Fatty Liver Expert: Your Liver Is Filling With Fat Right Now - Dr David Unwin

So half of that string should go around the fattest bit of your belly. And this is a really simple test for everybody at home. I mean, it's not, it is. You're just doing a pass. But fat on your belly is more worrying than fat on your legs or on your arms.

And unfortunately, we've started to normalize things like the dad bot, without realizing that isn't how you're supposed to be.

And maybe a third of all the people in the world would type to diabetes don't even know they have it.

But every year that you have poorly controlled type to diabetes, you're losing a hundred days of life. And it's because people don't know the truth being fooled with the packaging and advertising. So let's talk about the food we have on this table. Because this is how much sugar I would have thought was in all of these things.

You're cereal, potato, white rice, banana, and a chocolate bar. So now I'm going to give you the correct figure. The cornflakes is 1, 2, 3, 4, 5, 6, 7, 8. That chocolate bar is 7 and a half. The banana, that's 6.

And then the potato is actually.

Oh my gosh. And then 150 grams of boiled rice is... Oh, f***. I thought rice was healthy. But each of us has a number of different health futures.

“And what I'm interested in is how do I get you to pick a lifestyle that will get you the future you want?”

Because my job is about behavior change. The floor is yours. All right, so off we go. Guys, I've got a favor to ask before this episode begins. The algorithm, if you follow a show, deliver you.

The best episodes from that show, very prominently in your feed. So when we have our best episodes on this show, the most shared episodes, the most rated episodes, I would love you to know. And the simple way if you to know that is to hit that follow button. But also, it's the simple, easy, free thing that you can do to help us make this show better.

And I would be hugely grateful if you could take a minute on the app you're listening to this on right now and hit that follow button. Thank you so, so, so much. Dr. David Unwin, you were named in 2018 among the top 10 most influential doctors in the United

Kingdom. You've got an incredible list of accomplishments and your held in the highest regard.

Maybe of all the doctors I've ever had the chance to speak to, by many people that I've spoken to. We were talking before we started recording about what's on your mind. And what's been bothering you. And so the floor is yours. What is front of my few doctor, David? Well, front of mind for me is the idea that each of us has a number of different health

futures. So you have. So in your future, I don't know there could be cancer. There could be multiple sclerosis or there could be many futures. What I'm interested in is how do I get you to pick a lifestyle that will get you

“the future you want. And I think that's very difficult in the world now to know”

what is the best lifestyle because you've given so much conflicting advice. And the particular focus for me in terms of picking health futures is around young people. Because they've got the longest time to make a difference. And it's getting harder and harder and harder to make good health choices in your lifestyle. It's really hard. I'd say it's a pandemic or poor metabolic health.

Yesterday in clinic, I saw two people under the age of 25 who had poorly controlled diabetes. And one of them was too heavy for me actually to weigh. And this situation is completely new. So when I was a young doctor and just starting off in practice, that was in 1986. Wow, nice and long time ago, just north of Liverpool in the practice, I'm still there now. A obesity was rare and we didn't have a single case of type two

diabetes in anybody under 55. Not a single case. It was quite unknown. And in fact, type two diabetes had a different name. We've had to change the name because of the epidemic used to be called maturity onset diabetes. That meant old people. Right? Now we call it type two diabetes because we have to include so many young people. It's really, really serious because people are losing their life expectancy. And I'm witnessing this. We're all sleepwalking into

a metabolic disaster and the people praying the greatest price in my opinion are young people

“and it's a scandal. And I'm hoping mad really. I think we started to normalize the dad bod.”

You know, the big tummy and her her without realizing that maybe that isn't how you're supposed to be. So that's what's on my mind. Young people and their future and they don't even know.

trajectory of their future. Yes. But for the audiences listening, that might be in their 50s now. Is this advice also applicable? Absolutely. So we know from government figures, UK government figures. But for every year that you have poorly controlled type two diabetes,

you're losing a hundred days of life. That's about a third of a year, isn't it? So

whatever age you are, if you have poorly controlled diabetes, you're losing life expectancy. And maybe a third of all the people in the world would type to diabetes. Don't even know they have it because they haven't taken the test so they don't know. What do you think kills people with type two diabetes? Is it some cardiovascular issue? Yeah, well done. Well done. You don't

“think you're not being to medical school. You don't know. That most doctors, that's what they”

say because we know that a high blood sugar over time damages your arteries. So it's a cumulative thing over time. But what you may not know is that actually a rising cause of mortality for people with diabetes is cancer. Oh really? Yeah. So eight forms of cancer are strongly associated with diabetes. I want to just define that term diabetes because I think I went for a lot of my life assuming that diabetes was a disease that some people are born with and because I didn't have it,

I thought, I don't mean to worry about that. That's really important. Yeah. So first of all,

is type one diabetes and type two. But before I can explain about diabetes, I need to explain

“about insulin. This is absolutely key to our whole discussion. So I've already said that a high”

blood sugar damages your arteries. And in fact, there's work to show that a very high blood sugar damages the non-stick lining of your arteries within six hours. No. Really quick, it's called a glyco-k-lix, the non-stick lining. And damages occurring very quickly. So I'm going to ask you a really stupid question. Yeah. When you say high blood sugar,

I get high blood sugar when I eat lots of sugar. Okay. So first of all, we're actually talking

about glucose. Yeah. And sugar can mean tables, sugar or it could mean many different things. But we're actually talking about blood glucose. Which comes from lots of foods. Which comes from many foods. Carbohydrate heavy foods. Yes. Yes. It does. It does. So that's right. But you have the hormone insulin to defend you from poor dietary choices. So the question is what does insulin do with the sugar you just ate? And here's the answer. Incyline, the hormone

insulin produced by a pancreas gland, it pushes the sugar and it pushes it out of the bloodstream inside cells where it can be used for energy for you to run around. But what if you take in

“more carbohydrate than you need to run around? Well then that sugar is turned to fat inside cells.”

Because it's safer for you to turn that sugar into fat than it is to have it damaging your arteries. So I am somebody with type 2 diabetes so we can talk about me. So I had a really heavy biscuit habit. I was senior partner of the practice and it's stressful and I had patients used to bring me biscuits all the time as a gift because they, you know, they want the doctor to be happy. So in the draw and the top of my desk was packets and packets of biscuits. So I'm taking in

more sugar and I didn't run around and gradually my waist got bigger and what was actually happening was as I took in more sugar than I needed to run around. My insulin was working to get rid of that sugar and it was giving me two things. One. A belly. So you know and I thought it's just middle-aged spread you know and the other was I didn't know but my liver was filling with fat and that's that is very common now so we have well it's a third of everybody in the develop world has fatty

liver now. Here we got the wonderful props. Let's talk about these. Great. So fatty liver. This is the healthy liver here and you see the color. Look at this one. It's yellow. It's the wrong color and it's because of fat. So in that case like has happened to me over years my liver began to fill with fat.

much glucose. The insulin was doing it's good job of taking it out of my bloodstream and forcing

it inside cells in my belly but unfortunately in my liver. And so there's a progressive laying down of fat in the liver so if we look at actually some proper liver so this is the put on your seat belts now because this is some of these actual liver. So then that's the normal liver but look at this is larger. That's a real human liver. Yes these are human livers and that's as it should be but this look at this liver is larger and it's larger because of so much fat in it. Now the twist

in the story is fatty liver interferes with the good work of insulin. So you develop a thing called

insulin resistance which means your insulin is no longer as powerful as it was. It's beginning to

become difficult for you to deal with carbohydrate and sugar because your insulin isn't working as well.

“And the only way to deal with that is the next twist in the story. You have to start producing”

more insulin. Just see because it doesn't work as well. So your pancreas has to crank up the supply. We need more insulin. So now you have two things you have insulin resistance. Your insulin isn't working as well but at the same time you're trying to produce more insulin in the pancreas. This bit's called the long silence green from the liver. This is worked by Professor Roy Taylor,

a friend of mine at Newcastle University and he pointed out that you've got fatty liver for about

ten years. You don't even know. You wouldn't know that you've lived as gone fatty and yellow like that. But unfortunately this is another twist. Fat is being laid down in the pancreas gland, the very gland that your life depends upon producing insulin and your ability to produce enough insulin collapses. And at that point you can't regulate blood sugar anymore. But upstream of that, you have a problem. You've got that. But you don't even know. You're talking about what's in

“my mind. Why are we waiting until you actually have all the problems of type 2 diabetes?”

So since 2013 I've got hundreds of patients and I'm monitoring the baseline and latest follow-up. So what happens to them? It's really important. And now I have a huge data set that I can interrogate and answer questions. So number one question, let's think about prediabetes. So this is in the long silence screen. Well I can tell you that the people with prediabetes in my practice north of Liverpool, 93% of them will get a completely normal blood sugar if they go low carb

93% resolution and that will last for years because I've checked. Okay, how about we wait for the 10 years and Steven until Steven you've got type 2 diabetes and then you've got low carb. At that point if I can get you early, I've got a 73% chance of you having a normal blood sugar. Let's wait another few years because you don't want to give up bread and you don't want to give up chips and pizza. Very enough, I'll wait. But you know if we wait five years you only stand a 50% chance.

So do you see it goes 93% over 70% 50% so the chances of me not needed drugs and be able to do a good job for you are diminishing. So really it's a stitch in time and so much of this you don't even know you don't even know it's going on. One of the things that shocks me is how little we know

“about what's in our food. Yes, you know because I think we all know that like biscuits are a food”

that has a high glycemic index. Well done, which is a term that I've learnt from this podcast. Yes, some carbohydrates are more sugary than others and then so that's the glycemic index. What that is doing is comparing different carbohydrates with pure glucose. So you see pure glucose is 100 and then other sugars come further down. But there is there's something better than the glycemic index and that's called the glycemic load. The glycemic load takes portions of food and predicts

how will that portion of food actually affect your blood sugar? And am I right in thinking the

fiber. Yeah, because if you took water melon, well it's mainly water, isn't it? So you have to

factor in. You can have quite a lot of water melon to equal a chocolate bar. So the density you're

“looking at the density of sugar in it as well. Okay, so that's why the glycemic load is better.”

Was there a moment in your career where you started to question what you'd been told? Yeah, you know, so you started as a young doctor. I wanted to be part of a small community and stay there and make a difference. And then comes the sad bit really for the first 25 years. I was trying to do what's in the guidelines. I was trying to be a good doctor. But what I noticed, I noticed two things. Number one, I noticed what I've already said to you that the health

of the population I cared for was deteriorating. It wasn't getting better. So if I'm the doctor in charge of the practice looking after these people and health is deteriorating, am I not responsible? And where is all this difference I was hoping to make? It just wasn't pounding out. At the same

time, I'd always in my heart felt that prescribing lots of drugs felt a bit wrong. It felt like a

mini failure because how is somebody well if they're taking six tablets a day? Was there one particular patient that you met? There were two. Two things happened. Those to do with very powerful women. The first powerful woman was a lady I'd known for over 10 years. She and husband I'd cared for them both. They both had poorly controlled diabetes and they were both very heavy. At the time, I could monitor how how compliant my patients were with their medication. And if I had to be truthful

in part, that was how I was paid. So the part of my payment was to do with how the patients having in this case went form in the most commonly used drug for type 2 diabetes. Part of your payment. Yeah, yeah, because there's a you're supposed to the government approve of the fact that we give drugs that are needed for type 2 diabetes so that you're given a sort of quota where it's exposed regarded as good practice that's such a certain percentage of your patients will be

on met forming. What? Yeah. It's true. So is it fair to say that you were somewhat incentivized to

“give people met forming? Yes, that would be true. But I think we should also be fair to say that”

the body of evidence at the time would say that it's good practice to give met forming to people with type 2 diabetes and conversely poor practice not to use met forming, but we'll develop that. So the backdrop is when we're monitoring the patients who stop taking them at forming, because that is number one poor practice and number two actually costs me. So I wrote to the person "Do you miss this song?" So I'm concerned that you're not, you don't seem to be taking your met forming. Please make an

appointment with me at your earliest convenience. Very British, very polite. Anyway, nothing prepared me for what was going to happen that morning and it's changed my entire life on that point. So the lady will let's call her Mrs. Jones. That wasn't her. She marked she's in and she said to me, "You think you're going to tell me after you don't need dronrine?" Well, I've got news for you.

I'm going to tell you off. I was scared like what's going on. She'd never been like this before

she was a polite person. Anyway, she went on to explain. She said, "When you do my blood tests, you will find that my blood glucose is completely normal, despite not taking your met forming." And she said, "I'm wondering if you're actually qualified as a doctor because in the last 10 years did you ever once tell me that bread was sugar or breakfast cereals was sugar? I had to learn online that bread is sugar, that rice is sugar, that breakfast cereals are sugar.

And when I cut those foods, I don't need your met forming now."

“And she went, she made it worse. She said, "This is schoolboy biology. You should have learned”

that when you were 16." I was dead scared because you know, complaints as a GP

was true. And one thing I had learned about when you're an older doctor is you got to listen to

“people properly. If they're complaining, don't deny it, don't defend yourself, take it.”

So I said, "Okay, I want to learn what you know, if this is true, will you meet me again? Let's do the blood test." So we did the blood test. It was true. It was the first case of drug free

type 2 diabetes I had ever seen. I've never seen a single case in 25 years where people came off

medication. I was fascinated because she'd done it like a miracle but it was another detail I just share with you. She was one of 40,000 people online learning from each other how to do it. When I looked, they were being rubbished by the healthcare professionals. So people like me were telling them you'll die. What you're doing is dangerous and I was ashamed, really ashamed and it's complete coincidence, but in the same month we have to introduce my wife, Jen.

Is there a photo? Come on, let's see Jen. This is Jen. She's probably the cleverest woman in the

world. She's so clever. I love that woman. So Jen, so her back, she is a clinical health psychologist and she specializes. She's fascinated by the role of hope in disease and the difference it can make. She spent her life researching the difference that hope makes to clinical outcomes. So it just so happened that she was in a supermarket and she saw some discounted diet book. That's the book. A scoop of the diet just gave to Jen. Yeah, Dr. John Briffer, what a lovely guy. So Jen bought that book.

“Just around the time I'm telling her about this patient. So she said you have to read this book”

about the low carbohydrate approach to insulin resistance to type 2 diabetes. And in the book, everything that my patient had told me was there. But it was done in a medical way from and I understood. She said, David, why are you sort of failing? Why don't you do one thing before you retire? Why can't you do a cheerful something you really believe in? Why don't you have a go at this low carb yourself? Yeah, she said, why don't you and me go on this diet

for see if some patients would volunteer and do it with us? And I mentioned it to the partners and they said no. These are other doctors. Yeah, so I'm senior partner. I'm supposedly the boss.

“But the time low carb was not respectable and they didn't like it. And they said, we don't want”

you to do this. And partly because they said, well, how is that a good use of the resources of the practice? Because if you're doing this, David, maybe you're not treating chest infections or other things. And this pressure on the health service. So this felt a bit, they felt it was a bit self-indulgent. So go back to my wife and said, the partners say no. And she said, I'll tell you what we're going to do. We're both going to work for free and we'll do it. Why don't we do this in our own time in

in an evening when the practice no resources? So that's exactly what we did. We found 18 volunteers who were interested amongst the patients. And then Jen and I, so that was 20 of us, we started meeting every Monday night talking about low carb learning, how do you cook stuff, how do you do it? We did it together. And one of the nurses was so excited. Heather is her name. Let's give her a, you know, thumbs up to Heather. Heather said, I'll work for free. I'll help you.

I'd love to do this. I want to believe in what I do. And then the magic begins. The results,

I couldn't believe it. I could not, you know, I'd never seen anything like it. And the first thing,

the first thing I saw was the liver function improving. You see, because I'm doing blood tests, because I know I'm doing something weird. I'm doing something that I would be criticized for.

it's these are patients. So you can't just experiment and not be, am I doing harm?

“What's happening? What's happening to the cholesterol and the lipid profiles? So I was monitoring”

stuff really closely. The liver function, though, Steven. I got people who I thought they were drinking alcohol and I thought the liver problem was due to alcohol and they'd had abnormal liver

function for 10 years and suddenly within weeks, the liver function was improving often by a third or

50%. I was so excited. Can you imagine I'm sitting there and the laboratory results are coming in and they're like, wow. And then another and another. So that was the first thing, then the weight, to rule meeting every Monday night and we got the scales and everybody gets weighed every Monday night and the weight started falling off people. They really did. And then the all sorts of other weird stuff started happening. Some of which I couldn't make sense of for years. First one was,

people said, are you hungry because I'm not? And they started saying things like,

“do you have to eat breakfast? Where I also, I wasn't hungry. I wasn't hungry. They were telling”

me the truth because I was experiencing this with them. Why are we not hungry? That's so odd. And I was starting, I'm not bothering with breakfast. So I didn't eat it. We don't have to have it. I'm a belly went away. Next thing was, I noticed when I stood up from my desk. I felt dizzy. Weird. Now, I hadn't told anybody, but I had moderate high blood pressure for years,

but I didn't like to be a patient. So I never went to a doctor. I just put my head in the sun,

so I had high blood pressure for years. I wanted to talk about blood pressure. It was low normal. Why? I didn't know. But on the patients as well, I'm doing that as well. I'm measuring all the blood pressure. And it's improving. So it's getting weird and weirder and weirder liver function improving, weight going down, blood pressure improving. In those days, we were, the blood test that we, we did, was the thing called a hemoglobin A1C. The A1C in America.

This is the average sugaryness of your blood for the preceding three months. So the results

take a while. But then, when the hemoglobin A1C came in there, it was, we were getting

really spectacular improvements in average blood sugar. And that's kind of how it began. So that's 2013, so that's 13 years ago. And the rest is history. But that, I was completely blown away. And I was full of curiosity about all these other things and how was it? Why were these things improving? So in those 13 years, how is your fitness, your health changed? My mental powers were much greater. I could concentrate better. I wasn't Freddie. So I noticed that.

The next thing I noticed was, I needed a lot less sleep. So yeah, in the beginning, I used to have to have a little sleep on my doctor's couch every lunch time. So I was senior partner, so you press do not disturb and you put the curtains round and have a little nap on my own couch for 20 minutes. There was only way I could get through the day. I didn't need that nap anymore. I was less sleepy. I needed an hours less sleep a day. I could think better. I could cope with the same problems.

And this is so weird. But mentally, I was stronger. It was like being a younger man.

“The way, I don't know. Yeah, I think you have a sense of mental horsepower.”

Don't back to the top of this conversation. You talked about how everybody listening right now has a variety of different health features. Yeah, and which health future they end up in, it's going to be determined by the everyday decisions they make. Yes. So I want to really zoom in on some of those everyday decisions. We talked about viewing your biscuits. And at the time you said, you were, you were probably quite sad and trio's a doctor. Yeah. Sitting in a chair, patience

coming in. Yeah. You weren't doing exercise? No. I didn't fundamentally believe it would make that much difference. And this is such a great point. You really great point. So let's think about weight loss.

And I'd even sometimes say that belson thing. You know, the no-fat people came out of belson. But it's a horrible thing to say to a patient, isn't it? It's belson. Well, that's in world or two where they'll starve. Oh, okay. So the point is you're saying to somebody with an obesity

“problem. It's awful. Yes. You're blaming them as exactly the point. And that's what I did.”

And it's worse than that because I give them that advice and it just about never works.

I did a horrible thing. I used to say to them right. So why don't you just have two tables spoons of all-brander-day? Oh, breakfast room. Yeah. With skim milk and I would advise a few multivitimins and a couple of pints of skimmed milk a day. That was my advice. And then when it didn't work, who do you think I blamed? Yeah. And this was all part of my epiphany. I never joined the dogs that the failure was not theirs. It was mine. And that's horrible, isn't it? Imagine 25

years of I was blaming patients for their failure to lose weight. And it was my failure because I didn't give them advice that worked. And if you keep giving the same advice to people and it doesn't work, shouldn't I have questioned? But is that happening in society overall? How are we doing? How are we doing with health? How's it going? So disaster isn't it? So we need to do something different. But for me for 25 years I did not believe that lifestyle was key and now I do. And that's

why I didn't think that the biscuits made that much difference. Obviously I knew basic nutrition. So I made sure there's protein and there's iron and stuff. I fundamentally believed that drugs is what I should be using medication and that lifestyle was a sort of

“add-on. It's not terrible. I think this is so important because it really gets to”

what I believe the average person thinks as well. Yeah, yeah. We were talking before we started recording about some of my friends. There's two friends I mentioned. One of them is a very, very successful business man. Everybody knows who this person is and they asked me this weekend is pizza healthy. And I just couldn't believe it's my gobsmacking. It's like, oh, what pizza what? Because they would choose to try and choose between they usually have a big 12-inch pizza

for lunch and he was asking me, what's healthiest even? Nando's chicken or this 12-inch pizza he was going to get. And I literally looked at him like I was looking at gobsmacking. You wind him me up and he was genuinely serious. He's for me 60 years old now and he doesn't know if a chicken breast is healthier than a 12-inch pizza. And the other example that I mentioned before we start recording is a very famous Premier League football superstar legend who you would assume had gone through

those sort of 15-20 years of being an academy player and then a pro athlete knows what has sugar in and what doesn't. And he was asking me is a big spaghetti carbonara's that healthy, is that health food. Because he said to me during his football years they were told

always to carb load. And again this gave me a huge amount of empathy because it made me realize how,

even though there's podcasts that this will be talk so much about health and even though there's the internet now, this information is not getting through to the average person for some reason.

“And they too, I believe, but think exactly what you just said that health is, you know, it's this”

sort of accessory where my fate is determined anyway. And if I do this health stuff which is a bit of an inconvenience because these Percy pigs taste great, or these candies taste great, then I might be able to look a little bit better, a little bit more aesthetically pleasing, but my fate is determined. The simple point here in nutrition we're not teaching it. So there's only three macronutrients. There's only protein, fats and carbohydrates. And yet your friends there haven't

even got the three macronutrients and they are successful intelligent people. And so somewhere we're going badly wrong, aren't we? There was another example that's really front to mind to me, which was, you know, I'm in drag and stand at the moment and someone came in and pitched a

fruit smack the business and it's basically dried out fruit pieces. Now I look like I'm loving

this already. Yeah. I looked at the back and it said in the range of 60 to 70% sugar because what

little chip, which is this just piece of mango, 67% sugar. So I'm looking at the back of this thing,

thinking, this is candy. This is basically candy. Thank you. But I'm looking around and every because

it, because it uses the word fruit. Yes. People have this sort of halo assumption that if the word fruit is on it, fruit juice, fruit sample. Yeah. And also it's a sort of cares about the consequence, but we'll make a pile of money selling dried up fruit and they miss what you read on the back. Yeah. And I was like, this is okay. How's that? You know, what if somebody had type tooth out what? For kids, we'll just give them. Yeah. And you've touched on another thing about

what's going wrong. So when we look at my practice and this epidemic and really, as I've said already, it's not an epidemic. It's a pandemic. It's everywhere. I go all over the world and obesity type two

“diabetes, poor metabolic health is in it's everywhere. It's everywhere. And I think one of the things”

touching on what you just said is so you wake up and you have your cereals for breakfast.

If you've got some here, which we have some cereals there. And then you'll have why don't why don't you have a big glass of fresh orange juice as well? Great idea. And then, okay, that's your breakfast. But then on the way in, you have a little snack and people do. They buy a bar or some crisps or something like that. And then even at school, they might get a muffin, mid-morning, firing off. They might then have an apple. A lunchtime, you're going to have some sandwiches and then

you've eaten you sandwich, so you'll, I don't know, you might have, might have a cake or something, or some ice cream. Then you'll go home and then it's time for, you know, maybe a chip, so your pizza.

“What you've actually done is has sugar, with your sugar, sugar, sugar, sugar, sugar, sugar,”

all day long. There's hardly any protein going back then to those mac, where was the protein

to grow you? You know, and that, that's the thing that that's changed over time that we are the snacking. So I come across a lot of young people and the mother is saying I can't get him to eat any proper food. He just eats snacks all day long and it won't, I can't, the can't get protein in them. And some of the ratchy thin kids do not offer. Let's talk about what you just said there and we can walk through the day using, yes, the food we have on this table. Now just one portion that we do have

some people that are probably out walking their dog listening and can't see. So we're going to have to do a bit of a voice over. Okay, so what's going on? But you said, wake up in the morning, you have your cereal. Yeah. Now cereal, growing up, I thought was a health food. Me too. Yeah. Me too. How much sugar is in the average standard bowl of, let's say, frosted cereal? Well, we can do this different way, Stephen. This is actually like a test for you laid out here. Oh, gosh, that's it. Yeah, this is a

test for you and I'll describe it. So what you've got, you've got a bowl of, we'll call them their corn flakes. Then you've got a potato, a baked potato. It isn't baked yet, but you could bake it if you want. You've got 150 grams and this is boiled rice. So it's not dry, it's boiled rice. You've got a very ripe banana and at the end there, you've got a delicious looking chocolate bar. Yeah. So you've got there some cubes of sugar and this is the test bit you see as to how I'm

going to give you a real score you in the end. Okay. So what I'd like you to do is consider these relatively and each of those cubes of sugar represents a 4 gram teaspoon of sugar. Yeah. So if you could now just go along these and put beside each food, what you believe to be the equivalent in terms of teaspoon of sugar, and then I'll give you a score and see how you do. Okay. And those are the answers so I'm going to turn it down so you don't cheat. Okay. So I'm going to score them

as I would have thought two years ago. Thank you. Because because two years, I've interviewed a lot of experts, so I'm generally quite shocked by all these things, but I'm going to score them

“as I would have thought when I was 31 years old two years ago. So that's great. Serial, honestly. Yeah.”

I have no sugar on it. It's not a sugar cereal. It's just a dry flakes. I honestly didn't think there was sugar in that. Yeah. So if you had pushed me, I wouldn't, we'll give it one. I'll give it one. Thank you. But I didn't think there was sugar in that one. Again, a potato, I didn't think there was any sugar in a potato. So even giving it one feels like I'm lying

was any sugar in rice. Okay. A banana. It tastes sweet. Yeah. So my brain would have said one. Yeah.

But this this chocolate bar that's in front of me. I would have said, I'm going to say two. Okay. Two or, I'm going to say three. Right. I'm going to say three. I actually think it was two,

“but that's how much sugar I would have thought was in all of these things here. Serial, a potato,”

white rice, a banana, and a chocolate bar. Right. Well, to be fair, I still kind of do, but I knew that. So now I'm going to give you the correct figure. Now, this is worked out from the glycemic load

that we already discussed. So I explained about the glycemic load. And then, so in clinical practice,

I had a problem. My problem was in 10 minutes trying to explain to you how you could eat differently and why you should eat differently. And so I needed a way of quickly communicating with children, with old people, with a teacher, the consequences of dietary choices. So I came up with a new idea,

“which was, why don't we represent the glycemic load? And instead of using”

grams of glucose, which nobody understands, and what's glucose anyway. Instead of doing that,

we read the calculations, redoing it for tea, foreground, tea spoons of sugar. And that's my

tea spoon of sugar equivalent system. And I'm using that now to give you the correct answer. Okay, right. So the, the cornflakes is 1, 2, 4, 5, 6, 7 and 8, 1, 2, 3, 4, 5, 6, 7, 8. With no frosting, no frosting, no milk, nothing. The potato, obviously it depends on its size. That's quite a big one. So that one is 1, 2, 3, 4, and there's more, 5, 6. Is 9. There they go. No, look at mine sugar cubes. Is that nice? Yeah. Right.

I'm going to leave the rice to last. That chocolate bar is actually, you could do it for me. 7 and a half. So you can give it 7. 7. 7. Now the banana depends on the size and how ripe it is. A ripe banana has more sugar in as you probably know when you eat it. But that, let's say that banana is quite a right one. It looks quite ripe. Let's say that's 6 because it's a big banana. Okay, then the final one obviously is going

to be the killer isn't it? I thought rice was healthy. Well, I thought it was really healthy. It depends. So one, this is 150 grams of boiled rice, 3, 4, 5, 6, 7, 8, 9, and 10. So that's the winner. And I would say that's the single fact around the world. So my teaspoon of sugar, there we are. That's one of my teaspoon of sugar charts. So what you've got there is the food, a glycemic index, the serving size, and then the teaspoon of sugar there. So this is

available. The public health collaboration is a charity. I helped set up with Dr. Rangan Chaturgy. 10 years ago, it's our 10th anniversary tomorrow. These infographics, they're actually far more than this. This is the seven more. They're available in 35 languages. Volunteers have translated this to go all over the world. It's not copyrighted. I want people to steal it, take it, use it. So the the white rice fact, I would say has astonished people all over the world and led to me becoming far better known.

What about orange juice? A lot of them parents, including my parents, give me orange juice. And I used to think orange juice was a health food. So I would literally, I'd go to the fridge, I'd get open the sunny delight whenever it was sunny delight. And I would drink that.

“I think I'm going to be strong and bigger, my body's going to love me.”

Well, let's, so that there's a lot of sugar in orange juice. So a lot of sugar in orange juice.

and you juice it, the sugar hit is fast. So what that does is, if you think you've got back to insulin again, so you drink the orange juice. Your blood sugar goes up rapidly. So your body responds rapidly with insulin. Then what happens? Your blood sugar falls.

“But then you kind of hungry again. And that's what happens to me with the biscuits.”

Wasn't it? I ate biscuits. My blood sugar is up. Then insulin comes in heavy and slow, but too much. Then I thought I was having a panic attack, because I had no blood sugar. And what's the answer to that more biscuits and round you go round? And that's how, without thinking, you'd start the day, starting the day with a sugary breakfast. Without in a protein in it, is driving hunger. And then you wonder why you're

ravenously hungry at 10 o'clock. There was a few others that shocked me. One of them was, I was in Peru. And obviously, Bruce quite famous for chocolate, because of the cow and all that stuff. And so he went to a chocolate making class. And he told us to make dark chocolate, normal chocolate, and then white chocolate. And when I made the white chocolate, this guy got me this big glass cylinder. And he goes, here's some white sugar. He goes,

"Poor it in." So I get it and I pour some in. And he goes, "No, no, no, my friend." "Poor it in." And I pour it and pour it and pour it and pour it and pour it and pour it and pour it and pour it and pour it and pour it. And I'm not kidding you. I feel like and have to check the facts here. So community note me on the screen, barbs your team. I feel like I poured into this huge glass cylinder. Yeah. 80% of white sugar. Yes, and then it's true. Yeah. And then

you put some syrup in. Oh, poor. This is why it's sugar. It was like some syrupy stuff. And I was

like so white sugar. And so white chocolate is like 80%. It is like sugar. Yeah. I've never

eaten white chocolate since. Yeah. Ever. You've that's so important. So very often people think they're a chocolate. That's really common that people say to me, "I'm addicted to chocolate." If you look at, if you actually look at how much sugar there is in milk chocolate, you know, there's many teaspoons of sugar in milk chocolate. If you eat 90% dark chocolate, there's only about two teaspoons of sugar in a bar. And what you find with the

chocolate hollocks is I say, "Well, if you're addicted to chocolate, why don't you get a bigger heat and have the dark chocolate?" And they say, "Oh, I couldn't eat that. It's too bitter." What they're actually addicted to is the sugar. Well, they're right. So I've done it. There is the folks at home. There is one of these sugar infographics on chocolate on that subject of chocolate because I want people to understand the consequences of what they do. So just in a

“straight that's because I've just looked up the stats. I think this is, this is what I saw.”

I've just looked up the facts to make sure that something is true. When I made that bar of white chocolate in Peru, this was the total ingredients and this is how much sugar they asked me to

put into it. I've looked at it and thought, "Okay, so white chocolate is basically like 70

odd percent, just pure white sugar and nobody knows." Exactly. The other one I've got to be in my bonnet about is smoothies. Yes, I have one too. I thought smoothies were healthy. Yeah, no. They're the, you know, I'm on X or Twitter quite a lot and that's the kind of thing fills me with rage and I have to take a photo with like my look. There is sugar. There was, yeah, it fills me with rage. I've got another thing. This is fun. I've got a question. Right,

Stephen. Why don't we take all the blood out of me? Right? The five liters we could bleed me out right now. There would be five liters of blood in me. Let's get it in a bucket. All right,

“five liters of blood. How much sugar would be in that five liters of blood?”

I've no idea. It's an interesting question, isn't it? Because it relates to the consequences of eating some of these things. So I would just like you to estimate. So if let's say my blood sugar is normal. Yeah. If you have a normal blood sugar, I would like you to guess how much sugar

is there in my entire blood system? At one cup, like this. Thank you. No, the answer is this. Let me show

you that is all there is. You're joking. I am not. And you see immediately. One sugar to you. That's all.

and I have diabetes, there's too much sugar for me. You see, because glucose is number one vital,

but number two toxic if you have too much of it. The level of it in my blood is controlled

“minutely. Wow. It's controlled to this extent. And I think that's single fact. You didn't know”

that. No, I did not. And it immediately shows you how it's so easy to have more sugar than you actually need. Given that. I think you're insulin stops working. So for me, I've done an awful lot of this. So I'm monitored my blood sugar with a continuous glucose monitor. And I get my blood sugar upon my phone. So I can check at any time what my blood sugar is and we'll do it in a minute and see. But you see, if I eat a banana, it doubles my blood sugar because I can't regulate my blood sugar.

Because of the diabetes. Yeah. So a whole banana is far too much for me. And we'll double

my blood sugar because you see if I'm only supposed to have this much. And I have that much. God shit. It's too much for me. And I feel ill. Giving, you know, I go out into the world and I speak to the people that listen to the show and they're like taxy cab drivers. It's a lot of taxy. Do you know, I wouldn't. I've got this bias towards thinking that everybody listens as a taxy cab driver because I really only spend my time in the office or in a taxi. So I get lots of feedback from

these cab drivers. And the average person out there listening now. They don't know how to check if the food they are eating is good or not. Because the labels on these foods, I've got

Serbs asked by the marketing. Yes. And, you know, I was looking at this bag of sweets here,

the day, and it said, "made with real fruit juice." And they put it front and center. And I yeah, I was almost tricked. So I can't imagine someone who like me, who doesn't spend. I can't imagine someone who doesn't spend the time interviewing health experts. How easily the general public is

“being tricked. So what is your advice in terms of spotting this stuff? Like, what do I look at?”

Because right now, I spend a lot of time looking at the sugar part. Yeah, that's great. There's different ways we can do this. And obviously, this is how I spend every cleaning. That's I'm in clinic yesterday. This is what I'm doing. I'm trying to help people understand. It's sometimes easier to talk about what maybe what you would eat rather than what you would and eat. So for somebody with insulin resistance or type two diabetes, I would tend to say,

"Well, why don't you base your meal on protein?" So what have you got in the fridge? Could it be chicken? Could it be eggs? What would it be? So that's your protein? Have loads of it. Then I'm thinking, "Right, green veg." What green veg is? Would you tolerate what green veg could you buy? It might be frozen beans. It might be salad or whatever. And then I'm saying, "How would you make that green veg tasty?" Poor barbecue sauce on the top.

Ah, no, full fat mayo, full fat mayo or butter or olive oil or whatever. So that I say barbecue sauce because when I looked at the back of mine, I had the shock horror realising that this. It's a common one. Thirty sugar cubes in a bottle, a standard bottle of barbecue sauce. It's just pouring sugar around.

“Yeah, it is. It is. You have to be so vigilant to know. I think to do it successfully,”

I'm quite interested in the idea. Could you eat real food? That's not in a packet. It's Russian roulette food out of packets and yet I understand my patience, north of Liverpool. You know, where are they going to buy the stuff? So I try and help them with. You could do it that way. If you're not, if you're going to eat stuff out of packets, you have to wise up and you have to look at the carbohydrate content and bear in mind every four grams

is broadly equivalent to sugar. So if there's, if there's, if there's, if something's got to 100 grams of carbs in it, I've already said carbohydrate varies in how sugary it is, but it gives you an idea. It's very sugary. So you see the, the area made with the corn flakes. Is there's no sugar there, but it's all carbohydrate. And it's a very sugary carbohydrate. I think so. We need to just explain that for people, which is when I looked at those corn flakes,

the question I asked you is they're not frosted. So there's a sugar on them. Yes. But what the body is doing is it's converting the carbs into glucose. Right. I've got a good way. So we have to think of starchy carbs as actually glucose molecules holding hands. Okay. And then digestion comes along and breaks down. They're, they're not holding hands anymore,

Exactly. I don't know whether when you went to school was this thing where you chewed bread for ages, and then you could see if it became sweet or it turned into sugar. It's a schoolboy experiment that's done a lot to prove that the amylase, the enzyme in spit, turns starch into sugar. But that's the point. starch is soon to be sugar. Glucose holding hands. Yeah. And when it holds hands, it's not sweet, but then when you digest it. Exactly. It's no longer holding hands.

Perfect. And that was, he's broadly what, and you're not alone because didn't I make that error?

“Isn't that what the lady in 2012? That's what she was so furious that I was make. So here we are”

senior partner of a large practice had forgotten that starch was sugar. And we come for circle because I'm so many other people. They patient say to me, "Dr. Min, I know not have sugary things. I've given up sugar in my tea and coffee, and I don't understand why my blood sugar is so high." People say that very often and then of course we use the teaspoon of sugar equivalents or a continuous glucose monitor to really show them what's going on.

Something that a lot of people have is bread. Yes. And white bread. So I did some research and it said a single slice of white bread contains about 0.5 sugar cubes, but a full loaf can pack up to 12 cubes of sugar in it. That's true, but it doesn't include the fact that the wheat that makes the bread will turn into sugar as well. So on my tea spoon of sugary equivalent,

“even a small slice of brown bread is about 3 teaspoons of sugar. Is there a healthy bread?”

That's a really great, great question. And of course it depends how well your insulin is working. So if you're young and you take a lot of exercise and your insulin is really good, then maybe brown bread is okay. If you're like me though, with insulin resistance, it would have to be a low carb bread. So I wouldn't normally bread under any circumstances,

but I might have low carb bread. I didn't research that sprouted grain bread never had that before.

All 100% whole grain rye are the healthiest options because they contain zero added sugar and high fiber. So what I'd say to people, again, it depends. How much exercise do you take? How do you know? Have you had your fasting insulin measured? Do you know if you're insulin resistant or not? If your healthy take lots of exercise sounds good, fair enough. If you're beginning to develop a tummy, well maybe not so good. And if you don't know, I'm a great one for experimenting. And that's

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Am I wise to be looking at the back of packets? I look at the back of everything I eat. Yes. And I'm building a governmental model of the different levels of carbohydrates and sugar content

and fiber and so the things and proteins etc. But I always seem to zoom in on the sugar.

The added sugar. Right, there is an error there. Okay. So that's brilliant and the fact you're interested and trying is great because you learn so much more because of course the sugar is one thing but you must also look at the carbohydrate. Here a carbohydrate content now. This is done differently in the United States from here. Confusingly. Here we talk about carbohydrate separately from fiber so that in the UK when it says carbohydrate that turns into sugar. In the states

you've got the carbohydrate including fiber so it makes it more complicated for you because you need to know which how much of that carbohydrate you're going to absorb. Well let's go back to the three

“macronutrients so you should be interested in protein how much you want you want. You want to be a”

mostly kind of guy so you want your protein. The carbohydrate will why do you need that I'm wondering

and then fats when you might need those for fat soluble vitamins. So those are the three things so that you become more sophisticated and if things have a lot of preservatives if they have an awful lot of ingredients I'm immediately suspicious. I think one of the things that people that have come to learn through interviewing people like yourself is that it's not just the direct consequence of having a big glucose spike or you know having high blood sugar it's also the fact

that when I eat things like Mars bars or the white rice here I then get more hungry later exactly which means I eat even after that same day and then actually and of course that's what my patients

right back in 2013 it was the absence of hunger they found fascinating and I did because I'd been

hungry all my life because all my life I'd been carb heavy and I didn't realise that the more carbs you eat the hungry you become. I don't know have you ever tried fasting I bet you have. Oh my gosh yeah right I fast most days to be honest I haven't eaten today in one time we were one one PM and during the dragons then filming I don't eat often until the evening so great so isn't that interesting so I used to I used to have a model which was

that if I didn't eat I was hungry right so if I didn't eat for even twice as long I'd be twice as

“hungry and it would rise exponentially until I went mad yeah and what's surprising that you must have”

found is as you fast you don't become more hungry do you yeah it's crazy well it's not interesting that actually get the more I eat the hungry or I become same that one I'm on keto pattern when I'm on keto yeah I can't believe I can't it's like a hungry just vanishes and you do think that the remarkable thing I love what are those cinnamon roll things I'd love those cinnamon rolls usually I love them and when I started doing the ketogenic diet which is

very very very low carb I remember walking up to this cinnamon roll concession stand and keto I'm looking at them and they were doing nothing to my brain there was no temptation it's crazy I've had that so where's the crazy super power yeah honestly I've had that with Christmas cake it was my kryptonite it was the kind of thing I was sneaking down when they'd all gone to bed and I think more and then one day you can look at it and it and you think it's not

actually food you brain that isn't food yeah can I'm the same with buns as well and all sorts of things that a lifetime of and they're no longer food and it feels like a super power because I can I'm such a man if I throw this down as a challenge to men are you man enough to resist you know what whatever it is let's do a challenge come back in a week and tell me you've not had any biscuits it works it works what do you think of the ketogenic diet wow that's a that's a big

question isn't it I don't you think we need to begin with what you want so I think we need to

to sort out type to do by diabetes or I'm I mean Georgia E doctor Georgia E is a close friend and nutritional psychiatry is really growing and the this in Campbell in Edinburgh University is

doing some amazing work with bipolar disorder and other things so why you're doing it that's

so that's my first thing because this is I see it as there is a spectrum of carbohydrate that you're on so I try and find out where you now and I you know approximately where are you now and then I'd say well could you could you give up bread or reduce it and then I'd say let's let's measure whatever parameter we want which might be blood work or weight or whatever then we say how you're doing are you happy now is this is it or do you want would you like to go a bit lower and what I've

discovered with my patients over 13 years is they tend to go lower over time because when the

“experiment when they go keto what they like is the brain thing oh gosh yeah and that's what I'm”

that's right so I would say to you now because I'm interested yeah why would you go keto what you're after um so I'm gonna put the brain thing at the top of the list which is just the clarity of thought obviously in my job I have to sit here with very small people like you and I have to talk sometimes for three four hours whenever it might be but also I'm on television a lot now and I'm speaking you know cameras nine cameras rolling BBC one and I've got to think of something smart

to say to this one you've been asking in front of me and that's pitching to me and then also I'm in meetings you know I'll leave this conversation now I'll go straight downstairs and I have two hours of straight meetings about very very complicated things about buying companies

“I'll be meeting founders interviewing people and what I've noticed profoundly because so much”

my job centers on speaking and articulation is there is this wild, wild, wild variants that I hate and what I mean by that is some days I'm on it and some days I am almost embarrassed by my inability to string a sentence together today I'm almost testing myself now by trying to speak really really fast and think my brain is connected with my mouth that's like that's actually like what I do I try and see if I if it flows out today I'm okay but there are days where I'm

stumbling over myself and I get what's what's causing this what's the causal factor and how

do I prevent this that's one keto when I mean keto I always sound at bus to rhymes it always

just always it's always it's always working and then I'd say the aesthetic stuff because I want to look good as well especially for you know my fiancee so I want to be in shape I want to be that and then I'd say the third is being strong and then the fourth is I want to live long exactly I want to have a long health span which is a long life span but I want to be able to do things as I age so you see your that's exactly why I began this meeting with you've got

a clear idea about your preferred future and it's it's it's it's fairly specific to and the more specific you are the more likely you are to be successful and then you're noticing then afterwards comes the feedback do you think most people even have thought about this no I was just thinking about my listeners and I was thinking yeah they're listening right now I wonder if they have written down their top four yeah so I do you know what I'd love to do now is tell you something about my wife's

work because it relates to changing behaviour fast and that she wrote mine so that we're back to Jen now clever woman she spent two years thinking about CBT and what was what this is a type of therapy and what were the necessary parts of it and what was junk and she reduced CBT down to

something I'll teach you right now all right so well off we go off we go so the first thing is to think

about your health goals to to think about what in a year's time if what you do is great how does that look specifically so I'll give you an example you might think you'd like to lose weight but that isn't specific enough I want to know what difference would that make to you so you will do it now so if you said you wanted to be in shape yeah what I don't know what do you mean by that you want to lose

“weight what do you tell me more um I want to be able to hmm what I'm really I think”

scared of it's going to be completely honest there is I'm scared of having the same health profile as my dad right because I've seen we have the same you know we have a lot of the same

yeah and to make even more specific I remember walking down some stairs I've said this

“once before but I remember walking down some stairs in Bali long steep set of stairs down to”

go whitewater water rafting with my fiance and I remember as I walked down those stairs recalling that my dad loses can't walk up a single flight of stairs without problems and I remember thinking oh my dad wouldn't have been able to come whitewater rafting because we've got to walk back up these stairs and so my dad would have lost out on one of the great joys of life which is doing enjoyable things with friends and people you love because his health is now

in that regard is gone um so I've always thought of that and then generally like I

I remember when I was younger my dad used to play football with us and all these things and he's unable to do that now um and so I'm I know because I've done this podcast in his hands with health experts I've realized that the decisions I make at 30 which is where I am now exist on this really interesting quite predictable curve of inevitable decline however not like inevitable uh loss of lifestyle. What I mean by that is I just have this picture of my head of all

these graphs have seen where like your peak is around maybe 2030 and then you go in down which we all accept but how far you go down is determined by decisions you make right now the decisions I make now will end me at 70 80 years old and either the inability to walk or the ability to run yeah and it's all about what I do now is so that let's just refine that so we've we've I've got your goal yeah now so let's let's park your goal now the next thing we've got is in the past

what have you done that's worked towards those goals so you probably tell me some stuff you've

“done that's worked um things like going to the gym yeah yeah anything I think quickly that you”

did that work to Tim that was is is is is a first you know helped that you did new room of that

work so tell me one of my stuff one year that I was going to go to gym every single day terrible idea because I got five months in and then I missed a day then it was over I said to myself another year I think it's 2017 that I'm going to get a six pack for summer terrible idea because when summer came or I got the six pack my question was what did work in the past not what didn't work so what has worked for you in the past so those two incidents helped me change my idea and the idea that I

came up with was I said not a achievable thing as a goal but consistency as the goal consistency became for the last four years this idea that the goal my fitness goal is consistency

means that every day I wake up I get a shot of it and if I fuck up today then I've got another

shot of time right leave it there that's good so we did the goal and then we did the next thing what what I just the next thing is resources so it's it's what do you bring to the consultation that you've done in the past intelligence resources friends that will help you come already with the expertise in yourself so it's not I'm not the expert to tell you what to do you've already got some stuff now we go to the next thing so if we had your goal at the beginning which was the

fitness and the song so today what might be a small step towards your goal a realistic small step towards the goals we've already established so I can think of two good one of them is creating a social pact which again was one of the things that helps so we made a WhatsApp group this is quite funny we made a WhatsApp group we put 10 friends in it we made a simple rule whoever's the least consistent every month is evicted and we invite any friend in we've done that for four

years I've not been evicted in four years which means that I'm doing enough I'm consistent enough over this four years to not be evicted every day when we work out it puts our workouts into the group shots and every every week and every month there's a winner and there's this league table and you get these little emoji medals and there's actually I what one one year so I've got this physical massive gold belt on my bookshelf at home here's fitness blockchain while champion so I've

done that for four years so social pact really helped me the this sort of accountability to others

“yeah and the other the other honestly was just as I said a second ago when I”

set the goal of going to the gym every single day I set myself up for failure now I set myself the goal of consistency which means that I can do have bad days where I do 20 minutes or 15 minutes yesterday because I was finish drag and stand late drop down to London got home at 1 a.m. I did 18 minutes

brilliant we're nearly at the end of your degree in psychology okay and I'm gonna pull it together the final thing is when things if you what would you notice for you when things are going well what would you notice so you've done some of these things what is it you actually notice as in the benefit to me what do you notice so if you do if tomorrow is a really good day what might you notice at

the end of it because you've much experience in this now what would you notice I mean the first thing

that comes to mind is just hard feel yes I just feel do you mean emotionally or anything great all of it emotionally I feel good about myself yeah energetically I feel more energetic and there is

“this there is this element of identity and there where I have an opinion of myself and who I think”

I am and I think I'm a healthy person and I can come to someone that's in control and when I'm not going when I'm not performing the consistent behaviours that I want to I think I start to question that identity in a way that causes a lot of discomfort and say well you're not in control of your life like how that's crazy so I think it links into self esteem yeah it really so what we've just did we have the goals G yeah then we had your resources are yeah then we had increments what things

had you done little things on the way and then finally I invited you to notice and reflect

and that spells grin and that's Jen's published grin model I just did it for you right there and I could do it faster than that I do it in nearly every surgery I do because what I'm trying to do is find out about you and you didn't find out much about me in that process did you but I found out a lot of really useful stuff to you and it's motivational and much better to do that than me tell you what to do and I'm not a talking leaflet but motivation this is what Jen has taught

me is key in everything we do and the grin model isn't bad clever woman so what do we do with the grin model and so this is really helping me figure out how to change my behavior yes how does want to apply it or are you saying that everyone listening now should answer those four questions yes I do because otherwise it's possible to spend a lot of time blaming yourself you know and particularly around if we're discussing weight problems and so on you can spend a lot of time saying

I'm to blame or I wish or I shouldn't have that you know after Christmas everybody feels like this but what is much better rather than focusing you're wasting energy if you start thinking about guilt and negative stuff and what Jen's trying to do is getting you to engage by in in thinking about a better future and what the whole of that five minutes was engaging

you in in first of all the goal of a better future then some resources towards you better future

“then the first steps towards the better future and then noticing what's good because I think”

in medicine what we've done how do you get a doctor's attention you get a doctor's attention by saying oh it's so bad it's so so bad my pain is so so bad and I realized I had trained my patience to think that morning was how you know they got my attention and if you do that the result is a very miserable to our surgery but if you can talk even people having a terrible time have got hope if you can find it they have goals if you can discuss them and you can have somebody with a

drug addiction or you know I see people dying people also every clinic I'm seeing sad stuff but if you can also investigate hopes and good stuff as a doctor I'm so much more energetic so much more hopeful I'm having a great time and I wasn't when was 55 and that's the process I put there's so many people listening now that that maybe they you know because they listen to this show and they get this sort of basics they go you know what I understand this stuff and I'm

making good progress but I live with or love someone yes who I am I'm scared they're going down as slippery slope yes and I don't know what to do do I intervene do I hide their

“sweets do I blame what do I do so hard isn't it that's so hard I think you can”

why do you in that position to some degree yes yeah so my first wife had a very severe addiction

very very serious addiction for 12 years and what you're doing then is you're living with uncertainty

serious uncertainty you never you cannot say what you'll come home to you have no idea

no idea it brings chaos into your life it's very very hard addiction yes are you able to say what kind of addiction or a drug addiction or it was a it with nearly everybody can understand as died now sorry I don't know whether I can say or not but it was very serious multiple addictions I will say yeah and she actually died some years ago and it doesn't it it actually wasn't food addiction but it brings I've so much sympathy with dealing how hard it is

to deal with uncertainty and not be able to you love somebody and you can't do anything it's very hard

“there are things you can do I think if you can engage people in in that talking about goals that”

can help what we will do now is we'll change that conversation to the current Mrs Unwind which is what we

laughingly say this is Jen so we we've been together for 30 years now and Jen's story is that she actually is an ultra-processed food addict genuinely and what that means is I didn't understand neither of us understood what that was even though she's a consultant psychologist she didn't realize that she was an ultra-processed food addict what she saw a task was a weight problem and all her life she's she's been boomerang dieting so she'd be a big woman and then a little woman

and a big woman and I used to watch it all what's going on and then she would there be tray-bakes like she's tunnel is weight and making tray-bakes saying it's for the children and

“then scoffing a lot herself so then I because I love her and I think blocs we try and”

solve problems don't we we're like caveman yeah wanted to rescue her so I'm I'm either throwing the food away or I'm tackling her and then she we're having such arguments because she's defensive and cross I couldn't understand with an intelligent woman what's going on but then

this is only a few years ago she understood for the first time this is addiction when you have

intelligent people highly highly intelligent people doing stuff that harms their health repeatedly is this not like cigarettes is it not like alcohol that is ultra-process food addiction then there's a patient I'd like to tell you about that it is explains it even more clearly and this patient has consented for me to tell you because he wants to help the world so this is a guy who's a very successful guy he runs he's a wealthy person with a successful business he's not stupid

he has type two diabetes he's 55 he has type two diabetes he's very much overweight unfortunately he needs really serious surgery because both his knees have been so destroyed by his weight that he can hardly walk because he's in real agony but his type two diabetes is so bad his blood sugar control is so bad the anesthetists won't touch him so he's trapped he can't get the hop because his blood sugar is high he can't run his business easily because

“he can't hardly walk so obviously what we do is we say you need to go low carb and it works”

for a bit and he loses some weight but then he gains the weight again and this goes on for four years while I see him so regularly every month what's going on what's going on oh excuse is the grandchildren I've got a holiday Christmas it goes on anyway then his wife came to see me and she said Draman I need to level with you you need to understand what's going on I find that my husband is getting up at four in the morning and eating bread out of the fridge so what I do now what I

started doing was at the end of every day I put all the bread in the bin if it hasn't been eaten that day but then I discovered my husband was going in the bin to eat the bread then what she does she's a very formidable woman she started putting detergent liquid detergent

rummaging through the bin to eat the bread with a detergent on so then she tries something else

“and she says this is the only thing that will stop my husband from eating bread if it's there I spray”

bleach on the bread and leave the can of bleach by the bin so he knows don't even look okay what I've described to you is addiction this is an intelligent person and imagine his self-esteem how it was to live like that concealing what he was doing and not telling his doctor because I'm trying so hard for him for years and he's so sweet to me now and he often shakes my hand and gives me

hope he said you tried you really tried anyway my stories have a happy ending always what I did

for him in the end he needed everything so low carb then I got him using a continuous glucose monitor so that he would get feedback immediately and see that spike and also I could see the spikes as well because he had to come and show me his tracings and on top of that I did something unusual I gave him a low dose of the new GLP1 drugs as a pick one of those yeah and the three together he managed to not he couldn't moderate but he could abstain and then he could do it

the asempic helped reduce the noise the cravings in his head the feedback from the CGM helped him know how he was doing and the support he got from me and the low carb pull together and all three and he's had his operation now it's so it's a happy story but he's got maintenance all his life

“he's going to have to sort that out and it's a wonderful example because I think we trivialize”

this we call it carb creep like it doesn't matter but there are many people listening to us right now and they know they know they're addicted to various foods they know because when you ask them

they often burst into tears often I somebody will say I've never told anybody in my entire life

about and bread is a common one and if you're not addicted to bread you can't imagine it but if you are addicted to bread they say this sounds so stupid I'm so embarrassed to tell you I can't control how I eat bread and so it's not great for yourself as team is it but people might be addicted to many things and my wife's published many papers on this and written a book and this that and

“the other and she would say about 14% of the population has some aspects of ultra-processed food”

addiction and it kind of explained so much why are intelligent people eating foods they know do them I've got another example one of my patients with type 2 diabetes we got drug free remission hoor I've done that now 157 times so every one of them I'm cheering when it happens so this guy we did it drug free remission then he vanished for a while and came back with two dead toes and he had to have them amputated and what house yeah they started rotting because diabetes

takes the blood supply particularly from your toes so we had to have surgery to have part of his foot removed and so you call it carb creep and he ended up with half his foot taken off that's

not carb creep something far more sinister but I never give up and unfortunately the wounds took

a long time to heal because he was sugary so we do it all over again I got him back into remission because this time he and his wife are really determined but it's a struggle and he needs help and support to achieve that he's not a foolish man he's an intelligent man and yet various foods call to him eat me and it's very difficult for him to not and that I mean that's a very extreme example but many people with overweight and some who are not overweight are struggling

with very very significant carb cravings and they really really struggle to control them for those people and I assume there's a lot of people and actually some people have seasons where they're in control there are control very you know up in the what is step one today so they're listening

now now are we talking about for somebody with type 2 diabetes or somebody who can't control what they're eating someone that can't control what they're eating great right so step one we just did it

“I think step one is acknowledging that is your problem because if you don't if you're not honest”

about your problem how are you ever gonna sort it out honestly so the first thing is honesty and that's

very hard for people all of us have made excuses you know me and my biscuits I believed that it was easier for me to think that that was stress and a reasonable reaction to the stress of running a practice than it was to say I've got you know biscuits for me it took me a year to give them up a year how pathetic is that I was so driven that took me whole year how did you give them up I did it by winning myself off a bit like methadone so I went from I like chocolate

ginger biscuits and then I went to digestive plane and then I went to oat biscuits and then eventually I went to almonds why don't you just do all it once I should have done and Jen Jen's a great believer in cold turkey like what is the thing so I wasn't man enough for that and it took

me a whole year so the first the first thing is be honest truth be honest with yourself even if you

can't tell other people be honest with yourself is there an addictive potential there could that be does that fit number two specifically which foods is your problem and be honest because if you not honest then you number three is have a plan for abstinence because if if there isn't if you have got an addictive potential it won't be one biscuit and we all who you know how many of us

“have said I'm gonna give up ice cream or biscuits or pizza or whatever it is and then you have to”

be honest you did well I have a drink or whatever you think tomorrow works dress as you are yeah tomorrow tomorrow tomorrow tomorrow tomorrow so it's very important to be specific about the food and then to have a plan for how you are going to do it and then another thing is sometimes it's helpful you know the people around you that love you maybe share with them that it's it's that it's important and that I need I might need some help please be tolerant with me like cigarettes please be tolerant

if I'm short tempered I'm gonna try and do this thing because it's important the difficulty depends whether the person that loves you can be gentle or if they're heavy-handed if you confess this and then they police you judgmental yeah it doesn't help yeah what you're asking for is gentle support and tolerance I can think of a time of my life where I was with somebody yeah and I was they was so into the health yeah that it made me start to hide when I was eating bad I was exactly

“yeah thank you for that that's that's what happens and you see that people become”

deceitful yeah so the if you police somebody you love the result is deceit I was hiding the rappers if I think I was eating gendered that with me she would she knew that I was monitoring so she starts hiding the rappers or then I'd find them in the car and then but then we have a situation that we can no longer talk about it because so that if if somebody if you're forcing somebody to become deceitful you have to back off a little bit yeah because that

deceit of then affects self-esteem and that can make them worse and you didn't want to make them worse and then they're lonely because they can't share the bad days yeah it's really I wonder please could we show Jen's book at this point of course so can I just explain the book so this

this is Jen's book and the most important thing is Jen doesn't make a penny out of this book so

it's fork in the road with the idea they knew journey which one are you gonna pick do you see so it's fork in the road she doesn't make any money from this every penny goes to a charity that she's set up helping people with food addiction it's available on Amazon and self-published on Amazon how much does this book cost it's not a lie is it it's about 15 pounds or no it's less I think it might be 10 10 quid okay I'd say what I'll do yeah I'll buy a thousand of them fabulous and I'll

conversation and you'd like to get Jen's book fork in the road or fork in the road maybe we can

“even get some of them signed not all of them because we can't get a couple of them so that is brilliant”

click below and we'll send a thousand of them out and that's just a thank you from from me to both you and Jen but also to the community who tune in for these conversations and it's so great that people can get such simple information that's so accessible and so rigorous and it's scientific credentials in a way like this that they can that could change some people's lives great isn't that wonderful thing you know simple book like this which isn't long either so any of us don't

make read could change some people's lives that's such a wonderful thing it will do uh just making myself a delicious coffee from the freezer from the freezer you know how to about come to you oh my gosh this is gonna change in life I invested in this company called cometer last year and then I wanted the sponsors of this podcast because they've taken a

pretty revolutionary approach to making coffee every coffee is precision brood at 10 times the strength

and then they flash freeze it with liquid nitrogen to lock in the flavor and freshness and then it's delivered you on dry ice in these recyclable aluminium capsules still frozen like a

“ice cube all you have to do is pop the capsule out add some hot water and then you stir it and you”

are good to go you can also make delicious ice coffee drinks as well just pour it in stir it up and for anyone that hasn't tried it you can get 30 dollars off your first order of cometer coffee if you go to cometer dot com slash demon I've done almost 700 interviews with some of the most interesting people in the world and one of the things you learn which is unexpected is that vulnerability is the doorway to connection and after sitting here for two three hours with a guest I feel a deep

sense of connection to them and as they leave what I get them to do is to write a question in the diary of a CEO we've taken all of the questions from the diroversio we have put the question here on this card with the name of the person that wrote it so you consider home as I do with my fiance and my colleagues at work and other people in my life whenever we get a minute we play

the diroversio conversation cards and it is incredible what happens these are great if you're in a

romantic relationship and you want to connect your partner more these are also great if you're in a team and you want to bond your team together and I have to say they're also great for families that want to learn more about each other and that need a good excuse to spend some time in a digital world in the analog environment connecting human to human it is remarkable what the right question at the right time can do go to the diary dot com and you can get these conversation cards right now

you said something early run about the link between sort of your dietary choices and cancer I've actually got a friend of mine who used to work for me who is going through their cancer process at the moment she's very very young she's actually younger than I am and she was diagnosed with breast cancer she's a really good friend of mine and she was my actually my manager for a couple years she's called Katie she's very public about this so she's posting her journey

online so I can I can say her name and I've been following her and she's she's you know she's removing a lot of the foods we've talked about today from her diet so she's very friend of mine for me at the moment and I was looking at some of the stats around the link between our dietary choices and cancer outcomes and I'm going to read them now my team might cut some of them out but

“I think they're worth hearing because hearing them I think is quite enlightening a massive French”

study found that drinking just a hundred mil of sugary drinks per day which could be you know a

third of a kind of soda is associated with a almost 20% increased risk of overall cancer women who

consume two or more dietary drinks daily have over double the risk of early on set clerical cancer compared to those who drink less than one a week high consumption of sugary sweeten beverages is linked to a 78% high risk of estrogen dependent endometrial cancer in women drinking 20 ounces of sugar if sugary soda daily is linked to shortening your telemirs which are the protective caps on your DNA equating to 4.6 years of extra

biological aging which is a major risk of lack for cancer high sugar intake causes chronic hyper saluminia chronic hyper insulinemia so that is where I'm saying when the insulin levels are high high which I explained at the beginning which can inhibit apoptosis the natural process where damage to cancerous cells self-destruct it wow two more fructose is processed in the liver

show certain tumors directly consume to build their cell membranes and lastly diets high in

added sugars chronically elevate sea reactive proteins called CRPs and inflammation marker that is heavily correlated with tumour progression and metastasis yeah so what I'd like to this is that is so interesting and it brings to mind a really important point we talked so much around the world about treating cancer but what about prevention because for your friend that's a life sentence and she's living with uncertainty and fear and when I tell patients they have cancer

you know you feel it right here because you just took away so much and it's interesting do we

“try hard enough if we know that are we trying hard enough to prevent cancer because that's what we”

should be doing because we know a lot that I think after smoking diet is the next communist

cause of cancer and no how serious does it have to get when you you just gave all those references then and I know that junk food is linked to all cause mortality it's linked to so many things what what do we prepare to sacrifice for enjoying you know treats and snacks it's kind of when you look at it like that it's really bonkers really bonkers this sounds a bit crazy but sometimes I imagine receiving the diagnosis yeah and I do a bit of I guess they might call it pre-mortem

a pre-mortemote a post-mortem where I imagine on that day the decisions I wish I would have made

and I'm not saying all cancer is linked to what we because that's not the case but I'm imagining

like the worst diagnosis I could ever be given and the doctor telling me that my lifestyle choice is contributed to that over the last five, ten, fifteen years and in that moment is there any sugary drink that is worth it there's just not you just wish with every bone in your body where you come home and tell your fiance and your kids and you've got this horrific diagnosis you just wish that you made a different decision I also think that's a very good strategy for dealing

with problems you know your life must be so complicated it can't begin to imagine how many problems you're solving and the complications and the people you deal with and yet all of them are as nothing against the cancer diagnosis aren't they so that you would look at the problems you

“have right now and you laugh yesterday I was worried about the traffic or whatever and I think”

it's a leveler mortality is a leveler all my life I've been obsessed with death and it worries me I can't sort out in my head what does death mean or you know it really scared me when I was a child the idea of death but what it's given me is a drive to not waste time and to think about what's the best use of today and and you seem to have that kind of energy as well interesting thing about the side of wasting time as well is through everything you've talked about today

we can both waste less time but also have more time and when I learn about the difference between life span and health span that's also added to this equation you know people still live to 80 years old but really healthy for like 34 years and that's a very the idea of

“health span is very important because we know in the UK it's going down I was a yes it they're”

looking at that now life span is hanging out there as sort of stuttering along but health span is going down in the UK and it's worth thinking why that is well I would hazard a guess it's relates to all the things you've talked about in England you're totally right it says in England the situation is particularly alarming health span is actively declining even as overall lifespan slowly creeps up recent 2020 forward 2026 data from the office of national

statistics the RNS and the health foundation paints the stark picture of the UK's widening six years gap over the last decade healthy life expectancy in UK has fallen by roughly two years as of the latest data men in the UK can expect to spend about 60 years in good health and women about 60 years of good health as well because overall life expectancy in England is rising people are now spending roughly up to 23 years at the end of their lives with poor health

and in sickness this means the average person spends nearly a quarter of their life managing

and it relates to another thing I'd like to tell you about as well this is

government figures every taxpayer in England pays an extra £7,000 tax per year for the consequences of ultra processed food everybody's paying tax extra tax 7,000 pounds a year and this is because it's not just the cost of the drugs the bigger cost is the people not paying tax themselves and not able to work because they're ill and that is that's two thirds of the cost is the lack of revenue because so much of our population isn't well enough to work and that's very and lots of

“it's young people to its very serious I know I think about 30% of our listeners are in the United”

States so I've got some bad news for everybody in the United States as well the US is it there the US currently holds a rather grim record it has the largest health span to lifespan gap on earth despite the United States having lower overall life expectancy then almost all of its peer nations and premature death rate that is nearly twice the average of comparable countries its health spans that's it as the worst in the world so here in the United States as things

stand you will be sicker for longer we're trying to keep catch up though aren't we we're talking you know we're doing our best yeah we're doing our best to catch up I have this piece of string here yes and which is I guess a mechanism you use to figure out if the people's waste and I guess

“that levels are too high on the belly I think it's bigger than that because I'm interested in low”

cost ways for people to find out well how how are you doing how are you doing and so one recognised way looking at metabolic health is your waste should be less than half your height so if we have a piece of string which we have there believe your six foot one yes and you've you've marked halfway so half of that string should go around the fatest bit of your belly people come up to me all the time you know they get oh my god you're so it's taller than I thought yeah

because they've never seen me sat down yeah my entire career is there so that's right cut it in half

okay and then let's see will it go around your belly yes or no okay so cut the string in half yes which part of my belly because the fatest part yeah so be honest about the fat part okay can I look

“yeah you did it yeah is that I'm not not are you squeaky cheating let me see”

I mean it's it's not yeah you're just on it you pass yeah you pass you it's so interesting I'm so funny but that is a very interesting thing for you and as I say it's insulin resistance tends to put weight on your belly but you may have a very muscular abdomen let's pretend it's that you know but you're just a banger you're just a banger but it's a really simple test for everybody at home piece of string as long as you are tall cut it in half will it or will it not

go around your middle okay so everybody at home goodbye some string yeah I mean there's lots of other things you can do but that that's as a simple way because you wait alone as I said it it's where the fatest distributed it it's fat on your belly is more worrying than fat on your legs or on your arm

really so so one of the things people always ask me about supplementation um it's a good

bad and different yeah wish a point of view right so my point of view is if you can my gut reaction is to try and use diet to give you what you need if you can which diet although a real food low-ish carbohydrate diet is my preferred thing with plenty of protein in there and healthy fats I'm very interested in farming and regenerative agriculture and all that kind of thing and what I know is that the nutrient profile of crops grown today is not nearly as good as it was 100 years ago

so we have some problems and it it's to do with the soil if you keep just adding nitrogen and harvesting crops those crops do not contain as much zinc or magnesium particularly and so the tragedy is that although my aim would be to have you healthy with a real food diet there are some things you cannot get in the diet now that your grandparents could and one of them is magnesium it's very very difficult to get enough magnesium in your diet without supplementation and as you get all that

absorption particularly drugs for acidity so magnesium supplementation for most people

“okay in myself it was magic at getting rid of muscle cramps I sleep a lot better”

I think we also need to talk about magnesium which magnesium because it varies a hell of a lot and this bits embarrassing depends on your bowels right have you got fast or slow bowels you don't need to tell me if you if you tend to be a bit constipated magnesium citrate is very good it helps is more laxative and it your your absorbs some of it anyway if your bowels are not a problem and particularly if you're wanting better sleep or mood magnesium glycinate or three or

late is actually crosses the blood brain barrier but won't help with constipation so that's a very

quick thing on our magnesium have you have we got time for me to tell you about the first

cow I ever bought go ahead and it's relevant to magnesium right so my wife and I my wife Jen

“we have this idea that if you love somebody then gifts are you should try and think”

what would that person like don't buy somebody a present you would like yeah and it was Jen trying to get me to grow up yeah right and this is how she did it so she said to me one day right get a coat and a pair of wellington so I'm going to take you out and she drove me into Lancashire and there was a field of cows and she said I have bought you any one of those cows

because I'd always wanted a cow and we had a field and she didn't how what a woman is this

she knew I wanted she went to the farmer in advance and prepaid for any cow and said this field I bought a cow you just picked which one you like and he'll transport it home how does this relate to magnesium you're wondering well it does because the farmer said you can have whichever cow you like but I've lost 15 cows to a thing called the staggers this year and you cannot have the cow unless you promise me you'll buy magnesium supplements because the grass is now show short of

magnesium that cows die fitting if you don't give them a magnesium supplementation but it's better than that at the same time I had a patient that I couldn't work out why he was fitting I was really fond of this guy and I kept being called out and admitting him to intensive care fitting and we couldn't work out it wasn't a brain tumour why was he fitting and I expect you've joined the

dots it was magnesium deficiency because of medication he was on and that's the first time I have

a seriously thought about magnesium some most interesting subject very important and the modern diet is most people of magnesium deficient and a problem is you can't measure it so your blood magnesium serum magnesium doesn't reflect what's going on because magnesium is mainly inside

“your cells so in the you have to get the intracellular magnesium level but you know what it's just”

easier to try magnesium supplements see how you feel so do you take magnesium I do because the guests the experts for my podcast have told me that magnesium is one of my five for me I've said to myself I'll take five supplements a day five yeah I'll take five so vitamin D because I'm inside all the time vitamin D so yes definitely and I'm black so that you know well that combined but everybody and particularly in the most people just don't get enough sunshine it'd be better

if you could do it with some but yeah vitamin D's very very important I take magnesium yeah because people like you've told me how important it is that you make magnesium do take that's a great question I think it's it's it's it's it's it's it's it's right but I actually think it varies depending on what my team get me yes yeah um but that's good to know because I'll think about my bowels yeah yeah um there's this fiber supplement that I take because I did a couple of blood tests

and they said that fiber would help this particular fiber supplement would help reduce my LDL yep cholesterol yeah and multi vitamin it cover everything to cover everything that's probably I mean that sounds okay really yeah I mean one of the worries that are one of the clinical things I find is honestly if you ask people how many supplements they're taking it's a

quite easily particularly maybe vitamin D you can know various vitamins you handed this as well

“oh that's vitamin D yeah fine fine so I think that that's I would agree with you”

basically mine mine's also going um off my blood test results I've done two blood test results actually I've done two blood test results in the last month one with function health he was a partner of ours as well yeah and another one with um with meco health which is actually a company that I've just invested a couple of the inquit into which is this health testing company have you had about neica? neica health you all can $299 whatever you lay down you get all of your

your sort of blood tests done you get all of these incredible tests done on your body

they show like how you know how good your circulation is from your like neck to your toes you stand in front of this scanner it takes like two thousand three thousand footers of your body tracks all of your miles tracks your heart beat does all of these incredible things and then instead of waiting two weeks for the results you walk into a room and your entire body is on this screen yes and you can look at you know all these different parts of your body they do the blood tests

at the very start and then literally like it felt like 20 minutes later I'm in a room I've got my blood test results back I can see my entire body they're going through my LDL my this my that the other they're showing my heart beat they're showing every single mole on my body and it costs

£299 you get results then and I my alternative and this is me really plugging the alternative

“that I used to do every year was this honestly I'll be honest it was this £7,000 health screening”

where I'd take it would take me six seven hours and I'd get the results back in two weeks so what neica have tried to do it's actually a company started by the founder of Spotify Danielac and yes I did my blood test the day and both my function health test and my my neica health test said the same thing and then I took those results and I processed them using some AI tools and said like what am I deficient and one of the things that I was deficient

in was omega 3 that was the other one uh omega 3 uh vitamin D I had high LDL and so they said this fiber thing would be really good for you and yeah those are the main things otherwise I was great

but yeah high LDL I think well it just that makes me think of something when you're screening I think

the important point is that you don't just scare people that it has to be linked to what can you do about it so yes I've had a lot of experience of scared patients so GPs we we're we worry about screening because what happens is people do that and then people get scared and use up loads of appointments in the health service trying to sort out you know what what's good is if you do screening that relates to actionable points and then you help the people understand what they can

do and avoid leaving them as just worried exactly because that is for you you know if I can I might be able to tell you accurately you're going to die aged whatever of whatever but if you can't do anything about it you don't want to know yeah what you do want to know is what can I what can I take action on you can I you know it's about optimizing isn't it the things that I hate about the health checking process before Nico was like I hate how expensive it was and that's

quite it's quite a privileged thing to be able to get health a full body health scan especially like so but now you can do it for tonight and I but then it was I walked into a room straight away with a doctor yeah and the doctor sat me down beautiful screen of my body and was like yeah do this this this this is fine this is fine and she was so nice about it but yeah I say that because I'm so passionate about it because I realize there's a certain privilege that people that are able to access

“private health care have but I think is really really unfair well obviously I I think that's unfair”

because I only work in the health service yeah the state self I don't do anything other I won't take private patients or because I think it it would be wrong and because don't you think health inequality is getting really bad yes exactly really bad and it kind of troubles me and it also if you you start in the UK and you go northwards it just gets worse and worse and and the states is the same way it's not like the same nation oh my gosh you know believe you don't go to California

there's one kind of a thing and then you go elsewhere and it's not the same but hopefully this is changing this is I I think social media helps because it didn't cost much does it to go on social media and find out things exactly and people like you who've increasing increasingly loud voice across lots of podcasts and who are reaching millions and millions and millions of people I think what's difficult though is not to become confused you know because you have the newspaper saying eggs are good

eggs are bad and then you have this expert who's saying this and another expert saying the other

I'm very careful to take baseline data from my patients and then update it all the time so what I'm the publications I've done are based on real world the health service in the north of the UK I can't cherry pick my patients I'm allocated my patients by the state so it I can't just pick wealthy people or people that will live longer I'm allocated people and that's that so part of what I do is proof of concept because if you can achieve this in the north of England

near Liverpool and if other people can replicate it in Australia and New Zealand North America maybe it's true perhaps Dr David Unwin we have a closing tradition on this podcast with the last few weeks of question for the next not knowing who they're leaving it for and the question left for you is sure the guest will figure out who left this one and if humanity organised to make contact with a more intelligent species who should represent humanity and why

funny art that's a brilliant question who should the first person did this is a person

I'm going to nominate what's about David Attenborough you know the hundred years old and he spent so long thinking about the planet and wouldn't he be a wonderful ambassador and because I am passionate about biodiversity I'm passionate about sustainable agriculture and sustainable

“food I pick David Attenborough wonderful choice I think the aliens would really like him I think”

would they would that's my answer thank you so much for what you do you're really remarkable in a way that's quite rare listen I would know because I'll give you a feedback I look they'd know you're really remarkable you're really remarkable in a way that's very rare and I don't say this to all of my guests but you are for a variety of reasons I'm going to give you all of the feedback thank you the first the most notable is you're a very kind human and the way that you

speak is very nice to listen to again rare the other thing that I noticed is you're very very natural in good at telling stories and listen why does this matter because the human brain from what I've discovered from doing this podcast is really orientated towards stories now you

“could sit here and say but not in a bad or you can say magnesium good but I'll never forget the”

cow story yeah you know I'll never forget the cow story I could have I could have forgotten that

magnesium bad but the way that you tell these stories is so captivating that it enables me to learn in a way that is engaging and that is rare very very rare and the other is just you're your depth of experience your humility your willingness to admit when you are wrong which means that I trust you so much with what you're telling me because you're saying to me I'm an imperfect human too I've made mistakes both in myself with my patience and this is what I've learned from

it and the other thing is just your ability to simplify it's remarkable listen I sit here all day with super geniuses from this university of Harvard and Stanford and whatever else and I'm

struggling to understand how they're talking about because they don't take a second to build the

bridge between the science and the average person and you do that so naturally so I have no I've noticed the problems from you that means a great deal no it really thank you it's just what 40 years in general practice does to you because if you wish to be effective and if you notice as in the green model I'm I'm watching your face I'm watching an audience and I'm reading how I'm

“doing or you're getting bored or I need to move on and that's why I do with patience I watch”

very carefully to remember coming from you because you really do know because you've had all sorts that means such a lot it's a really rescue and actually because it's so rare I would just implore you to do more and I know you're already doing so much but it's like it's so rare that you can have such a massive impact yeah you know so I really really wish we need to talk about how how how we so I'm trying to get bigger on Twitter so this will help me immensely

well how can the audience help how can the audience help you with your mission well at low carb GP on Twitter please follow me on x at low carb GP yeah the other thing that would help very much is to support the British charity die set up the public health collaboration it's a 10 year anniversary we set up these work clinicians who got together 16 clinicians said

called the public health collaboration so please please support our charity go online find out about

it come to our conferences I'd also say notice each of us is on a journey

“be clear about your goals notice what works for you because that's what you're doing”

and each of us see yourself as an experiment don't be frightened of experimenting but if you're going to experiment notice measure something measure something and then you'll see how you're doing and I one thing I think that gives me hope is continuous glucose monitors because you're getting you know individualizing right there how is my blood sugar I can check mine in a minute see how I'm doing I think continuous glucose monitors which by the way I already

twenty thirty dollars yeah I would think you know what if you loved your dad or you had somebody

“in its Christmas and you could buy useless ornament or something and they don't need it anyway”

but would they be interested to find out about their blood sugar yeah you could maybe consider

you'd ask them first but if they've they've got a mobile phone they could try a continuous glucose

monitor and find out have you have you tried I have I have what did you learn I mean so much I did you well did you well did you learn I learnt that all these things I thought were had no sugar in them have loads of sugar in them exactly I had no idea about catch up I thought was it and the point is once you've seen it on your phone you can't see it no and I see them as the

“the cavalry coming over the hill because we can't be fooled much longer do you know I'm just”

going to look at seeing what my blood sugar is right now I did so can I just show you oh well

so what that is that somebody with type two diabetes but look my blood sugar is absolutely level wow and that's good because you want it but look how how level it is and that is because I don't eat stuff that puts on my blood sugar if I was to have some of those you'd get to you get to spy but that's feed by it also means if I get very stressed it puts on my blood sugar and you've been so kind I haven't been stressed so other podcasters are not as gentle and kind as

you and I get a horrible spy so I was going to open here's some feedback for you Steven so you and I have been together for a few hours and my blood sugar I felt safe so you've done your job too and there's some feedback for you most biking I'll tell you a final story a final story so type two diabetes is is brand new as a problem for pediatricians what is a pediatrician so a pediatrician is a doctor who specializes in the diseases of children people under 16 years old

and the the international problem is that children everywhere are now suffering from type two diabetes okay but the pediatricians have had no training because it's a new disease so a large group of pediatricians sent for me and said please do a keynote on teachers what to do because they although they're specialists they haven't experienced in type two diabetes this is a new disease of children what we're doing what we're doing

leave it at that we didn't show the phyagraph but I'll eat some of that later Dr David Alwyn thank you with them fabulous I enjoyed that