Breaking The Sugar Cycle, How to Use Food as Medicine, The Science of Metabolic Health & The Truth About Detoxification with Dr Mark Hyman #545

Is your ‘healthy’ breakfast actually dessert in disguise? Why is it that so many of us are struggling these days with our metabolic health? What is the relationship between our food and mood? And, what is the real deal with detox? My guest today is someone, who for many years, has been leading a global health revolution, one revolved around using food as medicine, to support longevity, energy, mood and happiness. Dr Mark Hyman has been a practising medical doctor for several decades and an internationally recognised leader, speaker and educator in the field of Functional Medicine. He is co-founder and the chief medical officer of Function Health, founder of the Cleveland Clinic Center for Functional Medicine and the author of an incredible fifteen New York Times best-selling books. This is Mark’s 4th appearance on my podcast and in today’s conversation we cover a variety of fascinating topics, including: The science of metabolic health How to break your reliance on sugar The connection between food and mood The multiple benefits of starting your day with protein The 10-Day food plan that can transform your energy, mood and digestion The problem that many people face with modern wheat and dairy The truth about food addiction The simple but effective method that can enhance the way you eliminate environmental toxins. Throughout our conversation, Mark's passion for empowering people to take charge of their health shines through. His accessible, evidence-based approach offers practical steps anyone can take. As he reminds us, small daily improvements in diet, movement and stress management compound over time – and it's never too late to start. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Thanks to our sponsors: https://drinkag1.com/livemore https://calm.com/livemore https://thriva.co Show notes https://drchatterjee.com/545 DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  It's so important for people to pay attention to their own bodies. Listen to how you feel. How's your stomach? How's your energy? How's your skin? How's your brain function? How's your sleep? How's everything else that matters to you? At the end of the day, you should be the CEO of your own health.

• 0:13Rangan Chatterjee?

  Hey guys, how are you doing? I hope you're having a good week so far. My name is Dr Rangan Chatterjee and this is my podcast, Feel Better Live More.

• 0:26Rangan Chatterjee?

  My guest today is someone who for many years has been leading a global health revolution. One revolved around using food as medicine to support longevity, energy, moods and happiness. Dr Mark Hyman has been a practicing medical doctor for several decades now and is an internationally recognized leader, speaker and educator in the field of functional medicine. He is co-founder and chief medical officer for Function Health, founder of the Cleveland Clinic Center for Functional Medicine and the author of an incredible 15 New York Times bestselling books.

• 1:08Rangan Chatterjee?

  This is Mark's fourth appearance on my podcast and in today's conversation, we cover a variety of truly fascinating topics, including: The Science of Metabolic Health; How to Break Your Reliance on Sugar; The Connection Between Food and Moods; The Multiple Benefits of Starting Your Day with Protein; The 10-Day Food Plan That Can Transform Your Energy, Mood and Digestion; The Problem That Many People Face With Modern Wheat and Dairy; The Truth About Food Addiction; And the Simple But Effective Methods That Can Enhance The Way That You Eliminate Environmental Toxins.

• 1:50Rangan Chatterjee?

  Mark is passionate, knowledgeable and a quite brilliant communicator. And throughout our conversation, he provides simple evidence-based tips that you can use to improve your life immediately. And he reminds us all that small daily changes compound over time and it's never too late to start.

• 2:20Rangan Chatterjee?

  I wanted to start off, Mark, by talking about breakfast. We live in a world where it's pretty normal to only consider things like cereal, muffins and bagels as our traditional breakfast foods.

• 2:36Speaker 00

  That's right.

• 2:36Rangan Chatterjee?

  How would you have us rethink about breakfast so that we can optimize our metabolic health, our gut health and our longevity?

• 2:46Speaker 00

  Great question, great question. I'm gonna put intermittent fasting or time restricted eating aside because it doesn't really matter if you do a 12 hour fast, 14, 16 hour, whatever your first meal is matters. And you're 100% right. Essentially, the world is eating dessert for breakfast. Most cereals are 75% sugar. It shouldn't be called breakfast, it should be called dessert. And whether it's that or it's a frappuccino from Starbucks or a bagel or a muffin or pancakes or french toast or waffles or just, you know, even worse, things like Pop-Tarts and things that kids eat for breakfast, Pop and that I used to eat Pop-Tarts for breakfast when I was a kid.

• 3:31Speaker 00

  It's absolutely the worst thing we can do because when you start your day with sugar for breakfast instead of protein and fat for breakfast, a whole cascade gets tipped off that is going to ultimately cause you to end up gaining weight and feeling like crap, potentially lead to diabetes and for sure probably pre-diabetes. And the reason is when, when our first meal is sugar or something that turns into sugar, because anything that's flour is equivalent. Below the neck, your body can't tell the difference between a bowl of sugar and a bowl of cornflakes or a bowl of sugar and a couple of pieces of toast. It's exactly the same when it hits your body. In fact, the bread is probably worse because it's got a higher glycemic index and it raises

• 4:16Speaker 00

  your insulin more. Although, sugar is fructose and glucose, so it's, it's a little bit of a different molecule, but it's still bad. So what happens is you take into this cascade where you drive up insulin, that's the fat storage hormone, you store belly fat, you partition the fat, which means it gets locked in there like a one-way turnstile on the underground where basically you can get in but you can't get out. So the fat gets locked in there. It slows your metabolism and it makes you hungry. So if you have oatmeal for breakfast, which we think is a healthy breakfast, it's kind of the least unhealthy of the unhealthy breakfast. It's not as bad as sugary cereals or a muffin. But it still raises your insulin, raises your adrenaline, raises your cortisol,

• 5:00Speaker 00

  raises your blood sugar, raises your triglycerides, and it then causes this spike in insulin and then a crash in your blood sugar. And that leads to this kind of up and down craving cycle that we all experience. And we end up eating more. So if you have, for example, looking at a study from Dr. Ludwig, it was a brilliant study. He gave people an omelet, steel cut oats, or instant oatmeal. Three breakfasts, same calories, so identical calories. They were overweight young kids. And they then put them in a room and they said, okay, eat these breakfasts. And then whenever you're hungry, hit the button, tell us, we'll bring you more food. The kids who had the oatmeal ate 86% more food in that day than the kids who ate

• 5:45Speaker 00

  the omelet. And the kids who ate the steel cut oats ate 56% more food than the kids who ate the omelet. So whether it's steel cut oats, I mean, you can modify steel cut oats and put nuts in there. You can put butter in there, you can put black seeds in there, you can put fiber in there, you can change the composition. But at the end of the day, the glycemic load of your meal matters the most. And you want to start the day with protein and ideally fat. So it could be a protein shake with some MCTL in it. It could be an omelet with avocados and tomatoes, olive oil. It could be a nut shake that I had talked about in my 10 day detox diet, which essentially you put seeds and nuts and good fats in there with protein and fiber and some frozen berries. It can be delicious. It doesn't have to be bad.

• 6:29Speaker 00

  But what it's going to prevent you from doing is ending up on this roller coaster of blood sugar swings, of cravings, of overeating, of eating too much sugar and starch, craving carbs, of gaining weight, of getting belly fat, of getting in this cascade of metabolic dysfunction, which is terrible in America. It's 93% of us are somewhere in that continuum. I don't know what it's in the UK, but you guys are probably not far behind us. And so it's pretty bad. And so the best thing you can do for yourself for breakfast is to start the day with protein and fat.

• 6:56Rangan Chatterjee?

  It's interesting that both you and I are very passionate about root cause medicine. We're always thinking, well, how do we get to the root cause of this problem? Instead of just suppressing symptoms, often with medications. But if we think about breakfast, it's looking at root cause through a slightly different lens. It's almost like a root cause behavior that if we don't get it right, has multiple downstream implications for the rest of our day. Do you know what I mean? It's like quite similar.

• 7:27Speaker 00

  Absolutely. And absolutely, it's a slippery slope. When you start your breakfast with sugar in any form that we talked about, it's going to create a day where you're going to end up in a metabolic cascade that is undermining your health. It's making you hungrier, it's making you crave more carbs and sugar. It's making you eat more food in general. And ultimately, day after day after day, what's going to happen? You're going to gain a lot of weight and you're going to gain belly fat and you're going to get into this metabolic crisis, which we see so much in the world now today, which is the spectrum of prediabetes and type 2 diabetes.

• 7:57Rangan Chatterjee?

  When you were talking about all the consequences of starting the day with sugar, two of the things you mentioned were adrenaline and cortisol. That's really interesting, isn't it? Because people, yeah, they might go, yeah, belly fat and triglycerides, which is a harmful form of cholesterol. But adrenaline and cortisol are stress hormones. So what's the relationship between our breakfast and our stress levels?

• 8:21Speaker 00

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

• 9:06Speaker 00

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

• 9:44Rangan Chatterjee?

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

• 10:23Speaker 00

  A hundred percent. Because remember what I said about this study? They were identical calories. So even though there was the same amount of energy in the food, the information in the food was different. And how that information was translated into biological signals was different depending on the quality and the type of food that we're eating. So the information is changing your hormones, it's changing your brain chemistry, it's changing your microbiome, it's changing your immune system, and many, many other things, your mitochondrial function, your stress hormones, your insulin hormones, your sex hormones, all of that's affected by what you're eating. And people don't understand that. They think, oh, it's just calories in, calories out, you want to lose weight,

• 11:06Speaker 00

  eat less, exercise more. Unfortunately, that blames the victim. And it's not such a simplistic view. Yes, energy matters, and energy calories matter, but you have to understand it's the quality of the calories that matter. So when you focus on what you eat, you don't have to worry so much about how much you eat. And there are many, many trials by David Ludwig and others, looking at basically Unlimited calories, but changing the composition of the diet so that the information is different. So you can do a calorie restricted diet, for example, low fat versus a low starch sugar diet that's unrestricted calories. And the group that has the unrestricted calories will eat less and be less hungry and weigh less at the end of the study and have better metabolic health.

• 11:51Rangan Chatterjee?

  Yeah. Mark, I want to make sure that everyone listening or watching really understands the gravity of what you're saying, okay? Now, there's a few things you mentioned. You mentioned bread sometimes is worse than sugary cereal. You mentioned oatmeal, which a lot of people consider to be a healthy breakfast. So let me just zoom out a minute and go, if 93% of Americans are metabolically unhealthy, and let's say it's probably not quite as high, but comparable in the UK and in many other countries around the world now, is it that these foods are particularly problematic on the backdrop of poor metabolic health?

• 12:32Rangan Chatterjee?

  I.e., if you went to a population somewhere where they were in exceptional metabolic health and they were exquisitely insulin sensitive, do you think they could eat those foods like bread and oatmeal without it having those negative consequences?

• 12:49Speaker 00

  Yes, but, yes, but, yes, maybe for a few days. But after a few days, what starts to happen is you start to adapt to this different diet. I mean, look, there were populations that were exquisitely metabolically sensitive, like the Pima Indians in southwest America, where there was zero diabetes, zero obesity, zero heart disease, zero metabolic dysfunction at the turn of the 1900s. And now 80% have diabetes by the time they're 30. They're the second most obese population in the world after the Samoans. Why? Because the government of the United States gave them government surplus food, which

• 13:30Speaker 00

  consisted of three main things: flour, white flour, white sugar, and white fat, otherwise known as Crisco, or shortening. And those three things really were the death of this population. So even though they were exquisitely insulin sensitive, over time, if you feed someone who's metabolically healthy, metabolically unhealthy food, they will become metabolically unhealthy. Even myself, I mean, if I'm unfit and I'm healthy and my, my insulin level's low and my A1C is really low and my blood sugar is good and my blood pressure is good and my triglycerides are low and my Hg is high, all that could change if I just started a diet of the average American person, which is 60% processed food and 152 pounds of sugar

• 14:14Speaker 00

  and 133 pounds of flour a year. So if I ate that much of that stuff, I guarantee you, I would not be looking like I do now.

• 14:21Rangan Chatterjee?

  It is the key thing there, Mark, whether the food is highly processed or not. And the reason I say that is because there are some populations, aren't there, around the world who are having quite high carb diets, but the carbs are sweet potatoes. They are, you know, whole food carbohydrates and they seem to still be in good health. So what I'm wondering is, in your view, is it, do we have like the perfect storm at the moment where it's all of this ultra-processed food and we've got a metabolically unhealthy population and we're not moving enough and we're overly stressed and we're under sleds. You put all these things together and would you even say that some of us are unable to tolerate even whole food carbs? Or is it just the ultra-processed carbs that are the main issue?

• 15:06Speaker 00

  It depends how busted your metabolism is. So if you're, if you're a generally healthy person, you want to chew on sugarcane, great. You want to eat wheat berries, no problem. But when you start consuming larger amounts of flour and refined sugars, because these are refined foods, they're not, they're highly processed. Now, they may not be ultra-processed in the sense of deconstructed and put in strange forms and had all kinds of food additives and what we call ultra-processed food. But even so, they're highly refined foods and they're quickly metabolized and absorbed. And we didn't even have refined flour until like the 120, 30, 40, 50 years ago, when they invented the, the flour mill and the

• 15:48Speaker 00

  electric flour mill and we got, you know, the industrial revolution, you know, because you end up grinding stuff pretty hard. I remember living in China for a while and I went to this remote village and there were these two guys with these two giant stones with sticks in them. That were grinding flour by walking around in circles like mules for like hours to grind their flour. I guarantee you that's never going to get to be like what we see in America where they completely remove the grain. From the bran and the germ, which are the fiber and the nutrient containing components. So I think, I think if you're looking at populations, for example, like we were visiting the Haza, they eat a lot of tubers and they eat starchy vegetables. But they eat also 150 grams of fiber.

• 16:30Speaker 00

  So if you took a Coca-Cola and you put in like two or three tablespoons of Metamucil. It's going to have a different impact on your biology because you're adding fiber to it. Now I'm not suggesting you do that. But it's really about the, the composition of the whole diet, not just one food. And we call this dietary patterns and we call this particularly around sugar, the glycemic load of the meal. So how much is the total load? So if you have oatmeal by itself, that's a problem, but if you add fat and you add protein and you add more fiber. It's going to change the load of that meal so that it doesn't spike your blood sugar as much. So the key here is what are the foods that are spiking blood sugar and insulin the most? And if you're susceptible, and there's probably 75% of the world's population is susceptible to this.

• 17:15Speaker 00

  Because we were hunter gatherers, because we're in adaptive diets, sugar, starch diets. We're going to end up in trouble. Now, certain populations are much worse. If you look at the Native American population, the US indigenous populations. If you look at Pacific Islanders, the East Indians like yourself.

• 17:32Rangan Chatterjee?

  Yeah.

• 17:33Speaker 00

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

• 18:06Rangan Chatterjee?

  Yeah. It's interesting. We're seeing more and more. Endurance athletes, competitive athletes, you know, winning triathlons for years and, you know, all kinds of things, coming out now with prediabetes or type 2 diabetes, which is really shaking things up for people because these guys are considered healthy. They're exercising loads, they're competing at a high level. I'm not saying everyone, but many of them are having these highly processed, high carb diets because they've been told that this is necessary to fuel them. But for some of them, it's coming at quite a serious consequence. Yes, maybe a gold medal, but at the same time, 20, 30 years of living with type 2 diabetes, right? And then you've got to go, well, is this

• 18:50Rangan Chatterjee?

  a good trade? Might there be another way of doing this? And I know Professor Tim Noakes is doing a lot of work on this and trying to show that maybe there are other ways to have elite performance, which don't necessarily require these high carb diets.

• 19:04Speaker 00

  Exactly, yeah. I think, you know, Peter Attia was giving a great TED Talk, TED Men Talk years ago, where he talked about, he was just an endurance athlete. He would swim from Los Angeles to Catalina Island, which is extremely far in the ocean, and do all these endurance sports, and he was using all these goos, which is pure sugar, and found out he had prediabetes. And how does an endurance athlete have prediabetes? Well, if you're constantly loading your body with insulin, spiking sugars, you're going to end up with kind of marbled muscle, you're going to end up with a little bit of extra belly fat, and that's all it takes. You know, there's very interesting theories around sort of sugar and starch, but, you know, the trick is when you start eating these foods, it starts this cascade where you get hungry fat. David Ludwig talks about

• 19:49Speaker 00

  this. So the belly fat, the fat around your middle, is actually hungry fat, and it makes you hungry. I guess it's stored in there because of the insulin, it doesn't get out easily, and so it slows your metabolism, and you end up in this... You know, horrible cascade where it's a vicious cycle. And the only way to break it is to stop eating those starches and sugars for a period of time. And it's really why I created my 10 day detox diet to get people to reset their metabolism. And it's basically getting rid of starch and sugar, having nuts and seeds, which have some starch. And you can have some berries, which have some sugar and lots of fiber and lots of vegetables and good quality fats and good quality protein. And what happens, people can get off all their meds in a few months if they stick to it

• 20:33Speaker 00

  because we see these dramatic shifts in their biology very quickly. And people don't realize how biologically addictive some of these foods are. According to the Yale Food Addiction Scale, which is a validated metric that's used by Yale University in the food addiction program there to understand how to evaluate if someone's a food addict, just like if you're an alcoholic. And what they found is, and this was a global study, but I think, you know, I don't know how many, it was like dozens of countries. And they found that 14% of the world's population is biologically addicted to food. Not just I have a few cravings for candy, but like biologically addicted. They go through withdrawal, they have cravings that interfere with their life. There's all these criteria. And 14% of kids are also food addicted.

• 21:18Speaker 00

  Now, 14% of adults are alcoholic, but 14% of kids are not. So we got 14% of kids and adults who are biologically addicted. And what happens is it changes your brain function. Again, it's a very elegant study done, I call it the milkshake study, where they looked at a group of overweight guys. And they did two different milkshakes and they did a wash up period in between where they weren't, you know, eating anything except their normal diet. The first milkshake was, and they were identical in calories, in protein, in fat, in carbs, in fiber. So they're identical and they tasted the same through some magic of food engineering.

• 22:00Speaker 00

  Except one had a very quickly spiking blood sugar type of carbohydrate and the other had a more slow metabolizing type of carbohydrate as the carbohydrate. The ones who had the high quickly released, high sugar or high insulin spiking carbs had all the same thing, they had high insulin, they had cortisol, adrenaline, all those things you mentioned. And when they looked at functional MRIs, their brain imaging, they found that their brains lit up in the same area as is activated by cocaine or heroin. So when you think about that for a minute, it's called the nucleus accumbens, this area of the brain is your addiction center. It's your pleasure center. And so when people were eating this basically sugary milkshake, it lit up the addiction

• 22:45Speaker 00

  center in the brain. Now, for some of us, we may be able to manage that, like just like someone's can have glasses of wine, we don't become alcoholics and other people do. There's some genetics involved in this. But it's important to understand that these foods are highly regulating many aspects of your biology, including your brain chemistry.

• 23:01Rangan Chatterjee?

  Did you say that it was 14, as in 1, 4% of children are showing signs of being addicted to foods?

• 23:09Speaker 00

  Yeah, and adults.

• 23:11Rangan Chatterjee?

  And adults. That's a staggering number, isn't it? I mean, Mark, it's very clear to me, as I'm sure it is to you, that most people, I would say, simply do not know how good they could feel. They're so used to feeling that way that they are feeling, they think that's normal. And still to this day, I've rarely found something as powerful as encouraging them to have, you know, 10 days or two weeks where they have completely a whole food diet. They take away everything else, they just do that. For so many people, it's life changes, go, oh, I didn't realize my mood could be better, my energy could be better, my sleep could be better, all these kind of things. And this is the message that you have been

• 23:57Rangan Chatterjee?

  I think for maybe three decades now, you've been trying to spread this message with the world, right? And it seems as though something is changing where people seem to be more receptive to this message, I believe, than ever before. So could you tell me a little bit about this 10 day detox program that you do? You obviously, you wrote a book about this a few years ago. Before you do that, you keep saying sugar and starch. For someone who doesn't know what you mean by that, because of course, fruit has sugar in it as well. Could you just clarify what you mean by sugar and starch?

• 24:29Speaker 00

  Sugar is sugar, sugar, just like a rose is but a rose by any other name. So it's can be white sugar, it can be high fructose corn syrup, it can be honey, it can be maple syrup, it can be all the hidden sugars and ultra processed food like maltodextrin or dextrose and so forth. There's a million names for sugar and you can literally, I think there's 50 different names for sugar that the food industry has come up with because at least in America, you have to put the major ingredient first and then all the following ingredients after in an order of quantity. And so if you come up with five different kinds of sugar, then you don't have to have sugar as the number one ingredient of food, which most food is the number one ingredient. So, so sugar is basically sugar. Flour is

• 25:12Speaker 00

  basically what I'm talking about, I'm talking about starch, refined flour and it can be rice flour, it can be whole wheat flour, it can be white flour, but flour for the most part, unless it's whole grain bread like they have in Germany where you need a meat slicer to cut it, is pretty much quickly absorbed starches, it's broken down, it's pulverized and it's, and it's not needing digestion in order to be absorbed and it just quickly spikes your blood sugar. That's, that's what I mean by such a sugar. Now, sweet potatoes are starch. You can have, for example, a big, starchy white potato, probably not a good idea, but a small, little, tiny red potatoes or purple potatoes, what they have like in South America.

• 25:53Speaker 00

  They never had diabetes down there. They weren't obese. They ate potatoes, but they were a different kind of potatoes. They're called fingerling potatoes. Yeah. So that's kind of what I mean by saturated sugar. Now, what in my, I'm a practicing physician. So what I, what I see is that people have come with a whole host of different ailments. There are inflammatory problems primarily, obesity, diabetes, autoimmune diseases, digestive disorders, mood disorders, depression. These are all inflammation diseases and they manifest in different ways in different people. But what I realized was that, that most people, if you remove the inflammatory foods and added the anti-inflammatory foods back in, then in a very short time, they would feel different. Now, most people walk around with

• 26:35Speaker 00

  what I call F L C syndrome. That's when you feel like crap. You know, basically, or there's a serious version called F L S. That's more advanced, but you know, the F L C syndrome is a very common problem. And it made me settle stuff like, oh, I'm just tired. I have brain fog. My tummy's not always right. I've heard about my joints are a little achy. I got headaches. I don't sleep so good. My, whatever it is, I'm a little depressed. I have no sex drive. It doesn't matter what the problem is. If you reset the body, I, I call it turning the body back to its original factory settings. It can happen very quickly. And it's just amazing to me. If I, if I hadn't have seen it literally tens of thousands of times with

• 27:15Speaker 00

  my own eyes, I would not believe it because it's so powerful and it's so simple. And so after doing this in my practice with patients for years and years and years, I'm like, I can't see that many patients in my lifetime. If I see 20,000 patients in my lifetime, that's a lot. But there's millions of people suffering. So I wrote this book, The 10 Day Detox, which lays out what to do for 10 days. And I figured people can do anything for 10 days. If I say the 10 year detox, people are not going to do it. If I said the 10 month detox, the 10 week detox, they wouldn't do it. But essentially 10 days, you take out sugar, starch, ultra processed food, alcohol, caffeine.

• 27:52Speaker 00

  And you eat real food, lots of vegetables, lots of nuts and seeds, lots of good quality protein, lots of good fats, avocados, olive oil, et cetera, and some maybe starchy vegetables, but not too much. And you can also have berries, which are a low starch fruit. And you're right, fruit does have sugar, but it's in a complex matrix, so it's not quickly absorbed. So when you have something that's in a complex matrix, it takes a while for your body to break it down. It comes with other things like fiber, it's got phytochemicals in there, inflammatory compounds, it doesn't spike your blood sugar as much. So whole fruit is fine. I mean, people are not going to eat 10 oranges, but they can drink a glass of orange juice, which contains oranges very quickly, right? So you want to be careful of that. So juice is not the same

• 28:33Speaker 00

  as eating the fruit. But that, again, that's just as bad. And it's kind of like soda with a few extra vitamins and minerals and fiber maybe in it. But the 10 Day Detox basically takes people through a very simple process, and we now have it online, go to 10daydetox.com, and we've had, you can see the testimonials, like, we're not making this stuff up. People just have incredible results. And it's, in functional medicine, we call it an elimination diet. I like to call it an addition diet, because we add in all the things that heal you, and we take out all the things that harm you. And it's really that simple. So you take out all the things like dairy, gluten, sugar, grains, beans, processed food, and you see what happens. Now, then you can add things back and see how you feel. So maybe after 10, you feel great, you want to keep going, you can. If you want to try to add

• 29:18Speaker 00

  things back, you can start to add things back slowly, three days at a time, and see what's triggering you. You go, oh, I added back wheat, and gee, my stomach ache come back, or my headaches came back, or I added dairy back, and I started getting pimples again, my skin was all clear, and then I started getting eczema or acne. So you can start to find out what your body's telling you. And I always say, the smartest doctor in the room is your own body. It's going to tell you what you need if you listen to it. Most of us have just tuned it out. Or we don't check the dots. And it's amazing, how many, how many people who I've seen who are super smart, like, top executives, leaders in the world, who have not made the connection between what they eat and how they feel?

• 29:59Rangan Chatterjee?

  And that's really the interesting point, the way that you set that 10-day detox diet up. This is where I think a lot of people get confused with foods. They only eliminate one thing at a time, right? So they might go, oh, I think dairy might be making my skin worse, for example. And so they go, well, what if I tried two or three days without dairy? Oh, it wasn't dairy. Put it back in. Do you know what I mean? A lot of people don't realise it. They want to do one at a time and then put it back in. But there's real value, isn't there, at cutting it all out? And then slowly reintroducing things one at a time.

• 30:41Rangan Chatterjee?

  Today's episode is sponsored by the daily health drink AG1. The clocks are about to change. The mornings are darker. Everyone around you seems to be coming down with something. And suddenly that wellbeing you felt in the summer seems a long time ago. I certainly know that feeling. And that's why at this time of year, I remind myself to lean into the fundamentals. And one of those fundamentals is AG1. AG1 is a daily health drink that has been in my own life for over eight years. And one of the many things I like about it is the fact that many of the nutrients it contains, for example, vitamin C, vitamin A, zinc and selenium, supports a healthy immune system. Some of the other things I really like about AG1 is that they are committed to continuous

• 31:24Rangan Chatterjee?

  improvement and updating their formula as a scientific research involves. And each batch is independently tested for quality and safety markers, including heavy metals, allergens and banned substances. This is how they can guarantee what's in your scoop and what's not. Right now, AG1 is offering a free AG1 flavour sampler and AGZ sampler to try all the flavours, plus free vitamin D3 and K2 and AG1 welcome kit with your first AG1 subscription order. That's $87 in free gifts for first time subscribers. All you have to do is head to drinkag1.com/livemore to claim this offer before it ends.

• 32:11Rangan Chatterjee?

  Today's episode is sponsored by the daily health drink AG1. The clocks are about to change, the mornings are darker, everyone around you seems to be coming down with something and suddenly that wellbeing you felt in the summer seems a long time ago. I certainly know that feeling and that's why at this time of year, I remind myself to lean into the fundamentals and one of those fundamentals is AG1. AG1 is a daily health drink that has been in my own life for over eight years and one of the many things I like about it is the fact that many of the nutrients it contains, for example, vitamin C, vitamin A, zinc and selenium, supports a healthy immune system. Some of the other things I really like about AG1 is that they are committed to continuous

• 32:54Rangan Chatterjee?

  improvement and updating their formula as a scientific research involves and each batch is independently tested for quality and safety markers, including heavy metals, allergens and banned substances. This is how they can guarantee what's in your scoop and what's not. Right now, AG1 is offering a free AG1 flavour sampler and AGZ sampler to try all the flavours, plus free vitamin D3 and K2 and AG1 welcome kit with your first AG1 subscription order. That's $87 in free gifts for first time subscribers.

• 33:33Rangan Chatterjee?

  All you have to do is head to drinkag1.com/livemore to claim this offer before it ends.

• 33:46Speaker 00

  100%, I think this is a big fallacy, like in medicine, we've learned and we've been brainwashing this, just do one thing at a time, so you know that one thing is causing and then you know what to do. So only if you want to treat Alzheimer's, just give vitamin D and do that for 30 years and see if that works and then just give vitamin E or give omega-3 fats or cut out sugar or whatever it is, take this drug. And it's just not the way the body works, the body is a system and you've got to unload the system from the toxic load and the future of medicine is what you and I have been doing is functional medicine or we call it systems medicine and the fundamental framework And this is from a textbook from Harvard. These guys wrote a book called Network Medicine. They said, really, we need to look for the multiple causes that are driving any particular one condition.

• 34:30Speaker 00

  It's not just one thing, and we need to create multimodal treatments, meaning it's not just one thing. You need diet, you need exercise, you need stress management, sleep. You need the right nutritional supplements, potentially. You might need, you know, other therapies that can help you adjunctive. So it really is about understanding the holistic nature of how we need to treat the body. If I said broccoli is good for you and all you use broccoli, you would die. Right. But that that's not how that's not how our bodies work.

• 34:56Rangan Chatterjee?

  Yeah.

• 34:56Speaker 00

  So I think it's really just more simple is just take out the bad stuff, put in the good stuff. See what happens. Now, some people won't get better. And the reason they don't get better is because they have heavy metals or they have mold or they have Lyme or they have some other more serious condition. But I've done this workshop where I do 30, 40 people around the world. We put them through this in just five days, not even 10 days. The average reduction in five days of eating this way of all symptoms from all diseases is 70%. Now, if there was a drug that could do that, it would be a multi-trillion dollar bestselling blockbuster drug. But guess what, folks? It costs almost nothing. It's available to everybody almost on the planet, and it's totally doable by you without going to the doctor. And it's called food.

• 35:41Rangan Chatterjee?

  Yeah.

• 35:44Rangan Chatterjee?

  It's almost hard to not come to the conclusion that you simply do not know how many of your symptoms are related to food until you address your food. Right. And it's it is madness, isn't it, that people still go to their doctor today all over the world? And they're being treated for symptoms that may well be related to food. Not always, but until you change the diet, you don't know. And I always say, listen, let's just figure out, you know, as we've spoken on your show before, that these these four pillars, food, movement, sleep and stress. So let's just start with food. Let's just get these things all cleaned up as much as we can. And then let's see what's left.

• 36:28Rangan Chatterjee?

  And a lot of the time, there's not much left, right? A lot of the time you realize, oh, wow, these are downstream symptoms from me not paying attention to the creation of health in my body. But of course, that's the leads to that wider point, Mark, doesn't it? Whereby We're not taught as Western medical doctors how to create health. We're simply taught to treat disease.

• 36:52Speaker 00

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

• 37:32Rangan Chatterjee?

  Yeah.

• 37:32Speaker 00

  We haven't gotten into the average doctor's office yet. And so what we're trying to do is change that from 17 years to 17 seconds. And get people quickly to kind of understand, here's how your biology works. You know, if you had a million dollar racehorse, would you feed it McDonald's, a Big Mac and a fries and a Coke? No, you wouldn't. But that's what we do to ourselves. It's what we do to our kids. We wouldn't feed to our dog what we feed to our kids. We literally would not. And so why do we think it's okay to feed to our kids? It's because the culture and predominantly the food industry has made us believe that it is good. That convenience is good, that, that it should be fine if it's ultra-processed, that it's safe, it's self-stable.

• 38:15Speaker 00

  You know, if, if, if it's in the food, it's got to be safe because the government must be protecting us. Well, that is not true. The government is not protecting us. And especially in the United States, I think it's better in Europe. You know, we're looking now at revising all of our standards for food safety and what should be in and out of the food.

• 38:30Rangan Chatterjee?

  Yeah. The problem is smart though, and you're really speaking to this. And I know we've spoken about this before, but the culture around us, the food environment around us is so toxic. That when you try and eat in a way that's appropriate with our evolution, right? In a way that our body is expecting to receive things.

• 38:54Rangan Chatterjee?

  You almost come across like a health nut these days, right? Because the norm is so unhealthy that when you start to really try and eat well and, what oil did you cook that in? You come across as actually someone who's obsessed. But I don't think it is that you're obsessed. You know, 93% of Americans are messed up looking unhealthy. We're not that far behind in the, in the UK. Normal is not what you want to be in 2025, is it?

• 39:22Speaker 00

  No. And, and normal, just so people understand, is, is basically a statistical number. And it has to do with the averages in a population. So if you're a Martian landing in America today and you look at what is the normal weight of an American, it's overweight because 75% of us are overweight. So you and I would be anomalies. We'd be abnormal because we're probably at the two standard deviations below the mean in terms of weight. Because the curve of normal is shifted over to the right, which means in English that we basically have normalized the bad thing, which is being overweight. And we think that it's okay.

• 40:03Rangan Chatterjee?

  Yeah.

• 40:03Speaker 00

  But it's really not. And the foods we're eating, you know, if our great grandmothers had a look at them, they wouldn't even recognize them as food, right? They wouldn't know what a Lunchable was or a Gogurt was or a Pop-Tart or Twinkie. I mean, they were like, what is this? I don't understand.

• 40:18Rangan Chatterjee?

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

• 40:36Speaker 00

  Well, it's not arbitrary. It's not because I just have a, um, some kind of vendetta against gluten or dairy. I think they're both delicious, you know? I think the, the reality is that the wheat we eat and the dairy we eat is not the wheat we ate or the dairy we ate. And so our biology is really affected by the new versions of these that are now in our food supply that are creating havoc. We've seen a 500% or 400% to 500% increase in true celiac disease in the last 50 years.

• 41:08Speaker 00

  Now, this is a very serious disease. It's not just some little gluten sensitive. It's true damage to your gut and you get very sick when you have this condition. And it creates a whole host of other autoimmune disease. So why would that happen? Well, these two foods have been so modified by breeding, not, I wouldn't say by GMO, but just by breeding. And because of the way they're grown, that they have adverse effects on us. For example, wheat is mostly dwarf wheat and this dwarf wheat is an incredible advance in agriculture, which won the Nobel Prize because it created a very sturdy, short wheat stalk with very dense, starchy grains. But the side effect of that was that it also has way more gluten proteins.

• 41:54Speaker 00

  Because when you breed plants, it's not like breeding humans. You know, you get 23 chromosomes for your mom, 23 for your dad. You get, you know, 23 pairs of 46 chromosomes. It's like 46 with 46, so it's like 92 if you're a plant. And so those genes make proteins and they make more gluten proteins and those gluten proteins turn out to be more inflammatory. And they cause leaky gut, they cause inflammation in the body and they are linked to all sorts of issues that we have dozens and dozens of different diseases. Same thing with dairy. We hybridized the cows. So the modern cows have a different composition of the protein in there called A2 casein versus A1 casein. So, modern cows have A1 casein, whereas heirloom cows and goat and sheep have A2 casein,

• 42:38Speaker 00

  which again is a lot less inflammatory. I mean, you look at the science around dairy. You know, Dr. Ludwig and Willett from Harvard, who are the top nutrition scientists in the world, among the most cited ever, they both wrote an article together in New England Journal of Medicine, which is not like some third-rate hippie journal, but basically the one of the most prestigious journals other than Lancet in the world. And it documented the science or the lack of science showing the benefit of milk and health. In fact, there was an adverse outcome for the most part. Milk didn't create strong bones or weaken bones. It didn't make, if you drank skim milk, skinny kids, it made fat kids because they ate more because there was no fat. It's linked to autoimmune diseases,

• 43:18Speaker 00

  to type one diabetes, to cancer. So I think it's a very inflammatory food and the way we raise these cows is often in feedlots with hormones. We milk them while they're pregnant and they become very inflammatory. So a lot of times when people have congestions, allergies, digestive issues, eczema, skin issues, rashes, dairy, acne, these are often dairy issues. So I find it very easy if you just take out the two biggest culprits, even if you just did those two, that would be amazing. But you're right, if you just do one, let's say you're allergic to gluten and dairy, you just take out dairy or you just take out gluten, you're not going to know which it was because you're still going to feel bad until you take it all out. And that's why I like 10 days because it's like resetting the clock and it doesn't take that long. And then you can decide what you want to do.

• 44:01Rangan Chatterjee?

  Yeah. Mark, we're on gluten for just a moment. So you're saying that the concentration now of gluten in, let's say, bread is very different to how it was several decades ago. Okay. You're saying that celiac disease is on the rise, but we also know that many people are self-reporting that they feel better when they go off gluten. Now, what's really interesting, we have seen a ton of people get better when you put them on elimination diets, right? But within the medical profession, there's still a view that if you do not have celiac disease, you should absolutely not be cutting out gluten from your diet, which I've always found a little bit odd and quite remarkable. It's not as if gluten per se

• 44:44Rangan Chatterjee?

  has any health benefits, like give me more gluten to help me with my well-being. I understand that there are some gluten-containing foods which have got fiber. So I think some dieticians get concerned that if people are cutting gluten out, are they getting enough fiber? I know that's one of the concerns that's often raised, but what's your take on that? Why do you think there's a case for some people who do not have celiac disease to not eat gluten?

• 45:10Speaker 00

  Well, celiac disease is defined as a biopsy proven atrophy of your small bowel. So when you take a scope, you put it on your shoulder, you take a biopsy of your small intestine, and it looks flattened, that's celiac disease. Okay. But there's a spectrum of disease, and this is where medicine just gets it 100% wrong.

• 45:28Rangan Chatterjee?

  Yeah.

• 45:29Speaker 00

  You have the disease or you don't. You have diabetes or you don't. Now, they have prediabetes. Oh, okay, because we're recognizing that's consequential in and of itself. It doesn't mean that you're just, might be a risk for diabetes. It means even though you have a blood sugar that's within the quote "normal range", it's a little higher than normal, that still puts you at risk for heart attacks, strokes, cancer dimension, everything else. There's now pre-hypertension, pre autoimmune disease. And the phenomenon is that gluten, like any other thing, it can be a trigger for illness. The dose affects people, and they, and different people are sensitive at different doses. And also, people have sensitivities, even though they might not fully be celiac.

• 46:11Speaker 00

  Now, when you look at the literature, about 35% of the population has the gene for celiac, but it's not expressed fully unless it's about 1% of the population. But about 20%, I would say, this is just ballparking it, have some level of gluten sensitivity that they might not be aware of. So, the, the idea is here that we should be paying attention to, one, how we feel, and that's the best barometer. Stop it for three weeks, start it again, and listen to your body. Like, don't let a doctor tell you what's right or wrong. Listen to how you feel. How's your stomach? How's your energy? How's your skin? How's your brain function? How's your sleep? How's everything else that matters to you? And if you also, you know, look at antibodies, you can see there's a spectrum of antibodies.

• 46:54Speaker 00

  Like, if you're, if you're diagnosed with celiac disease, you can be diagnosed by bloodwork. Let's say your gluten antibodies are 20 or more, that's considered celiac. What if it's 19? What if it's 18? What if it's 17? Does that mean you're fine? No, not necessarily. If it's zero, you're probably okay. And I see many patients with zero antibodies. But I also see a lot of people in that gray zone. And so, if you're in that gray zone, it's worth doing an elimination diet to see if you're going to be affected by it or not.

• 47:21Rangan Chatterjee?

  Yeah, and then, you know, I, I, it's, this is so important, and the reason I'm bringing this up is because a lot of people I know people who feel better off gluten containing foods, but they're made to feel bad by the world around them. A lot of the time, people are saying, oh, this is you don't have to see that. What the hell are you doing this? And it's again, it's this real misunderstanding that some people are a little bit sensitive. What you said there about how many people have the genetic predisposition for celiac, but don't actually have the disease. It's really interesting, this idea that, you know, genes load the gun, environment pulls the trigger, right? My dad had lupus. So he had antiphospholipid antibodies.

• 48:02Rangan Chatterjee?

  He had 15 years, you know, kidney failure and the autoimmune disease lupus. I know I've got the genes that predispose to autoimmune disease, right? Including celiac. So for me, it's an interesting conundrum, Mark, to think about this idea that if you know you have the genetics that are necessary for you to get celiac disease, if you never ever consumed gluten, would you even get it in the first place? And again, these aren't the sort of things that we think about in medicine. But, you know, people think, oh, it's a restriction. Oh, you know, it's too hard for people. But wait a minute, how do we know what's too hard for people? Let's give people credit. A lot of people are proactive about their health and actually are very happy to make

• 48:46Rangan Chatterjee?

  changes when they know there's a benefit, right?

• 48:51Speaker 00

  Totally, totally. I think, I think, you know, like I said, it's so important for people to pay attention to their own bodies. And doctors can be a good influence and can provide lab testing and guidance. But at the end of the day, you should be the seat of your own health. And you should be the one who's in charge of your biology. And you should be the one doing an N O one testing, which is probably the most valuable, valuable testing you can do.

• 49:18Rangan Chatterjee?

  I want to talk about testing because I know you're really excited about a new project that you've been involved with for a little while now. Just before we get to that, though, I heard on a recent interview, Mark, that your daughter is at medical school. So my question to you is, given how much information you put out into the public domain over several decades now, you've been trying to change public's perception of health, medical schools, governments. Have you seen any evidence with your daughter that what medical students are being taught has changed?

• 49:54Speaker 00

  No, zero.

• 49:55Rangan Chatterjee?

  Really?

• 49:56Speaker 00

  No. I mean, I asked my daughter, what have you learned about nutrition? Well, we learned about amino acids and fatty acids. I'm like, what are you going to tell your patients to have for lunch? Nothing about nutrition, nothing about the microbiome, nothing about insulin resistance, nothing about environmental toxins. Some of the most important drivers of the disease we're seeing today in modern society that doctors who are being trained today learn literally nothing about. Or if they learn anything about it, it's in a very academic way. It's not technically relevant and they don't know how to address or treat or monitor. And so it's sad. I mean, she's going to become a surgeon where she really doesn't have to worry so much about it. Although it does matter for surgery because you want your surgical patients to be healthy going in and going out. And so it matters on their health and their health status. But I think that it's sad.

• 50:40Speaker 00

  And so one of the things I'm working on is helping try to mobilize the US government to mandate that nutrition training is critical for undergraduate and postgraduate education for medical doctors and residents. And hopefully that'll come to fruition, but it's going to be a pushback.

• 50:59Rangan Chatterjee?

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

• 51:24Speaker 00

  Yeah, yeah, I know. I mean, food is the biggest cause of disease we're seeing in today's modern society. It's the biggest cure and doctors know nothing about food. It's tragic. It's really tragic.

• 51:37Rangan Chatterjee?

  Now, Mark, one of the things we've been talking about throughout this conversation is this idea that things are not black and white. And when you go and get your blood test done at your medical doctors, usually certainly in the UK, you're told it's either normal or abnormal. So I have used this example before on the podcast, but for anyone coming to this podcast for the first time, I want to just sort of frame it. And then I know you're doing a lot of work in America to try and change this. In the UK, we have different cutoffs for prediabetes to you guys in America. I believe in America, an HbA1c of 5.7 is prediabetes. Is that right?

• 52:21Speaker 00

  That's right.

• 52:22Rangan Chatterjee?

  Yeah, so here, it's not until six, right? So, you know, for anyone who doesn't understand, right? Type 2 diabetes is a condition where you have chronically elevated blood glucose. And the way it's diagnosed is with this blood test called the HbA1c, you know, two to three month average if your blood sugar. In the UK, 6.5 and above, I think like America, is considered type 2 diabetes. Six to 6.4 is considered prediabetes, which basically means, Mark, there will be hundreds of patients today in the UK who have got an HbA1c of 5.9, and they will be told that that is normal. Which is crazy, because in America, that would be prediabetes.

• 53:07Rangan Chatterjee?

  So just, you go across the pond, and here it's considered normal. But talk to me about this black and white issue in medicine, and how you're trying to address this with your company, Function.

• 53:19Speaker 00

  Well, thank you. So yes, with Function Health, which is a company I co-founded that allows people access to their own health data. It's a health platform where you can get over 110 biomarkers for your health and get a deep dive into everything from hormones, nutrients, and metabolic health, to cardiovascular health, to thyroid health, sexual health, to your nutritional levels, toxin levels. And it's a much deeper dive than you get when you go to your average GP and get, you know, 19 blood tests, which is your blood count, your chemistry, and your cholesterol, and maybe urine tests. And those are only abnormal when you're really sicker in the hospital, except maybe cholesterol. And it's kind of crazy that we have, you know, only this limited dataset we look at, when there's literally thousands and thousands of blood biomarkers that can be tracked. And there's many, many that aren't tracked that are really critical for disease.

• 54:04Speaker 00

  But when you look at this continuum concept, we work with Quest, which is a reference laboratory in America. And, you know, what was really interesting is they have data on thousands and thousands, and millions and millions of people. And they can analyze that data. And we were told, speaking back to the A1C, we were told that anything over 5.0, forget 6.0 or 5.7, just 5.0, there's a linear and steady progression of abnormal cholesterol or lipid biomarkers as your A1C goes up. So the more abnormal your blood sugar is, the worse your cardiovascular risk is from 5.0.

• 54:41Rangan Chatterjee?

  Even if, the key point there for me for people is, even if your result is considered normal or in the normal range, you're still at increased risk. I think there's really good research showing that an A1C of above 5.3 sequentially starts to increase your all-cause mortality, which is crazy that these have been reported as normal.

• 55:03Speaker 00

  Right. It's totally true. And I think, you know, we have the data on this. It just takes a long time to change. For example, in America, and we measure insulin, which is part of the key function panel. We measure metabolic health, you're not just your cholesterol, but your particle size, the quality of your cholesterol, your A1B, which is a very important predictor of your risk factor. It's probably one of the most predictive, more important than your LDL cholesterol, which is what everybody's testing. Look at statin therapy. You know, when we look at the biomarkers, we're seeing insulin, which I think is probably one of the most important biomarkers. And it's less than 1% of all tests that are done in America by doctors that are sent to Quest, according to Quest. The insulin

• 55:44Speaker 00

  reference range they have is 18 as normal. And anything above that is abnormal and anything below is normal. It should be fiberless. Now, why do they say it's 18? It's because everybody in America is insulin resistant and prediabetic, pretty much. So it's going to be skewed to being, quote, "normal" to be having high insulin. But it's not optimal. So we in Function Health actually provide for $498, easy access to five minutes sign up online, 15 minutes in the lab. You can get a deep, dense data dump of your own biology and also explanations of what it means and what to do about it. Not just what drug to take, but how do you change your diet for this? And what types of exercise will help? And how do you navigate stress and sleep? And what are the right supplements that help modify these pathways?

• 56:30Speaker 00

  And so we get a very nuanced view of what's going with your own biology is personalized. And then you own and you can track over time. And that people then can interact with and actually see the results change. And we've seen that over two years, we've just launched two years ago. We're one of the fastest growing companies in healthcare in the world. And we've seen just in the last couple of years, how people just doing the program and learning about their data makes them change their behavior such that their biomarkers get better at the end of the two years or whenever they repeat their tests. So they get it tested twice a year, but we're tracking it over a couple of years now. And we see it's really quite remarkable. So for me, it's all about personalization. It's about owning your data. It's about the being the CEO of your own health. It's about having access to information that you're not getting from your other doctor. They're not checking your insulin, they're not checking your lip particle size.

• 57:14Speaker 00

  They're not checking your APOB, which is the most important cardiovascular risk predictor we have now. It's not checking your sex hormones, it's not checking your thyroid antibodies, it's not checking autoimmune disease. We're seeing running in thirty three percent of our, we have one hundred and fifty thousand members now. Thirty three percent have a positive ANA, which is a pre autoimmune marker. Thirteen percent of thyroid antibodies, meaning their body has an autoimmune thyroid disease attacking their thyroid, making them feel bad. Forty six percent of ICRP, which is inflammation in their body, which we know is linked to everything from depression to dementia to cancer to heart disease to, to pretty much everything that we have in our modern society. And we're seeing sixty seven percent with nutritional deficiencies. So we're like finding all these things that are latent and that are causing people to have FLC syndrome

• 57:58Speaker 00

  or feel like crap that they actually, if they knew about, could do something about. And that's really the whole purpose here.

• 58:04Rangan Chatterjee?

  Yeah, Mark, there's a couple of really interesting things there for me. Okay. First of all, when you were talking about breakfast or your ten day detox diet, one of the things you said was that there's nothing better than doing this for yourself and paying attention to how you feel. And you were also talking about this idea that actually.

• 58:26Rangan Chatterjee?

  You know, you can wait for the medical system to change or medical training to change. You could be waiting a very long time. And so why not take control, as you say, be the CEO of your health, start to do things. So people are doing that already with wearables, right? So a CGM, a continuous glucose monitor, of course, can be a fantastic way of you kind of looking at your own breakfast and going, well, what is that doing to me? Right? Is it spiking my blood sugar into the diabetic range every morning when I have my cereal? Or is it relatively flat? And I've been experimenting with this new product called Lumen, this breathalyzer where they can tell you whether you're burning fat or carbs, depending on the combination of oxygen and carbon dioxide, which again, it's about this personalization.

• 59:11Rangan Chatterjee?

  You know, I, like you, am very health conscious, but even doing this has helped me change my behavior with my dinner, what time I have it, because I want to be waking up burning fat. I don't want to be waking up burning carbs. Right? So there's this wider point here that we now are living in a world where we can start to take control of our health. Now, of course, we might need education on what all these markers mean, but that seems to be one of the key things that you're trying to do with Function. You're basically saying, listen, and I appreciate it's only available in America at the moment. And so we have a different model here with the NHS, which we can talk about. But of course, in America, you're saying for $499, you can have a ridiculous amount

• 59:53Rangan Chatterjee?

  of blood testing done, which is going to give you, I guess, a bit like an MOT for your car, where you're literally looking under the hood. You also mentioned autoimmune disease, right? So if you could just touch on that for a minute, Mark, because I think people who listen to my show are understanding that blood sugar is on a continuum and prediabetes and type 2 diabetes is very late. You want to get involved much earlier than that. I don't think there's as much awareness of that with autoimmune disease. And you said quite an alarming statistic there about how many people who've done the tests with Function Health have got evidence of being on that autoimmune spectrum. So could you just speak to that for a moment, please?

• 1:00:40Rangan Chatterjee?

  Today's episode is sponsored by the daily health drink AG1. The clocks are about to change, the mornings are darker, everyone around you seems to be coming down with something and suddenly that wellbeing you felt in the summer seems a long time ago. I certainly know that feeling and that's why at this time of year, I remind myself to lean into the fundamentals and one of those fundamentals is AG1. AG1 is a daily health drink that has been in my own life for over eight years. And one of the many things I like about it is the fact that many of the nutrients it contains, for example, vitamin C, vitamin A, zinc and selenium, supports a healthy immune system. Some of the other things I really like about AG1 is that they are committed to continuous

• 1:01:23Rangan Chatterjee?

  improvement and updating their formula as a scientific research involves. And each batch is independently tested for quality and safety markers, including heavy metals, allergens and banned substances. This is how they can guarantee what's in your scoop and what's not. Right now, AG1 is offering a free AG1 flavour sampler and AGZ sampler to try all the flavours, plus free vitamin D3 and K2 and AG1 welcome kit with your first AG1 subscription order. That's $87 in free gifts for first time subscribers.

• 1:02:02Rangan Chatterjee?

  All you have to do is head to drinkag1.com/livemore to claim this offer before it ends. Today's episode is sponsored by the daily health drink AG1. The clocks are about to change, the mornings are darker, everyone around you seems to be coming down with something and suddenly that wellbeing you felt in the summer seems a long time ago. I certainly know that feeling and that's why at this time of year, I remind myself to lean into the fundamentals and one of those fundamentals is AG1. AG1 is a daily health drink that has been in my own life for over eight years. And one of the many things I like about it is the fact that many of the nutrients it contains, for example, vitamin C, vitamin A, zinc and selenium, supports a

• 1:02:47Rangan Chatterjee?

  Healthy immune system. Some of the other things I really like about AG1 is that they are committed to continuous improvement and updating their formula as a scientific research involves. And each batch is independently tested for quality and safety markers, including heavy metals, allergens and banned substances. This is how they can guarantee what's in your scoop and what's not. Right now, AG1 is offering a free AG1 flavour sampler and AGZ sampler to try all the flavours, plus free vitamin D3 and K2 and AG1 welcome kit with your first AG1 subscription order. That's $87 in free gifts for first time subscribers.

• 1:03:32Rangan Chatterjee?

  All you have to do is head to drinkag1.com forward slash live more to claim this offer before it ends.

• 1:03:46Speaker 00

  A third of everybody we've tested out of 150,000 people, that's shocking. And I don't know why, I think it's a combination of reasons, but you know, we think, oh, one day I get lupus, one day I get MS, one day I get rheumatoid arthritis, or one day I get whatever the autoimmune disease is, ulcerative colitis. And the truth is that this is a continuum. And when you're a good functional medicine doctor, you're taking a person's history from even before they were born. What was their mother's pregnancy like? What did her mother eat? What was the birth? Was it a C-section? Did they not get inoculated with good bacteria that colonized their gut microbiome where 60% of your immune system is? Did they breastfeed or not? And if they didn't breastfeed, what happens to their microbiome? Not a lot of good things. Did they get colic?

• 1:04:30Speaker 00

  Did they have infections of like ear infections? Did they take antibiotics? Did they have any gut issues or eczema or asthma or any of these things when they were younger? We often see the same story and unfolds over time. And by the time they're in their 30s and 40s, that's when autoimmune disease kicks in, particularly in more women than men. And so what we're seeing is this latent autoimmunity, this lowest preautoimmunity in this population because we've destroyed our microbiome, because we're exposed to environmental toxins, because we've taken low levels of antibiotics, because we have lots of stress, because we have things like gluten, which has way more gluten proteins than the ancient wheat. I did research for my book, Young Forever. I was eating zeh wheat, which was fueled Alexander

• 1:05:13Speaker 00

  and the greats, you know, charge across the continent to take over the world. And it was a very nutrient dense, high protein wheat with very low gluten content and very different forms of gluten. And also, the way they processed it was different. The way they leavened it was different. It wasn't this super leavening stuff. So we see, we

• 1:05:29Rangan Chatterjee?

  Did you feel a difference, Mark? Because are you sensitive to gluten in the US and you were not there? Or just help us understand that?

• 1:05:36Speaker 00

  Yeah, well, we hear this story all the time, by the way. You know, if you're an American, you can be sensitive. If you go to Europe, you can eat pasta in Italy and you're fine. Why is that? One, because Europeans don't usually have dwarf wheat. Two, they don't spray with glyphosate, which is a microbiome toxin. And so they're not exposed. And three, the way they leaven the wheat is much longer and they'll often use sourdough or other things. So I was in Sardinia and they had sourdough bread. They gave me 150 year old sourdough starter. They had various kinds of grain called grano capelli, which is, I'm pronouncing it terribly, but it's basically this form of wheat, this ancient form of wheat used by the shepherds in Sardinia when they would go out for long distances.

• 1:06:20Speaker 00

  So they were, they're eating heirloom varieties that had very different properties and very different kinds of effects on the body. So yeah, when I go to Europe, I can eat more of that stuff. I don't eat it much in America because it's, it's full of crap. And I think, I think, you know, gluten is one of the big triggers for autoimmune disease. It's one of the big drivers. It's leaky gut, it's inflammation, it's environmental toxins. And so we've done all these things that cause our gut to be damaged, our microbiome to be damaged. Even no ultra-processed food. I mean, Chris Van Telkens is in the UK, you probably know him.

• 1:06:49Rangan Chatterjee?

  I do, yeah.

• 1:06:49Speaker 00

  And he wrote a book called Ultra-processed People, and he talks about the harms of ultra-processed food, which I think are primarily due to the starch and sugar content and the, some of the additives, particularly emulsifiers. Now, emulsifiers make things smooth and create texture and so forth. And they're putting everything from plant-based milks like almond milk to

• 1:07:08Speaker 00

  Breads and all kinds of stuff. And so these emulsifiers may damage the gut and they cause leaky gut and they cause autoimmune disease. And we're eating 60% of our diet in America as these foods.

• 1:07:19Rangan Chatterjee?

  Yeah, I think a lot of people don't realize, you know, when I think about this, I think about this idea that, let's say gluten, for example. So you're saying the gluten now is much more concentrated than it used to be, right? So that the amount you've been exposed to has gone up, but also our defenses, our microbiome is completely different from how it used to be, right? So I think it's possibly not just how gluten has changed, it's also the fact that the defenses in our body, the fences that would protect us have been decimated, as we've covered on the show many times, you know, how modernity has negatively affected the quality of our gut microbiomes, which is why, of course, there's so much focus these days on gut health.

• 1:08:02Rangan Chatterjee?

  But Mark, if someone, let's say they do the function test and they realize that they're in that cohort who already has evidence of early autoimmunity, what can they then do?

• 1:08:15Speaker 00

  Great question, great question. So what's different about function is that the intel inside is really about the future of medicine. We can create a great tech platform, we can create a great user experience, we can create great interactive tools, we can create AI and machine learning and all these wonderful things. But if all we're doing is doing the same medicine better, we're not really advancing the paradigm very much. We're not really going to impact health that much. We're going to fix things around the margins, like rearranging the deck chairs on the Titanic. Probably not the solution here. What's really different is with function health focused on root cause medicine. So if you have an autoimmune disease, rather than saying, oh, you have rheumatoid arthritis,

• 1:08:58Speaker 00

  take steroids, take anti-inflammatories, take biologics, take these drugs to shut off the immune system, we ask a different question, which is why. So traditional medicine is the medicine of of what? What disease do you have and what drug do I give? This approach, root cause medicine, is really about why? Why do you have this? And what's going on? And so for autoimmune disease, it's a myriad of things. But we know the triggers for autoimmune disease. One is our microbiome and disturbances in our microbiome and leaky gut. That's probably the number one cause. And what causes a leaky gut in a lot of cases is gluten. And if you look at gluten, it's, can you count for dozens, probably 100 different autoimmune diseases?

• 1:09:43Speaker 00

  And if you just look at the New England Journal of Medicine paper, they're written like, I don't know, 30 years ago. They listed 55 different diseases that could be caused by celiac or gluten issues. It can be environmental toxins. They call these autogenes. So autoimmune inducing toxins. So it can be pesticides, can be heavy metals, can be glyphosate. They can cause autoimmune disease. It can also be infections. We know that infections like Epstein Barr will cause MS, for example. So whether it's a toxin, an infection, a leaky gut, a food sensitivity, an allergen, gluten. We now can start to dig around. It can even be things like Lyme disease, or it can be mold. All these things can trigger autoimmune disease. So we need to be able to investigate what these are.

• 1:10:27Speaker 00

  And function help provides you with a roadmap, which you will not get from your traditional doctor, on how to identify these problems and then what to do about them. And if a basic approach doesn't work to getting to the root cause, yes, then you need to go to the doctor. You might need medication and that's fine. But it's really about starting with the right first principles of why, not what.

• 1:10:47Rangan Chatterjee?

  And I guess one of the key points there is if you don't do that test and get the results, you may not do anything differently in your life. You may go about thinking, hey, life's okay. I don't feel great. Maybe I'm a bit bloated. My energy's not great, but hey ho, I can manage. Until five or 10 years later, that's when you show up with rheumatoid arthritis or lupus. But I think there is really good evidence, and it's been emerging for ages, that actually... Just as we know, blood sugar is on a spectrum and you don't, you know, you don't get type 2 diabetes overnight, it's building up in your body, five, 10, maybe longer years than some people. Alzheimer's, Dale Bredesen, last time I spoke to him, said Alzheimer's

• 1:11:31Rangan Chatterjee?

  starts 30 years, generally speaking, before the diagnosis, right? By the time you get the diagnosis, it's been going on for a long period of time. And I guess that's the principle here, which is you want to empower people to sort of find this stuff early so they can turn the ship around, so they don't end up with full-blown disease somewhere in the future, right?

• 1:11:54Speaker 00

  Absolutely. That's the whole point, is you don't want to wait till things have already gone really bad. You want to get things early, and the sooner you can get them, the better you are. And that's really the purpose of functional health, is to help people to get early diagnosis and identification of issues that they wouldn't have known otherwise. And we're seeing everything from just, you know, identifying people with prediabetes that they didn't know of, or pre autoimmune disease, to finding people with pituitary tumors that were affecting the quality of their life that they didn't know they had, which you can tell from a simple blood test, or cancer that they didn't know they have, through our cancer liquid biopsy screening tests, which you can find 50 different cancers. And that's really important, because you want to know where you're headed. You don't want to wait till you get there to find out. Benjamin Franklin said, now's the prevention's worth a pound of cure. And so that's where we're headed in medicine. It's predictive,

• 1:12:38Speaker 00

  personalized, preventive, and it's pretty extraordinary. You have to do it yourself.

• 1:12:44Rangan Chatterjee?

  Do any critics say, Mark, that actually this sort of testing may create health anxiety and causes more problems than it solves?

• 1:12:55Speaker 00

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

• 1:13:29Rangan Chatterjee?

  Okay, so Mark, not all my audience live in America. For those who do live in America and are thinking, okay, I can afford that, I would like to do that, how do they go about doing that?

• 1:13:44Speaker 00

  Yeah, so you know, basically, what we're talking about is in American dollars is a dollar thirty seven cents a day for the for the basic membership, which includes twice your testing of over one hundred and ten biomarkers and sixty a half year. And and it's fifteen thousand dollars worth of diagnostics that we've been able to kind of get the prices down because there's such price elasticity in the market in America. It's kind of crazy. I don't know if it's like that in the UK, but you could imagine buying a TeraCamry on one lot that's twenty thousand, another lot that's a hundred thousand, another lot's at ten dollars, another lot's a million dollars. That's kind of like the pricing in America when it comes to stuff. So we've been able to get the prices really affordable for people and and they just have to go to functionhealth.com and slash live better and they can sign up and get in and get access to the platform. We have

• 1:14:29Speaker 00

  a like half a million people on the waitlist. So we don't we don't want to have to have your listeners wait for that. So if you go to functionhealth.com slash live better, you'll be able to get an early access and jump in and jump the waitlist and see what's going on in your biology and then you can do something about it.

• 1:14:44Rangan Chatterjee?

  Yeah, thank you, Mark. I appreciate that for my US listeners who want to take advantage of that. Let's broaden it out now for people all around the world, even people in America who, let's say, can't afford that, or people in other countries of the world who go, actually, you know what, that all sounds great, but that's not available yet where I live. Can we just go through five or so of the tests that you think are most impactful for people? They're tests that can be commonly done at their regular doctor, perhaps they're not, but you know, what are some of those lower cost tests that we can help people with all over the world at the moment?

• 1:15:21Speaker 00

  Well, I'm going to answer in two parts. The first is the lower cost test. I think that there's some basic things that everybody should get. You need a lipid fractionation test. It's not your normal cholesterol, but it looks at quality of your cholesterol and the size of your cholesterol. And that, again, is not that expensive. ApoB, which is a type of cholesterol particle, very important for being a predictor of heart disease, insulin, measuring your blood sugar, obviously your A1C is very important, vitamin D, I would see very important. And then, you know, we can kind of go down the list of things that are more or less important. But those things can make a huge difference if you just learn what those are for your nutritional metabolic health. If you're doing the bare minimum of four or five things. But also what's coming is

• 1:16:05Speaker 00

  because our platform has got so much data, literally tens of millions of data points on 150,000 people and growing at an astronomical rate, we're going to be able to soon be able to predict based on your history and your own data, what's going on with you, even necessarily not having to do as extensive lab test. Now, the lab test will be helpful, but but if you're in a place where you're in a country where you can't get access to care, where there isn't a lab, where you don't have enough access to capital to do this, or the price is too high, you will be able to actually query your own biology by putting in your medical history, by putting in your past medical records, whatever tests

• 1:16:46Speaker 00

  you did have, and put it in there, and then it will learn from your data what is right for you and allow you to personalize your care. So that's where we're going. We want this to be available to 8 billion people.

• 1:16:58Rangan Chatterjee?

  Yeah, no, I love that. It's exciting what AI and all this sort of, you know, machine learning is going to do to actually how we even view health and look at it and predict our potential outcomes in the future. Those five tests you mentioned, let's just quickly go through them. I'd love for you, if you can, to provide what you consider optimal ranges to be. So help us understand, Mark, from your experience, when it's vitamin D, what do you like to see?

• 1:17:27Speaker 00

  What I like to see is at least 45 nanograms per deciliter or more. And between that and 75 to 100 is pretty safe and good. So that's, that's an important number because that regulates bone density, cardiovascular health, brain health, immune health. Again, the flu vaccine, if your vitamin D level is optimal, you, you have a 75% reduction in your risk of getting the flu, which is more than the vaccine. Now, I personally have never gotten the flu and I make sure my levels are that high. So I think it could be coincidence, but I've been around a lot of people with the flu. And I think it's quite amazing how powerful this nutrient is, which is really more like a pro hormone.

• 1:18:11Rangan Chatterjee?

  Okay. So that's vitamin D. Then we went to HbA1C, this average blood sugar marker that certainly in the UK, anyone can get on the National Health Service. It's a very cheap test. What do you like to see as a level there?

• 1:18:27Speaker 00

  I like five and a half or less. If people are five and a half or less, I'm happy. If I get people who are five, I'm thrilled. But, you know, I recently did mine and it was 4.8. I was happy about that.

• 1:18:37Rangan Chatterjee?

  But that's amazing.

• 1:18:39Speaker 00

  For a 65 year old, where one in two 65 year olds pretty much have diabetes or pre-diabetes. So it's, it's probably worse than that, actually.

• 1:18:46Rangan Chatterjee?

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

• 1:19:01Speaker 00

  It's, you know, keeping your body composition optimal, not having belly fat by reducing starched sugar or cutting it out dramatically, extra regular exercise, getting them asleep, managing your stress. It's not that hard. I mean, it, it sounds like a lot, but it's really, it's not rocket science. It's just the trigger is starched sugar. So I make that a treat, an occasional treat, not a daily staple.

• 1:19:24Rangan Chatterjee?

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

• 1:19:35Speaker 00

  Well, fasting insulin is very good. Now, I don't know if it's available in the UK yet, but there's a new test and we offer it with Function Health, which is revolutionary. It's called a insulin resistance score. And it's a new way of looking at insulin resistance, which is the fundamental pathology underlying most chronic diseases, from heart disease to cancer to diabetes to dementia, amen, depression. And what this measures is using fasting insulin plus a C peptide level. Now, what is C peptide? C peptide is the precursor molecule for insulin. So using a technology called mass spec, which is an old laboratory technology, but it's a little more expensive than regular lab testing.

• 1:20:17Speaker 00

  They're able to actually identify the level of insulin resistance in a patient, which is as good as any research-based tool that we use to identify insulin resistance, which is what we call a glycemic clamp test, which no one would want to undergo. They do it in animals, but it's a pain in the ass test or a glucose tolerance test with insulin, which is better, but still not as good. And this is just a simple blood test in the morning. And if I can get everybody on the planet to do this and see what their number was and try to improve it, I think we'd solve a lot of our health crisis because it's a beautiful, simple test and I think that's really good. But if you just can measure insulin, which is very inexpensive, like five bucks, 10 bucks or less, you're talking a level should be under five ideally.

• 1:21:02Rangan Chatterjee?

  Is this fasting insulin?

• 1:21:04Speaker 00

  Fasting insulin.

• 1:21:05Rangan Chatterjee?

  Okay.

• 1:21:06Speaker 00

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

• 1:21:51Speaker 00

  There's just one reference range. But the things that are lifestyle-related or diet-related, there are ranges.

• 1:21:57Rangan Chatterjee?

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

• 1:22:30Speaker 00

  Yeah, I mean, you know, the first thing that happened is your insulin goes up after a meal. The second thing that happens is your insulin goes up fasting. The third thing that happens is your blood sugar goes up after a meal.

• 1:22:45Speaker 00

  The fourth thing that happens is your blood sugar goes up fasting. That's when we usually pick it up at stage four. We don't even look at any other things. So we're way late in picking up problems with your blood sugar and insulin because we're not looking at these other factors. So you can do a two-hour glucose tolerance test with glucose and fasting insulin, and one and two-hour glucose, and one and two-hour insulin. That's helpful. But this new insulin resistance score is going to make that obsolete. And I think with a lot less pain because it's like drinking two Coca Colas to get your blood sugar and insulin to do gyrations. So it's important to keep your numbers in an optimal range for insulin. By the way, there's an easier test.

• 1:23:30Speaker 00

  If you look in the mirror and you've got belly fat, you probably have the problem. You don't even need a blood test.

• 1:23:36Rangan Chatterjee?

  Yeah, well, look, this is, you know, it's important stuff that we talk about and we help people with because a lot of people are struggling with their health and wellbeing. They're trying their best, they're trying to consume information, they're trying to apply it. And a world that doesn't make it that easy for them. But this thing about insulin is so, so interesting because

• 1:23:57Rangan Chatterjee?

  We talk about prevention and everyone loves to talk about, you know, prevention's more important than cure and all this kind of stuff. But if you look at medical practice in the UK, we don't really do prevention. We kind of, you know, we think looking at your blood pressure is prevention. And of course, you know, yes, keeping your blood pressure in the right range is important. But these things, you mentioned a term before, pre-hypertension, early on in this conversation, right? What does that term mean? Because I'm trying to get this idea across to people that actually, when medicine gets involved with you, that is quite late. That is why doing these markers regularly and earlier, and having someone be able to interpret it for you, or an app, or a program that does

• 1:24:41Rangan Chatterjee?

  that, is basically you taking control of your health at a much earlier stage, isn't it?

• 1:24:47Speaker 00

  A hundred percent. We really want to get people early in the continuum of disease. And this is a problem with traditional medicine, is we do not think about disease in continuums. Just like, you know, diabetes, we've started to with prediabetes, because the data showed it. Or blood pressure with pre-hypertension. Now, normal blood pressure should be 140 over 90, then it's like 120 over 80. Now maybe optimus 115 over 75. So what is the level at which there is no disease, right? What is the level at which you're never going to get a stroke or a heart attack, right? And that is a very different number than what is, quote, "normal." And that's really what I want to shoot for. I don't want to be average. I want to be optimal.

• 1:25:30Rangan Chatterjee?

  Yeah. Okay, the two more tests that you mentioned, let's go through. ApoB, you're saying a really powerful predictor of your risk of cardiovascular disease. Where do you like to see ApoB levels in your patients?

• 1:25:44Speaker 00

  So just to back up, what is ApoB? Well, if you don't have the ability to do what we call lipoprotein fractionation, which is a more complicated test where you look at particle size of your cholesterol, and HDL, and triglycerides, and the number of particles, it's not always available.

• 1:26:01Speaker 00

  It's not that expensive, but it's doctors are loath to often order it. ApoB is a surrogate marker for that. And ApoB is a lipid particle or apolipoprotein B for all the non-good cholesterol types of particles. For all the small particles, all the triglyceride particles. So it's a surrogate marker that you're heading in the wrong direction. And it's probably far more predictive, not probably, it is far more predictive than LDL cholesterol, which is what most doctors look at. And the level you should have is under 90, but ideally probably under 70. And if you have cardiovascular disease, maybe under 50. In other words, if you've already had a heart attack, you want to drive it even lower to see regression. So we're looking at levels of 100, 110, 150, you know, in people.

• 1:26:44Speaker 00

  And so, like I said, with function health, we see, I think, 51 or 56% of people who do the function panel have an abnormal ApoB above the reference range from the lab, not what I would say is optimal.

• 1:26:57Rangan Chatterjee?

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

• 1:27:37Speaker 00

  Look, it's really simple. How do you feel and how do you look? If you feel great and your body composition, meaning you look great in the mirror, meaning you don't have no belly fat, you might be okay. And you don't even have to potentially even go further than your doctor's office to do the most basic thing. So if you want to just get to the shortcut without any additional testing that you get at your doctor's office, it would be pretty simple. They're going to check a cholesterol profile. So make sure you look at numbers that they don't potentially look at, which is your number of triglycerides divided by your HDL.

• 1:28:17Speaker 00

  Now, we say good and bad cholesterol. HDL can be good and bad. LDL can be good and bad. So I don't like the good and bad reference. But basically triglyceride over HDL is a number that almost everybody's going to get on their basic checkup. If that number starts to creep over one or two or three, you're heading in the wrong direction when it comes to your insulin resistance. It's one of the first things to go wrong. And so it's very predictive, very predictive. Not quite as good as an insulin resistance score, but it's very predictive of having a heart attack. More than LDL, by the way. And that's something you can get. And then look at your blood sugar. If it's between 85 and nine and 100. And again, your reference ranges are different in the UK. But it was because I train in Canada.

• 1:29:02Speaker 00

  So I, it was 40, 40 years ago. I've forgotten all those reference ranges. But I know the American one. So it was between like 85 and 100. You're heading toward, you know, scope creep in terms of your blood sugar regulation, even if they don't measure insulin. If it's over 100, for sure, you're already in trouble. So make sure you pay attention to that. That's going to be on your annual checkup. And if you want to just get insurance about what you should basically take without having to worry about a lot of things, take a good multivitamin, take a good fish oil, EPA, DHA about a gram a day, and take a good vitamin D between 2,000 to 4,000 units a day. A vitamin D3. And if you combine it with K, that's better. And we're talking literally pennies a day

• 1:29:46Speaker 00

  to be able to do this if you can't afford most other things. That alone will help you identify and solve for many of the problems that people are having. You'll get the B vitamins more low and you'll get potentially a little bit of zinc you'll get. Maybe there's some iron and some multivitamins, depending on which they are, particularly if you're menstruating women. But we'll, we'll deal with a lot of the deficiencies. Magnesium often is a big deficiency. You might need an extra magnesium. But you can just cover your bases by doing those things. And just eating proteins and fat for breakfast, cutting off starch and sugar for the most part if you can, and, and trying to kind of move your body and do all the things you write about in your books. And you do so beautifully and elegantly. So you don't have to go crazy, but the basics are really going to solve most of the problems for you.

• 1:30:29Rangan Chatterjee?

  Yeah. Mark, you released your book, Young Forever, I don't know, two or three years ago now. And when it came out, we had a quite wonderful conversation.

• 1:30:41Rangan Chatterjee?

  What's changed in the last two to three years in the sense that if you were writing the book today, what would you add that wasn't in there?

• 1:30:51Speaker 00

  Well, I think with some, there's some really interesting stuff around the margins that I don't think really is ready for prime time yet, that there's more and more research on. For example, therapies that are being looked at for longevity, like plasma freezers, or things like stem cells, or exosomes, or even things, for example, that are being researched in certain labs, like Altos Lab from the Jeff Bezos's funding, or Sam Altman's lab, that are looking at these things called Yamanaka factors. And when it comes to longevity, you know, we're going to be able to, most of us do well, if, and live maybe 100 healthy years, which is our goal at Function Health, if you follow the foundational principles that you and I talk about.

• 1:31:36Rangan Chatterjee?

  Yeah, wow. It's pretty exciting to see all the research that's there. Going back to testing for just a minute, when I was in LA in November at our friend Darshan Shah's clinic, he did a full set of bloods for me, and in that he included BPA.

• 1:31:54Speaker 00

  Oh, yeah.

• 1:31:55Rangan Chatterjee?

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

• 1:32:14Speaker 00

  Wow.

• 1:32:15Rangan Chatterjee?

  Right? I was looking at them going, what the hell is going on? How do I have this much plastic going around my body, right? Or the BPA at least. And knowing that has completely changed my behaviour. Since then, I think, once when I was travelling, I drunk water out of a plastic water bottle, but I pretty much haven't done it. I never, ever, anymore, will get a takeaway hot drink in one of those plastic cups from a coffee shop, or whatever, you know, I'll either not have it, or I'll take my own flask, or my own cup. But this highlights...

• 1:32:53Rangan Chatterjee?

  The benefit of testing, right? When I saw that in my body, I'm like, okay, Rangan, this, this stops now. Do you know what I mean? So I think I'm just, I'm just sharing that to kind of highlight how test, it's power, isn't it?

• 1:33:07Speaker 00

  Yeah, information is power and I, I agree. I, I think it's so important to know what you're exposed to. And, and with function health, you can check your BPA levels, which is B-sulfonate that causes diabetes and potentially cancer and hormone disruption. And it's in credit card receipts, it's in, you know, and, and automatic teller receipts, your, when you get your gas or your petrol, as you call it, you get that receipt. It's all on those receipts. So you don't want to be touching those things.

• 1:33:34Rangan Chatterjee?

  Yeah.

• 1:33:34Speaker 00

  You know, they want to, you know, like, no, email it to me.

• 1:33:36Rangan Chatterjee?

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

• 1:34:21Speaker 00

  Yeah, I think it's a great question. And I've been talking a lot about this, particularly with the LA fires, because the LA fires release so many toxins in the environment, not just BPA and heavy metals and dioxin, but both organic compounds and pesticides and plastics. I mean, the, the amount of toxins released were just staggering. And people have had, even Brian Johnson actually reported on this, how his levels of these compounds skyrocketed after the LA fires. So I did a whole seminar on how do you reduce your exposure? Right? So your air filters, filter your water, you know, be careful when you go outside, if the air quality is not good, use a mask, an N5 mask, which is not fun. But there are a lot of things your body already does to, to get rid of these things. So I call it the, you know, the, the triple P system.

• 1:35:07Speaker 00

  Pee, poop and perspire system, you know, you wanna, you know, drink a lot of fluids so you're well hydrated and peeing out a lot of these things. And the solution to pollution is dilution, as we learned in med school, you probably learned that, right? You have an infection, you just put a lot of fluids and clear it out. Second is, you wanna make sure you're going to the bathroom a lot. And that means lots of fiber. Flaxseeds are great, chia seeds are great. If you're going to the bathroom, magnesium is great. And also lots of phytochemicals that have detoxifying compounds in them, like the broccoli family, garlic and onions. And pretty much any colorful fruit or vegetable is gonna have compounds that facilitate either antioxidant defenses or detoxification pathways. And then you wanna do things that can even take you up a level from just, you know, doing things

• 1:35:52Speaker 00

  like that, like sauna. Sauna therapy can be very, very effective. And that's something very important. And then insurance supplements that can be very effective, like N-acetylcysteine, which helps support glutathione, the main body detoxifier. And then there's even more advanced therapies to help cellular detoxification, which uses cell membrane replacements, like phosphocole, to replace all the toxins that get embedded in your cells. That's a much deeper can of worms we can talk about someday. But, you know, from a therapeutic point of view, that you can do with a doctor, there's certain things you can do. But on your own, it's just, you know, cleaning up your household products, cleaning up your toxins in your food, trying to be more organic if you can. Filtering your water, ideally getting an air filter if you're exposed to bad places. Avoiding like you things that things you

• 1:36:37Speaker 00

  can avoid, like plastic cups and bottles. And, I mean, BPA is not a microplastic, but it's lining plastic containers. So you're getting microplastics along with it. So we basically wanna reduce our exposures, we wanna maximize our excretion, and that's really, that's what it comes down to.

• 1:36:53Rangan Chatterjee?

  Yeah, and I guess, yeah, if you don't have a sauna, if you're doing things where you're sweating regularly, you're at least excreting stuff through the sweat. And of course, that highlights the need to open your bowels regularly, right? Because that's the way that actually people excrete stuff and sort of detoxify from the body. Mark, just to finish off, you've obviously been pioneering in the longevity space for a while. You're doing a great job with yourself in terms of, you know, the difference between your chronological age and your biological age. I don't know what it is these days, but you were pretty young biologically last time I spoke to you.

• 1:37:28Rangan Chatterjee?

  You know, I'm really fascinated as to as you get older year on year, despite everything that you know and all the things that you're doing, how do you actually think about your own mortality and death?

• 1:37:42Speaker 00

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

• 1:38:24Speaker 00

  as a car you drive off a lot, but it can still drive well if you take care of it.

• 1:38:30Rangan Chatterjee?

  Yeah. And finally, Mark, I understand when I was doing my research with this conversation that before you went to medical school, you studied Buddhism at university.

• 1:38:45Rangan Chatterjee?

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

• 1:39:11Speaker 00

  Oh, tremendously. I mean, I think what I learned about was a lot of the science of creating health without even knowing about it through just understanding what it took to create a health through the practice of yoga, which has a lot of built in philosophy around meditation, moving the body, about diet and so forth. When it comes to Buddhism, that was more about healing of the mind, but it also talked about Tibetan medicine and healing medicine, which is actually how I started getting into medicine. And I also think that the things I studied on the margins really also influenced me, which were really about systems thinking, you know, not looking at a reductionist view of the world, but looking at how everything's connected and how everything relates to everything

• 1:39:53Speaker 00

  else and looking at ecosystems, both biologically and also in other networks. And so network thinking was always a part of my kind of predisposed mind. And so when it came to medicine, I just didn't get the reductionist model at all. And when I personally got sick when I was in my 30s, I had to kind of resurrect myself and it required me to really step out of the bounds of what I learned in medical school and step into a new framework, which looked at the bodies, the interconnected network, where all the systems were interdependent and interacting, and I had to optimize them and understand them in order to be healthy. And that's what I did. And that's really what led to my career and that's what has been the foundation of my teachings and my work for the last 40 years.

• 1:40:31Rangan Chatterjee?

  Yeah, I love that. Thank you for sharing that. Well, for someone who's stumbled across our conversation and has been inspired by what they've heard from you and they're thinking that, you know what, I really need to do something now with my health, you know, I've neglected it for far too long. I want to be as healthy and as well as Mark Kymon when I'm 65. What are those final take home points that you would say to that person?

• 1:41:01Speaker 00

  You know, steady wins the race. I think, you know, for me, I've never gone in a shape and out of shape. I mean, I've had moments where I've had more or less, but I've always eaten well. I've always exercised. I've always focused on the basics and then dividend pays dividends. And if you invest, you know, $10 when you're born, it's going to end up being a lot of money, even if you don't add any more money to it by the time you're 65. And so it's really about, you know, starting as soon as you can, starting to invest little bits every day, whatever it is, a slight improvement to your diet, little bits of exercise, stress management practices. I noticed this new device someone sent me, which is essentially two minutes a day on your vagus nerve with a little vibratory stimulator. That's like, you know, getting a huge stress reduction reset on your nervous system.

• 1:41:45Speaker 00

  So I'm like, okay, four minutes a day, I could probably do that. And so there's little bits and bites that people can do. And then as you get more inspired, you want to do more, then do more. But I think, you know, If you're struggling, you've just got to start where you are and take the first step. And for me, we talked earlier about the 10 day detox diet, but it is such a profound and radical shift in your biology in such a short time. So you don't have to believe me, you don't have to listen to me, you don't have to believe you, listen to your body. What happens when you take out the crap and you put in the good stuff? Your body will be smarter than any one of us and tell you what to do. And then you listen or not. They say, well, you know, like I know, for example, if I have a glass of wine, I'm not

• 1:42:29Speaker 00

  going to sleep as well, but I'll know that and I'll make that conscious choice. But I would say now that I know that information, I do it probably a lot less, you know, maybe once a month, every few months. So it's really now a conscious choice to do something where I know might impact me like half some ice cream or whatever. I'll make that choice, but it's with the knowledge of how it's going to impact me.

• 1:42:51Rangan Chatterjee?

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

• 1:43:00Speaker 00

  Thanks so much for having me. I'm good. It's been great.

• 1:43:07Rangan Chatterjee?

  Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply into your own life. And also have a think about one thing from this conversation that you can teach to somebody else. Remember when you teach someone, it not only helps them, it also helps you learn and retain the information. Now, before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I'd be

• 1:43:50Rangan Chatterjee?

  consuming and quotes that have caused me to stop and reflect. And I have to say, in a world of endless emails, it really is delightful that many of you tell me it is one of the only weekly emails that you actively look forward to receiving. That sounds like something you would like to receive each and every Friday. You can sign up for free at drchatge.com/friday5. Now, if you are new to my podcast, you may be interested to know that I have written five books that have been bestsellers all over the world, covering all kinds of different topics, happiness, food, stress, sleep, behaviour change and movement, weight loss and so much more. So please do take a moment to check them out. They are all available as

• 1:44:34Rangan Chatterjee?

  paperbacks, ebooks and as audiobooks, which I am narrating. If you enjoyed today's episode, it is always appreciated if you can take a moment to share the podcast with your friends and family or leave a review on Apple Podcasts. Thank you so much for listening. Have a wonderful week and please note that if you want to listen to this show without any adverts at all, that option is now available for a small monthly fee on Apple and on Android. Or you have to do is click the link in the episode notes in your podcast app. And always remember, you are the architect of your own health. Making lifestyle changes is always worth it, because when you feel better, you live more.