Why Quitting Sugar Could Save Your Life

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a fifteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Richard Johnson
There are certain food that trigger you to want to eat more and trigger you to not satisfy your appetite so that when you eat, you don't feel, you know, you don't feel full. So you want more.

Dr. Mark Hyman
Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one on one, there just isn't enough time in the day. So I built several tools to help you take control of your health. If you're looking for guidance, education, and community, check out my private membership, the HymanHive, for live q and a's, exclusive content, and direct connection. For real time lab testing and personalized insights into your biology, visit Function Health.

You can also explore my curated doctor trusted supplements and health products at doctorhymen.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast ad free with Hyman Plus. Just open Apple Podcasts and tap try free to start your seven day free trial.

Dr. Richard Johnson
Well, sugar contains glucose and fructose, and these are two different sugars that are bound together to make table sugar or sucrose. And, it turns out that fructose can activate a biological switch that tells a person or sets off a program to gain weight. So when you eat sugar, you're actually, triggering, this biologic process to gain weight. At the same time, sugar tastes really good. We have these sweet taste buds that really like sugar, and we're eating a ton of sugar in high fructose corn syrup, as you know, like 15% of the diet.

And it's being put in all these foods, so it can be a real menace. What's really interesting about sugar, just

Dr. Mark Hyman
as an

Dr. Richard Johnson
aside, is that if you take an animal and you, genetically alter it, so it can't taste sweet or it can't taste at all, it still likes sugar. It loses its flavor or desire for artificial sugars, but it still will seek out foods that have

Dr. Mark Hyman
to Really?

Dr. Richard Johnson
That's fascinating. And they'll still get fat from the sugar, even though they can't taste it.

Dr. Mark Hyman
That's amazing. So so this fat switch you're talking about is quite interesting. And and what do you mean when you say fat switch? It literally, is there is there some kind of metabolic switch that gets turned on that makes us store fat and gain weight? Now how does that work?

Dr. Richard Johnson
Yeah. So this was one of our kind of big discoveries. I know so it, Everyone knows that obesity is linked with, eating a lot of calories, bad foods. And one of the classic theories is that it's driven by, the fact that we eat too much and we exercise too little, and so there's excess energy that, we end up eating that is not used, and that gets stored as fat. And, and so the when this hypothesis came out in the nineteen twenties, it was, you know, our we were the ones to blame because it's over nutrition.

You know, we're eating too much. We're exercising too little. All the da da da da. But we know It blames the victim.

Dr. Mark Hyman
It blames the victim, essentially. It's your fault if you're overweight. It's your

Dr. Mark Hyman
fault if you're overweight.

Dr. Richard Johnson
Exactly. So quit eating, you know? Why are you getting such a big plate of food? You know? Don't go back for seconds.

You know? It's your fault.

Dr. Mark Hyman
Exactly.

Dr. Richard Johnson
Exactly. You're you're you're taking the escalator when you should be taking the steps, you know? And and and so this has been the classic, teaching. But, it turns out that there are certain foods that trigger you to want to eat more and trigger you to not satisfy your appetite so that when you eat, you don't feel, you know, you don't feel full. So you want more.

There's certain foods that actually will reduce your, how much energy you have. So it will actually make you, drop your energy metabolism. So the formula is the same, you end up eating more and you exercise less, but the issue turns out not to be because, it's your choice. It's because you've eaten specific foods that activate the switch.

Dr. Mark Hyman
Yeah. So your work is sort of very similar to Doctor. David Ludwig's work. So the whole idea that it's our fault we're overweight is one that is promoted by the food industry, by the government, by most doctors, and certainly most nutritionists, which is really about this whole idea of the energy balance hypothesis, which is it's all about calories in calories out. And what you're saying, what I hear you saying, what Doctor.

David Ludwig, who's been on the podcast, is saying is that it's actually the quality of the calories that matter and the information in the food that matters and that, that not all calories are created equal.

Dr. Mark Hyman
Now, Ian,

Dr. Richard Johnson
that's 100% right.

Dr. Mark Hyman
We know, we know this kind of, you know, if you ask a fifth grader, if a thousand calories of soda or a thousand calories of broccoli are the same, they'd go, no. But if you and I've and I'm, by the way, Richard, I've I've asked this question to the vice chairman of Pepsi. I said, okay. Who, by the

Dr. Richard Johnson
way, was a diabetic. They said,

Dr. Mark Hyman
I said, look. I said, I said, let me ask you this. If, is a thousand calories of Pepsi the same as a thousand calories of almonds when you eat them? He's like, yes. I'm like, okay.

So, you know, this this is a great narrative if you're selling junk because it it just it it just all about moderation. Right? There's no good or bad calories. It's all about moderation. It's all about exercising more than eating less.

What you're saying is that there's there's a a a different biological imperative, which is that our bodies are designed to store fat under certain circumstances, which is a great adaptation to scarcity. But we have a problem of abundance. We don't have scarcity anymore. We have on every corner, in every gas station, and pretty much everywhere we look, there's an overabundance of food. And so what is happening with this ancient mechanism?

Tell us exactly how it, how it works. When you, when we eat sugar, we slow metabolism and we actually want to exercise less because we slow.

Dr. Richard Johnson
Exactly. So, so it turns out that, that, normally animals will try to stay at a certain weight. They don't want to gain a lot of weight. They, and they'll maintain their weight. If they eat more one day, they'll eat less the next.

If they exercise more one day, they'll exercise less. So they try to keep their weight normal. But there are some animals that really do want to gain weight, and those animals, will gain weight by, you know, like in preparation for hibernation, for example, like, when winter's coming and, you know, and they know there's not going to be much food around. So these animals will suddenly, you know, they'll be regulating their weight fine for most of the summer, then sometime in the fall, suddenly they start to eat a lot more. And, and they, they will eat, you know, thousands of thousands and thousands of more calories.

A bear will start gaining 10 pounds a day. And, I mean, it's just, it goes crazy. And, the animal, will stay hungry and thirsty and go foraging for food. And that's actually part of this behavioral response. And then, then they'll start storing fat and they do it by, by both synthesizing more fat, but also by breaking down the burning of fat.

And so the fat starts to accumulate and they will become insulin resistant as part of this. And it's actually a survival mechanism because, you know, it keeps the glucose elevated in the blood, which the brain likes because the brain doesn't really need a lot of insulin for it to work, whereas the muscles really do need insulin. So by making the tissues resistant to insulin, the glucose, instead of going to the muscles, is staying in the blood and it's good for the brain. So it helps shut the glucose from where it would be used in muscle to the brain. So insulin resistance is part of this survival response.

Blood pressure goes up, you know, because they want you to have strong circulation in this kind of setting. And so all this happens, and we know it in humans as the metabolic syndrome, but it's actually something that long distance migrating birds do before they migrate. It's, animals do it before they nest. It seems to be, like, triggered. So, you know, big insight, first one was that there was this trigger that created this.

And so, and then Is that what

Dr. Mark Hyman
you call the fat switch?

Dr. Richard Johnson
Yes. A biologic switch. You know, I also call it the survival switch when it's for these animals, because it's the same thing. Initially it's there to help you survive, but when you're chronically activating it, it becomes a fast switch. And, yeah.

You know, it's so funny.

Dr. Mark Hyman
I remember going to Admiralty Island with my daughter years ago on a kayak trip in Alaska. Was where they had the greatest density grizzly bears in the world. And they were they were fishing for salmon. We were watching them. It was this one little postage area, postage stamp area you could stand on with the guy with a shotgun.

And when the grizzly bears are all over, and they were just chowing down on the salmon. And and you know, uh-uh and then they go up into the mountains and the end of the summer and they just chow down on the berries and they gain 500 pounds. Yeah. Exactly. You know.

And and unlike unlike unlike the Game of Thrones for us, winter never comes. Winter never comes. So we just keep storing, and then winter never comes, and we just keep in this process. And and I think,

Dr. Richard Johnson
you know Right.

Dr. Mark Hyman
Think the other thing that I sort of happens is that if we eat the wrong food, we're hungrier. And I I wanna talk to you about this because, you know, I remember this study with, think, Kevin Hall did where he looked at people ate ultra processed food versus the whole foods and people and they can eat as much as they wanna buy. There was two groups where I think it was a crossover study. And they and they actually found that the people who, who got to eat the processed food ate 500 calories more a day. Now in a week, that's gaining a pound a week.

In a year, that's 52 pounds of extra weight simply by eating processed food, which is 60% of our diet.

Dr. Richard Johnson
This is the problem, right? Is a big problem because processed food is often filled with sugar and it's also filled with salt. And I know we're going to talk about that later because it turns out that this fructose pathway, can be activated by many different foods. So it's, not just the sugar we eat. So, so, but anyway, so yes, so what our discovery was, was that this switch is activated by fructose.

And when we gave fructose to animals, they got this very exact switch. They start foraging, they get hungry, they're thirsty, all the things that we talk about in the biologic switch. And so fructose turned out to be it. You know, one of the big questions we asked, you know, was, the weight gain because they're eating more? Is it this energy balance?

Or is there, another thing besides? And, and what we found, the way you do that is you actually feed animals the exact same number of calories. So one group gets sugar and another group gets, other foods that don't have sugar and everybody eats the same. And if one guy doesn't eat very much, then all the guys can't eat very much. And so, we actually did this, we did this study multiple times, but one time we did it, there was a little guy that did not eat much food.

So everybody was eating less than normal. All these, laboratory rats were eating about two thirds what they normally eat, but one of them was eating a high sugar diet and one was not. And the high sugar diet rats, they became diabetic. They all became diabetic. Every one They of all developed fatty liver.

They had fat in their tissues. Their blood pressure was high. So the sugar was activating this, switch, even though they weren't gaining weight because they were on a caloric restriction.

Dr. Mark Hyman
Yeah.

Dr. Richard Johnson
Now when we looked at weight-

Dr. Mark Hyman
So metabolically they were fat, even though they weren't overweight?

Dr. Richard Johnson
Yes, right. So weight, weight is driven, you know, it is related to energy belts. So, you know, when we measured their metabolism, their resting energy metabolism was lower. So even though they were eating the same amount of food, they were spending less energy. So they tended to be a little higher.

They were like 10%, you know, maybe 5% higher in weight.

Dr. Mark Hyman
You just said something really important. I want to highlight it and I want to let you continue because what you said was so important. I just want to underscore it. When you eat sugar, your metabolism slows down. Is that what you just said?

That's correct. That is mind blowing, right? If you eat sugar, your metabolism slows down. That should get everybody to pay a lot of attention.

Dr. Richard Johnson
Yes, it absolutely does. So you're, you're but it's your resting energy metabolism, actually. So you could they when you're foraging, you don't you, you, they, you know, nature didn't want you to not be able to forage for food because you're, you know, they're worried that, you know, you're preparing for a bad time ahead. So, so they want the sugar, you know, the fructose, still allows you to forage. It's when you're resting, instead of kind of moving around.

Like, I tend to, you know, jiggle at my seat and so forth when I'm just sitting because I, have a lot of energy. Right? But, but you know, when you're eating a lot of sugar, your resting energy metabolism falls. So your net energy metabolism drops. And so even though these rats were eating exactly the same amount, the one group actually started, was losing weight, right?

But the other group actually gained a little weight because of that. The sugar group gained a little weight, but it wasn't significant. The bottom line is that the major thing driving weight gain is the number of calories you eat. That's what drives weight gain. And so the energy balance people always focus on the weight.

But if you look at what specific calories are doing, this metabolic switch includes blood pressure, fatty liver, fat, you know, and those things, and insulin resistance, they're not driven by excess calories.

Dr. Mark Hyman
In other words, in other words, blood pressure, your cholesterol- Yeah. Your blood sugar, fatty liver, inflammation, diabetes, prediabetes, are driven by the quality of the food you're eating, by the quality of the calories. Because in the sense that, you know, we're eating really crappy quality calories, that's what's driving this problem. It, you know, you're saying reminds me of a study that David Little did years ago where he took grass and he bit him, you know, either high fat, low starch sugar diet, or a regular kind of high carb diet, which is what we all recommended. In fact, it's what we were recommending for the diabetics with eating a lot of carbohydrates, which was crazy.

Anyway, he found that, basically, he had to keep reducing he had he had to keep increasing the caloric intake of the low starch sugar rats, the high fat rats, because they were losing too much weight. And then when at the end of the experiment, it's kind of awful, but he opened them up, and the the ones who and they were eating exactly the same calories. The ones who were eating the high sugar diet had all this fatty liver and fat around their organs and fat, like all this visceral fat, belly fat. And the other ones didn't, even though they were eating exactly the same calories because they were eating high fat, low starch sugar.

Dr. Richard Johnson
Yep. You're a 100% right. And, and Dave Ludwig, you know, that's a was a beautiful study.

Dr. Mark Hyman
And he always said things he he he also says that being it's not overeating that makes you fat. It's being fat that makes you overeat. A, that's a flipping everything on it's upside down.

Dr. Richard Johnson
And that's pretty cool. I hadn't heard that. That's, that's really cool. Yeah. One of the questions we asked, I mean, which was, a question that actually Ludwig so a lot of people say that the, the primary problem with carbs is that they stimulate insulin, and then the insulin, drives the glucose into the tissues, and then that causes the fat accumulation.

And that turns out from our research, that's partly true, but it's not completely the story. So what we did is we had animals that could metabolize fructose, normal animals, we also had animals that we genetically modified so that they could not metabolize fructose, but they could still metabolize glucose, they could still produce insulin, all that kind of stuff. And what we did was we gave them, we gave them, fructose and we could block the effects of fructose in the animals, eating fructose. But then we gave them sugar. We gave them, soft drinks, high fructose corn syrup.

And so when we gave high fructose corn syrup, that contains both glucose and fructose. So we could see which was the more important player. And what we found was that if we blocked fructose metabolism, they still drank a lot of high fructose corn syrup, because, but they did not get fat. They did not get, they did not get fatty liver. They did not even gain weight very much.

That, they gained a little, but very little. And so that told us that it wasn't really the insulin that's causing the obesity, but really it was the fact that the fruit dose, that present in the high fructose corn syrup was really what was driving obesity.

Dr. Mark Hyman
Well, is really a remarkable statement because, you know, we, we, and this was like a, a common belief among nutritionists and doctors, was that, you know, fructose is good for diabetics because it doesn't raise blood sugar.

Dr. Richard Johnson
Right. Right? And,

Dr. Mark Hyman
and, and, and then the other thing about fructose is that, you know, in sugar, in regular sugar, it's bound tightly with, with glucose. Right. In high fructose corn syrup, it's free fructose. And and the high fructose corn syrup may be 55 to 75%. Right.

Fructose. We've never seen this before. Now, the other thing that's so fascinating about fructose, and I wanna unpack what and take us on the fructose conversation, how it works to actually generate fatty liver, insulin resistance, obesity, diabetes in a minute. But but what really what struck me years ago is, you know, doctor Bruce Ames is a researcher, Very famous guy. And I don't I hope he's alive.

I don't even know.

Dr. Richard Johnson
Yeah. I think I think

Dr. Robert Lustig
he is.

Dr. Mark Hyman
I think he's still he's, like, really old. Writes about aging now. But he basically said that they were doing studies looking at fructose requiring a lot of energy to be absorbed. And and the high fructose corn syrup leads to a ATP depletion in the gut, meaning that the energy source that we need to actually keep our our gut intact, preventing leaky gut, was impaired because when you have a lot of fructose in your diet, the energy gets depleted and the little tight junctions that keep our cells together in our gut, the little lining together, preventing leaky gut, starts to break down. So then you get all these proteins from food and bacteria and crap actually in your bloodstream causing inflammation, which causes even more insulin resistance and more weight gain.

So can talk about that and talk about why, why is high fructose corn syrup so bad? Because if you listen to, you know, the food industry and everybody else, like, oh, it's just the same. It's all the same high fructose corn syrup, sugar. There's no difference. And I, I, I wrote an article years ago called five reasons why high fructose corn syrup

Dr. Richard Johnson
will kill you. I remember reading that. No, I actually is, I have to compliment you, you know, on your, your knowledge and what you've been doing and how you've been helping people.

Dr. Mark Hyman
Oh, thank you. I appreciate that.

Dr. Richard Johnson
So we actually did studies where we compared high fructose corn syrup to, to sucrose or table sugar. And in general, even when you leveled the playing field by giving high you know, so high fructose corn syrup is free fructose and free glucose mixed together, and sucrose, they're bound together, so, one will be absorbed more differently, more rapidly, the high fructose corn syrup. And when we give them so that the high fructose corn syrup is 50% fructose and 50% glucose, and you give exactly the same amount of food. The animals that get high fructose corn syrup will get worse, fatty liver. So there's something beyond, you know, it's more than just the fact that, that there's more fructose, but it's also the problem that it's free fructose.

Dr. Mark Hyman
Now for years, you've heard me talk about the dangers of sugar, but what happens to your body when you quit sugar for fourteen days? All sorts of stuff can happen. Right? Maybe you have issues you didn't even know were fixable by quitting sugar. Maybe you're dealing with chronic stress responses and inflammation or anxiety, panic attacks, maybe hormone imbalances.

Maybe you have acne, or maybe you're just tired and lethargic and have brain fog or joint pain or digestive issues, cravings, fluid retention, the list goes on and on and on. Now these are all warning signs that sugar may be harming you or worse that you're addicted to sugar. And in fact, studies show that fourteen percent of adults and twelve percent of kids meet the criteria for food addiction. And just for comparison's sake, about fourteen percent of the total population has alcohol addiction. So it's about the same in the cat and the kids.

It's worse. Now the good news is that most of the health issues from eating sugar can be completely reversed, and you can break the cycle of addiction in as little as fourteen days or less. Everywhere you look, there's added sugar. From blended coffees to protein bars, drinks, dressing, salad dressing, sauces, ketchup, you name it. Sugar is lurking everywhere in our diet, even in seemingly healthy foods.

Now we eat today in the modern world about 22 teaspoons a day. Historically, as hunter gatherers, we ate 22 teaspoons a year, and kids now eat about 34 teaspoons a day. That's almost a 150 pounds per person of sugar. That's a lot of sugar. And aside from making us inflamed and causing us to gain weight by spiking insulin, which is the fat storage hormone, consuming too much sugar is also at the root of many health problems, including mental health problems.

And that's what we're gonna talk about today. Mood swings, anxiety, depression, and various metabolic diseases are all consequences of eating a high glycemic or also known as a high sugar and starch diet. Now in today's HealthBite episode, we're diving into the research linking sugar addiction to poor mental health and how you can detoxify from excess sugar in your diet as little as fourteen days. Now once you clean up excess sugar and you clean up the refined carbs in your diet, your brain's gonna work better. Your mental health is gonna improve.

And as a bonus, your skin's gonna clear up and your hormones get back in balance and a whole host of other things. Now I've done this with thousands of people and I wrote about how to do this in my book, The ten Day Detox Diet. And I've seen profound results. In fact, there's an average reduction of 70% from all symptoms from all diseases in just ten days, plus an average weight loss of seven pounds and a significant drop in blood pressure and blood sugar. So now let's dive deeper into the data about sugar.

How do we reset our body to its original factory settings? Alright. So why is sugar consumption so out of control in The United States? Well, 60% of American calories come from ultra processed foods. And what are ultra processed foods?

Well, essentially, anything comes in a bag or a box or a package, something with a long ingredient list. And these are typically energy dense foods that are high in calories but have minimal nutrition value. So they're basically high calorie, low nutrient. That's not good. They're high in sugar, like high fructose corn syrup, dextrose, cane sugar, fructose, any millions of the kinds of names of sugar that we have.

They're high in refined grains, from enriched wheat flour, sometimes corn. And these are the commodity crops that are put in all these ultra processed foods, and they act just like sugar in the body. I mean, below the neck, your body can't tell the difference between a bowl of sugar and a bowl of cornflakes. Now The US dietary guidelines recommended six servings of grains per day, which is a lot, half of which must be whole grains. That means the other half could be basically what amounts to sugar.

That's crazy. But seventy four percent of Americans exceed that limit for refined grains. So what we're way over in terms of what we're eating, crackers, pretzels, cakes, cookies, pancakes, breakfast cereals, bread, tortilla, pasta, rice, all of it is just stuff that's causing our blood sugar to spike, and it's the majority of our diet. Now 65% of our calories and 92% of added sugar in The US comes from ultra processed foods. So the one big thing you can do to really drop your sugar content is just get rid of all that stuff that's made in the factory.

Right? Factory made foods. We call that a plant based diet. If it's made in a plant, don't eat it, basically. Added sugars make up about 14% of kids' total energy intake, meaning they're eating a lot of sugar.

About one in every seven calories comes from sugar. Now school lunches is another huge issue. I mean, it's crazy that that we allow sugar in school lunches. That should not be allowed. And in fact, it's it's allowed a lot.

And the USDA report, 69% of school lunches and 92% of school breakfast, meaning this is food we're feeding our kids in school funded by the government. It they exceed the limit of the 10% total energy intake that's been set by the dietary guidelines for Americans, meaning they're eating way over that. The average American consumes 17 added teaspoons of sugar or 22. So it's it's a lot. And sugar sweetened beverages and coffees and teas actually may contribute up to 40% of the daily intake of added sugar.

So think about it. You know? You're going to get a coffee. You're going to get tea. You're having all this stuff you think is okay to drink, but it's not.

It's just a sugar bomb. I think Starbucks should just be recognized for what it is. It's a sugar dispensing factory, not a coffee shop. Now 30% of the sugar we eat comes from desserts, sweet snacks, candies, sweet and breakfast cereals. But 70% comes from just regular food.

It's in everything. Right? Or we're just eating so much. People don't realize it. You wouldn't put, like, 16 teaspoons of sugar in your coffee.

But if you drink a 20 ounce bottle of soda, that's what you're getting. That's 64 grams of sugar, which is a lot. The average medium sized blended coffee contains about 50 grams of added sugar. Again, that's about, you know, 14 teaspoons of sugar, 13 teaspoons of sugar. That's nuts.

Right? You don't put that in your coffee, but that would be what you'd find in a blended coffee drink. An average serving of flavored yogurt contains 16 grams of added sugar. So you're eating yogurt. You can eat healthy probiotics.

But the truth is that per ounce, most of your sweetened yogurts have more sugar per ounce than Coca Cola. Right? The average serving of packaged salad dressing, get this, has six grams of added sugar. That means you're eating over a teaspoon, about a teaspoon and a half of sugar in your salad dressing. Like, why should you put sugar on your lettuce?

Studies that link excess sugar to poor mental health are really abundant. This is not just my opinion. Again, all the things I'm talking about in this Health Bite, in all the Health Bites are from the peer reviewed literature. All the references are included in the show notes. Have a look yourself if you don't believe me.

It's pretty scary out there, but what I'm saying is actually based in science. Now here's a study that looked at a large group of people. It was a meta analysis of observational study. So it wasn't cause and effect, but it was pretty impressive study. So it gives you things that point in the right direction.

They looked at 37,000 people with depression, and they found that sugar sweetened beverage consumption was dramatically increasing the risk for depression. Those who drank the most soda had a thirty one percent increased risk for depression compared to those who drank the least. So basically, if you're a big soda drinker, you're more likely to be depressed. Compared to those who did not drink sugar sweetened beverages, those who drink two cups of soda per day, about 45 grams of sugar, which is 11 teaspoons of sugar, increase the risk by about five percent for depression. Those who drink three cans, right?

So you look at the dose response on these studies. So one can bad, it's two cans worse, it's three cans. So you kind of can see where the trend's going. But those who drink three cans of soda a day, which is 98 grams of sugar, which is like, I don't know, almost 25 pieces of sugar, increase the risk by twenty five percent for getting depressed. Another study, a prospective cohort study out of Spain, 15,000 Spanish university graduates, showed that those in the highest quartile of added sugar intake had an increased risk for depression, meaning those who had the most sugar in their diet.

Those who consumed the highest amounts of sugar had a thirty five percent higher risk of depression. Comparing it to those who had the highest intake of high quality carbs from whole grains, high in fiber, low glycemic diet, those people had the opposite. They had a thirty percent lower risk of depression. Right? So more sugar, more depression, less sugar, less depression.

Seems like a trend. Another large prospective cohort study of 70,000 women, postmenopausal women published in the American Journal of Clinical Nutrition. So they looked at, glycemic index, the highest glycemic index, I mean, the higher the likelihood of food was to spike your sugar, there was a twenty two percent increased risk of depression. If you had added sugars, right, the added sugars that are added to food, there was a twenty three percent higher risk of depression. And refined grains, even wheat, right, flour, that also was associated with depression.

And if you had higher amounts of fiber or fruit or veggies or even lactose, it was significantly associated with a lower risk of depression. So sugar and flour, higher risk. Whole foods, lower risk. Not surprising. Alright.

So let's talk about the why. Why does this happen? We're seeing the correlation. We're seeing the connection. People know, you know, you get the sugar blues.

You know, people understand that that mood and sugar are very connected even through their own experience. But what's the science behind how sugar affects our brain health, affects our mood, and obviously other things. But, you've heard me talk a lot about other things, but we're gonna talk about sugar and the mood and brain function today. So one is, you get reactive hypoglycemia, and we'll talk about what that is. But essentially, it's where you you get a spike in sugar followed by a spike in insulin that then causes your sugar to crash.

And then what happens is you overshoot and you get low blood sugar. Now what happens when you get low blood sugar is you get a spike in cortisol, spike in adrenaline, and it helps bring the blood sugar back up, But it also increases the activity of the amygdala. So cortisol will will increase amygdala activity, which is our emotional anxious brain. And it's interesting that the symptoms are are pretty obvious for people who have this, but you get cravings for carbs and sugar just a few hours after eating. That's kind of a mild symptom.

You can have, like, really serious feelings of anxiety, fear, anger, irritability, panic attacks, Doctor. Jekyll and Mr. Hyde. Mean, people heard of being hangry. Right?

I get that a little. Heart palpitations, shakiness, shortness of breath, feeling you're going to faint, like you're going to die, brain fog, fatigue, headaches. And so what happens is when blood sugar drops, it's a life threatening emergency. You got to find food right away. And I just tell you a quick story of a guy who told me that he was having these panic attacks.

And he was like, yeah, every day, the afternoon I start getting this overwhelming feeling of anxiety. I start sweating. I can't breathe. I, my heart's racing. I just feel like I'm going to die.

I said, what happens? Well, I drink a can of Coke and it goes away. So I think, you know, most people don't even connect the dots between what they're doing and how they feel. So now what happens if you continue to do this? You get insulin resistance, right?

If you keep having sugar over time and it'll drive your sugar up, your insulin up, and high levels of insulin resistance has a really significant negative effect on mood and mental health. And the data is really clear on this. We'll go through the research. But essentially what happens with insulin resistance, you get inflammation in the body. And anything that causes inflammation will cause depression or anxiety or mood disorders.

So what is the kind of link between insulin and metabolic dysfunction and mood disorders like depression, anxiety? Well, our researchers from Stanford, they looked at a nine year study over time in The Netherlands published in the American Journal of Psychiatry. And they found that those who got prediabetes during the first two years of the study were more than two times as likely to have major depression versus those who had normal blood sugar. So in other words, when they follow people over a long period of time, if you were more likely to have prediabetes, you're gonna get more depression. Right?

So you don't even have to have diabetes. Now they measured the sort of the the degree or severity of insulin resistance, and they use something called the triglyceride HDL ratio, which by the way is available on everyone's test. Your ratio should ideally be one to one. If it's more than two to one for triglycerides to HDL, you're starting to get into trouble. But if they had a higher ratio of triglycerides to HDL, there was an eighty nine percent increase in new cases of major depression.

Think about that. For every five centimeters of belly fat, just on your around your waist, right, if you take a tape measure, then that was associated with eleven percent higher risk of depression. And every slight increase in this one unit increase in their ratio of triglyceride to HDL. And for every bump in fasting glucose, that was linked to a thirty seven percent higher risk of depression. So as your sugar goes up, your insulin goes up, more depression.

Conservatively, at least one in three people have insulin resistance. But I think it's a lot more. I mean, if you look at the data, one in two people have either prediabetes or type two diabetes by very conservative measurements. If you open up those measurements a little bit and don't just look at deviations from the worst level, right, like if your blood sugar's over a 100 and you're prediabetic, well, maybe you don't even have to have a 100 to actually have insulin resistance. And so that goes to the ninety three point two percent who are metabolically healthy.

So maybe even ninety plus percent have some degree of this, right? One in five adults on top of that have a mental health issue, right? That's a lot. That's, twenty percent of the population. If you have diabetes, you're twenty percent more likely to have anxiety and you also have more depression.

So how does this work? Well, low grade systemic inflammation from any source, and mostly in our case, it's the diet and sugar is the biggest driver of inflammation because sugar is like pouring gasoline on the fire. So the problem with insulin resistance is that it causes low grade systemic inflammation everywhere in the body and the brain. And that causes dysregulation of cortisol, which is the stress hormone, dysregulates what we call the HPA axis, which is the hypothalamic pituitary adrenal axis regulating all sorts of things that mood. It screws up neurotransmitter signaling when you have too much sugar like serotonin and dopamine.

It leads to, energy problems in the cell, which you need good energy to have good mood, right? So actually this friend of mine, Casey Mead, she wrote a book called Good Energy, all about metabolic function and mitochondrial function and how that relates to our health and mood. Now the brain relies mostly on glucose as its primary source of energy, but it's extremely energy efficient. It only needs about 60 grams a day to do its job. And flooding the brain with too much glucose creates a lot of inflammation, oxidative stress, and insulin resistance.

And it leads to depression and mental health issues and even things like Alzheimer's, which now they're calling type three diabetes. So when you have too much sugar, it screws up your ability to make energy and it causes mitochondrial dysfunction. Mitochondria are really important for neurotransmitter function and production and the release of neurotransmitters in the body. When you have sugar, it also does something really bad. It activates stress responses in the body.

So when you look at the data on this, it's pretty clear. David Ludwig, my friend at Harvard, has done a lot of work on this. And he basically showed that feeding kids isocaloric, meaning same calories of, let's say, oatmeal, which basically turns into sugar in your body or eggs, that the ones who add the oatmeal had higher levels of cortisol and adrenaline because their bodies were having this perceived stress of eating too much sugar. Now that's kind of scary. We know that independent of your mental state, that your diet can make you stressed, right?

Can increase stress hormones. And that is bad for your brain. Insulin also helps regulate neurotransmitters like serotonin and dopamine and also something called BDNF. And when you have too much insulin resistance, which is what most America is suffering from, it impairs dopamine signaling, which means you don't get the pleasure sensation, which means you want more sugar and create more carbs. And it's a vicious cycle.

Also stress itself will increase cortisol, just emotional stress, and that can cause issues. So it can be that the sugar causes stress or that actually, literally stress causes stress. And that stress will spike your cortisol. And what does that normally do? When you have a stressful situation, like you're being chased by a tiger, you want to increase your blood sugar.

You want to have all the fuel available so you can run as fast as you can. So that's a good thing. You want have more adrenaline, but not chronically. And so you have chronically elevated cortisol in your body from chronic psychological stress that increases your blood sugar, it increases insulin resistance, and it's a vicious cycle. So if you give someone prednisone, for example, for an autoimmune disease, they can develop diabetes and they can develop high blood pressure just from the stress hormone that they're giving as a pill.

And also stress really messes up your gut. And gut is another factor that is influenced by our diet and particularly sugar. Now we've talked a lot about the microbiome and mental health in the podcast. I've written about this a long time ago in my book, The Ultramind Solution. Again, the data has been there for a long time.

It's mostly been ignored, but I think I'm glad people are talking about it now. There's a whole department of nutritional psychiatry at Harvard where they're talking about metabolic health and the gut health and mood health. And Uma Naidu has been on the podcast. We'll link to the show notes there. But just to get into this around mood, you know, when you have a high sugar starch diet, it has a really bad impact on your microbiome.

So it changes the composition of bacteria in there to be bad bugs. And those bad bugs reduce the abundance of good bugs, which do good things, and the bad bugs do bad things. And that creates inflammation, leaky gut, yeast overgrowth, bacterial overgrowth. All that can lead to mood swings, irritability, depression. There's something called the bacterial endotoxin.

So when you have too many bad bugs, it produces the toxins that that basically get into your system through a leaky gut, And that triggers your immune system to create an inflammatory response and that impacts the brain. It also makes you more insulin resistant. So it creates a vicious cycle. So gut health is extremely important for brain health and for mood health. And when you look at the data on this, it's very compelling.

Leaky gut, which we used to get laughed at for talking about is now well recognized, increased intestinal permeability. But it's been linked to things like anxiety, depression, schizophrenia, and lots of other mental illnesses. And it's actually fixable. Okay. So we know that we're all eating too much sugar.

We know that sugar is linked to mental health issues. We know that the mechanism is there through inflammation and some resistance and and gut dysbiosis and mitochondrial function. Great. Now what? Well, you can do a sugar detox.

That's what you don't have to take my word for it. You don't have to listen to me. Your body's the smartest doctor in the room. It'll tell you what's working, what's not working. And listen to your body.

It's very smart. And listen to how you feel. I encourage everybody to do this. It's why I wrote my book, The ten Day Detox Diet. I think fourteen days is a little longer and I encourage you to do that a little longer just to see what happens.

But let's talk about how to do it. The first thing is you've got to get rid of all the flour and sugar, right? Get rid of all the high glycemic foods. Get rid of all the added sugar. Get rid of ultra processed food.

Stop all the refined flours, you know, refined wheat flour, gluten, all those things. Get rid of those. My joke for bread is if you can stand on it, it doesn't smush, you can eat it. I was in Germany and they had these meat slicers in the house. I'm like, what is that for?

Just slice the bread because it's so dense. It's made from whole grains. It's not made from flour. It's made from actual rye and grains. So you have to cut it with a meat slicer, like a deli meat slicer.

I encourage also people to get rid of all the liquid sugar calories. Those are the worst sugar sweetened beverages, teas, coffees, energy drinks, you name it, juices, just eliminate all of that. And what do you eat? Well, real whole food. What I've been talking about for years, you can do the ten day detox, which is a little more extreme, but essentially they're blood sugar balancing foods.

And the way to do that is start with protein at every meal. A bit, not a huge amount, but about a palm sized portion, depending how big you are. It's a different size, right? If you're Shaquille O'Neal, it's different than if you're Nadi Komunichi, who you probably don't know who that is, but she was a very famous gymnast in the seventies. But she was very little, like four eleven or 10 or something.

But basically, you wanna eat the palm sized portion of protein every meal, usually about 46 ounces. You wanna aim to about your body weight in grams of protein depending on how active you are, anywhere from half to one gram of protein per ideal body weight. You wanna get really good quality protein. So regeneratively raised meats. I use force of nature.

I love them. You can get bison, elk, venison, even beef. Pasture raised chickens and eggs. Certain fish can be great. If they're small fish, you'd know the smash fish for me is a small salmon, mackerel, anchovies, herring, and sardines.

Most people don't like those, but it could be good. Also, you wanna eat a lot of fiber. Fiber basically is a sponge for sugar. In fact, last night, I had shiitake miracle noodles, which were so good. They're essentially made from cognac root.

Cognac root is a Japanese food, but it actually has zero calories and it absorbs all this water and it slows the absorption of sugar. And you can actually take it as a supplement called PGX, but you can actually just buy the noodles too. So we had this delicious noodles last night. You don't have to feel guilty for eating noodles. So lots of fiber, lots of good fats.

Fats are really important because fat also slows the spiking sugar. So olive oil, avocados, nuts, and seeds. For breakfast, really important, have fat and protein. If you wanna cut your cravings, you cannot start the day with sugar. If you wanna detox from sugar, you've got to start the day with protein and fat and no sugar.

That's going to set you up from having balanced blood sugar. It's going to avoid the swings that I talked about. It's going to avoid the spikes in insulin. It's going to avoid the hypoglycemia, avoid the cravings. So you'll see.

Also get on slow burning carbs that are high in fiber and that reduce blood sugar spikes, that are rich in polyphenols, that promote the growth of good gut bacteria. So all the veggies, right? These are what I'm talking about. Carbs are broccoli is a carb, right? Asparagus is carb.

Green beans are carb. Mushrooms are, you know, protein and carbs. And so you can get a lot of foods that are delicious to eat that are high in beneficial compounds that help reduce inflammation, support gut bacteria, help your mitochondria, reduce oxidative stress. And all these foods, what they do is they help in the gut particularly because they have a of benefits, but they increase something called short chain fatty acids. So when you eat a lot of fiber, you feed the good bugs, right, and it creates byproduct that is really essential for your health called butyrate, or this is a short chain fatty acid, and it's very anti inflammatory.

And that gets used by the body as a regulator of all sorts of functions, including cancer. You also want to eat a wide variety of low glycemic plant foods, right? 75% of your plate should be non starchy, colorful veggies like leafy greens, cauliflower, dandelion greens, brussels sprouts, asparagus, cabbage, bok choy, broccoli rabe, collards, unlimited. You can eat as much as you want. So if you want five pounds of broccoli, go ahead.

Low glycemic fruit is fine. Berries, cherries, blackberries, raspberries, cranberries, that's fine. Stone fruit can be helpful. No more than a few piece a day of apples and pears. Lots of whole grains that can be good.

You have to be careful about what you're eating, but you want the low glycemic phytonutrient rich grains. I love black rice, example, red rice, quinoa, buckwheat, teff. All these are great. Certain legumes can be helpful. Lentils, chickpeas, split peas, edamame, aduki beans, black, navy beans, zucchini beans.

All these can be part of your healthy diet. Do you want to really go extreme on the blood sugar stuff? You can cut out grains and beans for the first few weeks, but you don't have to, but I would for sure cut out gluten, lots of fats. So one or two servings of healthy fats. Can pour olive oil, coconut oil, ghee, macadamia oil, olives, avocados, fatty fish, lots of nuts and seeds, flax seeds, chia seeds, hemp seeds, hazelnuts, walnuts, cashews, pecans, all that's fine.

Really essential. Nuts are really great for you and also help you feel full and it's a great snack. Limit starchy vegetables. So you can have some, but like not don't be eating sweet potatoes all the time or tons of potatoes and so forth. Eat your foods in the right order, right, to lower the glycemic load.

So if you have protein and fat before the carbs, it slows the absorption and you don't end up getting these spikes. Don't eat carbs alone, right? So for example, if you're eating an apple, throw a little nut butter on there, a handful of nuts, or if you have sweet potato, make sure you have it with like say a piece of chicken or nonstarchy veggie. So you sort of create a mixture of the meal. It's called the glycemic load, basically how the overall composition of the meal affects your blood sugar.

So you can offset effects of some carbs by eating them in the right order or with protein and fat. Lots of spices are good too. Cinnamon is amazing. That helps blood sugar, green tea. And then also supplements can be really important.

So high quality multivitamin and mineral, vitamin D, omega three fats, and certain things are really important for blood sugar like lipoic acid, but B vitamins. Certain herbs are great that I use. Cinnamon, green tea, chromium, minerals like magnesium, also great. Fenugreek has been used a lot in Ayurvedic medicine, great for blood sugar. Exercise, obviously, I'm going to always talk about that, but, resistance and, aerobic exercise about one hundred and fifty minutes a week.

Muscle is critical and improves insulin sensitivity. Here's a, a simple hack is take a half an hour walk or even fifteen minutes after eating your dinner. It's gonna dramatically blunt the sugar spikes and insulin. So your body's gonna suck that Sleep also really important. We know that lack of sleep causes more sugar cravings, more carb cravings.

I've had it. I felt that I used to work at the ER in, Mercy Hospital in Springfield, Massachusetts. And I would sometimes get the night shift and it was two in the morning. The only thing open was McDonald's. And I would go in and get the, sort of apple turnover because it was the only thing that you'd get.

I mean, I didn't want a burger. And, you know, I craved the carbs. I felt it. I knew it even though I knew better. Really important to to get enough sleep.

So try to set a regular bedtime, stick to it, try not to eat at least three hours before bed, get rid of all late night snacking, give yourself at least a twelve hour overnight fast. So dinner at six, eat breakfast at six. Or if wanna you do fourteen, you

Dr. Mark Hyman
can eat breakfast at eight if you

Dr. Mark Hyman
eat dinner at six. So it's not that hard, but giving yourself that break will help improve your insulin sensitivity. What else can you do to help your sugar and and manage it? Well, get your stress under control. And it's more like what up here, you know, stress is defined as the the real or imagined threat to your body or your ego.

So it could be a real threat to your body like a lion chasing you, or it could be an imagined threat to your ego. Like you think your, you know, your wife is an hour late coming back from something and you think she's having an affair or something. So that could be totally fabricated in your head, but the end result in your body is the same. And this chronic levels of stress we all have are really driving a lot of health issues, including insulin resistance, diabetes, and depression, anxiety, and much more. So how do you do that?

Well, you kind of have to actively reduce stress, exercise, journaling, meditation, yoga, all this helps. I I've got this new app I I use called Newcom. It uses by Neural beats. So I put on my headphones. I go into a zone and kind of go into a deep state of relaxation.

So there's lots of ways to do it. No magic to it, but you said to find what works for you.

Dr. Mark Hyman
You frame all these diseases as really the tip of the iceberg. And underneath it, you say are these eight processes, these eight metabolic phenomena, these subcellular pathologies you call them, that are really driving everything. And I'll just list them and then we can kinda go into them all. We talked a little about insulin resistance, but glycation, oxidative stress, mitochondrial dysfunction, we've touched on this. Membrane integrity, inflammation, epigenetics, autophagy.

We talk a lot about this in the book, it's a lot of big words. But it's actually a lot of the same topics I wrote about in my book Young Forever, because it all drives chronic disease, all drives aging. They're underneath well, they're often these are also known as the hallmarks of aging, which are the phenomena that happen that are driving the disease. So hallmarks actually are upstream, and and they're not they're not symptoms. They're basically these phenomena that happen from different insults, mostly from food,

Dr. Mark Hyman
by the way.

Dr. Mark Hyman
We're talking about

Dr. Mark Hyman
how to

Dr. Mark Hyman
pick some of the food. And and you kinda break it down. I was just like jumping up and down when I saw it. I was like, wow. This is this is it.

You got it. Tell us about these eight processes and how they can lead to all these diseases.

Dr. Robert Lustig
Exactly. So these eight processes are, for the most part, not processes that you can sort of test for. They're happening in the cell. There are ways to do it. I mean, researchers can do it, but they're not, shall we say, clinically available.

Dr. Mark Hyman
But they're going on.

Dr. Robert Lustig
Yeah, yeah. They're going on in all of us. It is part of life. All of these are part of life. You can't stop them, but you can slow them down.

But you can only slow them down with food. All right? So they're foodable. They're all

Dr. Mark Hyman
foodable.

Dr. Robert Lustig
Exactly. Not druggable, all foodable. All right, example, glycation. So glycation. A glucose binds to a protein.

Now, when it does that, it makes that protein less flexible. It makes that protein end up being recycled. It might change the function of that protein. It might cause that cell to become more fragile and friable and might end up causing cell death. Okay?

So glycation is not a good thing. Now this is what diabetics measure when they measure hemoglobin A1C. This is glycated hemoglobin, glucose binding to the hemoglobin molecule. Well, that's happening all over your body. It's happening all the time.

The question is how much? It is the cause of wrinkles. Is the cause of cataracts. Yeah. The cause of cardiovascular disease in the Well, side of your blood it's one of the causes of dementia, not the only one.

The bottom line is you don't wanna be glycating. Alright? Now you're gonna be glycating because it is a process you can't stop. Okay? It is part of life, but you can slow it down.

How do you slow it down? Stop providing the substrate. Okay? And the substrate for glycation are two. At glucose?

Yes. But fructose is seven times worse. Both But do fructose does it seven times faster and releases 100 times the number of oxygen radicals, which we'll get to in number two.

Dr. Mark Hyman
I mean, that's why high fructose corn syrup isn't everything is super bad. Right? Exactly. Fructose.

Dr. Robert Lustig
Yeah. But there's there's fructose and sucrose too. I mean, so it almost doesn't matter. The point is sugar's a bad guy in the story. Okay?

You know, full stop. That's that's what we don't, you know, tell our patients, and that's the thing that they need to watch, and it's the thing that they can control themselves if they choose to. So that's number one. Number two, oxidative stress, those little hydrogen peroxides. Now hydrogen peroxide is good if you have a wound, but it's not good

Dr. Richard Johnson
if it's

Dr. Robert Lustig
inside the cell. Right? Because those hydrogen peroxide

Dr. Mark Hyman
Unless you want to kill an infection or cancer or something, then it can be good. But but you know when your body makes a little bit, but it shouldn't make too much.

Dr. Robert Lustig
Right. But you shouldn't be making it in your liver. Right?

Dr. Mark Hyman
No.

Dr. Robert Lustig
Well, every time a hydrogen peroxide gets made, it's doing damage. It's doing damage to a lipid. It's doing damage to a protein. Ultimately, it will kill cells. The bottom line is oxidative stress occurs every time that glycation reaction occurs.

It also occurs from iron. It also occurs from various other processes that go on in the body. But the sum total of that oxidative stress is the aging reaction. Is what aging is. And so we need to basically try to mitigate it as much as possible.

Now you can't mitigate the iron, but you can mitigate the sugar. You can mitigate some of the other reactive oxygen species drivers, like for instance, environmental toxins. Weird. Okay, like insecticides and things like that that will cause it as well. All right, number three, mitochondrial dysfunction.

Yeah. We talked about mitochondria being sort of at the heart of this whole problem. Well, it turns out fructose, that sweet molecule and sugar, inhibits three, count them, three separate enzymes that mitochondria need. We've talked about one, CPT one.

Dr. Mark Hyman
And mitochondria basically make energy from the food you're eating and the oxygen you breathe that runs everything in your body.

Dr. Robert Lustig
So when that process gets up, you're having an energy crisis. Exactly right. Exactly right. It inhibits an enzyme called AMP kinase, which is the fuel gauge on the liver cell. It inhibits an enzyme called ACADL, acyl CoA dehydrogenase long chain, which is necessary to get the fatty acids oxidized.

So the bottom line is if your mitochondria are dysfunctional, you're gonna be sick. And fructose is a three in one mitochondrial toxin. There are others. I mean, there's

Dr. Mark Hyman
Well, they're a good deal. Three for one, right?

Dr. Robert Lustig
Bottom line, that's like number one. Number four. Insulin resistance. Now we've spent enough time on that, so I think we'll go to number five. Number five, membrane instability.

Now imagine you have a balloon. Okay? You blow up the balloon and you try to pop a hole in that balloon with your finger. It won't pop. But if you pop if you take a pen, it will pop.

Okay. Now take a balloon, blow it up, and put it in your the corner of your bedroom for three weeks. It will slowly deflate. Okay. Now undo the knot, and now blow up the balloon again.

Now try to puncture the balloon with your finger. Now it'll puncture. What happened? How come the balloon would not puncture with your finger the first time, but it would three weeks later? Mhmm.

How come? Answer, because the membrane, the balloon, changed properties. So Yeah. The membranes of your cells and especially of your neurons, okay, have to turn over, and they have to basically maintain integrity. And the problem is that there are a lot of things that can inhibit that integrity.

Again, one of them being sugar, insulin being another one. But there's a way to fix that. There's a way to treat that. Omega-three fatty acids. Those are the things that improve membrane integrity in your liver, in your arteries, and most importantly, in your neurons.

So where did the omega threes come from? Well, unfortunately, not formed fish. They're omega sixes. The omega threes are made by the algae. The wild fish eat the algae.

We eat the wild fish. Well, unfortunately, wild fish is expensive and not immediately available in many parts of the country and parts of Another the reason for problem. Number six, inflammation. Now, you have talked about inflammation till the cows come home. Yeah, yeah.

I mean, your PBS special is all about inflammation. I know. And I agree. I totally agree. Okay.

Question is where's the inflammation coming from?

Dr. Mark Hyman
Could be from a

Dr. Robert Lustig
bunch of places. Like for instance, if you have an autoimmune disease like rheumatoid arthritis, you know, it's coming from your immune cells and stuff. But where's the inflammation coming from in people who don't have autoimmune disease? Yeah. It's coming from your gut.

Yeah. Your gut microbiome. So your intestine is functionally outside your body, and your intestine provides a barrier to keep the stuff in your intestine, the literal in your intestine. You might have to bleep that out, but hopefully- No, it's fine. Alright.

The bacteria, the cytokines, the lipopolysaccharides, the stuff you do not want to get into your bloodstream.

Dr. Mark Hyman
It's a sewer in there.

Dr. Robert Lustig
It's a sewer. That's exactly right. It is a sewer in there. And the goal is to maintain the barrier so that those bad guys don't end up in your bloodstream. Now you have two mechanisms for doing that.

One is the mucin layer. Okay, so there's a mucus layer on top Like mucus, yeah. Like mucus on the top of your intestinal epithelial cells. That's one. And the second is that there are proteins that guard the junctions between the cells, you know, where stuff could slide through.

Okay? Those are called tight junctions. Tight junctions like, for instance, zonulin. That's what goes wrong in celiac disease. Yeah.

So you need the mucin layer, you need the tight junctions, you need to all be effective, alright, in order to maintain that intestinal barrier. Well, guess what? If you don't feed the bacteria in your intestine, your bacteria will choose the mucin layer to be its food. Will chew through the mucin layer, exposing all those intestinal epithelial cells to all these bad guys, and you will need intestinal pathologies. Just saw a paper that just came out that showed that Crohn's disease severity and incense and severity is related to ultra processed food consumption.

Well, okay. For example, reason for exactly this reason. Interesting also if colitis was not, but Crohn's was. So you gotta feed your bacteria, your microbiome, those little you know, they're 10 you got a 100,000,000,000,000 bacteria in your intestine. Okay.

They gotta What do they eat? They eat the fiber in your food. So you have to feed your gut. Well, unfortunately, your diet is fiberless food. And so they're gonna eat the mucin, okay, exposing your intestine and generating inflammation.

Second, you have those tight junctions. Well, those tight junctions can become dysfunctional. You can nitrate those tight junctions. And guess what nitrates those tight junctions best? Sugar.

Yeah. Again. So, again, the bad guy.

Dr. Mark Hyman
Yeah. You know, I don't know if this is true, Robert, but I talked to Bruce Ames, and he said that he they did research in his lab where they found that fructose because it requires extra energy to be absorbed. Meaning, it requires more ATP to be absorbed. It actually draws energy out of the gut, and you need energy to keep those tight junctions together.

Dr. Robert Lustig
And so

Dr. Mark Hyman
just the fructose actually has another effect, which is to create a a leaky gut. And then you get this whole phenomena we call metabolic endotoxemia, meaning the bacteria and toxins leak out. It activates your immune system. Your immune system gets activated, and that causes insulin resistance in the cellular level. So it's like all connected.

Dr. Robert Lustig
It's all connected. Exactly right. So you need that intestinal barrier to be working, and you need to be working 20 fourseven. And you're right. Fructose, because it has to be phosphorylated in order to get across, is depleting ATP from those intestinal epithelial cells.

So again, know, oh, and the paper came out just about two weeks ago in the journal Cell from Ivanov's group at Columbia, which showed that sugar depletes the Th17 cells, which are the barriers, IL-seventeen, which is the barrier, which then allows all the fat to rush in and generate its own inflammation. So bottom line, you gotta keep your gut happy. And the way to do it is to feed it, and what you have to feed it is fiber. And the problem is processed food is fiberless food. So there you go.

Dr. Mark Hyman
Mhmm. That's it.

Dr. Robert Lustig
Number seven. Yeah. We're not done.

Dr. Mark Hyman
No, know. There's two more.

Dr. Robert Lustig
Two more. Two more. Number seven, methylation. So methylation is a process that goes on normally, but you don't want to methylate things out of hand. And if you are methylating proteins, okay, they are losing function.

Okay? You can methylate DNA and it will also cause problems in terms of function. We know this from various genetic differences, like for instance, the Agouti mouse and also from patients with methyl tetrahydrofolate reductase deficiency. They end up having high levels of protein called of amino acid called homocysteine. And homocysteine is a sticky amino acid that can drive cardiovascular disease.

And so by increasing b one, b two, b six, b 12 folate, we can keep methylation at bay. But again, processed food, not high in those things. And then finally, number eight, which is my favorite, autophagy. Autophagy is garbage night for the cell. Okay?

So your cell makes junk. Okay? During the course of the day, it makes junk. And that junk can be protein aggregates or lipid epoxides, various dysfunctional mitochondria because they burn out. And so you have to recycle the stuff to get it out.

So imagine, wherever you live, you live in Massachusetts, imagine your garbage men go out on strike. Okay? Yep. For the first week, now you're okay. For the second week, you know, maybe starting to smell.

Third week, you know, now the rats are kind of, you know, tempted. By the fourth week, you know, you may have some problems with your plumbing. And by the fifth week, you're gonna move out of your frigging All right? Oh, yeah. That's autophagy.

That's garbage night. Okay? You have to recycle all the junk in order to make room for the new stuff. Okay?

Dr. Mark Hyman
And that's a key part of longevity, is to activate autophagy.

Dr. Robert Lustig
Absolutely. Autophagy and longevity are part and parcel of the same thing. And we're actually very interested in that. We're studying a specific supplement that might improve autophagy and therefore improve longevity. So that's near and dear to home.

Dr. Mark Hyman
So Robert, you've talked about all these eight processes, and the key to fixing them is what? The key

Dr. Robert Lustig
to fixing virtually all of them is food. Okay? Now, glycation, fructose and glucose, oxidative stress, fructose, glucose, various fatty acids like trans fats, mitochondrial dysfunction. Again, fructose, cadmium, other insecticides, insulin resistance, fructose, glucose, branched chain amino acids, intestinal sorry, membrane integrity, omega threes, inflammation, fiber, methylation, vitamins B one, B two, B six, B twelve, folate, and finally, autophagy, intermittent fasting, fasting, and also keeping your insulin down. So bottom line, all eight fixable by food.

If you love this podcast, please share it

Dr. Mark Hyman
with someone else you think would also enjoy it. You can find me on all social media channels at Doctor Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the doctor Hyman show wherever you get your podcasts.

And don't forget to check out my YouTube channel at Doctor Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Doctor Hyman show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am chief medical officer. This podcast represents my opinions and my guests' opinions.

Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com, and request to become a patient.

It's important to have someone in your corner who is a trained, licensed health care practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.