 Okay, so city zero how markets and evolution can save lives and money gave you a little bit of a background on this I Wait one other Thought on the bacon piece. I had to live for almost 48 hours knowing that bacon was the most nutritious pork product on the planet sworn under Penalty of being dissolved in a hydrochloric acid bath if I gave it up. So That stuff's pretty cool. So So Moore's law any tech-oriented folks in here So Moore's law is a concept that was developed in the late 60s early 70s It was this observation that transistor speed tended to double at about a rate of every every 18 months So there was this kind of observation that computing power basically doubled about every 18 months and Guy named more kind of figured this out And so it's called Moore's law and this is held pretty consistent throughout the the recent history There's some thoughts that maybe at some point This is going to plateau out who knows quantum computing and stuff like that may keep driving this forward but in addition to this notion that computers get faster and they you know our ability to do Processing of information gets faster things also tend to get cheaper and shockingly so and so we see that as Cost per unit of computing drops the computing power goes up There are a ton of different observations or Market-based analyses that we can apply the same Investigation to even getting things out of the ground like natural resources mining and stuff like that tends to follow Moore's law We have a market-based intervention where we have innovation being applied to a tech to a problem Then typically we do things better faster and at less cost and and this is just a ubiquitous in various markets This is a hard drive cost Gigabyte of hard drive 1998 or 1980. It was about a million dollars to get your average Gigabyte of processing power today. It's less than ten cents a Gigabyte of processing is now so cheap that it's more valuable as a means of advertising than it is as the original artifact Intention, which is just amazing. I remember 1980. I remember you know wearing parachute pants and stuff And so at a time when when something was a value of a million dollars one million dollars We you know we have something that is now a Keychain trinket and so it's it's just an amazing change and it doesn't just apply to Let's say like hard drives and stuff like that like I said these these things apply to mining and a variety of other Activities, but the cost to to sequence a megabase of DNA back around 2001 was was again Enormously costly relative to what we can we can apply this problem today This this graph to two important things the first is that this is a logarithmic graph And so this drop is artificially stretched out It should look like a clip like a sheer face of a cliff for for one thing the other part That's interesting to point out with this. Is it the first phase of this? Decreasing costs of sequence in DNA was largely an outgrowth of the government Undertaking the human genome project and starting to sequence large amounts of human DNA Trying to to you know get a handle on what the human genome is Where the precipitous drop occurs who knows what caused that? Yeah, private enterprise intervened in the process and the whole the whole thing became it diverged away from Moore's law at a shocking rate It wasn't just a doubling of the information again It became a logarithmic change in the way that said this innovation occurred so today Let's say let's ask the question to the audience Do we know more today about genetics than we did 30 years ago? Yeah, how about pathology? Biochemistry epigenetics. I don't even know if epigenetics was a term 30 years ago So we know more about damn near everything that there is to know but yet costs of medicine this is a from the Congressional budgetary office. It says orthodox government as you could get there's nothing controversial No, tinfoil hats. Nothing weird about this at all and the projection is that by 2050 we will be spending We will be in debt 300% of GDP a massive allocation of that is going to go to health care costs Why is that how can that be? We know more about all of these problems Every other thing that we experience in our life gets cheaper and better With regards to technology we understand pathophysiology of any disease that you want to talk about Better than we've ever known at any time and tomorrow we're going to know it even better But yet every projection that we have is that costs are going to go up and they're going to go up in a way that is non-linear it's exponential and Another graph from the Congressional budgetary office. We cannot hang this on demographics We cannot simply hang this on an aging population It is clear that the bulk of these costs are related to health care and the bulk of the problems related to health care is Tied into diabetes, you know anything that you want to talk about that. I wanted to Bring in some information. Well quickly this graph it ranges the This is from Manage Care magazine in the middle bound. We're talking about one in three Americans being Officially type 2 diabetic the upper bound were basically between 1.5 and 1.2 I don't know how you get a half a person being Diabetic, maybe a leg falls off and it becomes like a zombie entity and goes on or something But again, this is following like a reverse Moore's law pattern. We are doing exactly the opposite of what every other industry or technological endeavor does You pick a thing I can Google it and find that some sort of innovation some sort of discovery is driving the prices down on something except medicine and Why the hell is that and can we sustain paying that and the answer to that is absolutely not People talk about national defense and all kinds of other stuff if you want to bankrupt this economy and there are several other Economies around the world that are relatively wealthy that have been Beneficiaries of a demographic bump when you have a small aged population a large youthful population that is very productive And they have very giving social welfare programs and whatnot Those things are changing because our costs for dealing with illness are increasing at exponential rates So my my I just generally asked this question. What the heck is it that we are doing that's so wrong And I would make the argument that we are not practicing Darwinian medicine that as Matt alluded in the beginning of his talk If we have a fleet of health care providers that don't really buy into or or use Darwinian medicine is kind of the beginning of their Hypothesis generation. We're really behind the eight ball with that This is like trying to do physics without an understanding of quantum mechanics, but that's a whole other whole other topic for a different day It would be nice if we had an example of something that actually does follow Moore's law type type patterns in medicine And in fact Lasix is a beautiful illustration of this even in non inflation adjusted dollars Lasix has plummeted in price and this this graph is out of date It's in 2004 current average Lasix prices are about six four hundred to six hundred dollars per eye And so what you have here is a situation in which you have a problem people with bad eyesight You have technological innovation that can deal with that problem because we have markets and a lack of third-party payers Which is the the definition of the the situation that we typically face Then we see a Moore's law type handling of this problem So as long as we maintain a third-party payer system as long as people think that Medicine is going to be free that they can have zero co-pay for everything which in basic economics means that everything becomes You try to take a limited resource and make it infinite then what you do is you make the price become infinite So we we've got some serious problems there, but we have obvious solutions in my mind to where we go with this So this is kind of part one part two or I guess I've got a little recap on it Technology in advances goods and services improve cost decrease We know more about pretty much everything under the sun. How can all this stuff be happening? So So I'm hoping that this next piece of the story is a little bit of the solution Hopefully it's the beginning of something that we as an organization as a movement can embrace if I if if what is happening here? Is legit what I think is occurring that it may again be the skinny end of the wedge towards an opportunity to change things in a really profound way so back around 2001 3 University of Nevada, Las Vegas police officers succain to cardiac events within a year's time less than a year's time The cost to retire an officer in the state of Nevada and different state a lot of states view police military and fire Anybody in that profession if they have a stroke a heart attack and autoimmune disease a host of different conditions If they develop that condition whether they are on the job or off the job It's assumed to be an on-the-job workman's comp L&I issue So not all states are like that but many states are like that Nevada happens to be one of them So the cost to retire an offer the officer when they suffer a heart attack or a stroke is about 1.2 million dollars That's the initial on the books number that people write down when they're trying to do their budgeting and when they do risk Assessment and whatnot the real costs are actually about ten times this amount and this is part of the reason why municipalities all over the country are going bankrupt because they are Reporting that they are going to spend one dollar amount on things and then they're spending ten times more on a variety of issues And this is a perfect illustration of this so this this situation with these doctors or with the Officers getting sick having cardiovascular disease costing the the state and the university huge sums of money to say nothing about the I Hope it's implicit that there's also the human life cost here when you have people dying on the job There's the you know the loss of human beings the loss of fathers the loss of mothers You know all the rest of that stuff I'm gonna focus on kind of the the hard real cost But the human cost are obviously enormous here brain drain and all the rest of that so especially health is a Health maintenance risk assessment program that was founded in 1993 there in Reno, Nevada I just moved to Reno back in November Kind of interesting backstory, which I'll try to weave into this here in a bit Initially these folks were an orthopedic risk assessment program So they worked with labor and industry claims workmen comp claims trying to figure out effective preventative measures for orthopedic issues, you know like a carpal tunnel C spine low back issues and stuff like that and then trying to recommend successful physical therapy medical procedures to offset costs so that these guys have been around since 1993 one of the folks at the University of Nevada Reno and Who was in the police department heard about the folks at UNLV and then they knew the the people at specialty health and they said hey Do you think you guys could develop some sort of a risk assessment program? We had three three officers almost died due to cardiovascular events down in Las Vegas We have a similar problem here in Reno for both the police and the fire. Could you guys? Possibly develop a risk assessment program and they said well We can certainly look into this and so they started putting the pieces together on a risk assessment program They did standard blood work HDL LDL total cholesterol triglycerides kind of the standard boilerplate blood work They did framing ham scores, which if you want to blow your brains out just try to figure out what the hella framing ham score is It's both worthless and Induces about a 50% suicide rate and those who study it Um They implemented it a when they put people through the blood work and they were found to have a High risk of say metabolic issues based off the blood work that they were looking at which at that time They were missing a ton of stuff They would recommend a high carb low fat American Heart Association diet and their results were absolutely dismal They were frequently Worse than the groups that did not receive intervention Let that one sink in These guys are getting paid by the city of Reno to do a risk assessment program trying to mitigate cardiovascular disease and the people Going through their high carb low fat framing ham score oriented program were typically developing type 2 diabetes at a higher rate triglycerides going up cholesterol going south and They were kind of like what the hell is going on. I mean they were following the American Heart Association guidelines They were doing the due diligence that physicians are supposed to do and follow the rules of the consensus And the results that they were seeing were obviously sub par It was not addressing the issues that these people suffered from at all So Luckily they kept looking and eventually the whole low carb concept got on their radar They found some work from gary tobs from mike eads and some other folks And they started doing a little bit of work around low carb intervention Uh, they got in contact with the national lipid association, which these guys are pretty cool. They they are far more sophisticated than the american heart association and Uh, they they will even openly endorse a ketogenic diet for high cholesterol issues elevated Ldlp and stuff like that. So they're they're pretty solid There's still some things that I would like to mold and change in the way that they they look at things But they're they're pretty solid They do nmr testing via liposcience labs, which I'll talk a little bit about what that is It's advanced testing look at looking at different lipoprotein fractions that seem to have A better correlate with actual cardiovascular events and I'm have some commentary on all that stuff too, but The current program they do a yearly risk screening So they pump all the the police and fire through a yearly risk screening now They they do all of them. I'll tell you about the pilot program here in a second Folks that are flagged as high risk either because of specific lipoproteins or because of overt insulin resistance Those folks receive a low carb slash paleo diet The paleo thing is kind of a newer addition the orientation towards gut health and what what not which I'll I'll get to here And just a bit they do some targeted pharmaceuticals some statins and some metformin which I'm going to comment on that They do sleep counseling They used to do it a bit since I've come on the scene They do it aggressively because it clearly like the paper that pedrobastos was was a part of talking about the ancestral biomedical environment and the changes in metabolic health associated with sleep I think if people are sleeping well, it's very difficult to kill them if they're not sleeping well It's hard to keep them alive So this is a a huge problem in police military fire and medical situations in which these people are forced to be in Suboptimum sleep conditions almost constantly and so we need to figure out strategies for mitigating those those effects And so we do sleep counseling and a variety of Kind of support material with that we recommend metabolic type conditioning circuit type conditioning to help reverse Insulin resistance and and whatnot, but that we are trying to emphasize an appropriate dose and and not kill folks with it So here's a a standard good Blood work They call it the big five. We we've got a Body mass index, which is kind of like eh, whatever blood pressure breathing is actually cardiac output and Whether or not the person's smoker Lipid profile and then blood sugar This person is is pretty solid I'm only going to show you the front page of this this NMR this advanced testing But this person has a this is nice also For police military fire because it's like red light green light yellow light kind of gay It's real real easy to get it's kind of like a bunch of red lights your fubard, you know And and a bunch of green lights are pretty good but the this first one when you look at the advanced testing the The further analysis of the lipoproteins also look good But I'm going to show you one that really Qualitatively is not that much different and this is what we call the discordance model This is the person that typically their doctor Doesn't really notice they If you can't see the numbers there's I have a chart at the end Which we will we'll be able to look at all of the the numbers But the concerning things here we we see an LDL cholesterol of only 117 And so for most physicians that wouldn't be particularly concerning That triglyceride that I think is in the 300s would cause me to probably wet my pants If I were the person's doctor a lot of docs, this is not a flag for them though They look at HDL LDL His his HDL is okay. It's a little on the low side And again, I've got a chart here and just a little bit to to show you what those are exactly The upper right, I guess your left hand corner LDLP It's above 2000 we want that number ideally to be below a thousand typically There's some contention with that like a dr. Atiya and myself and chris crescer We've been talking about this a little bit if you have somebody who has LDLP that's quite elevated like this, but they're eating a low-carb non-inflammatory diet doesn't matter We don't know the folks at the national ellipid association think that it does matter But it's an opinion because we don't have data to really support it at this point Uh, I'm kind of of the opinion that the elevated LDLP unless it's familial hypercholesterolemia is actually A symptom of something else going on. It's not the problem. It's actually a symptom of systemic inflammation I'll try to build my case on that a little bit But this is what they're looking at with this guy And so his triglycerides were 362 Total cholesterol was not super high But normally this guy would fly under the radar They'd send them back out at work and he's This guy looked like Off of a wheatie's box. He's a triathlete and ended up having a heart attack while giving a What's the you know the Neighborhood watch is given a neighborhood watch talk to a bunch of like You know 80 year old women and he collapses on their coffee table and they barely save his life But they they so the the importance here the the idea that's going on We could have equal amounts of total cholesterol When we're talking about these different cholesterol fractions and folks like christmaster john and a lot of other people are much more knowledgeable on it than I am but the uh You have lipoproteins and those lipoproteins are trying to carry lipid type fragments around our body Either carrying it from the body back to our our liver in the case of hdl Carrying it from the liver out to the body in the case of ldl And depending on the composition of these particles if they are small and dense Then they could be carrying the same total amount of cholesterol But we have more particles and the more particles we have the higher likelihood We have of these things associating poorly with the vascular endothelium and causing some sort of damage and in promoting atherosclerosis Or a plaque or something like that So the takeaway is that if we could have the equal amount of ldl cholesterol But yet different ldl particles ldlp and the higher the particle the supposition is that we have a higher Statistical probability of something going wrong. It's kind of the the basic idea on that So this is an after and I believe that these guys let me back up This was a four month intervention. I believe and so afterwards We've we've shifted things around pretty nicely The ldlp is now almost below a thousand and then this this chart kind of summarizes things pretty nicely The dude's like a mesomorph like he's he's just kind of brick poop house kind of kind of build on him and So he dropped some weight, but he's really thick meaty dude ldlp went from 2200 down to a thousand The other notables the triglycerides are still for me way too high Like in in this scene I would really like to see those more long like 50 to 70 or something like that Like I I still think that that's too high and it's showing some like that insulin resistant score I would like to see lower, but obviously a good improvement So another person here, this is what they call dead man walking and This dude when he came in it was it was you know a nightmare right from the beginning This is his after and you know what this was a 10-year intervention So it shows that with a Modification in his nutrition, which was primarily just low carb not even the the paleo orientation And a little bit of of a metformin and whatnot Then he had a pretty remarkable change and Yeah, like the uh Do we have the Oh, we don't yeah the triglycerides are better in this one than than what the other one was So we have one more and this I believe is a six year change and similar kind of dead man walking and in the The summary chart is I think really valuable. So over 2200 in the LDLP about a thousand at the end Really really remarkable triglyceride change. So I I like seeing numbers like that What it tells me is a person is very very insulin sensitive So we're getting no collateral damage with up your regulation of pro inflammatory pathways with with this person So that that still is kind of a question, you know, like can you get LDL or a Insulin sensitivity in this range, but then potentially have a higher LDLP Would that still be as problematic as somebody who has high oxidative stress and an insulin resistant profile? I don't I don't think the two are equal, but that stuff will have to figure out So this stuff does some pretty remarkable work Especially health They I think they have 1.5 million people in their database And so they have an enormous pool of data that they've been accumulating since 1993 So they're able to do some really nice statistical Kind of forecasting on, you know, if we have a white male 45 years old five foot nine Blah blah blah, you know and extrapolate all of the data They can do some pretty nice forecasting about disease rates And so the pilot study that was performed there were 33 participants at a cost of about $1,000 per person Based on the metabolic changes that we see in these 33 people and the 33 were the the There were 200 cops and firefighters that were screened 33 of them were found to be at high risk So these are the people that were the likely very high likelihood of a stroke or heart attack within the next five years So they did these in Yeah, and this is part of the cool thing which is is really important to point out the chief of police Had his life saved with this program chief of fire had his life saved with this program Six of the city council members had their lives saved with this program The cfo of the three largest uh casinos in town had his life saved with this program So this is an example of the old boys club actually doing something right They got together and these people who have significant power and significant sway Saw a problem. They saw that their police and firefighters were dying They saw a huge cost in regards to life And and the the cost of retirement and they actually got in and did the right thing And so the reason why this is working in part is because the chief of police chief of fire This is mandated stuff when they tell you to do this. This is your job to eat this way This is your job to exercise So it's not a compulsory, you know, like you do it and that's part of the reason why this stuff has worked Are they seeing a reduction in cardiac Well, we're seeing all of the markers that should indicate that and given that it's been running This this part of the program has been running five years Then we're we are starting to accumulate enough time on a large enough data set that it's favorable But we need some more time to run to be able to Fully fully address that the estimated return on investment is 20 to 1 ROI and about a 22 million dollar return on investment with that pilot study alone So I'll I'll talk about the the overall program at the end But I I'm still as cool as all this stuff is I'm still really Unimpressed with pieces of it. I still think we're treating symptoms I still think the elevated LDLP is is symptomatic of other things or It based on the metabolic profile. It may not be that big of a problem at all I think that it may be a sign of intestinal permeability systemic inflammation, etc I I'm really curious I I got thinking about the mechanism of action like the the national lipid association folks use Metformin and use statins Significantly they use very low doses, but they use them consistently But one day I started thinking about metformin And what metformin does it's actually a pretty cool little drug It improves insulin sensitivity both at the liver and at the muscle level And it just seems to do amazing things like the when folks are Going in for Reproductive medicine, you know, typically they'll look at the look of the male look the female and everything But typically the first line of intervention for females is they put them on metformin Which is an insulin sensitizer because insulin and estrogen and in progesterone and everything are very tightly lined up But I was thinking about all the benefits that we seem to get empirically Observationally from metformin. I was thinking I wonder if metformin actually has effect on LPS lipopolysaccharide lipopolysaccharide is the the part of the exo the outside coat of bacteria And mammals basically any vertebrate that gets bacteria into its system has a huge inflammatory response An interesting thing. I think I mentioned last year in my talk. It's physiologically Indistinguishable type 2 diabetes from acute sepsis Acute sepsis is when you have a high very high blood titer of bacteria or or lipopolysaccharide endotoxins and it dysregulates the the normal Glucose home of homeostasis coming out of the liver. Yeah, I've elevated blood glucose Yeah, I've elevated gluconeogenesis everything that you see in type 2 diabetes you see in sepsis And so I've been wondering is a bunch of you know, what we're seeing With systemic inflammation and the beginnings of insulin resistance leptin resistance Is this all related to low-grade sepsis? And so part of part of this thing that I started kind of putting together is that LDL particles are critical. They're part of the innate immune system So we have the adaptive immune system makes antibodies. We have the innate immune system macrophages and other white blood cells They act in an immediate kind of first responder Kind of fashion But they seem to be tied in really really tightly with a lot of systemic inflammatory diseases So lps binding protein circulates in association with apoby containing lipoproteins Enhances LDL and VLDL interaction What all that stuff means is that when we have an infection or some sort of septic event I would make it an analogy here of gut permeability Ciliac non-ciliac gut permeability a variety of issues that go into that Lipopolysaccharide makes its way into our system It is very very toxic to us and causes profound metabolic changes So our body really is highly motivated to deal with it You have lipopolysaccharide binding protein, which can then associate the lps with our our endogenous lipoproteins HDL LDL etc And if it goes through that route then we can neutralize the lps in a fairly non-toxic fashion If it goes the other way though if this lps associated with the cd14 protein on macrophages and and other white blood cells We then pump that through into the liver and we have a highly toxic response Basically akin to type 2 diabetes. This is that beginning of systemic inflammation Possibly this leads into leptin resistance a whole host of stuff so And this is also just a backup like A normal response that the body would have to chronic infection is to upregulate Cholesterol production because the cholesterol is attempting to remove these lps particles. So that that's some of my thought about Lps and and systemic inflammation But I started thinking about metformin as it relates to all this stuff And one day I was thinking I wonder if metformin has some effects on mitigating Lps lipopolysaccharide induced Hepato toxicity and so I opted into pub med and sure enough we found Several papers that seemed to indicate that metformin had potent anti Hepatic toxicity effects with regards to lps, which I thought was pretty cool And then I had another thought I wonder if Metformin has effect on gut permeability and sure enough it does and there's a pretty cool The I pulled a couple of things out of the paper The protective effects of metformin treatment on the onset of fructose induced non-alcoholic fatty liver disease Were associated with protection against the loss of tight junction proteins The the tight junction proteins occludin and zonula occludin is one and the duodenum of fructose fed mice And the increased translocation of bacterial endotoxin found in mice only fed with fructose Taken together these data suggest that metformin not only protects the liver from the onset of fructose induced non-alcoholic fatty liver disease Through mechanisms involving its direct effects on hepatic insulin sensitivity But rather through the altering of intestinal permeability and subsequent the subsequently the endotoxin dependent activation of hepatic coup fur cells So metformin is a really cool little drug. It improves insulin sensitivity in a variety of ways and it seems to prevent Lipopolysaccharide induced systemic inflammation And it seems to improve intestinal permeability or at least prevent the the normal signs and symptoms of intestinal permeability This is almost like a mirror image It's a drug that treats all of the problems that we're basically addressing in this kind of ancestral health Framework. It's pretty pretty cool stuff so I'll just really briefly talk about statins for a long long time The main mode of action in statins has been suspected or largely known to be the anti-inflammatory effects So again when we're talking about modifying Cholesterol levels and risk factors I don't really think that it has that much to do with the cholesterol modification numbers It has to do with the systemic anti-inflammatory effects that statins carry And this is an old paper. I think it's 2002 Yeah, so it's a pretty old paper. We have way more data on this now So when I came on the scene with the the specialty health folks I moved to Reno and about three weeks after being there a dr. Greenwald shot me an email and he said Hey, we really like your work We'd like to do some lunch with you and I sat down and these folks showed me all this stuff And I was like holy cats man. This is this is super cool And I started looking at what they were they were tracking. They were doing a low-carb intervention I said hey, have you guys started tracking auto immunity or intestinal permeability or any of that stuff? And they're like no and it turned out that both dr. Greenwald and Dr. Cox Jackie Cox who is kind of the statistical Brain behind this whole thing both of them have autoimmune conditions neither one of them really knew it But we kind of dug that up via Via blood work and where they were eating a low-carb diet previously And their their carb would inevitably be like a piece of toast and stuff like that We ended up doing an autoimmune protocol, which we've talked about quite a bit for I don't know maybe five five years now We've had some inkling of an autoimmune protocol variety of paleo both of them have responded remarkably well And we've started going back and looking at the data that they've had on their their police and fire that they've tracked And we've dug up some some kind of below the surface auto immunity in these folks So this is what we're looking at now screening for intestinal permeability also for overt auto immunity The stuff that we have cooking next We have a program that's been running now for three months four months that encompasses all of Reno police and fire The estimated savings on these folks based off the numbers that we have had currently Over a 30 year period is about 1.2 billion dollars Yeah, amazing amazing and at a time when it If you look at almost any corporation any municipality typically the greatest increasing cost that they are facing is health care costs It's going up at between 10 and 15 percent a year. So the this is Absolutely gutting the costs and the spending that they were they were putting into health care potentially. We'll see how it goes This is you know the low-carb intervention with the addition of this kind of paleo Gut permeability systemic inflammation mindset lots of sleep counseling We're going to spread this program to a global audience. We've been contacted by 45 municipalities globally thus far We have Scandinavia, Australia, New Zealand the uk all over the united states Especially health already had a very robust database and and networked Health maintenance program. So we're able to collect data on all these folks So basically these folks are going to be given the tools to implement these programs locally We will do the data collection and then we're we're going to kind of roll from there We're going to data consolidate that data with those folks The next step also we're working on a health care provider education covering Trainers coaches allied health professionals mds so that we can get folks up to speed in this ancestral health model And then the big goal is that we're going to develop a health insurance company pushing hsa's And referrals back to these gyms. I've said for a long time. Some of you folks may know that I've had On and off stuff with the crossfit entity and whatnot, but I think gyms like that Literally should be our primary care medicine We shouldn't go to the dock in the box for primary care We should go to a local Decentralized gym where we do functional training and we get sunlight and we have community and we have csa's in there So the development of stable well run gyms is actually a huge part of what i'm going to be up to And educating those people and then creating networks with allied health care providers Physicians etc and then providing Direct to consumer blood testing so that we can help those folks whether they're at high risk or low risk But the whole thing also is if we can develop a health care model That is based on darwinian medicine in the ancestral health model It is going to be so much more cost effective than anything else out there. I think it will crush things And there was a couple of people mentioned that we need to get more science coming out of the back end of this stuff I agree But the academics take a goddamn long time to get anything done And and I say that with respect being at harvard and all the rest of that We cannot wait for that to happen We need to bootstrap this and we need to take responsibility and we need to help each other do this Or it won't happen if we wait for the academic process to occur It'll be 20 years before we validate the things that we're suspecting today So we need to do this on our own and and make it it's still outcome based We're not just making stuff up We still are hanging our hat on the results that we get But the economics need to drive this thing and that's the in my opinion the the direction that we need to drive that boat As a closer Really interesting how the world works in small circles So the the gentleman on the far right is egg greenwald He is dr. Greenwald's father. He became a high ranking person at the fbi The gentleman next to him with the mustache Does anybody know who he is? Anybody particularly in the anthropology realm? His name is robert bravewood Does anybody know that name? We should all I I didn't know so i'm not gonna gonna hang you guys out to But robert bravewood was One of the first people to study the transition from the hunter-gatherer life way to the the settled Agriculturalist life way He wrote some of the very first papers detailing the changes in stature the changes in dentition The changes in health status of hunter-gatherers as they transitioned into agricultural is so he literally is one of the first people to ever Study this topic that we are now Amashed in right right in the the middle ground part of the significance is that he was a Super tight friend of the greenwald family and dr. Greenwald the co-founder especially health The reason why he went into medicine is because of this man and he's had a lifelong fascination of genetics evolution And and everything obviously health related and so this guy is the guy that contacted me after I was in reno for three Three weeks and he's the one that's been running this uh this Risk assessment program and it all largely is an outgrowth of this man that it's somewhere in the you know The history of all the anthropology side of this we can largely attribute his work as being foundational to it So it's really really amazing And so we'll dedicate this to the next generation That's zoe and that's uh sophie the giraffe so Um, I'm not sure. I think I was at 38 minutes. We were a little late if I need to to pull up I can definitely split if folks have questions. I can answer that later I really thank you guys though, but I are we good for a couple of questions I I just can't emphasize enough though that I feel like we are at a Both a precarious but also an amazing moment in history. I think we can change this all I really do 15 years ago None of this existed Is a couple of crazy, you know me talking to lauren cordain on on via email and and I mean none of this existed So this is uh an amazing time that we Are in and I think we have an amazing opportunity So we'll see how this goes for a year. We'll see if we can get these other programs off the ground We'll see what type of savings we can get out of it. Maybe the program doesn't work Maybe it does. I think it will time will kind of bear that out But I think that something like this and us taking responsibility for the way our food is produced for our own health Somebody needs to start this and it's got to be us and then we will drag the rest of the people along kicking and streaming So thank you Thank you. So we have about five minutes for questions Hi, very good talk. I was just wondering with the metformin data that you were Showing us. Uh, does that permanently affect how the body functions or is it only while people are taking metformin? It's only while they are taking metformin, but you do It's both to some degree because you are changing certain parameters of inflammation That if the person goes off metformin, they tend to get a long lag period with it And I think that if you use it as an intervention Like I think for like police military fire and and medical workers who are facing constant sleep deprivation and have an Sleep-induced metabolic arrangement. I think that those folks should be on low dose metformin across the board Like it is so safe But yet so efficacious in mitigating the effects of insulin resistance that for that population I would argue they they should be on a low dose like half what they would normally do But just a baseline dose and it's going to help undo the sleep-induced metabolic arrangement that is unavoidable from their life Yeah Yeah, great talk. Thanks for for giving it How is this changing your the training curriculum that you mentioned that we're all dying to know about And say the evos program that you had with uh, s1y new pulse. Is this changing some of the content that's going on there? Not really. I mean we it is in that way. It's very clear that My background is obviously more gem related, but we obviously need to get Sophisticated in how we educate allied healthcare providers and also physicians So that we can refer people to this program and like what blood work we're going to track and stuff like that An interesting backstory with this is dr Tara doll who is one of the folks at the national lipid association She and her husband were given a huge grant by the world health organization To provide a website where barefoot doctors in developing countries can do their whole medical school curriculum online And then the people will show up in the uk or australia do some clinical work But otherwise they're they're anointed and often running. So it's a huge Fully accredited medical school curriculum online These people have offered to host our our education material So we basically right out of the gate get a ccme accreditation, which is gold stattered AMA accreditation and peripherally. We're basically getting a nod from the who on this So we're basically just like need to bum rush this thing and make it happen. So yeah, thank you Awesome talk. Thank you so much. Um on a personal note, I'm one of those people my ldlp of 22 40 Um triglycerides of 40, uh insulin resistance score of four. So I've got this weird Sort of schizophrenic numbers Maybe it's time to get like this get folks like us Together and and watch us and and and and maybe we need like a forum or some kind of Way that those of us that are in that situation because it isn't it is kind of seemed like it is a gray area We don't know everything we need to know about this yet. Absolutely. I totally agree and how many of y'all know chris chresser chris can you rate So the one person in the room raises his hand everybody knows chris Okay, chris has some really amazing material coming out and looking at high cholesterol in the the paleo scene And so I think that we need to organize ourselves do some advanced testing and then consolidate this Especially health is is trying to work with me so that we can do some direct to consumer Blood work and they will be able to provide an analysis on this So then that way you guys will get you know, if you want to do advanced testing They'll be able to to send it right to you and you can do it and you wouldn't Very few doctors are even aware of this stuff. So it's hard to get them to order this whereas you'd be able to order it through Especially health Yeah, hey, Rob. Uh rick henricks. I'm a family physician and before everybody goes and runs and buys metformin or recommends it for everybody I just wanted to Hold the horses a bit. So there are some bad side effects right nausea diarrhea So it's not the wonder drug, but it is a fantastic medication and does work really well And I would just like to say I mean, this is great stuff and there are physicians that are doing Similar things like that that are here and and look for Good physicians to help you out with that. Awesome. Are you signed up on the physicians network? Sure are and I get The other day I had like five of my 7 a.m. Morning patients that were that were from the network. So it's actually working It's actually work. Cool. Thank you. Thanks. Thank you everybody We're gonna cut off questions right now If you have questions later, maybe Rob will answer them His answers will be much more colorful then