Recent MAHA report finally shines a spotlight on ultra-processed foods — Chef Dr. Mike

[00:00:00] 95% of the people involved in making the 2020 Dietary Guidelines for America have conflicts of interest with food and big pharma. That's just not acceptable. I'm Jane Z, and this is Farm to Future, the podcast all about eating better for the planet. Hello, hello, and welcome. It has been a while, and I have some exciting life updates to share. Drumroll, please.

[00:00:28] Please, I'm pregnant. Yes, my husband Ethan and I are expecting our first kiddo this October, hence why I've been a little quiet and why I've been on hiatus for the past few months. First trimester, I was basically living in a hole, and now I'm over the halfway mark and feeling mostly myself again, so I'm excited to hop back on the podcast horse.

[00:00:51] First trimester, I've got a bunch of new episodes recorded that I'll be slowly releasing over the next few months, so I'm excited to be back with y'all. As you can imagine, food and health have been top of mind for me still now, and probably now more than ever.

[00:01:06] Today's episode is particularly timely, as we have Chef Dr. Mike back on the show to break down the recent Maha Commission report, the Make America Healthy Again report, from Robert F. Kennedy Jr.'s team at the Health and Human Services Department. If you haven't read it, you can check out the link to the report in the show notes. It's a 68-page document, I recommend skimming through, and it focuses on childhood health specifically and chronic disease.

[00:01:35] What's exciting about this report is it's the first time that ultra-processed foods are being recognized as a serious public health concern at this level of federal policy. The report touches on some other factors, like exercise and screen time and over-medication, but ultra-processed foods is the first major cause that they dig into.

[00:01:57] And if you've been listening to this podcast for a while, you know that Chef Dr. Mike has been fighting the battle against ultra-processed foods for a long time, for over 20 years, in fact. So today we talk about how the food industry influences research, how scientists like Chef Dr. Mike have been silenced for speaking out against ultra-processed foods, and why this moment could be the turning point we need. Exciting and fun episode coming at you today. If you are new here, big welcome.

[00:02:27] Be sure to subscribe on Spotify or Apple Podcasts for more episodes like this. And you can find me, Jane Z, on Instagram at farm.to.future. All right, let's dive in. We are in the studio here with Chef Dr. Mike. Welcome on, Mike. Hey, Jane. Great to be back with you. Good to see you.

[00:02:51] So recently, RFK Jr. and team at HHS just released this new commission report. There was a Maha Make America Healthy Again commission from February. And they just released this big report, 68 pages, that folks can check out. And we'll link in the show notes. But essentially, it focuses on childhood health and chronic disease.

[00:03:17] And kind of frames this urgent nationwide problem around addressing these different factors around chronic disease for children and youth, including ultra-processed foods, chemical exposure. Those are the big ones, physical activity. And then they did touch on vaccines and medications as well. So there's a lot to unpack here. But I want to get your reactions first. Because Chef Dr. Mike, you've been working on ultra-processed foods for a long, long time,

[00:03:46] you know, through your work in culinary medicine. So I want to hear kind of your first reactions to seeing this report come out. Well, the first reaction was sort of a hallelujah moment that this has finally, you know, brought to a place in a serious manner for discussion and evaluation and to look to address this. You know, from a personal perspective, as you know, as we were talking earlier,

[00:04:12] anyone who's a regular viewer out there, you can read the section of this on the ultra-processed foods. And I think everyone who, a viewer of your program will go, yeah, duh. Because they've heard it here before for years. So that's great to see that out there. It's interesting to me having, as you said, this sort of long perspective on addressing this and the battle.

[00:04:40] I've been doing this, you know, writing and speaking and researching and publishing on this topic for over two decades. So one of my early books I gave to a good friend of mine. I actually trained him as a cardiology fellow. And he was, at that time, an assistant professor at a major university in the Southeast.

[00:05:07] And I sent him a copy of the book and said, you know, what do you think? And what are your opinions? He's like, I love this. Your data is incredible. You know, it's very detailed. This makes a lot of sense. And I was like, well, would you give me an endorsement, you know, a testimonial for this? You're a highly respected, well-recognized, you know, academic cardiologist.

[00:05:30] And he said, love to, but if I do, they'll fire me because this is contrary to all the conventional wisdom. So that's how old I am in sort of this discussion. And it's very interesting also now to see people come out of the woodwork and kind of jumping on this bandwagon like this is something new, throwing advice and things out there.

[00:05:56] I think it's a bit of a mixed blessing, to be completely honest. I think that, as I said, bringing it to the forefront, we can have discussions about it. You know, a few years ago, I submitted a National Science Foundation grant with a specific aim of identifying the amount of ultra-processed food people were eating and using tested methods to help people reduce their ultra-processed food consumption.

[00:06:25] And this was within the last five years. And one of the government experts, the reviewers, it did not get funded. And actually, the reviewers' comment, and this is the reason it did get funded, accused me of disseminating disinformation. Because to say that ultra-processed foods were associated with the development of chronic disability and disease was, and I kid you not, quote, disinformation, end quote.

[00:06:53] And went on to say, well, you know, people in food banks rely on ultra-processed food. And if you tell them that's bad, they might not eat it. And you'll notice in the report how that kind of correlates when you look at sort of the lower income people using food stamps or SNAP, I should say, and WIC, et cetera, that they have higher rates because we're pushing all this ultra-processed food on them.

[00:07:17] So, you know, my response was, gosh, if we're giving them disease, shouldn't we, you know, reevaluate exactly what and how we're doing things? One of the movements out there that some chefs are doing is reallocating what is, quote, food waste from restaurants and supermarkets, you know, ugly fruit, ugly vegetables.

[00:07:41] And getting that into those food distribution centers instead of these ultra-processed foods. And I can tell you, folks, remember Yellowstone that used to be a big hit? Well, I was on there right before it ended as an extra. Oh, cool. And so I was on set for, yeah, I made two episodes. If you look, you'll see Rip the next to last season. So I think it's whatever the last season is, part one, part two.

[00:08:11] At the end of part one, I think episode like four and five or five and six, you'll see Rip talking to the other cowhands at the corral. And then you see me walk behind Rip this way. And then he keeps talking and you'll see me walk back the other way. So that was my big, you know, me and Rip doing that, me and Cole doing the big scene. But I say that because that was a fascinating and enlightening experience for me talking.

[00:08:39] I actually got to know Gator and spent some time talking with him. He's a real chef. On the show, he plays the camp cook, but he's actually a real chef and actually really cooked food there. So he and I were speaking and he was telling me that the catering there, they spend $50,000 a day in catering for the crew, the extras and the stars.

[00:09:01] And I watched them at the end of the day take perfectly good food and put it in 55 gallon trash cans and fill up the back of pickup trucks and throw it away. And I was that like that could feed every food center, every food bank, you know, in the city of Missoula, you know, for a week. And so there are ways to address those sorts of things.

[00:09:28] But getting back to what I was talking about is that very recently, again, the politics of the people were unresponsive and very denigrating in terms of snubbing their nose and saying, no, you know, the ultra processed food is who we we have to keep doing our nutrient analysis the way it's been done for 50 or 75 years, even though it's never worked and people are getting sicker.

[00:09:53] And so, again, seeing this brought into the forefront for at least a reasonable discussion, I think at the end of the day is a really good thing. Now we have to hold our feet to the fire and hold the people who are going to talk about this in terms of ultra processed food and this and that hold them to scientific rigor as well.

[00:10:17] Because I've already seen sort of in the social media spaces, people jumping in, particularly physicians now with comments, health care providers and all measures, you know, jumping in with advice, some good, some bad. And some it's like, where do they come up with that? So I think it'll be an interesting journey over the next couple of years.

[00:10:40] Yeah. Yeah. Oh, for sure. I am looking forward to I think in 80 days there they're supposed to deliver an actual plan on how they'll execute on this report. So I'm curious to see that because in the 68 page report, there's only one page at the very end where they had some recommendations on on where to funnel research. By the way, side note, just because you mentioned the catering and food waste. I had on Robert Lee, who founded this wonderful nonprofit called Rescuing Leftover Cuisine.

[00:11:10] The next time you happen to be on set or anyone who's listening, if you have local restaurants that have leftovers or an event, they have a great program where you can, I think, just fill out a form or call them up. They'll have a volunteer come out and rescue the food and bring it to a local shelter or food bank. And that's exactly what I'm talking about.

[00:11:30] So so God bless them for doing that work, because, again, you know, a lot of the food that you're getting, the fresh fruits and vegetables that are just ugly or slightly bruised, but make delicious meals. Yeah. You know, these guys can salvage that. And again, a lot of restaurants use, you know, they're outdoor sourcing really good food. But for one reason or another, you don't serve it or you can't serve it. But it's still really good food, very nutritious, real food they can feed people.

[00:11:59] And those are the kinds of programs you just talked about. What are some of the answers? Those are some of the answers. You know, just because you don't happen to have money and or you're on hard times and you're in the SNAP program, you're in the WIC program that sort of doesn't give the government license to poison you with saying, well, all we can do is give you ultra processed food. And that was sort of the feedback I got, not only sort of personal vitriol at me for how dare I, you know, try to reduce ultra processed food consumption.

[00:12:29] She actually said, you know, if this program is approved, it's dangerous because we talked about educating people, you know, that this isn't true. And fruits and vegetables. Yeah. Yeah. You know, avoiding ultra processed food. That's that's dangerous rhetoric. But it was that's what it was labeled. And that's and we had two other reviewers who gave it excellent marks in different. They're from different categories. And it involves some computer AI type work. And that person was like, this is brilliant.

[00:12:59] We need to fund this. It seems really worthwhile. Another reviewer. But that one reviewer basically said, if anybody approves this, they're engaging in disinformation and this will harm people. And I mean, really went off and then, you know, took it a step further and went beyond just sort of personal.

[00:13:17] And so we just took a little text and against me and said that the research this all is based on, which was Professor Monteiro's, which we talked about, Carlos Monteiro from University of Sao Paulo in Brazil. So and Carlos and I communicate, we're friends. We've never met, but for years we've emailed back and forth because we both have an interest in this.

[00:13:39] And I think her comment was along the lines of it was really poor science by a bunch of, and I think she put scientists in quote, you know, from South America. And, you know, and what's funny is in this report, that's what they use is the NOVA classification, which you and I have talked about many times. And that's what Carlos developed. So, again, that's a great thing.

[00:14:06] You know, when I started teaching culinary medicine 10 years ago, I would say when we started 100 percent and if not 100 percent, 99 percent of the class would say, I don't know. I've never heard of NOVA. Why have I never heard of NOVA? And now, you know, a decade later, I'd say probably about 40 percent of the students coming in had heard of NOVA in one form or another.

[00:14:34] And I think something like this, because they used it in the document, that's going to grab everybody's attention. And so I think it will become part of the vocabulary that we have. It will become part of the recognized dialogue. And that's also a great thing. Yeah. Because for many years, what the food industry has done is conflate minimally processed food with ultra processed food and say they're the same thing.

[00:15:03] And say, well, if you make a sandwich from all scratch items that you do, according to NOVA classification, that would be a NOVA class three or a minimally processed food. Basically using a whole chicken breast and bread made from flour, yeast, water, salt and some fresh vegetables and maybe mustard or something. That would be NOVA three. So, you know, getting, you know, a Subway type sandwich might would be a NOVA class four. So a sandwich could be either.

[00:15:32] But they would lump them together and say, well, you know, you're trying to call a sandwich ultra processed. And they would throw around terms like highly processed, which really has no meaning. Yeah. So ultra processed is specific to NOVA class four. When you hear a discussion where people are just talking about highly processed, maximally processed, industrially processed, those really don't have any meaning.

[00:15:57] And a lot of times that's used to confuse the argument by lumping these things together to try to distract people. So that's something to pay attention to. And hopefully as the public becomes more educated to this, this becomes part of the conversation. And, you know, they won't be able to sort of pull the wool over our eyes anymore. Yeah. Yeah.

[00:16:21] I remember reading as part of the report, there was a piece about the school breakfast and lunch programs. So this is a program covering more than 30 million children and 100,000 schools. So they've started to make swaps and they've got this thing called the smart snack program that meets certain nutrition standards. And so they'll swap out some version of foods for other foods. And they don't give specific examples, but I'm thinking of like, you know, granola bars.

[00:16:51] You can have like minimally processed maybe things with just like fruits and nuts. Right. Like kind. I don't know if kind bars are ultra processed or not. I think they're on the safer side, but you can have a kind bar or you can have like a super processed. All these gum. Kind bars are actually super processed. Are they ultra processed? Yeah. Yeah. If you look, they have like brown rice syrup, a bunch of things on the label. And again, if you look, you can easily count like a whole bunch of stuff in the label.

[00:17:21] Yeah. And I think there are several like brown rice syrup just means sugar. Okay. And then there's like a not dextrose, which is another word for sugar. And they're delicious because they're ultra processed sweeties. A kind bar, which is a great example that you pulled and a sort of an example of the things that they talk about in the study, which are very true. What kind bar did is they actually paid for a study to make kind bars look really good.

[00:17:49] And so published in a journal was a study of kind bars saying kind bars are really good for you. They've got almonds and they've got these nutrients and things like that to kind of, again, obfuscate the fact that at the end of the day, they're an ultra processed product. Right. So if you look, they sort of address that in the ultra processed food section. And I could send you a link.

[00:18:13] I wrote an article about a year, maybe a year and a half ago that kind of talks about this. And one of the key references in that, and I'm forgetting who wrote it actually, but it's absolutely brilliant because what he did was basically mapped. There's this big sort of network map that connects big pharma, big food to all these NGOs and organizations.

[00:18:41] And you can see this sort of web of funding and how that influences. And there's something like 600 and plus seats on these boards of organizations that dole out the money, make the recommendations, so on and so forth for what's called global food governance. And so not just the United States, but all over the world, including the United States.

[00:19:03] And something like 60% of those board seats are occupied by either big food, like big soda, Nestle or big pharma. So over half of the board seats. And that's a huge influence on what gets funded, what the message is. And it sort of goes back to, you know, I think the first person I heard quote this was Jim Morrison of the Doors fame back in the 60s.

[00:19:29] And he's like, he who controls the media controls the world. And what he was talking about was, you know, control the narrative. And so it's all sort of behind the scenes. Nobody wants to be out front in a sort of leadership, high spotlight position. They want to be behind the scenes, controlling the money and controlling the narrative. And this article does address that. And so, you know, I'll give them kudos for that because that is a huge problem.

[00:19:58] Although it's a dated book, it was written several years ago. It's sort of an excellent primer. If anybody's interested in this, it's called Food Politics by Marion Nestle, the famous nutritionist. And she goes in and it's just eye-opening the influence. And I've written about this. And they actually did, again, quoted in this document, which I, again, tip of the hat to them for that,

[00:20:22] that 95% of the people involved in making the 2020 Dietary Guidelines for America, sort of the gold standard from which all the recommendations and things are derived, have conflicts of interest with food and big pharma. Wow. And that's just not acceptable. Yeah. Yeah, that's a lot. The report did mention the food industry funds the bulk of research in the field.

[00:20:49] And she spent over $60 billion on drug, biotech, and device research in nutrition science. And by comparison, the government only spends about $1.5 billion on nutrition research. And so if you're a person in academics and you have to get grants, you have to get money, you have to do research, and you have to publish. And that defines sort of your livelihood. Until you get tenure, you have to do those things.

[00:21:16] And now you can see a lot of these people, I'm not excusing what they do, but it's sort of, well, where am I going to get the money? $1.5 billion is a small pot from the government. I mean, it's a lot of money. Don't get me wrong. If I had $1.5 billion, I'd be happy. But it's a very small pot of money compared to $60 billion available from the food industry and big pharma.

[00:21:43] And so you can see kind of by controlling those purse strings, they can control those narratives because they're not going to find things that make their product or ultra-processed foods in general look bad. Totally. I got to see a little bit of this firsthand. I had a roommate, a dear friend who is a public health researcher, and she was doing her PhD at Harvard, and she was looking at indoor air quality.

[00:22:10] And she did a study that was sponsored by Dyson, the electronics company. And they came out with this new indoor fan that, you know, it claimed to, you know, have all these air purifying benefits, yada, yada, yada. We actually ran it in our apartment for a few months as part of the experiment. Lo and behold, the results were not as impressive as Dyson had originally claimed.

[00:22:34] But I think in order to complete the project and to get the funding, they had to kind of fudge the results a little bit. I'm not saying they, you know, like made up numbers or anything, but I think they had to position it so that the Dyson product still did something and kind of frame it in a positive way. Yeah, and that's very common. I've got an article on this from about two years ago, and this was very fascinating.

[00:23:04] And it's one of those things that should have gotten huge headlines, at least within the food and health community. And again, because at that time in particular, it didn't fit the narrative because the narrative was, and to a large degree still is, red meat is bad. And this was a study that was not done by health care people. It was done by statisticians. And they picked red meat because they knew it would get published because it sort of grabs headlines.

[00:23:33] You know, if you were doing statistics on widgets nobody cared about or, you know, statistics on the amount of snails on shrubbery, right? You're not going to get any headlines. So what they did is that they said, you know, the problem is exactly what you just pointed out. Because researchers can get data and you can get completely polar results depending on how you manipulate the data.

[00:23:59] So depending on the method that you use to look for what's statistically significant, that can change it. What you define as the endpoint can change it. So there's always a bias in even the very best experiments. They took the data from two or three different government studies that had, you know, large databases, so lots of people,

[00:24:24] and have been used to say, hey, you know, if you eat red meat, it's going to be bad for you for these reasons. And they said, well, you know, these researchers used a particular method to get at this result. There are about like 1800 different ways to analyze this data. So we're going to take this data set and we're going to run it in every possible way you can with no preconceived notion of what we're looking for and see is red meat neutral?

[00:24:53] Is it good for you or is it bad for you? And believe it or not, the aggregate sum of all the data run all the different ways that it could be was along the lines, I think, that eating red meat lowered your mortality risk by several percent. It wasn't huge, but it was like between three and six percent, maybe four or six percent, something like that.

[00:25:16] The point being, it was the exact opposite when conducted in a very statistically rigorous way from what's being promoted. Hmm. And it goes to exactly to your point, which is if the results aren't exactly what I'm looking for, I can use another statistical method. I can kind of change those endpoints, which you're really not supposed to do. But in the studies, you'll see something called, you know, an ad hoc or a post hoc analysis.

[00:25:46] And most people just kind of gloss over that. But that means, well, we're analyzing things that weren't originally what the experiment was designed to measure. You know, another way to do that is say, well, we'll look at these secondary endpoints. So that means that the purpose of the study is to look at X, but maybe X turned out to be not significant. So we're also going to look at why. A great example is looking at a drug and saying, does this prevent somebody from having another heart attack?

[00:26:15] And that's a pretty standard question. Or let me actually back up and make it even easier. Somebody has a heart attack. We give them a drug. Does this help them live longer so they don't die? Because that's what we call a very hard endpoint, right? There's either bodies in the morgue or there's not. And so there's no sort of fuzzy gray area in there. You're either alive or you're dead. And then a lot of times they kind of catch on and said, well, we'll look at something called a secondary endpoint.

[00:26:42] And very often in that study, it would be something we call MACE, which is Major Adverse Cardiovascular Endpoints. So that might include things like death, but it might also include heart attack. And it might even include just having chest pain. And that could be chest pain that somebody who has heart disease went to the emergency room. And it turns out that they stopped at Taco Bell and got a gordita and had an upset stomach with chest pain. And they went to the emergency room and they went home.

[00:27:10] But that would still count as under that MACE. So that could then get reported as, oh, this drug, well, it doesn't save lives, but it reduces major adverse cardiovascular endpoints. And so there's all these sorts of ways to package studies. Unfortunately, what gets put in the headline is this drug reduces your chance of having another heart attack. And maybe it does. Maybe it doesn't. You really have to get into the data.

[00:27:37] That's why every week, you know, at the Center for Food as Medicine dot org, you know, I do my study spotlight where we take apart these studies, these headlines and try to find out what they're really telling us. And what I advise people is don't hang your head on any study because you can go out there and find something to support your argument, you know, no matter how silly it is. But really, what is what is the sort of gestalt of the data telling us? What is most of it telling us?

[00:28:07] And I always like to look to the outliers. You know, what what doesn't make sense in the study? Well, what's really weird, because often that's where kind of the insight to information or undiscovered information or where we should be looking is really, you know, what's the mystery of the study? Mm hmm. But you see it all over like X and social media and Facebook. Right. It's like this study says this. Well, I'm going to quote this study. And it's like, that's great.

[00:28:36] Let's really look at those studies because some of them, when you get into the data, don't actually say what's on the headline. Right. And, you know, then look and say, you know, what is the data really telling us in terms of, you know, the bulk of the information? Right. There's a great tool that I want to call out called Consensus App. I think it's consensusapp.com or .ai. And it's an AI tool. Think of it like a search engine for scientific papers.

[00:29:04] So instead of, you know, going to PubMed or something, you can ask Consensus a question, say, you know, are seed oils bad for you? And it pulls up all the most recent and relevant research. It pulls up like all the articles, but it also gives a nice AI summary of, you know, here's what is the consensus. Here's what the major studies have found. Here's what's still kind of in question. So I find that to be like a really useful tool to just glean off the cuff.

[00:29:32] Like what's the general scientific consensus right now? And then from there, you can dig into individual papers. I would say that there's always a caveat with that as well, because, you know, the consensus again is to go to our red meat is bad storyline. That would be a consensus. There's lots of papers published that say that for one reason or another.

[00:29:56] A lot of them are not good, in my opinion, because almost all of them don't separate out ultra processed meat, which I do not recommend in any way, shape or form from red meat that is just fresh red meat. So it doesn't separate out, you know, an ultra processed fast food hamburger from grass fed bison. And they're two different, two different comestibles.

[00:30:21] And so you have to be careful and you also have to be careful of something called publication bias. And it's the old red wine conundrum. So I get asked this because people would come up to me after a heart attack and they'd say, well, doc, I read red wine is good for me for my heart. So, you know, I have a glass of red wine as opposed to, you know, a scotch and soda or a glass of white wine. And certainly there is good evidence that red wine is good for you.

[00:30:50] Part of the problem in trying to answer that question, honestly, is that because red wine was shown to be beneficial, everybody did research on red wine. And so in the literature, there is a huge amount of research on red wine and heart health compared to white wine, beer, other things. And so that's another form of bias called a publication bias.

[00:31:18] And it just means the consensus will be red wine is good for you above and beyond the other ones, which may be true or not be true. But it's because there's just a preponder because that's what everybody, you know, publishes on. And it's except. Yeah. So they said, you know, there's lies, damn lies. And then there's statistics. And I think that is so much the truth.

[00:31:39] We have to be really critical, even with what they're telling us about, you know, and I believe the data and the rational hypothesis. But even these studies that come out with ultra processed food, I try to approach them with a critical eye. You know, again, there's another bias called selection bias, where we tend to want to read the studies and support the studies that support our own preconceived notions.

[00:32:05] So I'm a big reader of stuff that is the opposite of what I say. So when I see something saying red meat is bad, I say, OK, I jump in with two both feet and I want to look at that study and say, OK, is this a good study or is it flawed or is it just not even really saying that? And I've come across studies where the headline from the media was one thing. And I read the study. I was like, the study doesn't even say this.

[00:32:34] It was like, you know, it's sort of that old telephone game where you have people on a line and you give a message. And then by the time the last person gets the message, it's not at all what it was originally. Right. So the information and the data is very sensitive to corruption. Yeah. Yeah. Right. Depends who carries that information over. Right. There was a recommendation. So the number one next step that was listed in the HHS report is around scientific studies.

[00:33:03] And I want to get your thoughts on what exactly this means. So I'll read it out. It says addressing the replication crisis. NIH should launch a coordinated initiative to confront the replication crisis, investing in reproducibility efforts to improve trust and reliability in basic science and interventions for childhood chronic disease. So it sounds like they're calling out something wrong with the current process of either designing or executing some of these studies.

[00:33:31] Can you give more color into what has been hard to replicate with these studies? Is it the statistics part that you were talking about or is it something else? No. No. Generally, that means that, say, I do an experiment or I do a piece of research and I submit it to a journal. And, you know, I follow the format. You know, here's the abstract. Here's the introduction. Here's our methods and materials. Here's how we did the data analysis.

[00:34:02] These are our results. This is our conclusion. And you, as the reviewer of the journal, say, looks good to me. These are, you know, fascinating results. We publish it. And so it gets published. And then those conclusions, you know, often find their way into recommendations and grants because it becomes a trusted, you know, piece of the scientific literature, if you will.

[00:34:28] Well, the problem is that sometimes we never know people's hearts when they do things. It can be unintentional. Something could have happened when I was doing those experiments. There could have been a bias like we were just talking about that crept in that is unrecognized. Something we call confounding bias, confounders. If it's affecting my results, I could draw the wrong conclusion. But because I don't know about it, it's unintentional.

[00:34:56] Say I did my research in Montana and I drew some conclusions and then somebody tried to replicate my results in New York City. It fails. Nothing like what I found. So even I did everything honestly with the best of intentions. There could have been something about doing it in Montana, the weather, you know, where people bought their meat, for example, or something that confounded my results unbeknownst to me.

[00:35:25] And that's an honest issue. And you'll see almost every study say, well, the limitation of the study is there could be confounders of X, Y, Z that we don't know about. And so what that speaks to is that my results are not able to be replicated by an independent third party doing them, which means we have to question my findings. And if not my findings, certainly my conclusions.

[00:35:49] Now, having said that, sometimes, you know, like anything else, when you have lots of people, some people are less than honest. And, you know, will they know what they want to say. And this the data can be manipulated in such a way to to get the results. It's sort of like I've got these are the results I want. I'm going to back engineer my experiment and my data and my findings to make sure that I get this, to make sure that the Dyson fan looks really good.

[00:36:20] So and then what happens again, when somebody does that as an independent third party, the results are not able to be replicated in this environment where we have so much information at our fingertips. And so many of these studies being published, you know, around the world that we can kind of get our hands on and use that quickly become the consensus and the conventional wisdom.

[00:36:43] You know, it could be a year or sometimes it's years later that it turns out that that wasn't true. That experiment was inaccurate, was a fraud, a fraud in the worst case. And you have all this other research that was built on that and it becomes a house of cards and everything comes tumbling down and maybe billions of dollars have been wasted.

[00:37:05] Lives may have been put at risk if things that were supposed to be helpful to treating a certain disease or preventing a certain disease turn out to be false. So it can be a big problem.

[00:37:17] And so there is no kind of mechanism in place right now within the scientific community other than self-policing and, you know, the honor code, if you will, that addresses whether what we might call landmark studies are then repeated, the results replicated.

[00:37:39] To be honest, a problem with that is what we talked about earlier, where it's so hard for a lot of researchers and people to get any money to do these studies. And a lot of these landmark studies are very, very expensive. I mean, you know, we're talking tens, if not in some cases, you know, a hundred or more millions of dollars, you know, to look at one thing.

[00:38:02] And so if you're going to write a grant or you're going to the food industry, nobody wants to fund something everybody already assumes is common knowledge. What's like they already did that. You're not doing anything new. You're not adding anything. So we're not going to give you any money. So it is something to look into. And it is a problem. I don't know what the right answer is. And hopefully maybe they'll come up with some ideas that we can look at.

[00:38:29] But I think when they're talking about replication issues, it really gets back to is our data any good? I mean, and we only have to look at our food recommendations to say, yeah, they kind of suck. Right. Don't eat eggs. Eggs are really bad for you. Oh, you should have lots of eggs every day. Don't eat avocados because they've saturated fat that's just like cholesterol. And you're going to have a heart attack if you eat avocados.

[00:38:55] It's like, oh, you should probably eat avocados every day because the, you know, testosterone is really good for you. And the same thing with walnuts and so on and so on and so on. And so if you just look at the food recommendations, people just throw up their hands and say, you guys don't know what the hell you're doing. Yeah. You tell me not to eat something one day. Then you tell me I should eat a lot of it. Then you come back and say, wait a second. Maybe we were right in the first time and people like, you know, the hell with you. I'll just eat what I want.

[00:39:22] And that's a very common example everybody can kind of relate to in terms of, you know, the reliability of data and then the recommendations derived thereof. Yeah. Is there a process to go back and redact scientific papers if those findings have been disproven? Journals do it all the time. Okay. And the problem is the media will run with the headlines and tell you something and we can only have to look at eggs are bad.

[00:39:52] I mean, I still, when I travel, I still see, you know, how about, you know, healthy omelet on the menu is made with egg whites, not egg yolks. Almost all of sort of the nutritional value of the egg is in the yolk. Egg white is a lot of good protein, but all the other sort of goodies, if you will, are in the yolk. And it's sort of been debunked for many, many years. But because it came out on page one and it was years later, the redaction was at the back of page 26.

[00:40:22] It just doesn't make it into the public consciousness, if you will. The zeitgeist just doesn't, doesn't get that. And I still see people putting out there that we have to really count calories and focus on, you know, well, how many calories is this? I'm doing calories. I was like, the truth of the matter is your individual metabolism is so unique. You have no idea how many calories you burn.

[00:40:46] You know, it's sort of like saying, well, you know, the blue book says that my car gets 12 miles to the gallon. Your actual mileage may vary, right? That's what the saying is. And it's the same with your metabolism. It depends on so many things. You know, instead of 12, you may be getting 25. You may be getting two.

[00:41:05] It's another sort of bias that we call the ecological fallacy that you and I have talked about before, where something that's true for a big group falls apart when you try to apply it to the individual. And so if we look at BMI is a good one. If we look at BMI, which is not a great measure anyway, another discussion. But, you know, when you look at like risk factors for disease and BMI, it does apply to big populations.

[00:41:34] But when you try to use that for the individual, it falls apart for a number of different reasons. The originator of what became the BMI, which is originally called the Ketelet Index by Adolphus Ketelet, who was a Belgian polymath in the early 20th century, I believe, and developed working for insurance companies how to predict mortality.

[00:41:59] He did, you know, a couple hundred white guys in the Belgian army and found that height and weight was a predictor of future death. And that was known as the Ketelet Index. In the 70s, that was reformulated in the way that we know it now into the Body Mass Index by Ancel Keys.

[00:42:19] But both Keys and Ketelet said, while we can apply these to populations, they should never, ever be used for the individual. And yet that's exactly what we do. Your electronic medical record sends your BMI information to the government. It's a mandatory part of any electronic medical record.

[00:42:43] So when the government gets information and searches, you know, hundreds of thousands of millions of medical records, just looking for what is BMI and how does that correlate to a disease, that's what they're doing. And then when you go to your doctor's office, your doctor is saying, well, your BMI is such and such, so you have to lose weight. In one of the best studies done looking at BMI, which was published in JAMA in the 2000s, maybe 2010s,

[00:43:10] and this was highlighted in a book, The Obesity Paradox by Dr. Chip Levy from Oxnard Institute. Chip's a great guy and a cardiologist, I have to add. And it showed that the lowest risk group, when you look at BMI, is not the ideal body weight. Ideal body weight has the same risk, generalized mortality risk, as people who are in mild obesity, obesity class one. The lowest risk group is actually the overweight group. Oh.

[00:43:36] And that has to do with how BMI works as you get taller. So it's not a completely linear relationship. Like if you ever look at the Godzilla model, you notice Godzilla looks like a triangle. His head's kind of tiny compared to the rest of his body. And that's actually how it works as height increases in terms of the body and mass. The proportions of things change as you get taller. It's just the physics of it.

[00:44:08] So taller people are more triangular? Is that what you're... If you take it to an extreme and make it King Kong and Godzilla size, yeah. It becomes more of a triangle shape. Huh. Interesting. Than the things... So if you look at Godzilla, he's actually modeled sort of physiologically correct. The horror movies with the spiders that are like 20 stories high, it wouldn't work. Particularly the way spiders breathe through their skin like insects.

[00:44:38] And so the amount of volume to the amount of surface area that they have changes as things get bigger. And so they actually wouldn't be able to breathe if they were 20 stories high. But you know. In the current atmosphere, if you look prehistorically, you'll see millipedes that were like two feet long. And dragonflies that had three foot wingspans.

[00:45:06] And that's because there was much more oxygen in the atmosphere at that time. So it could support giant insects and arthropods at that size because there was more oxygen. So they didn't need the surface area that they would require here. How we got on this conversation, I have no idea. Your audience is going, what does this have to do with Maha? And I have no idea. But I always like the horror movies that I used to watch as a kid with the giant bugs. Yeah. That's so funny.

[00:45:35] Oh my gosh. And the relief that it can't happen because they wouldn't be able to breathe. Right. I think we've added to everybody's safety about radiation and giant bugs being the end of the world. It won't happen. There we go. Yes. Confirmed. We should put that in the report. True. Yeah. Oh my gosh. On the BMI point, I learned, and I don't know if you're familiar with this, but there's

[00:46:05] an app I used. I did a DNA test through a company called Circle DNA, and they're based in Hong Kong. And they show you all these results, but they have a BMI chart. And apparently there's a different standard for Asian bodies. It's like generally a smaller BMI compared to, I guess, like Western Caucasian bodies. So that was new to me. Yeah. Yeah. No, you're 100% right, Jane.

[00:46:29] The BMI, as it is, as we said, was developed basically the origin is man in the Belgian army. Then Keyes did his analysis. But what you find is that Asian people, because they tend to be more of a slider build, can be in an unhealthy category, but have what we would consider a really healthy BMI.

[00:46:50] And the opposite is true for those of African descent, where they may be often labeled as obese and yet be at a very healthy weight because they tend to have a little bit more muscle mass. And remember, BMI just goes by weight and a little muscle equates to a lot of fat because muscle is much more dense. Yeah.

[00:47:13] So having that extra genetically endowed muscle puts them in one category. And so, yeah, and so I think your point is very well taken and 100% correct. And BMI is just not a good measure for a number of reasons, mostly because it doesn't account for muscle mass.

[00:47:35] So it's not an accurate measure of what we're really looking for is not only what is the fat, there are different types of fat in our body, white fat, brown fat, etc. But what seems to correlate with disease is what we call that central obesity, which is that sort of beer belly kind of fat, which, you know, just kind of locks in around the gut.

[00:47:58] And a little fat there, you know, can be much worse than having just a little fat everywhere, even if somebody was at a higher BMI. So waist circumference, waist to hip ratios, those types of measurements are a little bit more precise. The problem is they're more difficult to do. You have to kind of be in your doctor's office to get that.

[00:48:20] But hopefully, you know, with a lot of these RPMs or remote patient monitoring things that are coming out now that you could do with your iPhone or connects to your cell phone and get measurements, we'll have ways to analyze that and get better data. And it always, to me, the solution where you are asking like, well, how is Maha going to address some of these things? It always comes down to, you know, a lot of times we have to kind of get better data.

[00:48:47] I think people would be probably angry if they realized how much of what they're told to do is based on really crappy data and really incomplete data. Would that be, I was going to close out with a question around what's like the one thing you would like to see come out of this report and recommendations? Is that better data? Would that be your wishlist item?

[00:49:11] I'd like to see this carried into a real discussion in the food health space. As you mentioned, you know, I've been doing this for decades and I've been banging my head against the wall because no matter what, the people who are in charge of the politics and the policy want to keep the status quo. And medicine is like an aircraft carrier.

[00:49:36] Once it gets going, I mean, it's not going to turn on a dime and it takes a lot to turn that ship around. And so I hope that this, with all the good and the bad that we talked about at the beginning of the cast that is in there, at least gets us turning the wheel. We will have meaningful discussions about this and start to look towards it in meaningful ways.

[00:50:02] Another great study that did not get much headline at all, but I think is extremely important for the reasons that I'll share. What they did, and I won't get into the details, it'll be in my column in two weeks, but they were able to show that when you eat ultra processed food, what you excrete is measurable in terms of the compounds that you excrete in your urine and also what they find in your blood.

[00:50:31] In the terms of hundreds of different compounds. And what's really been sold to us for decades is that ultra processed food, it's food. It's just a natural evolution, right? Like we were hunter gatherers and we had berries and then we, you know, cook mastodon burgers over a campfire. And then we dried food and we made, you know, beef jerky. And then we were able to do these other things to ferment food and we were able to preserve it. And so the ultra processed food is food.

[00:51:00] It's just the evolution of ways to preserve it for longer shelf life, etc. And it's not, it is not natural food. And when they looked in both the urine and the blood, they found what are called xenobiotics. And these are compounds that are not found in nature.

[00:51:17] So the fact that they're in our blood and they're in our urine as a result of some sort of metabolism and excretion is proof positive that ultra processed foods are not just natural food in a preserved form. And I think, again, the conventional wisdom, the common consensus is that, you know, it's a hamburger, it's meat. And it's not real meat.

[00:51:45] It's altered meat in a way. Not like, you know, plant-based meat alternatives, but it's not real natural meat. It makes a difference. And so the fact that when you eat a lot of ultra processed foods, I can measure stuff in your blood that's like not known in the natural world. I think that should worry people. Yeah, yeah, absolutely. I think our very first episode together was on defining ultra processed foods.

[00:52:14] And you had a really good definition around these are substances that are created that you cannot create in a kitchen. You know, they have to be industrially produced. And that's a key difference. Yeah, and my TED Talk covers this as well. So if anybody hasn't seen the TED Talk, please get on it. And especially as we were talking about with what's going on, I walked through all the NOVA definitions. It's only 18 minutes long, which is all you're allowed to do. I took it right to the edge of the TED Talk.

[00:52:44] But we cover NOVA 1, 2, 3, 4, and what's different about these compounds and where we find them and what's allowed. So the TED Talk is a great short way to get that information as it's defined in the scientific literature. Amazing. Yeah, we'll link that. Okay, we'll have to regroup once the recommendations come out. And hopefully they'll, you know, wave a magic wand and make all of this happen. Thanks, Mike. This has been great. We'll talk to you next time.

[00:53:12] And never fear for giant bugs. Yes. Important takeaway. That's right. Thanks, Jade. And that's a wrap. Thank you so much for tuning in. Remember to nourish your body and I'll talk to you next time.