What Ultra-Processed Food Is Really Doing to Your Body and Brain with Dr. Chris van Tulleken - Transcript

Dr. Mark Hyman
So, Chris, it's amazing to have you on The Doctor Hyman show. I've been wanting to have you on for a long time. We had a chat last year. And your work around ultra processed food, your advocacy, policy work, your intention to sort of shift consciousness around what's killing us is is been tremendous. And I think, you know, this whole narrative around ultra processed food is catching steam.

It was sort of invisible until recently in with the Maha movement in America and Bobby Kennedy talking about it and now Trump talking about it, and it's a thing. And ultra processed food has become the new cigarette in the target for a lot of potential policy changes. And yet, there's still some controversy about the definition, whether it's the right classification to use, whether or not it's valid, and whether we should be focused on other aspects of nutrition like glycemic load or fiber content or other macronutrient ratios to actually explain what ultra processed food does or doesn't do. And, you know, in, and there's a lot of data, like, that that you've kinda write about in your book, Ultra Processed People, which is, by the way, a great book. Everybody should get a copy of it.

That kinda outlines a lot of the the harms that are done. And there's just even more recent studies that showed that ultra processed food is linked to 32 different kinds of health conditions from heart disease to mental health issues to type diabetes, obesity, cancer, sleep issues, GI issues, dementia, the way the list goes on and on. And and if if that's accurate, and these are observational studies usually mostly, which are population studies that don't prove cause and effect. But if if that association turns out to be causal, then this is this is a huge nuclear bomb when it comes to our health. It's kind of the smoking gun of why we're getting sicker and fatter and costing our governments around the world more and more money.

And and the question is, for you is is so how how how how did you kinda first come to understand that this was an issue? And then I'd love you to share your own personal experience because you you actually decided not to just research this issue, not just talk about it and write about it. You did something that I would never do is you ate ultra processed food for a month. It's kinda like supersize me, but kind of a little different, and then try to see what the consequences were. So I'd love I'd love you to kind of unpack, you know, first what, you know, what was it that got you kinda started thinking about this?

Because you're an infectious disease doctor. And two, you know, what was the experiment like, and what happened to you? And we'll start with that. I think kinda dive into the the data and the research a little bit more.

Dr. Chris van Tulleken
I think for start, any anyone who's watching the video, firstly, thank you for your wonderful kind words. That's a a lovely introduction. I'm gonna find it hard to live up to it, but I'll do my best. Anyone who has any doubt about the effects of ultra processed food need only look at the video feed for the podcast right now and sort of put Mark and my heads next to each other and go, that's four weeks of ultra processed. I used to look like you.

So it's it's I did it because my clinical work is I treat patients with complex infections at at the hospital for tropical disease in London, part of University College London Hospital. But my academic work is food systems and nutrition, and the two are linked because I many of my patients are from very low income countries where we see that, nutrient deficiencies and poor nutrition drives a huge number of poor health outcomes in the global North and in the global South. So so there's an overlap. In fact, I did this the experiment was, we filmed it for a BBC documentary. But the reason we did it, we got ethics approval because I was the first participant.

I was the kind of pilot, patient, if you like, in a big clinical trial that I think it's the largest randomized controlled trial of ultra processed food versus minimally processed food in free living subjects. And we're I'm one of the primary investigators on that trial.

Dr. Mark Hyman
Process right now. This is

Dr. Chris van Tulleken
This is in process. So I can't we Yeah. I now where are we? My one of my students is leading it, and I think I can't talk about any of the data. But it it will be the largest randomized controlled trial of UPF, and ever done so far in the world in free living individuals than I think at all because they will be the third published randomized controlled trial of UPF.

Mhmm. Because on top of the one you referenced earlier, there was a study that, replicated Kevin Hall's work in Japan, and now we will be the the third. But it's a slightly different trial design. Yeah. So I was the first participant to go, what changes in Chris?

What can we measure? How should we kind of design the rest of the experiment? And I'll be honest, kind of like Kevin Hall, who's the the my now very well known investigator at the NIH who did the first randomized control trial, I was maybe not skeptical, but it seemed to me that eating what is a normal diet for four weeks would not have any big effects on my health. You know, this is I ate 80% of my calories from ultra processed food for four weeks. This is a diet very typical for an American teenager.

You know, this is not a weird diet. So there were kinda three three big things that happened. I gained weight, a huge amount of weight, six and a half kilos, more than six and a half kilos in four weeks, which as you know

Dr. Mark Hyman
It's like 15 pounds. Right?

Dr. Chris van Tulleken
15 pounds. So

Dr. Mark Hyman
American pounds. Yeah.

Dr. Chris van Tulleken
I would have doubled my body weight in a year if I'd kept doing it. And you referenced Supersize Me. I was not force feeding myself. So I was just eating to appetite so long as 80% of my calories came from UPF. So I was the experience of doing it was incredibly educational.

I was never full. I was never hungry. I was just sort of eating all day because that's what the food allows you to do. So weight gain is very well evidenced. We then did brain we did functional MRI scans and looked at, connectivity between different parts of the brain.

This was sort of the most terrifying bit is we saw a massive increase in connection between that the automatic behavior bits at the back of the brain in the cerebellum, the the habit forming bits, and the reward addiction bits in the middle of the brain. And these changes were very surprising to all of us. They were very robust, and they persisted for eight weeks after I I switched back on the diet.

Dr. Mark Hyman
And what were the changes?

Dr. Chris van Tulleken
So we just saw huge amounts of increased connectivity between the the habit bits and the reward bits. And it was the the findings are best described as if I had developed a new addiction, I think. That it's it's you know, all of the fMRI data that you generate from any experiment is is hard to be really sure of of what's causing what, but we saw very significant changes. And it's notable they were between those two regions. And bear in mind, I was I was 43 when I was it was a few years ago.

I was, you know, I was in my mid forties doing it. You know, what is it raises the question of these kind of brain changes to children who are eating much more UPF over a more prolonged period of time. And then the other in a way, the the change I was most fascinated by well, there were two others. But the physical change was that we measured my satiety my hormone response to a normal meal. So this isn't something you can fake.

We would at the beginning of the experiment, I went and I ate a standardized meal, and we measured changes in the hormones you see. The you have fullness hormones and hunger hormones. They go up, down. And at the Just

Dr. Mark Hyman
doesn't rely on your subjective feeling about how hungry or full you were, you actually measure the hormone We measure and leptin that actually tell you whether or not you're full or hungry biologically.

Dr. Chris van Tulleken
Yeah. And what we see is that after eating eating the same standard meal, at the end of the UPF diet, my fullness hormones went up much less and my, hunger hormones stayed much higher. So at the end of the same meal So the diet is modifying your body's ability to feel full after any food. And that to me was was the most kinda significant thing. It's not just that the food doesn't fill you up, but we think it may be having changes about the whole way you you handle food and feel full at the end of meals.

Really important to say, I know. I'm one participant. That's why we've turned it into a big registered clinical trial funded by Yeah. You know, our research council and an independent research trust. And and that's why we're doing it robustly with ethics permission.

You know, it's a registered trial. Kevin Hall is

Dr. Mark Hyman
that trial.

Dr. Chris van Tulleken
So we've got, there are there are two arms, and we're doing how many have we registered? Somewhere over 30, I think. So it's not a huge trial. It's a bit bigger than Kevin's.

Dr. Mark Hyman
Yeah. Ethically, you know, it's like you're feeding people what you know is hurting them. It's a little tricky, but people are willing to do it. I think for science, that's amazing.

Dr. Chris van Tulleken
Well, the the of course, in so the the way the trial is designed is we're actually feeding we're trying to feed people the healthiest ultra processed food versus a minimally processed diet. So our we didn't feel it was ethical for them to just eat any old ultra processed food. I think the jury is in on that evidence. So instead, we fed people a diet of ultra processed food that is in line with our national dietary guidance versus a a minimally processed diet of the same thing. So we're trying to do, we're trying to investigate the claim that if we make the ultra processed food as healthy as we can, does it still cause negative health outcomes?

And especially does it do that in comparison to a minimally processed diet? So it's it's, it's asking the same question in a different and hopefully more ethical way.

Dr. Mark Hyman
That's interesting because I think, you know, people will say, well, it's not it's not the ultra processing. It's just the crappy food, and it's the low the high glycemic load or the lack of fiber or, you know, the macronutrients that are different and the calories that are different. And and and if you just ate a high glycemic diet like sugar and white flour that was organic or, you know, like, you'd have the same problem.

Dr. Chris van Tulleken
So the you're asking a a question. I think there there are two questions. First of all, and this has been very kind of hotly contested between people funded by the food industry and and more independent scientists is is the definition of ultra processed food useful, or is it just describing food that we already think is unhealthy? And there are a number of ways to answer that question. I think the way we currently define unhealthy food isn't working in policy terms.

Okay. So whatever definition you're using, in The US you have very weak definitions of unhealthy food. You might be able it's not entirely easy to say how you define unhealthy food in The United States. You have you have dietary guidance, which is which is fairly good and bits of it are aligned with international guidance. But there's nothing I can see where you go.

These are a set of thresholds and criteria by which we will declare a product to be unhealthy. So for a start, when we say is ultra is the definition useful? You have to say, well, is it useful in in comparison to what? There's no question it's been incredibly powerful as a research tool, and that's what it was designed for. So the definition is set in stone.

It it went through a revision, but it's been in stone since 2018. It's a very long definition.

Dr. Mark Hyman
Classification developed by Montero from Montero. Which is now part of their standard dietary guidelines as well as Canada and other countries, right, that are using this

Dr. Chris van Tulleken
So so as their

Dr. Mark Hyman
metric for food.

Dr. Chris van Tulleken
France France, Israel, Belgium, most South and Central American countries, Canada give advice using, de nova classification. And it's it's a nine paragraph definition. But the definition and it broadly describes modern prepackaged, preprepared American industrial food. And I'm sorry I know this is an American audience. And in fact, you know, many many transnational corporations make these products.

But we're talking about food wrapped in plastic made using additives. Now the definition was never designed to be used in law to ban something or tax something. So when commentators say, oh, the definition has it's it's too vague. You can't use it to define a product. Absolutely.

And no one I don't think anyone sensible is saying we should use this as the way of labeling food or taxing it or banning it. But the definition has had research power because it was testing a hypothesis. It was saying, is there something more to harmful food than simple levels of salt, sugar, and fat? And is industrially produced food different to the food you cook at home even when you adjust for that? And so Right.

Across now hundreds of research studies. I mean, you know, if just a few years ago, there were, you know, for any one health outcome, there were maybe 10 to 15 longitudinal studies. We now have really more than a hundred of the kind of prospective studies that we use to link cigarettes to lung cancer. We now have these for ultra processed food and negative health outcomes.

Dr. Mark Hyman
And what's the what's the sort of, hazard ratio? In other words, with with traditional, like, cigarettes, it was, like, ten to twenty times an increase in risk of lung cancer. So on an observational study, that's a that's a slam dunk. If it's over, you know, two or three, you you you usually probably have some causality. And that's two or three hundred percent, and smoking was, you know, two thousand percent.

And so the question is, how how big is the delta on them? Is it, like, a twenty percent increased risk, a %, two hundred %?

Dr. Chris van Tulleken
So almost not I can't think of anything other than maybe asbestos that has that same, hazard ratio or odds ratio, however you wanna calculate in epidemiological terms. In terms of it's its the the sig the the magnitude of harm it causes. What we see with UPF depending on the outcome you look at, is we see, we see increases of you know, it's times 1.5, times two, times three. So big increases in

Dr. Mark Hyman
Yeah.

Dr. Chris van Tulleken
Abs in absolute risk. That's fine. And ex exactly the kind of exactly the kind of risks that we accept for many, many other, links between, you know, let's say, poor sleep quality and, early mortality, for example. So cigarettes, we see we see enormous deltas. But we we, you know, ultra processed food, it's smaller because diet related disease has many it's it's very causally dense Yeah.

And there are lots of different ways that dietary patterns affect you. So one one of the really important things to say is when we look at those hazard ratios and different studies report this in different ways, Almost all of the epidemiological evidence has made adjustments for dietary pattern and for nutrient profile. So if we look at, this was a a study, a really well reported study done by one of my PhD students, Sam Dicken. He's now not a PhD student. He's now leading this update trial that I was telling you about.

So Sam did a review of the evidence. This is in 2021, and looked across at whether or not the epidemiological studies controlled for dietary pattern. And they almost all do.

Dr. Mark Hyman
Hold on one sec. Hold on one sec, Chris. The camera went off. You gotta put it on never go to sleep, and you need to have it plugged in. The camera's No.

The I don't see him. So in other words, the the iPad went to sleep. Yeah. So yeah, sorry, Chris. We're just just using the new system.

So it's it's $19.56.

Dr. Chris van Tulleken
Do not do not worry. Tell me tell me when you're But

Dr. Mark Hyman
now I can see. But but, I mean, you've gotta go to the settings and go to, screen, and they'll never go to sleep. And this should always be everything should always be plugged in. Yeah. Sorry to cut you off, Chris.

That was I'm sorry. I wanna actually, once you finish this point and kinda let you re we go through this, I wanna go through and sort of ask you, you know, to define what is make something ultra processed and why that's materially different than just having something cooked at home with more sugar, salt, and fat. Sure. So And I think, you know, we're we're not ready yet. I think that you you gotta go to the you gotta go to settings, and you gotta go to settings, and you gotta go to screen, and you gotta go to never go to sleep.

And then when it says, like, screensaver or whatever, you just gotta go to never so it never goes off. Otherwise, I like looking at you. I don't know why otherwise, I could be looking at a black screen. You want me to do it? Here.

I can I I can do it? Yeah. Yeah. Yeah. So you just gotta go to In the screen time?

Just put it here. Okay. Auto lock, fifteen minutes, never.

Dr. Chris van Tulleken
Okay. Perfect.

Dr. Mark Hyman
Okay. Alright. Whereas, this is like I said, this is our first use, the studio, in in the new setup, and so you're like the guinea pig.

Dr. Chris van Tulleken
Don't worry. Don't worry. I'm used to being the guinea pig.

Dr. Mark Hyman
Alright. I I know it sounds like and by the way, I did talk to that guy from the WHO. That was fascinating. I wanna jump into the commercial of terms of health. I wanna talk about what's happening in America and and some of the issues around, you know, the new administration and what what could be done and how do we do it and how do we navigate in conversations I've had with the FDA about the food labeling and how they came to what they're doing.

And so it's interesting. Okay.

Dr. Chris van Tulleken
So Go going back to your your question about how much ultra processed food increases your risk of a particular health outcome. One of the things is that, in those epidemiological studies, adjustments are made for salt, fat, sugar, fiber, and dietary pattern. Now the logic of doing that is you're trying to go, is processing itself playing a role? And we have lots and lots of evidence that factors other than those nutrients now are playing a role. It's not simply a deficiency of fruit and vegetables or or an excess of salt.

But, of course, one of the ways that ultra processed food harms you is because it is incredibly high in salt, saturated fat, sugar, energy density. It has a high glycemic index. And so all of those things, when you adjust for them, they, dilute essentially the effect. But the overall effect on of the food on your body will have all of those different factors coming to bear on your health. So these the questions you're asking are really complex epidemiological questions.

Yeah. But whether you make the adjustments

Dr. Mark Hyman
or not scientists, like, who are not scientists, when you do a observational or population study, you know, there's a lot of things called confounding factors or variables where, you know, for example, in the meat studies that I've talked about on the podcast before, it found that, you know, meat was harmful, but the people who ate meat in these large trials who are just population studies where they follow people over a long period of time, they get their dietary records and, you know, ask them a food frequency questionnaire, which is super unreliable. And, you know, it turns out that the meat eaters, you know, weighed more, smoked more, drank more, didn't eat fruits and vegetables, didn't take their vitamins, didn't exercise, and that was why they had more heart attacks and disease. It wasn't because of the meat. And and another observational study showed that, you know, people who shopped at health food stores who were vegans or who ate meat, both have their risk of death reduced in half. So it's it's a context of what your over dietary pattern is, your lifestyle is, and and, you know, so I think that's that's what these these these various factors are be being looked at as in these ultra processed food studies, and they're being controlled for as best you can.

But you're saying even even if you take into account all these variables that could mess up the results, you still see a signal for ultra processed food independent of the fact that it's got high sugar, salt, fat, or whatever else has got crap in it. Right?

Dr. Chris van Tulleken
You do. But it's really worth saying, Mark. If someone said to me, ultra processed food is only harmful because of its salt, sugar, and fat content and its energy density, I would go you know what? I would buy that as maybe 80% of the harms. If you wanna say a hundred, we can still do business.

No problem. So long as you're enthusiastic about improving justice in the food system, improve improving the equity of access to food, improving life for disadvantaged populations, about regulating corporate power. If you wanna do it, like the thing is what what you notice We're gonna

Dr. Mark Hyman
get into regulations of corporate power. That's a good one.

Dr. Chris van Tulleken
But it's it's the it's the people who say, oh, it's all sugar, salt, and fat. When you say, well, okay. Let's let's talk about progressive sugar taxation, you don't hear those same voices calling for that. You don't hear those voices calling for, strong marketing restrictions on foods that are high in sugar, salt, and fat. So the and to some extent, the ultra processed evidence, what it tells us is that food processing is important.

I mean, we know that processing affects human physiology. Do we are we saying that the only way that ultra processed food harms you is is not through sugar, salt, and fat? I mean, that would be absurd. What I would say, the simplest way of understanding it, is that the ultra processing, which includes the marketing, the coloring, the texture effects, the physical processing, thermal chemical processing, that is the stuff that enables and allows you to eat so much of the sugar, salt, and fat. Because no one eats sugar, salt, and fat from the bowl on the table.

It's the processing.

Dr. Mark Hyman
Matrix. Yeah. It's a different matrix. Yeah. I mean, I I think it's worth stopping for a second and defining what is ultra processed food and the NOVA classification, just briefly, that was developed by Montero in Brazil that's now used as a standard in many countries for their dietary guidelines.

And I I think it's a very useful way to think about things because we've been processing food for thousands of years. You know? Making sauerkraut is processing food. Making miso is processing food. You know?

Making tofu is processing food. But these are still relatively whole foods. There's also cooking and food added added things you add to your cooking at home that sort of makes it more complex. And so the the ultra processing is quite different, and it's an industrial process that breaks down the commodity crops, basically soy, wheat, and corn into these, sort of chemically different molecules that then are reassembled into what looks like food. But, technically, by the definition of food, it's not really food.

Dr. Chris van Tulleken
Well, we don't really I I mean, there is no definition in law in a lot of places that's widely agreed of what food is, but I think the idea that it's Well,

Dr. Mark Hyman
it's a Webster's dictionary definition I'm going by. You know?

Dr. Chris van Tulleken
The food

Dr. Mark Hyman
something that supports the health and growth of an organism. You know? Right.

Dr. Chris van Tulleken
And and should nourish us. Exactly. And the purpose of food should be to support health and growth. And and that's not what UPF does. So the the definition, you can look it up.

It's housed I've got it in front of me. It's housed on the United Nations Food and Agriculture Organization website. So this is not a definition agreed on by a single academic group promoting their work. This is a definition that UNICEF used, the World Health Organization in some context used, the UN used, many governments around the world used, and then research groups at Cambridge, Harvard, Yale, Princeton, Oxford, UCL, and so on. So the NOVA classification divides food into four groups.

Group one is these minimally processed foods. So, things like, an oyster or an apple, obviously, you haven't processed at all. You eat them raw. But minimally processed foods includes things like, you know, rice. You've you've husked it or or grains.

You know, it's gone through a degree of processing. Pasta's a minimally processed food. So they're not they're not, but they're usually single ingredient, and you can eat them whole or or you can you can boil them. Frozen frozen vegetables.

Dr. Mark Hyman
And then tomatoes is processed food,

Dr. Chris van Tulleken
which is

Dr. Mark Hyman
tomatoes, waters, and salt.

Dr. Chris van Tulleken
Exactly. So that's minimally processed. Then we have processed foods, which would be canned or bottled, things, tins of fish, they're processed. But these are processed using traditional methods, and they haven't been, there's not a lot of financial growth in in processed food. So we have number one, minimally processed.

Nova two is kitchen ingredients. So things like vinegar, salt, oil, spices, things like this. And then group four, and then So processed foods is is mixtures of one and two. That's how it's defined. So you take a, you know, you take some broccoli, you pour olive oil all over it, and you fry it, you add some salt.

Now you've got a a a group three processed food. So you can make NOVA group three foods at home. When you bake a cake, that's a NOVA group three food. You've combined groups one and two. NOVA group four is ultra processed foods.

When you say the term ultra processed foods, that is what you mean, and you you mean a particular definition. So you hear the whole time, oh, the definition isn't agreed on. The definition is agreed on. You may not like it, but it is it is agreed on. People may not agree about its utility, but it but it exists.

And it's it's long, but it describes products that are formulations of ingredients that have at least some ingredients that are purely of industrial use, and they contain cosmetic additives. So when you cook at home, you don't use artificial sweeteners, colors, humectants, foaming agents, bulking agents, antibulking agents. Right. You you use you you just cook with groups one and two. So UPF can only be made by an industry.

And, importantly, its purpose is profit, and it is marketed. So you you even if you go and buy food coloring at home, you're still not making UPF because your purpose isn't to make profit.

Dr. Mark Hyman
Yeah. For example, I'll just give an example. I I I think, you know, people can go bake a chocolate chip cookie at home Yeah. From real chocolate, regular flour, butter, eggs. Right?

But if you go get a Chips Ahoy cookie, the ingredients are un unbleached, enriched flour. Okay. That's you could say that's okay. Chocolate. But in the chocolate chunks, they have dextrose and soy lecithin, which are not things you have in your kitchen.

It has, also, weird things like ammonium phosphate, high fructose corn syrup, soy lecithin, caramel color, artificial flavor. These are the things that, you know, are kind of invisible. It looks like a chocolate chip cookie that you make at home, but it's not. And you're saying this is materially different in terms of what we're talking about?

Dr. Chris van Tulleken
The the definition was invented to test the hypothesis that industrially processed foods affected human health, in in ways beyond the ways that domestic cooking does, and it's done that robustly. What the hypothesis doesn't say is that that ammonium phosphate or the soy lecithin is harmful. Those things are are proxies for ultra processed food. They're a sign that your food has been designed in a system that is about profit, not health. So some we can argue there are certain class classes of additives, and I think you've had some very sophisticated thoughts on this and and have spoken a lot about this.

There are some classes of additives I think have quite good evidence for health harms. There are others where, you know, who knows? A bit of potassium sorbate probably doesn't do you any harm. There's lots of things like acetate or propionate your body makes anyway. So the the and and the color a lot of the coloring probably doesn't do much harm.

There's natural flavoring. You know. So these are signs that food is industrially processed. What we now I then so taking that definition, the question is then to go, if due for whatever reason, does that definition of food, do products that meet that definition, cause negative health outcomes? And so, we then have a set of criterias, you very well know, to evaluate evidence where we go, are we just mistaking food that's eaten by people who live in disadvantaged, people with low incomes, people who also smoke and drink?

Are we mistaking food that's signifying a poor lifestyle for food that's actually causing harm? And, of course Yeah. We we now have across I mean, we can go through this in detail, the Bradford Hill criteria. I would say ultra processed food has more than met the threshold for causality where we can say with confidence, it causes negative health outcomes. And we have experimental evidence.

We have epidemiological evidence and so on. On.

Dr. Mark Hyman
That's great. I mean, it's great. I I I I I kinda, you know, having you explain all this because I I recently read a paper that was published in 2022. It was a debate between Monterra, who developed the NOVA classification, and doctor Astrup, who's, from, Scandinavia who, you know, have opposing views. And, you know, the the the the argument from doctor Astrup was that this is just sort of not a very helpful classification because it can all be explained through other things that we you now kind of refuted.

And I went and actually looked up the conflicts of interest of doctor Astrup. And, you know, he worked for Nestle and, you know, other big food companies, and I'm like, McDonald's. I'm like, oh, okay. Okay.

Dr. Chris van Tulleken
So I wondered if you were gonna I wondered if you were gonna I have I have them I have them in front of me, actually. The look. I spend a lot of my academic life and my broadcasting life critiquing people who don't declare and who do declare significant conflicts of interest. The interesting thing about that debate is there was very little scientific merit to what Astrup was saying. In terms of the arguments he was making were not good faith.

So he would set up propositions that no one else was setting up in order that they would be easy to knock down. So he was he was setting up straw men saying, you know, you it's it's not a useful policy instrument. No one Yeah. Is saying we should take the evidence around ultra processed food and just directly apply it to policy, any more than we should say, you know, we have good evidence that alcohol is harmful, so we should ban alcohol. We should go back to prohibition.

I mean, no. That's that's not how you use scientific evidence. You use it with nuance. So it it's a it's a strange debate, and it did not feel good faith. He also understood some fairly basic misunderstood some basic epidemiology, which I think was embarrassing for him.

Dr. Mark Hyman
Well, this is really important point because, you know, as the world is getting sicker and fatter and America is, you know, tanking because of this, I think this is gonna be the end of us, literally, because the economic burden of it is huge. We we have over sixty percent with a chronic illness. We have ninety three percent who are metabolic and healthy. We're forty eighth in life expectancy. We spend 40% of our, of the of the dollars that are spent on health care from the federal government of the sort of almost $5,000,000,000,000.

It's it's about 30% of the entire federal budget, one in three dollars. And it's it's both, affecting us from a economic perspective, from a health perspective, from a social perspective, and it's a crisis. And and so now, you know, recently in America, Trump was elected president. Robert f Kennedy junior is, going to be secretary of health and human services, and he's been all about ultra processed food. And so the question is, you know, when you have the king keys to the kingdom and you're trying to make a difference, and how do you use the framework of ultra processed food to drive policy or don't you?

And and recently, the FDA came out with a ruling for front of package label labeling, and it's not been, adopted yet, but it it's out there for comment, which is, to me, kind of a throwback to the past, which is this concept of nutritionism that you talk about, this idea that most of nutrition science has broken down the, effects of food based on their individual ingredients, salt, sugar, fat, whatever, and then you can dial it up or down. So we found fat was the enemy back in this seventies and eighties. So we basically said everybody should eat low fat, and that led to the rise, I think, of obesity and increased sugar in food. So instead you guys snack well cookies and all these, foods that were ultra processed that actually had huge amounts of sugar but no fat. And so we kind of can, I think, invite food companies by having this new ruling, which basically says just the amount of saturated fat, sugar, and salt as metrics, high, medium, or low, to me, it doesn't go far enough to help educate people?

I think it doesn't really tell people the degree of processing or how it's gonna affect them. And what you're saying essentially based on the data is that salt, sugar, and fat are not enough to explain the full impact of ultra processed food. There's something else. There's another element that makes it even worse. And and so the question is how would you take this framework of ultra processed food and use it to help inform policy, whether it's dietary guidelines, whether it's front of package labeling, whether it's school lunches, or what we do with our food stampers or sort of assistance program.

That that's kind of where I'm sort of struggling to figure out how do we you know? Because to me, it's like if you put, you know, it's class one to four, four is, like, really bad for you, that would be an easy thing to do for a front of package labeling. What you're saying is not really the thing that we should be doing.

Dr. Chris van Tulleken
Well, okay. The, it's really you're really good at asking 10 very hard questions at once. Let me let me, let you're you're too smart, Mark. Hold on. Let me let me let me let me, let me try and break this down as I see it.

So, a huge amount of the harm of ultra processed food comes from the very high levels of salt, sugar, and fat, and and Yeah. And just calories. But here's the thing. When you cook at home, you also cook with salt, sugar, and fat. If you make a chocolate brownie at home, and you just gave me your your recipe for chocolate, your, you know, the Mark Hyman chocolate cookies.

Now, let's say we match them. You let's say you really let your hand slip with the salt because you you understand how food processing works. So you make salty, sugary, fatty cookies because that's what we all love. In fact, they're exactly as salty and sugary and fatty as the big brand you also mentioned. What you aren't able to do is to engineer your cookies so I'll have three of them.

So even if you cook with as much salt, sugar, and fat, because you haven't put people in MRI scanners in order to develop your cookies, and we know that the big food companies use brain scanners to do product development, you haven't employed a hundred PhD nutritionists to optimize every product through a thousand focus groups over over three decades. You I'm only gonna eat So we also know you won't use as much salt, sugar, and fat. So it's not it's per bite of the industrial cookie I get more salt, sugar, and fat, But because of the processing, the marketing, the coloring, the texture effects, the glycemic index, I eat more of it food. So I get more salt, sugar, fat per mouthful, and I take more mouthfuls. And that's what the those who resist the definition can't seem to grasp is the salt, sugar, and fat are part of the ultra processing.

They are Yeah. They're part and parcel. So in terms of what it teaches us, look, it tells us the products regulate. It tells us that the what we see with diet related disease, and we see this in natural experiments all over the world, when populations start eating an ultra processed diet, that's when their risk of obesity, metabolic disease, kidney disease, dementia, anxiety, depression, cancers, but it all starts to go up at the same time. So it tells us the focus of policy needs to be industrial in industrially processed products.

The difficulty is not that it would be wrong to put warning labels on UPF. It's that it would it has a loophole and it would be legally hard to do. The loophole is this. The companies are getting more and more sophisticated at selling us very high salt, fat, sugar foods that are very delicious. They're very soft.

They're high glycemic index, but they don't contain the additives. Or they use natural additives. And so, it functions like ultra processed food, but it doesn't quite meet the threshold. So it's not that the definition is too broad. It's the definition is now too narrow.

So we can give we can give people all dietary guidance should say avoid ultra processed food, and there should be a simple working definition of that. That's what France, Belgium, Israel, Canada, as I said, that's what they all do. In order to label a package, my research where I am at UCL, and we've partnered with the Pan American Health Organization with WHO to do this. We can show that more than 99% of ultra processed food has excessive calories, saturated fat, salt, and sugar. So in order to regulate the food, you can actually just

Dr. Mark Hyman
proxy.

Dr. Chris van Tulleken
Yeah. You can it's fine. Like, we're gonna miss 1%, but it's very hard to make addictive food that isn't either very energy dense or fatty or salty or sugary. And most of the time, it's all of them. Now the the front of package label you talk about so so the I mean, the problem is that I'm in the weeds of this.

Okay, Mark? So I can be boring. We could we could do, like, a four hour special on nutrient nutrient profile models and how to best capture unhealthy food. There's no perfect way of doing it, but you use tight levels for salt, fat, and sugar, and then you put a proper warning label on. So at the moment on your US on the pro on the FDA, proposal, which I'm just looking at now, there's gonna be high, medium, low for saturated fat, salt, and sugar.

It's not a bad way of doing it, but the low, you get low for added for well, for added sugars, and it should be free sugars, but that's a separate thing. But you get low if it's 5% sugar. Now WHO say, and UK government say you shouldn't eat more than 5% of your calories from free sugar at all. You'll get health benefits all the way down to 5% if you can get it down. So saying that 5% is low when that's at the upper edge of what WHO recommend for daily daily intake feels it feels lax.

Dr. Mark Hyman
Yeah.

Dr. Chris van Tulleken
So Yeah. But the Maybe if

Dr. Mark Hyman
you take the the on the front of package, you just change the repose rule. Instead of having it say low, medium, or high, you put low as green, you put medium as orange, and you put the high as red, like a stop sign.

Dr. Chris van Tulleken
I think you get. I think you know what I think about this. So what you then end up with is products that and we have these in The so we have the traffic lights in The UK, and you have a product with a red, green, and an amber. Now what do you do at that traffic light? Is it good?

Is it bad? So in South America, Central America, they've got a really good system where they just use black octagonal warning labels. Once you're over the Stop sign. So stop sign. Once you're over the recommended daily maximum, you get a black octagon.

And the but the most important thing, right, is the warning labels don't do much. For every policy problem, you need five policies to solve it, and every policy should be solving five solutions. This is the sort of public health maxim. So you can't just stick octagons on. If you if a product has an octagon, the monkey has to come off the box.

Okay? If it's got three octagons, it's gotta have progressive taxation. You know, you just cited some of the economic data around how much this is costing. So don't we don't wanna make food more expensive for people who who are disadvantaged, but you you have to tax the worst products. You if a product has an octagon, it cannot be marketed to children.

It can't have an online or TV ad. So you the the warning label does nothing. What you have to do is find a really tight way of defining unhealthy food, and the food you are trying to label is ultra processed. And so you're you use your fats, sugar, salt, energy thresholds to to label the UPF. The arguments, by the way,

Dr. Mark Hyman
to So you're in charge of the FDA. You get to decide how it's gonna go. You have full autonomy. What's the solution? Because, literally, we're in this conversation right now about how do we really change the labeling and what other policies need to happen.

And you mentioned ending marketing. You mentioned taxation. These are extremely unpopular ideas in America. I think free speech and first amendment is about marketing, and I I don't agree with it. I think, you know, we don't allow smoking advertising anymore.

We don't allow Joe Camel on the package front of cigarettes to advertise to kids about smoking. You know, we we we've done a lot to kinda roll those things back, but but it's a tough sell and the and the the taxation issue is a very big concern. And what I hear a lot is the pushback from the industry, you know, and there's hunger groups that I I know you you know and talked about are co opted, because a lot of big industry food companies are on the boards and fund those organizations. But the the talking points are pretty kind of obvious. They go, well, you know, we're gonna be taking away safe, affordable, convenient food.

We're gonna be penalizing the poor. We can't tax the poor. It's regressive. It's there's all these arguments that seem socially conscious and forward thinking and, you know, very elevated. And, of course, no.

We don't wanna take away food from people. We don't wanna make it hard for them to eat. We don't wanna take away the safety in food. We don't like who's against that? Right?

So it it's sort of a it's very smart, and it's propaganda from my perspective. And it's sort of like the old

Dr. Chris van Tulleken
Yeah.

Dr. Mark Hyman
And marketing.

Dr. Chris van Tulleken
Chris VanTullen wants to ban food for poor people is the way the headline gets written. If you make if you put me in charge of the FDA, I'll tell you what, the most important thing so I'm very careful how I use my voice. I'm ostentatiously a a man with with privilege of a particular age. You know, I'm educated. I'm insulated from the problem insofar as anyone is.

The most important thing is the goal of policy is not to reduce people's consumption of a particular product or food. The goal is to improve justice and to improve affordability and choice in the food system. If people want to eat ultra processed food, I to some extent, I don't care what people do. I'm a big believer in freedom and choice. I like freedom of expression.

I do think that, corporate free speech when it's misleading is, is better characterized as propaganda and and corruption. So in terms of how you do it

Dr. Mark Hyman
So free speech is good. Propaganda, no.

Dr. Chris van Tulleken
A lie, no. This this is not this is not rocket science. So the most important thing is you wanna make things so leave the taxation on the table for a bit. The first thing is warning labels. Like, I I think for the most part, we actually have a lot of data.

And and the traction that this is getting in The States is and we're seeing the same thing in The UK. I mean, the my book has been peculiarly popular for a for a kind of almost a, like, a quite a detailed science and food policy book, I think because people are at a point of maximum fury. So saying saying this is all about communication. If I was running the FDA, I'd say, look. We I don't think you want to be predated on by transnational corporations.

Many of them aren't even American. It's not like they're all paying loads of tax in America to clean up the plastic and the obesity crisis. So And

Dr. Mark Hyman
Nestle is a Swiss company, and Mondelez is a European company.

Dr. Chris van Tulleken
Well, many of them aren't even. They're they're housed in in other places if if, you know, they're not even paying tax in those places. So, the framing this as protecting people from predatory corporations as improving democracy and increasing choice. And taxation yeah. I mean, you've gotta be really careful you don't tax the bread and you don't tax ingredients.

You know, that's completely sensible. But, you you also need to make sure if you do have to I mean, food is already taxed. You just need to shift slightly change the proportions and and change the tax on on the healthy stuff.

Dr. Mark Hyman
Yeah. I mean, the taxation works. You know, they've demonstrated this in California. You know, there are states or cities in America where they've actually implemented this. And, and the consumption goes down and health gets better.

I mean, there there is data about this already. So I think it's unpopular, but but I think some kind of, strategy that's progressive taxation based on the the framework you talked about makes a lot of sense to me. I think it's it's gonna be a tough sell in America. I think I think the the thing I wanna dive into now a little bit is we've established that ultra processed food is different than just, you know, home baked cookies. And then it's these weird ingredients that are not in your kitchen cabinet that are put in food to make it addictive, to make it palatable, to make it easy to consume lots of.

It it makes it uniquely different than just regular processed food. And and there's something kind of particularly harmful. And I and I would say I would agree with that based on my experience. And I would also say that that, you know, it brings up the question that you kinda hinted at of how these corporations are operating in the world and what they're doing and what they know and what they don't know that are producing these foods and how it impacts our health. You you you kinda touched on the fact that these big companies put people in functional MRI machines to look at the effects of different foods on the addiction centers of the brain in order to optimize what they call the bliss point of food, which is something Michael, Michael Moss talked about actually on my first podcast I ever did.

And he and he he he really kinda was, like, wrote this book called Salt, Sugar, and Fat, where I interviewed all these food intrigue experts and ex executives and scientists and kind of whistleblowers, and they kinda peel back the the sort of the layers of how they how they do this. And they have taste institutes where they hire craving experts to create the bliss point of food and find out ways to create heavy users, meaning taking people who are already using it and get them to eat more. And it's a very deliberate thing. And there are many other examples of pernicious ways in which the food industry and big ag and and other industries like alcohol, tobacco actually push their products. And you introduced me to, a gentleman from the World Health Organization that I had a conversation with where they talked about this, white paper they're creating on the commercial determinants of health, the ways in which transnational, multi national corporations subvert public health and privatize profits.

And I didn't call it that in my book Food Fix, but, essentially, that's what I was writing about, which is the ways in the various ways in which they use, funding of research. They use funding of front groups. They use funding of social groups. They use funding of academic centers, universities. They fund they use heavy lobbying, and and every particular tactic they can come up with to, undermine, our public confidence and to actually confuse us, confound us, and kind of make the whole thing messy when it's really quite simple.

These foods are are bad for us, and we shouldn't be eating them. And and there's no argument really to say that they're healthy or safe. And if you eat it once in a while, fine. If you have a bag of Skittles once in a while, it's not gonna kill you or Reese's peanut butter cup. But but if you consume these things on a regular basis Yeah.

They're they're going to

Dr. Chris van Tulleken
It's like saying, you know, just just if you have one line of cocaine and one cigarette once a month, once a week, there's no gonna do any harm. But, you know, the the great difficulty about cocaine, cigarettes, alcohol, heroin

Dr. Mark Hyman
have one.

Dr. Chris van Tulleken
They're a little bit more ish. You know, you tend to tend to want that that second one.

Dr. Mark Hyman
Well, the Super Bowl was on, because we're recording this just after the Super Bowl, and it was on last night. And I was watching, and there was a commercial for Lay's potato chips. And the whole thing was about this organic farm. It looked like this little girl and these potatoes and how beautiful this bucolic scene was. And Yeah.

At the end, it was for Lay's potato chips. And I was like, oh god. It's just like they they they they, they are so good at just kinda capturing our imagination, and and they don't really kind of help us understand what's really going on. So it's I was kind of like, yeah. It's it's bad.

Dr. Chris van Tulleken
The the it's what's so interesting is, you know, you you've alluded, and I think you you and I can can name there's a there's a there's a community of scientists who have very aggressively opposed what I'm saying. I wanna say I sit on two World Health Organization expert working groups. Okay. I work at a big university as an associate professor in The UK. I'm I'm not a sort of fringe lunatic.

I work with UNICEF. But there's a community of industry funded academics who violently oppose this concept of UPF. What they don't wanna come up with, what they never propose, is what is causing the public health crisis Because we have had salt, sugar, and fat in our diet for a very long time. We've been processing food, as they frequently say, for hundreds of thousands of years. What happened in the mid nineteen seventies?

If you go and speak to Howard Moskovitz, who's the person who came up with the idea of the bliss point, he will tell you. And I know this because I've interviewed him for a BBC doc. And he was the one who said, well, look, we're trying to make good tomato sauce. Maybe we just need to make 50 different types and put it through a focus group, and it'll get better. And this way of developing products

Dr. Mark Hyman
looks like phone. Yeah.

Dr. Chris van Tulleken
Sorry. Go ahead. Don't worry. Don't worry. I'm pleased that hold on.

I'm gonna I'm gonna do I I I'm gonna do the same because I'm not on hold on. Okay. There we go. When you put

Dr. Mark Hyman
do not disturb, the alarm goes through even if it's undo not disturb.

Dr. Chris van Tulleken
I've just put mine on do not disturb because I'm doubtless gonna get bothered. Hold on. Is everything muted? We I went and spoke to Howard Moskovitz. He's in the in the seventies designing tomato sauce, and he they start making lots of different recipes and putting them through focus groups.

And Yeah. It's this this is adopted. Now I've seen this in big food companies. I've spoken to I spent I spent a huge amount of my time writing my book, Ultra Processed People, talking to food industry insiders, because the industry funded academics critique the concept. But the people on the inside are like, oh, yeah.

No. We we design the food to be addictive. How else do you think if the people at Danone are making the food that way, what are the guys at Nestle supposed to do? I mean, this is this is an arms race for customers. So That's right.

We know they

Dr. Mark Hyman
They call it stomach share.

Dr. Chris van Tulleken
Right. So they know we know two of the most important things they measure are how much food people eat and how fast do they eat it. And we interviewed Francis McGlone, who's head of neuroscience at Unilever, one of the world's biggest ice cream companies. And he talked about putting people in brain scanners and and looking at them eating ice cream, and he said the orbital frontal cortex, and I'm gonna quote him directly, lit up like a furnace. So when you find, if someone listening to this is eating ice cream out of the tub or or, you know, they do this later this evening, And, you know, you get the tub out, and you make yourself a little bowl, and then you put the tub back in the freezer, and then as if drawn by some gravitational force, you find yourself back at the freezer opening the tub again, and eventually the whole tub.

That's because the ice cream was invented by scientists using brain scatters. Like, it's Right. It's not your fault. You can't stop eating it. So Yeah.

To me, the the the inside industry

Dr. Mark Hyman
health, yeah, framework. Tell us, like, how you So what we see playing out and unpack that a little bit. Because I think people don't understand the way in which they're being taken advantage of, the way in which they're being manipulated by both, you know, commercials, marketing, the design of the food, the, you know, pernicious ways they subvert, you know, policy. I mean, the the this is not just, oh, we just made these foods, and we didn't know that they were a problem. They're actively trying to protect their territory and to con to kind of advance their products in the in the face of overwhelming research that they're harmful.

Dr. Chris van Tulleken
So the some of the ultra processing is, like, how you mix together the flavors. Some of it is the focus group. Some of it is the brain scanners. But part of ultra processing is suing the lawmakers who would seek to regulate you, is funding the patient group. So if we look in The UK at food in so the commercial determinants of health kind of academic framework is just asking how do profit making entities affect our health in good ways and in bad ways.

You know, we try and have a neutral perspective. In the case of food, one of the things they do is they control the entire narrative. So our government scientific advisory committee on nutrition, sixty five percent of members have financial relationships with companies like and including Coke and Nestle. We, the biggest food companies run, breakfast programs and education food programs in schools. They fund our biggest food charity, the break the British Nutrition Foundation.

Their Healthy Eating Week last year, two years ago, was funded was sponsored by Coca Cola. Okay? That's the British Nutrition Foundation. We have a How does

Dr. Mark Hyman
Coca Cola make that you eat? Only drink.

Dr. Chris van Tulleken
I just

Dr. Mark Hyman
drink. You

Dr. Chris van Tulleken
know, you can't credibly claim to have an interest in nutrition and do these kind of things in my in my strong opinion. We have our Science Media Center who do the briefings to the press. We have patient advocacy groups. We have social media influencers. You know, there's a tie I mean and then from my perspective, after I published the book, the first email that arrived from the food industry was not a lawsuit.

It was an invitation from McDonald's, to see if I'd become an ambassador for them.

Dr. Mark Hyman
So Here's a million dollars, Chris. Would you become an ambassador and shut up?

Dr. Chris van Tulleken
Well, I I should say I'm proud to speak to you today, Mark, in my capacity as, you know, global menu innovation ambassador for McDonald's. Amazing. No. I said Yeah. I did I wanted

Dr. Mark Hyman
issue with Coca Cola as chief science officer.

Dr. Chris van Tulleken
Should I should I have disclosed that before I came on the podcast? I wanted to ask them how much money, but I I couldn't risk I can send you the email. You know, I'm not making this up. I

Dr. Mark Hyman
I know McDonald's paid a friend of mine who was sort of a healthy eating proponent a million dollars to be their adviser a year. Yeah.

Dr. Chris van Tulleken
That's so painful. A million dollars. It's so much money to me. But, anyway, I did say no. I didn't want them to have an email from me going, how much are we talking here?

Dr. Mark Hyman
Yeah. Right. Right. Right.

Dr. Chris van Tulleken
So so the so we used to think that cigarettes was an exceptional industry. You know, this the tobacco industry made things they know kill people and are addictive, and they do it anyway. Then in the mid nineteen eighties, the cigarette industry bought the food industry. So the biggest food companies in the world, and and it was Michael Moss again, I think, who who did some of the work exposing this. Philip Morris, RJ Reynolds bought General Foods, Crust, Nabisco.

They used their molecules and their product development techniques and the supply chain to make the addictive foods. And now we see the same is true in automotive. We see it in fossil fuels, a perversion of academic interest, corruption of science, manipulation of policy. So exposing all this is important because once you because it helps you reseed that Super Bowl ad where you're like, oh, it's not you know, it's some some I don't know what some farmer in his kitchen stirring a pot of, you know, vegetable oil with, you know, hand chopping the potatoes. It's it's not like that.

And I I think the public I feel The US public are the I mean, look. Why are you popular? You know? You're not you you're saying all this, and peep people are up for this, that you have an asymmetry of power. You you aren't as powerful as as as Nestle, Mondelez, and and and and Kraft Heinz.

But but, you know, I I think truth gives you enormous power.

Dr. Mark Hyman
Yeah. I think you're right. I mean, just speaking truth to power is key, and I think exposing the the nefarious ways in which the food industry acts often can help people understand that this is not their fault. The people and and the the the big the big talking points of the big food has been essentially, it's your fault, you're fat. Number one, all calories are the same.

It's all about moderation. Eat less, exercise more. And implicit in that those talking points, which by the way have been used by government leaders, by scientists, by doctors that have bought it, is that all food's the same. You could have a thousand calories of Coca Cola or 2,000 a thousand calories of almonds, and it's exactly the same. Yep.

Now that that's true in a laboratory. If you burn them, they release a certain amount of energy, which is what a calorie is. Right? It's the amount of energy required to raise the temperature of one liter water, one degree centigrade. It's just a scientific term.

But when you consume them, you know, it's very different. A calorie burn is a calorie burn, but a calorie eaten is not a calorie eaten, to quote my friend Robert Lustig. And when you when you actually, like, get that, it's like, wow. Well, when you eat a food, it has to go through your microbiome, your, the the molecules that regulate your hormones, the immune system, you know, neurotransmitters. And you don't by the kind of food you're eating, and then people don't realize that.

Dr. Chris van Tulleken
And and you you know, the way your body interacts with a thousand calories of almonds is somewhat different to the way your body interacts with a thousand calories of of Coke in terms of appetite. I mean, we humans don't just choose to eat the 2,500 calories per day. You know, we're guided to it in the same way we're guided. Our our internal physiology guides us to breathe a certain amount and to drink a certain amount of fluid, and it's the same with food intake. So it's, yeah, it's it's very odd, this idea that humans can kind of eat eat to numbers.

Dr. Mark Hyman
And what's strange what's strange to me also is that the the food that they make in The United States is far worse than the food that they make, the same kind of food they make in Europe or even The UK. Like, Kraft macaroni and cheese is full of artificial dyes and chemicals in The US, but it's not in in The UK. Or if you look at, you know, the amount of ingredients or additives we have in The United States, it's, like, 10,000 different food additives, where in European Union, it's about 400. Now maybe 10,000 are are somehow how more so broken down into subclassifications and maybe it's not 10,000, maybe it's 5,000, but still a lot of things

Dr. Chris van Tulleken
No. No. In The US.

Dr. Mark Hyman
That are not proven. And then, by the way, people don't understand this. The way these things get into the food is the food company goes, hey. This food, the ingredient we've found is safe, FDA. And if it goes, oh, great.

Cool. We'll regulate it as a not as an a safe to eat substance, Generally recognized as safe. Whereas, imagine they did that for drugs. Imagine the drug company said, hey. We just developed this new drug.

It's safe. And the FDA goes, oh, cool. Great. Let's just prove it. That's exactly what happens with food.

Dr. Chris van Tulleken
Well, we we used to do that for drugs, and then we realized none of the drugs worked, and so we started regulating the drugs. But this is the the the system of food additive regulation so for the I'd put a chapter in the book on The US system because someone said to me food additives are not really regulated. Someone I trusted. And I was like, well, that's that's not true. Of course, they're regulated.

You've got an FDA. No.

Dr. Mark Hyman
That's not true.

Dr. Chris van Tulleken
So I I call up Emily Broadleap who's at Harvard. She runs the Food Law Policy Center there, and she's like, yeah. No. There's not any real you know, you have this self determination system where the the companies can, decide for themselves. It's astounding.

Dr. Mark Hyman
Right.

Dr. Chris van Tulleken
Yeah. So you do have no one knows how many additives you have because, because they're also not all formally registered. So, yeah, it is it's Yeah. And there's things

Dr. Mark Hyman
on the there's things that are in foods that are ultra processed that aren't even on the label. Like, microbial transglutaminase is basically gluten that's put in foods to make the food hold together. Gluten is like glue, and so they use it in in industrial food, and they grow it in bacteria, and it's a form of gluten. And then we've seen this incredible rise in gluten sensitivity and celiac disease, that, you know, potentially can create leaky gut. And we know that all salts for processed food has adverse effects in the microbiome, increases inflammation, and so forth.

But the transglutaminase is something that's not on the label. Right? Or there's emulsifiers in food that that are are most of these processed foods that, you know, make the food have a good mouthfeel and make it all sort of the right texture. And these compounds have been shown to cause leaky gut, autoimmune disease, and and many other inflammatory conditions, and yet, you know, we don't regulate them.

Dr. Chris van Tulleken
It it you know, the in terms of what what the industry responds to all that is they say, well, you can't prove harm. The the data on emulsifiers okay. You've got some animal epidemics. There's actually quite a lot of data on some of these emulsifiers now. But you haven't really proven it.

But the burden of proof should not fall to independent academics to say that adding synthetic molecules to food is is is, is harmful. The burden of proof should be

Dr. Mark Hyman
Right.

Dr. Chris van Tulleken
The other way around, and the the molecules should have to go through a proper stringent regulatory process. But we do have a much more stringent process in in in Europe and and The UK, but it's still not very strict. So we don't assess, molecules in combination. We don't often assess the right dosage. And we when it comes to food additives, we don't look at long term effects.

We don't have any assays for effects on the microbiome or obesity, for example. So I think one of the things we we know is that we can make very good, safe, cheap food without all these additives, and their primary function is to save the company's money. I mean, we we did a we did a paper last year on financialization of the food industry. So instead of working with nutritionists, I worked with a lot of economists. And we just used the food industry's own financial data and compared it to their claims.

Because all all the big companies will say that they're mainly interested in reducing carbon emissions, cleaning up plastic, improving public health, improving the nutritional profile of the of the product portfolio, and so on. You know, improving women and children's labor rights. And so you just say, okay. Well, we've got all these claims. How does this stack up?

When they make money, what do they spend it on? They spend it on share buybacks and dividend payouts. So even as Coca Cola claimed, for example, to be trying to create a world without waste, that was their kinda strap line for a while. They had been the world's largest plastic polluter for several years in a row. So the companies are very, very good at positioning themselves as being the solution to the problems that they've caused.

And for me, the the one thing, if you give me this control of the FDA, the one thing is to go, you need to be regulated. And regulatory relationships are at arm's length. You know, you cannot be taking money from the people you regulate. And that that's kind of step one if there's any progress to be made is to is to stop the flow of, I would describe it as dirty money between the companies that need regulation, whether they're whether they're tobacco, alcohol, or food, and those that would regulate them, whether they're formal regulators like the FDA or they're informal regulators like charities and activists and people like you.

Dr. Mark Hyman
Yeah. I think that that getting rid of the complex of interests and the, you know, perverse incentives that exist is a big part of the solution. I think, you know, I I think about this a lot, and I and and you're right. You know, there's not just one policy solution that's gonna fix it all. We need to start from the field and how we grow food, what we grow, how we subsidize agriculture to, you know, how we incentivize companies to make better food, to how we educate people about what's in their food, how we warn them with labels.

Like, anybody my wife was in Mexico. She sent me a picture of, like, a a a some food product and said, you know, here's all the warning labels. This is not safety for children at the bottom. Like, it was all these warning labels. Like, I was like, that's really good.

You know? That'll probably stop a mother from buying that food for their kid. And yet, you know, in America, we don't have any of that, and people don't know. And I think this is what's what makes me so upset is that people really don't understand. So if you're an individual who's listening and you wanna kind of not be caught in the web that the food industry has spawned to catch you to eat these foods, what what are the few things you can do personally to actually empower yourself to stop doing this, and and how do you sort of sort of take back control of your diet and, you know, simple changes they can make to kind of actually, not eat this stuff?

Dr. Chris van Tulleken
So, weirdly, in in my book, I do not advise anyone to stop eating ultra processed food. In fact, at the beginning, there's an invitation to the reader that they should eat UPF while they read the book. I'd I'd say, you know, eat more of it almost. And the reason for that is

Dr. Mark Hyman
I wouldn't I never did that. I read the book.

Dr. Chris van Tulleken
It's I didn't expect you know, I suspect you read it at a different level to to many other readers. But what had happened to me on this four week diet is around week three, I had a chat with a colleague in Brazil. We were designing this study, and she kept saying a thing that you I've heard you say before. It's not food, Chris. It's an industrially produced.

It's an industrially processed edible substance. She said this kind of again and again. It was it was like it was an annoying tick. By the I sat down that evening to eat my it's my favorite fried chicken brand. I got a little bucket of it, and I was so looking forward to it, and I couldn't finish it.

It it she had made it disgusting. And this is the gift I wanna give the reader is the food will be your greatest teacher. Eat the food. Lay it out on a china plate. You know, if you think you really love this, put it on a china plate, get a knife and fork.

This is not food that stands up to scrutiny. And by the end of the book, my I don't promise this. I'm not selling anyone a a a solution. But if you're addicted to something, we have pretty good evidence that this works with cigarettes that, first of all, engaging with the substance, not forbidding it is helpful, but understanding the incentives of those who are selling you the substance is important. Help understanding the tobacco industry massively helps smokers, and understanding the food industry really helps people who are addicted to UPF.

So my recommendation and you I mean, Mark, you you you've written some stuff on UPF where I was like, has he copied me? And then I realized you'd written it first. So then I was like, man, he's he's gonna think I've copied him. So you can you can read you can you can read you can read anything that either of us have written or there's other great stuff out there if you can't afford to to buy a book. You know, read about the food and eat it.

And you can do little experiments. One of my favorite things is get your tube of, you know, saddle shaped chip. I didn't even I I can never mention brands

Dr. Mark Hyman
in The UK.

Dr. Chris van Tulleken
So it's Pringles. It's my it's my

Dr. Mark Hyman
Pringles mention it.

Dr. Chris van Tulleken
Pringles or similar. So you get your Pringles or or other or or

Dr. Mark Hyman
similar independent media. This is a podcast. No one tells me what to say or do. I can say whatever I want. I can say any words I want.

I can name any company I want.

Dr. Chris van Tulleken
Get in touch with Mark's lawyers.

Dr. Mark Hyman
Me, but, you know

Dr. Chris van Tulleken
Well, they they your lawyers. I I also get I'm getting legal attacks constantly from the food industry. It's it takes up

Dr. Mark Hyman
Yeah.

Dr. Chris van Tulleken
A huge amount of my time, and it you think it'll be fun? And, actually, I wanna talk about lawsuits

Dr. Mark Hyman
and ethics. You. They they they pay attention. I mean, they write articles about me. They the corner finders of America send me nasty gram letters.

I mean, it's it's interesting.

Dr. Chris van Tulleken
It's how you know. I it's one of the ways I think you know you're saying the right thing. But get your Pringles, get them out of the tube or other brands, crunch them up into a powder, put the powder in a bowl, and eat it with a spoon. And that way, you will discover if you really love Pringles because the

Dr. Mark Hyman
Yeah.

Dr. Chris van Tulleken
The the pro part of that ultra processing is the the hyperbolic paraboloid shape. Part of the ultra processing is the mythology, the branding on the tube. And once you've reduced them to a powder, it it's a it's a really good experiment to do. So Yeah. But the law says experiment.

Dr. Mark Hyman
Actually actually, just before we go to the lawsuits, I just wanna tell you a story. I had a friend of mine who's a worked as a nutritionist. He was a psychologist of nutrition. And he had a patient who was trying to help lose weight, and the patient's like, I'm really busy. I wanna lose weight, but I'm really going so fast in my life.

And I I just stop it like Burger King, And I I get my, you know, whatever, big Whopper every night, and I this is what I do. And I have to do that because I can't I don't have time to do anything else. He's like, okay. What I want you to do is you don't stop eating it, but I want you to go in there, and I want you to sit down Yeah. In the restaurant.

And I want you to take each bite and savor it and take, like, at least, you know, twenty twenty chews on each bite. And just experience

Dr. Chris van Tulleken
the Think about it. The the

Dr. Mark Hyman
food you're eating.

Dr. Chris van Tulleken
I love this.

Dr. Mark Hyman
Like, he came back, and he was like, this was gross. I couldn't eat it after I did that. You know? And he just stopped eating it.

Dr. Chris van Tulleken
It is it is all like that. I've gone back. My wife and I were on a long long car journey, a couple of years ago, and we just stopped at a McDonald's kind of you know, as as you as many of us are in the habit of doing I mean, I know I'm embarrassed saying this. I'm a physician. Whatever.

We did, and not we were like, oh, now we know about we just couldn't we I'm embarrassed saying we just threw it all away and stopped and got some groceries. But, yeah, it's not food that stands up to scrutiny. It's not complex food. It is all almost equally salty and sweet. So the other thing to remember is your breakfast cereal is as salty as your microwave lasagna, and your pizza is as sugary as your pudding.

It's all like, there's quite a straightforward formula of, like, acid, salt, sweet, fat Yeah. Plus the additives and, you know, strip out all the real food, keep it cheap. So it's Yeah. It's weird stuff. So I I I feel I'm very conscious as well.

I don't like telling people what to do. I'm quite a weak, fallible person myself, so I also don't wanna put myself on some pedestal where if I am snapped going into McDonald's, anyone's gonna see me. But I what I can say at the end of my diet, I genuinely do not want any of it anymore. And I I eat Yeah. I eat it to be polite.

Are you ever in this position where you're at some thing? You have probably never at this, but I'll be at a friend's house and, you know, some parents at my kids' school, and I just don't wanna be that guy. So I'm like, yeah. Sure. I'll have some chips and dip.

Yeah. Absolutely. I'm I'm hip.

Dr. Mark Hyman
Yeah. No. I I can't bring myself to do that unless it's, like, actually real food. And then, you know, if it's tortilla chips and some, like, whatever, it's fine. But it's like, I I I definitely it's just it doesn't look like food to me.

It looks like a rock or a piece of wood. Like, it would I wouldn't just eat it. You know? Like, it's it's really I my experience has really changed. So when I go buy, like, a, you know, a a a case of, you know, delicious looking sort of processed things like you see in, like, the the window of a Starbucks, you know, kind of at the front of the store, it doesn't look like food to me.

And I just I don't I don't even I'm not even attracted to think about it. And and it's because I think I've reset my nervous system.

Dr. Chris van Tulleken
It's exactly my experience. And the the there were two part of it was Fernanda going it's not food. It's industrially produced edible substance. And part of it was, it was Nicola Vina who you you may have spoken to. She's a food addiction scientist.

And she said, it's not that the food would be beige. It's that a lot of this food, if it wasn't dyed, would be gray. And I thought that was amazing. I'm like, oh, it would be, wouldn't it? Once you start looking at the pastes and powders.

So that was very powerful. But, no, it I went cold. I went completely I just stopped wanting it. Or pee, whatever. I felt better.

I mean, I would say if anyone is listening to this and is wondering, I felt this so the there are all these things that people don't report on. The food is so salty that you get very you know, you eat it in the evening, and then you have to drink all this fluid. So then if you're a man in your forties, you're kind of up all night peeing as well, and then you're exhausted, and you get constipated. I mean, you get Right. Your soul and the your life start and you're angry and tired and stressed, and so you get up in the middle of the night, and then you're eating more because you're tired and your cortisol level goes up.

So within forty eight hours of stopping, I felt massively better. Losing the weight took me two years. And Wow. In the end, I just fasted it down. I mean, it was it was grim.

But if people are I mean, many of your listeners will be struggling with weight. I'm sure. I just wanna say, I wanna reach out and hug all of you losing I had to lose six kilos, and I have every possible advantage doing it. And it was really, really, really hard. So the the the the injustice of this is it it is it is really not people's fault.

It is it is this food that is engineered to get around your fullness system.

Dr. Mark Hyman
Yeah. So the the this has to get fixed. And if it doesn't get fixed, the consequences are pretty grim for society, for the world, not just America, but everywhere, which which is now being the receptacle of the inventions that happen here and elsewhere. And and and it's like America's created the worst diet on the planet and exporting it to every country. You know?

It's our biggest export. And, the countries there's a few countries that don't have fast food. I don't know if it's like, Myanmar, Myanmar, or, like, what used to be Burma.

Dr. Chris van Tulleken
Sure. North is it's North Korea.

Dr. Mark Hyman
North Korea. Right? Like, they don't have any of these problems. It's quite interesting. Right?

Like, we've we've we've embargoed them and and and had a sanctions on them, and we don't allow them to trade with us. And so they can't get all this stuff that that isn't all over China, by the way, now. And you got you know, I I remember when I I went to China in 1983, there wasn't anybody over in 1984, there wasn't anybody overweight. Yeah. And then I went back, you know, a few years ago, and it's like, wow.

And and now they've gone from, like, you know, one in a hundred and fifty people with type two diabetes to one in ten, which is almost approximating what we have in The US. And and it's because we basically exported our Western diet, the same in The Middle East. You know? They were nomads, you know, healthy, fit, drinking camel milk, and, you know, eating camel meat, and, herding their sheeps and goats. And then within a generation, they had enormous wealth, and they were able to purchase a lot of the things that we have in the West.

Just on I mean, you adapted to that. And they have now one in four people there have diabetes.

Dr. Chris van Tulleken
You're putting this so powerfully. And one of the things people who object to the UPF evidence, I'm left going, well, could just what do you think it is? This we are living not just in a crisis. This is an emergency in the sense of something that needs immediate action. You know, you we can't wait to deal with this.

The economic you know, we we always are like, oh, this will end up costing. It's like, no. In The UK, it already costs the economy a hundred billion a year, and we have a tiny economy compared to The US economy.

Dr. Mark Hyman
That's all.

Dr. Chris van Tulleken
It's it's like disgusting. You know? And in the so

Dr. Mark Hyman
trillions. Trillions.

Dr. Chris van Tulleken
It's alright. It's unaffordable in terms of its effects on the planet, plastic pollution, carbon, all the rest of it. So it's an emergency, but we've been living in the emergency for well over a decade. So the sort of, oh, well, we need to fiddle around the edges of policy and kind of make a, you know, put a put a salt, fat, sugar warning on foods. It's like, no.

You there has to be a spectacular kind of revolutionary thinking and really imaginative policy proposals. I have to say lawsuits are gonna be the way forward. So we've seen, and I think you you've helped with this. There's been a complaint.

Dr. Mark Hyman
That up.

Dr. Chris van Tulleken
Yeah. So there's already been a complaint, of, a a a sixteen year old boy. He was 16 at the time. Now he's 19. So it's not a class action yet, against some of the the biggest all the major food companies you can name brought by a small group of lawyers who I've been speaking with.

I think you've spoken maybe with them too. And, lawsuits lawsuits are gonna force discovery, and that's gonna expose documentation that whatever all the conflicted academics say about the evidence around UPF, it's just gonna be the company documents that are like, yeah. No. We invented all this stuff so that people couldn't stop eating it. It.

It's all it's all gonna be there, black and white. So the lawsuits Well,

Dr. Mark Hyman
that's really important.

Dr. Chris van Tulleken
I mean,

Dr. Mark Hyman
because that's how tobacco was stopped.

Dr. Chris van Tulleken
That was how it did. Yeah.

Dr. Mark Hyman
Legislation and regulation. It was these class action lawsuits that brought them down.

Dr. Chris van Tulleken
And it painted the industry as acting in a corrupt and criminal way. And I in the it's astounding to me. In The US and The UK

Dr. Mark Hyman
have a there was a cigarette was the boogeyman. Is ultra processed food the boogeyman we should go over and attack, or is it something

Dr. Chris van Tulleken
I was surprised. I mean, the complaint, you can download, let me I'll I'll I'll send you I'll send you a link that your your your listeners can can download because it's it's a great, great, great summary of the evidence. You know, lawyers are incredible at assimilating evidence. I was surprised they decided to pick ultra processed food. To me, the easy case to start with would be sugar, that it is an obscenity that a can of high sugar cola doesn't have a warning about tooth decay on it.

So I'd I'd keep it to that straightforward. You know, no one disputes that sugary drinks rot teeth. In The US and The UK, it is

Dr. Mark Hyman
Go to Appalachia where Mountain Dew is this beverage of choice. It's like these kids none of these kids have teeth.

Dr. Chris van Tulleken
And it's it's a tragedy. And we think, oh, it's only teeth, but it's like this is a major course of sickness and suffering in in low income communities and and across The United I mean, we my country has famously struggles with its teeth and has for a long time because of our sugar intake. So that to me would be the the easier, avenue. But the con complaint as they've made it is very persuasive. Whether it will win, I don't know.

I mean, this the first cigarette lawsuits didn't win either. But, eventually, you know, there's a drip drip drip, and I think I think there's more and more attorneys general that are focusing on this.

Dr. Mark Hyman
Yeah. No. I've been I've been involved with talking to some lawyers who are doing class action lawsuits against altered processed food and these companies. And I I think the discovery is key. And I think well, as I was researching my book, Food Fix, I got a lot of FOIA requests for documents, which you can get from the government.

So in other words, all government documents, unless they're both classified or available to the public, bit of a pain in the ass. You have to go through the Freedom of Information Act and ask for them. But for example, you can get emails from the CDC with Coca Cola. Like, Coca Cola is not gonna give you their emails, but the CDC has emails from Coca Cola.

Dr. Chris van Tulleken
To.

Dr. Mark Hyman
They read their and they have to release them. And they're like, yeah. Well, we're funding you, and we're doing this, and we're doing that. It's like, it's kinda crazy. So I think I think, when people start to understand that they're being taken advantage of, that they're being used, that they're being manipulated, that they're being controlled, that their health's undermined, that their well-being's undermined, their financial security's being undermined because if you're sick, you can't work and and be a productive member of society, both on an individual level and on also on a societal level, what we're doing to society, you know, with this burden of chronic disease.

I mean, it's it's, you know, I I've been a doctor for forty years, and, I just this has all happened in my lifetime. Like, when I I I I graduated from medical school, there was not a single state with an obesity rate over twenty percent. Now there's not one under 30, and most are 40.

Dr. Chris van Tulleken
It's all I mean, I've it's astounding you've been a doctor for forty years. I've been a doctor for, over twenty years, and it looks more like forty years. But but it's almost kind of in The UK, it's almost within my time. I mean, you you asked this great question

Dr. Mark Hyman
a long time. Like, wow. I'm old. You know? But it's it's okay.

Dr. Chris van Tulleken
I'm still kicking. It's it's it's all your telomeres. The the but you you asked this great question, is it the boogeyman? And you kind of threw that question away. But it it's such an important question because it's like I sometimes I duck and dive on this because question.

Well, I I want to be I I don't wanna be a UPF purist. I don't think anyone's saying, like, it's the only thing. But when you ask it that starkly, it's like, yes. Yes. Ultra processed food is the boogeyman.

And anyone who says now some people say, oh, the mechanisms of harm are disputed. Here's the difficulty with the way in which ultra processed food harms you. The barrel is so full of fish, it's hard to hit the right one. Is it the softness? Well, it's all soft.

Is it the energy density? The salt, the fat, the sugar? Is it the emulsifier content? Is it the marketing? We know marketing drives excessive consumption.

Is it the trans fats? Is it some other property of the RBD oils? Is it and on and on and on. It's like it's every aspect of every product has been optimized so you can't stop eating it. So I I wanna be clear.

It is I it is the boogeyman, and Yeah. It's just the food that needs to be attached to.

Dr. Mark Hyman
I think there are, I mean, there are problems with the definition, and there are arguments and, you know, often will get disputed by the food industry. But I think if you're gonna have a catalyzing concept for Americans Yeah. Or for the world, I think it's useful. And I and I think it somehow has to be embedded in in the way we think about policy and, how we shape policy. And we'll have an offline conversation because, you know, I'm involved in some of the policy conversations of what do we do next in America because we have this opportunity whether we like who's in power or not to actually do something.

And with people who are very aware, like, I know the commission of the FDA very well. You know, I know Robert F. Kennedy very well. I know doctor Oz who's head of Medicare very well. We've been friends for twenty two years.

So there's this like, all of a sudden, the the kids have the the keys to the candy store. What are we gonna do? And how do we how do we do the right things and not do the wrong things, which is, you know, the there's it's just fraud. It's a landmine kinda covered territory where we're trying to navigate to the right policies that make the biggest difference or the most leverage that have the greatest impact on the health of the population and and not and not be too punitive or too or too oppressive to the population or to taxation. So it's a very interesting moment.

And and, and, you know, this is concept has been around for a while, but now it's sort of like it sort of caught the national imagination here. And I I think I'm I'm happy for that. I'm a little concerned that, you know, the food industry is so big, so powerful. They're so on target. I mean, they're so deliberate about their their messaging.

They're so good at their So propaganda to confuse and confound people and to sort of discredit people who are making these claims like you or me. You know? So it's pretty interesting.

Dr. Chris van Tulleken
But the the framing you know, my my sister-in-law, Dolly, is is an academic in The UK at Cambridge, and she's all about she's about how you frame the problem. So she's aligned in The UK. She has been with the political right, unusually for a public health academic. And she's all about, look. If you frame this stuff as justice, as freedom, as choice, and also as as creating business opportunities for small and medium sized businesses.

So the the political economic right hates monopolies. You know, monopolies are terrible. They're terrible for the economy. They're terrible for everyone. And at the moment Yeah.

You've got oligopolies of food producers. You've got really you've you've got a huge amount of global grain being traded by a tiny handful of companies. You know? Like Yeah. It's it's half of the, you you know, the this very small number of crops traded by a very small number of companies.

I think

Dr. Mark Hyman
it's, like, nine nine big food companies really control almost all the market, and they own all the other companies that you might think are healthy brands, and they buy them up. You know? It's it's, yeah. Like General Mills, for example, bought up, you know, Epic meat bars, which are, you know you know, regenerative, organic, you know, grass fed because of bison bars. Right?

So they're like they kinda

Dr. Chris van Tulleken
have this kind

Dr. Mark Hyman
of sheet.

Dr. Chris van Tulleken
It's Coke buying innocent smoothies. You know? Right. So and this is something this comes up a lot in the discussion. It's going, well, a lot of vegan food is ultra processed.

Do you wanna ban that too? And it's like, woah. Woah. Woah. No one no one's saying we're gonna ban all ultra processed food.

No one's saying it's all that's another really important thing. It's not all equally bad, but it is all, almost without exception, bad. And Yeah. The vegan stuff is often made by the same companies that are producing enormous quantities of meat often in quite inhumane, unethical, unsustainable ways.

Dr. Mark Hyman
Tyson has just, you know, bought huge amounts of these alternative meat companies, stocks, and shares.

Dr. Chris van Tulleken
So if you if you're kind of really concerned about the ethics and you wanna eat a good vegan diet, eating an ultra processed food that's made by Cargill or Tyson, even if it's vegan, it will probably be made it it can only exist because it's made from the byproducts of the animal feed industry. So it's not I feel those those arguments don't have heft. There's a way of eating ethically and sustainably if you wanna be vegan, if you wanna eat meat. It none of it requires ultra processed food.

Dr. Mark Hyman
Yeah. Amazing. Wow. Chris, I could talk to you for hours about this. We haven't had to do it again.

I think, you know, it's an exciting moment because, I think both, in The UK, around the world, governments, people are starting to sort of pay attention. I'm very interested when this report comes out in the commercial terms of health if it'll sway governments to change their behavior. But we can see across South America, they've been extremely forward about this. Canada, countries like The UK already are doing things like banning a lot of marketing. They're already kind of doing better food labeling.

So we have a lot to learn from what's going on around the world, and I think you're right about the political framing of this as a choice, as, you know, autonomy, you know, freedom of speech, all these things that people care about. You can you can actually, kind of frame it in the right way so that it's it actually makes sense. And no and, again, nobody's talking about banning anything. It's about how do we tell people what's what so they make a choice that's good for them.

Dr. Chris van Tulleken
I love that. Yeah. If you want a strong military and a good football team, you've gotta fix the food system. You know? It doesn't matter where you're but if you care about social justice, you gotta fix it.

It all points that everyone's on the same team here. We all live on the same planet. Yeah. It's such a joy speaking to you, Mark. I feel so full of energy after we communicate on email or anything.

So I'm it's, it's such a delight.

Dr. Mark Hyman
Keep up the good work. Let's keep care of notes. Let's talk about policy more. Let's talk about lawsuits. I'll I'll get you offline.

I wanna talk to you about, you know, the right strategies going forward because we have this this very moment that's both, filled with pros possibility and fraught with danger. So, you know, I think it's a it's an interesting moment, and we're kind of at the precipice of potentially doing something that could shift things, and we'll see.

Dr. Chris van Tulleken
So, I'm very pleased you're in the discussion, and thank you so much for having me on today.

Dr. Mark Hyman
And everybody definitely check out Chris's book, Ultra Process People. Hopefully, that's not you, but if it is for sure you wanna read the book and, and keep up with his academic work and his policy work, I do have a place where people can find you or learn more about what your work is?

Dr. Chris van Tulleken
Instagram at doctor Chris doctor, d o c t o r, like spelled out Chris VT, I guess. Or I'm I'm on Twitter, this o x on the same the same handle, at doctor Chris VT.

Dr. Mark Hyman
Okay. Great. We'll put that on the on the show notes. Great to talk to you, Chris, and, see you soon.

Dr. Chris van Tulleken
Mark, it's such a pleasure.