How To Beat Diabetes, Weight Gain & Inflammation! - 3 Ways To Reverse It | Jessie Inchauspé

I want this to be as practical for people. I want to get your books for sure to get all the science and all the advice, but I really want some kind of maybe we could go over some common foods, for example, or common things that people do. just to explain blood sugar and maybe what people could do about it to limit the spike oats, right, I was going to say oats, oats, right, a common breakfast food around the world, which may not be best in all situations. We talked about oats, so oats are a grain and grains are full of starch and as I explained, there are two types of foods that create glucose cycles in the body, starches and sugars, so oats are a starch and in fact if you look at starch it's just a long one. chain of glucose molecules linked hand in hand and when you eat starch, those glucose molecules are released and then a glucose cycle is created, so oatmeal in the morning, if you only eat oatmeal, you are only eating starch, which means glucose Ghost Bike, so if you have oatmeal and feel hungry 2 hours after eating it or if you feel tired at any time during the day or if you have other symptoms that you want to treat, you might want to look at your oatmeal situation, you have two options , a You can learn to put some clothes on that oatmeal, so maybe a little nut butter, maybe you can put a little protein powder, maybe you have a little egg, you know, a little boiled egg in the oats, make it like salty oats, uh, you can find a lot of them. of nice little combinations to put protein, fat and fiber in the oatmeal, another option just change your breakfast completely and opt for what I call the salty breakfast and in the glucose guus method, many beautiful recipe ideas, but the The principle is this: The tasty breakfast that keeps your glucose level stable and helps you feel amazing is based on protein, so eggs, fish, nuts, tofu, protein powder, leftovers dinner, dinner leftovers, one of my favorite

ways

to get protein.

This morning I had leftover butter chicken for breakfast. I had Indian food last night, butter chicken for breakfast, perfect and then you can add a little fiber or a little fat so you know, olive oil, butter, avocados, maybe a little spinach if you want, and then The most important thing to remember is that in a salty. For breakfast you shouldn't eat anything sweet unless you want some whole fruit for flavor. No fruit juices. Not jam. No sweet cereals. No sweet yogurts. Etc. You can still eat sweet foods later in the day, but for breakfast if you want to set yourself up for success.

It is very important not to eat sweet foods and then start, you can also do it before tasting, so you can have some oatmeal before tasting. You know, if your body really feels like this, many people will feel like they don't have time. tomorrow to prepare a breakfast and they will be on their way to work and they will stop at a cafe and have a coffee and instead they will be tempted with Pano chakas or Quant or pastries and they will get a ham quason. of a chocolate quason because at least it has some protein or maybe on Sundays you can make a big batch of soft-boiled eggs and you can take a couple every day or in my book I have a recipe for egg cups that are really delicious , but in the cafeteria maybe they have nuts, maybe they have toast with something salty, yes, but I agree that it is a difficult food landscape to navigate, it really is and I think you know that having a tasty breakfast changes the rules of the game when I've never done it, you know, for years like you.

I've been talking to patients about eating your dinner for breakfast, yeah, you know, overcooking it and in the morning reheating it and there's a couple of people I have to pay attention to. I don't share his story now. I think I've talked about them on the podcast before and I wrote about one of them in one of my books. A completely different life experience. Yes, I say that phrase absolutely, it's that they are leaving. in the world, but their cognition, their performance at work, their hunger, completely different, it's like going through the looking glass, you know, in the movie, yeah, and if you think about what the common breakfast is now in the West and not only in the West, um, in India, I used to go every other summer and spend six weeks in India because that's where all my family lived and a lot of them are still alive and I can still remember so clearly playing with my cousins ​​but they were still at school in in the summer, you know, different schedules and different, you know, year and semester times in India, they had a full meal before they went to school during the day they ate, you know, they ate vegetable curry. you know, a whole plate full of food and I remember this was a while ago, but everything started to change when companies like Kelloggs started marketing aggressively, yeah, and it changed to being quick and easy, you know, we can, this is, this is. progress right, this is e This is us progressing, we can make a quick and easy breakfast with cereal milk on top and that's it, but in reality, through the lens of blood sugar, there is a big difference, right, this was invented, We all used to have breakfast that was just like any other food, yeah, and then the food companies were like, hmm, breakfast cereal, let me think, it's really cheap to make, it's addictive, people will enjoy it, let's tell them they should eat cereal and orange juice in the morning, that was invented.

It's a marketing question, the best thing for breakfast is dinner. I completely agree with you or even improve the dinner in a pan and also break two eggs to make a version a little similar to dinner for breakfast, but completely like having something sweet and starchy for breakfast massive glucose bicycle glucose rer roller coaster addiction to sugar

inflammation

low energy so breakfast is really the worst time to eat only sugars and starches, but it is the time when most of us eat only sugar and starches and it is the common breakfast for children, I know that and I understand the pressure on parents, you know, maybe two parents work, maybe there's not enough time, you know.

Financial concerns, I get all that and I don't know, but it's really not the best breakfast to give your kids, even at school. performance perspective and I wonder how many mid-morning behavior problems at school, for which they get detentions and detentions at school, how many of them are actually blood sugar problems. It would be very interesting to do a study that Sunday, you know, I grew up. eating Nutella crepe every morning for breakfast from when I was I don't know 5 until I was 16 Nutella crepe now that sounds delicious and then I was exhausted at 11 I was so hungry my stomach hurt, you know?

It would definitely affect my day on a daily basis. I just thought it was normal, but no, it wasn't normal. What has your research shown about plant milks? Many people today drink almond milk, rice milk, oat milk, what is that doing to you? blood sugar and presumably it matters what you take it with, it matters what you take it with, but it also matters what it comes from, so if you look at milks that come from starches, rice and oats are starches when you make a milk . From them you're basically making liquid starch and that's just pure glucose when you look at a glucose monitor.

What happens when you drink an oat milk latte versus a cow's milk latte? I mean, it's night and day, oat milk or rice milk creates a big glucose spike in the body and it makes sense because you're just drinking liquid starch, so it's pretty obvious if you think about the source of the Same thing, if you have something like almond milk, at least the almonds aren't as starchy. them, so it's a much better situation. Coconut milk is also better than cow's milk if you like dairy, but unfortunately oat milk has massive spikes in most people now.

I know people really love oat milk, so here's my recommendation if you don't have many. symptoms and you feel great and have good energy with no cravings, no problem and you love oat milk, go ahead, I have nothing to teach you, but if you could feel better, then you feel better and if you want to help with some of the symptoms. You may feel like you want to consider switching to another type of milk or you can also do another trick that I have, which is if you want to eat something sweet, have it at the end of a meal instead of on an empty stomach, so for me, oatmeal .

Milk is essentially sweet, so you can drink it after breakfast instead of on an empty stomach before breakfast. You can also go for a walk a little later. You can use some of the tricks to reduce its impact on your glucose, but in reality it is not. the vibe, yeah, not the best, no movement and blood sugar, this is a pretty easy trick for people, it's been in many cultures for years, but as you already explained, we've lost a lot of this kind of cultural wisdom Yes, what is it? the relationship between movement and blood sugar and how we can use movement to mitigate the effects of what we have eaten.

You know, the mitochondria I told you about earlier. The little factories that produce energy in our muscles, we have a lot of mitochondria. and they convert glucose into energy so your muscles can contract, so when you walk, when you dance, when you lift

weight

s, you know, when you play any team sport, your muscles use glucose to fuel themselves and then we can use that. to our advantage and here's the trick after a meal use your muscles for 10 minutes now this can be just walking it can be cleaning your kitchen it can be doing my new favorite activity which is calf raises so you just sit at your desk and just like putting your feet planted on the floor and just lifting up, lifting your feet up on your toes so just your toes are touching and doing these calf raises or calf curls for about five minutes either way. who wants to use his muscles.

This will be helpful because as you contract your muscles, the glucose from the food that reaches your bloodstream will be absorbed by the muscles and used for energy, so you will reduce the glucose cycle from that food without needing to change what's in it. food, so we can try to eat better quality foods to stabilize our blood sugar level. We can change the order of the foods, but let's say we don't want to make any changes and we've had a meal that we know is possibly not the best for us in terms of blood sugar spikes.

Yes, you're saying that if we do 10 minutes of movement after that meal, we can mitigate the effects exactly, so within 90 minutes of the end of the meal, use your muscles. a little bit and it really can be super simple, you can be sitting on the couch watching a movie after dinner, grab a bottle of water and do bicep curls with the water bottle, basically anything, anything, and really the lifts Calf exercises are a really easy place to start. Your calf actually has a muscle called the Solus muscle that is specifically capable of absorbing glucose from the bloodstream, which is why calf raises are a good option.

I saw this recently on your Instagram grid and I al

ways

look at things. through an evolutionary lens and think hard, what is so special about the calf muscle? We use it for walking, we use it for walking exactly and then yes, of course, the biceps kill. I get it, it's an easy and simple trick, but if you think about it, most of the movement. our evolutionary past, I can't imagine our hunters gathering or our ancestors just for the sake of picking up something heavy and lifting it, you know they're not going to use energy unless there's a good reason for it, right? so it makes sense that the cus Cal muscle is very important here, doesn't it?

Because it's like not moving to get food, moving anywhere to get back to safety, you need to use your Cal muscle, so I don't do it. I don't know, tell me about that because it makes a little bit of sense, right? So wait, so you think back in the Hunter days there people didn't like working out for fun or playing games, maybe playing games, maybe you're like wrestling with your friends or, hey, to be clear, I don't. I know right I'm not I'm not CL okay I'm just hypothesizing why the cus muscle might be so good at getting rid of glucose compared to other muscles maybe it's because I think you're right.

I think the fact that we use it for walking means that it has to be really efficient at using energy and the other muscles of course use glucose, but this valuable muscle is very, very good at taking glucose from the bloodstream, so Maybe it has something to do with the fact that after you've eaten and you need to walk or run or whatever, you need to have a muscle that can absorb that glucose. immediately maybe I don't know, I should look at the study a

gain

because I'm surewhich in the discussion they will probably explain some hypothesis as to why that is the case fruit vs fruit EOS oh my gosh I think this is one of my favorite topics okay.

See, you know how people say, well, it's fruit, so it's natural, yeah, okay, so I've got a scoop for you. The fruit we have in our supermarkets today is not natural, just as humans raised gray wolves with chihuahuas for entertainment. Crossbreeding and cultivating fruits for millennia to make them more palatable to humans to make them sweeter so they have fewer seeds less fiber if you look at an ancient banana it is small it is full of seeds it is quite dense and it is not very sweet if you look at a banana today It's very sweet very little fiber very few seeds super easy to eat humans have created these fruits to be extra juicy, extra sweet and extra full of sugar so one thing to keep in mind is that the fruit you see on the market today supermarket is not natural, however, a piece of fruit still contains fiber and fiber is protective, as I explained at the beginning, fiber helps reduce glucose.

The peak of a meal because it creates that mesh in the intestine, so that if you want to eat something sweet, eating fiber is still the best. Sorry, eating a piece of whole fruit is still best because that fiber cushions the sugar spike. The problem arises when we denature that piece of fruit, so maybe we're going to make apple juice, as a result we're removing all the fiber from the apple and we're concentrating the sugar that was already being concentrated for centuries by humans into that whole apple. , when we dry fruit, we take all the water out of it, so we concentrate the sugar and we eat many more pieces of dried fruit than we would normal fruit, yes, and what I think is particularly worrying is that there are quite a few companies now. that are aimed at kids with dried fruits and I think a lot of parents are doing it a

gain

.

I always say this and I want to reiterate this point. I genuinely believe that all parents are doing the best they can in the context of their life situation in the context of their knowledge, but I'm not sure those packets of dried fruits are the best thing to give to our children on an empty stomach. Yes, although you could argue that dried fruits are better than sweets because at least they have some fiber. but what would be even better if you really want to give dried fruits would be to combine them with some nuts for example, yeah, so you can make a little snack with a few, like dried apricots and then some walnuts or whatever, it's better because you're Put some clothes on carbs, right, I get it and that's what I love about all your suggestions, they can be applied by anyone in any situation, no matter what diet they're on, little tricks, little adjustments just to improve things a little. better than they would have been otherwise, exactly, we're not talking about a big overhaul of your life, of your eating habits, no, no, small adjustments, big impact, yes, adding those nuts to dried fruits, you can see how it could be really tasty and change. the blood sugar answer absolutely now, just thinking about that, Jesse, most of the time, the cultural wisdom that's there, now we're learning modern science again, that's why it works now, the only place I think that their recommendations do not match.

Certainly, the ancient wisdom that I know is with fruits on an empty stomach because I know that in juicy medicine for many years they have been talking about that if you eat a piece of fruit, eat it before the meal because then it is digested. It's very easy and then you don't have to party on top of your food. First of all, I appreciate your opinion on this, but just a small addition based on what you just said about the fact that the way fruit is grown now. Compared to how fruit was bread in the past, maybe two or three thousand years ago, maybe the low sugar fruit we had wasn't as sweet, maybe it worked then, maybe it doesn't work as well now, I don't know.

I know, but what is it? your kind of perspective on it, well this is a very common question and I was fascinated by it. I thought: where is this coming from? Why do we think that fruit rots in the stomach if it is eaten last? And through my research I discovered that There was a doctor in the Renaissance who said that fruits and this is a separate branch of matter ayura, but this doctor said that if you eat fruit after a meal, it will rot and become purified in your stomach and it will create all these vapors and stuff.

That doctor just said that, I mean, I don't know where he got that from, but it's just not true, nothing rots or purifies in the stomach, so that particular thing about decomposition just isn't true, nothing can rot in the stomach. stomach. In fact, there's this ancient wisdom about eating fruit on an empty stomach or at the beginning of a meal and to that I say, well, we have two opposing views, we have glucose science that says if you want to eat something sweet, it's better . The timing of your glucose is at the end of a meal and we have some ancient wisdom that might have some really good sources as well, so maybe where we get to is if you don't get any comfort from eating fruit after a meal, maybe you will. and if you're someone and your body says no, it's not working, maybe it's causing bloating or whatever, then you change it, you know it's up to you to adapt these recommendations to other things going on in your life, so, that?

What we recommend is that we take a pragmatic and nuanced approach to our health. It's mind-blowing, you know, it's 2023, that's not how it goes, yeah, I know, I know and I think this is also the reason why you know my work has been so well received is because it feels fresh. and nice and it's not an extreme diet anymore, it's not like eliminating entire food groups, it's okay guys, I think we're over dieting, I personally would prefer if we never had diets again, so how about we use all this science recent? and we find these principles that are easy and that have a great impact on our physical and mental health, that they are not very difficult, they do not cost money, yes, and what if we do that?

People seem to be very happy with that approach. Jesse, now it's almost one to have the size of the audience that you have and not be rejected. MH, okay, I'm sure it's technically possible, but I'd say it's almost impossible, yeah, if people reject your work, what's common? they say and how you respond, so I've experienced multiple waves of this um and I kind of classify rejection or criticism into two camps, so there are things that I really like and you can't do anything about it, for example, um people who don't want to hear any information about food because they don't, but you know, because maybe they had a desert to eat in the past, maybe they just say no, so for those people my job is like they just hate it because I'm talking about food, those things that I don't really pay attention to because you know it's not exactly for them and then you have helpful reviews and since the beginning of the glucose goddess project I've always heard comments about whether in comments or on DMS or in real life because my purpose here is to make science accessible so that it's inclusive and to make sure that I'm serving the people that I want to give this information to, so I would say the biggest criticism has been from people with

diabetes

type 1 maybe this was a year ago it started to happen that they didn't like that I was wearing a glucose monitor as a person without

diabetes

and I really listened to this very closely because, um, a lot of people were sharing with me how sad it made them. to show them my glucose monitor as if I was wearing a glucose monitor and to them it was a device they needed to survive, so I really took it seriously and started.

Thinking a lot about my glucose monitor approach and you know if I think it's for everyone. I also stopped posting photos of myself with the device saying, "Hey, ccos monitor." Now I'm really like I was using it to make the illustrative graphics, but I'm not using it as a fashion statement anymore, yeah, you know, that was really very useful. I think another thing that people reject is the carb clothing thing, they say yes, but if you take it to the extreme, it could be harmful. As I explained at the beginning, you could put two pounds of butter on a piece of bread and that would reduce the peak, but you need to be more nuanced and I think I actually address it quite well in the book, so I think so. address it very well I think you know that I have read both books and I think you are very clear that this is not to stress you out, this does not necessarily have to apply in all situations, this is to try to help you, yes. true, yes, sure in an ideal world we would all consume an all-whole foods diet that would naturally stabilize our blood sugar levels, but the reality is that most people, or at least many people, are going to have a difficult time with that, yes, and I think particularly in this second book. this new book The testimonies I love reading them you know you mentioned eating disorders there is a true testimony there is a testimony I don't remember which book it's in about bulimia and how a young woman I think with bulimia said that your method has really helped them and before they answer I have a lot of ideas about what you just said and you know I've been trying to communicate health messages to the public since maybe 2014 now through TV shows, books, podcasts, whatever it is, yeah, and you just Ya I can't communicate health information and not get pushback, and the reality is that not all information is for everyone, right?

I think I try, like you, to be as compassionate as possible in posting that information and now I can be relatively indifferent if and when. pushing back goes back and forth yes, I can actually learn from that, that's a good point or I don't actually agree with it or I can see that that person is really being triggered by something this is not about me, this is It's about them, right? I think taking a compassionate approach has been really helpful. I understand what you're saying about type one diabetics and I can understand why certain members of that community may feel that way, but technology and progress will come in all forms. they are here they are here to stay they will only become more and more popular.

I think they can be a valuable tool for some people with the right education and the right context. I think it could be an amazing tool for the right people. person, yeah, and to be fair, there's another part of the diabetes community and hardcore people that are super happy that you're using one because it stigmatizes it for them, so there's always pros and cons and about diet. Frontal disorders um I really got really interested in this topic and I talked to a lot of experts on the topic because I got some comments like, oh, these rules are just an eating disorder waiting to happen and I thought it was really unfortunate that you knew that I need to qualify something that is a diet and that it is really unhealthy, unscientific, completely random and could cause some difficult behaviors, but also with advice that people need because people are dying like this and it was hard for me to get through it.

I thought, what's up? Where do I land? What is true about not wanting to encourage eating disorders and what is true about wanting to provide very important, life-changing and potentially life-saving information? But it's a continuous journey, you know, the backtracking that I try to do. learn from every single thing that happens, yeah, you get this, um, I've definitely had it when we did podcasts about fasting before and I've thought a lot about this, it's that irresponsible, should I do it and where? I've landed, you know? I try to warn him. I try and make sure that in the introduction of each podcast we say that this may not be suitable for people who are recovering from or suffering from eating disorders, having said that some people with eating disorders find fasting incredibly helpful.

I know that CU people feed each other and let's also look at what's happening around us. Know? In the United States, what is it? 88 or 90% of people may have metabolic diseases. Stabilizing their blood sugar level will save their lives. Yeah, exactly, exactly like that, and I think we all know it's hard because I know sometimes it's parents of kids who struggle, they have like a 12 or 14 year old kid who's really struggling with an eating disorder and then they they come back often. and I can totally understand feeling very defensive and upset when you see certain posts but I'm not sure I have the solution other than trying to approach these things with compassion.

Yes, I don't know because not everything is for everyone. and then you know you also have to remember that of the people who read your books, listen to your podcast, and read your content, 99% of the people are very excited and happy, and then there are some people who get triggered or upset and comment and that's what we see well, but it's not really representative of reality, that being said, I think you know I'm in the same boat as you, that is, I try to learn and be as respectful and aware as possibleand then once I feel like you've done the right thing if someone still doesn't like it, well, you know, so be it, Jesse, it's been a great pleasure talking to you, it really has been.

I mean, we haven't even scratched the surface of what's in you two. books and I can see why so many people follow you online. So many people have been moved by your work. You are making a real material difference in their lives and therefore in the lives of the people around them. That's something I'm passionate about. You can change. You don't just change a person, they have more energy, they are less moody, they are less irritable, that affects the way they parent, that affects the way they are with their partners, how they are with their co-workers, so I think the work you're doing is so important that this podcast is called feel better live longer when we feel better about ourselves we get more out of our lives.

I think you would probably add that when we have stable blood sugar levels we get more out of our lives. Absolutely, how can you make a disease go away? But I think it really speaks to what our definition of disease is. I have been a doctor for almost 20 years and I can tell you that most of what I see. I would say that probably 80% of what I see is driven in some way by our collective modern lifestyles and when we change our lifestyles in the right way, I have seen many of these so-called diseases disappear, that is what I managed to demonstrate .

In my BBC show now shown in 70 countries around the world, I've shown things like type 2 diabetes, you know, gone away in 30 days, a change that's proven to be sustainable 2 or 3 years later, uh, seizures. Panic, attacks, anxiety reduced by 70, 80% in just 6 weeks by making these changes, chronic back pain for 30 years, just one time. We started to address the cause, everything went well and the list goes on and I realized that no matter who they were, no matter what the name of their illness was, you know what, when you make simple changes in four key areas of your lifestyle , it's surprising how many of those symptoms just start to go away.

You've said that this is the first generation that's born now that has a shorter life expectancy than the previous generation, which is quite scary, yeah, you know, in the US and I think in the Now in the UK. , also the current generation that is being born has a lower life expectancy than any generation before them or certainly in our recent history and that is quite worrying. Actually, I have two small children at home. myself and that worries me is what kind of world are they being born into, you know? Are there health problems now that are going to mean that they are going to be worse off than the generation before them?

And I think this really explains why there are so many disillusionments right now with the way medicine is practiced in the 20th century, even 30 or 40 years ago, most of what we saw as doctors, most of what that arrived and the people, what the people complained about. They were what we call cute problems, they responded very well to the kind of pharmaceutical model, the one pill for each sick model, so let's say you have pneumonia, for example, okay, this modern medicine is brilliant, so a pneumonia is the excessive growth of an insect. in your lung, right, you come to see the doctor, the doctor says yes, this is the problem, right, I will give you a pill to get rid of that virus and then within a week, within 2 weeks, you will know that your problem has disappeared, depending on the model. of the medicine that we have now responds, you know, it was created at that time, what we are seeing today in the 21st century are chronic diseases, whether it is type two diabetes, okay, it is like a modern epidemic, whether it is health problems mental in the UK, right? one in four people in any given year will have a mental health problem, whether it's Alzheimer's disease, you know, as we live longer, people now worry, you know, as I get older, you know how I'm doing To be.

Am I going to be able to function, am I going to be able to talk to my family or am I going to start to lose the health of my brain and my memory. We'll get back to the conversation in a moment. Now many of us struggle to do so. find time to eat all these amazing whole foods, that's why I'm a big fan of good quality whole food supplements like this one, which has been in my life for over 3 years and now contains over 75 Whole ingredients Food Source, vitamins, minerals, pre and probiotics and can help us support our energy-focused digestion and our immune system.

Ag1 is giving my audience a fantastic deal, a year's supply of Vitamin D and five free travel packs with their first order. You can see all the details at Drink a1.com for more information or just click the link below and now come back to the conversation, these types of conditions require a different approach and that is why life expectancy is decreasing because We are not really well equipped to address these problems because these problems do not respond to one pill for every sick model. You have to change several things. You have to understand it. And many people still don't understand, including many professionals, that these are conditions.

There may be a genetic tendency. a genetic predisposition that is not your destiny, although it does not mean that you will have that correct condition. We know there's a field called epigenetics, which is basically this whole idea that you know you're born with some genes. but your environment, how you live your life, is what shapes and determines whether those genes are on if they're off, how those genes are expressed and that's a big change actually and it's exciting because that means we're in a huge Part of us have control over what happens to us. I think that's incredibly exciting, so we need to start teaching our kids.

We need to teach our doctors. We need to educate the public. We need to change the spirit in the schools in the institutions to help. We foster a community where health is absolutely valued at the highest because if it's not right, we're going to have difficulties in our lives, so you know, I've watched a lot of your videos Tom and you know when I talk about trying to make a difference, trying to live a meaningful and purposeful life, proper health is an ingredient of that, when we feel better, we live longer most of the time, the problems that people tell me about disagreements they are having in the family.

The disharmony that they have is often because they don't feel well, they are putting the wrong things into their body, whether it's food, they don't get enough sleep, which changes their hormones, which makes them cranky, which makes them causes tension with your children, with your partner, with your co-workers and everything starts to add up and I have realized that often my training has taught me to suppress that Downstream symptom with a pill without really going against the grain and discovering well what is causing this in the first place. and the approach that I try to take on my TV show with my patients with my book is really about saying we've overcomplicated health, right?

I want to simplify it and we've focused too much on one area, so obviously everyone talks about food when Talking about healthy food is an important right, but it's not the only thing there is. There are other factors that I would say are equally important. Even if you had asked me 5 years ago, I wouldn't have known that you know five, six years ago, I thought. It was all about food, right, but I changed my mind. Now you would be better off saying that your diet is good enough, maybe the fact that you are on Netflix or YouTube until 1:00 am. m. every night and you only sleep 5 hours. hours per night, in fact, if you go to bed 1 hour earlier you will find that you will get more bang for your buck than trying to eliminate a little more sugar from your diet.

Yeah, one of the most interesting things about your approach is this whole notion of Lifestyle over diet is more important than that and I thought, wow, that's pretty radical and 5 years ago I would have said the same thing. I was at the top of building Quest Nutrition. I thought the answer to everything was what you were eating. 100% for me too and then my wife ends up having this catastrophic problem with her microbiome and it happened like this, she went from not feeling like we have a problem to our life being put on hold for a year because she just couldn't. eat and she was malnourished, it was really scary at one point and I thought my wife's diet is perfect so clearly there is something going on here that I don't fully understand, part of it was that my definition of perfect was totally ruined and Then, The other part was that there are many other lifestyle factors.

We talked about this notion of the threshold effect, which I think is very important for people to understand. Yes, it's the idea that we all have our personal threshold. Well, that's how I explain it. If you were in my clinic with me right now and I practically go through this with every patient, I say look, let's say you were born in perfect health here, we have this kind of staff, we have a threshold, so we can deal with multiple insults to a certain extent, so it could be, you know, bad diets, the fact that we don't move much, we may have broken up in a relationship, which is a stress on our body, we may have a job that we don't do.

It's not like that, everything is strengthening us, it's making us stronger, we're getting closer to our threshold, that's when they get sick. What I mean by that is that often a patient comes to me and says, "You know, doctor, I was fine, everything is fine." Okay and then you know I changed jobs. I don't like my new boss and then you know they suffer from autoimmune diseases. But when you look at his story, you see that things were not good at all. You know we are. We are very resilient as humans, we can deal with a lot of stresses, but there is something that is like the straw that breaks the camel's back and you can find the last stressor that tilts you and pushes you to the right side, but when it is gone you exceed your threshold. often it's no longer about eliminating that last stressor often you have to go back to the basics and building from scratch again it's like you know if we were juggling balls.

I often say that you know in your life when things get tough. busy you can juggle one ball, two balls, three balls, four balls and then someone throws a fifth and what happens, everything falls over and you know, we always look for what that is. Can I tell you a case story? This is a very typical patient of mine, but he was a guy in his 50s, I think he's a 52 year old guy, right, he has type two diabetes, now he's a successful businessman, he goes, he goes, he goes all the time, right, it's, you know, working. weekends working hard, he's always on his email and he was diagnosed with type 2 diabetes so he saw it on TV in the UK, he watched my BBC show the first series and he saw what I did with that diabetes patient type 2 so he drastically reduced the refined and processed carbs in his diet they were fine and then he read other blogs and really became obsessed with the low carb diet and was getting some changes right when his Bud was going down but then he became He stalled and was getting frustrated because he kept reading.

On more and more blogs he kept cutting his carb intake and just wasn't getting anywhere, so, you know, he ends up on my wait list. He comes to see me and I remember going through everything with him and I thought to myself. This is no longer a question of diet, because he did not realize, like many people, that his stress levels contribute to his blood sugar levels. The quality of his sleep contributes to his blood sugar levels. It's not just his diet, even diet is something. we can get it, you know, we eat a little bit of sugar that will raise our blood sugar, we understand that, but we don't do it well and there are some really good studies on this, if you only sleep four to five hours a night for six nights, okay you are 40% less good at controlling your blood sugar right you become prediabetic after 5-6 days just from lack of sleep it's amazing when you start to understand that you think well Of course we need an approach more balanced holistic to help these people, so this guy, so what I did with him I said, look, your diet is great, okay, you could say it's too good, you could say you're almost trying too hard now and It's stressful.

Outside, I said it's sleep and stress, so I talk about these four pillars, right, I talk about the movement of food, sleep and relaxation, which is not about perfection in any pillar, but about balance between the four . This approach requires pressure from people, it is not. about the perfect diet or the perfect gym Recreation scene is about making sure your D is good enough making sure you move enough making sure you're doing something for your sleep and something for your stress levels is an approach that works in the in the short term, but it will also work within six months, within 12months, so in this talk with diabetes with type two diabetes we came up with a system, I said, look, ideally you would have a 90 minute change before bed where you don't check work emails you don't use your computer says I can't do that 90 minutes no way I said okay how about 30 minutes so he's doing well so let's start with 30 minutes okay?

We also agreed to the consultation. I told him about meditation again. He was a little skeptical about meditation. I said, "Okay, look, listen to me here. I tell you what, we're going to get an app right, so we download an app at the clinic." This is free, you know, all I want you to do is commit to spending 5 minutes a day, okay, so all we agreed on was that 30 minutes before bed he would turn off his computer, his technology, and his work emails. , and the. He would do five minutes of meditation a day with his app.

Okay, that was it and start again. He comes back in four weeks and is fine. I'm already starting to feel better. You know he's sleeping better. He feels less anxious and stressed all the time. So that was my way in, then we had to increase it, so it was an hour at night. Well, it was only limited to 5 minutes of meditation, but then we introduced something I call the 34 five breaths when you inhale for three. hold for four and exhale for five and he did it several times during the week and slowly started to introduce these practices and increased his carbon intake because I said you're being too aggressive, you don't need to be like that. aggressive when consuming carbohydrates, okay, 6 months later, the guy's blood sugar is no longer in the type two diabetes range, okay, so he increases his carbohydrates, improves his sleep, reduces his stress levels and your blood sugar starts to drop and that's why I'm so passionate, Tom, that when we take this comprehensive 360-degree approach to health it not only produces fantastic results, but it feels more accessible and more attainable. for the people.

I have countless more case studies like that, but that one. I think that's pretty counterintuitive because you know five and six years ago I was using a lot of what's called a low carb approach with my patients um and again I'm not a big fan of the term auto low. I think the beautiful thing about this is that it simplifies the concept, so you know so clearly that people understand it, um, but I think you know we've done it unfairly. fat demonized for 304 years. I'm worried that we're going to do the same thing with another food group in the same way and I think ultimately you look at these blue zones around the world, these areas around the world where people have gotten high. longevity

weight

s, they are living to an old age in good health and if you look at what they are doing, I find it really interesting because a lot of them are on high carbohydrate diets like in Okanawa in Japan.

We are having an 80% carbohydrate diet, but the carbohydrates are not the refined, processed carbohydrates that we have here in the west, they are local sweet potatoes, which is very nutritious. You mentioned the gut microbiome of sweet potatoes and that kind of Colorful vegetables are fantastic for our gut health, absolutely fantastic, and in fact, I think that's what keeps all the diets around the world working well. I think the common thing is not the carbohydrate content or the fat content, the common thing is that they are all minimally local. processed food that nourishes our microbiome, that's what I think is the unifying factor and the other thing that I think about when we look at these blue zones like okan and try to really figure out why they're doing so well.

Finding out what's in your diet, that's the magic, but it's not just the diet, it's the whole lifestyle. These guys have low stress levels. They sleep well. They are physically active every day. They prioritize the community. That's why those guys. they're healthy, right, it's not just one thing and I think why this low carb approach seems to have such an incredibly beneficial role for so many people in the west. Well, I think what's happening here in the west is that we're physically inactive. We don't sleep well, we're overly stressed, we eat highly processed foods, okay, maybe it is, and all of those things make you insulin resistant, which is what actually leads to type 2 diabetes and is behind many cases. of obesity, maybe it is in this environment in our environment highly stressed and little sleep Western environment maybe it is in this environment where the low car approach has such a beneficial role maybe those guys stay below their threshold in a way different they don't need to be so aggressive with their carbohydrates, let's say because they are you know they are sleeping a lot, they are reducing their stress levels.

I think food is much more than fat versus carbohydrates, but good health is much more than food, right, wow, that's really strong, yeah, I've always been interested in it as a doctor. As for what works in real life, right? I love research papers, I love science, but I'm more interested in how to turn that into real life action for that person sitting in front of me and I can tell you you know one of my, um, one of the things most popular in this book is what I call five minute kitchen exercises and this again came from a need that I saw in my patients, so you know, strength training is very undervalued in society, you know, when we talk about activity, movement and exercise, we're always talking about, you know, walking more or doing more cardio or there's something wrong with that necessarily, but we neglect strength and once we hit 30, once we get past 30 years old we can lose 3 to 5% of our muscle mass each decade.

Can we lose even more after 50? And you know that your muscle mass independently predicts your mortality. It is one of the strongest factors in determining how well you do. be when you get older, so I was looking at all the research on this about five or six years ago and I remember patients coming in and I said, "Okay, guys, you know strength training is very important, you know I want you to work ". I go out for about 30 or 40 minutes three times a week, you know, maybe go to the gym if you can and I thought, "Okay, sure," I told them, I told them about the research, they came back 6 weeks later and said, Hey guys. , how are they?

Hey doctor, you know I've been busy, you know the gym is a little expensive, it's not on the way back from work, I haven't really done it much, I thought, okay, clearly I'm not giving them advice in a way that They feel that it is practical for them what they feel they can do in the context of their life, so I have to do something better and at that moment in my consultation room that F minute cooking exercise was born I said, okay, I I say it. Let's forget about the gym, let's forget about gym memberships, forget about buying equipment.

I'm going to show you a workout that you can do here and now in your kitchen. I have patients who are 20 years old doing it. I am 70 years old. patients who do it can modify it for any skill level and you know I believe that by setting the bar low with people correctly and getting them to feel good about themselves, they start to do more, these are simple approaches that work in life real, yes. All the science is there, but the science interests me, but it doesn't dictate what I do. I have to turn that into what will actually help my patients, real-life people with busy jobs, busy lives, right, who want to be healthy.

I want to talk about the program for a second because being with people who live with them for four to six weeks and going in there, what are you seeing? They're patterns of um, I'll call it bad behavior, but that's not what I mean. like the moral sense, I just want to say that it has an unintended consequence that you may not even realize and then what are some of the solutions that are these simple things? So in the movement pillar you have something simple that they can do in the kitchen um, but what are the things that you see over and over again that people do wrong to have a really simple solution?

So I'll tell you a few things, yes, the food was very big, there's no doubt you know that when you open people's cupboards. you open their drawers and you see what's there, you see the nauy drawers and you see the things that are there and then you don't just look at what's there, which is basically all the highly processed food, it's all the sugary delights that live inside the house well, but that's when you look there you see the family Dynamic you see how the wife oh you know that's not mine that's all he always brings that I tell him not to bring that he goes no no the husband says no no that's not him case at all, I brought them because you like them, right?

You see that in every house, so obviously there's this dynamic that, you know who's responsible, you know everyone's inadvertently shifting the blame to other people, it's not me. You know I'm doing it for the family so I find it quite interesting so one of the solutions is to control the environment you can control correctly if you're trying to make healthy choices let's say the foods are right don't stick with that . things in your house, so I tell you when you walk out the door of your house these days you have to exercise your willpower every step of the way, you go to a gas station and you go to pay, you are walking past all the chocolates or the bags of chips all good you have to exercise your willpower there if you want to buy coffee in a cafe you just stand in line you order raisins next to the muffins the cakes the Quant you are constantly having to use willpower when You leave your house.

What I'm saying is don't use it inside your house, if you really want to make those decisions and you want a sugary snack, you know, have it once a week, once every two weeks. Weeks when you go out and meet your friends and sit in a cafe and drink it there, don't bring it home because what will happen is that you will come back tired, you will come back stressed one day from work. You will feel a little depressed and start gorging on what is in the house. You know, a few months ago I came. I was having a very stressful time at work and all kinds of things were happening and I was sitting at home at night with my wife and I thought, you know, I feel like something sweet, but I looked in the cupboards there were nuts, there were olives, I thought , you know, I don't feel like it, but look, I want something sweet, but there was nothing there and you.

You know what 10 minutes later Craven says? It's what I call itchy mouth. I'm not hungry, you just know, I feel like something to put in my mouth. So you know, controlling the environment you can control. I think it's something very important. I taught all of those families how to do it and although they resisted at first, they really saw the benefit. Two things I want to delve into a little bit more, so number one, do you ever get into the psychology of, oh, I've got this for you, no, you've got this for you, what are you talking about?

Do you ever like to put a finger on it and say, hey, let's talk about what's driving that, yeah, absolutely and more these days than I used to because I've realized that. People have very powerful emotional attachments to why they do certain things. I'm going to tell you about the first day I filmed for this documentary series. This is the first family. This is me. I came to this town called Sho in the UK and you know a bit nervous because I'm the creator of the camera that was going to see me be a doctor and try to help these guys well the first time I did it and I met the lovely family that has been struggling with his health completely. variety of health problems and I said guys, what would you normally eat well?

Then the father tells the family. Hey guys, you know, tonight, as always, he said yes. Dad, as always, please, he says, come on doctor, come with me, so go sit in the car, we drive 15 minutes out of town to go to a McDonald's on the way, the guy tells me, he says doctor, You know what I know, this is not good for us and it is really very embarrassing for us. Actually, I'm going to take you here, but this is what we do well and I don't think I fully understood it back then, but I've thought about this a lot since then and that is, these guys knew that these were not healthy options.

I knew it, but it's only when this third party shows up, someone who has no emotional attachment to this family, he starts to feel really guilty and feels like he feels like he has to apologize to me for the decisions he's making, and that he's the first one. Anyway, he doesn't need to apologize, but I found it really interesting what's going on there. Why do people make decisions that you know don't serve them? Why do you think they really do it? Because I think those decisions you know, I think. those choices on some level nourish them, you know, they, if they are lacking something in some aspects of their life, they are getting it, they are nourishing their reward.

Ways, you know, a lot of people will eat to feel better, you know? You had a stressful day at work or you're feeling a little low. Food is a comfort to them. Food helps them feel better about themselves,even if it is for a short period of time. You know, we all know that feeling. If we eat sugary treats, you know we can. Feel good, yes, you know that, so we intuitively know that food can change our mood. There's a lot of science now behind all that, but I think it's because on a deep emotional level, maybe when they were kids they were conditioned to you know.

You don't feel so good, you feel good, oh, should we have some nice sweet option and this particular family, for example, again you know dad would say I buy these things because it makes my wife happy, she really likes? So, in some way, he felt that he was doing something very good for his wife, you know, his wife really enjoyed that kind of food, so he felt like a loving husband. I'm going to give it to him, you know, that's how I feel. On some level, he felt like it was him helping you know the part of him being a good husband, um, but I'll tell you with that particular family that when we went to McDonald's and he ordered the food and what was amazing to me. is that he ordered, it was about 48, that number is locked in my head, so it's about $65, $70, maybe something like that just for a meal for a family of four, but then we went back to the house with the right food and look at this we get there and in the kitchen they have right trays so they have McDonald's trays in their kitchen so they serve the traits and they serve them so this is what happened so the sun is sitting on the dining room table. eating alone while flipping the phone at the same time, okay, I think the mom was watching TV, okay, and she was eating while watching TV, I think the daughter might have been on the phone in a different part of the living room and I don't remember where the father was.

The point is that there was a family of four, the food was ready at the same time but they were not eating together. Okay, they were mindlessly eating while also, you know, sending their emails by texting. Their social networks update whatever and that is why the intervention that I did with them and I did with many of those families is to have one meal a day with someone else, if possible, sitting around a table and I tell you, Tom, that That was transformative. The whole social connection piece, when and one of the recommendations that I make in the relaxation pillar is that you eat around the table for at least one meal a day with another person, if you can, you will eat less when you do it well, why what, why, because you are If we don't eat mindlessly, we can easily overeat when we are doing something else.

There's a study that shows that if you eat while watching TV, you eat a lot more. Well, we know the feeling I get when I used to watch a lot of sports games on TV with my friends and that would be like a plate of chips or tea chips, right? How many of those things can you do while you're there? while watching the game, yeah, it's super interesting the way people treat food when you're talking about sitting there with your friends watching a show, or probably watching a sporting event honestly and just chowing down, and I thought it was a wave of I want doing that right now washed over meat because it's deeply pleasurable and one of the things that I think is so difficult when you're trying to make these kinds of global changes for people is that we optimize for the short term. pleasure with complete disregard for the long term consequences and even in the story where you were telling about the husband, oh he makes my wife happy and I want to bring him home, but at the same time I have seen some of your episodes.

The effect of things like that is also that she doesn't feel well, she has fibromyalgia, she has constant pain, she has a box of similar supplements that she's taking to try to mitigate some of the lethargy or you know, the symptoms that she has and that's it. I mean, yes, in the short term you're giving him a drug-like effect and that changes his mood, but then it starts again in this whole cycle, which, without addressing that whole relationship with food as essentially a drug , I do not see it. how long-term people get to the other side of this, so let's go over the four pillars real quick.

I know there are no universals, but I just want to get an idea of ​​what the problem is that you think is some kind of problem. The biggest problem, easiest to see, in each of the pillars and then as we move forward, what's one quick thing you want people to do per pillar? Well, I'll tell you what, so let's start with the food, we just talked about food. I would do it. I mean, for people who are struggling with their diets and what to eat, I would say: why don't you focus on when you eat? Interesting and very powerful research now, a lot of it coming from the sulk institutes in California, where we're showing that when you eat is possibly as important or certainly critically important as what you eat, so initially a lot of research has been done, especially in animals, which show that if you restrict food intake to about 10 to 12 hours, okay, okay.

Well, you can eat whatever you want for 10 to 12 hours. Well, you get improvements in your weight. Improvements in your blood sugar level. You improve the functioning of your immune system simply by changing the times you eat because what happens when you go over a period of time? where you're not eating, so once you haven't put food into your body for about 12 hours, we think that a process called autophagy has started. Autophagy is like cleaning your body's house, so it's like you're in your kitchen if you don't do it. Not cleaning every day if dishes started piling up at the end of the week, it wouldn't be a very pleasant kitchen to walk into when we don't eat for 12 hours, when that autophagy process starts cleaning. the mess that has built up and that is that the magic number of about 12 hours looks for different people, it will be different things, but you know, 12 hours a day where you don't eat for most of us, autophagy will have been activated, so what and the The reason I stick with 12 hours is because it can be achieved.

My approach is not about perfection in one particular area, but about doing a wide variety of different things and that's what synergy is, that's where the magic happens, that's where you start to have all these different paths. That the body provides information is not enough to make changes in your life. You have to take action. To help you take action after watching this video, I've created a free nutrition guide for you that contains the five most important practices I've seen. In more than two decades of caring for patients, they work for you no matter what your dietary preference.

There is a step-by-step action plan to help you implement those changes in your life. If you want to receive that free guide right now, just click the link. in the description box below, sure if you think you're going to get more benefits with 10 or 8 hours, fine, go for it, but I'd rather people go, yeah, I've got a tick there, I'm going to move on. to another, okay, so we have our brand there and that was good because it wasn't what I expected you to say, so the food is ready, what are we going to do next?

Okay, I think if we go with the movement, I would say Don't neglect. Strength training is fine and I would say do strength training, whether it's bodyweight, whether it's my 5-minute cooking workout or your favorite workout at least twice a week, but my approach, whether it's the recommendation of food I just made, whether it's the movement recommendation, just done or the sleep or relaxation ones it's about Simplicity, okay, that's what I would say and moving, so that's food and movement, okay, sleep, it's okay. I think this is possibly the most underrated pillar of Health, that's okay, because in 2018, if you are not prioritizing. you sleep, you're probably not getting enough sleep, it's just endless distractions, we all know that feeling that we still stay up late watching more and more content and again a lot of great content, but it could have a consequence so I can say it .

You know that most people who have trouble sleeping are doing something in their everyday lifestyle that they don't realize is affecting their ability to sleep at night. Okay, so my two main tips would be to not try Tech 90 and have 90 minutes beforehand. bed without technology, but the counterintuitive thing is to go out in the morning, right, a lot of people don't realize that these daily rhythms are set by light, in order to sleep at night, okay, you need a differential between your maximum light . exposure and its minimum exposure to light, so a dark room has something called zero Lux.

Lux is a unit of light, if you go out on a sunny day for about 20 minutes you will get around 30,000 bright lights, that is a really big differential if you have On a cloudy day you will get around 10,000 15,000 looks right if you walk into an office well lit in a modern, well-lit office you will get around 500, maybe 1,000 looks at most, so everyone is thinking about what they do before going to bed at night, but one life-changing tip and this has transformed the life of many of my patients is to go outside in the morning for half an hour, even that will help you sleep at night, what if I live in a super cold place and that sounds like the pain is sitting next to a window , going to work, no, you have to go outside, okay, okay, and I review, there are many ways you can do this.

You know, in the UK in January it's not so easy to want to go out. It's dark, often it's dark until 8:00 a.m. m. and it gets dark again at 3:30 p.m. m. Sometimes I put on my fleece and sit outside and have my morning coffee outside so I can expose myself to the light because it's fundamental to how we are as human beings, we need natural light, okay, and last but not least . relax, okay, relax again, there are a lot of suggestions, but I think the one I'm going to choose is 15 minutes of my time every day, okay, something for you and only you, something that doesn't involve your phone smart, it's fine and you're not allowed to do it.

Feel guilty about it, it could be anything important, you can literally be sitting in a cafe and enjoying your cup of coffee, but not rushing, drinking it and trying to do a million things, just sit there and people watch or just sit and read a book, right? We have lost stillness in our modern lives and we need to get it back. You are the architect of your health and happiness. You understand what works for you and what doesn't, so the locus of control has to pass from the doctor to the patient. The key to healthcare transformation is the doctor in charge or the patient in charge and the group is the structure by which that Locust can be transferred and trans and in which the patient can really participate, so let's get into it.

What people think about medicine today. If I have a problem with my health, whatever country I live in, then it might as well be an iPhone to make an appointment with a health professional, maybe do it with someone else, but because then I can tell that person about my problems, yes, and they with their training and experience can really tell me what is wrong and what I should do, yes, and the benefits of that for me are or the benefits sold, I am going to get advice from an expert, yes , from a professional, my medical care is private, I don't.

I don't have to share it with anyone, this is a private thing and I got a one-on-one consultation, but what you're doing with the groups shows that this model we're used to affects every healthcare system I know. Yes, they are fundamentally problematic for many of the conditions we see. Yes, let me give you my favorite example. It's actually here in the UK. Dr David Anwin, NHS Innovator of the Year 2016, what is he doing in his practice? So the first thing you figure out is that type 2 diabetes is reversible with diet and you know that better than anyone because you did it on the TV show like four times, so you realize that, but it's pretty laborious to do it in one go. individual visit to the GP when you have a million other things to do, so Dr David Anwin starts these type 2 diabetes groups, which are essentially community support plus a low carb diet, is pretty much what es, so you implement it in your GP clinic and over the next 5 years you

reverse

type 2 diabetes in the majority of patients who have type 2 diabetes in your clinic, the savings on medications just from doing that is 70 , almost £70,000 in that clinic and they have shown and this was in the bmj that if you extrapolate that to the whole NHS, you would save £270 million, a quarter of a billion pounds, a chronic condition, you would just make way a little bit differently in a group supported in that way, so you know if We're here if we want to talk about transforming the NHS and you're looking, you know what kind of examples we need to get out of the pandemic into the future, look at that and say Look, is there an example? is a good example of what we are looking for: lower cost, more access, morelove, more responsibility, more support, more professional satisfaction, the patient is getting better and is not dependent on the healthcare system.

I mean, that's amazing and you think those savings should be had by anyone anywhere. the health care system should be improving and going well, how do we do it? You obviously know how to do it because you're doing it well and I'm very hopeful that what you're doing in America is going to be able to bring it to the UK very, very soon because you're finding out what the obstacles are, what the problems are, we get to that, Right, but what does a group have? So what did you say the most before? A powerful thing for someone who struggles with their alcohol consumption and you know they want to cut down and ultimately quit, yes, is meeting another alcoholic who no longer drinks, what is the magic in the group that they are not getting from the experts , Yeah.

There is a key person that I would use the term that I would use is a health coach, right, and that is the term that we use in the United States and essentially the health coach is not a health professional, it is not a dietitian, He is not a nutritionist, he is really something like that, in my opinion, he is the equivalent of the Alcoholics Anonymous mentor, the sponsor, he is someone who has overcome a chronic illness, has learned a lot through that process, has the lived experience of illness, they have the lived experience of the opposite and now they can be a kind of peer leader where now you know someone you know and you can essentially leave space for someone else to come to their own conclusion, support people to come to to that, so in the groups that we run, we have this health coach in the model of Dr.

D. Dr. Unwin, what he realized is that the first people he helped

reverse

their type diabetes two at the clinic put them in the right group, so it's not just Unwin saying, hey, science says this. this is the most optimal look at the science it's like here's Jane and Jane did it Jane tell us your experience you know when we run these groups I'll tell you something Al so now we're doing it virtually like you would I love this think about when you walk in At the first Zoom with a group of people you've never met, most people have their camera off on zoom because what is this?

I don't even know what I'm talking about, you know? What is the first thing the coach who organizes these groups does? What is the first thing they do? They share the story of their own chronic illness. How painful it was. How traumatic it was. The effect on his entire family and then finding this. new operating system of care, lifestyle, medicine, starting to take care of themselves, learning and then their journey back to not having the chronic illness, that Bing Bing journey is just the zoom cameras turning on because people are feel safe to be seen because It's Me This reminds me of one of the biggest things people complain about to me, whether in person or on DMS on social media, is that I don't feel seen or heard by my doctor. .

They didn't really take it seriously. I don't feel like they really cared. Now let me defend the medical profession for a moment. I understand that the system makes it very difficult. Sometimes you know if you're working in a model where there are 10. one minute consultations, but even if I can do that as a doctor, it's not as good as someone who has had the same experience as you and I can see how that would be so powerful when of Suddenly that person says yes, I understand, it's difficult, you know? I get it, sometimes it has an impact on your relationship.

You don't want to get out of bed. Your children need a ride to school. You have no energy, that's what connects you to another person. Now, suddenly, that has more resonance, it's more, it's more. like, oh, and you know those struggles, you know how it feels and you've made it through to the other side, okay, tell me more, now I'm really engaged instead of the approach the more distant, the less engaged I might be in a more conventional, a sort of one-on-one appointment system with a doctor, yeah, I mean, the question I would ask anyone listening to this is, if you have a chronic illness, how many other people do you know that have had that Chronic illness? and we reverse it and if the answer is zero, you need to find those people and they are out there, they have their own podcasts and books and other kinds of things in almost all conditions, but ultimately, there is something very important to learn from someone who has been in your shoes and most people who have a chronic illness feel extremely isolated because they don't know anyone else who is going through the same thing, if you are addicted to psychotropic medications or pain relievers you don't know anyone who is and ultimately those relationships may not be empowering and ultimately what we've seen is that if you can find other people who have taken the journey that you're trying to go on, there's a shared resonance, there's a shared experience that people feel. safe, that's the great sense The community sends the safety signal, here you are safe, this is a safe environment where you can share because I am starting by sharing my experience and now it is safe for you to share and watch.

Some people feel safe right away and say, "Oh, great, I've been waiting to tell my story," but for other people it takes weeks or months and that's why the care episodes we've done are a group of six months, right? What does that episode of attention mean? So, in our model, when a doctor prescribes it, the group lasts six months and the goal is that each month we focus on one of the pillars of health, so the first pillar is the community. and connection, the first month is really about can I build trust in this Collective? Hence the first question, which of your friends, which of your community, which of your family is going to support you in this change, so that everything fuels this first month.

Pilar Comunidad, yes, other things we do in that first month. Smart goals. Everyone who has ever made any kind of change in business or coaching knows smart goals well. So what is your goal for the next six months? Do they have enough time? To do something truly transformative, what do you want to do and have it come from you? It is no longer the doctor who tells you that you must reverse your chronic illness in the next 6 months, it is as if I were to reverse my chronic illness in the next six months. That's what I'm going to do and it's like an internal motivation that comes from them.

The other thing is how I got here. How did I end up with a chronic illness? One of the things I think people hate the most. it's that in their mind the doctors were telling them it was like healthy, healthy, healthy, healthy, healthy lupus, it didn't go down like that, the body was breaking down over time, which eventually leaves a marker to be at a point in the that you have lupus. but it was a slow dysfunction, you know, over time you became more and more dysfunctional and then at a certain point your hemoglobin A1c goes over seven and you have type two diabetes, but something was happening before you were just not. healthy, it didn't happen well so I really understood where the illness came from so it was like the first month and then also we Pro matched people with what we called a progress partner when we started it was a responsibility. dude it turns out responsibility isn't that sexy and people don't want it but you just call it progress buddy and everyone's like oh I want progress that's cool so it's the same thing but you changed it to be something that people want, so, um.

Second month, what do we do in the second month? What is the one thing you can do that will make the biggest change in your chronic disease potential? Which is the answer? Change your diet and foods correctly. So, in that month, the objective of this program. With each month it's can I make a permanent change in what I eat now? The reason you need a month is because you need time to fail, try to do something, fail, come back to the collective, share why it didn't work for you and then we kind of change the plan, whatever the plan is, yeah didn't work, why didn't it work, deal with it and then come up with something that will be real and that's why we have challenges and The challenges are really simple in the third week of every month.

The challenge is like eating some new vegetables. Guess an example. What is the importance of someone eating some new vegetables in their physiology? If you then do it during the next 5 months. It can be transformative, right, there's that, so you know, month two, month three, stress, how do you manage stress? How do you know what your ways of dealing with stress are? Can you try some new stress reduction techniques? month four sleep, you know, I've heard you say a million times that a good night's sleep starts in the morning, so we really focus on what your morning routine is, sunlight, having good sleep hygiene, not having the phone in the room, you know, we've There were some people who went through the group who are doing all this perfectly, but their smart goal is: I want to change my relationship with social media.

It could be that kind of thing like people have their own goals and that's the point, it's not like that. like the doctor says, you know you need to do this, it's like people come with their own, the fifth month is general movement, it's like creating regular movement and structures where you can move every day and then the sixth is your environment and So what you see, if you make a permanent change in each of those things, in the end you are a dramatically different person and the results show it, so anxiety, depression, pain, fatigue, having difficulty sleeping In our groups, the vast majority of all those who have these problems. the groups have a remarkable transformation in those 6 months a clinically significant reduction in those areas, you just know that many of the best ideas are so simple in their calling, yes, you know, it makes a lot of sense.

I'm sure everyone understands right away if you're doing this with other people who are trying to do it at the same time you have the support hey I tried to do that guys I fell off the wagon you know this happened to someone . otherwise, you know, I get it, I did it, but this is what I've tried, this is what I helped, it's um and the fact that you have a month in each pillar and the request is that you only make a permanent change in that. month, it becomes very manageable, yes, you know, it reminded me before March 2020, yes, this podcast had a lot of podcast clubs around the world, certainly in the UK there were, I think, at least 60 or 70 in the United Kingdom throughout the country where people gathered. they were meeting with other camps, better live more listeners and they were going to WS together and discussing the changes they were making from the last episode and in fact I was about to attend one near my house, they invited me, I thought I'd love to go.

So whoever it was, if you get back in touch, I'd love to start coming, but I think it's even if you take a podcast. People often listen to the podcast while out for a walk or alone somewhere. Yes, and the conversation may inspire you. Think about your lives differently. Yes, I want to make that change. Yes, but then they have to go back to their normal life with their friends and their community and often it's a life that's the reason they've faced a health problem in the first place, their life actually. , in some ways it doesn't support the health outcome they want, it actually supports the health outcome they currently have, yes I know it's very obvious when you say it like that but then the onus largely falls on how I make this change , how I make this change myself and it is this power of the group.

I think I want to go back to your example in just a minute, but if you take it outside of medicine for a minute, yeah, think about the prices that people like to do, let's say yoga, like a lot of people like to do yoga and Because of the busyness of life, and how many things people feel they have to do these days, it clearly saves you time if you do it. a yoga class online or from a YouTube video, you don't have to go, you don't have to travel there, you don't have to find a parking spot or whatever you can do, so yes, it can be more efficient TimeWise Make it at home, but really again we're missing a big part.

There's something about being in person with 20 other people who also want to practice yoga and the interactions you get beforehand, the difficulties that other people may have and then you see what the teacher says. to them you say oh you know maybe that's what I am you know there's something about being together I don't, of course, it's not or, but I often tell my patient that if you like to do this at home, I'll do it. you do 10 to 15 minutes per week. day on Zoom or on YouTube, if you can also go to a real life club or a class where you are surrounded by humans and it really is transformative, isn't it when we interact with these groups?

Yes, super transformer. There's another amazing example from the UK that I love to share with you because I suppose the question might make people wonder: what does this look like at scale? Could it really bea transformative agent for the world? If it was made and right in the UK there was another big For example, it's actually quite close to where I grew up and it's a town called FR. In fact, you've had it on the podcast. You know their thesis was exactly that people are alone and that's what drives them. You know these health outcomes, so in Fr, which is 115,000 people, what?

They thought: Can we solve loneliness? Can we cure loneliness in the city of FR and how are we going to do it? There are five doctor's offices, so they hired a trainer for each of these offices. The trainers spent half their time in the clinic. talking to people and half the time in what they call these talking cafes right where people sit in cafes and actually just meet with people, but the key thing they did was they took an inventory of every group that they was happening, not just in Health. groups, but all kinds of groups, church groups, sports groups, men's groups, they took a big picture, there were 2,000 groups, they narrowed them down to 400, they were regular, anyone could join, they had a consistent location, a consistent location, and essentially, this was a website where you could see and essentially what would people do if they came in and saw that these people were lonely, especially older people, they would sit down with the coach and the coach would tell them what do you like to do, what do you want to do?

To be part. what you know how to do and then say hey, look, here are the different options, which one are you going to gather this time a week in this place, go get them. The other thing that happened is that they recruited 1,500 people in the community who walk with this green. right lanyard to let them know that they are a community connector and they would just send people to the website which they had no role other than to say hello here is the website go to it and find something for yourself so in a moment in whoever knows health care costs and you know everything was going up in Somerset, which is the city, emergency room admissions went down, drug recidivism went down and loneliness was essentially solved in a small town in the UK, so at one extreme is the example of David Unwin reversing chronic disease. disease in small groups, at the other end, there's sort of a social change driven again by medicine and ultimately you know the solution to the super elegant solution to a lot of healthcare is in my opinion.

The link between those two things and Julian has said it himself since I had the opportunity to meet him is that he realized that the first thing was to include people in these groups, but if you can enhance that connection with some type of other person healthy. The behavior is almost exponentially healthier, so you know, like you said, going to yoga and doing a yoga class, so instead of just getting together and sitting, what if we spent our time, you know, doing an exercise? of mindfulness or do we really do it? movement together or we actually eat as a community, so this goes back to the first question that you ask people in the group who in your life is going to support this transformation, it's a critical question because of course for many people in their current life there There is no one, yes, but by having these groups suddenly now you are part of a new community, a new tribe where actually these people will support it and I think this too.

I wonder what the experience has been for the people who have gone. through these six month groups, um, what's been done to their friendships because it's not necessarily a thing or like you know, oh, now I'm going to be healthy, so my current friends are no longer useful to my life. because that can be very scary for people. No"I think it has to be that extreme. You know these friends can still be of use to me. I can still enjoy hanging out with them, but it really speaks down, it speaks to this idea about relationships, right?

It takes a town, right? We can." I don't expect our partner to be everything, yes, and therefore, maybe our romantic partner plays certain roles in our life, maybe our friends play certain roles in our life, and maybe our health goals can be achieved by someone else. group, it depends a lot on who you are, of course. of people have friends that they like to go for walks or do yoga or whatever, you know what I mean? It doesn't have to be a formula for everyone, it's like different people in your life help you with different needs, but have you really thought about it intentionally?

Have you thought about who is helping with these needs that I have? Yes, and you know you need time to figure all that out. Yes, of course, you need time and space and a proven process to do it. My men's group did that because Honestly, being in the men's group and being a guy who's doing a group medicine business and you know, trying to get everyone to do group medicine has actually been extremely instructive because the group Men's isn't a health group, right? The men's group is an emotional maturity group, there are many different things, but ultimately, in my group I have seen people stop drinking, stop smoking, you know, transform their relationship with their loved ones, you know, I have seen the business success in all.

That's the key thing, James, for me, right? I'm Sor, I always harp on this point, but I think this is the key point for me, as I hear what you're saying, this is not a health group, right? a health group, yes, but people are getting health results, they're having incredible health results, quitting smoking, giving them alcohol, any business success, improving their relationships, right? It's not a health group, but nevertheless, they are having health benefits and this speaks to this broader idea that many of the problems that we are seeing now we talk about are related to lifestyle and of course , they are to a certain extent, but perhaps, as you say, going Upstream even more, are a consequence of the lack of community that we all or many of us have.

We all have a couple of things in our lives that I want to say about these groups of men, they have had a transformative effect on you. A very very close friend of mine joined one about three years ago and said so. You know, he's excited about it. He says it is completely. change his life his relationship his ability to be a good father his ability to be a good husband his job all kinds of things now I've heard that I've heard it from him mhm, I just heard it from you, yeah, I'm not part of a group of men, okay and honestly, you know I spent a lot of time with my wife and my kids.

I spent a lot of time working. I love my job, but I've often thought you know what you don't. I actually have really good quality close friends who talk to myself close to where I live, yeah, you know, I don't, and I have really good friends from college that I talk to a lot, but they're all hundreds of miles away, yes, and the last one. The night was a great example for me, so I'm in London, we meet for dinner and Rupe shows up, we're laughing and I knew in my head that part of me was saying I wouldn't stay long.

Go back to the hotel room and prepare a little more for tomorrow's podcast with the guests. Know. I had a conversation called Satchin Panda beforehand, but I realized it while I was there. This is incredible. I can really be myself and you know. I'm not, I'm not Dr. Chatti, yeah, with you, with rupe, it's just me, yeah, you know what I mean and I know of course it's me that shows up, like Chasty does on the podcast, every again? who never has, but there's still something about being open and honest, sharing the things you're struggling with, sharing the things that are going well and I realize that right now I'd rather spend another two hours with these guys.

Even if I sleep less tonight, that will nourish my soul much more than sleep will nourish my physical body tonight. You know what I mean? Absolutely yes, I mean what I would give as a businessman and as a father. And even if I spend three hours of my week hanging out with a group of strangers like I did in the beginning, it doesn't seem like a good use of time because there are a million other things I could do and I can justify it in so many different ways. but it really adds quality to everything else in a very interesting way and it's nourishing and it creates security and nourishment in a way that are things that you just can't do, why are men's groups increasing so much? and why or in your opinion, yeah, why don't we hear as much about girl groups?

Is there something fundamentally different about how we are? It has something to do with society. Have you seen any gender differences in this? I suppose it is broader throughout society, but also. within the groups that you're doing for chronic illnesses, uh, chronic, well, in our chronic illness groups, the vast majority of people who sign up are women, which is interesting, so you know, I think they, uh , you know, I don't feel that. I know enough about those dynamics to really understand them, but I would say that, in general, the type of people who come forward to lifestyle medicine are mostly women.

The numbers you know, the doctors who practice it, are many women too. because I think they understand on a kind of fundamental level, um uh, nutrition support and empowerment, it's just that you know something that is, you know, part of, you know part of so, I think men need it more and more because I think that many men I realize that the competitive side of men and the kind of emotionally dysfunctional part of men that is celebrated in society in a strange way, ends up being quite detrimental to their relationships, their abilities to lead, manage people.

I work with people, I have good long-term relationships with people and I think there's sort of a new generation of men who realize, as you know, if I want to be able to feel feelings and have a truly human experience in my time here. I'm going to take a job and I don't know what to do, so I want to go and find some people who will, yeah, sure, you know, the other people in my men's group, there's a guy who's 65, there's a guy who's 60, you know? I'm one of the youngest people in the group and these are people who in some cases have been doing this work for 20 years, they still have their own thing but they're working on it, but their advice is very powerful. and it's the same energy that we're talking about with the health coach, it's like a kind of unpaid life coach, you know, it's all free, there's no cost for me to be in the men's group, it's just the only one cost.

It's that we meet in this random room in a church and we pay them, you know, a small amount to be a part of this, like you said last night, people helping people are the only inexhaustible resource we have. 100%. I couldn't stop thinking about it. that last night, yeah, I mean, look, if you look, let's say we want to save the NHS and then it's like there's not enough resources, there's a resource that's inexhaustible and it's ridiculously powerful and it's being used at 0% of its potential. We need that's what we need to build, yeah, just talking to men and women and again, these are not gross generalizations, but you know, one thing I've noticed when I go for a walk in my neighborhood is that you often see women walking with other women.

I do not do it. you know, look, you live sacr Mano, I live in the northwest of England, right, I have observed that if this is not a scientific experiment, this is, you know, just to be GL, this is just my observation, where I live, what I have I dress well, I even take my wife. My wife often goes for a walk with her friends, they meet someone. I never do that. My hike is always alone, whereas hers, I'd say 80% of the time is with someone else, so you'll catch up with someone. with them and they will walk together.

I see that around me, so I find it quite interesting. There could be a variety of social reasons why there are, of course, but whatever it is, that's what I've observed. We talk about loneliness and how harmful that is to our health, but you know, I'm really at the stage James where I really think that not having a tribe around us feeling alone and correcting that is possibly more important than the food you eat, Yes, really. I mean, there's science to show that's the case and that's huge because when we think about loneliness, a lot of people think about older people stuck alone or stuck in their homes.

Yes, that's a big problem in the UK and I suspect it's the same in the US. The loneliest group in society, I think, is men between 30 and 50 years old and that is a group where there is a very high rate of suicide, this is massive and again, that is really interesting and then you talk about these groups What are you helping to settle in the United States? Can I say one thing about that? Because I've actually seen research that says that younger people are infinitely more affected by this than everyone else because of the society that has been created.

Social media is how people connect. Research says that one in four British teenagers didn't have a friend, right? And you know there is an epidemic of mental illness in adolescents. Think about howThese teenagers connect, as if your group of friends were in a chat. Fortnite that's not healthy behavior that's not a supportive community that's people you know that's a chat stream within a video game that's not healthy in and of itself, like where kids gather to be together and not be alone technology, their sport, they used to be Church, there is no church, you know, it's like there are these structures that used to exist where children would gather and play and ultimately, you know we're creating a severely mentally ill population, you know, younger population.

I am seriously concerned about this and yet it is very exciting to see that you know what happens to children when they have access to these types of tools, like in the work we are doing. Now you know that we are selling our program to pediatricians because Pediatricians are dealing with children ages 13 to 18 who have the highest rates of mental illness and those children, because grandma is not in the community, do not receive the training that we ever received about how to be healthy in the community. It's not reinforcing healthy behaviors, so you need to go through a six-month program to learn healthy behaviors, how to deal with stress, you need to be in a community of other people who are doing it, so I really feel like this is kind of like something fundamental.

The training on how to be a human being that is missing in society is reasonable and that we must give it back and the only place where there is a budget allocated to do it is in the medical system and that is why it has to come from there. although it should just be a social treat, the pediatric thing is interesting, he said it last night of course over dinner, and for people who don't know, A has been on the show a few times, he's a brilliant NHS GP and you know this because We run a course together, as you know, called LIC drug prescribing and we have trained thousands of health professionals and doctors around the world in terms of some of these principles and many of the people that we train are very interested in the group. medicine, they get it, they can see it but they don't know how to do it, like the system isn't set up, which is where I think you can come in, but he said a very good friend of his has used an item from this group. medicine with pediatric respiratory patients, yes, that was incredible, right, and when he shared his hospital admission rate and the number of times I go to the ER, now I think it was with asthma, he said it had gone down because these families and the children , their moms and dads help each other, so what's interesting to me is that a lot of these doctors that we train want to do this, but they don't know how, yeah, right, so what have you done? learned because you are like I say, you are transforming healthcare in America, you are putting this into practice, what are people trying and doing, what are they going wrong when they try to do this, what are they not understanding, what are some of these key things that you have learned that doctors definitely shouldn't do it, that's the key, because the doctor is an expert and the doctor has spent their late career, probably since they were 10 years old, being validated for their experience and their knowledge retention. your ability to regurgitate that knowledge and ultimately when you're in a group and someone asks a question, the most important thing is not to answer the question, the most important thing is to let someone else in the group answer the question because then you're building trust. in the collective and all the doctors that I know who are incredible at this and I know the best because I interviewed them for my book and spent time with them, they actually had to go through their own deconstruction. ego to be able to maintain a group because it is very tempting to answer the question because they are experts and we are coming out of this era so there is definitely room for experts 100% we need experts, but not in group medicine we need colleagues we need support we need you to know mentoring and that is not does a doctor when we started running these virtual groups we had some two say oh I've spent a weekend coaching I can do this I'll lead the groups it was a disaster there's also this like there's this thing where the doctor has the white coat and there's This innate relationship that patients have with what they assume the doctors will be and that can be, actually, you know that can be useless in building trust in a group, so the first thing is that you know, we've worked together.

For a long time, I think training doctors in lifestyle medicine, meaning training them in this kind of root cause lifestyle approach to health first, is amazing and I did it for 10 years and I'm still involved. in it, but what I have achieved What you have to see is that the fastest way to facilitate the transformation is for the doctor to prescribe it because there is something in the prescription like the doctor, the patients will follow the doctor's prescription, so I prescribe that group for you, you prescribe the one you are going to enter. this group, but the doctor doesn't lead the group well, the only reason you need the doctor in the group is to prescribe the medication, that's what we're seeing in America right now, the most exciting thing is chronic pain right before Co. came out.

Open opioids were the biggest problem in America, you know, opioid overuse, chronic pain, so in our groups the doctor comes once a month and the only reason that they are there, there are many reasons for them to be there, but the most important one. What they're hopefully doing is allowing patients to tell patients that yes, you can probably reduce your prescription a little bit. Now, deprescribing, the doctor has to be there because there are many factors and doctors have to know, but ultimately, which one comes first. What we see is that doctors should not lead the groups, the coach, this peer piece is part of this, which hurts on two levels, even doctors who want to see group medicine implemented and who have seen some of investigations of this type.

Of course, it makes sense, you know, last night, what do you say? I'd love to. I just don't have time, yeah right, so the doctors are overloaded anyway, so it actually helps because they don't have to do one more thing and I love it. which I can actually totally see why ego and the way that, fundamentally, to be in medical school there is a certain type of personality, right, and I could say this, you know, this is not in a derogatory way, but a lot of people are super competitive and you know a lot of people have been validated so a lot of them get their self esteem this used to be me you get your self esteem from success or external validation now you know how i got rid of those things and why i feel happy and more Content is something I've talked a lot about recently, but that's a separate topic.

The point is, I can totally see how doctors wouldn't be the right person and in fact their experience and knowledge can be completely harmful in this environment, so I think that's really, really powerful, you mentioned chronic pain, why? do you think this is so powerful for chronic pain? Because chronic pain is a big problem, yes, and the medical profession is not doing so well in dealing with this number one. Lonely people have higher pain scores, according to science. Chronic pain proves that it is and this is a great word that I'm going to use here. It is a bioc psychosocial disease.

There are biological parts. You know that the physical body is dysfunctioning, what is causing it. There are psychological parts. and then there are also the social parts and so you can't solve, uh, you can't solve a biological psychosocial problem with a biological input, a drug, it's just not compatible, so lonely people have scores of higher pain, the structure of actually Now working to improve your physiology is what leads you to know that you will no longer need the medication. You have to change your physiology if your current physiology is causing you ongoing chronic pain. you have to change your physiology and that's what group power can do and lifestyle medicine and then you know that ultimately having a doctor prescribe it to you gives validation of the medical article so it's important for the doctors to prescribe it But ultimately the action is happening with the group, okay, so the first thing we do is make a mistake and we think the doctors should execute it, yeah, so they're not okay.

Great, what's the next herd we fall into when trying to implement this? most of the rest comes down to the boring and annoying details of retooling a health system to do group medicine, so one of those is that we've had doctors try to execute this and do it in person correctly because being together in a group In person is better than online, but if your clinic only has four parking spaces and there are 20 people attending the group, you can't manage it if there isn't a space where people can sit together, you can. I don't run it, you know, what we found even though it might be more valuable to have the group meet in person with a completely virtual experience, like what are the benefits, what are the reasons why people love the telemedicine, why people love telemedicine, respect your time, you can come from wherever you are, you can use your phone, you can chat with the doctor directly, you don't have to wait in the waiting room, you don't have to deal with your kids , you know all those other things, it's very respectful of the patients' time, so they like, you know, they can come from wherever they are in the United States.

There is a big conversation about the social determination of health, how do you get to the office correctly? Whose car office is it, who, how do you get there and if you have to go there every week, then you know it can be complicated, but this is the most important thing that happens with health outside of those sessions, that's where you really health happens, that's when you're making the decision of what are you going to eat tonight or if you're going to go for a walk after dinner or what your movement is going to be during the day or if you're going to have the morning routine that you want to stay connected to. with the other people in the group at that moment is the critical moment that is high contact, that is, you can communicate with your people all the time, people know what this is wrong and because most people have had the experience of being in a Facebook group right where you see there's asynchronous communication, not everyone is there at the same time, yeah right, so I can put something in and say hey, I'm really struggling with this today, but you know, I did this and Did that put it in and then you go to work and then you see a minute later someone said oh, I had the same experience?

Know? or they said this really helped me. Here's an episode of Dr. Chat's podcast. Do you know that type of communication? that happens all the time and people help each other when they're not in the office and that's what we find most valuable and I think everyone would aspire to, wouldn't it be great if every patient could? They have that kind of access to their doctor, it's just that the resources don't add up. I'm an economist first and foremost, I'm a health economist, so I come at this problem from a resource constraint perspective, you know, I'm not.

I'm a doctor, but what I recognized is that this is the path that people have to follow and I spent the last 17 years trying to find a way to do it in a way that uses the right resources in the right way to create the right transformation. and ultimately you can see in that process that by allowing the people inside to already have an agreement about what they're doing together, they've set their smart goals, they've set their collective intention to another. What we do at the beginning is help them define as a group what this group is like, what it's called, what it's going to be about for them, so that they're attracted to it and then just supporting each other throughout the process and ideally forever, I mean , in the book I talked about some of the original group visits.

It starts out as a type 2 diabetes reversal group, but what do you do once everyone has reversed their diabetes? You know, in this case it became a salsa dance club and a garden club dancing salsa in the winter because it was raining in Massachusetts and they can't go out, so they get together once a week to dance salsa and in the summer it was a gardening club, both really healthy behaviors when they end up as an even healthier group and some of these groups have been around for 20 years, yeah, that Facebook group example, I think I think a lot of people will get it right away, yeah, I have my own kind of Facebook. group, I think it's called the four pillar tribe do chashi and you know, I rarely participate in it, but the interesting thing is that you say that people help each other there, it's something that I have created well, but I'm not there to Answering questions, it's people who help people post things like Oh, I'm really struggling with this in my healing, you know, and then everyone jumps in to helpTypical, you know, us Europeans or UK man burns about 3,000 kilos of calories a day, etc. that's about 11 megs if you prefer to do Mega um and that mainly has to do with how big you are, how much you weigh and particularly how much fat free mass you have.

Burn some calories. It really is. an active tissue produces hormones and that kind of stuff, but not as much, it's not as active as all the other tissues, so our fat is relatively quiet, so it's primarily your fat-free mass that determines how much you burn. Women in the US, UK, other parts of the industrialized world burn around 2400 kilocalories a day, and the difference is that in the amount of energy burned is because women are a little bit smaller and, You know, they tend to be a little bit smaller and also, women tend to have a little more body fat, so of course, if you're a man and a woman who get on the scale and have exactly the same total body weight, the woman will probably have a little less fat.

Free mass because women tend to have a little bit more fat and therefore their expenses, we would expect them to be a little bit lower, not because men and women are physiologically different, I mean, they are fundamentally physiologically different, but not because the expenses are fundamentally different. different just because the body compositions and sizes are a little bit different on average um and then a man and a woman hota tend to be a short group of people uh and then you know they're a little bit shorter on average than the typical us or UK men or women, then they actually burn fewer calories, women burn like 1,800 calories a day, men are 24-25 years old, they are all reduced because they have a smaller body, but once of course, We take into account body size and composition when Whenever we do these analyses, yes, I want this point, one of the central points of your work, to reach people because I think there are many people who are struggling to lose weight, They are trying. torturing themselves depriving themselves punishing themselves all the time and they're possibly doing it with the wrong equation in mind so it's doubly tragic is that it's not working and B it's like it's not working because you're actually putting in all this work. hard and effort and actually that's potentially not the right equation to use, so if we just break it down again, um, then we have, you know, let's say I'm a typical Western man who, on average, will burn 3,000 calories a day, so 3000 calories is what they are going to consume and you are saying that a brain can use 300 calories a day just to exist and do all the functions that we need from our brain, so there are 2,700 calories.

It stays in that kind of um in that very simple equation, so yeah, you're making the case. I think our immune system, our reproductive system, breathing, lungs, liver, spleen, basically every organ in our body, just to do their job, they're destroying it. and then there are a lot of calories being burned, nothing to do with exercise, just being alive and participating in life on a daily basis, so what happens to someone who then goes out for a 1 hour run and stuff? It's all they think is going to be using more calories, you know, what happens in the body to keep that at 3000, you know, on the one hand, you're taking it from here, but you're going backwards somewhere else. that's the idea, yes, that's right, that's right, and you have to be clear about a couple of things, first of all, day to day, your expenses may still fluctuate, so if you always run 10 miles on Tuesdays and you You sit on the couch the rest of the day. days, so yes, on Tuesdays you will burn more calories because your body cannot adapt 24 hours a day, it does not adapt as quickly, it is more a question of lifestyle, your body gets used to a lifestyle, so if you are the The kind of person who runs 20 miles a week, versus the kind of person who isn't the kind of person who runs 20 miles a week, and their body is adapted to that and spends 20 miles well, so it's about um TW , that's approximately 100 kilos of calories per week. correct mile at an age, that's a good rule of thumb, so 20 per 100 is 2000 calories per week, so you spend 2000 calories per week on exercise and that means that person is spending 2000 fewer calories on all other things, and that's how it is.

What's exciting to me as an evolutionary biologist is finding out what the body correctly prioritizes, and so we know that some of the things that the body cuts back on and takes away from are some of the really good things that it does. does the exercise. it does it for youSo if you look at who runs 20 miles a week, they will have lower levels of

inflammation

, but what is inflammation? Inflammation is actually an energetically costly immune function that your body doesn't need to do well, it's your innate immune function always on high. alert when it is not necessary and it is actually bad for you to have high levels of inflammation, yes stress, if we look at people who exercise versus those who do not, people who exercise have a lower level and more surge cut off things like epinephrine and cortisol in response to stress, right, and that's so that they expend fewer calories, in that response to stress, and if you're in the course of the day, you're constantly on high alert, because, That's not good either. for you, so actually suppressing that stress response is probably very good for you.

People who exercise a lot will have healthy levels, I want to emphasize that they are healthy but lower, on average, a little bit levels of testosterone, estrogen and progesterone. lower and that will also help you save energy, so your body is basic and that's probably not the only thing your body is doing. You could be making other kinds of subtle adjustments to how you know if you sit versus stand in that kind of thing, then your body is making all these adjustments and that's how you make the numbers work, that people don't spend the 20 miles a week and the sedentary person has no different overhead because the 20 miles a week is spending less on these other things, yes I love it, it just shows how smart and tuned our bodies are, oh it's really humbling to think that we are smarter than our bodies, we will know what we will eat. a little more here, run a little more, our body is like, oh wait a minute, we're so much smarter than that and I really love the fact that it seems like we can prioritize different functions depending on what's going on. you know in in in burn you write about not just the hatza you write about another um another population starts with t I don't know how you pronounce it the chimani yeah the how you pronounce it chimani the chimani yeah and I I found it fascinating that 70% of them have an infection active parasite in their intestines and so I think you're saying that because there's that background level of infection and therefore inflammation, so the body is potentially diverting more energy into the intestine. immune system and less to other parts of the body, yes, then the chimani show this.

There's another group where we've shown this even since the book came out. Actually, these things are moving so fast it's really funny, but there's a group called. The Schwar, which is another one, are also Amazonian, so the Chimani live in Bolivia, the Schwar live in Ecuador and they are both kind of Amazonian rainforest populations and the Schwar, my post at the time Sam Herlocker made this great study. Looking at the kids, we had schwar kids, um, who are very remote, they hunt and gather a lot, they do a little bit of farming, but you know, a simple, traditional subsistence lifestyle and they also have a high pathogen load. .

You can imagine that if you live without knowing any kind of modern medicine, uh, barefoot, mostly in really remote rainforest environments, you have a lot of parasites, a lot of bacteria, so your immune system is always active, um AC, uh, and those children. They have high basal metabolic rates, as we see with the Chimani, but the good thing is that with the Schwar population, we have them, we have children, so we can measure their growth while they are, you know, because they are them. Kids and Sam can show up very well if they look at the amount of immune activation, short-term immune function with something we call, we measure with CRP C-reactive protein, which is your body's first immune response to really you know, a acute stress, um kids who have to grow less in the next two weeks, kids who have these kind of long-term markers, you know, there are different markers of immune function that we can use to say, oh, that's long-term. infection or that is a short-term response, long-term responses correlate very well with the long-term growth of children, so the children who consistently receive the greatest immunological impact are regressing in their growth and and Indeed, when expenses are measured correctly, total energy expenditures are the same as children in the US or Europe, so these children are playing, in other words, all these children are playing with the same energy budget , everyone gets the same number. of calories and you can spend them however you want and if you spend them on immune function you have less to spend on growth, it has to be like that, and indeed, that is what we see, so prioritization is probably super interesting.

Seeing what happens, yeah, it's really fascinating and I mean, a moment ago you mentioned that the Hadsa tend to be shorter in stature, yeah, let's say the typical Western population also plays there because of their lifestyles. that maybe you know maybe we have I don't know, you know how you would do it, yeah, how you would put that together potentially, well, yeah, absolutely, I mean, you know we don't know, so height is a great example of a trait. that has a very strong genetic component, tall parents tend to have tall children and a very strong environmental component, so there is and it's this, it's not nature or nurture or nature versus nurture, it's those things acting together, um, and so a population like the Hodza. which tend to be short, Satur, probably have many genetic variants.

You'd know that even if they grew up here in the west, they'd probably end up a little shorter on average, so it's not just the environment, but I bet it's PL. And probably the best example of this is something called The Immigrant Effect, which was pretty well documented in the mid-20th century, and that is when you see people who grow up, their parents grow up in a developing country. country um and without you know, without access to great medicines and maybe without access to good food and maybe with a lot of physical stress in their lives, their parents grow up and they're relatively short and they move to a country. that has better medicine, better nutrition, less work stress for the children and the children are all you know, a few centimeters taller than the parents on average, the immigrant effect, um, and that has been well documented in people from many places. different from the world you come to.

From an energy-stressed environment we move you to an energy-rich environment and your children grow up correctly because your children spend less energy than you did as a child on all these other tasks. I think the idea of ​​a budget is brilliant, we've all done it. You have the same budget, so the question is where are you going to allocate your body's resources. It's like you know if you have a certain amount of income, do you want to spend it on a small house and a fancy car or do you want it on a Do you know if you want it on a big house and a not so nice car or whatever?

You know, it's a useful way to think about the body. I think yes, that's exactly right and we talk about, you know, in evolutionary biology. Talking about energy budgets all the time is how we think about it, and it's also been fun because for some reason in evolutionary biology people became very comfortable talking about energy budgets in terms of reproduction versus growth or maintenance, as a function immune. versus growth and talking about tradeoffs like that um and then somehow even in the evolutionary biology activity there was kind of an extra thing that you could always add on top of and you could always fund that somehow separately. and I don't know how to think.

It ever really took hold, but basically my work says that no activity is just another act, you know, physical activity is just another activity that your body has to do, that's just part of the mix, that's just part of the budget, you know, and somehow you know to expand or contract the budget as much as you can you know you could you could push a little you could get a little, but not as much as you think you're getting because your body wants to keep the same budget no matter what, yes, now I think it's important that with super cair you are saying that exercising more safely in the long term does not lead us to burn more calories, but you are not saying that we should not exercise in fact, you are saying everythingOtherwise, it's incredibly important and I love this SP of the book I'm going to read if you don't mind, I'm sure those ancient adaptations have consequences for us today, our bodies are designed to move freely in our modern industrialized worlds.

From the daily demands of searching for food, we need to exercise for our bodies to function properly. It is a legacy of our hunter-gatherer past. Why is it so important that we move our bodies? Yes, I think this is another benefit of taking an evolutionary perspective. and that is understanding that our bodies and our behaviors co-evolve, so a good example of this is fish. Have you ever heard exes talk about sharks? If sharks don't continue swimming well, they drown. A shark can drown. Because? Well, because you know, ancient fish, all ancient fish, when they evolve, the gills evolve, the ability to pump, they have muscles on the side of the gills that allow them to pump the water past the gills so they can, most fish can stay still. and they just slowly pump the water through their gills and they're fine because they can continue to get fresh, oxygenated water through their gills, sharks and tuna and a couple of other really active species like that really physically active species that are swimming so much that you know evolution actually favored reduction and then eventually elimination because why waste energy if you don't need that in that musculature?

Because they're moving all the time anyway, they might just like open their mouth and the water just goes over their gills and now if you take that same fish and you don't let it move it dies so it's all swimming behavior. time and anatomy what is this color pump mechanism or Gil pump mechanism co-evolves and that's just a good example that we can all understand, but it happens everywhere, that's how evolution always works, behaviors and anatomies coevolve in Humans, again, we've been hunting and gathering for two and a half million years and what does that do if you start hunting and if you start gathering in Savannah landscapes where food is scarce, you need to walk and you just move a little? much more to get your food, you have to choose the right food, it is further away to find that the animals will run away from you, you know they don't want to be caught, so hunting and gathering alone requires a ton of physical activity and your body, that is. the behavior and then the body adapts to that and gets used to that and you only your ex body you know that you were born into the world with a body that waits to move like those you know that a shark is born into the world with a with gills that wait being pushed through the water um and now, if we don't do that, if we deprive ourselves of that constant activity that we normally have um yeah, bad things happen, our physiology expects that and just like the Shark that stops swimming.

Bad things happen when we stop exercising because every aspect is really hard to find. I would challenge anyone to find a part of your body that doesn't work, that doesn't depend on that activity signal. for normal functioning, it reaches everywhere, yes, and I guess that then speaks to how we know, how we talk about physical activity to the population, do you know how I, as a doctor, talk about it with my patients because many of the time was made around fat loss and weight loss and I think there are two sides to that coin. I've seen some of your discussions on Twitter over the last few months about this and you know it's a pretty controversial topic in terms of First of all, you need to exercise to lose weight and so depending on what your point of view is In this regard, how do we articulate that message?

What is your kind of involvement in this for a few months and maybe several years? What is your current point of view? About that, yes, I think we should be honest with people. I think that's the best public health message, one that will be accurate to the science and I think the science says that exercise alone is not good weight loss. tool and even exercise along with dietary changes, exercise doesn't add much to weight loss, um is that long term, but because you're saying that for a week, two or three you'll see that you'll get a benefit you mean beyond that, yeah, long term, so I mean there's excellent data on this coming from all kinds of labs that aren't mine, so I'm not necessarily talking, this is if you look at the long term. long-term effects of exercise interventions exercise alone The long-term weight loss expectation is about two kilograms, so that's great if you're looking to lose two kilograms, that's perfect, but most overweight people u obesity seek to lose a lot. more and if you look at how much they are working, they should lose a lot more right, they burn tons of calories, but it doesn't work that way because the body adapts well, so I think you know sometimes my work becomes kind of like is mischaracterized as saying that exercise is not important.

I think that's not what I've ever said that exercise is very important now, do we do it? Do we exercise to lose weight? I would say that we don't exercise to lose weight, but you can exercise during weight loss to get all the other benefits. but I think if we want to move the number on the bathroom scale and if we want to achieve fat loss, then it has to be a correct dietary approach and you know, when you go anywhere, look, I'm not a doctor, so I would prefer to people who are in clinical practice like you, but someone comes in and has a serious weight problem and we think you know, we look at their blood profiles, we look at their blood pressure, we look at the direction things are going and we say: Look, this person needs to lose weight to get to a better place in terms of their health, there are a lot of things you could prescribe, but wouldn't you make sure to emphasize what has the biggest effect that should be is the diet, yeah Of course, then, what I think is wrong and that you see this in public health messages all the time is this equivalence between exercise and diet, that's what bothers me because that's not what science says.

Yeah, right, so you say, well, you have to diet and exercise, so if we put it like that, it sounds like maybe you just do one or the other and you could choose, or it sounds like maybe exercise and diet have the same effect. Same effect because energy goes in and out and I could decide to focus on one or the other and that's not really what the science says, the science says the diet will do all the heavy lifting and exercise to add. That's great and can do all kinds of good things, but it's the diet part that will really change the number on the scale.

If you enjoyed that conversation, I think you'll really enjoy this one about the power of food to transform your health. When we sit down every day to make a decision about what we eat or go to the store to buy some food, we must realize that whatever we put in our body will affect or improve our health.