A Masterclass On Plant-Based Nutrition

For the past year and a half, we’ve been creating quarterly episodes centered on a singular theme offered as an RRP Masterclass. These compilation episodes are derived from multiple past guests, and today, we focus our attention on plant-based nutrition. To gain the greatest insight into this topic, my team and I mined wisdom from the most esteemed doctors and the foremost experts in nutrition science that have graced the show—individuals who have direct experience with the impacts of a standard American diet, treatment protocols that include lifestyle changes toward plant fuel, the impact, and reversal of serious cardiovascular issues. The full guest list with links to their full episodes is below. Guest list: #678 – Dr. Gemma Newman #664 – Simon Hill #410 – Dr. Dean Ornish #79 – T. Colin Campbell #522 – Dr. Michael Greger #150 – Dr. Garth Davis #507 – Dr. Michael Klaper #492 – Dr. Neal Barnard #140 – Dr. Robert Ostfeld #589 – Drs. Dean & Ayesha Sherzai #349 – Dr. Joel Kahn #325 – Dr. Kim Williams #541 – Dr. Alan Goldhamer Show notes + MORE Watch on YouTube Newsletter Sign-Up Peace + Plants, Rich 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.

• 0:00Rich Roll?

  Eating well rarely falls apart because of one big failure. It's the daily question that wears you down. Like, what am I actually gonna make tonight? What's in the fridge? And it's exactly why we built the Plant Power Meal Planner. It's a personalized, plant-based meal planning program that matches you with recipes based on your taste, your allergies, your cooking skills, and how much time you actually have. You build, through this program, a balanced, nutrient-dense plan for your entire household in a few minutes. Then, it generates a grocery list for you with one click that plugs right into our delivery partners. All the recipes in the program are built by dietitians with culinary training. Plus, you get your own food coach to help you problem-solve along the way.

• 0:44Rich Roll?

  It's kind of an amazing thing. For listeners of the show, all you special people, we're offering an exclusive $20 off an annual subscription right now. To get it, go to meals.richroll.com, take your quick personalization quiz, and enter promo code RICHROLL20 at checkout.

• 1:13Rich Roll?

  The Rich Roll Podcast. One of the most fundamental aspects of being human is our innate, daily reliance on food to survive. The food we eat, of course, delivers essential nutrients to our bodies, gives us the energy to perform our daily tasks, and it can also unite people of every cultural background around this universal need that we all share. But no matter what your dietary restrictions may be, or what your preferences are, I think we can all agree that not all food is created equal. On a personal level, 16 years ago, I suffered a health scare and became motivated, for the very first time, to give up junk food and attempt to eat healthier.

• 1:58Rich Roll?

  And that journey led to a profound and surprising discovery, which is that the more whole-plant foods predominated my plate, the better I felt and the better I performed. This epiphany led me to adopting a 100% plant-based diet, which has served me better than well for the past 16 years. It's powered me through some of the world's most grueling endurance challenges, and it continues to motivate me to evangelize its many benefits. All of which brings us to today. For the past year and a half, we here at the podcast have been doing quarterly

• 2:36Rich Roll?

  episodes around a singular theme that we characterize and offer up as a masterclass. These compilation episodes are derived from multiple past guests, and we excerpted these guests' wisdom around a particular theme. For example, in past episodes of this series, we've covered addiction, we've talked about mental health, the gut microbiome, spirituality, and longevity. But today, we're going to turn our attention to plant-based nutrition. To gain the greatest insight into this topic, my team and I have primarily turned to the most esteemed doctors and the most foremost experts in nutrition science that we've ever had on the show.

• 3:17Rich Roll?

  Men and women who have direct experience with the impacts of a standard American diet, treatment protocols that include lifestyle changes toward plant fuel, the impact and reversal of serious cardiovascular diseases and issues, and of course, the evidence that being plant-based can and will have dramatically positive results for those that adhere to this lifestyle. And we're going to begin today's masterclass with talking about the difficulties of getting started on a plant-based diet, and why so many people unfortunately end up talking themselves out of this choice. And we're going to have that conversation with the Plant Power doctor herself, Dr. Gemma Newman.

• 3:57Rich Roll?

  But first. Okay, Dr. Gemma Newman. Gemma is a senior partner at a family medical practice in the UK, where as part of her practice, she provides evidence-based nutrition and lifestyle advice to her patients. In this first clip, Gemma helps us answer tough questions like, how can we choose a lifestyle that is typically not widely socially accepted? And what is the right mindset in a relationship when one partner chooses to be plant-based and the other does not? Dr. Newman is uniquely suited to help answer these questions because she herself reluctantly

• 4:40Rich Roll?

  came around to a plant-based lifestyle later in life and in her medical practice. So here we go. This is me and Dr. Gemma Newman.

• 4:52Rich Roll?

  Perhaps even the bigger issue in stumbling block is really the social issue. Like, people get all up in their heads about what other people are gonna think about them, what's gonna happen when they go to Susie and Dave's, you know, dinner party and they don't wanna make a fuss, or I have to go on vacation with my neighbors and, you know, it's just gonna be too problematic. And people, like, relinquish their boundaries or, you know, are just too afraid to stand up for themselves or to, like, make that conscious choice because they don't wanna be difficult.

• 5:25Gemma Newman?

  Yeah, I can totally relate to that because that was my instinct, first of all, when I started on this journey. My main thought was, oh, this is gonna be so awkward for everybody. People are gonna think this is so strange, you know. It's, I think, as social creatures, it's one of the main considerations that a lot of people have. And I guess it comes down to living in alignment with the things that you most want. And do you most want to be somebody that pleases others? Do you most want to be somebody that lives in alignment with things that are important to you? Are those things one and the same? If you can have a conversation with yourself around the values that you're living by,

• 6:08Gemma Newman?

  it becomes much easier to then make conscious choices that are in alignment to those values. So I would actually encourage everybody to have this conversation with their loved ones, or even just with themselves. They could write it down in a journal, write down their top values in life and how their food choices can relate to those values. And then it becomes a lot easier because you're taking away a lot of the extra choices that you're having to make, or the social situations that you're having to navigate, because you are consciously living in alignment with the things that matter. So if it matters to you to minimize your risk of heart disease because you have a relative that died young, you wanna see your children grow up, then you write that down and you find ways to

• 6:50Gemma Newman?

  make it work within that kind of framework, if you like, your values framework. If animal compassion is important to you, it's probably a lot easier because you've already made that decision for another outside purpose. It's something that's outside of yourself. And perhaps the same can be true for someone that cares deeply about the environment and the planet. They've already made that decision based on a value that's so strong to them that it actually makes it a little bit easier to stick to. I think health... Overall, it's probably one of the first ways people go towards plant-based nutrition, but it's also one of the hardest ways to stick with it if that's your only goal, because it's quite self-focused.

• 7:27Rich Roll?

  Mm-hmm.

• 7:28Gemma Newman?

  Whereas if you can focus on something outside of self, then it potentially could make those choices a lot easier, either environmental health, or animal compassion, or reasons to stay healthy for others. It tends to be, in my experience, ways that make it stick a lot more.

• 7:42Rich Roll?

  Yeah, that's a really good way of thinking about it. One of the questions that I get all the time, I'm sure you do as well, is, "I want to do this, but my partner doesn't want any part of it." And you began this journey, Richard was doing it ahead of you, two different dinners, meals, et cetera. But for a lot of couples, that becomes very problematic, especially when those values might come into conflict with each other.

• 8:06Gemma Newman?

  Yes, you're so right. And I think my advice from that, being the partner that was most reluctant, perhaps I can speak to this more, is the idea that what I needed was patience and time. And sometimes people will never come around. Sometimes the people you love the most will never want to do the things that are important to you when it comes to diet. And I think that taking away that expectation is important, because when you start to expect things of other people, that's where you can start to become very unhappy. You know, it builds kind of criticism in your mind, it builds comparison, it builds expectation,

• 8:51Gemma Newman?

  and that can be quite toxic for your relationship. So my best advice is just to do the thing that's making you happy, do the thing that brings you in alignment with who you want to be, and show your partner through your actions how much happier, how much healthier, and how much more abundant you feel in your life. And then if they want to come along for the ride, they can.

• 9:13Rich Roll?

  Right, but you have to be detached from that expectation. Otherwise, you're going to be vibing them all the time, and then that piousness creeps up, and then it just becomes a disaster.

• 9:23Gemma Newman?

  Exactly, you've got to let that go.

• 9:25Rich Roll?

  Yeah.

• 9:26Gemma Newman?

  You just gotta let that go.

• 9:28Rich Roll?

  Even if it's in the back, well, if I keep doing this, they'll eventually come around. It's no.

• 9:32Gemma Newman?

  No.

• 9:33Rich Roll?

  You gotta like get rid of that.

• 9:34Gemma Newman?

  I do think that that's probably the best way for you to sustain a healthy relationship with the people that you love the most. And it's hard because often the people you love the most may you feel need it the most, especially if they have a health condition that could benefit from doing that. But you have to let it go because it's not your life, it's their life.

• 9:51Rich Roll?

  I mean, that's advice for this particular scenario, but for, you know, a zillion others as well.

• 9:57Gemma Newman?

  Exactly.

• 9:57Rich Roll?

  Like in terms of like partnership dynamics.

• 9:59Gemma Newman?

  Yeah. And in a partnership, you will often have expectations of a partner that are unspoken. And that could be true for any kind of scenario. And that's not to say that you shouldn't communicate the things that are important to you. Of course you should, but it's the expectation that is attached to that, which I think can become very negative in the relationship. So letting go of the expectations of your partner is probably the key to a happier life in all sorts of ways.

• 10:28Rich Roll?

  Did Richard do that?

• 10:29Gemma Newman?

  Yeah, he was very patient with me.

• 10:33Rich Roll?

  But that brings up an important issue, which is, you know, somebody who's listening to this or watching it is thinking, well, my life is just going to become infinitely more complicated. It means like we're going to have to prepare two different meals. I'm going to have to spend all this time in the kitchen. I'm going to have to plan out everything in advance. It's probably going to be expensive and suddenly my life, which was kind of going along pretty good, suddenly gets hijacked by this new lifestyle habit that is going to commandeer all my time, energy and money.

• 11:01Gemma Newman?

  Yeah, and those are valid, very valid concerns. And I guess what I'd say to that person is you have to find the thing that helps you know where you're going for the future. I think a lot of the time we kind of coast through and we do things because they are the path of least resistance. And sometimes the path of least resistance is a great path and it works and everything's going well. But sometimes over the course of maybe weeks, months to years, we start to notice, actually, this isn't really working for me anymore. You know, although this is the easier route. I'm not feeling this. I either don't feel healthy

• 11:43Gemma Newman?

  or there's something niggling me in my conscience about things I want to do differently. And sometimes changes do require a certain amount of forward thinking.

• 11:55Rich Roll?

  So the person who's sticking that seed into the soil right now and getting ready to water it, but doesn't know how to water it, like, how do you think about the early phases of this? Like, I'm somebody who went all in. That's just my personality type. I recognize most people aren't like that. I suspect you're somebody who would counsel people to make tiny changes, master them. Like, how do you get somebody engaged in this and give them some actionable advice about how to begin in a very practical manner?

• 12:26Gemma Newman?

  So number one is literally write down the foods that you buy in your weekly shop. Number two is write down all the foods that you make with those ingredients. And if you can find one meal a week that you'd like to have more plants in, then that can be your first step. Is literally just cook one meal a week that is plant-based and see how you feel. And then if that works for you, then you can cook another one. And then maybe cook another one. There's always a starting point for everybody. If you're somebody that just eats takeout, then, you know what? For you, the best thing would be perhaps just to start with one home-cooked meal a week rather than trying to change everything. Just cook one meal at home rather than having all meals takeout. For my elderly patient

• 13:10Gemma Newman?

  who was just eating like small ready meals from the supermarket, switch to a plant-based one and see how you feel. See if it changes your health over time. So it's just, it is for a lot of people about those baby steps.

• 13:23Rich Roll?

  Yeah.

• 13:24Gemma Newman?

  For others like you, they jump in and they'll get started and they'll figure it out along the way and they'll enjoy that process. And that's great. But for most people, it's just little steps. And, you know, there was research by BJ Fogg to show that only one change is enough to then start changing, shifting that identity and then sort of adding in something new after that. So, yeah, just one thing. One thing is all you need to do.

• 13:49Rich Roll?

  It's one thing to go vegan. It's another thing to go strictly whole food, plant-based. And then optimizing your plant-based diet for things like health, longevity, and athletic prowess is yet another thing altogether. So let's better understand this. And to do that, we should talk to an expert, shouldn't we? About the early stages of your adoption of this lifestyle, some of the things that you should be made aware of, that you should focus on, and you should include in this adaptation to this new way of eating and living. So to do that, we're going to talk to the brilliant Simon Hill, my friend, who is a nutrition science expert. He's an author, a restaurateur. He is a fellow podcaster, just a fountain of practical knowledge

• 14:32Rich Roll?

  that can benefit the newly reformed, as well as the more seasoned, plant-based advocate among us.

• 14:43Rich Roll?

  So let's say, okay, Simon, I've been eating a plant-based diet for six months or a year. How do I know I'm doing it right? What are some of the common things that trip people up or where they go astray before they have kind of the full, you know, encyclopedic knowledge of how to do this properly?

• 15:02Simon Hill?

  There's probably two or three main things that I've identified anyway in working with many people who are going through this. And also through my own experience and talking to people like you. I think the first is understanding when you're minimizing or removing these animal foods that we have grown accustomed to eating all the time. What do you replace them with? Because there's a lot of different options. Everything from black beans and lentils to very processed vegan foods. The second would be understanding the difference between an animal-based diet and a plant-based diet in terms of calorie density.

• 15:45Simon Hill?

  So animal foods are typically much more calorie dense. And therefore, if you're wanting to eat a similar number of calories, your plate needs to look fuller.

• 15:58Rich Roll?

  Right.

• 15:59Simon Hill?

  When it's plant-based foods.

• 16:00Rich Roll?

  I mean, that's a pretty common thing that you hear, like, oh, I tried it, but I was starving all the time.

• 16:05Simon Hill?

  Yes, and that is something that I personally experienced. So as I was making these changes, I was not fully cognizant of the differences in calorie density. And I I was experiencing in in the very beginning of my transition, a little drop in energy. And I I was doubting whether the plant-based foods were working for me. And really, it was just that I was not consuming enough overall calories. So understanding what to replace animal foods with, calorie density. And then the third, I'd say, is having a general awareness of specific nutrients of focus. So all diets, whether it's an omnivorous diet or a plant-based diet, need to be appropriately planned,

• 16:50Simon Hill?

  or they can fall short. And, you know, if we look around at our current sort of state of health, the the omnivorous diet's not really serving us that well. It has a number of holes and gaps. And while a plant-based diet can really improve your overall disease risk profile, and we spoke a lot about that in terms of, you know, shifting these biomarkers in a favorable direction, your cholesterol, your blood glucose control, inflammation, blood pressure, and lower your risk of these chronic diseases that are plaguing our society. At the same time, there are a few nutrients that you need to be aware of

• 17:32Simon Hill?

  so that you are getting them in the the required amounts to not just prevent your risk of these chronic diseases long term, but to really optimize yourself and and feel at your best in your day to day.

• 17:45Rich Roll?

  So the obvious next question being, what are those nutrients?

• 17:49Simon Hill?

  Yeah. So I I call these nutrients of focus. And I think that's a positive spin on nutrients of concern. And I just, I want people, I wanna draw people's attention to them. In the book, I write about eight of these. And some of these are quite easy to get through your diet and or fortified foods, and then others are best accessed through a supplement. So as a list, these are vitamin B12,

• 18:20Rich Roll?

  Mm hmm.

• 18:21Simon Hill?

  vitamin D, omega three fatty acids, iodine, iron, calcium, zinc, and selenium.

• 18:31Rich Roll?

  Right. So, given that, a skeptic would say, well, if I have to pay extra close attention to these things, or I have to go outside of my food that I'm consuming and supplement, then this must be a deficient diet by definition.

• 18:50Simon Hill?

  Mm hmm. I think we need to zoom out a little bit and understand that nutritional gaps are nothing new. And it's the very reason that folate and iodine have been used throughout the food system, fortifying foods, to prevent iodine deficiency and folate deficiency in the general public. So this idea of fortification or supplements is nothing new. And lots of those nutrients I just reeled off, like zinc, selenium, iron, calcium, you can easily access them through your diet. You don't need to supplement those. It's just a matter of understanding what foods do you want to be incorporating in your diet regularly?

• 19:32Simon Hill?

  And for example, if you're choosing a plant-based milk to swap out dairy, which is rich in calcium, what should you be looking for?

• 19:39Rich Roll?

  Mm hmm.

• 19:40Simon Hill?

  Uh, and what we should be worried most about is heart health outcomes. So I, I have nothing against a diet that includes some supplementation, if that means the best outcomes for, be it for myself or, or anyone that I'm working with. And, and that is what the data suggests. If you wanna move down this path of very plant-rich, plant-predominant diets, or even plant-exclusive, to lower your, your risk of chronic disease, then taking some of these supplements is going to allow you to do that in a more optimal manner.

• 20:15Rich Roll?

  Right.

• 20:19Rich Roll?

  An early advocate and practitioner of preventative medicine long before it was trendy, Dr. Dean Ornish is an absolute legend in the plant-based nutrition movement for his groundbreaking work in the holistic prevention and reversal of chronic lifestyle diseases. His vast experience and deep wisdom are perfect primers for those curious about the benefits of a whole food, plant-based lifestyle, and he's here today, so let's hear from him.

• 20:50Dean Ornish?

  Well, first of all, unfortunately, because I debated Dr. Atkins so many times, and he was the low carb guy, I got pegged as the low fat guy. Our program has never just been about fat. It's really about a whole foods, plant-based diet that's low in fat and sugar, and stress management, moderate exercise, and what we call social support, which is really love and intimacy, or eat well, move more, stress less, love more, you know, that's it. But even the idea of fat, the problem was, number one, you know, people say, "Oh, Americans have been told to eat less fat, you know, we're fatter than ever, low fat is dead, it's all sugar." But we may have been told to eat less fat, but I went to the US Department of Agriculture database because they keep track of the entire food supply, not what people say they're eating, but what they're actually eating. And oftentimes, there's a big discrepancy, and what we found is that in every decade

• 21:35Dean Ornish?

  since 1950, we may have been told to eat less fat, but we're eating a lot more fat, 67% more fat, more sugar, more meat, and more calories.

• 21:44Rich Roll?

  More of everything.

• 21:44Dean Ornish?

  More of everything. So not surprisingly, we're fat, not because we're eating too little fat, but because we're eating too much of everything.

• 21:49Rich Roll?

  Yeah, so the idea is that it's not that the low fat thing didn't work, it's that people didn't actually do it.

• 21:55Dean Ornish?

  And the other thing is, besides eating more fat, is people, when they did replace fat, they would replace it with sugar. So you have the Snackwell cookies, and you know, the Entenmann's cakes, and things like that, and that's not a good choice.

• 22:05Rich Roll?

  Right.

• 22:06Dean Ornish?

  But I think if you actually look at all of the data, there's more evidence than ever that an optimal diet is low in fat and low in sugar, it's predominantly fruits, vegetables, whole grains, legumes, soy products in their natural forms. And we've been doing studies for 40 years, so, you know, having been in all these different diet wars and diet debates, I said, you know, "Look, I'm done." You know, we've done... Every study that we've done has shown that these same lifestyle changes can reverse heart disease. We're able to show that for the first time. Type 2 diabetes, high blood pressure, high cholesterol, obesity. We're doing another first randomized trial now to see if we can actually reverse Alzheimer's disease. We found that when you change your lifestyle, it changes your genes, you know, hundreds of genes, over 500 genes in three

• 22:48Dean Ornish?

  months, turning on the good genes, turning off the bad genes in just three months. We found that in a study we did, we published that with Craig Venter, who first decoded the human genome.

• 22:58Rich Roll?

  Right.

• 22:58Dean Ornish?

  We did a study with Elizabeth Blackburn, who got the Nobel Prize for discovering telomeres, the ends of our chromosomes that regulate how long we live. We've showed for the first time that in just three months, we can increase telomerase, the enzyme that repairs and lengthens telomeres, by 30%. And over a five-year period, we showed again for the first time, we can actually lengthen telomeres, in a sense reversing aging at a cellular level. So the more diseases we study, and the more underlying mechanisms we look at, the more reasons we have to explain why these simple changes are so powerful, and how quickly people can get better. These things are so much more dynamic than we once realized, that when you eat this way, your brain gets more blood flow. You can actually grow so many new brain neurons. In just a few weeks, your brain gets bigger, and particularly those parts of your brain, like the hippocampus,

• 23:40Dean Ornish?

  that control memory, that you want to get bigger. You know, when people get older, they say like, you know, what was, where did I leave my keys? And what was that person's name? A lot of that's reversible. Your skin gets more blood, so you don't age as quickly. Your heart gets more blood. We found you can reverse heart disease. Your sexual organs get more blood flow. And when people realize that it's not just about living longer, it's about feeling better and improving the quality of life, it really reframes that debate from, you know, fear of dying, which is not sustainable, to joy of living and feeling good and pleasure, which really are.

• 24:10Rich Roll?

  Right. What is the difference between how the body metabolizes animal protein versus plant protein? Or is it like the saturated fat and cholesterol that generally is conjoined with? The intake of animal protein.

• 24:23Dean Ornish?

  Well, animal protein is harmful and plant-based protein is not only not harmful, it's actually protective. There are literally hundreds of thousands of substances in fruits and vegetables and whole grains and legumes and soy products that have anti-cancer, anti-heart disease and anti-aging properties. Things like phytochemicals, bioflavonoids, carotenoids, retinols, isoflavones, genecine, lycopene, there's a whole alphabet soup of these things. And where do you find them? With few exceptions, you find them in plant-based foods. The animal-based foods, besides being high in saturated fat and dietary, I mean, you only get dietary cholesterol in animal products, is the animal protein itself is inflammatory. And in our new book, part of what this kind of unifying theory that we're putting together

• 25:05Dean Ornish?

  for the first time is, why is it that these same lifestyle changes are so powerful? The more diseases we study, the more underlying mechanisms we look at, the more reasons we have to explain why these changes are so powerful. And it's because although we tend to think of heart disease as being different than diabetes, different than prostate cancer, different than Alzheimer's disease and so on, the radical idea here is this unifying theory is that they're not. They're different expressions of the same underlying disorders. The mechanisms like chronic inflammation, oxidative stress, overstimulation of the sympathetic nervous system, changes in the microbiome, changes in, as we've been talking about, in gene expression and telomeres and angiogenesis.

• 25:45Dean Ornish?

  And each of these mechanisms in turn is affected by what we eat, how we respond to stress, how much exercise we get and how much love and support we have. And so, seeing this larger context, the animal protein activates all of these different mechanisms in negative ways, which is what makes it harmful, independent of the fact that it's also high in saturated fat, dietary cholesterol and other things like that. You know, it's like, people say, "Oh, I'm not going to get enough protein on a plant-based diet." Then you say, "Well, ask Mr. Elephant." Or ask Rich Roll. I mean, you're a living example of what can be done on a plant-based diet. I mean, most guys would be happy to do half of what you can do.

• 26:26Rich Roll?

  My next guest may not have invented the whole food plant-based diet, but he is certainly the regal lion of the movement. He's a guy who pioneered it from fringe acceptance all the way to widespread mainstream adoption. Of course, I can only be referring to the one, the only T. Colin Campbell, the man best known for writing an incredible book called The China Study, which to date is one of the most important groundbreaking massively bestselling books ever written on health and nutrition. This is excerpted from a conversation we recorded many years ago, so I'm very excited and proud to resurface this clip, this excerpt, between me and T. Colin Campbell on the power of a plant-based diet.

• 27:07Speaker 04

  It really coming back to the question concerning animal protein. I mean, that had been a lifelong or career-long question because we were able to, in the prior studies, were able to show that we could turn on and turn off cancer just simply by feeding, of all things, the protein of cow's milk, which brought me back to the dairy farm in a sense. And that was very provocative, to say the least.

• 27:32Rich Roll?

  And I think it's, you know, there might be a perspective out there that you were out to, you know, sort of prove, to establish an objective that you already believed in. But you're coming from this dairy farm background and it had been your whole, you know, the conviction of your entire upbringing that, you know, milk does a body good, that this is the perfect food, right? So where did you start to begin to see kind of cracks in the firmament of that concept?

• 28:02Speaker 04

  Well, it was the initial observation, I think, we did with the, there were some Indian researchers who had done some laboratory animal studies that showed that at the time that I was in the Philippines. But they didn't believe what they got. It was published in an obscure journal, but I kind of believed it because it was consistent with what I was seeing with the children. And so as we went into that research, we looked at it in great depth and I had become convinced, you know, by that time, we did it so many different ways, that animal protein actually increases cancer risk, period. And so I was really interested to know in the China study whether there was any evidence for that. And my bias was to find the opposite.

• 28:47Speaker 05

  Right.

• 28:48Speaker 04

  Really was, I mean, if I had a prejudice.

• 28:51Speaker 05

  And that's a very important point, you know, I think that, that you weren't out to, you know, sort of be on this crusade to, you know, with this foregone conclusion that you already had in your mind. You went out and you surveyed a gigantic population of people across innumerable variables and remained open-minded and to take what you just said, hopeful that maybe it might prove the opposite.

• 29:19Speaker 04

  That's right, absolutely. I was always kind of swimming upstream against my own sort of prior prejudices. But finally, the evidence was overwhelming. With respect to, for starters, was the effect of animal protein on encourage the development of cancers, if you will. But then there were other questions that arose too at the same time and always having this doubt, you know, about the significance of this. We would ask, I would want to ask broader questions. What if we eat animal protein-containing foods? What if it all the other nutrients that come along with it? What's happening there? Do they cancel each other? So we started investigating other nutrients, other cancers, other diseases. And the more that I looked, the more consistent became the data.

• 30:04Speaker 04

  Everything seemed to, all the nutrients in animal-based foods as opposed to all the nutrients in plant-based foods, they seem to be doing opposite things. And their activities were sort of mutually supportive, you know, at the biochemical, physiological level. So the story became, for me, even ever more impressive. Was, but it was always coming from a position, in my case, in a sense, of almost trying to disprove.

• 30:31Speaker 05

  Right.

• 30:31Speaker 04

  You know, what I had observed.

• 30:33Speaker 05

  And this is, this is a landmark discovery, right? This is, this had never been sort of established or presumed or even conjured by anyone prior to you.

• 30:44Speaker 04

  It's an interesting question, I'll comment it in just a minute, but yes, when we were doing all the research in the laboratory and because of my skepticism about a lot of things, what we ended up discovering were a lot of fundamental ideas that were against the rules, against what I was teaching and against what was in the books.

• 31:00Speaker 05

  Such as?

• 31:01Speaker 04

  Well, for example, turning cancer on and off by nutritional means. I mean, that was a big deal. And it turned out, we didn't do it just for protein and liver cancer. We also did it with dietary fat and pancreatic cancer and things like this. So that phenomenon of thinking about the causation of cancer and later other diseases as a result of simply modifying nutrient intake and the idea of actually reversing disease.

• 31:27Rich Roll?

  Right, it's the turning off part.

• 31:28Speaker 04

  We were reversing disease.

• 31:29Rich Roll?

  Yeah.

• 31:30Speaker 04

  And cancer, I thought, this is incredible. And so we were learning other things too, like that the relationship between nutrition and genes. A lot of people think, and a lot of people still think, that somehow genes predetermined whether or not we're going to get a certain kind of disease. And what we are showing, no, it's not the case. We can have the genes to cause it, to start the initiation of events, but that is, we can control it by nutritional means. Big thing. Another one, sort of principle, like if you will, and A, like protein, it causes cancer, let's say for starters. One of the things that I was really being pushed to do to prove my point was to find

• 32:12Speaker 04

  what the mechanism was, which enzyme, which is that. And so we started looking for the mechanisms. And I had a series of PhD students spending four or five years, each of them looking at a mechanism. And it turned out, there is no such thing. So that was another myth that I was all of a sudden running across too. And so a lot of the things that we learned really were, I think, the result of my skepticism.

• 32:35Rich Roll?

  Who's next? My friend, Dr. Michael Greger is next. That's who. Dr. Greger, for those that don't know, is one of the preeminent authorities on the plant-based lifestyle and plant-based nutrition. He's the man behind the Nutrition Facts website, which is an incredibly robust resource for searching for the latest, most up-to-date information on a vast spectrum of medical, nutritional, and lifestyle topics. He's also the wildly bestselling author of books, including How Not to Die and How Not to Diet.

• 33:17Rich Roll?

  He is an incredible communicator of nutritional information. I love him to death. So here is a clip between me and Dr. Michael Greger.

• 33:30Rich Roll?

  What is a day in your personal life with food? Like, how do you make it work?

• 33:34Michael Greger?

  Well, on the way, well, yeah.

• 33:36Rich Roll?

  Knowing that you're on planes. And how do you deal with the airports and all of that?

• 33:40Michael Greger?

  Yeah, airport food courts. Yeah, well, look, it's getting easier. Now you can get like brown rice in an airport. I mean, that's great. Like you see, like, you know, fast casual places like, you know, things you never expect to see before. And look, there's, you know, I've grown better, you know, if I can, you know, land someplace and find a Whole Foods and have a hot bar and I can grab some food and, you know, first few days I have snacks and then slowly it's all gone. You know what I've been doing recently is I, we tell the organizers, you gotta bring me food. You know, I mean, there's only so many.

• 34:07Rich Roll?

  Put it in the rider.

• 34:08Michael Greger?

  There's only so many sweet potatoes I can get on my plane.

• 34:11Rich Roll?

  Here comes Gregor, he's the guy with the crazy rider.

• 34:12Michael Greger?

  Right, right, right.

• 34:13Rich Roll?

  Who does he think he is, Van Halen?

• 34:14Michael Greger?

  Not only no green M&Ms, no M&Ms, period. It's all, right. Um, and so, right, and so, look, I, you know, I need to, I, yeah. And typically, I don't even have time, even if I could, I mean, right, even if there's healthy food around, here I am, Southern California, I can get healthy food, but I don't have time. I mean, it's just.

• 34:31Rich Roll?

  And on the rare days that you're at home.

• 34:33Michael Greger?

  Oh, now then, once I have control over my life.

• 34:37Rich Roll?

  I love how excited you are.

• 34:38Michael Greger?

  And no, that's a beautiful thing. I, well, I mean, I just, yeah, this is my first day of this, this few week stint. And so I'm feeling the, the leaving home thing. It was, it was, it was hard to get up this morning, but, um, yeah, then I can eat this beautiful diet. Oh my, and it's like, it's like, it's like, it's like a game, like, how healthy can I get? I mean, it's really, um, and, uh, and you know what helps? So I do a lot of food delivery, like Whole Foods delivery. And then, then you're not even tempted to buy junk because it's not in front of you, grab, and so it's like everything I eat. So my house just has healthy food. And so if you get hungry enough, you're gonna eat an apple, right? I mean, there's nothing, you will eventually eat that apple, right? And so with only healthy stuff.

• 35:23Michael Greger?

  You know, I can, I can build up my, my healthy immune system.

• 35:26Rich Roll?

  Always making the healthy choice the, uh, the, the most convenient.

• 35:30Michael Greger?

  Right. Oh yeah. I could go out in a, in a, in a Philadelphia winter and bike someplace to get something, to bike to the doughnut shop, but so much easier when I have a fridge full of yummy food.

• 35:42Rich Roll?

  And do you prepare stuff ahead of time?

• 35:44Michael Greger?

  Uh, I do a lot of batch cooking.

• 35:46Rich Roll?

  Yeah.

• 35:46Michael Greger?

  Yeah. Yeah. Um, particularly now I'm doing a lot of this, this prebiotic mix. I talked about my, uh, when I, in studying the, improving your, uh, uh, microbiome for the new big microbiome chapter in the, in the diet book. Um, and just learning how, again, how important microbiome is and where are the most concentrated source of prebiotics. And so I, I, I discovered sorghum for the first time, discovered all these weird millet's that I had no idea, that have poorly digested starch. And so they are fed to animals, but poorly digested starch is exactly what we want, because it's poorly digested in our small intestine, makes it down to our lower intestine, where our good gut bugs can have a bounty of prebiotics and then has all those knock on benefits.

• 36:26Michael Greger?

  And so that's the kind of thing where I just insta-pot a huge amount and just, you know, tempware in the fridge. Um, and, you know, take out one every day as soon as it's over and, you know, so I always have, uh, always have my intact grains and a whole bunch of wonderful black lentils. And then it's a matter of just getting greens in the house.

• 36:44Rich Roll?

  What else did you learn about the gut biome in prepping for this book?

• 36:48Michael Greger?

  What's neat is now we have these interventional trials. So we've always known, so, flashback a few years ago, it was a black hole, almost no pun intended, where, because most gut bugs are actually unculturable in laboratory conditions. Like we can't grow them outside of the human colon. We don't know without gas, we don't know. And so it, we had, it was black box. We had no idea what was going on there until we had genetic fingerprinting techniques. And all of a sudden, for the first time, we'd be like, oh, okay, we can actually track people's microbiome over time, compare people's different microbiomes, and we can correlate diseases with, um, with different, uh, bugs in our gut and change people's diets, change the microbiome, see the beneficial or adverse effects.

• 37:30Michael Greger?

  But that's the problem. If you improve someone's diet, all of a sudden you give people lots of whole grains and legumes, beans, split peas, chickpeas and lentils, lots of prebiotics, they get these beneficial changes in their microbiome and all of a sudden they have amazing health benefits. Uh, yeah, but you just fed them a whole bunch of healthy food. How do we know microbiome has anything to do with it? That's where fecal transplants come along, right? Then we can prove it's the microbiome because we can take those gut bugs and put it into somebody who's continuously the crappy diet and see if we can get those same metabolic benefits. And that's what we're seeing. So we're seeing, um, yeah. So, you know, someone gets a fecal transplant for someone who's overweight, all of a sudden they start packing on pounds, eating the same food. Um, or there's

• 38:14Rich Roll?

  That's crazy.

• 38:15Michael Greger?

  Mental health changes, um, all sorts of crazy things. Um, and then we can prove it's the gut bug. Now, what happens is of course it's temporary because, right, you, you infuse the gut bugs, but then you keep starving them by not eating any fiber and then they die away. But you see initially those same benefits. Of course, you got to feed those gut bugs or they're going to die off. But, but so, so what went from a, from a correlation science, now we have a causation science. Um, and it's just fascinating that we can transfer the benefits of healthy diet. So, so, I mean, so the, the black market rich roll stool, you could, I mean, you know, the, the, the, the, the, I mean, yeah.

• 38:58Rich Roll?

  Start selling that shit.

• 38:59Michael Greger?

  Exactly. I mean, who wouldn't pay?

• 39:02Rich Roll?

  It is, it is fascinating. I mean, the links to cravings as well, like the nature of the gut flora impacts the foods that you crave.

• 39:11Michael Greger?

  Yeah, yeah, yeah, yeah.

• 39:13Rich Roll?

  And it, it also, I think, is, is because it's so complex that it's ripe for confusion and people kind of making claims about what you should and you shouldn't do, that we don't necessarily have the ability to really back up at this point.

• 39:30Michael Greger?

  Particularly this kind of personalized nutrition, like people all the time are sending me things, I sent my stool sample in to this company and gave me back a thing and said, I should be eating this and I shouldn't be eating this. We don't have that kind of granularity.

• 39:42Rich Roll?

  The science doesn't back that up.

• 39:43Michael Greger?

  It does not. Same thing with DNA testing, right? People that get back their genome and say, oh, well, I, you know, I'm whatever, I shouldn't be eating the X, Y, and Z. We don't have that kind of.

• 39:51Rich Roll?

  But is it true, we should be eating fermented foods and we should be eating, you know, nutritionally, a variety of nutritionally dense foods to be kind of seeding that gut flora with a diversity of bacteria?

• 40:06Michael Greger?

  So it's the three, right? It's prebiotics, probiotics, and polyphenols, which are these kind of tend to be brightly colored pigments in fruits and vegetables. These are kind of the three, the three things that benefit a good microbiome and you can use all three of them or just two of them. I mean, the problem with probiotics is you take them and then they just die off. You don't continue to eat healthy. And so if you just have like antibiotic associated diarrhea or something, you wipe out your gut bugs, then I see a therapeutic role of something like probiotics. But otherwise, taking probiotics is useless because they'll just die off. If you put them in the same environment that didn't grow good gut bugs in the first place, putting in some good acidophus, they're just gonna die off because you're not feeding the acidophus. Because good gut bugs are by definition fiber feeders,

• 40:48Michael Greger?

  resistant starch eaters. These are, I mean, that's what makes good gut bugs grow. And so what we really need is we just need to feed our good gut bugs, prebiotics. And people are like, oh, I eat so many fruits and vegetables. But must realize, fruits and vegetables are almost all water. Like, you know, fruits are like 80% water, some water rich vegetables 90, 95% water. They're water in vegetable form, not actually a lot of fiber. You can actually have a pretty deficient, fiber deficient diet if you're not including whole grains and legumes, some of these drier foods into your daily diet.

• 41:21Rich Roll?

  Wow.

• 41:24Rich Roll?

  What can we learn from one of the leading weight loss surgeons in the country? Well, next up is Dr. Garth Davis. Garth is a friend. He's a multiple podcast guest. He's the author of an incredible book you should all read called Protein Aholic, and somebody who is well steeped in the medical literature of countless studies. The conclusions drawn from his in-depth reading and direct surgical practice experience are that if we want to prevent obesity and disease, if we want to attain and maintain ideal weight management, and if we want to ultimately achieve true optimal health and long-term wellness, we're going to need to embrace our inner herbivore.

• 42:06Rich Roll?

  So I think in one of your, I think it was in your talk that I saw recently, you said something like, you know, only 3% of the population is protein deficient, and but

• 42:17Speaker 07

  No, I would say less than that.

• 42:18Rich Roll?

  But like 97% of the population is fiber deficient. And what we should be talking about is fiber and not protein.

• 42:25Speaker 07

  Right. Right. When you look at, they came out the new NHANES data and what do we actually eat in this country? No one's protein deficient. You've got to understand the RDA.

• 42:33Rich Roll?

  Well, protein deficiency would be starvation.

• 42:36Speaker 07

  It would be starvation.

• 42:37Rich Roll?

  Like corn sugars.

• 42:38Speaker 07

  Yeah, exactly. You'd have to, you would have to not be eating, you'd have to be eating less than 1,000 calories to probably get it. And so we just don't see that. So the RDA, when they set up their recommendation for protein requirements, they based it on some nitrogen balance studies and all this kind of stuff. And they came up with a figure, like for men, 56 grams, and for women, 44 grams or 42 grams. And that figure is actually an optimal amount. It's not a minimal amount. I think people think that's the lowest amount that I should get. It's actually the optimal amount. Based on those studies, probably you would do fine with 30 grams of protein, but they just wanted to make sure that everybody was covered. Now, we eat seventy to a hundred, sometimes a hundred and thirty grams of protein a day.

• 43:22Speaker 07

  So, we're way over the optimal amount. We're way in excess. And all these studies where they've gone and interviewed people, the one thing everyone's looking for is even more protein. It's crazy. Yet, we eat unbelievably low amounts of fiber. And there are not a lot of good studies that show that there's long-term health in eating a lot of protein. There's tons of good studies, tons and tons, showing eating a lot of fiber is good for you long-term. And we are unbeliev- we're in a mass deficit of fiber, and yet, no one's talking about that. Because it's not just the fiber, it's what the fiber is. You know, there's no fiber in the animal products, there's only fiber in the plant.

• 43:56Rich Roll?

  Right, but if you forget, just forget about protein, and let's shift all of that focus that you had on protein and put it on fiber, and then see what would happen.

• 44:04Speaker 07

  Yeah, my message would be, it's almost impossible not to get enough protein, no matter what you're eating. That's number one. Number two, eating more protein will make you sick eventually. And number three, eating more plants is really like finding the fountain of youth. Makes you, it's not just, because people say, "Well, I don't care if I live, you know, ten years longer, if, you know, I have to eat that crap." The food's delicious, it's nutritious, your whole taste buds change.

• 44:35Rich Roll?

  That's the thing I think people miss or don't get.

• 44:38Speaker 07

  They don't get that.

• 44:38Rich Roll?

  And they can't imagine that they'll actually get to a place where they will desire or crave healthy foods.

• 44:44Speaker 07

  Yeah, I have patients say to me, "I wish I had your willpower." To me, it's not willpower, it's not willpower for me to eat a kale salad, I crave a kale salad. But I used to crave a double cheeseburger. And you could change that, I could talk about how I change that with patients, but you could change this thought process, and you could change your taste. And everybody who goes through it, I get this, you know, blessing, you know, all these people online yakking about this and that, and they've never treated a patient. I get to sit across from a patient, actually see these changes. And the changes are amazing, the way people feel, the way they look, what they're doing in their life, it's really- Rewarding and when I think about how many people in this world could benefit if we just got rid of this idea of protein and went to the idea of, you know, whole foods,

• 45:26Speaker 07

  fruits, vegetables, beans, it would really change the health of the country, the health of the environment and, uh, and, and have so many other benefits out there. I personally never count, ever, never count. I never think to myself, I need to get protein. I'll make a post-workout shake where I will throw in some hemp seeds and I'll get some protein there. I eat nuts during the day, I'll get protein there, I eat a lot of beans. And I'm only getting stronger and faster.

• 45:54Rich Roll?

  I mean, is there an argument to be made that, uh, that the protein from animal flesh is qualitatively different from the protein from plants? In other words, is an amino acid an amino acid irrespective of where it comes from? Or is the matrix in which it's delivered to your body, does that make a difference in terms of how you metabolize it, the bioavailability and all of that?

• 46:19Speaker 07

  Yeah, you know, um, you bring up a good point, but, um, the studies that have shown that bioavailability of plant-based proteins is excellent. Um, like for instance, plant-based proteins are much higher in glutamic acid. Now glutamic acid is fantastic for lowering blood pressure, which might be part of the reason plants are so good with lowering blood pressure. Meat-based proteins are higher in branched-chain amino acids. Now, if you're a bodybuilder, this is good for several reasons. It increases IGF-1. IGF-1 is a growth hormone. So it's a growth hormone, you're gonna grow your muscles. Number two, um, there are definitely, uh, things like leucine definitely stimulate muscle protein synthesis. And so if you're a bodybuilder, you wanna stimulate muscle protein synthesis. But here's the catch.

• 47:04Speaker 07

  We know from aging studies and from cancer studies that having a high IGF-1 and high leucine actually leads to premature aging and cellular death and cancer. Mm-hmm.

• 47:17Speaker 07

  What I'm seeing from these bodybuilding protocols that may in fact make a bodybuilder have more muscle, may make them unhealthier in the long term. I mean, it's impossible to do a good study on it, but if you look at old bodybuilders, they all have a scar down the middle of their chest. They've all had heart surgery. Now, is it the high protein diets? Or is it the steroids? You know, I can't differentiate that and tell you that. Definitely, a heavy animal protein diet is associated with heart disease, definitely is associated with high blood pressure, and it's definitely associated with a shorter length of life. And the interesting thing about the longevity studies is, we talked about taking out confounding factors. If you take out a lot of confounding factors, you get to the point where you're almost taking away a correlation. And yet, after

• 48:02Speaker 07

  really rigorous statistical analysis, there's still a finding that if you eat a plant-based diet, or if you eat less meat, you live longer.

• 48:15Rich Roll?

  After a lifetime, what do seasoned medical doctors have to say to incoming doctors as they pass through their medical training? Well, Dr. Michael Clapper personifies that question. Dr. Clapper is a renowned physician who spent his years treating diseases that he felt were reversible or completely avoidable. But rather than impacting single patients at a time, he shifted gears and went directly to the medical schools to lecture incoming physicians on the virtue of food as medicine. Here is Dr. Clapper.

• 48:52Rich Roll?

  Over the course of your many-decade career, I'm sure you've seen diet trends and fads come and go. And, you know, it's interesting to see what sticks and what doesn't and what passes. I'm sure you've seen it all.

• 49:08Rich Roll?

  And right now, we're in a moment where we are seeing, you know, the explosion of interest in plant-based diets and the science that backs it up. In lockstep with that, though, there's also a very, you know, strident, growing movement around low-carb eating and the keto diet. And so I'm sure these questions come up all the time, especially with these students and just in general. So how do you kind of think about that? And how do you communicate around those other protocols? And what is your perspective on that?

• 49:39Speaker 08

  Oh, my. There's another show in itself.

• 49:42Rich Roll?

  We've got time. We've got plenty of time.

• 49:44Speaker 08

  Great. Okay. Well, we'll go into it.

• 49:45Rich Roll?

  I mean, this is like, you know, listen, there's a lot of plant-based people that listen to this show, but there's people that are on different kinds of diets.

• 49:51Speaker 08

  Absolutely.

• 49:51Rich Roll?

  And I think the reason I'm asking you this question is, you know, for even a very well-educated, motivated listener, or just consumer in general, they go online, or they, you know, read whatever's happening, and they see the stuff about plant-based, but they also see the stuff about keto and low-carb. And it's confusing, even if you're, you know, going to PubMed and, and reading abstracts, which almost no one does, it's still confusing, right? There's science to support different perspectives, and it's all very disorienting. And so I'm always trying to drive people towards, you know, what is common sense here? Where, you know, what do the facts really say? What does the science really say? And what are some principles that we can hang our hat on that can guide

• 50:33Rich Roll?

  us in a trajectory that's doable in the context of our busy lives?

• 50:38Speaker 08

  Very important, of course. So we'll put on our miners cap here and drill that out. And it starts with a recognition on everyone's part, how toxic the standard Western diet has become. And if you're especially even dabbling in fast foods at all,

• 51:03Speaker 08

  Every piece of meat you eat is gonna be, come with, with white bread and sugary ketchup and hydrogenated oils and, and the toxic load that comes with, whether it's the peaches or the burgers or the buffalo wings, et cetera. And all the diets who are serious about getting people healthier, whether it's paleo or keto or plant-based, whatever, all of us, we all, we strip away that, that outer hull of toxic foods.

• 51:33Rich Roll?

  We can all, we can all agree that

• 51:34Speaker 08

  We all agree.

• 51:35Rich Roll?

  Standard American diet, the fast food diet is bad.

• 51:37Speaker 08

  Indeed. And once you do that, that, that step alone is a quantum leap, is a huge improvement. And you reduce a huge load of refined sugars and, and fats and foods that are grossly obesogenic. And as a result, people, especially the, the paleo folks, strip out the dairy products as well, and, as well as the oils. And when you take out the dairy, the oils and, and junk flour products, people are gonna lose weight. And the very act of losing weight does good things in most people's bodies. And their lipid profiles get better, their diabetes gets better, they feel better, their

• 52:22Speaker 08

  energy level goes up. And so you see this improve, this initial improvement in health in, in most all of these dietary styles. And it's enough to provide very powerful reinforcement. I went paleo, boy, I lost weight, felt good, man, that's the diet for me. And, and I hear that with, with the keto folks as well. But as a physician and as a person who respects the biology of this, this body that we have, I mean, no gorilla packs its intestines full of meat two, three times a day like, like we do. And having been in the medical game for so long, I have to say, wait a minute.

• 53:03Speaker 08

  Granted, you see this initial improvement, but I urge you not be seduced by this improvement that you're seeing. Now, what the reality is, you pack that colon full of meat two, three times a day, and you send this surge of cholesterol and saturated fat and oxidized meat proteins through the tissues, day after day after day, as the months go by, as the years go by. This is a recipe for colon cancer, this is a recipe for artery disease, this is a recipe for strokes, recipe for dementia, recipe for autoimmune disease from leaky gut. And the problem, and I put this in my slideshow, so medicines become very segmented, medical

• 53:47Speaker 08

  care has become very fractionated, very segmented. And the odds of you seeing the same doctor when you go back to the clinic are small, doctors move away, patients move away. And the point is, people, especially these young docs make these recommendations, oh, you ought to eat paleo, you ought to eat keto, and then you never see them again. And I ask those young docs, you make these recommendations, you're gonna be around in 10 years when this guy passes his first bloody stool from that colon cancer that your diet spawned? You won't even be around to see it. You're gonna be around in 12 years, this lady's joints light up from the autoimmune arthritis that your diet, this leaky gut gave her? You won't be around to see it. You think you've done something good for her.

• 54:28Speaker 08

  But are you gonna be around in 15 years when this guy has a stroke from that carotid plaque that your diet stirred up in his arteries? You won't be around to see that. And that's my concern, as a seasoned physician, who's been in this game a while. Now, what are you really brewing up in these patients' colons? What are you really brewing up in their arteries? What are you really brewing up in their joints? What are you brewing up in their immune systems, in their prostate glands, in their colon, in their breast tissue? And, and the folks who are making these initial recommendations, don't, I say, do you really know what you're doing, doctor? You know, the Fred, do no harm applies to dietary advice as well. And you can really hurt somebody with the wrong diet.

• 55:11Speaker 08

  And I think a lot of wrong advice is being given.

• 55:14Rich Roll?

  Yeah.

• 55:14Speaker 08

  We're plant eating creatures. We need to be true to that. Can you have a little piece of flesh once or twice a week? Yeah, I'd probably get away with it. But, but we're not homo carnivorous. We're not flesh eating apes. And we're meant to run on whole plant foods. And when we do that, the body gets lean and healthy and arteries open up. Inflammation subsides.

• 55:33Rich Roll?

  Right.

• 55:34Speaker 08

  The body has the, has the final word on that.

• 55:40Rich Roll?

  To quote the esteemed Dr. Neil Bernard, quote, "Some foods are fattening. Others are addictive. Cheese is both. If cheese were any worse, it would be fast and lean." End quote. While sugar and meat consumption across the U.S. has declined over the past decade, how should we think about dairy in the standard American diet? Well, Dr. Bernard is here to educate us. Dr. Bernard is the president of the Physicians Committee for Responsible Medicine. He's the author of more than 100 scientific publications and 20 books for medical and lay readers, several of which have been New York Times bestsellers. We have done three in-depth shows with him as he's a fountain of wisdom and practical advice in this area and beyond.

• 56:25Rich Roll?

  So here are a couple of clips that I believe you will find helpful.

• 56:32Speaker 09

  To see the truth of it, you just have to look at a country like Japan or China, where these are non-dairy consuming countries. And they really weren't eating much meat. You know, meat was a kind of a flavoring for the rice and noodles and vegetables and so forth. And back in 1980, diabetes was rare in Japan. It was between 1 and 5% of the adult population. McDonald's came in, fast food chains came in, meat came in in a big way, and cheese and dairy started to follow. Some of the people in Japan initially, and then China afterward, started to say, okay, we need to drink milk so that we're strong like Americans are. And what they've gotten is diabetes rates went up to now 11 to 12% in Japan by 1990.

• 57:15Speaker 09

  Diabetes is massive now in China. Cardiovascular disease, I'm talking heart disease, huge in China. And it's not because of rice. It's not because of vegetables.

• 57:27Rich Roll?

  But it seems that-

• 57:28Speaker 09

  It is meat and the dairy that is coming in and invading their diet.

• 57:31Rich Roll?

  And yet, the conventional wisdom, if you would ask, you know, the average person, or perhaps some of the researchers behind this study, what the underlying cause of that is, they're going to point to processed foods and sugar, most likely, right?

• 57:46Speaker 09

  Yeah, you know, sugar is not health food. That's true. That said, sugar consumption in the United States has been falling for almost 20 years. It rose, and I'm talking all sugars together. Sugar, like cane sugar, beet sugar, high fructose corn syrup, throw them all in. They rose up until 1999. At that point, sugar has been falling. Sodas have been falling. Largely because so many Americans are drinking bottled water or diet soda, whatever. Sugar is dropping. But obesity is not falling. Diabetes is not falling. And to say, and once again, sugar is not health food. But to say that is the whole problem? We should all be thin now.

• 58:27Rich Roll?

  Right.

• 58:28Speaker 09

  We should have cured diabetes by now. Because sugar has been falling for 20 years, but it's not. So I am going to say a particular amount of blame needs to go on cheese, especially cheese.

• 58:38Rich Roll?

  When you see an ad for a Wendy's Double Cheeseburger or the newest version of, you know, the Pizza Hut pizza with injected cheese into the crust and all these sorts of things, that actually, there is a relationship between those marketing campaigns and those products and the influx of government funding. So can you explain that a little bit? Because I think a lot of people would be shocked to hear that.

• 59:04Speaker 09

  By law, the US, and this has been the case for a long time. The US government, by law, must promote American agricultural products. This is something Congress in its- Wisdom passed a number of years ago. And they promote products regardless of their health value and often in spite of their health value. So they take this pot of money and they pour it into research studies. And the US government did work with Wendy's, with a contract that I can show you, to market the Wendy's cheddar lovers bacon cheeseburger. I'm not kidding. It sold two and a quarter million pounds of cheese. They then worked with Subway to, which Subway had two sandwiches that didn't have cheese on them. So on contract with the US government, they stuck cheese on those sandwiches.

• 59:47Speaker 09

  They worked with Pizza Hut to put an entire pound of cheese on one serving of pizza. They worked with Taco Bell, Burger King, all the others, so that cheese was promoted. For example, you go through the drive through and you can't imagine that what they say over the loudspeaker is going to be government speak. Welcome to Taco Bell. Would you like to try our quesadilla? You know, they don't say you want a strawberry smoothie or something. You know, it's like something cheesy. And so these are all done on contract. We got them through the Freedom of Information.

• 1:00:19Rich Roll?

  So those talking points are like upsells that are specifically kind of inserted into the talking points that that person at the fast food restaurant is sort of told this is how you communicate with the customer.

• 1:00:31Speaker 09

  Yeah, that was part of it. The government has supplied advisors to McDonald's. I'm talking about people going to McDonald's headquarters and advising them on their business practices. I mean, don't you think every computer manufacturer would like to have the government promoting their product? Well, it's wrong, it should stop, but that's where we are. We live in a country which, if this were a Latin American country, you could imagine drugs, it kind of infusing the, their influence in the government. Well, here it's agricultural products doing the same kind of thing. People are promoting cheese, they're saying, don't worry about it, has no effect. Cheese comes from milk. Milk comes from a cow who is pregnant. The cows, cows don't give.

• 1:01:13Speaker 09

  Cows don't give milk at all, but they don't make milk until they have been impregnated. They give birth and then the milk that their calf was gonna get goes to the dairy. A cow pregnancy is about nine months, similar to human pregnancy, and they're impregnated every year. So what that means, three quarters of their lives, they are pregnant. They are being milked during that time. The estrogen that the cow makes gets into the milk and it's just, it's not much, it's only a trace. But the milk is turned into cheese, the hormones go with the fat, and the average person eats 35 pounds of it every year. So researchers in Rochester, New York, looked at men.

• 1:01:53Speaker 09

  The men who ate the most cheese had the worst sperm counts, the worst sperm morphology, the lowest sperm motility. In other words- Because of the estrogen content of that? Well, that's the theory. The theory is this, you're consuming just little traces of estrogen with your breakfast, on your Egg McMuffin, the little cheese, and a little bit more at lunch, and quite a lot at dinner on your pizza. And could those little traces of estrogens matter? Now, we had all thought, couldn't be. But I gotta tell you, Rich, here's the worst. Here in California, researchers looked at women who had been diagnosed with breast cancer. And if you've had breast cancer in the past and you were treated for it, your concern is, is my cancer gonna come back? Of course.

• 1:02:37Speaker 09

  Well, the women who consumed the most cheese had a 49% higher breast cancer mortality compared to the women who ate the least. And the difference is small. The difference is one daily serving or more, less than a half a serving a day. So the women who eat little or no cheese, and other high-fat dairy products, it's cheese, it's butter, that's where the hormones go. You compare to these low-cheese consumers, the ones who eat one or more servings a day, which is not a lot, the increased risk was 49%. I'm talking about risk of dying of your cancer. So again, the amounts of hormones are small, but-

• 1:03:17Speaker 09

  It raises the question, do you want to feed any kind of dairy? I'm talking about cow's milk, goat milk, whatever. Do you want to feed it to your six-year-old daughter? Or your six-year-old son? Or your wife, or your husband, or yourself, or anybody? And my thought is that dairy products are this cultural aberration that has stuck because people get hooked on it. But it has nothing to do with human biology, and we should be avoiding it.

• 1:03:45Rich Roll?

  Here's a quote. "Outside of an emergency medical condition that requires an urgent intervention, I have never seen anything come close to providing the breadth and depth of benefits that the plant-based lifestyle offers." End quote. That quote is from my next guest, Dr. Robert Ostfeld, a summa cum laude graduate of the University of Pennsylvania with a medical degree from Yale and a master's in epidemiology from Harvard. Here is a deep dive into more on his perspective.

• 1:04:19Speaker 10

  There's this thing that I like to do called the CalScan. So we're all familiar with CAT scans, where they do a big radiologic picture, looking for a problem in your body, whether it's the chest, or the belly, or something like that. Well, I thought, wouldn't it be cool if we could do a CalScan? Which, instead of looking for a problem, could look for ways that a plant-based diet might be beneficial for you? And so I looked through some of the studies. And so, like we were talking about, a healthier diet doesn't just point to heart disease. So if I could, I'll go through the CalScan. And these are things that a plant-based diet has been associated, not necessarily unequivocally

• 1:05:02Speaker 10

  proven, but just other things pointing in the right direction associated with improving. So first of all, it's been associated with less mortality, less death. And so I'll start from the top down. Many of us are on social media, on Facebook. We were talking about Facebook just before. So a lot of us saw the ice bucket challenge. Well, a plant-based diet, elements of that, have been associated with less ALS, less stroke, less depression, less cognitive decline over time, less Alzheimer's, improved skin complexion, less acne. In fact, some investigators suggest that...

• 1:05:44Speaker 10

  Acne is so tightly linked to the Western diet that it's not actually a vestige of teenage angst, but actually your body crying out for help from lack of nutrition. Fewer ear infections, less periodontal disease, less laryngeal cancer, less heartburn, less lung disease, less lung cancer, less breast cancer, less heart disease, of course, less obesity. And the former Surgeon General, Dr. Carmona, said that this generation will be the first to live fewer years than its parents because of sequelae of obesity. Seventy percent of our population is overweight or obese. Less high blood pressure. We call high blood pressure the silent killer because you don't feel it,

• 1:06:27Speaker 10

  but it can kill you. And it's important that all listeners get screened for high blood pressure. But now, there's a statistic that I read that blows my mind. If you're a 55-year-old adult in the US, your lifetime risk of developing heart disease is about 90%, and that's based on information from the Framingham Heart Study. And every time I read it, I have to reread it. It's just so high. That's unbelievable. And but if you eat a plant-based diet, you are anything but the average adult. And, you know, for example, blueberries can lower blood pressure. There's less diabetes, there's less colon cancer, less inflammation, less constipation,

• 1:07:05Speaker 10

  less prostate cancer associated with less prostatic hypertrophy. And so guys may recognize that of having to wake up four or five times at the night, during the night to pee because I can't pee all the urinal because the prostate's big. Improved sexual function in men and women. And we call, of course, erectile dysfunction the canary in the coal mine for heart disease. And getting an erection is a psychological event, it's a neurologic event, and it's a vascular event. And by the time you have a blockage in the artery to the penis, because the artery to the penis is smaller than that to the heart, and by the time you have a blockage in the artery to the penis, giving erectile dysfunction, it's extremely likely you have

• 1:07:48Speaker 10

  such blockages in your heart that just have not yet clinically manifest.

• 1:07:51Rich Roll?

  Right, your body's just trying to tell you that you have something that you need to deal with.

• 1:07:55Speaker 10

  Exactly.

• 1:07:56Rich Roll?

  And the solution is not to take a small blue pill so that you can forget about it, but rather to do the opposite, which is to heat it and try to, you know, take a look at what you're eating and how you're moving your body and maybe make some changes.

• 1:08:10Speaker 10

  Totally agree.

• 1:08:11Rich Roll?

  So, when I look at, I mean, a couple of observations. First of all, it's, you know, thank you for that rundown. I mean, it's so compelling. And when I hear that and I think, you know, I put it in context of, you know, heart disease is America's number one killer, and thinking of that study and the 90% figure, it's just astonishing. And I wonder, why isn't everybody, you know, doing this? Like, what is the impediment to people adopting this? And, you know, that's the, that's the sort of frustration that I experienced, and kind of what I was getting at with the people that are out there trying to, you know, sort of debunk the China study, or poo-poo the, you know, the fantastic benefits

• 1:08:56Rich Roll?

  of eating a plant-based diet. So, when you see that, whether it's on Facebook, or, you know, some blog on the internet, or whatever, like, how do you, you know, what do you do? What is that, how does that make you feel? What do you think?

• 1:09:08Speaker 10

  Well, it's very frustrating to me, having some background in some of the science of it, and we're ramping up our research arm of our wellness program, too. But I think that people oftentimes like to have the behaviors that they're doing, whether they be good or bad, reinforced. People kind of like to get praise.

• 1:09:28Rich Roll?

  Good news about their bad habits.

• 1:09:29Speaker 10

  Yeah, you know, eating that animal product, yeah, that's great for you. Go for it.

• 1:09:45Rich Roll?

  Right now, at least 50 million people worldwide live with Alzheimer's disease, and rates could exceed 150 million people by 2050. Incredible. So, how should we think about brain function on a plant-based diet? Can we prevent neurodegeneration through the choices that we make around our diet and lifestyle? And what are the best foods to boost brain function? These questions are best answered by Doctors Dean and Aisha Shirze, the leading neurology team in the country studying Alzheimer's disease as their life mission. Directors of the Alzheimer's Prevention Program at Loma Linda University Medical Center, this amazing husband-and-wife team delivered two clips that address these questions head-on.

• 1:10:33Speaker 11

  All of the genes involved in Alzheimer's, except for those 3%, or three genes, all are lifestyle genes. How your lifestyle affects those genes, which means you have control over it. Even the most benign studies, the ones that had minimal effect, the MIND study and others. MIND study just looked at diet, very well-done study. Just a diet adjustment reduced your risk of Alzheimer's by 53%.

• 1:11:02Rich Roll?

  Wow.

• 1:11:03Speaker 11

  And that was a watered-down version of the diet we think is optimal.

• 1:11:07Rich Roll?

  And how long would you need to be eating in that certain way leading up to it?

• 1:11:14Speaker 11

  It varies from person to person, their background, other things, like if they had multiple head traumas, childbirth, like multiple variables. But in reality, if you're on that diet for several years, you continually reduce your risk. Like smoking, if you've smoked all your life, and if you come off of smoking, come off of that bacon, come off of that, you know, well, then the more years you pass, I believe in smoking, it's after five years? Five to seven years, yes. Five to seven years, you're back to baseline. Right. Meaning that you're back to the lowest risk factor. So the longer you stay on a healthy lifestyle, which is exercise and all the things that we say, and especially if you do all of them, the reason I say all of them, coming back to our grandparents,

• 1:11:59Speaker 11

  one of the elements is cognitive reserve, or what the term you and I love, idea density. You know, we say that if we have a musical band that's going to be called Idea Density. They had Idea Density, yes. It's a great, great concept. They both, both our grandparents had immense idea density and philosophers think, but they succumbed to Alzheimer's. Why? The other elements weren't taken care of. They had diabetes, cholesterol, high blood pressure.

• 1:12:28Ayesha Sherzai?

  Quite sedentary, bad food.

• 1:12:30Speaker 11

  Didn't exercise. Philosophers are not supposed to exercise for some reason. But, so you have to do all of it.

• 1:12:36Rich Roll?

  Right. So, we're going to get into these lifestyle interventions, but before we do that, let's talk about the brain more generally. We sort of think of the brain as this mysterious black box that is unknowable and something that sits outside of our body, right? Like, there's our body and then there's our brain, and these things don't really overlap. But in truth, brain health is really, it's about vascular health in the same way that heart health is, right? Like, we're dealing with, I don't know how many zillions of, you know, arteries that are going into the brain, you know, putting things into your brain and taking them out, et cetera.

• 1:13:21Rich Roll?

  And when you think about, you know, heart disease, we all know we're trying to not have plaque in our arteries and keep those pipes running clean, and brain health is really not that different, is it?

• 1:13:34Ayesha Sherzai?

  That's very true. You put it beautifully. When you look at the brain, it's about three pounds, like jello. It's like hard jello when you hold it in your hands. And it's about 2% of your body's energy. And when you look at the tissues and the vessels, they're the same vessels that are in your heart and in your kidney and your body. I'm a vascular neurologist, so I teach a lot of Anatomy to medical students and residents about the vasculature of the brain. But basically, you know, you have arteries shooting from your heart, going through the neck. There's two major ones in the front, the carotid arteries and the vertebral arteries. And these are the major vessels that take blood to your brain. And there's just branching of these arteries. And somebody actually calculated this, but if you put the vessels in your brain end to end,

• 1:14:19Ayesha Sherzai?

  it would span about 400 miles. So just imagine all these tiny hairline arteries taking in oxygen and nutrients to the susceptible areas of the brain for this incredible organ to function. And at any moment, our brain, as little and as small as it is, it can consume up to 25% of the body's energy. So just imagine the amount of work that it does. And if we don't address vascular health and if we don't really take care of it, it will succumb to disease. You know, we always say, and our cardiologists friends don't really like that, but we say the rest of the body is there to carry the brain.

• 1:15:01Ayesha Sherzai?

  And it essentially comes down to the same pathological processes that affect the brain that also affects the heart, the kidneys, and the other systems as well.

• 1:15:10Rich Roll?

  So let's look at the foods that are beneficial. Like when you look at the plant kingdom, what stands out? You know, I know we want to stay away from quote unquote, "superfoods", but some foods are better than others. Like what should people focus on who are trying to enhance their brain health?

• 1:15:28Ayesha Sherzai?

  Yeah, I think if I had to give a quick version of what's out there as far as data is concerned, consumption of green leafy vegetables, for example, seems to be very helpful. And it's like unanimous result that you see across different studies.

• 1:15:47Ayesha Sherzai?

  Berries such as blueberries and strawberries, they stand out, whether it's the Mayan diet or the Mediterranean diet, or even in the Adventist Health Study, because these are foods that have the highest amount of anti-inflammatories. Spices like turmeric, we actually wrote a paper when we were in Cedar Sinai, where we gave our patients high doses of turmeric. And turmeric seems to have the curcumin. And part of it is a very potent anti-inflammatory. And it seems to bind with amyloid, which is the bad protein associated with Alzheimer's disease, and it it removes it.

• 1:16:15Rich Roll?

  Oh, wow.

• 1:16:16Ayesha Sherzai?

  And we measured the amount of amyloid, the amyloid load in retina. And after giving them high amounts of turmeric, we actually saw the turmeric binding to the amyloid in the retina, which is really, really interesting. And we're learning more about it as we speak. And yeah, so high fiber, green leafy vegetables and berries and spices, especially turmeric, seems to be on the top.

• 1:16:40Rich Roll?

  Chian flaxseed.

• 1:16:42Ayesha Sherzai?

  Chian flaxseed, which are amazing sources of plant-based omega-3 fatty acids, hemp seeds, nuts like walnuts, whole grains. They seem to have the right kind of micronutrients, whether it's thiamine or riboflavin or folic acid, bound beautifully synergistically, supporting each other's absorbance and bioavailability. They all tend to reduce the risk for Alzheimer's disease. And we have studies that have looked at individual foods and risk of Alzheimer's disease and the combination thereof, too.

• 1:17:13Rich Roll?

  Are there any plant foods to avoid?

• 1:17:16Ayesha Sherzai?

  I would say the plant foods to avoid seems to be coconut oil. I know that that, again, is a controversial area and a lot of people are just, yeah.

• 1:17:24Rich Roll?

  A lot of people are getting mad right now.

• 1:17:26Ayesha Sherzai?

  I know, I'm sorry. But, you know, I love coconut.

• 1:17:29Rich Roll?

  Well, that used to be the thing, coconut oil for brain health.

• 1:17:31Ayesha Sherzai?

  Yeah, I know. And unfortunately, the data was pretty flawed when it came out. It was based on a couple of case studies. And as it happened, somebody gave their loved ones some coconut oil and they seemed to improve, but then there was no long-term follow-up. But coconut oil, and I'm happy to say that there's consensus on it. And, you know, as a scientist, I want to look at different sources of data, whether it's clinical trials, whether it's epidemiological, whether it's case series. And there's consensus between different scientists and doctors and physicians that coconut oil seems to increase our bad cholesterol LDL, which can result into vascular damage.

• 1:18:10Ayesha Sherzai?

  And the reason being is because coconut oil is one of the few plant oils that is more than 90% saturated fat, and so is palm oil.

• 1:18:22Rich Roll?

  Dr. Joel Kahn is an esteemed cardiologist who's authored hundreds of articles on heart disease and has performed thousands of cardiac procedures. Dr. Kahn was a feature contributor to the documentary What the Health and has been a guest on this show three times. I asked Dr. Kahn what the results might be if we were to introduce a fasting mimicking process to a plant-based diet. What he shares is astounding and further illustrates the unique power and healing capabilities of plant foods. Dr. Kahn references research by longevity experts like Dr. Walter Longo, and he brilliantly summarizes for us the benefits of adding intermittent fasting to a plant-based lifestyle. So, take a listen.

• 1:19:07Joel Kahn?

  Could we mimic fasting but still eat? Provocative, crazy idea. Could we create a diet that doesn't have the components that food causes, that accelerates the mTOR pathway, the PK pathway, these pathways that accelerate aging and destruction of cells? Can we create a diet that lets you eat some, and can we actually still benefit from what fasting seems to do, which is accelerate a process, a fancy word, autophagy, the clearing of damaged cells to allow them to function better? That process, real quickly, that won the Nobel Prize last year, autophagy, is like the hot button right now of anti-aging, that if you eliminated every case of heart disease, cancer, and diabetes, we'd extend human

• 1:19:49Joel Kahn?

  life by 13 years. If we could end damage to cells and improve the efficiency of autophagy, to take your cells that are aging and restore them to a youthful state, would extend human life by 30 years. So, the research is going now in this anti-aging world. And he created, bottom line, a diet that five days in a row of, in the human experience, 800 calories a day of a plant-based diet, low in sugar and low in protein, but containing whole food fats like olives and nuts, and containing moderate complex carbohydrates, so that the carbohydrate calorie load's about 35%, that he found in animal models and in a study published February 2017 in 100 humans, that you could see the responses you get with

• 1:20:33Joel Kahn?

  a complete fast, but you don't have the pain of a complete fast, you don't have the risk of a complete fast. He called that and patented that, FMD, fasting mimicking diets.

• 1:20:43Joel Kahn?

  And he has shown that not only do they favor losing visceral fat around your belly, which is what so many people are doing, 10-day belly bloats, five days in a row in a month, and you can do it as many months in a row as you can tolerate and all, and we're talking about eating a nut bar for breakfast, we're talking about eating soup and kale crackers for lunch, we're talking about eating soup, and occasionally a little cacao bar for dinner, these actually come prepackaged in a startup that he engaged in with the University of Southern California, that doing that five days in a row activates these primal pathways that actually not only favor improved metabolism, losing visceral fat, you don't lose muscle mass, which is fantastic, but you actually lower IGF-1 levels, which is one of the goals,

• 1:21:28Joel Kahn?

  and lastly, you actually create a flood of stem cells from your bone marrow into your bloodstream, stem cells that people are going to Tijuana and paying a ton of money for, that will go to injured and damaged parts of your body and clear out damaged cells. So, there's data now in animals and some human data that multiple sclerosis may be responsive to a five-day fasting-mimicking diet of plants, low in sugar, low in fat, that actually, brain growth occurs in animal models, and right now cognition is being studied in Italy using Dr. Longo's five-day fasting diet. In addition to just weight loss, that cancer patients, it's called ChemoLeve, it's a product they've developed and not released at, it's being studied at the Mayo Clinic and other places, that if you're getting

• 1:22:08Joel Kahn?

  chemotherapy and you do this fasting-mimicking diet, and use plants, and use low sugar, low fat, you actually get a better kill rate for the chemotherapy and you get less side effects, profound data. Athletes are being studied in Verona, Italy, right now to see if this enhances performance, if it'll enhance recovery and allow you to go back and do the next athletic event with more success. So, several hundred worldwide studies using this exact model. I would describe it, it's a plant-based cyclical ketogenic diet, cyclical because it's five days a month and it's plants, so it's not the extreme of what you're seeing on the blogosphere, it's the plants and the plant proteins that don't seem to activate aging like animal-based protein.

• 1:22:53Joel Kahn?

  And it's 800 calories a day. It's not water fasting. So there are people shouldn't do it, underweight people, pregnant people, brittle diabetics, brittle heart patients, 800 calories a day. I've done it seven of the last 11 months. I'm down 25 pounds. Wow. I have boundless energy. My labs show improvement. My blood pressure shows improvement. I have dozens of patients who have had the same experience. And you know, what do you do with a heavy vegan who's really doing it right? You've got to change their metabolism. And this is one of the hacks that might, you know, allow our movement, one, to have the scientific basis to say we're in the right sector of the food plate, and two, to actually help people get more out of it than they're getting. Because not everybody

• 1:23:36Joel Kahn?

  eating a whole food plant-based diet with oil, without oil, is going to achieve their optimal blood pressure, blood sugar, and weight. And we need more tools, and this is one of the tools.

• 1:23:49Rich Roll?

  The American College of Cardiology, a more than 50,000-member medical society, is the professional home base for the entire cardiology profession. And five years ago, I sat down with its former president, Dr. Kim Williams. Dr. Williams is one of the most inspiring, the most intelligent, and pioneering leaders in the growing movement to modernize how we think, treat, and hopefully prevent heart disease, which is still our most onerous threat to human health. One out of three people in America dies from cardiovascular disease. It is and remains our number one killer, and it's still the number one killer of cardiologists. Plants are the solution, and no masterclass would be complete without

• 1:24:33Rich Roll?

  the words of those who know best. So in his own words, here is Dr. Kim Williams.

• 1:24:42Speaker 14

  Last year was the first time in 40 years that cardiovascular disease deaths in the country went up. And that is just something that we just can't abide by. And, you know, we're always bragging about this decreasing curve, about 50% over 40 years in cardiovascular mortality. And it's bypass surgery, and statins, and beta blockers, and all these medications for heart failure and decreasing sudden death, because we put in defibrillators that shock people when they have a fatal arrhythmia and they come back to life. We were so proud of all this stuff. And then the American population somehow has overcome.

• 1:25:20Rich Roll?

  You can end run around this, no matter what you do.

• 1:25:23Speaker 14

  Exactly. And when the CDC put those numbers out there, they said it was obesity and diabetes that's driving it. And that's nutrition. And so it all, the fundamental issue that we've been dealing with for the last so many years is really at the core of all we do. And it will uproot and undo any success that we can do with devices and medications.

• 1:25:46Rich Roll?

  Yeah, it's got to be a shift in priorities and focus because it is amazing to reduce by 50% the mortality rate of people who are suffering from heart disease as a result of all this amazing science and technology. But if that comes at the cost of really addressing the fact that the incidence of people who are, you know, becoming patients in the first place, then you're waging a losing war.

• 1:26:15Speaker 14

  Ultimately, yeah, everyone's going to get older and they're going to pass away at some point. Wouldn't it be nice if we were as healthy as possible until that happened and not have these chronic diseases that are completely avoidable by lifestyle? A lot of the publications weren't out there in 2003, but the data's out there now. Animal protein is bad for you. Heme iron is bad for you. The cholesterol, the IGF-1 in the animal protein, this is all science. And so the difference is now I read it. Now, the other major controversy, which I probably shouldn't repeat one more time, but I guess I'm going to do it, was making that comment, which was completely half joking,

• 1:27:00Speaker 14

  but I was making a statement about cardiovascular research. And the fact that nutrition research is typically in the American Journal of Clinical Nutrition, it's not in the Journal of American College of Cardiology so much. And so it's not in front of the cardiologists. And so I made that statement, again, more than half joking.

• 1:27:22Rich Roll?

  The statement that...

• 1:27:24Speaker 14

  Two kinds of cardiologists. Yeah, why don't you, you say it. Right. Two kinds of cardiologists, vegans and those who haven't read the data. Uh huh. Now. I got you into a little trouble. It did. Well, the interesting part is that, you know, it's with, like, like, like they say, if you take the text out of the context, then all you're left with is the con. And so people were misunderstanding. They thought I'm throwing all my colleagues under the bus when I'm really claiming or asking for more research, more review articles, more, you know, more data to go into cardiology journals so that people are actually seeing it and they can influence their, their lives and their patients. But then, two things started to happen. One is, you know, the pushback from that was actually, I think most people understood

• 1:28:09Speaker 14

  that I was saying that if they know me at all, if they don't know me, they, they wouldn't say anything to me. If they did know me, they knew that I was, you know, saying that in a joke, in a jocular manner. But there were some people who took it seriously, particularly at Rush where, you know, I'm the chief of cardiology. And we now have, you know, nine vegan cardiologists. Wow. Because people looked at the data and they saw that, you know, this is probably something I shouldn't be eating. And they've, they've changed their own lifestyle, which is wonderful because it gives us a good cadre of people who work on prevention. The other thing that happened though, I have to say is that I'd spent six years on the American Board of Internal Medicine doing the cardiology exam. And then the ACC leadership position.

• 1:28:54Speaker 14

  So I'm seeing a lot of cardiologists. Then my time at the American Society of Nuclear Cardiology, I was president, my, 12 years ago. Each one of those organizations has had some luminary person who died of heart disease. And I'm kind of saying, that's where we really need to start. That is, in order to fix the population, through all the powers of our ACC, HA guidelines, the, the people who are actually getting that data out there and putting it in the hands of patients and the prescriptions and telling people what, how they should live is cardiology. So at this point, I've had enough of the sudden cardiac deaths.

• 1:29:36Speaker 14

  I'm actually, my, my new goal is to not retire until the leading cause of death in cardiologists is no longer heart disease.

• 1:29:45Rich Roll?

  Yeah, it's amazing that it precipitates at that level amongst, you know, amongst your peers. You know, on some level, it's like you can't transmit something you haven't got. Like if you're, if you're not living this life in a certain way where you're, you know, where you're an embodiment of the message that you're promoting, that's inherently problematic.

• 1:30:03Speaker 14

  Right. So I, it really has affected me in terms of the guilt when one of my friends would pass away. You know, they knew that I was eating different, I ate with them, they knew that I was eating different. And did I say anything? And did I say it loud enough? And so now, any quip that I can come up with that gets on my page today or Twitter, I'm, I'm fine with. I'll take the backlash if it's going to save some of my colleagues' lives. Ultimately, that will help our country. That will help reduce this, this terrible epidemic of, of heart disease, even if it makes me unpopular. Nutrition is the most important decision that we can make. If we could change one thing, it would be to have heart healthy information coming out

• 1:30:46Speaker 14

  and, and have that be a real definition. And so for the individual patient, finding out where they are and seeing what are the elements that are going to create more and more diseases, similar to what brought them to my office in the first place. And, and I, I understand that this, this is not primary care, this is not family practice. And that, you know, these are people who already have heart disease when they're seeing me. And so I have a little easier job because they're already motivated. The fact that they're in my office means that they're motivated to try to make some kind of change. They're expecting to come out of there with something different that's going to change their outcome. Not every physician has that advantage, but it's something that we all should take advantage of because, you know,

• 1:31:28Speaker 14

  almost everyone has had a, you know, a family member who suffers from heart disease or has had heart disease or has sudden cardiac death. And so just trying to get them to understand that there is a relationship between your lifestyle and your outcome, just make that connection. If we could do that, we would all be so, so much better off.

• 1:31:47Rich Roll?

  Right.

• 1:31:49Rich Roll?

  A whole food, plant-based lifestyle is also a recalibration of our relationship with things like salt, oil, and sugar, modern food additives that spike dopamine and can create all sorts of problems. So, how do we reframe our often dysfunctional relationship with food so that we are never again a victim of addictive behaviors? Well, taking us through this complex issue is Dr. Alan Goldhamer, co-author of the book "The Pleasure Trap." Here's an excerpt from one of our all-time most popular episodes.

• 1:32:24Alan Goldhamer?

  The social roadblocks to health are probably some of the limiting factors. I think that's probably true in all addiction, though. You know, one of the challenges for people with alcohol is oftentimes the social consequences of not participating, and this is definitely true with food. We've built so much of our social interaction around food that even if you're looking to just modify the type of food you eat, it can be very upsetting for people, and they can get really defensive about it.

• 1:32:50Rich Roll?

  Right. So, let's talk a little bit more about "The Pleasure Trap," specifically, what that is. You co-authored this book, seminal work with Doug Lyle. I've seen his TED Talk. I've seen him give his presentation many times on this subject. And that really elucidates this dysfunctional relationship with food and why it is from an evolutionary and psychological perspective.

• 1:33:14Alan Goldhamer?

  Well, you know, this idea of dopamine is a neurochemical associated with pleasure. And there's two behaviors critical for human beings' survival, and that is food and sex. You have to get enough to eat in order to be able to sustain yourself, and you have to engage in enough sexual behavior so that you can pass on your genes and the whole process can start over again. So, it's not surprising that food and sex are heavily reinforced. And the way the brain reinforces the body's behavior is by rewarding us with dopamine, which is the neurochemical associated with pleasure. So, the more dopamine, the more pleasure. The more dopamine, the better the food tastes. And so, you react to food in response to largely chloric density. The higher the chloric density, the more valuable it is in this environment of scarcity in which we evolved.

• 1:33:59Alan Goldhamer?

  And so the higher chloric density foods are tend to be more reinforced, more dopamine, better tasting. So what we've done as humans, we're innovative creatures. We said, oh, if a little good, a lot's better. Let's figure out a way to make the food taste even more special by increasing its chloric density. And we do that by adding things like oil and sugar to the food. And as a consequence, we like it better. And if that's what you get used to eating, that's all you like. And eventually, people get to the point, they really don't like the taste of simple, whole, natural foods anymore, because this hyper drug-like stimulating effect of the more concentrated foods is more appealing. So we literally become addicted. For example, if you want to neuroadapt to a lower salt or lower fat diet, it actually takes time in order for the body to go through that

• 1:34:43Alan Goldhamer?

  adaptation. We can speed it up with fasting, but the bottom line is there is a period of adaptation where food doesn't taste good. If you eat whole foods and you're used to eating highly processed foods, it's not that appealing. Now, over time, you adapt, and then the body gets to the point where you like the simpler foods again.

• 1:35:00Rich Roll?

  Yeah, people have a hard time believing that you adapt. There's this baked in assumption that you're, you're, you're, you're just gonna, you're looking, you're staring down the pipeline of a lifetime of drab foods that are unappealing, and you're just gonna have to tolerate it.

• 1:35:16Alan Goldhamer?

  And we know there's a literature on this, though, with, for example, sodium, people use on high sodium diet, it takes about a month on a low sodium diet for the average person to neuroadapt to a lower salt diet. You know, with fat, it takes almost three months.

• 1:35:28Rich Roll?

  Wow.

• 1:35:29Alan Goldhamer?

  It takes three months on a lower fat diet before that satiety mechanism that's used to being kicked in by the higher chloric density fat begins to adapt, and you will feel satisfied on a lower density food. So the fruits, the vegetables, the grains, the goons, you will now feel satisfied. Whereas initially, you don't, because you're used to being satiated with these high fat, this high fat intake. And that, that can take months. And so it's a problem. If you say to a person, well, look, you're gonna eat this new diet, you're gonna feel like crap, and you're not gonna like it. And but it'll only be a few months. Adherence may, may be lagging. Whereas if you can make that process happen more quickly, the ability to get people to make dietary changes speeds up. And that's what we found with fasting. And sometimes that's a way of getting people

• 1:36:14Alan Goldhamer?

  to the point where good food tastes good more quickly.

• 1:36:16Rich Roll?

  Yeah.

• 1:36:17Alan Goldhamer?

  What we're encouraging people to do is a really radical departure from what they're currently doing. But that's to adopt a whole plant food diet. That's free of this added chemicals, free of the salt, oil and sugar. And what you're left with is things like fruits and vegetables, raw or cooked, minimally processed greens, beans, nuts and seeds. But you don't have the meat, fish, fowl, eggs, dairy products, oil, salt, sugar, and highly processed, fractionated foods that make up the majority of the people's diet in industrialized society. And it's that diet that makes them fat and sick and develop the diseases of dietary excess, and that what makes you vulnerable to infectious disease. You know, when you look at what are the vulnerabilities about why does some people get an influenza or a COVID or an infectious disease?

• 1:37:00Alan Goldhamer?

  And, you know, they recover, they survive, they have minimal consequence. Other people, it's devastating or deadly. Well, if you look at the risk factors associated with what makes people vulnerable to these diseases, as well as the disease, the chronic diseases, the heart disease, the cancer, the stroke, it's the same metabolic syndrome and all of its associations. It's the same obesity and diabetes and high blood pressure and all the consequences of dietary excess. These are reversible and preventable conditions. People don't have to have these conditions. And even if they have them, they can largely reverse them by taking responsibility to control what they put in their mouth.

• 1:37:38Rich Roll?

  Okay, we did it. I hope this masterclass was valuable and actionable for you. And as we conclude this deep dive into the plant powered lifestyle, I want to acknowledge that in some cases, for a variety of reasons, not everyone can or will make the pivot to a 100% whole food, plant-based lifestyle. And if that is you, you'll find no judgment here. What I would like to submit, however, is that intentionally creating small goals for yourself toward moving away from an ultra-processed food-based diet and adding more plant foods to your plate could be transformative for your health, for your energy, for your performance, and for your longevity.

• 1:38:23Rich Roll?

  That has been my experience, and that has been the testimony of the experts collected here today. It's my hope that this masterclass has helped you on your journey, or could be used as a way of helping a loved one. And if you have been personally inspired, please consider visiting the full in-depth conversations with these esteemed guests. You can find links to each episode posted in the YouTube description or in the show notes at richroll.com.

• 1:38:52Rich Roll?

  Thank you for listening, thank you for watching, and please know that I'm wishing all of you the greatest life possible powered by as many plants as possible. Until next time, peace. Plants.