Gut Check: How the Missing Ingredient in America’s Diet Is Impacting Brain Health

Summary

Podcast Summary: The Dan Buettner Podcast

Episode: Gut Check: How the Missing Ingredient in America’s Diet Is Impacting Brain Health

Date: August 6, 2026
Host: Dan Buettner
Guest: Dr. Robert Lustig

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Episode Overview

In this compelling episode, Dan Buettner is joined by Dr. Robert Lustig—a renowned physician, scientist, and co-founder of Eat Real—to explore how a critical yet absent dietary component, fiber, is affecting not just metabolic health, but also brain function and the risk of diseases like Alzheimer’s. The conversation unpacks why ultra-processed foods are harming us, the science linking fiber to longevity and cognitive function, the challenges of overhauling America’s food system, and real-world solutions that can be implemented on both personal and societal levels.

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Key Discussion Points & Insights

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1. Ultra-Processed Food: The Root Problem

[00:30–04:05]

• Ultra-processed food is "baked into the cake" of the American diet and is not going away anytime soon.
• The largest "fast food chain" in the U.S. isn’t a restaurant—it’s the public school system, serving more meals than any major fast food brand.
• Processed foods are stripped of essential nutrients like fiber, increasing the risk of obesity and chronic disease.

Notable Quotes:

• “The number one fast food chain in America is our nation's public schools.” (Lustig, 00:49)
• “They line our arteries, they line our livers. They never go away. Never, never.” (Lustig, 00:51)

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2. Personal Food Rules & Moderation

[01:23–02:15]

• Dr. Lustig would never bring into his home: anything with trans fats (e.g., most candy bars, Twizzlers), factory yogurt, and sugary beverages like Coke.
• He does eat ice cream occasionally, framing it as a “celebratory food” in line with Blue Zones traditions.
• He likens food dose to smoking, emphasizing moderation:
  • “It’s a dose issue, and it’s a chronicity issue, but there’s a certain dose below which you can manage your exposure.” (Lustig, 02:35)

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3. Why Ultra-Processed Food Isn’t Disappearing

[03:13–03:42]

• There isn’t enough land or ocean to feed a future world population of 10 billion people exclusively with whole foods.
• Ultra-processed foods fill the caloric gap—but must be made healthier.

Notable Quote:

• “Ultra processed food is now baked into the cake.” (Lustig, 03:27)

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4. Eat Real: Reinventing School Food

[04:05–11:49]

• Eat Real is a nonprofit co-founded by Lustig and his colleague, aiming to educate the public and revamp what kids eat in schools.
• The team helped transform lunch programs in public schools, specifically the Mount Diablo Unified School District, by introducing scratch-cooked, real meals produced in a centralized local kitchen.
• Results: Cost savings for schools, expansion to 21 states, and improved student nutrition.

Notable Quotes:

• “If you fix the nation's public schools, you're doing a big service, plus you're teaching the kids at the same time, first of all, to like real food. And second of all, what real food is.” (Lustig, 05:48)
• “School lunch programs are profit centers in many schools.” (Buettner, 10:33)

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5. The Importance of Fiber

[12:49–16:56]

• 90–95% of Americans don’t get enough fiber.
• Fiber is not nutrition for you, but for your microbiome.
• Not eating enough fiber compromises the “three barriers” protecting your gut:
  1. Mucin layer: Protective mucus
  2. Tight junctions: Prevent “leaky gut”
  3. Immunologic barrier: Defends against unwanted bacteria and viruses.
• Fiber gets broken down into short chain fatty acids like butyrate, which are anti-inflammatory and protective against diseases, including Alzheimer’s.

Notable Quotes:

• “If you don't feed your bacteria, your bacteria will feed on you.” (Lustig, 14:22)
• “Fiber is your all-purpose cleanser…because the GI tract is happy.” (Lustig, 15:18)
• “Most importantly, [fiber prevents] Alzheimer’s disease.” (Lustig, 16:56)

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6. How Diet Ties to Brain Health & Alzheimer’s

[20:31–29:11]

• Lack of fiber leads to overgrowth of unhealthy gut bacteria, production of harmful byproducts, and increased inflammation—risk factors for neurodegeneration and Alzheimer’s.
• Dr. Lustig details a physiological pathway:
  1. Too much sugar/too little fiber → mitochondrial dysfunction
  2. Mitochondrial dysfunction → less ATP, more protein misfolding → plaque formation
  3. Inflammation activates microglia, causing neuron loss (dementia)
• Some damage can be reversed by changing diet—particularly by increasing fiber and reducing sugar.

Notable Quotes:

• “That’s a long chain of events. But it begins with too much sugar, not enough fiber.” (Buettner, 29:04)
• “You can reverse most of it.” (Lustig, 29:28)

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7. Monch Munch: Making Processed Food Healthy

[29:33–36:45]

• Dr. Lustig co-founded Biolumin, developing Monch Munch—a microcellulose “sponge” powder combining soluble and insoluble fiber.
• When added to food, it traps sugars and delivers fiber to the gut without changing taste or texture.
• Clinical trials show improved glucose and insulin response, gut health, and reduction in hunger and metabolic issues.

Notable Quotes:

• “Protect the liver, feed the gut, support the brain.” (Lustig, 34:21)
• “[Monch Munch] is harm reduction for ultra processed food.” (Lustig, 37:30)
• “Every component...is food. So the FDA recognizes it as safe.” (Lustig, 34:45)

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8. Food Policy, Subsidies, and System Change

[44:25–51:03]

• Lustig’s policy solution: End subsidies for corn, wheat, soy, sugar—foods that are overproduced and drive processed food consumption.
• Example: In Kuwait, Lustig consulted with KDD to reformulate ultra-processed foods (like chocolate ice cream) to meet health criteria (less sugar, added omega-3s, improved taste), proving it’s possible to sell healthier ultra-processed foods at scale.
• The “Metabolic Matrix” for healthful food: protect the liver, feed the gut, support the brain. Even ultra-processed foods can check these boxes.

Notable Quotes:

• “Get rid of the food subsidies because they’re distorting the market.” (Lustig, 44:40)
• “Any food that does all three is healthy, whether it’s ultra-processed or not.” (Lustig, 48:58)

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9. Dairy, Dietary Patterns, and Takeaways

[51:10–58:24]

• Saturated fat in dairy is metabolically different and healthier than that from meat.
• Whole milk, half-and-half, and cream are “net positives” if not consumed in excess sugar.
• The most favorable diets (from research and Blue Zones):
  • Low sugar, high fiber
  • Pescatarianism/Mediterranean diet: most inclusive and health-promoting.
  • Vegan/Vegetarian: need careful supplementation for B12, iron, and omega-3 DHA/EPA.
• Policy and environment, not individual willpower, are crucial: “You have to change the environment.”

Notable Quotes:

• “Whole milk [is] a net positive, nutritionally speaking.” (Buettner/Lustig, 53:30)
• “All the diets that work have two things in common: low sugar, high fiber.” (Lustig, 54:32)
• “Pescatarianism is probably the single most inclusive diet.” (Lustig, 58:09)

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10. Policy Solutions & Public Health

[60:14–64:22]

• City-level actions like soda taxes have measurable public health impacts, e.g., 77% reduction in gestational diabetes in San Francisco after its soda tax.

• Model of “differential subsidization” from Scandinavia: tax unhealthy substances, subsidize healthier ones (e.g., soda and water), shifting consumption patterns without consumer resentment.

• The “iron law of public health:”

  • “Reducing the availability of a substance reduces its consumption, which reduces health harms.” (Lustig, 61:17 & 63:29)

• The way forward is bold, system-wide change, driven by science and public will.

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Memorable Quotes & Moments

• “If you don’t feed your bacteria, your bacteria will feed on you.” (Lustig, 14:22)
• “Fiber does six things that are good for you in your intestine.” (Lustig, 21:21)
• “Protect the liver, feed the gut, support the brain.” (Lustig, 34:21)
• “All the diets that work have two things in common: low sugar, high fiber.” (Lustig, 54:32)
• “You have to change the environment. It’s not about behavior—it's about the environment.” (Lustig, 58:45)

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Timestamps for Important Segments

• 00:30–04:05: The problem with ultra-processed foods in schools and society
• 04:05–11:49: Eat Real’s school food revamp story and its impacts
• 12:49–16:56: Why fiber matters for our body, gut, and diseases like Alzheimer’s
• 20:31–29:11: Sugar, fiber, mitochondrial health, and risk of brain diseases
• 29:33–36:45: Monch Munch: the science and real-world solution to fiberless processed foods
• 44:25–51:03: Systemic policy proposals and real examples of industry transformation
• 51:10–58:24: Dairy’s surprising health story and how to eat for longevity
• 60:14–64:22: Policy, taxes, and the environmental levers for nationwide health

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Takeaways

• Fiber is not just nutritional—it is essential for gut health, metabolic balance, and even long-term brain protection.
• The absence of fiber in ultra-processed food is a central cause of metabolic disease and neurodegeneration.
• System-wide change (schools, subsidies, reformulation of foods) is not only possible but essential to true public health progress.
• “Protect the liver, feed the gut, support the brain”—this framework applies to both personal dietary habit and food industry reform.
• Policy levers like taxation and differential subsidization work and should be used to engineer healthier environments.
• For individuals: Reduce sugar, increase fiber, and prioritize real or smartly engineered foods—but also push for systemic food and environmental change for lasting impact.

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This summary reflects the wide-ranging and evidence-driven discussion between Dan Buettner and Dr. Robert Lustig. Listeners are invited to consider both their own choices and broader societal changes to move toward better health and longevity.

Transcript

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Visit wise.com, ts and Cs apply. The fact of the matter is, ultra processed food is now baked into the cake.

[C]

Are you telling me you can't grow enough beans and grains to feed the human population?

[A]

That's what I'm telling you. The number one fast food chain in America is our nation's public schools.

[C]

Another headline.

[A]

They line our arteries, they line our livers. They never go away. Never, never.

[C]

If you're a little bit overweight and you're blaming yourself, don't. Robert Lustig, one of the foremost scientists at explaining what ultra processed foods does to our bodies, is going to explain how a system is rigged against us and why if you're unhealthy and overweight, it isn't your fault. What are four foods that you would never bring into your home? You personally knowing what you know?

[A]

Well, anything with a trans fat for sure.

[C]

Name some.

[A]

Well, like candy bars. Candy bars. Well, you know, I mean, unless they're like straight chocolate.

[C]

Okay.

[A]

You know Twizzlers.

[C]

Damn, I love those.

[A]

Yogurt, you know, like factory store yogurt. You know what you do is you buy the plain yogurt and then you use your own fruit to mix in with it.

[C]

Yeah. How about coke?

[A]

Oh, yeah. I mean that's a, that, that's like a given.

[C]

You wouldn't bring that.

[A]

I would never bring a sugared beverage into my.

[C]

How about ice cream?

[A]

I bring ice cream in.

[C]

Interesting. Even though it's got sugar.

[A]

Oh, I love ice cream. But for dessert. For dessert. Do you know how often I have ice cream? No, not once a week.

[C]

So it's a treat.

[A]

It's a treat.

[C]

That was very blue zones, by the way. They enjoyed celebratory foods for celebrations.

[A]

Absolutely. I, you know, I'm for that. I mean, an easy, an easy analogy is cigarettes. If you smoke one cigarette every day for 10 years, anything bad going to happen?

[C]

I don't know the answer to that.

[A]

Probably not. If you smoke a pack of cigarettes a day every day for 10 years now, you're gonna die sooner. It's a dose issue, and it's a chronicity issue, but so there's a certain dose below which you can manage your exposure. And ultra processed food is the same thing. Ultimately, what we have to do, Dan, is we have to make ultra processed food healthy. That's what we have to do. And the reason is because ultra processed food's not going away.

[C]

The other thing you do is to make whole food taste delicious.

[A]

Well, that's good. But there isn't enough land or Ocean to feed 10 billion people by the year 2050 for the whole world to be able to pig out on whole food. The fact of the matter is ultra processed food is now baked into the cake.

[C]

Are you telling me you can't grow enough beans and grains to feed the human population?

[A]

No, that's what I'm telling you. You cannot. We can right now. In 30 years, we won't be able to.

[C]

So where do we get the calories if they're.

[A]

Well, you know, it's funny, several people have come to me and said, you know, I don't know what you're so worried about. This obesity thing, it's going to take care of itself. It's going to be famine. I said, really? That's how you want to think about this? I'm a physician. I can't do that.

[C]

So you, you've come up with two really groundbreaking ideas. The first one I want to talk about because we've had her on. We've had the executive director, the fabulous Nora Latore, on with the Eat Real. And. And here we discover that you were the founder.

[A]

I am the co. Founder, yeah, co founder of that.

[C]

So tell us a little. But we have a whole podcast on that. But just give us 60 seconds on eat Real and why it's important.

[A]

So I am the co founder of Eat. My colleague Jordan Schlane, who is a concierge physician in San Francisco. We are joined at the hip. We are very good friends. And we basically commiserated back in 2012 that things were not going to get better until we made them better. And we knew what the problem was. We knew that the problem was ultra processed food. And so we started a nonprofit specifically to, number one, train the public, educate the public, but also to have agency for being able to, number one, stay away from the minefield of the grocery store to buy the right things that are healthy for them and also do the same thing for their kids. Well, that meant actually fixing the schools.

[C]

So this is the number one food service organization in the country.

[A]

Absolutely. Bigger than McDonald's, bigger than the number one fast food chain in America is our nation's public schools.

[C]

Another headline there, right?

[A]

I mean, bigger than McDonald's and Subway and Wendy's and Burger King all put together.

[C]

Wow.

[A]

So if you fix the nation's public schools, you're doing a big service, plus you're teaching the kids at the same time, first of all, to like real food. And second of all, what real food is. And number three, then they go home and they actually go shopping with their parents. And. And they get the parents to do the right thing at the grocery store. They become the positive disruptive force in

[C]

the household right now. School food in average elementary, if. If 10 were the best imaginable food and one is the. The most toxic food, what would you give school food on average right now

[A]

in all of America?

[C]

Yeah.

[A]

Aside from Eat Real schools.

[C]

Aside from Eat Real 2.

[A]

2, 2.

[C]

So really almost the worst of the worst of fast food.

[A]

Almost. It could be worse, but not much.

[C]

And how does Eat Real come in and upgrade it? I know.

[A]

So let's do our origin story. So 2019, we hired Nora and we needed to basically develop the business model that Eat Real runs on. My colleague and cookbook co author Cindy Gershon worked in the Mount Diablo Unified School District in Contra Costa county, right across from San Francisco. We wrote a cookbook back in 2014 called the Fat Chance Cookbook. She had a very enterprising and smart and go getting food services director working in that school district. And his name was Dominic Mackey. And Dominic wanted to fix the problem. He understood the problem. He wanted to fix the problem. And what he did was he said, we need to stop buying processed food from Guggenheim and Cisco and McDonald's and Pizza Hut, and we need to basically bring real food into 27 schools in the Mount Diablo Unified School District. Well, how are you going to do that? None of those schools have food preparation facilities. They used to. They did when they were built, but they've all been repurposed into classrooms in part because the food industry basically made them do it by underselling initially to get all these schools to switch to processed food back in the 70s, where

[C]

you just have to basically heat it up.

[A]

Right?

[C]

Heat not to cook anymore.

[A]

That's right. And that was their goal. Because once you've lost your food preparation facility, you're hostage to the food industry for the rest of your life. You have branded, you have made them a permanent consumer. That was. That was their goal. So none of these schools had a food preparation facility. So, like, how are you going to get real food into them. Right. So Dominic being the enterprise and guy he was, he purchased a dilapidated factory in the center of the district. He repurposed it. He staffed it with food preparation facility workers, you know, which back in the old day, we would call the lunch ladies. Yeah, yeah. Now they're not the lunch ladies, but they're the food preparation facility people. And they turned out 27,000 meals per day.

[C]

Amazing.

[A]

All real food, all cooked from scratch, all procured locally or all, you know, where. We knew what was in the food because, you know, we, we sourced it.

[C]

For those of us who haven't seen a school lunch in 20 or 30 years, what does the average school lunch look like? And what does one of your the Eat Real school lunches look like?

[A]

Well, if you look at an average school lunch, it's probably a slice of pizza and a glass of soda. That's the standard soda lunch they serve soda pop in. Oh, sure.

[C]

It's an outrage. And an Eat Real meal.

[A]

A real meal will actually look like, you know, what you cook at home for, you know, might be a stir fry tofu, it might be a broiled chicken, might have home cut potatoes for fries instead. And of course it will absolutely have a fresh vegetable.

[C]

And how does a school afford that?

[A]

Believe it or not, when you buy in volume and you prepare locally, it actually costs less.

[C]

Go figure.

[A]

One of the reasons we were able to do this is because the business model showed that we could actually reduce the costs of the schools. They get to save the money. And that is one of the reasons why you Real is expanding state by state. We are now in 21 states and we're going national.

[C]

And as I understand it, you help the food service director in these schools understand what they're feeding students, help them understand how to change the menu, source the food, and figure out the economic model. Because it turns out school lunch programs are profit centers in many schools.

[A]

They used to be law centers. Now they can be profit centers if you know what you're doing. So we have to train the people who work there to be able to do that. So it's a three year commitment. So we don't just choose anybody. I mean, they have to really want to do this. They have to want to be Eat Real certified, they have to want to undergo the training program. But what we do is we work with them. We understand their vagaries, we understand their specific issues and vicissitudes. And can they source real food? Can they, you know, find a place for production? Can they manage, you know, oh, it's a very heavy lift, no question.

[C]

But you can walk them through it.

[A]

We walk them through it and we hold their hands for three years in order to be able to basically do a, see one, do one, teach one.

[C]

So the food industry is a trillion dollar plus industry. And here, Robert Lostego, academic and. And Nora Latorre, There you guys are. You must be a threat. Do you have a target on your back? There are people, are big food coming after you.

[A]

I used to have a target. Okay. There are enough people now in this space that if somehow something bad happened to me, nothing would change. So I, I don't feel like I have a target anymore. I once did, and I will tell you, the food industry did its absolute level best to discredit me. You know, I first started talking about this in 2007. It is now 20, 26, 19 years I've been talking about it, and I'm

[C]

still standing, thriving in many big ways. One of the nutrients we didn't talk about much, and I think it's the. I'm calling it a nutrient, but. Or the component of the diet that is probably most missed in America is fiber.

[A]

Yes.

[C]

I've read statistics that something like 90 to 95% of Americans don't get enough fiber.

[A]

Absolutely.

[C]

Why is fiber important and what is it?

[A]

Right? So first of all, if you ask any dietitian, they'll tell you fiber's important, but they won't be able to tell you why. After all, fiber's what ends up in the toilet, right? You don't absorb it. That's right, you don't. The fiber is not for you. It is for your microbiome. It is the food for your bacteria. Now, fiber is a string of carbohydrate, but the way the bonds between the carbohydrate molecules is set up, we don't have the enzymes in our intestine to chew those up and break those down and then use the carbohydrate for energy. But the bacteria do. So when you eat food with fiber, you're actually servicing your microbiome. Your microbiome gets healthier, your microbiome becomes more diverse, which is always good. You don't want one species of bacteria to predominate over every other.

[C]

And there's something like 30 trillion bacteria. And about all the good ones, about all they consume is fiber, Right?

[A]

Fiber is their food.

[C]

And why do we want to feed a bunch of bacteria in our gut?

[A]

Well, it's very simple. If you don't feed your bacteria, your bacteria will Feed on you. They want to survive.

[C]

But they give us something in return, don't they?

[A]

Oh, they absolutely do, but they want to survive. And if you don't feed them, if you don't give them what they want to eat, then they're going to go find it because they don't want to die. So what they do is they eat, they usurp the mucin layer off the surface of your intestinal epithelial cells that's protective.

[C]

So kind of mucin from all the

[A]

junk in your intestine so that it doesn't actually, you know, poison your intestine and cause inflammatory bowel disease or irritable bowel syndrome or leaky gut. So keeping that mucin layer intact is job one. You absolutely need that. You have three barriers in your intestine that keep you from the, you know what in your intestine.

[C]

Basically poop.

[A]

Poop. Right. There are three barriers. First barrier is the mucin layer. Okay? You've gotta keep that mucin layer intact.

[C]

It's like mucus.

[A]

It's mucus, yeah. Okay. But the bacteria can use it for food if they don't get what they need. Number two, there as a biochemical barrier, there are proteins called tight junctions that hold the cells together so that they don't separate so that things can't get in between. That's called leaky gut. Okay. And the fiber helps there as well from, keep that from happening. And then the third thing is the immunologic barrier, the TH17 cells and the IL17. These are things that basically keep the fungi and the viruses and the bacteria that are in there from being able to cross over. Okay. And the fiber helps with that as well. So basically fiber is your all purpose cleanser of your gi, not of your GI tract, but of your body, because the GI tract is happy. Okay. So when you consume fiber, the bacteria chew that fiber up into something called short chain fatty acids. The main one is butyrate, and it turns out butyrate is anti inflammatory. And that's what you need in order to, number one, not have irritable bowel syndrome, not not have inflammatory bowel disease, and most importantly, not have Alzheimer's disease.

[C]

Whoa, now that's a big leap.

[A]

Yep.

[C]

We just went from the bowel to the brain.

[A]

Well, turns out your GI tract is connected to your brain through this vagus nerve.

[C]

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you know, we joke in Minnesota that we only have two seasons, good sledding weather and bad sledding weather. And right now it's summer, which means bad sledding weather, which means it's officially time to head up to the cabin. I personally am looking forward to packing up and heading out to some quality time by the water. In fact, a few years ago, and thanks to Airbnb, I found a place where my entire family could stay for a weekend on the water. We had a fantastic time. We would not have found it if we didn't have a place like Airbnb to find just the right place for our family. But heading out to the cabin means leaving my home in the city completely empty. And honestly, letting an empty house just sit there just doesn't feel very practical. That's why I list my space on Airbnb while I'm out of town, and because it makes sense, it's a very practical way to earn a little extra money. It Fits seamlessly into my schedule because I only do it when I'm already traveling. It's not a full time job. Just a smart choice. If you have an upcoming trip on the books, consider listing your space on Airbnb. Your home might be worth more than you think. Find out how [e-mail] host so how is not eating enough fiber gonna favor the chances of Alzheimer's?

[A]

When you don't eat fiber, the bacteria in your intestine are going to basically over grow. The fragile bacteria are going to be crowded out by the problem bacteria and they tend to make things that are not good for you. And those things get absorbed and are toxic. They go to the liver and that's the unhealthy bacteria. Well, like the, the branch chain amino acids like leucine, isoleucine, valine. The things that are in protein powder that are good if you're building muscle, but not good if you're not. Okay. So like bodybuilders, you know, they take scoops of protein powder and put em in their smoothies. Okay. And if you're building muscle, that's where they go. But otherwise they go to the liver and they get turned into fat.

[C]

Oh, wow.

[A]

So if you and I were consuming protein powder, we'd have fatty liver from that. In addition, all that oxidative stress fiber keeps that at a bare minimum because it basically carries stuff out. So fiber does six things that are good for you in your intestine. Six. Okay. The first thing it does gives you a feeling of fullness. Okay. Number two, it acts like a gel. Okay. And you need both soluble and insoluble fiber. So the insoluble fiber is the cellulose, the stringy stuff in celery, the soluble fiber is like the kelp that blocks the holes in the fishnet. Sorry.

[C]

Yeah, it's in bananas.

[A]

Yeah, it's in bananas. It's in most fruit, actually, the sodium fiber. And what will happen is that the fishnet will form and the kelp will plug the holes in the fishnet and you develop a barrier. That barrier prevents glucose, fructose, sucrose, simple starches from getting into the bloodstream early. Remember we talked about how the duodenum will absorb and transmit stuff straight to your liver? Okay, well if you have fiber, then that doesn't happen. That keeps your glucose down. Oh, keep your insulin down. That promotes metabolic health. And the fructose doesn't get to the liver to get turned into fat. So that's all good. And because you didn't Absorb it early. Then the food goes through the intestine further where the microbiome will chew it up. So you end up feeding your gut, which is good. So you increase the microbial diversity, you increase the short chain fatty acids, which are then anti inflammatory. Also you move the food through the intestine faster, so you get the satiety signal sooner, so you might not eat that second portion. And the cellulose, the insoluble fiber, will act like little scrubbies on the inside of the intestine to get rid of the colon cancer cells. So the fiber in food does six things that are metabolically healthy. Now, fast food, processed food. Ultra processed food is fiberless food.

[C]

No fiber in french fries.

[A]

Not just french fries. There's no fiber in virtual anything that's ultra processed. And the reason is because you can't freeze fiber. I'll prove it to you. Take a orange, put it in your freezer overnight, take it out the next morning, put it on your kitchen countertop, let it thaw, try to eat it, see what you get, you get mush. You had an orange, now you get mush.

[C]

But you can freeze a high fiber bread, right?

[A]

Yeah. Because there's no water.

[C]

Okay.

[A]

Water's gone. Okay. But in the orange, the ice crystals will macerate the cell walls, let all the water rush in. That's why it turns into mush. Hey, the food industry knows that. So what do they do? They squeeze it and freeze it. Now it's frozen, concentrated orange juice. They have taken a food, an orange, and they have turned it into a commodity, frozen, concentrated orange juice which they can sell on the commodities exchange because it doesn't go bad. Because that's the definition of a commodity storable food. Food that doesn't go bad. The point was that the juice was actually the bad part of the fruit. The fiber was the good part of the fruit.

[C]

And.

[A]

And they threw the fiber away. That's why ultra processed food is such a problem. So ultra fiber makes it hard to cook. Ultra processed food, so they keep the fiber out. And the fiber, the fiber's essential.

[C]

It's way more important than we think, isn't it?

[A]

Absolutely. So the question is, if ultra processed food is fiberless food, and if ultra processed food's not going away, how can we make ultra processed food healthy?

[C]

Before we get to that, and I want to get the very next point we had in on the podcast a little while ago, Dean and Aisha Sherzai, who were talking about neurons and the connections that neurons have. You were saying early before we came in that there's some connection between sugar, fiber and Alzheimer's.

[A]

Yeah.

[C]

How does that work?

[A]

So this is complicated.

[C]

Make it simple.

[A]

It's about energy. It's about ATP. The cells for ourselves, fuels for ourselves. Our mitochondria make ATP. But our mitochondria are not working well. We know that. We know our mitochondria are not working well. How do we know that? Because our body temperature's gone down over the last 150 years. You know, you learned in school that our body basal body temperature is 98.6 degrees Fahrenheit. Yeah. No, no, it isn't really. Used to be. Not anymore. Now it's 97.0.

[C]

Wow. That's a big drop.

[A]

A big drop. And it doesn't matter if you're black or white, old or young, male or female.

[C]

97.

[A]

97. Well, that body heat comes from the mitochondria. And the fact that they didn't capture all of the energy in ATP, that the rest gets released as body heat. So if you've got a lower body temperature, that means that your mitochondria are not working as well. That's the only way to interpret it.

[B]

Wow.

[A]

So we know that mitochondria are dysfunctional. Now, if they're dysfunctional, that means they're not making enough ATP.

[C]

And just to go back, that's because of too much sugar.

[A]

So fructose poisons mitochondria. It is the primary mitochondrial toxin. There are others, but the ultimate bottom line is you're not making enough ATP. You have a problem with ATP generation. That's step one. Step two, Stress. Cortisol. Cortisol increases the need for ATP. That's why when you're stressed, you feel exhausted because you've burned through all your ATP. What are we stressed about? Pick your poison.

[C]

Yeah. Traffic late.

[A]

Well, that's increasing ATP utilization. So now you have a problem of reduced ATP generation and increased ATP utilization. Now you've got ATP depletion. Now you don't have enough ATP. Step three. You know that proteins get made in your cells and they have to fold into individual shapes.

[C]

Like origami.

[A]

Like origami, yeah. That takes energy, that process of protein folding. And if you don't have the energy, it leads to something called the unfolded protein response. And then the proteins don't fold. Right. That's one of the reasons for diabetes, because the insulin molecule doesn't fold. Right. If you don't have enough ATP, then you get the unfolded protein response and you end up with Plaques, because that's what the plaques are, is misfolded amyloid. And then finally, last inflammation, the reactive oxygen species that the defective mitochondria make. At step one, start the inflammatory process, which turns the immune cells of the brain, called microglia, into little bulldozers and basically get rid of all of the defective neurons. And that basically causes your neuron loss. That's dementia.

[C]

That's a long chain of events. But it begins with too much sugar, not enough fiber.

[A]

And that's what the data shows.

[C]

Let's just say 20 years. You know, I'm now 40 years old by being eaten too much sugar, no fiber, too much McDonald's, too much candy. I'm 40. Can I reverse this damage?

[A]

You can, yes.

[C]

All of it?

[A]

No, most of it. Most of it.

[C]

Oh, that's good news.

[A]

There's probably a baseline that you can't undo, but you can reverse most of it.

[C]

So you have created a product from fiber, and you've also proven, and this is the bigger point, that you can make ultra processed food healthy. And that seems like a fake claim from a food company, but from you it's not.

[A]

So, you know, full disclosure, it's moochmooch, munch, munch, munch, munch. Not much, everybody.

[C]

No, no.

[A]

Munch, munch, munch, munch. With an O, M, O, N, C, H, M, O, N, C, H, Yes. Okay, so let me, let me explain how this all came to be. I know that fiber is important. I've known that for decades. The problem was I didn't know what to do about it because the food industry was not going to put fiber back in the food for all the reasons we just talked about. And I know that it is important. In 2009, I'm sitting in my office at UCSF, minding my own business, keeping my head down, and an Italian engineer walks into my office. No appointment, ask some questions. I'm a nice guy, so I didn't throw him out. I answer his questions, he goes away. Two years later, calls me up on the phone, says, I have some more questions. I'll take you to lunch. I go, who's paying? He says, I'm paying. I said, okay. So we go to lunch, he asks his questions, I answer his questions, he goes away. Two years after that, he calls me up again, wants to take me to lunch again. This time he's got a prototype. And we go to the sushi bar and he's got these little petri dishes and he puts these little sponges in the petri dish and he adds Some water. And they go. And I go, that's pretty cool. Okay. So I give him some more information. He goes away. Two years after that, he shows up in my office with a CEO, six patents and a job offer. Wow. And it just so happened at that time, I was planning on retiring from clinical practice. And so I said, well, this will be a good thing to fall into. And so I have been the co founder and chief medical officer of a company called Biolumin. And we make a product called Monch Munch. Now, what is it? How does it work? Yeah, why do we care? So monchmaunch is a microcellulose sponge. It's a sponge, okay? The same thing you use on your kitchen countertop. That's cellulose, too, okay? It's just engineered super fine. It is seven microns in diameter, little sponge ball of seven microns. Your red blood cell is six microns. Okay? So the size of a red blood cell. Your tongue can't discern it because it can only tell 12 microns. So you can put it in food and not know it's there. Okay? And it's dry when it starts. You put it in food and you can put like, a teaspoon in, like, a cake or any entree you want or in chocolate or in bean dip or anything that's not aqueous. Because if it's aqueous, it'll start swelling too, too soon. Okay? But you put it in anything else you swallow, it goes into your stomach, starts expanding in your stomach, expands 70 fold over its original size, like so. So you get a little feeling of fullness, but that's minimal. When it expands, the little nooks and the crannies in the sponge become available and impregnated. In the nooks and the crannies are a set of proprietary hydrogels. Soluble fiber. Remember we talked about soluble and insoluble fiber? Well, this has both soluble and insoluble fiber.

[C]

Okay?

[A]

It's mostly cellulose, but it has some of these soluble fibers that are very specifically chosen to be number one. They're all food. They're all components found in food. There's nothing funky about them. You eat them every day anyway, and they hold onto, they glom onto, they sequester, they absorb glucose, fructose, sucrose, simple starches, rendering them unavailable for absorption. The duodenum. So basically, they pass through your intestine, and because they're attached to the sponge, you don't absorb them. So your glucose response stays low, which Means your insulin response stays low, which means you've protected your liver. And you go further down the intestine and the microbiome can chew it up for its own purposes. So you're fed the gut and they've turned that fiber into short chain fatty acids which like butyrate, which are preventative against Alzheimer's. And so you're supporting the brain, you are protecting the liver, feeding the gut and supporting the brain.

[C]

That's your mantra. Many years of research summed up into nine words.

[A]

And this is how you can make ultra processed food healthy. Protect the liver, feed the gut, support the brain.

[C]

Are you at all afraid? I mean the food industry is rife with these well intentioned substitutes for real food. Like remember Oleostra, the fake. Yeah, that fake fat that turned out.

[A]

I hear you.

[C]

You know, you take all the flavor of fat, but it turns out wreak habit with your.

[A]

Totally. I'm very familiar, I'm very aware. What I can say is that every component of Munch Munch is food. So the FDA recognizes it number one as safe. So all stuff that you normally consume in a day anyway, he's just delivered in a. So olestra was synthetic. It was, you know, something concocted in a lab.

[C]

Yeah, come Frankenstein.

[A]

This is not okay. And also we have done double blind placebo controlled clinical trials. And what we see is a reduction in the glucose response, a reduction in the insulin response, improved metabolic health, reduction in triglycerides, increased lean body mass, reduced fat mass, which is good, and reduced hunger because of the fiber piece and also improved gut health. So anybody who had diarrhea when the study started on Monchmaunch, they didn't. Anybody who had bloating when the study started on Monchmaunch, they didn't. Anybody who had constipation, the study started on Munch Munch, they didn't. Anybody who had pain with Munch Munch, they didn't. In other words, we fixed their GI problems. And the reason is because we were giving the gut what it wanted, the fiber. Remember I told you if you don't feed the gut, your gut will feed on you? Well, we're providing the food for the gut and the gut is getting better.

[C]

Is Munch Munch like a cookie or what is it?

[A]

No, no, it's a powder.

[C]

Powder that you.

[A]

It's a powder. It basically you can dump it into a glass of water, stir it up and take it and then eat your regular breakfast or you know, dinner or whatever. And it will work while you're eating. So you haven't had to change the food. So this is great for the food industry because they don't have to change their recipes.

[C]

You made a really good point earlier. Ultra processed food isn't going away. We want it to go away. And it.

[A]

We can't have it go away. And the reason is. Cause we have to feed 10 billion people by the year 2050. We don't have enough land and ocean to do it. So we need ultra processed food in part to extend food availability and also to reduce food waste. Ultra processed food is not going away. As much as I hate it, and I do hate it. Okay. We have to make our peace with it. This product is harm reduction for ultra processed food. Think back to the 1980s. Remember HIV?

[C]

Yeah.

[A]

HIV was terrible. It was a scourge. People dying right and left.

[C]

Yeah.

[A]

What did the public health department of New York City do? They gave out free needles to drug addicts. Why? Because they condoned drug addiction.

[C]

No.

[A]

Why?

[C]

Because HIV was spread with needles. By dirty needles. And getting rid of the dirty needles, you lowered HIV prevalence.

[A]

Exactly. Harm reduction. That's what this is. This is harm reduction. I'm not condoning ultra processed food. I think ultra processed food is terrible. Having said that, I also know it's not going away. We have to somehow make ultra processed food healthy.

[C]

Less bad anyway.

[A]

Less bad. And this is a way of doing that. And it works. And we have data to show it.

[C]

How can we get Munch Munch Munch

[A]

Munch online right now it's B2C, you know, directly with the consumer. What's the Munchmaunch shop?

[C]

Munchmunch shop. Okay.

[A]

Yes.

[C]

Or just Google it. I suppose you'll see it.

[A]

Oh yeah, Google Munch Munch. You'll find it. No problem.

[C]

American eating, the average American diet. It's a glass a day or something.

[A]

One teaspoon. That's not very twice a day. Perfect. So breakfast and dinner and what's the cost? About a dollar a meal. So it's raising your total food cost by $2 a day.

[C]

Yeah.

[A]

But in the process, small price to pay for health. Your health will get much better.

[C]

Instead of for most Americans. And pouring that scoop of protein powder in your drink in the morning.

[A]

Right.

[C]

Put that teaspoon of Munch Munch and you're much better off.

[A]

For most people you could do both. Yeah. So we are actually coming out with Munch Munch products that will have the fiber actually added to the. Yeah, yeah.

[C]

Why not formulate these foods with the

[A]

fiber in it, that's what we are doing.

[C]

It's a big idea. I love these giant system thinking. You know, I'm a big fan of what was called the North Karelia Project in Finland. They managed to lower cardiovascular mortality by about 80% from 1970 to year 2000 or so. And they did it not by hounding people to change their diet. They went in and they changed the food system.

[A]

Yeah.

[C]

And they got more fruits, berries in the grocery stores and in baked in products. They changed the oil from. Everybody was sort of cooking with too much lard and they brought on canola oil, which.

[A]

Yeah, I'm not sure if that's a good thing or a bad thing, but go ahead.

[C]

The other thing that was interesting, their sausages was full of sodium and fat and they over the course of time they took out about 30% of the sodium and replaced the fat with a cheap mushroom filler. Okay, so people were eating the same amount of sausage.

[A]

Right.

[C]

But they got healthier. And we see that in the population data. This is what you're doing. The potential anyway of engineering munch, munch into our food. People don't even know it's there. Everything tastes just as good, but all of a sudden they're getting the fiber they need that the food system isn't providing us. It's brilliant.

[A]

There are other things that are wrong with ultra processed food. I mean, you have fewer micronutrients, you know, the fast start.

[C]

The cost of doing nothing's way more expensive than the cost of doing something. And you're doing something, we're doing something

[A]

and we have data to show that that something is good. Having said that, one of the things that I told my Italian engineer co founder that he could not put it on the market until I said so because I was not going to hurt anybody. It had to meet my specifications for both efficacy and safety before we could market it. And he, to his credit, he stuck with that. But when I saw the results of the double blind placebo controlled trials, I actually in good conscience could not keep it off the market.

[C]

And what were those findings?

[A]

The improvements? Yeah, the improvement in triglycerides, the improvement in insulin and glucose, area under the curve, the improvements in butyrate production, the improvements in gut health.

[C]

And was this a big study or

[A]

was about 75 patients each? There were two studies, one in Australia, one in India.

[C]

Well proved in two neck. Two continents.

[A]

Two continents.

[C]

You know, we joke in Minnesota that we only have two seasons. Good sledding weather and bad sledding weather. And right now it's summer, which means bad sledding weather, which means it's officially time to head up to the cabin. I personally am looking forward to packing up and heading out to some quality time by the water. In fact, a few years ago, and thanks to Airbnb, I found a place where my entire family could stay for a weekend on the water. We had a fantastic time. We would not have found it if we didn't have a place like Airbnb to find just the right place for our family. But heading out to the cabin means leaving my home in the city completely empty. And honestly, letting an empty house just sit there just doesn't feel very practical. That's why I list my space on Airbnb while I'm out of town, because it makes sense. It's a very practical way to earn a little extra money. It fits seamlessly into my schedule because I only do it when I'm already traveling. It's not a full time job, just a smart choice. If you have an upcoming trip on the books, consider listing your space on Airbnb. Your home might be worth more than you think. Find out how [e-mail] host every bold

[B]

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[C]

Robert Lustig is now elected Czar of America and you got to change one policy. Yes, that would have the biggest impact of making us a healthier nation. What would it be?

[A]

Get rid of the subsidies.

[C]

Subsidies for what?

[A]

Get rid of the food subsidies because they're distorting the market.

[C]

What are we subsidizing right now?

[A]

Corn, wheat, soy, sugar, everything that's killing us. Why in the world would you subsidize the thing that's killing you? Answer Very simple.

[C]

Profit.

[A]

So it's basically their profit against our health. And the thing that's driving their profit is the subsidies.

[C]

So what would it take to get rid of these subsidies for corn, wheat, soybeans and sugar?

[A]

Right. What we need is that we need a new industrial model. Ultimately, the food industry has to make money. Okay? And I agree with that. The question is how? How should they make money? Should they make money doing the right thing or should they make money doing the wrong thing? If they're making money doing the right thing, I applaud them. I'm all for it. Can they make money doing the right thing?

[C]

Well, of course, the thing is, the demand is, is inelastic. We all want to eat, and we all want to eat delicious food. So if you ra the price of those commodities, we'll just spend money on something else.

[A]

Do you have to raise the price of those commodities? Can you make them better and keep the price the same? And the answer to that is yes, and we're already doing it. Dan example, it's in the Middle East. I've been working with a offshore food company for the last six years. I take no money, by the way, so gratis, as an experiment. This company is called Kuwaiti Danish dairy company KDD. Right. And in 2020, during the pandemic, their chief business officer called me up on the phone and said, we would like to employ you. I said, well, you can't employ me, but you can consult with me. Why? He said, we know we're the problem. Kuwait has an 18% diabetes rate and an 80% obesity rate. And we know our food is the reason. We don't want to be the problem, we want to be the solution. We know we make ultra processed food. We know ultra processed food is bad for you. Our question is, can ultra processed food be made good for you? I said, okay. And he also said, and by the way, the chairman and the chief financial officer are brother and sister. They own the company. There are no other shareholders, and they are willing to put their money where their mouth is.

[C]

So how do you make ultra processed food healthy?

[A]

So I convened a scientific advisory team of five people, each with their own special expertise, and we took KDD down to the studs. Over the next three years, we met two hours at a time, two days a week for three years online. And we basically sent everything that KDD procured, everything they produced, everything they marketed for biochemical analysis by the company Eurofins in Iowa City, Iowa. And they ran HPLC on everything so that we knew exactly what was in every Ingredient and every product. So we also then knew every procedure that KDD did, whether it be extruding or whether it be heating or boiling or, you know, whatever it was, what it did to the product, so that we could ultimately determine whether or not that product was healthful or not. We then developed a set of tiers criteria that any given product that they made could go through to go from tier three, which would be like poison, up to tier one, which would be like, healthy. Okay. And we called this entire project the metabolic matrix. And I can sum up the metabolic matrix in nine words. Three clauses, nine words. Here they are. Protect the liver, feed the gut, support the brain.

[C]

Simple enough.

[A]

Any food that does all three is healthy, whether it's ultra processed or not. Any food that doesn't, another three.

[C]

Give me an example. Give me an example of an ultra processed food that checks all three of those boxes.

[A]

Their new chocolate ice cream.

[C]

Okay, what's in?

[A]

So we got the sugar out. So there's one teaspoon of sugar per serving. One. It used to be 10. There's now one teaspoon of sugar per serving. We make up the difference right now with erythritol, and it will be allulose in the future. In addition, we added omega 3 fatty acids into the dairy fat that went into the chocolate ice cream. Okay. We also screened the chocolate that was being used as well as the milk powders that were being used in this process. And so we now have total calories of 140 per serving. It used to be 200 per serving because we've gotten rid of all of that excess sugar, yet it's just as sweet as it was before. And it keeps the LDL down, it keeps the glucose down, it keeps the insulin down. And we've tested it in clinical trials in Kuwait to demonstrate its metabolic health.

[C]

And this is ultra processed.

[A]

It's chocolate ice cream. Oh. And most importantly, we then did taste tests with the public, and they loved it. And so the question is, what happened to sales?

[C]

Right. That's where the rubber hits the road.

[A]

Absolutely. And this was the question for kdd, what's gonna happen to sales? And the answer is two things. Number one, we didn't tell the public we did it. So they didn't know that this was stuff was healthier. And number two, they didn't miss a beat. Sales didn't change.

[C]

That's amazing. What's the name of this ice cream?

[A]

It's called KD chocolate ice cream.

[C]

KD's chocolate ice cream.

[A]

Yeah, it's not here In America right now.

[C]

It's a great story, though.

[A]

But the point is, it could be

[C]

it's like that finished sausage. I just told you. Yes, absolutely.

[A]

That's what reminded me to tell you very much. Absolutely.

[C]

You were talking about that the difference between saturated fat in meat and the saturated fat in dairy. Aren't they the same thing?

[A]

No, they are not. They're not the same. And I can prove they're not the same. Number one, if you take saturated fat from meat and you throw it in a glass of water, what happens to it?

[C]

Congeals. Floats to the top.

[A]

It floats to the top. If you take the saturated fat in dairy in a glass of milk and throw it in a glass of water, what happens to it?

[C]

Well, it's homogenized, right?

[A]

No, it's not homogenized. I mean, it is homogenized. The milk is homogenized. But why does it not float to the top?

[C]

I don't know.

[A]

Number one, the saturated fat of the animal fat is C16, C18 palmitic and stearic acid. The saturated fat of the dairy saturated fat is C15 and C17 odd chain. It's metabolized differently in the liver, uses a different pathway. That's number one. And the second thing is that that saturated fat from dairy has on it a phospholipid head which basically keeps it polar so that it stays in solution in water. And that's why milk does not have to be shaken like cream does in order to get into solution. And so that phospholipid turns out to actually be metabolically healthy. And so the data show that the more dairy saturated fat that you consume, the less chance for heart disease and diabetes.

[C]

So the decades we were told to switch to skim milk, that was a disaster.

[A]

More than ill advised, it was actually detrimental. And the reason was because skim milk tastes like dishwater. So what did they do? They added the chocolate or the strawberry or whatever. You know, if you go into a standard school today, what do they serve? They serve, you know, chocolate skim milk. Okay. And the dietitian at the school says, well, we gotta get them to drink the milk somehow. Yeah. How about put the fat back in? Yeah, yeah.

[C]

So would you call whole milk a net positive, nutritionally speaking?

[A]

Absolutely. Without question. How about skim milk is actually a net negative.

[C]

How about half and half? Net positive?

[A]

Net positive.

[C]

How about cream?

[A]

Net positive.

[C]

Really?

[A]

As long as you don't add sugar

[C]

to it and it's a dose. I mean, can I have a glass of whipped cream a day?

[A]

You could. I don't know if you'd want, but you could. Certainly the keto enthusiasts do that.

[C]

Yeah. People like to hear what they can do, what general dietary advice you give them. What, what foods do you like people eating a lot of.

[A]

So first of all, I am not the food police. I am not watching your plate, and you should not watch mine either. I am a food informant. Yes, I am. Okay, fair enough. But there are a lot of ways to skin this cat. It's not like there's one diet that works. There are many diets that work. But all the diets that work have two things in common. Low sugar, high fiber.

[C]

Interesting. Low sugar, high fiber.

[A]

Now the carnivores out there will say, wait a second, we're not eating fiber and we're fine. And that's true, they are. And the reason is because the amino acids in the meat of the carnivore diet can also be converted to butyrate. So you get the short chain fatty acids that the fiber would have given you. You can get them from the amino acids, but you don't get the other

[C]

five things you enumerated.

[A]

That's right.

[C]

What about the. Even the vegans? You know, there's something called the Adventist health study that showed that. Yes, so the shortest lived people were the meat eaters, then the next shortest livers were the ovolocto vegetarians. And then the Pascal, the pescatarians did really well.

[A]

I am totally for pescatarianism. I think that is a terrific way to eat.

[C]

How about taking the fish out and just be completely 100% plant based?

[A]

Well, so the question is, are you missing something? The answer is yes, you're missing a few things. Number one, you're missing B12, which is essential. People don't understand just how important B12 is. And the only place you can get it is from animal sources. There are no others.

[C]

And supplementation though.

[A]

Right. Number two, the omega 3 story, the omega 3 fatty acids. Now the vegans will say, wait a second, we can do algal oil. And that will give us ala, alpha linolenic acid. And that is absolutely true. And that will improve cardiovascular protection. No argument. However, there are two other omega 3 fatty acids. One is called EPA, eicosapentaenoic acid, and the other one is called DHA, docohexaenoic acid. The only place to get those is marine life. The only place to get those is fish. So the question is, can the ALA be converted in the body to EPA or dha? And the answer is no, that'd be good if it was true, but it's not true. The conversion is 0.5%.

[C]

Oh, tiny.

[A]

So that's very tiny. And so veganism basically shortchanges EPA and dha, which are both necessary for mental health and neurotransmission, which I think are extraordinarily important, especially in today's society.

[C]

Yeah, yeah, yeah.

[A]

So the B12 story, the Iron story, because veganism is low in iron and iron is essential. And you know, iron goes both ways. Iron can be an oxidative stress, but iron deficiency can also be its own stress. So there's a sort of a sweet spot in terms of iron. And veganism does not really supply it. So I think there are ways to make veganism better. The way I would do it is if it's a question of care of animals, I would say be a vegetarian, because vegetarians that you get the Omega 3s from what, eggs? Okay, okay. And you also get the milk. You get the C15 and C17 phospholipid fatty acids that we just talked about. So I think that. And you get the B vitamins. So I think that vegetarianism is smarter than veganism from a purely nutritional standpoint. Are there things that vegans can do to make up the difference? Yes, but they become very complex.

[C]

And pescatarians.

[A]

And Pescatarians, they have the world by the balls. I think pescatarianism is probably the single most inclusive diet. And by the way, that's really what a Mediterranean diet is, is pescatarianism.

[C]

Pretty much, yeah. Enjoy a little meat here now and again.

[A]

Festivals. Right.

[C]

So the central tenet of blue zones, we work at a, at a municipal level.

[A]

Yeah.

[C]

It's basically choice engineering. We shape people's environment so the healthy choice is easier and the unhealthy choice has more friction. Is there a way we could partner that? Do what you're doing and.

[A]

But I am a great believer in. It's about the environment. Okay. It's not genetics, it's the environment. And the question is, well, what about the environment? It's not about behavior, it's about the environment. The obesity story shows it's about the environment.

[C]

Yeah. I mean, people didn't change. And we're 3x obesity and that's.

[A]

Right.

[C]

Isn't it like twice the incidence of chronic disease in middle aged people?

[A]

Exactly. And the obese newborn basically blows the concept of behavior right out of the frigging water.

[C]

Oh, yeah, that's a very good point.

[A]

So the only way to fix it is to Change the environment. Now the question is, who's going to do that?

[C]

Me.

[A]

Well, you can't change the environment across the board. What you can do is you can set the guideposts, and that's valuable. And so that's why I'm for that. Okay. But in and of itself, it's not like every place in America can become a Blue Zone.

[C]

No, we offer sort of in the way you offer the Eat Real certification. We offer blue zones certification. And the idea is that they've made their built environment, food environment, and sort of stress environment 10 to 20% better.

[A]

That's right.

[C]

If you were mayor of San Francisco, a powerful mayor, what policies would you be pushing that you think would have the biggest impact on how people eat?

[A]

Oh, boy, that's tough, you know, because if you're mayor of San Francisco, you have all the responsibility and none of the authority. That's kind of a problem.

[C]

Yeah.

[A]

Okay. We're doing it in San Francisco now. It's called the soda tax. You know, it's a 10. 10%, you know, surcharge on soda. And the question is, does it work? And the answer is, yes, it works. We have the data. Since the San Francisco State attack was instituted in 2016, we've seen a 77% reduction in gestational diabetes.

[C]

Wow.

[A]

In San Francisco. How about that?

[C]

I mean, it's. Why aren't people opening up their eyes? Oh, my God, I want a soda tax for my city.

[A]

Yeah, well, you know, because the food industry doesn't want it. That's.

[C]

Oh, yeah. It's preemptive.

[A]

For example, preemption in California. That's right. Well, San Francisco. But they've undone that now.

[C]

Okay.

[A]

It took us years to undo the preemption, but now it's.

[C]

What else? Anything else the city can do.

[A]

That's sort of a big one, you know?

[C]

Yeah, I agree.

[A]

Definitely a big one. Ultimately, the goal is you have to. It's the iron law of public health. Reducing the availability of a substance reduces its consumption, which reduces health harms. Something called differential subsidization. 1977, Norway, Sweden, Denmark, three countries, huge alcohol problem. Okay. And they were losing money on both sides of the ledger. They were losing money on the positive side of the ledger because people calling in on their benders. So reduction in productivity. And also on the negative side of the ledger, cirrhosis of the liver in car accidents because, hey, it's dark and it's dank and it's damp and it's cold and no Netflix. And so people just drank themselves to death. Okay. So these three countries banded together and passed two pieces of legislation that were yoked together. First piece of legislation, they nationalized all the liquor stores, so every liquor store sold the same fare at the same price, so you couldn't go someplace else and buy it cheaper. Second thing they did, they taxed high alcohol spirits, and they use the money from the tax to subsidize low alcohol beer. So it's a zero sum game to the country, because whatever money they're taking in, they're basically paying out in terms of the subsidy. Right. But what they did was they made low alcohol beer cheaper at the same time, they made high alcohol spirits more expensive. And so people by very nature gravitated toward low alcohol beer. And over the course of 20 years, you can see the reduction in the cirrhosis, the reduction in the car accidents, the increase in productivity.

[C]

Wow.

[A]

And those two pieces of legislation are still there today, 50 years later, because they worked. So how about you tax soda and subsidize water?

[C]

Yeah. The soda companies still make money.

[A]

You gotta drink. Yeah, they all make bottled water.

[C]

That's great.

[A]

Okay. That's an example of how you could use policy to solve some of these problems. But in each case, it's the iron law of public health, as you write that down. Reduction in availability leads to reduction in consumption, which leads to reduction in health harms. That's how it works. And that's how a city can use its, you know, policy arm to be able to effectuate improvements in public health.

[C]

That's great.

[A]

And then people won't even be mad about it because they're getting something for it.

[C]

Yeah, yeah. It's orchestrating those. Well, I salute you for taking the ethical high ground and, and letting science drive decisions and doing. Thinking big and doing what you can. At the end of the day, that's what matters.

[A]

That's what I'm trying to do. I'm trying to help wherever I can. And you're succeeding. Well, thank you. I appreciate that.