 Okay, hi everybody. I guess I should start off with a little background about myself. I grew up with a mother who was on Weight Watchers on and off most of my young life and it left me with a deep and lasting lack of interest in diet topics because they seemed not to work so I just assumed that the dietary guidelines were designed by smart people and they must have good science behind their recommendations. I used to refer to myself as Mr. Whole Wheat back before I discovered I was seriously gluten intolerant and luckily after I got so I was in my late 30s I was an executive had a big hedge fund in on Wall Street and I suddenly started getting very sick. I had what was initially thought to be a stroke when I was 38 years old which left me unable to talk and unable to see for several hours and a couple years later I got acute diverticulitis which left me with a perforated colon and several stays in the hospital and ultimately a resected colon and a couple years after that I discovered Stefan Guine's blog to give credit where it's due and got very interested into the what he was saying about diet. His malocclusion posts were the ones that first really convinced me that there was something to this because my dentist God bless him after making a lot of money off my cavities when I was a kid when I was 18 told me to stop eating sugar and I wouldn't get any more cavities and he was right. Lo and behold. So I was kind of primed for it and I've been reading labels for years to avoid added sugars so you know all of a sudden I had a couple of new things to look for unlike I was already on a low super low sugar diet for decades and I still managed to get fat and sick not as fat as some people did but you know the pound a year thing that so many of us have gone through. When I took fixing my diet seriously the first thing I did was something that nobody else ever does which was cut seed oils which is the topic of my conversation today out of my diet and I saw my 16 years of irritable bowel disease which it left led to the colon resection resolve in two days and I started to see a bunch of other health improvements my weight fell off you know I won't go into all that but you know it motivated me to learn what was going on because it went against everything I had been told as my doctor said to me when I told him I was going on a high fat low carb diet he said I'm really worried about you Tucker you know this is this goes against all the recommendations and I said well that's why I'm here doc you run the tests you tell me if I'm killing myself but this seems to be the right thing to do and shortly before I fired him he told me I was going to live to a hundred years so that was good he came around so my talk today is why did we all get sick the nutritional transition and how seed oils drove it oh hold on fix this setting down here this is way too complicated for me all right there we go so first off a lot of this is duplicative of lots of other excellent presentation so I'm just going to zip through it human nutritional transitions probably start about 65 million years ago that's the oldest primate ancestor back when we ate leaves fruit and one imagines insects that cute little fellow weighed three and a half ounces next big change six and a half million years ago we come down out of the trees we start eating tubers scavenged meat and hunting small game 2.6 million years ago we start since our teeth are poorly designed for eating meat we start developing tools to allow us to cut meat which makes it much more digestible 1.8 million years ago we start running after things and we get pretty good endurance running you've all heard that story million years ago start using fire makes our food more nutritious for us 600,000 years ago we start seeing problems that is a Neanderthal fossil we start running out of meat and we start moving out of Africa looking for more things to eat 140,000 years ago we start eating seafood and mass right shell middens really only really started about 140,000 years ago 50,000 years ago they became incredibly prevalent which corresponds with some later events that little red oval up there is a person in Latin America standing on top of a hill made of seashells that people had eaten the contents thereof and those are found all around the world 50,000 years ago we also decided we would start we would invent tools to make it easier to hunt animals that little guy down in the lower left-hand corner is Rob Wolf who is using an atlatal to kill an elk when he was on a TV show called I Caveman and atlatal is a throwing stick that's used to throw a spear so they're very effective that was his first he'd practiced with it obviously but that was his first attempt to hunt with it and he hit with the first try of course as Amber was mentioning hunger can be very motivational and he was starving at this point about 17,000 years ago we started coming up with alternative means for uses for food this is a lamp from the Lascaux cave in France animal fats were used to light you know to light the cave paintings 17,000 years ago beer the collection of wild grains and obviously the invention of pottery 10,000 years ago even less meat we started you know taking on plant agriculture obviously motivated by our experience with beer and then 9,000 years ago more meat we invent pastoral agriculture which is if you can't catch meat raise your own right pretty smart so the first part is basically human evolution up to humans the second part is running out of meat which we had then become dependent on that is a cave painting from the Lascaux cave in France probably lit by that little lamp when they were painting it and as everybody likes to joke in this community they weren't hunting broccoli then unfortunately came a reliance on less beneficial foods this is actually the first incident of cavities in the Paleolithic period from some folks who are eating a lot of acorns which are very sticky starch and snails so don't do that as you can see they didn't do all that well this is from a cave in Morocco so let's get on to the interesting stuff now that we've established a little bit of a baseline here let's talk about how chronic disease starts fitting into this timeline we're gonna ditch the old bit and about 5,000 years ago we see the creation of near vegetarian diets in India and Egypt which was as we've discussed largely driven by hunting animals to extinction 5,000 years ago same time we start using seed crops to produce oils that is apparently a sesame seed flower or a sesame flower 300 years ago industrial processing of starches the roller mills were invented in 1600s in Europe and then about 150 years ago industrial production of seed oils with the detoxification of cotton seed in the United States so the first chronic disease happened quite a while ago 14,000 years ago took a little while for the next one to come along stunting appears in the anthropological record 5,000 years ago around the this may be coincidence around the time of near vegetarian diets becoming a big thing and and then malocclusion started about 300 years ago along with the in you know it's at the same time of the invention of the roller mill and that's interesting because that was a long time after dental carries became a problem right and diabetes was a rare disease about two and a half thousand years ago shortly after you know the development of what you might call modern diets in India it was first mentioned in India and and also in Egypt and then a little later in China about you know 2,500 years ago diabetes of course became a common disease about 120 years ago same thing for heart disease rare two and a half thousand years ago we have records from mummies in Egypt 120 years ago it becomes a common disease cancer also 120 years ago becomes a very common disease and there are others that we're not going to get into today and unfortunately because we only have 30 minutes I had to cut the cancer part out of my presentation so maybe we'll do that another time what I'd like to do is shortly cover chronic diseases with known causation in my opinion at any rate these three we have clear well recognized cause causation increased carbohydrate decreased meat we have rcts confirming this causation mostly in humans the malocclusion is an animal model because he can't do that to kids obviously stunting and cavities are partially reversible through diet and we yes we do have rcts and human children coming out of Africa that show that stunted kids will rapidly regain lost ground in growth milk is okay but meat is best and these are to my knowledge the only common diseases where causation by carbohydrate and malnutrition has been shown as a quote from a paper by a dentist and an anthropologist malocclusion was one of the defining traits of the introduction of the roller mill and white flower so now let's get into things with disputed causation this is a little more interesting ancient heart disease and diabetes started several thousand years after seed oils became a part of the human diet they ramped up a couple decades after seed oil industrial production became a thing let's discuss quickly the old evidence just because we can dispose of it rather quickly it's largely circumstantial you know it's just we don't have great records type 2 diabetes is mostly written records you know we have good evidence of cardiovascular disease but it's impossible really to know prevalence because there just are no records back then most of this is an extrapolation back from modern hunter-gatherer agricultural societies so let's focus on the modern evidence and we can extrapolate back so we are just going to focus on the modern diseases they are highly correlated with each other both in their prevalence in populations and also in longitudinally in time as we just saw this suggests that there's a common mechanism all our new diseases at current prevalence I mean within living memory and we'll go through that there were industrial populations with low rates of cardiovascular disease and type 2 diabetes and every population that has transitioned to a modern American style diet has high rates of chronic diseases which suggests that it's something in the modern American style diet that has caused this I remember some fellow saying to me once well what about pollution and I said okay the fattest people on earth live on a island in the South Pacific Ocean what pollution are they getting right this is a quote from good calories bad calories between 1900 and 1920 the death rate from diabetes despite improved treatment of the diet disease obviously via low-carb diet had increased by as much as 400% and it increased 15 fold since the end of the Civil War so even in the United States these are new diseases and you'll notice there's a perfect correlation with the introduction of seed oils into our diet there so let's discuss a little bit about seed oils what are they they are oils that are produced from seeds not fruit seeds cotton seeds sunflower sesame seeds y'all know the list as opposed to fruits like olive avocado palm or coconut coconut sort of sits on the fence but we're gonna throw it in the fruit pile here just to make the argument cleaner seeds generally have high polyunsaturated fat content especially omega-6 fats macadamia is the exception fruits tend to have mono-insaturated or saturated fats much less omega-6 sesame seed oil as I first said was cultivated about 5,000 years ago in India extracted by crushing spread into Egypt the Mediterranean and Africa through trade safflower was also cultivated in Egypt use was common in the Ptolemaic period that's the period of Greek rule in Egypt but references begin to it about three and a half thousand years ago during the period of King Tut and I was really looking for a reason to use a King Tut image in this presentation and I actually it's like legit not just gratuitous it was used as food and for lamps interestingly enough animal fat was illegal in Ptolemaic Egypt we don't know why but there was a book that was rules about among other things fat usage and it said that animal fat was illegal to sell to use no idea why but an interesting factoid modern mass production of seed oil started in the 19th century 200 years ago by the early 19th century Russian farmers were growing 2 million acres of sunflower that's a lot of sunflower oil American production started with cotton seed which was originally in toxic industrial food waste product quote generally the manufacturers of the United States make no pretense of exporting pure lard the chief adulterant found is cotton seed oil this was from a investigation by the Canadian government into the problems with the American lard supply which is where they got most of their lard and you'll note the date on that 1890 seed oils in America started way before Crisco was an issue and then Crisco came along in 1911 and took vegetable fats mainstream cotton seed ruled until soybean oil was introduced here we have a couple of little graphs showing seed oil consumptions you can see soybean oil taking off there that's from a great paper that Chris also mentioned blasphal from 2011 this is also from that linoleic acid which is the primary omega-6 fat and seed oils and its increase across the 20th century it's important to note that there wasn't really any data before the early 1900s so most of what we have back then are narrative accounts like you know the Canadian investigation this is from a neat paper from 1997 the nutrition transition new trends in the global diet the single biggest new trend that they saw in the modern nutrition transition was the inclusion of vegetable oils soybean oil 70% of edible oils and fats in the United States unlike other nutrition transitions fat consumption always went up in this one fat consumption went up in poor countries too because they could afford these cheap seed oils and meat consumption went down fat intake stayed the same as animal fats were replaced by vegetable by seed oils mostly this is a quote from Bill Lans who is one of the leading lipid scientists over the last second half of the second century 50 years later I cannot cite a definite mechanism or mediator by which saturated fat is shown to kill people we still don't have any evidence for that surprisingly enough linoleic acid the primary omega-6 fat and seed oils compared to saturated fats this is very susceptible to oxidative damage because it is missing a few hydrogen atoms that steric acid on the right if you add hydrogen atoms for in this case you turn linoleic acid into steric acid and that is basically the idea behind hydrogenation you're turning you know a unstable fat into a stable fat of course this process generally isn't perfect which is where we get synthetic part partially hydrogenated fats from so like a lot of this stuff it came with a good idea originally in mind linoleic acid is part of the problem since it's unstable it oxidizes into other compounds like for hydroxynone and all H&E which is an aldehyde same family as formaldehyde many of these things are highly toxic it's a mutagen meaning it causes DNA damage it is toxic to cells in evolutionarily appropriate amounts it's a signaling molecule now amber earlier was talking about reactive oxygen species and how they can trigger the uncoupling proteins in the body this is the chemical that does that along with palmitic acid so there are two things that we know that trigger that process and this is one of them and you know at the right amount that's a very useful process it is involved in every aspect of chronic disease I've looked at it is a marker and a mediator of oxidative stress mediator means it is involved in the causative process it induces atherosclerosis insulin resistance DNA damage inflammation mitochondrial dysfunction fibrosis pain there's something called the capsaicin receptor capsaicin of course is the thing that makes hot peppers hot and we actually have a receptor for that which is why it works which is why you feel you know a burning sensation when you eat capsaicin and this also triggers that sensation of course it's produced in your body so you know nobody wants hot peppers running through their bloodstream and these are three reviews on you know an overview of the whole process the since I skipped the cancer section I will just note that the primary mutation in human cancers is the p53 tumor protection gene which when it breaks leaves your body unable to fight a tumor essentially this preferentially mutates that in your body and has been shown to do that in multiple human cancers all the ones that we've seen that go have been skyrocketing in the last year in the last few decades and it is derived exclusively from omega-6 fats which is why I use it as a marker for these processes so few fub subjects in the present survey were found to have any of the conventional signs of coronary disease that it would be futile to analyze the data with any hope of defining the existence of risk factors for the disease within this population this is from the two consent of popular paper that Chris discussed the other day cardiovascular disease is a modern disease while it existed in ancient Egypt quote heart disease was an uncommon cause of death at the beginning of the 20th century by mid-century it had become the commonest cause of death a period of decades and when heart attack was unknown it's important to note some of us were eating lots of animal fat that was the case in both the United States and the United Kingdom cardiovascular disease is still unknown in populations eating ancestrally which will define as no industrially produced food you don't need a paleo diet to be pretty healthy an agricultural diet can do you know you can do pretty well on an agricultural diet in the 1960s some researchers looked at cardiovascular disease in different countries they used heart attack determined by autopsy which is an extremely reliable method of determining cardiovascular disease when you have a heart attack it leaves permanent damage in your heart that does not ever heal so even if you die from a car accident on autopsy they can tell that at some point in your life you had a heart attack right so the question was is this genetic or environmental they use thousands of autopsy's even bringing some hearts back to the United States to confirm the diagnosis in the foreign countries and what they found confirms the earlier studies so this they started off looking at Caucasian Americans 24% rate of myocardial infarction found at death which is of course different from the death rate as I just said these were people who had had a heart attack at some point in their lives Japanese American 19% African American 13% this is done in the 50s in the 60s so it's interesting because the African American rate is much higher now I think the worst in this country then they went to Japan and they looked at autopsy results in Japan 3% had myocardial infarction at death this is really interesting the rate in Tokyo was 5.8% the rate outside Tokyo in the rest of the country was in the 1% and this is a modern first world industrialized society then they went to Africa 0.1% they looked at 4500 hearts in Nigeria and they found a single heart attack so what could the environmental factor be so in the 1970s Brown and Goldstein before they won the Nobel Prize for discovering the LDL receptor that we've all heard so much of attempted to induce the first step of atherosclerosis it failed what they were trying to do was feed LDL to macrophages to turn them into the foam cells that are the progenators of atherosclerotic plaques it did not work they discovered that the LDL must be modified they used a non physiological way of modification and they discovered that the macrophages would hoover up this modified LDL Steinberg and Whitstom demonstrated the nature of the modification fats in the LDL must be oxidized when they are sufficiently oxidized foam cells which are essentially poisoned macrophages will form oxidized LDL is cytotoxic it is toxic to cells and the toxins in ox LDL are oxidized omega-6 fat such as HNE human studies show that dietary seed oils lead to LDL oxidation these are two old studies there's a whole one of them by the famous Dr. Riven Steinberg and Whitstom did it first in rabbits and then in humans several human RCTs five minutes huh okay thank you sir several human RCTs demonstrate higher CBD events with seed oil feeding Ramston has a meta analysis of that one RCT reduced omega-6 to an approximately evolutionarily appropriate level so a 70% decline in cardiovascular disease events that's where the Mediterranean diet comes from by the way delogual at all 1994 the Leon diet heart study so if you remove oxidized LDL from LDL to derive a corrected LDL corrected LDL is no longer predictive of heart disease events this is from Sam Semicus and here's a tweet where he discusses that study so it basically LP little a is a type of oxidized LDL it basically says that it is LDL is only predictive if it contains oxidized LDL of heart disease events so it's not a normal disease it's recent depends on the environment only populations eating excess seed oils get cardiovascular disease at modern levels and it's important to note there are confounders including omega-3 fats and smoking of course that's just looking at the rate of seed oil increase in Asia okay on to the next one diabetes and seed oils we have to get something out of the way anybody know what that is thank you you all know the relevance of that right I presume okay the diet consisted almost entirely of sweet potatoes carbohydrate providing over 90% of the calories this is again the tucacenta population no clinical evidence of diabetes was found in this survey and since you're wondering this is the sugar composition of the baked of the sweet potatoes they were eating most of not much sucrose and if we compare it to other countries they're eating about half what they're eating what Chinese children are eating Chinese children have a higher rate of diabetes and obesity in American children nowadays so it's a question whether that level of sugar consumption is causative so lots of populations ate or eat traditional diets without type 2 diabetes oh wait a minute the Bushman the Bushman we're diabetic quote the relative carbohydrate intolerance of our primitive Bushman subjects is at first glance rather surprising they're the only population I've come across eating that primitive a diet that fails a glucose tolerance test including the Inuit by the way and here's a confirmation so they ate lots of mungongo fruit and nuts about a third of their calories mungongo nuts season was when that diabetic oral glucose tolerance test was taken one other test was done that didn't confirm this that was done we don't know when so we don't know if it was inside or outside a mungongo nut season when they stopped eating their hunter-gatherer diet they no longer tested diabetic and interestingly enough mungongo nuts are high in omega-6 fats like most other seeds and nuts so in 1961 soybean oil was introduced as an IV food supplement interlipid which we've heard about already in 1964 it was noted that this makes you insulin resistant and a proglycemic by 2004 this was a standard model for producing insulin resistance in humans and since it has really bad effects on the body when it's used as an intravenous feeding protocol they have been looking for different options here we see that using a fat called clinolaiic instead of an interlipid doesn't produce the same levels of gluconeogenesis they said it's probably because they're not getting insulin resistant that is an olive oil infusion low in omega-6 fats of course eating something is vastly different from injecting something thank you sir in humans insulin resistance proceeds type 2 diabetes by years oxidized LDL is associated with insulin resistant but precedes it by years and as we've discussed seed oils lead to LDL oxidation other sources of oxidized LDL smoking and sepsis also induce insulin resistance unexpectedly targeting oxidized LDL via antibodies improves insulin sensitivity in a monkey model switching from a high to a low omega-6 oil diet lowers insulin resistance a dose-dependent relationship liver fat also improves this was an NAFLD study I'm gonna drag on I almost there and you can see the composition of the diet pretty high in carbohydrates and this is the before and after the orange is the baseline the green is the after the intervention they were all told to exercise which is probably why even the control group improved lowering the omega-6 omega-3 ratio also lowers insulin resistance here's the ratio that they used similar diet composition to the premium study diet monitored by blood biomarkers including oxidized linoleic acid metabolites which are very important in these processes no control unfortunately but unlike the previous diet which was done in a community setting in India this was done at Yale and here's the improvement in plasma insulin during the oral glucose tolerance test before and after so people on a low omega-6 ancestral diet don't get type 2 diabetes carbs don't seem to matter and by the way that paper on the sweet potatoes also looked at how much glucose was liberated from the starch constructs if you want to go check that out insulin resistance and hyperglycemia are mediated in part by the immune system through LDL which is why sepsis causes insulin resistance and reducing omega-6 fat ameliorates those conditions in humans nevertheless I will point out it is type 2 diabetes is a condition of carbohydrate intolerance so the diet for type 2 diabetes should be a low-carb diet in 1616 Tokugawa the founder of the Japanese Edo government the precursor to the modern government died it is said he had been overeating fish fried in sesame seed oil from tempura another usage of lamp oil probably a good use for seed oils so humans can be healthy eating a wide variety of diets chronic diseases clearly linked to diet most date from the introduction of seed oils except for the ones we already discussed epidemiology and mechanistic studies confirm this the reduction in elimination or elimination of seed oils and animals concentrating seed crops should be the first step in fixing your diet thank you all so we have about five minutes for questions line up at the microphone all right tuck so I'm pretty sure you're gonna agree with everything I'm about to say but I just wanted to throw it in because I didn't want to get brushed by very quickly what you were describing with brown and goldstein is that non-modified LDL particles to macrophages the immune cells right are taken up to the appropriate level that they would take up and not much more than that so they do not take them up to the extent to well that they will then die and turn into foam cells correct however modified LDL particles at a threshold point can be taken up to the point will eventually the micro the macrophage gets overwhelmed and can get turned into foam cell but even then there is a threshold point that's correct right and it's yes keep going no and that's and that's I think an important distinction because I think it could have been taken one of your slides could have been taken as just one modified LDL particles starts this cascade that's now going to be in a positive feedback loop and there's no yes and it's important to note that all of these processes are normal processes ox LDL is generated in your body as part of the immune process right so it's not you know just like you can't get rid of omega-6 fat in a whole food diet you don't need to the idea is to keep it within an evolutionarily appropriate level and I think that this is a place where frankly tuck I think you get misquoted a lot I think a lot of people believe that you're just anti-poof across the board when in fact right acknowledge very frequently in this includes even in the ox LDL context right I mean even it's interesting even that's him on a have pretty high ox LDL but they also have a very high infectious load right what we see in Americans and people eating a modern diet is what they call sterile inflammation where you have an inflammatory response with no trigger right and that seems to be pretty clearly and mechanistically it's been demonstrated to be caused by excess oxidized omega-6 fats in the body specifically I mean ox LDL ox LDL causes inflammation right yes well as it should particularly a certain threshold point exactly that's right and David by the way is the guy who pointed out the research that led to that Samika's tweet quote so thank you for that sir go ahead I was just wondering if you'd be able to comment if I know cancer isn't part of your presentation but if you subscribe to the idea that cancer is a disease of mitochondria how the linoleic acids contribute to that just one or two cents oh it's I interviewed Thomas Seafreed a little while ago actually and we discussed this and there's a clear relationship as he pointed out oxidized cardiolipin which is a molecule that's crucial to mitochondrial function is found in every single cancer he ever looked at and it's important to note that the definition of oxidized cardiolipin is that it has oxidized linoleic acid in it so that's where the h&e comes from that goes on to cause the DNA mutations both in the mitochondria and in the nucleus of the cell so yeah there is a clear very tight linkage and I wish I could have you know if we had another 15 minutes here I could have gone through that too thank you yep fireway thanks there was there was really good I was really worried you were gonna get to the whole talk without saying Oxlams but you did get there and you did get there in the end that in a toot in common picture we're like major goals so I'm gonna ask you a question about a paper that I'm sure you've read but maybe not everybody else has and considering the senior author it was surprising to me that it wasn't just immediately throw out a ball as garbage but it's a meta analysis in the American Journal of Proliferation in 2020 by Lee et al which did a meta regression and meta analysis of two different sets of linoleic acid data so one was intake levels from population prospective studies from 1% to 12% on average and the other one was looking at tissue levels of linoleic acid these blood these adipose tissue these various other different markers and they basically didn't see any association of or dose response of linoleic acid increasing with cardiovascular deaths or cause waterity or cancer deaths and I'm not and they actually if anything they saw the opposite and so this isn't me saying you should all go out and drink seed oil but there wasn't even a signal of harm in that study so I'm just wondering if your thoughts about that paper I haven't looked at that particular paper it's the short answer I have looked at similar papers that do find relationships you know looking at intake and also at serum levels I find it I don't know where they got the data from obviously but I find it incredible that they found anybody in a modern context who has had 1% of linoleic acid in their diet I mean Ramsden and colleagues just did a targeted reduction of linoleic acid with the NIH and they weren't able to get down to anywhere close to that level right so the notion that you can because of the prevalence of linoleic acid so I have real problems with the data behind that yeah I mean nutritional epidemiology you can usually throw out but right with the with the you know tissue levels other just thought it's interesting and they didn't do any fancy statistical adjustments right it's a univariate meta regression so adjust other than so you're not adjusting for downstream like obesity or types diabetes which are going to be the actual thing that's right yeah yeah yeah which would be invalid right there are I mean what's interesting in a lot of these processes and are specifically there's a paper looking at linoleic acid in the bloodstream and what they saw was that as the disease progressed the linoleic acid levels went down because they were being converted into HNE which is the toxin right linoleic acid on its own is harmless right so in a lot of cases what seems to be happening is that high linoleic acid indicates that you don't have the inflammatory processes going on right and as the diseases progress and they've seen this in type 2 diabetes there's a Australian paper where intake of linoleic acid scaled like this against type 2 diabetes but then when they looked at people who had it their serum level was going down indicating this as the disease process progresses it's breaking down on the body and you see that in traumatic brain injury you see that in stroke you see that in a number of other diseases that involve these oxalams in the does it seem to involve these oxalams in disease progression that answer your question but I just think it's an interesting ongoing thing that we have to keep looking at yeah well I'll somebody I'll send you that paper yeah thank you sir eating into the break by notice she's been waiting very patiently ask if it's a quick question I'll let you come well just if you could go into we talked with this earlier obviously you're talking about you know type 2 diabetes we know is a situation of carbon tolerance if you can talk about what we know about some of the molecular pathways how you get from linoleic acid to this insulin resistance just how that operates about the same level well actually quite clearly demonstrated Peter Atea did an interview with a guy Gerald or Gerard Shulman masterclass on insulin resistance I'd never heard of this guy before listening to the podcast first thing he said was well we use interlipid to induce insulin resistance in people and when you start drilling down in his mechanism it is triglycerides are broken down into diacylglycerides which basically one of the fats is removed from the glycerol backbone and you know the requirement seems to be either oxidized linoleic acid or linoleic acid and palmitic acid in those triglycerides drive the process they up regulate protein kinase C epsilon which causes insulin resistance in the cells so they have a very you know I mean he's been working on this model for a long time he didn't take it quite to the extent that I did but he did some more research when people were came back to him and said well wait a minute these diacylglycerides don't always cause insulin resistance why not and it turns out that there's a requirement for the fats that it's composed of which is why interlipid works so great it's you know mostly omega-6 fats thank you so much Tucker thank him again we have a six minute break until dr. Tommy Woods is up so don't go far