This Decreases Your Lifespan Everyday (& Doctors Won’t Warn You) | Anti-Aging Reset w/ Mark Hyman

Dr. Rangan Chatterjee 0:00 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 0:15 That's right.

Dr. Rangan Chatterjee 0:15 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, 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 0:48 Right

Dr. Rangan Chatterjee 0:48 ... 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 1:08 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 th- 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 1:48 Yeah.

Dr. Mark Hyman 1:48 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. Y- 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 it to our kids. We wouldn't feed to our dog what we feed to our kids.

Dr. Rangan Chatterjee 2:15 Yeah.

Dr. Mark Hyman 2:15 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 the, 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 2:46 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's 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 y- you know, "What oil did you cook that in? 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 messing about 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 3:38 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 4:07 Yeah.

Dr. Mark Hyman 4:07 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 4:19 Yeah.

Dr. Mark Hyman 4:19 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 Go-Gurt was or a Pop-Tart or a Twinkie. I mean, they, they would be like, "What is this thing?" [laughs]

Dr. Rangan Chatterjee 4:32 Yeah.

Dr. Mark Hyman 4:32 "I don't understand."

Dr. Rangan Chatterjee 4:34 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 4:48 Yeah

Dr. Rangan Chatterjee 4:48 ... uh, why, why those two are in there.

Dr. Mark Hyman 4:52 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, 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, the, 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 get 23 chromosomes from your mom, 23 from your dad. You get, 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're 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 it's 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 8:17 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 8:30 Yeah.

Dr. Rangan Chatterjee 8:30 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 well-being. 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 9:26 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 9:44 Yeah.

Dr. Mark Hyman 9:45 Yeah. You 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 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 they... 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 10:52 Yeah.

Dr. Mark Hyman 10:52 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 11:37 Yeah, and then, you know, I, I... it's... This is so important, and the, 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. Why 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 gen- 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 13:06 Totally. Totally. I think, I think, you know, um, y- y- 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 13:24 Yeah.

Dr. Mark Hyman 13:24 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 13:33 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 13:48 Yeah.

Dr. Rangan Chatterjee 13:48 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 14:10 No. Zero.

Dr. Rangan Chatterjee 14:11 Really?

Dr. Mark Hyman 14:12 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 diseases 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 it. And so it- 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- 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 15:14 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 15:40 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 15:51 Yeah.

Dr. Mark Hyman 15:51 It's tragic. It's really tragic.

Dr. Rangan Chatterjee 15:53 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 test 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 5.7 is pre-diabetes. Is that right?

Dr. Mark Hyman 16:37 That's right.

Dr. Rangan Chatterjee 16:38 Yeah. So here, it's not until six, right?

Dr. Mark Hyman 16:41 Yeah.

Dr. Rangan Chatterjee 16:41 So, 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, 6.5 and above, I think like America, is considered type 2 diabetes. Six to 6.4 is considered pre-diabetes, which basically means, Mark, there will be hundreds of patients today in the UK who have got an HbA1c of 5.9, 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 17:35 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 110 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, 19 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 data set 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 d- 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 5.0-Forget 6.0 or 5.7, just 5.0, 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 5.0.

Dr. Rangan Chatterjee 18:57 Ev- 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 19:05 Right

Dr. Rangan Chatterjee 19:05 ... you're still at increased risk.

Dr. Mark Hyman 19:07 Right, right.

Dr. Rangan Chatterjee 19:07 I think there's really good research showing that an A1C of above 5.3 sequentially starts to increase your all-cause mortality, which is-

Dr. Mark Hyman 19:15 Yeah

Dr. Rangan Chatterjee 19:16 ... crazy that these are being reported as normal.

Dr. Mark Hyman 19:19 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 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 1% 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 18 as normal, and anything above that's abnormal, and anything below is normal. It should be 5 or less. Now, why they say it's 18 is 'cause everybody in America is insulin resistant and pre-diabetic pretty much. [laughs] 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 499 bucks, uh, easy access to five minutes sign up online, 15 minutes in the lab. You can get a de- 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 you 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 20:54 Yeah

Dr. Mark Hyman 20:54 ... 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 of 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 we're, 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, 33% of our, our m- we have 150,000 members now, 33% 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 22:00 Yeah

Dr. Mark Hyman 22:00 ... 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 22:18 Yeah.

Dr. Mark Hyman 22:18 And that's really the whole purpose here.

Dr. Rangan Chatterjee 22:20 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 or 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 22:57 Yeah

Dr. Rangan Chatterjee 22:57 ... 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, this 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 want to 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 an 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 24:51 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-

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Dr. Mark Hyman 26:41 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 see the same story, it, and 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 have things like gluten, which has way more glide proteins than the, than the ancient wheat. Where 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 this-

Dr. Rangan Chatterjee 28:15 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 28:22 Yeah. Well, we hear this story all the time, by the way. Uh, y- you know, if you're American, you eat wheat, 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, and they gave me a 150-year-old sourdough starter. 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 because 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 29:35 I do, yeah.

Dr. Mark Hyman 29:36 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, and are put in everything from plant-based milks like almond milk to breads and all kinds of stuff. And so these emulsifiers, they damage the gut, and they cause leaky gut, and they cause autoimmune disease, and we're eating 60% of our diet in America as these foods.

Dr. Rangan Chatterjee 30:06 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 31:01 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 deckchairs 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. 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 paper that was 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, it can be heavy metals, it 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, a 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 33:33 I want to talk about protein, Mark. Protein is something-

Dr. Mark Hyman 33:36 Ah [laughs]

Dr. Rangan Chatterjee 33:36 ... you've written a lot about, and I know it's a divisive topic, right?

Dr. Mark Hyman 33:40 Yeah, it is.

Dr. Rangan Chatterjee 33:40 So I wonder if you could help walk us through it, and, you know, you shared before in this conversation that one of the things you've changed as you have got older-

Dr. Mark Hyman 33:51 Mm

Dr. Rangan Chatterjee 33:51 ... is you've brought in resistance training into your life-

Dr. Mark Hyman 33:55 Mm

Dr. Rangan Chatterjee 33:55 ... which has made a big difference.

Dr. Mark Hyman 33:56 Yeah.

Dr. Rangan Chatterjee 33:56 So maybe just talk to us about this sort of area and why it's so important for aging.

Dr. Mark Hyman 34:01 Well, I think, I think, you know, the protein conversation's super important. I think it's polarized, and it's ideological unfortunately, but it should be scientific. You know, people think being a vegan is the way to go for longevity. Others think that you should be eating more protein, and I think there's a lot of confusion out there, and part of it has to do with, um, beliefs and ideology, and I'm not gonna get into all that. I do think that you can be a healthy vegan, but it is a lot of work, and you need to know what you're doing, and you need to supplement with certain things that can protect you from the challenges of being a vegan, which is getting adequate levels of certain amino acids for protein synthesis and muscle building, certain nutrients that are deficient. It's not easy, but it's doable [laughs] . So I'm not saying I'm opposed to it. I'm just saying it's, it's a, it's a harder row to hoe in terms of longevity and wellbeing. So when you look at protein, the, the feeling is that in the longevity community that we should potentially be vegan because we don't wanna overstimulate a particular pathway, uh, one of the hallmarks of aging, which we call mTOR. Now, this is one of the four nutrient sensing pathways in our body that samples the environment and the food we're eating and regulates all sorts of biological processes, and this is really the meta hallmark. This is the one that's, I think, the most important, which is how food interacts with our biology to create health and disease or longevity or early death. And so mTOR is stimulated by protein, and particularly by animal protein, 'cause it has higher levels of an amino acid called leucine. Leucine is so important for tripping the switch that builds muscle. So I'm just gonna stop for there for a minute, because I wanna emphasize how important muscle is to longevity. Without muscle, your metabolism goes down, your stress hormones go up, you become more insulin resistant and pre-diabetic. You become, uh, more inflamed, and it's this whole cascade of phenomena that occur because your muscle gets replaced with fat. So the key is to build and keep and increase muscle if you can as you get older, enhance longevity. And that you do, you have to do that by tripping the switch of mTOR to build muscle. The problem is, if you do that all the time, if mTOR's always stimulated, you actually don't give your body a chance to engage in one of the most important processes that are important for longevity, which is what we call autophagy. Autophagy means self-cleaning or self-cannibalism or self-eating, literally, like Pac-Man [laughs] . And, and this is a good thing, because it, our body has the ability to go and recycle parts to get rid of old proteins and old cells and clean them up and actually, you know, build new stuff, which is great. It's like recycling plastic bottles and making clothes out of it, right? So we, we have that internal system in our bodies that we have to turn on on a regular basis in order to clean up and, and prevent rapid aging. So that's a good thing, and the way you s- you activate autophagy is by inhibiting-... mTOR, which means don't give it food or protein [laughs] which is a good thing. So what do you do? Do you not eat protein to turn on autophagy? Or do you eat lots of protein to build muscle? Well, the key is both. You need, like any system, you need sometimes it on and sometimes off. You need to sleep, and you need to w- be awake. I mean, it's basically how the body works.

Dr. Rangan Chatterjee 37:15 Yeah.

Dr. Mark Hyman 37:15 So we need overnight to stimulate autophagy by giving ourselves a break from eating, meaning getting no food from dinner until breakfast, so no m- late-night snacking. And you should give at least 12 hours. So if you eat dinner at 6:00, you're gonna eat 6:00 in the morning. If you wanna extend to 14, that's eating at 8:00 in the morning. That's doable for most people. 16 hours is a little bit longer. That can also have benefits. And that gives your body a chance to sort of pretend that it's starving, 'cause you're, you're not really starving, [laughs] but your body thinks it's kind of is maybe starving. So it starts to turn on all these protective mechanisms that i- that is related to the stress of not eating called hormesis. And so basic- And we can talk about that more, but basically the idea is when you, when you activate autophagy at night, it's a good thing, and it extends life. However, you need to give a good protein load in the morning on a fasted state, probably 30 or 40 grams of high-quality protein. When I say high quality, I mean it has to have at least two and a half grams of leucine, which is almost impossible to get from plant protein unless you eat a huge amount, or, which people can't do, like having, you know, six cups of brown rice or two, three cups of beans. It's hard for people to [laughs] eat that much of that stuff. And, and then you can add the leucine to a plant protein, but you, you actually have to get the leucine to turn on this. So you can have plant protein powders that are supplemented with amino acids, or you can just have a whey protein shake or, you know, some animal protein, eggs or chicken or fish or whatever you wanna eat, and that will turn on mTOR and build muscle. And then if you, if you fast and then load up with protein in the morning and do the resistance training maybe before you, you do your protein load, that's the best strategy. And that's how I build muscle, which I basically would, would be in this fasted state. I would work out and do my half-hour band routine, and then I would have a good protein shake with 40 grams of protein and a bunch of other goodies in it to help me build muscle. And it really works. [laughs] And it works even despite the fact that as you get older, you get something called anabolic resistance, meaning your body is more resistant to building muscle, so you have to work harder and take more protein. So as we get older, we need more protein, and we need more h- high-quality protein, and I think that's really the, the, the clear evidence from the scientific literature about what we need to do. But people get into ideological battles about, you know, whether you should or shouldn't eat meat. I think, I think it's really beside the point. The point is how does our biology work? How do we work with it? How do we activate these pathways in the right way? And how do we give them a rest when we need to give them a rest?

Dr. Rangan Chatterjee 39:46 Yeah. Really, really useful. I think one of the key things that I've learned over the past, um, few years is regarding the science on leucine, right?

Dr. Mark Hyman 39:56 Yeah.

Dr. Rangan Chatterjee 39:56 That's probably something-

Dr. Mark Hyman 39:57 Mm-hmm

Dr. Rangan Chatterjee 39:57 ... I didn't know 5, 10 years ago-

Dr. Mark Hyman 39:59 Yeah

Dr. Rangan Chatterjee 39:59 ... how important getting that minimum threshold of leucine is, and you've written about that in the book. You've detailed it really nicely. And, you know, you've, you shared last time you came on this podcast that you have been vegetarian and I think vegan in the past.

Dr. Mark Hyman 40:15 Yeah. Yeah, yeah. I was. Yeah.

Dr. Rangan Chatterjee 40:16 You... So... And, and-

Dr. Mark Hyman 40:18 I was pretty much more vegetarian when you, when I took the 40-year-old picture. So [laughs] I was kind of vegan, vegetarian. I was a, a skinny kind of guy, and, and my body totally changed, which I, I couldn't do 10 pushups when I was 50. Now I can do, you know, 80 pushups without w- without, uh, rest. So [laughs]

Dr. Rangan Chatterjee 40:34 Wow. 80-

Dr. Mark Hyman 40:35 My body can do that.

Dr. Rangan Chatterjee 40:36 Yeah. That's, that's incredible. Right? You're getting stronger as you age.

Dr. Mark Hyman 40:40 Yeah.

Dr. Rangan Chatterjee 40:40 So a few things there, Mark, I just wanted to clarify. So for someone, and, and I guess anyone who listens to my show regularly will be familiar with this idea of time-restricted eating or intermittent fasting. Um, in your experience, right, is the minimum we should be all aiming for 12 hours in every 24-hour period-

Dr. Mark Hyman 41:02 Mm-hmm

Dr. Rangan Chatterjee 41:03 ... where we are not eating? Is that what you say-

Dr. Mark Hyman 41:05 Minimum

Dr. Rangan Chatterjee 41:06 ... minimum?

Dr. Mark Hyman 41:06 Well, that's what it's called breakfast. [laughs]

Dr. Rangan Chatterjee 41:08 I get it.

Dr. Mark Hyman 41:08 We break the fast, right? [laughs]

Dr. Rangan Chatterjee 41:09 No, I get it. These days-

Dr. Mark Hyman 41:10 And then we-

Dr. Rangan Chatterjee 41:10 These days we call that fasting, but that... And maybe 40, 50 years ago, that was probably the no- the norm for most [laughs] humans on this planet.

Dr. Mark Hyman 41:17 Yeah.

Dr. Rangan Chatterjee 41:17 In fact-

Dr. Mark Hyman 41:17 Exactly

Dr. Rangan Chatterjee 41:18 ... when you were on your travels, Mark, could you share what you observed with respect to meal timings? Uh, because those guys, I'm guessing, haven't-

Dr. Mark Hyman 41:27 Yeah, yeah

Dr. Rangan Chatterjee 41:27 ... heard the latest podcast on time-restricted eating-

Dr. Mark Hyman 41:30 No, no, no, no, no

Dr. Rangan Chatterjee 41:30 ... or intermittent fasting. Right?

Dr. Mark Hyman 41:31 No, no, no.

Dr. Rangan Chatterjee 41:31 What, what were they doing naturally, would you say?

Dr. Mark Hyman 41:34 Well, it's interesting. They would, they would, uh, they would ba- basically, um, you know, have a relatively light breakfast, and they would, they would eat a big lunch. They would kind of take a nap, [laughs] and then they would wake up, and they would work till late, and they'd have a sort of light dinner, and then they'd be up late, like 1:00 [laughs] in the morning. It was a very different lifestyle than I'm used to, but they managed to do it. So there's no one way to do it. If you're, you know, living a European lifestyle, they tend to have these sort of more, uh, relaxing, connected, them two-hour lunch. You go, you go to certain places in Italy, and everything is shut down, like the post office, the, you know-

Dr. Rangan Chatterjee 42:07 Yeah

Dr. Mark Hyman 42:07 ... the, the grocery store. Like, literally everything shuts down for hours in the afternoon, which you would never see [laughs] in the West. I mean, in at least the United States. So I think, uh, it, it... They kind of built their culture around these times of rest and connection and mealtime and pleasure, and I think that plays a huge role in it.

Dr. Rangan Chatterjee 42:23 Yeah, I think that there, I think that's a really important point, Mark. When we try and study, um, these different areas around the world, it's very hard to take one thing in isolation and go, "Oh, you know, implement that," right? It's the totality of everything they're doing.

Dr. Mark Hyman 42:38 Totally.

Dr. Rangan Chatterjee 42:39 All the, all the inputs they're putting in.

Dr. Mark Hyman 42:40 Totally.

Dr. Rangan Chatterjee 42:40 And so I agree with you. I think for, uh, most people in the West, aiming for a minimum 12 hours in every 24 hours is, it's a really good starting point that most-

Dr. Mark Hyman 42:51 Yeah

Dr. Rangan Chatterjee 42:51 ... people can do. And as you say, you can increase that up a little bit. Um, and for some people, they're gonna get all kinds of benefits. Um-

Dr. Mark Hyman 42:59 And the other key to that, uh, R- Rangan, is, is to not eat-For three hours before you go to sleep. So give three hours between you f- when you finish your meal and when you go to sleep. That's really important, 'cause you need to metabolize and digest your food, otherwise you store it, and it accelerates aging, and your body's in a, in a fed state, not a fasted state, when you go to bed, and that's not a good thing.

Dr. Rangan Chatterjee 43:19 There's a lot of interest in society about trying to find what is the perfect diet, you know?

Dr. Mark Hyman 43:28 Mm.

Dr. Rangan Chatterjee 43:28 What is the diet that humans are meant to eat? And I know, you know, you've, you've written about diet countless times. How, how many books [laughs] have you written now? It's, it's nearly 20.

Dr. Mark Hyman 43:37 18, I think the other one was 20, yeah. [laughs]

Dr. Rangan Chatterjee 43:38 18, right. Um, a- and, and they're still [laughs] absolutely fantastic, you know, and really, really helpful. Um, I guess the point I'm trying to get to is something I've been thinking about for a while, Mark, is that all we can ever do is find the right diet that works for us at that point in our life, right?

Dr. Mark Hyman 44:00 Mm-hmm. Absolutely. Yeah.

Dr. Rangan Chatterjee 44:01 And what you're speaking to, and you detail the PROTAGE study in the book, what it shows-

Dr. Mark Hyman 44:07 Mm. Mm

Dr. Rangan Chatterjee 44:07 ... um, which is very, very powerful, but we're almost making a case, I think, that as we get older-

Dr. Mark Hyman 44:14 Mm

Dr. Rangan Chatterjee 44:14 ... potentially we need to increase our protein intake.

Dr. Mark Hyman 44:17 Yeah.

Dr. Rangan Chatterjee 44:17 Is that something you would agree with?

Dr. Mark Hyman 44:19 Absolutely. Even the study that'll most, uh, vegans quote that show that protein is bad for you, show that as you get older, it's actually important that you increase your protein intake. So, m- you know, what people don't understand is that, uh, the, the recommended amounts of protein are the minimum amount to not get a deficiency disease. So how do you not get protein deficiency, which is a very serious disease? You have to eat .8 grams per kilo. But that's like how much vitamin D do you need to not get rickets? Probably 30 units. How much vitamin D do you need to optimize your immune system and to prevent cancer and heart disease and all these other benefits? Probably 2,000 to 4,000. Maybe, you know, 10 to 100 times the minimum [laughs] amount.

Dr. Rangan Chatterjee 45:06 Yeah.

Dr. Mark Hyman 45:06 So I'm not saying you should have 100 times the recommended dietary allowance of protein, [laughs] but you need more than the minimum amount. And for people getting older, it shouldn't be probably .8, it should be more like 1.6. And if you're doing a lot of vigorous activity and strength training, you can even have more. So I, I think, uh, both because there's resistance to the, uh, effects of eating protein, meaning it's, you need to more protein to get the muscle-building effect, and the fact that, you know, as we get older, we need to, to make sure our protein needs are, are met. We, we do need more protein as we get older.

Dr. Rangan Chatterjee 45:40 For someone who's listening, Mark, and goes, "Okay, I understand that. Okay, I'm gonna increase my protein a little bit. Um, but I'm not sure about strength training. You know, I like going for walks."

Dr. Mark Hyman 45:51 Mm. Mm. Yeah.

Dr. Rangan Chatterjee 45:52 Um, uh, you know, I hear you-

Dr. Mark Hyman 45:53 Yeah, yeah

Dr. Rangan Chatterjee 45:53 ... but I'm not interested in that. I'm not worried about my-

Dr. Mark Hyman 45:54 That was me. That was me. That was me. [laughs]

Dr. Rangan Chatterjee 45:56 Yeah. What, what, what, why is it so important that people don't neglect resistance training-

Dr. Mark Hyman 46:03 Yeah

Dr. Rangan Chatterjee 46:03 ... particularly as they get older?

Dr. Mark Hyman 46:05 Yeah. That, that was really, uh, that was me. I, I hated the gym. It was smelly. I didn't wanna go in with all the, you know, big guys who were intimidating and lifting all these heavy weights, and I was a skinny guy. So I just, I just kinda didn't go. And I, and I knew, I recommended it 'cause I, you know, the science was clear, but I just, myself, [laughs] I was kind of resistant to resistance training. [laughs] And I decided I was gonna do it, and I hit 60. It was, like, in my 59th year. I was like, "Okay, I'm gonna, at 59, I probably should get on it now." And I started to do it, and it was really life-changing. And I think that, that most people don't realize the impact of strength training on your balance, on your mobility, on your function, on your metabolism, on your overall wellbeing, on your hormones. Sex hormones decline as we age, so strength training boosts those. So it has so many benefits that, that i- if, if you wanna live a long, healthy life, aside from cutting out sugar and starch, probably the other most important thing is resistance training. If you just get two things from this podcast, is to understand that you need to dramatically reduce or eliminate starch and sugar from your diet, and to start resistance training in some form. It could be body weight, it could be bands, which I do, it could be weights. But make sure, make sure you work with someone to do proper form and so forth, so you don't hurt [laughs] yourself when you're starting out. But it's so important to do, and there's all these apps, there's YouTube videos. There's no lack of instruction out there. But it is something you should consider essential part of health as you get older, and it doesn't have to be a lot. It can be 30 minutes three times a week. I like to do more, but the reality is I probably only do three or four times a week, because I just don't have the time at this moment. But I, when I do, I try to do [laughs] it more and more often.

Dr. Rangan Chatterjee 47:44 Yeah.

Dr. Mark Hyman 47:44 But, but I think it, it, the mi- the minimum is very, is very adequate. An hour and a half a week. If you don't have an hour and a half a week to invest in your health and what's going on with your life. In fact, uh, I often use this cartoon in my talks where it shows a doctor telling his patient, "Do you have time to exercise an hour a day, or be dead 24 hours a day?" [laughs] You know, so I, I think that's a funny cartoon.

Dr. Rangan Chatterjee 48:06 Yeah, yeah. Thank you for the clarity there. I mean, a couple of things there. On Saturday, I tend to go to my local parkrun, um, sometimes with my son, sometimes with my family, and at the end of parkrun this Saturday, I bumped into a friend of mine who said, "Actually, Rangan, I heard your conversation with Gabrielle Lyon." I know Gabrielle's been on your podcast, and she said, "I heard it."

Dr. Mark Hyman 48:29 Yeah.

Dr. Rangan Chatterjee 48:30 "And for the first time in my life, I've actually went and started strength training." She's been doing that for about two months.

Dr. Mark Hyman 48:35 Mm.

Dr. Rangan Chatterjee 48:35 And she said-

Dr. Mark Hyman 48:36 Yeah

Dr. Rangan Chatterjee 48:36 ... she's in her mid-40s, right?

Dr. Mark Hyman 48:38 Yeah, yeah.

Dr. Rangan Chatterjee 48:39 And she-

Dr. Mark Hyman 48:39 Yeah

Dr. Rangan Chatterjee 48:39 ... says she feels absolutely fantastic. She was already really active. She would run.

Dr. Mark Hyman 48:44 Yeah.

Dr. Rangan Chatterjee 48:44 Right? She would-

Dr. Mark Hyman 48:45 Yeah.

Dr. Rangan Chatterjee 48:45 So, so that's in her 40s. But a wider point here, Mark, is, and why I've been thinking a lot about strength over the past two or three months, and again, we can know the science. We can write about it. We can try and practice things. But then sometimes things happen in our lives where the same information lands in a slightly different way.

Dr. Mark Hyman 49:07 Mm-hmm. Mm-hmm.

Dr. Rangan Chatterjee 49:07 So I've had some real challenges in my personal life over the past two or three months to do with the health of my mother.And mom is now, I think, sort of 82, 83.

Dr. Mark Hyman 49:18 Mm.

Dr. Rangan Chatterjee 49:18 And she's been mega unwell since-

Dr. Mark Hyman 49:21 Mm-hmm

Dr. Rangan Chatterjee 49:21 ... uh, Christmas. She was admitted-

Dr. Mark Hyman 49:23 Mm

Dr. Rangan Chatterjee 49:23 ... to hospital. She's come out. She's definitely not the same as she was now.

Dr. Mark Hyman 49:26 Mm-hmm. Mm-hmm.

Dr. Rangan Chatterjee 49:27 And what's really striking is that, you know, my brother and I try our best to look after her and care for her, but-

Dr. Mark Hyman 49:35 Mm-hmm

Dr. Rangan Chatterjee 49:35 ... sh- because of her muscle strength, or I should say her lack-

Dr. Mark Hyman 49:38 Yeah

Dr. Rangan Chatterjee 49:39 ... of muscle strength-

Dr. Mark Hyman 49:40 Yeah, yeah

Dr. Rangan Chatterjee 49:40 ... basic things now, like, you know, getting out of a chair, being able to get out of bed yourself-

Dr. Mark Hyman 49:48 Yeah

Dr. Rangan Chatterjee 49:48 ... when you can't do them-

Dr. Mark Hyman 49:51 Yeah

Dr. Rangan Chatterjee 49:51 ... the, the quality of your life can rapidly, rapidly-

Dr. Mark Hyman 49:55 Oh

Dr. Rangan Chatterjee 49:55 ... decline.

Dr. Mark Hyman 49:56 Yeah.

Dr. Rangan Chatterjee 49:56 And I know this of... I've seen it with patients before, but when I'm now witnessing it on a daily basis-

Dr. Mark Hyman 50:01 Mm

Dr. Rangan Chatterjee 50:01 ... with my own mother- Now, I'm a huge fan of Vivobarefoot shoes. I've been wearing them for about 12 years now, and one of the main reasons I love them is because when I'm wearing Vivos, I feel fully connected to the ground beneath my feet. What do we want? We want feet that move naturally, and because Vivos are wide, thin, and flexible, your foot can move in the way that it's meant to. A lot of modern shoes are stiff, they're narrow. They start to manipulate the way your foot functions. Whereas in Vivos, your feet can do what they're meant to do, and that means they help your feet become stronger. There was this trial that showed within four months of wearing Vivos, your feet are around 60% stronger. Your feet are your foundation, and when you've got problems in your feet, it goes all the way up the chain. It can go to your ankle, to your knee, to your hip, to your back, and even to your shoulder and neck. And as a doctor, I have seen back pain, hip pain, and knee pain actually start to get better when people start to wear barefoot shoes. To get 20% off your first order, go to vivobarefoot.com/livemore. I might run and you need to keep moving. You need to work on your muscle mass. And I think there's a wider point, Mark, which I, I hope you can speak to-

Dr. Mark Hyman 51:24 Yeah

Dr. Rangan Chatterjee 51:24 ... which is this idea that as we get older, our muscle mass is declining, right?

Dr. Mark Hyman 51:30 Yeah.

Dr. Rangan Chatterjee 51:30 So if we don't do anything about it, we're on that road to what I just described.

Dr. Mark Hyman 51:35 For sure.

Dr. Rangan Chatterjee 51:35 So could you maybe sort of speak to that-

Dr. Mark Hyman 51:38 Yeah

Dr. Rangan Chatterjee 51:38 ... inspire people about why they need to get going with this?

Dr. Mark Hyman 51:40 Totally. I mean, it starts, you know, when you're, when you're younger, you can kind of manage. But when you get into your 30s, 40s, not, we're not talking 60s, 70s here. We're talking 30s, 40s. You start to decline muscle mass. And unless you are fighting that entropy, by the time you're 60 or 70, you're gonna be twice as fat as you were, even though you're the same weight. You will become what we call skinny fat, and your muscle will be replaced by fat. So think of a wagyu rib eye versus a filet mignon. You want the filet mignon [laughs] 'cause it's much more functional muscle. And what happens is, is we lose that muscle, and we get a disease called sarcopenia, which is something most doctors don't know how to diagnose, don't test for, and don't treat. But it is among the most important and most, uh, deadly things that happen to us as we age. What is a big cause of death in the elderly? Falls. Falls. Falling [laughs] and then breaking your hip, and if you're, you're, you break your hip, it's worse than getting a diagnosis of terminal cancer in terms of your mortality rate. So it's, it's a really big deal, and I think that that can be almost entirely prevented by resistance training and giving people the strength to be able to hold themselves up, to, to fall properly if they [laughs] end up falling, to have stronger bone density, and all the things we need to, to do as we get older. So the reason people end up in nursing homes and long-term care facilities is not because they're sick with a chronic disease. It's 'cause they can't get out of bed or get out of a chair or tie their shoes or cut their toenails. And so that's the reason, and that is totally fixable by building muscle as we age and staying strong and fit. I mean, I see, I see, uh, you know, 100-year-old guys riding horses in these blue zones. [laughs]

Dr. Rangan Chatterjee 53:19 Yeah.

Dr. Mark Hyman 53:19 It's really impressive. People, most people wouldn't even go out without a walker at 100 years old or if they can get up at all or if they live that long. [laughs] So we're, we're seeing, you know, the ability to do functional things as the most important thing. Peter Attia is a friend. He talks about the, the, the, the centenarian decathlon. What are the, like, 10 things you have to do, like get up off the floor? I mean, I, I, I went skiing with my dad when he was in his 70s, and he fell on the ski, so he couldn't get up. He just could not get his body off the ground. And, and then I, you know, I, I helped him by getting him strength training, and I paid for a trainer for him, and he was able to actually start to regain strength even at, in his 80s. Uh, and even, even up to almost 90 years old, it was very impressive to see.

Dr. Rangan Chatterjee 54:00 Yeah. Couple of key messages there. Let's not wait until we're in our 70s and 80s to, to face those difficulties, right? The decline is starting already for many of us, so let's do something about it. That was one key message there. The other one was what you said about your father, that even in your 80s, it's not too late. You can-

Dr. Mark Hyman 54:19 No

Dr. Rangan Chatterjee 54:19 ... make a difference, right? And so-

Dr. Mark Hyman 54:21 No. Huge

Dr. Rangan Chatterjee 54:21 ... I think those are, those are, those are really key points, which again, you, you make very clear in the book. Mark, talk to me about hormesis. There's a chapter on hormesis-

Dr. Mark Hyman 54:29 Ah

Dr. Rangan Chatterjee 54:29 ... in the book.

Dr. Mark Hyman 54:30 Yeah.

Dr. Rangan Chatterjee 54:30 What is it, and how can we utilize it, I guess, to help us age better?

Dr. Mark Hyman 54:36 Well, you know, uh, I mean, we, we, we've all evolved in a much more stressful environment. You know, we didn't have perfectly controlled temperatures and humidity and air conditioning and heating and, and we just sort of lived out there in nature, and we had periods where we had access to food. We didn't have grocery stores, or periods where we didn't have access to food. And, and we had to move our bodies a lot just to function. And, and all these are stresses. So hormesis is essentially a stress that doesn't kill you.And it activates these ancient healing pathways, these ancient longevity switches in your body, in ways that we now are fully understanding. And I'll just go through some of them. What's a stress? Well, not eating is a stress, so starvation would be considered a stress. So n- not eating from 6:00 at night to 8:00 in the morning, your body's like, "Oh, I'm a, I'm a little short on food here. That's a stress. Let me kick into gear all these healing systems," like autophagy, which we mentioned before. Um, exercise is another kind of stress. You know, when you lift weights, you're tearing your muscles. When you sprint, you're stressing your mitochondria, and that causes them to rebound and become stronger. Uh, those are two a- examples of hormesis, but there's a lot of other cool ones that are now being used. Hot and cold therapy. Saunas, for example, show a reduction in death by, like, 40-something percent in s- in Finland in these large studies [laughs] uh, and, and, and in, and does so by, for example, activating your immune system by fixing your proteins that are damaged as we age with this, these products that they're produced in a sauna called heat shock proteins. Or cold therapy, uh, cold plunges. It doesn't even have to be a sauna. It can be a hot bath. It can be a cold shower. Most people have a bath and a shower, you know, so I take a cold shower in the morning for two minutes. It's a, it's a really inexpensive way to activate hormesis. If you wanna cold plunge and s- splurge on that, great. Uh, and those are powerful. But I just, you know, fill up my bathtub full of cold water, and if you live in a warm climate, you can throw a couple of bags of ice in, [laughs] you know? And then sit in there for three, four minutes. That activates these healing things in your body. And there, there are also other forms of hormesis that are phyto-hormesis, plant foods that have little stress molecules that they make to defend themselves. When we consume those in small amounts, they, they kind of trigger these healing responses, and many of them through these hallmarks of aging. For example, fisetin, which is from strawberries, uh, helps you kill zombie cells, and quercetin also helps to reverse your biological age for working on your epigenetics and reduces inflammation. So there's all these compounds that we can consume from plants that do this. And then there's some other kind of more advanced therapies like hyperbaric oxygen therapy or, or hypoxia therapy, where you reduce oxygen levels. These are stresses on the body, and it can actually help to r- activate longevity pathways. Like in Israel, they did a study in hyperbaric oxygen, and they found that it, it increased telomeres and killed zombie cells more than any other treatment. And these are things that we see as two of the hallmarks of aging that get worse, and it made them better simply by l- lying in 100% oxygen at, at a higher pressure than atmospheric pressure for 60 minutes for, you know, 60 sessions over a period of time. So we have, we have real insights into how-

Dr. Rangan Chatterjee 57:40 Yeah

Dr. Mark Hyman 57:40 ... these stresses can activate these ancient longevity pathways.

Dr. Rangan Chatterjee 57:44 Well, you mentioned a couple of terms there that some people may not recognize, zombie cells and telomeres, right?

Dr. Mark Hyman 57:50 Yeah, yeah, yeah, yeah.

Dr. Rangan Chatterjee 57:50 So you mentioned that some of these therapies can help with those two things, two hallmarks-

Dr. Mark Hyman 57:55 Yeah

Dr. Rangan Chatterjee 57:55 ... of aging. But perhaps-

Dr. Mark Hyman 57:56 Yeah

Dr. Rangan Chatterjee 57:56 ... you could just expand a little bit on what telomeres are and what zombie cells are.

Dr. Mark Hyman 58:00 Yeah. So, so we mentioned these 10 hallmarks of aging, and they're these things that kind of happen as we get older. One of them is, you know, we replicate our DNA, I don't know, some quadrillion times i- in, uh, in our lifetime. And so our DNA has to kind of open up. It, it has to be read, and then it has to close back up. And, and that's regulated by these things at the end of your chromosomes called telomeres. As, as they keep replicating, there's a little bit that gets cut off each time, and they get shorter. They're like the little caps on the end of your shoelaces that prevent it from unraveling. And when they get too short, you end up having, you know, problems, and that shortens your life. Uh, so telomeres are an important m- metric to look at as, as about how we're doing with longevity. The other is zombie cells. Zombie cells are the- also known as senescent cells, and normally, you know, when cells have gone through their normal process of doing what they do, they, they die off, and we have a process to do that in our body called apoptosis, which just means you kind of explode the cell, and you die, and you eat all the parts, and it's sort of a recycling system. But sometimes those cells don't die, and they become zombie cells, and those zombie cells produce all these inflammatory chem- chemicals that, that go all over your body, and then they kind of make other cells zombie cells, and it creates this whole zombie apocalypse inside [laughs] and end up with this state of accelerated inflammation. And that's why we call it aging, inflammaging. So senescent cells are things that can be changed or gotten rid of through some things like hyperbaric oxygen or certain senolytic therapies that, that can be from plant compounds that we can use. So maybe even drugs will be senolytic drugs. We're, we're learning more about this as we go on, but these zombie cells are not good for you, and, and hyperbaric oxygen can help to get rid of them, which is great.

Dr. Rangan Chatterjee 59:43 Yeah. You also, as you've just explained, and I, I really did enjoy reading this section where all these kind of plants, compounds can also help us get rid of zombie cells, and y- you mention a few of them there. In that section, Mark, you, you wrote quite a provocative sentence, um-

Dr. Mark Hyman 1:00:01 [laughs] What's new? [laughs]

Dr. Rangan Chatterjee 1:00:03 Yeah, what's new? But it, it was... It, it really got me thinking. Uh, it was... It's quite a beautiful statement, actually. You believe we co-evolved with plants to-

Dr. Mark Hyman 1:00:14 Yeah

Dr. Rangan Chatterjee 1:00:14 ... borrow their medicines-

Dr. Mark Hyman 1:00:16 Yeah

Dr. Rangan Chatterjee 1:00:16 ... to keep us healthy. Talk to me about that.

Dr. Mark Hyman 1:00:18 Yeah. Well, you know, like, guinea pigs make, uh, don't make vitamin C. Humans don't make vitamin C. Uh, many other species of animals do. We don't make it 'cause we're lazy. Our biology, we wanna, don't wanna do anything that we don't have to do with our biology to conserve energy. So we've co-evolved with plants to use their compounds as medicines to help regulate our biology, and animals do this. You know, if you see a, a wild animal or a cow that's pasture raised, they will graze on a few major food crops, but then they'll sample maybe 100 other crops, uh, plants, to actually activate medicinal properties in those plants for themselves. They're not-- They don't know that, but they, they kind of intuitively figure this out and keep themselves healthy, which is quite interesting. And so the same thing with humans. We've co-evolved with these plants and e- over 800 species of plants as hunter-gatherers that contain these rich phytochemical compounds that we now are understanding that maybe we thought there were 25,000. There may be a million of these things in plants, and we're starting to catalog them and understand their mechanisms of action, how they work. When we say food is medicine, that's what we mean. We mean inside-The food we're eating, there are medicinal compounds that our body uses to activate various pathways. For example, one of the key findings, for example, around longevity was the activation of sirtuins. Sirtuins is one of the four longevity switches that are in the hallmark of aging called deregulated nutrient sensing, meaning how do we sense our nutrition environment and how do we regulate different processes based on whether we're eating the wrong stuff or the right stuff? And so resveratrol, which comes from grapes, actually works on sirtuins to activate sirtuins, which kicks in this whole system of DNA repair and improving insulin sensitivity and mitochondrial function and helping to reduce inflammation, and it's a really amazing thing that happens when you properly regulate sirtuins. Well, resveratrol is a plant compound that is acting on that pathway, for example. Doesn't mean you should be drinking red wine. I wanna be careful with that because we now know that li- alcohol in, in, is actually, even in lower amounts than we thought, can be harmful and increase risk of cancer and is, is definitely not a health promoting activity. It's fine to do once in a while as a recreational fun thing to do, but it's not something you wanna do every day. [laughs] And I think the, uh, the, the, but the compounds in the red grapes actually do act on this pathway. So that's one example.

Dr. Rangan Chatterjee 1:02:38 Yeah. But then also I think we have to acknowledge that I'm guessing in these blue zones where you went to-

Dr. Mark Hyman 1:02:44 Yeah

Dr. Rangan Chatterjee 1:02:44 ... that people are-

Dr. Mark Hyman 1:02:46 Yes

Dr. Rangan Chatterjee 1:02:46 ... drinking as well, right?

Dr. Mark Hyman 1:02:48 Yeah, they are. Yeah, they are. They're having a glass of wine here and there. But, you know, we have to understand that, that, uh, there is a phenomena in science called healthy, the healthy user effect. And, and this means that it, we can get kind of confused in studies where we see, oh, it seems like people drinking alcohol live longer or they do this or that. It may be the other things they're doing, right? If, if we're told that, you know, having glass of wine is good for you, then maybe the people who are drinking the wine are engaging in other healthy behaviors, right? They're exercising, they're eating more fruits and vegetables. They're not smoking. So we, we have to be careful of these biases that are inherent in studying people where we thought, for example, that, uh, hormones were protective for women against heart disease and cancer and stroke and dementia because of a population study where they found, you know, women who seemed to take hormones had less of these problems. Well, it was 'cause these women were healthier as a group because they went to the doctor more. They paid more attention to their health. They exercised more. They didn't smoke. They ate more fruits and vegetables. That's why they had less heart disease, cancer, stroke-

Dr. Rangan Chatterjee 1:03:51 Yeah

Dr. Mark Hyman 1:03:51 ... and dementia. And when they did a randomized controlled trial called the Women's Health Initiative, it was a billion-dollar study, 160,000 women, they literally had to stop the trial partway through because so many women were dying who were taking the hormones. It's because of, of the bias in the first study that was called the healthy user effect, and that's what's going on when you look at some of the data. Well, yes, the people in the blue zones drink a little wine, but what else did they do? They weren't-

Dr. Rangan Chatterjee 1:04:16 Yeah

Dr. Mark Hyman 1:04:16 ... exposed to environmental toxins. They had really no chronic stresses. They had deep sense of meaning and purpose and community. They ate foods that were original, like almost heirloom foods. A lot of wild foods they ate in Ikaria. They had animal foods, but they had animals that were eating all these wild plants that had phytochemicals in them. [laughs] You know, they, they had, uh, natural exercise that they did as part of their life. So what was it? Was it the alcohol, or was it all this other stuff?

Dr. Rangan Chatterjee 1:04:42 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 1:04:54 That's right.

Dr. Rangan Chatterjee 1:04:55 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 1:05:05 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 things [laughs] that kids eat for breakfast, Pop and that 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 d 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 corn flakes 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've taken 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, 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 had talked 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 1:09:06 Yeah.

Dr. Mark Hyman 1:09:06 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 1:09:14 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 1:09:42 Yeah

Dr. Rangan Chatterjee 1:09:42 ... for the rest of our day. Do you know what I mean? It's like quite similar.

Dr. Mark Hyman 1:09:45 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 prediabetes and type 2 diabetes.

Dr. Rangan Chatterjee 1:10:15 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 1:10:23 Yeah.

Dr. Rangan Chatterjee 1:10:23 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 1:10:30 Yeah

Dr. Rangan Chatterjee 1:10:30 ... cholesterol.

Dr. Mark Hyman 1:10:31 Yeah.

Dr. Rangan Chatterjee 1:10:31 But adrenaline and cortisol are stress hormones.

Dr. Mark Hyman 1:10:35 Yeah.

Dr. Rangan Chatterjee 1:10:35 So what's the relationship between our breakfast and our stress levels?

Dr. Mark Hyman 1:10:40 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 response-

Dr. Rangan Chatterjee 1:11:27 Mm

Dr. Mark Hyman 1:11:27 ... 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 wanna eat a diet that doesn't stress you out [laughs] basically.

Dr. Rangan Chatterjee 1:12:02 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 1:12:39 Yeah.

Dr. Rangan Chatterjee 1:12:39 That's what you're talking about, isn't it?

Dr. Mark Hyman 1:12:41 100%. '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 that we're eating.

Dr. Rangan Chatterjee 1:13:04 Yeah.

Dr. Mark Hyman 1:13:05 So the information 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 1:13:43 Yeah.

Dr. Mark Hyman 1:13:43 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, 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 1:14:09 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 1:15:08 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's 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 1:16:39 I- it's the key thing there, Mark, whether the food is highly processed or not. And, 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 1:16:53 Yeah.

Dr. Rangan Chatterjee 1:16:53 They are, you know, whole food carbohydrates-

Dr. Mark Hyman 1:16:57 Yeah

Dr. Rangan Chatterjee 1:16:57 ... 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 underslept? 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 1:17:24 Yeah. It depends how busted your metabolism is.

Dr. Rangan Chatterjee 1:17:26 Yeah.

Dr. Mark Hyman 1:17:26 Right? So if you're, if you're a generally healthy person, you wanna chew on sugarcane? 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 it in strange forms and had all 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 1:18:03 Mm

Dr. Mark Hyman 1:18:03 ... when they inven- invented the, the flour mill and the electric flour mill, and we got, you know, uh, the Industrial Revolution. You know, 'cause [laughs] you had to grind stuff pretty hard. I, 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. And 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 were on adaptive diets, sugar and 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 1:19:50 Yeah

Dr. Mark Hyman 1:19:50 ... 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 ate 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 1:20:25 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 pre-diabetes 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 1:21:22 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 1:21:38 Yeah

Dr. Mark Hyman 1:21:38 ... which is pure sugar, and found out he had pre-diabetes. And how, how does an endurance athlete have pre-diabetes? Well, if you're constantly loading your body with insulin-

Dr. Rangan Chatterjee 1:21:48 Yeah

Dr. Mark Hyman 1:21:48 ... spiking sugars, you're gonna end up with, with kind of marbled muscle. You're gonna end up with a little bit of extra belly fat.

Dr. Rangan Chatterjee 1:21:55 Yeah.

Dr. Mark Hyman 1:21:55 And that's all it takes.

Dr. Rangan Chatterjee 1:21:56 Yeah.

Dr. Mark Hyman 1:21:56 Um, you know, there's, it, 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, and 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, and 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 1:23:01 Yeah.

Dr. Mark Hyman 1:23:01 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 1:23:16 Yeah

Dr. Mark Hyman 1:23:16 ... 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, uh, 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 were 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 1:24:56 Mm-hmm

Dr. Mark Hyman 1:24:56 ... 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 sugar 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 1:25:20 Did you say that it was 14, as in one four percent of children are showing signs of being addicted to foods?

Dr. Mark Hyman 1:25:28 Yeah, and adults.

Dr. Rangan Chatterjee 1:25:29 And adults. That's a staggering number, isn't it?

Dr. Mark Hyman 1:25:32 It is.

Dr. Rangan Chatterjee 1:25:32 I mean, Mark, 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.

Dr. Mark Hyman 1:25:44 No.

Dr. Rangan Chatterjee 1:25:44 They're so used to 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 1:26:34 Yeah

Dr. Rangan Chatterjee 1:26:34 ... a few years ago. 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 1:26:47 Sugar is sugar is sugar, just like a rose is but a rose by any other name. So it's, it's, 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'm talking 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, uh, 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 1:28:17 Yeah.

Dr. Mark Hyman 1:28:17 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.

Dr. Rangan Chatterjee 1:29:02 [laughs]

Dr. Mark Hyman 1:29:02 But 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 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. And 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 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 1:31:08 Yeah.

Dr. Mark Hyman 1:31:08 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 1:31:14 Yeah.

Dr. Mark Hyman 1:31:14 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, 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 tr- 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, uh, 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 1:32:04 Yeah.

Dr. Mark Hyman 1:32:04 Or we don't connect the dots. And it's amazing, uh, I don't 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 1:32:17 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 1:32:54 100%. 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's, 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's 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 1:34:04 Yeah.

Dr. Mark Hyman 1:34:04 So I, I think it's really 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 because 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 1:34:31 Wow.

Dr. Mark Hyman 1:34:31 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. [laughs]

Dr. Rangan Chatterjee 1:34:49 Yeah. Some people may not be familiar with the functional medicine approach.

Dr. Mark Hyman 1:34:55 Yeah.

Dr. Rangan Chatterjee 1:34:55 So you, you sort of outlined some key tenets there, which are really interesting. But I wonder if you could just-

Dr. Mark Hyman 1:35:00 Mm

Dr. Rangan Chatterjee 1:35:00 ... give an overview for people who think medicine is medicine.

Dr. Mark Hyman 1:35:04 Yeah.

Dr. Rangan Chatterjee 1:35:04 Maybe for someone who's never heard about the difference before, how do you sort of briefly summarize the, the key differences between-

Dr. Mark Hyman 1:35:12 Yeah

Dr. Rangan Chatterjee 1:35:12 ... conventional Western allopathic medicine and the functional medicine approach?

Dr. Mark Hyman 1:35:19 Well, you know, functional medicine is really what will be medicine. It's our, a whole view of biology that's shifting from a reductionist disease-based model to a systems model of understanding the body as an interconnected network of biological systems that we have to treat as a whole. And functional medicine from, from the perspective of the patient is about not treating all the individual symptoms and diseases separately, but really treating your whole system. And I'll just give you an example that illustrates the clear difference. This is a patient that I talk about in the book, Young Forever. She was, uh, about a 50-year-old woman, business executive coach, who had all sorts of problems. Psoriatic arthritis, which is a terrible condition of the skin and joints, it's quite, uh, kind of de- debilitating, and she was on a drug that cost $50,000 a year [laughs] for this, an immune suppressant. She also had terrible irritable bowel syndrome and bloating. She had been on lots of antibiotics and steroids. She also had reflux, she had depression, she had insomnia, she had migraines. She also had pre-diabetes, was overweight. And so rather than, you know, treating all her diseases separately, which were being done, right? She saw the psychiatrist for her depression, the endocrinologist for her pre-diabetes, the neurologist for her migraines, the gastroenterologist for her GI symptoms, the rheumatologist for her psoriatic arthritis, and she was given the best possible treatment by all these physicians. They were excellent physicians doing exactly what we were taught in medical school and what is exactly the current state of treatment for each of these diseases. However, she was [laughs] not better. She was marginally improved, and her symptoms were mostly or partly managed, but she wasn't better. And so rather than saying, "Well, I'm just gonna, gonna up your dose of these drugs or that drugs," I'm gonna get to the root cause. And all the diseases that she had were all inflammatory diseases.Her diabetes, her prediabetes, her weight issues, her migraines, her depression, her psoriatic arthritis obviously, her gut issues, these are all inflammatory. So from a functional medicine perspective, we go, what's causing the inflammation? And I joke and I say I'm an inflammologist [laughs] which is, uh, actually what we need to be if we're studying longevity, because the whole process of aging is called inflammaging. And so rather than treat all these things separately, I say, well, her gut is where 70% of your immune system lives. She's having terrible gut symptoms. I guarantee you she's got a leaky gut. She's got probably bacterial overgrowth, yeast overgrowth, and a leaky gut, and lots of food sensitivities and reactions. So what I did was simply put her on, uh, an elimination diet. I got rid of all the sugar, processed food, gluten, dairy, obviously alcohol, and get her on a whole foods diet with good proteins, lots of good fats, lots of fruits and vegetables. And I said to her, you know, take a fish oil, a vitamin D, probiotic, super simple regimen of supplements that, that I thought she needed based on her history. I, I said, "Don't stop your medication, but just continue to do this and we'll check back in and go over everything in about six weeks." So she came back six weeks later. She had stopped all her medication, including that $50,000 drug for her psoriatic arthritis, and I didn't tell her to do it, but she stopped everything.

Dr. Rangan Chatterjee 1:38:28 Yeah.

Dr. Mark Hyman 1:38:28 Her symptoms were completely gone from everything. Her skin was cleared up, her joints were cleared up, her migraines were gone, her depression was gone, her insomnia was gone, her-- she'd lost 20 pounds, her irritable bowel, her reflux was gone. I also gave her stuff to reset her gut, a n- non-absorbed antibiotic and an antifungal that got rid of all the bad guys in her gut that were causing all this inflammation. So this is a case that I really focused on the root cause, which was her gut, to treat all these other problems, and when we got her gut healthy, everything else went away. So when you create health, when you create a healthy system, take out the bad stuff, put in the good stuff, the body has a chance to repair and renew. And that's what's really the, the exciting part, uh, Rangan, about the longevity research, is that now we understand that the body has this extraordinary ability to renew, repair, rejuvenate, and reverse our biological age. Just as our skin-

Dr. Rangan Chatterjee 1:39:16 Yeah

Dr. Mark Hyman 1:39:16 ... has the ability to heal when we cut it, our body has that innate healing system. We've just done everything possible to interfere with it-

Dr. Rangan Chatterjee 1:39:25 Yeah

Dr. Mark Hyman 1:39:25 ... to impede it. And the book, Young Forever, is really a roadmap in how do you, how do you actually activate these ancient embedded healing systems in our body that can reverse our biological age and make us younger as we get older?

Dr. Rangan Chatterjee 1:39:38 Yeah. That, that was, that was brilliant. It's a really great summary, and, and it really showcases how this systems approach that you have been, you know, talking about for many, many years now beautifully fits alongside the new science of longevity, and I think that was one of the, for me, one of the really rewarding things, uh, about reading Young Forever-

Dr. Mark Hyman 1:40:00 Mm

Dr. Rangan Chatterjee 1:40:01 ... was that, yes, this systems biology approach [laughs] works beautifully for aging. It's the same approach in many ways that-

Dr. Mark Hyman 1:40:07 Same. Same. Same

Dr. Rangan Chatterjee 1:40:08 ... you've been talking about, and I've tried too for many years now. But actually, when you apply it through the lens of longevity, you can actually see it in a, in a completely different light that's very, very empowering for people.

Dr. Mark Hyman 1:40:22 Yeah.

Dr. Rangan Chatterjee 1:40:22 You mentioned, Mark, biological age and chronological age.

Dr. Mark Hyman 1:40:27 Yes.

Dr. Rangan Chatterjee 1:40:28 Please explain for people-

Dr. Mark Hyman 1:40:29 Yeah

Dr. Rangan Chatterjee 1:40:29 ... who, who don't know the difference.

Dr. Mark Hyman 1:40:30 [laughs] Sure. So, uh, you know, I'm 63. I can't change that. I was born in 1959, and that's gonna progress inevitably toward, you know, however many years I'm alive. However, my biological age is my age on the inside. It's not my chronological clock, it's my biological clock. And we now know that we can measure our biological clock and our rate of aging through a specific test called DNA methylations, something relatively new, and it, it tests w- what's called our epigenome. Our genes are fixed. We have 20,000 genes. We can't change that, or 25, whatever. But we have, on top of those genes, a regulating system. Epi means above. And the epigenome basically is like the piano player that plays all the different keys, which are our genes. We've got 88 keys, but they can play thousands of tunes. You can have rock, ragtime, jazz, blues, whatever, classical, all in the same 88 keys. Same thing with your epigenome, and it can control your biology in real time in ways that either accelerate or reverse the aging process. And now we know that a lot of the interventions that we discuss, whether it's diet and exactly what to eat, how to eat and so forth, exercise, the types of exercise, stress reduction, sleep, environmental toxins, nutritional level, our microbiome, all these things influence our epigenome and can change it either into something that's causing us to age fast or slow, or reverse our biological age. So if you're eating ultra-processed food, you're not exercising, you're under tons of stress, you're not sleeping, your nutrition's deficient, you're exposed to toxins, guess what? Your epigenome is gonna be bad. You will be older than your chronological age, as opposed to younger. So we know through interventions, even short interventions of, for example, eight weeks, we can-- of aggressive lifestyle and dietary change with functional medicine, you can reverse your biological age by three years. So in eight weeks, you turn back the biological clock by three years. That's profound.

Dr. Rangan Chatterjee 1:42:29 In eight weeks?

Dr. Mark Hyman 1:42:31 In eight weeks, yeah.

Dr. Rangan Chatterjee 1:42:32 And so [laughs] -- I mean, that's-

Dr. Mark Hyman 1:42:33 I'm trying to-- I'm 43. I'm trying to get to 25. We'll see how it goes. [laughs]

Dr. Rangan Chatterjee 1:42:37 But that-- But, but, you know, I think that's a key point here, Mark. When a lot of people think about longevity-

Dr. Mark Hyman 1:42:43 Mm. Mm

Dr. Rangan Chatterjee 1:42:43 ... right? I think there is a slight mismatch in their brain where it's like, well, why should I be bothered about what happens in 20, 30 years? I want to live my life now-

Dr. Mark Hyman 1:42:55 Yeah

Dr. Rangan Chatterjee 1:42:55 ... right? So there's-

Dr. Mark Hyman 1:42:56 Yeah

Dr. Rangan Chatterjee 1:42:56 ... there's always been this slight disconnect, whereas what I love about the things that you recommend in Young Forever is that, yes, it's gonna slow down the aging process if that's your goal, but it's also gonna help you feel great, like-

Dr. Mark Hyman 1:43:10 Yeah

Dr. Rangan Chatterjee 1:43:10 ... straight away, right? So it's, it's not-

Dr. Mark Hyman 1:43:12 Yeah

Dr. Rangan Chatterjee 1:43:12 ... something that we can kick down into the future.

Dr. Mark Hyman 1:43:14 No.

Dr. Rangan Chatterjee 1:43:14 It's gonna have immediate-- It's gonna have an immediate impact on the quality of your life.

Dr. Mark Hyman 1:43:18 Immediate. Immediate. Yeah, absolutely. Adding more life to your years, not just years to your life, right? So how do you actually feel good to do what you want in life? That's what this is all about. How do we be a moreEngage society. How do we become more connected to each other and supportive? How do we actually change this, sort of this inexorable sickness, both biologically and psychologically, that we see in our society? And a lot of it has to do with our biological health. We know that our mental health is connected to our physical health, and a lot of the sort of raging depression, and anxiety, and mental hea- health issues that are exploding across the globe are really related to, you know, our overall stress as a society, but also to the food we're eating. That literally the, the dietary things that we do drive our poor mental health, and that, uh, particularly starch [laughs] and sugar and processed food, and that can be changed, and that'll give us a sense of purpose, and meaning, and ability to do whatever we want.

Dr. Rangan Chatterjee 1:44:13 You posted a photo on, I think it was on Instagram a few months ago-

Dr. Mark Hyman 1:44:18 Mm. Mm

Dr. Rangan Chatterjee 1:44:18 ... of you in your 40s, and you now-

Dr. Mark Hyman 1:44:22 Yeah, yeah

Dr. Rangan Chatterjee 1:44:23 ... in your 60s, right?

Dr. Mark Hyman 1:44:24 Yeah. [laughs]

Dr. Rangan Chatterjee 1:44:24 And there was, uh, there was quite a noticeable difference, right?

Dr. Mark Hyman 1:44:28 There was, yeah. [laughs]

Dr. Rangan Chatterjee 1:44:29 Um, I think if people didn't know, they may not be sure which one was which. I think-

Dr. Mark Hyman 1:44:34 Which-

Dr. Rangan Chatterjee 1:44:34 You can tell which one's which from looking at your face

Dr. Mark Hyman 1:44:36 I have more gray hair. I have a lot more gray hair. [laughs]

Dr. Rangan Chatterjee 1:44:37 But, but wh- why did you post that? What was so important for you to show people?

Dr. Mark Hyman 1:44:42 Well, I think, I think two things. One, you know, when I was in my 40s, I was a- athletic. I was running. I was biking 100 miles. I was very active, um, and I was eating what I thought was healthy, uh, which was, which was whole foods, but I tended to eat a lot more carbohydrates, a lot less fat and less protein, and I didn't do resistance training. I thought, oh, I'm doing yoga. I'm, you know, that's good enough, or I'm doing, you know, biking or running, and I didn't. And so when I was 60, I decided to start, uh, doing resistance bands and strength training, and I also have changed my diet over the years to be much more, uh, low glycemic, to be higher in, uh, protein and fat, and, and lower in starch and sugar with lots of, of pla- uh, phytochemically rich fruits and vegetables. And I noticed my body composition change. I went from, like, you know, 12% body fat to 6% body fat. I had, you know, inc- increasing health and, and strength as I got older, which I think most people don't see. They see, you know, as you get older, you lose muscle, you become more flabby, y- you know, and that is truly usually what happens, and that is the death knell. If you wanna age fast, then don't exercise and, uh, keep your diet high in starch and sugar and low in [laughs] protein and fat. And that, that is the recipe for disaster. It's really the recipe that most of us are following. But the body has the ability to, uh, as I, as I, as I showed in that picture, to change radically at any age. So I, I've seen people at, you know, even at 80, 90 start to do things, and, and you see their, their, their strength and their function come back.

Dr. Rangan Chatterjee 1:46:15 Yeah. Well, we'll definitely, if you, if you're willing to send me that photo, we'll definitely pop it up on the video to-

Dr. Mark Hyman 1:46:21 Yes, for sure. I'll send it to you

Dr. Rangan Chatterjee 1:46:22 ... to, to show 'cause I think it's very inspiring for people, and I think there's a wider point there, Mark, which is, again, if you go down the street and you picked 10 people at random and asked them, "Would you like to live longer?" I suspect that many of them will say no because they perceive old age with frailty and morbidity.

Dr. Mark Hyman 1:46:44 Yeah. Yeah.

Dr. Rangan Chatterjee 1:46:45 And I think your book's really challenging that. But can you speak to that a little bit? I think you've, you've written in the book-

Dr. Mark Hyman 1:46:49 Yeah

Dr. Rangan Chatterjee 1:46:49 ... that actually what we see around us is actually what you call abnormal aging.

Dr. Mark Hyman 1:46:55 Yeah. Well, we've come to expect the typical person who's older as representative of what's supposed to happen, right? We become hunched over, weaker, more frail, less able to do things we wanna do. We, we become fraught with diseases, you know, and over, uh, probably 80% of people over 65 have one or more chronic illnesses. And, and, and we... So we've come to expect this is just how life goes, and we can't do anything about it. But what we're actually witnessing is an accelerated process of aging that has to do with these underlying hallmarks of aging that go awry, and things like damage to our mitochondria, inflammation, change in our microbiome, change in our nutritional sensing apparatus that regulates our, our food and metabolism, uh, our, our DNA damage that happens, epigenetic changes, shortening telomeres, zombie cells that develop. So all these things happen as a result of damage to our proteins, happen as a result of this abnormal process that now we can intervene in. And a lot of longevity scientists are looking for drugs or interventions to interrupt these hallmarks of aging, which may be helpful, like rapamycin for example or, or metformin. But the reality is that, that we have a greater, far greater influence through dealing with the root cause of those hallmarks, what I call dying of too much or dying of too little, which is not enough of the good stuff and none of the... m- too much of the bad stuff that we're exposed to. That all infl- these hallmarks, and then we don't, we don't actually, um, have to actually treat them individually. We, we can optimize our health, and our mitochondria will be better. Our blood sugar regulation will be better. Our inflammation will be less, and everything tends to work better when we deal with those, those root causes of the hallmarks. So we, we don't have to accept this decline and decrepitude and frailty as normal. We can reverse that. We can reverse that biological process and actually get younger as we get older.

Dr. Rangan Chatterjee 1:48:47 I know as part of the research for this book, you went on your travels. I really enjoyed-

Dr. Mark Hyman 1:48:52 I did

Dr. Rangan Chatterjee 1:48:52 ... watching you sharing-

Dr. Mark Hyman 1:48:53 I did

Dr. Rangan Chatterjee 1:48:53 ... a lot of these stories on your social media. This is probably-

Dr. Mark Hyman 1:48:56 Yeah

Dr. Rangan Chatterjee 1:48:56 ... I don't know, six, nine months ago. I can't remember-

Dr. Mark Hyman 1:48:58 Yeah, yeah. [laughs]

Dr. Rangan Chatterjee 1:48:58 ... when exactly. Um-

Dr. Mark Hyman 1:49:00 Yeah

Dr. Rangan Chatterjee 1:49:00 ... I know two countries you visited or two places you visited were Sardinia and Ikaria, I think.

Dr. Mark Hyman 1:49:07 Ikaria. Ikaria.

Dr. Rangan Chatterjee 1:49:08 And I wonder, could you paint us a picture of maybe some of the older residents who you met who really challenge that modern assumption that as we get older, we're gonna be frail, we're gonna be sick, we're gonna be sat down all day, we're not-

Dr. Mark Hyman 1:49:25 Mm-hmm

Dr. Rangan Chatterjee 1:49:25 ... we're not gonna be doing much? Because, you know, you shared yourself in your early 60s-How much vibrancy you have. Okay, that's fantastic.

Dr. Mark Hyman 1:49:34 Yeah.

Dr. Rangan Chatterjee 1:49:34 But paint us a picture from your travels as to, you know, a couple of people who you met who also showcased to us what may be possible as we age.

Dr. Mark Hyman 1:49:45 Yeah, I think that's a very, very important point that, uh, you know, we need to, to sort of look at cultures where they live a long time, and what are their habits and behaviors, and how are they different? And I think, you know, they, they age very well and live a long time. And now the blue zones are these places around the planet where people are the longest-lived humans. The thing is, when they move to the Western societies that, that we come from, they age at the same rate as we do. [laughs] They get old and sick and die sooner. And so really by default, their habits are those that promote longevity. They're not, you know, doing saunas and cold plunges, and taking a lot of supplements, and doing IV NAD, and doing exosomes, and plasma phoresis, and all these kind of cool things that are emerging around longevity. Their whole default culture is, is, is actually automatically providing them with the inputs that enhance health and promote longevity. For example, their diet is, is incredibly, uh, rich in phytochemicals, in, in whole foods, in things that are, are wild, and, and really simple foods that they've eaten for thousands of years. They exercise as a normal part of their life, whether it's gardening or whether it's, you know, shepherding and climbing up and down the mountains all the day long. [laughs] And it's, uh, the social connections, and the tight-knit family groups, and the social fabric, and the idea that we should just be there to help and support each other is, is really quite important. And, and so when you have these defaults, longevity happens as a natural consequence. Uh, they actually were quite incredible. I met this guy Pietro, who was 95 years old, had just retired, quote, retired from being a shepherd, where he was shepherding his sheep five miles up and down the rocky mountains every single day [laughs] from probably when he was, like, 12. And he was straight up as an arrow, booming voice, clear eyes, you know, just looked like the average sort of probably, uh, 67-year-old in America. And I'm like, wow, this guy's 95 years old. [laughs] There was, uh, Ele- Eleka, who was, uh, almost 90 years old. This woman cooked us a meal from her garden. She took care of this entire, I wouldn't call it a garden, more like a farm she had on a hillside, all these orchards and fruit trees, many, many garden beds, animals she took care of. And she lived all by herself. Her husband was, like, 100, so he was, he was sort of chilling. [laughs] But I mean, I mean, he, she just was, was so fit and fi- And I was literally chasing after her going up this hill, huffing and puffing, and she just was like a little mountain goat. And I was like, holy cow, this is impressive. And she cooks all her own food. They raise all their own food. She cans all her own food. She preserves all her own food. And she's like 90-something years old. I'm like, this is not what we see in America in 90 years old. We see people in nursing homes, or sitting in a wheelchair or rocking chair [laughs] and not doing a whole lot.

Dr. Rangan Chatterjee 1:52:24 Yeah. It, it's so interesting to hear that, Mark. And I just wonder for you as you're someone who's known the science that's come out of the blue zones, you've spoken about it before. You, you've, you, you've known about this for many, many years.

Dr. Mark Hyman 1:52:37 Mm-hmm.

Dr. Rangan Chatterjee 1:52:38 Was it different? You can know it with your rational mind, but then you show up and you-

Dr. Mark Hyman 1:52:43 Yeah

Dr. Rangan Chatterjee 1:52:43 ... spend time with these people, these families, these elderly individuals who are maybe more active than you are potentially in, you know-

Dr. Mark Hyman 1:52:52 Potentially. [laughs]

Dr. Rangan Chatterjee 1:52:52 ... going up mountains, right? You know, what did that do to, how did that influence your writing of this book? Because I, I, I always think about this as a, as, you know, you like me, as someone, we try to communicate these ideas in a simple way to the public.

Dr. Mark Hyman 1:53:07 Yeah, yeah.

Dr. Rangan Chatterjee 1:53:07 And we can know stuff with our rational brain, but I think there's something quite powerful about stories and actually seeing people who embody-

Dr. Mark Hyman 1:53:15 Yeah

Dr. Rangan Chatterjee 1:53:15 ... what we actually want, right?

Dr. Mark Hyman 1:53:17 Totally. I mean, it just was so inspiring about what really matters in life. It's not being on your cell phone or being on social media or achieving something or having some great goals. It's about just the process of living, and they did that so well. They really live close to the earth. They live close to each other. They celebrated together. It was just, it was just quite amazing. You didn't see any nursing homes. If somebody's spouse died, they would move in with their kids or their, you know, niece and nephew. It was just, there was one woman, Julia, she was 100 years old, and three months. She said, "I'm 103 months." I'm like, [laughs] "Okay." Like, I'm five and three quarters, you know, when your little kid says that. And she's like, "I'm 103 months." And, uh, you know, she, she didn't have kids of her own. She wasn't ever married. Uh, all, she said all the men she was dating when she was younger all died off. And she lived with her niece and, and nephew, and, and they were taking care of her. There was no sense that they would be putting someone in a nursing home. And she was still working at 100 years old. She was sewing all these doilies and embroideries for weddings and different celebrations. And so she was very active. She'd go on walks every day and, you know, she really didn't have any health issues. I think she said her thyroid was a little slow, so she, she maybe took some thyroid medication.

Dr. Rangan Chatterjee 1:54:23 Yeah.

Dr. Mark Hyman 1:54:23 But she was quite amazing, and clear-eyed, and sharp, and funny as heck.

Dr. Rangan Chatterjee 1:54:27 Would you say since coming back from your travels, seeing people like that, has it inspired you to change anything? Have you, are you more active than you were before? You've always been very conscious about your health, so-

Dr. Mark Hyman 1:54:43 Yeah

Dr. Rangan Chatterjee 1:54:43 ... I'm just so fascinated by what that experience did to you on a personal level.

Dr. Mark Hyman 1:54:49 Well, it was, it was just profoundly m- mo- moving and, uh, inspiring, and it made me realize that, you know, a lot of the things that we value in our Western culture are not the things that really matter. And, uh, you know, the, the, the, the, what matters is our friendships, our community, our connections, is, is taking care of each other, is taking care of the Earth, is actually living in a way that's not harmful to ourselves [laughs] or anybody else. And that's how they lived.

Dr. Rangan Chatterjee 1:55:14 Yeah.

Dr. Mark Hyman 1:55:14 And they lived that way for thousands of years, and they, they sort of naturally developed these en- environments and habits that fostered health and longevity. And so as much as I can, I try to learn from them and incorporate some of the habits they have. And, uh, it, you know-

Dr. Rangan Chatterjee 1:55:29 Yeah

Dr. Mark Hyman 1:55:29 ... it's beautiful for me.

Dr. Rangan Chatterjee 1:55:31 I've read every page of the new book, Mark, and as I say, I, I really, I really, really like it. I think it's gonna help a lot of people. And we're gonna talk about-A bit more on food and exercise and protein-

Dr. Mark Hyman 1:55:44 Yeah

Dr. Rangan Chatterjee 1:55:44 ... and stress.

Dr. Mark Hyman 1:55:44 Mm-hmm.

Dr. Rangan Chatterjee 1:55:44 You see, we're gonna get to all of that.

Dr. Mark Hyman 1:55:46 Yeah. Mm.

Dr. Rangan Chatterjee 1:55:46 But I wonder, this will surprise you, I think for me, through the lens at which I look at life now-

Dr. Mark Hyman 1:55:55 Mm

Dr. Rangan Chatterjee 1:55:55 ... I think the most powerful sentence in the book is this one-

Dr. Mark Hyman 1:56:01 Ooh

Dr. Rangan Chatterjee 1:56:02 ... in places like the Blue Zones, people seem to understand their place and purpose in the community in which they live.

Dr. Mark Hyman 1:56:13 Mm-hmm. Mm-hmm.

Dr. Rangan Chatterjee 1:56:14 Now, Mark, when I, when I read that, I paused because it really speaks to so much of what I've tried to write about in my book on happiness, how I think about the world now. You know, y- you've touched on this a little bit in a couple of ways, Mark. You've said they... These guys aren't doing cold plunges. They're not, like, thinking about their diet. They're not trying-

Dr. Mark Hyman 1:56:34 No

Dr. Rangan Chatterjee 1:56:34 ... to practice anti-aging.

Dr. Mark Hyman 1:56:36 No.

Dr. Rangan Chatterjee 1:56:36 Their environment just kind of supports them so that they-

Dr. Mark Hyman 1:56:40 Yeah

Dr. Rangan Chatterjee 1:56:40 ... they live well, right? And I, and I remember-

Dr. Mark Hyman 1:56:42 Totally

Dr. Rangan Chatterjee 1:56:42 ... I haven't been to these so-called Blue Zones, right? But last summer, I was in Ithaki, a small island in Greece, with my family.

Dr. Mark Hyman 1:56:51 Yeah. Mm-hmm.

Dr. Rangan Chatterjee 1:56:52 And we were there for about five days. It was this peaceful small island, and there's so many things I remember. There was one family restaurant which we would go to most days. Very small.

Dr. Mark Hyman 1:57:01 Yeah.

Dr. Rangan Chatterjee 1:57:01 It was all local foods.

Dr. Mark Hyman 1:57:03 Yeah.

Dr. Rangan Chatterjee 1:57:04 The, the families helped out.

Dr. Mark Hyman 1:57:05 Yeah.

Dr. Rangan Chatterjee 1:57:05 It was three or four generations all around-

Dr. Mark Hyman 1:57:08 Wow

Dr. Rangan Chatterjee 1:57:08 ... the entire time.

Dr. Mark Hyman 1:57:09 Mm-hmm.

Dr. Rangan Chatterjee 1:57:09 And I remember once, Mark, I remember-

Dr. Mark Hyman 1:57:12 Mm

Dr. Rangan Chatterjee 1:57:12 ... I think my kids were getting a bit tired of the same vegetables every night, so they say, "Daddy, they got broccoli."

Dr. Mark Hyman 1:57:18 Yeah.

Dr. Rangan Chatterjee 1:57:18 So I, I said, "Hey," uh, and I think I shared this once on the podcast before. I asked the lady who was serving us, "Um, do you have any other vegetables, for example, like broccoli?" And she looked at me. She was super nice. She said... She w- almost with a look of confusion, she said-

Dr. Mark Hyman 1:57:35 Yeah

Dr. Rangan Chatterjee 1:57:35 ... "Oh, that's not in season."

Dr. Mark Hyman 1:57:37 Right, right, right.

Dr. Rangan Chatterjee 1:57:38 Like, it w- it was... A- and it really, it, it was such a powerful lesson. I thought, actually, what they're feeding us is literally what is in season and being grown on that small island.

Dr. Mark Hyman 1:57:47 Yeah.

Dr. Rangan Chatterjee 1:57:47 So that was a very powerful lesson. But the, the, the overwhelming sense I got was that these guys aren't searching for status. They're not trying to necessarily compete-

Dr. Mark Hyman 1:57:59 No

Dr. Rangan Chatterjee 1:57:59 ... or certainly from what I could see, in a way that I think we are-

Dr. Mark Hyman 1:58:02 Yeah

Dr. Rangan Chatterjee 1:58:02 ... in the West.

Dr. Mark Hyman 1:58:03 Totally. Totally.

Dr. Rangan Chatterjee 1:58:03 They're not striving. And as, as I say, th- why that phrase in the book, it's so powerful. People seem to understand their place and purpose in the community in which they live.

Dr. Mark Hyman 1:58:14 Yeah. Yeah. Yeah.

Dr. Rangan Chatterjee 1:58:14 I think that's a big problem for many of us-

Dr. Mark Hyman 1:58:16 Yeah

Dr. Rangan Chatterjee 1:58:16 ... in the West, and I think that-

Dr. Mark Hyman 1:58:18 So true

Dr. Rangan Chatterjee 1:58:18 ... is getting in the way. Any, any, any thoughts on that, Mark?

Dr. Mark Hyman 1:58:21 Oh, my God, yeah. I mean, think about, you know, when you look at some of the data, it's a little startling. If you, if you were to erase heart disease and cancer from the face of the planet, we would maybe extend life globally by five to seven years, which is, these are the number one and two killers. If you have meaning and purpose, your life extension is seven years. [laughs] So having meaning and purpose in your life, meaning that you, you know who you are, why you're here, what you're doing, what your place is in the community, and connection to others, that actually is, is a benefit as great as eliminating heart disease and cancer from the face of the earth. I mean, think about that for a minute. [laughs]

Dr. Rangan Chatterjee 1:59:00 If you enjoyed that conversation, then I think you are really going to enjoy this one.

1:59:05 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.