How Our Health Suffers Because Of Corruption In The Food System - Transcript

Narrator:
Coming up on this episode of The Doctor's Farmacy.

Dr. Mark Hyman:
It is the biggest cause of chronic disease, period, and it kills more people than anything else. So why aren't we studying it? It's all because of how the system is set up.

Dhru Purohit:
Mark, welcome back to the podcast. Pleasure to have you here. I want to jump right in. We've done a couple episodes recently where we've talked about food corruption and just how kind of messed up the whole industry is, and with big food. You have your own story in this area that you wrote about in the book Food Fix, but I'd love for you to share it with our audience here.

Dr. Mark Hyman:
Yeah. I think we don't realize how much the food industry is embedded in our policies, in social groups that we think are representing people's best interests like the NAACP or the Hispanic Federation, how much they're infiltrated in professional organizations like the AMA, or American Diabetes Association, American College of Cardiology. I mean, every single professional organization, social group, policy organization, they're all infiltrated and influenced by the food industry to the tune of literally millions and millions of dollars. It's something that sort of happens below the surface and the face of corporate social responsibility, for example. It brings to mind an example of something that happened personally to me when I was helping promote the movie Fed Up, which was about the role of food and sugar in obesity, particularly childhood obesity, and exposed a lot of the sort of industry issues that were going on.
I went to Atlanta and a friend of mine introduced me to Bernice King, Martin Luther King's daughter, and got to have quite a bit of time with her. She realized that nonviolence that her father talked about also meant nonviolence to the self. Really, the African-American community really needed to be inspired to also look at that. And we talked about showing the movie Fed Up in the King Center in Atlanta. Now many of you know that the King Center in Atlanta is where Martin Luther King had his church [inaudible 00:02:14] Baptist church, but is also where Coca-Cola's headquarters is. And Coca-Cola funds the King Center. And at first, Bernice was very excited about sharing this movie in the King Center and having a show. And we had it scheduled, it was all set up. And a few days before this screening, I got a call from her saying, "Hey, we can't show the movie," and I was sort of flabbergasted. And really, it was because the King Center is funded by Coca-Cola.

Dhru Purohit:
She said that outright? She told you explicitly, or is this implied?

Dr. Mark Hyman:
I mean, it was kind of implied. And then I went to visit Spelman College, it's one of the major colleges for women, African-American women, in Atlanta. There's Morehouse, which is the men's college in Spelman College. It's one of the top African-American colleges. And I met with the dean in there and she said that 50% of the entering class had a chronic disease, of 18 year old women, heart disease, diabetes, high blood pressure, obesity. And I was like, "Wow." I said, "Then why are there Coca-Cola machines and vending machines all over the campus?" And she goes, "Well, a big portion of our funding comes from Coca-Cola. And if you look at the board of directors, one of the key members of the board is very high level executive at Coca-Cola." So she understood the problem of this.
We have a problem in our society where we don't fund education, we don't fund social groups, we don't fund the social safety net. So these large corporations step in to fund these groups when there's nobody else funding them. So for example, they really don't want soda taxes. So the soda industry does not want soda taxes. And they literally have funded the NAACP and Hispanic Federation to influence them to oppose soda taxes-

Dhru Purohit:
Which is the part of what Cali was talking about in helping out the strategy.

Dr. Mark Hyman:
Exactly. Discriminating against African-Americans and Hispanics by targeting them with taxes and it's regressive. And there's all these talking points they have.

Dhru Purohit:
[inaudible 00:04:17].

Dr. Mark Hyman:
They have all these talking points. They even funded an initiative in Philadelphia that was going to pass a soda tax. The children's hospital there, the CHOP, very famous children's hospital in Philadelphia, was in favor of a soda tax in Philadelphia. And Coca-Cola gave them $10 million as a, quote, donation, which then led to them abruptly withdrawing their support for soda taxes. So that's how-

Dhru Purohit:
It was that blatant.

Dr. Mark Hyman:
That blatant.

Dhru Purohit:
Was anybody making noise about it? Did you see it written about?

Dr. Mark Hyman:
Yes, it's not hard to find. I mean, you do little research and you don't have to dig very far to find these things. In big soda companies, and particularly in Coca-Cola, they targeted African-American and Latino populations because they already were using these compounds more. I call them compounds because they feel like drugs that are bad for you, the soda and sugar. And they realized that they could influence these groups and that they could get them to be even bigger users. So they have a view that if you're... For me, they're never going to get me to drink Coca-Cola, but if someone's already using it, you can get them to use more. And that's basically the strategy they use.
And they use this through various tactics, for example, with electronic benefits, the food stamp cards, whenever... They come out at the beginning of the month. They'll go to the local markets and they'll give them discounts and then they'll have huge advertisements in the front of the stores that you can get your two-liter bottle of soda for a couple of bucks. So they get these things discounted, they know when they're coming out, and they have whole marketing campaigns around this. So the whole thing is corrupt. These groups are co-opted. The professional medical nutrition groups are co-opted. Academy of Nutrition and Dietetics, 40% of their funding comes from the food industry. So it's problematic.

Dhru Purohit:
It is problematic. And why I wanted to have you on to talk a little bit more about it is that there's also a balance of... and it's in the context of a lot of these organizations and groups are looking for funding. They're looking for resources. Earlier, we were talking about Tufts University and we were talking about the food compass. And there was recently an article written that there are over 60 big food companies, including several that ranked highly on the food compass. And again, is there going to be any big institution that doesn't take that money? But also, I'm hearing you blatantly say that it's also corrupt. So where do we find that balance that's there? Or what does a new system look like?

Dr. Mark Hyman:
I mean, it's a really great point, and I did talk about this in Food Fix. The key is, whether it's the pharmaceutical industry or the food industry, they're all up in everybody's business. And in academic centers, a huge amount of the funding of academic medical centers comes from pharma through, quote, funding research and funding academic programs and education. So a lot of the way that they influence prescribing practices and what drugs get promoted and what drugs get researched is through these massive financial influx of money into the system. One of the original things that happened around this, which led to a lot of the conflict of interest disclosures that now have to happen in academic research, was two of the biggest researchers at Harvard back in the '60s who were paid by the sugar industry to vilify fat and exonerate sugar, and they published a paper in the New England Journal of Medicine. They were paid the equivalent of $50,000 in today's dollars to write this article, which essentially was a shill article for the sugar industry posing as a New England Journal article that was supposed to be biased and impartial.
Now there's been more rigorous conflict of interest statements that have to be released when you publish any kind of research. So if you look at a research paper, it'll say "conflicts of interest" if there's conflicts of interest. That's helpful, but it's not enough. And there are a number of really stringent guidelines that have been proposed and that I write about in my book Food Fix that can be used to limit the influence of outside funders on the design, the outcome, the control of the research. And so it's not terrible that if, at arm's length, somebody funds research if they want to advance things.
For example, the food compass, one of the researchers was funded by Danone, which is a big food company. So Danone didn't end up using this food compass rating system. They used another European rating system because they thought it was better for them. So they didn't end up using it even though they funded this. So a lot of companies will fund things at arm's length. They don't have control over the design, they don't have control over the writing of the papers, over the outcomes. So there can be a way to do it, but you have to have the firewalls in place. A lot of times, they're not, and that's part of the problem.
If you look at food industry research, if a food company has funded the study, you're going to see a likelihood of a positive outcome eight times more than you would see if it's a NIH or publicly funded study on the same product. So if the dairy industry funds milk studies, they're going to show the milk's great. But if you have impartial researchers studying milk, they might not show it's great.

Dhru Purohit:
Who was Dr. Gabrielle Lyon's mentor that you had on recently?

Dr. Mark Hyman:
Don Layman.

Dhru Purohit:
Don Layman. So I sought another interview with him and one of the things that he was talking about with his important research in the area of protein is he explicitly came out and said that, "If I didn't have industry funding, I wouldn't have been able to do the research that I did."

Dr. Mark Hyman:
Right, because he was funded by the meat board and-

Dhru Purohit:
He was funded by the meat board and people that are there. And so what are your thoughts about that? His work has been very influential in updating some of even your ideas in protein and some of his students and people that have been inspired by him like Dr. Gabrielle Lyon. What do you think about that?

Dr. Mark Hyman:
I Think it was probably more interesting if, actually, there was disclosure of what people's personal beliefs and habits were. So if you're a researcher and you're a vegan and you're studying meat, that would be interesting. Or if you're a carnivore and you're studying a vegan diet and you're publishing research on that, that would be interesting to me. I think that kind of biases is-

Dhru Purohit:
So you think the people who write paper should put it out there-

Dr. Mark Hyman:
Disclose.

Dhru Purohit:
What would it show in his case, for instance?

Dr. Mark Hyman:
I'm sure he's [inaudible 00:10:44].

Dhru Purohit:
He is openly an omnivore, right?

Dr. Mark Hyman:
Yeah, for sure.

Dhru Purohit:
He's doing work in protein and obviously that's going to influence... His findings are going to influence his probably dietary habits. Would that have discounted or you're just looking for more transparency?

Dr. Mark Hyman:
I think more transparency and then also being able to sift through the research. And this is the problem with nutrition research, it's very tough to do. Basically the ideal thing to do would be to take twins at birth, put them in different feeding wards for their entire life, feed them different diets, and sample their blood every week and watch what happened. One pair of the twin pairs would get a vegan diet, let's say, another would be a carnivore diet, or another would be a paleo diet, and see what happens. That would be interesting, but that's not going to happen because it's unethical, it's impossible, it would cause billions and billions of dollars, and it's never going to be done. So we have to take the knowledge we have from basic science research on animals, from clinical trials that are small, clinical trials from population studies, and it's fraught with all sorts of problems. I mean, you try to draw conclusions.
So you have to look at the sum total of all the evidence and make your conclusions based on that data, the best available data we have. And for me, I filter that data through the lens of my clinical practice of 30 years of being a doctor and treating real patients and seeing what happens in real time when you do different things, so just changing them to this diet or that diet. So you can say, "Oh, keto diets are great." That may be true for one person, but it may not be true for another person. I had a patient, for example, who was an overweight woman who tried to eat healthy, tried to exercise, but had severe insulin resistance. Her triglycerides were well over 300 or her cholesterol was like 300, very low HDL, and very much pre-diabetic. So I put her in a keto diet basically butter and coconut oil, which is all saturated fat.
And in the conventional view, based on the, quote, literature, you're going to see that this person's going to be a high risk for heart disease. Her lipids are going to get worse. It's really bad for them. But in her case, her cholesterol dropped from 300 to 200, her triglycerides dropped 200 points, her HDL went up 30 points, which never happens, she lost 20 pounds, and all her inflammation went away. So that worked for her. But I had another guy who was a 56-year-old avid biker, cyclist who cycled like 50 or 100 miles a day and was thin and fit and slim, and he wanted to try it just for performance. I said, "Okay, well let's just track it and see what happens," I didn't recommend it to him, but it turned out his cholesterol went nuts. It was just terrible. I said, "This is really dangerous for you. I don't think you should do this," because all his particles got small, all his particle numbers went up, his inflammation levels went up. I was like, "Well, this isn't good for you," even if it was the same diet.
So I think we have to get real about what works in real people in real time. Roger Williams said, "I'm not interested in statistical humans." So I think that's the problem with research. Population studies look for trends and populations and that can be helpful for guiding future research. But it's associations and randomized controlled trials may be specific to a particular type of person in a particular setting but not generalizable to the population. So if you're studying 70-kilogram white men from Kansas, it's different than if you're studying little kids or Asians or African-Americans or people from India. You're going to just have very different results depending on the population you're studying, depending on the age and the ethnicity and the sex.

Dhru Purohit:
So I want to go back to the food compass because, as I mentioned to you, I've had a lot of people on the podcast and people just bring it up naturally because it was such a viral moment. Just setting it up from that standpoint... And I saw an interview that you recently did with Dr. Mozaffarian from Tufts, and I'd love for you to just set up for the audience here, what was the food compass, what was its sort of intent, and why do you think it went so viral?

Dr. Mark Hyman:
Well, first of all, I think people misunderstood what it was for and what it was about. So there are food rating systems that have been used for a long time to rate the quality of foods, to guide policy, to guide food manufacturing, influence... and what processor ma de to make food. And they can be very helpful, but they're limited. So for example, in the past, they might have just like, "Oh, I'm going to just look at saturated fat, salt, and calories as the markers," or, "I'm going to use some other 10 things that I look at to determine the rating system." So there was really an opportunity to create a new rating system that looked across a broad category of foods that used a lot more relevant metrics that weren't used before. So the food compass was an attempt, and by admission, it's a limited attempt because we have limited access to certain types of data like glycemic index and other things. And there's all sorts of problems when you start to create algorithms because basically the algorithm is only good as the inputs to the algorithm.

Dhru Purohit:
Just to pause you there, do you feel like they let people know that?

Dr. Mark Hyman:
I think that if you read the fine print and you look at what it was, I think the ambition was to create a better rating system that could be a guide to better food choices for consumers when they have to choose among a wide variety of foods. So if you're going to buy cereal, what's the best cereal? Should you buy Fruit Loops or should you buy Cheerios? I think it's a reasonable attempt to try to guide people. And I think very clearly, in a perfect world, none of us would be eating processed food, especially ultra processed food. [foreign language 00:16:22] a processed food, yogurt's a processed food, canned sardines are processed food. So that's all fine. It's more the ultra processed food, the 60% of our diet. And I think the researchers and the authors would agree that in a perfect world, no one would be eating ultra processed food, maybe only minimally processed food and whole foods. That's the aspiration.
But in the world we live in today, that's just not possible. So there are all sorts of reasons why we have to rate these foods, and it's an imperfect process. And instead of using just a few metrics to assess the quality of the food, they used nine domains and 54 different attributes of the food. And they included polyphenols and phytochemicals from plants. They included all these horrible additives that they didn't like, whether it's MSG or trans fats or artificial sweeteners that ding the food for being bad. They looked at fiber and carbohydrate ratios to make sure if there was carbohydrate, how much fiber it was. They looked at sodium potassium ratios, which are really important. They looked at fatty acid ratios. So I think that's really important. They looked at levels of omega-3s, they looked at levels of MCT oil, they looked at levels of trans fats, they looked at a whole bunch of different attributes, 54 different attributes among nine different domains.
And I think it's more than ever was done before to look at food, but it still is imperfect. For example, my big beef with it is that there are really no large, great databases for the glycemic load or index of food, which in my book is probably the most important attribute of food in determining its ability to affect your health from the point of view of your weight or the point of view of your cardiovascular risk, from diabetes, from cancer, from dementia, from even your microbiome, and so many different things that require us to understand the way in which a food affects your blood sugar. So that was just absent from the calculation.
There was a sort of an intermediate kind of calculation that included sugar as a ding or maybe if it didn't have enough fiber as a ding on the score, but it wasn't really including the glycemic load or index of a food. And to me, that was a big failure of this. They're iterating it. They're coming up with a new version, a new version, new version. So they're learning. And it's not meant to be dietary guidelines, it's not a government funded thing. The National Institute of Health Heart, Lung and Blood Institute actually did fund most of the study. So it was a government funded study, but it still is not meant to be the dietary guidelines.

Dhru Purohit:
But it is meant to encourage certain investments. That was one of the things that was noted in [inaudible 00:19:00], especially companies that are focused on this whole ESG thing, so where companies should invest more in. And then there was some recommendations in [inaudible 00:19:07] of what should be encouraged to children or recommended to children.

Dr. Mark Hyman:
Yeah. It was more of a guide around how to pick among different foods within categories or across categories. So I don't agree with how it all came out. But the problem is when you create an algorithm, you can't necessarily control the results. If you think eggs were better than Cheerios, well, in the algorithm, that didn't come out that way. That doesn't necessarily mean, looking at all the weight of the evidence, that eggs are not better than Cheerios. It just means that in the way they calculate the algorithm, that's how it came out.

Dhru Purohit:
But isn't that-

Dr. Mark Hyman:
I think it's problematic. And if you were to ask the authors of study, you think people should be eating processed cereals and the answer is no. But if you're going to eat them, should you eat ones with less sugar and more fiber? Yeah. And do minimally processed whole grains have positive benefit across multiple studies? Yes. But does that mean you're going to be better off eating a whole oat groat versus steel cut oats versus oatmeal versus oat milk, yeah of course, or versus Cheerios, which is pulverized oats? So yeah, I think there's no debate about that.

Dhru Purohit:
Going back to your earlier comment, and I'm not trying to play a journalistic moment on you over here, I'm just [inaudible 00:20:27].

Dr. Mark Hyman:
Please, go ahead.

Dhru Purohit:
I look up to you. I want to get your honest thoughts about it. And I feel like you're an individual that you-

Dr. Mark Hyman:
That's only because I'm a few inches taller, otherwise it's fine. We're equal.

Dhru Purohit:
You are both with Food Fix nonprofit, right?

Dr. Mark Hyman:
Mm-hmm.

Dhru Purohit:
The goal is to influence the discussion in a bipartisan level and have congress talking about food, "Food is medicine," and you got to play on both sides of the aisle and make sure you really get those individuals to listen. So somebody would call that maybe change from the inside. You're at Cleveland Clinic previously, setting up the Institute of Functional Medicine over there.

Dr. Mark Hyman:
I'm still there, yeah.

Dhru Purohit:
Still there. That's another form of change coming in from the little bit of an insider-outsider thing. And then obviously, there's all your advocacy work, right?

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
But because you're my friend, I also want to make sure that I hold you to what you're saying earlier to get clarity.

Dr. Mark Hyman:
Yeah, for sure.

Dhru Purohit:
Clarity for me, clarity for the audience that's there. So earlier, you were saying these things are sometimes so embedded that people don't even know that their work is being influenced. So I want to just read to you, this is a post from our mutual friend Chris Kresser, just something that I put up earlier, and I thought it kind of summarized it. He said in a recent editorial, I'm not going to name the author, but in a recent editorial, an independent journalist asked, "What kind of dystopian world has nutrition science entered, science with a quote, whereby university, a peer-reviewed journal, and one of the field's most influential leaders legitimized, advised, telling the public to eat more lucky charms and fewer eggs." You talked about the first part of it.
This is the second part that I really want your thoughts on. "Perhaps the fact that Tufts School of Nutrition receives funding from 60 big food companies, including several that rank highly on the food compass has something to do with it?" It's a question mark that he's putting inside of it. Now you've mentioned that the study itself was only funded by one food company, Danone?

Dr. Mark Hyman:
One of the authors-

Dhru Purohit:
One of one the authors is funding-

Dr. Mark Hyman:
... of the study got some of their funding from Danone, which didn't end up using the food compass.

Dhru Purohit:
Didn't end up using it. Are the majority of the authors from Tufts?

Dr. Mark Hyman:
They're from Tufts, but they don't get their salaries from the food industry.

Dhru Purohit:
But I guess I'm pointing out in a little bit of what you're talking about in Food Fix. And this is the part where people are trying to piece apart because there's a general sentiment that people feel that, "The world is kind of crazy when we don't see some of the obvious things that are there." It kind of feels like... I think the word of the year for 2021 was gaslighting, right?

Dr. Mark Hyman:
Yeah, yeah.

Dhru Purohit:
People kind of feel like, "Wait, you're telling me..." So I think that people generally feel that there's a sense of, "How can you say that these things are not connected or influenced?" So do you feel that any of that general funding could be in the back of people's minds?

Dr. Mark Hyman:
I mean, for sure. People are human and they're influenced in ways that they may not even be aware of consciously or unconsciously. One of the favorite books about this was written by Marion Nestle called Unsavory Truth, and she talked both about the medical industry and pharma and primarily about the food industry influencing research, influencing professional societies, influencing dietary guidelines, influencing pretty much all of our food policies. So there's no doubt that it's going on and that people have unconscious bias. I certainly do, for sure, when I read something.
For example, I think personally that that is very, very tough to be a healthy vegan for a lot of reasons. And I come to that conclusion both through my reading of the literature and through my practice as a physician where I see people who are tending to be healthy beacons. These aren't people who are eating donuts and Coca-Cola and french fries and pasta all day. These are people who are really working at it. And I see just massive nutritional deficiencies. I do worry about that, and that's my unconscious bias. So when I'm reading literature, I'm filtering it through my unconscious orb, maybe conscious bias, that I don't think this is a good idea for most people. And then so-

Dhru Purohit:
I've heard you talk about that before. You publicly... you've shared that, that, "I have an unconscious bias." Even I'm sure your podcast and my podcast exists because of sponsors. There's definitely unconscious bias that comes in even when you have sponsors that are there. I guess the one big difference is that you're kind of acknowledging it and you're saying, "Look, I'm a human being and that sort of thing." Where people feel that it gets a little bit messy is when there's not an acknowledgement that can play a role in the background.

Dr. Mark Hyman:
Yeah. Part of the challenge though, really, with research is that even if you do sort of aggregate research, which is what the food compass was, it was basically taking all the existing nutritional databases, all the NHANES data, all the things that we kind of use to evaluate research on diet and nutrition and health, and tried to use that data, which by varying nature is imperfect to come up with a rating system.

Dhru Purohit:
The inputs going into the algorithm themselves-

Dr. Mark Hyman:
Yeah, are imperfect.

Dhru Purohit:
... are imperfect. Or even maybe in some cases, you might say, just based on our previous conversations, misguided because they don't include things like, in some instances with food, the impact of a food would have on a glycemic index, which would have an impact on somebody's metabolic health.

Dr. Mark Hyman:
So it's basically what can't be measured may matter, and everything that can be measured may not matter. So if we can't measure accurately the glycemic load of food and it's not included in a food rating system, that's a major flaw to me, and that brings the whole framework into question. It doesn't mean that the motives or the intent of the people doing it were flawed. It just means that we're dealing with an imperfect amount of data and information. So I mean, would I like to see funding of nutrition research so we can get answers to these questions? Absolutely. Right now we spend $6 billion a year on cancer research, which is okay, but it was a huge win to get $100 million to do nutrition research. We should be funding literally billions and billions and billions of dollars in the NIH budget to focus on nutrition and chronic disease because it is the biggest cause of chronic disease, period, and it kills more people than anything else. So why aren't we studying it? It's all because of how the system is set up.

Dhru Purohit:
And is one of those proposals to be a National Institute of Nutrition?

Dr. Mark Hyman:
I mean, many other countries have it. India has one, but we don't have one. We should have a National Institute of Nutrition and it should be funded to the tune of billions of dollars by the federal government. I mean, look at COVID for example. I wrote about this in March 2020. It was published in the Boston Globe basically saying, "Hey, the early data show that the people who were getting sick and dying of COVID have a chronic lifestyle-induced disease caused by food. So we better get on this." And basically it was zero media about this, and nobody was talking about it and still people aren't talking about it. Why are we 4% of the world's population but had 16% of the COVID cases in deaths? It wasn't because we don't have doctors and hospitals and healthcare system. It's because we are a pre-inflamed, pre-sick population. When the virus hit, our immune systems weren't working because of our crappy diet and because we have chronic diseases, and that's why we're dying.

Dhru Purohit:
Well, this is another area that kind of plays right into this, in funding and criticism and other stuff. People, at the end of the day, are allowed to put out whatever they do. In the case of COVID, a lot of... even individuals that have been on this podcast and then friends of mine who also interview top experts that are out there that do a lot of research, they felt like they wanted to speak up more about nutrition. They felt like they wanted to speak up more about public policy. But the vast majority of their funding comes from the NIH, which largely is controlled by a small group of people. And the concern was, "If I criticize, will I get sort of ostracized from the community and will my research get funded?"

Dr. Mark Hyman:
Yeah, I think that's fair. Tufts, which published the food compass, they also published and Dr. Mozaffarian published a paper that said that 63% of all hospitalization and deaths from COVID could have been prevented by better diet because they were resulting from chronic diseases caused by food. So imagine that, a major institution like that calls it out. It's not like they're saying, "It's okay to be eating this junk food and processed food." They're not saying that. They're saying, "We need to really look at the quality of our diet."
I know Dr. Mozaffarian personally, and he's a tireless researcher, he's a tireless worker for moving things forward in Washington. I'm working with him, for example, on a medically-tailored meals bill to fund food as medicine for actually paying for food for chronically ill people instead of drugs. So there's so many things that people don't see below the surface, and nobody's perfect. I'm not perfect. No, he's not perfect. We're all doing the best we can with limited data we have, but I don't think we should sort of vilify efforts to try to improve things. Unless you're in there, in the trenches doing the work, it's easy to throw stones from the outside. So I've been in Washington-

Dhru Purohit:
I could see big sodas saying the same thing. I could see big sodas saying the same thing for people who criticize them. I heard this great podcast episode of [inaudible 00:29:26] where the guy who was talking was like, "Look, if you have criticisms about this other dude, don't come to me because he's my friend. You're not going to get an honest take on the situation, but I'm going to be upfront and I'm going to let you know. Go to somebody else. They might have a better honest take about it." So I guess what I'm saying is that that same sort of idea that everybody's just doing the best they can, everybody has that, especially organizationally.
And I can imagine big soda coming out with that same sort of statement. It's like, "Look at the amount of jobs we do. Look at all the good that we invest in. This is one piece of the calorie component." And who's to say that you should decide which communities don't have access or have access to soda. So the question is always that argument can be extended out further and further and further to essentially everyone and then nobody's corrupt, and everything's the way that it is.

Dr. Mark Hyman:
I mean, there are sort of levels of integrity that have to be in business or in science or in politics. And I think there are ways to look at and evaluate that. If you're, for example, getting NIH funding and your university's getting some funding from pharma or from the food industry, but there's conflict of interest requirements, there's arm's-length transactions where the funder doesn't have any authority to read the papers, to look at them, to determine that it's research design, to do anything with the study, which is the case in most of the ways. That's one thing.
But it's another thing if Coca-Cola is giving the Global Energy Balance Network $20 million and funding research scientists and writing papers and producing them and building their websites. That's just total corruption. And that's what happened with Rhona Applebaum and Coca-Cola and with guys like James Hill at University of Colorado where they were putting out all these nonsense papers that is all about energy balance and soda, and sugars from soda's no different than any other calories, that all calories are the same. And basically, if you don't overeat and if you don't under exercise, you'll be fine. And that's basically propaganda.
So I think there's a difference between corruption. Marcia Angell, who was the New England Journal of Medicine editor for years, has written a lot about this, wrote about the corruption in pharma and medicine, and basically said that a lot of the data we have is just compromised in many ways because of this. But it doesn't mean that you can't still learn and grow and learn how to sift through the available evidence from a wide array of studies. It's not like one study you should focus on, but it's just looking at the cumulative load of evidence.

Dhru Purohit:
In terms of fixing it, so one idea which some people are a little wary of because the feeling is sometimes... Again, looking back at COVID and the emphasis on certain approaches in public health, generally speaking, public health gets away with a lot looser science recommendations than what would need to happen for a medicine, for example.

Dr. Mark Hyman:
Yeah. When there's a pandemic, people are going to want to act fast.

Dhru Purohit:
But even outside of a pandemic, even something I've heard you share a lot is a lot of our nutrition guidelines come from the best done but still poorly done observational studies that we have. Right?

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
And so is there a solution for that, for doing better studies that are out there? Does-

Dr. Mark Hyman:
Yeah, I think there are. Without getting too technical, there are ways to look at biology that determine sort of intermediate risk factors. I mean, it's hard to do long-term studies in nutrition, look for hard endpoints like heart attack, stroke, or death, for example, or cancer, because it takes a long time. So for example, there was a study done in seed oils. This is a whole controversy about-

Dhru Purohit:
Yeah, I want to talk to you about that.

Dr. Mark Hyman:
Seed oils. But yeah, I think doing nutrition research is very tough. In the '60s and '70s, there were some really large nutritional trials funded by the government to look at fat and heart disease. And there was a whole interest in studying that, and they did sort of large studies. Based on some of these studies, there's [inaudible 00:33:38] and some of the more other observational data that having more soybean oil and refined oils, what we call PFAs, polyunsaturated fatty acids, was protective against heart disease, that it lowered cholesterol, that it reduced heart attacks and strokes-

Dhru Purohit:
Because it primarily moved us away from animal fats.

Dr. Mark Hyman:
Yeah, because it was moving away from animal fats.

Dhru Purohit:
At least, that was what the hope was.

Dr. Mark Hyman:
Yeah. But the problem with those studies was they were very confounded by lots of things, including using trans fats and using oils that were some of their omega-6, some were a combination of omega-6 and 3. So for example, soybean oil and canola oil are relatively good combos of both omega-6 and omega-3. Whereas corn oil and safflower oil and cotton seed oil and peanut oil, these are almost primarily omega-6. So it depends on what you're studying. And when they looked at, for example, all the trials that combined omega-6 and O-3s, there wasn't really a significant bad outcome. In fact, there was a reduction in cardiovascular events. When you looked at just the omega-6 studies, there was actually a worsening of the outcomes.
And there was a couple of big trials in Minnesota Coronary study and others where they literally had locked people up in psychiatric hospitals and they gave, half of them... This was like 9,000 people, so a lot of people in a randomized controlled trial, which you couldn't do no ethically. But they basically gave half of them corn oil or half of them butter, basically. Otherwise, kept everything the same in their diet. So they basically had a controlled population because they were locked in a psychiatric hospital. And they found that even though the LDL cholesterol dropped significantly, which is we think a good marker for reducing the risk of heart disease, there was a dramatic increase in the risk of heart attacks and deaths in the group that had the corn oil versus the butter. Now that's an omega-6 oil. In other studies, they looked at combinations of omega-6 and omega-3, and they found that the risk wasn't as bad.
Now the veterans study, there was a big veterans study that was an [inaudible 00:35:49] study that was a long-term study. It was one of the few long-term studies, but it was... In the initial part of the study, there was a reduction in cardiac events with soybean oil and there was a reduction in cholesterol and a reduction in deaths, and men all seemed good in the early trends. But as the study went on, there were more deaths and there were more cancers. And so at eight years, it looked like there was a high risk of, for example, cancer with these oils. But those studies aren't really talked about because they're kind of older studies. But it's really hard to make conclusions when you're dealing with this sort of really complicated biology of omega-6 and omega-3s and how the studies were done and how long they were done and what the populations were and what their underlying risks were. And so you end up with kind of squishy data.
So I would say that, from my perspective, it's better to eat fat from whole foods. If you're going to have any kind of refined oils, they should be expeller or cold pressed. If you're going to have any kind of cooking oil that you use, and I really don't recommend this, but soybean oil and canola oil have omega-6 and omega-3, so they'd be less harmful. Definitely stay away from cotton seed oil, grape seed oil-

Dhru Purohit:
If you're going to-

Dr. Mark Hyman:
... peanut oil, [inaudible 00:37:03] corn oil, safflower oil, those are all terrible. My view is, and always been, is stick with more whole foods and avocado oil, coconut oil, grass-fed butter, olive oil obviously, extra virgin olive oil is probably the best. So I think we kind of have to be careful when we look at these studies and when we do this whole, "All seed oils are bad," or, "All are good." Well, it's complicated. They're all the same. Is grape seed oil the same as soybean oil? No. Is soybean oil from [inaudible 00:37:29] raised, farmed, that's not sprayed with glyphosate-

Dhru Purohit:
I don't know that soybean oil are out there like that. Do you?

Dr. Mark Hyman:
Well, I think there's organic soybeans and yeah, there's organic tofu and organic tempeh and there's organic soybean oil you can buy and that are cold pressed and expeller pressed. So those are likely to be less contaminated, less processed with hexane, not processed full of deodorizers that are... So there's all these sort of subtle things. So at the end of the day, soon after you combine common sense with science and come up with a reasonable way of looking at these things... But as Mark Twain said, "The problem with common sense is not too common." And the problem with scientists is they go, "Well, it's all about the evidence." Well, the evidence is fine if you have good evidence. If every day that you wake up and the sun comes up, that's a pretty reliable evidence of scientific things happen. The sun rises and sets every day. Nobody's going to argue with that. But when you're talking about nutrition research, it's not clear cut like that.

Dhru Purohit:
If you wanted to do a study to see are these highly processed, which that in itself doesn't obviously mean anything, but if these highly processed vegetable oils really have a negative impact comparatively to what humanity might have been eating before, as you just mentioned, virgin oils, expeller pressed, cold pressed, and then potentially animal fats, we know that there's been consumption of that, what would you be looking at? What do you think would need to be done?

Dr. Mark Hyman:
Well, I think there's so many variables that we can measure now that we can never measure before. You can look at gene expression. You can look at metabolomics. You can look at huge profiles of cytokines and inflammatory markers. You can look at what happens to all these other various intermediate biomarkers. And you can start to see how these are influencing our biology. I've talked about this before, but just because you're eating meat, it doesn't mean it's all the same, or just because you're eating oil, it doesn't mean it's all the same. It depends where it's grown, how it's grown, what's happening, what it's eating. So for example, I just had a professor on from Utah State who studies the metabolomics of animal food. So what is it between a bison that is pasture raised that's eating a bazillion different plants versus a bison that's raised in a feed lot, which is actually way better than a cow that's raised in a feed lot for many reasons?
And there was 1,500 different metabolites that were measured and they were profoundly different and they had profoundly different potential impacts on health from everything, from the essential fatty acids in them, to the level of minerals, to the level of antioxidants, to the level of phytochemicals. So there's so many variables in the food we eat that, really, it depends on the quality of what you're doing and where one might raise inflammation or others might lower inflammation. So I think in the future as we begin to use machine learning, AI, metabolomics, gene expression studies, once the price of this stuff comes down, it's going to be a lot easier to see what's going on.
I think, again, no matter what we do, it's going to be really tough to do these large, randomized controlled trials of human beings unless you lock people in a ward. And there are some sort of studies that have done this, like Kevin Hall has done small couple of week or week-long studies looking at different changes in your biomarkers and your health and fat metabolism when you change, for example, to eat a high or low carbohydrate diet or high fat or low fat diet.
But that might not be relevant because it might take three to six weeks for your biology to adapt eating a low carbohydrate diet and switch to fat metabolism. So you might not see the benefits for 6, 8, 12 weeks, whereas he's looking at one or two weeks. So it depends on how you do the studies, how long they are, what's going on. That's why the average consumer is so confused when they look at the data because, pretty much anything you believe, you could find evidence for-

Dhru Purohit:
I want to-

Dr. Mark Hyman:
... including aliens, which maybe really a thing.

Dhru Purohit:
So I want to read you a tweet to just get your thoughts on something because we're talking about a lot of different ideas. We're talking about corruption, influence, food system, making healthier choices for people, and a bunch of other things that are there. And then we're going to get into some of the conversations around obesity and some of the drugs and interventions that people are proposing now. So this tweet is from Tamar Haspel. She's an award-winning Washington Post columnist. This kind of caught storm and I saw a bunch of people retweeting it from the kind of more traditional food industry sort of point of view, and I want to just get your thoughts on it. So she wrote, "There's a zombie idea that just won't die, and I'm going to kill it with math. If we put all crop subsidies into fruit and vegetables..." so all the subsidies. A lot of people have talked about subsidies. You talked about subsidies in your book.

Dr. Mark Hyman:
Well, they're more like insurance. Yeah, but-

Dhru Purohit:
"If we put all our crop subsidies into fruit and vegetable subsidies, it would not change the way Americans eat one iota." And then she says, "Okay, maybe one iota but not two. Here's why and here's the math." So she goes into a whole bunch of things, but I'm just going to read, pull from a few. "The subsidies we have now mostly go to corn and soy will include both insurance premium subsidies and what used to be called direct payments, which are now called ARC/PLC. The amount varies by year, but it's reasonable to say that 11 billion for insurance and 5 billion for this ARC/PLC program, which is a total of 16 billion." And she says, "... total amount to redistribute to fruit and vegetables. Let's distribute that 16 billion over the acres that grow fruit and vegetables, call that specialty crops by the USDA. That's about 15 million acres. For the sake of having a nice round number, let's say that means that we have $1,000 an acre for all fruit and vegetable."
Jumping to kind of the conclusion of this, because it's kind of a tweet storm, we'll link it in the show notes so people can see it... She goes through a few different of these specialty crops and she says, "Example one, an acre of broccoli produces about 16,000 pounds. The subsidy would make broccoli 6 cents a pound cheaper." So the moral of the story that she's getting to is that we keep on talking about subsidies being a big problem, but if we took that money and we put into fruit and vegetables, and because fruit and vegetables and specialty crops as they're considered by the FDA are so expensive to grow, it wouldn't make them that much cheaper. And then she concludes with, "The reality is that people just don't like vegetables and they don't eat a lot of fruits and vegetables. So that's why these other foods end up becoming more eaten." And what are your thoughts about that?

Dr. Mark Hyman:
Oh, my God. Well, that last sentence just... is a problem. It's a big problem, I think-

Dhru Purohit:
Well, I'm sort of paraphrasing that. She didn't write that exactly, people can look up the thing exactly, but she essentially says, "Vegetables are way more expensive to grow. Growing a calorie of broccoli costs 50 times more than growing a calorie of corn. P.S., people don't eat veg because they don't like them, not because they're expensive." What are your thoughts on this idea? I've heard a few people say this, by the way, and so I just want to stress test the idea-

Dr. Mark Hyman:
What do kids in Japan eat? Seaweed? Raw fish? What do they like? Pickled vegetables? They eat what they're used to eating. If we raise a generation of kids that are addicted to highly processed food, that are hyper palatable, that hijack their brains, that hijack their hormones, that hijack their microbiome, that make them eat this food through really a kind of various nefarious, almost like the body snatchers are driving our biology. It's not about people not liking vegetables. It's about people not understanding that their biology has been hijacked. And if given the chance to eat delicious vegetables and getting their biology reset, they would like them. I strongly believe that. And I've seen this over and over again in my patients and around the world or populations and little kids eat tons of vegetables. So it's not that human beings by nature don't like vegetables. It's because Americans have been completely corrupted by the food industry and have had their taste buds and their biology hijacked. So I think I'm just going to say that at the start.

Dhru Purohit:
I don't disagree with you, by the way.

Dr. Mark Hyman:
And then we can get into the fact of how agriculture's finance, what the challenges are with agriculture, what we're doing. And it's not just about crop insurance, it's not just about subsidies, it's not just about funding more fruit and vegetable growing. It's about reforming the entire agricultural system to create a regenerative system that produces better quality, more nutrient dense food that's lower cost, that makes farmers more money, that restores biodiversity, restores the water tables and prevents the droughts and floods that we have that are destroying our agriculture system, that stops the pollution of our waterways and our environment by pesticides and glyphosate, that prevents the dumping of nitrogen fertilizers on the soil that goes into waterways and kills hundreds of thousands of tons of fish, and just on and on and on. I could literally go on and on and on. So I think that it's about fixing the agriculture system as a whole to produce more high quality food.
And that's possible. And I think it can happen at scale. And I think it's about shifting our kind of government system's policies to a form of regenerative system to fund farmers to do this. And this is what, with Food Fix, we worked on in Washington. It's part of the IRA bill. And maybe there is many issues with that bill, but one of the things we did was we got $20 billion for reform in agricultural policies and regenerative agriculture and funding farmers' education and funding them converting to regenerative farms, and a lot of things that people don't even know about. So things are moving in the right direction.
But it's tough to take away the things from farmers because they're stuck in a complete bind between the need to grow foods the way they've always grown them because they get bank loans to buy the seeds and the chemicals. They get crop insurance from the government. And so they're caught in this tribe between the seed and chemical companies, the banks and the government, which is all supporting the system that keeps farmers locked, producing the wrong food. Now, if they were given a chance and they were taught how and they were given an economic bridge, they would create an agricultural system that's much better than one we have now, and this is being demonstrated over and over. It's more profitable and more effective and produces better food. So I don't completely agree with her. I think it's not as simple as just ending crop insurance for corn and soy, although that is problematic. It's about shifting the whole system.

Dhru Purohit:
I guess what she was saying is that she hears a lot of people making that argument. And what you're saying to her is that that may not be wrong, the math may be right in what she's breaking down, but what you're talking about is so much bigger than just that. You're talking about a whole shift in the ecosystem.

Dr. Mark Hyman:
Yeah, exactly. It's a whole reform of agriculture, and that may take a long time to happen, but it's got to happen. I think we don't have the support of institutions and group purchasing from industry, from government, from schools that produces an incentive to actually make more good food and cheaper. There are ways to do it at scale, and the question is how do you make stuff cheaper? I think you can. I mean, it requires different methods of farming and different practices, but it's totally doable.

Dhru Purohit:
All right. We're going to pivot to obesity here for a second.

Dr. Mark Hyman:
My favorite topic.

Dhru Purohit:
There was a viral 60 minutes clip with White House advisor, Dr. Fatima Cody from Stanford University. The government has named her one of the members of the 2025 Dietary Guidelines Advisory Committee, and she was on 60 Minutes basically saying the number one risk factor for obesity is genetics.

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
Let's get your hot take on the situation and her comments.

Dr. Mark Hyman:
Well, if that were true, then our species has undergone a major genetic series of mutations since I was born. Because when I was born, 5% of Americans were obese. Now, it's 42%. So an eightfold increase, an eight over 800% increase in obesity since I was born is not due to some massive genetic mutation. It's just not. And if you look at all the genes, and this is... There's something called the GWAS analysis, which is genome-wide association study. So is any one particular gene the obesity gene? No. So they go, "Well, is there a family of genes that all increase your risk?" They looked at all the genes that might potentially impact your hunger, weight, metabolism, obesity risk. They determined that if literally you fixed all these genes, that the maximum weight loss would be 22 pounds in a person, which is nothing when you think of the fact that the average American is obese and overweight and is metabolically unhealthy. That would not fix the obesity problem.
It would not get people lose 50, 60, 100 pounds, which many Americans need to do, so this is not a genetic problem. I even heard this around kids like, "Wait a minute. We've seen a quadrupling of obesity rates in kids since the '60s. Is this genetic?" So all of a sudden, we need drugs and a surgery, according to the American Academy of Pediatrics, to fix the obesity problem in children without addressing at all the food, environment, the way we process food, the way it affects our biology? It makes me a little crazy when I hear that, and I think that's very frightening. Now, do genes play a role? Absolutely. Are some people more predisposed to obesity? Absolutely. Like the Native Americans or the African Americans or Latinos, because of their genetics, but that doesn't mean that they're destined to be obese. If you look, for example, at the Pima Indians, which I've written about for years in my books, in America, they're the fattest population in the country.
They're second in the world only to the Samoans who put... Basically, for breakfast, they have ramen noodles with MSG powder, which by the way makes you eat a lot more. It's how they induce obesity in animals, is give them MSG and sugar. They put sugar and MSG powder and ramen noodles. That's their breakfast. So that's why they have like 80% rates of diabetes. In the Pima Indians, it's the same thing. 80% are diabetic by the time they're 30, their life expectancy is 45. It's like living in a developing country here in the US. There are cousins in Mexico, same genetics. The only difference is an artificial border called the US-Mexico border, but genetically they're the same population. They're thin and they're healthy and they're fit, and they eat their traditional diets that they've eaten for thousands of years. When they start to adapt their Western diet, they also get obese. So genetically, they're more predisposed, but that doesn't mean that it's a genetic problem.

Dhru Purohit:
So the question that I have for you is this, as somebody who's genuinely trying to make change from the inside as well as the outside, the advocacy of the podcast, having on different people with different opinions, and writing books and other stuff, when you hear that our current president has made somebody who has this belief... Now, I don't know if she still has this belief. I looked up recent news articles. I haven't seen any backtracking on it.

Dr. Mark Hyman:
Yeah. I don't know what she actually said. I'm just saying if that was the sound bite-

Dhru Purohit:
That's what she said. That's literally what she said. We can play it.
VIDEO:
If you die it, you lose weight, right?
For many of us, we can go on a diet, something like The Biggest Loser, right? You go and you strict people, you make them work out for 10 hours a day, and then you feed them 500 calories. For most people, they will acutely lose weight. But 96% of those participants in The Biggest Loser regained their weight because their brain worked well. It was supposed to bring them back to store what they needed or what the brain thinks it needs.
So will power?
Throw that out the window.

Dhru Purohit:
So the question is that somebody who's trying to make change from the inside as well as the outside, when you hear that our president has appointed somebody who has that belief to the dietary committee, does it make you more disheartened? Does it change your viewpoint about working in collaboration with government to try to fix the food system? How does it make you feel?

Dr. Mark Hyman:
I mean, listen, the whole subject of obesity is fraught. I mean, there are people who now believe that we shouldn't be treating obesity, that it's okay that you're healthy at any size, that it's racist to talk about obesity. There's all sorts of memes going out there across the culture. But the truth is that nobody wakes up and goes, "Geez, I want to be overweight. I'm going to see if I can gain weight." I mean, maybe if you're really skinny and anorexic. Maybe you've got cancer, and you may want to gain weight. But for most of us, gaining weight is not something we aspire to that we want to do or that is good for us. And then, I think the data really support clearly that obesity is a huge risk factor for all age-related diseases and chronic illness.
The question is why are we overweight? Why are we obese? And that's a complicated question that has to do with genetics. It has to do with the toxic food environment. It has to do with our epigenome, and how our genes were influenced by what our mother ate in utero, or it has to do with obesity agents in the environment that are environmental toxins that affect our metabolism like bisphenol A. It's all on your credit card receipts that causes insulin resistance. It has to do with cultural patterns. It has to do with your social network. I mean, if you look at Christakis', for example, work out of Harvard, he showed that your 171% more likely to be overweight if your friends are overweight. Then if your family's overweight, you're about 40% more likely to be overweight. So maybe is it a social problem or a genetic problem? It's complex. It's all of the above.
I think people who try to reduce it to one thing are missing the full story, and then it's a complex disorder. But for the most part, it really wasn't a problem until the last 40 or 50 years. And when you look back, for example, in the '50s, you see now African Americans are among the worst affected. They were the worst affected by COVID because of their chronic illnesses. In the '60s, they were far healthier than whites, and then they adopted and were targeted by the food industry and had become enormously overweight. 80% of African American women are overweight. I mean, it's a big problem. I think it's because of the toxic food environment, and all the things that are influencing our choices and our behavior, and the kind of flood of marketing, the flood of easy access, the supersizing of everything, the policies of agriculture in the '70s under Nixon who wanted to make milk and meat prices cheap.
So basically, his secretary of agriculture, Earl Butts, and that's his real name, basically said, "Go big or go home," which led to the massive scaling up of industrial agriculture, the huge productions of corn and soy as staples, the commodification of our food system and the [inaudible 00:56:47] of processed foods. So now, 60% of adult and 67% of kids' diet is ultra processed food, which means food that's comes from highly industrial ingredients that are polarized beyond recognition and reassembled into all sizes, colored shapes and tastes of chemically extruded foods like substances that have nothing to do with their original form. I mean, eat tofu, great. That's a processed food. Eat tempeh, that's fine, but weird kind of soybean extract derivatives or corn extract derivatives that are in your food. No, that's not really food, and that that's really led to this real problem, I think.

Dhru Purohit:
So just going back to the question, because I feel like you didn't fully answer it, so I just want to make sure-

Dr. Mark Hyman:
[inaudible 00:57:28] about the president having someone appointed who believes that obesity is genetic to the US Dietary Guidelines Committee? I mean, I think to be fair, I have to look at her whole perspective and all of her views and all of the data she's published. I think that there are nuances, and I'd probably want to ask her 100 questions. I think the sciences of obesity is complex, so I think I can't really make an opinion unless I have more information, to be honest, about her in particular. I'll do the homework, and look at it. But as a rule, a lot of the dietary guidelines have gotten better over the years, but they're still fraught. And for example, dairy is a great example how dairy is part-

Dhru Purohit:
Well, before we go to dairy, actually you mentioned something that I don't want to go on a tangent yet.

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
You mentioned about obesity and how it's being used when you have certain beliefs that it impacts treatments. So if you are making a statement that the number one cause of obesity is genetics, which then kind of went into her explanation being, not to pick on her, but just using it as a statement because she's such a high profile figure and this kind of created this viral commentary, is then she kind of said a little bit more of being brought up in a household of obese parents, then you're likely to be obese. Well, it's probably the environment that you're being brought up in, socioeconomic condition, all the things that you were mentioning, those play a role. And when you have somebody so high up who says that this genetic thing is the number one thing, she added in at the end of the clip, even for people who eat well and exercise, now all of a sudden the interventions that you feel that are going to make a difference, you're left primarily with pharmaceutical. And that's kind of the big conversation right now, right?

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
So talk to us a little bit about what's going on right now with how they're thinking about treating, especially kids with a lot of these super aggressive drugs, which a lot of people don't realize that even if they worked perfectly and didn't have any kind of side effects, and you have to be on them for the rest of your life, they literally have the potential to bankrupt us.

Dr. Mark Hyman:
Yeah. I mean, look, the American Academy of Pediatrics is trying to address the staggering rates of obesity and overweight in kids. 40% of kids are overweight. One in two teenage boys has pre-diabetes or type two diabetes, which I never saw when I was in medical school 35 years ago. It just didn't exist. And now, they're trying to grapple with how do we manage this burgeoning epidemic of obesity and risking kids, and it's serious. Because if your kid is overweight and obese, their life expectancy is 13 years less, their economic earning capacity is lower, their risk of disease is higher, they have higher risk of mental illness and depression. I mean, it's really bad news. So the idea that we should talk about it and address it is a good one. The question is, what are we saying? And this is where I thought the guidelines from the American Academy of Pediatrics were concerning because they were saying, "We need to aggressively screen for obesity."
Great. "We need to aggressively treat it." Great. "We need to use drugs and bariatric surgery." Not so great. Okay? So let's do the math. If we looked at Wegovy or Ozempic, which is being used off-label for obesity, it's about $1,700 a month for Wegovy. Depending on where you buy it, $1,370. You do the math. 75% of Americans overweight. If we prescribe it to everybody, and being overweight is now considered a problem and a disease, that's $425 billion a month, $5.1 trillion a year. That's more than our entire national expenditures on healthcare, which is $4.1 trillion. It's just a ludicrous idea that we should be approaching it from a pharmaceutical perspective or a bariatric surgery perspective. I mean, I was talking to my daughter on my way over here, and she's in medical school. She was talking about a case that of a guy that came in and presented at their medical school, which was a bariatric surgery patient who ended up having severe vomiting and nutritional deficiencies and had thymine deficiency.
He ended up with something called WWernicke's encephalopathy, which is a severe neurological condition with permanent consequences, and he's suing hospital. I mean, having bariatric surgery is not a cakewalk, and these drugs may increase the risk of cancer and other things. So the question is, what's causing it? I was so perplexed when I heard... The New York Times had a podcast, daily, where they had Gina Kolata on who's a New York Times reporter in health, and she's very well-educated, and she said something just didn't make any sense to me. She says, "Well, we've seen obesity rates grow up from 5% to now 20% in kids in just 40, 50 years, but we know that obesity is genetic." And I'm like, "How do you make those two statements within 15 minutes of each other and make any sense at all?" Because it can't be, right? It just can't be. Now, what can be true is epigenetics.
Epigenetics are influenced by what we do in our environment and toxins and everything, and that can create genetic programming that will influence your metabolism and your weight, for sure. But we know we can reverse epigenetic programming. That's what my book Young Forever is about. It's about how do we reverse the epigenetic programming that makes us age fast, and how do we reverse that. We can do that, but I think that the notion that we should be treating obesity with pharma and bariatric surgery as a nation as the solution... It's one solution for some people who might benefit okay. But I've had patients who've lost 200 pounds without any drugs or surgery and kept it off. And other patients have had bariatric surgery and lost a bunch of weight initially, and then gained back 200 pounds because they just decided they could eat M&M'S all day long without stopping. And they would get enough food because it would satisfy their cravings, but they wouldn't be too full because they only eat one M&M at a time.

Dhru Purohit:
Do you think that-

Dr. Mark Hyman:
This is a doctor, by the way.

Dhru Purohit:
Yeah. Do you think the thinking is... Because I always try to put myself in different people's shoes, right? Do you think the thinking is, "Okay, great. Mark, that's awesome for that patient who had the resources to be able to see you." Well, it's awesome for that person who had the resource to be able to shop and get groceries, and they don't live in a food desert. We need to figure out, is the thinking... I'm not saying it's right, but is the thinking that, "Yeah, sure. If you have the resources, you can do it, and the education. Or you're not working three jobs, so those people don't," and we don't want to hurt people's feelings by telling them to do something that they can't do, so instead we have to look at the pharmaceutical option. Do you think it's that?
Or do you think there's a little bit of a component of like, "Hey, everybody's already on pharmaceuticals for all these other things. That's the only thing that's going to move the needle forward"? Sure, it's not affordable long-term, but we've made it this far. That's somebody else's problem to deal with. What do you think the thinking is?

Dr. Mark Hyman:
I mean, first of all, I just want to say that people need to understand that if you're overweight, it's not your fault. And to blame the person who's overweight for a lack of willpower or having poor moral character or being a glutton just ignores the biology and the effect of the foods we're eating on our health and our brains and our hormones, our gut, and all of that influences this obesity epidemic. We can't ignore that and we can't blame the person who's struggling. With that said, we have to take a hard look at our choices. And if we don't honestly look at what we're doing as a nation, we're in trouble both economically, both from a global competitiveness standpoint. I think the basic meme out there is that it's elitist to talk about eating healthy. It's elitist and poor people can't do it. And people who don't have means can't do it. And it's just people know what to do, but they don't do it because they just don't have the ability or the money.
I think that's a fallacy. Honestly, I fully admit that I bought into that many years ago. And then, I was part of this movie Fed Up that we talked about earlier. I shared this story before but it's worth repeating, because I met this family in South Carolina and they lived in one of the worst food deserts in America. And there's something called the Retail Food Environment Index, which is how many fast food restaurants there are to grocery stores and stuff. It was one of the worst in the country. This family lived on food stamps and disability. The father was 42 on dialysis for kidney failure from diabetes from eating junk food. The mother was hundreds of pounds, couple of hundreds of pounds overweight. I mean, huge. The son was 16 years old, 50% body fat should be 10 to 20 and almost diabetic at 16. They lived in a trailer, family of five, for a thousand dollars of food stamps and disability payments.
I basically sat with them and I'm like, "Why do you want to be part of this? Why do you want to lose weight?" They started crying because their father could not get a new kidney until he lost 45 pounds. They wouldn't do the surgery, and they couldn't figure out how to do it. And I said, "Okay. Well, I'm giving you a lecture on what to eat or tell you to eat vegetables." I said, "Let's go shopping. Let's buy some food. Let's cook a meal together." I used a guide called Good Food on a Tight Budget, which is how to eat well for you, well for the planet, and well for your wallet. We made Turkey chili from scratch. We made roasted sweet potatoes. We made salad not from iceberg lettuce. We made olive oil in vinegar dressing.
We made some stir-fried asparagus. Simple food. And when I went to their trailer, I went in their freezer in their fridge, and I was like, "Gosh, everything is bad in here and processed and packaged." So I started taking everything out, and then we started going through it. They had no idea it was bad for them. They were buying all the food entry claims, "This is a little whole grain. This is zero trans fat." I mean, Cool Whip is zero trans fat, even though the two main ingredients are high fructose corn syrup and hydrogenated soybean oil. The reason they get away with it is because it's mostly air, and it's less than half a gram per serving. So you can get away with it according to the FDA loophole that was given to the food industry, so they wouldn't have to get all the trans fat out of the food.
It's just more corruption. They were shocked, and they were really uneducated about what was going on, what they were eating, what they should eat, and what they shouldn't eat. Their salad dressing was just full of high fructose corn syrup and refined oils and all kinds of thickeners and gums and things that really damage your gut. And so, "Look, let's just cook a meal," and they ate it. This one kid who hated vegetables, he made the chili and he wanted to know if there were any vegetables in there because he didn't want to eat it. We kind of joked and it was like, "Those are onions, but they're kind of like candy because they get sweet when you cook." He's like, "All right." So the kid ate it, they loved it, the father loved it. They ate all the food, and they devoured it.
And I was like, "Okay." Well, I mean, they didn't have cutting boys, they didn't have knives. I didn't know what was going to happen when I left. I'm like, "Okay. Well, maybe this won't make a difference, but let's try." So I said, "Here's my cookbook. Here's a guide on how to eat well for less. You can buy inexpensive vegetables, inexpensive cuts of meat, grains and beans. You can do this." I left and I bought them a cutting board and knives, because they didn't have a cutting board or knives. We cut the sweet potatoes with a butter knife, which was not easy, raw sweet potatoes and the butter knife. The first week, the wife text me back, the mother says, "We lost 18 pounds as a family, first week." I'm like, "Wow, great." They went on, and the mother lost over a hundred pounds.
The father lost 45, was able to get a new kidney. The son lost 50, and then had to go get a job and worked at Bojangles, gained it all back and more. But then, eventually, reached out to me and I coached him a little bit. He lost 136 pounds. Nobody in his family ever went to college. He went to college, and he actually reached out to me and asked for a letter of recommendation to medical school. And here was a kid who was terrified when I showed him his body composition because he says, "I'm 50% fat. Am I going to be 100% fat if I keep eating this way?" I'm like, "Well, no. You're going to have bones and some muscles and stuff. You can get up there."
And it was a very enlightening experience for me because I was like, "Wait a minute. We're one meal away from saving America." If we created millions of community health workers to go out in people's homes to show them what to buy, to show them what was good and what wasn't good, to teach them how to cook, to show how to choose foods that are reasonably priced, that you don't have to break the bank to get, that we can really fix this. I've seen this all across the country. I've seen it in Cleveland, in underserved areas we've worked. I've seen it in many, many places. I think there's an underlying belief that this is just an elitist idea that people should healthy and everybody should hop shop at Whole Foods. That's not what I'm saying. I'm saying we need to, as a nation, create a national campaign to deal with this and to educate people about what to do and to help them and guide them and teach them. But sometimes, it's not telling them what to do, it's showing them what to do.
I remember I was working with a friend who worked up in East Harlem, and they were working on a sort of this chronic disease program to try to help patients not end up in the emergency room all the time and not end up on the street. They told me the story about this one guy who kept coming back and back with heart failure every time to the hospital. They told them what to eat, and they told them exactly what to buy, and they told them everything. This guy didn't know what to do, so they sent someone to his house and they were like, "What are you doing?" They showed him his cupboard and it was just full of junk, and he's like, "This is all I know how to make, and I don't know what else to do." So they took him shopping, and they showed him how to cook. They totally transformed him, and literally saved hundreds and hundreds of thousands of dollars in hospital bills for this just simple home visit that caused close to nothing.

Dhru Purohit:
It's an inspiring story and it really shows... Number one, early in the podcast, you painted out a lot of the problem. If we don't do something, we're just headed off the cliff. Right?

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
In fact, we're more likely going to have a major divide in society. You have a very small percentage of people that are just very healthy with all the new technologies, advancements, access, et cetera. And then the vast majority, probably 80% or more that are just extremely unhealthy. We're already seeing a little preview of that, and we don't want more of that. We need to unwind that. But then, also, what does it look to have a true sort of almost like boots on the ground, major sort of industrial undertaking of having people... I don't mean industrial in the industrial sense, I mean a large undertaking of truly what it would look like to invest in our health, and get people who are suffering the most educated on at least the basics that we know that works.

Dr. Mark Hyman:
Yeah. I think that's true. I mean, if you take SNAP, which is food stamps for example. I mean, there's provisions for SNAP education, for nutrition education, but it's minuscule. When you think of the Farm Bill, it's a trillion plus dollar bill. One of the biggest government programs that exist. Three quarters of it is food stamps, and three quarters of food stamps is junk food and 10% is soda. So we all know that's bad for people, but nobody wants to create restrictive guidelines around what you can and can't buy. They think that's aggressive, they think it victimizes the poor, and there's a whole bunch of reasons for it. But they can easily create SNAP education, which guides people on how to use their food stamp benefits and get the most for their dollars and true stuff that's healthier for them and their families and not be hungry. But we don't invest in that.

Dhru Purohit:
Mark, anything else you want to get into right now?

Dr. Mark Hyman:
Yeah. I just think that we kind of have to come together, as a nation, to address some of our biggest problems. The biggest thing that breaks my heart is the division and divisiveness and oppositional behavior and thinking among all different segments of society, whether it's politics or nutrition or religion. We got to get over ourselves, because we're on a sink and ship, and I think it's time for us to sort of come together to really work on things together. We've done this before, whether it was World War II, as a nation, where we came together, whether it was 9/11 when we came together. Whatever these moments are in American history, where our better angels take over, I think it's time for that.

Dhru Purohit:
I would add maybe one of other layer that I'd love to get your opinion on. I think that polarization and divisiveness is not so much the issue, because we want actually smart people who disagree with us to fight for their version of what they want.

Dr. Mark Hyman:
Debate is great.

Dhru Purohit:
It's really the kindness that we're looking for and the compassion. I think that long format podcast is a really great opportunity, and independent media is a really good opportunity to do that. But we want people to have different opinions. We want people to have different viewpoints because we've changed our mind on things. You've changed our mind on things because of people who have had different viewpoints. The question is, can you do it in a way that is kind? And then, there's another layer, which just goes back to some of the things we talked about before. Some people again would say that, "You calling big soda corrupt, is that not understanding all the components and things?"
I think we're always trying to find a balance that's there. And I'm not saying don't call them corrupt, right? What I'm saying is that, we're in a little bit of the sort of free market version of this. People speak up, and if you're lucky enough to speak up where you catch a sort of viral moment in society on something that needs attention, more people start focusing. And then, your hope is that the next generation starts working on better and better versions of a problem instead of trying to keep the system intact that was there previously.

Dr. Mark Hyman:
Yeah. No, it's true. Buckminster Fuller said this, "You don't have to sort of fight the system. You just have to create a new one that makes the old one obsolete," or some variation of that quote.

Dhru Purohit:
Some version of that.

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
Awesome. Well, Mark, it was a pleasure to have you out. Young Forever, the book, is out. It's already sold tons and tons of copies. I'm super excited for you, super excited for the entire team working on it. People can get it on the web-

Dr. Mark Hyman:
Everywhere.

Dhru Purohit:
... everywhere. Amazing. Pick it up. There's a bunch of pre-order bonuses and stuff. They can follow you at Dr. Mark Hyman, MD.

Dr. Mark Hyman:
Thank you.

Dhru Purohit:
Or Mark Hyman, MD-

Dr. Mark Hyman:
No. Dr. Mark Hyman.

Dhru Purohit:
Dr. Mark Hyman. Mark, thanks for coming off.

Dr. Mark Hyman:
Be my boss. You should know.

Narrator:
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.