#94 – Mark Hyman, M.D.: The impact of the food system on our health and the environment

1. 0:00 – 0:11

   Intro

   1. PAPeter Attia0:01

      [intro music]

2. 0:11 – 8:59

   Why Mark Hyman Moved Upstream to the Food System

   1. PAPeter Attia0:11

      Hey everyone, welcome to "The Drive Podcast." I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in-depth content if you want to take your knowledge of this space to the next level. At the end of this episode, I'll explain what those benefits are, or if you want to learn more now, head over to peterattiamd.com/subscribe. Now, without further delay, here's today's episode. [upbeat music] My guest this week is Dr. Mark Hyman. Mark is a family physician, a New York Times bestselling author, and the director of the Cleveland Clinic Center for Functional Medicine. Turns out we're going to talk about pretty much none of that today. We talk almost exclusively on his new book, which is due out tomorrow, called Food Fix: How to Save Our Health, Our Economy, Our Communities, and Our Planet One Bite at a Time. And if that sounds like a mouthful, it's because it is a mouthful. This is a kind of staggering topic, and even by the standards of this podcast, it's probably too much for one episode. Mark basically lays out a thesis that if you fix the food system, you fix a lot of problems. So it's not a one-fer, it's not a two-fer, it's like somewhere between a three-fer and a four-fer. We don't spend a lot of time talking about the health consequences of fixing food, although we open our discussion with that, talking about the health impact of food. We talk a little bit about gut health. But we spend more of our time probably speaking about some of the social consequences and the environmental consequences, and of course, it ultimately does come down to health at the individual level. We do get a lot into agriculture, energy usage around food. We talk a lot about the impact on climate. We also talk quite a lot about GMO, the strength of the evidence for and against it. We go through a lot of the policy ideas around how one might fix the food system, and actually we close with a nice anecdote of an explanation that I thought Mark provided that was pretty interesting around the difference between food in Europe and North America. Many people, myself included, have commented on this, which is, "Why is it that when you go to Europe you seem to be able to eat with impunity things that in the United States just feel like they're about to kill you?" Anyway, this is a really interesting episode. I learned a lot in kind of preparing for it, and truthfully, I still feel like there's a lot I just don't understand in this system. There's probably a lot I need to go back and get smarter on. There are so many big numbers in this type of a discussion that the scale sort of doesn't make sense at times when you start to think about what it means to feed the world and how making changes in that system can have enormous knock-on effects, uh, for both good and bad. So without further delay, please enjoy my discussion with Mark Hyman, and we may end up revisiting this topic with other guests, uh, should people find this interesting. [upbeat music] Hey Mark, thanks for coming over, man.

   2. MHMark Hyman3:30

      No, I'm so happy to be here. It's beautiful. Chickens running around and everything. [laughs] Venison in the freezer, my kind of place.

   3. PAPeter Attia3:36

      Yeah, yeah, yeah. It's in keeping with a lot of what we're going to talk about today. I think, Mark, a lot of people would associate you with other topics that we might get into, functional medicine, the role of toxins in the environment. Certainly food, but from the standpoint of health, what to eat. But what we're talking about today is actually something that when you first mentioned to me you were working on this book... Actually, at the time you were putting the finishing touches on it about a year ago. I was like, "Wow, that's definitely something I want to understand more," so I can't wait to kind of have this discussion with you today. And that is basically how food is made, how food is delivered, and how food is consumed, and what the impacts of that are. I mean, what made you decide to tackle a problem of this magnitude, which is not just-

   4. MHMark Hyman4:18

      [laughs]

   5. PAPeter Attia4:18

      ... a scientific problem, but it's a political problem.

   6. MHMark Hyman4:21

      Totally.

   7. PAPeter Attia4:22

      It's a religious problem, if we're going to be brutally honest.

   8. MHMark Hyman4:24

      You mean the nutrition religion?

   9. PAPeter Attia4:26

      Yes, exactly.

   10. MHMark Hyman4:27

       [laughs]

   11. PAPeter Attia4:27

       So it's about as complicated as a topic as one would go after.

   12. MHMark Hyman4:31

       It is, and I think as a doctor, seeing patients day after day for 30 years, as a functional medicine doctor, my focus is on why. Why are my patients so sick? And not always, but the majority of them, it has some relationship to food. And then I began to wonder, "Well, I could sit here all day bailing the bucket and the boat with a hole in it, but I have to figure out why they're eating the food they're eating." And then you got to think about it and go upstream, and well, the food they're eating is caused by the food system. And I'm like, "Well, why do we have the food system we have?" Well, our food policies. And then I'm like, "Why do we have our food policies?" It's the food industry that influences our government policies through lobbying and other, other influences that they do across the spectrum of society to drive their products to the market and sell them, which are predominantly killing us. I mean, there's 11 million people that die every year from eating ultra-processed food and not enough of the good food, and I think it's an underestimate. So basically, the answer to your question is I realized I couldn't treat my patients in my office or in the hospital or the clinic. I had to go to where the source of the problem was. [laughs]

   13. PAPeter Attia5:35

       Yeah, yeah. And I want to sort of put this in context, which is the evolution of this. The domestication of crops, the institutionalization of agriculture has for-- We're going to demonize it a little bit here, but the reality of it is it's been kind of a remarkable transformation.

   14. MHMark Hyman5:54

       Yeah.

   15. PAPeter Attia5:54

       It would certainly be akin to the printing press when you think about step function changes in our civilization.

   16. MHMark Hyman6:01

       Mm-hmm.

   17. PAPeter Attia6:01

       When we went from hunter-gatherers to an agricultural society. So I want to be careful that we're not just sort of saying the answer is agriculture is-

   18. MHMark Hyman6:11

       No

   19. PAPeter Attia6:11

       ... the end of the, the-

   20. MHMark Hyman6:12

       No, the agriculture is a solution if we do it right. [laughs]

   21. PAPeter Attia6:15

       Yeah. So let's start with- What you see as the sort of main pillars of the problem, how did we get to a point where the food environment is toxic? 'Cause that's effectively what you're saying, right? Is if you eat on default, you're gonna probably eat the wrong things.

   22. MHMark Hyman6:34

       Yeah. It goes deeper than that. The food system as a whole, as I began to dig in this rabbit hole, I realized it wasn't just causing chronic disease, but it was causing most of the global crises that we're thinking about in silos that are all connected. And I'll just sort of quickly lay them out, and it'll be good to go over them in detail as we go through the podcast, but clearly food is the biggest driver of chronic disease affecting six out of 10 people. It's clearly the biggest driver of economic stress in this country, in our $22 trillion debt. One-third of all Medicare expenses are for diabetes alone, and one-third of all of our federal budget is Medicare. If it was a company, it would be the biggest company in the world at a trillion dollars [laughs] annually. It's also driving climate change. A food system end to end, and we'll unpack it, is the number one cause of climate change, more than fossil fuels. It's causing massive environmental degradation, including loss of biodiversity, plant species, animal species, livestock species. It's driving social injustice in many ways through how it affects our kids' cognitive development and ability to learn, and there's huge academic achievement gaps. It leads to massive health disparities 'cause poor communities are more affected by these foods and are more targeted by them. It affects even behavior, violence, conflict. We see such a divisive society today. Why do we have that? 40 years ago it wasn't like that. And I think our diet has changed so radically, not just in the last 10,000 years, but in the last 40 years with the advent of massive amounts of ultra-processed food, and that's driving cognitive behavioral issues, violence, suicide, conflict, and even threatens our national security 'cause 70% of military recruits are unfit to fight and are rejected. So we've got these global problems that are affecting us. And then of course that leads to massive political instability because of our food system, of climate refugees, because the food system is driving climate. What is that gonna do? I mean, think about it. We had a million Syrian refugees, and that created a global crisis. The UN estimates that within a decade or a few decades we're gonna have 200 to a billion climate refugees. That's unimaginable. So how do we begin to sort of grapple with these problems and think about the solutions? And the beauty is, since they're all connected by food, they can all be solved by going to the root and fixing our food system. And that's the leverage we have, which is so exciting to me because it's not, oh, doom and gloom, the world's ending. It's yeah, we identify the problem, how it's connected, think of it as a system, and then be able to solve the problem by going to the root and dealing with these issues collectively.

3. 8:59 – 18:33

   Is Food Awareness Lacking? Processed Food, Insulin and the Brain

   1. PAPeter Attia8:59

      So which one of those would you like to start with? Would you like to start with sort of the impact of processed food on health, which is probably not one that we need to spend a lot of time on. I don't think there's many people that would debate that. Are there?

   2. MHMark Hyman9:11

      Oh, [laughs] you'd be surprised. I mean, there's $12 billion spent by the food industry on nutrition, quote, research that confuses peoples, muddies the waters, declares that Gatorade is great sports drink and that sugar doesn't cause obesity, and that... I mean, I could go on and on. People are confused, and then certainly our political leaders certainly don't get this. And I think when you think of our healthcare system, it certainly doesn't get that food is medicine.

   3. PAPeter Attia9:37

      Do you really think that political leaders, I know you've spent some time interacting with said folks, do you really think they don't get it, or do you think that they're just in a difficult position, which is how do you appease all of these constituents? On the one hand, a lot of the bills get paid by the entities that endorse these agendas, and on the other end, they probably have empathy for the damage that's done. I mean, do you actually think there's a lack of awareness?

   4. MHMark Hyman9:59

      I do. I mean, forget about politicians. Academics, doctors, health professionals have no clue how powerful food is to heal disease. I mean, they get that if you eat too much you're gonna get fat, right? But that's about it. Or if you eat too much carbs, maybe now maybe you'll get diabetes. But not even that. I mean, the American Diabetes Association is still telling people to eat a lot of carbohydrates. [laughs] I think we have a real lack of understanding of the power of food to cause disease and the power of food to cure disease. And so there's a real gap in that. I think it's starting to become in the public awareness that food is medicine, that there's a Food Is Medicine working group in Congress. Cleveland Clinic, where I work now, has a Food Is Medicine initiative. There's hospitals around the country that are talking about this. It's more the exception than the rule. So I, I do think people don't understand the magnitude. I mean, if you say to a politician, "What is the biggest killer on the planet?" They're gonna go, "Smoking or lack of exercise or whatever." [laughs] Maybe they're gonna get that it's being overweight, but they don't get that it's the ultra-processed food that kills more people than smoking, violence, wars, everything else. So I mean, I think if there was a disease like Ebola or Zika that was killing 11 million people a year, I mean, people would be talking about it, and it's just not in the conversation that's happening. Even, for example, Medicare, Medicare for All. Has anybody said the reason we have such trouble with Medicare is because people are eating bad food, and that we need to fix the food? They're, "No, let's get Medicare for All. Let's repeal Obamacare." I mean, those aren't the solutions. It's like that would be a disaster if we had Medicare for All because everybody's sick, and it's just gonna bankrupt the country unless we fix why they're sick in the first place.

   5. PAPeter Attia11:34

      What do you think it is about processed foods that are particularly difficult metabolically for our species?

   6. MHMark Hyman11:40

      Historically, we ate 800 different species of plants, a lot of roots and tubers, 100 grams of fiber a day. Now the average American eats about eight grams, which is nothing. And we had, you know, a very complex diet, which was very difficult to obtain sugar. You got lucky if you found a honey thing. I mean, I remember this, reading this article about these Nepalese honey hunters where they have to climb up 100 feet into the trees with a burning bush. And it's [laughs] like if you had to climb a tree with a burning bush to get a cookie, you probably wouldn't eat so many cookies. [laughs] And I think it's just become so easy for us to have this abundance of sugar and flour and refined foods. And the good intentions that were there in the ... post-war period that led to the development of industrial agriculture were to provide a lot of starchy, abundant calories to feed the hungry and solve real hunger issues around the world. And I think that was a good thing, but there was unintended consequences of the intensive chemical agriculture that we're using, intensive fertilizer use, and the commodity products, which are wheat, corn, and soy, and rice in some other areas of the world, that are driving this obesity epidemic. So our biology isn't adapted to eating highly refined foods, which essentially is most of what we're eating now. It's 60% of our calories, and every 10% of your calories that's ultra-processed food, your risk of death goes up by 14%. So [laughs] it's not, it's not something our bodies like, it's not something we're adapted to. And then of course, there's all the other stuff in there that may be problematic, like refined soybean oil or food additives or chemicals that are in our food that have all sorts of metabolic consequences like BPA or other metabolic toxins that are consumed within the food we're eating. So it's complicated. It's, it's sugar and starch and flour are the big drivers, but there's all these other components, and then who knows what's happening with pesticides and glyphosate affecting our microbiome. I mean, it's such a complex web of different factors that alter our metabolic pathways that drives disease.

   7. PAPeter Attia13:29

      And just kind of digging into this a little bit more, how much of it do you think is the energy balance and the dysregulation of energy balance that comes from these processed foods? So there are certainly people out there that would argue that part of the trouble with processed food is it sort of hijacks our energy homeostatic systems. So if you put a human in an environment akin to what our ancestors evolved in, there was enough auto feedback and regulation that you sort of maintained energy balance. You would eat more when you needed to eat more. You would eat less when you needed to eat less. One of the drawbacks of processed food, if not the biggest drawback, is it sort of hijacks that system, and if you cut the feedback out of that loop, they're eating when they don't really need additional energy. Do you think that's the biggest issue, or do you think it's the void of nutrient that then creates sort of an abundance of junk calorie as the body search for nutrients?

   8. MHMark Hyman14:22

      Yeah.

   9. PAPeter Attia14:22

      Do you think it's this loss of fiber?

   10. MHMark Hyman14:24

       Probably both of it [laughs] . I mean, kids who are iron deficient eat dirt. It's called pica, and it's well known that if you're looking for nutrients, you're just gonna eat anything. So I... That may be part of it. I think the main part of it is, is... And you've talked about this a lot, is the, is the ways in which these refined starches and sugars affect your biology. They raise insulin, which has a cascading effect of fat storage in your belly, which is a dangerous fat. It leads to increased hunger, affects your brain chemistry. It actually locks the fat in the fat cells so they can't get out, so it gets like a one-way turnstile. It gets in, but can't get out, and it slows your metabolism. So you're in this cascade of vicious cycles. So you talked about energy balance, and I think most people, when they hear that, think about calories in, calories out. I think, uh, you know, I both understand that it's more complex than that, that there's different effects of food on your biology independent of calories. In a lab, all calories are the same. 750 of Coke, 50 calories of Coke is the same as 750 calories of broccoli. But to get 750 calories of soda, you'd have a Big Gulp, which is 40, 60 teaspoons of sugar, and 750 calories of broccoli is 21 cups of broccoli with 35 grams of fiber and no sugar. Profoundly different effects on your biology, same calories. But we don't really appreciate that in medicine, and most of our current thinking about weight loss is focused on calories in, calories out. It suits the food industry 'cause they go, "Well, it's all about moderation. There's no good or bad calories. It's exercise more, eat less." Like, that's their mantra, and it serves them to sell more of their junk food as long as it's part of a quote, "balanced diet." But the truth is that these foods affect our brain chemistry and create all sorts of metabolic issues that are incredibly difficult. You know, I was chatting with my friend David Perlmutter, who just wrote a book called Brainwash, where he's talking about... He's a neurologist. Where the prefrontal cortex and the amygdala are uncoupled with an inflammatory diet, which is what we're eating, most of us in America and around the world. What that means is that the adult in the room, the prefrontal cortex, which is the decision maker that understands the consequences of its behavior, is not talking to the impulse part of your brain, the, the fight or flight part of your brain, the pleasure-seeking part of your brain. So there's this disconnection, and your decisions are not in your best interest, and that's why we have so much bad behavior and conflict and so forth 'cause we're eating this inflammatory diet that's literally dysregulating our brain. So the adult in the room is asleep.

   11. PAPeter Attia16:48

       Say a bit more about that. What is it about the diet that could be inflammatory, and how could one measure the consequences of that? Because is it possible that two people could consume the exact same subpar diet and have very different inflammatory responses?

   12. MHMark Hyman17:03

       Yeah, sure. I mean, there is a... Listen, if people are eating junk food and processed food, their metabolism, whatever they look like, whether they're overweight or not, is not gonna be as good as someone who's eating a whole foods, unprocessed diet. But there is a lot of genetic variability. But you can actually measure inflammation in response to diet through various biomarkers. There's, there's new panels of, of sort of looking at the inflammasome, which is really cool. It's more than just a CRP or a sed rate, which are blood tests you can do to look at inflammation. And the ways in which it causes it, particularly we're talking about insulin, it also drives this visceral belly fat, which is a basically metabolic fire that starts [laughs] in these cells that spreads inflammation throughout the body. So just the nature of eating sugar and processed food drives up inflammation.

   13. PAPeter Attia17:46

       If a patient has normal biomarkers through the lens of all of those things, their interleukins and C-reactive protein, fibrinogen, if all of those things were normal, would you still think that there's potentially an inflammatory response that's coming through their diet?

   14. MHMark Hyman18:02

       The question is, how sensitive are our, are our current tools for assessing the immune response to food? And I think they're pretty crappy [laughs] . And I think there's more and more lab diagnostic measures that are coming about that are gonna help us look at that. I was talking to someone from the Buck Institute of Aging last week, and he said, "Yeah, there's a r- whole new panel of-" Inflammatory biomarkers that are much more specific and much more sensitive and enable us to really look at the inflammatory response that's happening in the body related to aging or diet or anything else.

4. 18:33 – 27:24

   Gut Health, Leaky Gut and the Microbiome

   1. PAPeter Attia18:33

      How much of that inflammatory response do you think is mediated by permeability in the gut specifically versus... 'Cause I have to be honest with you, Mark, this is an area that I've never understood. It gets talked about a lot. There's lots of hand-waving.

   2. MHMark Hyman18:47

      Mm.

   3. PAPeter Attia18:47

      Sometimes I see it certainly in patients. I mean, when we see subtle elevations in fibrinogen and/or C-reactive protein or at least two of the interleukins, we usually put patients on elimination diets till we find out what the culprit was, and, and we're trying to basically titrate symptoms versus these biomarkers. But I find that to be staggeringly crude.

   4. MHMark Hyman19:07

      Yeah.

   5. PAPeter Attia19:07

      And to your point, I don't know what we're missing, and I don't know what's true, true and unrelated. And then, of course, it gets back to the question of what's the mechanism of this? And so one potential mechanism is that the permeability of the gut is altered, and if bacteria that could normally not translocate across the lining of the gut do so, that would certainly be a reason for inflammation. A, do you think that that's-

   6. MHMark Hyman19:33

      Yeah

   7. PAPeter Attia19:33

      ... a prevalent source of it?

   8. MHMark Hyman19:35

      Oh, yeah. Huge. I mean, all our guts are messed up, and there's a whole phenomena called metabolic endotoxemia. It's been well described and studied, and the fact that your gut microbiome plays a huge role in regulation of weight independent of calories. So they literally can take the poop out of a skinny rat into a fat rat and make them skinny and vice versa. They've done it in humans. I think the way in which it works is that your microbiome is regulated by what you eat. A lot of fiber, prebiotics, the phytonutrients, the phytochemicals, the polyphenols all affect the quality of the garden you have growing inside of you. And you can get a lot of nasty weeds in there, and when that starts to happen, they start to disrupt the gut microbiome. They disrupt the lining of the gut. They cause what we call leaky gut on top of everything else, which is our low fiber diet, high sugar, processed food increases bad bugs in the gut, antibiotics, acid blockers, anti-inflammatory drugs, hormones all screw up our gut. And of course, toxins, environmental toxins. Glyphosate is super toxic to the, uh, microbiome. And so all these things that we know and those things we don't know are disrupting the microbiome, and when that happens, the lining of the gut becomes slightly damaged. The biofilms get disrupted, and you end up absorbing bacterial products, bacterial toxins, as well as food antigens, things that we should normally tolerate, that start to create an inflammatory response. And 60% of your immune system is in your gut. And you know what's really striking to me, Peter, is, you know, sort of the discovery that many of our metabolites in our blood, probably a third or more, may be from microbiome. In other words, when you check your blood tests, we're checking human analytes. But when you actually start to do s- more sophisticated metabolic testing and the metabolome, you find all these things that aren't human that come from bacteria that are regulating your immune system, that are activating your, your mitochondria, that are regulating your DNA, that are affecting your brain chemistry, affecting your mood, affecting all sorts of diseases. So this is, like, a really exciting area, and I think getting people's microbiome sorted often happens when you shift to a whole foods, plant-rich diet. Not plant-based, but plant-rich.

   9. PAPeter Attia21:36

      How can one measure these things? I mean, one of the things that I've found difficult is finding valid commercial tests-

   10. MHMark Hyman21:43

       Mm

   11. PAPeter Attia21:43

       ... that can enable patients or physicians to understand if they're in this sort of regulated state. I mean, I... to me, the black box is when someone comes in and says, "I have gut dysbiosis," or, "I have poor gut health." And they may be right, but it's very different than someone who says, "I have type 2 diabetes," where we have-

   12. MHMark Hyman22:04

       Mm-hmm

   13. PAPeter Attia22:04

       ... really clear ways to diagnose it.

   14. MHMark Hyman22:06

       Yeah.

   15. PAPeter Attia22:07

       We kind of have some understanding what the pathophysiology is here. This is much more squishy, and frankly, there's an enormous disconnect between people like you and sort of the stuffy, upper-lipped gastroenterologist who makes his or her living in the gut but doesn't necessarily sort of see the problem this way, right?

   16. MHMark Hyman22:31

       Mm.

   17. PAPeter Attia22:31

       They're looking at different problems.

   18. MHMark Hyman22:32

       You know, honestly, Peter, the evidence has become so overwhelming that mainstream medicine is bought into this whole microbiome story. And Cleveland Clinic, for example, they're studying the microbiome in heart disease and arthritis and cancer, and it's like they just got a $12 million grant from the NIH to study the microbiome in heart disease [chuckles] which is pretty amazing. And yet-

   19. PAPeter Attia22:51

       And yet if you go to your doctor and say, "Is there any evidence that I should be on this probiotic or this?"

   20. MHMark Hyman22:56

       Yeah, they don't know. The clinical translation is challenging. So I'm somebody who's been practicing m- functional medicine for 30 years, and the gut has been the number one focus of our ability to really move diseases in a powerful way. And they used to call me Dr. See Every Poop 'cause I've done literally tens of thousands of stool tests, and I've looked at all the different ones. And you're looking at a moving target. You're looking at an ecosystem. And so we look at a lot of different biomarkers to assess what's going on in the gut. Is there adequate pancreatic enzyme function? Looking at pancreatic elastase. Are there absorption issues looking at fecal fats? Are there inflammatory markers in there? For example, calprotectin or eosinophil protein X, which are standard markers to look at inflammation in the gut. What's your IGA levels, your antibody levels? And then we look at indicators of dysregulated gut microbiome, such as short-chain fatty acids, which are essentially produced by good bacteria that are the fuel for the gut and have anticancer properties, anti-inflammatory properties. And those can be low, like butyrate, and we can see that. Then we look at sort of different microbiome characteristics using DNA or PCR analysis through the microRNAs. And that allows us to see, for example, if there's low Akkermansia, which is a very important bacteria that regulates your biofilm, that regulates immunity, that's linked to autoimmune disease and cardiometabolic diseases, cancer treatment therapy risk. So we can modify those things. And then we l- we look at culture. We look at other kinds of testing for parasites. It's PCR testing. So there's a lot of things that we look at. And get a gestalt. It changes over time, but you can see if someone's got a good gut or a okay gut or a terrible gut.

   21. PAPeter Attia24:34

       So if you take a patient who is both symptomatic and by some constellation of tests has a, quote-unquote, "bad gut," what percentage of those are, quote-unquote, "fixable by subtraction," so you take things out of their diet, or addition, you add more of certain food to their diet, or the third choice would be intervention-based, where you have to use sort of supplements and-

   22. MHMark Hyman25:03

       Antibiotics. Right

   23. PAPeter Attia25:03

       ... yeah, antibiotics or probiotics or things like that. So that's an oversimplified look at this, but if there's three levers you have, which means take something out of their food, add something to their food, or add a different type of food, or then use a, a bigger gun like a supplement, how do those tools fit into this treatment?

   24. MHMark Hyman25:20

       Well, functional medicine has a very organized framework for addressing gut dysfunction called the 5R Program. The first R is to remove. Remove things that shouldn't be there, whether it's foods that are triggering a problem like gluten, which affects permeability, or dairy, grains for some people. Remove bad bugs, so if you have a parasite. I mean, I just had a patient who had a common parasite. She had stomach issues for 20 years. She was always waking up feeling like crap. I gave her Alinia, which is an antiparasitic medication. Six days she says she's never felt better. [laughs] So sometimes you just need to do that. And maybe bacterial overgrowth you have. Maybe there's yeast overgrowth. Uh, you need to address that, and so that's the first step. The second step is to replace what might be missing, so fiber, prebiotics, enzymes, various things that may be s- needed to support the system.

   25. PAPeter Attia26:07

       And sometimes that's just through food, but sometimes that's also supplements?

   26. MHMark Hyman26:11

       Sure. You can take prebiotic fibers and prebiotic foods like plantain and artichokes and all kinds of different foods, and then reinoculate, which would be provide probiotics where necessary, and that can be through foods like fermented foods or can be through probiotic supplements. And those are... That's still sort of a Wild West, but there are things out there that really work. And then to replace what's missing, so maybe there's nutrients that the body needs to heal, things like glutamine, vitamin A, fish oil, maybe even things like butyrate, and replace things that might be needed for healing the gut, like polyphenols, for example, are a wonderful thing you can get from food, pomegranate, cranberries, green tea, et cetera, that have powerful, great effects on the microbiome that we didn't really appreciate. So we thought it was prebiotics and probiotics, but it turns out the polyphenols in plant foods are super helpful for the gut microbiome. And then the last R is to restore, which means to sort of restore your nervous system because you need to sort of deal with the way in which your stress level and everything affects your gut and your gut microbiome. You can get a leaky gut just from stress, for example. So working on all those in a systematic way that's personalized is really the approach. There's no sort of, "Oh, take this or do that and it's gonna work."

   27. PAPeter Attia27:16

       So bringing it back to what you started this point with-

   28. MHMark Hyman27:19

       Yeah, we got down the rabbit hole.

   29. PAPeter Attia27:20

       Yeah, yeah. Well, it was just...

   30. MHMark Hyman27:21

       Poof. [laughs]
5. 27:24 – 31:09

   Chronic Disease Statistics and How Other Countries Respond

   1. PAPeter Attia27:24

      You've laid out basically the enormous health consequences of eating poorly.

   2. MHMark Hyman27:28

      Yeah. Six out of 10 Americans have a chronic disease. Four out of 10 have two or more. In 10 years, 83 million Americans will have three or more, which is bankrupting our country. And one in two Americans has prediabetes or type 2 diabetes. These statistics are staggering. 75% of us are overweight. Most states now have 40% obesity rates. I mean, when I graduated medical school, there wasn't a single state that had a 20% obesity rate. Now everybody's got 30 or almost 40. These are massive things that are happening at a scale that we've never seen in human history, that we haven't been equipped to deal with, that we haven't really thought of how to address, and it's like we're trying to scramble to fix it.

   3. PAPeter Attia28:00

      And you certainly in the book talk about how there are racial differences in terms of the susceptibility to the bad policy, which we'll get to down the line. Is there also sort of racial variability and discrepancy in the actual physiology in response to this?

   4. MHMark Hyman28:18

      There's clearly economic health disparities. There's... Health disparities are a result of targeted marketing from the food industry that are driving various problems. There are obviously the food swamps and the food deserts and food apartheid. All of that is true. But genetically, there's certain segments of the population that are much more likely when they are in an abundance of sugar and flour to get diabetes and obesity, and that includes Native Americans, probably the worst, African Americans, Latinos, and of course the people from the South Pacific, and even Indians from India. Chinese and Asians often are at much higher risk even at lower body rates. So this is really a global problem, and that's why we're seeing 80% of the world's type 2 diabetics in the developing world.

   5. PAPeter Attia29:05

      Is there any country or government in particular that seems more attuned to this problem than the American government?

   6. MHMark Hyman29:11

      Uh, many. [laughs] In fact, most. [laughs] Chile, for example, was seeing massive obesity rates in kids and adults. Healthcare costs staggering for that country. And again, we're inundated by all the processed food from the food industry and soda industry. And it took a doctor who was elected to the Senate, who was vice president of the Senate, and a doctor who was elected president, Michelle Bachelet, who's a pediatrician, to stand up and say, "Enough," and put in a set of regulations to try to stop the onslaught of these conditions on their population driven by the food industry. So they did a number of things. One, they put in an 18% soda tax. Two, they put on warning labels on the front of bad food, so on your Frosted Flakes cereal box there's black warning labels. They eliminated any cartoon characters from all the kids' food, so no Tony the Tiger, no Toucan Sam on Froot Loops. [laughs] They eliminated any processed food from schools, and they made the school lunches healthy. They eliminated any advertising on junk food from 6:00 in the morning till 10:00 at night so kids wouldn't see it. And then they measured these outcomes based on that, and they've seen tremendous improvements. And it was surprising to me. I talked to Barry Popkin who, who... from UNC, who worked with them on developing these, and Michael Bloomberg I think gave them $30 million to assess the impact and so forth, so they're studying this. And even more than the 80% soda tax, the restriction of food marketing and the warning labels and so forth had a fourfold increased benefit compared to the soda tax [laughs] which is being heavily fought here. There's incredible opposition to any limiting of marketing to kids. And, you know, they're saying it's the breach of the First Amendment and free speech and so forth. The First Amendment doesn't abdicate our responsibility to protect our children. If a foreign nation was doing to our kids what the food industry is and our government is through its policies, you know, we'd go to war to protect our kids. And we just sort of sit back and let this happen.

6. 31:09 – 38:20

   The Tobacco Playbook and Industry Influence

   1. PAPeter Attia31:09

      It's interesting. I'm not a constitutional expert, which would be such an overstatement anyway.

   2. MHMark Hyman31:12

      [laughs]

   3. PAPeter Attia31:13

      I know nothing about the Constitution.

   4. MHMark Hyman31:14

      There is a Constitution.

   5. PAPeter Attia31:14

      Yeah, I know.

   6. MHMark Hyman31:15

      There's a few... [laughs]

   7. PAPeter Attia31:16

      But here, my understanding of the First Amendment is provided the advertising is, quote-unquote, "honest," it is constitutional. Is that-

   8. MHMark Hyman31:23

      Mm-hmm. Yeah.

   9. PAPeter Attia31:24

      Is that... And, and that's a gray area because-

   10. MHMark Hyman31:26

       Yeah

   11. PAPeter Attia31:26

       ... what con- if you say Fruit Loops are part of a healthy breakfast, how do we know that's honest? I can't help but think about the analogous situation, which is tobacco. And what I think most people don't know, and it- it's possible I'm wrong, but I believe everything I'm about to say is correct, 'cause at one point I knew this story well. When the surgeon general came out with his declaration of the harm of tobacco, which was in about the mid-'60s, and that was the peak of smoking in the United States. I believe something to the tune of 50, 55% of people over the age of 18 smoked cigarettes at the time the surgeon general came out and said definitively, "Cigarettes are causing lung cancer." A number of things took place that got us to where we are today, which is somewhere below 20% of people. Last time I looked, it was about 18% of adults smoked.

   12. MHMark Hyman32:14

       Yeah, a lawsuit is what worked. [laughs]

   13. PAPeter Attia32:16

       Well, but here's, here's a big one. A big one was the removal of advertising.

   14. MHMark Hyman32:21

       Mm-hmm.

   15. PAPeter Attia32:22

       But here's the part that I was surprised to learn. It was voluntary on the part of tobacco. In other words, the tobacco industry was not banned from advertising. What the policymakers said is, the law is now that every time a tobacco commercial airs, it must be followed by an anti-tobacco commercial. So they didn't ban tobacco. They added anti-tobacco-

   16. MHMark Hyman32:48

       So every time you have a McDonald's commercial, you say how bad the food is, it's gonna kill you, right? I think that's not a bad idea.

   17. PAPeter Attia32:52

       Well, what's interesting is the anti-tobacco ads were so devastating that the tobacco industry voluntarily withdrew its ads. They were getting hurt so bad by the anti-tobacco ads that they said enough is enough, and that's... to this day, we don't have tobacco ads on television. So, A, someone needs to fact check that to make sure I have that story correct, but I, I believe it is correct, and secondly, if it is, it at least suggests another angle to this problem, which is rather than go down the First Amendment fight, maybe, great, okay.

   18. MHMark Hyman33:24

       I love that idea.

   19. PAPeter Attia33:25

       Keep all the commercials you want on, but we're gonna come up with something different. Now, of course, it's much harder.

   20. MHMark Hyman33:29

       Or like a, like a drug ad. You can eat this soda, but it's gonna cause obesity, diabetes, cancer, dementia, and kill you early. [laughs] Fine. Maybe that's a good idea.

   21. PAPeter Attia33:39

       Yeah, and of course, tobacco is the easiest thing to demonize because you just show somebody, you know, a hole in their throat after they've had throat cancer or a black lung or a corpse. I mean, there's so many grotesque ways that you can make the point that are more difficult with food. But-

   22. MHMark Hyman33:51

       The limp cigarette. [laughs]

   23. PAPeter Attia33:53

       Yeah, yeah, exactly. But nevertheless, I've always found that to be a very powerful point because it's true that eventually taxes were introduced into tobacco, and they turned out to be quite powerful, and additional measures. In 1989 was also a big step when secondhand smoking became well enough understood that they banned tobacco in airplanes and things like that. But I wonder how much of a playbook there is there on tobacco to copy.

   24. MHMark Hyman34:20

       Well, there is, but guess what? The food industry is copying tobacco's playbook to slow or stall or stop this. And one of the most egregious things was something they've picked up recently, which is from the tobacco playbook. There have been soda taxes that passed predominantly in the 2016 election in California and other states, and the soda industry is vehemently opposed to this. They passed in California. They, they spent about $38 million avoiding these taxes, against these taxes. And Bloomberg and the Arnold Foundation spent about 20 million, and it didn't pass. I mean, it did... taxes did pass, and it freaked out the soda companies. So the American Beverage Association essentially went and tried subversive tactics. So they went to California, where the most of these taxes were passed, and they put in a ballot measure which was designed to prohibit local taxes unless there was a two-thirds majority, meaning you couldn't fund your school, your police department, your fire department, your cleanup, road cleanup, unless there was a two-thirds majority. That would hamper local governments dramatically, and they spent millions of dollars pushing this ballot measure, even though it had nothing to do with food. And at the last minute before the election, they went to Governor Brown, who's probably the most liberal governor in the history of the United States, Governor Moonbeam, and they said, "Look, we'll pull this measure, but you have to put in place a preemptive law that prohibits any future taxes on soda or junk food." [laughs] And it happened all behind closed doors, completely co-opted the government. It pressured them to do something that they didn't want to do, and they're doing this in state after state after state. And this is exactly what tobacco did. So we could say, "Oh, they're not bad actors, they're trying to do things that are good. They're making water. They're making low sugar beverages." They know exactly what they're doing, and they have an existential threat, and they're trying to fight it in every way possible. And that's just one example.

   25. PAPeter Attia36:14

       There's another funny example, which is an initiative called the Global Energy Balance-

   26. MHMark Hyman36:19

       Balance Network. Yeah

   27. PAPeter Attia36:20

       ... Network, GERN or something like this, right?

   28. MHMark Hyman36:22

       Yeah. Yeah, yeah.

   29. PAPeter Attia36:23

       Anahad O'Connor, I believe, played a pretty important role at The New York Times exposing this for what the sham it was. Do you wanna tell people a little bit about that?

   30. MHMark Hyman36:31

       Sure. The Global Energy Balance Network. So the whole idea of this is that energy balance is the mantra of the food industry, and what that means is all calories are the same. Soda calories, broccoli calories, no different. So it's just a matter of balance, calories in, calories out, moderation, et cetera, et cetera. And so they essentially, Rona Applebaum, who was one of the top VPs at Coca-Cola, put together a strategy because she saw the vilification of soda and all these horrible outcries against sugar that were unmet by enough aggressive force from the sugar industry and the soda industry. And she said, "Look, let's start this something called the Global Energy Balance Network." She found a bunch of scientists who she could co-opt, paid them lots of money, funded their research to actually promote the idea that all calories are the same. Like James Hill, for example, who was part of an NIH study, legitimate scientist, but completely co-opted. And they funded about 20 million, and they built the website, they organized this messaging and the talking points, and they did it all sort of behind the scenes. And when there was discovery, and so they FOIA, Freedom of Information Act, it was a public university, we got all the data, it was really clear how they were behind the scenes manipulating all this to fund literally millions of dollars of corrupt research to prove their point and tell a different story. And then as soon as the New York Times article came out, overnight it was disbanded saying it's run out of resources. I mean, come on, Coca-Cola has, what? Billions and billions [chuckles] of dollars of sales every year. They have plenty of resources. And, and the whole thing collapsed because of investigative journalism. But it just goes to show how these food companies are co-opting scientists, co-opting professional associations, co-opting social groups, co-opting the government, putting forth front groups, and spinning all kinds of misinformation in a very coordinated strategic strategy to disrupt public opinion, to confuse the public, and to allow their shenanigans to keep going.

7. 38:20 – 42:07

   Individual Action Versus Structural Change

   1. PAPeter Attia38:20

      Is the opposition to this industry that you can't fight this at the individual level? In other words, it has to be solved structurally because of the economic disparity? Uh, let me ask the question another way. Why not focus all of the efforts on helping people understand so that they can make the informed choice, which is if you have to have a Coke, make it a Diet Coke.

   2. MHMark Hyman38:44

      That may not be as good either. [chuckles] Yeah.

   3. PAPeter Attia38:47

      Yeah, but using that as an example, right? But in other words, do we really believe that this has to be solved at the level that seems almost unwinnable, which is fighting an unethical opponent with infinite resources? I mean, that's a very dangerous combination.

   4. MHMark Hyman39:03

      Yeah. Well, look what happened to tobacco. I mean, think about this country.

   5. PAPeter Attia39:06

      But you don't need tobacco to live, right? The advantage that you would have as an anti-tobacco crusade person is the ground is not muddied by the notion that tobacco is part of a group called food that you need to live.

   6. MHMark Hyman39:23

      Although it depends how you define food. [chuckles] Are Froot Loops food? I don't think so. I mean, they're a highly industrialized processed product that-

   7. PAPeter Attia39:30

      But they still fit into this bucket of food.

   8. MHMark Hyman39:32

      They do. They do.

   9. PAPeter Attia39:33

      And therefore they sort of, they ride a little bit of the coattails of... They're still riding on the, "Hey, we're putting B vitamins in these things, and they're fortified," and da, da, da, da, da, all this other sort of nonsense.

   10. MHMark Hyman39:45

       So what you're asking is, do we need just a grassroots effort to focus on individual choice and action, or do we need a public policy change?

   11. PAPeter Attia39:52

       Well, and I wouldn't even ask it as either/or, because the obvious answer to that would be you could do both. I guess what I'm getting at is, would you be better off putting more effort into sort of the grassroots campaign?

   12. MHMark Hyman40:02

       It's complicated. When you think of the big changes that happened in policy in this country, the abolition, I mean, there were a few people running people on the Underground Railroad and pushing for ab- abolition back in the early 1800s, and it took decades and decades for change. But eventually, our entire agricultural and economic system collapsed that was founded on slavery, and it was reimagined and rebuilt. And I think, look at women's rights, same thing. Gay rights, civil rights, all those things are, are things that were really starting on the periphery through grassroots movements, but had to push Congress to make different laws, and I think that's what has to happen. But I think we have to be smart about it as well. I mean, yes, consumers make a difference. That's why we're seeing General Mills commit a million acres to regenerative ag. It's why we're seeing big companies like Nestle reformulating their products, and why there's sustainable regenerative ag, uh, initiatives at Danone. I mean, these companies are starting to see that the consumers want different things, and they're starting to shift their product lines. They're starting to shift their focus on how their supply chain works and where they get and source their products through regenerative agriculture. So I, I do believe that the individual has a huge impact through their vote with what they're eating, their fork, with their wallet, and of course, even with their vote and their voice. And I think we don't use the latter enough. That has to all happen. I... And unfortunately, I do believe that the individual's voice matters. Yes, we can all have compost piles. We can have community gardens. We can have a garden in our backyard. We can choose to eat regenerative meat. We can be like you, Peter, and go hunting our wild deer. I mean, I'm [chuckles] like, I'm jealous. But that alone is not enough, 'cause there are structural problems that are not solvable unless we change how we grow food, what we grow, how we process, distribute, market, sell, eat, and waste it. And if we don't deal with every aspect along that food chain, we're really not gonna solve this problem. And I... We haven't really talked about it yet, but things like climate change are, are an increasingly important part of the conversation about food, and that is something that's just not in the radar. Like, how does fixing food fix climate? It does. It's actually one of the only ways to really reverse climate change.

8. 42:07 – 46:39

   Soil, Carbon and the Food System's Role in Climate

   1. PAPeter Attia42:07

      Let's talk about that.

   2. MHMark Hyman42:08

      Some people don't think climate change is real. They call it weather. I mean, whatever [chuckles] you wanna call it, there's stuff happening. We're having a million acres flooded in the Midwest, cropland that's destroying farmers' livelihood. We're seeing, you know, increasing weather patterns of hurricanes and wildfires in Australia and California. We're seeing melting of three trillion tons of ice from the Antarctica. These are just undeniable facts.

   3. PAPeter Attia42:30

      Can I give you my two cents on this?

   4. MHMark Hyman42:31

      Yeah.

   5. PAPeter Attia42:31

      I think the term climate change, global warming, were sort of, in retrospect, not the best ways to describe this phenomenon, and climate volatility would've been a better way to-

   6. MHMark Hyman42:43

      Yeah

   7. PAPeter Attia42:43

      ... have explained it because, one, it's actually more accurate, and two, it provides a better explanation for what you're describing. Because when you say global warming is a problem, well, then how do you explain a record cold year? It's the high highs, the low lows, and the frequency with which they're cycling, both through, you know, hurricanes, fires, things like that, so I wish we could have gone back in time and said, "Look, the, the problem is climate volatility."

   8. MHMark Hyman43:10

      Yeah, instability. 2019 was the hottest year on record, other than 2016, in human history. So it... And all of us can feel it. We know it. And I think... So the question is why is it happening, and what's the cause of it? And clearly most people think it's fossil fuels, and taking up all the carbon that was stored in the Earth's crust, and burning it, and releasing that carbon through fossil fuels. And that's a big part of it, maybe a third. But half of it comes from our food system through all sorts of different mechanisms. One, deforestation, so you lose the carbon capture from the trees. The soil destruction from destructive agriculture, which we have, which essentially is a method of industrial growing of food that tills the soil, which disrupts the normal organic matter, causes soil erosion, releases carbon in the environment. It also, when you look at the soil as an issue itself, it's probably the biggest cause and the biggest solution to fixing climate change. And most people don't think about that. They think about oil, not soil. But a third to 40% of all the carbon in the atmosphere today that's causing climate volatility is from the loss of soil. That's a staggering amount.

   9. PAPeter Attia44:20

      So explain how that's the case.

   10. MHMark Hyman44:21

       Yeah, I will. The soil, when it's alive and has living matter and carbon in the soil, organic matter, which is carbon, it can hold three times the amount of carbon that's in the atmosphere today, which is a trillion tons of carbon. It can hold three trillion tons. [laughs] The UN estimated that if we take two million of the five million degraded hectares of land around the world, and we intensively use regenerative agriculture, which I'll explain in a minute, and restore the soil, we could stop climate change and delay the progression for about 20 years, and it would cost $300 billion, which is essentially what we pay every year for diabetes in America through Medicare, and it's basically the amount of budget for the total global military spend for just two months, or 60 days. So this is a solvable problem. And the reason that the soil is such an issue is that it basically takes, when the grasses are on there and the plants are on there, it sucks the carbon out of the environment.

   11. PAPeter Attia45:18

       Can you explain the difference between soil and dirt?

   12. MHMark Hyman45:20

       Yeah. Soil is alive. Soil has all kinds of bugs in it, mycorrhizal fungi. It has all kinds of bacteria. It has all kinds of carbon in it from the plants, and it holds a huge amount of water. It can hold, for example, for every 1% organic matter can hold 27,000 gallons of water, which would prevent floods and droughts, which it does, and creates more resilient farms.

   13. PAPeter Attia45:41

       Explain that again.

   14. MHMark Hyman45:42

       When you have soil, it's like a sponge. So when it rains, instead of the, the rain running off or running through, gets stored like a sponge in the soil so that you don't need to irrigate, that you don't have to worry about floods and droughts. Now, the reason we had so much of these floods and these flooded farm fields in the Midwest was because these soils are just dead, and they have to do more and more fertilizer. So we're killing the soil by using fertilizer, by pesticides, herbicides, tilling, not using cover crops, not using crop rotations, not using animals in an integrated way to actually create more soil. And everything we're doing is just destroying the soil. When you have alive soil, when you have the, the ability of these plants to suck out carbon dioxide, 'cause they breathe carbon dioxide. That's what plants do. They breathe out oxygen, which we breathe, and it's a vicious... I mean, a, a beautiful, virtuous cycle. And the carbon dioxide from the atmosphere gets pulled through the plants, into the soil, and stays there. And you can build soil simply by using this technology and integrating animals that poop and pee.

9. 46:39 – 54:16

   Fertilizer, Energy Use and Crop Yields

   1. PAPeter Attia46:39

      So I don't think I was aware of that. I'll put my ignorance on full display. I always assumed that the majority of the carbon that came in, that the plant brought in through the photo cell, was for carbon fixation, which was creating biomatter. So in other words, carbon and oxygen are coming in in the form of carbon dioxide. That carbon is being fixated to other carbons. That's how we make hydrocarbons within the plant.

   2. MHMark Hyman47:05

      Yeah, carbohydrates. [laughs] That's carbon, right?

   3. PAPeter Attia47:06

      That's right. And then, and then the oxygen is being released. But I didn't realize that there was any carbon dioxide stored in soil.

   4. MHMark Hyman47:13

      Yeah, and if you look at the mechanism, it, it goes into the plant, but it also goes into the roots. And so you've got this incredible root system, and then you've got mycorrhizal fungi that are fed off of-

   5. PAPeter Attia47:21

      Oh, oh, I see. So you're just saying the hydrocarbon within the roots of the plant-

   6. MHMark Hyman47:25

      Yeah

   7. PAPeter Attia47:25

      ... is the storage.

   8. MHMark Hyman47:26

      Yeah, but the-

   9. PAPeter Attia47:26

      Not in the soil per se, not in the actual dirt and bacteria?

   10. MHMark Hyman47:29

       Well, no, no. Then it gets eaten by the bacteria, eaten by this mass of mycorrhizal fungi, and it creates a lot of necrotic dead, but, like, actually organic matter. It's an incredibly rich living organism. And dirt is just dead. Dirt doesn't hold water. It doesn't have much carbon in it. It doesn't have much nutrients. And in order to actually to extract the nutrients from the plants, you have to have organic matter, which allows this, and bacteria, and all these mycorrhizal fungi which make the nutrients in the soil available to the plant. And since we've... are growing food in dirt, we see 50% less nutrient density of even healthy food. [laughs] Like broccoli has less minerals than it did 50 years ago. So you have all these complicated factors that are driving the destruction of our soil. Fertilizer's another one. I don't think people really understand the fertilizer story. There's 400 billion pounds of fertilizer used everywhere in the world. It's a sevenfold increase over the last 40 years because they're two-thirds as effective. The way you make fertilizer is a chemically intensive process that uses energy. It's one of the biggest utilizers of energy and the number one utilizer of fracking produced natural gas, [laughs] which I didn't even know. So when you look at the fertilizer industry, they use more natural gas than Exxon. And in order to make the gas-

   11. PAPeter Attia48:45

       I'm sorry. They use more fertilizer than Exxon produces?

   12. MHMark Hyman48:49

       They use more-

   13. PAPeter Attia48:49

       Sorry, they use more energy than Exxon produces.

   14. MHMark Hyman48:52

       Natural gas. Yes, they use more natural gas than Exxon uses. So the Yara and Mosaic, these big fertilizer companies, are making fertilizer using this intensive energy process that needs natural gas. When you frack, you actually release methane from these methane leaks that come out of these fracking wells. Recently there was one in Ohio that you could see from space. And then that actually is about a quarter of all methane released gas in the environment today, which is as much as factory farm cows, [laughs] and that's from growing plants.

   15. PAPeter Attia49:24

       Do you know what percent of... I don't know the numbers anymore, but there was a day when the United States was consuming 20 million barrels of oil and oil equivalent per day. It's probably a bit less than that today. Do you know what, what amount of that is in the production, transport-

   16. MHMark Hyman49:41

       Oh, yeah. Sure

   17. PAPeter Attia49:41

       ... consumption of food?

   18. MHMark Hyman49:42

       One-fifth of all our oil consumption is for the food system. It's more than all cars, planes, boats, transportation combined. So it's a staggering amount of oil, and part of it is a-

   19. PAPeter Attia49:53

       It can't be combined, though, because those-

   20. MHMark Hyman49:55

       Combined. No, combined. All the transportation combined-

   21. PAPeter Attia49:57

       Is less than one-fifth of our total oil consumption?

   22. MHMark Hyman50:00

       Mm-hmm, 'cause a lot of it's industry and other things. So yeah, it's pretty staggering.

   23. PAPeter Attia50:05

       Wow.

   24. MHMark Hyman50:05

       And so the fracking and the-

   25. PAPeter Attia50:06

       So 20% of our energy utilization is to make fertilizer, deliver seed-

   26. MHMark Hyman50:12

       Yeah

   27. PAPeter Attia50:12

       ... harvest.

   28. MHMark Hyman50:13

       Yeah, pesticides, herbicides, all come from fossil fuels.

   29. PAPeter Attia50:15

       Distribute.

   30. MHMark Hyman50:16

       So, so the fertilizer story gets even worse because once... Now you have all the, the gas you're using, the methane released from that. When you put it on the soil, it kills the soil.
10. 54:16 – 1:08:15

    Regenerative Agriculture: Economics, Scale and Counterarguments

    1. MHMark Hyman54:16

       That's right. There's sort of a fallacy in the idea that we can't produce the same amount of food using regenerative methods. I think that's been disproven.

    2. PAPeter Attia54:26

       Do you believe... In other words, there is 200 bushels per acre per year using regenerative methods?

    3. MHMark Hyman54:31

       Well, let me just share a quick story. Now, I wanna share this story, and I'm gonna come back to the fertilizer and talk about the rest of the different aspects that are causing climate change 'cause I think people need to understand that. There's a guy named Gabe Brown who was a North Dakota farmer, 5,000 acre farm, devastated by hail, devastated by weather, and was about to go bankrupt, and then decided he wanted to try regenerative agriculture. And many years ago, he started it, and now he says he's built 29 inches of soil. He uses no chemical inputs, makes his own fertilizer from the animals and the plants that he plants, the nitrogen fixing plants. He produces more food, better quality food, and makes 20 times as much money as his neighbor. So in terms of productivity, a regenerative farm is far more productive. And I think there's this fallacy that we need green revolution, we need industrial agriculture to feed the world. That's really been disproven, and I think that's the mantra of big ag. It's the mantra of Monsanto and, and now, which is Bayer, and a lot of these big agrochemical companies that are trying to push their products on the marketplace. And so I think we have to sort of be smart about going, "Wait a minute. It's not just about trying to sort of go back to some old form of agriculture that isn't gonna produce the yields." No, I think this is not what was done. This is a sort of a new way of thinking. It combines organic, but it also goes beyond that. And the reason is it, it sort of interrupts all these problems that are actually driving climate change. So we talked about the fertilizer. Once you put it on the soil, it damages the soil and it releases nitrous oxide, which is 300 times more potent a greenhouse gas than carbon dioxide. So you're getting all the fracking, you're getting the destruction of the soil on top of that, and you're just like a, it's like a triple threat. As a back-end side effect, all that runs off into the rivers, streams, and lakes, and goes in, into the oceans, and it's created dead zones in 400 areas around the world the size of Europe. There's one the size of New Jersey in the Gulf of Mexico that kills 212,000 metric tons of fish every year. It's a lot of gumbo and sushi, and there's 400 of those around the world that are feeding 500 billion people. So this is what fertilizer does alone. And then, of course, you have deforestation, the soil erosion, so forth.

    4. PAPeter Attia56:38

       And why is that not a problem when the fertilizer is coming from an organic nitrogen source versus an inorganic one?

    5. MHMark Hyman56:46

       Well, of course, right. So an organic nitrogen source, poop goes in there, and nitrogen-fixing plants, and it stays in the soil, as opposed to running off through this degraded soil into the river or stream.

    6. PAPeter Attia56:58

       So is the issue the fertilizer or the nature of the soil that can't hold the fertilizer?

    7. MHMark Hyman57:02

       It's both. It's both. In order to get dirt to produce plants, you need to put on huge amounts of fertilizer. Like I said, the increase in the use of fertilizer is sevenfold compared to 40 years ago.

    8. PAPeter Attia57:14

       So if I'm understanding what you're saying, the problem with fertilizer is it allows us to be lazy and rely m- less on healthy soil, and... 'Cause you can dump fertilizer on dirt and eventually grow.

    9. MHMark Hyman57:27

       Beating a dead horse. [laughs]

    10. PAPeter Attia57:28

        But if you actually want the healthiest soil possible, you will get your nitrogen contribution from an element that stays within the ecosystem of the soil because it's a part of it, and therefore you're not gonna have the runoff. Is that accurate?

    11. MHMark Hyman57:41

        Exactly. And so you've got deforestation, you've got damage to the soil and all the ways we talked about, and you've got transportation, refrigeration, processing, distribution. Those all cost energy, and then food waste, which is a big cost. So-

    12. PAPeter Attia57:53

        How do you estimate that? That is a staggering number that a third of our food is wasted.

    13. MHMark Hyman57:58

        That is just what the sort of conventional, the assessments are around, around food waste in the world. It's not my opinion. It's what the UN says.

    14. PAPeter Attia58:04

        Right, but, I mean, what's the methodology by which one calculates that?

    15. MHMark Hyman58:07

        Good question. I don't know the answer [laughs] to that question, but that's a good question. But I think it's a generally accepted thing. It's between 30 to 40%. It's different in, for different reasons in the developing world versus here. We throw out food in our kitchen. They f- have loose food in the food chain 'cause of lack of storage and transportation, refrigeration. So you've got all these causes of, of... which add up to about 50% of climate change. And by shifting how we grow food and f- focusing on regenerative agriculture, which specifically means regenerating soil and ecosystems, in other words, increasing the amount of organic matter in the soil, increasing water retention, using crop rotations, using cover crops so there's no bare soil so the soil doesn't... or using animals in very specific grazing patterns that mimics nature to actually intensively graze the land and move the animals around to actually stimulate the growth of the plants, stimulate the soil, and so forth. So all those techniques could be easily applied and are done in literally millions of acres around the world with great benefit and high productivity, and mitigating climate at the same time.

    16. PAPeter Attia59:07

        What's the obstacle to it?

    17. MHMark Hyman59:09

        The obstacle is, you know, you've got a $15 trillion food industry that's dependent on the products of industrial farming and is actually selling the seeds. It's selling the fertilizer. It's selling the pesticides and herbicides. It's selling all the-

    18. PAPeter Attia59:22

        Is it the convenience? Like for example, when you talk about the gentleman you alluded to earlier who basically switched... How many acres does he have?

    19. MHMark Hyman59:30

        5,000.

    20. PAPeter Attia59:31

        5,000 acres, and he switched over to fully regenerative.

    21. MHMark Hyman59:33

        Mm.

    22. PAPeter Attia59:34

        Sounds like he's increased his profitability.

    23. MHMark Hyman59:36

        Dramatically, and clime and resilience of all-

    24. PAPeter Attia59:38

        And has that increase in profitability come through higher price, higher volume, or lower cost?

    25. MHMark Hyman59:45

        I mean, these farmers lose an average in this country about $1,600 a year. That's their net is minus $1,600 a year. [laughs]

    26. PAPeter Attia59:52

        Per acre?

    27. MHMark Hyman59:53

        No, per farm. Like if you're a farmer, the average farmer, according to the USDA and other statistics, loses money every year. He's making money because-

    28. PAPeter Attia1:00:02

        On the subsidies.

    29. MHMark Hyman1:00:03

        What do you mean?

    30. PAPeter Attia1:00:03

        Like is the only reason he can make a living because of the subsidy?
11. 1:08:15 – 1:16:29

    GMOs, Glyphosate and the Precautionary Principle

    1. PAPeter Attia1:08:15

       So let's talk a little bit about GMO. This is a loaded topic. Again, I think people don't understand what it means, and that's sort of... I wanna talk about it, but I also wanna just put it in context for people so that we understand what GM means and why it came about. So we go back to the 1940s, we had growing old maize on, you know, 20 bushels per acre per year. Well, we gotta remember, that used to be something called teosinte. That was like this little tiny silly crop that was the size of our finger, and it had like four little kernels on it. That's where corn came from. So I was explaining this to my kids the other day 'cause we were... my kids are obsessed with gardening and stuff, and I was saying, "Look, there's four things about a plant that really matter. If you're planting crops, yield matters, how much do you have? Product profile."

    2. MHMark Hyman1:09:04

       I mean, is it good to eat or not?

    3. PAPeter Attia1:09:05

       Yeah, or in the case of teosinte, it had a lousy product profile 'cause it just had four kernels on it.

    4. MHMark Hyman1:09:11

       Mm.

    5. PAPeter Attia1:09:11

       Harvestability. The other problem with teosinte is the little kernels would always fall off it. You actually wanted the kernels to stay on the thing so you could harvest the whole plant. And crop protection, can you keep it away... Can you keep the critters away from it? So GMO has had by far its greatest impact in crop protection. The Bt insertion is basically what allowed Roundup-ready crops to be resistant to glyphosate. We'll use the terms glyphosate-

    6. MHMark Hyman1:09:39

       Well, Bt is the... is for the cotton, right?

    7. PAPeter Attia1:09:41

       Oh, yeah, yeah, yeah.

    8. MHMark Hyman1:09:41

       Which is pesticide resistance.

    9. PAPeter Attia1:09:42

       Yeah, pesticide resis- So there's a glyphosate resistance that... And we'll use, like I said, we'll use glyphosate and Roundup interchangeably. But if you could basically genetically modify a plant to be resistant to the thing that you use to kill the pest, you can use that thing liberally, right?

    10. MHMark Hyman1:09:57

        Yeah, I mean, for all the promise of GMO, the, basically the only two inventions have been the Bt pesticide resi-

    11. PAPeter Attia1:10:03

        The Bt and the glyphosate

    12. MHMark Hyman1:10:03

        ... and the glyphosate resistance.

    13. PAPeter Attia1:10:05

        Yep.

    14. MHMark Hyman1:10:05

        Yeah. That's it. And [laughs] and that's led to massive increases in the use of pesticides.

    15. PAPeter Attia1:10:10

        The first point to make here is most of the yield gains came long before this. So obviously you do get some yield gain with crop protection.

    16. MHMark Hyman1:10:18

        Mm.

    17. PAPeter Attia1:10:18

        So there's an overlap, but virtually all of it came before this. All of the harvestability, to my knowledge, there's been no GM addition to harvestability and no GM addition to product profile, although some might argue that it's low-hanging fruit. For example, I know Monsanto was very aggressively looking at trying to engineer tomatoes that could grow in brackish water, and that way you would obviously open up the ability to grow it in areas that... where you don't have fresh water. Okay, so with all of that said, the next question for the person to be thinking about that you're gonna take us through is, there are at least two things about GM that could be problematic. The first is it could be problematic that you are eating an organism that now has a gene that looks different from the gene that we evolved to consume it. In other words, it now makes different proteins that it didn't make that are foreign.

    18. MHMark Hyman1:11:17

        And 'cause food is information, so how is that different information affecting your biology, and how is it regulating the different body functions? I don't think we know much about that.

    19. PAPeter Attia1:11:25

        The second thing that could be harmful about GM is that by its very success, it enables the use of chemicals in a higher concentration than you would be able to use them in the absence of GM, and we'll use Roundup or glyphosate as the poster child for that. Can you talk through both of those and what the state of the evidence is for the harm of GM? Because it should be noted that what you're about to say is that the backdrop or stands at odds with what the USDA would tell us-

    20. MHMark Hyman1:11:55

        Mm

    21. PAPeter Attia1:11:55

        ... what the National Association of Scientists would tell us, which is GMO is safe. Feel free to consume it liberally. And so tell us where you think that might be questionable.

    22. MHMark Hyman1:12:05

        Well, there's a bunch of issues there. First is it's a large uncontrolled experiment on humanity. Just like Crisco was invented in 1911 as this great new invention and was in our food supply for, I don't know, 80 or 90 years [laughs] more before people were like, "Wait a minute, this isn't good for us, and it's killing hundreds of thousands of people a year. Let's get it out." So we don't know. I think there's animal studies that looks concerning. There's, there's various issues. I think in terms of the use of these chemicals, there's two issues there. One is the plants are increasingly are mutating to be resistant to these substances, so you need more pesticides and more glyphosate to do the same job. So there's all these weeds that are becoming resistant to glyphosate that they're trying to fight, and then that's a problem 'cause we're using more and more of these chemicals. Europe followed a different path. It didn't allow GMO foods, didn't allow any of that. And so what the comparative analysis of agriculture in the US versus Europe was no difference in yields and far less use of pesticides and herbicides. So it didn't fulfill its promise of yields and decreased use of chemicals.

    23. PAPeter Attia1:13:08

        It was transient. I believe there was a transient reduction in pesticide use until we started to see resistance. Is that correct?

    24. MHMark Hyman1:13:15

        Yeah. Yeah. And we're using more and more of these chemicals, and glyphosate is 70% of the agrochemicals used on the planet. It's increasingly being linked to harmful human effects. So forget about the insertion of the gene as an issue. We know that these chemicals are harmful. They just-

    25. PAPeter Attia1:13:28

        Do we know this? This is an important point.

    26. MHMark Hyman1:13:30

        Yeah. I mean, aside from, you know, the litigation, which is not a scientific judgment, it's a traditional judgment, but there's 14,000 lawsuits around glyphosate. There's been billion-dollar settlements. A friend of mine's a lawyer, is involved with those lawsuits. He told me that on discovery they found that the Trump administration said to Monsanto, now Bayer, "We have your back." And the EPA recently is trying to shut down any further lawsuits on glyphosate, which is fascinating to me [laughs] 'cause these are disclosed emails. And I think the effects on animal studies are really clear. I just read a study on epigenetics in glyphosate where they looked at interventional studies on rats, where they looked at giving the generation zero glyphosate, and it affected their grand rats in m- multiple ways, through prostate disease, cancer, various things.

    27. PAPeter Attia1:14:16

        But we've seen this before, Mark. I mean, we've seen lots of things where in the lab they're using doses that are significantly higher than the human exposure and/or laboratory animals behave differently than humans.

    28. MHMark Hyman1:14:26

        Okay, fine, but are we willing to take that risk? I know some other study where glyphosate disrupts the microbiome in significant ways in animals, and the dose that's in one Impossible Burger is 110 times the dose that was used in the animal studies to totally disrupt the microbiome of the rats.

    29. PAPeter Attia1:14:40

        But do we know how bioavailable it is and how much remains?

    30. MHMark Hyman1:14:45

        Well, it's in the... on the food. I mean, I, I try to eat organic. I try to eat non-GMO. Like, I travel. I'm not perfect. And I did my urine test to look at my glyphosate levels, and I was shocked. I have a 50th percentile glyphosate in my urine. [laughs]
12. 1:16:29 – 1:20:56

    Small Farmers, Big Ag Lock-In and Biodiversity Loss

    1. PAPeter Attia1:16:29

       I sort of, uh, interrupted you when you were about to make a point about biodiversity. That was something I learned recently.

    2. MHMark Hyman1:16:34

       Yeah, yeah. It's an important issue. But before I get to that, I just wanna finish this thought about how this industrial system has sort of usurped small farm holders, which are the majority of farmers that feed the majority of the world. And these farmers are getting squeezed by these big ag companies are coming in and saying they're gonna improve their livelihood, but then force them to buy their seed, force them to buy their chemicals. And there's increasing suicides and terrible economic consequences from these farmers around the world because they're, they're not able to maintain a livelihood doing what they're doing. So it's not just that it's a, it's an issue around health. It's also an issue around squeezing a lot of the people who do grow most of the food in the world. So it's, uh, another issue I talk about in the book.

    3. PAPeter Attia1:17:15

       Before we leave that then, do you know what the median farm is in the United States-

    4. MHMark Hyman1:17:19

       Mm

    5. PAPeter Attia1:17:19

       ... in terms of acreage?

    6. MHMark Hyman1:17:21

       I don't. I did know, but I don't... I can't keep all the facts in my head. [laughs]

    7. PAPeter Attia1:17:24

       That's all right. And what is approximately-

    8. MHMark Hyman1:17:27

       Most farmers in the world, it's like less than five acres, is most of the farmers in the world that f- feed most of the world.

    9. PAPeter Attia1:17:31

       Does that include the United States?

    10. MHMark Hyman1:17:33

        Mm, no.

    11. PAPeter Attia1:17:34

        We're more industrial.

    12. MHMark Hyman1:17:35

        Yeah. More industrial. Yeah, for sure. I mean, th- there's less and less farms, fewer and fewer farmers. It's decreasing all the time, bigger and bigger farms. I mean, Earl Butz said it under Nixon, "Go big or go home."

    13. PAPeter Attia1:17:45

        In doing the research for your book, Mark, did you spend any time with these farmers, and did you sense in them a degree of dissatisfaction or letdown with this promise of big ag that came about 20 years ago?

    14. MHMark Hyman1:17:56

        Oh my God, yeah. I think more and more farmers are thinking about this. There was, uh, an article in Time magazine where all the Democratic candidates in Iowa were going out on the farms, and the farmers were like, "Look, our livelihoods are being destroyed. We're having floods. We're not able to grow food. The system isn't working. We want to explore regenerative agriculture." So it's definitely happening, not because they're hippies who want to go back to the land. It's happening just from an economic imperative and the way to restore and save their farms.

    15. PAPeter Attia1:18:21

        But do farmers feel captive now to Monsanto and Pioneer and these other companies?

    16. MHMark Hyman1:18:26

        They do. They have a system, and they don't have a way to get out of it, so they're in a vicious cycle. They've got all this capital in their equipment. They're stuck in this vicious cycle of growing the same crops, and they have no way out. So we do need a bridge for these people, and we do need mechanisms through government and private equity and others to actually help fund the transition. I think, like I said, you know, the UN said $300 billion, boom, we could solve the problem of climate change and give us 20 years more runway to solve the bigger issues. [laughs] So it's a massive effort that could actually transform our quality of our food, the quality of our soils, save our water, increase biodiversity, which we'll talk about, and, and so many of our global problems, just starting at the seed. So back to biodiversity. So what that means is that we talk about extinction of species. But it's not just some frog in the Amazon. We've lost 90% of our edible plant species. Basically, 60% of our calories comes from corn and wheat and rice and soy, and mostly from 12 species. We've lost 90% of our edible plant species, half of all our livestock species. You know, there's a lot of weird animals all over the place, and you travel to foreign countries, you see these weird cows and weird pigs and weird goats, and they all look different, and now they're all the same that we produce in this country. And we have lost 75% of our pollinator species on which our agriculture depends, which Einstein said if we lose bees from the face of the earth, humans have four years left to live, which may be true or not, but it's an existential threat. Butterflies, pollinators, all damaged also by these pesticides and chemicals that are indiscriminate in what they kill. They were basically nerve gases that were produced in the World War I and II that were factories retooled to produce agrichemicals. That's what the bombs were. Nitr- I mean, how Timothy McVeigh bombed in Oklahoma, that building was through going to an a- a [laughs] like a farm store and buying nitrogen fertilizer and turning it into a bomb. That's where it actually came from. So these chemicals that we use in the soil, the methods of farming destroy the ecosystems, both from all those, but also the biodiversity of the soil, the organism in the soil that are so critical, the mycorrhizal fungi, the bacteria, the nematodes, the worms, all these different animals that live in the soil that are necessary to actually create food and to create sustainable agriculture. And so I think we're, we're sort of asleep to the idea that we're sort of running out of soil, we're running out of these biodiverse animals that are essential for our health and our survival. I mean, coral reefs, I mean, with climate change, we're destroying all the coral reefs. And again, 500 billion people depend on these coral reefs for food.

13. 1:20:56 – 1:30:22

    What Consumers Can Do: Organic, Regenerative and Composting

    1. PAPeter Attia1:20:56

       So how would one go about moving the needle on this?

    2. MHMark Hyman1:21:00

       Well, I'm trying. I'm trying. So I wrote the book Food Fix: How to Save Our Health, Our Economy, Our Communities, and Our Planet One Bite at a Time in order to lay out the problem and lay out the solutions, and they're multifaceted. They're what citizens can do. They're what c- can happen in business innovation, like I mentioned. We can come back and talking about an example around food waste, and they're what policymakers need to do. And there needs to be the political will, but it's really tough. So-

    3. PAPeter Attia1:21:21

       Can we start at the bottom of that? And let me ask you another couple of questions. What does organic really mean when it comes to plant or meat? If a person says, "Okay, Mark, you've definitely convinced me that I want to be more mindful of what I'm buying." Let's just assume that this is a person who has the economic flexibility to make the food choices that might even increase their, their budget on groceries. So first of all, what does it mean when you go to the grocery store and you see two boxes of strawberries, one's organic, one's not?

    4. MHMark Hyman1:21:50

       Well, organic is a certification that's delivered by the government that means no antibiotics, no pesticides, no herbicides, and has to, to be certified that it's clean of all of that. However, it doesn't certify the method of growing the food. So Michael Pollan, in his book Omnivore's Dilemma, talked about industrial organic. So if you have these massive monocrop lettuce fields, you're doing tillage, you're not doing cover crops, you're not doing crop rotations, you're also not super helping the soil. It's better than industrial farming, but it's not fully regenerative. Regenerative is a method of farming that actually includes organic, but goes beyond it, and there is now a regenerative organic certification, which you can look up, and I talk about in my book. But the chemicals and the pesticides that we consume have an impact on our health. It's been estimated that pesticide exposure just in children is responsible for an average loss of seven IQ points or forty-one million IQ points in kids. [laughs] So there's a lot of brain power that's killed, and not to mention-

    5. PAPeter Attia1:22:50

       How many per kid?

    6. MHMark Hyman1:22:51

       I think it's like seven IQ points. There's literally millions of pounds of these pesticides and herbicides that are in our food supply and our water, and some plants have more than others. So I'm on the board of the Environmental Working Group, and they produce a really great guide called The Dirty Dozen and The Clean Fifteen. So you can look at that list, and if you're having economic issues or whatever, you can say, "Well, strawberries are the worst thing I could buy if they're not organic." Whereas, you know, banana or an avocado may be not a big deal if it's not organic. So you can look at that list and go, "I'm gonna save money by buying organic of the things that are the worst contaminated, and I can cheat on the other ones that are not."

    7. PAPeter Attia1:23:29

       And is part of that because in the case of bananas and avocado, you're eating what's inside and not outside.

    8. MHMark Hyman1:23:34

       Yeah.

    9. PAPeter Attia1:23:34

       Whereas in the strawberry, it's like got this surface that can collect and aggregate anything.

    10. MHMark Hyman1:23:38

        Yeah, it sucks it all up, [laughs] right, right. Celery's terrible. Never have any, anything but organic celery, for example.

    11. PAPeter Attia1:23:43

        And meat, besides not using hormones in the animals and not giving them antibiotics, is there anything else that comes in the distinction of organic meat?

    12. MHMark Hyman1:23:53

        Again, it's not using the inputs that are chemical inputs that are on the corn that you have or the soil that they have. So that's good. But again, it doesn't mean that they couldn't be fed organic corn that's still grown in ways that are destroying the soil. So we really have to sort of think more nuanced about what that means. That's why regenerative is sort of organic plus, you know? It's like a whole next level.

    13. PAPeter Attia1:24:16

        How ubiquitous is that, uh, regenerative organic label?

    14. MHMark Hyman1:24:19

        It's not. It's not. It's not. There's not even a label yet. There's just a proposal for a regenerative organic certification. And yet there are farms who are doing this, and there's ways to regulate it and measure it, and I think the government's gonna be able to sort of put out field service workers to measure soil, to measure these things, to look at is it regenerative. And places like Mariposa Ranch in California, you can buy half a cow with a bunch of friends, and it's eight bucks a pound, which for a four-ounce serving is less than you'd pay for a McDonald's hamburger. So you can, with a little ingenuity and effort, you can actually start to sort of find how to get these things. But it's the demand that's gonna increase, and that's why, for example, General Mills and Danone and Nestle and Pepsi even are looking at how do we get our supply chain to be more regenerative, and how are we going to move that needle? It's kind of exciting to me.

    15. PAPeter Attia1:25:03

        Is there anything else a consumer can do absent the types of bigger changes that you're pushing for and hoping for?

    16. MHMark Hyman1:25:10

        I mean, I think being really focused on what you eat and where it comes from Buying at local farmer's markets, joining a community supported agriculture, looking for regenerative sources online, buying things together with friends

    17. PAPeter Attia1:25:22

        What are the resources people can use to find those things? Are these centralized in any way?

    18. MHMark Hyman1:25:26

        Yeah, they're in my book [laughs] . They're in my book, Food Fix, and they're on our website.

    19. PAPeter Attia1:25:30

        What's the URL?

    20. MHMark Hyman1:25:31

        Foodfixbook.com, and there's a video on there of five steps to heal the planet and yourself, and there's an action guide that is good for citizens, businesses, governments, and so forth, so that it says, you know, what, what can you do? And so yes, you can vote with your fork in all the ways I just mentioned. You can be active in your community. M- maybe you should have a compost pile. We'll talk about that, but you can be active to sort of have community garden, to get a com-

    21. PAPeter Attia1:25:55

        You know, my son, for his fifth birthday, it's like, "Okay, what do you want, Reese?" He wanted a compost box.

    22. MHMark Hyman1:26:01

        All right. There you go.

    23. PAPeter Attia1:26:01

        You know how hard it was to find one? You couldn't go to Home Depot and get one. You couldn't go to the local garden store. Like, it took-

    24. MHMark Hyman1:26:07

        Really?

    25. PAPeter Attia1:26:08

        It took-

    26. MHMark Hyman1:26:08

        They have them on Amazon. You can buy them and have them shipped to you

    27. PAPeter Attia1:26:11

        I think ultimately, it sounds silly, I think ultimately we did that, but I was... But I think with kids sometimes it's fun to take them to the place and get the thing.

    28. MHMark Hyman1:26:18

        Yeah.

    29. PAPeter Attia1:26:18

        I was amazed how hard it was to get a big composter.

    30. MHMark Hyman1:26:20

        You don't even need that. You... I just put a little fence, a little, like kind of some two-by-fours and built a little box, and you just throw it in my backyard and just throw it in there year after year, and I've got like tons of feet of this dark, rich soil, like a, like a humus that goes on the garden and it's great. If you're wanna be politically active, you can go in your municipality and say it to your local government, say, "Look, let's have a, a composting law. Let's make it mandatory," like San Francisco did. You can't go and, and throw your garbage in San Francisco anymore. And for example, in, um-
14. 1:30:22 – 1:35:22

    Food Waste, the USDA and Policy Failures

    1. PAPeter Attia1:30:22

       The USDA, what's their role in this?

    2. MHMark Hyman1:30:25

       [laughs] Oh, my God. You have another couple hours. Uh, I go through all this in the book, but just at the high level, the USDA is responsible for a number of different food and ag policies that are the majority of the things that are going on. Our dietary guidelines, which are messed up. Our school lunch guidelines, which are messed up. Our SNAP program, our food stamp program, which is $75 billion a year. It's one of our biggest government programs that feeds 46 million Americans, including one in four kids who are food insecure. Great idea, but there's no nutrition guidelines in that, so there are $7 billion a year just in soda that we spend, about 30 billion servings a year.

    3. PAPeter Attia1:31:02

       You can buy soda with food stamps?

    4. MHMark Hyman1:31:04

       Oh, yeah. [laughs] Of course. You can buy anything except alcohol and cooked food. So you can buy a two liter bottle of soda, but you can't buy a rotisserie chicken in the grocery store. And 75% of the food stamps is junk food or soda. That's about a $730 billion program, which is massive over a period of 10 years. And so there's no nutrition guidelines in there. And so you've got all these government programs plus the crop insurance and g- agricultural supports that support an industrial agricultural system, and those are harmful in the sense that if you have a big soy and corn farm and you wanna grow a whole bunch of veggies, you can't, even if you want to, because you will get penalized and not get your crop insurance. So farmers are disincentivized from growing fruits and vegetables. And the government tells us on the one hand to eat half of our plate as fruits and vegetables, but less than half a percent of industrial supports, of agricultural supports from the government are for fruits and vegetables. So it's like basically if we were eating what the government actually funded in agricultural supports, we'd be having a giant corn fritter deep-fried in soybean oil [laughs] you know? And it's like, that's not exactly what we should be eating.

    5. PAPeter Attia1:32:14

       That's a very powerful image, Mark, is that not that necessarily the USDA's recommendations on nutrition are correct, but even if you took that as an aspiration, it's interesting to note that the funding doesn't align with that. So how does the USDA respond to that, especially because it's not a subtle... They're not off by a little bit. They're off by an order of magnitude.

    6. MHMark Hyman1:32:35

       A quarter, less than a half a percent versus 50%.

    7. PAPeter Attia1:32:38

       So what is their response to that?

    8. MHMark Hyman1:32:41

       I don't know. [laughs] I just-- Like, I think it's just the right hand's not talking to the left hand. And so there's all these disparate policies. I was working with Tim Ryan and my friend Dariush Mozaffarian from Harv-- Tufts to get an analysis by the Government Accountability Office to look at what our disparate policies were doing to our public health and to our economic health as a nation, because they're all cross-purposes. We say, "Don't drink soda. Eat healthy diet," so forth with dietary guidelines, but then we pay for $75 billion a year in junk food for the poor. How does that make sense? And so I think we have all these government agencies, which the FDA that has confusing food labels or that allows antibiotics in our animal feed or that allows substances that are banned in other countries to be-- that are toxic to be in our food supply, like azodicarbonamide, which is basically a softener for flour products, for bread. I mean, if you use that in Singapore, you get a $450,000 fine and you go to jail for 15 years. [laughs] I mean, Singapore is Singapore, but still, like, it's not even allowed. And we have the, the FDA... The FTC, which regulates the airwaves, allows all this unrestricted marketing to kids. So you've got all these different agencies that are working cross-purposes, that aren't coordinated and aren't creating a coherent food policy. So we need a national food policy. We need activism to change some of these food policies and, and support regenerative ag and to reform food stamps and dysfunctional policies, to reform school lunches, and, and to actually help advance in healthcare food as medicine. All these things can be done. And I'm actually working on a campaign with some extraordinary people who are-- We're launching a nonprofit and, and an advocacy group, otherwise known as a lobby group for the good guys, to start to, to work on these issues in Washington 'cause while it may seem like nothing can be done, I think behind the scenes a lot can be done, and I think there are a lot of these issues are bipartisan issues. I just think people are ready for this. There's a movement and a readiness around the country and even in Washington to address these issues. I mean, I just gave a talk at somewhere, and someone knew one of the senators from Maine, and they called me the next day and was like, "Well, can you help with this?" And I say, "Well, 70% of the military recruits are unfit to fight, and 70% of the evacuations from Afghanistan and Iraq were not for war injuries but were for obesity-related injuries." [laughs] So... And the soldiers. And they, they wanna figure this out. So I am hopeful because I see that despite all these issues, people are waking up to these problems. I see these big food companies like Nestle, Danone, Unilever, and so forth, General Mills, actually starting to take on these issues. I mean, they still are part of the problem, but they are trying to move their supertanker ships, and it takes a while. But I do see room for hope. I see business innovations. Food and ag tech companies are... Billions and billions are flowing into these areas for innovation, which is all a good thing.

15. 1:35:22 – 1:42:11

    Food Czar Priorities and the Plant-Based Environmental Debate

    1. PAPeter Attia1:35:22

       What do you think are the top three changes if you were food czar-

    2. MHMark Hyman1:35:27

       Ah, yes

    3. PAPeter Attia1:35:27

       ... and you had to rank order sort of the biggest... Are there three things that could make 70% of the difference?

    4. MHMark Hyman1:35:32

       Yes. I would immediately transform healthcare reimbursement to focus on food as medicine through paying for food for those who are food insecure, for reimbursing fruit and vegetable prescriptions, for making food a central part of the government, and that would include having all... The government is probably the biggest food purchaser in the country. Have them only purchase food that is going to promote health and not disease. I would then secondly reform these dysfunctional food policies. I would transform SNAP, transform school lunches, transform the dietary guidelines to be science-based. And lastly, I would actually support regenerative ag in every way possible through government policies and through business innovations, incentives, and other things. So those three pillars, you know, one, fixing food as medicine into the healthcare system and reimbursement policies and, and every government institution, reforming dysfunctional government food policies, and supporting regenerative ag. And that's really the whole agenda of The Food Fix campaign.

    5. PAPeter Attia1:36:31

       We sort of glossed over it a little bit, but I guess no discussion on this would be complete without coming back to maybe some of the confusion that exists around a plant-based diet exclusively as a solution for... And let's put aside the health issues for a moment 'cause there's obviously lots to debate around whether, uh, animal-based products have deleterious health consequences, and let's put aside also the sort of egregious cruelty to animals that takes place under farm conditions and-

    6. MHMark Hyman1:37:02

       Factory farming should be banned, period, full stop.

    7. PAPeter Attia1:37:04

       Yeah, I, I don't think anybody that's spent any time actually going and watching how animals are harvested in that way would, would disagree with that. So let's instead focus on specifically the environmental concerns. You've already talked about it a little bit, but can you say a bit more about it?

    8. MHMark Hyman1:37:19

       Yeah. You know, there's an interesting report came out called the EAT-Lancet Report, which was, uh, very well-intentioned and had a lot of great science in it that talked about how we link climate and diet and food, and what is a healthy diet, and how do you define that. And there's a lot of great science in there. There were challenges though, because some of the language in there was really driven through the food industry, and a lot of the sponsors for that were big food and big ag. One of the, for example, messages is we need to grow more plants, more grains, and more beans through something called sustainable intensification or climate-smart agriculture. These are buzzwords, sort of like clean coal, [chuckles] which sound good, but when you look behind the curtain, who funds those organizations? 60% of the members of climate-smart agriculture are the fertilizer companies. Sustainable intensification means using more and more chemical inputs on farms in the developing world to grow more grains and beans. That's not the solution. And lastly, without animals integrated into regenerative agricultural systems, you cannot restore soil in the way we need to restore it as fast as we need to restore it. It's just a scientific fact. So when you-

    9. PAPeter Attia1:38:34

       And is that based on the need for the, basically the transfer of nitrogen through the animal?

    10. MHMark Hyman1:38:39

        Yeah. Pooping, peeing, digging. The saliva makes the plants grow. It's a whole symbiotic ecosystem, and when used properly, not overgrazing, but proper management, which is called holistic management or managed grazing or adaptive multi-paddock grazing, there's a science to it, you can dramatically increase soil. So it takes like, I think, 1,000 years to get three centimeters of soil naturally. Gabe Brown in North Dakota got 29 inches of soil just through these methods that are sort of supercharged methods. They're like sort of agriculture 2.0. It's not about going back to old ways. It's about inventing new ways, using all the science to actually grow soil. 'Cause a lot of... I mean, through human history, we were destructive. I mean, we would grow food on land, and we would deplete the land, and we'd move to the next plot of land. Problem is now we're running out of land. [chuckles] There's no more place to go. So I think we absolutely need to actually scale this regenerative agriculture model in order to solve all these global issues.

    11. PAPeter Attia1:39:34

        Can regenerative ag be superimposed on fallow land?

    12. MHMark Hyman1:39:38

        Yeah. There are people that are basically taking degraded land, which is almost desert, and turning it back into lush fields and lush agricultural practices. So when those people say we have to be vegan to save the planet, it's actually not accurate. Whether you eat meat or not is a personal choice, a moral choice. If you think it's a health choice, fine. But whether or not you believe in eating meat or not, from an environmental, from a regenerative, from an e-- climate standpoint, we must have animals integrated into the process in order to restore soil, which is the biggest carbon sink. So the take-home message here for people is there are a lot of ways to fix climate change, but the quickest, fastest, and most effective and scalable way, and using ancient carbon capture technology that is more effective than anything that exists today, and it's free, called photosynthesis, [chuckles] it's basically sun and carbon dioxide in the air, we can solve a lot of the global issues that we have.

    13. PAPeter Attia1:40:30

        So Mark, how are you spending your time today? You wear a ton of hats.

    14. MHMark Hyman1:40:33

        Talking to you. [chuckles]

    15. PAPeter Attia1:40:34

        Yeah. I mean, you know, you're involved in the education of functional medicine at the Cleveland Clinic. You commute there and back from your home in New York. You're obviously very involved in this initiative. What does the pie graph look like of how you allocate your time?

    16. MHMark Hyman1:40:48

        Well, I'm always doing the same thing in my mind. I'm trying to end the needless suffering through the power of functional medicine, systems thinking, and sort of restoring communities and behavioral change through that, and this is just part of that story. Like I said, there's so much suffering that's unnecessary, whether it's chronic disease or poverty or mental illness or kids struggling with learning in schools or violence. These are all needless suffering. If we have the solutions, then we need to focus on them. And as I, again, began at the beginning talk about, as I sort of went down the rabbit hole of why are my patients sick, I came to this bigger conclusion that unless we deal with the systems issues, unless we go upstream, we're just gonna be treading water or bailing a sinking boat. And the acceleration of these problems is so big that I feel like I'm focusing more and more on these bigger issues in order to solve them. So yes, I write books, and I feel like this is my last one for a while, [chuckles] but I like to write books and teach and speak and do all these things, have clinics, but at the end of the day, this is an existential threat, and once you've seen it, you can't unsee it. I just went researching the book for the last two and a half years. I just sort of was shocked by a lot of things that I learned that are not really common knowledge, uh, even with really educated people. If I go in a room of highly educated people and say, "What's the number one source of climate change?" They're not gonna say food. But when you actually unpack it, that's the biggest threat.

16. 1:42:11 – 1:50:27

    Why European Bread Feels Different, and Closing Thoughts

    1. PAPeter Attia1:42:11

       Well, Mark, thank you very much for making the time today, and more importantly, of course, for doing this work and bringing it to our attention. This is an area that I have become increasingly interested in, and my views are kind of constantly evolving. I mean, I think there was a day when I didn't question the health of GMO. I'll just share with you an anecdote, which is when I went to Europe a year ago, I just made the glib observation, which was sort of the bread, the pasta, all of the food that I ate in Europe, which I actually went out of my way to eat, did not seem to produce the same effect as it did here. And that was actually kind of the thin end of the wedge in my mind that said-

    2. MHMark Hyman1:42:54

       What's going on?

    3. PAPeter Attia1:42:55

       ... what is the difference between the crops that they are using in Europe? And it's funny 'cause it reminded me of-

    4. MHMark Hyman1:43:01

       I can give you four reasons why that's true.

    5. PAPeter Attia1:43:03

       Yeah, yeah. Yeah. Well, it reminded me of my childhood because when I was a kid, we used to go to Egypt every year, and... 'cause that's where my parents are from. And I'd go with my mom each year and usually spend two months there. And I remember the way bread tasted there. It had a very distinct taste that you'll never taste. Even if you buy, like, pita bread or other Middle Eastern bread here in the US, it tastes very different. And I remember sort of having those neurons tickled again when I was in Europe, going out of my way, 'cause most of the previous times I'd gone to Europe, I had kind of don't eat that sort of stuff. But on this trip I was like, "Hey, I'm gonna... When in Rome, right?" So yeah, tell me about what you think those four differences are.

    6. MHMark Hyman1:43:39

       So you're talking about wheat products, right? So what's happened to wheat is that we've hybridized the wheat to make it extremely drought resistant and hardy, and it's called dwarf wheat. And the guy who invented it, Norman Borlaug, won the Nobel Prize. And it increased in yields, but what was sort of the unintended consequences is the starch in there is called amylopectin A. It's a super starch. It raises your blood sugar more than regular sugar. So one, it's basically just like eating sugar or worse. Two, when they breed plants, it's not like humans. You get 23 pairs of chromosomes, one from your mom, one from your dad, 46 chromosomes. In plants, it's 46 plus 46, so it's like 92. And so there's extra proteins that are formed, and there are many more gliadin proteins, which are inflammatory and more active in terms of causing disruptions in the gut. So they're more likely to cause leaky gut and inflammation. The third thing is they spray wheat, even though it's not a GMO food plant, they spray it with glyphosate at harvest. Why? Because it defoliates the plants. It gets rid of all the sort of leaves and stuff, so it makes it easier to harvest. So right at harvest, they spray this with glyphosate. And your Cheerios have more glyphosate than vitamin A and vitamin D that are added in there per amount of wheat.

    7. PAPeter Attia1:44:54

       So even if you buy organic wheat?

    8. MHMark Hyman1:44:56

       Organic wheat, no. Organic wheat could still be the dwarf wheat.

    9. PAPeter Attia1:44:58

       Yeah. Yep, yep.

    10. MHMark Hyman1:44:59

        And then lastly, and this is interesting. Actually, maybe five reasons. But second to last, the calcium propionate, which is a preservative, is added to the wheat in this country, and it's known to cause toxic neurological effects, behavioral hyperactivity, and even has been linked to autism. In fact, when you give babies breast milk, it increases butyrate, which is a powerful short chain fat in the gut that makes your gut healthy. When you have formula, it causes high propionate levels, which can cause neurotoxic effects. And in animal models, it's caused autism if you put propionate in, in rats' brains. And then lastly, in Europe, they have different methods of making the bread. Here it's like quick, quick, quick, quick. They want it to leaven and rise in a couple hours. There it can take overnight, 12 hours, 14 hours, and it tastes very different, and it's a very different structure, and it does different things to the gluten and so forth. So there's a lot of reasons that that happens. But I would say over and over, I see this happen with my patients who can't eat this stuff here, and they go over there, and there's no GMO over there. It's a complex web of things.

    11. PAPeter Attia1:45:57

        Can one make bread here in the US on their own using wheat, like an actual wheat that comes from Europe?

    12. MHMark Hyman1:46:02

        Sure. You could, or you could get heirloom wheats like einkorn wheat, which is very different. Or now there's new forms of wheat like Kernza wheat by West Jackson. It was developed in the Midwest. It has incredibly deep roots. It's a perennial wheat, super nutrient dense, really amazing, amazing product. So there's incredible grains out there that... I was talking to my friend Jeff Bland the other day, who's developing his company, and he's working with this guy to develop these, you know, phytochemical rich foods, super foods. And he got a bunch of things from the USDA, a bunch of seeds, and [chuckles] one packet came in. It was like 43216 or something. He's like, "What's this? I don't know what this is." And they sent it to him by accident. And it was this Himalayan buckwheat, which apparently is one of the most protein rich, low glycemic, phytochemical dense, hardy super food on the planet. And they're now... They have this sort of seed, 'cause... And they're not selling it, distributing it, but they couldn't give it back. So he's like literally taking this packet of seeds and turning it into a whole business, [chuckles] which is pretty amazing. So there's a lot of stuff out there that we could use. It's much better for us, but we just kind of homogenized our food supply, and we've taken out all... Like I said, we ate 800 species of plants before when we were hunter gatherers. And our bodies need all those different phytochemicals and nutrients and minerals and so forth and vitamins to actually run itself. And we're now just in this sort of nutrient devoid diet. Even if we're eating organic stuff, if it's not grown in good soils, if it's hybridized plants, it's just not great. I always say eat weird food. So I always try to eat weird food. [chuckles]

    13. PAPeter Attia1:47:30

        I gotta tell you, I'm hungry right now.

    14. MHMark Hyman1:47:31

        [chuckles] I know. Me too.

    15. PAPeter Attia1:47:33

        So, uh, all right, Mark. Well, thanks very much.

    16. MHMark Hyman1:47:35

        Sure. Thanks a lot, Peter, for having me.

    17. PAPeter Attia1:47:37

        Thank you for listening to this week's episode of The Drive. If you're interested in diving deeper into any topics we discuss, we've created a membership program that allows us to bring you more in-depth, exclusive content without relying on paid ads. It's our goal to ensure members get back much more than the price of the subscription. Now, to that end, membership benefits include a bunch of things. One, totally kickass comprehensive podcast show notes that detail every topic, paper, person, thing we discuss on each episode. The word on the street is nobody's show notes rival these. Monthly AMA episodes, or Ask Me Anything episodes, hearing these episodes completely. Access to our private podcast feed that allows you to hear everything without having to listen to spiels like this. The Qualies, which are a super short podcast, typically less than five minutes, that we release every Tuesday through Friday, highlighting the best questions, topics, and tactics discussed on previous episodes of The Drive. This is a great way to catch up on previous episodes without having to go back and necessarily listen to every one. Steep discounts on products that I believe in, but for which I'm not getting paid to endorse, and a whole bunch of other benefits that we continue to trickle in as time goes on. If you want to learn more and access these member-only benefits, you can head over to peterattiamd.com/subscribe. You can find me on Twitter, Instagram, and Facebook, all with the ID PeterAttiaMD. You can also leave us a review on Apple Podcasts or whatever podcast player you listen on. This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice from any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. Finally, I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit peterattiamd.com/about, where I keep an up-to-date and active list of such companies. [outro music]

Episode duration: 1:50:27