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- [00:00]
Dr. Mark Hyman
Coming up on this episode of the Dr. Hyman Show.
- [00:03]
Dr. Jeffrey Bland
Your chronological age was 79, but your biological age was 62. Your testosterone levels were that of a 30 year old. What's most contributed to that?
- [00:11]
Jeff Bland
It's about how do you maximize the genetic potential that lies within your genome to be the best person you can be?
- [00:17]
Dr. Jeffrey Bland
Jeff Land is the father of functional medicine, a pioneering nutritional biochemist who turned his own body into a lab for longevity. Most doctors don't know how to assess mitochondrial health, assess function. Now we're realizing it's connected to so many of the chronic illnesses. It's an energy problem.
- [00:34]
Jeff Bland
If you have impaired mitochondrial function, your immune system is tired, it's worn out, it's engaged with reduction of longevity.
- [00:42]
Dr. Jeffrey Bland
The most effective treatments for everything that I've come across is something we call.
- [00:52]
Dr. Mark Hyman
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- [01:54]
Dr. Jeffrey Bland
Off your first month.
- [01:55]
Dr. Mark Hyman
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- [02:05]
Dr. Jeffrey Bland
Month of seeds DS01.
- [02:07]
Dr. Mark Hyman
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- [03:01]
Dr. Jeffrey Bland
Before we jump into today's episode, I'd like to note that while I wish I could help everyone by my personal practice, there's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand. Well, you if you're looking for data about your biology, check out Function Health for Real Time Lab Insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, the Hyman Hive. And if you're looking for curated and trusted supplements and health products for your health journey, visit my website@drhyman.com for my website store for a summary of my favorite and thoroughly tested products. Welcome to the Dr. Hyman Show. I'm Dr. Mark Hyman, and this is a place for conversations that matter. And today's conversation is with one of my heroes, one of the unsung leaders in medicine and who I think should win the Nobel Prize. But maybe he will, maybe he won't. We don't know. It's Dr. Jeffrey Bland. He has taught me more than any other human about how the body works and how to work with patients to heal them from all sorts of things that are really tough to heal. All the chronic disease we suffer from, from diabetes to autoimmune diseases to digestive problems to mental health issues. All of the stuff that I have done for the last 30 years has been really the result of knowing Jeff.
- [04:19]
Dr. Mark Hyman
Bland and.
- [04:21]
Dr. Jeffrey Bland
His helping me understand how the body works and how to work with people. So he's been working for 50 years in this field. He's almost 80 years old now. He's the founder of the functional medicine movement, and it's really a vision of a new healthcare system that's grounded in our understanding of our body as a system and systems biology. He's able to synthesize massive amounts of data across all these disciplines and specialties and see the linkages between things and way before anybody else saw them. And whether it's understanding insulin resistance or inflammation or how the gut plays a role in our health or mitochondria, the list goes on and on. The role of toxins in our health. And all through his work, he's constantly evolving, creating, learning. It's quite amazing to see how much he's still going. He founded the Personalized Lifestyle Medicine Institute PLMI as well as the Institute for Functional Medicine. He's the author of many bestselling books, 120 peer reviewed books, papers. He's traveled millions of miles teaching hundreds of thousands of doctors how to think differently. And his new venture is Big Bold Health, which is a very bold company that I'm proud to be an investor in and advisor for, which is revolutionizing our idea of how our immune systems work and how to use food as medicine through the application of one of nature's great foods, which is Himalayan Tartary Buckwheat. So I think you're going to love this conversation with Jeff. We dive deep into the immune system, into his personal story, into how medicine is shifting and changing, into sort of the mechanisms of some of the ways in which food regulates our gene expression. So I think you're love this podcast. It's part one of a two part series. The second part will be a deep dive into the field of immuno rejuvenation, immunosenescence, the aging of our immune system, immunometabolism, Our metabolism connects to our immune system and how we can actually start to use that information to optimize our health and to prevent and treat chronic disease. So let's dive right in into Jeff's conversation right now. Welcome Back to the Dr. Hyman Show. Jeff Bland, it's great to have you again. I can never get enough of you.
- [06:26]
Jeff Bland
Well Dr. Hyman, I can't tell you what a privilege this is to once again engage in this narrative with you.
- [06:32]
Dr. Jeffrey Bland
I really want to start with your own personal story because you been a nutritional biochemist for ever and you're 79 years young and keep getting younger. You have said to me just earlier, you, you probably have measured your clinical chemistries, your blood tests more than most humans over decades and decades and have seen sort of the effect of lifestyle diet food on these biomarkers and have made changes in yourself and you, you share with me some of your results. A Little earlier, it was pretty remarkable how good they were. For someone who's 79, your testosterone levels were that of a 30 year old. I mean, you had very low levels of inflammation. I mean, no detectable inflammation. You, your kidneys, your liver all look great. Your cholesterol was good. I mean, you really, it's like if I saw you as a patient, there might be a few little things I might tweak. But, you know, overall your health is remarkably good for someone who's, you know, 45, not the less 79. But, you know, your father and your grandfather Both died at 73. Kind of gone past your father and your grandfather in terms of your health and age. And at 79 you're basically involved in a startup company called Big Bold Health and most people are golfing. What's most contributed to that and how have you sort of kept going, not just a little bit, but at full speed?
- [07:59]
Jeff Bland
I think that this thing that we call our life is a really fascinating opportunity, isn't it, of exploration. We're all kind of the explorers to figure out what our genes might be able to give us in terms of our ability to perform in the years that we call our life. As I've thought about this over the years, it's always been my belief that our genomic potential for most people, and I would include myself in this, is probably greater than that that we're really doing in terms of our phenotype, how we look, act and feel. So how do you maximize the genetic potential that lies within your genome to fully express the humanness that is within you and be the best person you can be? Do you realize that when you are ill and your immune system is activated, that 50% of your metabolic energy is being consumed by your immune system? And how is it making its energy mitochondrial function? So if you have impaired mitochondrial function, your immune system is tired, it's worn out, it has immunosenescence, it's producing oxidants, it's creating free radical damage, it's engaged with reduction of longevity. And so mitochondrial health is intimately connected to immunological health. It's another part of that story. So this is why ultimately I landed six years ago on asking, what have I learned after 40 years being in this field? If we want to talk about root cause, what is root cause? Where does it start? And as you said, you can keep going up the tree. And I finally landed on the fact that there are only three plants, places that our body is communicating with the outside world. 365, 24, 7 and those are the nervous system, the mucosal surfaces of our body, and our immune system. Those three areas are communicating continuously with the outside world and telling our inside body how to function. And I said, well, now let me think about.
- [10:00]
Dr. Jeffrey Bland
Sid Baker talked a lot about this. He wrote about this whole idea of these interfaces.
- [10:04]
Jeff Bland
And so you got to think about how are we responding to the outside world through signals or through messages. And so when I went to that level, I said, okay, so let's look at that. You have the gut microbiome, you have the nervous system, and you have the immune system, all of which are intimately interrelated, one with the other, and are communicating with the outside and inside world. Which of those is most able to change quickly? And then I recognize that the immune system turns over every 120 days. Every 120 days, our immune system are different cells than they were previously. Now just think of that for a moment. We're making over 2 million new white blood cells, immune cells a minute. We are constantly reproducing our immune system. So the question is, is it as good as better or worse than the cells that it's replacing? The answer to most people over life is it's worse.
- [10:55]
Dr. Jeffrey Bland
It's worse.
- [10:56]
Jeff Bland
That's immunosenescence. Our immune system declines, so people still.
- [10:59]
Dr. Jeffrey Bland
So immunosenescence means senescence, means getting older.
- [11:02]
Dr. Mark Hyman
That's right, aging.
- [11:03]
Dr. Jeffrey Bland
So it's the aging of our immune.
- [11:05]
Jeff Bland
System, which can be more rapid than our number of birthdays.
- [11:08]
Dr. Mark Hyman
And it's.
- [11:08]
Dr. Jeffrey Bland
And it's why. It's why people who are older were more likely to get severe Covid and die.
- [11:14]
Jeff Bland
Exactly right.
- [11:14]
Dr. Jeffrey Bland
And people with chronic disease also were more likely to end up in the hospital and die because their immune systems were not working properly.
- [11:20]
Jeff Bland
And so then it begs the question, doesn't it? During SARS CoV2 infection, why did we in the United States do more poorly than any other developed country in terms of intubation, hospitalization, death? And it was not because we're an older society. It was because we had the poorest immune state of vigilance. We were immunosenest as a country, and our bodies were not able to manage the effective SARS cov, you know, spike protein as people in other countries that had a more vigilant, resilient immune system.
- [11:51]
Dr. Jeffrey Bland
That's right.
- [11:52]
Jeff Bland
And shame on us.
- [11:53]
Dr. Jeffrey Bland
I mean, we were 4% of the world's population and 16% of the cases in deaths. And basically we were pre inflamed when the virus hit us. Everybody remembers that Term cytokine storm. That's what happens when you're pre inflamed. It's like lighting a match to gasoline. It just blows up. And then that's why we saw such a catastrophic amount of death and suffering in America compared to other countries, despite having better medical care, better hospitals, better doctors, better nursing care. I mean, we literally have the best healthcare system in some ways, but we also have the worst in other ways because we're dealing with problems in ways that are, aren't getting to the root cause.
- [12:30]
Jeff Bland
So it was absolutely just what you said that caused me to wake up one morning and say, maybe I need one more shot at the goal here. Maybe I need to really focus my attention. Now that we've gone through gastrointestinal restoration, now that we've gone through metabolic detoxification, now that we've gone through mitochondrial resuscitation, maybe we need immunorejuvenation. Maybe we need to study how to rejuvenate the immune system. It's not boosting the immune system. We don't want to boost immune system. That's imbalanced. That only makes it worse. We want to activate resilience and make it more functionally adaptive, and that is immunorejuvenation. So the cells that we replace are better than the ones they came from, not worse. And that becomes a whole different strategy. And when I hit on this idea, my colleagues Annette Giardi and Trisheri, who work with me now for 30 years, they said, jeff, you know, you're a fairly big guy in stature. This is a pretty bold idea. So maybe you need one more company. Why don't we call it Big Bold Health, and let's just go after this concept and see if we can't find a way of approaching how to rejuvenate the immune system. And lo and behold, the last five years, we're learning it. We're learning how to do that. And it's not just us. The whole field of immunology is changing. This whole nutri immunological connection is now blossoming. It's revolutionary how fast things are changing.
- [13:51]
Dr. Jeffrey Bland
Yeah, I mean, one of the things that I learned as a young functional medicine doctor was the power of food to regulate inflammation in the body. And one of the tools that we were taught, and I think it's probably one of the most effective treatments for everything and anything that I've come across, is something we call the elimination diet. But I, I don't like that term. It's really more the addition diet. It's it's getting rid of the crap, but it's adding the good stuff. I created a kind of my own adaptation of that diet. I call it the 10 day detox diet. And now I've had thousands and thousands of people go through it. We've measured their results through in depth questionnaires that give people a score about their overall symptoms from all diseases. And I've done this online, I've done it in person, I do workshops. And in literally five days, we've seen people's score drop an average of 70%. There was a guy recently who was in a workshop I did, his score dropped from 132, which is really high, to 30, which is more normal. Ideally, like to see under 20. But whatever the symptoms are, whether it's migraine headaches or irritable bowel or depression or insomnia or joint pain or nasal congestion or allergies or arthritis, I mean, the list goes on and on. It doesn't matter what you're suffering from. When you reset the diet, it happens like this. It's not a month long process, it's not even a week long process. It can happen within five days. And it's sort of shocking to me. I'm like, this can't be real. If I say this, it sounds like heresy. I'm going to give you this magic diet and 70% of symptoms from all diseases in everybody just get better. A 70% reduction in all symptoms from all diseases in five days. That sounds like snake oil. But the shocking truth is it actually works. And we don't completely know how it works. I don't think I really completely fully understood, but it's modulating pathways that are influenced by our food in a very profound way. So I'd love to maybe unpack because I can try to do it. But I think it would be better to come from you unpack. How does this radically different diet that's anti inflammatory, that supports the microbiome, that is full of phytochemicals, actually work so quickly and so fast to change so many diseases?
- [16:24]
Jeff Bland
I'm so excited that you asked this question. I'm so excited you brought this up.
- [16:27]
Dr. Jeffrey Bland
Because we're talking about inflammation, the immune system. And what's happening is all these people with all this inflammation get better so fast when you change your diet. I mean, one guy came up to me just at Cleveland Clinic when I was first there giving a lecture. He had rheumatoid arthritis. He said, Dr. Hyman, I did your 10 day detox diet and my rheumatoid arthritis went away. Is that possible? I'm like, yeah, it's possible because it went away with you, but it's shocking.
- [16:54]
Jeff Bland
So no one has ever asked me this question. So I'm so excited about us talking about it. I asked you many years ago if you would become the editor of a journal that I had been writing for Alternative Medicines in Health and Healing, in which you did a fantastic job as an editor. The first issue of that magazine, that journal, I published a research paper that was on this very topic that you're talking about. And I'm very proud of this paper because it was the stake in the ground around this concept that you're describing that you've developed so wonderfully over the decades. And what we did is we took a group. This is our little research center we had in Gig Harbor, Washington. At the time we studied, I think it was 80 people that we had. 30 of those people were on a kind of a standard of care, and then 50 of them were on an intervention program like you've just described, this kind of dietary program that was high in phytochemicals but was low in allergic substances, was free of gluten, didn't have sugar, dairy. Yeah, all those kind of things. And we followed them. And we were the first group, I think, ever to look at liver detoxification, look at gut integrity using lactalose mannitol test to measure gut permeability.
- [18:17]
Dr. Jeffrey Bland
How do you measure leaky gut?
- [18:19]
Jeff Bland
Exactly. And we looked at caffeine clearance. We looked at benzoate excretion for liver phase one and phase through detoxifications and clinical symptoms over the course of, I think it was two months, and we saw about a 60% reduction in symptoms of the treatment group versus the control group. And that was published in 1991. That was a foundational statement starting functional medicine. At that point, you have taken that and moved it to a much higher state of refinement. But I'm very, very proud to say that what we were starting to understand, and I wouldn't. I want to emphasize starting, that the gut was connected to the immune system. The immune system was connected to the liver. The liver has its own immune system. 10% of the liver is occupied by what are called Kupfer cells that are immune cells. Those cells then speak to the brain through systemic circulation of messenger substances. All these things were started to be developed out of that early 1990s recognition that this is a system of. That the control that ultimately is seen in people with different ranges of symptoms of different duration, variety and intensity. And so we were setting the tone, I believe, in that, that early study for what later became the architecture for functional medicine as a, as a systems biology approach towards healthcare.
- [19:42]
Dr. Jeffrey Bland
I mean, I would say if I had one quote, drug to use as a doctor, and I was on a deserted island somewhere and I only had one therapeutic agent, it would be this diet. Yeah, it is. And it's removing a lot of the foods that are driving inflammation. Ultra processed foods, sugar, gluten, dairy for some people. And not to say that some people can't tolerate gluten or dairy, it's just that you kind of clear this slate. You, you get rid of all that and you add in whole foods, a lot of phytochemically rich foods, lots of fiber, good quality fats, protein. You know, in the tended detox diet, I take also out grains and beans as an initial step because they may be problematic for some people with inflammation and you know, getting knots and nuts and seeds and berries and really just a whole foods, real food diet that has all these incredible benefits. We have an online program, it's called the 10 Day Detox. Go to 10daydetox.com and you can kind of try it out. But it's quite amazing because it does it, it seems to affect so many different pathways all at once.
- [20:44]
Jeff Bland
Yes.
- [20:45]
Dr. Jeffrey Bland
And it's working through modifying gene expression, hormone regulation. I mean, we've had people come off insulin in three days who are type 2 diabetic. You know, we have, you know, reversal of heart failure. We have like all kinds of crazy stuff that you would think is heresy when you say it in traditional medicine. They look you cross eyed and say you're, you're a quack. And I, you know, that was my, my, my moment when I, when I realized I finally had made it in the world was when I ended up on Quack Busters because Jeff was on there and I was on Now, I was on there, I was like, I finally made it.
- [21:16]
Jeff Bland
There are three things that we collaboratively develop that have now stuck as clinical tools that I think are important to acknowledge as we move into this immune question. So let's just review quickly. I want to review quickly what really we have collaboratively developed as clinical therapeutic tools. Number one is gut restoration. Yeah, we originally called it the 4R program, now it's the 5R program. We called it remove, replace, reinoculate, repair. It was a way to actually intervene with patients that we could teach docs to understand pretty quickly that once they started doing this with the Patients, the response they were getting was like, whoa. Then it caused them to see the paradigm shift. So that was our first collaborative development of that algorithm that we called the 4R program. Remove, replace, reinoculate, repair. The next thing we worked on collaboratively.
- [22:12]
Dr. Jeffrey Bland
And by the way, that's important because in your gut is where most of your immune system is, and that's where the inflammation starts. And when you have an imbalance in your gut microbiome and you have a leaky gut, it causes the introduction of foreign antigens from food and bacteria that create this havoc. And the kind of manifestations are different in different people, but the cause is the same. And so even though we didn't really even have a word back then for the microbiome, I mean, I think Leo Galland coined the term dysbiosis, which is now in all the scientific literature. Traditional gastroenterologists talk about it. I think it's kind of funny when I see that. But it's like we were kind of treating it even before we fully understood the complexity of it. And we just followed these basic principles and they worked. Which is how you restore gut function.
- [23:00]
Jeff Bland
Precisely. My first lecture, I recall, in fact a doc sent me the notes from my first lecture on dysbiosis and leaking at 1985. So that was number one, number two, which we collaborated on, which then also is tied to the immune system, has to do with the liver, and that's metabolic detoxification. So what happens when stuff comes from the gut to the liver, which is the organ that has to process that, it has these processes that allow those molecules to be converted into non toxic byproducts and be excreted that are called the detox pathways. Phase one, phase two, phase three, detox. We were the first people to really bring that up as a clinical therapeutic tool, metabolic detoxification. So that was another of our contributions.
- [23:43]
Dr. Jeffrey Bland
To the field, which by the way, most physicians still, still ridicule and laugh at detoxification and doing detox is kind of laughed at as an idea. But it's so important to treating patients to understand these pathways, to understand their body's own built in detoxification systems and how to optimize those to deal with both internal and external toxins. And that was something that again I learned briefly in medical school. How the liver works, but nothing about how to regulate it, optimize it, how nutrients are involved, how phytochemicals are involved, how to change your diet, how the microbiome affects it. I mean, none of that was part of our training. And, and yet it's so critical to understand because we live in a world where we're seeing an increase in the toxic load from environmental chemicals and we're also seeing an increase in the toxic load from our own gut and microbiome and also the waste products of our own metabolism because we're, we're not living in ways that actually support optimal health and detoxification. So it's so important. So this again, it's like one of those sort of key ideas that is, I think maybe now even starting to emerge as mainstream.
- [24:51]
Jeff Bland
Yeah, I think that that's probably the thing that's helped it to go mainstream is when we develop the genetic ability to evaluate people's ability to detoxify drugs called pharmacogenomics or pharmacogenetics. Suddenly doc said, oh, that's right. I guess different people respond to drugs in different ways because they detoxify them in different ways.
- [25:10]
Dr. Jeffrey Bland
That's right.
- [25:11]
Jeff Bland
It's the same metabolic pathways that are used to detoxify our foods and our foreign chemicals and xenobiotics. So suddenly now detox is in the main because of pharmacogenomics, when docs have been, you know, criticizing that this is something species. Well, the third thing that we developed, which I think is equally important, and I take a pretty reasonable degree of pride in this, the first discussion that we ever had with physicians around bioenergetics and the energy powerhouse of the cell called the mitochondrion was in 1990, 1990, I introduced the concept of mitochondrial bioenergetics. Yeah, and, and that then thanks to you and, and your colleagues, then people started to say, oh, maybe this is something related to fatigue, maybe this is something related to muscle function, maybe this is related to cognitive function. Gee, what cells are high in mitochondria? Oh, the cardiac cells, 70% of volume.
- [26:08]
Dr. Jeffrey Bland
And brain cells.
- [26:08]
Jeff Bland
Mitochondria, the neurons in the brain. Gee whiz. All these cells that are really important, that are working hard for us 247 are really energy rich. Mitochondria. What happens if mitochondria gets tired or is not functioning correctly? And so we developed a program called mitochondrial resuscitation. And we were the first people to start to actually provide a clinical intervention opportunity. Now that's a standard affair. And so this is the third thing that we all.
- [26:35]
Dr. Jeffrey Bland
Well, I wish it was a standard of care, but again, most doctors don't know how to assess mitochondrial health, assess function. They don't know how to treat it. They don't understand its role in chronic disease, there are these kind of rare mitochondrial disorders we learn about in medical school, and there's specialists who deal with that, but we don't traditional medicine do that. But now we're realizing it's connected to so many of the chronic illnesses. It's an energy problem. And Chris Palmer from Harvard is one of the key pioneers in, in this understanding in psychiatry and how mitochondrial energy deficits lead to psychiatric illnesses, whether it's schizophrenia or bipolar or depression. Suzanne Goh from Harvard and Oxford, incredible pediatric neurologist who's been on the podcast, did a lot of work looking at autism and the brains of autistic kids, using very sophisticated MRI technology, looking at mitochondrial energy function in the brain and seeing these kids all had energy deficits and then use mitochondrial support nutrients, basically co factors that help with the pathways of producing energy to help treat these kids with autism, and actually found improvement in these kids with autism. I mean, there's a whole conversation about why they have a deficit in the first place, which is again, upstream, because, you know, mitochondria are upstream of the diagnosis, but what's upstream of the mitochondrial problem, and that's kind of what we're taught in functional medicine, is to keep thinking of what's the cause of the cause of the cause of the cause of the cause and keep going until you reach the end of it. That's another area where I think, you know, we're starting to understand important in dementia and Parkinson's disease and diabetes and, you know, obesity and cancer. I mean, it's just. It's at everything you can think of that we're suffering from in the chronic disease epidemic today in. In America, whether it's kids or adults, it's in some ways related to the mitochondria. It was remarkable when I. When I took the concepts that you and. And this group of physicians incubated and I started applying them to pay patients, I was just shocked because the things that I thought were immovable in medicine that you could, quote, manage with medications were going away, like autoimmune diseases like acne, like chronic eczema, like chronic migraine headaches, depression, you know, even more extreme things like autism or Alzheimer's. And I was like, what is going on here? And I just didn't fully understand the science behind it all because there's a lot to know. But I just started following these principles, this new model that make the old one obsolete, as Buckminster Fuller said, and it worked. And now we're seeing there's this kind of awakening around this 40 years later, like an overnight success that took 40 years. And the world is sort of waking up to the importance of thinking differently about chronic disease. And this new way of thinking is something that came out of your work. And you mentioned Linus Pauling, and I think it's worth talking about. He kind of was the father of this concept of orthomolecular medicine, which was first sort of described in a science journal paper which 1968 was talking about orthomolecular psychiatry. How to use nutrition and different nutrients to change biochemical reactions to drive pathways that were stuck and to unlock them to create a resolution in psychiatric symptoms, which is crazy to think about. And now we have departments of metabolic psychiatry, nutritional psychiatry at Stanford and Harvard, and guys like Chris Palmer talking about mitochondria and energy. And Mayo Clinic now just got a $3 million grant plus to study keto diets and schizophrenia and bipolar disease. This was sort of a total heresy before. And, and it's taken. That was 50 years ago and, and you took that little seed and, and, and created a movement. And now you've literally helped millions and millions and millions of people around the world through your teachings and work and education and the sort of fertilization of all these minds with these ideas, including mine. And, and that has led to this, this incredible shift that we're now seeing in, in medicine that there's like, I just got invited to Cleveland Clinic grand rounds in psychiatry to present on, on new ways of addressing mental health because they realize that, you know, their old model just doesn't work. So I, I think we're in this really interesting moment, you know, and it's, it's taken like you, 50 years of hard work. We've talked a lot about, about some of these concepts, but I kind of want to get into the, the role of the immune system and our health and kind of unpack it a little bit, because most people kind of go, oh yeah, my immune system's good. I don't get sick. Or my immune system is bad. I get colds a lot. Or, you know, people don't really understand what it is. And I think in, in terms of this, the stage that I want to set. The immune system, it turns out, is. Is probably one of the most consequential parts of our biology and is responsible for our health at every level. And in almost every single disease out there today is a disease that, that impacting our immune system that's causing inflammation. It's actually the conditions that are. We're suffering from, whether it's diabetes or obesity or heart disease or cancer or dementia or depression or autism or else heimers like autoimmune diseases, allergies, and the list goes on and on. Our gut issues, these are all dysfunctions of our immune system. This is sort of this common thread that links all that together. In fact, the aging process itself has been called inflammaging, you know, inflammation with aging. And there's a whole set of things that go on that cause us to have more inflammation as we get older. And. And we've never really learned about how to impact our immune system in medicine. It's not something that's part of our training. And we learned about it. You know, we learned about T1 and T2, TH2 and TH1 pathways and how they regulate different parts of our immunity. And we learned about our antibodies and our immune system and our. And our original sort of primitive immune system that predated our inability to fight specific infections or bugs or things with antibodies. We learned about that, but we didn't really learn about what to do about it. How do you. How do you optimize someone's immune system? How do you treat inflammation? It's not just by taking a steroid or an Advil or an aspirin or some chemo drug. It's really a whole new science around immune system health. Why is understanding immune health so important today with all these incredibly aggressive chronic diseases that we're facing?
- [33:13]
Jeff Bland
I think it's very important to recall that this was only as good as its ability to be taken up by a clinician that could then test this in patients. And you are the quintessential example of a person who saw the utility and the safety effects as it relates to its balance against the therapeutic effects and willingness to try this then with your patients in a very discreet way and codify that in such a way and to communicate it. You're a marvelous, obviously, communicator, both in writing and orally. And I think that that teamsmanship between the conceptualization and then the execution and the categorization of what works and what doesn't work, and then getting other people to feel more comfortable then in trying this allows for the birth of a new discipline. You need all those things working together.
- [34:03]
Dr. Jeffrey Bland
You just came back from a Mediterranean research trip, which I would sort of wonder if that was all research.
- [34:13]
Jeff Bland
Had some good meals.
- [34:14]
Dr. Jeffrey Bland
You went to Greece, Argentinia, Morocco, and you went to these places where the diets have a long cultural context, that they're kind of indigenous to the place. And we talked about the Mediterranean diet. It's kind of a vague term. You know, was it pasta and pizza or is it, you know, olive oil and fish and nuts and like, you know, so what is it exactly? But, but I think, you know, when you kind of lean toward the healthier frameworks of what is a Mediterranean diet? It seems to be one of those diets that everybody, including nutritional medicine, agree is beneficial and may be helpful for many chronic diseases, whether it's mental health or, or whether it's cardiovascular health or cancer or dementia. When you went on this trip, what kind of were the insights that you had that you maybe hadn't thought about.
- [35:01]
Jeff Bland
Before when we asked the question, what's the seminal clinical study that has been ever done on diet and its relationship to the outcome of diabetes, cardiovascular disease and dementia? Is there any study or studies that we can hold our hands up and say this is the study and it would be the predimed study. The predimed study, which was a Spanish directed study, followed several thousand people, 7,000.
- [35:28]
Dr. Jeffrey Bland
Which by the way, to do a nutritional study, a randomized controlled trial with 7,000 people and diet is so hard to do. It's so expensive. It's such a big study and most studies are done with a couple hundred people or 100 people or 50 people. This is 7,000 people. And tell us more about what we learned from that.
- [35:47]
Jeff Bland
Yeah, so I was at the University of Madrid and was able to kind of talk with some of the original investigators in the PREDIMED study as well as I was in Portugal and I was, which was one of the companion places where the study was also done. The exacting approach that they took towards being able to control the variables on people's eating habits, which is, as you said, really a complicated thing to do in people with real lives, not in America.
- [36:15]
Dr. Jeffrey Bland
Free living humans.
- [36:16]
Jeff Bland
That's right. But they overcame many, many objections and were able to really deliver a study that I, the world scientific community now says this data looks real. And the more that that data is evaluated now there are literally hundreds of papers that have been written out of the data set from the PREDIMED study. The more as people kind of dice and slice that data to look at how it connects to different conditions, everything from brain function to musculoskeletal function, to arthritis to diabetes to cardiovascular disease, the more that you start seeing these positive benefits in these different cohorts of individuals. So it cuts across it's agnostic to disease.
- [37:04]
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- [39:40]
Dr. Jeffrey Bland
And just for people to know what that study was, they basically randomized people to either a liter of olive oil a week or basically a big handful of nuts every day compared to a low fat diet.
- [39:49]
Jeff Bland
But it was those plus the kind of the composition of the diet, the base diet, which was getting rid of a lot of the stuff that, that you have spoken to so eloquently, like the sugar, processed foods, highly convenient shelf, stable stuff to stuff that looks like it was once grown in the ground. Those types of decision making which by the way, on my trip, of the various countries that I had the privilege of visiting on this journey, I was amazed to see that just as was in Britain at the turn of the 17th to the 18th century, the history was that the people that had the lowest incidence of chronic disease happened to be the people that were of the lower socioeconomic because they didn't have access to the white flour and white sugar.
- [40:36]
Dr. Jeffrey Bland
That's right.
- [40:36]
Jeff Bland
They had these rough breads that had all these.
- [40:39]
Dr. Jeffrey Bland
Peasant food.
- [40:40]
Jeff Bland
Exactly. Peasant food. And their cultural history outcome in terms of their health was much better than the aristocracy of people that had access to these other foods. And that's what I found. Similarly, when I travel, the med is that people who eat those traditional diets and in fact there's a paper just published in Nature that is fascinating. In Africa and Tanzania, they studied Tanzanians that were eating the traditional African diet, which was things like fermented banana and a very high plant based diet versus people that had been moved in the same country over into the westernized diet. And they compared the health outcomes and the effects on the immune system. They studied immunological activities of all these subsets of immune cells. And just as we would expect, the people that transition in Tanzania with the same genes transition to the western diet. They got the genes of their immune system suddenly expressing inflammation, suppressing high levels of lipoproteins that are associated with cardiovascular risk with insulin resistance. Those that stayed on the traditional African diet, same genes had these lower incidence of out. So this goes across all sorts of genotypes, all across different cultures. But there are certain principles that tie them together, whether you're living in Tanzania or you're living in Sardinia.
- [42:06]
Dr. Jeffrey Bland
So what are those principles? Like, what are the things that you kind of learned from going over there.
- [42:11]
Jeff Bland
That take ones for people? My takeaway, and maybe it's because of my bias, but the thing that has changed the most in our diets is the addition of simple rapid glycemic index products like starch and sugar. So that is added, and the thing that's been eliminated are the natural coloring agents of foods that come from vegetables across the full range of polyphenols and flavonoids, of which there are thousands that we just don't get in the westernized, highly processed diet.
- [42:43]
Dr. Jeffrey Bland
You know, we have to put food dyes to make stuff colorful because it's interesting, because I think, you know, I just kind of realized this. But part of what attracts people to different foods is the richness of the color because we've removed the phytochemicals that provide those colors in our food. Food companies have added all these dyes to make foods pop, like fruit Loops or what do they call them, Skittles, you know, M&Ms. All these brightly colored things. They're attracted to us because, you know, historically, I think as humans, we've been attracted to these compounds because they're good for us.
- [43:15]
Jeff Bland
Going all the way across the visual spectrum from orange, red, to blue, purple, those foods each, those colors are related to the composition of specific types of these polyphenols and flavonoids and carotenoids. And those phytochemicals all impart unique structure, function, specific effects on cell activities. It's specifically on the immune system I want to emphasize. This is not like a class effect. This is a specific structure, function relationship. We're eating information that's very defined with a specific language, a specific dialect, and that's why we want to eat a variety of foods. We don't want to just eat carrots. We want to eat a whole variety of foods because these bring different languages to our genes. That then creates an outcome that becomes our functional health. That's an amazing breakthrough in understanding because we used to think, well, just eat fruits and vegetables. That's going to be good, and it is good. So I'm not denying that. But there may be specific properties that they have that each individually influences our biochemistry, our genomics, in such a way that it enhances our immune system function. And that's what we're learning, what are those families of specific nutrients across the range of orange, red to blue purple products like you think of delphinium, that's anthocyanin, that's in berries. It has a different effect than does polyflavin 3 ols like quercetin, which then influences a different collection of immunological principles. So it's the combination of this portfolio that gives rise to the harmony that we call the orchestra of our biology.
- [44:56]
Dr. Jeffrey Bland
So basically the way this works, just to get a high level people understand is that is, you're you, you have a set of genes that you're born with. They regulate many, many different processes in our body. And there's a whole set of genes that regulate your immune system function, that turn on inflammation or turn off inflammation, that suppress cancer, that turn on cancer. We really now are unpacking what those genes are and what we call the epigenetic effects are on these genes. So the genes are kind of fixed. You can't change them like he's on a piano, but the epigenome, which, like the piano player can play all kinds of different songs on that piano. And so food is communicating to our genes through our epigenome and modifying their function. Right. And so when you have different phytochemicals in food, they're regulating different pathways. Now we, we think of vitamins and minerals as essential nutrients, but I've come to think of these phytochemicals as this neglected class of compounds that if we don't have in our diet over a long period of time, will lead to chronic illness.
- [46:04]
Jeff Bland
Hear, hear.
- [46:04]
Dr. Jeffrey Bland
It's not, it's not a deficiency disease directly, but it's kind of what we call these long latency deficiency diseases that Robert Heaney talked about, which is this idea that, you know, gosh, if your vitamin D is enough so you don't get rickets, that's good, that's gonna prevent the short term deficiency disease. But if it's not high enough over a long period of time, you're gonna get osteoporosis or cancer or heart disease or dementia. Right. So how do we, I think about these phytochemicals in that way. And I think, can I just say.
- [46:33]
Jeff Bland
I wanna celebrate that for a moment. That's a drop of the mic, what you just said. I hope everybody who's listening to this podcast is picking up. This is a seminal change in thinking in nutrition, what you've just stated. Bruce Ames, God rest his soul, he just recently passed away. Our extraordinary contributor to our field had this triage theory. The triage theory is just like what you're saying that there are different levels of insufficiency. Triage is like the worst on the battlefield is the person dying and you immediately need something to keep them alive. Then there is the people that are on the road to dying, but still kind of maybe second tier. Then there are the people that are early on that are just maybe suffering minor injuries. That is the way that nutrition can be seen depending on where that person's status is. If you want to get to a completely well person, you want to be off the triage system.
- [47:23]
Dr. Jeffrey Bland
You know, you don't often get the credit because you're kind of behind the scenes a little bit. Unless you're in the space. The average person doesn't know Jeffrey Bland, but they should because, you know, I honestly think you should win the Nobel prize for what you've done to get this out there. I mean, from that like little idea that I'm going to quit and teach doctors about nutrition to where we are now and from your inception of even starting as a faculty member studying nutrition and human health. I mean, it's a half a century.
- [47:51]
Jeff Bland
My first real job was an academic position in 1970 on Earth Day. The University of Puget Sound in Tacoma, Washington was in search of a chemist that would be in their department, but they wanted to start an environmental science department. And so they hired this kid, me. I was 25 years of age, just finished my postdoc. I was to start in an environmental science program as well as being an organic nutritional biochemist. Over the years that ultimately got me to meet some extraordinary people because of my speaking in the environmental science side. I was involved with ecology, I was involved with soil health. I was involved with environmental pollution studies that we were doing on air pollution related sulfur oxides and the largest copper smelter in the Pacific Northwest, so called Osarco smelter, which we eventually were able to get shut down in Tacoma, Washington. And so all this together then ultimately got me introduced to a wide variety of different people. And it reminded me that I need to learn across multiple disciplines if I'm going to be involved in this field.
- [48:54]
Dr. Jeffrey Bland
Well, back then nutrition was such an orphan science. I mean, why would you even consider going into that? Because it was sort of like a less than black sheep of the scientific research field. Like nobody who was a credible scientist would really study nutrition.
- [49:09]
Jeff Bland
What happened to me was one of those moments. And you've had these in your life. I know, a seismic unexpected event. I Had by that time gotten a second job in the night. I was a clinical director of a medical laboratory. I was a part owner of the Bellevue Redmond Medical Lab that was serving the only nutrition focused physician in Seattle, Washington, Lee Bowles. I was in, in our laboratory one day in Bellevue, Washington. And our receptionist came back into the lab and she said, so Jeff, we have a visitor. Actually two visitors. Dr. Linus Pauling and Dr. Emil Zuckerkandel, who is the director of the Linus Pauling Institute of Science and Medicine in Palo Alto. And it just blew me away.
- [49:47]
Dr. Jeffrey Bland
Those of you who are listening don't know who Linus Pauling is. He's a two time Nobel Prize winner. He discovered the structure of proteins and won the Nobel Peace Prize for the Nuclear Test Ban treaty to ban above ground testing that happened in the 60s. And he was also, you may have heard, the guy who was promoting vitamin C for the cold and was ridiculed and kind of laughed at at the end of his life and his career. But, but he was onto something.
- [50:10]
Jeff Bland
Was he ever orthomolecular medicine? It's what he discovered or he found it. Much to my surprise. He said, you know Jeff, I've listened to a couple of your lectures, I've read your research papers and no, I'd really like to maybe have you come and spend a sabbatical year or two with us at our institute and to run some research projects down at our facility near Stanford. That was a life changing experience. That was 1981. Meeting he and his wife Eva Helen really was a life changer because I recognized that there was much more to this than just the science. These were stewards of the universe. They were broad thinkers, they had friends. You can imagine the dignitaries that came in, artists and politicians and poets and all sorts of people visited the institute that I had a vicarious opportunity to meet. So it changed my whole thing. And so what happened to me at that point, and I think this set me on the path and ultimately led into the functional medicine model. Was on my way home after I finished my two years. My, my family was in the car. I had my box with my stuff in my office, which was next to his office in the Pauling Institute. And as I was walking out, he said, so Jeff, do you think your classroom is big enough?
- [51:20]
Dr. Jeffrey Bland
Wow.
- [51:21]
Jeff Bland
And I thought, wow, what does that mean? And I got in the car now to drive 1100 miles home and I finally recognized what he was asking me. I went in. My parents had been very kind to look at our house and keep Watch over it while we were gone. Over the two years, we sat down and I said, so I just have some news that I want to. I want to relate to you. And by the way, my father kind of lived vicariously with me as a professor because I think he would always have liked to have been a professor himself. So he kind of liked me in that position. I said, so I've come to a conclusion, and that is I'm giving up my tenured faculty position to start a venture to help doctors understand how to apply nutritional medicine in their practice.
- [51:59]
Dr. Mark Hyman
Crazy.
- [52:00]
Jeff Bland
You could have heard a pin drop.
- [52:03]
Dr. Jeffrey Bland
So, like, you were joining the circus, right? Yeah.
- [52:05]
Jeff Bland
It was like a total silence. Then my mother broke the silence. He said, jeff is very impetuous, but, you know, when he makes up his mind, I think he's probably serious. So my dad then said, if you're going to do this, it sounds like you are, then I better come out of retirement. Because I do have an accounting background. I know something about business. You know nothing about business. And you're, you know, you're giving up the security, college education being paid for for your kids, your mortgage, your house and everything. So, you know, you're going to have to make a living. Away we went. My dad was my business manager. My mother was a copy editor. My wife was corporate development. And we started down the road to have me going out and start to help docs understand how this all fits together, really spreading the news from Linus Pauling, orthomolecular medicine, and then ultimately into the functional medicine model.
- [52:54]
Dr. Jeffrey Bland
Well, you know, you mentioned Buckminster Fuller earlier, and he said, you never change things by fighting the existing reality. Change something. Build a new model that makes the existing model obsolete. And I would say nothing is more true of functional medicine than that. It's a new model for thinking about disease. I start off as nutritional medicine and education, but as you began to sort of encounter different doctors who were experimenting with different approaches, whether it was Sid Baker or Leo Galland or other folks who are kind of the pioneers as the practitioners, the AIM group, which is kind of funny because it was. I think it was alternative integrative medicine Group.
- [53:34]
Jeff Bland
Group.
- [53:35]
Dr. Jeffrey Bland
I think that's what it stood for.
- [53:36]
Jeff Bland
Yeah.
- [53:37]
Dr. Mark Hyman
And they.
- [53:37]
Dr. Jeffrey Bland
They. There were groups of physicians that met in the Northeast, in Lenox, Massachusetts, where actually my clinic is, which is wild. And. And they would have different experts come, including you, to talk about different topics like, you know, essential fatty acids or magnesium or, you know, the gut or. And. And. And they basically were the sort of incubator for this application of nutritional medicine, functional medicine, systems medicine to everyday practice. We now are really understanding this and your work with Big Bold Health and with one particular plant called Himalayan Tarvy buckwheat. This is an ancient plant. It's actually a flower, not a grain. Even though it's called buckwheat, it's not wheat or it's not a grain.
- [54:18]
Jeff Bland
No connection to the genes of wheat at all.
- [54:21]
Dr. Jeffrey Bland
This sort of ancient grain turns out it's very high in a lot of these immune regulating phytochemicals.
- [54:26]
Jeff Bland
3,500-Year-Old food, can you imagine in the Fertile Crescent, there were really two. A major source of nutrients kind of husband and crop was that was millet. And so millet is in the Indio regime considered a very, very important non gluten grain. It's a cereal product that's not gluten containing in the Himalayan region of the world. In China you had a similar 3,500 year old product that was agriculturally husband and it was this tartery buckwheat. Tartery stands for the tartan district of China, which is up against the Himalayans.
- [55:07]
Dr. Jeffrey Bland
Northern China, which is now was Tibet. Now China.
- [55:11]
Jeff Bland
Yeah.
- [55:11]
Dr. Jeffrey Bland
And actually the, the Tibetan yakurders and their typical breakfast is something called sampa.
- [55:17]
Jeff Bland
Yes.
- [55:18]
Dr. Jeffrey Bland
Which is basically roasted buckwheat.
- [55:21]
Jeff Bland
Yes.
- [55:21]
Dr. Mark Hyman
Or barley.
- [55:22]
Dr. Jeffrey Bland
They use different compounds and they actually turn into like a little cookie dough kind of thing they eat for breakfast.
- [55:28]
Jeff Bland
In fact, I just was in discussion this last week with a farmer of tartary buckwheat in Bhutan and he was saying how important that food has been in the, in the Bhutanese culture and why they have very good health outcomes. And of course it's a happy group of people too. So maybe there's lots of things going on there. But he's been very concerned that they're converting the tartery buckwheat, which they call black buckwheat, over into other crops now because of the pressure of getting increased yields. And so people are losing the nutritional benefit in Bhutan. And he was very worried about maintaining their cultural heritage. And we in the United States, actually it's interesting. Our colonial ancestors brought over tartery buckwheat because it was such a hardy crop. It didn't need irrigation, it didn't need fertilizer and bugs don't like it because it has such a high level of these phytochemicals that it's almost like it's natural pesticides. Years ago, tartery buckwheat was lost in, in North America. People stopped Growing it and replaced it with seed and soy and wheat and soy corn. And so it got lost in this country as well.
- [56:36]
Dr. Jeffrey Bland
You know, in, in some of these countries, they actually will, will use it in many ways. They make noodles. So soba noodles is in Japan, but they also have in Japan, this, instead of derivative, which is this tea, which is a thick kind of, almost like a kind of porridge y thing that comes as a, as a waste product from the water, but it's actually full of a lot of these phytochemicals. And they drink that as a, as a part of their diet. So it's interesting. And you look at these cultures, they've incorporated this as part of their way of eating. But in the sort of marriage of this ancient grain with the modern science of being able to sort of understanding the ways in which our genes are regulated by these foods, we're uncovering so many remarkable discoveries that show us how different parts of our immune system are controlled.
- [57:17]
Jeff Bland
That's right.
- [57:18]
Dr. Jeffrey Bland
Right. So some parts are actually suppressed, which you want and for health. And some are, are, are activated which help you fight different, different chronic diseases.
- [57:27]
Jeff Bland
Our immune system could be considered, divided into two components. And that was the part of the immune system that produces antibodies. It gives rise to a, a memory effect that we used for immunizing people. And that's our B cells. That's so called the adaptive immune system. Those cells adapt to the exposure to something and remember that so that the next time you're exposed, they will produce something that helps to detoxify it, an antibody.
- [57:55]
Dr. Jeffrey Bland
It's kind of like smart bombs against a particular bug or infection.
- [57:58]
Jeff Bland
That's good.
- [57:58]
Dr. Jeffrey Bland
They're very targeted.
- [57:59]
Jeff Bland
And people have thought historically, over decades about immune system is. That's where the action really is, is in the adaptive immune system. But there's another part of the immune system that's the first level of the immune system, which is called the innate immune system.
- [58:13]
Dr. Jeffrey Bland
And it's more ancient, more primitive, and.
- [58:15]
Jeff Bland
Yet goes all the way back. Plants have an innate immune system. So this is definitely ancient. It's phylogenetically conserved. It goes through all different insects and into organisms of all types. And it has been said until recently, and when I say recently, I mean within the last 10 years, that this part of our immune system is kind of dumb. It doesn't, it can't learn anything. Whatever you were given genetically for your innate immune system, that's what you got. And it's the first line of defense. And those cells basically just respond by engulfing foreigners and killing Them by certain kinds of biological processes. And you just hope it's working well that. Because there's not much you can do about it if it's not.
- [59:00]
Dr. Jeffrey Bland
And they. And they do it through hydrogen peroxide production, through ozone production in the body.
- [59:05]
Jeff Bland
Exactly.
- [59:05]
Dr. Jeffrey Bland
We literally have like, natural antimicrobials, some of the strongest ones ever discovered on the planet that are in our bodies that are being produced in small amounts to help fight these foreign invaders.
- [59:18]
Jeff Bland
The macrophage, which is a member of those cell type in the innate immune system, has these arms as it's a big floppy Jabba the Hut type cell. And it puts its arms around foreign stuff and then it squeezes it and then it releases chemical. The Klebanov reaction, which, as you said, are hydrogen peroxide and oxidants that kill it. So it's chemical warfare.
- [59:38]
Dr. Jeffrey Bland
It's like Pac Man, I think of macrophages like Pac Man. They just go around gobbling up the bad stuff.
- [59:43]
Jeff Bland
But there's not much we supposedly can do about that. It's either going to work for us or not. Now, within the last 10 years, da da. New discovery. The innate immune system can be taught and it can learn and it can be trained to be better.
- [59:55]
Dr. Jeffrey Bland
And it's something that's important because it helps you to be more immunoresilient.
- [60:00]
Jeff Bland
It, let's say why. Because it turns out if you ask, where is the innate immune system concentrated, where is it localized in the body? In higher levels, it's in the mucosal surfaces in your gut. And the first place that our body sees foreigner is where you find most of your innate immune system, like the gut mucosa, the lung, epithelia in the nasal passages. And so if your innate immune system is kind of not doing the job, then it slips through the innate immune system, whatever that is, and now it has access to the second line of defense. And you talked about this situation that we saw with regard to COVID 19, where people died in their own fluids because their immune system overreacted and they produced all this stuff trying to. Well, that's because the innate immune system never had a chance to kind of do its work the first time. And the second set, the adaptive immune system, now got overwhelmed and it just went wild and went into the cytokine storm is what they called it, which was a consequence of, yikes, I'm under siege. I just have to throw all the tools against it. And that person actually ends up dying of their own immune system, overreacting the construct that we have an appropriate first line of defense, we teach that immune system, the innate immune system to be vigilant and resilient is.
- [61:20]
Dr. Jeffrey Bland
But it's not specific, it's just, it's not treating it to be specific. Is it like antibodies?
- [61:24]
Jeff Bland
It's a different kind of specificity because on the surface of your innate immune system you have what are called toll like receptors. And those toll like receptors pick up information of specific types like gut bacterial lipopolysaccharides, and then respond to that by defending you against that message. And so it, it has a specificity, but it's not the memory effect that you have with the, the adaptive immune system and antibodies. But I think that what we recognize, and this is an important new aha. Is that you can fairly quickly train the innate immune system to be more resilient. It doesn't take months.
- [62:02]
Dr. Jeffrey Bland
And how do you do that?
- [62:03]
Jeff Bland
Here is where the polyphenols play a principal role. This may be, as you said earlier, this list of nutrients that have only gotten a page or two publication in nutrition textbook because we weren't considered to be essential nutrients. This whole flavonoid family of compounds now we're seeing they play principal roles in priming the innate immune system and regulating the genes that are associated with immune defense. This is all new discoveries. I'm talking about the last five years. So this is like aha. Stuff that then makes diets become ever more important for how we therapeutically modulate our immune systems.
- [62:41]
Dr. Mark Hyman
And do we know, we know how.
- [62:42]
Dr. Jeffrey Bland
The innate immune system relates to the development of chronic disease and its dysfunction as we get older.
- [62:47]
Jeff Bland
Just the so called immunosenescence that you were talking about. Inflammaging. Yeah. And so now we're starting to recognize it when you get this secretary phenotype of inflammation because the body has started to collect injury to immune cells and other cells, it gets locked into the state of being constantly. That's where the immune system is aged more than your years of birthdays. And you have an accelerated series of aging that can appear as a brain dysfunction, as a cardiac dysfunction, as diabetes. It can present itself. And by the way, we now recognize that this new class of drugs that we call GLP1 agonists that are being used for diabetes and for obesity, those affect the immune system through the adipocyte, the fat cells. So now we're starting to learn that these are all interconnected into another system, which is the gut connected to the fat cell, connected to the brain, connected to the immune system. And so when we're giving GLP1 agonist drugs, we're also having a therapeutic influence on that system as well.
- [63:50]
Dr. Jeffrey Bland
Which you can do through diet.
- [63:53]
Jeff Bland
Exactly right.
- [63:54]
Dr. Jeffrey Bland
That's why the sort of elimination diet works, because it's a profoundly anti inflammatory diet. And my guess is it's working on both antibody mediated pathways as well as the innate immune system and how those regulate.
- [64:09]
Jeff Bland
And the answer is yes, those clinical studies have been done and published showing exactly what you said, that it has an effect on B cells and has an effect on Tregs, the thymus dependent regulatory cells. And we now know the genes that actually are regulated by specific flavonoids that ultimately affect the personality of those immune cells, that then speak to your B cells to change your antibodies. All of this is a giant system that interrelates you to your diet and your lifestyle.
- [64:36]
Dr. Jeffrey Bland
And it's interesting also we're seeing new age related biomarkers and there's been a lot of work done by David Furman, who's been on the podcast talking about immune age and what is that and how do you measure it? And he's documented something called the immunome, which is all the different changes in the expression of genes that relate to various parts of your immune system, to cytokines, to innate immune system and how and how those are correlated with chronic diseases. And so now through biomarker testing that are now clinically available, and we offer these now through function. And there was just a major paper published about P Tau 217, which is a biomarker for Alzheimer's that you can detect often even decades before you get any symptoms, that then you can intervene with and modify the pathways. Because at the end of the day, Alzheimer's is inflammation in the brain. It's the final common sort of insult that happens in the amyloid, which I've been targeting for decades and spend billions of dollars and hundreds and hundreds of studies with no effect because they're just dealing with the downstream effects of the body trying to deal with the inflammation, which is the development of amyloid plaques in the brain and tau. And so we can now measure through biomarkers a lot of these things that we couldn't measure before. And so we're actually able to see the changes and we're seeing this with function health. People are modifying their lifestyle and we're seeing changes over time in these biomarkers, which is pretty amazing. I mean, think about even the heresy of saying, gee, there's a blood test for Alzheimer's, you can detect even up to decades before that if you change what you're eating and your lifestyle and your sleep and stress and relationships and everything else, and nutrient levels and phytochemical intake, then you can actually change that and reverse it and normalize it. This is like a whole new frontier of thinking about disease. When does it start and how do you measure it?
- [66:24]
Jeff Bland
That's exactly the paradigm shift that I'm so excited that I'm still involved with this field. It has been my wish and dream that I would still be around in this field when this ultimate shift in paradigm would occur. I knew it would ultimately occur, I didn't know when. And we're living it right now. This is like no period of history in changing the whole fundamental paradigm of healthcare. Anybody that's practicing from that which it was is an artifact. That which it will be is where we need to be concentrating our attention. Because these are modifiable, these are executable, these deliver real results. Asking the right questions and getting the right answers, not just looking for when you get a disease. That is old school thinking. We have to be looking at the prognosis, not the diagnosis of where these are going, what's their trajectory? And that is what we're seeing as food, as medicine is one of the therapeutic tools because lo and behold, we're relearning what nature has been trying to tell us, the wisdom of nature, that these modulate these functions in our body in real ways, not in decades of living, but in months of living. In months you can change your genetic expression patterns.
- [67:34]
Dr. Jeffrey Bland
And we've seen this. You know, you've done studies where you intervene with giving people 90 days of assimilating toy buckwheat as a supplement and have shown reversal in biological age and immune age. And this is really a critical, important part of research because you know, if you wait till something happens, and this is what's so screwed up in medicine is that we, we wait till you're out of range on a biomarker or wait till you know you're, you have some symptoms or wait till you have a disease rather than thinking that there's a way to detect this, these problems decades before along the continuum of dysfunction that leads to pathology because you know you're going to have imbalances that occur way, way, way, way, way before you ever get a symptom.
- [68:17]
Jeff Bland
Right.
- [68:18]
Dr. Jeffrey Bland
And, and now we're able to sort of detect these. And that's even getting to a, I think even a more meta level, which is maybe measuring our epigenome on a regular basis to see the Changes in expression of our genes that will lead to problems even before they show up as a traditional biomarker. So now we're getting into kind of a world where medicine really is not practiced in this way, but it will be. And I think these kinds of diagnostics and assessments and watching what happens, not just to how you feel, but actually to your disease risk biomarkers is going to change everything about medicine.
- [68:51]
Jeff Bland
Well, everything you said, and I 100% agree with one variation, you said medicine will practice. Medicine is being practiced by enlightened practitioners.
- [69:00]
Dr. Jeffrey Bland
Well, sure, there's a few of us out there, but it's like, not when you go to most, most medical schools. I mean, my daughter just graduated medical school like there was zero. She didn't learn about mitochondria. She'll learn about insulin resistance. She didn't learn about the gut, she didn't learn about nutrition. I mean, all the things we just talked about earlier in this podcast that are fundamental to understanding health are not being taught to doctors today.
- [69:19]
Jeff Bland
You know how long it takes to understand anatomy, physiology, pathology, cytology, Those are all skills that are really important to understand what we know about the organizational structure of the body. And it takes quite a while to get competent about those understandings upon which you then build this new enlightened architecture of how we're going to use those things that we've learned that are givens to create a more dynamic process that will take us to health. And having 50 years in my life of measuring my biomarkers on a routine basis and now having the excess of function, health, it provides many more biomarkers, I can see the important value of layering on top of my traditional background in training of anatomy, physiology, pathology that I probably wouldn't have understood in the absence of understanding the body. So all this fits together. And your daughter, I know, as with many other practitioners, as they gain more experience in life and practice, will see that there are other things they need to learn.
- [70:15]
Dr. Jeffrey Bland
I mean, she's going to orthopedic surgery because she realized that internal medicine and our approach to cross chronic disease through all the specialties is just kind of a big minefield of problems that doesn't really work for the most part. I mean, there's great rescue medicine, and that's fine. I've benefited from it. You benefited from it. I mean, we need surgeons, we need intervention, we need procedures, but for basically treating people with chronic illness, we suck. And so that's why she's going to orthopedic surgery. But she even said to Me, dad, an orthopedic surgery. We don't really learn about regenerative medicine. It's kind of dismissed as something that is not part of their traditional training. And this is another field of really how do we activate the body's own repair, renewal, regenerative systems? That's what you're doing with personalized lifestyle medicine. That's what you're doing with your research and Himalayan Terry Buckwheat is you're actually not treating a disease. You're activating the body's own systems to fight disease and to prevent disease and to treat disease. You're activating the body's own innate wisdom. The ancient built in systems for healing that we have. We're a healing machine. I mean, Andy well talked about the spontaneous healing, but he sort of, in a way, I think brought this idea forward, which was that our bodies have a natural healing system. If you cut your skin, you don't go, hey stem cells, would you go to my finger where I just cut it? And would you recruit also white blood cells and cytokines and healing repair factors and fibroblasts. And we don't think that our body naturally has a system of healing, repair. And a lot of the work you're doing and a lot of the work in the regenerative medicine space is really about how do we do that in an intelligent way to activate the body's own healing capacity. Because when we did these elimination diets for the 10 day detox diet, I wasn't treating a disease. I just took away the impediments to health and provided some of the ingredients. And the body's own healing system did all the work.
- [72:10]
Jeff Bland
I think you just said to drop the mic. I mean, that is the fundamental raison d' etre for functional medicine is finding an operating system that can deliver on that opportunity. Because that opportunity is in all of us, in our genes. Our genes have that potential if we give them half the chance to express it.
- [72:29]
Dr. Jeffrey Bland
Yeah, I mean, there's a very famous quote, I'm kind of going to butcher it. But it's really about how basically the doctor just kind of has to of, you know, let nature take its course, to kind of heal the body, that nature does most of the work. We're now able to accentuate nature by providing nature in the form of things like Himalayan chartered buckwheat or other foods that are going to heal and repair the body. This is an amazing conversation. I kind of want to end by asking you what are the next frontiers in this field of Personalized longevity medicine. How do they get to the average person? Because people don't want to wait around for 30 years till science gets turned into medical practice, which is often what it takes.
- [73:08]
Jeff Bland
I think that what's happening right now, and Mark, you're an exemplar of this, is the use of these digital communication tools to be able to accelerate the adoption of these concepts so we don't wait at the roadblock of somebody holding back on the information because they are the gatekeeper and that accessibility of information and truth wills out. I believe ultimately, I think truth will find its path. But you need to have distribution systems to get the information out. And those are now happening. I mean, your podcast alone is an exemplar of a distribution system of a different set of principles upon which a person can operate. I think that what I'm very excited about is a combination of AI with the data set analysis now from big data banks that start looking at wearable device information in real time, coupled with biometrics, like what function health is doing, and then tying that together with the regenerative agriculture and planetary survival methods. So we think that there is a system that people can participate in, that their body is getting healthy as they're helping the planet to maintain its health, that we're all part of a system because that feed forwards the psychology of wellness. And I think there is. Let's not dismiss the sociobiology of wellness as a community process. All these things work together to create a shift of the paradigm that can happen, I think, remarkably quickly. I mean, when I think in my life of coming down to the wall between east and west and Germany, which people never happened, all these various things can happen remarkably quickly when you get a certain critical mass of individuals who recognize that the alternatives and options are there and available for their action.
- [74:50]
Dr. Jeffrey Bland
So really, we're entering a world where we're moving from analog medicine to digital medicine, and we're moving from the Norman Rockwell doct in his office with a notepad, taking a history and doing a physical and a few tests, to being able to sort of navigate a world where we have massive data sets on individuals, where we can look at patterns in that data and create discoveries that really were never known before about what's going on in the body and what to do about it.
- [75:18]
Jeff Bland
Precisely.
- [75:18]
Dr. Jeffrey Bland
And I think that's really, for me, what's most exciting is we're sort of leapfrogging over the old model. We're literally like Buckminster Fuller said, you talked about the beginning of the podcast as you know, we're creating a new system that makes the old one obsolete.
- [75:32]
Jeff Bland
That's exactly right.
- [75:33]
Dr. Jeffrey Bland
And it's going to help accelerate the medicine because I think it'll end up creating the AI enabled superdoc where you're still going to need a physician or practitioner, but they will be so much smarter because they'll be enabled by the ability of tech and AI and machine learning to synthesize massive data sets in an individual. You know, whether it's hundreds of biomarkers or thousands of metabolites, or the hundred thousand petabytes of data in your microbiome, or the you know, 7 million SNPs in your genome, I mean they just, the amount, like the amount of information is so huge. To take that information and turn it to knowledge and turn into kind of nuggets that the average practitioner can then apply clinically to create to true personalized lifestyle medicine is just staggering. Like for me I think this is so exciting and it's happening so fast, literally from week to week it's getting better.
- [76:33]
Jeff Bland
I totally agree. And you know, it's interesting, I've been criticized by some for many decades that I had this view that personalization was the future where we were hitting and everyone said that's not scalable, that's idealistic, that'll never happen, you can't have each person treated as individual. I'm going to stand on this concept as you just stated that with these new tools there will still be the sentient relationship between a provider and the patient, but they will have access as the super doc to all this ability to categorize and to interpolate this massive amount of data to make it accessible to personalization. And that will become then precision personalized healthcare of which nutrition, lifestyle will play big important roles as we start to to understand how individuals genotypes interact with their worlds and their environments and their diet. So we're right on the threshold of that actually becoming real. And I think those who criticized me heavily for being overly idealistic about personalization, they may have to change their position.
- [77:33]
Dr. Jeffrey Bland
It's happening so fast Jeff, and I'm excited that you're helping lead the way. And that Function Health is actually providing kind of a consumer based platform for people to own their own health, to have their own data, to compare it to other data sets from other members. We now have over 20 million biomarkers in our data set in 180,000 people at the time of this recording. And we're expanding that literally every single day. What does all that mean? How do we make sense of it? How do we learn from it? What is it going to teach us? It's a pretty exciting moment. I think we're at this pivotal fulcrum in science and medicine. This moment has been a long time in coming, but I almost can't keep up. It's just so exciting. And I think your work has just sort of led us to a lot of the things that we're all doing now in medicine and a lot of things that are being talked about across a whole series of specialties that are now in academic centers that are now sort of mainstream. And I'm sort of excited to see what you're going to do in your next 80 years.
- [78:35]
Jeff Bland
Well, thank you. I hope we'll share it together.
- [78:38]
Dr. Jeffrey Bland
All right, Jeff. Well, thanks for this conversation, everybody. Stay tuned for the next podcast with Jeff. We're going to dive deep into the immune system, into the concept of immuno senescence, immuno rejuvenation, immunometabolism, how food is medicine. What food is medicine. How it regulates all the things that we really need to think about as we get older and are even not older in this country, because most people when they're younger, are older biologically. So even the young are now getting cancer and heart disease and diabetes. And so, so we're seeing the disease of aging occurring in teenagers and in.
- [79:11]
Dr. Mark Hyman
20 year olds and 30 year olds.
- [79:13]
Dr. Jeffrey Bland
So this is going to be a really interesting thing for people to understand in order to actually deal with this onslaught of inflammation where we have literally a firestorm like a wildfire moving through us biologically, that we have a lot of control over. Not, not complete control, but a lot of control over. And that's what we're going to get into the next podcast. So, Jeff, thanks for, for. Thanks for being here and being my mentor and teaching me so much and helping me be a better doctor. And I'm excited for our next conversation. Everybody should tune in for that.
- [79:43]
Jeff Bland
Thank you. Really a pleasure to have this conversation.
- [79:46]
Dr. Jeffrey Bland
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- [79:49]
Dr. Mark Hyman
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Dr. Jeffrey Bland
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Dr. Mark Hyman
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Dr. Jeffrey Bland
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Dr. Mark Hyman
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Dr. Jeffrey Bland
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Dr. Mark Hyman
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Dr. Jeffrey Bland
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Dr. Mark Hyman
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Dr. Jeffrey Bland
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- [80:37]
Dr. Mark Hyman
Hive that's Dr. Hyman.com hive hive if you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Drmark Hyman for video versions of this podcast and more.
- [81:01]
Dr. Jeffrey Bland
More.
- [81:01]
Dr. Mark Hyman
Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness center, my work at Cleveland Clinic, and Function Health where I am Chief Medical Officer. This podcast represents my opinions and my guests opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner and if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways to of improving health to the public, so I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.