How To Lose Belly Fat

Mark Hyman, MD

Full Transcript

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

Speaker 1: Coming up on this episode of The Doctor's Farmacy. Dr. Mark Hyman: Sugar and starch, and this belly fat is the number one cause of aging and age-related diseases. So if you want to die early, get a belly fat. Dr. Mark Hyman: Hi, everybody. It's Dr. Hyman. Welcome to The Doctor's Farmacy, and a new series we're doing called Masterclass where we dive deep into popular health topics, including inflammation, autoimmune disease, brain health, and lots more. And today, I'm joined by my guest host, my good friend, my business partner, and host of The Dhru Purohit Podcast, Dhru Purohit himself. And we're going to be talking about the foods you need to stop eating to lose belly fat, and what you should start eating that actually will help you lose belly fat and feel better. Well, welcome, Dhru. Dhru Purohit: Thanks, Mark. Great to be here. It's a little bit of a click baity topic, but I figured you're great at giving the people what they think they want, but then really you end up giving them what they need. So we're going to meet the people where they're at, and we're going to talk about this because a lot of people are very interested. And we're going to jump right in with two of the top foods or food categories that we can stop eating or be more mindful around or limit or minimize when it comes to their role of increasing belly fat. So Mark, what are these two categories and what do you want to say about them? Dr. Mark Hyman: Well, we're going to learn a lot about belly fat on this podcast, but the truth is, it's the most dangerous thing in your body. If you have belly fat, it is a risk factor for every single age-related disease, period. Forget about smoking, this is the killer. One of the two things that are the worst, one is liquid calories. I don't mean like a protein smoothie, what I mean is soda, juices, even nut milks, which you think are healthy, can be spiking your sugar, sweetened coffee, sweetened teas, energy drinks. We are living in a sea of liquid sugar and it's different, it's really different than regular sugar. Regular sugar's bad enough, but this seems to just accelerate the development of belly fat by being quickly absorbed, spiking blood sugar, spiking insulin, and that just leads to this whole cascaded belly fat. It's really bad. Dr. Mark Hyman: So if you can do a single thing to dramatically improve your health is get rid of liquid sugar calories. The second is flour, which is everywhere. And it turns out that flour is worse than table sugar when it comes to raising your blood sugar. When you raise your blood sugar, you raise insulin, you raise insulin, you sweep all the fuel out of your bloodstream and throw it into your belly fat cells. It's basically what happens. So it's like insulin basically opens the gates, all the fuel, fat, sugar, carbs, everything goes flooding into your fat cells. And then the gate closes like a one-way turns style in the subway, you can't get back out. Dr. Mark Hyman: So it's really bad. So flour and sugar. Now, do I eat flour occasionally? Yes. Do I try to eat flours that are better? Yes, I'll have coarsy grain flour or I'll have flours that are full of extra fiber or lignins, I'll have Buckwheat flour, Himalayan Buckwheat flour, which is actually full of phytochemicals and low glycemic load and high protein, high minerals and microbiome-enriching fiber. So there's ways to "hack it." Coconut flour, almond flour, those are all fine. I'm talking about wheat flour or grain flour, even brown rice flour, all these healthy gluten-free snacks. They're actually often worse than regular flour, because they're just so highly processed and are quickly absorbed. So those are also huge things. Dr. Mark Hyman: And it is different eating a whole grain versus whole grain flour. Even if you eat whole wheat bread, it's still a problem. So I would stay away from flour and sugar except on occasion as a treat and make sure you have a meal that includes protein and fat and fiber so you actually can mitigate the effects of the flour on your blood sugar. Dhru Purohit: So Mark let's break down the basics. What is belly fat and what are we learning about why it's so problematic for our long term health? Dr. Mark Hyman: Most of us were talking, "Oh, fat is just fat, it's like this inert thing. It's just there holding up your pants. It doesn't really do much, not good to be fat or have fat on your body too much, but it's not a thing really." That's how it was when I was in medical school. But now we've learned that the fat cells in the belly, we call visceral fat or belly fat, it's essentially the fat around your organs, around your liver, kidneys, intestines, all this fat is very different qualitatively. And when you see someone with a big belly or even who's skinny with a little belly, that is a sign that they're accumulating this belly fat. And what these cells are are a whole another organ. They produce cytokines. You've heard of the cytokine storm. Dr. Mark Hyman: Why is it that people with obesity are at the highest risk of hospitalization and death? Because their belly fat cells produce what we call adipose cytokines. One in particular called Interleukin-6 or IL-6 is one of the key cytokines that's driving the cytokines storm in COVID. That's why we're seeing this problem, is because of belly fat. Why people are dying from COVID is because of belly fat. That is important to understand. If everybody in America was thin and had no belly fat really to speak of, COVID would be like a non-issue unless you're really old or have a chronic disease or something terrible. But 88% of us have some degree of belly fat that's driving this problem. So that's one issue. Dr. Mark Hyman: They also produce all kinds of hormones. So you see all kinds of changes in people's bodies. For example, women, when they have a lot of belly fat will get acne, they'll get facial hair, they'll lose the hair on their heads. Men, the opposite will happen. They'll get high estrogen levels because the fat converts testosterone to estrogen, they'll get breasts, they'll lose all the hair on their body, they'll get soft skin like a woman. So these are real things that happen. They also change your brain chemistry, and they affect your hormones and your mood and your appetite. There's literally hundreds of molecules that are being produced by these fat cells. Dr. Mark Hyman: They're not just storage units for extra calories, they're literally organs that are dangerous organs that are producing inflammation, screwing up your hormones, screwing up your brain chemistry and making you sick and causing all the diseases of aging. Dhru Purohit: So Mark, talk about how actually belly fat and fat as a whole, but specifically belly fat, might have been used as a survival mechanism, but now it's gotten completely out of whack in the way that it's around with us 24/7. Dr. Mark Hyman: Yeah. Well, Dhru, we evolved in a sea of scarcity, now we live in a sea of abundance. And our genes are adapted to scarcity very well. So we are very good at accumulating and storing any excess calories. I remember going to Alaska a few years ago with my daughter and we were watching this grizzly bears hunt the salmon in the early part of the summer. And we were told by the guide that they eat the salmon, they do fine, but they don't really gain a lot of weight. And then they go up into the mountains in the end of the summer and they eat berries and they will gain 500 pounds of fat by eating sugar essentially. And they gain all that weight. And then what do they do? And they hibernate. So they lose all the weight through the winter. Dr. Mark Hyman: That's why they don't get high blood pressure and diabetes and just continue with other problems. We just keep eating all winter, that's the problem. And I think the challenge with our modern diet is the absolute excess of calories, the absolute excess of sugar and starch in our diet and the endless ability to overeat. We were producing between 500 and 700 more calories a day per person in America than we did in when I was born. So I think we have to really take a good, serious look at the way our bodies are adapted, which is to store as much fat as possible, as quickly as possible when we have an excess of calories or we have an excess of sugar calories. Dr. Mark Hyman: That's a good thing in the context of these feast-famine events that happen throughout human history. The problem now, we just keep eating, so we have to actually stop this process of overeating and eating the wrong foods that's driving this belly fat because it is the single biggest thing that's driving disease. So at one point, it was an adaptive mechanism, now it's a maladaptive mechanism. Dhru Purohit: Yeah. There's a great new book out and you're doing an Instagram Live with the author. And I believe the book is called Nature Wants Us to Be Fat, and it's Dr. Richard Johnson. And he's one of the top researchers in the space of uric acid and belly fat. And he, through his investigations in hypertension discovered that... The theory is that millions of years ago, human beings developed disability to basically use fruit, high amounts of fruits just like you're talking about other animals like bears to pack on all that fat and survive the winter. It's a fascinating Instagram Live. We're going to tune in to watch it in. The book is really interesting as well. Dr. Mark Hyman: Well, think about it, the fruit trees all come in at the same time. What are you going to do? They didn't have canning, they didn't have like freeze drying, they just had to eat as much as they could while they could get it. And that's basically what we're designed to do. And then the more you eat it, the more you want it. So that's how it works. So your body is triggered into overeating when there's an abundance of sugar, it's how your body's set up and designed. It's not a design flaw, it's actually a good thing, except it's only a flaw when we have highly processed industrial food system. Dhru Purohit: Talk a little bit more about liquid sugar. Why is it that liquid calories, specifically liquid sugars, again, sodas, large amounts and frequent use of fruit juices, especially on an empty stomach first thing in the day like the classic American orange juice, energy drinks, over sweetened and highly sweetened coffees and lattes that people are getting from places like Starbucks. Why are they so problematic? And how is it that they produce so much more belly fat than other foods that people are consuming? Dr. Mark Hyman: As I said earlier, sugar calories are bad and liquid sugar calories are worse. And the reason is they're unpacked from the matrix of food that they're in. They're not in a matrix of fiber or protein or fat, they're just pure sugar. And often, it's pure fructose, which is, when you need fruit juice or if we have, for example, high fructose corn syrup, that's up to 75% fructose in sodas. What those liquid calories do is they get quickly absorbed because there's not anything buffering their absorption. They spike your blood sugar that creates a spike in insulin. And that creates the flood of all the available fuel that's in your bloodstream into your cells. Dr. Mark Hyman: So it goes right into your belly fat cells, it doesn't go into your butt or arm or your ear lobe, it goes right into your fat. And that is why the liquid sugar calories are the single biggest correlate with obesity in America. If you look at, what of the things that people do that are most linked to obesity? It's liquid sugar calories. And people are clueless about the amount of sugar they're consuming. Most people don't know that for example, they have their Starbucks Mocha Frappucino latte or whatever, it's got up to twice as many sugar calories as a Cola, as a can soda. Dr. Mark Hyman: And you think, "Oh, I'm eating something healthy or it's got milk or it's got whatever." It's definitely bad news. So I think if there's a single biggest thing you can do to improve the quality of your health is get rid of liquid sugar calories. Occasionally, a glass of wine is fine, beer, not so much. Occasional beer is fine, but not a staple. A shot of alcoholic tequila, okay. But more and more researchers coming out that alcohol may not be really that great for us, so I think we have to really be cautious about it. But those tend to be less of a problem, but they're still bad. Dhru Purohit: So I'm going to pull one of the studies that our team member, Melanie, listed for us that are on this topic. And I'll just ask you to maybe expand on what the connection might be there. So here's a study out of the European Journal of Preventative Cardiology, coronary heart disease incidents in women by waist circumference within categories of body mass index. And the study, which looked at hundreds of thousands of women found that waist circumference, which is part of belly fat, increased the risk of coronary heart disease looked at over a period of 20 years. How could that be possible? How is that your waist circumference and belly fat could be connected to heart. Dr. Mark Hyman: Oh, that's easy. This is what I've been spending my whole life doing, so thank you for that easy question. People say, "How do I know if I have this or not? What do I do?" Well, I always joke. I say you could do the mirror test is where you jump up and down in front of a mirror without your shirt on. If your stomach jiggles, you have it. It's basically that. You can and take a tape measure and you can measure around your belly button around the widest point in your hips and you divide your waist by your hip. And if it's over 0.9, if you are a man over 0.8, if you're a woman, you're in trouble. If your waist is bigger than your hips, that's bad, if your hips are bigger than your waist, that's good. It's just obvious. Dr. Mark Hyman: Now, why is it a problem? Well, as I said, when you have this belly fat, it's driving insulin resistance inflammation in the body, and also what we call atherogenic dyslipidemia, which is a medical word for really crappy lipid or cholesterol profile that's causing heart disease. What causes this profile? What is this profile? It's small cholesterol particles, it's small HDL, small LDL, a lot of particles, and a large fluffy triglycerides that are full of fat, which is not good. And it leads to this horrible problem of high triglycerides, low HDL, small particles, which is the big driver of heart disease. Dr. Mark Hyman: If your cholesterol's 300 and your HGL is 100 and your LDL 70, or let's say your LDL is 150, I'm not that worried, and your triglycerides are normal. If your cholesterol's 150 and your triglycerides are 300 and your HGL is 30, that's terrible, I'm really worried about you. Even though one cholesterol is 150, one is 300, I'm much more worried about the 150. So you have to look at the quality of the cholesterol. And you talked about your NMR profile, your lipid profile. This is really key. So we have to look at the right type of cholesterol. And when you have this belly fat, it causes the wrong type of cholesterol. Dr. Mark Hyman: The second thing is that it drives inflammation, which we know is that the root cause of heart disease, and without inflammation, you don't get heart disease. The third thing it does is it makes your blood clot. So if you have too much sugar and starch, it makes your blood thick and it leads to this increased clotting risk. And the heart attack is a blood clot in the heart, a stroke is a blood clot in the brain. So basically, that's why you don't want to have belly fat and it's why it's so bad to eat these liquid sugar calories or anything that's going to cause belly fat. Dr. Mark Hyman: And by the way, it's a linear correlation, so it's like this, the more your waste to hip ratio goes up, the more your risk of heart attacks and death. Dhru Purohit: Powerful, powerful reminder. Let's take another category that people are familiar with, and that is dementia, cognitive decline. And there is a study that we'll link here in the show notes. And the title of the study in the Journal of Neurology is Central Obesity and Increased Risk of Dementia More Than Three Death Decades Later. And I'll read out the conclusion for you and you can expand on it. Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. 50% of adults have central obesity, therefore, the mechanisms linking central obesity to dementia need to be unveiled. Why would something like belly fat be connected to dementia? Dr. Mark Hyman: Well, basically the bottom line is bigger belly, smaller brain. The bigger your belly is, the smaller the hippocampus is. It literally shrinks, which is the memory center in the brain. And the reason this happens is you get a phenomena we call diabetes of the brain, type 3 diabetes we're calling Alzheimer's now, or insulin resistance in the brain. And this can happen independent of cardiovascular disease. So we know that, as I said earlier, that sugar and starch and this belly fat is the number one cause of aging and age-related diseases. So if you want to die early, get a belly fat. If you want to have a heart attack, get belly fat. If you want a stroke, if you want cancer, if you want Alzheimer's, if you want have blood pressure, belly fat's your ticket. Dr. Mark Hyman: So you don't want that going on in your body because it leads to all these metabolic changes. This whole phenomena of insulin resistance or diabetes in the brain is what's driving this problem. So it's no not just about heart disease, it's not just about high blood pressure, it's not just about, diabetes or being a little overweight, it's really about the quality of your life and what's going to happen to you as you grow older. And often, people don't understand that this is a 100% reversible problem. 100%. Dhru Purohit: Mark, I'd love you to talk about, and you've been talking about this for year, but I'd love for you to talk about it in the context of this podcast. You have a few articles on the internet saying that when it comes to belly fat, there are two aspects. Number one, we have to understand that it's not your fault. And for the people that are listening or watching on YouTube, I'd love you to explain, what do you mean by that that it's not your fault? And then along with that, there's so much that's in your control that you can do. Let's start with the first piece of it. Why is it not your fault if you are carrying a ton of belly fat or excess fat from a medical standpoint? Dr. Mark Hyman: From a medical standpoint and from a scientific standpoint, from a nutrition standpoint, the dogma is really clear, calories in, calories out. The reason you're overweight, the reason you have belly fat is because you eat too much and you don't exercise enough, #yourealazyglutton. That is just a bunch of malarkey. And here's why, we know that all calories are the same in a laboratory. So you say, "Oh, you say all calories are not the same, Dr. Hyman, who are you to say that? The first law of thermodynamics is all energy is conserved, and so calories in, calories out. This is the way it is. This is just science." Dr. Mark Hyman: And I'm like, "Well, yes, you're right, in a vacuum." What the first law of thermodynamics says, for those of you who are not up on your physics is it says that energy is conserved "in a system," meaning a closed system, like a vacuum. When you drop a pound of feathers in a pound of lead off a bridge, the feathers float through the air and the lead goes crashing down. If you drop them in a vacuum, they drop at the same exact rate. Why? Well, they don't have to contend with air. The feathers have to contend with air. When you eat food, it has to go through your metabolic processes, it has to deal with your microbiome, it has to deal with your genetics, it has to deal with your hormones, it has to deal with your brain chemistry, it's interacting with that all the time. Dr. Mark Hyman: So if you eat 1,000 calories of broccoli or drink 1,000 calories of soda, they're going to have very different effects on your body, versus if you burn them in a laboratory, they release the same amount of energy. A calorie is defined as basically the amount of energy required to raise the temperature of one liter of water one degree centigrade, that's it. So yes, in a lab, they're the same. So the message that it's about eating less and exercising more misses the central science, which has overturned that theory that all calories are the same. And this is what we call the carbohydrate-insulin hypothesis. Dr. Mark Hyman: And the key proponent of this has been Dr. David Ludwig, who's a colleague and friend of mine, who's one of the most published, researched, and esteem scientists in the field of nutrition today from Harvard Medical School. And he's written really in depth about this. You can read his articles on Medium, you can go to PubMed and find his work. He wrote a very extensive review view of this called the carbohydrate-insulin hypothesis, and essentially shows through the science that when you eat a carbohydrate-rich diet, if you are genetically susceptible, which is most of us on the planet, some aren't, but probably 80% of us are, you are carbohydrate intolerant. Dr. Mark Hyman: And when you eat X amount of carbohydrate in the form of sugar or starch, not talking broccoli carbohydrates here, it raises your insulin more than someone for example, like me, who doesn't have that problem. So it's really important to understand that if you are consuming starch and sugar in any form, that you are driving this pathway of weight gain, central weight gain, inflammation, active stress, blood clotting, hormonal dysregulation, brain chemistry changes. And it's really based on the information in the food, because food is not just calories, it's information, it's instructions, it's code. It can upregulate your genes in our downregulate them. It changes your microbiome. It changes your immune system. It changes your hormones, your brain chemistry. Dr. Mark Hyman: We have tremendous power to understand now the quality of our food determines the quality of our health. The quality of the information of the food is what changes the messages that get turned on or off in your body that regulate everything, not just your weight. So it's so important for people to understand that when they're eating food, not only are they eating calories, but they're eating information. The second thing around it's not your fault you're fat is we live in a toxic nutritional landscape. It's almost impossible to go out there and hunt and gather in America and find stuff that's not going to kill you. Dr. Mark Hyman: I travel, I go to airports. They've gotten better, for sure, but I never travel without my emergency food pack in my bag. I carry protein and fat in my bag for at least a day's worth of food so I don't have to get stuck in a food emergency. But it's rough out there in America, and we are living in a toxic nutritional landscape where the easy choice is the wrong choice and the hard choice is the good choice. Dhru Purohit: It's such an important reminder for everybody who's watching, because I think there's so many individuals, and Mark, I'm sure you've had patience, and I'd love to talk about a case study. There's one that comes to mind, somebody who suffered tremendously with excess weight and specifically belly fat and what they did to get better. But there's so many people that carry around the guilt because they've been told their whole life through the media, maybe even their doctor, their well-intentioned doctor who's just repeating what they learned, that they need to finally get some willpower and get their life together. Dhru Purohit: And so many of these people have tried so hard. They tried so hard and they tried so many different things, but because they are trying the standard advice, which is just eat less and exercise more, which is the same advice that they gave to the people on the show, The Biggest Loser, I'd love for you to talk about that and what we've found out from that experiment. They feel like it's not working. So talk a little bit about The Biggest Loser, and then we'll go into a case study. Dr. Mark Hyman: Well, The Biggest Loser was a problem because people were motivated by money, they were given extremely low calorie diets, they were pushed beyond their limits in exercise, and they were able to achieve some significant weight loss, which you will do. And the problem is when you do that, your body is in a state of crisis. And as soon as you stop, it's going to rebound and you're going to gain back that weight and often more, because often when you lose fat, you lose fat and muscle. When you gain back, you just gain back fat. So you could be basically the same way as you were when you started your diet and actually burning less calories. Dr. Mark Hyman: So that happens to people and you see all the people who are really overweight or struggle with yoyo diet in their whole life because they go, "I don't really eat that much. I don't know what's going on." And they're right. They're right. Their metabolism has slowed down so much because they've lost so much muscle and they've screwed up their metabolism. So, if you lose weight, you have to work on your muscle mass, which is important, and that has to do with the quality of the food you're eating. But the whole idea that you can go on these crash diets, I never put people on a calorie-restricted diet, never. I never say, "Count your calories, cut your calories. Don't eat too many calories." Dr. Mark Hyman: I don't even say the word calories, it's just so irrelevant. And I've had people lose hundreds of pounds, and it works because when you use science, not willpower, it's easy. People, aren't hungry, they feel nourished, they feel satisfied, they don't feel deprived, it's sustainable, they want to continue it, they feel good. You've got to use science, not crazy amounts of external force or internal force like willpower to actually get you to do it. Dhru Purohit: Mark, let's get into that case study. And is there somebody in mind that you want to talk about and what they did to radically reduce the amount of belly fat, which then besides looking better, and everybody cares about looks, it actually reduced their risk of many of the chronic diseases that we talked about earlier? Dr. Mark Hyman: Well, this is a great example, Drew, because it illustrates all the bad crap that going to happen to you if you eat sugar and starch your whole life, really. And then it illustrates how quickly it turns around if you change, because think about it, we spend 40, 50 years it and sick, it can take a few months to get better, which people don't realize, it's really dramatic. So, it takes a while for food to screw you up, but it can take very quickly for you to get fixed by it. And this woman was named Janice, she came to see us at Cleveland Clinic. She was 65 years old and she had every chronic disease except cancer and dementia. Dr. Mark Hyman: She had a high blood pressure, she had pretty bad heart disease with needing stents and all kinds of procedures. She had heart failure because her heart muscle was damaged. She had Type 2 diabetes on insulin, her kidneys were starting to fail, she was getting fatty liver. So pretty much her whole body was starting to shut down. And she came in pretty desperate and she was a barely well-educated woman, but her family just had no food sense and they grew up on junk and she thought, this is just what you eat, processed food. She never knew how to cook or do anything. Dr. Mark Hyman: And so within three days, and she was on insulin for 10 years, within three days of changing her diet to a whole foods, anti-inflammatory, phytonutrient rich, high fiber, high quality fat diet, essentially the 10-day detox diet, which I wrote a book about in 2014. Essentially within three days, she was off insulin. In three months, she was off all her medication, her heart medication, her blood pressure medication, her diabetes medication and her numbers normalized. Her blood sugar went from way out of control, A1C of 11.4, I think to 5.6. So just to put a perspective, if a drug be caused a one point drop, it's a blockbuster benefit like, "Wow, this is amazing. This new drug lowered A1C by one point." That's how about sensitive scale, it's what we call logarithmic scale, it's not a linear scale, it's like exponential scale. Dr. Mark Hyman: She went down from 11 to 5.6. She don't see that with medication. There's no drug that can do that. Second, her blood pressure normalized and she got off her blood pressure pills. Her heart failure, which we measured on echocardiogram reversed, which you never see. You just don't see that in traditional medicine, unless you get a heart transplant. Her kidneys got better, her liver got better and she lost like 45 pounds in three months. And then she went on to lose 116 pounds and looks like a completely different person. And she was on her way to the graveyard by way of a heart transplant and a kidney transplant. And then she avoided all that and she's doing amazing and back to being a powerful contributing member of her community. Dr. Mark Hyman: So that's the power of food when you understand that. And she had this giant massive belly and you could see her face before and after, it was just red and inflamed and that inflammation was driving all the obesity and everything else. Dhru Purohit: And if anybody wants to see a photo of Janice with her approval and also how her numbers improved over time, we have the link to that inside of the show notes that Dr. Hyman has put together. So Mark, let's go into the portion of the podcast where we take some audience questions, some questions from your community. Here's the first question. What about belly fat after menopause, is there a difference and is it more dangerous? Dr. Mark Hyman: I don't think it's different, but it gets more dangerous as you get older, for sure. So often women are in a hormonal chaos in that time of their life. They get thyroid dysfunction, adrenal dysfunction from too much stress, their blood sugar and insulin are often more deranged because they're more stressed. They're in that sandwich generation between like getting their kids launched and their parents getting older and a very busy career time, and it's just a disaster. And you see this terrible triad of sex, hormone, dysregulation, insulin resistance, thyroid, four things, insulin resistance and adrenal dysfunction. Dr. Mark Hyman: And that leads to increase belly fat and metabolic issues. It's not inevitable. There are many 50-year-old women or 55 year women who manage it and who eat well and exercise and take care of themselves in ways that actually prevent this. But you have to be more vigilant, you have to be more careful and you have to be more on top of it. I'm 62 years old, so I have to pay way more attention to my health than I did when I was 32 or 42, just to be able to do the same thing. So if I go for a couple weeks without exercising, it's a lot worse now than it was when I was 25. It takes me a little more time to get back to where I was. Dr. Mark Hyman: So really important to understand that you need more inputs as you get older, but you can still maintain vigorous health and strength. And they've shown that with the research that actually you can stay vital and healthy and fit very, very long into your later life. Dhru Purohit: All right, next question. What's the challenge with eating late at night, regularly having dinner at 9:00 PM, 10:00 PM or even eating late night snack at 11:00 or midnight, maybe even 30 minutes, 10 minutes before people go to bed? Dr. Mark Hyman: One of my first books, UltraMetabolism, I wrote about what we call the sumo wrestler diet. And basically the sumo wrestlers, the way they gain weight because you got these little Japanese people who are not genetically prone to being obese, and how do they get them to be those few huge sumo wrestlers? Well, they basically wake them up, they do their routine of exercise and training and then they eat a humongous meal called chanko nabe, which is basically, it's really actually healthy stuff, but it's a massive amount of food and protein and fat and rice. And it's like this massive meal. I love it actually. I love to eat it, but it just makes him gain a lot of weight Dr. Mark Hyman: So they basically have this giant lunch and then they go to sleep and take a nap and then do the same thing, afternoon, they may wake up, a little exercise, big dinner, go to bed and sleep with a big full stomach. That will make you gain weight. Why? Because when you're sleeping, your body's in repair storage mode. So all these hormones change from day to night and the hormones at night are storage hormones. So you're going to store all that food as belly fat. So you don't want to eat before bed, three hours at least. Occasionally if you'll go out to dinner or whatever, it's fine, but if you're on a regular schedule, I eat, 5:00, six o'clock, bed, 9:00, 10, o'clock, give myself three hours to digest my meal and don't have snacks. Dr. Mark Hyman: Snacking first of all is the worst invention of humanity. We all of a sudden got six, 700 extra calories a day per person and the [inaudible 00:31:40] goes, "What are you going to do with that?" Well, let's make all these fun snacks and convince America they need to snack and never be hungry. It's the worst thing. So snacking is terrible and you should really eat in a shorter time window, you should definitely not eat before bed. And if you do, I promise you, you're going to gain weight. Dhru Purohit: Yeah. One other thing that the sumo wrestlers do is they drink a big pint of beer in addition to that meal. I was watching a documentary on sumo wrestlers and I was talking about this with Dr. Richard Johnson we mentioned earlier. He was saying, "Yep. That flood of uric acid that comes in and that's a sign to store up the belly fat." So don't live like a sumo wrestlers, the moral story, unless you want to look like one. Dr. Mark Hyman: That was basically yeah, the multi metabolism way back when- Dhru Purohit: Here's another question from our community. If insulin drives weight, why are diabetics put on insulin? Dr. Mark Hyman: Great freaking question. Here's the thing, most doctors know this most average people don't know this. When you have a diabetic and you put them on insulin, what happens? Do you know? Dhru Purohit: They gain weight. Dr. Mark Hyman: Their blood sugar goes down, but they gain weight. Their blood pressure goes up and their cholesterol gets screwy. So it's like a whack-a-mole. Yes, it keeps the sugar down, but what you actually learn, and this was a huge study, it was called The Accord Study of 10,000 diabetics who were in aggressive blood pressure management. In other words, they were like, "Let's get these people's sugar as close to normal as possible. Let's give them lots of insulin, lots of drugs. Let's drive their sugar down and let's see how they do." And you think, "Oh, well, if sugar is the problem with diabetes if they got their sugar normal, they'd be fine." It turned out the opposite was true. Dr. Mark Hyman: The lower their blood sugar, the worse they wear, the more heart attacks, the more deaths. Why? Because they use a lot of insulin and insulin makes you die, it makes you fat, it kills you. It's the worst thing when it's in excess. And I often, by the way, Drew, I see Type 1 diabetics, often getting double diabetes. In other words, they will have Type 1, but then they get Type 2. So here's how that works. Normally you should make about 20 units of insulin, 15, 20 units of insulin a day to manage your blood sugar. That's the average person. What happens if you're a diabetic Type 1, if you, let say you want to eat cake and ice cream and cookies and whatever, you can do it and you can keep your blood sugar normal, but you need to give yourself more insulin. Dr. Mark Hyman: And so they keep your immune cells more and more insulin and they get insulin resistant, which means they need more and more insulin just to keep their sugar normal. So they might be using 50, 60, 100 units of insulin. That's terrible. So you can get double diabetes by eating too much crap and using insulin to manage your blood sugar. So the key is to keep your blood sugar as low as possible. And a friend of mine is a Type 1 diabetic and she uses a ketogenic diet and she basically uses the one or two units of insulin a day, which is ridiculously low. Because if you eat fat, you don't need insulin. Dr. Mark Hyman: And that's why ketogenic diets work so well for Type 2 diabetes where they cure 60% of people or 95% or 100% get off the main medication, over 90%, get off their insulin or reduce it dramatically. It leads to the most weight loss of any study I've ever seen, which is about 12%, which doesn't sound like a lot, but most studies you get 5%, everybody's jumping up and down and super happy. So it's more than double what you see with a normal weight loss study. Dhru Purohit: Right. And there's a way to do cleaner versions of keto and there's ways to do dirty versions. We're obviously talking about the cleaner ones that are plant forward, plant rich at the base of it to get all that. We don't want to just be eating bacon all day and- Dr. Mark Hyman: No, olive oil, avocados, nothing to eat there. Dhru Purohit: Yeah. There's plenty ways to do keto in a clean way. All right. Couple more questions here before you wrap up today's podcast on belly fat. Why is it so important to practice stress management techniques to help with losing belly fat? Is there a connection between the mind and the body when it comes to belly fat? Dr. Mark Hyman: Well, yes. Stress makes you fat, relaxing makes you thin. It's that simple. Here's how. I actually, I had a patient, I learned this from her. She was a woman who had a daughter living in Israel, and it was during the time of like maybe 15 years ago, whenever they had the intifada, it was really bad. And she was terrified for her daughter. And she was so stressed and she could not lose weight. She was like 40 pounds overweight. And she struggled to lose fat. Her daughter moved back to America, 40 pounds went away. And what happens when you're stressed, you make cortisol and you send all sorts of signals through the vagus nerve and the parasympathetic nervous system to your fat cells. Dr. Mark Hyman: So basically, every cell on your body is wired to your nervous system. So when you're eating and you're trying to metabolize your food, your fat cells are listening to your signals from your brain and they're telling it what to do. And it turns out that the wiring that goes to your fat cells when you're under stress, tells the fat cells to store fat and that's wow. So you never want to eat a meal if you're stressed, you want to stop, take a breath. Why do people say grace, have a prayer, take a moment? It's to reset your nervous system. And I think there's a simple practice called take five that you can do before you eat, where you take five breaths, five seconds in, five seconds out, five times, just... like that with your nose ideally, but just five deep breaths and you'll see your body will change, your physiology will change, your pH will change, your brain chemistry will change and your body will be more in a state of relaxation that receives eating. Dr. Mark Hyman: Also, you can't actually absorb nutrients as well when you're stressed. So there's a lot of issues around stress, but between the innovation of the fat cells that makes them store fat and the high levels of cortisol by the way, cortisol is a drug also that we use called prednisone or steroids. Your body makes it and you need it, it's there, but when it's in excess, when people are taking it, for example, what happens to them? There's actually a word for it, it's called cushingoid. They get looking like Cushing patients, which are people who have a tumor that's making too much cortisol. So they'll get really big bellies and belly fat. They'll get skinny arms and legs. Dr. Mark Hyman: They'll get high blood pressure, they'll get diabetes, they'll get all the things that we see from people who have too much sugar, but it's from the cortisol that raises blood sugar, raises insulin and all these secondary effects. Because you want that, if you're running from a tiger, you want your blood sugar to be as high as possible so you don't run out of gas if you're running from the tiger. Dhru Purohit: All right. Last question that we have here, Mark, and then we'll do a little bit of a recap for today's episode. What is the role of fasting or intermittent fasting when it comes to losing our belly fat? And are there techniques or resources that Dr. Hyman has to make it fasting easier or less scary is what I'm reading into the question? Dr. Mark Hyman: Yeah. So time restricted eating, intermittent fasting, fasting mimicking diets, ketogenic diets, they all do the same thing. They basically give your body a break, a period of non-eating or appearance of not eating. If you're eating keto, you're not eating carbs, but you're still eating, but the body doesn't register it as anything that's driving insulin. So if you could drink a liter of olive oil on empty cell, your insulin will not rise one bit even if it's a million calories, it just doesn't go up. But if you eat that fat with sugar, it's a problem. So the key to fixing the belly fat is to lower the insulin and to turn on all the other signals that make you burn fat. And the way to do that, and there's a lot of ways to do that, but one of the ways to do that is to do time restricted eating. Dr. Mark Hyman: So you eat within an eight hour window. So let's say you eat dinner at 6:00, you can eat the next morning at 10:00. It's not that terrible. If you eat at 8:00, you can't eat till 12, whatever, but you really need a break from eating. And if you really have a lot of belly fat, the eight hour window to eat is really effective. And it turns on all the signals that repair your body, reduce insulin resistance, get rid of belly fat, build muscle, reduce inflammation, increase your antioxidant enzymes, improve your brain function and cognitive awareness. So it's really beneficial. You can also do periodic fast, like a day fast, 24 hours, 36 hours. You can also do other things like fasting mimicking diets, where you restrict your calories for five days like Valter Longo has talked about, and he's in on the podcast talking about that. Dr. Mark Hyman: Or you can go on a ketogenic diet, which basically, you can do with time restriction or not, but that also does the same thing. So when you think it's scary, it's because you think it'll be hungry, but the truth is, if you learn how to eat with the right composition and information, the food, it will make you feel full, satisfied, you won't be hungry. And there's hacks. You can drink a lot of fluids, you can sometimes use a MCTL because that won't kick you out of ketosis. So you can really use a lot of techniques, but it's very safe, it's very effective. And it's actually not that scary because it's not that hard for most of us. Now, if you're really underweight, if you've got cancers or stuff like so like that, you don't want be doing the too much of restricted eating. Dr. Mark Hyman: I know for me, I can do 16 hours, if I go more than that, I'm in trouble, I get in trouble. So I have very low body fat and I'm probably too stressed, but I don't really feel stressed, but I think my adrenals have beat up over my life, but I've been trying to recover from my life. But the truth is, your body usually does really well if you have any visceral fat doing time restricted eating, intermittent fasting, or ketogenic diets, Dhru Purohit: All right, Mark. Those are all the questions that we have for today. I'm going to pass it over to you to a little bit of recap of what we covered foods to avoid that are linked to belly fat, why it's important to bring our belly fat down, not just for looks, which often brings people in, but actually for chronic disease. And maybe a message of hope because a lot of people feel very stuck when it comes to this topic and feel like they've tried everything. Dr. Mark Hyman: Yeah. Well, to me, it's one of the most satisfying parts of my practice, Drew, because the power of changing the composition of your diet is so extreme and work so well and it's so relatively easy to do that it should give people a lot of hope. And so just to recap a little bit, it's not rocket science. It's sugar and flour and particularly liquid calories. So any sugar, any flour, pretty much, unless it's like coconut almond or maybe the Himalayan Tartary Buckwheat flour, you want to really be careful about. The second thing is that when you get excess amounts of sugar and flour, it does a couple of key things just to recap. One, it spikes your blood sugar and then that spikes your insulin, and then that puts all the fuel that's circulating in your bloodstream, both fat and sugar and everything into your fat cells, and it locks them in there. Dr. Mark Hyman: And when it does that, it slows your metabolism, it creates inflammation, it makes you hungrier. It causes all kinds of brain issues in terms of depression, it leads to Alzheimer's, heart disease, cancer, diabetes, high blood pressure. It's basically the worst thing you can have. And yet when you switch up the way you're eating and understand that food is information and change the quality of your diet and change the kinds of carbohydrates you're eating from starch and sugar to more vegetables and fruit, you literally will change this overnight. So it's about cutting down out the sugar and starch depending on where you are and then increasing the proteins and the fats, particularly the fats, avocados, olive oil and nuts and seeds. All those really help cut appetite, regulate your metabolism better, speed up everything. Dr. Mark Hyman: And it's really easy to fix. And I can't tell you how many thousands of patients I've had who've gotten so much better and fixed all their numbers. And then the millions who've read my books and done others programs that we've done have seen so much amazing results. So it's not that hard, it's a little scary, and I think people are struggling. I encourage people to fall back on the 10-day detox. It's 10 days, highly structured, that gives you exactly what to eat, when to eat what, and how to actually regulate your hormones and your brain chemistry so you're not hungry, you're not starving, you feel good, you minimize any of the withdrawal effects. Because a lot of stuff can happen. If you stop eating sugar and start, you start dumping sodium. Dr. Mark Hyman: And when you start dumping sodium, you dump water and you can get dehydrated, electrolyte, all kinds of issues happen. Going from being really unhealthy to healthy, there's a doorway and you have to know how to manage that. So all that's in the 10-day detox, I think will link to it. And if you've loved this podcast, please share with your friends and family on social media, subscribe where you get your podcast, leave a comment, we'd love to hear from you. And we'll see you next week on the Doctor's Farmacy. Speaker 1: Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search there, Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health.