Confronting Dr. Gundry On Lectins | Inflammation & Leaky Gut

I have 25 million subscribers of people who listen to every word I say and correct every mistake I make and I could tell you how your information comes very confidently to them and it doesn't come the way you want it to and I just urge them. that in your next books and in the speeches that you make just keep that in mind because when you make statements like apples are horrible, the worst thing you can do for your mitochondria is a fruit smoothie, it's not just taking a little freedom with information. It's really tricking people into making bad decisions for their health, that's all I'll say.

Dr. Steven Gundry is a cardiothoracic surgeon who has found success in coming out of the operating room and shifting his focus to prevention, as well as writing several best-selling books, including Plant Paradox and his upcoming book titled gut check, you may have seen his content on social media highlighting his highly controversial claim that certain healthy foods are actually bad for you. His most popular claim is that foods like beans, tomatoes, whole grains and bell peppers are actually unhealthy because they contain proteins called

lectins

and are therefore destroying the gut, this has drawn harsh criticism from the community. medical and nutritional in general, given the large amount of evidence that shows that those who eat these foods are significantly healthier, have lower risk factors and do not require the elimination of said foods.

Being completely honest about food, I was one of those critics, so when Dr. Gundry's team approached him to come in for the checkup, I made sure St Ed was early and openly told that if he came, he would probably It would be a critical conversation to his credit. He welcomed the discussion I also mentioned given that he is a cardiac specialist and I am a family medicine doctor. I would like to bring in Dr. Danielle Bardo, who is a cardiologist very focused on disease prevention research, in fact, she is on the committee that is presenting new guidelines aimed at decreasing the number one cause of death for all of us, heart disease.

Dr. Gundry again agreed, so here we go with the checkup podcast. Well, we're talking about heart disease prevention and it's great to have two people who are passionate about the heart. disease prevention because for me as a primary care provider, a lot of my patients come in too late with heart disease and then we're focusing on trying to reverse that and reverse that not only through medication methods but also by giving them some modifications in the lifestyle and That takes a lot of work because currently the American Standard diet is an absolute disaster. The things that my patients consume, high ultra-processed foods, are very problematic, but Dr.

Gund, I'd like to start with you because part of, I would say, your success. on social media and with your books, the plant paradox has been that the advice doctors give patients when it comes to diets, including what we call healthy foods, is actually not healthy, tell us that, yeah, I think that's certainly my observation about the Over the last 50-odd years I've been doing this as a cardiac surgeon, we knew that if we put a stent in someone or did a bypass we would probably see them for their next procedure in five to seven years. , in general, and we were taught that this was inevitable and that there was not much we could do to slow down the process.

Statins, blood pressure medications, lifestyle modifications, exercising more, but in fact, those were really insignificant little things in the scheme of things, so when 28 years ago I saw a gentleman from Miami Florida Big Ed in all my books M reversed 50% of the blockages in his coronary arteries that were basically completely eliminated in six months with diet and taking a bunch of supplements from my health food store whether he wanted to or not, MH. I knew it. uh that he was onto something and he spent the last 28 years figuring out how he did it, that's interesting to me because you know in medicine we always look at anecdotal situations as maybe not the strongest level of evidence, so why is this case?

I have patients come to me and follow all kinds of unique diets. I have patients who have smoked for 45 years and live healthy lives and they say it's because I smoke and obviously we laugh about it because we all agree it's not like that. It's true, so why did this case move you? So let me stop you right there. It's probably because he smoked and is doing so well. Okay, we have to back up, how can we get there? Well, I have a whole gut check chapter. Looking at healthier people who live longer and one of the unique characteristics of most blue zones is that, in particular, men are heavy smokers and smoking, in fact, the nicotine in cigarettes is one of the best mitochondrial uncouplers that have ever been discovered and we've looked at this through the wrong lens and said, Wow, what other healthy lifestyle things are these guys doing that prevent smoking from harming them?

In fact, we should have seen it differently. What do these people who are smokers have that allows them? live to be 105 110 years old and when you do that then you're fine, smoking was good for them, why don't we see the oxidative stress that smoking causes? We all know it happens, why don't we see the cancers in these people and it's because the rest of their diet facilitates the absorption of oxidative stress in these guys, so their state is that if you smoke but you eat this specific way, can negate the effects of smoking, the negative effects of smoking, yes, which is fascinating as a cardiac surgeon, a long time ago.

In the old days, most of our patients were smokers and had specific proximal lesions in their coronary arteries, the rest of their blood vessels were absolutely beautiful and, for the most part, they were thin, so how was that calculated? I mean, we operate, but you operate on what other vessels that you saw, like you would screen those patients for peripheral arterial disease and you would find out that I used to operate because one of the number one risk factors for arterial disease is smoking. smoking, oxidative stress is not easy, our current diet does not stop it, let me give you an example, okay, we are one of the few animals that do not produce vitamin C MH and vitamin C, and I have written about this normally, unfortunately, collagen it breaks when the blood vessels flex and contract and it mainly breaks, it bends and when that collagen breaks down, the vitamin C normally rebuilds, that rebuilds that collagen in smokers, they don't have vitamin C because the vitamin C has been depleted in manipulation. oxidative stress, so you basically have raw collagen that's left out and then we start the process of an inflammatory attack and cholesterol is basically a compound that expands and continues to expand in that area.

The good news about smoking is that it always happens in these curves where they flex. It happens if, like these people in the blue zones who live a long time as smokers, if you have large amounts of foods containing vitamin C in your diet and, by the way, olive oil doubles our own production of vitamin C, which which is great, then you mitigate those effects. and you don't see the negative effects of smoking, you actually see the positive effects of nicotine. Is there research to support that if you change someone's diet to be high in vitamin C, it negates their risk of smoking because I've never seen that?

Of course, everything has been done in the blue zones. Well, blue zones are not research studies. In fact, you've been quite critical of blue zones even in your book. Yes, for example, let's take Sardinia, for example, one of the blue zones. People who live in the mountains actually have longevity; people who live near water do not. What is different about those people is that they are sheep herders and goat herders and what they eat is a lot of fermented sheep cheese, sheep yogurt and what makes them have longevity is that men smoke 95% of men and only 25% of women do not.

What is unique is that, as we all know, women live about seven years longer than men, men in Sardinia have a life expectancy seven years longer than men. women because they are smokers, that's what BR, it's an incredible conclusion to come to the same with kavans, but I say there are so many variables that influence one's life, how do you isolate the one that we have trouble isolating something to investigate ? the kavans stepan lindenberg spent his life studying the havans in Pape Nini smoke like hell they have never had a documented case of stroke or coronary artery disease they have never had a documented case of lung cancer I am confused how in this scenario we are using blue zones as an example for this, but then in your book you point out that in Okanawa you think the blue zone is not true because they may be trying to collect pensions and their family members don't report their deaths properly, so, how in one?

On the other hand, are you using the blue zones as a way to back up what you're saying versus other times saying that's actually all I'm talking about about coronary artery disease and longevity, so these people don't They have coronary artery disease even though they are smoking, so I say we should look at this backwards and say: wait a minute, all of these people are smokers, is there any benefit to smoking for nicotine? I'm not saying, don't get me wrong, I've never smoked a cigarette. in my life, but we deny the fact that maybe we are missing out on a positive benefit, for example, the reason I dismiss the blue zones is because Dan Butner would like to convince us that grains and beans are the secret to the longevity of the blue zones and since then you mentioned okan they don't eat grains or beans they don't eat rice 85% of their diet is a purple sweet potato they don't eat soy unless it's fermented they don't eat tofu they eat miso and natto which are fermented soybeans and they get the benefits of fermentation, so I give you another example in another Blue Zone, the Ngoya peninsula in Costa Rica, this is like a gerrymander district, everyone in Costa Rica eats beans and corn, which is their staple food, but in the Ngoan Peninsula and only in that part of the country are sheep herders and eat sheep cheese, sheep yogurts which actually contain large amounts of medium chain triglycerides, which are excellent coupling and mitochondrial, and the people of the peninsula de Ngoan says that cereals and beans are the negative aspect of his diet that is offset.

Because because of their other lifestyle I think I have to back off. Do you think the Blue Zone project is something valuable for us to see as a form of evidence? uh no, so why are you using it to describe all these things to me? because there are interesting factors that influence these people, but they are not the factors that a given individual would like us to believe are interesting. Paul Simon said that a man listens to what he wants to hear and doesn't take into account the rest and if you are and that's not what No, I'm saying what makes these areas unique and look, I'm the only nutritionist who He spent most of his career living in the Blue Zone of Lolinda, California so he should have some idea or they eat a ton of beans in Lolina they don't actually eat a ton of beans in Lolina although they do eat a ton of walnuts and a lot of walnuts Yes, a lot of nuts and 50% of their diet is fat mainly from dairy products, what is your opinion on the Blue Zone project? as a whole, so I think blue zones are interesting as an idea to talk about, but when we form dietary recommendations, I believe in evidence-based nutrition, which synthesizes multiple levels of evidence in order to reach a conclusion. to know what a healthy dietary pattern will be, you know nutrition is complex because there is no placebo in nutrition studies, so essentially we can't look at one study, one anecdote to form our recommendations about what is healthiest, we have to look at multiple levels of evidence, so We have preclinical studies, a lot of what Dr.

Gundry talks about things with mitochondria that are very interesting, but they raise hypotheses about the mechanisms. We observe them in rats, we observe them in vitro, but then we have to take a good look at what happens in reality. human studies, then we look at outcomes trials, so we want to look at randomized control trials where you actually randomly assign people to a certain dietary intervention and then evaluate them based on a placebo control, then we have long-term epidemiological studies because you can't randomly assign someone to something for 15 years, but then we have a lot of cohort data for nutritional epipia where we look at the effects of eating certain doses of food over the course of the year. time and the results are evaluated based on outcomes such as cardiovascular diseases, autoimmune diseases,gastrointestinal diseases.

Things like that, so you have to synthesize all the multiple levels of evidence to be able to come to a picture and a conclusion of what the recommendations are for a diet. Last year we published. I was lucky enough to be the lead author of our last article. nutrition and cardiovascular disease guidelines for the American Society of Preventive Cardiology and you know we had to evaluate and synthesize multiple levels of evidence looking at several different types of studies and while the blue zones are really interesting, I think they tell us that I know you can have a wide variety of diets because if you look at Greece, for example, in the blue zones, compared to Okaba, Japan, they have different amounts of fat that they consume, they have different amounts of carbohydrate intake and they have multiple, you know. success and longevity at several different ratios of carbohydrate, fat, and protein intake, but I think the reason the blue zones are interesting but not super scientific is because we have to look at more controlled studies to be able to really synthesize all of those levels of evidence.

To get to the recommendation when you were making those guidelines, was there ever a conversation among the doctors who were doing this about whether or not I recommend smoking along with vitamin C, so I'll stick to the fact that, you know, I think that it's pretty well established in the scientific literature that smoking is incredibly harmful, probably the feeling of smoking is probably one of the most important, if not the most important. The most important advice we can give and help patients. Fortunately, we now have many tools in modern medicine to help our patients quit smoking because it's certainly not easy, but I don't think we even have randomized control trials for smoking. because the data is so strong, they just assess how patients eventually do, whether it's peripheral artery disease, coronary heart disease, or cancer outcomes, obviously, with smoking, as far as I believe in the scientific community, it's not really debatable. right now, so yeah, the feeling of smoking. great recommendation for cardiovascular disease prevention, but also probably one of the best things people can do to prevent cancer, dementia, you know a variety of different diseases and have you seen evidence that vitamin C negates the risks of smoke?

No, but what I do think is that Dr. Gundry may be pointing out that, you know, smoking is a variable, a very, very important variable, but of course, if someone smokes but also eats an incredibly healthy diet and lives in the blue zones where you know they have excellent CU relationships. that's a part of it too, people have great interpersonal relationships, a great community, lower stress levels, great life satisfaction, exercise, active smoking doesn't help them, but maybe all these other factors contribute to your longevity, whereas if you're smoking and eating, you know, highly processed, um, hyperpalatable foods and um, not exercising, it would have a more negative impact, but we know that all things considered, the feeling of smoking has a big impact on the health, that's fair, many times, there are so many. prejudices when it comes to the life expectancy of an individual, if they are a vegetarian they tend to practice healthier habits, if someone smokes they most likely also drink, stay out late at night, so of course that way contributes The bottom line here is that just because you have one bad habit doesn't mean you have all the bad habits exhibited in the blue zones.

What is your conclusion from the fact that some people in the Blue Zone smoke? We should smoke, we should take nicotine, what do you take away from that? So what I take away from this is, if you first look at nicotine as a drug, first of all, it's addictive, as any tobacco executive knows, so even I don't recommend it. Dave Asprey takes nicotine drops and puts them under his tongue or uses a nicotine patch, but I think we really need to look at whether or not nicotinic acid is a useful longevity drug and we don't have to look very far to find out. check it. the literature discusses the various forms of nicotinic acid that are now available as nnm or NR nucle, sorry, nicotinamide riboside, which have published clinical studies on their effects on mitochondrial uncoupling, so I give you a long and interesting history .

I use nasin to treat my patient P. who make LP little A lipoprotein little a It is very effective in reducing LP little a and I and others think that LP little a is one of the most important effectors of cardiovascular diseases, without a doubt, in the family history, what does nin have to do with ni reduce? LP littlea no, how is that connected to the nicotine component? Nicotinic acid is not interesting. I have to address this because it is a very passionate topic for me. In fact, I just moderated the um major uh LPA session in one of our most important Cardiology sessions. conferences this year and what's really fascinating from the experts that I've learned from lipoprot is that we no longer recommend nasin for lipoprot, the reason is that the three major randomized control trials that looked at nin with difficult results, so you know there are many things that can be great from a mechanistic theory, we have many ideas about why in preclinical research you think something would be a good idea, you have to test it in trials of real results in humans to see and when I talk about results we talk about things which are the most important adverse cardiovascular events, a heart attack, a stroke, so the three main trials that looked at lipoprotein reduction and those that looked at reducing any risk of cardiovascular disease with niin showed that all three demonstrated that there is absolutely no benefit in reducing cardiovascular risk with nasin, so in cardiology we no longer recommend niin to um for cardiovascular disease risk for lipoprotein a because even though it reduces lipoprotein a, it doesn't actually improve the results and the interesting thing is that there are things that are really bad for you that actually also reduce lipoprotein a, so lipoprotein a is complex, so the European Society of Cardiology published the latest guidelines on lipoprotein a um and The recommendations are simply to reduce apob lipoproteins as much as possible through a dietary lifestyle if they need statin therapy and for anyone.

Listening, that's like what is lipoprotein? What are they getting into? It is an arthrogenic lipoprotein. I agree with Dr. Gundry. It's incredibly important. Recommendations now are that everyone get screened for LP at least once in their lifetime. but we no longer recommend niin because concrete trial results show that it does not reduce cardiovascular risk and in fact there are things that can actually reduce your LPA that are harmful, so things like thyroid disease, Untreated thyroid can actually reduce your lipoprotein and liver disease. Lower your lipoprotein. These do not reduce cardiovascular risk. A high content of saturated fats.

A diet rich in animals can actually artificially lower your lipoprotein A and we know that increases your apob and can also increase cardiovascular risk. That's why it's so important that, as we are. uh when looking at different biomarkers and assessing cardiovascular risk, we take into account real heart outcome trials and we actually take into account what really matters to our patients, which is heart attack, stroke and mortality for all causes, and now with lipoprotein a in process. They are specific drugs that are not available yet, but they are going to be lipoproteins specifically targeting Snips and several other different modalities, but right now all our cardiac evidence shows nias and it doesn't improve them, so even though you can reduce the number it doesn't necessarily improve them. the results, so it's actually a perfect example.

I think you illustrated that, at least because you know in cardiovascular disease prevention why something, in theory and mechanism, can be really interesting and useful. It may be worth trying. when you do preclinical research in a rat or in an in vitro model, you know that you can find a really interesting theory, a really interesting mechanism that is worth exploring, that's when you translate it to human studies and see if this improves the results in humans and us. I found out that it hasn't gone well, that's because you didn't compensate for what was going to happen with nasin by increasing homocysteine ​​and also increasing lpa2 levels and if you treat the increase in lpa2 and homosysteine ​​with supplements that I published in the American Heart Association . then you negate those effects of Ni.

Well I looked for your posts Dr. Gunder, I couldn't find anything posted on aha um. I saw that you had an abstract that was presented at the conference, but it was never a published paper, well peer-reviewed abstracts. They're peer reviewed, it wasn't a study, but I have to be honest, it's just that that's a little misleading. I mean, it's against our cardiology guidelines. Our card. Our cardiology guidelines do not recommend Lio protein. I realize that, but. the guidelines, for example, and I'm sure you understand that statins increase LP levels only a little to a clinically insignificant way and the reason why our guidelines recommend that for people with elevated lipoproteins they must be taking statins if they have a high Apo it's because the goal of therapy now for lipoprotein a uh is to keep the apop as low as possible.

Right, but the goal of therapy to reduce epob as much as possible is oxidized phospholipid epob measurements and that's the only one. measurement that correlates with LPA levels, that's a very good theory about oxidation, um, it's not a theory, it's published by several researchers, it's a theory because we don't have real trials that can really debunk that we know that research to reduce apob and we know that cardiovascular mortality is incredibly strong, there is no cardiovascular organization across the board, whether it's ESC, uh, ACC ASPC, which even recommends checking oxidized levels of anything because we know that reducing apob is the gold standard for reducing cardiovascular risk in patients with elevated lipopro, so why wouldn't you want to measure oxidized fossil lipids?

Apple is because we, oh, because I mean you could, but honestly, change, it doesn't alter the management because the management will be the lowest because the management will be the lowest possible, Dr. Gundra. I think what's interesting to me here as a primary care physician who follows guidelines like these is how you decide, because some of the things you propose have a really solid mechanism basis, as you can get. explain how it works, you can explain the theory of how you can get from point A to point B, but many times in medicine, when we start with mechanisms, once we take it to human data, we find the complete opposite, I mean, like simple.

The example that my viewers are probably thinking of is that Viagra was initially started to treat pulmonary hypertension and then we found out that it's a great erection medication, so it started mechanically to treat one thing and then ends up going in a different direction, so okay, I still use Viagra to treat pH, but it's true, we just call it down. Yeah, it's the chocolate chip cookie mistake where we thought the chocolate chips would melt and they did, and then we've also seen the same thing with beta blockers and cardiomyopathy. Initially we thought it would be somewhat problematic and now we see that it actually reduces mortality, so how do you make the decision of when to move from a mechanistic model where you say, look, this oxidative measurement works?

I can explain it to you. why it works, but if we are missing the actual end points of people having fewer strokes following your model, how can we prove that what you are saying is actually true? Well, again, that will take a long time, but I see. patients six days a week, I even see them on Saturdays and Sundays and I don't need it at this point in my career. I draw their blood every 3 months in various laboratories that analyze, among other things, the oxidized phospholipid ampoule as a therapy marker. and many of my patients also see other doctors, family doctors, other cardiologists and we see a manipulation, let's say someone decides to increase a statin to reduce Appo, that's an idea, but when I see that the oxidized phospholipid of Appo increases even more.

As the Appo goes down and then I step in, can I ask you a question about that? Because that is very important. You just pointed out that if their Appo goes down but their oxidation level goes up and they have fewer heart attacks, do you care? No. we have fewer heart attacks, but we have hard data on tons of data thatthey don't have more less difficult, for example, you mentioned beta blockers, the most recent recommendations are that we should not use beta blockers as a treatment. for coronary arteries not for hypertension, yes, so as a first line for hypertension, yes, and so, for and exactly and um for coronary artery disease, we no longer standardly put people on beta blockers yeah have not had an MI.

You already know that and yet that was the correct standard of care, but the reason it changed was because the human models showed that that is exactly correct, but the human models initially did beta blocker therapy after a heart attack. myocardial arrest or after coronary bypass, the standard of care then changed. You couldn't send anyone out of the hospital and get a Medicare fine if you didn't put them in beta. Bo agrees, but similarly, human trials are the reason you know we don't initially recommend beta blockers or heart failure. It was believed that they were the mechanisms that it was believed that this was going to be very dangerous for heart failure, etc., and now it is the standard of directive medical therapy for systolic heart failure with quadruple therapy um qu for gdmt, so which is so important. why you know the multiple levels of evidence why preclinical data is important to generate ideas and then test results in humans so I'm not saying people shouldn't look into oxidized lipoproteins so I'm a big fan of lipids .

I'm a very lipid-focused physician and lipid scientist and Thomas Dpring, who is a world-renowned lipidologist, is one of my mentors and I have great respect for the research that's being done in that space. But the thing is, we already know it about you. Across the entire field of cardiovascular disease and across all major medical organizations around the world, reducing the risk of cardiovascular disease decreases, so while these other biomarkers are interesting, you know we don't have the correlation with the data from concrete results that we have with the reduction of apob. Also, the assays vary depending on which lab you're looking at, which we could really go into detail about, but there are a lot of people who believe that the assays that test for those markers aren't even correct, so there's not even much to it. weakness in many of the advanced lipid tests, you know, it's exciting to talk about that in theory, but for clinical utility, you know, I think with evidence-based medicine and we have to use the best evidence available to date and that includes search with a variety of levels of evidence, especially the most important ones, randomized control trials with difficult outcomes to give our patients the choice to do the things that are best for them, for which we have the best outcome data to summarize their positions for people watching, seems to be the reason. you make the decision to treat the way you are treating your patients, if you are seeing good results in your patients, you are finding the mechanistic approach, that makes a lot of logical sense and you could follow it along a path, follow it and you could track it with your patience and Dr.

Bardo is using some kind of difficult heart disease stroke endpoints to reduce apob. My question is that I have many doctors that I ended up having to treat patients after they retired. your attention has made you aware of crazy recommendations that you would strongly disagree with, that say you should only eat beef or some very harsh carnivore type diet and they claim the same improvements with their patients, so how do I distinguish myself as family medicine doctor? Among their recommendations that lack these final concrete data regarding carnivore diets, I may have a patient on a carnivore diet and I have several patients who choose to do a carnivore diet.

I'll have patients who will do an elimination diet, um. to treat

leaky

gut and at the end of the day 3 months 6 months we start to see their inflammatory markers increase we see their pla2 markers increase we see their hscrp markers increase we see their il6 increase and so tnf Alpha come up and we'll say hey guys, you know, look, they can feel really good and this is what's happening, they know beneath the surface, it's like they know that the girl from JAWS swimming on top of the ocean doesn't realize there's a great white shark underneath. She when they see them leaving, um, okay, you have my attention, now they don't feel it yet, in fact, a lot of them feel very good, so there's also a whole group of a diet tribe sect, there's a whole group .

Plant-based foods, no oil group, right, and I'm personally vegan. I think you don't have to be vegan. You should only be vegan for ethical reasons. Actually, vegans have canceled it, so yeah, because I. oil-free plant-based whole foods vegans don't necessarily like my point of view because I think olive oil is incredibly healthy, why because of much of our evidence of concrete results, yes, anyway, but low-fat whole plant food. vegans actually believe that olive oil is toxic they have exactly the same claims as you, identical, they reverse autoimmune diseases, they claim to reverse heart disease, which I have faced many of them in debates, they claim to reverse all types of disease and

inflammation

, they reduce the highest CRP in these incredibly high lectin diets without olive oil and they claim that olive oil is incredibly toxic and they can cite thousands of endothelial studies that will tell you that olive oil is toxic and my argument against That's when you look at the multiple levels of evidence and you look at the randomized control, we know that olive oil is not harmful, it's actually beneficial and it's healthy, but I think one of the points that Mike and I discussed is also. that you already know when. you are a consumer of this information and our patients, who are listening closely, I follow these low-fat plant-based people or I follow you because they have as many anecdotes as you do and so how do we classify and differentiate the evidence and here it is where I think the evidence is looking at evidence-based medicine, looking at the hierarchy of evidence, looking at meta-analysis and then looking at systematic reviews and then looking at randomized control trials and then being able to synthesize that into our dietary recommendations. who are eating a diet full of fruits, vegetables, whole grains, legumes, lean proteins, fatty fish, olive oils, great, you know, high in poly and saturated fats because otherwise, if we're just going anecdotally anecdotally, then we really do have many different dietary tribes. the exact same claims and they all have really believable stories and I really totally get it and it's heartwarming.

I have seen patients improve even though I am vegan. I've seen patients improve dramatically on a carnivore diet, you know, because in many ways it's Of course, I don't strongly recommend an elimination diet, a carnivore diet because it can increase the risk of color cancer and heart disease, increases stroke and They're losing a lot of vitamins and minerals and important things, but that being said, you know we can see the The carnivore group has tons of anecdotes where they can reverse disease X, Y, or Z, so I think that's where it is. Complicated for the general consumer of dietary information is how they select which anecdotes are best and why you know which anecdotes are best. the lowest form of evidence and we have to look at all levels, from long-range epidemiology to randomized control trials and Free Living studies that last longer than two years, such as the Leon Har study or similar studies that look at the two-week metabolism. board highly controlled by my friend Kevin Hall at the NIH, so we have multiple levels of evidence to synthesize what comes in our guidelines, otherwise it can be confusing for the consumer.

Do you agree with that that we need multiple layers of evidence and not anecdotal evidence? mechanism, oh absolutely, so what is your conclusion about the evidence that Dr. Bardo uses for her guidelines? Do you think the evidence is wrong? Do you think it is incorrect? Do you think it is incomplete? I think it's incomplete, let's put it that way, for example, um and I've talked about this in Plant Paradox. The possible reason why a low-fat diet is effective in those believers is that there is no longer a mechanism for lipopolysaccharides to travel in microns of kyom through the gut wall and create

inflammation

, and I love inflammation theory of lipopolysaccharides and if you do not have fat that transports fat through the wall of the intestine, unless you have

leaky

intestine for other reasons, then you will not have LPS in circulation, but those of plant origin low in fat and without oil. which I don't endorse, I don't love olive oil either, but of course, that's why I say it because I know you're huge, we agree with olive oil, we think olive oil is great, so what what I'm saying is they think you know they're on lectin rich diets with exactly the same results as you so I think what we're saying is how to differentiate that so I think the levels are good and They treat a lot of ornamental faults, faults de cilon, uh, they have progressive coronary heart disease on those programs and I'm sure they have artillery failures that they see exactly, so how do I decide what I should do?

What should I teach my residents to do? For example, I don't have one. I think the best controlled trial of a low fat diet versus a high fat diet was the Lionheart Diet. I think it was very well designed. It's my favorite studio. I'm glad you said that the Lionheart study has a statistically significant increase in the Lionheart Diet for your listeners who are not familiar with one of the best randomized control trials that we cite in all of our guidelines where they looked at people who they randomly assigned to be on a reference diet and then um, randomize them to a diet that increases legumes, a statistically significant increase, a dramatic increase in legumes, an increase in whole grains, a decrease in fat saturated fats, an increase in polyunsaturated fats, so pretty much everything that we recommend in our latest cardiology recommendations and in our nutrition statement for the ASPC is in the Lion's Heart study, so you increase the beans, you increase the whole grain , what did they find in the Lion's Heart study within a year of the study?

And I think it was a four year study, it was five years, they stopped it for three years because they had uh 50 to 70% reduction in the risk of cardiovascular disease and that was actually a yes, all in events in the heart, results of events, heart attack, serious stroke, so I was going to ask you with them, you know, quadruple your lectin intake, what's your counter how? In a study like that, oh, that's easy, it turns out the only thing she doesn't mention is that the study group they were compared to on a low-fat diet from the American Heart Association, wasn't a low-fat diet. , but it was the original, so they actually just replaced, they replaced the saturated fat with poly, but it didn't, they basically replaced it with rapeseed oil, which is, quote, canola oil, it's incredibly high in of alpha linolenic acid, which is a short-chain omega-3 fat.

The fascinating thing is when the researchers analyzed all the possible changes what was the factor that made the difference, the only one was the blood level of alpha linolenic acid that predicted the outcome and I wrote a lot about that in my previous books. I analyze it again and check if it is the alfal linolenic acid. acid that is actually making a difference, so I don't agree with posting the data, go ahead, look because it's also similar, there were multiple variables that were the only ones that impacted it, not because, but how can you decide that ?

Because that was the only difference between the two groups, it's true, not because they also had the leonart group, the leon har group. The intervention group also had a higher intake of antioxidants because they consumed more fruits and vegetables and that is true, but they were all compensated for in the final analysis. and the only thing that surprised me was that it was just allinic acid, so I had a feeling that you were going to say that the intake of poly and saturated fats, which I'm a big fan of, the biggest fan of poly andur fat, a me and I love it.

I love canol oil, I'm a big fan of canol oil and organic canol oil, but, um, there were a multitude of factors that improved the results, so your theory is that polyunsaturated fat intake offsets the

lectins

, yes, absolutely because polyunsaturated fats alfin acid actually prevent andreduces LPS levels, okay, so let's look at that theory because I think it's very valuable. There is a whole list in your books of foods that you say: Don't eat high in lectin. Some of them are common foods that doctors even label as healthy why not instead of telling them to stop eating these foods that are rich in antioxidants vitamins minerals etc and instead tell them to consume these fatty acids that are healthy well I tell them that but what I do when most of my patients that I see About 80% of my patients now are autoimmune patients that don't get better despite why do you think that's okay?

Because for some reason my program, if you follow it, your autoimmune disease will go away 90% of the time it will be in remission. in 9 months to a year, then people end up in my office specifically for autoimmune diseases. What about people looking to lose weight? People who have heart disease are also those people in your practice. Oh absolutely, but why is it so biased towards autoimmune because well, we have, like, I treat a diverse population and I can't get to 80%, we have an epidemic of autoimmune diseases in this country and I, among others , I believe that all coronary heart disease AR is in fact an autoimmune disease and So if you solve the underlying problem of the autoimmune disease, which I and others think is intestinal permeability, leaky gut, then that autoimmune disease is resolved.

It's very powerful that you say that because when you say it's leaky gut that causes autoimmune disease and you say I think this I'm skeptical because I try not to be cynical I want to be a healthy skeptic here you think this and I think it's wonderful I think we need to look into it. rather Leio Fano of Harvard not only thinks this but has done a good job of showing that all diseases come from a leaky gut. he said 200 years ago, yes, but 2500 years ago we balanced the humors and made people vomit and bleed them dry, there are many things we did in the past. doesn't mean we should look at that as a guide, so the question is how do we get from an individual saying this as theory to modern practice because we can measure these things, but measurement doesn't produce results in all scenarios, it sure does. .

This is not the case because I have patients who have abnormal thyroid levels and yet they feel perfectly fine and the second I try to change them with medications they develop symptoms. Did I help or hurt this patient? Why would you try to change someone who feels fine because their levels are off like you said the levels are more important no no I'm talking about we can measure the degree of intestinal permeability with good blood tests and we can observe changes in intestinal permeability and we can observe how it heals. Do exactly that with your patients.

How do you measure intestinal permeability with your patients? So we use Vibrant Wellness we use anti-zonulin IG anti-actin IG and anti-lps yes IG these are the food sensitivity tests that measure IGG this is what food sensitivity does but this looks at intestinal permeability and this is actually what alesio Fano developed as the way to measure intestinal permeability uh, I didn't recommend the test, yeah, I'm just confused because when I work with gastroenterologists, gastroenterologists teach me, I go to some of their meetings, this is not the only time it comes up. the concept of leaky gut and not leaky gut syndrome is in autoimmune diseases like celiac disease, where there is real damage that mitigates the damage of the immune complex of the villi, how do we get out of there?

That's the tip of the iceberg, so the tip of the iceberg has data behind it, data that we can act on, yes, there is good data behind leaky gut and reversing leaky gut, for example. I mean, what surprised me when I started looking at this is that every single one of my ITP patients with coronary artery disease had leaky gut when they walked in the door, every single one of my patients with an autoimmune disease, let's take Hashimoto's, had leaky gut. Every one of my rheumatoid arthritis patients and you know these are blood markers that we can measure had leaky gut, so when we put them on a program and we remeasure their leaky gut every 3 months. we can see it go away and it will resolve and the interesting thing is the markers will resolve and go away but that's not the interesting part, the interesting part would be treating your leaky gut, that's what we do for example in the gut exam.

I know I'm very excited about the microbiome there, it has a lot of untapped potential and we still have a lot of work to do to discover it and then I saw on a certain podcast that there are statements that you mentioned, you know? you take the microbiome of a depressed mouse and you implant it in a happy mouse, the mouse becomes depressed or you mentioned a study where I couldn't find the study where there was an individual in the era when people were institutionalized for their depression. they would give them a colon and then they would give them a fecal enema and 66% of them would get better that was a statement I have seen you make, what do I do with that information?

Because put yourself in my shoes for a Secondly, I have a patient who comes to my office who is depressed, they heard him say that they wonder why I'm not giving them the fecal enema. He wouldn't give them shit, why doesn't he just say that he has evidence of a 66% cure rate? that's the last thing I would give them, but how if you said a study did this in the 1930s, for one thing, believe it or not, when I went to medical school in the Middle Ages, we were actually the first People at the Medical College of Georgia will use fecal animas from medical students to treat cicil.

We didn't even know what IC was back then, it was entercolitis pseudo memus and my professor Arley mansberger said you know that and that's when broad spectrum antibiotics first came out in the mid 70s. he says, you know, I think something is happening in the gut and we have to reconstitute the gut, so once a week the medical students would shit in what we called the Honey Bucket, go to Arley Mansburg's lab and put it in a blender. it and stuck it in the butts of people with pseudo memoris in colitis and cured it, cured it and we became children of god, this is crazy and we do it now, we don't do it to that degree, but obviously we are trans, but no we do.

We don't need to do that, we can reconstitute the microbiome by one thing: we have killed our microbiome because of all the antibiotics that we take well, that's why we put it in all the antibiotics that we give to animals and the best most powerful antibiotic. There is Roundup glyphosate, it was patented as an antibiotic by Monsanto, so if you want to do something to your microbiome, we have created The Perfect Storm to kill our microbiome and what is really interesting is that glyphosate in particular kills tryptophan. Pawy produces insects that produce serotonin, so if you wanted someone to feel anxious and depressed, you would eliminate the tryptophan pathway from the microbiome, so what you want to do is eat organically and stop taking antibiotics unless there is a problem that puts you at risk. in danger your life and the good news is that if you stop eating animals you will lose those antibiotics the bad news is that most of our grains are contaminated with glyphosate my question I don't think we have the answer here yet because I think it's important when we discover that FAL transplants work specifically in the case of ciif but not in the case of depression, right, I'm not advocating that, yes, in fact, I don't know if maybe in Europe it is being used for that, but certainly not in the United States because the FDA Don't let it, yeah, I just don't know what's the point of mentioning that study because there's chapter after chapter in a gut review that shows the correlation between a diverse microbiome and lack of depression, lack of anxiety and we're getting getting closer and closer to understanding. what insects do what but we're not there yet we're getting close we're close but I just want to put that on the record we're not there yet we know Diversity is good, yes, but no I don't know which ones, we don't know exactly which ones, there's still room to explore here, yeah, I mean, for example, there are now bugs that make oxytocin the love hormone and you can actually swallow some of these and produce more oxytocin. can be a good thing, maybe, so I'd like to counter that with the fact that I think the gut microbiome is fascinating and I think we're at the beginning, I think if you talk to world-renowned gut microbiome researchers.

They will humbly tell you that we are at the beginning of elucidating the answers to the questions of how important. I don't think anyone doubts that the gut microbiome is an important facet of health, but we really don't have them. answers yet and I think that may be the most you know, world renowned microbiome researchers will tell you that we are not even sure of the exact population and what percentage of which colonies of which bacteria are most beneficial so we can't even prescribe in right now exactly what is most beneficial for the gut microbiome right now because we don't even know, that's why probiotics, that's why the American College of Gastroenterology, will know because as a family provider, I'm sure.

You get asked about probiotics all the time and that is why the ACG does not recommend the use of probiotics for people, generally outside of very few clinical conditions that require it, because we don't even know what strains, at what doses and in what scenario go. be beneficial and we know that with a lot of research on probiotics it doesn't have benefits and it can have harms and risks and that's why the ACG um uh is U sees it that way and I think we're in the infancy of gut microbiome research and I agree in that it's important, but we don't have enough concrete results data to give us yet, you should know how to eat these exact types of foods to improve your gut microbiome.

I think in general you know most things with a healthy diet, a varied diet, you know, a predominantly plant-based diet, of course, we believe that you can help your overall gut health with the consumption of fiber and fatty acids from short chain and all the things that happen in the gut microbiome, but I do believe. We're in the infancy of that research and not knowing that it's not that prescriptive yet, which is why probiotic trials have failed and why we don't recommend probiotics only in certain small clinical scenarios because we don't. I don't fully understand it and there's tons of research to be done in that space and also I just wanted to counter glyphosate quickly um uh organic when we look at organic versus non-organic and I don't have any dog ​​in this fight personally because sometimes I buy organic if it's Conveniently for me, sometimes I buy conventional products, but I think it's very important to make it clear to your audience that when we look at research with cardiac outcomes, that is, we are looking at cancer risk.

When looking at heart disease risk, the reason there are no guidelines that make dietary recommendations, including the American Cancer Society, that recommend eating organic produce, is because all the research with concrete results, there are two main studies that They analyzed it, Bradbury and I forgot the other one. show no differences between organic and conventional products, so although the mechanisms and ideas of glyphosate may be interesting, there has not been shown to be any difference in outcomes with respect to cancer risk, cardiovascular disease risk, or other cardiac outcomes that have been evaluated in the cohorts, everything that is interesting, here is my conclusion for me as a primary care doctor, the reason why America is sick, the world is sick, we have an obesity epidemic, we have people who consume ultra-processed foods at an unprecedented rate, um, my patients overeat ultra-processed foods. they eat tons of unnecessary added sugars and as a result they are very sick, cardiovascular disease, stroke, diabetes, etc., none of my patients eat fruits excessively and yet in your book and your podcast you make fruits almost an enemy , they are not an enemy, they should be. our friend, when it would have been available, no great apes eat fruit all year round, they eat in season and great apes really only gain weight during fruit season and we don't, we'll take a trip to the Central Park Zoo, why do we need it?

To go to the Central Park Zoo, none of my patients eat excessive amounts of fruit. Why are we talking about there being no juicers at the Central Park Zoo, but do you think that in general throughout the United States fruit consumption is a problem? No fruit products are a totally different problem. what is a fruit product like apple juice like orange juice we don't agree with thatwe are not talking about juice but that is not what we are talking about we are saying that an apple is not ideal to eat you said grapes are sugar bombs, that is, sugar bombs, there is as much sugar in a cup of grapes as in a Hershey's chocolate bar, yes, but that requires new ones because I would never tell a child to eat a Hershey bar before a grape, that will never happen in my practice, would you recommend?

You could allow the mother to give them apple juice. That's not, we're not talking about Apple saying grapes, it's simply that a child hears that a mother hears that grapes are a sugar bomb. Might as well give them Hershey's. them, Hershey's could too and his example, why could it too? Don't you think grapes have more nutrients than Hershey's? Believe it or not, extra dark chocolate has one of the highest polyphenol contents, but we're talking about milk chocolate, yes, it would. I don't exactly give anyone milk chocolate, so why even make the comparison? It has some great animated examples, Dr.

Gundry and I, they're pretty good. I appreciate that there are textbooks written on excellent APs, I mean, I believe you, but the interesting thing is that because in these modern times and We don't really know the guidelines, how much did they take into consideration the diet of the great apes? We didn't consider great apes because the good news is that we have multiple EV levels of evidence looking at fruit intake in humans as in reality. human species, so we don't need to look at the great apes to help us indicate how much fruit is healthy and if you look at the epidemiological data over time, I mean it is without a doubt that the individuals found in the top tertiles of fruit consumption is always always associated with lower risks of cardiovascular disease, autoimmune diseases, cancers in humans, so you know, although the great ape theory is cool, but we're not apes, you know?

So you think fructose is good for us. I think that's what I hear right. What I'm saying is that I don't recommend apple juice and in fact I think all the major medical organizations don't include in cardiology guidelines that we don't recommend sugar sweetened beverages and apple juice is not beneficial. neither is orange juice, but fruit in its whole form, thank goodness, yes, fruit in its whole form, you know, it comes with a lot of other things besides just glucose, fructose, fructose, it comes with, you know , polyphenols, vitamins, minerals, fiber, things that are really healthy for us.

So, you know, the comparison of fruit to, you know, a chocolate bar is a little disingenuous and I think the ape example, while interesting, we have a lot of human data that we can look at that shows us how beneficial and healthy is the fruit. It may be and I'm not saying that everyone needs to eat a ton of fruit. I'm not here recommending a fruitarian diet by any means, but you know we do know that, as Mike mentioned you know the vast majority of our patients who are having difficulty with the diet it's not from overdosing on bananas it's not from eating too many grapes you know I think we can all agree at least the three of us think we can be on the same page here that the main problems with diet in In our current time, a lot of this has to do with these very tasty processed foods that are super convenient and, you know, ubiquitous in society.

Yes, Dr. Gundra, I think what we're pointing out is that we're on the same page with being anti-prococo. Olive Oil Pro Mediterranean diet, we are all on the same page here, the problem is that people overeat these over processed foods, they do not consume enough fruits and vegetables, Leonart's study showed that if you increase legumes and whole grains, your main stance in your books is eliminate whole grains limit legumes fruits are your enemy how is that, I eat beans several times a week, as long as they are pressure cooked. I think ancient societies always fermented their legumes when you put the beans in a pot and soak them.

For 24 hours, have you ever noticed foam rising to the surface, but who's defending raw beans here? Well, no one other than normal cooked beans you haven't destroyed the lectin, which is well proven, fermentation will destroy them and these people in their own heart study ate those no- Fermented beans are great if, if you cook them, They were fermented, you won't hear, no, if you cook beans properly, even in a pot, you can remove over 95 percent of the lectins and I agree that none of us advocate raw beans, but cooked beans and also, by the way, canned beans, big fan for anyone listening who wants something convenient.

Canned beans, as long as they are sodium free, wash them, they are already pre-cooked and the lectins are minimized and there are only two companies that pressure cook their Eden and Joil brand canned beans now. I'm not a consultant for any of them so, but so easy, the problem in our society is that people don't eat Whole Foods and here we are making a List of Whole Foods to Avoid. I'm not telling you to avoid them. Hall Grains. If you have millet and sorghum that don't have Hall, they are perfectly safe, but you can even overeat them and go back to eating anything. with enough excess carrots, you go back to fruit for a second.

I can watch my patients, you know, go to Costco and consume grapes or blueberries and I can see their triglycerides go up and you might agree with me that the triglyceride HDL ratio could actually be very helpful, so in cardiology we no longer focus on the Tri to HDL ratio because we now know that the most important prognostic factor is APO, so the cheat sheet for that is to look incredibly at non-HDL cholesterol triglycerides. important but triglycerides are just a temporary measure and days and exactly so we don't really look at your HDL triglyceride ratio anymore like u but as triglycerides go up overall your Apple will go up but well yeah , sure. but you are the htl ratio, it's not a very important part, but the fruit will actually know it, Dr.

Gundry. All the research shows us that people who eat higher amounts of fruit actually have significantly lower hypo um apob in all randomized control trials. table due to dietary fiber and low saturated fat content, so eating tons of fruit, especially not in the form of fruit juice, in terms of whole fruits, can significantly reduce cardiovascular apob and R, subsequently, All this is valuable, but why are we? arguing about fruits when it's not the enemy the enemy is people who think that fruit is we shouldn't have 365 days of endless summer, but who eats fruit in excess? Americans overeat ultra-processed foods.

The Americans are hot dogs from Ting Burgers. I totally agree with that. Can't. make my patients eat fruit what research shows us that people should not eat fruit when I just mentioned that every um like if you look enhan D look I'm not saying don't eat fruit, I'm saying eat fruit in the seas try I'm trying to ask you I'm trying to ask you there is no year available there is no research that shows us that fruit must be eaten in season to be healthy all the research shows us that in a dose-dependent manner, people who eat more fruit in the highest tertiles of fruit consumption, people who eat a varied diet of fruits, vegetables and whole grains and all of these things, have all of Mar's markers of lower risk of disease, whether it's risk of cardiovascular disease. obesity, weight control, diabetes, so my question to you is: in addition to the seasonality that you are discussing with respect to apes, which is not us, when we have all this human outcome data showing us that there is no seasonality When it comes to fruit consumption, it's just about eating a varied variety. predominantly plant-based diet that is very helpful, how do you make that jump from animals to when we have all this human data that shows the opposite of what you say?

In the Mediterranean, people eat fruit seasonally, in the Mediterranean they also do not respect the The research that Dr. Bardo is pointing out says that people who eat fruits in greater quantities have lower risk factors and better results because they are following people mainly in the Mediterranean and it is not true. I'm talking about major cohort data. in the United States, that's the nurses' health study, we're talking about the doctors' study, like all these cohorts are in the United States, and even in the Mediterranean, I mean, now we live in a modern society where fruit is accessible to most people.

Modern society all year round and a lot of people don't eat seasonally, so you know the seasonal, the seasonal idea. I think you know this based on animal studies and things, although it is an interesting idea, it is not confirmed in Alem's data in humans, which shows us that you can eat fruit healthily all year round without not only not There are no adverse events in any disease, at least cardiovascular or all-cause mortality or cancer research, you know, but there are a multitude of benefits to more fruit consumption and I'm not. tell anyone to eat all fruit all day every day, but there's no reason for it to be seasonally limited and the reason why I also think it's very important is that there's a reason why the American Cancer Society guide to the American College of Cardiology guidelines are um um The ASPC guidelines are all for nutrition, they're very similar, as well as the endocrine society guidelines, all the guidelines for preventing cancer, preventing diabetes, preventing cardiovascular disease, All nutrition recommendations are similar because the science is similar, so eat. a diet with a variety of fruits, vegetables, whole grains, legumes, lean proteins, fish, things like that have been shown to reduce the risk of a variety of diseases, which is why we have so much synergy in the different specialties as a spectator listening to the experts talk to the Dr.

Gundry. reason for not recommending year round fruit you reference apes she references longitudinal studies here in the US how can I be on your side? Come to my clinic and see what happens when many people can do that. I have nothing against fruit, maybe you Don't listen to me fruit, I need to read some of the safe seasonal fruits. It's excellent. The fruit contains polyphenols. They are one of the best ways to obtain polyphenols in the diet. In fact, what I recommend is the reverse juice. Go buy all your organic fruit. put it in a juicer, throw away the juice, take the pulp and put it in plain coconut.

I love fiber. I'll share it on Lou House's podcast. This is a sentence: Apples are horrible for you, yes, they are. I mean, because an apple is not a It is not an apple anymore and in fact on Instagram it is true that it is not an apple anymore, it has bigger eyes for sugar, yes, but it is high in fiber, it has polyphenols , all the things you just said are healing nutrients, it doesn't have them anymore, but it does. totally changed, it has less vitamin C than 50 years ago, but it still has vitamin C, it has a little bit, a small apple, but how can you say that apples are horrible of you from that deduction of that apple the size of a big grapefruit?

Right and then when we look at research of people who eat apples they live very well my unhealthy patients don't eat apples when they eat one of the right size and guess what apples are not available all year round normally again all those statements that you can back up that the apples yes that application is not the same size it should not be available all year round how does that lead you to the apples deduction? Apples this size are horrible for you. Did you say that a fruit smoothie is the worst thing you can make? do it for your mitochondria I think that's true.

You don't think cyanide is worse for your mitochondria as it blocks oxygen and kills it. You're not going to eat cyanide unless you eat the exact apple. So how can fruit smoothie be the best fruit smoothie? it's a pure fructose bomb and if you want to stop your fructose, I'll argue with you about that because when you take glucose, when you make a shake, by the way, when you make a shake, the reason I think shakes can be beneficial, not for control weight, because I know that often drinking your calories can't be very useful, but in general, the reason why shakes are useful is that when you mix them, that's why I'm an anti-glare Pro shake when in You actually blend a fruit and vegetable, etc., to put it in a smoothie, it actually preserves the fiber matrix and therefore the fiber stays in the smoothie, so when you blend a blackberry, raspberry and apple smoothie you getTons of fiber, tons of phytonutrients, tons of amazing healthy benefits.

The only downside I would say, in my opinion, is that for weight management you might not get as much satiety as if you chewed it, but that's a whole different discussion, but I had to chime in with the shake's defense, give it a little bit of a defense. to smoothies because you do keep research shows that the fiber matrix is ​​maintained when smoothed, now juice, on the other hand, is not beneficial because the important parts of the fiber in the pl are removed, we can all agree on that Yes, I want to read you a statement and tell me if you agree.

Dr. Gundry says that my research, along with the research of others, has shown that year-round fruit consumption is associated with kidney damage and diabetes, among other diseases. , so not only is this not confirmed at all in humans. data, we don't even have multiple levels of research evidence that drastically disagree with this, so you could start with EP research, as I mentioned, so perspective cohort research is where you're observing someone for years and years in time. you're looking at 20 or 30 years, you're assessing someone's dietary intake and you know it's just one level of evidence, you can't make all the decisions based on the nutritional epidemiology in that area and level of evidence that we see, as I mentioned in the tertiles. higher fruit consumption people have less diabetes, this is well known, less heart disease, less risk of cancer, etc., then we look at the randomized control trials, there are numerous randomized control trials in which when replaces a standard American diet with a higher diet. in fruits, vegetables and fruits included in that variety of fruits, we know that we can reduce the risk of diabetes, the risk of heart disease, the risk of cancer, etc., in short-term randomized control trials, even my friend Kevin Hall from the NIH did a "do you want to go to an even more meticulously controlled trial" trial.

If you look at Kevin Hall's study at the NIH, where people went to live in the metabolic water at the NIH in two weeks and did a really low-fat plant-based diet, and I'm not even a big proponent of the diet low fat, no way, um, I think. There are multiple different dietary compositions that can work for people, but he looked at a 100% plant-based low-fat diet, high tons of fruits, tons of lectins versus a high-fat anigenic diet, a ketogenic diet. I know St. and you know, and he found that when he strictly controlled for two weeks, they lived at the NIH, he measured every MO Ule that they ate, you know, evaluated and you know that everything improved dramatically in the low-fat arm in comparison to the keto arm, um and it was because they were eating more. fruits, vegetables and whole grains, and you know foods like that, so I think we have multiple levels of evidence that show fruit is healthy and I think what you're trying to say is you know we have bigger fish for the problem. in the world of unhealthy eating is fruit, and I think unfortunately I think discouraging people from eating fruit can give them the mixed message that they know that a food that is healthy for them may not be as beneficial and So they may even find something that is even less healthy.

Do you think that might be a reasonable thing for a person to deduce? First of all, if I have someone with kidney failure and the first thing I do is they have high uric acid. is to modulate your fruit consumption, why not meat consumption, since you modulate your meat, you forget, I'm, I'm a little bit anti-meat, um, well, I'm not, I'm not necessarily anti-good, you're not anti-meat. Be it you, I am very much, but you said small amounts of meat are small amounts, but that's why I say, guys, I've been looking for new 5gc for a long time and there is more evidence that scares the hell out of me about the new one. 5gc, but let's go back to the fruits, then the uric acid.

I think we would agree that fructose is a big driver of uric acid. Fructose, animal proteins, particularly fish and shellfish, will boost uric acid anyway in my patient population and I'm talking about my patients who I do their blood work every three months when I reduce their fruit consumption i look for other sources of fructose in his diet high fructose corn syrup Etc. we see his uric acid drop and we see his cathine C and cathine C based egfr go up there and that for me and then if we change and allow If your uric acid comes back, it will go in exactly the opposite direction, how do we generalize what you are doing to the select population of PA?

He said he did the same thing, he even wrote a book about it, you know, he drops acid. um, I'm not such a strong proponent of the name cute and cute, only Boomers get the joke, it's called acid drop, but since all of these things are individual cases versus generalized advice, this is generalized advice I give to a patient What do I see with kidney failure? not to do it when you write your book, your book is not aimed at people with kidney failure, well, even people with kidney failure, by the way, I just intervene so that even people with kidney failure can eat fruit, there is actually no limitation, I mean.

People with kidney failure may have specific dietary restrictions of potassium or protein, but in general we know that all the cohort data and RCT data show that people are less likely to develop kidney failure if they eat a diet with a variety of fruits . and vegetables, whole grains and legumes, so I think the problem is that Dr. Gundra is again like the other dietary group, like the low-fat plant-based and no olive oil dietary group. I mean, they'll say they can reverse kidney disease. in his exact cohort, I mean, if you had Dr. Estelon sitting here, you would know that he would be saying that he reverses every disease that you claim to reverse with your diet plan, he will say that he does it with a diet high in olive oil without lectins and I.

I'm here in the middle saying that there are a variety of different dietary paradigms that can be healthy for health, but where we have to get that evidence it can't be from an individual cohort, it has to be from a variety of levels of evidence to be able to inform our decisions because you know anecdotes are, you know, of course. They're going to be meaningful to you and your anecdotes are meaningful to him and we've all seen patients who have improved on a variety of different dietary paradigms, but the way we report to our patients in the general public has to be based on good sound. scientific evidence, yes, I think it gets more confusing when we start selecting certain biomarkers to look at and criticizing certain problems and then we create this very confusing picture where patients come into my office and say I don't eat fruit anymore because I heard this in this on the Lewis house podcast and that scares the hell out of me because I don't see what happens with their blood tests when they do that, which is what I do, they don't do it because what they do is turn off fruit to the Milky Way according to your statement.

I never told anyone to eat the Milky Way. You say if you're going to eat grapes, you might as well eat a Milky Way. It was actually a Hershey's chocolate bar, so yeah people who eat fruit and all. The research, how do you explain that if people who eat more amounts of fruit in all the research have a lower apob, a lower weight, a lower risk of diabetes, a lower um, a high resed CRP, as in many tests So how do you explain why it is so dangerous? So wait, wait, wait, wait, fruit is one of the best sources of polyphenols and if you want to feed your gut microbiome, it turns out that polyphenols are the best prebiotic there is, but not year after year, don't look at the achievements, but why the hanzas?

I'll give you a perfect example: we want to change our gut microbiome seasonally based on the foods consumed during the wet season, when hodas only eat fruit and honey, they have a really interesting diverse gut microbiome in the dry season. when all you eat is meat, your microbiome changes 180° and I think other people think that seasonal shift was built in perfectly. You think it's a theory, but how can we generalize this so that everyone should follow it from this theory? It's a theory because that's how we emerged, well, that's how they emerged, but there are people who live, they are one of the last collectors of humans.

If you talk to Herman Ponzer, you know who Herman is, he's probably studied bodies more than any other individual. He is a good friend of mine. I texted him before our debate today to ask him a few questions. You know, if you talk to Herman about it, you know that he would never advocate for eating-only season because you know the evidence doesn't support it. That and he studies the Hza in great detail because you know that the Hza eat the way they do because they are hunters. They gather the right population. They are stagnant and we have a lot to learn from them.

But we live in the United States, where. things are ubiquitous and not available, we have data that looks at people who eat all year round and shows positive results for each cardio, that is for diabetes, hypertension, weight, inflammation, cancer risk , that's because of the polyphenols, so I feel like we're going around a little bit because you seem to agree that fruits are good because of the polyphenol. There are much easier ways to get polyphenols than eating fruit, which is my point. I think it's a much easier way. I think fructose is a mitochondrial poison. Do you think it is more beneficial to take polyphenol supplements than to eat whole fruit?

It depends on the season, for example a couple of days ago I ate a cute little apple that I bought at the Santa B farmers market, four bites and the apple was gone do you think our disease epidemic our disease epidemic chronic our our disease our cardiovascular disease our diabetes epidemic the risk of cancer autoimmune disease do you think fruit is a problem there or do you think it has to do with everything else me why not I don't think it's our highly processed foods, among others Things, I agree, but a lot of our highly processed foods are loaded with fructose, but that's not fruit, it's different than fruit.

I'm just saying fructose is a problem and please correct it. Me, if you think fructose is good for you, it's not about thinking about the fruit. I don't want to separate it as an ingredient and make it a villain because that doesn't help in real life if I start villainizing individual ingredients that I can't give to my patients. good guidance that is universally valuable, it's the same way as any restrictive diet, if you restrict patients to eating toilet paper, they will lose weight, but that doesn't mean they have a nutritious diet, so when I tell someone that fructose is bad for you, you can get fructose from a Hershey's chocolate bar or a grape.

I would rather they get it from a grape and fructose can be converted to glucose and the brain processes glucose and yet too much glucose is a problem. Inflammation can be a very big problem in the intestinal area it causes permeability, we know it, you say it very often, but inflammation can also be a wonderful thing when we exercise, we have spikes in blood sugar, we have spikes in inflammation, so Generalizing that fructose is terrible isn't valuable to the general public, you know what I'm saying? Yes, but the problem is that fructose is now ubiquitous in our diet and the more we can identify where it is hiding, the better off we will all be and the claim that you are proposing is that it is hiding in all these fruits people consume all these big fruits outside of season yes, but no one eats fruit, none of my patients can't.

I live in California we eat fruit in California sorry, but in America we talk about how much fruit is in the Standard American Diet, it depends on where you live. No, I'm asking about the standard American diet when we're very young, so why are we talking about it? I even give you another example. Joseph Marolo has recently become a bit addicted to fruit. kick and which is funny because he was one of the original high fat guys and he says man I feel so much better, all I do is eat fruit all day. I don't care how some people wait a minute and then say hey, but wait a minute, I notice that when I'm really going crazy on fruit, my triglycerides start to go through the roof and my insulin starts to go up. through the roof and, uh, you have to be careful, well, that's also listen, it's also not a randomized control trial where I'm controlling calories, right?

I just don't know what to make of that because it's not generalizable what Dr. Mola does or doesn't do with his insulin. It's not a controlled feeding study where, of course, you're looking at whether you're gaining. calories and you areincreasing, you're going to make changes in lipoproteins and you're going to see a variety of changes, but overall, on balance, when we look at all the data, we know the people who eat, I just don't want your listeners to be confused because when we look all the research, the totality of the evidence is that people who eat higher amounts of fruit generally have a much lower risk of obesity, diabetes, hypertension, and so, you know, I don't think you can sit here honestly. and think that fruit is the main problem in our obesity epidemic or our disease epidemic, you know, it's like that, it's just Dr.

Gundry. I'll simplify it to a metaphor, it's like we're sitting here and we're saying that the evidence shows that eating carrots is healthy and carrots are a healthy food and you sit here and say, but if you eat enough of them you'll turn orange, no one is debating that. Yes, carrots are cars, they are really good for you, yes I know, but you see what I'm saying. that we say that in general this food is healthy, fruits are healthy all year round and you say, but in some cases fruits can be bad, yes, great, but why say that?

Because if fruits are picked out of season, they are picked unripe and not ripe. They're actually loaded with lectin and then we ripen them when they get here. Is there a time when lectins are good for you? Oh yeah, there are a couple of really good lectins, so why are we generalizing that lectins are terrible? Because most of them are part of the plant. defense system against being eaten, but there are many of them that are being investigated for their benefits. We used to have a great lectin defense system in our microbiome. There are insects that enjoy eating gluten.

Most people are gone. Unfortunately, there are insects that eat oxalate. And among other things, quite a few people who have oxalate kidney stones or who are sensitive to oxalate don't have those oxalate-eating bacteria in their gut microbiome. If you cool those guys down, the oxalates no longer become a problem, so again, I guess going back around the gut microbiome that's been decimated by everything we've done is part and parcel of all of this and going back. to the achievements. I think it builds the idea that maybe we should have changes in our microbiome seasonally. in our evolutionary fiber, that's a fair theory, okay, but we have to be humble enough to say it's a theory, yeah, I didn't say, I didn't say, it's proven, that's great, so would you say that in general Do you make lectin a villain in general?

Yes, in our American diet, so do you think of the problem of simplifying something as all good or all bad in healthcare? How could it become a problem? I started doing this because I asked patients to eliminate certain foods from their diet and let me see what happened with their blood tests let me see what happens with their intestinal permeability. Did you do that when you were a cardiac surgeon or practicing as a cardiac surgeon because you're still a cardiac surgeon? Did you make those recommendations to eat fruits, vegetables, all those things? Yes and what? I think the reason for the failure of those patients' diets that led them to come back every few years was the fact that they couldn't stick to them or didn't stick to them, couldn't afford it, or the fact that they ate fruits and vegetables and still got sick. .

Well, a new article was published last week looking at a basically vegan diet versus a well-proportioned Chris Garders diet. Yes, I just read it and it turns out that the vegan diet did wonderful things in terms of. of cholesterol markers inflammatory markers the other diet did well, but it wasn't as good as a vegan diet, right? Mhm, what's interesting if you read the newspaper is that yes, this is all true, but sticking to the vegan diet is so difficult it's unsustainable and the compliance behind their list of yes and no's is easier, it's actually a lot easier. easier. 90% of my patients follow that list, but that doesn't mean there is a little selection bias, well, they are interested, it's like saying, my followers watch.

Well, 90% of my videos are my followers because if they see if their autoimmune disease goes away they are very interested or support what you do and what do you mean they are your patients my followers watch my videos because I have chosen to subscribe, they would not be my patients if they did not see a change in their autoimmune disease. I'm not saying that the recommendations you make about eliminating processed foods are all bad, that's not where our debate is coming from. In fact, there are so many things that you do very well for your patients that lead to good outcomes, the danger comes when we start to generalize that foods are bad or bad apples are horrible for you, those statements fool patience. and they lead her to make bad decisions because when you say that apples are terrible for you, you are making this statement from a very well-informed position about the change in polyphenols, this change and you wish they were a little smaller, the patient listens, too I could eat a Hershey's Kiss, you know? how that happens, yeah, and that's a big problem because your books are bestsellers and then patients say, "I don't want to eat apples anymore." Great because the apple they are eating is the wrong apple, that is so hard to do, that makes me very happy.

It's very difficult to say what your conclusion is. My conclusion is that, you know, there are many different dietary patterns that patients can be healthy on, although there is a lot of research that informs our recommendations and guidelines, patients need to find what works best for them and their diet. a predominantly plant-based diet full of fruits, vegetables, legumes, whole grains, lean proteins, you know, there's a reason I think there's synergy in all the Major Medical Society guidelines for Cardiology, cancer, endocrine society, etc., and in reality, there is no perfect diet, no one. food in a single dose is going to cause illness and that it is actually the patients who find something that is sustainable and works for them in the long term.

I'm going to say something almost controversial when we talk about leaky gut syndrome, not the concept of leaky gut syndrome. I feel that patients who have gastrointestinal conditions often have vague and non-specific symptoms and our healthcare system is rubbish at helping those people, this is true for many reasons, one of which is that our system is flawed, so doctors don't have enough time to spend with their patients to listen to them properly two, we don't have enough research to find out exactly what is going on, so we don't have all the diseases diagnosed already in the icd10 classification and then three, many of These patients fall into the bucket of looking elsewhere for an answer, usually in the form of supplements that are sold to them, diets that promise them solutions to their things that are largely unproven, and as a result, those patients and why I suspect that 80% of your patients are autoimmune patients because Our system has harmed me, but that is not because there is some kind of definitive proof in the solution for all autoimmune diseases, it is simply because you are offering them a solution that our system of care does not have a doctor.

That is absolutely true for most of my patients. in the autoimmune spectrum there have been six eight 10different centers different doctors look for an answer and don't get it and that's how they end up in my office do you like to walk away? Does it seem strange to you that patients who have a gastrointestinal disorder, an autoimmune condition, or a rheumatologic condition go to many gastrointestinal centers? Rheumatology centers are not getting help, but then a thoracic surgeon is helping them. Not anymore, because really, what do you know? Rheumatologists don't know anything about what. For example, all of this comes from intestinal permeability.

As? I know this because when intestinal permeability stops by whatever mechanism you want, do it and there are several ways. I happen to like my way because it works when that stops, the autoimmune condition goes away, and rheumatologists don't want to help their patients and follow their m. They want to believe in the system of using a biologic to treat what can be treated with food. , then you are saying that a rheumatologist who has gone through 15 years of higher education does have such a strong faith in other treatment methods that they refuse to see the very simple solution that he has presented, example of the Paradox plant, a young woman with the Crohn's disease who was treated by the chief of gastrointestinal at the Mayo Clinic and who believes that Crohn's disease has some genetic components, but it does not.

A lot happened on my program he resolved his Crohn's disease he called his gastroenterologist he said I was cured by following this diet and he says that's just a bunch of nonsense uh this is all in your head he's a Charon she hung up the phone her mother was baking Christmas cookies she ate a couple of Christmas cookies 2 hours later she was in the bathroom severe gastrointestinal upset. The doctor called me on the phone and told me why doesn't my doctor learn from this. I told him, look, you can't see unless your eyes are open when I met Big Ed 28 years ago, fortunately, for some reason, my eyes were open and, for example, Dale Bredeson from the end of Alzheimer's and David perid a brain of grain and a drop of acid, we joke that your people know the neurology community and the people of Cardiology and Cardiac Surgery the only thing we talk about is the intestine because everything comes from the intestine just as Hippocrates said and I am learning that remember that illness is good for business.

The disease will exist regardless of whether we follow Dr. Gundry's diet or not. Do you agree? It depends on you. you are saying that you can eliminate all diseases, Hippocrates believed it. I see him every day. I'm not asking the hippocrates, no, yes, I think I mean that, just think about the statement you say that you can eliminate all diseases, yes, I mean, so we are in the middle of a profit, why do you think That I still work six days a week at my age when it's not necessary? Because I can see how these things happen and the more I see them, the more firmly I believe that Hippocrates was right. like Fano, you see why I see a lack of humility in a statement where this is not the case.

I can see Milagros every day why I show up to work, but I also do it when I start with my patient. I am a foreman and his hemoglobin 81c is low. I see a miracle too, yes, but you're trying, you're trying to fix the underlying cause, sure, but my patients don't always follow the lifestyle guide, but you know why your patients follow your guide and mine doesn't. . I don't always follow mine because they are usually at the limit, yes, and because you have pre-selected the patients who want to follow your guidance, I don't call them, no, they call you, they have pre-selected you, okay?

If I took his model and then started doing it on my patients it would not have the same effect because it is not preselected but we have proven it we have proven it with all the research that Dr. Bardo has shown that if you eat high concentrations of fruit you live longer leonart study you eat grains you live longer and these are all the things that you get as acid in your body but you also live longer um no one is arguing about the Ala what we are saying is that you live longer by eating a diet rich in grains in the study of the Lionheart and you're arguing against those things and you live longer if you smoke in some of these areas, who isn't, it's not because if you smoke it's in spite of the smoke, no, you're wrong. but how are you wrong, you know that smoking pro-inflammatory acid is one of the best mitochondrial in the Dr.

We have to talk about this. A British doctor's study is not good. We need to at least put an end to the British smoker. British doctors who smoke have 30% fewer incidents of Parkinson's and because they die from 10 other diseases beforehand, so Dr. I have an anecdote to share with you. I had a patient in residency who reversed his illness. I actually don't like to use the word reverse, sorry, he put his diabetes into remission, improved his hemoglobin. A1c this was not on my advice this is just something I observed the patient told me this patient went from eating just a ton of processed foods and went on a cocaine binge for a few months well literally a bingeing on cocaine and, um, eating.

Twinkies candy bars but low in calories and his hemoglobin A1c and high-risk CRP are completely normalized. Yes, based on that anecdote, would we universally recommend cocaine and Twinkies as a diet? Of course, it is not correct. We cannot extrapolate from anecdotes that the individual lost a substantial amount. weight, so that happened in a really negative way. They lost weight because they didn't eat because they used cocaine, that's something I would always recommend to patients, so many of the anecdotes that we can all have. I mean, I have patients who are exclusively plant-based and who are on reallyextremely restrictive ones that improve all your biomarkers and the reason I don't recommend that anyone follow a plant-based diet without olive oil even though it has been recommended. by tons of people with tons of anecdotal evidence it's because when you look at multiple levels of evidence we know that eating olive oil can be healthy we know that eating fruit can be healthy we know that all fats are not necessarily bad in any way Polyunsaturated fat is incredibly healthy and that is why I believe in anecdotes, although they are interesting, we have to base our recommendations on the strongest outcome data evaluating various levels of evidence.

Yes, I was lost when we said that lectins are pro-inflammatory. so we should stop eating them and smoking is pro-inflammatory but prolongs life in some conditions. No, the pro-inflammatory effects of smoking can be counteracted with a diet high in polyphenols. I can't, period, I can't, so how do these guys do it? For it to be so long, how does my grandfather, who follows the less healthy low vitamin C diet, live to the age of 95 when he smokes? Yes, that's what I'm asking you. Yes, this is what it is in medicine, we have to have the humility to say it.

I don't know and my answer is I don't know and I could say it, but let's find out, we should do it, that's why I do what I do, let's find out there's a difference between saying, let's find out, verse, I am the prophet with the answer is not a prophet, but when you say you can end all diseases, that is prophetic, no, all diseases come from the intestine and all diseases can end from the intestine, that's all I'm saying, how does AIDS happen from the intestine? Well, actually, there is some interesting evidence that the microbiome in AIDS patients is totally different, well, yes, because they have auto, they have disease and you can change their microbiome.

How does herpes H occur, which on the lip comes from the intestine? I mean some of these, how does a blocked gland occur? it happens to my eye like we have to hum, believe it or not, there is now really interesting evidence that hearing loss is due to dysbiosis in the gut. period when you say really excellent evidence. I'm curious to know what's going on in your mind, uh, what's going on in my mind. In the next book, believe it or not, there is a really strong correlation between mitochondrial dysbiosis and LW's hearing. There is also a very good correlation between ice cream sales and shark attacks and I found that that is not very valuable, so why not manipulate the gut microbiome and find out if there was quality evidence.

I wouldn't look. Can. I have a channel here with 12 million subscribers. I can sell them probiotics and make a lot of money. I can sell your probiotics to you, in fact. You'd probably sell me your probiotics. I could sell them to my audience and make millions of dollars and help people. I would prefer if you sold prebiotics and postbiotics. How is that? I would sell them to my audience. Do you think I'm holding back from making money? Do you believe? I'm refraining from helping patients on principle, no, so why do you think I'm not selling those things?

Because maybe you don't believe the evidence that they work like I do, how's that, but the evidence that you believe they do? It's not based on human results, that's the problem. Actually, you just said that you found some correlational data and it leads you to make this general recommendation selling yes, you're not just the person in the room that we're discussing, why not? Do you read Alesio Fiso, a Harvard professor, if you don't believe it's called authority bias? Yeah, I mean, no, I just don't want to talk to those people because I'm talking to you and we're looking at correlations and we're looking at mechanisms and we're looking at your theories that you admitted are unproven, that was your previous statement, they are theories and yes they are theories. , just like the cholesterol hypothesis of coronary artery disease is one hypothesis, there are many other hypotheses, oh oh no.

No, no, it is a hypothesis, we know that high LDL cholesterol is the cause, without a doubt, of cardiovascular diseases, we know why yes, we know why you ask as if it were a god, why not. I mean, in other words, what about having a high LDL cholesterol is very bad for you UC. Frankly, I have patients who have LDL cholesterol of 400 and have absolutely normal CT coronary motor and that is not typical and that is very. You were talking about a unicorn that is very rare, we know this from all the research on people with familial hypercholesterolemia.

We know that regardless of some, we know that there are metabolic health factors that lead to increased ascvd. We know that diabetes increases the risk. We know that hypertension increases the risk, but all that. completely controlled regardless i ate high levels of apob itself causes asvd so all our um hyp don't measure clinically insignificant lpp2 levels well its clinically significant and the assays are not validated its funny that the Clinic Cleveland use It's a Cleveland Clinic that does a lot of things that, um, doesn't. I think they would be very interested in heart disease. Well, I mean, no.

I don't personally know any doctors at the Cleveland Clinic that recommend it because it's not in our guidelines because those trials are not inv validated and they don't have results, but anyway we have an answer for at least um and at least we agree on that apop B is positive, we don't have answers for everything and in medicine you are aware of this as more evidence emerges we update our practice of changes like I used to poop in a bucket when I was a medical student and now at Harvard they freeze R capsules to be able to deliver these transpl.

FAL, so we will literally take what we learned and update our guide and from there we need to have a strong layer of skepticism before accepting something as a change in the way we do things. I completely agree with you and I don't feel the caliber of evidence that is used to make certain claims rise to the level where we should make blanket claims that apples are horrible and that smoking is not bad as long as you have high antioxidant levels, because those are dangerous claims because they mislead people. to think that smoking is safe, that apples are bad, and that they might as well eat a Milky Way and, ultimately, know that's not what you want.

I know you really want to help people. You want to help people give up ultra-processed foods. Do you want to help. people achieve a healthy weight more muscle mass less fat those are the things you want is the mechanism by which we are talking about mechanisms the mechanism by which you chose to get here is very dangerous and I tell you this because while you are an expert with your patients . I am an expert in mass communication. I have 25 million subscribers of people who listen to every word I say and correct every mistake I make and I could tell you how your information comes very confidently to them and it doesn't land the way you want and I just urge you that in your next books and In the speeches you make, keep this in mind because when you make statements like apples are horrible, the worst thing you could do for your mitochondria is a fruit smoothie, it's not just about taking a little freedom with information, it's really tricking people into making bad decisions for their health, that's all I'll say in each of my books.

I tell people that if you don't smoke, smoking is bad. for you, but we should learn what's in cigarettes, we should learn that it's a factor in these people living a long time. We should learn, okay, that's what I'm saying, nobody and if you want to increase triglycerides, one of the best ways. doing it is fructose and I think triglycerides are a real problem in cardiovascular disease and we could agree that triglycerides are a problem, but fruit does not produce fruit itself not in whole food form it does not increase triglycerides by and I say reverse juice take all the fruit you want put it in a juicer pour out the juice and eat the pulp well I agree everyone oh I love the P we all agree that juicing is a bad idea so again , that's all.

My only caveat, yes, I think there are a lot of things we agree on, I think that's the mechanism by which we disagree and I hope the audience got something out of this. I appreciate that you took the time to have a critical discussion because a lot of people wouldn't have that conversation, so first of all, I'm very grateful that you're willing to do that. have this debate and thank you Dr. Bardo for the comments and all the work he does with Cardiology institutions around the world. G. check, we are looking forward to January 9th. G. check, okay, thanks Dr.

Gundry, Dr. Bardo, another popular offender. There's some stickiness in this class, click here to see my takedown, and as always, stay happy and healthy