published on July 17, 2020

Okay so with the processed food industry has certainly advanced and evolved over the past 50 years to provide us with all of this fare which we are now consuming but what's interesting is with all of the different processed food that's out there for us to be able to choose from

Today how many companies do you think make those not it turns out they're 10 and here they are ok Kraft Coke Pepsi Kellogg's Mars Unilever J&J P&G and Nestle they control 90% of the food

Distribution and marketing in this country these 10 conglomerates and to be honest with you they all do the exact same things so that's very interesting so basically our food has been uniformly changed over the past 50 years a very

Good experiment in terms of before and after so let's talk about that ok so here's what processed food is number one it has to be mass-produced ok on a big scale you know we're not talking about individual chefs here we're talking

About you know conglomerates anybody ever been to a food processing plant you have huh what was it like it's a plant are there any windows there are no windows why is that why are there no windows in a food processing plant

Because they don't want you to see what's going on in there because if you did you wouldn't eat it okay surely you can't believe what's going on there there's not one piece of machinery that is recognizable that

Would be in a normal kitchen nothing it has to be consistent batch to batch because not just batch to batch but in fact location to location because they're making it in different places at different times okay has to be

Consistent country to country for obvious reasons like McDonald's right you know because after all you know it's McDonald's that carries the brand that's got to you know convey a certain taste specialized ingredients from specialized

Companies we're not talking about you know just food here we're talking about all sorts of additives and we're talking about all sorts of other things that you add to the food in order to make those things consistent from country to

Country virtual every macronutrient is pre frozen the only thing that's not pre frozen other spices everything comes from a freezer fascinating yeah okay and that means that the fiber had to be removed because what happens when you

Freeze fiber you get mush go home take an orange put it in your freezer overnight take it out the next day put it on the counter thought try to eat it see what you get what do you get you get mush because the ice crystals macerate

The cell wall of the plant with the orange okay and allow the water to rush in and turns it into mush but of course food industry knows that so what do they do they squeeze it and freeze it lasts forever becomes goes from being a food

To being a commodity that's the definition of a commodity storable food and you can buy and sell commodities on a commodities exchange you can't buy and sell food on a food exchange but you can with commodities so this works for

People trying to make money okay it has to stay emulsified what does that mean everybody know what emulsifiers so these are chemicals they're detergents really that help bring fat and water together all right

That's why you add detergents to the washing machine is so that you can get the soaps to the stain otherwise you couldn't do that so what happens if those emulsifiers are working inside your intestine what you think happens it

Actually strips off the mucus layer of the epithelial cells inside your intestine and they're actually studies now in animals at least we don't have in human studies let's say that you can actually show closer opposition of the

Food to the cells because the mucus layer has been damaged and has actually been lost in some in some cases and that may be part of the problem of food allergy and irritable bowel syndrome and several of the other food related

Diseases that we know about today although that's not known for sure yet but there was a paper in Nature just three weeks ago that opposed that at least in animals okay and again it has that very long shelf life or freezer

Life everybody knows the ten-year-old Twinkie right right it's got to last forever all right and that's again for depreciation so let's list what processed food is how it's different from real food everybody got

It so not enough what not enough fiber because you have to take the fiber out in order to freeze it not enough omega-3 fatty acids which you find in wild fish and not farmed fish because the fish don't make the omega-3 is what makes the

Omega-3s the algae make the omega-3 is the fish eat the algae we eat the fish so if you're consuming farmed fish which is processed food you might as well be eating a steak all right everybody got that very important you understand that

So you have to know where your fish comes from well of course how do you find out sometimes not so easy micro-nutrients okay not enough micro digits because the micronutrients travel with the fiber fraction so when you

Remove the fiber you remove a lot of the micronutrients so most of the processed food is deficient in micronutrients that we need in order to be able to metabolize food properly and then there's a whole bunch of things that are

Too much too much trans fats now we know that trans fats are bad this stuff is consumable poison so much so that the Food and Drug Administration finally after 25 years finally on November 7th 2013 agreed that trans fats were not

Generally recognized as safe and so they will be disappearing from our food supply all right took 25 years what else branch chain amino acids leucine isoleucine valine these are three amino acids that you

Have to eat you can't make and levels of these in your blood correlate with metabolic syndrome all the cardiovascular diabetes diseases the non communicable diseases all the chronic diseases that we know are all on the

Rise and levels of these amino acids correlate with those in humans and they are higher in corn-fed anything which of course is processed food corn fed beef corn fed chicken corn fed fish which is farm fish ok omega-6 fatty acids so what

Are omega sixes those are pro-inflammatory now you need Omega 6s you need Omega threes you need both but you need them in the right ratio and Omega 6s is what you find in seed oils like corn oil soybean oil and these are

Pro-inflammatory now you need inflammation because you need to be able to knock out bacteria you need to be able to mount an immune response when you're sick and have a virus etc but you don't need it all the time so we're

Supposed to have an omega-6 to omega-3 ratio of about one to one we're told we right now have an omega-6 to omega-3 ratio of about 25 or 30 to one so the question is is that pro-inflammatory or not all these different additives and I

Don't want to get into all the different additives because we could go off for 10 hours on all the different additives and you know that would you know there's not enough videotape in the camera for that emulsifiers like I

Mentioned okay the ones that you may have heard of are called polysorbate 80 and carboxymethyl cellulose those are the emulsifiers that are typically used too much salt right everybody knows about salt so salts very complicated

There are some people who are exquisitely salt sensitive and they need a reduction in their salt content and there are some people who aren't as salt sensitive and it's not as important now as a doctor I care about everybody and

We are triple over our salt limit so I'm for reducing salt but it's inch but when you look at the data it's complicated as to who benefits and who doesn't but nonetheless it's still a good thing to reduce salt and then the big one sugar

Okay and that's we're going to talk mostly about today because the food industry uses sugar like you use salt okay they hype up virtually every food to make it more palatable and they do it with sugar why because there are five

Taste buds on your tongue okay there's sweet of course there's salty there's sour there's mommy everybody knows what that is that's like roast beef or soy sauce and then there's bitter so here are examples of each of

Those so sugar hides salty that's like Chex Mix or honey roasted peanuts it hides sour like the German wines you know I mean nobody would drink that stuff except that they add a little bit of sister reserve back because there's

So much citric acid in the German wines because they don't get any Sun okay that you have to cut the acidity and you do it with sugar it's the same reason why you add a little sugar to your salad dressing when you make balsamic vinegar

And oil because it makes you know it cuts the sourness or the a little bit how about and lemonade of course it cuts Emami like sweet and sour pork you know that's half soy sauce you wouldn't touch that except you add a

Little sugar you can't even tell that there was any soy sauce in there and then finally it cuts bitter like milk chocolate right okay so why here's why because there are no foodstuffs in nature that are both sweet

And acutely poisonous none it was the signal to our ancestors that any given food that they found in nature was safe to eat wouldn't make them keel over and die liking sweet is ingrained into our DNA

We love this stuff we will go out of our way for the stuff it is completely vestigial from a metabolic standpoint it generally it gives us no benefit in terms of anything but as an energy source

There is no biochemical reaction in the body that requires dietary sugar yet we love it anyway some calories cause disease more than others because different calories are metabolized differently in the body

It's called nutritional biochemistry and you want to know the kicker of all this I learned this in college I majored in nutritional biochemistry at MIT in 1975 I knew this and then I went to medical school and they beat it out of me and I

Forgot all this because that wasn't what we learned in medical school we learned the calorie was a calorie we learned obesity was the problem we learned that if you eat too much and you exercise too little you gain weight and we learned

That that fat that you gained caused all of the metabolic disturbances that we now see and then I started doing my own research in 1995 and you know what by 2005 I was absolutely convinced a calorie was not a calorie and I came to

The realization waiting I started having night sweats I started waking up in the middle of the night with like post-traumatic stress disorder because like I knew this and I had lost it and I got it back maybe that's why I'm so

Passionate about it now is because medical education does not discuss this because they don't get it they don't understand it and if you kick that out from under what happens to you know your your understanding of physiology of

Science of nutrition of biochemistry and of Health basically we're kicking it out from under and people don't want to kicked out and so there's this big fight this big tension and that's why we're having this discussion now but a calorie

Is not a calorie now how do I know that because we have the data so here is a study from Europe called the epic interact study what they did was they asked do sugar sweetened beverages cause diabetes so if you look at the black out

Of the red box at the bottom what they do is the use called the adjusted model they looked at sugar every sugared beverage per day adjusted for its calories and adjusted for its effects on obesity by BMI and they

Showed that every sugar beverage increases your risk for diabetes by 29% and we're not consuming one sugar beverage we're consuming two and a half on average so take that up to 68 percent we did this study which didn't look at

Consumption we looked at availability within countries what we did was we took the Food and Agriculture Organization statistics database which listed line item country by country for the entire decade 2000 to 2010 total calories

Fruits excluding line meats cereals fiber containing foods oils sugar sugar crops and sweeteners line by line item by item for the whole decade country by country we then regressed that with the

International Diabetes Federation statistics database for diabetes prevalence country by country for the same period and then we regress that with the World Bank gross national income database which controls for

Poverty urbanization aging physical activity and obesity all the confound us remember you have to adjust for the confound is when you do science right and we asked the question what about the world's diet predicts diabetes change

Country by country over the decade and the answer only sugar nothing else nothing else even came close for every hundred fifty calories extra any country ate diabetes prevalence went up a total of 01 percent nada but if those 150

Calories happen to be a can of soda instead diabetes prevalence went up 11 fold 11 percent and again we're not drinking one soda day were drinking two and a half this study actually meets the criteria which were set up by Austin

Bradford Hill back in the 60s to implicate tobacco and lung cancer that is dose more sugar more diabetes duration longer sugar exposure more diabetes directionality countries where sugar went up more diabetes countries

Where sugar went down in there were few less diabetes and most importantly for causation you have to show precedence three years we never should have changed diabetes changed in the same direction three years later that's causation same

Level of proof we have today for tobacco and lung cancer okay why here's why because sugar four drives fat accumulation in the liver that's why because when you put fat in your liver then your pancreas has to

Make more insulin and that burns out the pancreas it causes diabetes and you can see from this study from my colleague jean-marc Schwartz that was just in JCM of like three weeks ago you can see that you can put the you can do the

Controlled period and then the sugar you can do the sugar peri then the control bottom light doesn't matter the amount of liver fat went up 38% for the same number of calories over a two-week period and that drives insulin

Resistance and that drives increased a pancreatic insulin release which of n drives chronic metabolic disease and we just had an abstract at the endocrine society just a month ago and you can read it here restricting fructose and

Obese Latin and Latino and American African American children reduces fat accumulation in the liver 30% reduction on the same number of calories in 10 days which also improved their insulin resistance and every other aspect of

Their metabolic health without changing weight it didn't change their subcutaneous or big butt fat it changed their visceral fat bandid absolutely lowered their liver fat same number of calories because a calorie is not a

Calorie and this is for heart disease death this was published last year by yang it all from the Harvard School Public Health in the CDC so what you're looking at here is a histogram of percent of calories consumed as added

Sugar over a two-decade period and the median of this histogram is 18 percent can you believe that half the country consumed more than 18 percent of their calories as added sugar that's insane it's supposed to be 4% was

It 18% okay now that red line in the center is the hazard risk ratio for heart disease death and the inflection point is at 15% medians 18% inflection point 15% what does that mean it means that more than

Half the United States has an increased risk of heart disease death due to their added sugar consumption controlling for obesity controlling for calories just because of the added sugar because it's not about the calories and it's not

About the obesity alcohol is not dangerous because its calories alcohols not dangerous because it causes obesity alcohol is dangerous because it's alcohol sugar is the same thing it's dangerous because it's sugar because of

Its unique stereochemistry and because of what it does and because of how the liver metabolizes it because it's not necessary because it's not really a nutrient it's an energy source it's not a nutrient in fact we have causation for

These four diseases and these four diseases will be on that warning label if this California State Legislature passes the motion diabetes heart disease fatty liver disease and tooth decay we have causation for every single one

Of those ones we all have correlation for today so we don't discuss them yet is cancer and dementia but I'm really interested in both of those and I just met with Stan prisoner the Nobel Prize when her up at UCSF about whether or not

Sugar could cause dementia and how we might be able to actually look at that question going forward in the next couple of years

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