 Welcome to the Dr. Gundry podcast. So these days it seems like more people than ever are confused about what to eat. Should you go low carb? Is a high fat keto diet actually healthy? How about the carnivore diet? How much protein do you really need? Well to help answer these questions and cut through the noise, I brought on a heavy hitter. Sean Stevenson is a nutritional expert, host of the model health show and author of a brand new book called Eat Smarter. Cool. On this episode, Sean and I are gonna discuss why fat isn't your enemy, the truth about calories and how much protein you actually need for optimal health. Sean, so glad to have you back on the podcast. I'm grateful to be here. I'm excited. So we've talked about your background growing up before and we've talked before about your degenerative dysdiagnosis and recovery, but you write in the book, the role that food played in all of this. Can you repeat that story for the listener? I think it's a great story. Absolutely. So I was an aspiring athlete. I was like the fast kid in the neighborhood, the guy you always picked first and really just even in my environment, there was essentially two ways to success. And one was through athletics. The other way was through drugs. That's just kind of what was in my sphere. And I fortunately had great exposure for my grandmother kind of instilling in me the importance of education. But still like sports was my thing. And at the age of 15, I ran a 4540, which is NFL time already at 15, but that same year at track practice, doing a 200 meter time trial with my coach, I broke my hip just from running as a 15 year old kid. And obviously you know this, it's usually something that's associated with folks who are in their elderly years, oftentimes more so happening with women in some aspects. And so it should be a sign that something's off. There's something going on with my body, maybe even with my hormones, but nobody stopped to ask this question, what made a 15 year old kid break his hip from simply running? I went through what's called standard of care. Here's some insides, stay off the leg. They actually gave me some ultrasound treatment, which is another little sidebar. How sound is a treatment? But we hear the name, but we don't really get how powerful it can be. But anyway, so I got better sort of. I got back on the field, but a string of other injuries happened and really derailed my vision of being able to play professionally. And so my identity was shattered. And ultimately when I was 20, I got diagnosed with this so-called incurable degenerative disc disease. And my physician put the MRI up for me to see and he told me that I had the spine of an 80 year old man. And not a healthy 80 year old by the way, just to be clear, but it was really obviously just earth shattering for me to hear this. And he gave me a prescription, told me bed rest, and he said, I'm sorry, there's nothing we could do. We can manage this. And I always encourage folks, whenever they get a bad bill of goods, bag diagnosis, it's a good idea to seek out a second or third opinion before you take drastic action. And I did that. I saw three other physicians over the course of two years and they all said the same thing. And each one gave me a new prescription. Now I got some Celebrex added to the mix and they also told me bed rest. I could walk, Dr. Gundry. I could walk, I was in pain, but they kept telling me to do nothing. And the worst thing you could do in some instances is to do nothing. It wasn't just my bones atrophy now, my spine, everything else was. And I also just gained a tremendous amount of weight, doing nothing, eating what I call the typical university diet, typical university food or tough diet. And this game changing moment happened two years later when after seeing the final doctor, I realized I had this habitual question going on in my head, why won't somebody help me? Why won't somebody help me? Why me? And that night I asked, what can I do to get better? It was the first time I asked a more empowering proactive thing for myself. And the brain is really wired up to answer questions that you pose it. It's called instinctive elaboration. A brain is just driven by questions. Oftentimes they're unconscious or subconscious, but it helps us to filter out all the stuff coming at us. There's trillions of bits of data even right now as we're sitting here and everybody listening. There's even data coming into your toes right now. And maybe we just thought about our toes a little bit. You noticed that. Right. There was it there before? Your brain just didn't see it as a top priority and your attention was somewhere else. But anyway, so that sent me on a pathway of discovery. Simply by asking this question, my filter started to zoom in on different things. And one of the things that really changed everything, I asked, okay, my bones are degenerating rapidly. What are my bones actually made of? And the marketing would tell me, calcium. You know, you see the milk mustache, that's the one I need. And I was guzzling milk like crazy every day. It was part of my tough diet. It was coming along with my cereal. I was getting butt loads of milk. Why are my bones still degenerating? And I asking that question, I searched. And I was in college at the time still. And so it's not that it guaranteed access, but I had the ability to just ask questions and to search. And I found there was like 20 other things, some of them more important than calcium in increasing your bone density. Even a mega threes were important. And I was like, I'm not getting any of this in my McDonald's hotcakes and sausage and my Hawaiian punch. I'm not getting any of these nutrients. And it struck me for the first time that my tissues, I wasn't giving my body the very basic raw materials it needed to regenerate me, to build my body. I was made out of the stuff that I was eating. And this is an overarching thing for everybody today is that every single thing about us, as we're sitting here, I'm seeing the food that you've eaten. Our brain cells, the axons, the dendrites, the neurons themselves are made from the food that we eat. This is what allows us to have thought and feeling and emotion is made from food. Even people hearing us, the tiny bones in the ears are made from the food that you eat. Sending those electrical signals to your brain, I can go on and on, your heart is made from the food that you eat. It's so important, but it's not a part of the conversation, the popular conversation yet. And so to put a kind of ball in the story, it's a happy ending. Once I got this, that food mattered so much in creating a better, basically a better printout of me because food, nutrigenomics and nutrigenetics, some of the things I cover in the book, it literally decides what your genes are doing. And I started to just provide my body with all these powerful raw materials. And it didn't just change my body, it also changed my mind because food isn't just food, it's information. And so making my brain out of better stuff, I just had a higher quality of thought process. I felt better, you know? And once I turned my own health around, that feeling, I was so self-centered in the beginning, you know, early in my life because of the environment I was in, I had to protect myself. I shifted so far to the other end of the spectrum, I became so other focused. I wanted to help as many people as I could to feel like I did. So just to highlight this story in a nutshell, you know, food really does make us up at a very foundational level. And if we can get the food right, so much else becomes easier. No, you're so right about that. We were talking off camera and I got to share this because it's pretty good. I grew up in Omaha, Nebraska and my best friend's father was actually head of what's now Conagra. It was Consolidated Mills back then. And his mother made great chocolate chip cookies and particularly chocolate chip cookie dough. And so my friend and I would go there after school and we'd sit there and eat raw chocolate chip cookie dough. One day, his dad comes in early from work and we're sitting there throwing down the chocolate chip cookie dough and he goes, don't eat that stuff. There's bugs in there. And we drop the spoon and go, what bugs? Aren't any bugs in there? And he says, yeah, there's actually lots of insect eggs in the flour that that's made out of. And we're going, what? I've never seen an insect in flour. They're little bowl weevils. And he says, that's because the eggs are in there but they can't grow because there's nothing in that flour that can sustain them. And it was, if I thought back, I'd go, holy cow, that's one of the smartest thing I ever heard anybody ever said. If a bug can't live on this stuff, what in the ding dong are you putting it in your mouth for? That's powerful. Because when you first hear that story, I'm like, okay, we want to avoid the bugs but the bigger overarching meta perspective is that the bugs can't even live off of this stuff. That's powerful. Yeah, yeah, this is your hour but we lost our home in Montecito a couple years ago to the mudslide and we bought a new home and it came on the kitchen counter with a big jar of Oreo cookies that were beautifully arranged and it was artwork. And we decided, I haven't had an Oreo cookie in 20 years but we decided, you know, that's kind of cool. Let's just leave it there. Because it's so, people walk in and go, oh, you know, what are the Oreo cookies doing in your house? That thing has been there for two and a half years. Nothing has changed. There's not a mold growing, there isn't a bug. It hasn't shifted. It's exactly the same two and a half years later. And to think that nothing can live on that and yet we think we can live on that. That's not food, folks. That's not food. That's not food. That reminds me of seeing when I was a kid, I would randomly find like a french fry in my mom's car, you know, like this would be months later and the fry looks the same. Looks like you pick it up and, you know, toss it down. Why isn't it breaking down? You know, it's not food. It's perfectly preserved. Right, it's mummified food. That's right, mummifies us. Right, oh yeah. All right, speaking of mummifying, you write in your book that our fat's number one concern is keeping us alive. Oh come on, now everybody knows that fat, you know, is gonna kill us and why do we have to change our thought about fat? You know, it's not trying to kill us, it's trying to keep us alive, for sure. This is the same kind of thinking about targeting, trying to destroy all the microbes. You know, it's the same kind of premise. It's a self-fulfilling prophecy in how we're hurting ourselves because our body fat is one of the greatest evolutionary advantages that we have as humans. It's what enabled us to get here and it's simply doing the job it was designed to do but it's existing in conditions that have never existed before. Our body, without our body fat, it allowed us during times when we didn't have access to food to store energy and to keep us going to fight another day. And our body fat is just very, very good at doing this job. And what I wanted to do was to help to kind of demystify and to create more of a kindred friendship, kindred spirit relationship with our body fat because we're trying to kill something we don't even understand and we don't understand its benefit. And so the first thing is understanding there's different types of body fat and also there's different types of fat cell communities. And these cells are communicating with each other literally as an organ. Your body fat, these body fat communities I'm gonna share are organs meaning they produce their own hormones. The neurotransmitters, the communication is like instantaneous. And again, it's a highly intelligent system but we can definitely gum it up. And the first type of body fat is what we generally think when we're targeting trying to kill body fat is storage fat. And these are again a category of white adipose tissue. And there's three. The first one is subcutaneous fat. And so this is the stuff that's just below your skin. And this can be the fat on the back of your arms or on your butt. You can even have some on your belly as well but this is stuff you can pinch. The other type of fat, storage fat is visceral fat and it's also known as omentum fat which is the etymology. It's basically means fatty apron. And so this is the deep organ fat, abdominal fat that's like kind of surrounding and putting pressure on your internal organs. This is more hard. It's a little bit more difficult to get your grip on. And we know that this storage fat is also the most dangerous. It's most associated with insulin resistance, with hypertension, the list goes on and on. But it still serves a purpose. Having a little bit of visceral fat, the reason that we can develop it is the evolutionary adaptation. But the way that it's getting fed today is abnormal. The third type and this one might be new to a lot of folks is called intramuscular fat. And when I was in my typical university classes, I was taught that muscle and fat were really dichotomous. Like these two things had nothing to do with each other. You wanna get more muscle, lose the fat. But intramuscular fat actually functions as onsite energy for your muscles. So when you're going out for a jog or when you're lifting weights, it's got its energy bank right there coming from your fat. And if you wanna think about what it looks like it's sort of like the marbling of a steak. All right, now the catch is this can get overburdened too. And so you can have excess intramuscular fat storage and get chubby muscles is what I call it. And so these are all in the category of storage fats. Now the other type of fat, these fats are more in energy usage potentially. One of them definitely is, and this is brown adipose tissue with a lot of folks have heard of it at this point, hopefully. So brown fat is a type of fat that burns fat. And the reason that it's brown is it's so dense in mitochondria. And mitochondria are really an endpoint when we're talking about burning fat, we're talking about emptying those cell contents from the storage fats, getting them over to the mitochondria to be used as fuel because they can actually get released and get absorbed somewhere else. So we wanna get it to the mitochondria. This tissue is so dense in mitochondria that it's actually brown, you know, brown adipose tissue. Babies have a lot of it. And this is kind of again, a evolutionary adaptation to protect against hypothermia. But as we get older, our percentage, our ratio of brown adipose tissue goes down dramatically. But we do carry some largely around our clavicles, shoulder blades, down your spine. And the other type of fat that can potentially burn fat is called beige fat. All right, now beige fat is really interesting. It has its own precursors and it can actually become white adipose tissue or it can become brown adipose tissue depending on what you eat in your environmental exposures, right? So we want to nudge it to get a tan. We wanna nudge it into that brown adipose tissue range and I'll just throw this out there. One of the ways to do that that a lot of folks are doing today is like cold thermogenesis can potentially stimulate this. But there are some things with the nutrition too we can talk about today. Lastly, I'll share this one really quickly. And if we have time, we might get into it a little bit. We hear this all the time that your brain is mostly fat, all right? First of all, of course, it's mostly water. It's almost 80% water, but if we say the dry weight of the brain is about 11% fat, 8% proteins, not that far behind protein matters a lot. And then a little mix of some trace minerals and minerals, things like that. But your brain is a different type of fat. And again, it's thinking that dietarily eating fat is going to make you fat. That's like thinking a blueberry is going to make you blue. It doesn't work like that biochemically. The same thing for your brain just because you eat fat doesn't mean it gets directly to your brain. Your brain is made of something called structural fats. We got storage fats, we have structural fats. If your brain was made of any storage fats during times of famine, theoretically, your brain would eat itself like homemade zombie food. And we wouldn't be here today, you know? So this is why our body has made these different fat cell communities. And I want to create more admiration and love and respect for our fat communities so that we can optimize them and get them in the right ratios. So you're saying we can actually show our fat communities love? This is the thing too, you know? We're in a very PC culture, of course, where we don't want to shame anyone. We don't want to shame and have any kind of distaste towards ourselves. But we can love ourselves into hell. Once we get to a place where we can be thick, but when we're in a place where we are compromising our health, because here in the United States, about 400,000 people every year die associated with obesity. You know, whether it's from heart disease or diabetes or whatever the case might be, 400,000 people every year. So we want to be aware of that aspect and making sure that we are healthy regardless of our body composition. And so, but I think a big part of this transformation is understanding how the process works. Understanding what's actually happening in our bodies that we live with all the time and empowering people. Because I think once we do this, it makes the job so much easier. And that's the first time in book form taking people behind the scenes and showing them how their metabolism actually works. The hormones involved, the process of fat loss, how does it work? Where does the fat go? When we quote burn it, does it just go to a different dimension, a quantum jump or something? So we go through all of that stuff. So, you know, I think that's a very important point that you just made. And I want to go back to that for a second. You're right. 400,000 people are dying every year from obesity in one or more ways. And we're rapidly closing in on 400,000 people dying from COVID-19. And, you know, when we have this moonshot project to get a vaccine and, you know, wonderful. But why haven't we put the exact same attention on the fact that 400,000 of our fellow citizens are dying every year from obesity? Where's the cry for that? Where's the task force for that? And if we put the same amount of effort on saving those 400,000 lives, wow, we instantly eliminate a susceptibility as well. You know, the CDC published this and I'm shocked that we're not talking about this. 94% of the folks who lost their lives in association with COVID-19 had an average of 2.6 pre-existing chronic diseases. Yeah. Why are we not talking about this? And mainly those, the top three, hypertension, diabetes and obesity. And obesity, yeah. We can do something about this. We can help to reduce our susceptibility, but we have to get our citizens healthier. All right, and your book is gonna tell us how to do that. So, you know, we're always talk about calories and we gotta count calories to lose weight and calories in, calories out. Is a calorie ever really a calorie? This in my nutritional science class, big auditorium class, you know, of course this was back in the day we were taught the food pyramid. We need to get folks that we work with to eat seven to 11 servings of whole grains. Yep. If it's brown, it's going down. If it's white, it's not right. You know, we were taught these premises. And day one, I was taught that truly the most important metric is calorie management. That was the monarch, the emperor, the king of nutrition was the calorie. And for this project, I wanted to go back and look at the history of the calorie. And I love this about you too. Just when I talk to you and you start sharing stories from these historical events is so fascinating to me. And I do that same thing. I wanna know where something came from. And when the calorie was discovered, if you think about, we just talked about this earlier, Hippocrates, he didn't put people on a calorie management program. It wasn't a thing. This was a time people just ate food. The ancient Romans and Greeks, the ancient Egyptians, there's nothing on the pyramids about calorie management. And when it was actually discovered, because it's used as a measurement of energy in food, but it wasn't what it was when it was discovered, it was used in engineering and physics. And it made us jump into the nutritional realm thanks to Wilbur Atwater. But he's a little bit of a side note, even though we use the Atwater system of labeling on food, which is basically just doing math. They're not actually- It's actually not accurate. They're not accurate at all. And it completely negates the complexity of human digestion. That's the most important part. But the woman who really pioneered and made the calorie such an integral part of our culture, we've really been inundated with it, is a woman named Dr. Lulu Hunt-Peters. And she had a nutritional bestseller at the earlier part of the 1900s. And part of it was the key to calories. And she relented that from here forward, if we will not eat food, we will eat calories of food. And we took, and I shared this a little bit earlier, food is one of the most dynamic, multifaceted things in our universe. It makes up everything about us. Our hormones, neurotransmitters, our brain cells, our heart cells, the blood running through our veins is made from the food that we eat. It is incredibly powerful, but now it's numbers. And she said, and I'm taking this directly from her book, these old fangled writings I went and read, from now on you will not eat bread, you will eat 100 calories of bread. You will no longer eat a slice of pie, you'll eat 350 calories of pie. And that's one thing, looking at food as numbers. Another thing she impressed upon culture, which was really detrimental, is still experiencing so much today, is associating food with morality. And if you can't manage your weight, it's a character defect. There's nothing wrong with this diet framework, it's something wrong with you. And she related words like punishment and sin. And the side note, just like my university professor, my nutritional science class, she battled with her weight her entire life, trying to do the thing that she was promoting. My nutritional science teacher was bordering on obesity. And I know he was a great guy, he was smart. He was doing the thing that he was teaching us, but it wasn't working. And he just had this psychological thing, it's something wrong with him. I'm just not doing it right. I need to brown rice harder. I need more whole grains to make this work. And so those were some really dangerous ideas that we still carry today. And one more that I'll share. She also associated hunger with diet success. If you're hungry, you're doing it right. And she said that for, this was during a time of food rationing. She said, for every hunger pang you feel, you should have a double joy knowing you're saving the hunger pangs in another person. And it's one of the most dangerous ideas. And people will come into my office, my clinical practice for years, just thinking like if they're hungry, they're doing it right. It's a subconscious belief. And the truth is we can all have a natural kind of modicum of hunger. But when we get into chronic hunger, when we get into abnormal cravings, these are signs that something is wrong. And this is what we get into in the book. And there's six factors, and we can go through them really quickly, that I'm putting into culture. I'm gonna make this a part of our lexicon, epicoloric influences. These are things that control what calories do in your body. Calories are, yes, they can be used as a unit of measurement. Like a unit of measurement of distance as a meter. But the distance is gonna be the same whenever we measure it. The calorie is gonna be different what it does in your body versus somebody else, versus even your body next week. And that's the difference, is that the human digestion is so complex. And if you want, we can go through and hit six of them really quickly, but two of them are mostly not. Yeah, let's do that. Okay. Number one, the type of food matters. And people have been saying this for years. It's not just the calories, it's the quality of the calorie. Now we know for certain. And this was highlighted in a study, and this was published in Food and Nutrition Research. And they wanted to find out when folks eat a meal of whole foods versus a meal of processed foods, what happens with their body's interaction with calories? And this blew my mind. These are one of those moments when you're by yourself in your office writing and you're just like, oh my God. So here's what happened. The meal they deemed to be whole foods was a whole food sandwich. So it's multi-grain bread and cheddar cheese. So this was the whole food meal. Then the processed food meal was a processed food sandwich, white bread and cheese product. And some folks might be, well, I don't eat cheese product. What is that? That's craft. You can't legally call it cheese. It's not enough cheese in the cheese. So on paper, they're the same amount of calories, both sandwiches, same amount of proteins, fats and carbohydrates should have the same impact. But here's what happened. The folks who ate the processed food sandwich had about a 50% reduction in calorie burn after eating that sandwich versus the folks who ate the whole food sandwich. Now I want folks to really get that 50% reduction in their body's expenditure. Their body decided to hang on and get stingy with those calories. It created some hormonal clogs and dysfunction to the metabolism. And this isn't accounted for in product labels. This isn't accounted for in your caloric deficit diet that this weight loss doctor's telling you to do. And we need to talk about this. The type of food matters and we know this for certain. So that's one. Second thing, the way that the food is prepared. I won't spend much time, all of these are detailed and it's smarter. The way the food is prepared affects the amount of calories that you can absorb from the food. So and also using spinach for example, the cell wall when it's a baby spinach, you can get more energy from it versus the cell wall getting sturdier as the spinach becomes more mature. But cooking it breaks the cell wall down, making the nutrients more bioavailable. Is it a good or bad thing? Neither, it's taking this into consideration because one of the greatest things for the development of the human brain was the advent of fire and cooking. We can now suddenly get more from our food. So but this isn't taken into consideration on the product label. Another thing is the basic energy exchange which it costs calories to absorb calories. This is the thermic effect of food. I was taught this in school but not in a way that actually made sense. Protein is the most powerful and we'll talk more about protein in a moment but protein, it's expensive for your body to break down but it is incredibly important. Protein is the building blocks for so many things. And so your body's gonna take those complex protein structures and break them down to amino acids and just say you consume 100 calories of protein, you're gonna use about 30 of those calories to break that protein down. So you're getting a net gain of 70 calories, not accounted for in a product label. And for carbohydrates, you're gonna use about 10 to 15% of the caloric energy from the carbohydrates to digest the carbohydrates, zero to 5% from the fats. We're really good at digesting dietary fats which should tell you, it's not the body we've made a flaw, it should tell you how important fats are. And so that's the thermic effect of food. Another thing is the digestive efficiency. And this gets into the conversation one of the biggest takeaways, your unique metabolic fingerprint. Every single human being right now, your metabolism is unlike anybody that's ever existed before in human history. And anybody that will come after you, no one will ever be the same. I knew I was special. You are. Thank you, thank you. You are special, you're a diamond in the rough. And now here's the craziest part. Your metabolism next week is different from the metabolism you have right now. It's constantly changing, constantly in flux. It's dynamic, it's fluid. But again, this is negated in conversation. So your ability, how much stomach acid you produce, the enzymes you produce in your saliva, your ability to churn the food. The length of your digestive tract, you could have a couple extra feet in there that other folks don't, truly. And you've got that long track. And so you're gonna inherently absorb more food. But these are- I knew that was my problem. I just got more room to absorb all this stuff. You've got that long track, Dr. G. So here's the thing, all of these things create our unique metabolic profile, but the fifth thing, and one of the most remarkable, and this is something that I've learned so much from you and just grateful for you sharing this work, is the makeup of our microbiome. And this was published in the journal Cell, they found a particular strain of bacteria that blocked mice from absorbing as many calories from their food. And what allopathic thought process, that tunnel vision was like, we just need to bottle up whatever the bacteria is and sell it. But not looking at, maybe that bacteria is helping you to absorb B12 or to make scaffolds. It's not, it's looking at health through a vacuum. That's how we tend to do. So it's not good or bad, but we know this happens. And this is one of the things we talked about a couple of years ago, you and I, and this was done by the Wiseman Institute. And I know this as well. Like I can have a patient send out for a stool sample and I can get the report back. I can look at their bacteria makeup and know if they're obese or not before I even see them. And so these researchers took this quote fat bacteria that you call, that you put a good name on that's associated with insulin resistance and obesity from folks who are obese and implanted them into mice. And they took samples from lean human subjects and implanted them into lean mice. The mice who received the samples from the lean human subjects, nothing happened. They didn't gain weight, they stayed the same. But the mice who received the fecal matter from the obese test subjects became insulin resistant, gained more weight and gained more body fat just by changing their bacteria. And now we stretch this out into human studies that we, it's so cool, this is all coming out now. Identical twins, they take identical twins. All right, they're coming from, they're from the same egg. All right? They're literally matching humans really in so many different aspects, but what they found as a prerequisite is when they didn't have matching microbiomes, we can see what happens. And so they looked, they found twins where one had more of a microbiome associated with obesity and insulin resistant, eating the same diet, one twin, identical twin gained weight while the other one did it. So the makeup of the microbiome, the last one, that's a epicoloric controller is your hypothalamus or just your brain period. Your hypothalamus is really marrying your endocrine system and your nervous system. And it's a big major regular. It's really known as the master gland regulating your metabolism, your HPA axis, your thyroid is along that axis. One of the biggest crises we were facing right now is hypothalamic inflammation, brain neuro inflammation period. And nobody's talking about this. When you're going on this cookie cutter diet plan, nobody's telling you, we need to address the inflammation in your brain because it's the epidemic that's happening right now. And one of the things I highlight in the book, hypothalamic inflammation can reduce your rate of calorie burn by hundreds of calories a day, just because of that factor and how your body, how your brain is regulating things. So that's six different points and we dive in deep into each of them. And also, of course, we talk about things we can do to help to fix these things. All right. Now I'm really depressed because now I have six new things to worry about. Oh. So, let's talk about one of your and my favorite subjects on this line. Food diversity is very important. Is that one of the things that we can do to help fix all this? Yeah. And this is the, I love talking with you because we know that there's no need to get depressed because fixing one thing often makes everything else work better. And it's actually really simple. And so the microbiome makeup, as I mentioned, our microbiome is really the front line determining what your body's going to do with those calories, the energy expenditure and the list goes on and on. They're the first thing to really interact with the food internally inside your body. And so what we found in the data is that as microbiome diversity goes down, obesity goes up. As diversity goes down, insulin resistance goes up. All manner of chronic diseases goes up as the diversity goes down. And so they looked at hunter-gatherer tribes. Folks eating more of an indigenous kind of diet. And they found that they have upwards of four times, five times, eight times more diversity of their microbes than the average person here in the Western world in the United States. And it's shocking because I love the analogy of looking at it as like a rainforest. We have a lot of endangered species and a lot of things have gone extinct. And some researchers believe that some of these things we can't get back, just like in nature. And I don't like to be an extremist. One of the things that is most important is providing the food for those microbes to come back and proliferate. We can take probiotics until we become a probiotic. You're walking down the street and somebody's like, look at that strain over there. But these probiotics will not proliferate. And I've been talking about probiotics for 15 years. They will not proliferate if they don't have their food source, right? The prebiotics. So we have prebiotics, probiotics and postbiotics. That's symbiotic relationship, the things they make in you for you. And so what do we need to do to increase our diversity now? This is so simple. Increase the diversity of foods that you eat. That's the thing that we know for certain. And different strains of bacteria prefer different foods. And so we wanna look at, first of all, by the way, when I say increase the diversity of foods, real food, every type of real food is functions as some type of a probiotic, or prebiotic. Now we wanna be mindful of what they're feeding, what kind of bacteria they're actually feeding because we do have opportunistic bacteria as well, but they all play a part. If everything is in balance, this is one of the things you talk about too, then we're going to be okay. They're probably doing a role. They might be assisting in that B12 production or creating scaphas for us, but when they get out of balance, is when things can happen. So everybody can go to Google and look up a list of prebiotic foods. That's a cookie cutter thing. That's great. Jerusalem artichoke, asparagus, garlic and onions, but truly every real food functions as a prebiotic. So one step I want folks to take today is to be more mindful, even if we're eating healthy, we tend to get in healthy eating in a rut. We're eating the same types of food over and over and over again. And one of the things we also know for certain, and I highlight this a little bit in the book, is that when we're looking at folks eating more of an indigenous diet, there is a changing of our bacteria based on the seasons. Correct. It's amazing and these different food, these different bacteria looking for different foods at different times of the year as well. And so I want everybody to be mindful to add in. I don't want to talk about taking away. Add in two new foods each week. Two new foods that are Dr. G approved each week to help to provide a different source of prebiotics for the healthy flora. So you're not implying that next week I should add in Wendy's to my repertoire instead of just the square burger. Yeah, instead of just McDonald's. That's not diversity, right? No, that's not it. Yeah, and it's fascinating. When you actually study people's eating patterns, when I learned this actually in my first book, most people will for dinner, get down to about five different choices that they have for dinner. And they repeat that over and over and over again. And even my best organic eaters, they may actually only eat 20 different organic foods. And when you look at hunter-gatherers like the Hansa in Tanzania, they're eating 250 different plant species on a rotating basis. And it's just amazing how even the best of us, including me, we just pale compared to hunter-gatherers. So you're right, you have lists of food, I have lists of food. You don't challenge yourself in the next year. Are you right? Even one new one a week, you'll have 52 different new foods by the end of the year. That's so powerful. And again, this is very simple. It's simple, but it's just getting our awareness there to knowing that this is important and knowing all the downstream effects that we can get from this. It's gonna improve our body composition. It's gonna improve our, give us a buffer against insulin resistance by increasing the diversity of our foods and increasing the diversity of those microbes. All right, all right. Let's go on to one of our favorite subjects, protein intake. Now you write in the book that Americans are either eating too much or too little protein. What do you mean by that? This is a really important topic. And just going back to how important protein is, it's a building block for just about everything about us. In the conversation about hormones and we're talking about insulin or glucagon or whatever the case might be, we need proteins, we need amino acids for many of these things to be built and to do their jobs. It's that important. And we believe, there's an overarching belief in our culture which so many things we believe to be true or not true that, especially Americans, we're overeating protein. And I went and looked at the data and it was very different from what the popular narrative is. And so the RDA for protein is really just above what can prevent a protein deficiency, you know? And it's not really necessarily what can help you to thrive. And so one of the studies, and I just pulled this up so I could tell you directly, this is right out of Eat Smarter, University of Kansas Medical Center, use fMRIs and discover that adding in more protein, specifically for the first meal of the day, literally decreases the signals in the brain that stimulate appetite and lead to overeating. What? Just by including more protein for that first meal in which your first meal doesn't have to be at 7 a.m., this could be at 10 a.m., this could be, you know? So, but getting more protein in that first meal and this is just stretched out to another study that I talk about where they looked at protein for the first meal versus carbohydrates for the first meal. And so they used eggs versus bagel. And you, earlier, you shared a bagel story with me and I was just, I was so fascinated by it because that bagel is a carbohydrate-dominated food, very strongly so. And so, of course, you can just be from the perspective of, you know, something closer to whole food versus something more processed, but we're just looking at the macronutrient makeup. And here's what they found. And this was a, they put them into a caloric deficit. All right? Slight caloric deficit, let's be clear about that. But that first meal, everybody's eating the same amount of calories. It's the same amount of calories for breakfast, the eggs and the bagel. Here's what happened. After the course of the multi-week study, the folks who had the protein-dominated breakfast lost over 50% more weight. They had about a 17% decrease in their body fat. Their production of their major satiety hormones went up. Hunger hormones went down. BMI, it's like 59% more reduction in their body mass index. The list goes on and on. It's remarkable. It makes no sense because they're eating the same amount of calories and yet they're getting these heightened results because of the macronutrient that they're bringing in. And this should speak volumes about, because for again, we think we're eating so much protein for a lot of us here in America. We start our day with carbohydrates. I know I did every day, especially cereal, muffins, pancakes, bagel from trying to be, trying to be healthy. But what are these things? Like if I came to your office, if any of us went to see Dr. G and he's like, okay, so tell me about your breakfast. And we're like, I have cake for breakfast, Dr. G. He'd probably be a little shocked, but most of us have had cake for breakfast many times. What's a muffin? It's just cake. Just cake. Cake without a hat. The same thing, pancakes, they're just flat. And so it's changing the dimensions. It's like, oh, it's not cake anymore. Not to say we can't have any of these things and they can't even upgrade the quality of those things. It's just understanding that the way that we approach eating here in America is definitely skewed. So one other thing I wanna share about protein here is this aspect of how much, like eating too much protein is going to, like this is associated with cardiometabolic risk. And so this was published in the peer review journal of nutrition and covered that despite the generally accepted belief that protein intake above the RDA increases cardiometabolic risk, higher protein diets are associated with lower BMI, lower levels of visceral fat and improved cholesterol profile compared to protein intakes at the RDA levels. And data, this looked into other factors that they accounted for, sex, age, carbohydrate intake, physical activity, the scientists found surprisingly the higher ratio of protein can actually lower your risk of developing cardiometabolic disease. Wow, well, well, well. But this gets in the conversation of the quality of that protein as well. That definitely matters. So a KFC stacker or snack or whatever where you got the fried chicken bun versus some whole eggs or some wild caught fish, very different in the impacts that they have on your system. Yeah, and I see this particularly in my autoimmune patients. So a chicken that's fed corn and soybeans, that chicken breast is basically a ear of corn with feathers, as I say. And it's not the same as our great grandparents ran around and caught a chicken out in the yard that had been eating bugs and chopped its head off and ate it. It's a totally, it may look like a chicken, but it's totally different. And most of our commercial meat is no longer a cow anymore. The same way, it's actually the same way with farm fish. Originally farm fish were fed ground up fish. And that's not bad. But now it's too expensive to farm fish with ground up fish. So they're fed ground up corn and ground up soybeans. And fascinatingly, the Omega-3s in farm raised fish are totally not only not there, but they take the Omega-6s in these corn and soybeans. And now they manufacture long chain Omega-6s instead of long chain Omega-3s in farm raised fish. So, oh, I eat farm raised salmon, Atlantic salmon or organic salmon to get the Omega-3s. And they're actually not there anymore. So buy or beware. Yeah, this is definitely a big concern right now that, like you just mentioned, it's not that Omega-6s are bad, it's the ratio. Correct. They're more associated with being the kind of pro-inflammatory Omega-6, but we need, inflammation is critical to so many processes in our body, but the way that our diet has been constructed and the ratio of Omega-3s to Omega-6, if you look at the data, we, as we evolve, we were somewhere in the ballpark of three to one, Omega-6 to Omega-3. One, three. And now it can be 17 to one on a good day, 20 to one, 50 to one, Omega-6 pro-inflammatory to anti-inflammatory. And again, I talked about that inflammation happening in our brain, a lot has to do with our Omega intake. And one of those things, and we talk about this in Eat Smarter, is in the section focused on cognitive performance, Omega-3s, but DHA and EPA specifically have the ability to, it's like an express pass the blood-brain barrier to feed your brain cells, essentially, create those structural fats to provide stability and plasticity and transduction. They're so important. And the American Journal of Clinical Nutrition did this fascinating study and found that simply increasing your intake of DHA, these anti-inflammatory Omega-3s, immediately, like within a matter of days, improves your memory, improves your ability to focus. Also improves your ability to focus when you're under stress. And wouldn't that be helpful right now? But here's the most shocking thing. They found that the folks who had the lowest intake of DHA and EPA had the highest rate of accelerated brain shrinkage. Yep. And this isn't the kind of shrinkage like when it's cold outside, kind of, Dr. G. This is the shrinkage that is very, very bad and it doesn't come back potentially. Of course, again, I don't like to talk in extremes, but when you start losing the mass of your brain, this is a serious, serious issue, and here's the barometer. It was just under a teaspoon. If folks are getting under a teaspoon a day, they have that accelerated brain shrinkage. 1.2 teaspoons was that barrier that protects your brain from shrinkage of DHA. Food first, I'm a big advocate of food first. Does this show up in the data? Yes. The journal Neurology found that folks who ate just one seafood meal per week did in fact perform significantly better on cognitive skills test than folks who ate less than one seafood meal per week. So, mackerel, wild caught salmon, sardines, but also fish eggs. And in talking with one of my really good neuroscience friends who's, again, she's actually looking at what happens in the brain when you consume these things, she found the caviar and salmon roe would be three times more DHA than you'll find in the fish itself. But I know some folks, if they're subscribed to different framework, and by the way, each smart is a unifier of the different diet frameworks that many people have found success with. So if you're doing a vegan protocol, vegetarian protocol, please understand we have to get DHA to your brain. We have to get EPA to your brain to protect your brain. And the omega-3s in plants are not the same. All right, this is ALA. It is so important for your body, it can convert some of the ALA into DHA and EPA, but you can lose upwards of 80 to 90% in the conversion process. So to get the amount of DHA you need from chia seeds and hemp seeds, I mean, you literally might as well put a beer bong on and like just funnel in chia seeds all day. It's just not doable. And so what do you do? The next step and what has the most clinical evidence when we're talking about omega-3s is fish oil. That's what's studied the most. But from there, and there's again, that's 99% of studies, but krill oil is starting to get a lot of research behind it as well, which is a microscopic shrimp. And when you say shrimp though, people are like, I can't do it. But I think it's a microscopic microscopic shrimp. If you just lick the air, you'll probably kill more sentient organisms than you know, which you'll find in a capsule. But for some people it might be on their ethics list, but it's great source of acesanthin, list goes on and on. Now we have algae oils. So I highly recommend, at least get that, but it doesn't have a lot of clinical evidence, but we know the DHA is there. So it's probably able to do something good. And I'm always airing on the side of like, whatever data we can get to the public, because on average, when we have a randomized controlled trial, finding efficacy to krill oil, for example, it can take on average upwards of like 17 years for it to go from proven in randomized controlled trials to actually being implemented in clinical practice. Even today at the age of the internet, I'm really sick of it. I think that this is why I'm so grateful for the work that you do is getting this information directly to the public. Once we get the data, and the funny thing is a lot of this information is just affirming things that our ancestors knew already, just using science to disclose these things. So make sure regardless of your nutritional approach, you must make it a mandate to get in your DHA and EPA as often as possible. Yeah, no, you know, mother's always said fish is brain food. They didn't know why, but now we know that that's why. Yeah, and there are now a really good algae based DHA, EPA and DPA products as well, the third long chain omega-3. All right, I want to shift gears in the time remaining. A big article in New York Times a few months ago that more and more people are retreating into comfort foods during the pandemic. And you write in the book about the importance of food on our emotional state. So how come people are going for comfort foods? This conversation is so important. And I wanted to leave no stone unturned in this book because food is so multifaceted, but we put in this pithy little box and a lot of us just relate nutrition and diet to weight, unfortunately. But we've already talked about some things with cognitive performance and literally just making your brain work better. But food is a major controller of our EQ, right, our emotional intelligence. And this was highlighted in a study conducted by the Ohio State University. They found that if we can just get a little bit of dysfunction in your blood sugar, we can make you more aggressive and less likely to perspective take. With people you love, let alone people you don't like or don't know. And so they took couples and it's easy to have blood sugar dysregulation, eat one of these crazy processed foods, you get a blood sugar spike and you get the correlating crash. And when that crash happens, your body takes that very seriously when your blood sugar is too low. This is like a survival mechanism kicks in place will produce these catecholamines, adrenaline, cortisol, the side effect is they can make you irritable. And this term hangry, this is real. And so what they found was that when they had dysfunction or dysregulation with the couple's blood sugar, they were far less likely to resolve their conflicts and their relationship, less likely to perspective take and they became more aggressive towards their partner. And if we stretch this out into the realm of even violent behavior, and this was done by researchers at Oxford University, they took prison inmates and they want to see what would happen if they improved their nutrition. And so they gave a group of inmates more, vitamins, minerals, a mega three fatty acids, supplements, and then they gave another group placebos. And after the four month study, they found that the folks who received the increased nutrition had a 40% reduction in behavioral offenses. And what really stuck out to me the most, there was a 37% reduction in violent offenses simply by improving their nutrition. And so that emotional stability, our ability to manage ourselves goes down because it literally is affecting what's happening in our brain, that prefrontal cortex and more evolved part of our brain responsible for social control, distinguishing between right and wrong, decision-making, I'm not gonna go and crush those Oreos that had been sitting on the counter for two years, even though they're still quote, fresh. That part of the brain starts to go cold and the more primitive aspects of our brain really start to take over. And this is not a joke, it's just a very real thing that happens. When, number one, we're nutrient deficient. When we're nutrient deficient, nutrient deficiency leads to chronic overeating. So going back to Lulu Hunt-Peters, she advocated hunger. She wanted you to get hungry. Then you know the diet's working, but it's the complete opposite. We wanna be nourished and in control so we can better manage our emotion and our brains because these are things that we own those things. It's the one thing we do own in this life is us, our bodies, our emotions, what's happening with our minds. But many of us, we don't get the owner's manual with these things. And once you become aware of this and number one, improving the nutrition, specifically fundamentally for managing your emotions and your cognitive performance, magnesium is critical. Magnesium is one of the most critical things. It functions as a electrolyte in the brain and it functions with repair and also neuroplasticity. And one of the studies that I highlighted in the book found that folks who increased their intake of magnesium in this particular study reversed their brain aging by upwards of nine years. It didn't make sense to me that this could be possible. But when you understand it's responsible for over 650 biochemical processes we know about, it's just remarkable. So magnesium rich foods, this is gonna help to buffer that emotional stress and also help to reduce the ravenous kind of cravings. What are those foods? Green leafy vegetables? Are a great source of magnesium. Anything green is gonna be a good source. And that's another thing we talk about colors, flavors indicate certain nutrients as well. But this was by researchers at Rush University, Medical Center. They found that folks who had just two servings of green leafy vegetables a day had on average brains that were 11 years younger. All right, so just something to consider, increasing our magnesium as we talked about DHA. But right now, so our nutrition affects our activity, but the environment also affects our nutrition and our levels of stress. And so this is another thing we talk about is how your environment and who you're eating with can affect your food. Wow, two servings a day and 11 years younger. So I've got the brain of a two year old. I knew it. My wife has accused me of that many times. It's all the greens. Me too, we're babies. All right. So why is it so important to eat with others and nobody's eating with other people right now? Is that one of the problems you think that's going on with COVID-19? I know that you grew up in a time when folks ate dinner together. True. You know, there's a family dinner. I grew up in a time when that was falling apart. In the early part of my life, I live with my grandparents for a bit and we did have like we sat down to eat dinner together. And right now there's been a shattering really of displacement and a separation of the American family. And just families all over really because of work, because of convenience, because of distractions and Harvard University researchers found that simply sitting down for dinner with your family led to directly lower rates of obesity, higher intakes of whole foods, fruits and vegetables and reduced intakes of processed foods and soda. Just in a county for other factors simply eating together as a family. And they also found that was correlated with greater intake of the things that create all these cool processes we've been talking about. You know, B12, vitamin D, omega-3 fatty acids and reduced intake of things that create dysfunction in our bodies just by eating together. And if you stretch that out, there are several other studies I talk about highlighting this very thing. But one of the most remarkable was a study that was done on low income families, which you would think again at the highest risk less access to higher quality foods. But again, eating four meals in a week together as a family dramatically reduced disordered eating, abnormal weight gain, increased their intake of whole foods and reduced their intake of chips and soda simply by eating together, making that a practice because there's an intention behind it. And also they noted of course, like not in front of the television, you know. Which again, we can have a movie night, but this is a time it's a unifier just like Eat Smarter really is, it's a unifier. It's a unifier where people can come together and connect. It reduces that kind of sympathetic fight or flight nervous system and it proves digestion. The list goes on and on when you sit down and eat together with people you care about. I always ask my guests, tell me one thing you were surprised to learn when you were writing Eat Smarter. I was surprised to learn how our psychology, how our thoughts affect how food affects us. And what I mean by that was, this was Dr. Aaliyah Crum and some other researchers. They found that just your belief about the food you were eating affected how that food affected your body. And this was demonstrated in a study. They made up a batch of milkshakes and the milkshakes would just say there's somewhere around 380 calories. But they labeled a batch of the milkshakes as low calorie sense of shake. And they put that they were like 180 calories sensible milkshake. And that's some folks got that shake. And then there was another group of folks where they labeled the milkshake as a high calorie indulgence milkshake, which was 600 calories. And so folks believe that they were consuming different things even though they were consuming the exact same amount of calories. And here's what happened. The folks consuming the indulgent milkshake, well, it was actually the same milkshake, but just believing that there's the indulgent milkshake, had a dramatic decrease in their body's production of ghrelin. And ghrelin is that kind of team captain of the hunger hormones. So they were more satisfied and less likely to engage in overeating and also to be hungry again soon after because of that dramatic decline in ghrelin. Now the folks who had the sensey milkshake, there was barely a nudge, barely a change in their ghrelin levels. They still stayed elevated. So what does that do? Makes you drink more of the milkshake, make you hungry again soon after because of your belief about what you were eating. And if we can leverage this, this is where my thought process went. If we can placebo ourselves and leverage our own psychology instead of the world just doing it to us and starting to cultivate attitudes of like when they take on a new diet protocol and begin to bring in new foods and things like that just to recognize and talk about how good they feel, how satisfied they are, how much of a great process this is instead of it being deprivation, restriction, I can't. And that framing that literally frames your brain up to be deprived and to have less enjoyment and less satisfaction. So that was one of the things that definitely jumped out at me that is remarkable that we simply don't think about. So what you're saying is now I can go home tonight and have my half gallon of Ben and Jerry's and as long as I say that's a really decadent thing, I will lose weight having my half gallon of Ben and Jerry's. That's not what you're saying, I think. You just have to believe that the Ben and Jerry's that when you eat it, it's not gonna go to your butt, it's gonna go to the ethers. Believe your way thin. I can see your next book already. You should write that. I'm gonna write that book now. All right, Sean, it's always good to have you back on the show. Where can, it's obvious, where can they pick up, eat smarter? Yeah. Anywhere? Yes, anywhere books are sold, Barnes and Noble, Amazon, all that good stuff. But also we have a national campaign going with Target stores. So you can go and pick it up at Target as part of the 2021 wellness campaign. Oh, fantastic. And where do people find you in your work as if they've never heard of you? Well, maybe somebody hasn't. Well, folks can find me wherever they're listening to this amazing podcast. My show is called The Model Health Show and just grateful to be many times over the years the number one health podcast in the country. And this is coming out of, we're both from the Midwest. Yeah, that's right. So making some amazing things happen. We just have a good time. We do master classes on different subjects and I think you guys would enjoy it a lot. And you can find me at themodelhealthshow.com, all my social media and stuff is there, but definitely run out and grab a copy of Eat Smarter. And this is definitely one to get for somebody that you love as well and to help to shift the conversation of health and wellness. Yeah, I just remember it's actually Sean Stevenson. Everybody looks up, Sean Model wrote a book. Yeah, it's the Sean Model, The Model Health Show. All right, well, thanks again for coming on. I do an audience question now and you're just gonna have to sit here and listen. Actually, no, this will be good. You're gonna get to answer the question. Okay, time for the audience question. And I was setting you up. This week's question comes from Deanne on drgundry.com who wrote, what are the best foods for high blood pressure and which are highest in potassium and magnesium? Well, you already wrote about magnesium. You're right. Number one, potassium and magnesium are great for lowering blood pressure. And here's a fun fact for those of you who have soft water systems in your homes. Please, please, please get a potassium based soft water system rather than a sodium based soft water system. You'll make a huge difference in your health if you're going to use one. Sean, what say you about lowering blood pressure with food? Oh, those two, these are electrolytes. Again, it's in that category and it has an electrical energy and your blood is really run on that too. So what are some great food sources? We mentioned magnesium a little bit earlier, but one of the interesting things about magnesium is it could be absorbed through your skin too. Exactly. You can do a topical magnesium spray or Epsom salt baths. This is one of the cool things too that needs to be talked about more. There's not just one type of these nutrients. There isn't just one type of B12 or one type of magnesium. This is why food is so phenomenal because you get an array of these things rather than a synthetic supplement. On the potassium side though, we tend to think banana, right? But we might want to be careful about that in managing the sugar. Please don't eat a ripe banana, please. Actually avocados are a phenomenal source of potassium. My favorite source of potassium, gram for gram, most dense source of potassium is a sea veggie called dulce. Yeah, dulce is pretty great. And it's something, you know, it's kind of salty. You could sprinkle on your salads or on your entrees. Those are a couple of my heart-healthy foods. And it's kind of reddish, which is an indicator it might be good for that blood. Yeah, all right, great. All right, now, finally, it's time for the review of the week. This week's review comes from Derek Stutz, who left us a five-star review on iTunes and wrote in to say this, Dr. Gundry has completely changed my outlook on what I consider healthy eating. After reading a few of his books, I can't help but share his information with my family and friends. They don't like you anymore, probably, Derek. I highly recommend listening to each one of his podcasts. Well, thank you very much, Derek. And thanks to all of you for tuning in each and every week. This show could not exist without you. So I'm gonna sign off with that because I'm Dr. Gundry and I'm always looking out for you. See you next week. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher, or wherever you get your podcasts because I'm Dr. Gundry and I'm always looking out for you.