasted state.
joe rogan
It does make sense, but I would feel like talking to you based on your experience, I would avoid being in ketosis altogether because it sounds like it sucks for you.
chris kresser
No, it doesn't.
Those first two weeks are really great.
You feel great.
Yeah, and then it starts to shift over.
joe rogan
Dom D'Agostino said that there's an adaptation period.
chris kresser
Yeah, usually three weeks is the full period for most people.
But like I said, I've done a full, longer experiment, so I know it wasn't just a question of me not being fat adapted.
joe rogan
I think he was talking about several months in terms of athletic performance, when your performance starts to...
chris kresser
Yeah, I think that varies a lot from person to person.
It also varies how quickly someone can get into and out of ketosis.
I go into it very quickly for me.
joe rogan
How many days?
chris kresser
If I do one day of fasting or one day of keto, on the second day I'll generally be at 1, 1.2, which most people say is in a therapeutic range.
And then by the third or fourth day I'll usually be at 2 without a lot of effort.
joe rogan
And do you regulate your protein intake when you're doing a ketogenic diet as well to avoid protein converting to glucose?
chris kresser
Again, that's highly individual from what I've seen.
For me, protein doesn't seem to be that significant of a lever.
I've tried, you know, I did an experiment where I was just fasting in the morning so I had no protein.
And then I would have three ounces of protein only with the salad at lunch.
And then I would have a kind of normal size portion of protein.
So that's actually pretty low protein for someone of my size.
Yeah.
And then I've done it where I've just done keto where I've had protein for breakfast, lunch, and dinner.
It doesn't seem to make a big difference for me.
But I have patients for whom that's actually as big of a lever as carbohydrate.
joe rogan
Yeah.
I had Tom Bilyeu on the podcast, and he was one of the founders of Quest Nutrition.
And he said one of those Quest bars would knock him out of ketosis.
chris kresser
Right.
joe rogan
Just because of the amount of protein.
I'm like, that's crazy.
And I think they're only like, what is it, like 18 grams or something?
Somewhere in the range.
chris kresser
That's why it's so important for us to get over this idea that there's one approach that will work for everyone.
It's just stupid.
joe rogan
I know you know Rob Wolf.
Have you ever seen Rob Wolf's experiments that he does on his Instagram with him and his wife?
They both eat the same things.
Totally different results.
Totally different results as far as their blood sugar.
His wife metabolizes things far quicker than he does.
It's really interesting.
That's really interesting because you're seeing two people that live together that are eating the exact same foods.
chris kresser
Yeah.
joe rogan
And, you know, that he's so fascinated by it himself.
It makes it interesting, too.
chris kresser
Yeah.
I mean, it's so necessary for us to take that step because you see so much, like, you know, wasted energy, in my opinion, of people arguing back and forth.
Yeah.
You know, Joe Blow goes on a low-carb diet, has a life-changing experience, and becomes like an almost religious zealot for the low-carb lifestyle.
joe rogan
Right.
chris kresser
And assumes that because it had that effect on him, that it's going to have that effect on everybody else, and just starts, you know, proselytizing for low-carb.
joe rogan
Yes.
chris kresser
Not recognizing that for someone else, for example, many of my female patients go on low-carb, and if they're like...
You know, working and taking care of kids and doing CrossFit several times a week, you know, that could be a disaster for them.
It really might not work.
And so, you know, we just got to take the next step.
joe rogan
Yeah, you have to take into account biodiversity.
But there's a lot of people that dismiss ketogenic diets because that's not what they've been promoting.
That's an issue as well.
Like, you gotta be real careful about someone who's not citing actual science when they're talking and dismissing the ketogenic diet.
Like, I read someone talking, saying that it was a fad, that it's hard to get into ketosis, that it rarely happens.
Like, well, that's just not true.
chris kresser
Yeah, that's actually factually wrong.
joe rogan
Yeah, it's not hard at all, and it happens all the time.
And I've been in it.
I've done it many times.
I'm not in it right now, but I do the same thing.
But for me, it's just out of boredom.
I get bored and I want a peanut butter and jelly sandwich or something, then boom, I'm out.
chris kresser
Well, again, I think that's probably closer to the ancestral pattern of not being in it continually.
But, you know, there are some people who need to be in it continually.
Like ketosis can be a life-changing intervention for a kid with epilepsy, for example.
unidentified
Yes.
chris kresser
And those kids benefit from being in deep ketosis.
So they might actually even need exogenous ketones on top of the ketogenic diet.
But they can go from having, you know, 40 seizures in a day or being on like just brutal anti-seizure meds, which are horrible for kids.
I mean, the side effects are so bad.
To being completely off medication with a ketogenic diet.
And so for them, they're not going to have that sandwich because it's going to cause a seizure.
joe rogan
What was unique in my experience was the cognitive benefits.
I was like, this is really fascinating because I felt so much more clear-headed from the fog of refined carbohydrates.
But I think that...
That is, I don't know if it's the same, but very close if I just follow a low-carb diet.
Not necessarily ketogenic, but eliminate refined carbohydrates, but don't eliminate salads or fruit or things along those lines.
Like if I want a pear, eat a pear.
You know what I mean?
But the very strict application of it, one of the first immediate things that I recognize is that my hunger is a very different thing.
Yeah.
When I'm hungry, it's not that big a deal.
Whereas when I was eating a large amount of refined carbohydrates, the hunger was ferocious.
It's almost like drums playing in the background.
chris kresser
And that's the ketones, you know, because the brain can utilize ketones and may even prefer ketones to glucose.
And so when you're producing those ketones, it really does take the edge off of hunger.
joe rogan
Yeah, and it also fuels the brain in an odd way.
I mean, I find that before I do difficult tasks, mental tasks, I like to drink exogenous ketones.
I like to take them.
chris kresser
Do you actually like it, though?
joe rogan
Yeah, I do.
chris kresser
You do like the taste?
joe rogan
Yeah, I don't mind.
I've got that, what is that stuff called?
Kegenics?
chris kresser
Oh yeah, Kegenics.
They're probably the best.
I like them the best, too.
joe rogan
It doesn't taste bad at all.
I drink it before I work out.
I like those.
I don't think they're bad.
You know, and I throw some alpha brain in there, I just shake it up, and it actually tastes pretty good.
chris kresser
Yeah.
Yeah, I think there's definitely a role for the ketogenic diet and for ketosis in general.
And, you know, fasting, as I mentioned before, has some really interesting benefits above and beyond ketosis that I've been exploring a lot in my work with patients.
Have you heard of the fasting mimicking diet?
joe rogan
No, what's that?
chris kresser
Dr. Valter Longo.
So, Dr. Longo is at USC Center for Longevity, a superstar scientist, and he basically came up with this approach to get, you know, the idea was to get the benefits of fasting without doing a full water fast.
And so it's a reduced calorie diet that's done for three to five days with specific macronutrient ratios.
And he's done some really interesting research.
Most of it is in animals, so you have to take that with a little bit of a grain of salt, but there has been some in humans as well.
And it's shown things like in animals with MS, just doing this fasting mimicking diet has led to regeneration of the myelin sheath.
Which is what breaks down in MS, which is just, you just don't see that.
I didn't even know animals got MS. Well, they have animal models of MS where they create an MS-like condition in the animal in order to study it.
And they've shown changes in the brain, you know, where actually things are regrowing.
And the reason for its thought is that fasting can promote stem cell regeneration.
So you can actually, through fasting, rebuild certain parts of your body, according to this research.
So, and then there was the autophagy, which I mentioned before, which is like almost, you can think of it as like a cellular recycling or cleanup or repair process that happens in that fasted state.
And so, if you look in the research literature, it's really fascinating because they're more older, you know, older studies, there hasn't been as much research until recently on fasting, but fasting has been shown to be a cure for all kinds of different conditions.
You know, severe rheumatoid arthritis, a patient can fast and then be completely symptom-free.
And of course, they can't keep that up.
You can't just fast forever.
You obviously will die.
But that alone tells us something interesting about fasting and about food and how food is impacting those conditions.
joe rogan
Yeah, that is absolutely fascinating.
The consumption of carbohydrates, Dom D'Agostino put something up about it recently about sugar and carbs, that they're closer and closer to connecting sugar and carbs to cancer.
chris kresser
This is a pretty controversial area, and I'll say right off the top that I don't consider myself to be an expert.
So, you know, I'll probably just pass on this.
But I think there's certainly enough research pointing in that direction to continue to look at that, and they're You know, even he probably talked about this, but drugs like metformin, which limit the availability of glucose, are being studied even by the NIH, you know, very traditional mainstream scientific organizations as therapeutics for cancer, as is ketogenic diet.
I'm studying that and others are as well.
But I think it's a little too early to say that all cancer is caused by high blood glucose levels.
joe rogan
Yeah, I don't think anybody's saying all, but I think they're saying there's a strong correlation between the two.
Now, when you look at the overall American diet and the number of chronic diseases and all the different various things that we have, and you correlate all these factors when you think about sedentary lifestyle, you think about the lack of sleep, and then, of course, you think about diet and exercise.
When do you think people are going to recognize, or how do we get people to recognize, that what they're eating and what the average person is eating is not what the body is designed for?
And this may very well be what has triggered this whole cascade of effects.
chris kresser
That's the trillion-dollar question.
Literally trillion-dollar question, because we spend $3.2 trillion on health care a year.
So, you know, I think there's an easy way and a hard way to get there.
So the easy way is that we continue to raise awareness through books and podcasts and things like this.
And, you know, we make proactive changes to the health care system that support the most important interventions.
So let's use an example again.
Imagine, so you go into the doctor right now, let's say you're one of those hundred million people that has, you know, type 2 diabetes or prediabetes, and they test your blood sugar, they say your fasting glucose is 96, Joe, and your hemoglobin A1c is 5.5.
Good news, that's normal.
Well, yeah, okay.
It's in the normal range, but it's in the high end of the normal range.
In the current system, they'll just tell you it's normal.
They might maybe, maybe not make any kind of dietary recommendations and then send you on your way.
And the idea is we're not going to pay attention to this until it's not normal.
We're not going to pay attention to this until you actually do have prediabetes or diabetes.
And so they'll wait until you have that.
And then, of course, the longer that you wait to treat it, the harder it is to reverse.
And then once they do find that you have it, they just give you a drug rather than...
You know, give you any kind of real support to make diet changes.
So even if the doctor does know what to do or what to tell you about diet, which they often don't because they just don't have a lot of training in that area.
joe rogan
And it's also how few people really have the contents of their body analyzed.
How many people actually get blood work done on a regular basis?
chris kresser
Right.
Well, as I said, 88% don't even know they have prediabetes.
But let's assume that they do and let's assume they get to the doctor and let's assume the doctor even knows what to tell them.
If they tell them that, is that going to be enough to make that person successful in changing their diet?
Absolutely not.
joe rogan
Especially not if their gut biome is programmed to crave that sugar and they have low willpower, especially if they get very little sleep.
chris kresser
Absolutely.
joe rogan
They work all the time.
All those factors.
chris kresser
All those factors.
And we know, most importantly, information alone is not enough to change behavior.
I said that before, that's well-established scientifically, just telling someone, hey, you should eat a healthier diet.
You know, 1% of people are going to be able to take that information and act on it successfully, especially over the long term.
But let's imagine a different scenario.
Let's imagine you go into the doctor, same thing, they test your blood sugar, it's, you know, high normal fats and glucose, high normal A1C, and they sit down and they say, look, Joe, and this is obviously happening in an appointment that's longer than eight minutes, right?
They sit down, they say, well, you're not pre-diabetic yet, but your blood sugar is starting to creep up.
And I'm worried that if we don't do something now, you're going to become pre-diabetic and eventually diabetic.
You know, I could give you a drug, but that's just putting a Band-Aid on the problem.
So what I'm going to do instead is I'm going to hook you up with our health coach and nutritionist.
And he or she is going to create a recipe for you, a meal plan.
They're going to come to your house.
They're going to clean out your pantry, get rid of all the bad foods.
They're going to go shopping with you and show you actually exactly what you need to buy.
They're going to help you set up these meal plans and give you recipes so that you know exactly what you should be doing or they're going to set you up with this meal planning service that we work with.
And I'm also going to set you up.
You're going to get a gym membership and you're going to get set up with a personal trainer at that gym.
And so that you can start getting, you know, becoming more physically active.
We're going to give you this online class that talks about sleep hygiene and how to get better night's sleep.
It's a six week program.
You do it for a half hour a day.
No problem.
And here's the good news, Joe.
This is all going to be covered by your insurance.
You're not going to have to pay for any of this.
That, you know, that is totally possible.
And not only that, is there any doubt that even if we spent $10,000, let's say, which is more than that would cost, even including the health coach and the fees for the gym and the fees for the personal trainer, if we spent that amount of money right up front...
We could get that person's blood sugar back to normal level, prevent them from ever getting type 2 diabetes in the first place, give them way more confidence in their own ability to take care of themselves and prevent disease, make them feel better in probably every other way, and save the healthcare system $640,000 over the next 45 years.
We could have that.
There's nothing stopping that from happening.
joe rogan
The real question is, how do you get someone to act?
That's the question.
Is it through inspiration?
chris kresser
That's what I said with the health coach.
This is well defined.
There's so much research on behavior change and evidence-based principles that support behavior change.
There are techniques like motivational interviewing, coaching to strengths, Coaching to strengths.
Yeah.
So that means helping people identify and work with their strengths rather than trying to fix what's broken.
Motivational interviewing is a...
joe rogan
What would be an example of that?
Like you have a person who works a regular normal job and...
They've got a big gut and they want to lose weight.
chris kresser
It's shifting the focus from what's wrong, which is really disempowering, like I can't do that, I'm this way, I have no willpower or whatever, to helping them become aware of certain personality traits or characteristics that they can then use to make the change that they want to make.
Motivational interviewing is like this.
Imagine a woman who's 55, you know, finds out that she has type 2 diabetes and the doctor's like, you should eat a better diet.
And she would like to, but she's overworked and tired and it feels overwhelming.
And she's just not really finding the motivation to do that.
But she has grandkids.
She loves her grandkids.
She wants to see them grow up.
She wants to be able to play with them without becoming blind and immobile from type 2 diabetes.
And so the health coach who's trained in motivational interviewing can help that patient to be able to tie those deeper values and goals and motivations with the health goal.
So that it's not just eating a healthy diet for the sake of eating a healthy diet.
It's eating a healthy diet because I really want to see my grandkids grow up and be able to play with them.
And then there are these principles of behavior change that are totally well established.
So one is shrink the change is a colloquial way of putting it.
Let's say you're going to start a meditation practice.
The way to not do it is to say, okay, so do an hour meditation a day.
Good luck with that.
That's going to fail in 99.9% of the cases.
The way to do it might be, okay, step one.
Not even that.
Step one, download the Headspace app on your phone.
That's it.
That's your first step.
You know, step two, get a meditation cushion.
That's it.
Step three, you know, open the Headspace app and do your first two minute meditation.
I mean, the Headspace app is actually built in this way where they start you very small and you build up gradually over time because they know about those principles of behavior change.
We know that behavior change works better in community.
This is a head spinner too.
Obesity, some people have argued, is a contagious disease because people who have friends that are obese are more likely to be obese themselves.
joe rogan
You know what?
That makes a lot of sense.
And here's an example of something, one of the reasons why that makes a lot of sense.
We just did this thing called Sober October, me and Ari Shafir, Tom Skor, Bert Kreischer and I, we took 15 hot yoga classes, no booze, no weed for a month.
But because we were doing it all together and we kept checking in on each other, it was very motivating.
No one strayed and we all were doing it to...
We knew that we had We had a responsibility.
We had a responsibility to the group and that we knew that we were motivating each other as well as pushing each other and talking shit to each other and making fun of each other, which is what we do professionally.
But at the end of it, we were like, wow, that was great.
There's something to that.
A lot of us were like, I'm never doing yoga again, funk yoga, and I'm getting drunk for a week.
The real takeaway from it was there was some measurable motivation and inspiration from having three friends doing it with me.
chris kresser
Absolutely.
And that's, again, been proven in the science.
And even just having one person, like a health coach, who can play that role and be accountable, they can help you get in touch with the real motivation for doing it.
They can actually design a program for you that's likely to succeed instead of fail.
joe rogan
Or perhaps online groups.
There's got to be online groups you can get involved with.
chris kresser
We have the knowledge and the technology to do this.
And it doesn't take a long time.
You can train a health coach in six months or a year.
They don't need to have nine years of pre-medical training and biological sciences and all this.
They just need to be trained in behavior change.
They need to be people who can form a good relationship with somebody else and build that trust and rapport.
They need to have some knowledge, of course, of diet and lifestyle and stuff.
But like I said, imagine that you go into your doctor and they actually hook you up with someone like that who has all that training.
Um, If you think of the healthcare population as like a pyramid, yeah, at the top of the pyramid you've got people who are really sick and who are in the hospital or in some kind of acute care setting.
They absolutely need intensive support from the conventional medical system.
Then you go down, you've got another 25% of people who have some kind of pretty debilitating chronic disease where they need to be seeing a doctor regularly.
But then in the bottom 70%, you've got a lot of people who are just overweight, they're a little bit tired, they're not sleeping very well, they've got some gut issues, they've got some skin problems.
My argument is that those people could be really well served by well trained health coaches and nutritionists who can work intensively with them on diet, lifestyle and behavior change.
And we know that those changes are the single most important step we can take to prevent and reverse disease.
But we also know that just telling people about it doesn't work.
unidentified
Right.
chris kresser
You have to create that support system.
joe rogan
Well, our whole food system is so crazy because it's so fraught with peril.
Everywhere you go, it's a goddamn minefield.
unidentified
Exactly.
joe rogan
I mean, if you're trying to eat a healthy diet, you have to go way out of your way to find what you can consume.
Oh, there it is.
Over there.
Whereas if you just want to eat a shitty diet, it's everywhere in front of you.
The vast majority of the food that's available to us is not healthy.
chris kresser
Yeah.
Which is crazy.
If you took somebody from our culture and dropped them into, like, there's this group called the Simane in Bolivia.
They're a hunter-gatherer group that still follows their traditional lifestyle.
If you took someone from here, dropped them in there, and just made them live that way, they'd get healthy.
Because they wouldn't have any choice.
You know, they would eat what was there, and they'd be living outdoors, and they wouldn't have iPads that they're staying up and looking at until 2 in the morning.
And, you know...
They would be healthy, but likewise...
joe rogan
Or they'd get killed by a jaguar.
chris kresser
Right.
Or they'd get...
Yeah, exactly.
That's exactly possible.
But if you took one of those people and you drop them into here, like Woodland Hills or New York City or San Francisco or anywhere else, is there any question that what's going to happen there?
The same exact thing that happens to all of us in this modern culture.
joe rogan
Well, we've seen that with the Inuit.
When the Inuit...
One of the more fascinating things about studying the Inuit was how small...
The number of people that got cancer was, which is an incredibly small number.
And they essentially had no vegetables.
They were eating fats from seals and whale and whatever they could consume.
Extremely limited diet.
chris kresser
Harsh environment, yeah.
joe rogan
Very harsh environment.
But they had adapted to it.
And then when Western America came into their lives in terms of like cigarettes, Shitty food, alcohol, refined carbohydrates.
Cancer rates went through the roof.
chris kresser
Yeah.
joe rogan
Just through the roof.
chris kresser
Yeah.
joe rogan
Which is fascinating.
chris kresser
Because their genes hadn't changed.
joe rogan
Right.
chris kresser
Absolutely the same genes.
They're not going to change in one generation.
Yeah.
Or even two or three.
joe rogan
Yeah, it's horrible.
chris kresser
Have you seen Weston Price?
You're familiar with his work?
joe rogan
I know the name.
Who was he?
chris kresser
He was a dentist back in like the 1920s and 30s.
And he wrote a book called Nutrition and Physical Degeneration.
And what he, as a dentist, his main interest was, why are there so many cavities?
It doesn't seem natural.
It doesn't seem normal that we're designed to just develop rotten teeth.
You thought, this is stupid.
So I'm going to go around and study all of these traditional cultures all over the world.
And first, I want to find out, do they have cavities in dental decay and like a narrowing of the dental arch and changes in facial structure that we have in the industrialized world?
And the second question is, if not, what is the common element, you know, with all of these cultures that's different than our culture?
And in his book, So first of all, the answer to the question was no.
It's not normal for humans to develop cavities and rotten teeth.
I mean, how could it be?
How could we survive in a natural world if our teeth are all falling out?
So he went and he took pictures of these people all around the world, like in Africa, the Maasai, hunter-gatherer people, people living in the remote part of Switzerland, isolated up in the hills that had maintained their traditional diet and lifestyle.
And all of them had these beautiful teeth, big wide round faces, you know, wide dental arches, you know, all of these signs of health.
But he also in the book had pictures of people from those same areas that had switched to, moved to the city, you know, switched to modern lifestyle within one generation.
You see people with these wide faces, big healthy teeth, smiling on one side of the page, and on the other side of the page you see people with these narrow faces like mine, rotten teeth, totally crooked teeth, and the kind of dental problems that we all have where most of us get braces and all this stuff.
And that happened in just one generation of switching from a traditional diet to a modern diet.
joe rogan
What made their face thin?
chris kresser
So vitamin K2 and a number of vitamins are responsible for facial development.
So if you look in the book of Wes and Price's pictures, you'll see most people in those traditional worlds have these broad, healthy dental arches.
In our culture, because of nutrient deficiencies, we're not eating the healthy nutrient-dense foods, our faces get more narrow, our chins recede, our mouths become more crowded, which is why many people can't fit the number of normal adult teeth in their mouth because their dental arch is so narrow.
joe rogan
Really?
So that's all from a nutritional deficiency?
chris kresser
Absolutely.
unidentified
Wow.
chris kresser
I had to get adult teeth pulled when I was a teenager because my mouth didn't have enough room for all of my adult teeth.
unidentified
Whoa.
joe rogan
Does the rest of your family have similar facial structure?
chris kresser
Yeah, largely.
Yeah, I mean, you can check this out.
It's really interesting things to do in the airport.
I like to, you know, you just look at people's faces.
Often you'll see, like, the chin is really receded and not, you know, not like a strong...
You'll see a narrow face like mine.
And if you...
You might see a person from Africa or someone who's more connected to their traditional diet and lifestyle.
They'll typically have a rounder face, a more full face, a broader dental arch.
They'll have straight teeth with wider teeth.
Anyone can do this.
Anyone can see and look and you can almost predict how long has that person been away from their traditional diet and lifestyle.
joe rogan
Wow.
I never knew that.
You know, that's a fascinating point.
It's a big variable in martial arts.
chris kresser
Yeah.
joe rogan
And the ability to take a punch.
chris kresser
Well, your face is pretty round.
joe rogan
Yeah.
chris kresser
You have a broader.
But it's not just what you're eating.
joe rogan
It's your ancestors.
My mom is very wide.
I have a thick mom.
She's a pit bull.
chris kresser
Yeah.
Well, it's probably part of why you're probably a good performer is you've got that structure that supports it.
joe rogan
Yeah, I'm sure it has something to do with it genetically.
But the ability to take a punch is, I think, directly related to the size of your face.
chris kresser
Yeah, it makes sense.
joe rogan
Guys with smaller jaws and smaller faces, they have a much harder time getting hit.
chris kresser
I wouldn't last long.
joe rogan
Yeah.
Well, like, Samoans are the best at it.
chris kresser
Yeah.
joe rogan
Like, they have just such rigid bone structures.
chris kresser
And Weston Price has a lot of pictures from people in the South Pacific and that region.
They're a perfect example.
You know, examples of these beautiful...
You should check it.
You would love the book.
It's really amazing to see the juxtaposition of those traditional faces with the modern ones.
It's like, I mean, a picture's worth a thousand words, right?
You just look at those pictures and you're just like, oh my god.
joe rogan
Totally makes sense.
chris kresser
Yeah.
joe rogan
Yeah, it's very weird when you think about what we're doing to the human body.
And when you're talking about the diabetes levels that you're talking about are pre-diabetes and chronic disease and all the different issues and 40% obesity rate and all these different factors.
It's an epidemic that's sweeping through the entire nation and it's largely ignored other than health fads, weight loss videos.
It's like peripherally examined.
chris kresser
I like to call it a slow-motion plague.
unidentified
Whoa.
chris kresser
Because like the bubonic plague, you know, which was a fast motion plague, it threatens us in the same way.
Like it's literally threatening the health of future generations.
It's shortening our lifespan.
It's destroying our quality of life.
joe rogan
That's a big one.
Even if you stay alive, the quality of life is being devastated.
chris kresser
There was a recent article that came out saying just that.
It was a paper that looked at what's happening in our older years and saying, yeah, we have a long lifespan, but our quality of life has significantly declined in those later years because we're burdened by all of these chronic diseases.
You know, the average, something like...
One in five or two in five elderly people over 65 are taking more than five medications.
It's a huge problem.
And this is the thing.
You hit on this point, so I want to reiterate it because it's super important.
We have accepted chronic disease as normal because it's so common, but there's a really important difference between common and normal.
What's common is not necessarily normal.
It's now common for people to have chronic disease, but that's not normal.
How do we know?
Again, the Samane, it's a subsistence farming hunter-gatherer population in Bolivia.
And recently there's been some articles in the New York Times about them.
There's some anthropologists, medical anthropologists, and doctors and researchers have gone down there to study them.
They wanted to see, it's like, this is one of the last places on Earth where people are still living pretty traditional diet and lifestyle, so we better study this quickly, you know, to see what's normal, what's truly normal for humans.
Not common, but normal.
joe rogan
Yeah.
chris kresser
So they eat...
Paleo type of diet, fruits and vegetables, some meat and fish, nuts and seeds, some plantains, other kinds of starches.
They walk an average of 17,000 steps a day, which is about eight miles, so quite a bit.
They live in sync with the natural rhythms of light and dark.
They don't have a lot of artificial light exposure like we do.
They sleep seven to eight hours.
In fact, the researchers are trying to ask them about insomnia.
They don't even have a word for it in their language.
joe rogan
Wow.
They work.
chris kresser
Yeah, they just, you know, they live in their normal, that's as close as we're going to get to a normal human population, right?
So they studied, they did blood markers on them for heart disease, but not only that, they did scans, CT scans of their heart, you know, to see if they had calcification of the arteries.
They found that the rate of heart disease in this population was 80% lower than it is in the U.S. 80% lower.
9 in 10 Tsimane adults that they studied had absolutely no plaque buildup in their arteries, which means they have virtually no risk of a heart attack as far as we understand it.
And, you know, before anyone who's listening to this says, oh, yeah, that's just because hunter-gatherers all die when they're 35 years old, you know, that familiar argument.
Well, this study included people between the ages of 40 and 94 years old.
What's more, the researchers estimated that the average Simane 80-year-old had the same vascular age as an American in his mid-50s.
unidentified
Whoa.
chris kresser
There's almost no cognitive disorders or Alzheimer's disease in the Simone.
So that's a really clear example of what happens when you give human beings the right inputs and they're not exposed to all this crap that we're exposed to.
They live long and healthy lives that are virtually free of chronic disease.
And that's despite the fact that they have much higher rates of infection than we do.
They live on a river.
They've got parasites galore.
All of them have parasites.
And yet they still are healthier than us in almost every way you can measure it.
They have lower body mass index, lower blood pressure, lower weight.
They don't get heart disease.
They don't get Alzheimer's and dementia, which is now like...
Climbing up the list of causes of death and tripling.
joe rogan
I'm glad you brought up Alzheimer's because I read something recently.
I didn't read the whole article.
I just read the title of it.
It was connecting Alzheimer's to gut bacteria.
chris kresser
Yeah, absolutely.
There's a strong, there's actually something referred to as the gut-brain axis, which is this very well-known connection between the gut and the brain, and it goes both ways.
So, you know, the gut can influence the brain strongly, and the brain can influence the gut strongly.
So, I mean, my point is just that What you said.
When are we going to realize that just these changes, you know, making these changes is what we need to do to prevent and reverse chronic disease?
And we have these examples of people like Tsimane that show us very clearly that it's the way we're living, not our genes, that are causing this chronic disease epidemic.
So the easy way would be to Write books about it, have shows like this, keep educating people and doing that.
And that's what I'm hoping for, and that's why I wrote my book.
But the hard way is that our system fails, that it becomes so overburdened by the rising rates of chronic disease and the unsustainable expenses of that, that it basically falls apart.
And it becomes...
You know, we respond in a kind of to it as the crisis that it really is because it becomes apparent at that point that our way that we've been doing it has not been working and that we desperately need to find a new way.
And that's another possibility.
And which one you think is going to take place kind of depends on whether your glass is half empty or glass is half full type of person.
joe rogan
Yeah, well, from your own personal point of view, if you're listening to this, don't rely on all those things to happen.
Just try to go out and do something about this for yourself.
chris kresser
And I think that's how it's really gonna...
My personal view is it's gonna be a little of both, actually.
So I think what's gonna happen is you're gonna start seeing some big changes on the more local grassroots level.
So we've already seen stuff like this.
Examples would be There's a group called Iora Health in Denver.
It's a primary care group, and they're reversing type 2 diabetes with health coaches.
You know, they still see the doctor, but they work primarily with a health coach who does all those things that I just said.
I wasn't making that up.
They actually go to their house.
They do pantry clean outs.
They go shopping with them.
They teach them how to eat well.
But more than that, they're like the accountability buddy.
They call them every week.
They visit their house.
How are you doing?
How can I help?
And that person's totally empowered, and they make these changes, and they're reversing it without drugs or with a minimum of medication.
There's Mark Hyman, who's a doctor.
Pioneer in functional medicine, he recently, they tapped him to start a Center for Functional Medicine at the Cleveland Clinic, one of the most prestigious international medical institutions, always on the forefront of the newest changes in medicine.
And when they first started, they were in this tiny little space.
But within a few months, they had like 3,000 patients on their waitlist and they moved to 17,000 square foot space in Glickman Tower, which takes the whole second floor of this building in Cleveland Clinic.
And they've got patients from nine countries on the waitlist coming from all over the world to do functional medicine because they have, you know, People know that the system, as it's set up, isn't really effective for chronic disease.
It's fantastic.
I mean, if I get hit by a bus, I want to go to the hospital, right?
I mean, antibiotics revolutionize how we treat infections.
You have anesthesia made surgery, like...
You know, imagine surgery without anesthesia.
It was like a bottle of booze, you know?
Right, right.
Antisepsis, like, you know, cleaning the surgical theaters has dramatically reduced infections.
You've got radiologic images that's improved diagnosis of disease.
So conventional medicine is amazing, and it's here to stay, and we need it.
But it's just the wrong tool for the job, for chronic disease.
joe rogan
It's the wrong tool for nutrition and for management.
unidentified
Yeah.
chris kresser
Using a hammer, going around everywhere with a hammer, you know, expecting not to work.
Hammer works really well when you're pounding a nail, and it doesn't work as well with a screw or, you know, with something else.
So, I mean, Cleveland Clinic, it's just an amazing proof of concept for functional medicine.
Then Rob Wolf, who, you know, we both know, He did some incredible work with the city of Reno and the first responders, where they projected that just by doing this dietary intervention, so what happened was that the firefighters and police cops were having heart attacks and strokes.
And because of the way the pension plans are set up, if the city of Reno has to medically retire these people, They're going to spend millions of dollars over the course of their lifetime taking care of them.
So Rob went in there with this other group, Specialty Health, and they got them on a good paleo-type diet, lower-carb diet, got them doing some more physical activity.
Well, the estimate was that they saved the city of Reno something like $25 or $30 million just with this simple intervention.
We're doing a pilot now with the Berkeley Fire Department, with our clinic, with a similar kind of goal.
So I think you're going to see all these kind of examples of things happening on local community level because you can make changes more quickly that way.
And then over time, some of those things are going to scale up.
And, you know, we're going to start seeing them maybe on the state level or the, you know, local government level.
And then eventually, at some point, that's going to get attention of people on the federal level who are looking around and going, oh, my God, it's 2025 or 2030. Healthcare expenditures are 35 or 40% of GDP. This is completely unsustainable.
We're not even going to exist as a country in 25 years unless we do something about this.
So I kind of think it's going to go like that.
joe rogan
Well, I hope it goes towards the...
The model of the Cleveland Clinic where businesses sort of rise up and take advantage of this opportunity to get people healthy and to profit.
I mean, it seems like that's the best way to make things happen.
Make it a business or someone can profit off of it.
As long as it's affordable for the vast majority of people, if it's not unreasonable.
chris kresser
Well, that's the thing.
And Rob has talked about this a lot for years.
If you look at economies of scale and you look at things like microprocessors and DNA testing, the first human genome sequence cost like $500 million.
Now you can just go out and pay $200 to have your genome sequenced.
And microprocessors, when they were first introduced, the computers were as big as the The room and, you know, millions of dollars, and now anyone can go buy a computer for a few hundred bucks.
joe rogan
Well, your phone is many times stronger than what they used from NASA in the 1960s.
chris kresser
But we don't see that kind of innovation in healthcare.
Like, we see expenses going up instead of going down.
Every year it gets more expensive.
joe rogan
I feel like there's a lot of hijacking going on with big money, and big money in particular in the pharmaceutical industry.
They don't want anything that interferes with this gravy train of money going right into their pockets when people have diseases.
chris kresser
And that's the key point.
I mean, Rob, we did what we call a rally to end chronic disease the other night, and Rob came and spoke, and so did Mark Hyman from Cleveland Clinic and a few others.
And in Rob's talk, he mentioned that Healthcare should essentially be free.
If we allowed the same forces that made microprocessors go from being extremely expensive to extremely cheap, DNA testing go from being extremely expensive to extremely cheap, if we allowed those same forces to work on healthcare, healthcare would be extremely affordable.
The problem is, as you pointed out, we have a lot of misaligned incentives.
So insurance companies, for example, they only benefit when the overall healthcare expenditures rise.
So the more procedures are ordered, tests are ordered, treatments are prescribed, the more the insurance company benefits.
joe rogan
That seems counterintuitive to people because you would think that you're paying for insurance and the insurance company is hoping that nothing goes wrong because then they'll have to pay out far more than you're paying in.
chris kresser
Yeah.
There's a great book called Catastrophic Care that I recommend by David Goldhill for anyone who's interested in this.
It really pulls the curtain back on the whole system and how it's set up.
Then you've got, of course, pharmaceutical companies.
joe rogan
How is it set up though?
Why do insurance companies benefit from things going wrong?
chris kresser
As the whole edifice or the whole system of healthcare grows, they benefit because they're involved in all of those transactions.
joe rogan
Oh, okay.
chris kresser
And then you have Big Pharma that is basically, you know, their incentive is to sell more drugs and they're for-profit corporations and their duty is to make a profit for shareholders and that's how they do it.
And so...
Selling more drugs is not always aligned with the interests of patients or even of doctors.
joe rogan
Well, the real issue to me that stands out as an example of that is these stupid fucking commercials that they have for pharmaceutical drugs where people are having the best time ever.
Well, you're looking at them and like, this is so deceptive.
You're showing me like best case scenario, grandpa running, pushing the bike and the little kids laughing and everyone's having the time of their life like, oh, I want the time of my life.
How do I get in on that?
chris kresser
Until the last 15 or 30 seconds, which is like...
This drug may cause, you know...
joe rogan
Explosive diarrhea, anal bleeding, eyeballs fall out, your feet don't work.
It's crazy how many...
chris kresser
They seriously go on for like 15 seconds.
joe rogan
What was that one that we saw the other day, Jamie?
unidentified
Humira.
joe rogan
Yeah, what is that stuff?
unidentified
It was for, remember she said it's like 120 grand for hepatitis?
chris kresser
Yeah, and death is a side effect of that drug.
joe rogan
Death.
Suicidal thoughts.
Contact your physician.
He'll tell you to fuck yourself.
Wake him up.
Wake him up in the middle of the night.
Here, give me some volume on this so we can hear this.
I thought I was doing okay, too.
But I'm not.
unidentified
Look at her.
joe rogan
She's managing.
unidentified
Oh, my.
Crohn's.
Significant.
Ah, remission.
chris kresser
Then I'll tell you what significant means.
unidentified
...inclusive tuberculosis, serious sometimes fatal infections and cancers, including lymphoma, have happened, as have blood, liver, and nervous system problems, serious allergic reactions, and new or worsening heart failure.
Before treatment, get tested for TB. Tell your doctor if you've been to areas where certain fungal infections are common.
And if you've had TB, hepatitis B, are prone to infections, or have flu-like symptoms or sores, don't start Humira if you have an infection.
Just managing your symptoms.
joe rogan
Hold up.
Stop.
Okay, kill it right there.
Why is that lady so fucking sweet and cheery while she's talking about imminent death and the music just does not fit?
And look, the woman is on a TV set, too.
Like, she's a successful producer on a television set.
unidentified
That's right.
joe rogan
What a bizarre choice for, like, what she does for a living.
Like, watch her...
Kill the volume, but watch her wander around the office there.
Like...
Who the fuck works on a TV show?
We're supposed to relate to this lady?
How many people work on the set?
Look at her.
She's got her folder.
She grabs a piece of cake.
Even though she has Crohn's.
chris kresser
It has nothing to do with Crohn's disease, what you eat.
joe rogan
She's going to fucking die.
In an explosive, imploding, rectal disaster.
chris kresser
Or just, you know, get an infection that would be totally, you know, not a threat for you or anyone else, but because they had taken a drug that globally suppresses their immune system, can kill you.
joe rogan
Yeah, that whole thing, like, if you, you know, if you have an infection, don't take it.
Like, what?
Wait a minute.
chris kresser
Aren't those pretty common?
joe rogan
The fuck are you saying?
chris kresser
What kind of infection are we talking about?
Don't get an infection while you're taking Humira.
Do you ever try to get an infection?
I mean, how do you not try to get an infection?
joe rogan
Yeah, but this is what kills me, is the bizarre choice of her being some sort of a director or producer of a television show.
That we're supposed to relate, well, she is so successful.
chris kresser
This is amazing.
Yeah, maybe if you take Humira, you could also become a producer of a television show.
joe rogan
There was another one, Abilify, that killed me.
And it was an antidepressant that you give to people that are suicidal while taking antidepressants.
Like, what?
Hang on.
chris kresser
Yeah, let's talk about Abilify.
I think it's the sixth or seventh most prescribed drug in the U.S. It's an antipsychotic.
Okay, so if those two things are not resonating, there's a reason for that.
We don't have that many psychotics in this country where Abilify could be only used as an antipsychotic.
joe rogan
Give me some volume.
Let's hear this.
Yeah.
unidentified
...and carry on.
But other days, I still struggled with my depression.
I was handling it, but sometimes it still dragged me down.
joe rogan
She's a cartoon.
unidentified
I've been feeling stuck for a long time.
So I talked to my doctor, and she added a bilify to my antidepressant.
She said I could help with my depression, and that some people had symptom improvement as early as one to two weeks.
I'm glad I talked to her.
I wish I'd done it sooner.
Now I feel more in control of my depression.
Results me very like a motherfucker.
Call your doctor if your depression worsens or you have unusual changes in behavior or thoughts of suicide.
Antidepressants can increase these in children, teens, and young adults.
Elderly dementia patients taking Abilify have an increased risk of death or stroke.
Call your doctor if you have high fever, stiff muscles, and confusion to address a possible life-threatening condition or a view of uncontrollable muscle movements as these could become permanent.
High blood sugar has been reported with Abilify in medicines like it and in extreme cases can lead to coma or death.
Other risks include increased cholesterol, weight gain, decreases in white blood cells, which can be serious, dizziness on standing, seizures, trouble swallowing, and impaired judgment or motor skills.
What in the fuck?
Depression is always hanging over me.
Don't drive.
Don't drive.
Bitch!
joe rogan
Depression is the least of your concerns.
You're gonna die if you take this shit.
Most of that commercial is telling...
When does it start where they're talking to you?
Cut the segment of the commercial where the lady comes out, the doctor comes out.
Show where the lady doctor is.
That's like halfway in, the lady doctor comes out.
chris kresser
Well, it's actually a third in.
joe rogan
A third in!
unidentified
So two thirds is the lady doctor saying, you're gonna fucking die!
chris kresser
Can we just break this down?
Because this is a drug that's added to a prescription of someone who's already taking antidepressants to prevent suicidal thoughts.
But then one of the first side effects they said to look out for is suicidal thoughts.
joe rogan
Yeah, what in the fuck?
chris kresser
Maybe there'll be a third drug that people who are already on antidepressants and Abilify can take for the suicidal thoughts that Abilify wasn't able to get rid of from the original antidepressant.
joe rogan
Yeah, maybe we're just being cynical.
Maybe we just need to trust in that cartoon lady with the great voice that says...
Amnesia?
Bone loss?
chris kresser
I mean, this is a good example.
Like, we've all heard this term evidence-based, right?
And the idea is that conventional medicine is evidence-based and everything else is not.
Well, that's total BS because this, and Abilify is a great example.
It's an anti-psychotic.
That's what it was approved for, for psychosis.
And yes, we have a lot of people, I mean, recent events indicate that we do have quite a few psychotic people, mass shootings, etc.
Not that many.
You know, not enough to make Abilify the seventh leading drug on a sales basis.
joe rogan
That's an insane number.
chris kresser
Yeah.
So what Abilify is prescribed off-label.
So off-label means a way of using the drug that has never been studied or approved by the FDA for that particular purpose.
So it's using a drug in a way that was not originally studied.
joe rogan
How is that legal?
chris kresser
It's legal.
Doctors have the authority to prescribe medications off-label.
joe rogan
As long as they're FDA approved medications.
chris kresser
As long as they're FDA approved for something.
joe rogan
That sounds insane.
chris kresser
The vast majority of Abilify prescriptions, therefore, are off-label, which means they've never been studied or shown to be safe or effective for the conditions that it's being prescribed for.
joe rogan
So your doctor could legally prescribe you birth control pills?
chris kresser
Yeah.
I mean, it would be frowned upon, and maybe if they did that enough and it was causing problems, they would have to justify why they were doing it.
joe rogan
That's the missing key to bilify for men.
Female birth control pills.
Like, oh, wow, look at this.
chris kresser
And it also means they can use it in a population that it hasn't been studied for.
So, for example, a drug has been studied and approved for adults.
Did you see that it said not safe, you know, shouldn't be used for children and the elderly?
Because it's never been studied.
But that doesn't mean it's not being prescribed for children or the elderly.
It still definitely is.
You know, antidepressants have been shown a cause to ink suicidal ideation in adolescents and teenagers in particular, and yet they are still often used in that group, even though they were never studied or approved for that population.
joe rogan
What is this one, Jamie?
Abilify is top-selling...
chris kresser
Yeah, seven billion a year.
joe rogan
Seven billion...
chris kresser
Oh, it's the top-selling...
Sorry, it's the top-selling drug.
It's not the number seven, it's the...
Silly me.
joe rogan
What?
chris kresser
So the top selling drug is an anti-psychotic.
joe rogan
Is that real?
chris kresser
It's real.
joe rogan
But is it still the top selling drug?
Whatever.
Let's not even look.
But in 2014, it was the top selling drug.
That is crazy.
It has become the best selling drug in the United States.
unidentified
Wow.
chris kresser
The alarms about the dangerous and sometimes deadly side effects of anti-psychotics affecting children and the elderly, among others, have been mounting for years.
joe rogan
That's terrifying.
And many of these symptoms could be directly related to gut biome, gut bacteria, and you might be able to nip it in the bud with a change in diet, with addressing the sedentary lifestyle, rigorous exercise.
chris kresser
So let me tell you...
joe rogan
Rest, all these things.
I mean, it seems like what you're prescribing, like, oh, come on, it can't be that easy.
chris kresser
Let me tell you a story.
It's actually the first chapter in my book.
It's about a kid named Leo that I treated in my clinic a few years back.
He was eight years old when he came to see me.
His parents were like a wreck when they came to the office because they were just totally worn down.
He would throw these epic tantrums where he'd be...
You know, screaming and crying or writing on the floor for just the most random stuff, like trying to get his shoes tied as they were going out the door or, you know, not cutting the crust off his bread sandwich in just the right way or getting a stain on his favorite t-shirt.
He had a super limited diet.
He ate only a handful of foods, all of them processed and refined, like toaster waffles, bread, crackers, cookies, et cetera.
You know, they were concerned about nutrient deficiency, but every time they tried to reintroduce, like to introduce a different food, he would go ballistic.
And they didn't have the energy to fight him at every meal.
He was really rigid about his behavior and environment, so everything had to be just right.
If the toys in his room weren't arranged in just the right way, he'd fly off the handle.
Desks in his classroom weren't just the right way, he'd fly off the handle.
He was really anxious in unfamiliar environments, so it was hard for them to leave the house for even a few hours, much less travel or go on vacations.
I mean, this seems extreme, but there are a lot of kids with these kinds of behavioral disorders now.
He's not alone.
So, they took him to see doctors locally, and they started with a primary care doctor, then went to psychiatrists, and then several behavioral disorder specialists actually down here at USC or UCLA. You know, first diagnosed on the autism spectrum, then eventually OCD and something called sensory processing disorder, which is like on the autism spectrum where they're really sensitive to, you know, sense, input, touch, you know, sound, etc.
The doctors, you know, they were relieved at first to have these diagnoses, but very quickly it became apparent that they were just labeled for the symptoms.
It wasn't anything that actually gave them information about what to do.
And then when they asked the doctor what the treatment was, the answer was medication.
So they first started with Adderall, which you mentioned earlier, then Ritalin, both stimulants, and then eventually antidepressants, which again have not really been approved as safe or effective in kids.
And they did help at least a little bit with some of the symptoms, but then he got a lot of brutal side effects.
Gut pain, dry mouth, irritability, headaches, and the worst thing was severe sleep disruption.
And he had two younger brothers and sisters, so his parents definitely didn't need more of that.
And the crazy thing throughout this entire period, not one of his doctors even hinted at the possibility that something in its diet or like a disrupted gut microbiome or nutrient deficiency could even be contributing to his symptoms.
Nobody even brought that up.
And that's not the exception, that's the rule.
So, you know, his parents weren't thrilled about, I mean, they weren't thrilled about medicating him, but they did it because they had no other option and nobody suggested that it could be anything other than just, you know, something wrong with their son.
But fortunately, one of his mom's friends sent a couple articles for my blog.
One was on the gut-brain axis, which we've been talking about.
Another was on all of the underlying causes of behavioral disorders in kids.
So they brought him to my clinic.
We did a whole bunch of testing, as I do, with all my new patients.
And not surprisingly, we found he had a disrupted gut microbiome.
He had SIBO, bacterial overgrowth in the small intestine.
He had non-celiac gluten sensitivity, and gluten was in almost every food he was eating.
But he also had intolerance of some other proteins like dairy and soy and corn and buckwheat, which were in the toaster waffles he was eating every night.
He had deficiencies of vitamin D, B12, folate, and iron because he was eating just flour, basically, you know, flour and sugar.
And he had high levels of arsenic, which is a heavy metal, because the only other beverage he would drink, aside from water, was rice milk.
And rice milk's been shown to have, you know, higher levels of arsenic.
So if a kid's just pounding rice milk, they could actually start to develop levels of arsenic that could be problematic.
joe rogan
That's crazy because a lot of people think of rice milk as being a healthy alternative.
chris kresser
As a healthy beverage, right.
So we started treating him, which wasn't easy because of his OCD-like tendencies.
It was really hard to get him to change his diet.
So we just started focusing just on those mechanisms that I talked about.
Getting him some more nutrients and treating his gut and trying to get some of those things out of his food.
Initially just switching those brands of toaster waffles so that at least they were made from stuff that he wasn't clearly reacting to.
And then gradually over time shifting.
Within several weeks...
He was having fewer tantrums.
He was less set off by the things that would have done that before.
About four months into the treatment, his teacher called home from school and was like, where's Leo?
You know, what have you done with Leo?
And who's this guy you're sending to school in his place?
Because it had been horrific for her as his teacher at school, to the point where its parents often had to come pick him up and bring him home from school because he was so disruptive.
Then I talked to Leo's mom maybe six, seven months into the treatment.
By then we had the follow-up test back.
A lot of the issues that we set out to address had been resolved.
His diet had expanded significantly.
He was eating foods that he would have thrown against the wall just a few months before.
He was more tolerant, you know, more affectionate, less controlling and rigid and just better adjusted kid overall.
And at the end of that time, his mom said, Something that really struck me, and it's why I wrote the book.
She said, why don't more doctors know about this?
There's so many kids out there like Leo who are suffering from these kind of behavioral disorders, but neither their parents nor their doctors are even looking at this other stuff, like the diet and the gut and all these things.
So it's not even a consideration.
And that's why I wanted to get this book out there, because we can't know and treat what we're not even looking for.
joe rogan
What's crazy is what you're saying is revolutionary, but it's not.
chris kresser
Right.
It's common sense, right?
unidentified
Yeah.
joe rogan
I mean, it's food.
But you essentially restructured the ecosystem of this child's body and brought them back to homeostasis.
You brought them back to some sort of...
Normal function.
And this poor kid was living with a diet that a giant percentage of our country is consuming.
A lot of kids are eating sugary cereals in the morning and peanut butter and jelly sandwiches and just white bread and sugary juices.
chris kresser
Lunch packs with the Lunchable, all the crap in there.
joe rogan
Yeah.
chris kresser
It's even worse in kids because there's this idea that big food has been very successful at perpetuating that kids need special kids' foods.
unidentified
Right.
chris kresser
You know, they can't just eat what we're eating as adults.
We have to prepare kids' meals.
You go to a restaurant and there's the kids' menu.
You go to a great restaurant that has meat and vegetables and all this stuff.
unidentified
Right.
chris kresser
What does the kids' menu have on it?
joe rogan
Chicken fingers.
chris kresser
Grilled cheese, pasta with nothing on it.
Bullshit.
Just total crap.
joe rogan
Bullshit, yeah.
chris kresser
And the idea, you know, when we go out with my daughter, they always bring us a kid's menu.
And my daughter's like, no, I don't need to see that.
I'm ordering off this menu.
And it's like, yeah, we don't need breakfast cereal or Pop-Tarts or any of this crap.
Kids just need to eat.
It's even more important for kids to eat well than it is for us because their brain is still developing.
Their body's still developing.
So yeah, I mean, someday we'll go to the doctor and you have something like this, the first questions are going to be around, what are you eating?
How are you living?
Oh wait, let's do some tests to find out how your gut is.
Let's do some tests to see if you're nutrient deficient.
Let's actually look at the causes instead of just assuming that every chronic disease is a deficiency of a medication.
That's basically how it's approached.
You have high cholesterol, you have a statin deficiency.
So we better correct that by giving you a statin.
You have high blood pressure, you have a diuretic deficiency.
We're going to give you that.
You have depression, you have an antidepressant deficiency.
So we're going to give you that drug.
Basically how it's looked at.
joe rogan
That is how it's looked at.
It's crazy that what you're saying is eat food.
chris kresser
Eat real food.
joe rogan
Eat food.
chris kresser
I mean, I think if we ate real food, probably that could shave off a couple trillion dollars from the healthcare budget.
joe rogan
And how much more effective would we be at whatever we're doing?
How much healthier would people be?
How much happier would people be?
chris kresser
Yeah, it's not just about health in that narrow sense of the absence of symptoms of the body.
We're talking about your ability to perform at work, your ability to relate to your kids, to your partner.
joe rogan
I wonder how much of the antidepressant, like the people that are prescribed or people that are experiencing depression has to do with their diet.
chris kresser
I would say quite a high percentage.
Again, I think there are situational factors that cause depression.
I mean, for someone who is poor and lives in an economically and socially depressed area and is fighting systemic oppression, there's good reason to be depressed in that situation.
Sure.
Nevertheless, given what we understand now about this inflammatory model of depression, it's also true that that is at the very least going to exacerbate it and make it worse, but in some cases may be the primary driver of depression.
And I can't tell you how many patients I've had who've had depression that they thought it was something wrong with them, there's something broken about them, They're not cut out for this world.
They don't fit in here, that sort of thing.
And then we go in, we see, oh, you've got a severe B12 or folate deficiency.
That affects your neurotransmitter levels.
Oh, you've got a disrupted gut microbiome.
Oh, you've got blood sugar abnormality.
Oh, your hypothyroid.
We know 20 or 30% of patients with depression have hypothyroid.
So just correcting that could correct it.
So when we address all those things, all of a sudden that person's no longer depressed.
And I've had people say things like, oh my god, for the last 20 years I thought something was wrong with me.
I thought I was broken.
I thought it was me and something was just really wrong.
joe rogan
It's a crazy word too.
The problem with depression is that it's a diagnosis.
And that if you just said, feel bad.
Feel bad would not be like, oh, he's been diagnosed with feel bad.
But that's essentially what depression is.
It's so blanket.
It can cover a host of different neurological issues, physiological issues, or behavioral issues that are because of your environment and your life experiences.
chris kresser
Absolutely.
And that was not an unintentional thing, Joe.
That was drug companies creating it as a disease because diseases require medications to be fixed in our culture.
And this happens across the board.
Do you know the story of Viagra and how that was developed?
joe rogan
Yeah, it was some sort of a blood pressure medication, correct?
chris kresser
Right.
joe rogan
They hit the jackpot on that one, huh?
chris kresser
Yeah, so they found like, okay, this isn't working very well for what we designed it for, but it's got some pretty interesting effects.
But they knew it wasn't enough to just then go out there and start selling it to say, hey, here's a drug that will help make you perform better in the bedroom.
That wasn't enough.
What they had to do was create a disease that it could be prescribed for.
And you know how they did that?
They hired an advertising agency.
And the ad agency came up with the term erectile dysfunction.
joe rogan
No way.
chris kresser
And created this.
joe rogan
No way.
chris kresser
Absolutely.
It's publicly available information.
joe rogan
An ad agency named a disease.
chris kresser
Created a disease.
This is not the only case where this has happened.
So they create this disease category and then they get it out into the world and they advertise it to people and to doctors.
And so all of a sudden people are going in with the magazine.
They're like...
This is me.
I have erectile dysfunction and I know now there's a drug called Viagra that I need because I have erectile dysfunction and the doctor has seen that they have their own brochure.
They pull out their brochure and it says erectile dysfunction.
Here are the signs and symptoms.
Okay, check, check, check, check.
Yes, this patient's got erectile ED. So here's the drug prescription.
joe rogan
How is it legal for an advertising agency to name a disorder?
chris kresser
Well, I'll tell you that it's illegal in every single country in the world, except for New Zealand and the United States, to advertise drugs to consumers.
joe rogan
Please, New Zealand, be the first to change.
Please, turn it around, make us look terrible.
chris kresser
They can do it first, because this is the result.
This is the result of allowing drugs to be advertised, is that you get advertising agencies creating conditions that then require drugs to be treated.
joe rogan
That is fucking amazing.
What else has been named by advertising agencies?
chris kresser
Off the top of my head, I don't know.
But next time I'm on the show, I'll definitely have a list for you.
joe rogan
Goddamn!
I can't believe that that's legal.
chris kresser
It's legal.
And, you know, there's another book I read a while back.
And the quote in the book was really revealing.
It was by the CEO of Merck, which is one of the biggest pharmaceutical companies in the world.
And again, I'm going to paraphrase.
I don't remember the exact words.
But the gist of it was, the real money in drugs is in selling them to healthy people.
So he had realized that, you know, we basically saturated the market of medications that can be used to treat sick people.
So the only way we can continue to grow and expand is to come up with ways to sell drugs to healthy people.
joe rogan
When did they first start prescribing antidepressants?
chris kresser
Well, the SSRIs, I think, go back to the 80s or late 80s or early 90s, but they had other kinds of antidepressants before that called tricyclic antidepressants and other types of medications.
So they've been around for a while.
But I mean, my point is like this creation of erectile dysfunction as a disease was a way of selling drugs to healthy people.
joe rogan
Yeah.
chris kresser
Because they basically shifted them from being healthy people that otherwise wouldn't see themselves as someone who needed a drug to people who now have a condition.
joe rogan
Yeah, from what I understand, Provigil, that was the initial creation of Provigil, they were trying to come up with a performance-enhancing drug for cognitive function.
And they couldn't just sell it as such, so they had to come up with some sort of a reason why people need it, so they went with narcolepsy.
chris kresser
Right.
And then you, I mean, you have people who've been arguing that statin should be put in the water supply.
joe rogan
What?
chris kresser
Yeah.
There literally was- Who the fuck says that?
There was a doctor in the UK- That guy's a monster.
unidentified
Who lit- That guy's eating a baby salad right now.
joe rogan
Fucking monster.
Put it in the water supply.
That's poison.
chris kresser
He seriously advocated for that.
It wasn't a joke.
It wasn't an exaggeration.
joe rogan
Who is this?
What year is this?
chris kresser
A few years back.
I have a blog article about it.
Oh my god.
Because his argument was, you know, these drugs are so effective for reducing the risk of heart disease that, you know, we should just be giving them to everybody despite whether they want to take them or not.
joe rogan
Well, he's a moron.
Because doesn't that, don't they seriously disrupt performance?
chris kresser
Well, you know, the bigger question is whether statins actually extend lifespan in people without pre-existing heart disease.
And a lot of the research suggests that the answer to that question is no, or in an almost non-insignificant way.
And then you have to balance that with the potential side effects, like the increased risk of diabetes, particularly in women, and now we have 100 million people with diabetes, and then the muscle fatigue and myopathy and that sort of thing.
But, yeah, I mean, I think that's, this is, I mean, we got off on this when we were talking about misaligned incentives, and all of these things we've been talking about are just examples of how what's in the best interest of a drug company, duh, is not necessarily in the best interest of us as patients or for doctors.
joe rogan
When it goes back to what you were saying about tooth decay and then fluoride in the water.
chris kresser
Right.
joe rogan
Like how much tooth decay is really because of our diet, and it's not because of fluoride.
chris kresser
It's not because we...
joe rogan
And fluoride is not good for you.
chris kresser
Well, you look at...
joe rogan
Especially in large quantities.
I mean, you can get away with it in some of the quantities that's in our water supply, but from what I understand, it's not really...
We don't need it.
chris kresser
So I know this might sound controversial, but...
Do we think that our hunter-gatherer ancestors were brushing their teeth twice a day and flossing twice a day?
joe rogan
No, they probably had horrible breath.
chris kresser
Well, here's the thing.
There's an oral microbiome, just like there is a microbiome in the gut.
It's what's likely, and archaeologists know that when they uncover remains from traditional, our ancestors, our Paleolithic ancestors, they have great healthy jaws and teeth.
joe rogan
Not Egyptians.
You know about that?
chris kresser
Well, that was civilization already.
joe rogan
Yeah, when they started grinding food.
chris kresser
I'm talking about further back, you know, further back in our history prior to agriculture.
Right, prior to bread.
And so, what that suggests is that, you know, Look, I brush my teeth and I floss.
I'm not suggesting that people shouldn't now and that there hasn't been some improvement.
But the fact that Weston Price went around to all these traditional cultures and found that they had beautiful, healthy teeth and wide dental arches, they weren't brushing their teeth twice a day and flossing twice a day.
But they had root, you know, underlying foundation of health and a healthy microbiome, not only in their gut, but an oral microbiome.
That led to healthy teeth even without that kind of dental hygiene and dental care.
And there are now oral probiotics, dental probiotics, which are chewable tablets that you can just pop one in your mouth after you brush your teeth, you chew.
And I've had patients who had been having recurring cavities, dental issues, periodontal issues.
That just by chewing one of these dental probiotics twice a day have had like a complete reversal in their dental health where, you know, they go from having like a cavity every time they go to the dentist to having no cavities at all.
joe rogan
Because that's one of those woo-woo subjects where people go, oh, you fucking crystal hippie.
When you start talking about fluoride in the water.
But do we really...
I mean, we definitely need to somehow or another clean the water of bacteria and treat the water so that it doesn't have pollutants in it.
But...
That can be done with filtration systems.
You know, people in the wild, not in the wild meaning like the Chumani, but people that live in camps for months at a time, like friends of mine that go on these backcountry trips, they use water filters.
They'll take like a wallow that like an elk have been stomping around in muddy water and they'll put this water through this filtration system and make it so you can drink it.
And there's SteriPens.
They have these pens that you could spin the pen around in the water for a predetermined period of time and it kills everything that's bacteria, all the bacteria in the water.
There's a bunch of different filtration systems, pumps that they use on creeks to keep beaver fever.
What's that stuff called?
Jardia.
From beaver shit in the water.
So this all can be done without chemicals, is my point.
So the chemicals that we have in the water, they might be terrible for you.
They're not necessary.
And especially in terms of fluoride, it might be completely misguided.
chris kresser
Have you read, I forget the book on just, you know, big thick book on fluoride.
Bryson, I think is the last name of the author.
It's a yellow cover.
joe rogan
No, I haven't read it.
chris kresser
I think he mentioned something about how, and this comes up in other contexts too, where companies that have something that's toxic that they would otherwise have to pay for, to dispose of, have figured out ways to actually sell that stuff to the food industry.
Or to another industry that then puts it in some product.
So industrial seed oils like soybean oil, cotton seed oil, those kinds of things, originally were not considered foods.
They were waste products from agriculture, from growing those crops.
And then the brilliance of those companies at that time was figuring out a way to turn those things that would have otherwise been seen as waste into a food product that they could then sell and make money off of.
unidentified
Really?
joe rogan
And those are amongst the worst.
chris kresser
Those are ubiquitous in the American diet.
If you pick up any packaged food, you're going to see soybean oil, corn oil, cottonseed oil, etc.
All these highly processed and refined omega-6 vegetable oils.
joe rogan
And those vegetable oils are very difficult for your body to process.
chris kresser
Well, first of all, they're almost completely devoid of nutrients.
Some of them have vitamin E, but they have almost no other nutrients at all.
Historically, humans consumed a balance of omega-6 and omega-3 oils that was somewhere between 1 to 1 ratio or maybe a 4 to 1 in favor of omega-6.
The amount of omega-6 oils that we consume today is much higher.
You know, sometimes like a 20 to 1 ratio of omega-6 to omega-3.
And this is a controversial topic.
There was just a research study published that seemed to suggest that these oils actually may not be as harmful as we thought they were.
But I haven't had a chance to read the full text of the study yet.
And you have to look at the overall weight of the evidence.
You know, if you've got...
40 studies showing that they're harmful and then one that shows that they're not.
Well, okay.
But you've got to consider that in the whole context.
joe rogan
Yeah, yeah.
And you've got to find out who funded that study.
chris kresser
There are a lot of questions to ask.
And whether even the studies said what people say it said, which is often not the case when you look into it.
joe rogan
That fluoride one is really freaking me out now that we're talking about it.
Because I wonder, how would you ever stop that?
chris kresser
Hasn't there been connections or correlations between fluoride and low IQ? That sounds familiar, but again, it's not a topic I've looked into in detail, so I don't want to say something that's not correct.
joe rogan
That's the difference between you and me.
I think I heard fluoride exposure in utero linked to lower IQ in kids, study says.
Can you scroll up a little bit there, Jamie?
Increased levels of prenatal fluoride exposure may be associated with lower cognitive function in children, a new study says.
Published Tuesday in the Journal of Environmental Health Perspectives, evaluated nearly 300 sets of mothers and children in Mexico and tested children twice for cognitive development over the course of 12 years.
Fluoride is not added to public water supplies in Mexico, but people are exposed to it through naturally occurring fluoride in water and fluoridated salt and supplements.
Wow.
chris kresser
Yeah, and I mean this highlights something else we haven't talked about much at all in terms of an aspect of the modern environment that's problematic, which is toxins.
Fluoride being one of them, but also things like mercury, bisphenol A, BPA, which is in the plastic water bottles, receipts.
joe rogan
What's this?
Thousands of U.S. locales where lead poisoning is worse than fluid.
chris kresser
So there's lead.
joe rogan
Did you see that new study on India?
I think it was New Delhi.
I forget, but air pollution in India had an all-time high, and they showed these photographs of this city, and it is insane.
chris kresser
Yeah, you just can't see anything.
joe rogan
You can't see anything.
You can't see a building 100 yards ahead of you.
chris kresser
Yeah, so, I mean, air pollution's been linked to obesity and cardiovascular disease and stuff you wouldn't even think, not just respiratory things, like systemic inflammatory conditions.
And the problem with toxins is...
Our initial understanding of toxicity was only like acute toxicity.
Like, what happens if you get so much mercury in your body so quickly that it causes like an acute problem?
And we assume that, you know, if you don't see acute toxicity, then there's no problem.
Like, there's nothing in between acute toxicity and just normal.
But we know now that there was a really interesting study a couple years back.
I wrote about this on my blog.
I think the title was something like Mercury, Fish Consumption, and Kids.
joe rogan
Look at this image that Jamie just pulled up.
unidentified
This video came out today.
jamie vernon
This is a really bad air pollution-caused car accident pileup in New Delhi.
These people are trying to get people out of that car in just a couple seconds.
It's just like a...
chris kresser
Snowstorm here in America.
Another car's gonna come slamming into them.
jamie vernon
They're gonna tell them to hurry up and get the fuck out of there before another one comes in.
chris kresser
It happens like three or four times in a row right here.
joe rogan
Oh my god.
So these people- So these people are standing there- They just can't see.
Oh my god.
chris kresser
This is on a freeway.
Oh my gosh.
joe rogan
Oh my god.
jamie vernon
They gotta get the fuck out because another one's coming.
chris kresser
Yeah.
It's insane.
joe rogan
Oh my god.
jamie vernon
This is all just air pollution there.
joe rogan
Oh my god.
This is incredible.
This is like they're in a fog on a mountain road and they're on the highway.
What is the name of this video?
chris kresser
It's on Twitter.
I had to find it on Twitter.
It's literally going around the day.
I saw it right before the show started.
joe rogan
That's why I was trying to find it real fast.
jamie vernon
It's like New Delhi, car accident, air pollution.
joe rogan
Oh my god.
This is insane.
And they're telling these people, get out of the car.
chris kresser
What do you do?
You go up to try to warn people.
They can't see you there either.
joe rogan
Yeah, and then what if someone takes a turn and hits those people to the side?
Oh my god, this is horrific.
chris kresser
That's about where it ends right here.
joe rogan
Oh my god.
chris kresser
Yeah, so the mercury thing, the idea for a long time was, oh, if your blood level is below 10 parts per million, you're fine.
There's no evidence.
There's no issue.
So this new study came out and they looked at kids and they looked at cortisol levels and inflammatory markers.
And they found that kids that had mercury levels that were even as low as 1, so almost 10 times lower than the level of concern, had higher levels of cortisol and higher levels of inflammatory markers.
So that totally turned things on their head.
It was like, all of a sudden, lower levels of these toxins than we thought were problematic are actually problematic.
And when they dove in and looked deeper, they found Some of the kids who were affected had certain genetic polymorphisms.
There's something that made them more susceptible, or maybe they had nutrient deficiencies that made them less able to detoxify the mercury as they normally should be able to.
You know, what further complicates it is that the symptoms that you see with high levels of a toxin can actually be different at low levels.
So let's say researchers design a study to see the toxic effects of mercury when the exposure is severe, and they're looking for certain studies, and then they start lowering the dose of mercury to see when those effects go away.
They will completely miss the effects that are caused by the low doses of mercury because they're different than the effects that they were studying at the higher doses.
So this caused a problem for years where it was assumed that the low doses were harmless because they weren't observing the same effects they saw at the high doses.
And now they know this and so they've redesigned studies to look, just cast a wider net and see what's happening and sure enough at those lower levels of toxins they're seeing all kinds of effects that are actually in some cases opposite of the effect that you see with the high dose of the toxin.
joe rogan
Have you adjusted like where you live or anything because of all this?
chris kresser
We just bought a house a couple years ago, and we had a choice of where to live.
We wanted to live in Berkeley.
That's where my office is.
And so we ended up living up on top of the hill.
And that was somewhat intentional for me.
It's right near Tilden Park, which is an outdoor regional park space with a lot of green area and stuff.
And there are parts of Berkeley that You know, where the air quality is really, really bad, like surprising if you don't know that area.
If you go online to some of these air quality rating sites, you can see that parts of Berkeley are like C minus or D because there's so much industry there and the Chevron plan and stuff.
But this is where it gets really, you know, the inequality is brutal because guess who ends up often living in the areas that are most toxic are the people who are, you know, economically disadvantaged and they're the least influential when it comes to any kind of political power to make changes in those areas.
So it's unfair.
And they're disproportionately affected by that because nobody's watching out for them.
joe rogan
Yeah.
Well, there's a lot of factors we could talk about, but I think it's so important that there's people like you out there that are highlighting these things and writing books about these things and talking about these things on podcasts.
So thank you so much, man.
Thank you for your book, and thank you for the last time you were here.
We learned so much, too.
So tell people one more time the name of the book, where to get it.
chris kresser
Yeah, it's Unconventional Medicine.
You can get it on Amazon and also unconventionalmedicinebook.com.
You can actually download the first three chapters for free.
joe rogan
Do it.
Get on it.
Change your health, folks.
Get your shit together.
Thank you, Chris.
chris kresser
Really appreciate it.
Always great to see you.
joe rogan
Great to see you too, man.
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