How Ultra-Processed Foods Are Fueling Chronic Disease

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a fifteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

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

Dr. Mark Hyman
Coming up on this episode of the Doctor. Hyman Show. I'm just gonna say it really clearly, unambiguously. Ultra processed food is the number one cause of death in the world today, period. This is not my opinion.

This is from the global burden of disease study of 195 countries. The data is very clear, too much of that crap and not enough real food. Now, before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out function health for real time lab insights.

And if you're in need of deepening your knowledge around your health journey, well, check out my membership community, doctor Hyman Plus. And if you're looking for curated, trusted supplements and health products for your health journey, visit my website, doctorhyman.com, for my website store and a summary of my favorite and thoroughly tested products. What's ultra processed food? What's not? So let's talk about what exactly are ultra processed foods?

What are the characteristics? How do we define them? Well, there's something called NOVA classification I'll get into a minute. But, essentially, it's deconstructed food. Basically, take raw materials from things like corn, wheat, and soy.

You deconstruct them chemically in a lab. You all structurally alter them so they're not actually the same chemical structure. And our body, remember, gets messages from the outside environment and regulates this biology through chemical signals that depend on the structure and shape of the molecule to create a signal in the body that does good or bad. Right? This is really important.

So these are funky, weird, Frankenmolecules. And then they're turned into food like substances that come in every color, size, and shape of chemically distributed yuck, basically. Now they're super energy dense usually. They're high in calories. They have pretty much no nutritional value usually.

They're high in sugar. I mean, they may may have added vitamins. You know, you get your cereal or fruit loops with added vitamins. Well, that's not exactly a healthy. They are high in sugar.

They can come from all different sources, high fructose corn syrup, dextrose, maltodextrin, cane sugar, fructose. There's a million different names of sugar. You can Google it and see. I'll put a link to all the different kinds of names of sugar, but they hide the names of sugar on the label, so you get confused. It doesn't just say sugar.

It's also high in refined grains. So these are highly pulverized grains that mostly wheat that are chemically altered and are not resembling their original form. And they're maybe from corn, from wheat, from beans like soy. Also high in unhealthy fats, usually trans fats still on market, refined oils, and so forth. They contain often excess salt.

They're hyperpalatable. They're easy to overeat. They're low in fiber, typically low in protein. They're low in vitamins and low in minerals. So all the things you need to thrive, they don't have.

They also tend to spike your blood sugar a lot. They also don't make you feel full. So people who eat ultra processed food eat 500 calories more a day. This was a controlled study at the NIH with Kevin Hall. Really impressive data.

So, basically, people who were allowed to eat whole food versus ultra processed food as much as they wanted, the ones who ate the ultra processed food ate 500 calories more a day, 3,500 calories a week. That's a pound a week. If you keep doing that all year, that's fifty two pounds of weight gain in a year. So what are the examples of ultra processed food? Well, it's potato chips, crackers, pretzels, candy, microwave, popcorn.

Don't ever eat that. Muffins, donuts, sandwich breads, cookies, flavored yogurts, puddings, Jell O, breakfast cereal, granola bars, things with added sugar, food dyes, natural artificial flavors, colors, preservatives, gums, emulsifiers. Oh, my. Right? It's a lot of stuff.

So don't eat that. It's not food. Ready to eat meals, instant noodles and soups, frozen TV dinners, canned ravioli, pastas, packaged meal kits, nasty. Unless they're made from whole food. Processed meat and dairy.

Again, we eat a lot of this stuff. Hot dogs, deli meats, fish sticks, which I don't even know what they are. Often, they're not fish. Chicken nuggets, most chicken nuggets have, like, 35 ingredients, only one of which is chicken. Process cheese slices are not even allowed to be called cheese because it's not actually cheese.

It's not 51% cheese. Various spreads, flavored milks, non dairy beverages, coffee creamers, various protein shakes you have to be careful of, like isolated soy protein is deconstructed soy. Potentially, we're a cancerous, so we would be careful of that flavor. So it says soy, a soy shake, and that's like maybe really bad for you. Flavors, sweetened nut milks often can be problematic.

You have to watch what's in them. And of course, sugar sweetened beverages, soft drinks, lemonade, iced tea, soda, food drinks, punches, energy drinks, flavored coffees, all this stuff is just nasty. So you wanna stay away from that. When it comes to a healthy diet, we hear a lot of these terms, ultra processed food, processed foods. Most people have no clue what they are, and I think it takes a little bit of education to understand how to navigate this landscape of processed and ultra processed food.

Now what does it mean? We're gonna talk about the difference between ultra processed food and other types of processed food. For example, Doritos versus a can of sardines. They're both processed, but highly different in their effect on your biology. You know, is one worse than the other?

How do we tell the difference? We're gonna get into all of that. Part of the problem today is that most people need a PhD to understand nutrition labels. And many must fall into the trap of convenience and just sort of get whatever seems good or whatever the package looks like. It's gonna be healthy.

And, basically, there's a health claim on the label. You think it's good for us, but that's basically one of my rules of eating. If it has a health claim, it's not good for you. In other words, gluten free potato chips or sugar free this. When it says that, it's always something bad that's added.

So these are made by big food in order to allure you in and get you sucked in and trapped. As a result of that, we have a nation and a world, increasingly, where more than half the calories come from this hyperpalatable, easy to overeat, ultra processed, food like substance. And you look at the definition of food. Food is something that supports growth and life. The truth is these don't.

So by definition, they are not food. Just look it up in the dictionary. If you can convince me that these things are food, well, good luck because they're not, and they don't meet any definition of what food should be like. And it essentially is a substance that helps support life and growth, and ultra processed foods do neither. In fact, they do the opposite.

Now I'm not just making this stuff up. There's an amazing study. Now it's a it's an observational study, but it's it's a very well done study recently published, just news just out in the British Medical Journal. They looked at 45 different pooled meta analysis involving 10,000,000 people. The hook here is that these were studies that were not funded by ultra processed food companies.

You know, might have heard me talking the other day about artificial sweeteners and how there's a large study that showed artificial sweeteners are not harmful at all. But when you look at the funders of the study, it was the American Beverage Association, formerly known, my friends, as the American Soda Pop Association. Clearly, we need to look at data that is not corrupt. And when you look at studies that are funded by the food industry, it's eight to 50 times more likely to show a positive impact for their food product, whether it's dairy or artificial sweeteners or whatever. And when they looked at the data from this large pooled meta analysis, I looked at people who ate higher amounts of ultra processed food.

There was a fifty percent increase in the risk of cardiovascular death. It was a forty eight to fifty three percent increased risk of anxiety and other mental health disorders like depression. Now think about that. The risk of having heart disease and a heart attack and mental illness are the same from eating ultra processed foods. We we get that, you know, these foods can cause obesity and diabetes and heart disease, but mental health crisis is also driven by these ultra processed foods.

We did a whole episode on this. I think it's really important. You go back and listen to it. We'll link to it in the show notes. There's also a higher risk of type two diabetes and many, many other conditions.

And they go through many conditions, autoimmune disease, inflammatory disorders. The evidence also showed that there was a link between ultra processed food and a greater risk of death from any cause and a forty to sixty six percent higher risk of heart disease related deaths, obesity, type two diabetes, sleep problems, and a twenty two percent increase of depression. We're seeing this mental health crisis, obesity crisis, diabetes crisis, heart disease crisis, autoimmune crisis. I mean, the list goes on. Chronic disease is the number one driver of our health care expenditures.

It's the number one driver of death globally. Why is this happening? We never had these problems. You know, I saw something on Instagram the other day. There was a video of, from nineteen thirties, a film, and there was not one person who was overweight in the entire video of people walking down New York.

Big change from then to now. And this has led to the epidemic of chronic diseases driven by this ultra processed foods. We're gonna get into it. We're gonna go deep in this topic, and we're gonna learn about how we begin to determine what is ultra processed food, what we should avoid, and, hopefully, maybe we'll live in a day when food labels are clear. I'm working on that in Washington with my food fix campaign on clear labeling and child friendly labeling.

Let's get started with with a case example of what an ultra processed diet can do to our bodies in as little as two weeks. You think, oh, this takes years and years to develop problems. Well, not really, my friends. You see the results very quickly. Now Tim Spector and a scientist from King's College in London performed a short term study on a 24 year old set of healthy twin girls.

This is a different twin study than the vegan twin study. Now one twin was assigned to eat an ultra processed diet, which included a typical breakfast, a pancake syrup, or a cereal with a blueberry muffin, pretty much our average diet. Lunch was a peanut butter and Philly sandwich on white bread with chocolate milk and chips, and dinner was either cheeseburger and fries or a meatball sub with cheese, crackers, and a Diet Coke. The other twin ate a minimally processed whole foods diet. Now each diet this is really important.

Each diet was controlled for calories. So they ate exactly the same amount of calories. I'm gonna say that again. They added they ate exactly the same amount of calories. They also had the same amount of fat, same amount of sugar, and fiber.

But the difference was the processing of the food. Now we're gonna get into what this means in a minute. What was striking about the study after just two weeks, that the twins eating an ultra processed diet had higher blood cholesterol and lipids, higher blood sugar. They gained more weight. Now remember, they had the same amount of calories, friends.

So it's not all about the calories. It's what the calories do to your biochemistry, to your hormones, to your immune system, to your inflammation, your gut microbiome. It's not just calories in calories out. It's more complex than that. Also, the study showed they look at their microbiome, had a really negative effect on the gut microbiome.

Now we know that if you swap out in animals a healthy microbiome for a microbiome, for example, an obese mouse, that the other mouse eating the same amount of food will gain weight. So we know that it's it's not all about calories, how they're processed, how they're metabolized, and so forth. Now none of these changes, these adverse changes that were in the twin eating the ultra processed diet, were seen in the twin eating the whole food diet. She actually lost weight. So one twin, again, eating the same amount of calories, gained weight on ultra processed food.

The other twin lost weight. Just register that for a minute. Now, the results aren't published yet. Hopefully, they will be. Again and again, I see in my practices over and over again, how ultra processed foods wreak havoc on our health, and they do it very fast.

The good news is you can reverse it very quickly too. Right? So eating real health foods can reverse these effects. That's what I did with my ten day detox diet, and we saw amazing results in thousands of patients. And I often talk about this one patient I had in three days was off insulin simply after, ten years of diabetes on insulin.

Three days of eating this way completely eliminated her need for insulin. Now how did this happen? How did this become 60% of our diet, 67% of kids' diet? Globally, it's increasing everywhere. Well, the industrial revolution spawned a whole bunch of advancements in food processing technologies and the mass production of canned goods and refined grains.

And it seemed to be a boon to humanity. And it did help a lot. We got to preserve food. We got to store it longer. We got to, you know, be able to feed people who couldn't be fed.

We have hunger. So it wasn't all bad. In World War I and II, there was a huge catalyst for ultra processed food production because there was a huge demand for non perishable foods shipped to soldiers overseas. And so it needed to be something that was stable. It could be sent to the battlefield.

It wouldn't rot. One of the basic rules of all the eating is only eat food that rots. I don't know if you saw it was something I saw once. I don't know if there's a movie or something, but some guy had forgotten, like, a Big Mac in his pocket for years, and it was fine. It hadn't degraded.

It hadn't decomposed. It hadn't gone moldy. It was just fine. Now you wanna eat food that rots. That's a good that's a good concept.

So after World War two, you know, the economic growth and lifestyle changes, that happened, women entering the workforce, was the increased demand for convenience foods, fast food, TV dinners. There was a gathering of all the fast food and processed food makers in the in the late fifties, as I recall. This was written about in Salt, Sugar, and Fat by Michael Moss. We had he was my first podcast guest, actually. And in that meeting, all these companies were like, we have to fight this trend towards eating real food, which there was another sort of group of people promoting that.

They decided to make convenience king. And so they created a culture of convenience. They disintermediated people from the kitchen. They invited Betty Crocker to get recipes of junk food in the house. So you pie your Ritz crackers on top of your broccoli casserole or, you know, Velveeta cheese or your can of cream of mushroom soup from Campbell's all in your recipes.

So it was a lot of processed food in the recipes. And there was no Betty Crocker. She was a made up person. I thought she was real because my mom had the cookbook. But, anyway, in the eighties and nineties, the food companies began engineering foods even more.

And and they were engineering foods at an accelerated pace using all such technologies, a lot of additives, preservatives, emulsifiers, which are terribly damaging for your gut and microbiome. There's, like, 600,000 of these products out on the market, and starch sugar, refined grains, and processed oils became ubiquitous at supermarkets, vending machines, fast food outlets, and are basically what we call the S SAD, or the SAD diet, the standard American diet. Now, as I said, it's 60% of diet here, 67% of kids' diets. It's more than half the energy in high income countries, even like Canada, The UK, Australia. It's nasty.

The studies are clear on this, and we link that way, we're linking to all the studies. Everything I'm saying is evidence based, is is backed by references. You can just go to the show notes. You'll see them all. So studies show that the more ultra processed foods that make up your diet, the less nutritious their diet quality tends to be overall and the greater risk they are of developing chronic inflammatory diseases, heart disease, obesity, diabetes, cancer, high blood pressure, stroke, dementia, autoimmune diseases, depression.

I mean, the list goes on and on. And according to CDC, more than seventy percent of deaths or one point seven million deaths a year in The US are caused by chronic diseases, mostly caused by our processed food diet. This is a kicker. I've mentioned this before, but for every 10% of your diet that comes from ultra processed food, the risk of death goes up by fourteen percent. This is from the global burden disease study.

We'll talk about that in a minute. Yeah. That's enormous. So if you think of sixty percent, right, so it's six times fourteen. It's a big number.

It increases your risk of death, not just getting a disease. Now what's really scary is that the government is funding this. They're funding the subsidies that go into the agriculture that produces the commodity crops that return to ultra processed food, you know, benefiting from, the incredible food stamp program, which is great, except that 75% of the SNAP benefits are used for ultra processed food and 10% are used for soda. It's about 10,000,000,000 a year. We're working on trying to change this in Washington, and we have a bill now in to prevent ultra processed food from being purchased with SNAP dollars if you're a kid.

Because we know these are deadly for kids. The data is so clear. Now what's the difference between ultra processed food and just regular processed food? I read an article in a nutrition journal years ago about defending processed food as being something as old as humans. And we've been, you know, drying food and preserving food and fermenting food and curing food for a long time.

So what's the big deal about processed food? If you look at the funders of it, if you look at the journal, it's just funded by the food industry. It's so corrupt, my friends. It's so corrupt. I wrote about that, I think, in my book Food Fix or, you know, one of my other books, but it's it's a pretty frightening thing.

Unless you just pick an apple from a tree and eat it, or just eat a raw egg, most food is processed to some degree. Cooking is a form of processing. Right? It's not really that processing is bad. It's it's what is the processing?

So minimally processed foods are fine. Like we've been doing it for thousands of years. Olive oil is processed food. Yogurt, but hopefully from a to cows or goat or sheep, right, that are regenerated raised. Cheese is a processed food.

Canning food, so sardines, canned tomatoes, fermented foods, sauerkraut, miso, frozen foods, beef jerky, dried foods. Basically, those are all processed foods, but they're fine. If you can recognize the ingredients, if you know where they are, if you can see the number of steps it took to get from farm to your fork, it's okay. If it doesn't have a list of weird franken ingredients, that's okay. It depends on on how they're processed.

Certain foods may seem they're like, they're minimally processed. There may be some protein powders that are okay or protein bars from whole ingredients, canned beans, you know, frozen vegetables. Those are all fine, but be very wary about what you're eating. Even if it comes from Whole Foods or Erewhon or some great, you know, natural food store you're shopping at, it can still be fraught with all sorts of problems. Now what, does the science say about what is an ultra processed food versus what is not?

And there are many classification systems. The most, reliable and the most common and and most well accepted is something called the NOVA classification. It's kind of the most comprehensive, version, and it has some flaws, but it's still pretty good. So it just gives us a rough idea. There's basically four classifications of food with NOVA.

The first is minimally processed and unprocessed food. So it's basically peanuts. Right? Taking the shell off of a peanut is processed food. Any kind of husking, shelling, drying, crushing, grinding, roasting, caerization, refrigeration, freezing, these are fine.

They often can be placed in containers or packages without having to add sugar, salt, oil, or fat. Things like whole grains, beans, fruit, veggies, nuts, seeds, milk, meat. These are all fine. And when I say milk, I'm being, you know, you know what I say on dairy. I'm being very specific.

It should be a two casein dairy. It should be regeneratively raised. It should be either goat or sheep, ideally. So you want to make sure you're eating the right dairy. The second classification is NOVA group two.

It consists of processed culinary ingredients derived from nature. Oils, fat, sugar, salt. So it could be pressing olive oil. It could be grinding of flour, milling. It could be seasoning, and cooking of foods that are in group one.

So if you wanna put a a chicken in the oven and and bake it for twenty minutes, that's processing. Right? So that's group two. And things like olive oil, butter, flour, salt, vinegar, these are all NOVA class two. And NOVA class three is more processed foods.

You're adding things to it. You're adding salt and oil and sugar to group one and two foods, and they make them more durable, more palatable, more enjoyable, last longer. So it could be canning, smoking, fermenting that extends shelf life. And it may include adding other things like salt, sugar, fats. You can add salt and, for example, sugar to beef jerky.

Well, you may not wanna do that. I like the South African biltong. It's just pure dried beef with some spices on it. We've been processing food for as long as we've been human. Cooking is a form of processing.

Fermentation is a form of processing, like sauerkraut, yogurt, cheese, canning, jarring vegetables. I used to do that when I was in college. We'd jar vegetables in the winter, fruit, vegetables, pickles, olive, cans of tuna, cans of chicken, salmon, cured meats, cheeses. These are all processed, but often without bad stuff, but sometimes with bad stuff. Right?

Had it solved. Class one is the best. And two, three, you have to be smart, but you can get away with it. Now, class four is what really is the boogeyman here. This is the ultra processed food category, and it's a series of industrial formulations of five or more ingredients.

Could be less, but it's generally more than five. This is something that's not actually considered food. I don't think they should call it food. They shouldn't call it ultra processed food. They should call it ultra processed, science projects or food like substances or non food edible things or something.

I don't know why. But ultra processed foods are really made from whole foods originally. Right? But then they're broken down. They're mechanically altered.

They're chemically separated, and they're changed to, you know, isolated sugars, fats, oils, protein, starches, fiber extracts to to make food look and taste good and make it resemble food when it's not food. And they're purely derived from commodity crops that are funded by our industrial agricultural system. Corn, wheat, soy, sugarcane, beetroot are the basis of these foods. You know, I mean, corn is hundreds of different things that are made from it. They're all highly processed.

And I think 5% of the corn that is grown in America for, quote, human consumption is is actually corn of the cob or corn things that we eat. It's it's mostly turned into junk food. And now they'll add a whole variety of bad stuff. They'll add, if they're make manufacturer will make really bad stuff, and they'll reassemble them into food like substances. They'll add high fructose corn syrup, different kinds of sugar, maltodextrin, lactose, dextrose, various oils that are often hydrogenated, soy protein isolates.

They'll add extra gluten, casein, mechanically separated meats, flavors, emulsifiers, gums, various thickening agents, and basically makes your product look good, have a good mouthfeel, be hyper palatable, create a highly profitable product. There's a cheap product to make with long shelf life, and they mark up something hugely to an enormous price, so the profit margins are huge. I mean, think about it. This is the most significant industry in the country. When you combine food and health care, I think it's $10,000,000,000,000 Okay.

That's a lot of money. And a lot of this is driving us a sick and diseased society. Now there are some limitations to the NOVA. Right? It's qualitative in nature.

It basically assigns food products to groups, and sometimes it's a little subjective and maybe a little ambiguous and maybe inconsistent, but it's still helpful. As for example, minimally processed foods, maybe high in natural sugars or fats, while some ultra processed or processed foods, maybe okay, but probably not. Minimally processed foods for sure. It doesn't really address portion size or eating pattern. When you have mixed meals, the classification regulations due to misinterpretation among consumers, but all processed foods are unhealthy when some may be okay, like whole food protein powders or protein parts from whole ingredients or grass fed meats or pasteurized turkey sticks.

I like venison sticks. Tofu is a processed food, dairy alternatives, canned fish. They're obviously processed, but they're whole foods. They're made from real ingredients. Now machine learning technology may be the future of predicting food processing.

And this is interesting, actually. We use AI to help figure this out. In a 2023 paper, which we'll link to in the show notes, researchers create a machine learning algorithm that takes nutritional measures into account to predict the degree of food processing and what NOVA group the food falls into. It's done in reproducible, scalable fashion. And based on this data, it predicted that 73 of The US food supply is ultra processed, so even more than the 60%.

So it's almost three quarters of what we eat is crap and not food. No wonder we're also sick and overweight. Now, what does this stuff do to us? I mentioned early on some of the things, but in addition to being loaded with sugar, starch, processed carbs, oils, additives, the re the reason they're often bad is they need to have a long shelf life. What they do is they put it in packages, plastics, and different kinds of packaging that often contains BPA, phthalates, PDAS, microplastics, nanoplastics that end up on our food.

So stuff not even that in the food when you originally produced it, even if it's a highly processed food or ultra processed food, it's actually what it's delivered in, what it's stored in, what it's sold in is plastics and packaging that can leach into the food. Now this is a big deal. As a result of this food processing, there's other things that happen. Right? Toxic compounds can be produced in the very act of this processing.

For example, like heterocyclic amines, which are highly carcinogenic, polycyclic aromatic hydrocarbons, or PACs, AGEs, or advanced glycation end products, which are changing the chemical structure causing glycation, which is where sugars and proteins bind up to various proteins in your body and create a lot of inflammation. It includes trans fats that can be formed, acrylamide, which are really bad, cause many, many health issues. Many, many animal studies and human studies have shown these compounds to cause disease in humans. Animal studies have shown that food additives have a really bad effect on mental and physical health due to their bad impact on the gut microbiomes. That can lead to inflammation.

That can lead to DNA damage. This is just kind of a mess. And it's you know, often when the research is done on various ingredients, they they only look at one. For example, look at one element of the processed food diet, but they won't look at this whole cocktail of additives in these foods and their combinational effect on our health. And that's a problem because these are not just one ingredient that we get.

Like, we get all sorts of these things, and our body doesn't know what to do with them. We eat about three to five pounds of additives a year per person. That's not including all the ultra processing of the food of the raw materials. So it's just the additives. We eat three to five pounds of these compounds from emulsifiers, colors, additives, sweeteners.

Many of these things that are in our food supply in America are banned in Europe. Things like titanium dioxide, classified as a two b carcinogen according to the, committee in in Europe that determines what's carcinogenic. Azodicarbonamide. It's a bleaching and defoaming agent, and it's a potential carcinogen common in yoga mat ingredients and was in Subway sandwich brand, for example. And what is the impact on ultra processed foods on our risk of chronic disease?

Studies really clearly link the NOVA class four foods to an increased risk of bad cholesterol profiles in kids, to an increased risk of poor cardiometabolic health, bleeding obesity, type two diabetes, cardiovascular disease, and we call all all cause mentality in adults, which means death from any cause. Just to recap that new British Medical Journal study, which I think is an important study. It's sort of a landmark study. Again, it's observational data, but it's, you know, mass amounts of people looking at significant trends, and I don't think we could ignore this. And when they looked at ultra processed food, they found a fifty percent increased risk of heart disease related death, fifty plus percent increased risk of anxiety and mental health diseases like depression, twelve percent higher risk of diabetes, twenty one percent higher risk of death from any cause, up to a sixty six percent increased risk of death from heart attacks and obesity, type two diabetes, sleep issues, and a twenty two percent increased risk of depression.

Now that's a lot, and it's a lot of suffering, a lot of cost, a lot of death, and it's totally preventable. I'm just gonna say it really clearly, unambiguously. Ultra processed food is the number one cause of death in the world today, period. This is not my opinion. This is from the global burden of disease study of a 95 countries.

The data is very clear. Too much of that crap and not enough real food.

Vani Hari
The chemicals that have entered the food supply are, largely there only for one reason, and they're not to improve nutrition or improve our health. They're actually just there to improve the bottom line of the food industry because we live in a capitalistic society and our government doesn't really regulate the food system like we think they should or they or we are under the assumption that they are. I mean, there's this underlying assumption, I believe, along with a lot of people that this the FDA is this big, you know, con you know, big huge part of government that's independently testing all of these different chemicals and and overseeing all of these food companies and what they're producing and what they're putting in the food supply, but they don't have the manpower to do it. They've never had the manpower to do it. And they don't usually act unless they're sued by a third party organization or a, nonprofit that sees some issue with some of these chemicals.

And so, you know, you see right now there's big lawsuits happening. There's one big very, very big lawsuit that happened actually with artificial flavors. There were seven artificial flavors that were linked to cancer. Many of them found in every single candy that kids eat and, it took organizations like the NRDC and others to point this back out to the FDA to finally get them banned. But they gave these companies two to four years to make these changes.

So we we just gonna allow these chemicals that cause cancer in our food for two to four years even though it's been proven, you know, that they cause cancer. And so it's you know, we we are in a situation where we don't have a lot of regulation around the food system. And once you understand that that we don't have the regulation

Dr. Mark Hyman
Or we don't have regulation or supervision. Right?

Vani Hari
Or the supervision. I I

Dr. Mark Hyman
I just interrupt quickly. I was in the hospital, and I got a creamer for my coffee. And it was full of hydrogenated fats, which five years ago, the FDA ruled is not safe to eat and mandated the company to remove from the food supply, gave them a little bit of a runway and window, but they're still there. And they're not safe to eat, and the FDA said that, but there's no FDA police going around supervising all the grocery stores.

Vani Hari
And the worst part is when things are banned like trans fats, food companies find other chemicals that act the same way as trans fats. So one, chemical that you'll see in tons of bakery bed bread products and other things that have to stay on the shelf for a really long time is monodiglycerides. That is actually a minute amount of trans fats in in every single, molecule of that. And so it's still clogging up our hearts. It's still clogging up our arteries.

And, you know, trans fats are linked to, like, twenty thousand deaths, or seven thousand deaths, twenty thousand heart attacks a year. I mean, that's from the CDC. Yeah. But we still allow these chemicals in our in our food and even allow food chemists to come up with different ways to continue to include them, which is just very frightening. And so once you understand that the food isn't regulated, then you also need to understand that the information that we get in the media is being largely manipulated by the food industry and front groups, groups that seem very, you know, Legitimately.

Reputable, like the American Heart Association or, you know, the, the Center for Science and Public Integrity or, the American

Dr. Mark Hyman
Council on Science and Health. Right?

Vani Hari
Yeah. Exactly.

Dr. Shebani Sethi Dalai
You took

Vani Hari
it out of my mouth.

Dr. Mark Hyman
You know? Life.

Vani Hari
You hear all all these organizations. They're like, oh, they're looking after our health. They care about our heart. They you know, these are organizations that are made up of doctors and and specialists and experts. And and when you look behind the scenes, you find out they're being manipulated by big industry.

They're getting money from these chemical, and food companies, and they're they're really just PR spokespeople for these food companies to continue operating by selling us food that, is is truly harming our health. And so once you recognize those two pieces of the puzzle, you kind of understand wait a minute. So food's not regulated. The information I'm getting being told is being manipulated by the food company so it benefits them, not me and my health, you start to realize the only thing that you can do is to take control of your health and understand what you're putting in your body. And once you understand that, you start reading ingredient labels and then you go, I get it.

I understand why I need to eat real food.

Dr. Mark Hyman
Yeah. I mean, we obsessively should be reading not just the nutrition facts, but the ingredient list. And and you and your book provide a really detailed explanation of how to read those ingredient lists and pick out the things that are bad for you and that you shouldn't be eating. And it's not that hard. And, you you know, just to sort of loop back on your how industry is influencing public health, the American Heart Association gets about a hundred and 90 plus million dollars a year in funding from industry, both pharma and food industry.

So how are they an independent group? And doctor Ayanidis, who's a professor at Stanford, has written about these a lot and has talked about all these professional societies, whether it's the Academy of Nutrition Dietetics, American Diabetic Association, American Heart Association, said they should not be making recommendations about what to eat. For example, the American Heart Association says tricks are for kids and Lucky Charms are heart healthy foods. Why? Because they're low in fat despite that they're full of additives, chemicals, and tons of sugar.

Vani Hari
Oh, you you hit on a sore subject for me, cereal. Uh-huh. Well,

Dr. Mark Hyman
I'm a serial killer. I hope you know that. I I like let's with a c e a r, you know.

Vani Hari
Yeah. Definitely. You know, one of the the most unethical companies out there right now is Kellogg's. It's a company that back in 02/2015, they said that they would remove artificial food dyes for children, in in all their cereals, and they said they'd do it by 02/2018. And I I wondered at the time why it was gonna take them three years to do it because they were already selling Fruit Loops and Apple Jacks and all of their famous cereals overseas without artificial food dyes.

And it wasn't like they had to reinvent the formula or come up with a new, you know, a recipe or anything like that or or invent a new way to make something blue or red. They're already doing this to avoid a warning label that Europe requires that says may cause adverse effects on activity and attention in children when a product has an artificial food dye. So they're avoiding that warning label. So they know this affects children's health, so completely unethical. They already know how to make the products better and safer, and they're not doing it for their own citizens.

So not only did they not do it by 02/2018, it's now 02/2020, and they've invented four new cereals with artificial food dyes, a whole line of waffles with artificial food dyes, directly targeting children, directly targeting toddlers. You know, I have a toddler at home. So, you know, I have a three year old and she loves that song baby shark and, of course, they come out with a baby shark cereal full of artificial food dyes. Yeah. I actually started a petition.

You can if anyone's watching this, you could go sign it. It's foodbabe.com/babyshark to finally get Kellogg's to to to uphold their commitment to remove artificial food dyes and to stop making these new products that are harming our children and, you know, they're they're coming out with these products in the middle of a pandemic, you know, and, you know, we're in a situation right now where we need to take our health very seriously. If anything if anything about the world's events today show you is that government is not gonna save us. We need to save ourselves. And so and we're gonna have to save our kids and we're gonna have to save our families.

And so we have the responsibility to learn about these chemicals in food and make a choice and not, make a choice not to, you know, obviously, buy these products and support these companies and vote with our dollars.

Dr. Mark Hyman
I'm a little more hardcore than you. I'm like, don't buy anything with a label.

Vani Hari
I love it. I love it.

Dr. Mark Hyman
You know, if if it ain't made by God, don't eat it. If it's made by man, eat, don't eat it. You make sure you don't eat it. Right?

Dr. Shebani Sethi Dalai
Yeah.

Dr. Mark Hyman
So you wanna make sure if you look at a food, you recognize what it is. An avocado is made by God, but a Twinkie isn't. Lucky charms are certainly not made by God. So that's an easy thing. It's hard to do because people want convenience.

I understand. But we we really have a a crisis in this country because, you're saying Kellogg's and other companies have really not stepped up to the plate to do things which they know are integrity, which they can do, which are not gonna add to their cost, but actually are gonna provide better health for for the population. That doesn't make cereal as healthy even if you took out all that crap because I don't think it is because it's full of sugar. But that that's that's that's that's another story. The the thing

Vani Hari
I mean, but we're we're up against a mega PR campaign too against our health. And I'll I'll just give you, you know, the example of Kellogg's. We'll just go on this one. You know, when they came out with their new waffles, there was press up the wazoo. Every single mainstream media outlet reported on the fact that Kellogg's has created this new unicorn mermaid waffles for kids.

Right? But when my friend who was very famous, just you know him too, Jesse Itzler, the, husband of Sarah Blakely, one of the, you know, billionaire women in this world that owns Spanx, He challenged the CEO of Kellogg's to a hundred thousand dollar, live fifteen minute interview on Instagram. He said he'd give a hundred thousand dollars to any charity of the CEO of Kellogg's Choice, and not a single media report on this. Not one single anything, but, you know, you watch, you know, you watch the mainstream media report on all sorts of garbage and and not, you know, interesting news. But this is, like, real news that could affect children's health in a debate or, you know, even an interview about these new products that they've created, and and no one's challenging these companies.

And it's just you know, we're in a really

Dr. Mark Hyman
smart situation. What do you say? You are. Oh, five feet, whatever you are. You know?

I mean, the, the other thing about Kellogg I wanna ask you about was that they recently announced that they were gonna get glyphosate out of their products by 2025. Is that a smoke screen? Is that real? Do they do they plan on doing it?

Vani Hari
Announced a lot of things that they say they're gonna do, and I haven't seen it done yet. So, I'll believe it when I see it for sure. You definitely and that's another thing. There's this there's this assumption when these companies announce these changes that they're gonna actually go ahead with them. A lot of times they change leadership or they realize that, oh, they'll lose too much money or, oh, people suddenly don't care about this issue anymore because it's not a hot button topic in the media.

You know, the glyphosate issue was very, a hot button topic because of a bunch of different reports that the environmental working group put out about glyphosate in food and, the GMO debate at the government level. But once that those issues became less important or people forgot about them, these companies think they can get away with murder.

Dr. Mark Hyman
Yeah. It's pretty bad. Alright. So your book, the food babe way feeding lives and the new book, food babe kitchen, which everybody should get. It is This

Vani Hari
is in your mailbox at home, Mark.

Dr. Mark Hyman
It's so it's such a beautiful book. It's full of incredible recipes. It helps you take Bonnie's ideas about how to eat and create health and puts them into delicious recipes that are easy to follow, that are nourishing and yummy and they're even your kids will love. So everybody get that book. But, one of the things you help us understand is how to read labels, and how to be a smart consumer because unless we're paying attention and I even get duped sometimes.

Sometimes I'll I'll pick up some and look healthy, and I'll forget to turn the ingredient list over, and I'm like, I get home, like, oh god. This is terrible. Why would I even wanna eat this? So how do you how do you, pay attention to what is important? What should you look for?

I mean, if it says natural flavors, that sounds, like, great. Right? It's, like, healthy. Right? But is it really?

And and, you know, one one joke I always tell is that, you know, one of the natural flavors they use is vanilla natural flavor, and that comes from beaver's anal glands. So I think, you know, we gotta be very careful. And also, you know, why should we be wary of fortification of foods?

Vani Hari
Yeah. All great questions. So in the first fifty five pages of food bank kitchen, I actually show you how to read labels, take you through every grocery store aisle so that you can stock your kitchen like a food babe. And, everything from how do you prepare your foods to how you warm them up and everything is in this book at the beginning. And then, you know, of course, a hundred plus recipes with color photos for each one.

So, just so excited to have this book out and so happy. I know you've written many cookbooks, Mark, and, you know, it's this is my first one. So it's, the first of many, though, because I've got I've definitely got more recipes than me. But, you know, I think what's really important about reading labels is that, you know, there's this kind of three question detox that I I talk about at the end of feeding you lies, and this is kind of how you start the process of really training your mind to eat real food.

Dr. Shebani Sethi Dalai
You

Vani Hari
start with the question the first question, what are the ingredients? So you have to know kinda everything that you're eating. And so if you sit down for a meal and you don't know the ingredients, stop eating that meal and find out. And once you read the ingredients and and and look at them, do you understand them all? Do are they real food?

Are they you know, is it an apple, cinnamon, and sea salt, or is it TBHQ and, you know, glue number one? TBHQ, by the way, is a very popular synthetic preservative that they use in very popular products and, you know, Reese's peanut butter cups comes to mind, cheese Oh, no.

Dr. Mark Hyman
I used to love those.

Vani Hari
Oh, yeah. And, and, you know, this is actually an ingredient that, negatively affects your t cells in your bodies and promotes allergies. So, like, if you have an allergic just an allergy to anything, it can

Dr. Shebani Sethi Dalai
just increase your immune

Vani Hari
response to that allergy, and you can response to that allergy, and you can you can have a very adverse reaction. And if you eat a lot of foods with this, it's been linked to vision disturbances, stomach cancer, behavioral problems in children, all sorts of things. And this this is a preservative that's in a lot of things. But, you know, when you read that on a label, TBHQ, you have to ask yourself, what is that? Right?

You know? And so that comes that leads you to the second question, which is, are these ingredients nutritious? Is TBHQ nutritious?

Dr. Mark Hyman
Hell no.

Vani Hari
Hell no. Right? And, and so then you start to realize, like, why am I eating these non nutritious ingredients and maybe I need to choose something different. And then the third question you ask yourself is where do these ingredients come from? Are they made in a laboratory in a chemical factory and in the case of natural flavors that you mentioned?

Yes. They are. People see the word natural and think it's coming from nature. Yeah. It starts in nature, but the way they manipulate, for example, a strawberry in a laboratory or they can manipulate some other substance, that comes from nature and make it act like a strawberry or taste like a strawberry or create the one millionth best part taste of something so that they can put in a product that normally would not taste good on the shelf that lasts there for, you know, that's nine to twelve months.

They could put it in a product and it would taste like a real strawberry even though it has no real strawberries in it. And and that's what natural flavoring is, and so it tricks your brain into thinking you're eating real food when you're not, but your body is still wondering where the nutrition from that strawberry is coming from, so you start to crave more than you should. And so natural flavors are one of the most, evil ingredients I believe in our food supply because

Dr. Mark Hyman
they

Vani Hari
trick your brain and they hijack your taste buds and they continue that craving so you eat more than you should. And with obesity, heart disease, and diabetes is is our biggest issue in in this in this country and cancer, you know, we have to take control of our taste buds. And the only way to do that is not to allow the food industry to control them. And so removing natural flavors from your diet is, like, the number one thing I think. And it's so you know, even though there's many more chemicals that are many more much more harmful to you, almost 99% of the products on product shelves at the grocery store have natural flavor.

So if you avoid natural flavor, you avoid many of those, and it's actually one of the reasons I started my company, Truvani. I just wanna mention because there are so many supplement companies out there, protein powder companies and supplement companies that use these natural flavors.

Dr. Mark Hyman
Yeah.

Vani Hari
Yeah. I wanted to create, a line of products that were were made from real food and non synthetic substances. It didn't trick your brain into craving a flavor more than it should. I want people to be able to turn off their normal mechanism to to crave food. And it's important reasons why we're doing what we're doing at

Dr. Mark Hyman
I mean, that's just so important what you're saying is because these these chemicals and some of these things are not put in there necessarily as a preservative, but they're put in there deliberately to hijack our brain to make us eat more, crave more, want more. And one of those is MSG, which is got 50 different names or more. So So it's hidden, and it doesn't say necessarily MSG or monosodium glutamate because people are are hip to that. They change the name, like hydrolyzed yeast protein or extract. And and that actually is what's used in research to fatten up rats or mice to study obesity.

So they give them MSG as a way to increase their appetite, make them eat more, and get fat. And I I remember once I was talking to a nutritionist who lived in Samoa, which has the most obese population in the entire world, and most of them are diabetic. And she said for breakfast, they had ramen noodles, sugar. They had, MSG. MSG.

Yeah. And they well, they put Kool Aid powder on it, which has all these artificial colors, and they put MSG powder on it. So it's it's extraordinary. That's their breakfast. Basically, Kool Aid, MSG, and ramen noodles.

And that's why they're so obese because they can't stop eating. And I I think your book really points out a lot of these chemicals and goes through details about which one you should pay attention to, what they are, where what they're doing to our biology. In fact, where they're banned in other countries and why do we have them here. It's really powerful. And I encourage you to really check it out because there's very other, few other places where you can get this kind of information that tells you exactly what you should be looking for.

Even my books, I don't go into as much detail because, you know, Vonnie's an expert on this food additive thing, and she's been taking down large companies based on her work. And I think it's it's pretty exciting. So one of the things besides the companies I think we wanna talk about is the government and how the government affects our food choices. And they have different programs that they do this with that we think are, you know, government programs for the public good, but they're actually helping companies not improve public health, but private profit. And one of these programs is called a checkoff program.

Can you can you talk about that? Because you write about in your book, and it was very enlightening to read about.

Vani Hari
Yeah. Absolutely. So, you know, in in feeding you lies, I kinda go off all of the different, like, I guess, phases of things that the government has done in terms of, trying to, help, you know, in terms of you know, when we look at the root cause, and you you know this, Mark. So the root cause of a lot of our issues is because of where our subsidies in our agriculture, producers are are basically being, given, subsidies so that they produce really cheap commodities for, for America. And those cheap commodities like corn and soy are what make up the majority of processed foods.

And so these checkoff programs actually give the corn and soy and canola industries power in the government to make decisions, whether it's something that makes a decision on my plate, which the government, creates to kind of, give guidelines to children and schools on how their plate should look at the end of the day, if if if dairy should be on there or not be on there, how much of grain should be on there versus not be on there, and and, you know, you've you've written a lot about, in your detox books and other books about, how some of these, ingredients, the things that we make the most of corn and soy have been very detrimental to our health because, not only the glyphosate that's sprayed on majority of those crops that is linked to cancer, but also the fact that it imbalances your omega three to omega six fatty acid ratio in your body.

Dr. Mark Hyman
And for people to understand, those those corn and soy I mean, you can eat corn on the cob and soybeans. That's not the problem. But about 1% of the stuff grown actually is eaten as the whole food. Most of it's turned into industrial products, food products, commercial products, gasoline. I mean, it's it's just an enormous problem, in terms of our our government strategy.

So keep seems to keep going and tell us about the checkout program.

Vani Hari
Yeah. So, you know, we have and then and this also happens within the meat industry too. The different check off programs, and it it all stems from this one organization within the government. It's the, government accountability office or it's called the the GAL, the USDA GAL, and it basically oversights all of these check off programs where they allow these food companies to continue to market food to us even though it's unhealthy.

Dr. Mark Hyman
Yeah. So, you know, think about the so people kind of make sense of it, you know, programs like, you know, what's for dinner or, you know, pork the other white Right. Pork the other white meat. Yeah. Got milk.

These are all not industry funded programs. These are programs that are funded in collaboration with the government. So the the government is actually pushing these products into the marketplace through advertising and marketing. What the money is supposed to do is further research and understanding, not the marketing dollars to pay for ads that make these companies billions of dollars. So when your hot milk ad was was out there, it was so popular, they had every celebrity in it, they everybody had the white mustache, they had all these health claims, you know, it's gonna make stronger bones, it's gonna be great for sports performance, it's gonna do this, it's gonna do that, help you lose weight.

And and what happened was another branch of the government started paying attention to this, the Federal Trade Commission, which regulates truth in advertising. And they were like, hey, guys. There's no data to back up what you're saying in these ads. You've gotta stop these ads. That's why you don't see got milk ads anymore because, basically, they went got proof, and there was no proof.

Vani Hari
Yeah. Exactly. And I'm thinking of another one. You know, the whole grain, the grain society too was doing that a while with, you know, by saying whole grain was heart healthy. Yeah.

Whole grain cookie crisp cereal. And everything.

Dr. Mark Hyman
Right. My favorite is the whole grain cookie crisp cereal with, like, you know, seven teaspoons of sugar or something like that. It's like it's ridiculous. If you let people eat as much as they want and you give them ultra processed food versus whole foods, they'll eat about 500 calories more a day of ultra processed food because they'll keep eating and they're hungry and they keep driving. And you you talk a lot about it then in your work about the the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you literally become addicted to these compounds and how that affects you.

Dr. Shebani Sethi Dalai
Right. So the rates of obesity and binge eating and addictive like eating are rising alongside the increasing dominance of ultra processed foods in the modern food environment. And there are several mechanisms as to how this works. Some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated, and the brain is connected to the body.

And we used to learn in medical school that you have this blood brain barrier that nothing can get across it, but that's not it's like the Berlin Wall. But in reality, it's it does leak. Right? And there are things that do cross and

Dr. Mark Hyman
It's more like a coffee filter. You know? It's a sip.

Dr. Shebani Sethi Dalai
Right. Yeah. So so ultra processed food and sugar decrease our dopamine receptors and make us eat more compulsively, invoke addictive like behaviors, which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra processed food, continuing to eat these things despite knowing the the adverse consequences to it, and repeated attempts to try to quit. Right? I'm describing addiction here, basically Yeah.

And and the consumption of larger quantities over time than intended.

Dr. Mark Hyman
So People go all the terms like emotional eating. It's not really biological, true addiction. What you're saying is is really a true biological addiction just like heroin or cocaine or alcohol that you get withdrawal, you get cravings, you get increased need for more and more of the substances receive the same pleasure, You down regulate the receptors for pleasure, so you have to take more of the stuff to actually stimulate that reward pathway. And and it's really this vicious cycle that people get into, and then they blame themselves, and they feel guilty, you know, for doing it, and they think they just have no willpower. But you're saying it's much bigger than that.

Dr. Shebani Sethi Dalai
Yeah. That's exactly right. It's so sugar is an addictive substance. It's not just something we say. It has a straightforward neurochemical basis in the brain just like any other drug.

And I think of sugar as a It's a recreational food. It's not a it's it's not a food that's essential for survival. We make sugar, you know through the process of gluconeogenesis through through other foods, that we consume. And so it's really about excess carbohydrates. It's not

Dr. Mark Hyman
That's what I call I call sugar a recreational drug. I've never heard anybody say it, but I've both I always write down in my book, sugar is a recreational drug. So, like, if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America.

Dr. Shebani Sethi Dalai
Exactly. Yeah. And and we also actually, I I would like to share a story about about this, just during the the era of COVID since we're in it. Yeah. You know, just to give context as to, you know, why I wrote about this and why I'm working on this as well and continuing to feel, you know, motivated to continue to do my work is the shelter in place order had come, you know, a couple months back for my county, and I'm in California.

I live in Menlo Park. When it was announced, my husband, he's an infectious disease physician at Stanford, and I'm a psychiatrist and a UC medicine physician as you, mentioned. We both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store, and we saw many people loading up their carts with pop tarts, Hawaiian punch, popcorn, anything ultra processed, basically. And they weren't loading up their carts with fresh vegetables or, you know, they were out of cookies at the at the grocery store.

Dr. Mark Hyman
Yeah. There was using toilet paper.

Dr. Shebani Sethi Dalai
And toilet paper. Exactly. And there were still, you know, produce left in the store. You know, it wasn't like they ran out of produce. No.

So here I was

Dr. Mark Hyman
run on, broccoli.

Dr. Shebani Sethi Dalai
No And here I was at the checkout counter and I was thinking to myself, you know staring at the person's car in front of me that It's full of the recreational food as I mentioned food That's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic and or helping their immune system and, if anything, weakening it. And and this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access.

That is what motivated me to to kinda get that public message out, on this topic.

Dr. Mark Hyman
Yeah. You did write a great article on the Hill, and I I read it. And you really talked about the way in which, the pandemic we're facing is much more serious because of the underlying chronic disease pandemic we have in our society where it's driven by this ultra processed food that makes us overweight and sick and causes all these underlying chronic inflammatory issues like diabetes and heart disease and high blood pressure, which are really the same mechanisms. If you look at the mechanisms of high blood pressure, heart disease, and diabetes, it's insulin resistance, it's oxidative stress, it's inflammation, and it's the same thing that's affecting our psychiatric illnesses, which is so fascinating. And most people don't think about using the doorway of food to help treat the brain.

And you're doing that in your in your research and in your practice. So tell us some of the kinds of things you're seeing, in your patients using this approach because it's pretty radical. You're going all the way sometimes to ketogenic diets with these patients with bipolar disease, schizophrenia, depression. It's fascinating.

Dr. Shebani Sethi Dalai
Yes. What I have noticed is that a lot of my patients that come for psychiatric treatment and evaluation, a lot of them have prediabetes and diabetes. And when I look up the statistics on this in our country, forty four percent of adults today in our country are either prediabetic or they have diabetes. And I wonder to myself, what is that doing to our brain? We know that affects all these different organ systems, the liver, the pancreas, the heart, but what is that doing to the brain?

Right? And so, I'm happy to talk more about my research and and patient care. But one thing that I that I felt I didn't completely answer, before was kinda how these hormones affect the brain with the addictive piece. And how

Dr. Mark Hyman
does it drive inflammation and all of that? Yeah.

Dr. Shebani Sethi Dalai
Yeah. Yeah. So kind of going back to that, you know, so I was talking about the the definition of addiction. And we know that hormones like insulin and leptin, which is the hormone that tells us we're full, it sends a signal to our brain, and and ghrelin that tells us that we're hungry. These hormones modify natural and drug reward pathways in the brain.

I mean, they have so many effects on the brain. Our hunger hormones go awry, and it can actually increase the reactivity itself of the dopamine system. And so this happens when we consume that excess sugar and the excess carbohydrates in our diet, and they cause these rapid shifts in blood glucose and insulin levels similar to other addictive substances. So my approach in patient care has been to work on this system to decrease these shifts that occur in our our blood sugar and our hormone levels to kind of go back to the homeostatic state that our body and our brains were meant to be in. And so I treat the metabolic dysfunction, and I look at how that improves both metabolic issues as well as psychiatric outcomes.

Dr. Mark Hyman
Yeah. So it's fascinating. So you basically are treating the body to fix the brain. Right? You're you're dealing with these physiologic changes that have to do with our diet and nutritional psychiatry that most psychiatrists aren't thinking about.

I mean, most psychiatrists aren't thinking about, you know, psycho emotional issues. They're thinking about medication and and prescribing antidepressants, but they don't really work as well. And I, you know, I just found that the amount of benefit you get by addressing these underlying factors is so much greater than you get with medication, which are marginally effective for most people. I think, you know, unless you have really severe depression. But but I think the data is just not that exciting about these drugs.

Right? I mean, they can be helpful for people and they can be life saving, but but there are also other doorways that you're exploring, which are seem to be way more fruitful. Is that your experience?

Dr. Shebani Sethi Dalai
So, you know, the field has come, you know, a long way, babe. There's a lot of research that's been done on the biological piece and neuroscience and looking at, you know, obviously, the serotonin hypothesis, but that's the hypothesis and an observation from, like, thirty years ago. And all of these research and money has been thrown on developing drugs, but we're not necessarily addressing some of the root causes of of why are these chemicals imbalanced. And so that's an important question that I and others are trying to study through research studies and and clinical trials. And like you said, we know that although our medications are necessary and lifesaving for many, they have undesirable side effects that can worsen metabolic health.

And while it's helping in one domain, it may, in some people, also be hindering improvement in psychiatric symptoms, especially if the metabolic health is poor. So psychiatric treatment is never going to be a one size fits all approach. Mental health conditions are are varied. They're heterogeneous, and they have different phenotypes or presentations. We don't have a single mutation or a gene that we can point to or a lesion.

There's no smoking gun. It's a complex relationship of multiple genes and environment. And, unfortunately, a metabolic assessment is not part of that, routine care, and stigma certainly plays a role in this. Obesity stigmatized and so is mental health Education about nutrition metabolism is lacking in in medical education most psychiatrists recognize this relationship.

Dr. Mark Hyman
They do? They get understand the connection between food and mood?

Dr. Shebani Sethi Dalai
They're starting to. They understand the that That there are side effects with psychotropic medications. I think they don't necessarily have expertise to treat it or address it They don't know necessarily what to do about it but most most psychiatrists that I speak with, and my department certainly has been very supportive of this idea, and someone has to do the research and someone has to do the work to kind of move the field forward.

Dr. Mark Hyman
And Yeah.

Dr. Shebani Sethi Dalai
There is a a growing body, you know, of of other researchers working on this. And we hope, you know, that evidence based research has to be done to to kinda change the mainstream's generative care.

Dr. Mark Hyman
Yeah. I know. I mean, you're you're talking about metabolic psychiatry. I was also, noticing that Harvard had a whole department of nutritional psychiatry, which is, you know, seemed like bookends on the country. I don't know.

The rest of the psych psychiatric world is thinking about this, but, you know, you you mentioned earlier that you you work with Bruce Ames, who's an incredible biochemist and nutritional scientist from, California. He's one of the most published, sort of scientists in the world, and and I spent a lot of time with him. And he talks about this whole idea of a metabolic tune up and that so many of our biochemical reactions are regulated by vitamins and minerals and that each of us have different needs for different components of those, vitamins and minerals. I remember when one, one guy was I was sitting in my office one day working on something. I was thinking I might have been working on that book, and I was talking to somebody about folate and b twelve and b six.

He said, oh, yeah. I I had really bad depression, and I took some of these b vitamins, and it just went away. And I think, you know, there are some people who have a higher need for, for example, folate or b six or b twelve based on these genetic variations that Bruce Ames talks about that really are are are so prevalent. In fact, one third of our entire genome codes for enzymes, and those enzymes all need helpers, which are vitamins and minerals, and and we don't really pay much attention to that. So when I look at depression or psychiatric illness, now I see so many different things that are going on there, whether it's it's insulin resistance and prediabetes or vitamin D deficiency or folate insufficiency or zinc or magnesium.

All these various nutrients play a role in brain function, and they're not something we really learn about when we learn about psychiatry. Right? Is that is that changing?

Dr. Shebani Sethi Dalai
I think that is changing. Yeah. There's a complex relationship between metabolic dysfunction and nutrition, food, and mental health. And, you know, I wanna start off by saying that the idea of food is medicine. It's not a new concept in the field of nutritional psychiatry has really grown over the past few decades by several prominent psychiatrists and researchers.

However, the focus has largely been looking at specific foods or supplements, eliminating certain things from the diet, the microbiome. You know, we're looking at the Mediterranean diet, for example, affecting depression symptoms. And these are all very important questions, but what I thought was missing and why I named our clinic in our group's work metabolic psychiatry is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms.

Dr. Mark Hyman
Yeah.

Dr. Shebani Sethi Dalai
Now back to this week's episode. If a majority of us are suffering from obesity, type two diabetes, insulin resistance, metabolic syndrome, what is that doing to our brain? We know that these diseases affect multiple things. Mental illness, rates have increased over the past twenty years, in fact doubled. We know that mental illness like depression, bipolar disorder, psychosis, they're strongly associated with inflammation.

That's that research is really indisputable. And research is also showing that there's an energy deficit in these brain illnesses, and the mitochondria, the energy powerhouses of our cells, are not functioning optimally, causing changes in brain signaling itself. And the thought is if we can target inflammation, insulin resistance, the abnormal blood sugar, etcetera, as a method to improve mental health symptoms, then we can really improve our patients' lives further. And, again, mental illness has many different causes, but even if we, you know, can five to ten percent of people have an improvement in these symptoms with this method, then I think that would've that would be a pretty significant improvement of the overall mental and physical health of our country.

Dr. Mark Hyman
I think it's a lot more than five to ten percent. I mean, when you think about that, the most amazing thing you just said to me is such a paradigm shift, which is that depression is inflammation in the brain. And that when you look at autopsy studies and when you look at the biology of this disease, the brain's on fire. And it's also on fire in autism, in Alzheimer's, in schizophrenia, and a lot of these disorders that are we think of as mental disorders, but are actually brain disorders that are manifestations of inflammation that show up differently in different people. And the question is, you know, what's driving that inflammation?

And I think diet clearly is probably the biggest factor, which makes it an incredible thing to use to actually alter the course of these diseases because it's a easy tool to change and actually get a result. And that's what you're talking about, your therapeutic use of, you know, metabolic medicine to actually fix psychiatric problems, which is pretty amazing. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at doctor Mark Hyman. Please reach out.

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