00:00:00
Your waist should be less than half your
00:00:03
height. So half of that string should go
00:00:05
around the fattest bit of your belly.
00:00:07
And this is a really simple test for
00:00:09
everybody at home.
00:00:10
>> I mean, it's not.
00:00:11
>> Yeah, you've just done it. You've
00:00:12
passed. But fat on your belly is more
00:00:14
worrying than fat on your legs or on
00:00:16
your arms. And unfortunately, we've
00:00:18
started to normalize things like the dad
00:00:20
bot without realizing that isn't how
00:00:22
you're supposed to be. And maybe a third
00:00:24
of all the people in the world with type
00:00:25
2 diabetes don't even know they have it.
00:00:27
But every year that you have poorly
00:00:29
controlled type 2 diabetes, you're
00:00:31
losing 100 days of life. And it's
00:00:33
because people don't know the truth
00:00:35
being fooled with the packeting and
00:00:36
advertising.
00:00:37
>> So, let's talk about the food we have on
00:00:39
this table because this is how much
00:00:40
sugar I would have thought was in all of
00:00:42
these things here. Cereal, a potato,
00:00:44
white rice, a banana, and a chocolate
00:00:46
bar.
00:00:46
>> So, now I'm going to give you the
00:00:48
correct figure. The corn flakes is 1 2 3
00:00:52
4 5 6 7 8. That chocolate bar is 7 and
00:00:57
1/2. The banana that's six. And then the
00:00:59
potato is actually
00:01:01
>> Oh my gosh.
00:01:02
>> And then 150 g of boiled rice is
00:01:06
>> Oh, I thought rice was healthy.
00:01:09
>> But each of us has a number of different
00:01:12
health futures. And what I'm interested
00:01:14
in is how do I get you to pick a
00:01:16
lifestyle that will get you the future
00:01:17
you want? Because my job is about
00:01:20
behavior change.
00:01:21
>> The floor is yours.
00:01:22
>> All right. So, off we go.
00:01:26
This is super interesting to me. My team
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given me this report to show me how many
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And some of you have told us according
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If you are a regular viewer of the show
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hit that subscribe button and to double
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00:02:01
I'll make sure every single week, every
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single month, we fight harder and harder
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Dire of Sio, and I will not let you
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down. Please help us. Really appreciate
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it. Let's get on with the show.
00:02:20
Dr. David Unwin, you were named in 2018
00:02:24
among the top 10 most influential
00:02:27
doctors in the United Kingdom. Um,
00:02:28
you've got an incredible list of
00:02:30
accomplishments and you're held in the
00:02:33
highest regard maybe of all the doctors
00:02:34
I've ever had the chance to speak to by
00:02:36
many people that I've spoken to. We were
00:02:38
talking before we started recording
00:02:39
about what's on your mind and what's
00:02:42
been bothering you. And so the floor is
00:02:44
yours. What is front of mind for you,
00:02:46
Dr. David?
00:02:46
>> Well, front of mind for me is the the
00:02:49
idea that each of us has a number of
00:02:52
different health futures. So you have so
00:02:55
in your future uh I don't know there
00:02:58
could be cancer. There could uh be
00:03:00
multiple sclerosis or there could be
00:03:02
many futures. What I'm interested in is
00:03:06
how do I get you to pick a lifestyle
00:03:09
that will get you the future you want?
00:03:12
And I think that's very difficult in the
00:03:15
world now to know what is the best
00:03:17
lifestyle because you've given so much
00:03:19
conflicting advice. And the particular
00:03:22
focus for me in terms of picking health
00:03:25
futures is around young people because
00:03:28
they've got the longest time to make a
00:03:32
difference.
00:03:33
And it's getting harder and harder and
00:03:36
harder to make good health choices in
00:03:39
your lifestyle. It's really hard. I'd
00:03:42
say it's a pandemic
00:03:44
of poor metabolic health. Yesterday in
00:03:47
clinic, I saw two people under the age
00:03:49
of 25 who had poorly controlled diabetes
00:03:54
and one of them was too heavy for me
00:03:56
actually to weigh. And this situation is
00:04:00
completely new. So when I when I was a
00:04:03
young doctor uh and just starting off in
00:04:06
practice, that was in 1986.
00:04:09
Wow. A long time ago, just north of
00:04:12
Liverpool in the practice, I'm still
00:04:13
there now. Obesity was rare and we
00:04:17
didn't have a single case of type 2
00:04:20
diabetes in anybody under 55. Not a
00:04:24
single case. It was quite unknown. And
00:04:26
in fact, type 2 diabetes had a different
00:04:28
name. We've had to change the name
00:04:31
because of the epidemic. Used to be
00:04:32
called maturity onset diabetes. That
00:04:35
meant old people, right? Now we call it
00:04:38
type two diabetes because we have to
00:04:40
include so many young people. It's
00:04:42
really really serious
00:04:45
because people are losing their life
00:04:48
expectancy and I'm witnessing this.
00:04:51
We're all sleepwalking into a metabolic
00:04:54
disaster and the people praying the
00:04:55
greatest price in my opinion are young
00:04:59
people and it's a scandal and I'm
00:05:02
hopping mad really. I think we've
00:05:04
started to normalize
00:05:06
the dad bod, you know, the big tummy and
00:05:09
haha without realizing that maybe that
00:05:12
isn't how you're supposed to be. So that
00:05:15
that's what's on my mind. Young people
00:05:18
and their future and they don't even
00:05:21
know.
00:05:22
>> You say young people there. Yeah.
00:05:24
>> Because they've got the biggest
00:05:26
opportunity to change the trajectory of
00:05:28
their health future.
00:05:29
>> Yes.
00:05:29
>> But for the audiences listening that
00:05:31
might be in their 50s now. Is this
00:05:33
advice also applicable?
00:05:34
>> Absolutely. So, we know from g
00:05:36
government figures, UK government
00:05:38
figures
00:05:40
that for every year that you have poorly
00:05:43
controlled type 2 diabetes, you're
00:05:45
losing a 100 days of life. That's about
00:05:48
a third of a year, isn't it? So,
00:05:51
whatever age you are, if you uh have
00:05:54
poorly controlled diabetes, you're
00:05:57
losing life expectancy. and and maybe a
00:05:59
third of all the people in the world
00:06:00
with type 2 diabetes don't even know
00:06:02
they have it because they haven't taken
00:06:04
a test so they don't know. What do you
00:06:07
think kills people with type 2 diabetes?
00:06:11
>> Um is it some cardiovascular issue?
00:06:15
>> Yeah, well done. Well done. you see
00:06:18
you've not been to medical school that
00:06:20
most doctors that's what they say
00:06:22
because we know that a high blood sugar
00:06:25
over time damages your arteries. So it's
00:06:29
a cumulative thing over time. But what
00:06:32
you may not know is that actually
00:06:37
a rising cause of mortality for people
00:06:40
with diabetes is cancer.
00:06:42
>> Oh really?
00:06:43
>> Yeah. So, eight forms of cancer
00:06:46
are strongly associated uh with
00:06:49
diabetes.
00:06:50
>> I want to just define that term diabetes
00:06:52
because I think I went through a lot of
00:06:53
my life assuming that diabetes was a
00:06:55
disease that some people are born with
00:06:57
and because I didn't have it, I thought
00:06:58
I don't need to worry about that.
00:06:59
>> That's really important. Yeah. So, first
00:07:02
of all, there's type 1 diabetes and type
00:07:04
two. But before I can explain
00:07:08
about diabetes, I need to explain about
00:07:11
insulin. This is absolutely key to our
00:07:14
whole discussion.
00:07:16
So, I've already said that a high blood
00:07:19
sugar damages your arteries. And in
00:07:23
fact, there's work to show that a very
00:07:25
high blood sugar damages the non-stick
00:07:28
lining of your arteries within six
00:07:30
hours.
00:07:31
>> Oh wow.
00:07:31
>> Really quick. It's called the glycoalix,
00:07:33
the non-stick lining. And uh damage is
00:07:36
occurring very quickly. So,
00:07:38
>> I'm going to ask you a really stupid
00:07:40
question. Yeah. When you say high blood
00:07:41
sugar, I get high blood sugar when I eat
00:07:43
lots of sugar.
00:07:45
>> Okay. So, first of all, we're actually
00:07:47
talking about glucose.
00:07:49
>> Yeah.
00:07:49
>> And sugar can mean table sugar or it
00:07:52
could mean many different things, but
00:07:54
we're actually talking about blood
00:07:56
glucose,
00:07:57
>> which comes from lots of foods,
00:07:58
>> which comes from many foods.
00:08:00
>> Carbohydrate heavy foods.
00:08:02
>> Yes. Yes, it does. It does. So, that
00:08:05
that's right. But you have the hormone
00:08:08
insulin to defend you from poor dietary
00:08:11
choices. So the question is, what does
00:08:14
insulin do with the sugar you just ate?
00:08:17
And here's the answer. Insulin, the
00:08:20
hormone insulin produced by your
00:08:22
pancreas gland.
00:08:24
It pushes the sugar and it pushes it out
00:08:29
of the bloodstream inside cells where it
00:08:32
can be used for energy for you to run
00:08:34
around.
00:08:36
But what if you take in uh more
00:08:39
carbohydrate than you need to run
00:08:41
around? Well, then that sugar is turned
00:08:45
to fat inside cells because it's safer
00:08:49
for you to turn that sugar into fat than
00:08:52
it is is to have it damaging your
00:08:54
arteries.
00:08:56
So, I am somebody with type two
00:08:57
diabetes. So, we can talk about me. So,
00:09:01
I had a really heavy biscuit habit. uh I
00:09:04
was senior partner of the practice and
00:09:06
it's stressful and I had patients used
00:09:09
to bring me biscuits all the time as a
00:09:11
gift because they you know they want the
00:09:13
doctor to be happy. So in the drawer in
00:09:15
the top of my desk was packets and
00:09:17
packets of biscuits. So, I'm taking in
00:09:20
more sugar and I didn't run around and
00:09:23
gradually my waist got bigger.
00:09:26
And what was actually happening was as I
00:09:31
took in more sugar than I needed to run
00:09:34
around, my insulin was working to get
00:09:37
rid of that sugar and it was giving me
00:09:40
two things. One, a belly.
00:09:43
>> Mhm. So my, you know, and I thought it's
00:09:45
just middle-aged spread, you know, and
00:09:48
the other was I didn't know, but my
00:09:51
liver was filling with fat and that's um
00:09:54
that is very common now. So we have
00:09:59
well it's a third of everybody in the
00:10:01
developed world has fatty liver. Now
00:10:03
here we got the wonderful props. Let's
00:10:05
talk about these. Great. So fatty liver.
00:10:09
This is the healthy liver here.
00:10:12
And you see the color. Look at this one.
00:10:16
It's yellow. It's the wrong color. And
00:10:19
it's because of fat.
00:10:21
So in that case, like has happened to me
00:10:25
over years, my liver began to fill with
00:10:30
fat
00:10:30
>> because it was essentially overworked
00:10:32
and glucose was being stored there.
00:10:34
>> Yes. So I was taking in too much
00:10:36
glucose.
00:10:38
Insulin was doing its good job of taking
00:10:41
it out of my bloodstream and forcing it
00:10:44
inside cells in my belly but
00:10:46
unfortunately in my liver.
00:10:48
>> Okay.
00:10:48
>> And so there's a progressive laying down
00:10:50
of fat in the liver. So if we look at
00:10:52
actually some proper liver. So this is
00:10:55
the put on your seat belts now because
00:10:57
this is
00:10:58
>> somebody's uh somebody's actual liver.
00:11:01
>> So then that's the normal liver. But
00:11:04
look at this. It's larger.
00:11:05
>> That's a real human liver.
00:11:06
>> Yes, these are human livers. And that's
00:11:08
as it should be. But this, look at this
00:11:10
liver. It's larger. And it's larger
00:11:13
because there's so much fat in it. Now,
00:11:15
the twist in the story is fatty liver
00:11:19
interferes with the good work of
00:11:21
insulin.
00:11:23
So, you develop a thing called insulin
00:11:25
resistance, which means your insulin is
00:11:27
no longer as powerful as it was. It's
00:11:30
beginning to become difficult for you to
00:11:32
deal with carbohydrate and sugar because
00:11:34
your insulin isn't working as well. And
00:11:37
the only way to deal with that is the
00:11:40
next twist in the story.
00:11:42
>> You have to start producing more
00:11:44
insulin.
00:11:46
>> Do you see? Because it doesn't work as
00:11:48
well.
00:11:48
>> Yeah.
00:11:49
>> So your pancreas has to crank up the
00:11:52
supply. We need more insulin. So now you
00:11:55
have two things. You have insulin
00:11:59
resistance. Your insulin isn't working
00:12:01
as well, but at the same time, you're
00:12:05
trying to produce more insulin in the
00:12:07
pancreas. This bits called the long
00:12:10
silent scream from the liver. This is
00:12:12
work by Professor Roy Taylor, a friend
00:12:14
of mine at Newcastle University, and he
00:12:17
pointed out that you you've got fatty
00:12:20
liver for about 10 years. You don't even
00:12:22
know. You wouldn't know that your
00:12:25
liver's gone fatty and yellow like that.
00:12:29
But unfortunately, this is another
00:12:31
twist. Fat is being laid down in the
00:12:33
pancreas gland, the very gland that your
00:12:36
life depends upon producing insulin. And
00:12:39
your ability to produce enough insulin
00:12:42
collapses.
00:12:43
And at that point, you can't regulate
00:12:46
blood sugar anymore. But upstream of
00:12:49
that, you have a problem. You've got
00:12:51
that. But you don't even know. You
00:12:54
You're talking about what's in my mind.
00:12:56
Why are we waiting until you actually
00:12:59
have all the problems of type 2
00:13:01
diabetes? So since 2013,
00:13:05
I've got hundreds of patients and I'm
00:13:07
monitoring the baseline and latest
00:13:10
follow-up. So what happens to them? It's
00:13:12
really important.
00:13:14
And now I have a a huge data set that I
00:13:17
can interrogate and answer questions. So
00:13:20
number one question,
00:13:23
let's think about pre-diabetes. So this
00:13:25
is in the long silent screen.
00:13:28
Well, I can tell you that the people
00:13:30
with pre-diabetes in my practice north
00:13:33
of Liverpool,
00:13:35
93% of them will get a completely normal
00:13:40
blood sugar if they go low carb. 93%
00:13:43
resolution and that will last for years
00:13:46
because I've checked. Okay, how about we
00:13:50
wait for the 10 years and Stephen until
00:13:52
Steven you've got type 2 diabetes and
00:13:55
then you go low carb at that point if I
00:13:58
can get you early I've got a 73% chance
00:14:02
of you having a normal blood sugar let's
00:14:05
wait another few years because you don't
00:14:06
want to give up bread and you don't want
00:14:08
to give up chips and pizza fair enough
00:14:10
I'll wait
00:14:12
but you know if we wait five years you
00:14:14
only stand a 50% chance so do You see it
00:14:18
goes 93 over 70%, 50%. So the chances of
00:14:23
me not needing drugs and be able to do a
00:14:26
good job for you are diminishing. So
00:14:30
really it's a stitch in time.
00:14:31
>> Mhm.
00:14:32
>> And so much of this you don't even know.
00:14:34
You don't even know it's going on.
00:14:37
>> One of the things that shocks me is um
00:14:39
is how little we know about what's in
00:14:41
our food.
00:14:42
>> Yes. You know, because I think we all
00:14:43
know that like biscuits are a food that
00:14:46
has a high glycemic index.
00:14:48
>> Well done.
00:14:48
>> Which is a term that I've learned from
00:14:50
this podcast, which means
00:14:51
>> some carbohydrates are more sugary than
00:14:53
others. And then so that's the glycemic
00:14:56
index. What that is doing is comparing
00:14:59
different carbohydrates with pure
00:15:01
glucose.
00:15:02
>> Okay?
00:15:02
>> So you see pure glucose is 100 and then
00:15:05
other sugars come further down.
00:15:09
But there is there's something better
00:15:11
than the glycemic index and that's
00:15:13
called the glycemic load. The glycemic
00:15:17
load takes portions of food and predicts
00:15:23
how will that portion of food
00:15:27
actually affect your blood sugar.
00:15:29
>> And am I right in thinking the glycemic
00:15:31
load would factor in the amount of
00:15:33
nutrients in the food that so like
00:15:35
protein, fiber?
00:15:36
>> Yeah. Because if you took watermelon
00:15:38
Yeah.
00:15:38
>> Well, it's mainly water, isn't it?
00:15:40
>> Mhm.
00:15:40
>> So, you have to factor in, you can have
00:15:43
quite a lot of watermelon
00:15:45
uh to equal a chocolate bar.
00:15:47
>> Mhm.
00:15:48
>> So, the density you're all you're
00:15:50
looking at the density of sugar in it as
00:15:52
well.
00:15:52
>> Okay.
00:15:53
>> So, that's why the glycemic load is
00:15:56
better.
00:15:56
>> Was there was there a moment in your
00:15:58
career where
00:16:00
you started to question what you had
00:16:02
been told?
00:16:03
>> Yeah. you know, so you start as a young
00:16:07
doctor. I wanted to be part of a small
00:16:10
community and stay there and make a
00:16:12
difference. And then comes the sad bit
00:16:14
really. So I for the first 25 years I
00:16:19
was trying to do what's in the
00:16:20
guidelines. I was trying to be a good
00:16:22
doctor. But what I noticed I noticed two
00:16:26
things.
00:16:28
Number one, I noticed what I've already
00:16:30
said to you that the health of the
00:16:33
population I cared for was
00:16:35
deteriorating. It wasn't getting better.
00:16:37
So, if I'm the doctor in charge of the
00:16:40
practice looking after these people and
00:16:43
health is deteriorating,
00:16:46
am I not responsible? And where's where
00:16:49
is all this difference I was hoping to
00:16:51
make? It just wasn't panning out. At the
00:16:54
same time, I'd always in my heart felt
00:16:58
that prescribing lots of drugs felt a
00:17:00
bit wrong. It felt like a mini failure
00:17:04
because how is somebody well if they're
00:17:07
taking six tablets a day?
00:17:09
>> Was there one particular patient that
00:17:11
you met?
00:17:12
>> There were two two things happened both
00:17:15
to do with very powerful women. The
00:17:18
first powerful woman was a lady I'd
00:17:20
known for over 10 years. She and her
00:17:23
husband had cared for them both. They
00:17:25
both had poorly controlled diabetes and
00:17:28
they were both very heavy at the time. I
00:17:32
could monitor how my how compliant my
00:17:37
patients were with their medication.
00:17:40
And if I'm to be truthful, in part that
00:17:42
was how I was paid. So part of my
00:17:46
payment was to do with are the patients
00:17:48
having in this case metformin the most
00:17:50
commonly used drug for type 2 diabetes.
00:17:53
>> Part of your payment?
00:17:54
>> Yeah. Yeah. How would you?
00:17:56
>> Well, because there's a you're supposed
00:17:57
to the the government approve of the
00:18:00
fact that we give drugs that are needed
00:18:03
for type 2 diabetes. So that you're
00:18:06
given a sort of quot it's it's regarded
00:18:08
as good practice that such a a certain
00:18:11
percentage of your patients will be on
00:18:13
metformin.
00:18:14
>> What?
00:18:14
>> Yeah, it's true.
00:18:16
>> So is it fair to say that you were
00:18:18
somewhat incentivized to give people
00:18:19
metformin?
00:18:20
>> Yes, that would be true. But I think we
00:18:22
should also be fair to say that the body
00:18:24
of evidence at the time would say uh
00:18:27
that it's good practice to give
00:18:29
metformin to people with type 2
00:18:31
diabetes. and
00:18:34
conversely poor practice not to use
00:18:37
metformin but we'll develop that. So the
00:18:40
the backdrop is we're we're monitoring
00:18:42
the patients who stop taking their
00:18:44
metformin because that uh is number one
00:18:48
poor practice and number two actually
00:18:49
cost me. So I wrote to the person dear
00:18:53
Mrs. So and so, I'm concerned that uh
00:18:56
you're not you don't seem to be taking
00:18:58
your metformin. Please make an
00:19:00
appointment with me at your earliest
00:19:02
convenience. Very British, very polite.
00:19:06
Anyway, nothing prepared me for what was
00:19:08
going to happen that morning. And it's
00:19:10
changed my entire life on that point. So
00:19:16
the lady, well, let's call her Mrs.
00:19:18
Jones. That wasn't her name. She marches
00:19:21
in and
00:19:23
uh she said to me, "You think you're
00:19:25
going to tell me off, don't you, Dr.
00:19:26
Enwin?" Well, I've got news for you. I'm
00:19:30
going to tell you off. I was scared.
00:19:32
Like, what's going on? She's never been
00:19:34
like this before. She was a a polite
00:19:37
person. Anyway, she went on to explain.
00:19:40
She said,
00:19:41
"When you do my blood tests, you will
00:19:44
find that my blood glucose is completely
00:19:46
normal despite not taking your
00:19:50
metformin."
00:19:52
And she said, "I'm wondering if you're
00:19:56
actually qualified as a doctor because
00:20:00
in the last 10 years, did you ever once
00:20:03
tell me that bread was sugar or
00:20:05
breakfast cereals were sugar?" I had to
00:20:08
learn online
00:20:10
uh that bread is sugar, that rice is
00:20:13
sugar, that breakfast cereals are sugar,
00:20:17
and when I cut those foods, I don't need
00:20:19
your metformin now. And she went she
00:20:22
made it worse. She said, "This is school
00:20:26
boy biology. You should have learned
00:20:28
that when you were 16."
00:20:31
I was dead scared because you know
00:20:34
complaints as a GP, it's really bad.
00:20:36
They go on for years and years. But
00:20:39
mainly I was scared because every word
00:20:41
she said was true. And one thing I had
00:20:44
learned about when you're an older
00:20:45
doctor is you've got to listen to people
00:20:47
properly. If they're complaining,
00:20:50
don't deny it. Don't defend yourself.
00:20:54
Take it. So I said, "Okay,
00:20:58
I've got I want to learn what you you
00:21:00
know, if this is true, will you meet me
00:21:02
again? Let's do the blood test." So we
00:21:04
did the blood test. It was true. It was
00:21:06
the first case of drug-free type 2
00:21:10
diabetes I had ever seen. I'd never seen
00:21:13
a single case in 25 years where people
00:21:16
came off medication.
00:21:18
I was fascinated
00:21:20
because she'd done it like a miracle.
00:21:23
But there was another detail I just
00:21:24
shared with you. She was one of 40,000
00:21:28
people online learning from each other
00:21:32
how to do it.
00:21:34
And when I looked, they were being
00:21:37
rubbished by the health care
00:21:39
professionals. So people like me were
00:21:41
telling them, "You'll die. What you're
00:21:44
doing is dangerous." And I was ashamed,
00:21:48
really ashamed,
00:21:51
and it's complete coincidence.
00:21:54
But in the same month,
00:21:57
uh, we have to introduce my wife, Jen.
00:22:00
Is there a photo? Come on, let's see
00:22:02
Jen. This is Jen.
00:22:03
>> Oh, she's probably the cleverest woman
00:22:06
in the world.
00:22:08
>> She's so clever. I love that woman. So,
00:22:10
Jen, uh, so her back, she is a, um, a
00:22:15
clinical health psychologist and she
00:22:18
specializes, she's fascinated by the
00:22:20
role of hope in disease and the
00:22:24
difference it can make. And she spent
00:22:25
her life researching the difference that
00:22:28
hope makes to clinical outcomes. So, it
00:22:31
just so happened that she was in a
00:22:33
supermarket and she saw some a
00:22:36
discounted diet book. That one. That's
00:22:39
the book.
00:22:40
>> Escape the diet trail by Dr. John Brier.
00:22:42
>> Yeah, Dr. John Briffer. What a lovely
00:22:44
guy. So, Jen bought that book just
00:22:48
around the time I'm telling her about
00:22:50
this patient. So she said, "You have to
00:22:52
read this book about the low a low
00:22:54
carbohydrate approach to um insulin
00:22:59
resistance to type 2 diabetes."
00:23:02
And in the book,
00:23:05
everything that my patient had told me
00:23:08
was there
00:23:09
and but it was done in a medical way for
00:23:13
and I understood. She said, "David, why
00:23:17
why are you sort of failing? Why don't
00:23:21
you do one thing before you retire? Why
00:23:25
can't you do a cheerful something you
00:23:27
really believe in? Why don't you have a
00:23:29
go at this low carb
00:23:31
>> yourself?
00:23:32
>> Yeah. She said, "Why don't you and me
00:23:36
go on this diet for see if some patients
00:23:39
would volunteer and do it with us?"
00:23:43
And I mentioned it to the partners
00:23:46
and they said, "No,
00:23:47
>> these are other doctors."
00:23:48
>> Yeah. So I'm senior partner.
00:23:50
>> I'm supposedly the boss. Uh but at the
00:23:54
time low carb was not respectable and
00:23:58
they didn't like it and they said we
00:24:00
don't want you to do this and partly
00:24:02
because they said well how it you know
00:24:06
is that a good use of the the resources
00:24:08
of the practice
00:24:10
because if you're doing this David maybe
00:24:12
you're not treating chest infections or
00:24:14
other things and there's pressure on the
00:24:15
health service. this felt a bit they
00:24:18
felt it was a bit self-indulgent. So go
00:24:20
back to my wife and said the partners
00:24:22
say no. And she said I I I'll tell you
00:24:25
what we're going to do. We're both going
00:24:28
to work for free and we'll do it. Why
00:24:30
don't we do this in our own time in on
00:24:34
in an evening when the p is no
00:24:37
resources.
00:24:39
So that's exactly what we did. We found
00:24:42
18 volunteers
00:24:44
who were interested amongst the patients
00:24:47
and then Jen and I. So that was 20 of
00:24:49
us. We started meeting every Monday
00:24:51
night
00:24:53
talking about low carb learning how do
00:24:56
you cook stuff? How do you do it? We did
00:24:59
it together. And one of the nurses was
00:25:02
so excited. Heather is her name. Let's
00:25:05
give her a, you know, thumbs up to
00:25:07
Heather. Heather said, "I'll work for
00:25:09
free. I'll help you. I'd love to do
00:25:12
this. I want to I want to believe in
00:25:14
what I do.
00:25:16
And then the magic begins. The results.
00:25:20
I couldn't believe it. I could not, you
00:25:22
know, I'd never seen anything like it.
00:25:24
And the first thing the first thing I
00:25:26
saw
00:25:28
was the liver function improving. You
00:25:31
see, cuz I'm doing blood tests cuz I
00:25:32
know I'm doing something weird. I'm
00:25:35
doing something that I would be
00:25:37
criticized for.
00:25:40
So if you're going to do a weird thing,
00:25:41
you need to measure stuff.
00:25:43
>> You can't, you know, these are patients,
00:25:46
so you can't just experiment and not be,
00:25:48
am I doing harm? What's happening?
00:25:51
What's happening to the cholesterol and
00:25:52
the lipid profiles? So I was monitoring
00:25:55
stuff really closely.
00:25:57
The liver function though, Stephen, I
00:26:00
got people who I thought they were
00:26:03
drinking alcohol and I thought the liver
00:26:06
problem was due to alcohol
00:26:09
and they'd had abnormal liver function
00:26:11
for 10 years and suddenly within weeks
00:26:15
the liver function was improving often
00:26:17
by a third or 50%.
00:26:20
I was so excited. Can you imagine? And
00:26:22
I'm sitting there and the laboratory
00:26:24
results are coming in and they're like,
00:26:27
"Wow." And then another and another.
00:26:33
So that was the first thing. Then the
00:26:34
weight. So we're all meeting every
00:26:36
Monday night and we got the scales and
00:26:38
everybody gets weighed every Monday
00:26:40
night and the weight started falling off
00:26:42
people. It really did. And then the all
00:26:46
sorts of other weird stuff started
00:26:48
happening. some of which I couldn't make
00:26:50
sense of for years.
00:26:53
The first one was
00:26:55
people said, "Are you hungry?" Because
00:26:57
I'm not. And they started saying things
00:26:59
like, "Do you have to eat breakfast?"
00:27:03
>> Where? And I also I wasn't hungry. I
00:27:06
wasn't hungry. They were telling me the
00:27:08
truth because I was experiencing this
00:27:10
with them.
00:27:12
Why are we not hungry?
00:27:15
That's so odd. And I was starting I not
00:27:18
bothering with breakfast. So, I didn't
00:27:20
eat it. You don't have to have it. And
00:27:22
my and my belly went away. Next thing
00:27:26
was I noticed when I stood up from my
00:27:29
desk, I felt dizzy.
00:27:33
Weird. Now, I hadn't told anybody, but I
00:27:36
had moderate high blood pressure for
00:27:39
years, but I didn't like to be a
00:27:42
patient.
00:27:43
>> So, I never went to a doctor.
00:27:45
>> I just put my head in the sand. So I had
00:27:47
high blood pressure for years. When I
00:27:49
took my blood pressure, it was low
00:27:50
normal.
00:27:52
Why? I didn't know. But on the patients
00:27:56
as well, I'm doing that as well. I'm
00:27:58
measuring all the blood pressure and
00:28:00
it's improving. So it's getting weirder
00:28:03
and weirder. Liver function improving,
00:28:06
weight going down,
00:28:09
blood pressure improving.
00:28:11
In those days we were the blood test
00:28:14
that we we did was a thing called a
00:28:16
hemoglobin A1C. The A1C in America this
00:28:21
is the average suginess of your blood
00:28:23
for the preceding 3 months. So the
00:28:26
results take a while.
00:28:27
>> Mhm. But then when the uh hemoglobin A1C
00:28:31
came in there, it was we were getting
00:28:34
really spectacular improvements in in
00:28:36
average blood sugar
00:28:39
and that's so that's kind of how it
00:28:41
began. So that's 2013. So that's 13
00:28:44
years ago and uh
00:28:48
the rest is history. But that I was
00:28:51
completely blown away and I was full of
00:28:53
curiosity about all these other things
00:28:56
and how was it? Why were these things
00:28:58
improving?
00:28:59
>> So in those 13 years, how is your
00:29:01
fitness your health changed?
00:29:03
>> My mental powers were much greater. I
00:29:06
could concentrate better. I wasn't
00:29:08
fatty. So I noticed that. The next thing
00:29:12
I noticed was
00:29:14
I needed a lot less sleep. So yeah, in
00:29:18
the beginning I used to have to have a
00:29:21
little sleep on my doctor's couch every
00:29:23
lunchtime.
00:29:25
So I was senior partner. So you press do
00:29:28
not disturb and you put the curtains
00:29:30
round and have a little nap on my own
00:29:32
couch for 20 minutes. It was the only
00:29:34
way I could get through the day. I
00:29:37
didn't need that nap anymore. I was less
00:29:39
sleepy. I needed an hour's less sleep a
00:29:42
day. I could
00:29:45
think better. I was I could cope with
00:29:48
the same problems.
00:29:50
And this is so weird
00:29:53
mentally. I was stronger. It was like
00:29:56
being a younger man.
00:29:58
Um the way
00:30:00
>> I don't know. I think you have a sense
00:30:02
of mental horsepower.
00:30:05
>> Going back to the top of this
00:30:06
conversation, you talked about how
00:30:07
everybody listening right now has a
00:30:09
variety of different health futures.
00:30:10
>> Yeah. and which which health future they
00:30:13
end up in is going to be determined by
00:30:15
the everyday decisions they make.
00:30:17
>> Yes.
00:30:17
>> So I want to really zoom in on some of
00:30:19
those everyday decisions. We talked
00:30:20
about you and your biscuits and at the
00:30:22
time you said you were you were probably
00:30:24
quite sedentary as a doctor.
00:30:25
>> Yeah.
00:30:26
>> Sitting in a chair, patients coming in.
00:30:28
>> Yeah.
00:30:28
>> You weren't doing exercise.
00:30:30
>> No. Um I didn't fundamentally believe it
00:30:34
would make that much difference.
00:30:37
>> And this is such a great point. you
00:30:39
you've a really great point. So, let's
00:30:42
think about weight loss. So, I would
00:30:44
give advice on weight loss to my
00:30:46
patients and I would say eat less and
00:30:49
move more. And I'd even sometimes say
00:30:52
that Bellson thing, you know, the no fat
00:30:54
people came out of Bellson.
00:30:56
>> I've never heard that before.
00:30:57
>> But it's a horrible thing to say to a
00:30:59
patient, isn't it?
00:30:59
>> What's Belson?
00:31:00
>> Well, that that's in World War II where
00:31:02
they all starved things. Okay. So the
00:31:05
the point is you're saying to somebody
00:31:06
with an obesity problem,
00:31:08
>> it's their fault.
00:31:09
>> Yes, you're blaming them. That's exactly
00:31:12
the point. And that's what I did. And
00:31:15
it's worse than that because
00:31:18
I give them that advice and it just
00:31:20
about never works.
00:31:22
I did a horrible thing. I used to say to
00:31:24
them, "Right,
00:31:26
so why don't you just have two
00:31:28
tablespoons of all brand a day?"
00:31:30
>> Oh, breakfast cereal.
00:31:31
>> Yeah. uh with skim milk and I would
00:31:34
advise a few multivitamins
00:31:38
and uh a couple of pints of skimmed milk
00:31:41
a day. That was my advice. And then when
00:31:45
it didn't work, who do you think I
00:31:46
blamed? Them.
00:31:47
>> Yeah. And this was all part of my
00:31:50
epiphany. I never joined the dots. That
00:31:55
the failure was not theirs. It was mine.
00:31:59
And that's horrible, isn't it? Imagine
00:32:01
25 years of I was blaming patients for
00:32:04
their failure to lose weight and it was
00:32:07
my failure
00:32:09
because I didn't give them advice that
00:32:12
worked. And if you keep giving the same
00:32:15
advice to people and it doesn't work,
00:32:17
shouldn't I have questioned?
00:32:19
But isn't that happening in society
00:32:21
overall? How are we doing? How are we
00:32:24
doing with health? How's it going? It's
00:32:27
a disaster, isn't it? So we need to do
00:32:29
something different.
00:32:31
But for me for 25 years I did not
00:32:35
believe that lifestyle was key. And now
00:32:38
I do.
00:32:39
>> And that's why I didn't I didn't
00:32:43
think that the biscuits made that much
00:32:44
difference.
00:32:46
Obviously I knew basic nutrition. So I
00:32:49
made sure there's protein and there's
00:32:50
iron and stuff. I fundamentally
00:32:55
believed that drugs is what I should be
00:32:58
using, medication, and that lifestyle
00:33:01
was a sort of add-on.
00:33:04
Isn't that terrible? I
00:33:06
>> I think this is so important because it
00:33:07
really gets to what I believe the
00:33:10
average person thinks as well.
00:33:11
>> Yeah. Yeah.
00:33:12
>> Um we were talking before we started
00:33:14
recording about some of my friends. They
00:33:16
are there. There's two friends I
00:33:17
mentioned. One of them is a very very
00:33:19
successful businessman. Um, everybody
00:33:21
knows who this person is. And they asked
00:33:24
me this weekend, "Is pizza healthy?" And
00:33:26
I just couldn't believe I It shook my
00:33:28
mind.
00:33:28
>> Gobsmacking. It was like, "Oh, what
00:33:30
pizza? What?"
00:33:31
>> Cuz they were choose trying to choose
00:33:32
between they usually have a big 12-in
00:33:34
pizza for lunch. And And he was asking
00:33:37
me, "What's healthier, Steven? Uh,
00:33:39
Nando's chicken or this 12-in pizza he
00:33:42
was going to get?" And I literally
00:33:43
looked at him like I was looking at a
00:33:44
ghost. I was like, "Are you winding me
00:33:46
up?" And he was genuinely serious. He's
00:33:49
almost 60 years old now and he doesn't
00:33:51
know if a chicken breast is healthier
00:33:54
than a 12-in pizza. And the other
00:33:57
example that I mentioned to you before
00:33:58
we started recording is a very famous
00:34:00
Premier League football superstar legend
00:34:02
who you would assume had gone through
00:34:05
those sort of 15 20 years of being an
00:34:07
academy player and then a a pro alete
00:34:09
knows what has sugar in and what
00:34:12
doesn't. and he was asking me is is a
00:34:14
big spaghetti carbonara is that healthy
00:34:16
is that a health food because he said to
00:34:17
me during his football years they were
00:34:19
told always to carb load and again this
00:34:23
it it gave me a huge amount of empathy
00:34:24
because it made me realize how even
00:34:26
though there's podcasts like this where
00:34:27
we talk so much about health and even
00:34:28
though there's the internet now the this
00:34:30
information is not getting through to
00:34:32
the average person for some reason and
00:34:33
they too I believe think exactly what
00:34:36
you just said that health is you know
00:34:38
it's this sort of accessory where my
00:34:41
fate is determined anyway. And if I do
00:34:44
this health stuff, which is a bit of an
00:34:46
inconvenience because these Percy pigs
00:34:47
taste great.
00:34:48
>> Yeah.
00:34:48
>> Um or these these these candies taste
00:34:50
great, then I might be able to look a
00:34:53
little bit better, a little bit more
00:34:54
aesthetically pleasing, but my fate is
00:34:57
determined.
00:34:58
>> The simple point, yeah, nutrition, we're
00:35:01
not teaching it. So, there's only three
00:35:02
macronutrients. There's only protein,
00:35:06
fats, and carbohydrate. And yet your
00:35:09
friends there haven't even got the three
00:35:11
macronutrients and they are successful
00:35:14
intelligent people. So somewhere we're
00:35:18
going badly wrong, aren't we?
00:35:20
>> There is another example that's really
00:35:22
front of mind to me which was, you know,
00:35:23
I'm in Dragon's Den at the moment and
00:35:25
someone came in and pitched a fruit
00:35:28
snack business and it's basically dried
00:35:31
out fruit pieces. Now I looked at the
00:35:33
back.
00:35:33
>> I'm loving this already. Yeah.
00:35:36
>> I looked at the back. Yes.
00:35:37
>> And it said in the range of 60 to 70%
00:35:41
sugar because what they've done is
00:35:43
they've taken exotic fruits like mangoes
00:35:46
>> dried them out and now you have this
00:35:48
little chip which is this just piece of
00:35:50
mango 60 70% sugar. So I'm looking at
00:35:52
the back of this thing thinking this is
00:35:54
candy.
00:35:55
>> This is basically candy.
00:35:56
>> Thank you.
00:35:57
>> But I'm looking around and every because
00:35:59
it uses the word fruit.
00:36:01
>> Yes. People have this sort of halo
00:36:03
assumption that if the word fruit is on
00:36:05
it, fruit juice fruit,
00:36:06
>> it'll sell.
00:36:07
>> Yeah. And who And also it's a sort of
00:36:09
who cares about the consequence but will
00:36:10
make a pile of money.
00:36:11
>> Yeah.
00:36:12
>> Selling dried up fruit and they miss
00:36:15
what you read on the back.
00:36:17
>> Yeah. Sugar. I was like this is
00:36:19
>> okay. How's that? You know what? If
00:36:21
somebody had type two diet what for kids
00:36:23
is we'll just give them Yeah. And I
00:36:28
you've touched on another another thing
00:36:30
about
00:36:32
what's going wrong. So when we look at
00:36:35
my practice and this epidemic and really
00:36:39
as I've said already it's not an
00:36:40
epidemic, it's a pandemic. It's
00:36:42
everywhere. I go all over the world and
00:36:45
obesity, type two diabetes,
00:36:48
uh poor metabolic health is in it's
00:36:50
everywhere. It's everywhere.
00:36:53
And I think one of the things touching
00:36:56
on what you just said is so you you wake
00:36:59
up and you have your cereals for
00:37:02
breakfast
00:37:02
>> which you've got some here
00:37:03
>> which we have some cereals there and
00:37:06
then uh you'll have why don't why don't
00:37:08
you have a big glass of fresh orange
00:37:11
juice as well. Great idea. And then uh
00:37:16
okay, that's your breakfast. But then on
00:37:18
the way in, you have a little snack, and
00:37:20
people do. They buy a bar or some crisps
00:37:24
or something like that. And then even at
00:37:26
school, they might get a muffin midm
00:37:28
morning. Fair enough. They might then
00:37:31
have an apple. At lunchtime, you're
00:37:33
going to have some sandwiches.
00:37:36
And then you've eaten your sandwich. So
00:37:38
you'll, I don't know, you might have
00:37:40
might have a cake or something or some
00:37:42
ice cream. Then you'll go home and then
00:37:44
it's time for you, you know, maybe your
00:37:46
chips or your pizza. What you've
00:37:48
actually done is have sugar with your
00:37:51
sugar with your sugar sugar all day
00:37:54
long. There's hardly any protein going
00:37:56
back then to those macro. Where was the
00:37:59
protein to grow you, you know? And that
00:38:02
that's the thing that that's changed
00:38:05
over time that we are the snacking. So,
00:38:09
I've I come across a lot of young people
00:38:13
and their mother is saying, "I can't get
00:38:15
him to eat any proper food. He just eats
00:38:17
snacks all day long and it won't I can't
00:38:21
they can't get protein in them." And
00:38:23
some of them are actually thin kids.
00:38:25
They're not all fat.
00:38:26
>> Let's talk about what you just said
00:38:27
there. And we can walk through the day
00:38:29
using
00:38:30
>> Yes.
00:38:30
>> the food we have on this table. Now, I
00:38:32
just want to caution that we do have
00:38:33
some people that are probably out
00:38:34
walking their dog listening and can't
00:38:35
see. So, we're going to have to do a bit
00:38:36
of a voice over as to what's going on.
00:38:38
But, you said wake up in the morning,
00:38:40
you have your cereal.
00:38:41
>> Yeah.
00:38:41
>> Now, cereal growing up, I thought was a
00:38:44
health food.
00:38:44
>> Me, too.
00:38:45
>> Yeah.
00:38:46
>> Me, too.
00:38:47
>> How much sugar is in the average
00:38:49
standard bowl of, let's say, frosted
00:38:50
cereal.
00:38:51
>> Well, we can do this different ways,
00:38:53
Stephen.
00:38:54
>> Mhm.
00:38:54
>> This is actually like a test for you
00:38:56
laid out here.
00:38:57
>> Oh, gosh. Is that okay?
00:38:58
>> Yeah. This is a test for you, and I'll
00:39:00
describe it. So, what you've got, you've
00:39:03
got um
00:39:05
a bowl of we'll call them they're corn
00:39:08
flakes.
00:39:09
>> Then you've got a potato, a baked
00:39:12
potato. It isn't baked yet, but you
00:39:14
could bake it if you want. You've got
00:39:17
150 grams, and this is boiled rice, so
00:39:19
it's not dry. It's boiled rice. You've
00:39:22
got a very ripe banana.
00:39:24
And at the end there, you've got a
00:39:27
delicious looking chocolate bar.
00:39:29
>> Yeah. So you've got there uh some cubes
00:39:33
of sugar and this is the test bit you
00:39:35
see
00:39:36
>> as to how I'm going to give you we'll
00:39:38
score you in the end. Okay.
00:39:39
>> So what I'd like you to do is consider
00:39:42
these relatively
00:39:44
>> and each of those cubes of sugar
00:39:46
represents a 4 g teaspoon of sugar.
00:39:49
>> Yeah. So, if you could now just go along
00:39:52
these and put beside each food what you
00:39:55
believe to be the equivalent in terms of
00:39:57
teaspoons of sugar and then I'll give
00:40:00
you a score and see how you do.
00:40:01
>> Okay?
00:40:02
>> And and those are the answers. So, I'm
00:40:03
going to turn it down so you don't
00:40:04
cheat.
00:40:05
>> Okay? So, I'm going to score them as I
00:40:08
would have thought two years ago.
00:40:10
>> Thank you.
00:40:11
>> Because because two years I've
00:40:12
interviewed a lot of experts, so I'm I'm
00:40:14
generally quite shocked by all these
00:40:15
things, but I'm going to score them as I
00:40:17
would have thought when I was 31 years
00:40:18
old 2 years ago. So, That's great.
00:40:20
>> Cereal, honestly.
00:40:22
>> Yeah.
00:40:23
>> Um I
00:40:23
>> And there's no sugar on it. It's not a
00:40:25
sugared cereal. It's just the dry
00:40:27
flakes.
00:40:28
>> I honestly didn't think there was sugar
00:40:29
in that.
00:40:30
>> Yeah.
00:40:31
>> So, if you had pushed me, I would have
00:40:35
>> We'll give it one, eh?
00:40:36
>> I'll give it one. But I didn't think
00:40:37
there was sugar in that.
00:40:38
>> One
00:40:38
>> again. A potato. I didn't think there
00:40:41
was any sugar in a potato. So, even
00:40:43
giving it one feels like I'm lying
00:40:45
because I didn't think there was sugar
00:40:46
in a potato. And I'll be honest, rice, I
00:40:48
didn't think there was any sugar in
00:40:49
rice.
00:40:50
>> Okay.
00:40:51
>> A banana,
00:40:52
>> it tastes sweet.
00:40:53
>> Yes.
00:40:53
>> So, my brain would have said one.
00:40:55
>> Yeah.
00:40:56
>> But this uh this chocolate bar that's in
00:40:58
front of me, I would have said I'm going
00:41:01
to say two.
00:41:03
>> Okay.
00:41:03
>> Two or
00:41:05
I'm going to say three,
00:41:06
>> right?
00:41:06
>> I'm going to say three. I actually think
00:41:07
it was two, but
00:41:09
>> that's how much sugar I would have
00:41:10
thought was in all of these things here.
00:41:12
Cereal, a potato, white rice, a banana,
00:41:14
and a chocolate bar.
00:41:15
>> Right. Well, to be fair, I still kind of
00:41:16
do, but I know better.
00:41:18
>> So, now I'm going to give you the
00:41:19
correct figure. Now, uh this is worked
00:41:24
out from the glycemic load that we
00:41:26
already discussed. So, I explained about
00:41:29
the glycemic load
00:41:32
>> and then so in clinical practice, I had
00:41:34
a problem and my problem was in 10
00:41:37
minutes trying to explain to you how you
00:41:40
could eat differently and why you should
00:41:42
eat differently. And so I needed a way
00:41:46
of quickly communicating with children,
00:41:49
with old people, with a teacher the
00:41:52
consequences of dietary choices.
00:41:55
>> So I came up with a new idea which was
00:41:58
why don't we represent the glycemic load
00:42:03
and instead of using
00:42:06
grams of glucose which nobody
00:42:08
understands and what's glucose anyway.
00:42:10
Instead of doing that, we redid the
00:42:13
calculations,
00:42:15
redoing it for t four gram teaspoons of
00:42:18
sugar. And that's my teaspoon of sugar
00:42:20
equivalent system. And I'm using that
00:42:23
now to give you the correct answer.
00:42:25
>> Okay.
00:42:25
>> Right. So the the cornflakes is one,
00:42:30
two,
00:42:32
four,
00:42:34
five, six, seven, and eight.
00:42:38
One, two, three, four, five, six, seven,
00:42:42
eight.
00:42:44
>> With no frosting.
00:42:45
>> No frosting.
00:42:47
>> No milk, nothing.
00:42:49
>> The potato, obviously, it depends on its
00:42:52
size. That's quite a big one. So, that
00:42:55
one is one, two, three, four, and
00:42:58
there's more. Five, six
00:43:04
is nine.
00:43:06
There they go. equivalent of nine sugar
00:43:08
cubes.
00:43:08
>> Is that nine?
00:43:09
>> Yeah.
00:43:10
>> Right.
00:43:14
I'm going to leave the rice till last.
00:43:17
That chocolate bar is actually You can
00:43:20
do it for me.
00:43:22
>> Is seven and a half. So you
00:43:26
>> you can give it seven. Seven.
00:43:31
Seven.
00:43:33
Now, the banana depends on the size and
00:43:36
how ripe it is. A ripe banana has more
00:43:38
sugar in as you probably know when you
00:43:40
eat it. But that, let's say that banana
00:43:43
is quite a ripe one. It looks quite
00:43:44
ripe. Let's say that's six cuz it's a
00:43:46
big banana.
00:43:47
>> Oh my gosh.
00:43:53
>> Okay, then the final one obviously is
00:43:57
going to be the killer, isn't it?
00:43:59
>> I thought rice was healthy.
00:44:02
Well, I thought it depends.
00:44:04
>> Was really healthy.
00:44:05
>> Depends. So, one, this is 150 gram of
00:44:10
boiled rice. 3 4
00:44:14
5 6
00:44:18
7
00:44:19
8 9 and
00:44:23
10. So, that's the winner. And I would
00:44:26
say that's the single fact around the
00:44:28
world. So, my my teaspoon of sugar.
00:44:31
There we are. That's one of my teaspoon
00:44:33
of sugar charts. So, what you've got
00:44:35
there is the food,
00:44:38
the glycemic index,
00:44:41
the the serving size, and then the
00:44:44
teaspoons of sugar there. So, this is
00:44:47
available. The public health
00:44:48
collaboration is a charity I helped set
00:44:50
up with Dr. Rangan Chattery 10 years
00:44:53
ago. It's our 10th anniversary tomorrow.
00:44:56
These infographics,
00:44:59
there are actually far more than this.
00:45:01
This is there's seven more. They're
00:45:03
available in 35 languages. Volunteers
00:45:06
have translated this to go all over the
00:45:08
world. It's not copyrighted. I want
00:45:11
people steal it, take it, use it. So the
00:45:15
the white rice fact
00:45:19
I would say has astonished people all
00:45:21
over the world and led to me becoming
00:45:24
far better known.
00:45:26
>> What what about orange juice? A lot of
00:45:28
um parents including my parents give me
00:45:30
gave me orange juice and I used to think
00:45:32
that orange juice was a health food. So
00:45:33
I would literally I'd go to the fridge
00:45:35
I'd get open the sunny delight or
00:45:37
whatever it was
00:45:38
>> sunny delight
00:45:38
>> and I would drink that and I'd think I'm
00:45:40
going to be strong and big and my body's
00:45:42
going to love me. Well, let's so that
00:45:45
there's a lot of sugar in orange juice.
00:45:47
There's a lot of sugar in orange juice
00:45:50
and you've taken away all the once you
00:45:53
take it from the fruit as it was meant
00:45:55
to be and you juice it, the sugar hit is
00:45:58
fast. M
00:46:00
>> so what that does is if you think if we
00:46:04
go back to insulin again
00:46:07
um so you you you drink the orange juice
00:46:11
your blood sugar goes up rapidly so your
00:46:14
body responds rapidly with insulin then
00:46:17
you what happens your blood sugar falls
00:46:20
but then you're kind of hungry again and
00:46:22
that's what happened to me with the
00:46:24
biscuits wasn't it I ate biscuits
00:46:27
my blood sugar is up. Then insulin comes
00:46:30
in heavy and slow but too much. Then I
00:46:34
thought I was having a panic attack cuz
00:46:35
I had low blood sugar. And what's the
00:46:37
answer to that? More biscuits. And round
00:46:39
you go. Round. And that's how without
00:46:42
thinking you'd start the day. Starting
00:46:45
the day with a sugary breakfast
00:46:48
without enough protein in it is driving
00:46:50
hunger. And then you wonder why you're
00:46:53
ravenously hungry at 10:00. There was a
00:46:57
few others that shocked me. One of them
00:46:58
was um I was in Peru and obviously Peru
00:47:01
is quite famous for chocolate because of
00:47:02
the cacao and all that stuff. And so we
00:47:04
went to a chocolate making class
00:47:06
>> and um he told us to make dark
00:47:08
chocolate, normal chocolate and then
00:47:10
white chocolate.
00:47:11
>> Yeah.
00:47:11
>> And when I made the white chocolate,
00:47:13
this guy got me this big glass cylinder
00:47:16
and he goes, "Here's some white sugar."
00:47:18
He goes, "Pour it in." So I, you know, I
00:47:20
get it and I pour some in and I and he
00:47:22
goes, "No, no, no, no, my friend. Pour
00:47:24
it in." Yeah.
00:47:24
>> And I pour it and pour it and pour it
00:47:27
and pour it and pour it and pour it. And
00:47:29
I'm not
00:47:31
check.
00:47:35
I feel like I poured into this huge
00:47:37
glass cylinder.
00:47:38
>> Yeah.
00:47:39
>> 80% of white sugar.
00:47:42
>> Yes.
00:47:42
>> And then
00:47:43
>> it's true.
00:47:44
>> Yeah. And then and then he said, "Put
00:47:45
some syrup in." I was What?
00:47:47
>> This is This is white sugar. It was like
00:47:48
some syrupy stuff, some oil stuff. And I
00:47:50
was like, "So, white sugar?" Um, so
00:47:52
white chocolate is like 80% white sugar.
00:47:56
>> Yeah.
00:47:57
>> I've never eaten white chocolate since
00:47:59
ever.
00:48:00
>> You That's so important. So very often
00:48:03
people think they're a choahholic.
00:48:05
>> That's really common that people say to
00:48:07
me, "I'm I'm addicted to chocolate."
00:48:10
>> If you look at if you actually look at
00:48:12
how much sugar there is in milk
00:48:13
chocolate,
00:48:15
>> uh, you know, there's many teaspoons of
00:48:17
sugar in milk chocolate.
00:48:20
If you eat 90% dark chocolate, there's
00:48:24
only about two teaspoons of sugar in a
00:48:26
bar. And what you find with the
00:48:28
choahholics is I say, "Well, if you're
00:48:31
addicted to chocolate, why don't you get
00:48:33
a bigger hit and have the dark
00:48:35
chocolate?" And they say, "Oh, I
00:48:36
couldn't eat that. It's too bitter."
00:48:38
What they're actually addicted to is the
00:48:39
sugar. what there are. So I've done a
00:48:42
there is for the the folks at home there
00:48:45
is one of these sugar infographics on
00:48:48
chocolate on that subject of chocolate
00:48:51
because I want people to understand the
00:48:54
consequences of what they do.
00:48:56
>> So just to illustrate this because I've
00:48:59
just we've just looked up the stats,
00:49:01
right?
00:49:02
>> I think this is this is this is what I
00:49:04
saw, right? I've just looked up the
00:49:05
facts to make sure I'm saying is true.
00:49:08
When I made that bar of white chocolate
00:49:10
in Peru,
00:49:11
>> yeah,
00:49:12
>> this was the total ingredients and this
00:49:14
is how much sugar I they asked me to put
00:49:16
into it.
00:49:17
>> Blind.
00:49:17
>> I've looked at it and thought, okay, so
00:49:19
white chocolate is basically like 70
00:49:22
odd% just pure white sugar and nobody
00:49:25
knows.
00:49:26
>> Yes, exactly.
00:49:26
>> Nobody knows.
00:49:27
>> Exactly.
00:49:28
>> The other one I've got to be in my
00:49:29
bonnet about is smoothies.
00:49:30
>> Yes, I want one, too.
00:49:32
>> I thought smoothies were healthy.
00:49:33
>> Yeah. No, they're the, you know, I'm on
00:49:37
X or Twitter quite a lot and that's the
00:49:38
kind of thing fills me with rage and I
00:49:41
have to take a photo with like my Look
00:49:43
at the sugar. Uh, there was Yeah, it
00:49:47
fills me with rage. I've got another
00:49:48
thing. This is fun. I've got another
00:49:50
I've got a question.
00:49:51
>> Right, Stephen?
00:49:53
Why don't we We could take all the blood
00:49:55
out of me,
00:49:56
>> right? There'd be five liters. We could
00:49:59
bleed me out right now. There would be
00:50:01
five lers of blood in me. Let's get it
00:50:04
in a bucket. All right. Five lers of
00:50:06
blood. How much sugar would be in that
00:50:11
five lers of blood?
00:50:13
>> I have no idea. I didn't.
00:50:14
>> But it's an interesting question, isn't
00:50:16
it? Because it relates to the
00:50:19
consequences of eating some of these
00:50:21
things. So, I would just like you to
00:50:24
estimate. So, if let's say my blood
00:50:26
sugar is normal.
00:50:27
>> Yeah. Um, if you have a normal blood
00:50:31
sugar, I would like you to guess how
00:50:33
much sugar is there in my entire blood
00:50:36
system.
00:50:37
>> One one cup like this.
00:50:39
>> Thank you.
00:50:41
No, the answer is this. Let me show you.
00:50:45
That is all there is.
00:50:47
>> You're joking.
00:50:48
>> I am not. And you see immediately
00:50:50
>> one sugar cube.
00:50:51
>> That's all. And I'll do it on Twitter
00:50:54
for you. X I can show you the
00:50:56
calculations.
00:50:57
So you see, if I have a banana
00:51:00
and I have diabetes, the there's too
00:51:03
much sugar for me. You see, because
00:51:05
glucose is number one vital, but number
00:51:08
two toxic if you have too much of it.
00:51:11
The level of it in my blood is
00:51:13
controlled minutely.
00:51:14
>> Wow.
00:51:15
>> It's controlled to this extent. And I
00:51:19
think that single fat, you didn't know
00:51:20
that, did you? I did not know how to.
00:51:21
>> And it it immediately shows you how it's
00:51:24
so easy to have more sugar than you
00:51:26
actually need.
00:51:27
given that
00:51:28
>> and if your insulin stops working.
00:51:30
>> So for me, I've done an awful lot of
00:51:33
this. So I monitor my blood sugar with a
00:51:35
continuous glucose monitor and I get my
00:51:39
blood sugar up on my phone so I can
00:51:41
check at any time what my blood sugar
00:51:43
is. And we'll do it in a minute and see.
00:51:46
But you see, if I if I eat a banana, it
00:51:50
doubles my blood sugar because I can't
00:51:52
regulate my blood sugar
00:51:53
>> because of the diabetes.
00:51:54
>> Yeah. So, a whole banana
00:51:57
is far too much for me and will double
00:52:01
my blood sugar because you see if I'm
00:52:03
only supposed to have this much and I
00:52:05
have that much.
00:52:06
>> Gosh. Yeah.
00:52:07
>> It's too much for me and I feel ill.
00:52:10
>> Giving, you know, I go out into the
00:52:12
world and I speak to the people that
00:52:13
listen to the show and they're like taxi
00:52:15
cab drivers. It's a lot of taxi. Do you
00:52:16
know I wonder I've got this bias towards
00:52:18
thinking everybody that listens is a
00:52:19
taxi. I've got this bias towards
00:52:21
thinking that everybody that listens is
00:52:22
a taxi cab driver because I really only
00:52:25
spend my time in the office or in a
00:52:27
taxi. So, I get lots of feedback from
00:52:29
these cab drivers and the average person
00:52:31
out there listening now,
00:52:34
>> they don't know how to check if the food
00:52:36
they are eating is good or not because
00:52:38
the labels on these foods I I've got so
00:52:40
obsessed by the marketing.
00:52:42
>> Yes. And um you know I was looking at
00:52:44
this bag of sweets the other day and it
00:52:46
said made with real fruit juice and they
00:52:49
put it front and center and I I was
00:52:52
almost tricked. So I can't imagine
00:52:54
someone who like me who doesn't spend I
00:52:56
can't imagine someone who doesn't spend
00:52:57
their time interviewing health experts
00:52:59
how easily the general public is being
00:53:01
tricked. So what is your advice in terms
00:53:03
of spotting this stuff? Like what do I
00:53:06
look at? Cuz right now I spend a lot of
00:53:07
time looking at the sugar part.
00:53:09
>> Yeah that's great. There's different
00:53:11
ways we can do this and obviously this
00:53:13
is how I spend every clinic. That's I'm
00:53:14
in clinic yesterday. This is what I'm
00:53:16
doing. I'm trying to help people
00:53:17
understand.
00:53:19
It's sometimes easier to talk about what
00:53:22
maybe what you would eat rather than
00:53:24
what you wouldn't eat. So I for somebody
00:53:28
with insulin resistance or type 2
00:53:31
diabetes, I would tend to say, well, why
00:53:33
don't you base your meal on protein? So
00:53:36
what have you got in the fridge? Could
00:53:39
it be chicken? Could it be eggs? What
00:53:41
would it be? So that's your protein.
00:53:45
Have loads of it. Then I'm thinking,
00:53:47
right, green veg.
00:53:50
Will you What green veges would you
00:53:52
tolerate? What green veg could you buy?
00:53:54
Might be frozen beans or it might be
00:53:56
salad or whatever. And then I'm saying,
00:53:59
how would you make that green veg
00:54:01
tasty?
00:54:02
>> Pour barbecue sauce on the top.
00:54:04
>> Ah, no. Full fat mayo. full fat mayo or
00:54:07
butter or olive oil or whatever. So that
00:54:11
>> I say barbecue sauce because when I
00:54:12
looked at the back of mine, I had the
00:54:14
shock horror of realizing that there's
00:54:15
>> it's a common one.
00:54:17
>> 30 sugar cubes in a bottle, a standard
00:54:20
bottle of barbecue sauce.
00:54:22
>> It's just pouring sugar on top.
00:54:23
>> It is. It is. You have to be so
00:54:25
vigilant. And I I think to do it
00:54:27
successfully,
00:54:29
I'm quite interested in the idea of
00:54:30
could you eat real food that's not in a
00:54:33
packet.
00:54:34
It's it's it's Russian roulette food out
00:54:37
of packets. And yet I understand my
00:54:40
patients north of Liverpool, you know,
00:54:43
where are they going to buy the stuff?
00:54:44
So I try and help them with
00:54:46
you could do it that way. If you're not
00:54:49
if you're going to eat stuff out of
00:54:50
packets, you have to wise up and you
00:54:53
have to look at the carbohydrate
00:54:55
content. And bear in mind, every four
00:54:58
grams
00:55:00
is broadly equivalent to sugar. So if if
00:55:03
if there's a if there's if something's
00:55:06
got 100 grams of carbs in it, I've
00:55:10
already said carbohydrate varies in how
00:55:12
sugary it is, but it gives you an idea.
00:55:15
It's very sugary. So you see the the
00:55:17
error you made with the corn flakes is
00:55:19
there's no sugar there but it's all
00:55:20
carbohydrate
00:55:22
>> and it it's a very sugary carbohydrate.
00:55:24
I think we need to just explain that for
00:55:27
people which is when I looked at those
00:55:28
corn flakes the question I asked you is
00:55:30
they're not frosted so there's no sugar
00:55:32
on them but what the body is doing is
00:55:34
it's converting the carbs into glucose
00:55:37
>> right I've got a good way so we have to
00:55:40
think of starchy carbs as actually
00:55:44
glucose molecules holding hands
00:55:47
>> okay
00:55:47
>> and then digestion comes along and
00:55:50
breaks down
00:55:52
they're they're not holding hands
00:55:54
anymore more and they become free sugar
00:55:56
again
00:55:56
>> cuz we think if it's not sweet it's not
00:55:58
glucose.
00:55:58
>> Exactly. Exactly. I don't know whether
00:56:00
when you went to school was it this
00:56:02
thing where you chewed bread for ages
00:56:04
and then you could see if it became
00:56:06
sweet or it turned into sugar. It's a
00:56:08
school boy experiment that's done a lot
00:56:11
to prove that uh the amalayise the
00:56:14
enzyme in spit uh turns starch into
00:56:18
sugar. But that's the point starch is
00:56:21
soon to be sugar. glucose holding hands.
00:56:24
Yeah. And when it holds hands, it's not
00:56:26
sweet. But then when you digest it
00:56:28
Exactly. it's no longer holding hands.
00:56:29
>> Perfect. And that was is broadly what?
00:56:32
>> And you're not alone because didn't I
00:56:34
make that error? Isn't that what the
00:56:37
lady in 2012?
00:56:39
That's what she was so furious that I
00:56:42
was making. So here here we are, senior
00:56:44
partner of a large practice
00:56:47
had forgotten
00:56:49
uh that starch was sugar. And we come
00:56:51
full circle because and so many other
00:56:54
people they they patients say to me,
00:56:58
"Dr. Roman, I know uh not to have sugary
00:57:02
things. I've given up sugar in my tea
00:57:05
and coffee and I don't understand why my
00:57:08
blood sugar is so high." People say that
00:57:11
very often. And then of course we use
00:57:12
the teaspoon of sugar equivalents or a
00:57:14
continuous glucose monitor to really
00:57:16
show them what's going on.
00:57:18
Something that a lot of people have is
00:57:20
bread.
00:57:21
>> Yes.
00:57:21
>> Um, white bread. So, I I did some
00:57:24
research and it said a single slice of
00:57:25
white bread contains about 0.5 sugar
00:57:28
cubes, but a full loaf can pack up to 12
00:57:31
cubes of sugar in it.
00:57:33
>> That's true, but it doesn't it doesn't
00:57:37
include the fact that the wheat that
00:57:40
makes the bread will turn into sugar as
00:57:42
well.
00:57:43
>> Okay. So on my teaspoon of sugar
00:57:45
equivalent,
00:57:46
even a small slice of brown bread is
00:57:50
about 3 teaspoon of sugar.
00:57:52
>> Is there a healthy bread?
00:57:55
>> That's a really great great question.
00:57:57
And of course it depends how well your
00:58:00
insulin's working. So if you're young
00:58:03
and you take a lot of exercise and your
00:58:05
insulin's really good,
00:58:08
then maybe brown bread is is okay. If
00:58:12
you're like me though with insulin
00:58:14
resistance there it would have to be low
00:58:18
carb bread. So I wouldn't normally eat
00:58:20
bread under any circumstances but I
00:58:22
might have low carb bread.
00:58:25
>> I did some research said sprouted grain
00:58:27
bread. Never heard of that before. Or
00:58:29
100% whole grain rye are the healthiest
00:58:31
options because they contain zero added
00:58:33
sugar and high fiber.
00:58:35
So,
00:58:35
>> right. I mean, what I'd say to people
00:58:40
>> again, it depends. How much exercise do
00:58:43
you take? How do you know? Have you had
00:58:45
your fasting insulin measured? Do you
00:58:47
know if you're insulin resistant or not?
00:58:50
>> Mhm.
00:58:51
>> Um,
00:58:53
if you're healthy, take lots of
00:58:54
exercise. Sounds good. Fair enough. If
00:58:56
you if you're beginning to develop a
00:58:58
tummy, well, maybe not so good. And if
00:59:01
you don't know,
00:59:03
I'm a great one for experimenting. And
00:59:06
that's where I come back again to
00:59:08
consider
00:59:10
uh buying a continuous glucose monitor.
00:59:13
The thing you wear on I've got one on me
00:59:15
now. And it tells my phone how is my
00:59:17
blood sugar. So I can experiment then. I
00:59:19
could try your bread and within an hour
00:59:21
I would know. This has had probably the
00:59:25
single biggest impact on my office. Of
00:59:27
all the products that I've tried that
00:59:29
have given me productivity gains or
00:59:31
cognitive boosts, I would say that
00:59:33
exogenous ketones are in the top three
00:59:36
most pivotal things that have given me a
00:59:39
massive productivity gain. It's some
00:59:40
Stanford graduates that have been able
00:59:41
to basically bottle up the effect you
00:59:44
get from being in a ketogenic diet in a
00:59:47
small shot that you can take that makes
00:59:50
you feel incredibly focused and gives
00:59:52
your brain an incredible source of
00:59:53
energy. And the clinical studies that
00:59:54
have been done on exogenous ketones have
00:59:56
absolutely blown my mind. I reached out
00:59:58
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01:00:36
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01:00:38
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01:01:27
>> Am I wise to be looking at the back of
01:01:29
packets? I look at the back of
01:01:31
everything I eat.
01:01:31
>> Yes.
01:01:32
>> Um and I'm building, I guess, a mental
01:01:33
model of the different levels of
01:01:35
carbohydrates and sugar content and
01:01:37
fiber and all these other things and
01:01:38
proteins, etc. But I always seem to zoom
01:01:40
in on the sugar,
01:01:42
>> the added sugar.
01:01:44
>> Ah, right. There is an error there.
01:01:45
>> Okay. So you that's brilliant and you
01:01:47
the fact you're interested and trying is
01:01:51
great because you'll learn so much more
01:01:53
because of course
01:01:56
the sugar is one thing but you must also
01:01:58
look at the carbohydrate
01:02:01
>> the carbohydrate content. Now um this is
01:02:04
done differently in the United States
01:02:06
from here.
01:02:09
Confusingly here we talk about
01:02:11
carbohydrate
01:02:13
separately from fiber. So that in the UK
01:02:17
when it says carbohydrate that turns
01:02:20
into sugar. In the states you've got uh
01:02:24
the carbohydrate including fiber. So it
01:02:28
makes it more complicated for you
01:02:30
because you need to know which how much
01:02:33
of that carbohydrate are you going to
01:02:34
absorb. Well, let's go back to the three
01:02:37
macronutrients. So
01:02:39
you should be interested in
01:02:42
protein. How much you want? You want you
01:02:44
want to be a musly kind of guy. So you
01:02:47
want your protein. Uh the carbohydrate.
01:02:50
Well, why do you need that? I'm
01:02:51
wondering. And then fats. Well, you
01:02:54
might need those for fats soluble
01:02:55
vitamins. So those are the uh the three
01:02:58
things so that you become more
01:03:00
sophisticated and if things have a lot
01:03:03
of preservatives, if they have an awful
01:03:05
lot of ingredients, I'm immediately
01:03:07
suspicious.
01:03:08
>> I think one of the things that people
01:03:10
that I've come to learn through
01:03:11
interviewing people like yourself is
01:03:12
that it's not just the direct
01:03:13
consequence of having a big uh glucose
01:03:16
spike or
01:03:18
you know having high blood sugar. It's
01:03:20
also the fact that when I eat things
01:03:22
like Mars bars or the white rice here, I
01:03:26
then get more hungry later.
01:03:27
>> Exactly.
01:03:27
>> Which means I eat even more sugar that
01:03:29
same day and the next day and the next
01:03:30
day.
01:03:31
>> And of course, that's what my patients
01:03:34
right back in 2013, it was the absence
01:03:37
of hunger they found fascinating. And I
01:03:39
did cuz I'd been hungry all my life
01:03:41
because all my life I'd been uh carb
01:03:45
heavy. And I didn't realize that the
01:03:47
more carbs you eat, the hungrier you
01:03:49
become. I don't know. Have you ever
01:03:51
tried fasting? I bet you have.
01:03:52
>> Oh my gosh. Yeah.
01:03:53
>> Right.
01:03:53
>> I fast most days to be honest. I haven't
01:03:55
eaten today. And what time are we? Well,
01:03:57
I don't know. Uh 1 1:00 p.m. And during
01:04:00
the Dragon's Den filming, I I don't eat
01:04:03
often until the evening. So
01:04:05
>> great. So isn't that interesting? So I
01:04:08
used to I used to have a model which was
01:04:11
um that if I didn't eat, I was hungry,
01:04:14
right?
01:04:14
>> Mhm. So if I didn't eat for even twice
01:04:18
as long, I'd be twice as hungry and it
01:04:20
would rise exponentially until I went
01:04:22
mad.
01:04:23
>> And what's surprising that you must have
01:04:25
found is as you fast, you don't become
01:04:28
more hungry, do you?
01:04:29
>> Yeah, it's crazy.
01:04:29
>> Well, isn't that interesting
01:04:31
>> that actually get the more I eat, the
01:04:33
hungrier I become.
01:04:35
>> When I'm on keto,
01:04:36
>> pardon?
01:04:36
>> When I'm on keto,
01:04:37
>> yeah,
01:04:38
>> I I can't believe I can't It's like
01:04:40
hunger just vanishes. The other thing
01:04:42
that the remarkable thing I love, what
01:04:43
are those cinnamon roll things? I love
01:04:45
those cinnamon rolls usually. I love
01:04:47
them. And when I started doing the
01:04:48
ketogenic diet, which is very, very,
01:04:50
very low carb. I remember walking up to
01:04:52
this cinnamon roll concession stand in
01:04:54
Cape Town and looking at them
01:04:56
>> and they were doing nothing to my brain.
01:04:59
There was no temptation.
01:05:01
I've had that.
01:05:02
>> It's like a superpower.
01:05:04
>> Honestly, I've had that with Christmas
01:05:06
cake.
01:05:06
>> It was my kryptonite. It was the kind of
01:05:09
thing I was sneaking down when they'd
01:05:12
all gone to bed and having more.
01:05:14
>> And then one day you can look at it and
01:05:16
it and you think it's not actually food.
01:05:19
>> Your brain that isn't food.
01:05:21
>> Yeah. Exactly.
01:05:22
>> And I'm the same with buns as well and
01:05:24
all sorts of things that a lifetime of
01:05:27
and they're no longer food and it feels
01:05:29
like a superpower because I can I'm such
01:05:31
a man. In fact, I I throw this down as a
01:05:34
challenge to men. Are you man enough
01:05:37
>> to resist? You know what? Whatever it
01:05:40
is.
01:05:41
>> Let's do a challenge. Come back in a
01:05:43
week and tell me you've not had any
01:05:44
biscuits.
01:05:46
>> It it it it works. It works.
01:05:49
>> What do you think of the ketogenic diet?
01:05:52
>> Wow. That's a Oh, that's a big question,
01:05:55
isn't it?
01:05:57
And don't you think we need to begin
01:05:59
with what you want? So, I think we need
01:06:01
to begin with your goals and hope. Why
01:06:04
would is it are you wanting to lose
01:06:08
weight? Are you wanting to sort out type
01:06:11
two do diabetes? Or I'm I mean George
01:06:14
Reed, Dr. George Reed is a close friend
01:06:17
>> and nutritional psychiatry is really
01:06:19
growing and the Ian Campbell in
01:06:21
Edinburgh University is doing some
01:06:23
amazing work with bipolar disorder and
01:06:25
other things. So why are you doing it?
01:06:29
That's so that's my first thing because
01:06:32
there's I see it as there is a spectrum
01:06:34
of carbohydrate that you're on. So I try
01:06:37
and find out where are you now and I you
01:06:40
know approximately where are you now and
01:06:42
then I'd say well could you could you
01:06:45
give up bread or reduce it and then I'd
01:06:49
say let's let's measure whatever
01:06:51
parameter we want which might be blood
01:06:53
work or weight or whatever then we say
01:06:56
how are you doing are you happy now is
01:06:58
this is it or do you want would you like
01:07:02
to go a bit lower and what I've
01:07:03
discovered with my patients over 13
01:07:06
years is they tend to go lower over time
01:07:08
because when they experiment
01:07:11
>> when they go keto, what they like is the
01:07:13
brain thing.
01:07:14
>> Oh gosh. Yeah.
01:07:15
>> And that's what I'm that's right. So I
01:07:17
would say to you now cuz I'm interested.
01:07:19
Yeah.
01:07:19
>> Why would you go keto? What are you
01:07:21
after?
01:07:22
>> Um so I'm going to put the brain thing
01:07:23
at the top of the list which is just the
01:07:25
clarity of thought. Obviously in my job
01:07:26
I have to sit here with very smart
01:07:28
people like you and I have to talk
01:07:29
sometimes for three four hours whatever
01:07:31
it might be. But also, I'm on television
01:07:33
a lot now and I'm speaking, you know,
01:07:35
cameras, nine cameras rolling BBC 1 and
01:07:38
I've got to think of something smart to
01:07:39
say to this entrepreneur sit in front of
01:07:40
me on that's pitching to me. And then
01:07:42
also I'm in meetings, you know, I'll
01:07:44
leave this conversation now and I'll go
01:07:45
straight downstairs and I'll have two
01:07:47
hours of straight meetings about very
01:07:48
very complicated things about buying
01:07:49
companies. I'll be meeting founders,
01:07:51
interviewing people. And what I've
01:07:53
noticed profoundly because so much of my
01:07:54
job centers on speaking and articulation
01:07:56
is there is this wild wild variance that
01:07:59
I hate.
01:08:01
And what I mean by that is some days I'm
01:08:03
on it
01:08:04
>> and some days I am almost embarrassed by
01:08:06
my inability to string a sentence
01:08:07
together. Today I'm I'm almost testing
01:08:09
myself now by trying to speak really
01:08:10
really fast and see if my brain's
01:08:11
connected to my mouth. That's like
01:08:12
that's actually like what I do. I try
01:08:14
and see if I if it flows out. Today I'm
01:08:16
okay.
01:08:17
>> Yeah.
01:08:17
>> Um but there are days where I'm
01:08:19
stumbling over myself
01:08:22
>> and I go what's what's causing this?
01:08:24
What's the causal factor and how do I
01:08:25
prevent this? That's one. Keto, when I'm
01:08:27
in keto, I always sound like Buster
01:08:29
Rhymes. it always just
01:08:31
>> it it's always uh it's always working.
01:08:34
>> And then I'd say the aesthetic stuff
01:08:36
because I want to look good as well,
01:08:37
especially for, you know, my fiance. So,
01:08:38
I want to be in shape. I want to be uh
01:08:40
And then I'd say the third is being
01:08:42
strong. And then the fourth is I want to
01:08:44
live long.
01:08:46
>> Exactly.
01:08:46
>> I want to have a long health span, not
01:08:48
just a long lifespan, but I want to be
01:08:50
able to do things as I age.
01:08:51
>> So, you see, you're that's exactly what
01:08:53
I began this meeting with. you've got a
01:08:57
clear idea about your preferred future.
01:09:00
>> Mhm.
01:09:00
>> And it's it's it's it's fairly specific,
01:09:02
too. And the more specific you are, the
01:09:05
more likely you are to be successful.
01:09:07
And then you're noticing. Then
01:09:08
afterwards comes the feedback.
01:09:10
>> Do you think most people even have
01:09:11
thought about this?
01:09:12
>> No.
01:09:13
>> I was just thinking about my listeners
01:09:14
and I was thinking they're listening
01:09:15
right now. I wonder if they have written
01:09:17
down their top four.
01:09:19
>> Yeah. So I do you know what I'd love to
01:09:21
do now is tell you something about my
01:09:23
wife's work because it relates to
01:09:26
changing behavior fast and that she
01:09:29
won't mind. So that we're back to Jen
01:09:31
now. We have a woman. She spent two
01:09:33
years
01:09:35
um thinking about CBT and what was what
01:09:39
this is a type of therapy and what were
01:09:41
the necessary parts of it and what was
01:09:43
junk. and she reduced CBT down to
01:09:47
something I'll teach you right now. All
01:09:49
right. So, we'll off we go. Off we go.
01:09:52
>> So, the first thing is to think about
01:09:56
your health goals. So, to think about
01:09:59
what in a year's time, if what you do is
01:10:02
great, how does that look specifically?
01:10:07
So, I'll give you an example. You might
01:10:09
think you'd like to lose weight, but
01:10:12
that isn't specific enough. I want to
01:10:14
know what difference would that make to
01:10:17
you? So, we'll do it now. So, you said
01:10:20
you wanted to be in shape.
01:10:21
>> Yeah.
01:10:22
>> What I don't know what do you mean by
01:10:23
that. Do you want to lose weight? What
01:10:25
do you tell me more?
01:10:27
Um, I want to be
01:10:30
able to
01:10:34
h
01:10:41
what I'm really I think scared of, I'm
01:10:44
going to be completely honest,
01:10:46
>> is I'm scared of
01:10:55
>> having the same health profile as my
01:10:56
dad.
01:10:57
>> Ah, right. Yes.
01:10:59
>> Because I've seen we have the same, you
01:11:01
know, we have a lot of the same genetic
01:11:03
profile.
01:11:04
>> Yes.
01:11:04
>> So, I think a lot of us look at our
01:11:07
parents and go, "Is that my future?"
01:11:10
>> Yes.
01:11:10
>> Yeah.
01:11:11
>> And to make it even more specific, I
01:11:14
remember walking down some stairs. I've
01:11:16
said this once before, but I remember
01:11:17
walking down some stairs in Bali,
01:11:20
>> long steep set of stairs down to go
01:11:22
white water rafting with my fianceé. And
01:11:25
I remember those stairs recrafting
01:11:35
because we've got to walk back up these
01:11:36
stairs.
01:11:37
>> And so my dad would have lost out on one
01:11:39
of the great joys of life, which is
01:11:40
doing enjoyable things with friends and
01:11:42
people you love because his health is
01:11:44
now in that regard is gone.
01:11:46
>> Um, so I've always thought of that. And
01:11:49
then generally like I I remember when I
01:11:50
was younger, my dad used to play like
01:11:52
football with us and and all these
01:11:54
things and he's unable to do that now.
01:11:56
Um and so I'm and because I've done this
01:12:00
podcast so many times with health
01:12:01
experts, I realized that the decisions I
01:12:04
make at 30, which is where I am now,
01:12:07
exist on this really interesting, quite
01:12:09
predictable curve of inevitable decline.
01:12:13
However, not like inevitable
01:12:20
uh loss of lifestyle. What I mean by
01:12:21
that is I just have this picture in my
01:12:23
head of all these graphs I've seen where
01:12:24
like your peak is around maybe 2030 and
01:12:27
then you're going down which we all
01:12:29
accept
01:12:30
>> but how far you go down is determined by
01:12:32
decisions you make right now.
01:12:33
>> Absolutely.
01:12:34
>> The decisions I make now will end me at
01:12:36
70 80 years old in either the inability
01:12:39
to walk or the ability to run.
01:12:43
>> Yeah.
01:12:43
>> And it's all about what I do now. is so
01:12:46
that let's just refine that. So we've
01:12:48
we've we've I've got your goal. Yeah.
01:12:51
Now
01:12:52
>> so let's let's park your goal.
01:12:55
Now the next thing we've got is in the
01:12:57
past what have you done that's worked
01:13:01
towards those goals. So you probably
01:13:02
tell me some stuff you've done that's
01:13:04
worked.
01:13:05
>> Um
01:13:08
things like going to the gym.
01:13:10
>> Yeah. Yeah. anything anything quickly
01:13:11
that you did that worked that that was
01:13:14
is is a is a first you know helped that
01:13:18
you did and you remember that worked so
01:13:19
tell me anything
01:13:20
>> so I said to myself one year that I was
01:13:21
going to go to the gym every single day
01:13:22
terrible idea because I got 5 months in
01:13:24
and then I missed a day then it was over
01:13:26
I said to myself another year I think
01:13:27
this was 2017 that I'm going to get a
01:13:29
six-pack for summer terrible idea
01:13:32
because when summer came or I got the
01:13:33
six pack
01:13:34
>> my question was what did work in the
01:13:36
past not what didn't work so what has
01:13:38
worked for you in the past
01:13:39
>> so those two incidents um helped me
01:13:41
change my idea and the idea that I came
01:13:44
up with was I set not a achievable thing
01:13:47
as a goal but consistency is the goal
01:13:50
>> and consistency became for the last four
01:13:53
years this idea that the goal my fitness
01:13:55
goal is consistency means that every day
01:13:57
I wake up I get a shot at it and if I
01:13:59
up today then I've got another shot
01:14:01
tomorrow
01:14:01
>> right leave it there that's good so we
01:14:03
we did the goal and then we did the next
01:14:06
thing what what I just the next thing is
01:14:08
is resources is
01:14:10
>> Mhm.
01:14:10
>> So it's it's what do you bring to the
01:14:13
consultation that you've done in the
01:14:15
past? Intelligence, resources, friends
01:14:18
that will help.
01:14:20
>> Yeah.
01:14:20
>> You come already with expertise in
01:14:23
yourself. So it's not I'm not the expert
01:14:25
to tell you what to do. You've already
01:14:27
got some stuff. Yeah.
01:14:28
>> Then we go to the next thing. So if we
01:14:30
had your goal at the beginning which was
01:14:33
the fitness and the so and so today what
01:14:38
might be a small step towards your goal
01:14:41
a realistic small step towards the goals
01:14:44
we've already established.
01:14:50
>> So I can think of two good
01:14:52
>> one of them is uh creating a social pact
01:14:55
which again was one of the things that
01:14:57
helped. So we made a WhatsApp group.
01:14:58
This is quite funny. We made a WhatsApp
01:15:00
group. We put 10 friends in it and we
01:15:02
made a simple rule. Whoever's the least
01:15:03
consistent every month is evicted and we
01:15:05
invite a new friend in.
01:15:06
>> Wow.
01:15:07
>> We've done that for four years. I've not
01:15:08
been evicted in four years, which means
01:15:10
that I'm doing enough. I'm consistent
01:15:12
enough over those four years
01:15:13
>> to not be evicted. Every day when we
01:15:15
work out, it puts our workouts into the
01:15:17
group chat
01:15:18
>> and um every every week and every month
01:15:21
um there's a winner and there's this
01:15:23
league table
01:15:24
>> and you get these little emoji medals
01:15:26
and there's actually I won one year so
01:15:27
I've got this physical massive gold belt
01:15:29
on my bookshelf at home. It says fitness
01:15:31
blockchain world champion.
01:15:32
>> Brilliant.
01:15:32
>> So I've done that for four years. Um so
01:15:34
a social pack really helped me the the
01:15:36
sort of accountability to others. Yeah.
01:15:38
>> And the other the other honestly was
01:15:43
just
01:15:45
as I said a second ago when I set the
01:15:47
the goal of going to the gym every
01:15:49
single day, I set myself up for failure.
01:15:51
Now I set myself the goal of
01:15:53
consistency, which means that I can do
01:15:55
have bad days where I do 20 minutes or
01:15:57
15 minutes. Yesterday cuz I was finished
01:15:59
Dragon's Den late, drove down to London,
01:16:00
got home at 1:00 a.m. I did 18 minutes.
01:16:04
>> Yeah. and reducing the size of success
01:16:07
really helped me to
01:16:10
keep my feeling of momentum.
01:16:12
>> Brilliant. We're nearly at the end of
01:16:13
your degree in psychology. Okay.
01:16:15
>> And I'm going to pull it together.
01:16:17
>> The final thing is
01:16:20
um when things if you what would you
01:16:23
notice
01:16:25
for you when things are going well? What
01:16:27
would you notice?
01:16:30
>> So you've done some of these things.
01:16:32
What is it you actually notice
01:16:34
>> as in the benefit to me?
01:16:36
>> Yeah. What what do you notice? So if you
01:16:38
do if tomorrow is a really good day,
01:16:41
what might you notice at the end of it?
01:16:42
Cuz you've much experience in this now.
01:16:44
What would you notice?
01:16:46
>> I mean the first thing that comes to
01:16:47
mind is just how I feel.
01:16:49
>> Yes.
01:16:49
>> I just feel
01:16:51
>> Do you mean emotionally or
01:16:52
energetically? Great.
01:16:53
>> All of it. Emotionally I feel good about
01:16:55
myself.
01:16:55
>> Yeah.
01:16:56
>> Um energetically I feel more energetic.
01:16:59
Um, and there is this um
01:17:03
there is this element of identity in
01:17:05
there where I have an opinion of myself
01:17:08
and who I think I am and I think I'm a
01:17:09
healthy person and I think I'm someone
01:17:11
that's in control.
01:17:12
>> And when I'm when I'm not going when I'm
01:17:14
not performing the consistent behaviors
01:17:16
that I want to I think I start to
01:17:19
question that identity in a way that's
01:17:20
that causes a lot of discomfort and say,
01:17:22
"Well, you're not in control of your own
01:17:23
life." Like, how that's that's crazy.
01:17:24
>> So, I think it it links into
01:17:26
self-esteem. Yeah,
01:17:27
>> it really. So, what we've just did, we
01:17:29
had the goals G.
01:17:32
>> Yeah.
01:17:32
>> Then we had your resources R.
01:17:36
>> Yeah.
01:17:36
>> Then we had increments. What things had
01:17:39
you done? Little things on the way. And
01:17:42
then finally, I invited you to notice
01:17:44
and reflect. And that spells grin. And
01:17:47
that's Jen's published grin model. I
01:17:49
just did it for you right there. And I
01:17:51
could do it faster than that. I do it in
01:17:54
nearly every surgery I do because what
01:17:56
I'm trying to do is find out about you.
01:17:58
>> Mhm.
01:17:59
>> And you didn't find out much about me in
01:18:01
that process, did you?
01:18:02
>> No.
01:18:03
>> But I found out a lot of really useful
01:18:05
stuff to you and it's motivational. And
01:18:07
much better to do that than me tell you
01:18:09
what to do. And I'm not a talking
01:18:12
leaflet, but motivation, this is what
01:18:15
Jen has taught me, is key in everything
01:18:17
we do. And the grin model isn't bad.
01:18:22
clever woman.
01:18:22
>> So what do we do with the grin model?
01:18:24
And so this is really helping me figure
01:18:26
out how to change my behavior. Like how
01:18:29
how does one apply it or are you saying
01:18:31
that everyone listening now should
01:18:32
should answer those four questions
01:18:34
themselves? I do because otherwise it's
01:18:37
possible to spend a lot of time blaming
01:18:40
yourself,
01:18:41
>> you know, and particularly around if
01:18:43
we're discussing weight problems and so
01:18:44
on, you can spend a lot of time saying
01:18:48
I'm to blame or I wish or I shouldn't
01:18:52
have that. You know, after Christmas,
01:18:55
everybody feels like this. But what is
01:18:58
much better rather than focusing
01:19:01
you're wasting energy if you start
01:19:03
thinking about guilt and negative stuff
01:19:06
and what Jen's trying to do is getting
01:19:09
you to engage
01:19:11
by in in thinking about a better future.
01:19:15
And what the whole of that five minutes
01:19:16
was engaging you in in
01:19:21
first of all the goal of a better
01:19:23
future, then some resources towards your
01:19:27
better future, then the first steps
01:19:29
towards the better future, and then
01:19:31
noticing what's good.
01:19:33
>> Mhm.
01:19:34
>> Because I think in medicine, what we've
01:19:36
done, how do you get a doctor's
01:19:38
attention? You get a doctor's attention
01:19:40
by saying, "Oh, it's so bad. It's so so
01:19:44
bad. My pain is so so bad. And I
01:19:48
realized I had trained my patients to
01:19:52
think that moaning was how you know they
01:19:55
got my attention. And if you do that,
01:19:57
the result is a very miserable 2-hour
01:20:00
surgery.
01:20:02
But if you can talk, even people having
01:20:04
a a terrible time have got hope if you
01:20:07
can find it. They have goals if you can
01:20:10
discuss them. And you could have
01:20:12
somebody with a drug addiction or what
01:20:14
you know I see people dying people all
01:20:16
sort every clinic I'm seeing sad stuff
01:20:20
but if you can also investigate
01:20:24
hopes and good stuff as a doctor I'm so
01:20:28
much more energetic so much more hopeful
01:20:30
I'm having a great time and I wasn't
01:20:33
when I was 55 and that's the process
01:20:36
>> I bet there's so many people listening
01:20:37
now that maybe they you know because
01:20:39
they listen to this show and they've got
01:20:40
the sort of basics. They go, "You know
01:20:42
what? I understand this stuff and I'm
01:20:44
making good progress, but I live with or
01:20:46
love someone."
01:20:47
>> Yes.
01:20:48
>> Who I I'm I'm scared they're going down
01:20:51
a slippery slope and I don't know what
01:20:53
to do. Do I intervene? Do I hide their
01:20:55
sweets? Do I blame? What do I do?
01:20:57
>> That's so hard, isn't it? That's so
01:20:59
hard. I think you can.
01:21:02
>> Weren't you in that position to some
01:21:04
degree?
01:21:05
>> Yes. Uh yeah. So, uh, my first wife had
01:21:10
a very severe addiction problem. So, I
01:21:12
lived with that for 12 years and she's
01:21:14
unfortunately died now. Um, so I lived
01:21:18
with very, very serious addiction for 12
01:21:22
years. And what you're doing then is
01:21:24
you're living with uncertainty.
01:21:27
Serious uncertainty.
01:21:29
Uh, you never you cannot say what you'll
01:21:31
come home to. You have no idea. No idea.
01:21:35
It brings chaos into your life. It's
01:21:37
very very hard.
01:21:39
>> Addiction.
01:21:40
>> Yes.
01:21:41
>> Are you able to say what kind of addict?
01:21:42
Was it a food addiction or a drug
01:21:44
addiction or
01:21:44
>> It was a It would nearly everybody
01:21:47
concerned has died now. So I don't know
01:21:50
whether I can say or not, but it was
01:21:51
very serious multiple addictions. I will
01:21:54
say that. And she had she died some
01:21:56
years ago.
01:21:58
And it doesn't it it it actually wasn't
01:22:01
food addiction. Mhm. But it brings I
01:22:05
have so much sympathy with dealing how
01:22:09
how hard it is to deal with uncertainty
01:22:11
and not be able to you love somebody and
01:22:13
you can't do anything. It's very hard.
01:22:16
There are things you can do. I think
01:22:20
um if you can engage people in in that
01:22:24
talking about goals that can help.
01:22:28
Uh what we will do now is we'll change
01:22:31
that conversation to to the current Mrs.
01:22:34
Unwin, which is what we laughingly say.
01:22:36
This is Jen. So we we've been together
01:22:39
for 30 years now.
01:22:41
And Jen's story is that she actually is
01:22:44
an ultrarocessed food addict genuinely.
01:22:48
And what that means is I didn't un
01:22:51
neither of us understood what that was.
01:22:54
Even though she's a consultant
01:22:55
psychologist, she didn't realize that
01:22:58
she was an ultrarocessed food addict.
01:23:01
What she saw it as was a weight problem.
01:23:05
And all her life she's she's been
01:23:09
boomerang dieting. So she'd be a big
01:23:11
woman and then a little woman and a big
01:23:13
woman. And I used to watch it all.
01:23:15
What's going on? And then she would
01:23:18
there'd be tray bakes like she's trying
01:23:20
to lose weight and making tray bakes
01:23:23
saying it's for the children and then
01:23:24
scoffing the lot herself.
01:23:27
So then I'd because I loved her and I
01:23:31
think blo we try and solve problems
01:23:33
don't we?
01:23:34
>> We're like caveman you wanted to rescue
01:23:36
her. So, I'm I'm either throwing the
01:23:39
food away
01:23:41
or I'm tackling her and then she we're
01:23:44
having such arguments cuz she's
01:23:46
defensive and cross.
01:23:48
I I couldn't understand with an
01:23:50
intelligent woman what's going on. But
01:23:53
then uh this is only a few years ago.
01:23:55
She understood for the first time this
01:23:58
is addiction. When you have intelligent
01:24:02
people,
01:24:03
highly, highly intelligent people doing
01:24:06
stuff that harms their health
01:24:08
repeatedly,
01:24:10
is this not like cigarettes? Is it not
01:24:14
like alcohol? That is ultrarocessed food
01:24:18
addiction. And there's a patient I'd
01:24:20
like to tell you about that is explains
01:24:23
it even more clearly. And this patient
01:24:25
has consented for me to tell you because
01:24:27
he wants to help the world.
01:24:30
So, this is a guy who's a very
01:24:32
successful guy. He runs um he's a
01:24:34
wealthy person with a successful
01:24:35
business. He's not stupid.
01:24:38
He has type 2 diabetes. He's 55. He has
01:24:41
type 2 diabetes. He's very much
01:24:43
overweight.
01:24:45
Unfortunately, he needs really serious
01:24:48
surgery because both his knees have been
01:24:51
so destroyed by his weight that he can
01:24:54
hardly walk because he's in real agony.
01:24:57
But his type 2 diabetes is so bad, his
01:25:02
blood sugar control is so bad, the
01:25:03
anesthesis won't touch him. So he's
01:25:06
trapped, he can't get the OP because his
01:25:09
blood sugar is high. He can't run his
01:25:12
business easily because he can't hardly
01:25:14
walk. So obviously what we do is we say
01:25:18
you need to go low carb.
01:25:21
And it works for a bit and he loses some
01:25:24
weight, but then he gains the weight
01:25:25
again. And this goes on for four years
01:25:28
while I see him so regularly every
01:25:31
month. What's going on? What's going on?
01:25:33
Oh, excuses. The grandchildren.
01:25:36
Um, I've got a holiday, Christmas, it
01:25:38
goes on. Anyway, then his wife came to
01:25:40
see me and she said, "Dr. I need to
01:25:42
level with you. You need to understand
01:25:44
what's going on. I find that my husband
01:25:46
is getting up at 4 in the morning and
01:25:48
eating bread out of the fridge.
01:25:52
So what I do now, what I started doing
01:25:56
was at the end of every day, I put all
01:25:59
the bread in the bin if it hasn't been
01:26:01
eaten that day. But then I discovered my
01:26:03
husband was going in the bin to eat the
01:26:05
bread.
01:26:07
Then what she does, she's a a a very
01:26:09
formidable woman. She started putting
01:26:12
detergent, liquid detergent on any bread
01:26:14
that goes in the bin. But he still eats
01:26:17
it. He's getting up at 4 in the morning,
01:26:20
rumaging through the bin to eat the
01:26:22
bread with the detergent on. So then she
01:26:25
tries something else and she says, "This
01:26:27
is the only thing that will stop my
01:26:29
husband from eating bread if it's there.
01:26:31
I spray bleach on the bread and leave
01:26:34
the can of bleach by the bin so he knows
01:26:37
don't even look."
01:26:39
Okay. What I've described to you is
01:26:43
addiction. This is an intelligent
01:26:45
person. and imagine his self-esteem, how
01:26:49
it was to live like that, concealing
01:26:51
what he was doing
01:26:53
and not telling his doctor cuz I'm
01:26:55
trying so hard for him for years and
01:26:58
he's so sweet to me now and he often
01:27:01
shakes my hand and gives me a hug. He
01:27:03
said, "You tried. You really tried."
01:27:05
Anyway, my stories have a happy ending
01:27:08
always. What I did for him in the end,
01:27:11
he needed everything. So, low carb. Then
01:27:14
I got him using a continuous glucose
01:27:17
monitor.
01:27:17
>> Mhm.
01:27:18
>> So that he would get feedback
01:27:19
immediately and see that spike and also
01:27:22
I could see the spikes as well cuz he
01:27:24
had to come and show me his tracings.
01:27:27
>> And on top of that, I did something
01:27:30
unusual. I gave him a low dose of the
01:27:33
new GLP-1 drugs,
01:27:36
>> one of those. Yeah. Um and the three
01:27:39
together
01:27:42
he managed to not he couldn't moderate
01:27:45
but he could abstain and then he could
01:27:47
do it. The ampic helped reduce the noise
01:27:52
the cravings in his head. The feedback
01:27:55
from the CGM helped him know how he was
01:27:58
doing and the support he got from me and
01:28:01
the low carb pulled together and all
01:28:04
three and he's had his operation now.
01:28:06
And so it's a happy story, but he's got
01:28:09
maintenance all his life. He's going to
01:28:11
have to sort that out. Um, and it's a
01:28:14
wonderful example because I think we
01:28:17
trivialize this. We call it carb creep
01:28:20
like it doesn't matter. But there are
01:28:22
many people listening to us right now
01:28:25
and they know they know they're addicted
01:28:28
to various foods. They know because when
01:28:30
you ask them, they often burst into
01:28:32
tears. Often I somebody will say I've
01:28:34
never told anybody in my entire life
01:28:37
about and bread is a common one and if
01:28:40
you're not addicted to bread you can't
01:28:42
imagine it but if you are addicted to
01:28:44
bread they say this sounds so stupid I'm
01:28:47
so embarrassed to tell you I can't
01:28:49
control how I eat bread
01:28:51
>> and so it's not great for your
01:28:54
self-esteem is it
01:28:56
>> but people might be addicted to many
01:28:57
things and uh my wife's published many
01:29:00
papers on this and written a book and
01:29:02
this that and the other. Um and she
01:29:05
would say about 14% of the population
01:29:09
has some aspects of ultrarocessed food
01:29:12
addiction.
01:29:13
Um and
01:29:16
it kind of explained so much why are
01:29:19
intelligent people eating foods they
01:29:22
know do them harm. I've got another
01:29:25
example. One of my patients with type 2
01:29:28
diabetes, we got drug-free remission.
01:29:31
Hooray. I've done that now 157 times.
01:29:35
So, every one of them I'm cheering when
01:29:37
it happens. So, this guy, we did it.
01:29:39
Drug-free remission.
01:29:42
Then he vanished for a while and um
01:29:46
came back with two dead toes and he had
01:29:50
to have them amputated. Now,
01:29:51
>> dead toes.
01:29:52
>> Yeah. They started rotting because
01:29:55
diabetes takes the blood supply
01:29:58
particularly from your toes. So we had
01:30:00
to have surgery to have part of his foot
01:30:02
removed.
01:30:04
And so you call it carb creep and he
01:30:06
ended up with half his foot taken off.
01:30:09
That's not carb creep. Something far
01:30:11
more sinister.
01:30:13
But I never give up. And fortunately the
01:30:15
wounds took a long time to heal because
01:30:17
he was sugary. So we do it all over
01:30:19
again. I got him back into remission
01:30:23
because this time he and his wife are
01:30:24
really determined. But it's a struggle
01:30:27
and he needs help and support to achieve
01:30:32
that. He's not a foolish man. He's an
01:30:34
intelligent man and yet various foods
01:30:38
called to him. Eat me, eat me. And it's
01:30:41
very difficult for him to not. And that
01:30:45
I mean that's a very extreme example but
01:30:48
many people with overweight and some who
01:30:52
are not overweight are struggling
01:30:55
with very very significant carb cravings
01:30:58
and they really really uh struggle to
01:31:02
control them. There should be a button
01:31:04
just down below here and if it says
01:31:06
subscribed you're already subscribed. If
01:31:08
it says subscriber that means you're not
01:31:10
yet. And if you're not subscribed,
01:31:12
please could you do us a favor and hit
01:31:13
that button? It helps the show more than
01:31:14
you know. And according to the
01:31:16
algorithm, you're someone that watches
01:31:17
our show, but you haven't yet hit that
01:31:19
button. Thank you so much.
01:31:21
>> For those people, and I assume there's a
01:31:22
lot of people, and actually some people
01:31:24
have seasons where they're in control,
01:31:26
they're out of control, they're in
01:31:27
control. You know, I've been there.
01:31:30
>> Um, what is step one today?
01:31:34
>> So, they're listening to you, they go,
01:31:35
"Fucking, I don't want to lose my toes
01:31:36
and all of these problems." What is step
01:31:38
one now?
01:31:40
>> Now, are we talking about for somebody
01:31:42
with type 2 diabetes or somebody who
01:31:44
can't control what they're eating?
01:31:45
>> Someone that can't control what they're
01:31:47
eating.
01:31:47
>> Great. Right. So, step one, we just did
01:31:51
it. I think step one is acknowledging
01:31:55
that is your problem. Because if you
01:31:58
don't, if you're not honest about your
01:31:59
problem, how are you ever going to sort
01:32:01
it out?
01:32:02
>> Honesty.
01:32:02
>> So, the first thing is honesty. And
01:32:05
that's very hard for people. All of us
01:32:08
have made excuses. You know, me and my
01:32:10
biscuits. I believed that the it was
01:32:13
easier for me to think that that was
01:32:15
stress and a reasonable reaction to the
01:32:18
stress of running a practice than it was
01:32:20
to say I've got a you know biscuits for
01:32:23
me it took me a year to give them up. A
01:32:26
year.
01:32:27
How pathetic is that? I was so driven it
01:32:30
took me a whole year.
01:32:31
>> How did you give them up? Um, I did it
01:32:33
by weaning myself off a bit like
01:32:35
methadone. So, I went from um I like
01:32:39
chocolate ginger biscuits and then I
01:32:41
went to digestive plane and then I went
01:32:43
to oat biscuits and then eventually I
01:32:47
went to almonds.
01:32:48
>> Why didn't you just do it all at once?
01:32:49
>> I should have done. And uh Jen Jen's a
01:32:52
great believer in cold turkey. Like what
01:32:54
is the thing? Stop it. I wasn't man
01:32:57
enough for that and it took me a whole
01:32:59
year. So the first the first thing is be
01:33:02
honest truth. Be honest with yourself.
01:33:05
Even if you can't tell other people, be
01:33:08
honest with yourself.
01:33:11
Is there an addictive potential there?
01:33:13
Could that be? Does that fit? Number
01:33:16
two,
01:33:18
specifically which foods is your
01:33:20
problem? And be honest.
01:33:24
Um because if you if you're not honest
01:33:26
then you number three is have a plan for
01:33:31
abstinence.
01:33:32
>> Mhm. Because if you if if there is an if
01:33:35
you have got an addictive potential
01:33:38
um
01:33:40
it won't be one biscuit and we all who
01:33:43
you know how many of us have said I'm
01:33:46
going to give up ice cream or biscuits
01:33:49
or pizza or whatever it is
01:33:51
>> and then you have a day and
01:33:52
>> you did or you have a drink or whatever
01:33:54
you think tomorrow
01:33:55
>> work stresses you out.
01:33:56
>> Yeah. Tomorrow tomorrow tomorrow. So
01:33:59
it's very important to be specific about
01:34:02
the foods and then to have a plan
01:34:06
for how you are going to do it. And
01:34:09
another thing is sometimes
01:34:11
it's helpful you know the people around
01:34:13
you that love you.
01:34:14
>> Mhm.
01:34:16
>> Maybe share with them
01:34:18
that it's it's that it's important and
01:34:22
that I need I might need some help.
01:34:24
Please be tolerant with me like
01:34:26
cigarettes. Please be tolerant if I'm
01:34:28
short-tempered. I'm going to try and do
01:34:30
this thing because it's important.
01:34:33
The difficulty, it depends whether the
01:34:35
person that loves you can be gentle or
01:34:38
if they're heavy-handed. If you confess
01:34:40
this and then they police you,
01:34:42
>> judgmental.
01:34:43
>> Yeah. It doesn't help.
01:34:44
>> Yeah. Yeah. Yeah.
01:34:45
>> What you're asking for is gentle support
01:34:49
and tolerance.
01:34:50
>> I can think of a time over my life where
01:34:52
I was with somebody Yeah.
01:34:53
>> and I was they were so into their
01:34:55
health. Yeah,
01:34:57
>> that it made me start to hide when I was
01:34:59
eating bad. I would
01:35:00
>> exactly thank you for that. That's
01:35:02
that's what happens. And you see that
01:35:05
people become
01:35:07
deceitful.
01:35:08
>> So the if you police somebody you love,
01:35:11
the result is deceit.
01:35:12
>> I was hiding the rappers of the things I
01:35:14
was eating.
01:35:14
>> Jen did that with me. She would uh she
01:35:18
she knew that I was monitoring. So she
01:35:21
starts hiding the rappers or then I'd
01:35:23
find them in the car
01:35:24
>> and and but then we have a situation
01:35:26
that we can no longer talk about it
01:35:28
because
01:35:29
>> so that if if somebody if you're forcing
01:35:32
somebody to become deceitful, you have
01:35:34
to back off a little bit.
01:35:36
>> Yeah.
01:35:36
>> Because that deceit
01:35:38
then affects self-esteem and that can
01:35:41
make them worse. And you didn't want to
01:35:43
make them worse
01:35:43
>> and then they're lonely because they
01:35:44
they can't share the bad days.
01:35:46
>> Yeah. It it's really good. I wonder
01:35:48
please could we show Jen's book at this
01:35:50
point?
01:35:50
>> Of course.
01:35:51
>> So, can I just explain the book? So,
01:35:54
this this is Jen's book. And the most
01:35:58
important thing is Jen doesn't make a
01:36:01
penny out of this book. So, it's fork in
01:36:03
the road with the idea that in your
01:36:05
journey, which one are you going to
01:36:07
pick?
01:36:08
>> Do you see?
01:36:09
>> So, it's fork in the road. She doesn't
01:36:12
make any money from this. Every penny
01:36:14
goes to a charity that she's set up
01:36:16
helping people with food addiction. It's
01:36:19
available on Amazon and self-published
01:36:22
on Amazon.
01:36:22
>> How How much does this book cost? It's
01:36:24
not a lot, is it?
01:36:26
>> It's about £15. Oh, no, it's less. I
01:36:28
think it might be 10 10 quid.
01:36:32
>> Okay, I'll tell you what I'll do.
01:36:33
>> Yeah,
01:36:34
>> I'll buy a,000 of them.
01:36:35
>> Fabulous.
01:36:36
>> And I'll put a link below in the comment
01:36:38
section. And so I all you've got to do
01:36:41
is if you've really enjoyed this
01:36:43
conversation and you'd like to get Jen's
01:36:46
book um
01:36:49
>> fork in the road.
01:36:50
>> A fork in the road. Maybe we can even
01:36:51
get some of them signed. Not all of them
01:36:53
cuz that hand get a couple of them.
01:36:55
>> Oh, that is brilliant.
01:36:57
>> Click below and um we'll send a thousand
01:36:59
of them out. And that's just a thank you
01:37:00
from from me to both you and Jen, but
01:37:03
also to the community who tune in for
01:37:04
these conversations. And it's so great
01:37:06
that people can get such simple
01:37:08
information that's so accessible and so
01:37:10
um rigorous in its scientific
01:37:11
credentials
01:37:13
um in a way like this that they can that
01:37:15
could change some people's lives.
01:37:16
>> Great.
01:37:17
>> Isn't that a wonderful thing? You know
01:37:19
that a simple book like this which isn't
01:37:21
long either. It's only
01:37:23
>> not a big read
01:37:25
>> could change some people's lives. That's
01:37:26
such a wonderful thing.
01:37:29
>> Steve, what you doing? Uh, just making
01:37:31
myself a delicious coffee
01:37:33
>> from the freezer.
01:37:35
>> From the freezer. Have you not heard
01:37:36
about Comtier?
01:37:36
>> No.
01:37:37
>> Oh my gosh. This is going to change your
01:37:39
life. I invested in this company called
01:37:41
Cometier last year and they're now one
01:37:43
of the sponsors of this podcast because
01:37:44
they've taken a pretty revolutionary
01:37:46
approach to making coffee. Every coffee
01:37:48
is precision brewed at 10 times the
01:37:51
strength and then they flash freeze it
01:37:54
with liquid nitrogen to lock in the
01:37:56
flavor and freshness. And then it's
01:37:58
delivered to you on dry ice in these
01:38:00
recyclable aluminum capsules, still
01:38:03
frozen, like a little ice cube. All you
01:38:05
have to do is pop the capsule out, add
01:38:09
some hot water, and then you stir it and
01:38:13
you are good to go. You can also make
01:38:15
delicious iced coffee drinks as well.
01:38:17
Just pour it in,
01:38:20
stir it up. And for anyone that hasn't
01:38:23
tried it, you can get $30 off your first
01:38:26
order of Cometier coffee if you go to
01:38:28
cometier.com/stephven.
01:38:32
I've done almost 700 interviews with
01:38:34
some of the most interesting people in
01:38:35
the world. And one of the things you
01:38:36
learn which is unexpected is that
01:38:38
vulnerability is the doorway to
01:38:41
connection. And after sitting here for 2
01:38:42
three hours with a guest, I feel a deep
01:38:45
sense of connection to them. And as they
01:38:47
leave, what I get them to do is to write
01:38:49
a question in the diary of a CEO. We've
01:38:53
taken all of the questions from the
01:38:54
diary of a CEO. We have put the question
01:38:58
here on this card with the name of the
01:39:00
person that wrote it. So you can sit at
01:39:02
home as I do with my fiance and my
01:39:04
colleagues at work and other people in
01:39:05
my life. Whenever we get a minute, we
01:39:07
play the diio conversation cards and it
01:39:10
is incredible what happens. These are
01:39:13
great if you're in a romantic
01:39:14
relationship and you want to connect
01:39:16
your partner more. These are also great
01:39:17
if you're in a team and you want to bond
01:39:19
your team together. And I have to say
01:39:20
they're also great for families that
01:39:22
want to learn more about each other and
01:39:24
that need a good excuse to spend some
01:39:26
time in a digital world in the analog
01:39:28
environment connecting human to human.
01:39:31
It is remarkable what the right question
01:39:33
at the right time can do. Go to the
01:39:36
diary.com
01:39:37
and you can get these conversation cards
01:39:39
right now.
01:39:42
You said something earlier on about the
01:39:43
link between
01:39:45
sort of your dietary choices and cancer.
01:39:47
I've actually got a friend of mine who
01:39:49
used to work for me who is going through
01:39:51
a cancer process at the moment. She's
01:39:53
very very young. She's actually younger
01:39:54
than I am. Wow.
01:39:55
>> And she was diagnosed with breast
01:39:57
cancer. She's a really good friend of
01:39:58
mine. Um and she was my actually my
01:40:00
manager for a couple of years. She's
01:40:01
called Katie.
01:40:02
>> She's very public about this. So she's
01:40:04
posting her journey online so I can I
01:40:06
can say her name. and um I've been
01:40:08
following her and she's she's you know
01:40:10
she's removing a lot of the the foods
01:40:12
we've talked about today from her diet.
01:40:14
So she's very front of mind for me at
01:40:15
the moment and I was looking at some of
01:40:17
the stats around the link between our
01:40:19
dietary choices and cancer outcomes and
01:40:20
I'm going to read them now. My team
01:40:22
might cut some of them out but I think
01:40:23
they're worth hearing because hearing
01:40:25
them I think is quite um enlightening. A
01:40:29
massive French study found that drinking
01:40:31
just 100 mil of sugary drinks per day,
01:40:34
which could be, you know, a third of a
01:40:35
can of soda is associated with a almost
01:40:39
20% increased risk of overall cancer.
01:40:43
Women who consume two or more dietary
01:40:45
drinks daily have over double the risk
01:40:47
of early onset calorical cancer compared
01:40:51
to those who drink less than one a week.
01:40:54
High consumption of sugary sweetened
01:40:55
beverages is linked to a 78% higher risk
01:40:59
of estrogen dependent endometrial cancer
01:41:02
in women. Drinking 20 ounces of sugar of
01:41:06
sugary soda daily is linked to
01:41:08
shortening your telomeres which are the
01:41:10
protective caps on your DNA equating to
01:41:12
4.6 Six years of extra biological aging
01:41:15
which is a major risk facilimia.
01:41:23
>> Chronic hyperinsulinemia.
01:41:26
Can I so that is when I'm saying when
01:41:28
the insulin levels are high which I
01:41:30
explained at the beginning
01:41:31
>> which can inhibit aptosis the natural
01:41:35
process where damaged or cancerous cells
01:41:37
self-destruct.
01:41:38
>> Wow.
01:41:39
>> Two more. Fructose is processed in the
01:41:42
liver and converted into lipids which
01:41:43
are fats which is what we were talking
01:41:45
about earlier which recent studies show
01:41:47
certain tumors directly consumed to
01:41:50
build their cell membranes. And lastly,
01:41:53
diets high in added sugars chronically
01:41:55
elevate C reactive proteins called CRPS,
01:41:59
an inflammation marker that is heavily
01:42:00
correlated with tumor progression and
01:42:03
metastasis.
01:42:04
>> Yeah.
01:42:06
So what I'd like to this is that is so
01:42:09
interesting and it brings to mind a
01:42:11
really important point.
01:42:14
We talk so much around the world about
01:42:17
treating cancer,
01:42:19
but what about prevention? Because for
01:42:22
your friend, that's a life sentence and
01:42:26
she's living with uncertainty and fear.
01:42:28
And when I tell patients they have
01:42:31
cancer, you know, you feel it right here
01:42:34
because you just took away so much.
01:42:37
And it's interesting. Do we try hard
01:42:40
enough? If we know that, are we trying
01:42:43
hard enough to prevent cancer? Because
01:42:45
that's what we should be doing because
01:42:48
we know a lot that I think after
01:42:51
smoking,
01:42:53
>> diet is the next commonest cause of
01:42:55
cancer.
01:42:57
And you know how serious does it have to
01:43:00
get when when you you just gave all
01:43:03
those references then and uh I know that
01:43:08
uh junk food is linked to all cause
01:43:10
mortality. It's linked to so many
01:43:13
things. Uh what what are we prepared to
01:43:16
sacrifice for enjoying you know treats
01:43:19
and snacks? It's kind of when you look
01:43:21
at it like that it's really bonkers.
01:43:24
Really bonkers. This sounds a bit crazy,
01:43:26
but sometimes I imagine receiving the
01:43:28
diagnosis.
01:43:29
>> Yeah.
01:43:29
>> And I do a bit of I guess they might
01:43:31
call it a premortem. Um a premortm, not
01:43:34
a postmortem, where I imagine on that
01:43:36
day the decisions I wish I would have
01:43:38
made. And I'm not saying all cancer is
01:43:41
linked to what we eat because that's not
01:43:43
the case. But I'm I'm imagining like the
01:43:45
worst diagnosis I could ever be given
01:43:47
and the doctor telling me that my
01:43:49
lifestyle choices contributed to that
01:43:50
over the last 5, 10, 15 years. And in
01:43:53
that moment, is there any sugary drink
01:43:57
that is worth it?
01:43:59
>> There's just no You would just wish with
01:44:01
every bone in your body where you come
01:44:03
home and tell your fiance, your partner,
01:44:05
your kids
01:44:05
>> that you've got this horrific diagnosis,
01:44:07
you would just wish
01:44:08
>> that you had made a different decision.
01:44:11
>> I also think that's a very good strategy
01:44:14
for dealing with problems.
01:44:16
>> You know, your life must be so
01:44:17
complicated. I can't begin to imagine
01:44:20
how many problems you're solving and the
01:44:22
complications and the people you deal
01:44:23
with. And yet all of them are as nothing
01:44:27
against a cancer diagnosis, aren't they?
01:44:29
So that you would look at the problems
01:44:31
you have right now and you'd laugh.
01:44:34
Yesterday I was worried about the
01:44:36
traffic or whatever and I think it's a
01:44:40
leveler. Mortality is a leveler. All my
01:44:44
life I've been obsessed with death and
01:44:46
it worries me. I can't sort out in my
01:44:49
head what does death mean or you know it
01:44:53
really scared me when I was a child the
01:44:55
idea of death but what it's given me is
01:44:58
a drive to not waste time and and to
01:45:02
think about what's the best use of today
01:45:06
and and you seem to have that kind of
01:45:07
energy as well. The interesting thing
01:45:10
about this idea of wasting time as well
01:45:12
is through everything you've talked
01:45:13
about today, we we can both waste less
01:45:16
time but also have more time. And when I
01:45:18
learned about the difference between
01:45:20
like lifespan and health span, that also
01:45:22
added to this equation. You know, people
01:45:24
still live to 80 years old, but
01:45:26
>> they're only healthy for like 30, 40
01:45:27
years.
01:45:28
>> And that's a very the idea of health
01:45:33
span is very important because we know
01:45:35
in the UK it's going down.
01:45:37
>> Oh, is it?
01:45:37
>> Yes.
01:45:38
Um uh it's it they're looking at that
01:45:41
now. Lifespan is hanging out there as
01:45:44
sort of stuttering along, but health
01:45:47
span is going down in the UK and it's
01:45:49
worth thinking why that is.
01:45:52
>> Well, I would hazard a guess it's uh
01:45:54
relates to all the things you've talked
01:45:55
about today.
01:45:56
>> I think it may do.
01:45:57
>> In England, you're totally right. It
01:45:59
says in England, the situation is
01:46:00
particularly alarming. Health span is
01:46:03
actively declining even as overall
01:46:05
lifespan slowly creeps up. Recent 2024
01:46:10
to 2026 data from the Office of National
01:46:12
Statistics, the ONS and the Health
01:46:13
Foundation paints a stark picture of the
01:46:15
UK's widening sick years gap. Over the
01:46:18
last decade, healthy life expectancy in
01:46:20
the UK has fallen by roughly 2 years. As
01:46:22
of the latest data, men in the UK can
01:46:24
expect to spend about 60 years in good
01:46:27
health and women about 60 years of good
01:46:29
health as well because overall life
01:46:31
expectancy in England is rising.
01:46:34
Um people are now spending roughly up to
01:46:37
23 years at the end of their lives with
01:46:40
poor health and in sickness. This means
01:46:42
the average person spends nearly a
01:46:44
quarter of their life managing chronic
01:46:46
illness and or disability.
01:46:49
>> And that's exactly the point, isn't it?
01:46:51
That's exactly the point
01:46:54
and it relates to another thing I'd like
01:46:56
to tell you about as well. This is um
01:47:00
government figures. Every taxpayer in
01:47:03
England pays an extra £7,000 tax per
01:47:07
year for the consequences of
01:47:09
ultrarocessed food.
01:47:12
>> Everybody's paying tax, extra tax,
01:47:15
£7,000 a year. And this is because it's
01:47:19
not just the cost of the drugs.
01:47:22
The bigger co bigger cost is this is the
01:47:24
people not paying tax themselves and not
01:47:27
able to work because they're ill. And
01:47:30
that is that's twothirds of the cost is
01:47:32
the lack of revenue because so much of
01:47:35
our population isn't well enough to work
01:47:37
and that's very and a lot of it's young
01:47:38
people too. It's very serious.
01:47:40
>> I know I think about 30 40% of our
01:47:42
listeners are in the United States. So
01:47:43
I've got some bad news for everybody in
01:47:45
the United States as well. The US how is
01:47:46
it there?
01:47:47
>> The US currently holds a rather grim
01:47:49
record. It has the largest health span
01:47:52
to lifespan gap on Earth. Despite the
01:47:56
United States having lower overall life
01:47:58
expectancy than almost all of its peer
01:48:00
nations and premature death rate that is
01:48:03
nearly twice the average of comparable
01:48:05
countries, its health span stats sit as
01:48:08
the worst in the world. So if you're in
01:48:10
the United States, as things stand, you
01:48:12
will be sicker for longer um or have
01:48:14
less We're trying to keep catch up
01:48:16
though, aren't we?
01:48:18
>> We're doing, you know, we're doing our
01:48:19
best.
01:48:19
>> We're doing our best, you know. We're
01:48:21
doing our best to catch up. Um,
01:48:23
>> I have this piece of string here.
01:48:25
>> Yes.
01:48:25
>> Which is, I guess, a mechanism you use
01:48:27
to figure out if people's
01:48:30
>> waste and I guess fat levels are too
01:48:32
high on the on the belly.
01:48:33
>> I think it's bigger than that. So, I'm
01:48:36
interested in lowcost ways for people to
01:48:39
find out well, how are you how are you
01:48:41
doing? How are you doing? And so one
01:48:44
recognized way looking at metabolic
01:48:46
health is your waist should be less than
01:48:50
half your height. So if we have a piece
01:48:52
of string, which we have there, I
01:48:54
believe you're 6'1.
01:48:55
>> Yes.
01:48:56
>> And you've you've marked halfway. So
01:48:58
half of that string
01:49:00
should go around the fattest bit of your
01:49:03
belly.
01:49:03
>> People come up to me all the time, you
01:49:04
know, and they go, "Oh my god, you're so
01:49:05
much taller than I thought."
01:49:06
>> Because they've only ever seen me sat
01:49:08
down. My entire career is people
01:49:09
watching.
01:49:10
>> That's right. Cut it in half and then
01:49:12
let's see.
01:49:13
>> Will it go around your belly? Yes or no?
01:49:15
>> Okay. So, I've cut the the string in
01:49:16
half.
01:49:16
>> Yes.
01:49:17
>> Which part of my belly? Cuz
01:49:18
>> the fattest part.
01:49:19
>> The fattest part. Okay.
01:49:20
>> Yeah. So, be honest about the fat part.
01:49:22
>> Okay.
01:49:23
>> Can I look?
01:49:24
>> Yeah.
01:49:25
>> You did it. Yeah.
01:49:26
>> Is that squeezing in?
01:49:27
>> It's not. No, I'm not.
01:49:28
>> Are you sque Are you cheating? Let me
01:49:30
see.
01:49:33
>> I mean, it's it's not it's Yeah, you've
01:49:37
just done it. You've passed. Thank you.
01:49:40
It's so interesting. So funny
01:49:42
>> but that is a very interesting thing for
01:49:45
you.
01:49:46
>> And as I say, insulin resistance tends
01:49:48
to put weight on your belly,
01:49:51
>> but you may have a very muscular
01:49:52
abdomen. Let's pretend it's that, you
01:49:54
know, but you're just about there.
01:49:55
You're just about there. But it's a
01:49:57
really simple test for everybody at
01:49:59
home. Piece of string, as long as you
01:50:02
are tall, cut it in half. Will it or
01:50:04
will it not go around your middle?
01:50:05
>> Okay. So, everybody at home, go buy some
01:50:06
string. Yeah, it's I mean there's lots
01:50:09
of other things you can do but that
01:50:11
that's as a simple way because your
01:50:14
weight alone as I said it's where the
01:50:17
fat is distributed it it's fat on your
01:50:20
belly is more worrying than fat on your
01:50:22
legs or on your arms really. So,
01:50:25
>> so one of the things people always ask
01:50:26
me about is supplementation. Um,
01:50:29
>> supplements, good, bad, indifferent.
01:50:30
What's your what's your point of view?
01:50:33
>> Right. So, my point of view is if you
01:50:35
can,
01:50:38
my my gut reaction is to try and use
01:50:41
diet
01:50:43
to give you what you need if you can.
01:50:45
>> Which diet? a lower a real food lowish
01:50:50
carbohydrate diet is my preferred thing
01:50:53
with plenty of protein in there and
01:50:56
healthy fats.
01:50:59
I'm very interested in farming and
01:51:01
regenerative agriculture and all that
01:51:03
kind of thing. And what I know is that
01:51:07
the nutrient profile of crops grown
01:51:09
today is not nearly as good as it was
01:51:12
100 years ago. So, we have some problems
01:51:15
and it it's to do with the soil. If you
01:51:18
keep just adding nitrogen and harvesting
01:51:20
crops, those crops do not contain as
01:51:23
much zinc or magnesium particularly.
01:51:27
And so,
01:51:29
the tragedy is that although my aim
01:51:31
would be to have you healthy with a real
01:51:33
food diet, there are some things you
01:51:36
cannot get in the diet now that your
01:51:38
grandparents could. And one of them is
01:51:40
magnesium.
01:51:41
It's very very difficult to get enough
01:51:46
magnesium
01:51:48
in your diet without supplementation.
01:51:51
And as you get older, you absorb the
01:51:53
magnesium
01:51:55
less and less. Also, a lot of medication
01:51:57
interferes with magnesium absorption,
01:52:00
particularly drugs for um acidity. So,
01:52:04
magnesium supplementation for most
01:52:07
people.
01:52:07
>> Okay. In myself, it was magic at getting
01:52:10
rid of muscle cramps. I sleep a lot
01:52:14
better.
01:52:17
I think we also need to talk about
01:52:18
magnesium. Which magnesium? Because it
01:52:20
varies a hell of a lot. And uh this
01:52:23
bit's embarrassing. Depends on your
01:52:26
bowels.
01:52:27
>> Okay.
01:52:27
>> Right. Have you got fast or slow bowels?
01:52:29
You don't need to tell tell me. If if
01:52:33
you if you tend to be a bit constipated,
01:52:35
magnesium citrate is very good. It
01:52:39
helps. It's more laxative
01:52:42
and it you're you absorb some of it.
01:52:45
Anyway, if your bowels are not a problem
01:52:49
and particularly if you're wanting
01:52:50
better sleep or mood, magnesium
01:52:54
glycinate or thriionate is actually
01:52:56
crosses the bloodb brain barrier but
01:52:59
won't help with constipation. So that's
01:53:01
a very quick thing on magnesium.
01:53:04
Have you have we got time for me to tell
01:53:06
you about the first cow I ever bought?
01:53:09
>> Go ahead.
01:53:09
>> And it's relevant to magnesium.
01:53:11
>> Go ahead.
01:53:12
>> Right. So my wife and I, my wife Jen, we
01:53:16
have this idea that if you love
01:53:19
somebody,
01:53:20
then gifts are you trying to think what
01:53:24
would that person like? Don't buy
01:53:26
somebody a present you would like.
01:53:28
>> Yeah. And it was Jen trying to get me to
01:53:30
grow up.
01:53:30
>> Yeah.
01:53:31
>> Right.
01:53:33
And this is how she did it.
01:53:36
So she said to me one day, "Right, get a
01:53:39
coat and a pair of Wellingtons. I'm
01:53:41
going to take you out." And she drove me
01:53:44
into Lancaster and there was a field of
01:53:47
cows. And she said, "I have bought you
01:53:49
any one of those cows." Because I'd
01:53:51
always wanted a cow. And we had a field.
01:53:55
and she'd how what a woman is this. She
01:53:59
knew I wanted she went to the farmer in
01:54:01
advance and prepaid for any cow and said
01:54:04
this field I've I I bought a cow. You
01:54:07
just pick which one you like and he'll
01:54:09
transport it home. How does this relate
01:54:11
to magnesium? You're wondering. Well, it
01:54:14
does because the farmer said you can
01:54:17
have whichever cow you like, but I've
01:54:19
lost 15 cows uh to a thing called the
01:54:22
staggers this year. And you cannot have
01:54:24
the cow unless you promise me you'll buy
01:54:27
magnesium supplements because the grass
01:54:30
is now so short of magnesium that uh
01:54:34
cows die fitting if you don't give them
01:54:37
a magnesium supplementation. But it's
01:54:40
better than that. At the same time, I
01:54:43
had a patient that I couldn't work out
01:54:45
why he was fitting. I was really fond of
01:54:48
this guy and I kept being called out and
01:54:50
admitting him to intensive care. fitting
01:54:53
and we couldn't work out. It wasn't a
01:54:55
brain tumor. Why was he fitting? And I
01:54:58
expect you've joined the dots. It was
01:54:59
magnesium deficiency because of
01:55:01
medication he was on.
01:55:03
>> And that's the first time I ever
01:55:05
seriously thought about magnesium. It's
01:55:07
a most interesting subject, very
01:55:10
important. And the modern diet is most
01:55:13
people are magnesium deficient. And a
01:55:16
problem is you can't measure it. So your
01:55:19
blood magnesium, the serum magnesium,
01:55:23
um doesn't reflect what's going on
01:55:25
because magnesium is mainly inside your
01:55:28
cells. So in the you have to get the
01:55:32
intracellular magnesium level. But do
01:55:34
you know what? It's just easier to try a
01:55:36
magnesium supplement and see how you
01:55:38
feel. So do you take magnesium?
01:55:40
>> I do because the guests, the experts on
01:55:42
my podcast have told me that magnesium
01:55:43
is one of my five. For me, I've said to
01:55:46
myself, I'll take five supplements a
01:55:47
day. Um,
01:55:48
>> five.
01:55:49
>> Yeah, I'll take five. So, vitamin D
01:55:51
because I'm inside all the time.
01:55:52
>> Vitamin D. So, yes, definitely.
01:55:55
>> And I'm black, so that you know,
01:55:57
>> well, that combined, but everybody and
01:56:00
particularly in the most people just
01:56:02
don't get enough sunshine. It'd be
01:56:04
better if you could do it with sun. But
01:56:06
yeah, vitamin D is very, very important.
01:56:08
>> I take magnesium.
01:56:09
>> Yeah,
01:56:10
>> because people like you've told me how
01:56:11
important it is.
01:56:12
>> Which magnesium do you take?
01:56:13
>> That's a great question. I think it's
01:56:14
citrate. Citrate, right? But I actually
01:56:16
think it varies depending on what my
01:56:18
team get me.
01:56:18
>> Yes. Yeah.
01:56:19
>> Um but that's good to know because I'll
01:56:21
think about my bowels. I take creatine.
01:56:24
>> Yeah.
01:56:24
>> Um there's this fiber supplement that I
01:56:27
take because I did a couple of blood
01:56:30
tests and um they said that fiber would
01:56:32
help this particular fiber supplement
01:56:34
would help reduce my LDL.
01:56:35
>> Yeah.
01:56:36
>> Cholesterol.
01:56:37
>> Yeah.
01:56:38
>> And
01:56:40
multivitamin
01:56:42
>> to cover everything.
01:56:42
>> To cover everything. That's probably I
01:56:44
mean that sounds okay really. Yeah. I
01:56:48
mean one of the worries that or one of
01:56:50
the clinical things I find is honestly
01:56:52
if you ask people how many supplements
01:56:54
they're taking there's a carrier bag
01:56:56
comes in and there's a blue one and a
01:56:57
yellow one and it is possible to overs
01:57:00
supplement quite easily
01:57:03
>> particularly maybe vitamin D. You can
01:57:05
know various uh vitamins. You handed
01:57:07
this as well. Oh that's vitamin D. Fine
01:57:10
fine.
01:57:11
So, I think that that's I would agree
01:57:13
with you. Basically,
01:57:15
>> mine's mine's also going um off my blood
01:57:18
test results. So, I've done two blood
01:57:19
test results. Actually, I've done two
01:57:20
blood test results in the last month.
01:57:23
>> One with Function Health, who are a
01:57:24
partner of ours, a sponsor of ours, and
01:57:26
another one with um with Nico Health,
01:57:30
which is actually a company that I've
01:57:31
just invested a couple of million quid
01:57:33
into, which is this health testing
01:57:35
company. Have you heard about Nico
01:57:37
Health?
01:57:38
>> Nico Health. You walk in, $299,
01:57:40
whatever. You lay down, you get all of
01:57:43
your your sort of blood test done. You
01:57:44
get all of these incredible tests done
01:57:46
on your body. Um, they show like how,
01:57:48
you know, how how good your circulation
01:57:50
is from your like neck to your toes. You
01:57:53
stand in front of this scanner. It takes
01:57:54
like 2,000 3,000 photos of your body,
01:57:57
tracks all of your moles, tracks your
01:57:58
heartbeat, does all of these incredible
01:57:59
things. And then instead of waiting two
01:58:02
weeks for the results, you walk into a
01:58:04
room and your entire body is on this
01:58:06
screen.
01:58:07
>> Yes. and you can look at, you know, all
01:58:08
these different parts of your body. They
01:58:10
do the blood tests at the very start and
01:58:12
then literally like it felt like 20
01:58:14
minutes later, I'm in a room. I've got
01:58:16
my blood test results back. I can see my
01:58:18
entire body. They're going through my
01:58:20
LDL, my this, my that, the other.
01:58:22
They're showing my heartbeat. They're
01:58:23
showing every single mole on my body.
01:58:25
And it cost £299. And you get the
01:58:27
results then. And I my alternative, and
01:58:30
this is me really plugging, the
01:58:31
alternative that I used to do every year
01:58:33
was this. Honestly, I'll be honest. It
01:58:35
was this £7,000 health screening where
01:58:38
I'd take it would take me six, seven
01:58:41
hours and I'd get the results back in 2
01:58:43
weeks. So, what Nico have tried to do,
01:58:44
it's actually a company started by the
01:58:46
founder of Spotify, Daniel. And yes, I
01:58:50
did my blood test the other day and both
01:58:51
my function health test and my my Nikico
01:58:54
health test said the same thing. And
01:58:56
then I took those results and I I
01:58:57
processed them using some AI tools and
01:58:59
said like, what am I deficient in? And
01:59:00
one of the things I was deficient in was
01:59:01
omega-3. That was the other one. uh
01:59:04
>> omega-3, vitamin D. I had high LDL
01:59:08
>> and so they said this fiber thing would
01:59:10
be really good for you.
01:59:11
>> And yeah, those were the main things.
01:59:14
Otherwise, I was great. But yeah, high
01:59:16
LDL.
01:59:16
>> I think one of just that makes me think
01:59:19
of something when you're screening. I
01:59:21
think the important point is that you
01:59:23
don't just scare people
01:59:25
>> that it has to be linked to what can you
01:59:27
do about it. So I've had a lot of
01:59:29
experience
01:59:30
>> of scared patients. Mhm.
01:59:32
>> So GPS, we we're we worry about
01:59:34
screening because what happens is people
01:59:37
do that and then people get scared and
01:59:40
use up loads of appointments in the
01:59:42
health service trying to sort out. So
01:59:44
what what's good is if you do screening
01:59:47
that relates to actionable points and
01:59:50
then you help the people understand what
01:59:52
they can do.
01:59:53
>> Yeah.
01:59:53
>> And avoid leaving them as just worried.
01:59:56
>> Exactly. Because that is for you,
01:59:59
>> you know, if if I can I might be able to
02:00:01
tell you accurately you're going to die
02:00:02
aged whatever of whatever, but if you
02:00:04
can't do anything about it, you don't
02:00:06
want to know.
02:00:06
>> Yeah.
02:00:07
>> What you do want to know is what can I
02:00:09
>> what can I take action on? What can I
02:00:11
you know, it's about optimizing, isn't
02:00:13
it? The things that I hate about the
02:00:15
health checking process before Nico was
02:00:16
like I hated how expensive it was and
02:00:18
that's quite it's quite a privileged
02:00:19
thing to be able to get health a full
02:00:21
body health scan especially like so but
02:00:23
now you can do it for $2.99 but then it
02:00:24
was I walked into a room straight away
02:00:26
with a doctor
02:00:27
>> and the doctor sat me down
02:00:29
>> beautiful screen of my body and was like
02:00:31
do this this this is fine this is fine
02:00:33
and she was so nice about it but yeah I
02:00:36
say that cuz I'm so passionate about it
02:00:37
cuz I realize there's a certain
02:00:38
privilege that people that are able to
02:00:40
access private healthcare have that I
02:00:42
think is really really unfair.
02:00:44
>> Well, obviously I
02:00:46
>> I think that's unfair because I only
02:00:48
work in the health service.
02:00:49
>> Yeah.
02:00:50
>> The state self. I don't do anything
02:00:52
other. I won't take private patients or
02:00:55
because
02:00:57
>> I think it it would be wrong.
02:01:00
>> And because don't you think health
02:01:02
inequality is getting really bad?
02:01:04
>> Yes, exactly.
02:01:05
>> Really really bad.
02:01:06
>> And it kind of troubles me. And also if
02:01:09
you you start in the UK and you go
02:01:12
northwards, it just gets worse and worse
02:01:14
and and the states is the same where
02:01:16
it's not like the same nation.
02:01:18
>> Oh my gosh, it's you go to California,
02:01:20
there's one kind of a thing and then you
02:01:21
go elsewhere and it's not the same.
02:01:24
>> But hopefully this is changing. Um this
02:01:26
is I I I
02:01:28
>> Well, I think social media helps because
02:01:31
it doesn't cost much, does it, to go on
02:01:33
social media and find out things.
02:01:35
>> Exactly. and people like you who have um
02:01:39
increasing increasingly loud voice
02:01:40
across lots of podcasts and who are
02:01:42
reaching millions and millions and
02:01:43
millions and millions and millions of
02:01:44
people um and teaching them.
02:01:47
>> What's difficult though is not to become
02:01:49
confused,
02:01:51
you know, because you have the
02:01:52
newspapers saying eggs are good, eggs
02:01:54
are bad,
02:01:56
and then you have this expert who's
02:01:57
saying this and another expert saying
02:01:59
the other. I think what I've tried to do
02:02:03
is base what I say on real world data
02:02:07
and that's different. So I'm I'm very
02:02:11
careful to take baseline data from my
02:02:14
patients and then update it all the
02:02:17
time. So what I'm the publications I've
02:02:19
done are based
02:02:21
on the real world the health service in
02:02:24
the north of the UK. I can't cherrypick
02:02:27
my patients. I'm allocated my patients
02:02:30
by the state. So I I can't just pick
02:02:33
wealthy people or people that will live
02:02:35
longer. I'm allocated people and that's
02:02:38
that. So
02:02:41
part of what I do is proof of concept
02:02:44
because if you can achieve this in the
02:02:46
north of England near Liverpool and if
02:02:49
other people can replicate it in
02:02:51
Australia, New Zealand, North America,
02:02:54
maybe it's true
02:02:56
perhaps.
02:02:57
>> Dr. David Unwin, we have a closing
02:03:01
tradition on this podcast where the last
02:03:02
guest leaves a question for the next,
02:03:03
not knowing who they're leaving it for.
02:03:04
And the question left for you,
02:03:05
>> yeah,
02:03:06
>> is I'm sure the guests will figure out
02:03:08
who left this one. Um, if humanity
02:03:10
organized to make contact with a more
02:03:12
intelligent species,
02:03:14
>> yes.
02:03:14
>> Who should represent humanity and why?
02:03:19
>> Funny. God, that's a brilliant question.
02:03:21
Who should
02:03:28
The first person, this is a person I'm
02:03:31
going to nominate.
02:03:33
What about David Atenburgh? you know,
02:03:35
he's 100 years old and he spent so long
02:03:40
um thinking about the planet and
02:03:42
wouldn't he be a wonderful ambassador
02:03:44
and because I am passionate about
02:03:47
biodiversity, I'm passionate about
02:03:51
sustainable
02:03:53
agriculture and sustainable food. I pick
02:03:56
David Atenburgh.
02:03:57
>> I think that's a wonderful choice.
02:03:59
>> I think the aliens would really like
02:04:00
him.
02:04:00
>> They would. They would. That's my
02:04:03
answer.
02:04:05
Thank you so much for what you do. Um,
02:04:07
you're really remarkable in a way that's
02:04:09
quite rare. And listen, I would know
02:04:10
because I
02:04:10
>> Give me feedback. I love feedback.
02:04:12
>> No, you really are remarkable. You're
02:04:13
really remarkable in a way that's very
02:04:15
rare. And I don't say this to all of my
02:04:17
guests, but you are for for a variety of
02:04:19
reasons. Okay, I'm going to give you all
02:04:20
of the feedback.
02:04:21
>> Thank you.
02:04:22
>> The first the first the most notable is
02:04:23
you're a very kind human and the way
02:04:26
that you speak is very nice to listen
02:04:28
to. Again, rare. The other thing that I
02:04:31
noticed is you're very very very natural
02:04:33
and good at telling stories. And listen,
02:04:36
why does this matter? Because the human
02:04:37
brain, from what I've discovered from
02:04:39
doing this podcast, is really orientated
02:04:41
towards stories. Now, you could sit here
02:04:43
and say banana bad or you could say
02:04:45
magnesium good, but I'll never forget
02:04:47
the cow story.
02:04:48
>> Yeah.
02:04:49
>> You know, I'll never forget the cow
02:04:50
story. I could have I could have
02:04:51
forgotten that magnesium good, magnesium
02:04:53
bad, but the way that you tell these
02:04:54
stories is so captivating that it
02:04:57
enables me to learn in a way that is
02:04:59
engaging and that is rare, very very
02:05:01
rare. And the other is just um your your
02:05:04
depth of experience, your humility, your
02:05:06
willingness to admit when you were
02:05:07
wrong, which means that I trust you so
02:05:09
much with what you're telling me because
02:05:10
you're you're saying, "Listen, I'm I'm
02:05:11
an imperfect human, too. I've made
02:05:13
mistakes both in myself, with my
02:05:15
patients, and this is what I've learned
02:05:17
from it." And um the other thing is just
02:05:19
your ability to simplify. It's
02:05:21
remarkable. Listen, I sit here all day
02:05:22
with super geniuses from this university
02:05:24
and Harvard and Stanford and whatever
02:05:26
else and I'm struggling to understand
02:05:28
what the hell they're talking about
02:05:29
because they don't take a second to
02:05:30
build the bridge between the science and
02:05:34
the average person and you do that so
02:05:36
naturally. So I I have no I have no
02:05:38
surprise
02:05:38
>> coming from you that means a great deal.
02:05:40
No, it really does. Thank you. It's just
02:05:43
what 40 years in general practice does
02:05:45
to you. Because if you wish to be
02:05:46
effective and if you notice as in the
02:05:49
grin model,
02:05:51
>> I'm I'm watching your face.
02:05:53
>> I'm watching an audience
02:05:56
>> and I'm reading how I'm doing or you're
02:05:58
getting bored or I need to move on or
02:06:00
whatever. And that's what I do with
02:06:01
patients. I watch very carefully.
02:06:04
>> But coming from you because you really
02:06:06
do know because you've had all sorts. So
02:06:08
that means such a lot.
02:06:09
>> It's a really rare skill. actually
02:06:11
because it's so rare, I would just
02:06:12
implore you to do more. And I know
02:06:15
you're already doing so much, but it's
02:06:17
like it's so rare that you can have such
02:06:20
a massive impact.
02:06:21
>> Yeah.
02:06:22
>> You know, so I really I really wish
02:06:23
>> But we need to talk about how the how we
02:06:26
so I'm trying to get bigger on Twitter,
02:06:28
so this will help me um immensely.
02:06:32
>> Um
02:06:33
>> well, how can the audience help how can
02:06:34
the audience help you with your mission?
02:06:38
Well, lowcarbgp on Twitter. Please
02:06:41
follow me on X, lowarb GP. Yeah.
02:06:45
>> The other thing that would help very
02:06:46
much is to support the British charity
02:06:49
that I set up, the public health
02:06:51
collaboration. Um, it's our 10y year
02:06:54
anniversary. We set up, these were
02:06:56
clinicians who got together, 16
02:06:59
clinicians said, "How we doing rubbish?
02:07:02
Can we do better? Can we give clearer
02:07:04
public health advice?" So, it's called
02:07:06
the public health collaboration. So,
02:07:08
please, please support our charity. Go
02:07:12
online, find out about it. Come to our
02:07:14
conferences. I'd also say notice
02:07:19
each of us is on a journey. Be clear
02:07:24
about your goals.
02:07:26
Notice what works for you because that's
02:07:28
what you're doing.
02:07:30
>> And each of us see yourself as an
02:07:32
experiment. Don't be frightened of
02:07:34
experimenting. But if you're going to
02:07:36
experiment, notice, measure something,
02:07:40
measure something, and then you'll see
02:07:42
how you're doing. Um, and I I one thing
02:07:46
I think that gives me hope is continuous
02:07:48
glucose monitors because
02:07:51
you're getting, you know,
02:07:52
individualizing right there. How is my
02:07:55
blood sugar? I can check mine in a
02:07:57
minute and see how I'm doing. I think
02:07:59
continuous glucose monitors
02:08:01
>> which by the way are only 20 $30 on on
02:08:05
Amazon or
02:08:06
>> Yeah. I I would think you know what if
02:08:09
you loved your dad or you had somebody
02:08:11
and it's Christmas and you could buy a
02:08:13
useless
02:08:15
ornament or something and they don't
02:08:16
need it anyway. But would they be
02:08:19
interested to find out about their blood
02:08:21
sugar?
02:08:22
>> Yeah. You could maybe consider, you'd
02:08:24
ask them first, but if they've if
02:08:26
they've got a mobile phone, they could
02:08:29
try a continuous glucose monitor and
02:08:31
find out. Have you Have you tried one?
02:08:33
>> I have. I have.
02:08:34
>> And what did you learn?
02:08:35
>> I mean, so much.
02:08:37
>> Ah, well, did you learn? I learned that
02:08:39
all these things I thought were were had
02:08:41
no sugar in them have loads of sugar in
02:08:42
them.
02:08:42
>> Exactly.
02:08:42
>> I had no idea about ketchup. I thought
02:08:44
it was
02:08:45
>> And the point is once you've seen it on
02:08:47
your phone,
02:08:48
>> you can't then see it.
02:08:49
>> No. And I see them as the the cavalry
02:08:53
coming over the hill because we can't be
02:08:57
fooled much longer. Do more. I'm just
02:09:00
going to look at see what my blood sugar
02:09:01
is right now.
02:09:02
>> So, can I just show you?
02:09:04
>> Oh, wow.
02:09:04
>> So, what that is, that's somebody with
02:09:06
type 2 diabetes. But look, my blood
02:09:09
sugar is absolutely level.
02:09:12
>> Wow.
02:09:12
>> And that's good. uh because
02:09:17
you want it. But look how how level it
02:09:19
is. And that is because I don't eat
02:09:21
stuff that puts up my blood sugar. If I
02:09:23
was to have some of those, you'd get a
02:09:25
um you get a spike. But that's feedback.
02:09:28
Also means if I get very stressed, it
02:09:31
puts up my blood sugar. Really? And
02:09:32
you've been so kind. I haven't been
02:09:34
stressed.
02:09:35
>> Great. Thank God for that.
02:09:36
>> So other podcasters
02:09:38
>> are not as gentle and kind as you and I
02:09:40
get a horrible spike. So, I was going to
02:09:42
open. Here's some feedback for you,
02:09:44
Stephen. So, you and I have been
02:09:47
together for a few hours, and my blood
02:09:49
sugar I felt safe. So, you've done your
02:09:52
job, too. And there's some feedback for
02:09:54
you. No spiking.
02:09:56
>> I'll tell you a final story. A final
02:09:59
story.
02:10:01
>> Um, so type 2 diabetes is is brand new
02:10:05
as a problem for pediatricians.
02:10:07
>> What is a pediatrician? So a
02:10:09
pediatrician is a doctor who specializes
02:10:11
in the diseases of children, people
02:10:14
under 16 years old. And the the the
02:10:18
international problem is that children
02:10:20
everywhere are now suffering from type 2
02:10:23
diabetes.
02:10:25
Okay. But the pediatricians have had no
02:10:30
training because it's a new disease.
02:10:33
So um a large group of pediatricians
02:10:37
sent for me and said please do a keynote
02:10:41
and teach us what to do because they
02:10:44
although they're specialists they
02:10:45
haven't experience in type 2 diabetes.
02:10:48
This is a new disease of children
02:10:51
what we're doing what we're doing. Leave
02:10:55
it at that. We didn't show the fuagra
02:10:58
but
02:10:59
I'll eat some of that later.
02:11:02
>> Dr. David Unwin, thank you. We're done.
02:11:05
>> Fabulous. I enjoyed that.
02:11:07
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