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