For 30 years, well - over 30 years, I've made a career of preventing the major
causes of death and disability and diet is, by far, the most important way to do
that. Now, given that perspective and
background, you're probably going to be surprised to hear me say "Here the
biggest mistakes" - I'm going to do a brief series on the three most common diet
mistakes. None of them have to do with food choice. I know that sounds weird but
let's go a little bit further and what you'll see, why? Now, how did I come up
with these again? My experience as a Doc, I taught prevention at one of the world's
leading medical universities. I've got experience with hundreds or actually
thousands of patients and supervision of hundreds and, again, even thousands of
Docs. I can tell you for example that internists know a lot of the stuff that
we're getting ready to talk about but in the day to day drill of what they do,
they tend to forget about it and they tend to get focused more on the
standards rather than what's best for prevention for every patient. ER Docs
often don't even know about it. Many other Docs don't know about it
either. Family practitioners are sort of halfway
in between the two but let's not even worry about the Docs so much. Let's talk
about the diet's. Let me go - let me start by saying I'm not talking about
plant-based. I know plant-based and (oh my lord) there is so much heat, maybe more
heat than light on this debate. This is a book by a Jennifer Marshall on the
plant-based diet and so I think a lot of you would look at that and say "Oh, look
at that tortilla shell, that's got a lot of grease" She could theoretically call
that plant-based but that's really bad because
that's processed food. Well, maybe it's not even processed food. She's saying
here in her own title that it's Whole Foods but again this is not that. I don't
think this is the most common error with a diet. Other folks would say "Ok, really
it's - carbs is a big, big issue and it's really stuff-only sugar. There's a book
called SOS stuff-on the sugar and they're focused on getting out the bad
carbs, the simple carbs - low in fiber and nutrients, white bread sugar, brown sugar,
either brown or white fruit juices, white rice muffins, candy cookies, pretzels
sugary cereals - a big killer and replaced that with whole-grain bread, brown rice,
beans, nuts, seeds, oatmeal. I think those are valid points but, as I said, I
don't think they're the major cause - the major dietary mistake that I tend to see.
I don't even think they hit the top three and, again, this may sound weird.
Let's go - let's go on and talk a little bit about some things that I don't think
it is. There's just, again, I'll talk about emotion, you've got a lot of Paleo folks
out there who say "Paleo is the way to go" and this book is 300 delicious Paleo
diet recipes. I think Paleo has a lot to go for it. Just like picking the right
kind of carbs if you're - if and when you're eating carbs but I don't - I don't
think that it's Paleo versus Non-Paleo. That's clearly not the most common error.
Well then, there's clean eating. Now, I've studied what the people that came
up with the term clean eating. I used to know what it means but the reality is
even when I knew what it meant, I didn't know what it meant.
Clean eating - my grandma used to say "Well, a food is no longer clean if it touches
the floor" Well, I don't think that's what Emma Katie is talking about in this book
and I think that's what the founders of the
recent fad and focus on "clean eating" meant either and I still don't
think those are the number one causes or problems with diet. Then, there's this
thing about processed food and I think, once we all get tired of having these
debates about low-carb, high-fat vs high-fat, low-carb now, vs high-carb
low-fat and all of the macronutrient debates and plant-based vs animal-based.
People, quite often, will go back and then they'll make what I think is also a
valid point - unprocessed foods. But, you know what? I still would tell you - hmm
I don't think eating processed foods is the major dietary problem I see out
there. Same thing with this, you know this - this book is about 75 of the best carbs,
proteins, and fats. How to find them, again as you see on this picture, it looks to
be focused on unprocessed foods. Again, I think - very laudable, very plausible, very
important but nothing number one issue. Ketosis. How does ketosis work? Again, you
know - once you start getting into that whole argument about how much carbs
vs fat, you start getting into the whole discussion of keto diet. The higher
fat diet vs a higher carb diet. Again, a lot to be said for that so I've spent
a lot of time talking about what it's not. I will say this
(Pardon the the bad image here. As you know, I'm notorious for having bad images
in my videos) This is the cover of a book by Brad Bale and Amy Doneen.
Why am i covering that at this point? There's is not a diet book. They don't
really talk that much about diets. They talk about cardiovascular inflammation.
And cardiovascular inflammation as the major cause of heart attack and stroke.
They also talk about insulin resistance as, by far, the major cause of
cardiovascular inflammation and I think they're right about that. In fact, I don't
think. I mean - look at the research. I know it's - they get really focused on
cardiovascular inflammation. In fact, just sort of mention insulin resistance. They
cover it in a couple of areas but they really - I'd love to see them emphasize
insulin resistance more. What is insulin resistance? Pre-diabetes. It's the
inability to manage sugar in a healthy way. Now, wait a minute did I just take a
big digression from diet - the best diet into insulin resistance? Yes, I did. Now,
why would I do that? Well, as I said, I don't think it's dietary choices.
I think it's approaching your diet being totally unaware that you have insulin
resistance and so as you can see from this headline, now, you can say "Well I'm a
right coast person, not a left coast person." I'm not into - you know - those guys
are cooks in LA and UCLA is located there so they can't be right. You're right,
this has been - this has gone through journal judging. This is correct. Their
estimate is 55% of Californian adults, 30 and older have pre-diabetes. Now, this is
not new research. This actually came out in 2016. John's already done a video on
this actual - this article. Unfortunately, people just aren't getting it. They're
not looking. We've had like 200 views on that video. It's frustrating that people
are not listening. Pre-diabetes is higher among adults of color - Pacific Islanders,
American Indians, African Americans. Higher rates of pre-diabetes, but why - why
talk about it and look at images? Why don't we just look at
the actual numbers that they saw in this UCLA study. Okay,
18 to 39, a third or more depending on your ethnic group had insulin
resistance and a third overall for the state of California. How about 40 and
above? 49%. So these are pre diabetes rates. How about 55 - 69?
60% and then it goes back down, maybe a percentage. Maybe that's not
significant. 70 and above - now, what's interesting about these numbers is this -
they were developed looking only at hemoglobin a1c and fasting glucose. Again,
let's go back and let me re-emphasize why I made that right turn and started talking about insulin resistance.
I have patient after patient come to me and say "I don't know what's causing my
plaque", "I don't know what's causing my heart attack and stroke risk" and you've
seen this. John shared this on his videos a couple of times when - a Jon Lorscheider
As much as he knows about heart attack and stroke risk, I remember the
first - the first time he and I met, I went there, started asking about and he
said, with a lot of confidence, "Well, you can look at sugar problems, diabetes,
pre-diabetes, but I don't have it. We check it every year. My Docs have looked
at it every year and I've encouraged them to do so I know that's a major cause
but I don't have it and I said "Okay, but would you humor me, and maybe get a
couple of tests?" and he agreed. Well, the first thing we did was something that
again, Brad Bell and Amy Doneen recommend - a GTT
Glucose Tolerance Test. That's where you go NPO or nothing by mouth, you fast for
at least eight hours, then you take a glucose challenge. You get your blood
sugar before, then at thirty minutes, one hour, and two hours after taking the
glucose and why would they recommend that? because this number is conservative
compared to what you see with OGTT. in other words, if you actually do the test
where you challenge people with glucose, you'll see that these numbers are
actually low. But, here's the other thing, those numbers are actually low, as well.
If you look at fasting glucose, I mean fasting insulin, you'll see that
even the OGTT numbers are low. This is a book called "The Diabetes Epidemic In
You, Should Everyone be Tested? Absolutely Not - only those concerned about their
future" this was by Joseph Kraft. He was a pathologist that wrote this book
and, you know, you can argue with his style of writing but you can't really
argue that much with his results. They saw levels 75-80 % or more depending on
the age group of insulin resistance. Now is that - actually, I have heard people
argue with the results and the test itself. John, again, shared in one of his
videos that he went back and took this Kraft insulin study - insulin survey
to his doc and his doc said "Well, those are geared to fail" Well, here's the thing
I guess you could say that but here's what we found with John's and, again, he
shared it before. OGTT was actually normal for John but as he - as we did the
the Kraft and survey, there's a similar one called
Hayashi H-A-Y-A-S-H-I and that showed that he had what's often called a pattern
three or four with Kraft or Hayashi and that is - you peak on your glucose numbers
after the second hour, and sure enough as John said he got way over 200
plus to 300 and maybe 300 in hours 2, 3 or 4, so
what does that mean? Well, that means that whenever John was getting over a certain
amount of carbs in his diet - not just from the time he had the test, but in his
diet on a regular basis, he was going up to weigh over 200 for his blood sugar
and staying there for hours. In fact, the pattern 3 and 4 appears to be
people that missed that first phase of release of stored insulin and are
waiting for their pancreas to make insulin de novo that's - (if you don't get
that, don't worry about that, just worry about this issue) The vast majority of
people that come to see me, their major dietary problem is they don't know that
they have insulin resistance, pre-diabetes, or even full-blown diabetes.
So, therefore, that knowledge makes all the difference in the world. Again, as
you've seen through a couple of John's videos, you've seen through my videos -
Once you know that your blood sugars are going up to damaging levels after
you eat, it gives you a whole different perspective. A whole different framework
for - this is how I'm eating and this is what I should do. Now, there are other
ways to check for insulin resistance and check for this problem. One of them, for
example is fasting insulin vs hemoglobin a1c.
Are we getting it right? This is from a CM E-type journal called Clinical
Advisor. The reality is, there is a major place for getting fasting insulin levels.
You could get that but, again, with the Kraft insulin survey, you get a fasting
insulin level and you get insulin levels after your glucose challenge so -
Diabetes Care, this is - I mentioned a fellow named Hayashi Tomoshige
Tomoshige Hayashi, his name is also put together with Doctor Kraft's, in terms
of looking at OGTT patterns - oral glucose tolerance patterns, and
predicting the risk of type 2 diabetes. So, again this - it started off in terms of
maybe being very simple, very non-clinical but, as usual, I got fairly
clinical at the end and, here's the issue - it's not which diet you take, it's not
Paleo vs Clean vs Plant vs Animal. It's not knowing that you're not
metabolizing one of the top 3 or one of the 3 macronutrients and, in fact,
knowing that one of those macronutrients - carbohydrates is causing damage to the
intima lining of your artery. It's not knowing that that is by far, in my mind,
the major error that folks are making in their diet. I've just gotten through one.
I'm going to be covering two other major errors in diets, but we'll do that in
parts 2 and 3. Thank you for your interest.