How to Lose Weight and Improve Blood Sugar by Eating...

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How to Lose Weight and Improve Blood Sugar by Eating Fat Guest: Dr. Mark Hyman The following presentation is for informational purposes only and is not intended to diagnose, treat, or cure your condition or to be a substitute for advice from your physician or other healthcare professional.

Dr. Mowll: Hello and welcome back to the Diabetes Summit 2016. It's Dr. Brian Mowll, The Diabetes Coach, certified diabetes educator and IFM certified, functional medicine practitioner. And I have with me today the chairman of the IFM that’s Dr. Mark Hyman. So, Mark, thanks so much for being on with me today.

Dr. Hyman: I'm so glad to be here thanks for having me.

Dr. Mowll: Great. And Dr. Hyman is sort of one of my virtual mentors. Like a lot of functional medicine practitioners, I'm sure you inspired my path. And I've learned a lot from you from your blogs and talks and presentations over the years. So, I owe debt of gratitude for my direction. I appreciate you.

Dr. Hyman: Thank you.

Dr. Mowll: So I'm going to introduce Dr. Hyman. And then we are going to jump in and talk all about diabetes and natural solutions. We're going to talk about his new book, Eat Fat Get Thin and how we can apply some of that information to help control blood sugar.

Dr. Hyman is a practicing family physician, a 10-time number one New York Times bestselling author and an internationally recognized leader, speaker, educator, and advocate in his field.

He is the Pritzker Foundation chair in Functional Medicine Cleveland Clinic


and the director of the Cleveland Clinic Center for Functional Medicine. He is also the founder and director of the Ultra Wellness Center, chairman of the board as I mentioned of the Institute for Functional Medicine. Medical editor of the Huffington Post and was a regular medical contributor on many television shows including CBS This Morning, Today's Show, Good Morning America, CNN, The View, Katie, and of course the Dr. Oz Show.

Dr. Hyman, welcome back to the Diabetes Summit.

Dr. Hyman: I'm so glad to be here.

Dr. Mowll: So I saw you speak recently up in New York at the Integrative Healthcare symposium. And you really just blew the crowd away there with your keynote presentation. It was incredible. You talked about a mile a minute and covered a ton of information there. In fact, I had to go back and buy the recordings just so I could listen to it a couple of times.

Dr. Hyman: I told you. You could play it back in slow motion.

Dr. Mowll: You covered a lot of information there. But I'm just curious, why did you feel inspired to write this new book of all about fat at this time?

Dr. Hyman: Well, you know, I've written a number of books about sugar: The Blood Sugar Solution, The 10-Day Detox Diet about insulin resistance and the phenomena of how sugar and refined carbohydrates have driven this epidemic of diabesity. And what I realized is that the other side of that is, what are you eating if you're not eating starch and sugar, right?

You’ve got to be eating protein, or fat, or other kinds of carbohydrates. And I realized that the whole figure of fat, the whole sort of edifice of fat was just kind of confusing for people. I was actually confused. When I stopped and thought, I'm like, “How much do I really know about the fat and how deep is my knowledge?”

I was like, “Well, I know basic stuff.” I probably know way more than most


because that’s what I spent my life studying. But I realized that I had a superficial knowledge. I was like, “What did I really know about saturated fats? And what did I really know about omega-6 fats? And what about the fat's role in metabolism and weight? What do we know and what do we think we know?”

I just saw a guy today who was a doctor. He's 55, a year younger than me, as a patient. He has type II diabetes. He has hypertension, sleep apnea. He has coronary artery disease. He's had three stents. And he’s eating a low-fat diet because he's worried about his heart and he's worried about his cholesterol. And I said, "What's your cholesterol?" He said, "My cholesterol is under a hundred. My HDL is under 60. My LDL is under 60 because I'm on Crestor 20 milligrams." I said, "Yeah, but what's your triglycerides?" He said, "Oh, that’s 200." I said, "What's your HDL." He said, "Oh, that’s 30."

So he thought he was fine because the LDL is fine. But the fact is that sugar and refined carbs and driving up his triglycerides, driving down his HDL, and giving him small LDL particles. So even though he's got a low LDL number, it’s not as very good for him. And he's really sick. He's like 250 pounds, big visceral-fat guy, belly fat.

And he's really in bad shape and it's because he's eating this low-fat diet and he's diabetic. I said, "The things that raise your HDL are saturated fats. They're things that raise your HDL saturated fat and fat. And what lowers your triglycerides is fat. And what fixes your LDL is fat." It will raise your LDL total but actually it makes it large, and light, and fluffy.

I was just reading a paper yesterday by Dr. Krause. They did this interventional study where the gave people's saturated fat watched their lipids. And actually their lipid profile improved in the sense that the ratio of total to HDL got better. The particle size got better. Particle number got better. The HDL went up. The triglycerides went down. So everything went in the right direction with fat.


So I realized, we really didn’t know enough about fat. So I wanted to write this book to really tell the story about how fat affects weight and metabolism, because we all think that fat makes you fat. And how fat affects heart disease and chronic illness in general.

And I realized that we actually need to be eating most of our calories as fat, for most of us, especially those who are carbon-tolerant. And those people are the people who have diabesity. They are the belly-fat people, the ones who have high triglycerides, low HDL, family history of diabetes.

People who are ethically more predisposed like Latinos, and African-Americans, and Asians, and Indians from India, and Pacific Islanders, and Native Americans. All these groups are actually much higher likelihood of having carb intolerance. So the guy I was telling you was a Latino doctor. He's eating pasta and bread and rice and beans. That’s his diet. He's not eating sugar but he's eating so much starch. And that’s just worse than sugar.

That’s why I wrote the book. I really wanted to tell the story. I wanted to find out for myself. I wanted to really help people understand the role of fat in their biology. And how it actually is the key to weight loss and to healthy metabolism, as well as reducing heart disease.

Dr. Mowll: So it sounds like the conventional standard sort of have it backwards with the cholesterol panel or the lipid panel. It's sort of focusing all the attention on total cholesterol and LDL because that’s probably what statins affect most and then paying less attention to triglycerides and HDL.

Dr. Hyman: Yeah, I mean if you have small LDL particles, you have triple the risk of heart attacks. If you have a high triglycerides-to-HDL ratio, that’s a better predictor than LDL. If you have a high total-cholesterol-to-HDL ratio – which is connected to the HDL right, if that’s low, you get a high ratio because of carbs and sugar – that’s a much higher risk.

LDL is not a very good predictor. I reviewed for the book. One of them was a study of a hospital admissions for heart attacks. They looked at it, I think,


231,000 admissions, 541 hospitals. 59% of all heart attacks were people who actually had their blood checked for lipids. So there was about, I guess, 130,000 had their blood test for cholesterol. And 75% of people who are admitted to a hospital with a heart attack had normal LDL.

75% had normal LDL. 50% had ideal LDL, under a hundred. And 17% had super normal LDL, which is under 17. And what was also true was that 10%, only 10%, had HDLs over 60. So 90% of them had low HDLs.

Dr. Mowll: That’s amazing. What do you think? A lot of conventionally trained doctors still get very alarmed with a cholesterol that’s around 200, or an LDL that’s over the standard. With somebody with diabetes they want it usually under 75 even. So where does that come from?

Dr. Hyman: Well, I hate to say this, but I think it's pharma. I think pharma has driven this epidemic of statin abuse, and focused on LDL because it's the drug that lowers LDL. If the drug has lowered the triglycerides and raised the HDL, guess what, they'd be pushing that. But there are no drugs that actually do that so they have to focus on LDL.

I think if you look at the Jupiter trial and the statin data on that, the statins lowered risk only if they lowered inflammation as well. But what's fascinating is the people who were at risk in that study when they went back and looked at their lipids was only the ones with the small particles. It wasn’t related to the total LDL.

Small particles are related to sugar and carbs, and not on the fat. So, we have to really rethink this whole cholesterol thing. And then statins are not a benign drug.

Dr. Mowll: Right, true.

Dr. Hyman: You know, I just was at a presentation at Cleveland Clinic. We have now the Cleveland Clinic Center for Functional Medicine, and we had grand rounds with Dr. Dale Bredesen, who was an Alzheimer's researcher.


And he said, "Mark, I need to talk to you and all the researchers and doctors at Cleveland Clinic.” He said, "Statins affect this thing amyloid precursor protein. And it increases the amyloid in the brain, which causes Alzheimer's."

So the very thing you're trying to avoid when you are trying to prevent Alzheimer's, statins actually cause that. It's very concerning to me. And I think there is evidence that it causes a neurologic problem. Statins increase, at one study of 26,000 people prospectively treated, were healthy with statins from preventing heart disease. 87% increase in diabetes risk. 87% increase in risk of getting Type II Diabetes from taking Statins.

Women's Health Initiative, randomized controlled trial, 48% increase in women who took statins are getting diabetes. And it's worse if you're African-American or Hispanic. These are real issues…And I think the key answer is—and it's so paradoxical because it's so contradictory to what we learned—is that fat is the answer to fixing this. The diabetics, the treatment that we're using now is extremely low-carb diets and very high-fat diets.

And when I say low-carb, I mean low starch and low sugar. Because essentially we want a very high-carb diet, a high-carb diet by volume. Broccoli is a carb right? 21 cups broccoli is all carbs but it has half a teaspoon of sugar and 35 grams of fiber. So that’s a different kind of carb than a bagel, or rice, or bread, or pasta, or sugar.

By volume, most of your diet should be plant foods. By calories, most of it is going to be fat, probably 50% or more.

Dr. Mowll: Very nutrient dense, not cholerically dense. And certainly not dense in carbohydrates which is good especially for people who are, as you mentioned, carb-intolerant. And I wanted to ask you about that a little bit. You’ve talked about this in some of your previous books, but how does one become carbohydrate intolerant?

Dr. Hyman: Well, I think there are two issues. One is genetics and then there's environment. Genetics are certain populations are more adapted to


probably a hunter-gatherer past, like if you're African descent. If you're Native-American descent, Latinos are often from Native-American descent, if you're a Native-American, if you're Indian, if you're a Pacific Islander, your diet is very low glycemic.

You're a hunter-gatherer. You weren’t eating a lot of starch and very little grains until recently. All of a sudden are flooded with sugar or flour, 152 pounds of sugar. Sugar used to cost more than gold. It was so rare. And now it's like – I mean even at the turn of the century a pound of sugar was equivalent to $7 a pound. Now it's nowhere close to that, right? So, we really have sort of made this too abundant. And then starch, we’ve increased the flour milk. In the turn of the century with industrial evolution, we got to grind flour and mill rice. And all of a sudden we had white flour. And that also created this huge problem.

And then you combine the genetics with that and you get this epidemic. And then there's other factors that also accelerate it: environmental toxins, alterations in our gut flora, overuse of antibiotics. All these things changed our ability to regulate metabolism and insulin.

Dr. Mowll: Okay great. As you mentioned earlier, if we're going to cut down on the carbohydrate, at least the calorie rich carbohydrates that we're eating, we're going to replace it with something. And healthy fats are a good something to replace it with. Could you talk about some of the benefits of fat, of including fat in the diet?

Dr. Hyman: Yeah, let's talk about this because I think people are confused. If fat has more calories than carbs, it has more calories than proteins. They got more than twice as many. It’s nine versus four. So if you eat more fat, you're going to eat more calories and you're going to gain weight. Here is the trick, metabolism is not a math problem. It's not calories in, calories out. It's not about energy balance.

You go, "Dr. Hyman who are you to say that the first law of thermodynamics is


not true?" I'm not saying that right? The first law of thermodynamics says that energy is conserved in a system. and that means a closed system. If you take a thousand calories of Coke and a thousand calories of broccoli, you burn them in a lab, they release the same energy. If you eat them, they're not the same.

If you eat a thousand calories of soda, that’s like a little more than a big gulp, that turns on all sorts of hormonal signals that drive weight gain. They cause triglycerides to go up. They cause HDL to go down. They cause inflammation. They lower testosterone. That causes you to be hungry. That leads to shifts in your fat burning that are bad. Everything changes for the adverse.

When you eat the broccoli, the opposite happens. Well you'll get so full you can't eat that much. But it has low sugar. It has 35 grams of fiber. It will reduce inflammation. It will prevent you from having a fatty liver. It will help you detoxify. It does all sorts of things that are the opposite even though it's the same calories because when you eat calories they're not the same.

When you eat sugar and refined-carb calories it increases insulin. Insulin is the fertilizer for your fat cells. It’s sort of the fat storage hormone. When you increase insulin, if you have fuel floating around your blood it's going to get shunted in your fat cells because they like to suck them up. Then your body thinks, “Wait a minute. The fuel gauge is going down.”

So you get hungry. You get lazy because you don’t want to move, right? If you're conserving energy, you do not want to exercise. So you get lazy, right? And then you slow your metabolism down. Then you don’t release fat from your fat cells. So all these horrible things happen. It's like a starvation response even though you just ate a bunch of sugar and carbs.

When you eat fat none of that happens. When you eat fat you don’t increase insulin. You actually burn the fat. You actually increase the liberation of fat from the fat cells. You turn off the hunger switch in your brain. And you actually lose weight. And you'll end up eating less because you're going to feel satisfied.


People binge and eat a whole sheet cake, but people don’t eat 12 avocados, right? So that’s the problem. It’s that we basically can't really over eat too much fat if we just eat it as part of our diet. I have a friend of mine who is a professor David Ludwig, who is a metabolism expert from Harvard. And he said, "Mark, think about it. When you have a type I diabetic, when they come in, what are their presenting symptoms? They're hungry all the time. They're eating 10,000 calories a day. And, guess what, they're losing weight. Why? Because they have no insulin.”

They have no insulin. Insulin is needed to store fat. So if you eat sugar and carbs with fat, that’s a bad combo. I call that sweet fat. Think of a doughnut, French fries, ice cream, bagel and butter. Bad news. Because you're combining something that produces insulin with fat, then you'll store it. But if you cut out the starch and the sugar, and you eat fat in your diet, and you have a very low glycemic diet, your insulin level is going to be even. You're not going to spike your sugar. And won't gain weight. And you will actually stimulate weight loss.

It's stunning to see this happen. I have patients who get off insulin in three days. I have one guy who was diabetic. His sugar is 250. Within a day they were 100 simply by changing his diet. Before I started recommending this, I was like, I've never seen anybody get off insulin in three days. I would say, eat whole grains, eat beans, eat you know, good food.

But I didn’t switch the focus to saying, make sure you eat fat with every meal, protein with every meal, and no starch, no sugar, and actually no grains and beans if you're diabetic. And no fruit or very limited fruit, berries. And just really focus on keeping a very low glycemic diet.

Now actually, there's something called the Dexcom, which is a continuous glucose monitor that you can buy if you're a diabetic. And you can put it on and it monitors on your iPhone. And you can see and you can watch. I eat this and you can see it goes up. I got a patient yesterday who said, "You know Mark, when I had steak and wine, my blood sugar went down. When I had


breaded, whatever, calamari it went up” because of the breading. He could see it instantly and it's instant feedback, right? So you don’t have to believe doctors, you can believe your own body. It's going to tell you immediately a feedback on what's working.

Dr. Mowll: So, I knew you cover a lot of these in your book and you have a great 21-day program that people can do. Can you give us an idea of sort of what this looks like to add more fats and eat a high-fat diet?

Dr. Hyman: Sure. So basically, the principles of eating are pretty straightforward. I think most people actually – when you think about it, it’s sort of common sense and I talk about eating real food, right? The overall principles are basically if it has a label, or a barcode, or nutrition facts on it, it's probably not good for you. There are some exceptions, right? If you're having tomatoes, water, and salt in a can, or sardines with olive oil and salt, that’s fine. You know all of the ingredients.

But for the most part, you want to stay with me, you want to eat real whole food. And you want to eat most of your food as plant foods. Lots of non-starchy veggies. So it’ll be like all the broccoli family, asparagus, green beans, salad. There is a whole list of them in my book. It is more than you can ever want.

So non-starchy veggies. You want good quality protein. And they can be tofu or tempeh if you want to eat vegetable protein. Those are really low glycemic. Beans are okay for some, but they can be starchy for some who are diabetic. And whole eggs are fine. Don’t worry about the fat and the cholesterol.

By the way, the government came up with the new dietary guidelines this year. And the guidelines said, "Hey, we got it wrong. 35 years of telling you to eat low fat, sorry. Don’t worry about the fat anymore. You can eat as much as you want. And by the way, cholesterol. We thought that was bad for you. Well we were wrong and don’t worry about cholesterol anymore. It's not a nutrient of concern. Go and eat your eggs."


So now we can eat whole eggs. You can get your protein from nuts and seeds. So, all kinds of nuts and seeds. Nut butters, that’s a great staple. And not so much peanut butter but the other nut butters, because peanut is really a bean anyway. And then you want to eat good quality protein. It could be also grass fed meats. It could be small fish, like salmon, sardines, things that are not too big with mercury in them.

If you're going to have animal food, you want to have sustainably raised. Because feed lots are terrible for the planet, and they're not as healthy for you. Because they're full of hormones, antibiotics, and lower levels of omega-3 fats, and nutrients, and antioxidants. Because meat has all these great nutrients but it's less so if you're getting feed-lot meat.

And then good fats. And so I focused on including fats on every meal. So it can be olive oil on your salad. It could be on your vegetables. It could be avocados, which I love to eat. It could be nuts and seeds. It could be eggs. It could be fatty fish, like sardines. It could be grass-fed meats. All those things are fine sources of fat. So those are where you're going to get your fat from.

Coconut oil, that’s actually a fat or it's actually high in saturated fat but. You shouldn’t worry about it. But actually it raises the HDL the most. And it actually has the best impact on the total-to-HDL ratio of anything.

I think everybody is different though. Genetically we have to see how our population plays out because there are differences in people and how they respond to saturated fats and other fats. They have to be careful but I think if you just experiment with yourselves, try and see, and look at your numbers and see what happens.

Again, you can't mix it, all that fat with a ton of starch. If you want to have an occasional sweet potato or winter squash that’s fine. But I keep my starch and sugar into a minimum. I use them as a treat. They're like a condiment as opposed to having a big pile of rice or a big pile of pasta. It's more like a side dish if anything.


Dr. Mowll: Okay, now a lot of people who are eating a higher-fat-low-carb diet love to eat cheese. It's kind of like staple for them. So could you talk to us a little bit about dairy, and if that fits in or how you look at that?

Dr. Hyman: Dairy is tricky right? We are the only species other than nobody who actually continue to eat dairy after weaning. And 75% of the population is lactose intolerant. Dairy has been linked to prostate cancer, autoimmune disease, heart disease, obesity. I worry about it. It's got 60 different hormones in it. Naturally it increases insulin by 300%. And it actually is very allergenic for many people causing eczema, allergies, digestive issues. I think it’s problematic.

It's the number one cause of anemia in children, the number one cause of constipation in children. It causes GI bleeding in them. I'm not a big fan. I think if you're having dairy that comes from an heirloom cow, that’s raw milk, that’s not pasteurized or homogenized. It's grass fed, organic. Okay. A little bit is probably fine. But as a staple, I do not think it's a good idea for most people.

I like butter is a little different because butter is more fat than casein in the way. If you want to get rid of it you can use ghee or clarified butter. That’s just pure butter fat which has got CLA, which is a great form of fat that actually helps with metabolism. It helps with cancer. It has Butyrate, which is great for your gut. If it's grass fed it's got a lot of vitamins in it as well as antioxidants.

So I think that can be used as well. But I think that you really have to be careful about the general dairy issue.

Dr. Mowll: Okay great. Would you mind sharing the story about how you coined this term “pegan diet”? Because I think it's hilarious and I love the concept.

Dr. Hyman: Well, I was sitting at a conference with a couple of friends of mine who are doctors. One was Joe Connors, who’s a vegan cardiologist. And there was Frank Lipman, who was a paleo sort of doc. And I'm like listening to them


going back and forth. And I'm like, “This is silly. I guess I must be a “pegan,” right? If you're paleo. You're vegan. I'm in the middle.” And then I kind of joked about it. And then I actually wrote a blog about it and it became a thing.

I didn’t realize it became a thing. And then CNN picked it up. And USA Today picked it up. And then The Herald, The Tribune in England picked it up. It was like this thing. And somebody wrote a book about it. I'm like, "Oh my God this is a joke." And then I really got to thinking about what it actually was. And then I realized that the principles are really similar, right? So if you look at the principles of being a paleo and vegan, they're actually quite similar.

It’s whole foods, unprocessed food. It’s low sugar. It’s tons of fruits and vegetables. It's nuts and seeds. It's good fats. It's really nontoxic foods, organic, sustainably raised, no additives, chemical, or preservatives. Everybody agrees on that right?

And the things that there were differences are basically where you got your protein. Is it beans and grains? Or is it meat, and eggs, and dairy? With dairy, both of them said no. So vegan and paleo, both of them would take out dairy. And then you’ve got basically meat, beans, and grains left, and eggs. So the question is then if you look at what they agree in, they both agree that if you actually are going to eat meat, it should be not feed lot, sustainably raised, humanely and environmentally sustainable husbandry.

I think there are a lot of issues around the meat thing that we can go into. But I kind of think that you can downsize your meat and upsize your vegetables. And it's a compromise.

Dr. Mowll: Yeah, I love it. It struck a chord with me because, especially in diabetes care, when you get into natural diabetes and this whole idea of reversing Type II Diabetes it really is sort of polarized between the vegan camp. A lot of people say, “Oh, I read this book or that book. Should I go vegan or should I go raw foods?” And then there's more of the paleo sort of low-carb approach. And they really are very similar. There's just a few


differences which you illustrated well. It's kind of beans, grains, and eggs, and obviously meat. They seem like big differences but really it's a very small portion of the diet.

Dr. Hyman: It's true right?

Dr. Mowll: Yeah.

Dr. Hyman: Like your fats and your carbs are basically the same. And then the protein is a little different. And you know, if you want to be a vegan I think it's okay but you have to eat good quality protein, and very low glycemic, and good quality fats. If you're a low fat vegan, that’s the most dangerous because then you're eating a lot of starch and then you end up in trouble.

I had a woman the other day who was diabetic. She came in one of my lectures and she said, "I'm a diabetic. I had a heart attack. I went to Dr. Esselstyn’s group at Cleveland Clinic. And I got an extremely low fat diet." She doesn’t allow nuts. She doesn’t allow oil. She doesn’t allow anything, right? You can have like an almond.

She then got another heart attack. And she said, "I can’t keep my sugar under control. I need more and more insulin." And what she needed was a very high fat, very low carb diet. And it's hard to do. There are different kinds of heart disease but I think for people who are carbohydrate intolerant and insulin resistant the data is really strong.

Osama Hamdy from Harvard runs one of the top obesity and diabetes centers in the world. And he is like writing about how we should be using up to 70% fat for treating diabetes. In fact Joslin, Dr. Joslin who is the founder of Joslin Diabetes Center, I guess the name was named after him, he actually in the 20s used 75% fat, 25% protein and 5% carbs to control diabetes.

Dr. Mowll: I know, I always find that amazing that one of the world's leading diabetes centers is named after a doctor who mostly used nutrition to treat it. So it's pretty amazing.


Dr. Hyman: Yeah. Right.

Dr. Mowll: So you have been the director of the Cleveland Clinic Center for Functional Medicine, heading up this great movement for functional medicine. What have you learned so far from being involved with that group? And what are your predominant thoughts right now around addressing Type II Diabetes?

Dr. Hyman: Well, you know, Cleveland Clinic has been amazing. I was invited to go there to lead up a group to develop a program in functional medicine, a research program, a clinical program, education program, community based program.

And we were getting randomized controlled trials going. We're starting with diabetes. And we're really looking at, how do we address this more aggressively? In fact, I saw the guy who was the head of the diabetes program there. He was the head of the Endocrinology Institute and he has diabetes. He came to see me as a patient and he was heading medical school. And he was shocked when he followed what I said and actually everything normalized: his blood pressure, his blood sugar, his weight dropped 20 pounds, and he was like, "Woah! This is pretty wild, because it’s everything I wasn’t taught to do.”

So there's a real change in the whole model and our thinking about diabetes. And I think it's really exciting to be in this time where major institutions like Harvard and Cleveland are actually moving forward in this area and seeing there’s future.

I met with the head of cardiology who was the vice chairman of the Cardiology Institute, which is the number one heart hospital in the world. We had this conversation and he was like, "You know what? I actually was having trouble controlling my cholesterol, my lipids, my triglycerides, HDL. I was gaining weight. And I was like, ‘I better start eating fat.’" And so he started eating fat and his numbers all got better. He lost weight. Here was the guy who was the heart doctor.

Dr. Mowll: What happens when you have a patient who does the basics, like


you just described? Eats a high-fat low-carb diet, and they get results but then they sort of hit this wall. Because we see that a lot with our clients and patients. What are some of the other things you look at with diabetes?

Dr. Hyman: I think the first thing you have to look at is, what are your mitochondria doing? Because that can be a big factor. And if your muscles are down, what happens is as you get diabetes and you start to lower your hormones, your testosterone goes down. You lose muscle mass. Your mitochondria don’t work so well. And so you can improve it to a degree with diet, but once you hit that diet plateau you got to exercise. You got to do interval training and muscle building. And it’s so critical. That makes your muscles more insulin sensitive and that starts to move the needle a little bit.

So this guy I talked to yesterday, he lost 20 pounds. His blood sugar is down from 250 to 120s. His body sort of stopped so he has to start exercising. So he needs to then start to go and exercise.

The other thing is, I wrote a guide called "Beyond Food." And it's basically about the eight causes of weight loss resistance. And the other causes are damaged metabolism and obesity. And it's things like food sensitivities. Its environmental toxins. It's disturbed gut flora. It's hormonal dysregulation like thyroid or adrenal issues. It's social issues. It's mitochondrial issues.

There's a lot of things that I go through and help people identify as nutritional factors. And we kind of tweak that and then that often helps get them over the hump. So I think it's really where functional medicine comes in because yes it's about food but there are also other factors involved.

Dr. Mowll: Yeah that’s great. So, I highly recommend people finding that, Beyond Food, and checking out that guide.

If you had a magic wand right now, because I know you work a lot with trying to change health policies, so if you had a magic wand right now you have the ear of, which sometimes you do, of these health policy makers, what do you think would be the thing that you would want to see change the most?


Dr. Hyman: I can tell you. I think we have a food policy that doesn’t support health and we need to change that. And the things that I think would make the most difference are a number of things. One is ending all food marketing to kids for junk food or processed food. Two is really seriously looking at sugar tax and maybe a junk food tax.

Three is having clear food labeling, where food is clearly labeled so you actually know if it's good for you or bad for you. Right now it's confusing as hell. You can't tell what's going on. The government tells us to reduce our added sugars to less than 10% of our diet. But it doesn’t say added sugar in the label because the food lobby doesn’t want the FDA to do that.

We need to create all of our food programs that are consisting with good science. And that means our dietary guidelines need to be changed. They were improved, but they need to be changed so they actually represent the science. And that means an independent review of the guidelines advisory process and of the recommendations.

And then we need to just implement that. If the government is saying, reduce added sugar to less than 10% of our calories, then we shouldn’t be spending $4 billion a year on food stamps for the poor for soda. That doesn’t make sense. And we shouldn’t be shipping trans-fat to Native-Americans and the reservations as Crisco or shortening so they can use it for their rye bread which isn’t even an Indian food.

We need to make our policies consistent. We need to end any government funding for food service programs that aren’t promoting healthy foods. We need to make our school lunches and our school food programs consisting with the science and not the congress saying pizza is a vegetable, right?

We need to end the use of antibiotics in food and feed lot growing because that actually promotes super bugs and a lot of other consequences. It’s used mostly as a growth factor and it’s preventing infections.


We need to end the subsidies for commodities like soybeans and corn, which are turned into high fructose corns syrup and trans fats and makes cheap food available for the fast food companies to make and the processed food companies. I met with the vice chairman of Pepsi. He said, "Mark, the reason I use high fructose corn syrup is because the government makes it so cheap. I can't use anything else." That's a problem. We need to subsidize fruits, and vegetables, and other foods.

And we need to think about having a public service campaign that actually educates Americans to do this. We may want to start what we had before, federal extension workers going around communities like community health workers. And training families how to cook, and make food for themselves, and grow small gardens, and do things that actually empower them to eat real food and realize it's not so difficult.

So all those things need to happen. It's not any one thing that’s going to make a big difference but you start to add all of these together then it becomes real.

Dr. Mowll: Wow. So right now, a lot of these junk foods are being subsidized so it's actually cheaper to eat unhealthy. If the playing field was sort of leveled, if there is no subsidy or if some of the health foods are subsidized and made less expensive that could change a lot overnight.

Dr. Hyman: Well what is the real cost of a can of Coke, right? What is the real cost of a cigarette, right? What is the real cost of a French fry? It's not the price you pay at the store. It's the full-on cost to the environment – How you grow the food. How it happens to our soil, air, or water. The use of fossil fuels. Contribution to climate change – It's the effects on healthcare, on disease. Our entire healthcare budget is exploding because of chronic diseases and that’s driven by the food we're eating.

So if you actually embedded all that into the price of Coke, Coke could be $20. That’s what it should cost. And a vegetable because of all the diseases it prevents should be three cents.


Dr. Mowll: That’s a lot to think about. I doubt that people would be drinking Cokes if they were $20 a piece.

Dr. Hyman: Well cigarettes are now $10 a pack.

Dr. Mowll: I know. Yeah, and certainly it's helped. I think it's difficult to smoke now where it used to be much easier that’s for sure.

Dr. Hyman: Yeah.

Dr. Mowll: Last question I have for you today, last September there was a study in study in JAMA that talked about how nearly 50% of the US population is now diabetic or pre-diabetic. I think we're on a crash course towards obviously a major, major problem with health as well as the cost of our healthcare with diabetes, not just here but globally. What do you think we need to do really to change the trajectory of diabetes?

Dr. Hyman: Everything I just said! [Laughs]

Dr. Mowll: Yeah.

Dr. Hyman: Everything I just said, because we have to have a food policy and a food system that supports health. We have to build models in the community that are actually supporting people to make the right choices. I've worked with a large church in Southern California where we got people to work together to get healthy.

Getting healthy is a community based activity. And if our social environment is driving disease and bad choices, we need to think about ways of changing that and making healthy sexy, right? And not promoting all the values that are on convenience and fast food. Those are all things that are driving so much of the problem.

So, we need a concerted effort. We need to deal with the food system right up front. And we need to empower people in communities to actually take back their health.


Dr. Mowll: Yeah, I love the idea of empowering people in communities to really make a grassroots change when it comes to health. I think that’s the ticket.

Dr. Hyman: I went to the church in Southern California. We got 15,000 people to sign up for this program called the Daniel Plan. We lost a quarter of a million pounds in the first 10 months by doing it together. And they got rid of their sodas. They got rid of all the ice cream socials, the pancake breakfast, the crap. It just was a great community effort where it became a value. And also the whole culture changed.

Dr. Mowll: I’d love to see more churches embrace that. It's amazing to me when you walk into a place where they call the body the temple of the living spirit and they're stuffing doughnuts and pizza into. It is not a very good way to treat the temple.

Dr. Hyman: I got to get up and say this. Hey, if you all believe God lives in you, why are you feeding Him crap?

Dr. Mowll: That’s right, that’s a good point. All right Dr. Hyman thank you so much for being a part of The Diabetes Summit. If you people want to find your books and find out more information about you, follow your blogs and so forth, where do they get that information?

Dr. Hyman: They can go to DrHyman.com I've got a weekly house-call video I send out every week and a blog. And my EatFatGetThin.com website, you can watch a 45-minute Q&A where I answer all the questions about fat. It's free. And also there are a lot of free resources as well. You can also join the Eat Fat Get Thin Challenge. It’s a great experience to do this together in the community.

Dr. Mowll: Very good. Thank you so much for taking the time to do this, being part of the Diabetes Summit 2016.

Dr. Hyman: Thank you.


Dr. Mowll: And for those of you watching and listening today, thanks for tuning in. Stay tuned for the next session. Remember, guys, keep climbing and don’t ever give up. Thanks, everybody.

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