10-Day Anti-Inflammatory Diet: Stop Feeling Tired, Bloated & Achy! | Dr. Mark Hyman

Dr. Rangan Chatterjee 0:00 We live in a world where it's pretty normal to only consider things like cereal, muffins, and bagels as our traditional breakfast foods.

Dr. Mark Hyman 0:11 That's right.

Dr. Rangan Chatterjee 0:12 How would you have us rethink about breakfast so that we can optimize our metabolic health, our gut's health, and our longevity?

Dr. Mark Hyman 0:22 Great question. Great question. I'm gonna, I'm gonna put intermittent fasting or time-restricted eating aside because it doesn't really matter if you do a 12-hour fast, 14, 16 hour. Whatever your first meal is matters. And you're 100% right. Essentially, the world is eating dessert for breakfast. Most cereals are 75% sugar. It shouldn't be called breakfast, it should be called dessert [laughs] . And whether it's that, or it's a frappuccino from Starbucks, or a, a bagel, or a muffin, or pancakes, or french toast, or waffles, or just, you know, even worse, things like Pop-Tarts and [laughs] things that kids eat for breakfast, Pop... I used to eat a lot of Pop-Tarts for breakfast when I was a kid. It's absolutely the worst thing we can do because when you start your day with sugar for breakfast instead of protein and fat for breakfast, a whole cascade gets tipped off that is going to ultimately cause you to end up gaining weight, and feeling like crap, potentially lead to diabetes, and for sure probably type, uh, pre-diabetes. And the reason is, when, when our first meal is sugar or something that turns into sugar, because anything that's flour i- is equivalent. Below the neck, your body can't tell the difference between a, a bowl of sugar and a bowl of cornflakes, or a bowl of sugar and a couple of pieces of toast. It's exactly the same when it hits your body. In fact, the bread is probably worse 'cause it's got a higher glycemic index and it raises your insulin more. Although br- sugar is fructose and glucose, so it's, it's a... I mean, it's a little bit of a different molecule, but it's still bad. [laughs] So what happens is, you kick into this cascade where you drive up insulin, that's the fat storage hormone, you store belly fat, you partition the fat, which means it gets locked in there like a one-way tur- turnstile on the underground, where basically you can get in, but you can't get out. So the fat gets locked in there. It slows your metabolism, and it makes you hungry. So if you have oatmeal for breakfast, which we think is a healthy breakfast, it's kind of the least unhealthy of the unhealthy breakfast. It's not as bad as, you know, sugary cereals or a muffin, but it still raises your insulin, raises your adrenaline, raises your cortisol, raises your blood sugar, raises your triglycerides, and it then causes this spike in insulin and then a crash in your blood sugar. And that leads to this kind of up and down craving cycle that we all experience, and we end up eating more. So if you have, have... For example, looking at a study from Dr. Ludwig, it was a brilliant study. He gave people an omelet, steel-cut oats, or instant oatmeal. Three breakfasts. Same calories, so identical calories. They were overweight young kids. And they then put them in a room and they said, "Okay, eat these breakfasts and then whenever you're hungry, hit the button, tell us, we'll bring you more food." The kids who had the oatmeal ate 86% more food in that day than the kids who ate the omelet, and the kids who ate the steel-cut oats ate 56% more food than the kids who ate the omelet. So w- whether it's steel-cut oats, I mean, if you can modify steel-cut oats and put nuts in there, you can put butter in there, you can put flax seeds in there, you can put fiber in there, you can change the composition. But at the end of the day, the glycemic load of your meal matters the most, and you wanna start the day with protein and ideally fat. So it could be a protein shake with some MCT oil in it, it could be an omelet with avocados and tomatoes and olive oil. It could be a, a nut shake that I talk about in my 10-day detox diet, which essentially you put seeds and nuts and, and good fats in there with protein and fiber and, and some frozen berries. It can be delicious. It doesn't have to be bad. But what it's gonna prevent you from doing is ending up in this rollercoaster of blood sugar swings, of cravings, of overeating, of eating too much sugar and starch, craving carbs, of gaining weight, of getting belly fat, of getting in this cascade of metabolic dysfunction, which is terrible in America. It's 93% of us are somewhere in that continuum. I don't know what it's in the UK, but you guys are probably not far behind us.

Dr. Rangan Chatterjee 4:24 Yeah.

Dr. Mark Hyman 4:24 And, [laughs] and so it's pretty bad. And so the best thing you can do for yourself for breakfast is to start the day with protein and fat.

Dr. Rangan Chatterjee 4:32 It's interesting that both you and I are very passionate about root cause medicine. We're always thinking, well, how do we get to the root cause of this problem instead of just suppressing symptoms, often with medications? But if we think about breakfast, it's looking at root cause through a slightly different lens. It's almost like a root cause behavior that if we don't get right, has multiple downstream implications-

Dr. Mark Hyman 4:59 Yeah

Dr. Rangan Chatterjee 4:59 ... for the rest of our day. Do you know what I mean? It's, like, quite similar.

Dr. Mark Hyman 5:02 Absolutely. It absolutely, it's a slippery slope. When you start your breakfast with sugar in any form that we talked about, it's gonna create a day where you're gonna end up in a metabolic cascade that is undermining your health, it's making you hungrier, that's making you crave more carbs and sugar. It's making you eat more food in general. And ultimately, day after day after day, what's gonna happen? You're gonna gain a lot of weight and you're gonna gain belly fat, and you're gonna get into this metabolic crisis which we see so much in the world in today, which is the spectrum of pre-diabetes and type II diabetes.

Dr. Rangan Chatterjee 5:32 When you were talking about all the consequences of starting the day with sugar, two of the things you mentioned were adrenaline and cortisol.

Dr. Mark Hyman 5:41 Yeah.

Dr. Rangan Chatterjee 5:41 Now, that's really interesting, isn't it? Because people, yeah, they might go, yeah, belly fat and triglycerides, which is a harmful form of-

Dr. Mark Hyman 5:47 Yeah

Dr. Rangan Chatterjee 5:47 ... cholesterol.

Dr. Mark Hyman 5:48 Yeah.

Dr. Rangan Chatterjee 5:48 But adrenaline and cortisol are stress hormones.

Dr. Mark Hyman 5:52 Yeah.

Dr. Rangan Chatterjee 5:52 So what's the relationship between our breakfast and our stress levels?

Dr. Mark Hyman 5:57 Great question. So Dr. Ludwig, in this study, he hooked these kids up to an IV, and he would draw their blood very frequently, and he could see the response in their blood- Of all these biomarkers, your blood sugar, your insulin, your adrenaline, your cortisol, or your triglycerides and other things that change quickly. And what he found was that the kids who ate sugar for breakfast, and when I say sugar for breakfast, I mean oatmeal and steel cut oats, which isn't half as bad as what most kids are eating. What happened was the cortisol went up. So when you eat sugar and starch, it's like a stress on your body. The body perceives it as a physiological stress. It's not a mental stress, like where someone's yelling at you, or you're in a fight or you almost, you know, get in an accident, you feel this rush of cortisol and adrenaline. It's a physiological-

Dr. Rangan Chatterjee 6:43 Mm

Dr. Mark Hyman 6:43 ... response to eating a food that creates higher levels of these stress hormones in your body. And again, that's bad because when you have higher levels of cortisol over time, one, you gain more belly fat, you get high blood pressure, you get diabetes, you lose muscle, you lose bone density, you cause cognitive impairment. It can lead to dementia over time when you see high cortisol levels, and we see this, it shrinks the hippocampus, the memory center of the brain. And so you end up in this horrible kind of, uh, snowball effect. And, and it's not just the sugar, it's also the cortisol. So you want to eat a diet that doesn't stress you out [laughs] basically.

Dr. Rangan Chatterjee 7:19 Yeah. I mean, that's crazy, isn't it, to think about this idea that our breakfast can literally stress our body out. Again, it's just broadening the lens through which we look at food. You know, food is not just calories, it's not just energy. As you've said for many, many years, food is information. And in fact, in fact I have it here in your last book. For me, there was a real magic in that book that I really enjoyed, and one of the things you wrote in that book was, "The single biggest input to your biology is what you eat every day, and the information in that food is changing your biology in real time."

Dr. Mark Hyman 7:56 Yeah.

Dr. Rangan Chatterjee 7:56 That's what you're talking about, isn't it?

Dr. Mark Hyman 7:59 100%. 'Cause remember what I said about this study. They were identical calories. So even though there was the same amount of energy in the food, the information in the food was different, and how that information was translated into biological signals was different depending on the quality and the type of food they were eating.

Dr. Rangan Chatterjee 8:22 Yeah.

Dr. Mark Hyman 8:22 So the information-

Dr. Rangan Chatterjee 8:23 Yeah

Dr. Mark Hyman 8:24 ... is changing your hormones, it's changing your brain chemistry, it's changing your microbiome, it's changing your immune system, and many, many other things, your mitochondrial function, your stress hormones, your insulin hormones, your sex hormones. All of that's affected by what you're eating, and people don't understand that. They think, "Oh, it's just calories in, calories out. You wanna lose weight, eat less, exercise more." Unfortunately, that blames the victim and it's not such a simplistic view. Yes, energy matters, and energy calories matter, but you have to understand it's the quality of the calories that matter. And so when you focus on what you eat, you don't have to worry so much about how much you eat.

Dr. Rangan Chatterjee 9:00 Yeah.

Dr. Mark Hyman 9:00 And there's been many, many trials by David Ludwig and others looking at, uh, basically unlimited calories, but changing the composition of the diet so that the information is different. So you can do a calorie restricted diet, it's for example low fat, versus a low starch sugar diet that's uns- unrestricted calories, and the group that has the unrestricted calories will eat less and be less hungry and weigh less at the end of the study, and have better metabolic health.

Dr. Rangan Chatterjee 9:26 Yeah. Mark, I wanna make sure that everyone listening or watching really understands the gravity of what you're saying, okay? Now, there's a few things you mentioned. You mentioned, uh, bread sometimes is worse than sugary cereal. You mentioned oatmeal, which a lot of people consider to be a healthy breakfast. So let me just zoom out a minute and go, if 93% of Americans are metabolically unhealthy, and let's say it's, uh, probably not quite as high, but comparable in the UK and in many other countries around the world now, is it that these foods are particularly problematic on the backdrop of poor metabolic health? I.e., if you went to a population somewhere where they were in exceptional metabolic health, and they were exquisitely insulin sensitive, do you think they could eat those foods like bread and oatmeal without it having those negative consequences?

Dr. Mark Hyman 10:25 Yes, but. Yes, but. Yes, maybe for a few days, but after a few days what starts to happen is you start to, to adapt to this different diet. I mean, look, there were populations that were exquisitely metabolically sensitive like the Pima Indians in, in, uh, Southwest America, where there was zero diabetes, zero obesity, zero heart disease, zero metabolic dysfunction at the turn of the 1900s. And now 80% have diabetes by the time they're 30. They're the second most obese population in the world after the Samoans. Why? Because the government of the United States gave them government surplus food, which consisted of three main things, flour, white flour, white sugar, and white fat, otherwise known as Crisco or shortening. And those three things really were the death of this population. So even though they were exquisitely insulin sensitive, over time, if you feed someone who's metabolically healthy metabolically unhealthy food, they will become metabolically unhealthy. Even myself, I mean, if I'm, I'm fit and I'm healthy and my, my insulin level's low and my A1C is really low and my blood sugar is good and my blood pressure's good and e- my triglycerides are low and my HDL is high, all that could change if I just started a diet of the average American person, which is 60% processed food and 152 pounds of sugar and 133 pounds of flour a year. So if I ate that much of that stuff, I guarantee you I would not be looking like I do now. [laughs]

Dr. Rangan Chatterjee 11:56 I-

Dr. Rangan Chatterjee 11:56 it's the key thing there, Mark, whether the food is highly processed or not. And the, and the reason I say that is because there are some populations, aren't there, around the world who are having quite high carb diets, but the carbs are- ... sweet potatoes.

Dr. Mark Hyman 12:11 Yeah.

Dr. Rangan Chatterjee 12:11 They are, you know, whole food carbohydrates-

Dr. Mark Hyman 12:15 Yeah

Dr. Rangan Chatterjee 12:15 ... and they seem to still be in good health. So what I'm wondering is, in your view, is it ... Do we have, like, the perfect storm at the moment where it's all of this ultra-processed food, and we've got a metabolically unhealthy population, and we're not moving enough, and we're overly stressed, and we're under-slept? You put all these things together and would you even say that some of us are unable to tolerate even whole food carbs, or is it just the ultra-processed carbs that are the main issue?

Dr. Mark Hyman 12:41 Yeah. It depends how busted your metabolism is, right?

Dr. Rangan Chatterjee 12:44 Yeah.

Dr. Mark Hyman 12:44 So if you're, if you're a generally healthy person, you wanna chew on sugar cane, great. You wanna eat wheat berries, no problem. But when you start consuming larger amounts of flour and refined sugars, 'cause these are refined foods. They're not ... They're highly processed. Now, they may not be ultra-processed in the sense of deconstructed and put into strange forms and had all-

Dr. Rangan Chatterjee 13:06 Yeah

Dr. Mark Hyman 13:06 ... kinds of food additives and what we call ultra-processed food, but even so, they're highly refined foods, and they're quickly metabolized and absorbed. And we didn't even have refined flour until, like, the 120, 30, 40, 50 years ago-

Dr. Rangan Chatterjee 13:20 Mm-hmm

Dr. Mark Hyman 13:21 ... when they inven- invented the, the flour mill, and the electric flour mill, and we got, you know, um, the Industrial Revolution. You know, 'cause [scoffs] you had to grind stuff pretty hard. I mean, I remember liv- living in China for a while, and I went to this remote village, and there were these two guys with these two giant stones with sticks in them that were grinding flour by walking around in circles like mules for, like, hours to grind their flour. Now, I guarantee you that's never gonna get to be like what we see in America, where they completely remove the grain, uh, from the, the bran and the germ, which are the fiber and the nutrient-containing components. So I think, I think if, if you're looking at populations, for example, like, uh, we were visiting the Hadza. They eat a lot of tubers, and they eat starchy vegetables, but they eat also 150 grams of fiber. So if you took a Coca-Cola, and you put in, like, two or three tablespoons of Metamucil, it's gonna have a different impact on your biology because you're, you're adding fiber to it. Now, I'm not suggesting you do that, but it's really about the, the composition of the whole diet, not just one food. And we call this dietary patterns, and we call this, particularly around sugar, the glycemic load of the meal. So how much is the total load? So if you have oatmeal by itself, that's a problem, but if you add fat, and you add protein, and you add s- more fiber, it's gonna change the load of that meal so that it doesn't spike your blood sugar as much. So the key here is what are the foods that are spiking blood sugar and insulin the most? And if you're susceptible, and there's probably 75% of the world's population is susceptible to this because we were hunter-gatherers, because we're an adapted diet, sugar, starch diets, we're gonna end up in trouble. Now, certain populations are much worse. If you look at the, uh, Native American population in the US, indigenous populations. If you look at Pacific Islanders, the East Indians like yourself.

Dr. Rangan Chatterjee 15:07 Yeah.

Dr. Mark Hyman 15:08 Uh, even at, even at lower weights, you're gonna get metabolic dysfunction. That's why there's such high rates of diabetes and heart disease in India. If you look at African Americans, Asians, even at lower weights, will become metabolically dysfunctional when they eat a diet that's high in starch and sugar. And you can say, "Oh, look, the Chinese, they eat so much rice." They did. But I, again, I traveled and lived in China. I speak Chinese. I understand the culture. And you know, you go see these Chinese, skinny Chinese guys eating giant bowls of white rice. But what, what you also had to understand was that they were out there in the rice fields 12 hours a day working their butt off, so they burned it all off.

Dr. Rangan Chatterjee 15:42 Yeah. It's interesting. We're seeing more and more endurance athletes, uh, competitive athletes, you know, winning triathlons for years and, you know, all kinds of things, coming out now with prediabetes or type 2 diabetes, which is really shaking things up for people because these guys are considered healthy. They're, they're exercising loads. They're competing at a high level. I'm not saying everyone, but many of them are having these highly processed, high carb diets because they've been told that this is necessary to fuel them. But for some of them, it's coming at quite a serious consequence. Yes, maybe a gold medal, but at the same time, 20, 30 years of living with type 2 diabetes, right? And then you've gotta go, "Well, is this a good trade? Might there be another way of doing this?" And I know Professor Tim Noakes is doing a lot of work on this and trying to show that maybe there are other ways to have elite performance which don't necessarily require these high carb diets.

Dr. Mark Hyman 16:40 Exactly, yeah. I think, you know, there, there ... Peter Attia was a ... gave a great TED Talk, TED Med talk years ago where he talked about he was just an endurance athlete. He would swim from Los Angeles to Catalina Island, which is extremely far in the ocean, and do all these endurance sports, and he was using all these Goos-

Dr. Rangan Chatterjee 16:56 Yeah

Dr. Mark Hyman 16:56 ... which is pure sugar, and he found out he had prediabetes. And how, how does an endurance athlete have prediabetes? Well, if you're constantly loading your body with insulin-

Dr. Rangan Chatterjee 17:05 Yeah

Dr. Mark Hyman 17:05 ... spiking sugars, you're gonna end up with, with kinda marbled muscle. You're gonna end up with a little bit of extra belly fat.

Dr. Rangan Chatterjee 17:12 Yeah.

Dr. Mark Hyman 17:12 And that's all it takes.

Dr. Rangan Chatterjee 17:13 Yeah.

Dr. Mark Hyman 17:14 Um, you know,

Dr. Mark Hyman 17:14 there's, uh, l- very interesting theories around sort of sugar and starch, but you know, the, the, the trick is when you start eating these foods, it starts this cascade where you get hungry fat. David Ludwig talks about this. So the belly fat, the fat around your middle, is actually hungry fat, and it makes you hungry. Again, it's stored in there because of the insulin. It doesn't get out easily, and, and so it slows your metabolism. You end up in this, you know, horrible cascade where it's a vicious cycle, and the only way to break it is to stop eating those starches and sugars for a period of time. And it, it's really why I created my 10-day detox diet, to get people to reset their metabolism. Uh, and, and it's basically getting rid of starch and sugar, uh, having nuts and seeds, which have s- some starch, um, and you can have some berries, which have some sugar, and lots of fiber, and lots of vegetables, and good quality fats, and good quality protein. And what happens to people is they can get off all their meds in a few months if they stick to it because they, we see these roma- dramatic shifts in their biology very quickly. Uh, and people don't realize how, how- Um, biologically addictive, some of these foods are

Dr. Rangan Chatterjee 18:18 Yeah

Dr. Mark Hyman 18:19 Um, according to the Yale Food Addiction Scale, which is a validated metric that's used by Yale University and the food addiction program there to understand how to evaluate if someone's a food addict, just like if you're an alcoholic. And what they found is, and this is a global study of-

Dr. Rangan Chatterjee 18:34 Yeah

Dr. Mark Hyman 18:34 ... I think, you know, I don't know how many, it was like dozens of countries. And they found that 14% of the world's population is biologically addicted to food. Not just I have a few cravings for candy, but like biologically addicted. They go through withdrawal, they have cravings, it interferes with their life. There's all these criteria, and 14% of kids are, are also food addicted. Now, 14% of adults are alcoholic, but 14% of kids are not. So we got 14% of kids and adults who are biologically addicted, and, and, and what happens is it changes your brain function. Um, again, it's a very elegant study done, I call it the milkshake study, where they looked at a group of overweight guys, and they did a, uh, two different milkshakes, and they did a washout period in between where they weren't, you know, eating anything except their normal diet. The first milkshake was-- And they were identical in calories, in protein, in fat, in carbs, in fiber. So they're identical, and they tasted the same through some magic of food engineering. Except one had a very quickly spiking blood sugar type of carbohydrate, and the other had a more slow metabolizing type of carbohydrate as the carbohydrate. The ones who had the high, quickly released high sugar, high insulin spiking carbs had all the same things. They had high insulin, they had cortisol, adrenaline, all those things we mentioned. And when they looked at functional MRIs in their brain imaging, they found that their brains lit up in the same area as is activated by cocaine or heroin. So when you think about that for a minute, it's called the nucleus accumbens. This area of the brain-

Dr. Rangan Chatterjee 20:13 Mm-hmm

Dr. Mark Hyman 20:13 ... is your addiction center. It's your pleasure center. And so when people were eating this basically sugary milkshake, it lit up the addiction center in the brain. Now, for some of us, we may be able to manage that. Like, just like some of us can have a glass of wine and we don't become alcoholics, and other people do, there's some genetics involved in this. But, uh, it's, it's important to understand that these foods are highly regulating many aspects of your biology, including your brain chemistry.

Dr. Rangan Chatterjee 20:37 Did you say that it was fourteen, as in one four, percent of children are showing signs of being addicted to foods?

Dr. Mark Hyman 20:45 Yeah, and adults.

Dr. Rangan Chatterjee 20:46 And adults. That's a staggering number, isn't it? I mean, Mark-

Dr. Mark Hyman 20:50 It is

Dr. Rangan Chatterjee 20:51 ... it's very clear to me as I'm, as I'm sure it is to you, that most people, I would say, simply do not know how good they could feel. They're so used to-

Dr. Mark Hyman 21:02 No

Dr. Rangan Chatterjee 21:02 ... feeling the way that they are feeling, they think that's normal. And still to this day, I've rarely found something as powerful as encouraging them to have, you know, 10 days or two weeks where they have completely a whole food diet. They, they take away everything else. They just do that. For so many people, it's life-changing. Just go, "Oh, oh, I didn't realize my, my mood could be better, my energy could be better, my sleep could be better," all these kind of things. And this is the message that you have been, I think for maybe three decades now, you've been trying to spread this message with the world, right? And it seems as though something is changing where people seem to be more receptive to this message, I believe, than ever before. So could you tell me a little bit about this 10-day detox program that you do? You obviously wrote a book about this-

Dr. Mark Hyman 21:52 Yeah

Dr. Rangan Chatterjee 21:52 ... a few years ago.

Dr. Rangan Chatterjee 21:53 Before you do that, you keep saying sugar and starch. For someone who doesn't know what you mean by that, because of course fruits has sugar in it as well, could you just clarify what you mean by sugar and starch?

Dr. Mark Hyman 22:05 Sugar is sugar is sugar, just like a rose is but a rose by any other name. [chuckles] So it's, it's, it can be white sugar, it can be high fructose corn syrup, it can be honey, it can be maple syrup. It can be all the hidden sugars in ultra-processed food like maltodextrin or dextrose and so forth. There's a million names for sugar, and you can literally-- I think there's 50 different names for sugar that the food industry has come up with because at least in America, you have to put the major ingredient first and then all the following ingredients after in an order of quantity. And so if you come up with five different kinds of sugar, then you don't have to have sugar as the number one ingredient of food, which most food is the number one ingredient. So, so sugar is basically sugar. Flour is, is basically what I'm talking about when I talk about starch. M- refined flour, and it can be rice flour, it can be whole wheat flour, it can be white flour. But flour, for the most part, unless it's whole grain bread like they have in Germany, where you need a meat slicer to cut it, it's pretty much quickly absorbed starches. It's broken down, it's pulverized, and it's, and it's not needing digestion in order to be absorbed, and it just quickly spikes your blood sugar. So that's, that's what I mean by starch and sugar. Now, sweet potatoes are starch. Uh, you can have, for example, a big starchy white potato, probably not a good idea, but a small little tiny red potatoes or purple potatoes, what they have like in South America, they never had diabetes down there. They weren't obese. They ate potatoes, but they were a different kind of potatoes. They're called fingerling potatoes.

Dr. Rangan Chatterjee 23:34 Yeah.

Dr. Mark Hyman 23:35 So that's kind of what I mean by starch and sugar. Now, what-- In my-- I'm a practicing physician, so what I, what I see is that people have come with a whole host of different ailments. They're inflammatory problems, primarily. Obesity, diabetes, autoimmune diseases, digestive disorders, mood disorders, depression. These are all inflammation diseases, and they manifest in different ways in different people. But what I realized was that, that most people, if you remove the inflammatory foods and added the anti-inflammatory foods back in, that in a very short time they would feel different. Now, most people walk around with what I call FLC syndrome. That's when you feel like crap. You know, basically, or there's a serious version called FLS, that's more advanced. But-

Dr. Rangan Chatterjee 24:19 [laughs]

Dr. Mark Hyman 24:19 ... you know, the FLC syndrome is a very common problem, and it may be subtle stuff like, oh, I'm just tired, I have brain fog, my tummy's not always right, I have an irritable bowel, my joints are a little achy, I get headaches, I don't sleep so good, my... Whatever it is. I'm a little depressed, I have slow sex drive. It doesn't matter what the problem is. If you reset the body, I, I call it turning the body back to its original factory settings, it can happen very quickly, and it's just amazing to me. If I, if I hadn't have seen it literally tens of thousands of times with my own eyes, I would not believe it because it's so powerful and it's so simple. And so after doing this in my practice with patients for years and years and years, I'm like, "I can't see that many patients in my lifetime. If I see 20,000 patients in my lifetime, that's a lot." But there's millions of people suffering, so I wrote this book, The 10-Day Detox, which lays out what to do for 10 days, because I figured people can do anything for 10 days. If I said the 10-year detox, people are not gonna do it. If I said the 10-month detox or the 10-week detox, they wouldn't do it. But essentially, 10 days, you take out sugar, starch, ultra-processed food, alcohol, caffeine, and you eat real food. Lots of vegetables, lots of nuts and seeds, lots of good quality protein, lots of good fats, avocados, olive oil, et cetera. And, uh, and some maybe starchy vegetables, but not too much. And you can also have, uh, berries, which are a low starch of fruit. And you're right, fruit does have sugar, but it's in a complex matrix, so it's not quickly absorbed. So when you have something that's in a complex matrix, it takes a while for your body to break it down. It comes with other things like fiber. It's got phytochemicals in there, anti-inflammatory compounds. It doesn't spike your blood sugar as much. So whole fruit is fine. I mean, people are not gonna eat 10 oranges, but they can drink a glass of orange juice, which contains 10 oranges very quickly, right? So you wanna be careful of that. So juice is not the same as eating the fruit. But that, again, that's just as bad. And, and, I mean, it's kind of like soda with a few extra vitamins and minerals and fiber maybe in it. But The 10-Day Detox basically takes people through a very simple s- process, and we, we now have it online. You can go to 10daydetox.com. And we've had... You can see the testimonials.

Dr. Rangan Chatterjee 26:26 Yeah.

Dr. Mark Hyman 26:26 Like, we're not making this stuff up. People just have incredible results, and it's... In functional medicine, we call it an elimination diet.

Dr. Rangan Chatterjee 26:32 Yeah.

Dr. Mark Hyman 26:32 I like to call it an addition diet, 'cause [laughs] we add in all the things that heal you, and we take out all the things that harm you. And it's really that simple. So you take out all the things like dairy, gluten, sugar, grains, beans, uh, processed food, and, and you see what happens. Now, then you can add things back and see how you feel. So maybe after 10 days you feel great, and you wanna keep going, you can. If you wanna try to add things back, you can start to add things back slowly, three days at a time, and see what's triggering you. You go, "Oh, I added back wheat, and gee, my stomach ache come back," or, "My, my headaches came back," or, "I added dairy back and I started getting pimples again. My skin was all clear, and then I started getting e- eczema or acne." So you can start to find out what your body's telling you. And I always say the smartest doctor in the room is your own body. It's gonna tell you what you need if you listen to it. Most of us have just tuned it out.

Dr. Rangan Chatterjee 27:21 Yeah.

Dr. Mark Hyman 27:22 Or we don't connect the dots. And it's amazing, uh, you know, how many, how many people who I've seen who are super smart, like top executives, leaders in the world, who have not made the connection between what they eat and how they feel.

Dr. Rangan Chatterjee 27:35 And that's a really interesting point. The way that you set that 10-day detox diet up, this is where I think a lot of people get confused with foods. They only eliminate one thing at a time, right? So they might go, "Oh, I think dairy might be making my skin worse," for example. And so they go, "Well, what if I try two or three days without dairy? Oh, it wasn't dairy. Put it back in." Do, do you know what I mean? A lot of people don't realize that they, they wanna do one at a time and then put it back in, but there's real value, isn't there, at cutting it all out and then slowly reintroducing things one at a time?

Dr. Mark Hyman 28:11 100%. I think this is a big fallacy. Like in medicine, we've learned and we've been brainwashed to this. Just do one thing at a time, so you know that one thing is causing, and then you know what to do. So only... If you wanna treat Alzheimer's, just give vitamin D and do that for 30 years and see if that works, and then just give vitamin, uh, E or give omega-3 fats or cut out sugar or whatever it is, take this drug. And it's just not the way the body works. The body's a system, and you've gotta unload the system from the toxic load. And, and, and the, the future of medicine is, what you and I have been doing is functional medicine, or we call it systems medicine. And the, the fundamental framework, and this is from a textbook from Harvard. These guys wrote a book called Network Medicine. They said, really, we need to look for the multiple causes that are driving any particular one condition. It's not just one thing. And we need to create multimodal treatments, meaning it's not just one thing. You need diet, you need exercise, you need stress management, sleep. You need the right nutritional supplements potentially. You might need, you know, other therapies that can help be adjunctive. So it really is about understanding the, the holistic nature of how we need to treat the body. If I said broccoli is good for you and all you ate was broccoli, you would die, [laughs] right? But that, that's not how, that's not how our bodies work.

Dr. Rangan Chatterjee 29:21 Yeah.

Dr. Mark Hyman 29:21 So I, I think it's really the sim- more simple, is just take out the bad stuff, put in the good stuff, see what happens. Now, some people won't get better, and the reason they don't get better is 'cause they have heavy metals, or they have mold, or they have Lyme, or they have some other more serious condition. But I've done this workshop where I do 30, 40 people around the world. We put them through this in just five days, not even 10 days. The average reduction in five days of eating this way, of all symptoms from all diseases, is 70%.

Dr. Rangan Chatterjee 29:48 Wow.

Dr. Mark Hyman 29:48 Now, if there was a drug that could do that, it would be a multi-trillion dollar best-selling blockbuster drug. But guess what, folks? It costs almost nothing, it's available to everybody, almost, on the planet, and it's totally doable by you without going to the doctor, and it's called food.

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Dr. Rangan Chatterjee 31:36 It's almost hard to not come to the conclusion that you simply do not know how many of your symptoms are related to food until you address your food, right?

Dr. Mark Hyman 31:51 That's right.

Dr. Rangan Chatterjee 31:51 And it's, it is madness, isn't it? That people still go to their doctor today all over the world, and they're being treated for symptoms that may well be related to food. Not always, but until you change the diet, you don't know. And I always say, "Listen, let's just figure out," you know, as we've spoken on your show before, that these, these four pillars, food, movement, sleep, and stress. And let's just start with food. Let's just get these all, things all cleaned up as much as we can, and then let's see what's left. And a lot [laughs] of the time there's not much left, right? A lot of the time-

Dr. Mark Hyman 32:24 Right

Dr. Rangan Chatterjee 32:24 ... you realize, oh, wow, these are downstream symptoms from me not paying attention to the creation of health in my body. But of course, that's the, leads to that wider point, Mark, doesn't it? Whereby we're not taught as Western medical doctors how to create health, we're simply taught to treat disease.

Dr. Mark Hyman 32:44 That's right. That's right. I mean, that's exactly it. Uh, you nailed it on the head. We- if you go to the doctor and say, "Gee, I want you to help me optimize my health or create great health," they go, "Well, gee, you don't have any symptoms. Your labs are normal, your exams are normal. There's nothing wrong with you. So go home, and if you're really feeling bad, then it must be you need Prozac." [laughs] You know? And the, and the truth is that most people wanna understand how to feel better and not just survive but thrive. And for me, for me, the goal here is to teach people how this meat suit that we've got works. Uh, you know, we've learned a lot through science, a tremendous amount through medicine, but we haven't gotten into the clinic yet.

Dr. Rangan Chatterjee 33:24 Yeah.

Dr. Mark Hyman 33:24 We haven't gotten into the average doctor's office yet. And so what we're trying to do is change that from 17 years to 17 seconds [laughs] and, and get people quickly to kind of understand, here's how your biology works. You, you know, if you had a million-dollar racehorse, would you feed it McDonald's, a Big Mac and a fries and a Coke? No, you wouldn't. But that's what we do to ourselves. It's, we do to our kids. We wouldn't feed to our dog what we feed to our kids.

Dr. Rangan Chatterjee 33:51 Yeah.

Dr. Mark Hyman 33:51 We literally would not. And so why do we think it's okay to feed to our kids? It's because the culture, and predominantly the food industry, has made us believe that it is good, that convenience is good, that, that it should be fine if it's ultra-processed, that it's safe, it's shelf stable. You know, if, if, if it's in the food, it's gotta be safe 'cause the government must be protecting us. Well, that is not true. The government is not protecting us, and especially in the United States. I think it's better in Europe. Uh, you know, we're looking now at revising all of our standards for food safety and what, what should be in and out of the food.

Dr. Rangan Chatterjee 34:22 Yeah. The problem is, Mark, though, and, and you're really speaking to this, and I know we've spoken about this before, but the culture around us, the food environment around us is so toxic that when you try and eat in a way that's appropriate with our evolution, right? In, in a way that our body is expecting to receive things, you almost come across like a health nut these days, right? Because the norm is so unhealthy that when you start to really try and eat well and, you know, "What oil did you cook that in? And what..." You, you come across as actually someone who's obsessed. But I don't think it is that you're obsessed. You know, 93% of Americans are massively looking unhealthy. We're not that far behind in the, in the UK. Normal is not what you want to be in 2025, is it?

Dr. Mark Hyman 35:13 No. And, and normal, just so people understand, is, is basically a statistical number, and it has to do with the averages in a population. So if you're a Martian landing in America today, and you look at what is the normal weight of an American, it's overweight because 75% of us are overweight. So you and I would be anomalies. We'd be abnormal 'cause we're probably at the two standard deviations below the mean in terms of weight.

Dr. Rangan Chatterjee 35:43 Yeah.

Dr. Mark Hyman 35:43 Because the whole curve of normal is shifted over to the right, which means, in English, that we basically have normalized the bad thing, which is being overweight, and we think that it's okay.

Dr. Rangan Chatterjee 35:54 Yeah.

Dr. Mark Hyman 35:55 But it's really not. And the foods we're eating, you know, if our great-grandmothers had a look at them, they wouldn't even recognize them as food, right? They wouldn't know what a Lunchable was or a Gogurt was or a Pop-Tart or Twinkie. I mean, they, they would be like, "What is this thing?" [laughs]

Dr. Rangan Chatterjee 36:08 Yeah.

Dr. Mark Hyman 36:08 "I don't understand."

Dr. Rangan Chatterjee 36:10 Why in your 10-day detox do you recommend that people cut out gluten and dairy? Because these are two things that seem to be quite controversial with doctors as to whether they should be cut out or not. But I'd love to hear from your perspective-

Dr. Mark Hyman 36:24 Yeah

Dr. Rangan Chatterjee 36:24 ... uh, why, why those two are in there.

Dr. Mark Hyman 36:28 Well, it's not arbitrary. It's not 'cause I just have a, um, some kind of vendetta against gluten or dairy. I think they're both delicious, [laughs] you know? I think the, the reality is that the wheat we eat and the dairy we eat is not the wheat we ate or the dairy we ate. And so our biology is really affected by the new versions of these that are now in our food supply that are creating havoc. We've seen a 500% or 400% to 500% increase in true celiac disease in the last 50 years. Now, this is a very serious disease. It's not just some little gluten sensitive. It's true damage to your gut, and you get very sick when you have this condition, and it creates a whole host of other autoimmunities. So why would that happen? Well, th- these two foods have been so modified by breeding, not... I wouldn't say by GMO, but just by breeding, and because of the way they're grown, that they have adverse effects on us. For example, wheat, uh, is mostly dwarf wheat, and this dwarf wheat is an incredible advance in agriculture, which won the Nobel Prize 'cause it created a very sturdy, short wheat stalk with very dense, starchy grains. But the side effect of that was that it also has way more gluten proteins. 'Cause when you breed plants, it's not like breeding humans. You know, you got 23 chromosomes from your mom, 23 from your dad. You got f- you know, 23 pairs or 46 chromosomes. It's like 46 with 46, so it's like 92 if you're a plant. And so those genes make proteins, and they make more gluten proteins, and those gluten proteins turn out to be more inflammatory, and they cause leaky gut, they cause inflammation in the body, and they are linked to all sorts of issues that we have, dozens and dozens of different diseases. Same thing with dairy. We hybridize the cows, so the modern cows have, uh, a different composition of the protein in there called A2 casein versus A1 casein. So modern cows have A1 casein, whereas o- heirloom cows and goat and sheep have A2 casein, which again is a lot less in- in- inflammatory. I mean, you look at the science around dairy, you know, Dr. Ludwig and Willett from Harvard, who are the top nutrition scientists in the world, among the most cited ever, they both wrote an article together in New England Journal of Medicine, which is not like some third-rate hippie journal, but [laughs] basically the... one of the most prestigious journals other than The Lancet in, in the world, and it, it documented the science or the lack of science showing the benefit of milk in health. In fact, it was an adverse outcome for the most part. And milk didn't create strong bones. It weakened bones. It didn't make, if you drank skim milk, skinny kids. It made fat kids 'cause they ate more 'cause there was no fat. It link, it's linked to autoimmune diseases, to Type 1 diabetes, to cancer. So I, I think it's a very inflammatory food. And the way we raise these cows is often in feedlots with hormones. We milk them while they're pregnant, and, and they become very inflammatory. So a lot of times when people have congestions, allergies, digestive issues, eczema, skin issues, rashes, dairy, acne, these are often dairy issues. So I, I find it very easy if you just take out the two biggest culprits. Even if just, you just did those two, that would be amazing. But you're right. If you just do one, let's say you're allergic to gluten and dairy and you just take out dairy or you just take out gluten, you're not gonna know which it was because you're still gonna feel bad until you take it all out, and that's why I like 10 days, 'cause just, it's like resetting the clock, and it doesn't take that long, and then you can decide what you wanna do.

Dr. Rangan Chatterjee 39:53 Yeah. Mark, uh, we're, we're... on gluten for, for just a moment. So, um, you're saying that the concentration now of gluten in, let's say, bread is very different to how it was several decades ago. Okay.

Dr. Mark Hyman 40:06 Yeah.

Dr. Rangan Chatterjee 40:06 You're saying that celiac disease is on the rise, but we also know that many people are self-reporting that they feel better when they go off gluten. Now, what's really interesting, we have seen a ton of people get better when you put them on elimination diets, right? But within the medical profession, there's still a view that if you do not have celiac disease, you should absolutely not be cutting out gluten from your diet, which I've always found a little bit odd and quite remarkable. It's not as if gluten per se has any health benefits, like, "Give me more gluten to help me with my wellbeing." I understand that there are some gluten-containing foods which have got fiber, so I think some dieticians get concerned that if people are cutting gluten out, are they getting enough fiber? I know that's one of the concerns that's often raised, but what's your take on that? Why do you think there's a case for some people who do not have celiac disease to not eat gluten?

Dr. Mark Hyman 41:02 Well, celiac disease is defined as a biopsy-proven atrophy of your small bowel. So when you take a scope, you put it down your throat, you take a biopsy of your small intestine, and it looks flattened, that's celiac disease. Okay? But [laughs] there's a spectrum of disease, and this is where medicine just gets it 100% wrong.

Dr. Rangan Chatterjee 41:20 Yeah.

Dr. Mark Hyman 41:20 You either have the disease or you don't. You have diabetes or you don't. Now they have pre-diabetes. Oh, okay, 'cause we're recognizing that's a, consequential in and of itself. It doesn't mean that you just might be at risk for diabetes. It means even though you have a blood sugar that's within the, quote, "normal range," it's a little higher than normal. That still puts you at risk for heart attack, strokes, cancer, dementia, and everything else. There's now pre-hypertension, pre-autoimmune disease, and the phenomena is that gluten, like any other thing that can be a trigger for illness, the dose affects people, and the... and different people are sensitive at different doses. And also, people have sensitivities even though they might not fully be celiac. Now, when you look at the literature, about 35% of the population has the gene for celiac, but it's not expressed fully unless it's about 1% of the population. But about 20%, I would say, this is just ballparking it, have some level of gluten sensitivity that they might not be aware of. So the, the idea is here that we should be paying attention to, one, how we feel, and that's the best barometer.

Dr. Rangan Chatterjee 42:28 Yeah.

Dr. Mark Hyman 42:28 Stop it for three weeks. Start it again. And listen to your body. Like, don't let a doctor tell you what's right or wrong. Listen to how you feel. How's your stomach? How's your energy? How's your skin? How's your brain function? How's your sleep? How's everything else that matters to you? And if you also, you know, look at antibodies, you can see there's a spectrum of antibodies. Like, if you're, if you're diagnosed with celiac disease, you can be diagnosed by blood work. Let's say your gluten antibodies are 20 or more, that's considered celiac. But what if it's 19? What if it's 18? What if it's 17? Does that mean you're fine? No, not necessarily. If it's zero, you're probably okay, and I see many patients with zero antibodies, but I also see a lot of people in that gray zone. And so if you're in that gray zone, it's worth doing an elimination diet to see if you're gonna be affected by it or not.

Dr. Rangan Chatterjee 43:13 Yeah. And then, you know, I, I... It's... This is so important, and the reason I'm bringing this up is 'cause a lot of people ... I, I know people who feel better off gluten-containing foods, but they're made to feel bad by the world around them. A lot of the time people are saying, "Oh, this is... You don't have celiac. What the hell are you doing this?" And it's, again, it's this real misunderstanding that some people are a little bit sensitive. What you said there about how many people have the genetic predisposition for celiac but don't actually have the disease, it's really interesting this idea that, you know, genes load the gun, environment pulls the trigger, right? Um, my dad had lupus, um, so he had antiphospholipid antibodies. He had 15 years, you know, with kidney failure and, uh, the autoimmune disease lupus. I know I've got the gene- the genes that predispose to autoimmune disease, right? Including celiac. So for me, it's an interesting conundrum, Mark, to think about this idea that if you know you have the genetics that are necessary for you to get celiac disease, if you never, ever consumed gluten, would you even get it in the first place? And again, these aren't the sort of things that we think about in medicine, but it ... You know, people think, oh, it's a restriction or, you know, it's too hard for people. But wait a minute, how do we know what's too hard for people? Let's give people credit. A lot of people are proactive about their health and actually are very happy to make changes when they know there's a benefit, right?

Dr. Mark Hyman 44:42 Totally. Totally. I think, I think, you know, um, i- i- i- like I said, it's so important for people to pay attention to their own bodies, and doctors can be a good influence and can provide lab testing and guidance. But at the end of the day, y- you should be the CEO of your own health.

Dr. Rangan Chatterjee 44:59 Yeah.

Dr. Mark Hyman 45:00 And you should be the one who's in charge of your biology, and you should be the one doing a N-of-1 testing, which is probably the most valuable, valuable testing you can do.

Dr. Rangan Chatterjee 45:09 I wanna talk about testing, um, because I know you're really excited about a new project that you've been involved with for a little while now. Just before we get to that, though, I heard on a recent interview, Mark, that your daughter is at medical school.

Dr. Mark Hyman 45:24 Yeah.

Dr. Rangan Chatterjee 45:24 So my question to you is, given how much information you've put out into the public domain over several decades now, you've been trying to change public's perception of health, medical schools, governments. Have you seen any evidence with your daughter that what medical students are being taught has changed?

Dr. Mark Hyman 45:46 No. Zero.

Dr. Rangan Chatterjee 45:47 Really?

Dr. Mark Hyman 45:48 I mean ... No. I mean, I asked my daughter, "What have you learned about nutrition?" "Well, we learned about amino acids and fatty acids." I'm like, "What are you gonna tell your patients to have for lunch?" [laughs] Uh, nothing about nutrition, nothing about the microbiome, nothing about insulin resistance, nothing about environmental toxins. Some of the most important drivers of the disease we're seeing today in modern society, that doctors who are being trained today learn literally nothing about. Or if they learn anything about it, it's in a very academic way that's not clinically relevant, and they don't know how to address or treat or, or monitor. And so i- it's sad. I mean, she's gonna become a surgeon, where she really doesn't have to worry so much about it. Although, it does matter for surgery, 'cause you want your surgical patients to be healthy going in and going out, and so it matters on their health and, and their health status. But, uh, I think that, that it's, it's sad. And so one of the things I'm working on is, is helping try to m- m- m- uh, mobilize, uh, the US government to mandate that nutrition training is critical for undergraduate and postgraduate education for medical s- doctors and residents. And hopefully that'll, that'll come to fruition, but it's, it's gonna be a pushback.

Dr. Rangan Chatterjee 46:50 Yeah. It's interesting, though, even this idea of nutrition education is challenging, isn't it? Because there's lots of different, uh, approaches to nutrition education, and then there's also, you can learn the theory of nutrition as a medical student, but that is also often very different from the actual practice of how you would do that with a patient, right? So it's, it's, it's challenging on multiple levels.

Dr. Mark Hyman 47:16 Yeah. Yeah, I know. [laughs] I mean, to feed ... Food is the biggest cause of disease we're seeing in today's modern society, it's the biggest cure, and doctors know nothing about food.

Dr. Rangan Chatterjee 47:26 Yeah.

Dr. Mark Hyman 47:26 It's tragic. It's really tragic.

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Dr. Rangan Chatterjee 48:54 Now, Mark, one of the things we've been talking about, um, in-- throughout this conversation is this idea that things are not black and white. And when you go and get your blood tests done at your medical doctor's, usually, certainly in the UK, you're told it's either normal or abnormal. So I have used this example before on the podcast, but for anyone coming to this podcast for the first time, I wanna just sort of frame it, and then I know you're doing a lot of work in America to try and change this. In the UK, we have different, uh, cutoffs for pre-diabetes to you guys in America. I believe in America, uh, an HbA1c of five point seven is pre-diabetes. Is that right?

Dr. Mark Hyman 49:38 That's right.

Dr. Rangan Chatterjee 49:39 Yeah. So here it's not until six, right? So-

Dr. Mark Hyman 49:42 Yeah

Dr. Rangan Chatterjee 49:42 ... you know, for anyone who doesn't understand, right, um, type 2 diabetes is a condition where you have chronically elevated blood glucose, and the way it's diagnosed is with this blood test called the HbA1c, you know, two-to-three-month average of your blood sugar. In the UK, six point five and above, I think like America, is considered type 2 diabetes. Six to six point four is considered pre-diabetes, which basically means, Mark, there will be hundreds of patients today in the UK who have got an HbA1c of five point nine, and they will be told that that is normal. Which is crazy, 'cause in America, that would be pre-diabetes, so just you go across the pond, and here it's considered normal. But talk to me about this black-and-white, uh, issue in medicine and how you're trying to address this with your company, Function.

Dr. Mark Hyman 50:36 Well, thank you. So yes, with Function Health, which is a company I co-founded that allows people access to their own health data, it's a health platform where you can get over one hundred and ten biomarkers for your health and get a deep dive into everything from hormones to nutrients to metabolic health to cardiovascular health to thyroid health, sexual health, to your nutritional levels, toxin levels, and it's, it's a much deeper dive than you get when you go to your average GP and get, you know, nineteen blood tests, which is your blood count, your chemistry, and your cholesterol, and maybe urine test. And those are only abnormal when you're really sick or in the hospital, except maybe cholesterol. And it's kinda crazy that we have, we have, you know, only this limited dataset we look at when there's literally thousands and thousands of blood biomarkers that can be tracked, and there's many, many that aren't tracked that are really critical for disease. But when you look at this continuum concept, we w- we work with Quest, which is a, a reference laboratory in America, and, and, you know, what was really interesting is they have, they have da- data on thousands and thousands and millions and millions of people, and they can analyze that data. And we were told, speaking back to the A1c, we were told that anything over five point zero, forget six point zero or five point seven, just five point zero, there's a linear and steady pr- progression of abnormal cholesterol or lipid biomarkers as your A1c goes up. So the more abnormal your blood sugar is, the worse your cardiovascular risk is, from five point zero.

Dr. Rangan Chatterjee 51:58 Even, even if-- the, the key point there for me for people is even if your result is considered normal or in the normal range-

Dr. Mark Hyman 52:06 Right

Dr. Rangan Chatterjee 52:06 ... you're still at increased risk.

Dr. Mark Hyman 52:08 Right, right.

Dr. Rangan Chatterjee 52:08 I think there's really good research showing that an A1c of above five point three sequentially starts to increase your all-cause mortality, which is-

Dr. Mark Hyman 52:16 Yeah

Dr. Rangan Chatterjee 52:16 ... crazy that these are being reported as normal.

Dr. Mark Hyman 52:20 Right. It's totally true, and I think, you know, we have the data on this. It just takes a long time to change. For example, in America, and, and we measure insulin, which is part of the key function panel. We measure your metabolic health. Not just your cholesterol, but your particle size, the, the quality of your cholesterol, your ApoB, which is a very important predictor of your risk factor. It's probably one of the most, the most predictive. More important than your LDL cholesterol, which is what everybody's testing to look at statin therapy. You know, when, when we look at the biomarkers, we're seeing insulin, which I think is probably one of the most important biomarkers, and it's less than one percent of all tests that are done in America by doctors, uh, that are sent to Quest, according to Quest. The insulin reference range they have is eighteen as normal, and anything above that is abnormal, and anything below is normal. It should be five or less. Now, why they say it's eighteen is 'cause everybody in America is insulin resistant and pre-diabetic pretty much. [chuckles] So it's gonna be skewed to being, quote, "normal" to be having high insulin, but it's not optimal. So we in Function Health actually provide for four hundred and ninety-nine bucks, uh, easy access to five minutes to sign up online, fifteen minutes in the lab. You can get a deep, deep, dense, uh, data dump of your own biology and also explanations of what it means and what to do about it. Not just what drug to take, but how do you change your diet for this, and what types of exercise will help, and how do you navigate stress and sleep, and what are the right supplements that help modify these pathways? And so we get a very nuanced view of what's going on with your own biology that's personalized and that you own and that you can track over time, and that people then can interact with-

Dr. Rangan Chatterjee 53:55 Yeah

Dr. Mark Hyman 53:55 ... and actually see the results change, and we've seen that over two years. We've just launched two years ago. We're one of the fast-growing companies, uh, in healthcare in the world, and we've seen just in the last couple years how people just doing the program and learning about their data makes them change their behavior such that their biomarkers get better at the end of the two years or whenever they repeat their tests. So they get it tested twice a year, but w- we're tracking it over a couple of years now, and we see it's really quite remarkable. So for me, it's all about personalization. It's about owning your data. It's about the, being the CEO of your own health. It's about having access to information that you're not getting from your regular doctor. They're not checking your insulin. They're not checking your lipid particle size. They're not checking your ApoB, which is the most important cardiovascular risk predictor we have now. It's, it's not checking your sex hormones. It's not checking your thyroid antibodies. It's not checking autoimmune disease. We're seeing, Rangan, thirty-three percent of our, our m-- we have a hundred and fifty thousand members now. Thirty-three percent have a positive ANA, which is a pre-autoimmune marker. 13% have thyroid antibodies, meaning their body has an autoimmune thyroid disease that's attacking their thyroid, making them feel bad. 46% have ICRP, which is inflammation in their body, which we know is linked to everything from depression to dementia to-

Dr. Rangan Chatterjee 55:00 Yeah

Dr. Mark Hyman 55:01 ... cancer to heart disease to, to pretty much everything [laughs] that we have in our modern society. And we're seeing 67% with nutritional deficiencies. So we're, like, finding all these things that are latent and that are causing people to have FLC syndrome, or feel like crap, that they actually, if they knew about, could do something about.

Dr. Rangan Chatterjee 55:19 Yeah.

Dr. Mark Hyman 55:19 And that's really the whole purpose here.

Dr. Rangan Chatterjee 55:20 Yeah. Mark, there's a couple of really interesting things there for me, okay. First of all, when you were talking about breakfast or your 10-day detox diet, one of the things you said was that there's nothing better than doing this for yourself and paying attention to how you feel. And you were also talking about this idea that, actually, you know, you can wait for the medical system to change and medical training to change. You could be waiting a very long time. And so why not take control, as you say, be the CEO of your health, start to do things? So people are doing that already with wearables, right? So-

Dr. Mark Hyman 55:58 Yeah

Dr. Rangan Chatterjee 55:58 ... a CGM, a continuous glucose monitor, of course, can be a fantastic way of you kind of looking at your own breakfast and going, "Well, what is that doing to me?" Right? [laughs] Is it spiking my blood sugar into the diabetic range every morning when I have my cereal, or is it relatively flat? Um, I've been experimenting with this, uh, new product called Lumen. It's a breathalyzer where they can tell you whether you're burning fat or carbs, depending on the combination of oxygen and carbon dioxide, which again, it's about this personalization. You know, I, like you, am very health conscious. But even doing this has helped me change my behavior with my dinner, what time I have it, because I wanna be waking up burning fat. I don't wanna be waking up burning carbs, right? So there's this wider point here that we now are living in a world where we can start to take control of our health. Now, of course, we might need education on what all these markers mean, but that seems to be one of the key things that you're trying to do with Function. You're basically saying, listen... Uh, and I appreciate it's only available in America at the moment, and so we have a different model here with the NHS, which we can talk about. But of course, in America, you're saying for $499, you can have a ridiculous amount of blood testing done, which is gonna give you, I guess, a bit like an MOT for your car, where you're literally looking under the hood. You also mentioned autoimmune disease, right? So if you could just touch on that for a minute, Mark, because I think people who listen to my show are understanding that blood sugar is on a continuum, and pre-diabetes and type 2 diabetes is very late. You wanna get involved much earlier than that. I don't think there's as much awareness of that with autoimmune disease. And you said a quite alarming statistic there about how many people who've done the test with Function Health have got evidence of being on that autoimmune spectrum. So could you just speak to that for a moment, please?

Dr. Mark Hyman 57:52 A, a third of everybody we've tested out of 150,000 people, that's shocking, and I don't know why. I think it's a combination of reasons. But, you know, we think, oh, one day I get lupus, one day I get MS, one day I get rheumatoid arthritis, or one day I get whatever the autoimmune disease is, ulcerative colitis. And the truth is that this is a continuum. And when you're a good functional medicine doctor, you're taking a person's history from even before they were born. What was their mother's pregnancy like? What did her mother eat? What was the birth? Was it a C-section? Did they not get inoculated with good bacteria to colonize their gut microbiome, where 60% of your immune system is? Did they breastfeed or not? And if they didn't breastfeed, what happens to their microbiome? Not a lot of good things. Did they get colic? Did they have infections of, like, ear infections? Did they take antibiotics? Did they have any gut issues or eczema or asthma or any of these things when they were younger? We often sh- see the same story, it, and it unfolds over time. And by the time they're in their 30s and 40s, that's when autoimmune disease kicks in, particularly in, more in women than men. And so what we're seeing is this latent autoimmunity, this low, this pre-autoimmunity in this population because we've destroyed our microbiome, because we're exposed to environmental toxins, because we've taken loads of antibiotics, because we have lots of stress, because we h- have things like gluten, which has way more gliadin proteins than the, than the ancient wheat. When I did research for my book Young Forever, I was eating Zea wheat, which was, uh, fueled Alexander the Great's, you know, charge across, uh, across the continent to take over the world, and it was a very nutrient-dense, high-protein wheat with very low gluten content, uh, and very different forms of gluten. And also, the way they processed it was different. The way they leavened it was different. It wasn't this super leavening stuff. So we see, we see-

Dr. Rangan Chatterjee 59:35 Did you feel a difference, Mark? 'Cause are you sensitive to gluten in the US and you were not there? Or, uh, just help us understand that.

Dr. Mark Hyman 59:42 Yeah. Well, we hear this story all the time, by the way. Uh, y- y- you know, if you're American, you, we, you can be sensitive. You go to Europe, you can eat pasta in Italy, and you're fine. Why is that? One, because the Europeans don't usually have dwarf wheat. Two, they don't spray with glyphosate, which is a bio- microbiome toxin. And so they're not exposed. And three, the way they leaven the wheat is, is much longer, and they'll often use sourdough or other things. So I was in, in Sardinia, and they had sourdough bread. They, they gave me a 150-year-old sourdough starter.

Dr. Rangan Chatterjee 1:00:13 [laughs]

Dr. Mark Hyman 1:00:14 They had, um, various kind of a grain called grano capelli, which is... I'm pronouncing it terribly, but it's basically this form of wheat that's this ancient form of wheat used by the shepherds in Sardinia when they would go out for long distances. So they were, they were eating heirloom varieties that had very different properties and very different kinds of effects on the body. So yeah, when I go to Europe, I can eat more of that stuff. I don't eat it much in America 'cause it's, it's full of crap. And I think, I think, you know, gluten is one of the big triggers for autoimmune disease. It's one of the big drivers. It's leaky gut, it's inflammation, it's environmental toxins, and so we've done all these things that cause our gut to be damaged and our microbiome to be damaged. Uh, e- even though ultra-processed food... I mean, Chris Van Tulleken is, uh, is in the UK. You probably know him.

Dr. Rangan Chatterjee 1:00:55 I do, yeah.

Dr. Mark Hyman 1:00:55 And, uh, he wrote a book called Ultra-Processed People, and he talks about the harms of ultra-processed food, which I think are primarily due to the starch and sugar content and the, some of the additives, and particularly emulsifiers. Now, emulsifiers make things smooth and create texture and so forth. They're put in everything from plant-based milks, like almond milk, to Breads and all kinds of stuff. And so these emulsifiers may damage the gut, and they cause leaky gut, and may cause autoimmune disease, and we're eating 60% of our diet in America as these foods.

Dr. Rangan Chatterjee 1:01:26 Yeah, I think a lot of people don't realize, you know, what, when, when I think about this, I, I think about this idea that, let's say gluten, for example, so you're saying the gluten now is much more concentrated than it used to be, right? So the, the, the amount you're being exposed to has gone up, but also our defenses, our microbiome is completely different from how it used to be, right? So I think it's possibly not just how gluten has changed, it's also the fact that the defenses in our body, the defenses that would protect us, have been decimated, as we've covered on the show many times, you know, how modernity has negatively affected the quality of our gut microbiomes, which is why, of course, there's so much focus these days on gut health. But Mark, if someone, let's say they, they do the function test, and they realize that they're in that cohort who already has evidence of early autoimmunity, what can they then do?

Dr. Mark Hyman 1:02:21 Great question. Great question. So what's different about Function is that the intel inside is really about the future of medicine. We can create a great tech platform, we can create a great user experience, we can create great interactive tools, we can create AI and machine learning and all these wonderful things, but if all we're doing is doing the same medicine better, we're not really advancing the paradigm very much. We're not really gonna impact health that much. We're gonna fix things around the margins, like rearranging the deck chairs on the Titanic. Probably not the solution here. What's really different is, with Function Health focused on root cause medicine. So if you have an autoimmune disease, rather than saying, "Oh, you have rheumatoid arthritis. Take steroids, take anti-inflammatories, take biologics, take these drugs to shut off the immune system," we ask a different question, which is, "Why?" So traditional medicine is the medicine of, of what? What disease do you have, and what drug do I give? This approach, root cause medicine, is really about why. Why do you have this, and what's going on? And so for autoimmune disease, it's a myriad of things, but we know the triggers for autoimmune disease. One is our microbiome and disturbances in our microbiome and leaky gut.

Dr. Rangan Chatterjee 1:03:37 Yeah.

Dr. Mark Hyman 1:03:37 That's probably the number one cause, and what causes a leaky gut in a lot of cases is gluten. And if you look at gluten, it's, can account for dozens, probably 100 different autoimmune diseases. And if you just look at the New England Journal of Medicine papers that were written, like, I don't know, 30 years ago, they listed 55 different diseases that could be caused by celiac or gluten issues. It can be environmental toxins. They call these autogens, so auto- auto- autoimmune-inducing toxins. So it can be pesticides, can be heavy metals, can be glyphosate. They can cause autoimmune disease. It can, it can also be, um, infections. We know that infections like Epstein-Barr will cause MS, for example. So whether it's a toxin, an infection, a leaky gut, a food sensitivity, an allergen, gluten, we, we now can start to dig around. It can even be things like Lyme disease, or it can be mold. All these things can trigger autoimmune disease, so we need to be able to investigate what these are, and Function Health provides you with a roadmap, which you will not get from your traditional doctor, on how to identify these problems and then what to do about them. And if a, a basic approach doesn't work to getting to the root cause, yes, then you need to go to the doctor. You might need medication, and that's fine. But it's really about starting with the right first principles of why, not what.

Dr. Rangan Chatterjee 1:04:54 And I guess one of the key points there is if you don't do that test and get the result, you may not do anything differently in your life. You may go about thinking, "Hey, life's okay. I don't feel great. Maybe I'm a bit bloated. Uh, my energy's not great, but hey ho, I can manage," until five or 10 years later. That's when you show up with rheumatoid arthritis or lupus, right? I think there is really good evidence, and it's been emerging for ages, that actually just as we know blood sugar is on a spectrum and you don't, you know, you don't get type 2 diabetes overnight, it's building up in your body five, 10, maybe longer years in some people. Alzheimer's, Dale Bredesen, last time I spoke to him, said Alzheimer's starts 30 years, generally speaking, before the diagnosis, right? By the time you get the diagnosis, it's been going on for a long period of time, and I guess that's the principle here, which is you want to empower people to s- to, to sort of find this stuff early so they can turn the ship around, so they don't end up with full-blown disease somewhere in the future, right?

Dr. Mark Hyman 1:06:00 Absolutely. That's the whole point, is you don't wanna wait [laughs] till things have already gone really bad. You want to get things early, and the sooner you can get them, the better you are. And that's really the purpose of Function Health, is to help people to get early diagnosis and identification of issues that they wouldn't have known otherwise. And we're seeing everything from just, you know, identifying people with prediabetes that they didn't know of, or pre-autoimmune disease, to finding people with pituitary tumors that were affecting the quality of their life that they didn't know they had, which you can tell from a simple blood test, or cancer that they didn't know they have through our cancer liquid biopsy screening test, which you can find f- 50 different cancers. And that's really important because you, you wanna know, it, where you're headed. You don't wanna wait till you get there to find out. Benjamin Franklin said, "An ounce of prevention is worth a pound of cure," and so that's where we're headed [laughs] in medicine. It's predictive, personalized, preventive, and it's participatory. You have to do it yourself.

Dr. Rangan Chatterjee 1:06:51 Do any critics say, Mark, that actually this sort of testing may create health anxiety and causes more problems than it solves?

Dr. Mark Hyman 1:07:01 100%. I mean, listen, [laughs] anytime you come up with a new idea, anytime you try to challenge the existing paradigm, you're gonna get critics, and we've certainly got critics, and I, I'm not so worried about that. Uh, I mean, I've seen this for 30 years in functional medicine. What I do- We do a lot of diagnostics 'cause we wanna find out what's, what's going on in the person's biology so we can optimize it. We wanna create health, not just treat disease. And so, uh, w- yes, you might create a, uh, an uncertainty or an anxiety about something, but I'd rather do that and find out you don't have anything wrong than miss something and have you have some disease that's really incurable at some point later on.

Dr. Rangan Chatterjee 1:07:36 Okay. So Mark, um, not all my audience live in America. For those who do live in America and are thinking, "Okay, I can afford that. I would like to do that," how do they go about doing that?

Dr. Mark Hyman 1:07:50 Yeah. So, you know, basically what we're talking about is in, in, in American dollars, it's $1.37 a day for the, for the basic membership, which includes twice-a-year testing of over 110 biomarkers, and 60 a half year. And, and it's $15,000 worth of diagnostics that we've been able to kinda get the prices down, because there's such price elasticity in the market in America, it's kinda crazy. I don't know if it's like that in the UK, but you could- imagine buying a Toyota Camry on one lot that's $20,000, another lot that's $100,000, another lot's at $10, another lot's at a million dollars. That's kinda like the pricing in America [laughs] when it comes to stuff. So we've been able to get the prices really affordable for people. And, and they just have to go to functionhealth.com and slash live better, and they can sign up and get in and get access to the platform. We have, like, half a million people on the wait list, so we don't, we don't, you know, wanna have to have your listeners wait for that. So if you go to functionhealth.com/livebetter, you'll be able to get an early access and jump in and, and jump the wait list and, and see what's going on in your biology. And then you can do something about it.

Dr. Rangan Chatterjee 1:08:51 Yeah. Thank you, Mark. I appreciate that for, for my US listeners who, who wanna take advantage of that. Let's broaden it out now. For people all round the world, even people in America who, let's say, can't afford that, or people in other countries of the world who go, "Actually, you know what? That all sounds great, but that's not available yet where I live", can we just go through five or so of the tests that you think are most impactful for people? They're tests that can be commonly done at their regular doctor, perhaps they're not. But, you know, what are some of those lower cost tests that we can help people with all over the world at the moment?

Dr. Mark Hyman 1:09:27 Sure. Well, I'm gonna answer that in two parts. The first is the lower cost tests. I think that, that there's some basic things that everybody should get. You need a lipid fractionation test. It's not your normal cholesterol, but it looks at the quality of your cholesterol and the size of your cholesterol, and that again is not that expensive. ApoB, which is a type of cholesterol particle, very important for being a predictor of heart disease. Insulin, measuring your blood sugar. Obviously, your A1C, uh, is very important. Uh, vitamin D I would see very important. [laughs] And then, you know, we can kinda go down the list of things that are, are more or less important. But those things can make a huge difference if you just learn what those are for your, uh, nutritional metabolic health, if you're doing the bare minimum of four or five things. What I'll say what's coming is, because our platform has got so much data, literally tens of millions of data points on 150,000 people and growing at an ex- astronomical rate, we're gonna be able to soon be able to predict, based on your history and your own data, what's going on with you, even necessarily not having to do as extensive lab test. Now, the lab test will be helpful, but, but if you're in a place where you're in a country where you can't get access to care, where there isn't a lab, where you don't have enough, uh, access to capital to do this, or the, the price is too high, you will be able to actually query your own biology by putting in your medical history, by putting in your past medical records, whatever tests you did have, and put it in there, and then it will learn from your data what is right for you and allow you to personalize your care. So that's where we're going. We want this to be available to eight billion people.

Dr. Rangan Chatterjee 1:11:04 Yeah, no, I love that. Information is not enough to make change in your life. You have to take action. So to help you take action after watching this video, I've created a free nutrition guide for you. This contains the five most important practices I've seen in over two decades of seeing patients. They work for you no matter what your dietary preference. There's a step-by-step action plan to help you implement those changes in your life. If you wanna receive that free guide right now, just click on the link in the description box below. It's exciting what AI and all this sort of, you know, machine learning is gonna do to actually how we even view health and look at it and predict our potential outcomes in the future. Those five tests you mentioned, uh, let's just quickly go through them. I'd love for you, if you can, to provide what you consider optimal ranges to be. Um-

Dr. Mark Hyman 1:11:56 Okay

Dr. Rangan Chatterjee 1:11:56 ... so help us understand, Mark, from your experience, when it's vitamin D, what do you like to see?

Dr. Mark Hyman 1:12:03 What I like to see is, is at, at least 45 nanograms per deciliter or more, and between that and 75 to 100 is pretty safe and good. So that's, that's an important number 'cause that regulates bone density, cardiovascular health, brain health, immune health. Uh, again, you know, flu vaccine. If your vitamin D level is, uh, optimal, you, you have a 75% reduction in your risk of getting the flu, which is more than the vaccine. Now, I personally have never gotten the flu, and I make sure my levels are that high. So I think it could be coincidence, but I've been around a lot of people with the flu, [laughs] and I think it's quite amazing how powerful this nutrient is, which is really more like a prohormone.

Dr. Rangan Chatterjee 1:12:47 Okay.

Dr. Mark Hyman 1:12:47 Um-

Dr. Rangan Chatterjee 1:12:48 So that's vitamin D. Uh, then we went to HbA1c, this average blood sugar marker that, uh, certainly in the UK, anyone can get on the National Health Service. Uh, it's a very cheap test. What do you like to see, um, as a level there?

Dr. Mark Hyman 1:13:03 I like five and a half or less. If people are five and a half or less, I'm happy. If I get people who are five, I'm thrilled. [laughs] But, you know, I recently did mine, it was 4.8. I was happy about that.

Dr. Rangan Chatterjee 1:13:13 Oh, that's amazing.

Dr. Mark Hyman 1:13:15 For a 65-year-old, we're, one in two 65-year-olds pretty much have diabetes or pre-diabetes, so it's, it's probably worse than that, actually.

Dr. Rangan Chatterjee 1:13:22 Can I just ask you, you're 65 You're fit, you're well. What is it you attribute your A1C of 4.8 to? I know it's a combination of things, but that is lower than most patients in most practices

Dr. Mark Hyman 1:13:36 It's, it's not rocket science. It's, you know, keeping your body composition optimal, not having belly fat by reducing starch or sugar or cutting it out dramatically. Exer- regular exercise, getting enough sleep, managing your stress. It's not that hard. I mean, it, it, it sounds like a lot, but it's really, it's not rocket science, it's just the trigger is starch and sugar. So I make that a, a, a treat, an occasional treat, not a daily staple.

Dr. Rangan Chatterjee 1:14:00 Okay. So you said vitamin D, A1C, insulin, right? So when you want people to test their insulin, is this at any time of the day, or is this a fasting insulin that you want?

Dr. Mark Hyman 1:14:11 Well, fasting insulin's very good. Now, I don't know if it's available in the UK yet, but there's a new test and we offer it with Function Health, which is revolutionary. It's called a, uh, insulin resistance score, and it's an, it's a new way of looking at insulin resistance, which is the fundamental pathology underlying most chronic diseases, from heart disease to cancer, to diabetes, to dementia, and even depression. And what this measures is using a fasting insulin plus a C-peptide level. Now, what is C-peptide? C-peptide is the precursor molecule for insulin. So using a technology called mass spec, which is a, an old laboratory technology, but it's a little more expensive than regular lab testing, they're able to actually identify the level of insulin resistance in a patient, which is as good as any research-based tool that we use to identify insulin resistance, which is what we call a euglycemic clamp test, which no one would want to undergo. They do it in animals, [laughs] but it's, it's, it's a pain in the ass test, or a glucose tolerance test with insulin, which is better, but still not as good, and this is just a simple blood test in the morning. And if I can get everybody on the planet to do this and see what their number was and try to improve it, I think we'd, we'd solve a lot of our health crisis 'cause it's a beautiful, simple test, and I, I think that's really good. But if you just can measure insulin, which is very inexpensive, like five bucks, 10 bucks, or less, you're talking a level should be under five ideally.

Dr. Rangan Chatterjee 1:15:38 Is this fasting insulin?

Dr. Mark Hyman 1:15:40 Fasting insulin.

Dr. Rangan Chatterjee 1:15:41 Okay.

Dr. Mark Hyman 1:15:42 Fasting insulin. Like I had a guy the other day, his fasting insulin was 39. I almost like, my eyes came out of my head. It was so high. I've seen higher levels, but usually in very young, uh, very obese people who are pancreas are just pumping out huge levels of insulin. They're drinking, you know, like a two, a two-liter or three-liter bottle of soda every day. Uh, and so five or less is the ideal. Five to 10 is sort of intermediate. Over 10 is not good, but again, the reference range in our lab here is 18. And now in, in the Function educational content, we'll say, here's the reference range and here's the optimal range, and here's how you get to optimal, and here's how you get to optimal, 'cause they're different for some. Like, if your sodium is, you know, is optimal, it's normal. It's like there's a very narrow range, or calcium. These are things in your blood tests that don't really have normal or optimal. They're just, there's just one reference range. But the things that are lifestyle related or diet related, there are ranges.

Dr. Rangan Chatterjee 1:16:34 Yeah. Let's just relate this back to how we started the conversation, Mark, talking about breakfast, right? And so we've mentioned blood sugar, we've mentioned type 2 diabetes, you've mentioned insulin, right? So we're saying that type 2 diabetes is, is quite late when by the time you've had that, there's been problems going on for a period of time. I've also mentioned HbA1c, this average blood sugar marker that you've also shared what you like to see with your patients. But even that is a late marker, isn't it? Which is, of course, where insulin comes in.

Dr. Mark Hyman 1:17:07 Yeah. I mean, you know, the first thing to happen is your insulin goes up after a meal. The second thing that happens is your insulin goes up fasting. The third thing that happens is your blood sugar goes up after a meal. The fourth thing that happens is your blood sugar goes up fasting. That's when we usually pick it up, at stage four. [laughs] We don't even look at any other things. So we're way, we're way late in picking up problems with your blood sugar and insulin because we're not looking at these other, other factors. So you can do a two-hour glucose tolerance test with glucose and fasting insulin, and one and two-hour glucose and one and two-hour insulin. That's helpful. But this new insulin resistance score is gonna make that obsolete, and I think, I think with a lot less pain because it's like drinking two Coca-Colas to get your blood sugar and insulin to do gi-

Dr. Rangan Chatterjee 1:18:01 Yeah

Dr. Mark Hyman 1:18:01 ... gyrations. So it's, it's important to keep your numbers in an optimal range for insulin. By, by the way, there's an easier test. If you look in the mirror and you got belly fat, you probably have the problem. You don't even need a blood test. [laughs]

Dr. Rangan Chatterjee 1:18:14 Yeah. Well, look, this is, you know, it, it's important stuff that we talk about and we help people with because a lot of people are struggling with their, their health and wellbeing. They're trying their best. They're trying to consume information. They're trying to apply it in a world that doesn't make it that easy for them. But this thing about insulin is so, so interesting because we talk about prevention, and everyone loves to talk about, you know, prevention's more important than cure, and all this kind of stuff, but if you look at medical practice in the UK, we don't really do prevention. We, we kind of... You know, we think looking at your blood pressure is prevention, and of course, you know, yes, keeping your blood pressure in the right range is important, but these things, you mentioned a term before, pre-hypertension, early on in this conversation, right? What does that term mean? Because the, I'm trying to get this idea across to people that actually when medicine gets involved with you, that is quite late. That is why doing these markers regularly and earlier, and having someone being able to interpret it for you, or an app or a program that does that, it's basically you taking control of your health at a much earlier stage, isn't it?

Dr. Mark Hyman 1:19:26 100%. We, we really wanna get people early in the continuum of disease. And this is a problem with traditional medicine, is we do not think in, about disease in continuums. Just like, you know, diabetes, we've started to with pre-diabetes because the data showed it. Or blood pressure with pre-hypertension. You know, normal blood pressure should be 140 over 90, and it's like 120 over 80. Now maybe optimal is 115 over 75. So what is the level at which there is no disease, right? What is the level at which you're never gonna get a stroke or a heart attack, right? And that is a very different number than what is, quote, normal. And that's really what I wanna shoot for. I don't wanna be average. I wanna be optimal. [laughs]

Dr. Rangan Chatterjee 1:20:07 Yeah. Okay, uh, the two more tests that you mentioned, let's go through. ApoB, you're saying a really powerful predictor of, uh, your risk of cardiovascular disease.

Dr. Mark Hyman 1:20:18 Yeah.

Dr. Rangan Chatterjee 1:20:18 Where do you like to see ApoB levels in your patients?

Dr. Mark Hyman 1:20:22 So just to, just to back up, what is ApoB? Well, if you don't have the ability to do what we call lipoprotein fractionation, which is a more complicated test where you look at particle size of your cholesterol and HDL and triglycerides and the number of particles, uh, it, it's not always available. It's not that expensive, but it's, doctors are loathe often to order it. ApoB is a surrogate marker for that, and ApoB is a lipid particle, or apolipoprotein B, for all the non-good cholesterol types of particles. For all the small particles, all the triglyceride particles. So it's a surrogate marker that you're heading in the wrong direction, and it's probably far more predictive... Not probably. It is far more predictive than LDL cholesterol, which is what most doctors look at. And the level you should have is under 90, but ideally probably under 70. And if you have cardiovascular disease, maybe under 50. In other words, if you've already had a heart attack, you wanna drive it even lower to see regression. So we're, we're looking at levels of 100, 110, 150, you know, in people. And so, like I said, with Function Health, we see, I think 50, uh, 1 or 56% of people who do the function panel have an abnormal ApoB above the reference range from the lab, not what I would say is optimal.

Dr. Rangan Chatterjee 1:21:35 Yeah.

Dr. Rangan Chatterjee 1:21:36 Mark, make the case to someone, if you, if you don't mind, someone who's listening to this and goes, "Okay, listen, either I don't live in America, or I can't afford or I don't want to spend a lot of money on blood testing," right? And they're thinking, "Well, look, I feel okay. Why can't I just go about doing what I'm doing, go and see my doctor for a medical once a year, and if he or she tells me everything's okay..." You know, whether it's function or whether it's these four, five simple tests that are available all over the planet, make the case to someone why you think they would benefit from doing these tests early.

Dr. Mark Hyman 1:22:14 Look, [laughs] it's really simple. How do you feel, and how do you look? [laughs] If you feel great and your body composition, meaning you look great in the mirror, meaning you don't have no belly fat, you might be okay. And you don't even have to potentially even go further than your doctor's office to do the most basic things. So if you wanna just get to the shortcut without any additional testing that you get at your doctor's office, it would be pretty simple. They're gonna check a cholesterol profile. So make sure you look at numbers that they don't particularly look at, which is your, your number of triglycerides divided by your HDL. Now, we say good and bad cholesterol. HDL can be good and bad. LDL can be good and bad, so I don't like the good and bad reference. But basically, triglyceride over HDL is a number that almost everybody's gonna get on their basic checkup. If that number starts to creep over one or two or three, you're heading in the wrong direction when it comes to your insulin resistance. It's one of the first things to go wrong. It's, it's very predictive. Very predictive. Um, not quite as good as an insulin resistance score, but it's very predictive of having a heart attack. More than LDL, by the way, and that's something you can get. And then look at your blood sugar. If it's between 85 and 9 and 100, and, and again, your reference ranges are different in the UK, but if it's... 'Cause I, I train in Canada, so I for- I... It was 40, 40 years ago. I've forgotten all those [laughs] reference ranges, but I know the American ones. So if it's between, like, 85 and 100, you're heading toward cr- you know, scope creep in terms of your blood sugar regulation, even if they don't measure insulin. If it's over 100, for sure you're already in trouble. So make sure you pay attention to that. That's gonna be on your annual checkup. And if you wanna just get insurance about what you should basically take without having to worry about a lot of things, take a good multivitamin, take a good fish oil, uh, EPA, DHA, about a gram a day, and take a good vitamin D, between 2 to 4,000 units a day, uh, vitamin D3. And if you combine it with K, that's better. And we're talking literally pennies a day to be able to do this if you can't afford most other things. That alone will help you identify and solve for many of the problems that people are having. You'll get the B vitamins were low, and you'll get potentially a little bit of, of, of zinc. You'll get, maybe there's some iron in some multivitamins, depending on which they are, particularly if you're a menstruating woman. But we'll, we'll deal with a lot of the deficiencies. Magnesium often is a big deficiency. You might need a little extra magnesium. But you can just cover your bases by doing those things and just eating protein as, and fat for breakfast, cutting out starch and sugar for the most part if you can, and, and trying to kind of move your body and do all the things you write about in your books, uh, and that you do so beautifully and elegantly. So you don't have to go crazy, but the basics are really gonna solve most of the problems for you.

Dr. Rangan Chatterjee 1:25:07 Yeah. Mark, you released your book, Young Forever, I don't know, two or three years ago now, and when it came out, we had a quite wonderful conversation. Um, what's changed in the last two to three years in the sense that if you were writing the book today, what would you add that wasn't in there?

Dr. Mark Hyman 1:25:28 Uh, well, I think with some-- there's some really interesting stuff around the margins that I don't think really is ready for prime time yet that there's more and more research on. For example, uh, therapies that are look- being looked at for longevity, like plasmapheresis or things like stem cells or exosomes or even things, for example, that, uh, they're being researched in certain labs like Altos Lab from the Jeff Bezos' funding or Sam Altman's lab that are looking at these things called Yamanaka factors. And when you-- when it comes to longevity, you know, we're gonna be able to, most of us, uh, do well if and live maybe a hundred healthy years, which is our goal at Function Health, if you follow the foundational principles that you and I talked about.

Dr. Rangan Chatterjee 1:26:13 Mm-hmm.

Dr. Rangan Chatterjee 1:26:14 Yeah. Wow! It's pretty exciting to see all the research that's there. Um, going back to testing for just a minute. When I was in LA in November at our friend Darshan Shah's clinic, he did a full set of bloods for me, and in that he included BPA.

Dr. Mark Hyman 1:26:31 Oh, yeah. Yeah.

Dr. Rangan Chatterjee 1:26:32 Now, just, just to sort of highlight the point of, um, how testing can be so powerful, I am pretty proactive about my health. It's my career. It's what I talk about. It's what I do. When those blood tests came back, my BPA levels were in the red.

Dr. Mark Hyman 1:26:52 Wow.

Dr. Rangan Chatterjee 1:26:52 Right? I was looking at them going, "What the hell is going on? How do I have this much plastic going around my body, right?" Or the, the BPA at least. And knowing that has completely changed my behavior. Since then, I think once when I was traveling, I drunk water out of a plastic water bottle, but I pretty much haven't done it. I never, ever anymore will get a takeaway hot drink in one of those, uh, plastic cups from a coffee shop or whatever, you know. I'll either not have it or I'll take my own flask or my own cup. But this highlights the benefit of testing, right? When I saw that in my body, I'm like, "Okay, Rangan, this, this stops now." Um, do you know what I mean? So I think I'm just, I'm just-

Dr. Mark Hyman 1:27:40 Yeah

Dr. Rangan Chatterjee 1:27:40 ... showing that to kind of highlight how tests-

Dr. Mark Hyman 1:27:43 It's power.

Dr. Rangan Chatterjee 1:27:43 It's power, isn't it?

Dr. Mark Hyman 1:27:44 Yeah. Information is power, and I, I agree. I, I think it's so important to know what you're exposed to. And, and it-- with Function Health, you can check your BPA levels, which is bisphenol A, that causes diabetes and potentially cancer and hormone disruption, and it's in credit card receipts. It's in, uh, uh, you know, uh, in automatic teller receipts. Your-- when you get your gas or your petrol, as you call it, and you, you get that receipt. It's all on those receipts, so you don't wanna be touching those things. [chuckles]

Dr. Rangan Chatterjee 1:28:11 Yeah.

Dr. Mark Hyman 1:28:11 You know, they want a print. I'm like, "No, email it to me."

Dr. Rangan Chatterjee 1:28:13 [chuckles] So Mark, I haven't done yet an episode on microplastics. I hope to very shortly, and the potential impact on our health. But I also don't wanna scare people, so you just said [chuckles] a lot of things there, receipts, um, you know, takeaway coffee cups. All these things, you know, are loaded with this stuff, and especially when the hot water goes into that takeaway coffee cup. The, the, you know, once you start delving into this, you can see it's everywhere. Yes, you can reduce your exposure, um, but also, what's your take on things like sauna therapy? And of course, if people have, you know, access to it, which of course not everyone does, what are some of the other things people can do to help them detoxify a lot of the toxins that are there in the modern environment?

Dr. Mark Hyman 1:28:59 Yeah, I think that's a great question. And I've been talking a lot about this, particularly with the LA fires, because the LA fires released so many toxins in the environment, not just BPA and heavy metals and dioxin, but volatile organic compounds and pesticides and plastics. I mean, the, the amount of toxins released were just staggering. And people have had-- even Bryan Johnson actually reported on this, how his levels of these compounds skyrocketed after the LA fires. So I did a whole seminar on how do you reduce your exposure, right? So your air filters, filter your water, you know, be careful when you go outside. If the air quality is not good, use a mask, an N5 mask, which is not fun. Um, but there are a lot of things your body already does to, to get rid of these things. So I call it the, you know, the, the triple P system, the pee, poop and perspire system. [chuckles] You know, and you wanna, you know, drink a lot of fluids, so you're well-hydrated and peeing out a lot of these things. And the solution to pollution is dilution, as you learned in med school. You probably learned that, right? When you have an infection, you just put a lot of fluids and clear it out. Second is, uh, you wanna make sure you're going to the bathroom a lot, and, uh, that means lots of fiber. Flaxseeds are great. Chia seeds are great, uh, for going to the bathroom. Magnesium is great, uh, and also lots of phytochemicals that have detoxifying compounds in them, like the broccoli family, garlic and onions. Uh, and pretty much any colorful fruit or vegetable is gonna have compounds that facilitate either antioxidant defenses or detoxification pathways. Uh, and then you, you wanna do things that can even take you up a level from just, you know, doing things like that, like sauna. Sauna therapy can be very, very effective, uh, and that, that's something very important. And then there are certain supplements that can be very effective, like N-acetylcysteine and which helps support glutathione, the main body detoxifier. And then there's even more advanced therapies to help cellular detoxification, which uses cell membrane replacements, uh, like phosphatidylcholine, to replace all the toxins that get embedded in your cells. That's a, that's a much deeper can of worms we can talk about someday. But, you know, from a therapeutic point of view that you can do with a doctor, there's certain things you can do, but on your own, it's just, you know, cleaning up your household products, cleaning up your, uh, toxins in your food by trying to buy organic if you can. Filtering your water. Ideally, getting an air filter if you're exposed to bad places. Avoiding like the things that-- things you can avoid, like plastic cups and bottles. And I mean, BPA is not a microplastic, but it's lining plastic containers, so you're getting microplastics a-along with it. So, um, we, we basically wanna reduce our exposures. We wanna maximize our excretion, and that's really-- that's what it comes down to.

Dr. Rangan Chatterjee 1:31:30 Yeah. And I guess, yeah, if you don't have a sauna, if you're doing things where you're sweating regularly, you're at least excreting stuff through the sweat, and of course, that highlights the need to open your bowels regularly, right? Because that's the way that actually people excrete stuff and, and sort of detoxify from the body. Mark- Just to finish off, you've obviously been pioneering in the longevity space for a while. You're doing a great job with yourself in terms of, you know, the difference between your chronological age and your biological age. I don't know what it is these days, but you were pretty young, uh [laughs] biologically last time I spoke to you. Um, you know what? I'm, I'm really fascinated as to, as you get older year on year, despite everything that you know and all the things that you're doing, how do you actually think about your own mortality and death?

Dr. Mark Hyman 1:32:19 Well, I, I, I, I'm not one of those people who wants to live forever and not die. I think that mortality is what makes life so sweet and beautiful, 'cause you know eventually it's gonna end. Uh, and it makes me treasure every day more as I get older. Uh, it also makes me prioritize what matters, and the things I care about, and not do things that I don't really think are going to be the things that matter to me. Uh, and so that's, that's really shifted for me. Also, I've realized that it takes more time to invest in, in, in my health. When I was younger, I could do anything and, you know, was sort of resilient, but now I have to make sure I exercise, I have to make sure I eat well, I have to make sure I take my supplements. I have to do the basic things to optimize my health. It's like if you have a, you know, a 50-year-old car, it's not gonna run as well as a car you drive off the lot, but it can still drive well if you take care of it.

Dr. Rangan Chatterjee 1:33:07 Yeah. And finally, Mark, I understand when I was doing my research for this conversation, that before you went to medical school, you studied Buddhism-

Dr. Mark Hyman 1:33:20 Yeah

Dr. Rangan Chatterjee 1:33:20 ... at university.

Dr. Mark Hyman 1:33:22 Mm.

Dr. Rangan Chatterjee 1:33:22 And that's really interesting to me. I also know that you trained to be a yoga instructor many, many decades ago, before it was big in the wellness space, right? So I'm really interested as to your life journey and the fact that you were a very early adopter, certainly in this kind of online wellness space, into yoga. You studied Buddhism at a very young age. How did what you learn back then influence how you think about health today?

Dr. Mark Hyman 1:33:48 Oh, tremendously. I mean, I think what I learned about was a lot of the science of creating health without even knowing about it, through just understanding what it took to create a health through, through the practice of yoga, which has a lot of, you know, built-in philosophy around, you know, meditation, movement of the body, about diet and so forth. Uh, when it comes to Buddhism, that was more about healing of the mind, but it also talked about, you know, Tibetan medicine and healing medicine, which is actually how I started getting into medicine. And I, I also think that, that the, the, uh, things I studied on the margins really also influenced me, which were really about systems thinking. You know, not looking at the reductionist view of the world, but looking at how everything's connected and how everything relates to everything else, and looking at ecosystems, both biologically and also in other networks. And so network thinking was always a part of my kind of pre- predisposed mind. And so when it came to medicine, I just didn't get the reductionist model at all.

Dr. Rangan Chatterjee 1:34:44 Mm-hmm.

Dr. Mark Hyman 1:34:44 And when I personally got sick when I was in my 30s, I had to kind of resurrect myself, and it required me to really step out of the bounds of what I learned in medical school and step into a new framework which looks at the body as an interconnected network, where all the systems were interdependent and interacting, and I had to optimize them and understand them in order to be healthy. And that's what I did, and that's really what led to my career, and that's what has been the foundation of my teachings and my work for the last 40 years.

Dr. Rangan Chatterjee 1:35:09 Yeah, I love that. Thank you for sharing that. Mark, for someone who's stumbled across our conversation and has been inspired by what they've heard from you, and they're thinking that, "You know what? I, I really need to do something now with my health. You know, I've neglected it for far too long. I wanna be as healthy and as well as Mark Hyman when I'm 65," what are those final take-home points that you would say to that person?

Dr. Mark Hyman 1:35:37 Um, you know, steady wins the race. I think, you know, for me, I've never gone into shape and out of shape. I mean, I've had moments where I've had more or less, but I've always eaten well, I've always exercised, I've always focused on the basics. And the dividend pays dividends, and if you invest, you know, uh, you know, $10 when you're born, it's gonna end up being a lot of money, even if you don't add any more money to it, by the time you're 65. And so it's really about, you know, starting as soon as you can, starting to invest little bits every day, whatever, whether it's a slight improvement to your diet, little bits of exercise, stress management practices. I [laughs] noticed this new device someone sent me, which is essentially two minutes a day on your vagus nerve with a little vibratory stimulator that's, uh, like, you know, getting huge stress reduction reset on your nervous system. So I'm like, "Okay, four minutes a day, I could probably do that." Now, so there's little bits and bites that people can do, and then as you get more inspired, you wanna do more, then do more. But I think, you know, if, if you're struggling, y- you know, you've just gotta start where you are and take the first step. And for me, we talked earlier about the 10-day detox diet, but it is such a profound and radical-

Dr. Rangan Chatterjee 1:36:44 Yeah

Dr. Mark Hyman 1:36:44 ... shift in your biology in such a short time. So you don't have to believe me, you don't have to listen to me, you don't have to believe you. Listen to your body. What happens when you take out the crap and you put in the good stuff? Your body will be smarter than any one of us [laughs] in telling you what to do. And then you listen, or not. [laughs] And they say, "Well, you know..." Like I know, for example, if I have a glass of wine, I'm not gonna sleep as well, but I'll know that, and I'll make that conscious choice. But I, I would say now that I know that information, I do it probably a lot less. You know, maybe once a month or every few months. So it's really now a conscious choice to do something where I know it might impact me, like have some ice cream or whatever. I'll, I'll make that choice, but it's, it's with the knowledge of how it's gonna impact me.

Dr. Rangan Chatterjee 1:37:29 Yeah, Mark, I love that. Mark, I always enjoy talking to you. You've been helping so many people around the world for so long. Thank you for coming back on the show.

Dr. Mark Hyman 1:37:38 Thanks so much for having me, Rangan. It's been great.

Dr. Rangan Chatterjee 1:37:40 [upbeat music] If you enjoyed that conversation, then I think you are really going to enjoy this one.

Dr. Mark Hyman 1:37:45 Who wants to live longer if you're not able to have good brain health? You could live to 150, 200. Go for it. But if your brain isn't working, it's not worth living.